Objective  To understand the current status of surgical treatment for hemophilia osteoarthropathy (HO) in China.  Methods  Using an online questionnaire, select domestic hospitals that partici-pated in the compilation of the 'Guideline for perioperative management of hemophilia patients undergoing orthopaedic surgery in China ', in addition to members of the National Joint Surgery Group, and the Orthopedic Branch of the Chinese Medical Association for targeted investigation and analysis.  Results  A total of 17 domestic hospitals were included, all of which were general hospitals. Hospitals that started HO surgery treatment before 2000 accounted for 35.29%. A total of 3057 surgical cases of HO were reported by those hospitals. The most commonly performed surgical procedures were hip and knee joint replacement. The most commonly used coagulation factor replacement regimen was recombinant coagulation factor preparation. Ten hospitals reported finding patients with transfusion-related infectious diseases. Bleeding and hematoma formation were the most frequently reported surgical complications. Excessive length of hospital stay and high economic costs were the most frequently reported problems.  Conclusions  Surgical treatment for HO in 17 hospitals is mainly carried out in some large comprehensive medical centers in the eastern region. Compared with the patient base, the popularity and number of surgeries are still relatively insufficient. It is necessary to further standardize the treatment system by standardizing factor replacement and strengthening rehabilitation to improve surgical treatment outcomes.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To discuss the correlation between serum uric acid (SUA) level and the severity of coronary borderline lesions in acute coronary syndrome (ACS) and the prognosis of percutaneous coronary intervention (PCI).Methods The 192 patients who were diagnosed as coronary borderline lesions in ACS and PCI were measured.All Patients were divided into two groups:hyperuricemia group and normal SUA group.The severity of coronary arterial lesions and flow in PCI was compared.The cardiac function changes and incidence of major adverse cardiovascular events (MACE) were recorded.Results The results of correlation analysis showed the positive correlation of SUA level and Gensini score (r =0.710,P ＜ 0.05).Patients with hyperuricemia group had a significantly higher prevalence of no-reflow on angiography,in-hospital and six-month prevalence of MACEs compared with the normal SUA group (P ＜ 0.05).The UA on admission has an independent association with coronary slow flow following primary PCI and in-hospital MACEs among patients with ACS (P ＜ 0.05).Conclusion The patients has higher the level of SUA of ACS borderline lesions patients will has more serious the coronary arterial lesions.The risk of coronary slow flow increased in the patients complicated with hyperuricemia who underwent PCI.

OBJECTIVE:To improve HPLC for content determination of ketoprofen in Ketoprofen enteric-coated capsules. METHODS:HPLC method was adopted. The determination was performed on Chiralpak IC column with mobile phase consisted of n-hexane (0.1% TFA)-isopropanol(90:10,V/V)at a flow rate of 0.8 mL/min. The detection wavelength was set at 268 nm,and column temperature was 25 ℃. The sample size was 10 μL. RESULTS:The linear range of ketoprofen were 0.025-0.5 mg/mL(r=0.9998). The limit of quantitation was 1.0 mg/L,and limit of detection was 0.2 mg/L. RSDs of precision,stability and reproduc-ibility tests were lower than 2%;recoveries were 96.36%-100.32%(RSD=1.87%,n=6). CONCLUSIONS:The method is sim-ple,accurate and rapid,and can be used for the content determination of ketoprofen in Ketoprofen enteric-coated capsules.

AIM:To explore the effects of PPARγon the elevated level of reactive oxygen species ( ROS) in-duced by high glucose and its mechanism .METHODS:Human umbilical vein endothelial cells ( HUVECs) were cultured with DMEM containing high glucose (33 mmol/L D-glucose), and DMEM containing lower glucose (5.5 mmol/L D-glu-cose) was used as control .Superoxide anion and nitric oxide fluorescence probes were used to observe the effects of PPAR γagonist on ROS and NO productions in the HUVECs .The uncoupling protein 2 (UCP2) protein level in the HUVECs was detected by Western blotting .RESULTS:PPARγagonist pioglitazone inhibited the ROS generation and prevented the de-crease in NO level under high glucose condition , and these effects were reversed by pretreatment with PPARγantagonist GW9662.The results of Western blotting indicated that PPARγagonist pioglitazone up-regulated the UCP2 expression un-der high glucose condition , and this effect was also blocked by GW 9662.Inhibition of UCP2 by genipin attenuated the effect of pioglotazone on the ROS production .CONCLUSION: Activation of PPARγinhibits ROS generation under high glucose condition , and this effect may mediate by up-regulation of UCP2.

Objective To observe and care Ahmed glaucoma valve implantation early postoperative complications for diabetic patients with neovascular glaucoma , hoping to reduce complications and all its implications hazard .Methods The clinical data of 38 patients ( 38 eyes ) with diabetic neovascular glaucoma who underwent Ahmed glaucoma valve implantation were observed and targeted treatments .Results Among 38 patients (38 eyes) with diabetic neovascular glaucoma , there were 7 cases (7 eyes) with ocular hypotension and shallow anterior chamber , 4 cases ( 4 eyes ) with transient ocular hypertension , 12 cases ( 12 eyes ) with hyphema, 2 cases (2 eyes) with valve tube blockage in the early postoperative .Compared postoperative intraocular pressure with that of preoperative , intraocular pressure was decreased with the average decline (34.17 ±14.99)mmHg.There were 11 cases (11 eyes) with improved vision, one case (one eye) with decreased vision, and 26 cases (26 eyes) with stable vision.Conclusions Blood sugar of stability control in perioperative , patient psychological counseling , individualized treatment of intraoperative and timely detection of postoperative complications to give the right treatment and care with the doctors , can get a more satisfactory clinical efficacy .

Objective To investigate the effect of hypoxic preconditioning on hepatocytes early growth response factor 1 ( EGR-1 ) in a rat liver autotransplantation. Methods The rat portal vein perfusion model was established for donor liver autotransplantation. Rats were then divided into group A:hypoxic preconditioning was done before transplantation; group B: rats undergoing liver transplantation without preconditioning; group C: Normal control group of rats. Liver histopathological changes, the mRNA expression of HIF-1, TNF-1 and the WB results of EGR-1 were compared between groups. Results The expression of HIF-1 α RNA determined in group A was more obvious than in group B and group C. Six hours after surgery, the expression in group A was significantly higher than that in group B (t =9. 601, df= 10, 2-tailed Sig = 0. 000, P<0. 05 ) ; Egr-1 protein expression in group A and group B increased after surgery,with that in group A being significantly lower than that in group B. The RT-PCR expression of TNF-α RNA in group B compared with group A and group C was more obvious. Six hours after operation, the expression of TNF in group B was significantly higher than that in group A ( t = -12. 067, df = 10, 2-tailed Sig =0. 000, P<0. 05 ). The expression of Egr-1 was positively correlated with that of TNF. A liver cell pathology showed less severe injury in structure of hepatic lobule, mild swelling of liver cells, no significant changes in liver tissue. Conclusions Hypoxic preconditioning adaptation in rat liver transplantation generates modest increase in EGR-1, and reduces the production of TNF and other inflammatory factors.

Objective To investigate the causes of pancreatic injury after autologous liver transplantation in rats. Methods Forty-two SD rats were randomly divided into post autologons liver transplantation 1-hour group, 6-hour group, 12-hour group, 24-hour group, 48-hour group, 72-hour group and sham group (6 rats per group). The plasma concentrations of amylase and lipase were measured to assess pancreatic exocrine function. The histomorphological changes of pancreatic tissue were studied under optical and electron microscopes. All data were analyzed via one-way ANOVA. Results The plasma concentrations of amylase and lipnse in post autologous liver transplantation 1-hour group were significantly higher than those in sham group, and they gradually increased as time passed by. The plasma concentrations of amylase and lipase reached peak at hour 48, after which they decreased gradually. There was a significant difference in the plasma concentration of amylase and lipase among the 7 groups (F = 538.622,489.417, P < 0.05). Acute edematous pancreatitis was observed 1 hour after autolognus liver transplantation, and acute hemorrhagic necrotic pancreatitis was observed 6 hours after transplantation. The degree of injury reached a peak 48 hours after transplantation. The number of mitochondria was increased, and endoplasmic reticulum and Golgi apparatus were swollen 1 hour after transplantation, and the area, perimeter, specific surface area and mean gray value of mitochondria were (312±40) mm~2, (80.3±3.8)mm, 0.332±0.039 and 113±11, respectively. As time passed by, the injury of the pancreatic cells was aggravated and autophagosomes were observed. The injury was most severe 48 hours after transplantation, and the area, perimeter, specific surface area and mean gray value of mitochondria were (466±7) mm~2, (108.8±3.7) mm, 0.298±0.009 and 195±12, respectively. There were significant differences in the specific surface area and mean gray value among all the groups (F = 9.322, 76.560, P < 0.05). Conclusion The pancreatic injury after autologous liver transplantation is related to the energy metabolism of the pancreatic cells induced by hypoxia.