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Objective To compare the clinical effects between rivaroxaban and warfarin on preventing deep vein thrombosis (DVT) in elderly hip fracture patients with diabetes mellitus (DM) after operation. Methods One hundred and sixty-eight elderly hip fracture patients with DM were randomly divided into the observation group and the control group. The observation group (88 cases) were treated with rivaroxaban (10mg, po, qd) after surgery, and the control group were treated with warfarin and low molecular weight heparin calcium for 14 days. Respectively after 7, 14, 21 and 28 days, the color doppler ultrasonography was used to examination vein blood flow and the DVT of affected lamb. In addition, the levels of D-dimer and bleeding were observed during treatment. Results The incidence of DVT in observation group (2 cases, 2.23%) was significantly lower than that in control group (7 cases, 8.75%), and DVT of control group was happened on 7th day after surgery. In addition, the level of D-dimer on 7th day post-surgery in observation group significantly decreased, while it significantly decreased on 14th day post-surgery in control group (P<0.05). However, the incidence of bleeding events in observation was less than that in control group (P<0.05). Conclusion Rivaroxaban can be more effective compared with warfarin in preventing diabetes mellitus elderly hip fracture patients with postoperative DVT formation and significantly reduce the bleeding risk, with more safe and convenient.
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Objective To analyse the risk factors of medical complications after hip fracture surgery.Methods Clinical data of 327 hip fracture patients undergoing surgical treatment in Beijing Haidian Hospital from January 2009 to December 2013 were retrospectively studied.There were 114 males and 213 females with a mean age of (75.1 ±15.6) years, 129 patients(39.4%) had femoral neck fractures, and 198 patients ( 60.6%) had intertrochanteric fractures.Fifty four patients had medical complications during hospitalization ( complication group) and 273 patients did not have complications ( non-complications group ) . The clinical features, presurgical comorbidities and operative parameters were documented and compared between two groups.The risk factors of medical complications were assessed by regression analysis.Results Univariate analysis showed that age ( t =2.85, P=0.007), lying in bed before fracture(χ2 =12.86,P =0.000), the history of chronic obstructive pulmonary diseases(COPD) (χ2 =9.45, P=0.000), coronary heart disease(χ2 =10.67,P=0.000), heart failure(χ2 =15.85,P=0.000), diabetes (χ2 =3.22,P=0.024), cerebrovascular disease(χ2 =4.21,P=0.008), anesthesia method(χ2 =8.67,P=0.018), American Society of Anesthesiologists(ASA) score ≥3 level(χ2 =2.01, P=0.042) and the delay time of operation (t=4.24, P=0.037) were significantly different between two groups.Multivariate regression analysis revealed that age(β=0.030, OR=1.030), lying in bed before fracture (β=2.303, OR=10.716), the history of COPD (β=0.831, OR =1.995), coronary heart disease(β=0.858, OR=2.392), heart failure(β=1.971, OR=7.333)and ASA score ≥3 level(β=0.809,OR=2.583) were the independent risk factors of medical complications after hip fracture surgery. Conclusion Age, lying in bed before fracture, the history of COPD, coronary heart disease, heart failure and ASA score≥3 level would increase the risk of postoperative medical complications for patients with hip fracture.
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Objective To investigate the expression of kallikrein 9 (KLK9) in liver cancer and to determine its significance.Methods The expression of KLK9 in liver cancer was detected by immunohistochemistry and RT-PCR techniques.Results The rate of expression of KLK9 protein in liver cancer tissues was significantly higher than paracarcinoma tissues and normal liver tissues (P ＜ 0.05).The expression of KLK9 mRNA in liver cancer cells was significantly higher than normal liver cells (P ＜ 0.05).The expression of KLK9 was related to metastasis,size of tumors,degree of malignancy and clinical staging of the liver cancer (P ≤ 0.05),but there was no associated with age,HbsAg and sex (P ＞ 0.05).Conclusions KLK9 may play an important role in the occurrence and development of liver cancer.It may be used as a tumor marker and a prognostic factor.It may also provide a theoretical basis for the diagnosis and biological targeted therapy of liver cancer.
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Thirty-seven patients with primary osteosarcoma treated with local radiation and arterial perfusion of cytotoxic agents followed by systemic chemotherapy from April 1986 to April 1992. Several patients themselves stopped the treatment. All patients were divided into 3 groups: Group A (18 cases) were treated by local radiation and arterial perfusion of DDP, followed by systemic chemotherapy; Group B (14 cases) were treated by local radiation and arterial perfusion with no or insufficient dose of systemic chemotherapy; Group C (5 cases) were treated by local radiation and arterial perfusion with insufficient half dose and no systemic chemotherapy. Except the patients in group C, all other patients(32 cases) were followed-up from 24 to 95 months. Local control rate of the tumors was 93.8%, hypokinesis rate of the limps decreased from 93.8% to 40.6%, and mean survival time with no evidence of cancer was 38 months after treatment . survival rates of 2,3,5 and 7 years in group A were 94.4%,92.3%,72.7% and 50%,respectively.The mean survival time from lung metastasis to death in 19 patients was 13.6 months. Our date showed that long term survival of group A was superior to other groups (P