Objective To develop and validate a prediction model for in-hospital mortality in hip fracture patients 85 years of age or older undergoing surgery. Design multicenter prospective cohort study SETTING six Dutch trauma centers, level two and three PARTICIPANTS hip fracture patients 85 years of age or older undergoing surgery INTERVENTION hip fracture surgery MAIN OUTCOME MEASUREMENTS in-hospital mortality RESULTS The development cohort consisted of 1014 patients. In-hospital mortality was 4%. Age, male sex, ASA classification and hemoglobin levels at presentation were independent predictors of in-hospital mortality. The bootstrap adjusted performance showed good discrimination with a c-statistic of 0.77. Conclusion Age, male sex, higher ASA classification and lower hemoglobin levels at presentation are robust independent predictors of in-hospital mortality in geriatric hip fracture patients and were incorporated in a simple prediction model with good accuracy and no lack of fit.Objectives The purpose of this mechanical study was to compare two methods of augmented stabilization of Pauwels Type III femoral neck fractures. Methods Ten matched pairs of young cadaveric femurs were cut 22cm distal to the lesser trochanter. All specimens received a 70-degree osteotomy which was stabilized with a 135-degree sliding hip screw (SHS). One of each pair received augmented fixation with a 6.5mm fully threaded cannulated screw. The other specimen in the matched pair had additional fixation with a 3.5mm 5-hole tubular plate placed at the inferior-medial femoral neck. Each specimen was tested under cyclic axial loading conditions (5000 cycles between 200N-1400N at 2 cycles/sec) and subsequently loaded to failure.  https://www.selleckchem.com/products/usp22i-s02.html  The angular displacement (varus), inter-fragmentary (shear) displacement, and failure loads were calculated. Results In the augmented plate group, 7 specimens failed by angular displacement, and 3 failed by shear displacement. In the augmented screw group, 8 specimens failed by angular displacement and 2 by shear. The plate group was found to have significantly less angular displacement, regardless of completed cycles, than the augmented screw group (0.75 ± 0.35° vs 2.15 ± 1.99° averaged across completed cycles, p less then 0.01). Similarly, the plate group was found to have significantly less shear displacement, regardless of completed cycles, than the augmented screw group (0.77 ± 0.70 mm vs. 1.22 ± 0.92 mm averaged across completed cycles, p=0.01). The average failure load of the plate group (4930 ± 1578 N) was also larger, but not significantly different from the screw group (3824 ± 2140 N), p = 0.12. Conclusions Augmenting SHS stabilization of a Pauwels Type III fracture with a medial plate applied to the femoral neck significantly decreases angular displacement and shear compared to augmentation with a derotational screw.Rationale It is very difficult to treat patients with aplastic anemia accompanied by chronic kidney disease. The nephrotoxicity of cyclosporine limits its use in these patients. Most of these patients also lack suitable sibling donors. Sirolimus, as a new type of immunosuppressive agent, has good therapeutic effect, lower toxicity, especially lower nephrotoxicity, thus attracting the attention of hematologists. Patient concerns This 55-year-old Chinese male patient suffered from pancytopenia and renal insufficiency and has a poor quality of life. Diagnosis The patient was diagnosed as severe aplastic anemia with chronic kidney disease-G3a. Interventions We started the sirolimus therapy with the initial dose of 1 mg per day. Based on the good tolerability and clinical effect, we increased the dose of sirolimus to 2 mg per day after 2 weeks. Outcomes By taking sirolimus, the patient's peripheral blood cell count gradually increased, and he achieved blood transfusion independent, and eventually the blood cell count was completely normal. Lessons We consider that sirolimus is a safe, effective, and well-tolerated oral drug that can be used as a treatment for aplastic anemia patients with chronic kidney disease.Rationale Pulmonary sarcomatoid carcinoma (PSC) is an uncommon type of non-small cell lung cancer, exhibiting aggressive behavior and resistance to the conventional chemoradiotherapy. To date, the optimal treatment for PSC has not been elucidated. Patient concerns Three male patients including a 69-year-old smoker (Case 1), a 45-year-old non-smoker (Case 2), and a 69-year-old smoker (Case 3) were admitted because of cough, back pain, and loss of body weight respectively. Diagnoses Radiographical examinations in these patients showed bulky intrathoracic lesions, which were pathologically diagnosed as PSC staging III-IV by computed tomography-guided percutaneous biopsy and endoscopy. Interventions Immunotherapy was not covered by their health insurance and they refused immune checkpoint inhibitors for financial reasons. In addition, a radical resection was not appropriate due to the advanced staging of these lesions. Therefore, first-line albumin-bound paclitaxel (nab-paclitaxel, 260 mg/m of the body surface area) and carboplatin (area under curve 5) combined with oral apatinib (425 mg, daily) were administered empirically. Outcomes Two patients achieved a partial response and the other case showed stable disease lasting for more than 6 months. However, 1 of them indicated progression on the 7-month follow up. Lessons Nab-paclitaxel/carboplatin plus apatinib showed limited short-term efficacy in advanced, unresectable PSC. The rapid resistance of PSC to the current therapeutic regimen necessitates further researches, as more effective agents are urgently needed.Introduction Coronavirus disease 2019 (COVID-19) is pandemic and is a medical issue. However, children account for a small portion of those with the disease, and there are few published reports of COVID-19 in children. The patient reported in this case report is the youngest case reported in Chengdu, China to date. Patient concerns A 3-month-old male infant presented with cough and rhinorrhea. Diagnosis Family members from Wuhan, the epicenter of the epidemic came to stay in the patient's home 16 days before the onset of his disease, and his mother had been diagnosed with COVID-19. He was diagnosed with COVID-19 based on a history of exposure and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), detected using reverse transcription polymerase chain reaction (RT-PCR). Interventions The patient was admitted to hospital and treated symptomatically with oral medication. Outcomes The patient recovered completely and was discharged after one month of hospitalization. He tested negative for SARS-CoV-2 using RT-PCR and a chest CT performed 4 weeks after admission showed marked improvement prior to discharge.