Objective To study the respiratory and circulatory changes in elderly patients, and their relationship with pulmonary complications after thoracotomy. Methods 58 elderly patients either aged over 75 years, with major organ dysfunction or underwent highly invasive procedures (group 1). Respiratory and circulatory status, including arterial blood gas under room air, water balance, urine gravity, and hemodynamics monitoring through pulmonary artery catheter were documented. The results were compared with those from 56 young patient controls receiving thoracotomy in the same period (group 2). Results All 12 patients having pulmonary complications were from group 1 (group 1A). Ten of them presented on the 2nd or 3rd postoperative day with hypoxemia. The other 2 died of type II respiratory failure after severe infection. Preoperative pulmonary co-morbidity (P=0.026, Exp(B)=5.4) and obesity (P=0.043, Exp(B)=4.9) were identified as independent risk factors for pulmonary complications after thoracotomy in elderly patients. During the first 3 postoperative days, PaO_2 of group 1A was significantly lower than group 2 as well as the other elderly patients who did not develop pulmonary complications after surgery (Group 1B). PaCO_2 of group 1A and 1B were significantly lower than group 2. There were also significant differences between the three groups in water balance on the first postoperative day (group 1A +832ml, P=0.006 vs. group 1B +109ml, P=0.004 vs. group 2 -243ml ). Urine gravity in group 1A was also significantly higher than in group 2 in the first 3 postoperative days. Pulmonary artery catheter monitoring revealed increased cardiac output and decreased systemic vascular resistance, showing a hyperdynamic status, in elderly patients after surgery. Pulmonary vascular resistance was elevated in the same time. Conclusion Pulmonary co-morbidities commonly seen in elderly patients are responsible for pulmonary complications, the major cause of surgical mortality after thoracotomy. Hypoxemia in the early postoperative period is mainlycaused by relative volume overloading from trauma induced interstitial edema. Close monitoring of arterial blood gas under room air, water balance, and urine gravity after thoracotomy may identify elderly patients at risk of developing pulmonary complication and prompt timely intervention.

Nanomedicine offers great promise for early diagnosis and treatment of formidable diseases. The unique morphology and biology characteristics of bacteriophage provide unprecedented opportunity for such endeavor. The paper summarizes the application of bacteriophage in nanobiomaterials, nanomedicine, nanomedicine delivery and nanodiagnosis, especially the nano-imaging reagents and future direction concerning nanomedicine based on bacteriophage.

Objective To explore the effect of individualized nutritional nurses involved in intervention on quality of life for cancer patients. Methods The articles were searched by Chinese full- text periodical database, Wanfang database, VIP database, PubMed, Cochran Library from 1995 to July 1 2015, and the articles and data were extracted by two researchers using Cochrane systematic review methods using RevMan5. 3 Meta- analysis software. Results The final results included five randomized controlled study, 358 cases of patients. Individualized nutritional quality of life of patients in the intervention group compared with the usual care group, within three months 27.76 points high quality of life, MD = 27.76,95% CI was 8.83-46.68; three months of life high quality 31.64 points, MD = 31.64, 95% CI was 9.70-53.59,6 months or more (including 6- month) high quality of life 34.26 points, MD = 34.26, 95% CI was 3.69-64.84, were statistically significant (P<0.05). Conclusions Nurse participation can improve the quality of life of patients and long-term effects also have some role in promoting. Due to the limitations of this study we need more high quality randomized controlled studies and Meta analysis to verify.

Objective:To explore the effects of the natural plant ingredients lemon essential oil(LEO),limonene(LIM)and tea poly-phenols(TP)on the cell surface hydrophobicity and adherence of Streptococcus mutans(S.mutans).Methods:S.mutans were treated by sub-minimal inhibitory concentration(MIC)levels of LEO,LIMand TP respectively.Adsorption to hexadecane was used to measure the hydrophobic interaction of S.mutans.A classical 96-cell microtitre plate production assay using crystal violet staining was employed to visualize the adherence of S.mutans to hard tissue surface.Results:LEO,LIMand TP at sub-MIC levels could inhibit the cell sur-face hydrophobicity and adherence of S.mutans in a dose-dependent manner(P <0.05).At 1 /2 MIC and 1 /20 MIC,the inhibitary effect of LEO was stronger than that of LIMand TP(P <0.05).Conclusion:LEO may possess anticariogenic potential.

Objective:To explore the antioxidant activity of natural plant ingredients lemon essential oil(LEO),limonene(LIM) and tea polyphenol(TP).Methods:The UV-Vis spectrometry was used to determine the 3 agents on the scavenging activity of 1 ,1 diphenyl-2-trinitrobenzene hydrazine free radicals(DPPH·)and hydroxyl free radical (·OH).Results:LEO,LIM and TP showed scavenging effect on the 2 kinds of free radicals.The (DPPH·)scavenging effect:LEO(IC50 =0.01 4)>TP(IC50 =0.01 4)>LIM (IC50 =0.002);the (·OH)scavenging effect:TP(IC50 =0.079)>LEO(IC50 =0.01 3)>LIM(IC50 =0.004).In a certain con-centration range,scavenging effect was increased with the concentration increase.Conclusion:As a nontoxic natural extract,lemon essential oil has strong antioxidant activity.

Objective:To construct the rehabilitation strategy of anterior cruciate ligament reconstruction based on the evidenced method and evaluate the effectiveness in clinic.Methods:The rehabilitation strategy was firstly built based on evidenced method. And then 80 patients from Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing University Medical School Affiliated Drum Tower Hospital from January to August, 2019 were randomly and equably sent to experiment group and control group. Patients in experiment group or control group were accepted the evidenced method or regular method as treatment strategy, respectively. The visual analogue scale (VAS), thigh circumference, motion range of knee joint and Lysholm score were recorded before and after surgery.Results:Six papers met the inclusion criterion and were been screen out from 1 535 papers, and then the evidenced rehabilitation strategy of anterior cruciate ligament reconstruction was made. The VAS scores in 12 and 24 h were 1(0-2), 1(1-3) in experiment group and 2(1-3), 3(1-3)in control group, the differences were significant between two groups( Z values were 4.955, 6.489, P<0.001). The motion ranges of knee joint in 2, 4, 6, 12 weeks after operation were (61.6±5.1)°, (85.3±6.6)°, (114.6±5.2)°, (127.6±3.4)° in experiment group and(54.9±4.6)°, (71.0±8.8)°, (105.1±5.9)°, (115.8±4.0) °in control group, the differences were significant between two groups( t values were 6.209-14.138, P<0.001). The Lysholm scores at 6,8,12 weeks after operation were 58.8±3.7, 71.1±3.1, 84.3±3.7 in experiment group and 56.0±3.4, 65.4±4.3, 75.6±3.0 in control group, the differences were significant between two groups( t values were 3.511, 6.867, 11.439, P<0.001). Conclusions:This evidenced rehabilitation strategy of anterior cruciate ligament reconstruction in this study was helpful to alleviating the pain, improving motion range of knee joint after anterior cruciate ligament reconstruction.

Objective To investigate early changes of angiopoietin-2(Ang-2)in multiple trauma patients and assess its clinical significance.Methods Forty-five multiple trauma patients aged 2060 years admitted to the hospital within one hour after injury were randomly divided into three groups according to injury severity score(ISS).Blood specimens were obtained immediately upon arrival in the emergency department and plasma samples were assayed for comparing changes of Ang-2,TNF-a and IL-6.Meanwhile,plasma level of Ang-2 was measured and analyzed under different oxygenation index,shock index and base deficit.Results Plasma level of Ang-2 was positively correlated with ISS(P ＜ 0.01)and was concordant with the plasma levels of TNF-a and IL-6(P＜0.01).Furthermore,plasma level of Ang-2 was elevated upon increase of shock index or decrease of oxygenation index(P ＜ 0.01).Plasma level of Ang-2 was elevated with the increase of base deficit(P ＜ 0.01).Conclusions High level of Ang-2 is a marker of endothelial activation and dysfunction early after trauma.Ang-2 is related tightly with the injury severity,inflammation factors,systemic oxygenation and tissue hypoperfusion and may have a tight relation with pathophysiological development and clinical outcome after trauma.

In recent years, researchers have become more interested in fish scrap collagen collection .Fish collagen, thanks to its low antigenic and hypoallergenic properties , is superior to that of higher animals .Meanwhile , fish collagen derives from a wealth of sources and has a moderate price .Based on recent fish collagen extraction and modification , this article summarizeds extraction technologies , such as hot-water, chemistry, bio-enzyme, compound extraction and such modification methods as physical and chemical processes to improve the thermal stability .

One hundred patients with Parkinson's disease (PD) aged 60 and above treated with levodopa were enrolled in this cross section study.The general conditions,medication,unified Parkinson's disease rating scale (UPDRS) scores and the incidence of levodopa-induced dyskinesia (LID) were documented.The incidence rate of LID in this group of PD patients was 37.0％ (37/100).The incidence was significantly higher in patients with levodopa treatment ≥ 4 years than that in patients with levodopa treatment ＜ 4 years (55％ vs.26％,x2 =8.770,P =0.003).The incidence rate ofpeak dosage dyskinesia in tremor-dominant PD patients was lower than that in rigidity-dominant PD patients(x2 =4.399,P =0.036).The incidence rate of LID was correlated with the duration of levodopa therapy.Amantadine may reduce the incidence of off dystonia.

To explore the safety of ropinirole in the treatment of Parkinson′s disease( PD).A total of 221 PD patients participated in a multi-center,12-week randomized,bromocriptine-controlled,double-blind, double-dummy and parallel-group trial.The safety was assessed on the basis of adverse reactions , blood pressure,pulse,laboratory parameters and electrocardiography recordings.The incidence of adverse reaction was 34.9%in ropinirole group and 34.8% in bromocriptine group.And the frequency of adverse reactions had no inter-group statistical significance (χ2 =0.000,P=0.995).Ropinirole has an excellent profile of safety in the treatment of Chinese PD patients.