With the accelerating process of aging society, people's life style is changing accordingly, elderly patients due to physical decline in daily activities, often prone to hip fracture, its basic reason is osteoporosis, which belongs to brittle fracture, evaluation of preoperative examination and the systemic function is very important.Perioperative treatment is the key to the success of surgery treatment , a considerable part of the success of surgery depends on the factors of internal diseases.The incidence of cardio cerebral stroke in hip fracture surgery is also increasing , especially in elderly patients, often and there are a variety of medical diseases, the majority of organ function reserve is low, tolerance to anesthesia, surgery and other stress ability is poor, Patients in the perioperative period of traumatic stress, easily lead to stroke secondary cardiovascular disease, in clinical treatment, we should strengthen the prevention measures of perioperative stroke in elderly patients with hip fracture , Salvia miltiorrhiza ligustrazine injection can effectively prevent the occurrence of myocardial ischemia, myocardial infarction, or cerebral infarction by reducing platelet aggregation function and blood viscous degree, expanding coronary artery, cerebrovascular, improving the flow rate of red blood cells and microcirculation.In this paper mainly for Salvia miltiorrhiza ligustrazine in recent years in elderly hip fracture patients perioperative cardio cerebral apoplexy therapy application review to provide some reference value for clinical research .

Objective To explore the aursing points for patients with acute pancreatitia.Methods Retrospectively summarized the nursing courses among 65 patients with acute pancreatitis.Results Among the 65 patients with acute pancreatitis,there were 10 patients receiving operation,there were 55 patients receiving conservative treatment.5 cases died,and the others rccoverd.Conclusion The key nursing points for patients with acute pancreatitis are careful observation,systematic nursing intervention according to the conditions of patients and preventing complications.

Objective To explore the clinical effect of conventional surgical treatment of tibial plateau fractures and traditional Chinese medicine intervention. Methods Sixty-eight patients with tibial plateau fractures who had received medical treatment from Hangzhou Cancer Hospital (May 23, 2015 to May 23, 2016) were randomized to the surgical group and the combined group as the subjects of this study. 34 patients in the operation group were treated with surgical treatment. 34 patients in the combined group were treated with traditional Chinese medicine on the basis of operation. The clinical efficacy and knee function scores of the patients with tibial plateau fractures were compared. Results The total effective rate was 91.18% in the combined group, which was significantly higher than that in the operation group (73.53%) (P<0.05). The knee function score of the combined group was (25.36±3.85) The operation group (21.24 ± 3.89) was significantly higher (P<0.05). Conclusion The intervention of traditional Chinese medicine combined with traditional Chinese medicine can significantly improve the function of knee joint in patients with tibial plateau fractures.

Objective To study the clinical and pathological features of hepatic steatosis in patients with chronic hepatitis B (CHB)based on a matched case-control study.Methods Cross-sectional study was carried out on CHB patients who received liver biopsy in the Department of Infectious Diseases, Shunde First People′s Hospital from January 2006 to December 2014.Clinical data of the patients were collected.A total of 216 matched pairs were created according to gender and age.The clinical and pathological feathers of both groups were compared and analyzed. Quantitative data with normal distribution were compared by t test and those with abnormal distribution were compared by nonparametric rank sum test of two- or multi-independent samples. Categorical data were compared by χ2 test. Results In matched pairs,rates of overweight/obesity were 84.2% in fatty liver group and 18.5 % in non-fatty liver group (χ2 =189.30,P =0.001 ),patients with high cholesterol in the two groups were 30.6% and 13.4%,respectively (χ2 =18.47,P =0.001 ),high triglycerides were 27.3% and 9.7%, respectively (χ2 =22.15 ,P =0.001),high low-density lipoprotein were 16.7% and 5 .6%,respectively (χ2 =13.50,P =0.001),high uric acid were 31 .0% and 15 .3%,respectively (χ2 =15 .04,P =0.001 ) and rates of alcohol history were 38.9% and 25 .9%,respectively (χ2 =8.08,P =0.001).The differences of hepatitis B virus (HBV)DNA and status of hepatitis B e antigen between the two groups were not statistically significant (both P >0.05 ).Compared to fatty liver group,rates of hepatic inflammation activity degree ≥ 3 (54.6% vs 37.5 %,χ2 = 12.75 ,P <0.01 )and fibrosis staging ≥ 3 (53.2% vs 41 .7%,χ2 =5 .80,P =0.016)in non-fatty liver group were both significantly higher.Conclusions CHB patients with overweight/obesity,high cholesterol,high triglycerides,high low-density lipoprotein,high uric acid and drinking history are more likely to develop hepatic steatosis.The inflammatory grade and fibrosis stage in non-fatty liver group are more serious than those in fatty liver group.

Objective To study the effect of Shuanghuanglian injection on CRP, PCT and IL-6 in pneumonia children.Methods 68 cases of pneumonia children were selected and divided into the control group and the experiment group.33 case in the control group and 35 cases in the experiment group.The two groups were treated with conventional symptomatic treatment and anti infection treatment for the two groups were implemented routine symptomatic treatment and anti infection treatment.The control group were treated with cefotaxime sodium injection, the experiment group were treated on the base with Shuanghuanglian injection.CRP, PCT and IL-6 in serum were compared before and after the treatment.Results Compared with the control group, the level of CRP in serum was lower(P<0.05), the level of PCT in serum was lower(P<0.05), the level of IL-6 in serum was lower(P<0.05).Conclusion Shuanghuanglian injection has a good clinical effect on children’s pneumonia.It is speculated that the mechanism is related to the decrease of serum CRP and IL-6 level.

Objective To systematically evaluate the effect of routine insertion of double-J stents to prevent major urological complications(MUCs)in kidney transplant recipients.Methods Medline,Embase,Cochrane Library,and Chinese Biomedicine database were searched to locate relevant randomized controlled trials(RCT).Data extraction and assessment of methodologic quality were performed independently by two reviewers.Meta-analysis was performed by Revman 5.0 software.Results Ten RCT(including 1616 patients)were identified.By comparing the routine stent group with the no stent group,the meta-analysis showed:(1)incidence of urine leak,urinary obstruction and UTI was 4 times lower,6 times lower,increased by 52 % respectively(P＜0.0001);(2)Patient and graft survival,rate of acute rejection,delayed graft function and hematuria were of no significant difference.In subgroup analysis,it was found:(1)Compared with the no stent group,the group in which stent duration was≤ 4 weeks had a lower incidence of MUCs and a higher incidence of UTI;meanwhile,the group in which stent duration was ＞ 4 weeks had a much lower incidence of MUCs and the rate of UTI was increased without significant difference;(2)In the RCT of which urethral catheter duration was ＜ 5 days,there were no significant differences between the two groups in MUCs and UTI.In the RCT of which urethral catheter duration was ≥5 days,the stent group had a lower incidence of MUCs and a higher incidence of UTI.Conclusion Routine stenting reduces the incidence of MUCs.Although the double-J stent increases the risk of UTI,it seems that UTI doesn't affect the outcome of transplantation.The stent duration should be within 4 weeks.For the stent recipients,the longer duration of urethral catheter,the lower incidence of MUCs,the higher incidence of UTI;thus,it is up to clinicians to decide the optimal duration of urethral catheter.Long term prescription of 480 mg cotrimoxazole once daily,from the operation day till after stent removal,effectively reduces the risk of UTI associated with stent placement.

OBJECTIVE: To explore the three-dimensional ultrasound locatization in endoscopic thyroidectomy for multinodular goiter (MG). METHOD: Thirty two patients with MG underwent ET via bilateral areolar approach. Preoperative ultrasonography were used to locate lesions and marked in the 3-D map designed by us. Dur ing ET procedure, surgery skills were adopted to expose inferior pole of thyroid, glands in the area of Berry ligament or (and) upper pole were retained according to the preoperative location map. RESULT: According to the preoperative ultrasonic orientation, 3 lobectomy were performed in 15 cases of unilateral lesions, 12 subtotal thyroidectomy were performed in 17 cases of bilateral lesions, and 5 patients performed unilateral lobectomy add partial thyroidectomy. All patients had successful ET using bilateral areola approach. No conversions to open surgery, no complication occurred, and no nodules were found missing in the postoperative ultrasonography examinations. CONCLUSION Preoperative ultrasonic orientation and intraoperative operating skills are contributing to a successful ET for MG.
Adolescent ; Adult ; Aged ; Endoscopy ; methods ; Female ; Goiter, Nodular ; diagnostic imaging ; surgery ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Thyroidectomy ; methods ; Ultrasonography ; Young Adult

OBJECTIVETo show the changes of heat shock protein 70(HSP70) expression at cellular level in different heat exposure stages and the significance of HSP70 expression in heat exposure organism.

METHODThe heat exposure model was established in rats with artificial hot climatic chamber[34 +/- 1) degree C, RH 60%]. SD rats were randomly divided into control groups(C) and heat exposure groups(A), and into subgroups including 2, 7, 14, 28 d stages from each one of the groups. The immuno-histochemistry was used to detect HSP70 expression in rat liver and cardiac muscle, and photography analytic software was used to analyze HSP70 expression in liver and cardiac cells.

RESULTSThe expression intensity of HSP70 in heat exposure groups(gray values of liver were 137.0 +/- 5.1, 137.0 +/- 5.2, 137.8 +/- 7.1, 139.2 +/- 5.2 respectively; of cardiac muscle 156.1 +/- 4.4, 155.1 +/- 6.2, 155.4 +/- 4.5, 156.2 +/- 5.1 respectively) was stronger than that in control groups(P < 0.01 or P < 0.05) during all stages of the heat exposure; There was no significant difference in expression intensity of HSP70 among various stages of heat exposure; after 2 d of heat exposure, HSP70 expression in cell nuclei of the liver and cardiac muscle cells was stronger than that in cytoplasm in heat exposure group; HSP70 expression in Kupffer's cells of liver was also stronger than that of control(P < 0.05), but not on 7, 14 and 28 d; the activities of alanine aminotransferase(ALT), aspartate aminotransferase(AST), creatine kinase(CK) and hydroxybutyrate dehydrogenase(HBD) showed an increase on 2 d and 28 d of heat exposure.

CONCLUSIONThe vital organs would be damaged on 2 d of heat exposure. High expression of HSP70 at this stage may be a marker of cell damage; Increased HSP70 expression on 7-14 d of heat exposure may play an important role in adaptation to heat, while long term(28 d) heat exposure, the protection of HSP70 from tissue damage may not be enough.

Adaptation, Physiological ; Animals ; HSP70 Heat-Shock Proteins ; biosynthesis ; Heat Stress Disorders ; metabolism ; Liver ; metabolism ; Myocytes, Cardiac ; metabolism ; Rats ; Rats, Sprague-Dawley ; Time Factors

Objective To investigate the surgical methods and experience of laparoscopic radical cystectomy and orthotopic ileal neobladder for invasive bladder cancer. Methods The clinical data of 14 patients with invasive bladder cancer underwent laparoscopic radical cystectomy and orthotopic ileal neobladder were collected retrospectively during March 2011 and October 2014. Results The 13 patients with invasive bladder cancer were successfully completed laparoscopic radical cystectomy and orthotopic ileal neobladder. 1 case was treated with laparotomy because of unsatisfactory surgery ifeld caused by excessive tumor bleeding. Twelve cases of the urethra-neobaldder anastomosis were completed through the abdominal incision, while for the other 2 cases, the anastomosis was done under the laparoscope, 2 cases were performed neovesicourethral anastomosis using single-needle running sutures through laparoscopy. The median operative time was 444 minutes, the mean intraoperative blood loss was 490 ml. Postoperative pathologic results conifrmed that 12 cases were bladder transitional cell carcinoma (1 case with partial squamous cell carcinoma) and 2 cases with bladder adenocarcinoma. No severe complication occurred except for 2 cases of urinary leakage and 1 case of urinary incontinence. Patients were followed up for 6-56 months,within which 3 patients were died of distant metastasis, 1 case was detected with intracranial metastasis, 1 case was found with urethra-vesical anastomotic stenosis while cured after urethrotomy. Ten cases were well recovered and the mean volume of the neobladder was 300 ml. Conclusions Laparoscopic radical cystectomy and orthotopic ileal neobladder have the advantage of better therapeutic effects, safety, minimal invasion and rapid recovery, which are the preferred therapeutic methods for invasive bladder cancer.

Objective To investigate the effects of different immunosuppressive agents on mesangial cell proliferation through a mesangial cell injury model in vitro. Methods Mesangial cell line (HBZY-1) in period of proliferation was cultured in vitro with cytochalasin B for 2 h, then HBZY-1 cells were divided into 5 groups: blank (control) group, cyclosporine A (CsA) group, Tacrolimus (Tac) group, mycophelonate mofetil (MMF) group and rapamycin (RAPA) group. Subsequently,the number of HBZY-1 cells at different time points was measured by using the professional image analysis software after treatment for 6, 12 and 24 h, respectively. Results Damaged HBZY-1 cells recovered in all groups. At 6 h, the number of HBZY-1 cells in Tac group was significantly more than that in control group (P＜0.05), but the difference had no significance between the other treatment groups and control group (P＞0. 05). At 12 h, there was no significant difference in of the number of HBZY-1 cells among the all groups (P＞0. 05). At 24 h, there was no significant difference in the cell number between MMF and control groups (P＞0. 05). CsA, Tac and RAPA resulted in HBZY-1 cell proliferation, and the cell number in CsA and Tac groups was significantly more than that in the other groups (P＜0. 05). As compared with the control group, the cell number in RAPA group was significantly increased (P＜0. 05). Conclusion CsA, Tac, MMF and RAPA contribute to recovery of damaged HBZY-1 cells, but CsA and Tac result in over-proliferation of HBZY-1 cells. RAPA and MMF can prevent HBZY-1 cells against over-proliferation, and MMF scarcely results in HBZY-1 cell proliferation.