Objective Compare the difference on vision,vision field between treating on central retinal artery with compound anisodine retrobulbar injection associate with emporat artery side injection and emporal artery side injection simply.Estimate the curative effect of the two ways on the disease.Methods Observe the patients'vision,vison field and cross-check,analyze the results who have central retinal artery and there are 20 who treated by compound anisodine retrobulbar injection associate with emporal artery side injection together with 20 who treated by emporal artery side injection purely.Results The therapeutics that is compound anisodine retrobulbar injection associate with emporal artery side injection is excellence to 10,effective to 6 and ineffective to 4;the therapeutics that is arter3,side injection purely is excellence to 5,effective to 5 and ineffective to 10.The two therapeuticses has significant difference on improving vision and ameliorating vision field.Conclusion It's quite effective to treat central retinal artery occlusion by compound anisodine retrobulbar injection associate with emporal artery side injection.

Objective To evaluate the effect of acute hypoxia on the contractile function of isolated small pulmonary arteries in patients with moderate chronic obstructive pulmonary disease (COPD).Methods Seven patients with lung cancer,of both sexes,scheduled for elective pulmonary lobectomy,with no pulmonary hypertension and with normal pulmonary function after examination,were included in the study.Six cases were diagnosed as having moderate COPD.Lung tissues 5 cm away from the tumor tissues were taken during operation and the small pulmonary arteries were isolated and divided into 2 groups:control group (n =7) and COPD group (n =6).The contractile amplitude of small pulmonary arteries was detected using vasomotor tone meter under the state of acute hypoxia.Results Contractile amplitude of small pulmonary arteries in response to hypoxic stimulus was significantly decreased in COPD group compared with control group (P ＜ 0.01).Conclusion Acute hypoxia can further reduce the contractile function of isolated small pulmonary arteries in patients with moderate COPD.

Objective The feasibility and the curative effect of bipolar hemiarthroplasty for hemiplegic side femoral neck fractures in elderly patients were evaluated.Methods The patients suffering from hemiplegic side femoral neck fractures and undergoing bipolar hemiarthroplasty in Beijing Tongren Hospital were followed-up during 2012-2015.The postoperative Harris Score and the complications such as infection,deep vein thrombosis and dislocation were collected.Results Totally 25 patients(25 hips)were followed-up.The average age was 70.1 years,and mean follow-up period was 24.3 months (10-42 months).The mean Barthel index score was higher (77.4 ± 14.7,ranging from 40-95 points) after operation than before operation[25.00 ± 5.95 (15-35 points)] with a statistically significant difference(t=-21.374,P＜＜0.05).The postoperative Harris Score was 83.5± 8.9(60-95 points).According to Harris score,the excellent and good rate was 80.0％.The patient's satisfaction rate was 88.0％.Conclusions Choosing proper prosthesis and fixing measure,and keeping the function and tension of short extorsion muscles can achieve the satisfactory results for hemiplegic side femoral neck fractures in elderly patients.

Objective:To detect the expressions of COX-2 protein and BCL-2 protein in transitional mucosa adjacent to rectal carcinoma,and determine whether the transitional mucosa was the cancer precursor event.Methods:Mucin histochemical method was employed to detect the distal mucosa 2 cm away from rectal tumor and the transitional mucosa was found in 54 cases of rectal carcinoma.Immunohistochemical method was used to investigate the expressions of BCL-2 and COX-2 protein in the specimen of rectal carcinoma mass,transitional mucosa and non-transitional mucosa,and 20 cases of normal rectal mucosa,and the points of the expressions of COX-2 protein and BCL-2 protein were counted.Results:35.19%(19/54)of distal mucosa were characterized as the transitional mucosa.The expressions of COX-2 and BCL-2 protein were detected in carcinoma mass and distal mucosa.Significant difference was observed in carcinoma mass and transitional mucosa(p<0.01).But there were no significant differences between the expressions of those in transitional mucosa and non-transitional mucosa(p>0.05),as well as transitional mucosa and normal mucosa(p>0.05).Conclusion:The performance of transitional mucosa was not the cancer precursor event,but the non-specificity reaction of carcinoma or inflammation.

Objective To evaluate the clinical significance of implanting an inferior vena cava filter to prevent pulmonary embolism.Methods Reviewed the causality of 180 cases,which was undertaken the ultrasound examination,patients were diagnosed as the deep vein thrombosis,male patients were 128 cases, female patients were 52 cases,median age was 65 years old,all received the transfemora] implantation of inferior vena cava filter implantation.Results All the operations were successfully conducted,filters were placed into inferior vena cava at 1-3 cm inferior of renal vein,without hematoma in the puncture position and thrombosis.One hundred and forty-nine cases (82.8%) were followed up at 1,6,12 months respectively, 55 cases(30.6%)were followed up more than 36 months, no filter drift,deformation and inferior vena perforation complications was observed.There was no fatal pulmonary embolism occurred for all the cases,the inferior vena unobstructed rate was 95.6%.Conclusion Vena cava filter is an effective and safe method which can prevent and cure pulmonary embolism.

Objective To explore the effects of L-carnitine on the plasma lipid profile and liver function in elderly patients receiving total parenteral nutrition after abdominal operations.Methods In this prospective blinded randomized controlled trial,24 eligible elderly patients were given 6-day total parenteral nutrition.They were further equally divided into L-carnitine group(administered with L-carnitine 50 mg/kg)and control group(without L-carnitine).The changes of lipid profile and liver function and the clinical outcomes were recorded and compared.Results The plasma triglyeride levels were lower in L-carnitine group than in control group on the 4th and 7th post-operative day,but there were not significant difference(P>0.05);There was a significant difference between the two groups in the change of the 4th post-operative day and pre-operative day(P<0.05).However,the liver function indicators were not significantly different between these two groups.Conclusion Administration of L-carnitine during total parenteral nutrition can improve the triglyeride metabolism in elderly patients after abdominal operations and may benefit the recovery of liver function.

BACKGROUND:Extracorporeal membrane oxygenation(ECMO)adopts heparin-coated oxygenator as key membrane oxygenation,which is a covalent bonding of artificial material surface with mucopolysaccharide on one side of heparin.Thas artificial materials can stimulate human vascular endothelial function partly,leading to decrease production of lactic acid,increase biocompatibility of the matedals,prevent thrombogenesis and relieve inflammatory reaction after operation.OBJECTIVE:To discuss the relationship between the plasma lactic acid level and the prognosis of patients after ECMO applied with heparin-coated oxygenator.DESIGN:Self-controlled clinical study,grouping by age and survival prognosis.SETTING:Department of Cardiopuimonary Bypass,Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences.PARTICIPANTS:Forty patients received ECMO in Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences were selected from December 2004 to September 2006.They suffered from failing weaning of cardiopulmonary bypass postcardioctomy,cardiogenic shock based on dilated cardiomyopathy or cardiogenic shock based on coronary heart disease.All patients were divided into four groups according to age and survival prognosis:adult survival group,adult death group,infant survival group and infant death group.METHODS:All the patients received venoarterial ECMO support treatment.ECMO perfusion system consisted of centrifugal pump,water tank,heparin-coated membrane oxygenator(Jorstra Novalung,Germany)and corollary circuits (Bioline Coating,Germany,batch number:SFDA-I-20063450801).MAIN OUTCOME MEASURES:The concentrations of lactic acid were measured at the ECMO institution,6 hours later,the median time at ECMO support,6 hours before weaning off and at the time of weaning.RESULTS:①In 26 patients of adult groups,20 of them(76.9%)weaned from ECMO,16 of them(61.5%)survived and 10 of them died.In 14 patients of infant groups,7 of them weaned from ECMO(50%),5 of them(35.7%)survived and 9 of them died.②The concentrations of lactic acid in two survival groups were significantly lower than those in death groups(P＜0.05 or 0.001).The concentration decreased significantly at the time points of median time,6 hours before weaning off and at the weaning time,compared with the level at the time of ECMO institution(P＜0.01),indicating a decreasing concentration of lactic acid.CONCLUSION:①The concentration of lactic acid in patients after ECMO decreascs obviously.②Patients with high lactate level at the weaning time show unfavourable prognosis.

Abstract] Objective To analyze the molecular characteristics of the full-length genome of a new-ly isolated genotypeⅤJapanese encephalitis virus (JEV) strain (XZ0934) in China and the first genotypeⅤJEV strain ( Muar) isolated in Malaya 60 years ago.Methods Several softwares including ClustalX 2.0.9, DNAStar 7.1, Bioedit 7.2.5 and MEGA6.06 were used to conduct sequence alignments and phylo-genetic analysis.Results The full-length genomes of XZ0934 strain (isolated in Tibet, China in 2009) and Muar strain (isolated in Malaya in 1952) were composed of 10 983 and 10 988 nucleotides, respective-ly.The XZ0934 strain was highly similar with the Muar strain showing the homology of 90.6%in nucleotide (nt) and 98.3%in amino acid (aa).The open reading frame (ORF) of the two genotype Ⅴ JEV strains encoded 3433 aa while the ORF of other four genotypes (Ⅰ-Ⅳ) (10 299 nt) encoded 3432 aa.Compared with JEV strains of other genotypes, a serine were inserted into the NS4A gene of JEV strains genotype Ⅴand 10-14 nucleotides were inserted into the downstream of the ORF stop codon in 3′-untranslated region. Phylogenetic analysis of E sequences of all JEV strains genotypedⅠ-Ⅴrevealed that in the cluster of geno-typeⅤ, XZ0934 and 10-1827 ( isolated from mosquitoes in South Korea, 2010) stains formed a branch and were divergent from that of Muar strain indicating that there were molecular genetic differences among geno-typeⅤJEV strains after a 60 years hiatus.Conclusion The two genotypeⅤJEV strains showed high lev-els of identity in nucleotide sequences and amino acid sequences with serine insertion in the NS4A gene. However, there were molecular genetic differences between genotypeⅤJEV strains isolated after a 60 years hiatus.

Objective To evaluate the muscle mass in elderly patients with inguinal hernia using CT scan.Methods 30 male (age 70-90 years) hospitalized patients scheduled to receive surgery for inguinal hernia were selected into study group, 10 male health volunteers (40-50 years) were involved in adult control group, and 10 men of the same age as the study receiving annual physical examination were enrolled as elderly control group.General information were recorded;CT scanning of the stomach muscles and thigh muscles were conducted, and the muscle area was calculated using a special software.Results The index of grip strength in the study group was significantly lower than the adult control group [(36.44 ± 14.15) kg vs.(77.30 ± 22.69) kg, P =0.001], the calf circumference in the study group was significantly less than the adult control group [(25.18 ±2.31) cm vs.(27.62 ±2.33) cm, P =0.006].There was no significant difference in L3 abdominal area, subcutaneous fat area, abdominal fat area, and vertical spinal muscular volume between the study group and the adult control group;while the L3 abdominal muscle area and vertical spinal muscular mass was significantly less in the study group than in the adult control group [(12 094.23 ± 1 970.30) mm2 vs.(17462.00±1 600.58) mm2, P=0.001;(1 642.60±266.90) mm2 vs.(2 003.50±350.91) mm2,P =0.007].L3 skeletal muscle index of the study group was 50.64 ±7.52 and 66.7％ (20/30) of the study group had sarcopenia (≤52.4％).The CT findings of abdominal muscle of the study group were not significantly different from those of the elderly control group.The thigh muscle mass in the study group was significantly less than that in the control group (P =0.001), but there was no significant inter-group difference in thigh fat and femur areas (P ＞ 0.05).Conclusion The muscle mass and strength in elderly patients with inguinal hernia are significantly lower than those of adult controls, for which CT scan can be applied for assessment.

ObjectiveTo investigate the prevalence of nutritional risk and malnutrition among hospitalized elderly abdominal surgical patients with malignant tumors.MethodsTotally 269 elderly patents ( ≥ 65 years) with malignant tumor who were hospitalized in our department of abdominal surgery from December 2009 to November 2010 were consecutively enrolled.Nutritional Risk Screening 2002 ( NRS 2002 ) was performed on the next morning after admission.Body mass index (BMI) lower than 18.5 kg/m2 was considered as malnutrition.Results The NRS 2002 was completed in all the 269 enrolled patients.The overall prevalence of malnutrition was 30.1％ (81/269) ; more specifically,37.5％ (21/56) among geriatric patients ( ≥80 years) and 17.6％ (43/245) among the other age groups (P =0.001 ).The overall rate of nutrition risk was 38.3％ (103/269) ; more specifically,57.1％ (32/56) among the geriatric patients and 29.3％ (72/245) among the other age groups (P ＜0.001 ).The rate of nutrition risk in patients with pancreas cancer was 58.3％,which was higher than other elderly patients; on the contrary,and the rate of nutrition risk in the patients with colorectal cancer was relatively lower.ConclusionThe rates of nutrition risk and malnutrition in hospitalized elderly abdominal surgical patients ( ≥ 65years) with malignant tumor are relatively higher than other age groups,especially among the geriatric patients.