Objective To investigate the reason for hidden hemorrhage of hip fracture in elder.Methods All of 94 elder patients,who were diagnosed with intertrochanteric fracture or femoral neck fracture and received treatment in our department from October,2013 to September,2015,were included in this study.The time between injuries to admission was less than 4 hours of the two groups of patients.And the patients whose hemoglobin was less than 100 g/L were removed when admission,in order to avoid the interference of primary anemia.All information,including height,weight,and the value of hemoglobin (Hb) and hematocrit (Hct),were collected.Blood tests were performed immediately after admission,at daily morning preoperatively,and at the morning of the day of surgery.Preoperative blood loss (hidden hemorrhage) was recorded.With respect to blood loss of hidden hemorrhage,statistical analysis was performed at different times (immediate time after admission,and day 1,2,and 3 postoperatively)in the group of intertrochanteric fracture or in the group of femoral neck fracture,and subsequently performed between the two groups.Results The blood loss in the group of intertrochanteric fracture was 196.3 ml,310.1 ml and 418.3 ml in the 1st day,the 2nd day and the third day after admission.There was a significant difference among different time with respect to blood loss.The blood loss was 39.8 ml,65.7 ml and 82.9 ml in the 1st day,the 2nd day and the third day after admission in the group of femoral neck fracture.There was also a significant difference among different time with respect to blood loss.In experimental group,mean blood loss was 418.3 ml and mean Hb decreased by 23.7 g/L at day 3 postoperatively.In control group,mean blood loss was 82.9 ml and mean Hb decreased by 6.7 g/L at day 3 postoperatively.A significant difference was observed between the two groups.The blood loss in patients with intertrochanteric fracture was higher than that in patients with femoral neck fracture.Conclusion The blood loss was gradually increased in elder patients with intertrochanteric fracture over time.There was a significant difference in different time with respect to blood loss.Moreover,a significant difference was found in blood loss of hidden hemorrhage between intertrochanteric fracture and femoral neck fracture.

Objective To explore how to effectively prevent and detect cancer early postoperative intestinal obstruction and treatment methods and means.Methods This retrospective analysis of 13 years occurred in 57 patients with rectal cancer diagnosis and treatment of cases of early postoperative intestinal obstruction process, including fasting,gastrointestinal decompression,fluid therapy,liquid paraffin,diatrizoate and surgical treatment of oral contrast.Results In 57 cases,paralytic intestinal obstruction in 7 cases,conservative treatment was relieved,the success rate was 100.0%;early inflammatory intestinal obstruction in 37 cases after conservative treatment of 36 cases of remission,the success rate was 97.3%;mechanical intestinal obstruction in 13 cases after conservative treatment could not be alleviated,conservative success rate was 0.0% and was cured by reoperation.The first two groups of patients compared with mechanical intestinal obstruction patients,conservative success rate had statistical differences (χ2 =40.08,11.08,all P<0.01).Conclusion Cancer treatment lies in early postoperative intestinal obstruction effective prevention,early detection,close observation and timely and effective treatment,a good grasp of timing of surgery and surgical indications.

Objective:To explore the traits of gray matter volume in general anxiety disorder (GAD)and ob-sessive compulsive disorder (OCD)by using magnetic resonance imaging (MRI)technique.Methods:Twenty-eight GAD,25 OCD and 39 normal controls were recruited.All patients were met the Diagnostic and Statistical Mannal of Mental Disorders,Fourth Edition,Text Revision (DSM-IV-TR)or the International Statistical Classifica-tion of Disease and Related Health Problems Tenth Revision (ICD-10)diagnostic criteria for GAD or OCD.All subjects underwent structural MRI scan.The severity of anxiety and OCD symptoms were rated in all patients with the Hamilton Anxiety Rating Scale (HAMA)and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).The gray matter volume (GMV)was compared between all groups by using the voxel-based morphometry (VBM)a- nalysis.The correlation analysis between GMV and total scores of HAMA and Y-BOCS was performed in GAD and OCD.Results:The GMV was increased in regions including left anterior cingulate cortex in GAD (P =0.016,small volume correction),while only decreased GMV was observed in OCD in bilateral orbitofrontal cortex (OFC)(P <0.001,uncorrected).GAD had larger GMV than OCD in several regions including bilateral OFC (P <0.001,un-corrected).The higher total score of HAMA was associated with increased GMV of right temporal cortex in GAD, and with the GMV of OFC in OCD (P <0.001,uncorrected).Conclusion:No sharing of GMV abnormalities in GAD and OCD was observed in the current study.The traits of brain structure and the potential neural substrate of anxiety symptom in GAD and OCD may be significantly different.

AIM: To study the recombinant plasmid pDL121 and its expression product in E.coli. METHODS: pDL121 was analysed by using 6 different restriction endonucleases and dot blotting, and the isolated 23 kDa protein band was cut and injected twice into rabbits to raise anti - 23 kDa serum. RESULTS: The restriction map of pDL121 was quite different from other leptospiral genes reported and digoxin labeled recombinant DNA probe of pDL121 could detect the pathogenic leptospires, whereas, not the nonpathogenic leptospires. The anti - 23 kDa serum could recognize the sonicated antigen of L. interrogans serovar lai strain 017 and 23 kDa protein expressed in pDL121 and the titer of the antiserum were very high, approximately 1/12 800. Injection of the E. coli lysate of pDL121 with Freund's adjuvant into guinea pigs resulted in some protection of the animal against the challenge with strain 017. CONCLUSION: It indicated that 23 kDa protein had good imunogenicity and could serve as a candidate for protective antigen of L. interrogans and the inserted fragment of pDL121 could be a new gene .

AIM: To study the recombinant plasmid pDL121 and its expression product in E.coli. METHODS: pDL121 was analysed by using 6 different restriction endonucleases and dot blotting, and the isolated 23 kDa protein band was cut and injected twice into rabbits to raise anti-23 kDa serum. RESULTS: The restriction map of pDL121 was quite different from other leptospiral genes reported and digoxin labeled recombinant DNA probe of pDL121 could detect the pathogenic leptospires, whereas, not the nonpathogenic leptospires. The anti-23 kDa serum could recognize the sonicated antigen of L.interrogans serovar lai strain 017 and 23 kDa protein expressed in pDL121 and the titer of the antiserum were very high, approximately 1/12 800. Injection of the E.coli lysate of pDL121 with Freund's adjuvant into guinea pigs resulted in some protection of the animal against the challenge with strain 017. CONCLUSION: It indicated that 23 kDa protein had good imunogenicity and could serve as a candidate for protective antigen of L.interrogans and the inserted fragment of pDL121 could be a new gene .

OBJECTIVE:To determine the content of ceftazidime in renal dialysate effluent in burn patients.METHODS:HPLC was used.The sample was separated on Bondapak-C18 analysis column with a mobile phase of mixture of methanol-ammonium acetate(17∶83,V/V).The flow rate was 1.0ml/min.The UV detector wavelength was set at 254nm.RESULTS:A linearity was obtained from 0.5～100?g/ml with a good correlation(r=0.9 999).The RSDs of inter-day and intra-day precision were not more than 3.The average recovery was 100.30%.CONCLUSION:The method is simple,rapid and accurate.

Objective To investigate the correlation between the biomarkers related to radio-sensitivity and preoperative radiotherapy in rectal cancer patients, and to establish a logistic regression model to predict the effect of the preoperative radiotherapy through detecting the expression levels of the molecular markers. Methods 33 patients with rectal cancer who received preoperative radiotherapy from January 2010 to January 2015 were retrospectively analyzed. Patients' information was also collected including the serum level of carcino-embryonic antigen (CEA), the immune-histochemical expression levels of vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), thymidylate synthase (TS) and Ki-67, and image data (CT or magnetic resonance imaging) before radiotherapy, preoperative clinical staging and the postoperative pathologic staging. According to the postoperative pathological remission, the treatment effects of preoperative radiotherapy included effective (CR+PR) and ineffective (PD+SD) were evaluated. The relationship between these molecular markers and the curative effect of preoperative radiotherapy was analyzed by logistic regression analysis using SPSS v17.0 software, and a logistic curative effect prediction model was established. Results As a result of single factor and multiple factors logistic binary regression analysis, CEA, VEGF and Ki-67 were recognized as the interested factors for the radio-sensitivity predicting in patients with rectal cancer who received preoperative radiotherapy. A molecular markers predictive model for radio-sensitivity in preoperative radiotherapy in rectal cancer is as follow: log P=1.700-0.276×CEA-0.238×VEGF-0.135 ×EGFR+1.377 ×TS+0.080 ×Ki-67. Serum CEA level and the expression of VEGF might associate with radio-resistant, and the expression of Ki-67 might associate with better reaction to preoperative radiotherapy. Conclusion The levels of serum CEA, VEGF and Ki-67 may be the predictors of radio-sensitivity in rectal cancer patients who received preoperative radiotherapy.

Objective To explore the influence of oral administration of glucose before surgery on insulin resistance and oxidative stress in castric cancer patients undergoing surgery.Methods 63 cases of castric cancer patients undergoing surgery were divided into observation group (n=32) and the control group (n=31) according to random number table method.Patients were given fasting after ten o'clock the day before surgery.Patients in the observation group were dealed with 500 ml 100 g/L glucose solution orally,while patients in the control group were dealed with the same amount of distilled water 3 hours before surgery.The general information and operation indicators were recorded.Blood glucose (GLU),insulin,malondialdehyde (MDA) and superoxide dismutase (SOD) levels were detected before surgery and 4 hours after surgery.Insulin resistance index(HOMAIR) was recorded also.Results The general data between the two groups before the test started had no statistically significant difference (P＞0.05).All patients completed test successfully,and the complications such as choking cough,aspiration did not happen during the treatment.The operation time,Intraoperative fluid infusion,intraoperative blood loss and postoperative pathological stage between the two groups had no statistical difference (P＞0.05).GLU,insulin and HOMA-IR in the two groups after surgery increased significantly than those before surgery,and the difference had statistical significance (P＜0.05).GLU,insulin and HOMA-IR were significantly lower in the observation group than in the control group,and the difference had statistical significance (P＜0.05).SOD and MDA in the two groups after surgery increased significantly than those before surgery,and the difference had statistical significance (P＜0.05).SOD in the observation group was significantly higher,while MDA was significantly lower than those in the control group,and the difference had statistically significance(P＜0.05).Conclusion Oral administration of glucose before surgery in castric cancer patients undergoing surgery can reduce insulin resistance and oxidative stress,and it is safe.

Objective In order to investigate the relationship between erythrocyte immune function and seleni- um(Se) level. Method Red blood cell immune adherence(RCIA) function,serum RCIA regulatory factor, blood Se content and activities of glutathione peroxidase(GPX) of residents in Keshan disease(KD) endemic and non-endemic areas were comparatively studied. Forty-eight residents in KD endemic area aged 13～ 16 years were divided into 2 groups. The residents in the experimental group were orally given 200μg Se daily as Se yeast for 12 weeks, and their erythrocyte Se content and activity of glutathione peroxidase (GPX),RCIA function,serum RCIA regulatory function and circulating immune complexes(CIC) content were determined. ResultsThe results showed that the rosette for- mation rates of erythrocyte and blood Se levels of the residents in KD area were significantly lower and the rosette formation inhibitory rate of serum RCIA of the residents in KD area was significantly higher than those in the non-endemic area. Erythrocyte Se contents, GPX activities and rosette formation rates of erythrocyte were sig- nificantly increased and the rosette formation inhibitory rates of serum RICA were significantly decreased after sup- plementing Se,but the difference in the contents of serum CIC was not significant. ConclusionThe increase of ery- throcyte immune function by Se-supplement might be one of the effective mechanisms in the prevention of KD by Se- supplement.

Objective To analyze the influence of different digestive tract reconstruction methods on blood sugar in T2DM patients after subtotal gastrectomy,and to explore the possible mechanism.Methods The clinical data of 64 cases of T2DM patients undergoing subtotal gastrectomy because of gastric ulcer or cancer were retrospectively analyzed.They were divided into Roux-en-Y group (34 cases) and Billroth Ⅱ group (30 cases) according to the different reconstruction methods of digestive tract,and they were treated by Roux-en-Y anasto-mosis and Billroth Ⅱ anastomosis respectively after subtotal gastrectomy.They were followed up for 6 months.BMI,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,insulin resistance index (HOMA-IR),glucagon peptide 1 (GLP-1),gastric inhibitory peptides (GIP),and GIP/GLP-1 before surgery and one week,one month,3 months,and 6 months after surgery were compared between the two groups.Results BMI of the two groups 3 months,and 6 months after surgery was significantly lower than those before surgery (P＜0.05),and it had no statistical significance between the two groups at the same time point (P＞0.05).Compared with preoperative,the fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,HOMA-IR one week,one month,3 months,and 6 months after surgery in the two groups were significantly lower than those before surgery (P＜0.05).The fasting blood sugar,and 2 h postprandial blood glucose were lower in Roux-en-Y group than in Billroth Ⅱ group (P＜0.05).The glycosylated hemoglobin in Roux-en-Y group was lower than those in Billroth Ⅱ group at 3 months,and 6 months after surgery (P＜0.05).Compared with those before surgery,GIP and GIP/GLP-1 in the two groups at one week,one month,3 months,and 6 months were significantly decreased after operation (P＜0.05).Also,they were significantly lower in Roux-en-Y group compared with Billroth Ⅱ group at the same time point.Conclusion Roux-en-Y anastomosis after subtotal gastrectomy may be more beneficial?for reducing blood glucose in T2DM patients,which may be more beneficial for keeping the balance of entero-insular axis.