Objective To explore the incidence rates of lower respiratory tract infections after general anes-thesia in the elderly orthopedics patients and to analyze the related risk factors.Methods A total of 45 patients with lower respiratory tract infections in 479 elderly orthope -dics patients who received general anesthesia were enrolled in the study.The bacterial identification and drug susceptibility testing were preformed after the collection of sputum specimens.The univariate factor analysis and multivariate logistic regression analysis were performed to identify the risk factors for the lower respiratory tract infections after general anesthesia,including the age,gender,smoking histo-ry,chronic respiratory diseases history,basic cardiovascular disease,diabetes,mental disease,and endotracheal tube type,anesthesia ventilation time,postoperative extubation time,and postoperative analgesia.Results Smoking history (Wald =5.058,OR =4.618),chronic respiratory diseases history(Wald =37.950,OR =20.507),mental disease (Wald =26.303,OR =75.644),endotrac heal tube type(Wald =9.035,OR =11.758),anesthesia(Wald =15.035, OR =20.163)and postoperative extubation time(Wald =14.243,OR =12.613)were identified as the risk factors for lower respiratory tract infections after general anesthesia in the elderly orthopedics patients (all P <0.05 ). Conclusion Risk factors should be intervened in elderly orthopedics patients who receive general anesthesia,and the antibiotics should be chosen on the basia of the drug susceptibility testing.

Objective To evaluate the accuracy of enhanced spiral CT scans on the clinical staging of renal cell carcinoma.MethodsThe enhanced CT and clinical data of 48 patients with renal carcinoma verified by surgery and pathology in Chongqing Donghua hospital were retrospectively analyzed.Robson's classification was used to determine the clinical stages of CT data,and the staging findings based on CT data were compared with the postoperative and pathological outcomes.Results The results showed that the accuracy of preoperative CT on the staging was 91.7％.Enhanced scanning by spiral CT was useful to identify the boundaries of tumor and the filling defect of renal vein or inferior vena cava.Conclusion Enhanced scanning using the spiral CT can improve the accuracy of clinical staging for renal carcinoma,which provides guidance about the clinical therapeutic schedules for patients with renal carcinoma.

AIM:To evaluate therapeutic effect of Zhiqi oral solution on adult periodontitis. METHODS: Supragingival scaling and root planning were carried out in 100 patients with adult periodontitis. Then the patients with periodontitis were divided into two groups randomly. 32 patients in the control group took orally Metronidazole and 68 patients in the experimental group took orally Zhiqi oral solution. The pain reaction, bleeding index, probing depth, plaque index, changes of microorganisms in periodontal pocket and side effect before and after the treatment were observed at a 30 days observation period. RESULTS:Zhiqi oral solution had a therapeutic effect on periodontitis, compared with the control group ( P

Objective To investigate and evaluate the changes of T lymphocytes and red cell immunity of peripheral blood in patients with primary hepatocyte carcinoma (PHCC) after radiofrequency ablation(RFA) treatment. Methods The pre- and post- RFA(3d,7d,14d) peripheral blood T lymphocyte subsets(T3,T4,T8,T4/T8) and red cell immunity (RBC C3 receptor flower and RBC-immuocomplex formation rate) were investigated in 120 patients with PHCC treated by RFA. Results On 7d, 14d after RFA, T3, T4 lymphocytes and T4/T8 were higher than those on preoperative day significantly(P

Objective To investigate the effects of small volume resuscitation on hemodynamics and visceral perfusion in dog model of hemorrhagic shock. Methods Twenty-four dogs were hemorrhaged to hold mean arterial blood pressure at 45-55 nun Hg for 45 minutes, and then eight dogs were resuscitated with 6 ml/kg of hypertonic saline (HS group) solution and the other eight resuscitated with 6 ml/kg of hypertonic saline-hydroxyethyl starch (HSS group) solution. The rest eight dogs were set as control and resuscitated with normal saline (NS). Hemodynamics and gastrointestinal intramucosal pH (pHi) were detected after fluid resuscitation. Results (1) All three kinds of solutions could improve early hemodynamics and visceral perfusion. But 30 minutes after fluid resuscitation, the hemodynamics of dogs in HS group, HSS group and NS group began to decrease, with more obvious decrease HS group and NS group compared with HSS group. (2) pHi of three groups began to decrease 120 minutes after fluid resuscitation, but the level of arterial lactate remained unchanged. Conclusions (1) HS has the similar effect as NS in aspect of resuscitation, and HSS is better than HS and NS.(2) pHi is an ideal marker in monitoring the visceral perfusion and has higher sensitivity than arterial lactate.

BACKGROUND:Conflicting data have been reported regarding the expression of retinol-binding protein 4 in non-alcoholic fatty liver disease. OBJECTIVE:To evaluate the impact of dietary interventionversus metformin treatment on expression of retinol-binding protein 4 in rats with non-alcoholic fatty liver disease. METHODS: Fifty male Sprague-Dawley rats were randomized to six groups, including two normal control groups (rats were kiled after 8 and 16 weeks of normal diet), two HFD groups (rats were kiled after 8 and 16 weeks of high-fat diet), one dietary intervention group (rats were kiled after 8 weeks of high-fat diet and 8 weeks of normal diet) and one metformin treatment group (rats were kiled after 8 weeks of high-fat diet and 8 weeks of high-fat diet and metformin treatment). The levels of retinol-binding protein 4 in serum and biochemical indexes were detected through enzyme-linked immunosorbent assay. The expression of retinol-binding protein 4 mRNA in liver tissues was measuredvia western blot analysis, immunohistochemistry and RT-PCR. RESULTS AND CONCLUSION:Non-alcoholic fatty liver disease models were successfuly established by high-fat diet. Liver tissues of high-fat diet fed rats showed progressing non-alcoholic fatty liver disease histology, from non-alcoholic fatty liver to non-alcoholic steatohepatitis. Dietary intervention increased retinol-binding protein 4 expression in liver tissue as wel as improving liver enzyme, dyslipidemia and insulin resistance, and aleviated impaired liver histology. Metformin treatment only aleviated hepatic steatosis caused by high-fat diet. The results indicated that retinol-binding protein 4 expression might play a role in the pathogenesis of non-alcoholic fatty liver disease. Metformin treatment can aleviate non-alcoholic fatty liver disease histology,dietary intervention should be the fundamental treatment.

Objective To investigate the effect of decompression with long-segment (L) or short-segment (S) fusion on the outcomes of the surgical treatment for degenerative adult scoliosis (ADS) patiens.Methods A retrospective study on 32 patients treated in our department for ADS from April 2013 to May 2015 was carried out, including 12 male and 20 female (1 : 1.7).Their average age was 66.4 (range: 51-77 years).All patients underwent decompression and fusion surgeries through posterior approach.They were divided into long-segment fusion group (L) and short-segment fusion group (S) according to fusion range.During follow-ups (FU), clinical outcomes were assessed by means of visual analog scale (VAS) and Oswestry disability index (ODI).Radiographic evaluation on full-length standing film included coronal Cobb's angle, distant between C7plumb line and center sacral vertical line (C7PL-CSVL), thoracic kyphosis (TK) angle, lumbar lordosis (LL) angle, pelvic incidence (PI), and pelvic tilt (PT), PI-LL, sagittal vertical axis(SVA).Postoperative complications were also recorded.Results All patients were followed up for average 2.2 years (range:1.5-3.5 years).No significant difference of age or gender was found between two groups (L: 22, S:10) of patients (P=0.066, 0.182).As for the fusion segments, group L (6.3±1.5) was more than group S (2.9±0.3) (P=0.001).Operation time and blood loss of group L were statistically more than group S (P＜0.05).Postoperative VAS sores of back pain and leg pain as well as ODI were all improved significantly in two groups (P＜0.05).At the final FU, back pain VAS was more in group L than in group S (P＜0.05) , but no significant difference was found in leg pain VAS between two groups (P＞0.05);at the final FU, group L's ODI showed better functional recovery than group S's[(12.8±9.3)％ vs.(25.4±11.4)％, P＜0.05].With no obvious difference in the two groups (P＞0.05), coronal Cobb's angle corrected more satisfactional in group L than group S (P＜0.05).The same situation was found in C7-CSVL correction in two goup in FU (P＜0.05).Sagital balance was restored to normal alignment better in group L than group S, with increase of lumbar lordosis after surgery.The overall incidence of postoperative complications was 31.3％, including wound infection, cerebrospinal fluid leakage, transient neurological symptoms and internal fixed rod breakage, more common in group L than group S.Conclusions Decompression and fusion with internal fixation showed good clinical outcomes in the treatment of ADS.Long-segment fusion yielded better coronal and sagittal correction outcomes with higher peri-operation risks;however, short-segment fusion showed higher safety with relatively inferior correction effect.Appropriate fusion mode should be chose according to the patient's deformity features.

Objective To study about the cardiac function of the mice suffering from sepsis induced by lipopolysaccharide (LPS) so as to probe the physiopathologic mechanism of the cardiac dysfunction of the mice.Method Sixty male C57BL/6 mice of eight weeks old were randomly (random number) divided into four groups:one control group (n =15) and three experimental groups (n =15 in each group).The mice of control group received intra-peritoneal injection of normal saline (10 mg/kg) while the mice of experimental groups got intra-peritoneal injection of LPS (10 mg/kg).The cardiac function of mice (n =12) was determined by echocardiography 6 h,12 h and 24 h later,respectively.The heart,kidney and lung tissues of mice (n =6) were stained with Haematoxylin-Eosin (HE) staining after embedding with paraffin for observing the histopathological changes under optic microscopy.The expressions of PECAM-1 and α-SMA of the heart tissue of mice (n =3) in three groups determined by immunohistochemical method.The RT-PCR method was used to test the expressions of VEGF (vascular endothelial growth factor) and HIF-α (hypoxia-inducible factor) of the myocardium of mice.In addition,the Western blot method was employed to test the levels of p53 and HIF-1α proteins in myocardium of mice,while ELISA was utilized to detect the level of tumor necrosis factor-α (TNF-α) and the interleukin-6 (IL-6).The data were analyzed by independent samples of t-test and one-way ANOVA respectively.Results The experiment result proved that the thickness of anterior wall of left ventricle of mice during systolic and diastolic periods increased and the inner diameter of the left ventricle also increased during the diastolic period in mice of the experimental group,while the stroke volume decreased compared with the control group (P ＜ 0.05).The immunohistochemical method showed that the new vessels of the mice' s heart in experimental groups increased compared with the control group (P ＜ 0.05).RT-PCR showed the expressions of VEGF and HIF-1α of the mice heart of experimental group increased (P ＜ 0.05) and Western blot showed the levels of HIF-1 α and p53 proteins in experimental groups increased significantly compared with the control group.The experimental group had higher levds of VEGF,HIF-1α,and IL-6 were evidenced by using ELISA than those of the control group (P ＜ 0.05).Conclusions The lipopolysaccharide can lead to cardiac dysfunction.In this process,myocardium angiogenesis and apoptosis phenomenon coexists,as VEGF and HIF-1α participating in angiogenesis,whereas BAX and p53 playing a role in the process of apoptosis.

Objective To explore the impact of ischemic stroke on intestinal barrier changes in dogs.Methods Totally 20 mongrel dogs were divided into 2 groups by random number table with 10 in each.Double silicone cylinders measuring 1.1 mm in diameter and 8 mm in length were placed into their internal carotid arteries in all dogs of group A.Group B served as a control group and received sham operation.Light microscopy was performed for morphological measurement of intestinal epithelial cell.Immunohistochemistry was used to analysis the changes of protein zonula occludens-1(ZO-1)localizing at tight junction of intestinal epithelial cells.Results Ischemic stroke was confirmed by cranial CT scanning in all dogs of group A.Compared with the test results in group B,the occludin and Zo-1 protein levels in group A were significantly lower than those in group B(occludin:0.20 ±0.01 vs 0.22 ±0.01,P =0.007; ZO-1:0.20 ±0.01 vs 0.22 ±0.02,P =0.008).The apoptotic index in group A was significantly higher than in group B(29.04 ± 3.79 vs 6.44 ± 1.24,P =0.002).There was a positive correlation between occludin and ZO-1(R =0.71,P =0.02),and the apoptotic index was negatively correlated with levels of occludin,ZO-1(R =-0.91,P =0.00; R =-0.77,P =0.01).Light microscopy showed that the dogs in group A had intestinal mucousal injuries while no obvious change was detected in group B.Conclusions Dogs with ischemic stroke tend to develop intestinal barrier dysfunction,during which the destruction of tight junction plays a key role.The up-regulated apoptosis of intestinal epithelial cell constitutes one of the cellular bases of intestine injury.

Humans ; Leukemia ; Leukemia, Large Granular Lymphocytic ; Lymphoma, Extranodal NK-T-Cell ; Prognosis