Objective To investigate the risk factors of pneumonia associated to elderly patients with cerebral stroke.Methods Totally 248 elderly patients with stroke were retrospectively analyzed on medical history,treatment and prognosis.Results In 248 cases of senile stroke patients,78 cases had an associated pneumonia,accounting for 31.5％.The onset with admission period ≥48 h was in majority (48 cases),less than 48 h in 30 cases (38.5％).12 patients (15.4％)were involved blood culture,38 cases sputum culture,accounting for 48.7％.In the univariate correlation analysis,older age,consciousness,basic diseases,stroke location,NIHSS score of nasal feeding therapy were associated with associated pneumonia (all P＜0.05).As compared to patients without no associated pneumonia,the patients with associated pneumonia had more aged and higher proportions of bulbar paralysis and impaired consciousness,more underlying diseases.At the time of admission,increased occurrences of National Institute of Health Stroke Scale (NIHSS) score,brainstem stroke and multiple feeding treatment appeared in most of patients.Multivariate Logtistic regression analysis showed that age≥ 65 years,history of pulmonary disease,bulbar paralysis,disturbance of consciousness,nasal treatment among older stroke were the associated pneumonia risk factors.The hospitalized time was prolonged [(31.3±20.4)d and(17.6±8.1)d,t＝7.57,P＝0.001] and fatality rate increased (41.0％ vs.4.1％) in patients with pneumonia than without pneumonia(x2＝ 54.96,P＝ 0.000).The independent factors of death were aged ≥ 75 years(OR＝1.6,95％CI:1.0-2.6),NIHSS＞13 (OR＝5.0,95％CI:1.7-24.6) and pulmonary infection(OR＝5.2,95％ CI:1.8-17.3).Conclusions The occurrence of associated pneumonia in elderly patients with cerebral stroke is related with age,underlying disease,state of consciousness and NIHSS scores.The prevention and treatment of relevant factors can improve prognosis.

BACKGROUND:Articular capsule ligaments can lead articular surface to move normally and limit the excessive movement, especially to prevent any non-physiological movement. They are the important structures for stabilizing hip joints. It was previously thought that articular capsule should be routinely resected in the total hip arthroplasty (THA). OBJECTIVE: This study was designed to investigate the effect of retaining articular capsule in THA through posterior approach on maintaining hip stability. DESIGN, TIME AND SETTING: This study, a retrospective case analysis, was performed on 61 patients with femoral neck fracture, who received treatment in the Department of Orthopedics, Xiangya Second Hospital of Central South between January 2005 and December 2006. PARTICIPANTS: Twenty-nine patients who underwent THA with retaining articular capsule from January to December 2006 were included as retaining group, and thirty-two patients who underwent THA with routine resection of partial articular capsule were included as routine group. The two groups were kept identical in case selection, prosthesis selection, post-surgery processing and operators. METHODS: Four holes were drilled on greater trochanter on the proximal femoral bone. The superior part of articular capsule valve was sutured to the superior part of original articular capsule using No.1-0 absorbing thread, then sutured to base of femoral neck in mattress manner, and the suture was not ligated. The inferior part of articular capsule valve was sutured to the inferior part of original articular capsule using another suture. And the suture passed through two bone holes on base of femoral neck. The lower limbs were externally rotated and the suture was ligated. Subsequently, the excised extortor was repaired. Prior to and subsequent to suture, hip was slowly bent for 90° and femur was internally rotated for45°to investigate the suture of articular capsule on strengthening articular stability. MAI OUTCOME MEASURES: Operation time, bleeding volume and hip dislocation after THA. RESULTS: The operation time and bleeding volume were lower in the retaining group than in the routine group (P < 0.05). After THA, hip dislocation did not occur in any patients in the retaining group but occur in 2 patients (6.2%) in the routine group. Statistical tests could not be performed due to less data, resulting in no statistical significance.CONCLUSION: There has been no precise conclusion about the effects of retaining articular capsule or not on hip stability.But retaining articular capsule shortens operation time, reduces intrao-perative bleeding, unable raise operation risk, and re-establishes hip soft tissue balance.

Objective To study the influencing factors on the time of acute cerebral apoplexy patients visiting the hospital.Methods 64 patients with acute ischemic stroke were researched.The clinical data of all patients were collected.The influencing factors on treatment time were analyzed by univariate and multivariate Logistic regression analysis.Results In the 64 patients, 26 cases of the visiting time≤6 h(40.63%), 38 cases of visiting time>6 h(59.37%).The results of single factor analysis showed that the relationship between the time of treatment,pre-hospital transfer mode (x2=6.650,5.081,all P<0.05),educational level,living location,MRS score,whether or not know the stroke(x2=4.561,6.557,8.788,4.146,all P<0.05);the disturbance of consciousness and symptoms ≥3 symptoms compared with the visiting time had significant difference(x2=5.133,5.926,all P<0.05);in the multiple factors Logitic regression analysis,the degree of education(OR=2.332,95%CI:1.402~3.904),severity of illness(OR=3.956,95%CI:1.934~7.446),understanding of stroke(OR=3.621,95%CI:1.563~8.125),disturbance of consciousness(OR=4.336,95%CI:2.394~11.374),pre-hospital transport mode(OR=5.658,95%CI:2.546~12.554) were the risk factors of treatment time.Conclusion There is a close relationship with extension and various factors of acute ischemic stroke patients,in the future,not only need to improve the pre-hospital emergency care system,but also need to strengthen the public understanding of the disease.

Objective:To compare amony ceftriazone, penicillin, and ciprofluxacin in the treatment of lower respiratory tract infection. 　Methods:Cost-effectiveness was comparitively analysed by using the principle of pharmacoeconomics with ceftriazone, penicillin, and ciprofluxacin in the treatment of lower respiratory tract infection. 　Results:Three drugs in the treatment of lower respiratory trace infection, while cost of penicillin was the lowest.　Conclusion:Penicillin is a first selective drugs for lower respiratory tract infection.

The right chest electric admittance plethsmography (RCEAP) is a simple no invasive and reliable method in detecting the blood flow volume in the pulmomary artery and vein, an indirection of the left heart function. In this clinical study, the RCEAP, left heart catheterization for measurement of LVEDP and coronary angiogram and echocardiography for investigating the LVEF were performed on 34 patients with coronary heart disease. Of these 34 patients,24 had single or no left vessel lesion (Group A), 10 had left main coronary artery or its double branches lesions (Group B) ;8 underwent percutaneous trans-lumin coronary angioplasty (PTCA)and 10 had coronary artery bypass graft (CABG).The data obtained were analysed and compared to evaluate their respective diagnostic values. Correlation analysis demonstrated the values of hc/hz ratio, ha/hz ratio were moderated with LVEDP(r = 0. 68 or 0. 73,P

AIM: To study the effect of chronic hypoxia(CH) on the intracellular calcium([Ca~(2+)]i) in pulmonary artery smooth muscle cells(PASMCs) and the role of L-type calcium channel and calcium store. METHODS: The rat chronic hypoxia model was set up and intervene the PASMCs with normal PSS,calcium-free PSS,nifedipine,and heparine respectively.The resting [Ca~(2+)]i was determined with the Fura-2/AM calcium imaging technique.RESULTS:(1) The [Ca~(2+)]i in CH group in normal PSS was higher than that in control group in normal PSS(P

BACKGROUND:Bone marrow mesenchymal stem cel transplantation for myocardial infarction becomes popularized in recent years, but transplanted cels cannot survive and proliferate under early inflammatory reaction or local ischemia/hypoxia microenvironment, eventualy hampering the therapeutic outcomes.
OBJECTIVE:To investigate the therapeutic effect of PTEN-silenced bone marrow mesenchymal stem cels on acute myocardial infarction.
METHODS:(1) Bone marrow mesenchymal stem cels from Sprague-Dawley rats were randomly assigned to receive no treatment, NCsiRNA transfection using Lipofectamin2000orPTEN siRNA transfection using Lipofectamin2000. Cel growth curves were described using MTT method to detect cel cycle using flow cytometry. (2) Thirty Sprague-Dawley rats were selected to prepare myocardial infarction models that were randomized into three groups (n=10 per group): blank control, negative control and RNAi group. Six hours after modeling, bone marrow mesenchymal stem cels transfected with nothing, NCsiRNA and PTEN siRNA were respectively injected into the infarcted center of the left ventricular anterior wal in these three rat groups. After 4 weeks, al rats were subjected to cardiac function detection using echocardiography, and the survival and proliferation of bone marrow mesenchymal stem cels in the rats were observed by fluorescence microscopy.
RESULTS AND CONCLUSION:Compared with the other two groups, a significant increase in the absorbance values at different culture time, the proportion of cels in S+G2phase, and the number ofbone marrow mesenchymal stem cels in the myocardial tissue was found in the RNAi group (alP< 0.05). Additionaly, the left ventricular ejection fraction and left ventricular shortening fraction were significantly reduced in the RNAi group than the blank control and negative control groups at 4 weeks after cel transplantation (P< 0.05). Bothin vivoandin vitroexperimental findings showed that PTEN silencing could effectively improve cel survival and proliferation in the infarcted myocardium. Moreover, in thein vivoexperiment, an overt improvement in rat’s cardiac function was achieved.

Objective To investigate the recombinant human fibronectin (RetroNectin,RN)on prolifera-tion,immunological characteristics and cytotoxicity of cytokine -induced killer cells ( CIK) .Methods Peripheral blood mononuclear cells(PBMCs)were cultured in vitro by precoating with RetroNectin (R-CIK group),CD3Ab (C-CIK group),RetroNectin combined with CD3Ab(R+C-CIK group)and traditional method(CIK group) were to generate CIK.The changes of growth rate,characterization,cytotoxicity and apoptosis of CIK were deter-mined by cell counting ,LDH assay and flow cytometry respectively .Results R+C-CIK cell showed a higher proliferation rate than other three groups .The difference was statistically significant (P<0.05);The percentage of CD3/CD56 double positive cells in R +C-CIK and R-CIK group had a higher proportion than those in C -CIK and CIK group at day12 and day15(P<0.05);Cytotoxicity of CIK towards K562 cells in R+C-CIK group and R-CIK group were significantly higher than that in C -CIK and CIK group ,when effector-to-target ratio was 20∶1 and 40∶1(P<0.05).We also found that the cytotoxicity of CIK towards LOVO cells in R +C-CIK group and R-CIK group were higher than that in C -CIK group and CIK group(P<0.05).Conclusion RetroNectin and Anti-CD3-MAb synergistically promote antitumor efficiency of CIKs by increasing proliferation and cyto-toxicity.

Objective To modify HLA-A2.1 restricted epitope of tyrosinase related protein-2 (TRP-2) (180-188) of human melanoma differentiation antigen and enhance HLA-A2.1 molecule its affinity to. Methods The TRP-2 (180-188) nave epitope was altered with the predominant amino acid for the primary anchor residues and auxiliary anchor residues. Altered peptide ligands (APLs) were scanned by polynomial method, the quantitative motif method and OSAR methods. The analogues their affinity to HLA-A2.1 molecule were assayed. Results Compared with the nave peptide, APLs had stronger affinity to HLA-A2 molecules. Conclusion Our results suggest that altered nave epitope with P1 (Y) and/or P2(L, M) can enhance affinity to HLA-A2 molecule. However, the immunogical efficacy of APLs needs to be identified in studies in vitro and in vivo.

Objective To investigate the MRI features of pilomyxoid astrocytoma ( PMA ) in children.Methods MRI features of seven children with pathologically proven PMA in 2011-2013 were retrospectively analyzed.The ages of the patients ranged from 10 months to 32 months at initial diagnosis.Results All tumors were well-circumscribed masses.Six tumors were located in the hypothalamic-chiasmatic-third ventricular region , two tumor involved the bilateral temporal lobe , and one tumor was associated with NF-I.One occurred in the basal ganglia region.Four tumors were solid masses , whereas the other three showed cystic components.Six tumors were hypointense and one was isointense on T 1-weighted image.Five tumors were hyperintense and three were isointense on T 2-weighted image.Four tumors were hypointense , one was iso-hypointense and one was isointense on DWI.After contrast administration , four tumors enhanced homogenously and three tumors enhanced heterogeneously , with intratumoral irregular hypointense region in two tumors and rim enhancement in one tumor.Cerebrospinal fluid ( CSF ) dissemination, hydrocephalus and peritumor edema were observed in 2, 4 and 1 of cases, respectively.Proton magnetic resonance spectrum of two PMA showed elevated Cho /Cr ratios and decreased NAA/Cr ratios.Conclusions The imaging features of pilomyxoid astrocytoma include common origination from the midline of the neuroaxis in younger children about 2-3 years old.The CSF dissemination is common.The presence of hemorrhage and peritumor edema is not common.