Objective To investigate the clinical value of thromboelastogram(TEG) in predicting the deep venous thrombosis(DVT) formation of bedridden senile patients and further explore the risk factors for hypercoagulability in those patients.Methods Patients lying on bed for at least 1 year because of alzheimer's disease,stroke and fracture,aged between 70 to 90 years old,were selected in the Geriatrics Department of Shougang Hospital of Peking University from February 2013 to February 2014.Those patients were divided by Clotting composite index(CI) measured with TEG,CI less than and equal to 3 was control group,CI more than 3 was hypercoagulable group.The patients were followed-up for one year to identify the formation of DVT.Logistic regression analysis was used to analyze the independent risk factors of elderly patients with high blood coagulation state in bed.Results Two groups of baseline blood clots elastic graph indicators:Angle(α) of solidification,CI,coagulation time(K),the biggest thrombosis(MA),blood coagulation reaction time(R) comparative differences were statistically significant(P<0.05).In view of the bedridden elderly patients of high coagulation state,according to the result of single factor analysis of related factors,high coagulation state revealed with age(P=0.047),history of diabetes(P=0.001),bed time(P=0.043),tumor(P=0.001),fracture(P=0.002),but unrelated with sex,blood lipids,blood pressure,alcohol consumption,left ventricular ejection fraction.The multivariate logistic regression analysis indicated that fracture(OR(95%CI):5.634(1.114~28.496),P=0.037),tumor(OR(95%CI):4.652(1.142~18.955),P=0.032) and diabetes mellitus(OR(95%CI):6.269(1.528~25.725),P=0.011) were independent risk factors for DVT.Conclusion The incidence of DVT in bedridden senile patients with hypercoagulability identified by CI is higher than those with normal coagulability.Tumor,fracture and diabetes mellitus are independent risk factors for DVT.

Objective To compraison the of exposure in the endonasal transsphenoidal approach to the sellar between microscope and endoscope. Methods Ten formalin-fixed, silicone-injected adult cadveric heads were studied. A direct endonasal transsphenoidal approach was performed via the right nostril, pushing aside the nasal septum, then reach the sphenoidal sinus. The approach was performed with the operating microscope first, then with the endoscope. For each step (sellar, suprasellar, parasellar and clival), the operative region afforded by direct microscopic view was measured and then compared with that obtained by using the edndoscope. Results It was found that the endoscope provided greater view than microscope in this approach. Although the microscope provides an adequate view of the midline structures and part of the contralateral parasellar areas; under direct endoscopic vision, the lateral extension could be widened by an additional 6.5 mm on the ipsilateral and 4 mm on the contralateral side. At suprasellar region, the microscope provides could expose the posterior part of, optic nerve and optic chiasma; but could not expose the areas anterior and superior the interspace superior the optic chiasma. Compare with the microscope, the endoscope allowed extension of bone removal and dual opening for an additional 4 mm anteriorly at the sagittal axis and an additional 3.5 mm on the ipsilateral and 4 mm on the contralateral side. At the clivus region, the medial surface of the vertical segment of the ICA and the basilar artery could be partially 7 exposed by the microscope. By the endoscope, it could gain an additional 4 mm on the ipsilateral side and 2.5 mm on the contralateral side in width. Because of the anatomical boundaries of the sphenoid sinus, the anatomincal exposure by the microscope same as the endocope at the sagittal axis. Conclusion The endoscope allows for a panoramic view and permits widening of the operative exposure in all directions. The endoscope is more suitable in the the minimal and expanded endonasal transsphenoial approach.

Objective:To explore the feasibility of high-flow nasal cannula(HFNC)therapy for respiratory failure in elderly patients.Methods:A total of 300 patients with respiratory failure admitted to Peking University Shougang Hospital from December 2016 to March 2019 were enrolled in this prospective study.Patients were divided into three groups: the HFNC group, the conventional oxygen therapy(COT)group and the non-invasive positive pressure ventilation(NPPV)group(n=100 in each group). Arterial oxygen saturation(SPO 2), oxygen index(OI), heart rate(HR), respiratory rate(RR), mean arterial pressure(MAP), comfort level, discharge rate, tracheal intubation rate, rate of referral to ICU, mortality and rate of referral to another group after therapy were compared between the HFNC and COT groups and between the HFNC and NPPV groups. Results:SPO 2 after oxygen therapy for 30 minutes( t=-2.992, P=0.003), 1 hour( t=-2.884, P=0.005)and 6 hours( t=-3.196, P=0.002)and OI before discharge( t=-2.060, P=0.048)were higher in the HFNC group than in the COT group.The HR in the above two groups was lower before discharge than before therapy, and the HR in the COT group was even lower(73.1±25.1 beat per minute vs.75.1±25.9 beat per minute), but both were within the normal range.The discharge rate was higher( χ2=-1.969, P=0.049), while the rate of referral to another group was lower in the HFNC group than in the COT group( χ2=-3.115, P=0.002). There was no significant difference in the tracheal intubation rate, ICU transfer rate and mortality between the HFNC and COT groups.SPO 2 after oxygen therapy for 30 minutes( t=-2.026, P=0.046)and 6 hours( t=-2.101, P=0.040)were higher in the HFNC group than in the NPPV group, but there was no significant difference in OI and SPO 2 between the two groups before discharge.The HR in both HFNC and NPPV groups was lower before discharge than before therapy, and there was no statistical difference between the two groups.The mortality, discharge rate, tracheal intubation rate, ICU transfer rate and rate of referral to another group had no significant difference between the HFNC and NPPV groups.The comfort level was higher in the HFNC group than in the COT and NPPV groups( t=-3.758 and -19.180, both P=0.000). Conclusions:HFNC is a new type of oxygen therapy equipment introduced after COT and NPPV, and possesses more advantages for elderly patients with respiratory failure.

OBJECTIVETo assess the relationship of homozygous deletion status of p16 (MTS1/INK4a/CDKN2A), p15(MTS2/INK4b/CDKN2B) genes and laryngeal squamous cell carcinoma(LSCC) progression.

METHODSDNA was extracted from fresh tumors. Homozygous deletion of p16 exon 2(p16E2) in 80 cases of LSCC and p15 exon 2(p15E2) in 67 cases of LSCC were detected by the polymerase chain reaction technique.

RESULTSThe p16E2 deletion rate in 80 cases was 12.5%(10/80); the p15E2 deletion rate in 67 cases was 11.94%(8/67); the p16E2 and p15E2 codeletion rate in 67 cases was 5.97%(4/67).

CONCLUSIONHomozygous deletion of p16E2 and p15E2 is related with LSCC oncogenesis, and it may play a role to some extent in LSCC malignant progression.

Carcinoma, Squamous Cell ; genetics ; Cell Cycle Proteins ; Cyclin-Dependent Kinase Inhibitor p15 ; Cyclin-Dependent Kinase Inhibitor p16 ; genetics ; Gene Deletion ; Genetic Markers ; Genetic Predisposition to Disease ; Homozygote ; Humans ; Introns ; genetics ; Laryngeal Neoplasms ; genetics ; Polymerase Chain Reaction ; methods ; Transcription Factors ; genetics ; Tumor Suppressor Proteins

OBJECTIVETo identify and characterize laryngeal cancer related novel genes located on chromosome 6q25.

METHODSElectric hybridization was performed in human genome database using EST (expression sequence tag) as probe. Novel genes were deduced by software from positive DNA clones and their cDNAs were amplified by RT-PCR using primers designed according to the sequence of the putative genes.

RESULTSA novel gene was cloned successfully. The full length of this gene was about 21 kb. It contained two exons and produced a 1006 bp transcript coding a protein with 235 amino acid residues. It's 5'flanking sequence contained two binding sites of oncoprotein c-Myc, thus it was named MTLC (c-Myc target from laryngeal cancer cells). Homologous assay showed that MTLC exhibited little overall homology to known human proteins but it exhibited good overall homology to mouse MT-MC1 protein with an identity of 78%. The primary structure of MTLC protein contained a nuclear location signal motif, but it did not have other conserved domains. The results of subcellular location experiment showed that MTLC expressed in nuclei of human hepatocellular carcinoma cell line Bel7402 cells, while a wide distribution of MTLC in various tissues was demonstrated by Northern blotting.

CONCLUSIONMTLC may play an important role as a target gene of c-Myc and as a transcription factor in keeping the normal physiological process of cells.

Amino Acid Sequence ; Base Sequence ; Blotting, Northern ; Chromosomes, Human, Pair 6 ; genetics ; Cloning, Molecular ; DNA, Complementary ; chemistry ; genetics ; Gene Expression ; Green Fluorescent Proteins ; Humans ; Laryngeal Neoplasms ; genetics ; Luminescent Proteins ; genetics ; metabolism ; Microscopy, Fluorescence ; Molecular Sequence Data ; Nuclear Proteins ; genetics ; Recombinant Fusion Proteins ; genetics ; metabolism ; Sequence Alignment ; Sequence Analysis, DNA ; Sequence Homology, Amino Acid ; Tumor Cells, Cultured