Delirium is a common complication after elderly hip fracture, and is associated with high rates of mortality and morbidity. There is no enough attention for delirium compared to deep vein thrombosis, pulmonary embolism, heart failure, etc. This paper reviews the definition, diagnosis, incidence, prognosis, treatment and other aspects of delirium in order to better under?stand delirium clinically. Delirium is an acute mental disorder of consciousness, attention, perception, thinking ability, memory, mental activity, and emotion. It is characterized by the disorder of sleep or wakefulness, and these changes are difficult to explain by dementia. The confusion assessment method (confusion assessment method, CAM) is generally accepted as the current diagnos?tic tools for delirium, and mainly depends on the patient's consciousness and cognitive function. The mechanisms of delirium are unclear, and it is influenced by many factors, such as agedness, cognitive impairment, pain, sleep rhythm disorders, and theories mainly include neurotransmitter theory, the central inflammatory response theory, the theory of stress response, sleep wake cycle, et al. The delirium is difficult to explain by using single, liner factor, but is elaborated by many various factors. However, the influ?ences of delirium on outcome for hip fracture are unclear, and it is definite that these patients have poor functional recovery, poor independent living ability, longer time in bed, demand for more care. The prevention should be implemented as mainly measures for delirium. Elimination of risk factors, including correct hypoxia, reduce pain, avoid water electrolyte disorders, improve sleep rhythm, and avoid using of opioids should be tried. In addition, adequate analgesia and appropriate anesthesia should used, and some inappropriate drugs should be avoided. Multidisciplinary cooperation mode, including doctors from orthopedics, anesthesiolo?gy, and geriatric department should be conducted to reduce the incidence of delirium as far as possible. Once diagnosed, some measures should be applied, such as maintaining of airway patency, adequate nutritional support, correction of water and electro?lyte disorders, anemia and low serum albumin, to ensure adequate physical and mental support, and to create a good environment for the ward, as well as to remove the possible etiological factors, such as anemia, low protein acidosis and electrolyte disturbance.

Magnesium alloys have been a hotspot in the field of implanted medical devices due to their biodegradable absorbability, excellent mechanical properties and good biocompatibility.The reduction in their rapid corrosion rates becomes the key to the application of implant medical device materials.In this paper, the latest research progress and the existing problems of magnesium alloys as the material for implantation of medical devices in the fracture internal fixation, bone tissue porous scaffold, and cardiovascular stent are reviewed.Improving corrosion resistant of magnesium alloys by means of alloying, improving purity, surface modification,rapid solidification, deformation processing, non crystallization and preparation of nano alloy technology in body fluid are expounded, and research direction and application prospect of magnesium alloys in the field of implanted medical devices are also expected.

Objective To investigate the protective effects of hypereapnia on acute lung injury(ALI)in an model of rabbits in vivo,and to observe its effect on oxygen free radicals in the lung tissue in order to uncover the potential mechanisms.Method In the laboratory of pharmacology,China Medical Univereity,twenty-two healthy New Zealand white rabbits were randomly assigned to control group(Group C,n=6)with the injection of normal saline(0.1 ml/kg),and sixteen rabbits were injected with oleic acid(0.1ml/kg)intravenously,and then were randomly dirided into normocapnia group(Group N,n=8)and hypercapnia group(Group H,n=8,FiCO2=8%).Then tracheostomy was performed,and the experimental animals were ventilated for 3 hours after oleic acid or sterile normal saline administration.Lung mechanics,hemodynamics,blood-gas analysis were monitored.The rabbits were exsangninated.and the lungs and heart were taken out from the thorax.The concentration of superoxide dismutase(SOD)and malondialdehyde(MDA)in the lung tissue were assayed.Lung tissue wet/dry ratio and pulmonary permeability index were measured and histologic damage was assessed after three hours'mechanical ventilation.Results Peak airway pressure in Group H was significantly lower than that in Group N and the dynamic lung comphance Was significantly higher than that in Group N(P＜0.05).PaO2 in Group H was significantly higher than that in Group N(P＜0.05).The concentration of MDA in the lung tissue in group H was significantly lower than that in Group N(P＜0.05),and SOD in group H was significantly higher than that in Group N(P＜O.05).Lung tissue wet/dry ratio and pulmonary permeability in group H were significantly lower than that in Group N(P＜0.05).Histological tissus damage in Group N wassignificantly severer than that in Group H.Conclusions Hypercapnia induced by inhalation of high concentration of carbon dioxide(8%)plays protective role in this in vivo model of ALI.The mechanisms may be associated with enhanced SOD activity and the attenuation of lipid peroxidation in the lung tissue.

Objective To observe the effect of leptin on proliferation and apoptosis of breast cancer MCF-7 cell line,and to explore the effect of leptin on occurrence and development of breast cancer.Method The MCF-7 cell line was treated with different concentration of leptin in vitro.Cell proliferation was evaluated by MTT assay. Distribution of cell cycle was determined by flow cytomery, meanwhile the rates of apoptosis were estimated on the basis of Annexin V-FITC/PI apoptosis detection. Results When treated with different concentration of leptin for 24 h, 48 h and 72 h, they could significantly induce the proliferation of MCF-7 cells by MTT method.There was not interaction between concentration of leptin and time course (F=0.919,P=0.523).The main effect of concentration of leptin and time course was statistically significant (F=12.699,P=0.000;F=647.881, P=0.000). Compared 200 ng/ml and 400 ng/ml with the control group, we found the difference was statistically significant by multiple comparison (P=0.007,P=0.000,respectively).The difference was also statistically significant among time course by multiple comparison (P=0.000,respectively).By the flow cytometry analysis,it was found that the 100 ng/ml and 400 ng/ml leptin groups could change the distribution of cell cycle of MCF-7 cell line after 48 h. Compared with control group, the cell number decreased by 14.42 ％ in G0/G1 phase (F=10.464, P=0.044),but increased by 7.57 ％ and 22.19 ％ respectively in S phase (F=47.361,P=0.005).The difference was not statistically significant in G2/M phase (F=1.77, P=0.311).However, the effect of apoptosis inhibition was not obvious. Conclusions Leptin could stimulate the proliferation of MCF-7 cell line and change the distribution of cell cycle.But leptin could not inhibit apoptosis of MCF-7 cell line.It suggested that leptin may serve as a risk factor of breast cancer development.

AIM: To investigate whether hypercapnia is protective against acute lung injury (ALI) in a rabbit model, and study it's potential mechanisms. METHODS: Twenty-two healthy New Zealand white rabbits were involved in this study, and randomly allocated to control group (group C), normocapnic group (group N) and hypercapnic group (group H). Oleic acid (0 1 mL/kg) was injected intravenously to establish ALI model. Lung mechanics, hemodynamics, blood-gas analysis, the content of malondialdehyde (MDA) and superoxide dismutase (SOD) activity in lung tissue were measured. Apoptosis was analyzed after 3h mechanical ventilation. RESULTS: (1) Peak airway pressure in group H was significantly lower than that in group N (P

Objective To investigate the efficacy and safety of different acoustic power of high-intensity focused ultrasound (HIFU) in treating human pancreatic xenograft models. Methods Human pancreatic cancer cells (YY-1) were implanted subcutaneously in nude mice to establish animal models. The tumor bearing mice were divided into low-power HIFU treatment group (200 W,n=10), high-power HIFU treatment group (300 W,n=10) and blank control group (n=10). The change of tumor volume, the tumor growth rate and side effects were recorded. The apoptosis rate of tumor cells of each group was determined by TUNEL method. Results The tumor volume and the tumor growth rate of the low-power group and the high-power group were significantly lower than those of the control group (P<0.05), while no statistically significant differences in the tumor volume and the tumor growth rate existed between the low-power group and the high-power group (P>0.05). Compared with the low-power group, the incidence of side effects in the high-power group was significantly higher (P<0.05), including mainly skin burn (60%) and acoustic channel injury (20%). At the 7th and 14th day after the treatment, the apoptosis rates of tumor cells in both the low-power group and the high-power group were significantly higher than that of the control group (P<0.05), but the difference in the apoptosis rates of tumor cells was not statistically significant between the low-power group and the high-power group (P>0.05). Conclusion For the treatment of human pancreatic xenograft tumor in nude mice models, HIFU with low power is effective and safer.

Objective To evaluate regulatory effects of glutamate receptor antagonists on the proliferation and migration of WM451LU malignant melanoma cells, and to explore their related mechanisms. Methods WM451LU cells at exponential growth phase were classified into 3 groups to be treated with the glutamate receptor antagonist MK?801 at 100μmol/L(MK?801 group), the glutamate receptor antagonist CPCCOEt at 10μmol/L(CPCCOEt group), or culture medium(control group). After 24?hour treatment, methyl thiazolyl tetrazolium(MTT)assay was performed to determine cell proliferation rates, scratch assay to evaluate the migration activity of cells, and Western?blot analysis to measure expression levels of proliferating cell nuclear antigen (PCNA), protein kinase Cα(PKCα) both on cell membrane and in cytoplasm, and phosphorylated mitogen?activated protein kinase(p?MAPK). Results After 24?hour treatment, cell proliferation rates were significantly decreased in the MK?801 group and CPCCOEt group compared with the control group(63%± 3.1%and 60%± 2.4%vs. 100%± 1.1%, both P<0.05). The scratch assay showed that cell?free zones in the control group gradually narrowed over time, and the scratch wound tended to close. However, the cell?free zones in the MK?801 group and CPCCOEt group narrowed more slowly compared with the control group, and were still wide after 24?hour culture with no obvious closure of the scratch. The MK?801 group and CPCCOEt group both showed significantly decreased expressions of PCNA(77.0% ± 5.4% and 72.0% ± 4.2% respectively), PKCα on the cell membrane(0.12 ± 0.02 and 0.14 ± 0.02 respectively), and p?MAPK(0.48 ± 0.03 and 0.36 ± 0.04 respectively) compared with the control group(PCNA:100.0%± 1.3%;PKCα:0.38 ± 0.01;p?MAPK:1.00 ± 0.02;all P<0.05).Conclusion In vitro suppression of glutamate receptors can inhibit the proliferation and migration of WM451LU cells, likely through the mediation of the PKCα?MAPK signaling pathway.

Objective To investigate the role of adiponectin in the cell growth,apoptosis and cell cycle of the T47D breast cancer cell line and to find out the pathogenesis of breast cancer.Methods The cell cycle of the T47D cell line was examined by flow cytometry and apoptosis was detected by Annexin Ⅴ-FITC/PI stain method.Results T47D cell line adhered to the cell wall by single layer culture,irregular shape,and cell amounts increased over time.(1) Though different concentrations of adiponectin had a certain action on restraining the cell in different times,there were no significance(P＞0.05).(2)After treated with 500 ng/ml and 2000 ng/ml adiponectin on T47D cells for 48 h,the proportion of G0/G1 phase was (91.07±0.63)％,(91.60±0.98)％,respectively.Compared with the control group (85.31±1.07)％,the difference was statistically significant(F=29.277,P=0.011).But the difference of S and G2/M phase was not statistically significant(P＞0.05).(3) The difference of early apoptosis rate among control group,500 ng/ml and 2000 ng/ml adiponectin was not statistically significant(P＞0.05).The same concentration of adiponectin could not induce the early apoptosis and total apoptosis of T47D cells(P＞0.05,respectively).Conclusion The low adiponectin level may be the risk factor of breast cancer.The adiponectin may regulate the distribution of cell cycle.It may induce G0/G1 phase arrest of T47D cells and reduce the DNA synthesis.It suggested that adiponectin may serve as a protective factor of breast cancer development.

Objective To investigate the anti - stress activity of thymopentin ethyl ester. Methods Anti - stress activity was evaluated by heat stress model and chronic uncontrolled stress model. Heat stress model;of 60 KM mice were divided into six groups. Except the controlled group, the other mice were maintained in 42℃ for 1h. Chronic uncontrolled stress model:of 60 KM mice were divided into six groups. Except the controlled group, the other mice were given three different stimulations once a day for continuous 21 d. The controlled group and model group were injected saline 0.2ml, and the three test groups were respectively injected thympentin ethyl ester at 2mg/kg,0.2mg/kg, 0.02mg/kg subcutaneously. The positive controlled mice were given thymopentin 0.2mg/kg subcutaneously. At the end of the experiment, plasma corticosteroid, IL -2 and SOD were determined according to the kit instructions. Results The activities of thymopentin ethyl ester in suppressed corticosteroid up - regulation and the elevated plasma IL - 2 and SOD level were more significant than those of thymopentin(P

Objective To characterize the clinical manifestations, laboratory findings of patients with occult sys?temic malignant neoplasms, whose initial manifestation presented as multiple acute cerebral infarcts including coagula?tion function,radiological imaging and microembolic signals (MES) detection by transcranial Doppler sonography (TCD) and to explore the possible underlying mechanisms. Methods All clinical records, laboratory hematological tests includ?ing hypercoagulable states measured by D-dimer levels, brain MRI including DWI, and TCD monitoring MES, the treat?ment and prognosis were retrospectively reviewed in 12 patients with multiple acute cerebral infarcts as the first manifes?tation of occult systemic malignancy. Results The clinical manifestations presented as localized neurological dysfunction, e.g. hemiparesis, aphasia, hemiparesthesia, dysarthria, vertigo and seizures, etc. DWI revealed multiple disseminated acute cerebral infarcts in multiple arterial territories such as the bilateral anterior or anterior plus posterior cerebral circu?lation in all patients. Eleven of 12 patients tested had elevated D-dimer. TCD detected MES in 5 of 7 patients. There were 12 patients diagnosed with occult systemic malignancy including 5 lung cancer, 3 pancreatic cancer, 1 gastric can?cer, 1 colon cancer, 1 endometrial adenocarcinoma and 1 metastatic poorly differentiated mucinous adenocarcinoma with unknown primary. Ten patients already had remote metastasis at diagnosis. The prognosis was usually poor and there were 7 cases with ischemic stroke recurrence, 4 cases with acute myocardial infarction, 3 cases died during hospitaliza?tion. Conclusions When patients present with multiple disseminated acute cerebral infarcts involving multiple arterial territories as initial manifestation, the underlying occult systemic malignancy should be considered. Hypercoagulopathy and MES might provide the clues to the diagnosis.