Objective To evaluate the relationship between plasma substance P (SP) and calcitonin gene-related peptide (CGRP) concentrations and intraoperative cardiovascular events in diabetic patients.Methods Twenty-two patients of either sex with type 2 diabetes mellitus and 22 non-diabetic patients of either sex,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 50-77 yr,undergoing elective knee arthroplasty under neuraxial anesthesia,served as diabetes mellitus group (group DM) and non-diabetes mellitus group (group NDM),respectively.The patients of either group were further divided into 2 subgroups (n =11 each) according to whether or not the patients had cardiovascular diseases before operation:no cardiovascular disease subgroups (NDM-NCVD subgroup and DM-NCVD subgroup) and cardiovascular disease subgroups (NDM-CVD subgroup and DM-CVD subgroup).The plasma SP and CGRP concentrations were dertermined by enzyme-linked immunosorbent assay at 30 min before operation and at the end of operation.The plasma cardiac troponin Ⅰ (cTnI) concentrations were measrued by enzyme-linked immunosorbent assay at 30 min before operation and 24 h after operation.The development of intraoperative cardiovascular events was recorded.Results Compared with group NDM,the incidence of intraoperative cardiovascular events and plasma cTnI concentrations at each time point were significantly increased,and the plasma concentrations of SP and CGRP were decreased in group DM (P＜0.05).Compared with group DM-NCVD,the incidence of intraoperative cardiovascular events and plasma cTnI concen trations at each time point were significantly increased,and the plasma concentrations of SP and CGRP were decreased in group DM-CVD (P＜0.05).Conclusion The development of intraoperative cardiovascular events is related to the decrease in plasma concentrations of SP and CGRP in diabetic patients.

Objective To evaluate the efficacy of modifiedXiaochengqi decoction in treatment of gastroparesis syndrome (GS).Methods A total of 81 patients with GS from 2010 July to 2013 July in HuiZhou Municipal Central Hospital were selected and randomly recruited into a control group and a treatment group. The control group was treated with domperidone, 15-30 min before the meal, while the treatment group was additionally treated with modifiedXiaochengqi decoction on the basis of the control group. Both groups were treated for 4 weeks. The clinical curative effect, and the symptoms in both groups were observed. The serum motilin and gastrin concentration were measured by radio-immunity, the preprandial and postprandial electrogastrography was performed.Results The total effective rate in the treatment group was significantly higher than that in the control group (72.5%vs. 31.7%;χ2=11.911,P=0.000). The serum levels of motilin (treatment group: 532.8±16.7 ng/Lvs. 355.2±14.3 ng/L,t=51.089,P=0.000; control group: 505.1 ± 21.3 ng/Lvs. 372.9 ± 18.4 ng/L,t=30.074,P=0.000) and gastrin (treatment group: 69.8 ± 15.3 ng/Lvs. 54.3 ± 13.8 ng/L, t=4.758,P=0.000; control group: 62.6 ± 14.2 ng/Lvs. 53.4 ± 12.3 ng/L,t=3.136,P=0.002) were significantly reduced, and their decrease in the treatment group were greater than those in the control group (t values were 6.503, 2.196, allP<0.05). After the treatment, the dominant power (preprandial period: 84.5 ± 14.8μVvs. 72.3 ± 15.0μV, t=3.684,P<0.01; postprandial period: 100.5 ± 17.3μVvs.89.3 ± 15.9μV,t=5.713,P=0.000) and dominant frequency (preprandial period: 4.3 ± 0.4 cpmvs. 3.9 ± 0.2 cpm,t=3.035,P=0.000; postprandial period: 4.7 ± 0.5 cpmvs. 4.4 ± 0.5 cpm,t=2.700,P=0.000) were significantly higher, while the percentage of bradygastria (preprandial period: 50.6% ± 16.6%vs. 60.1% ± 16.3%,t=2.599,P=0.000;postprandial period: 36.6% ± 14.8%vs. 57.4% ± 15.3%,t=6.217, P=0.000) was significantly lower in the treatment group compared with the control group at preprandial and postprandial periods.ConclusionXiaochengqi decoction can obviously promote the gastric motility, and reduce the serum levels of motilin and gastrin in patients with GS.

Panax ginseng is a precious medicinal herb both in China and abroad with high medicinal and economic value.Ginseng disease has been recognized as the main factor restricting its application.Modern molecular biology for the disease resistance of ginseng promoted the development of new methods.In this study,it was found that the antimicrobial proteins of ginseng involved lipid transfer protein,cyclophilin,defensins,PR-4 and PR-10,showing inhibitory effects on various pathogens.These findings provided a reference for the control of ginseng diseases.

Objective To study the microstructural characteristics of white matter fiber tracts of visual pathways using diffusion tensor imaging (DTI)in the patients with primary glaucoma.Methods Twenty patients with primary bilateral glaucoma and 30 nor-mal adults were recruited and scanned with visual pathways magnetic resonance imaging (MRI)and DTI,obtaining T1 FLAIR ima-ges and directionally encoded color (DEC)images.On DEC images,ROIs were put in the anterior,middle and posterior part of bi-lateral optic nerve,optic tract and optic radiation,to calculate the average FA and MD value of each region.Results T1 FLAIR and DEC images could clearly show the optic nerve,optic tract and optic radiation.In patients with glaucoma,the FA values of optic nerve,optic tract and optic radiation were:0.372±0.040,0.340±0.036,0.31 5±0.026,while the MD values were:1.760±0.1 1, 1.831±0.09,1.927±0.10.The FA values of optic nerve,optic tract and optic radiation of normal adults were:0.538 ±0.073, 0.460±0.082,0.455±0.083,whilst the MD values were:0.995 ±0.27,1.312 ±0.40,1.347 ±0.37.Compared with the normal controls,FA values of all parts are deceased whereas the MD values of all parts are increased in patients.Conclusion Glaucoma is a central nervous system disease involving the whole visual pathways.Use DTI can evaluate the microstructural characteristics of white matter fiber tracts of visual pathways in the patients with glaucoma.

Objective To explore the methods for quality management and continuous improvement of nursing care quality in the orthopedic demonstration ward by taking the hospital accreditation as an opportunity. Methods From July 2012 to June 2013, the continuous care quality improvement in the ward was carried out to find out the problems with PDCA (plan, do, check, action) cycle method, including enhancing the function of orthopedic nursing quality management groups, conducting all-staff training and improving the knowing rate by referring to the standards of hospital assessment standards. Results After the performance of whole-process quality management, the percentage of indexes assessed at level A, B and C was increased from 42.2%to 50.0%, 17.2%to 14.7%and 40.2%to 35.3%, respectively. The score of nurses' responsibility accreditation was increased from 92 to 95. The rates of patient and nursing staff satisfaction were increased from 91.8%to 98.9%and 92.57%to 97.7%, respectively. Conclusion In accordance with the standards for hospital accreditation, the continuous improvement of nursing quality in the orthopedic demonstration wards can improve the specialist care of orthopedic care, improve patients' and nurses' satisfaction, thus making the daily work more scientific and standardized.

Objective To investigate the characteristics of 18F-FDG PET/CT imaging in pulmonary sclerosis pneumocytoma (PSP).Methods The clinical and PET/CT data of 16 patients with pathologically proved PSP were retrospectively analyzed.The location,shape,size,internal and external edge of the lesion,as well as the metabolism of the lesions were observed.The mean retention index (RI) was calculated in 6 patients with 18F-FDG PET/CT dual phase imaging.The difference of SUVmax between early and delayed phase were compared.And the correlation between the diameter of lesions and SUVmax were analyzed.Results There were 16 lesions in all 16 patients,including 7 cases located at right lung and 9 located at left lung.The lesions were round with the diameter of (1.97-4-0.61)cm.The uniform density were observed with the CT value of (29.87±4.71)HU.And there was no cystic degeneration and necrosis.Calcification was found in 5 lesions.The edge of 14 lesions was smooth,and the edge of another 2 lesions showed short spicular sign.Two lesions showed visible edges of ground glass opacity.There were 12 lesions with vascular welt sign and 3 lesions with air crescent sign.The SUVmax value of PSP was 2.71 ± 2.13.There was no significant difference between the early SUVmax (2.44±1.57) and delayed SUVmax (2.74±1.83) in patients with dual phase imaging (t=2.09,P＞0.05).RI was (7.23±10.29)％.There was no correlation between PSH diameter and SUVmax(r=0.188,P＞0.05).Conclusion Most of PSP showed solitary pulmonary nodules in PET/CT imaging.The radioactive distribution was mild and moderate increase.The vascular welt sign,air crescent sign and the surrounding ground glass opacity are the references findings of PSP.

Objective:To observe the efficacy and safety of intrapleural injection with urokinase ( UK) in the treatment of tubercu-lous pyothorax. Methods:Totally 120 patients with tuberculous pyothorax were randomly divided into two groups. The vomicae in the control group were rinsed with 5% sodium bicarbonate, and those in the observation group were treated with UK. The total effective rate, symptom relief time, closure time of vomicae, pleural thickness changes and adverse reactions were observed in the two groups. Results:The total effective rate of the control group and the observation group respectively was 81. 7% and 98. 3%, which showed sta-tistically significant difference (P<0. 01). The symptom remission time and the pus cavity closure time of the observation group were shorter than those of the control group (P<0. 05). The pleural thickness of the observation group was thinner than that of the control group at the end of the treatment (P<0. 05). The incidence of adverse drug reactions in the observation group was significantly higher than that in the control group (P<0. 01). Conclusion:The curative effect of UK in the treatment of tuberculous pyothorax is better than that of sodium bicarbonate, however, it is necessary to pay attention to monitoring such adverse reactions as bleeding, low heat and the others.

Objective To assess the effects of different administration timing of prophylactic antibiotics on infections after hip arthroplasty. Methods 535 patients having undergone arthroplasty were divided into two groups: the experiment group (n=273)and the control group (n=262): The former groupwere administered with antibiotics until 24 hours postoperatively and the latter until 72 hours postoperatively. The two groups were compared in terms of postoperative infection rate. Results The infection rates in the experimental groupand the control group were 4.396%and 3..817%, with insignificant differencebetween them. Conclusion For those patients undergoing hip arthroplasty, extended administration of antibiotics after operation (over 48 hours) may not reduce the risk of recent the infection rate.

Objective To compare the thin-section CT findings of pulmonary candidiasis,aspergillosis and eryptococcosis wim histopathology in immunoeomprimised rabbits and impmve the diagnostic accuracy of fungus infection. Methods Heathy New Zealand white rabbits were used for immunoeompromised animal models.Thin-section CT scan was performed before and 2,4,6,8,10,12,14 d after inoculation.The pattern and distribution of the pulmonary abnormalities were retrospectively assessed by two thomeic radiologists and compared with histopathology.The granulocyte count was compared before and after administration of immunosuppressive agents.The pmred t test,chi square test and the Fisher's exact test were used for the statistics.Results Fourteen rabbits had candidiasis.16 rabbits had cryptocoecosis,15 rabbits had aspergillosis.The granulocyte counts before and after administration of immunosuppressive agents were(2.91±0.92)and(0.35±0.19)×109/L respectively in eandidiasis group,there was a significant difference(t=12.484,P＜0.05);(2.51±0.82)and(0.76±0.71)×109/L in aspergillosis group,there was a significant difference(t=5.792,P＜0.05);(2.10±0.65)and (0.48±0.22)×109/L in cryptococcosis group,there was a significant difference(t=8.199,P＜0.05).The onaet time of infections on CT were not significantly different in three groups (P＞0.05).Ground glass opacity (GGO) and consolidation were the two most colnlnon findings in immunocompromised rabbits with three fungus infections,areas of GGO was correlated with the congestion,hemorrhage,inflammatory cell infiltration and interstitial hyperplasia in pathology. Consolidation was correlated with the severe congestion,hemorrhage, inflammatory cell infiltration, interstitial hyperplasia, necrosis and vascular embolism in pathology. Conclusion GGO and consolidation are the two most common findings of fungus infections in immunocompromised animal models and thin-section CT findings can reflect the pathological changes.

Objective:To investigate the efficacy of microsurgical treatment in cavernous sinus tumors.Methods:The clinical data of 87 patients with cavernous sinus tumor treated by microsurgery from January, 2010 to August, 2019 were analysed retrospectively. The surgical approaches and microsurgical skills for common tumors in Cavernous Sinus region were discussed. The follow-up included outpatient and telephone follow-ups, and the follow-up results were evaluated by KPS score.Results:Among the 87 cases, 57 were totally resected (65.5%), 14 were subtotal resected (16.1%) and 16 were major resected (18.4%). Hospitalisation ranged from 14 to 98 days, with an average of 29 days. Postoperative complications occurred in 30 cases with cranial nerve injury, 2 brain stem injury, 4 postoperative bleeding, 5 cerebrospinal fluid leakage, 4 infection, 1 Pituitary damage and 1 death. Prognosis and follow-up analysis showed 68 cases with KPS>60 and 66 with KPS>80 at 1 month after surgery; 74 with KPS>70 and 72 with KPS>80 at 3 months after surgery; 78 with KPS>80 by 12 months after surgery. During the follow-up period of 6-120 months, 3 cases died. Recurrence: 6 of incomplete resection of meningioma, were in 1-6 years after the surgery, 4 of incomplete resection of schwannoma in 1-8 years, 2 of pituitary adenoma respectively in 13 and 16 months after the surgery. There was no recurrence after reoperation. Two cases of chondrosarcoma, 3 of chordoma and 3 of germinoma were treated with radiotherapy, and during the follow-up, there was no progress of the focus. No tumor progression or recurrence was found in other cases during follow-up.Conclusion:Surgery of cavernous sinus tumor is difficult due to frequent postoperative complications. Reasonable preoperative plan, surgical approach and precise microsurgical techniques are the keys in reduction of postoperative complications and in the improvement of prognosis.