OBJECTIVETo study protective effect of ulinastatin on perioperative cardiac function in elderly patients undergoing major gastrointestinal surgery.

METHODSSixty elderly patients (32 male and 28 female patients) aged 60-82 years scheduled for major gastrointestinal surgery were randomized into ulinastatin group and control group. The patients in ulinastatin group received 2×10(5) U ulinastatin rapidly administered via a intravenous pump immediately before operation with subsequent continuous infusion at the rate of 1×10(5) U until the completion of surgery, and those in the control group received the same amount of saline instead. In both groups, the mean arterial pressure (MAP), heart rate (HR), left ventricular ejection fraction (LVEF), and cardiac output (CO) were monitored immediately before surgery (T0) and at 1 h (T1), 2 h (T2) and 3 h (T3) after the start of surgery. The total dopamine dose used was recorded at the end of surgery, and blood samples were collected at T0 and at 6 h (T4) and 12 h (T5) after the operation for determination of serum levels of cTn, CK-MB and BNP.

RESULTSIn both groups, MAP, LVEF and CO were significantly decreased at T2 and T3 (P<0.05) and serum levels of cTn, CK-MB and BNP significantly increased at T4 and T5 compared to those at T0 (P<0.05). Compared with the control group, the patients in ulinastatin group showed significantly higher MAP, LVEF and CO at T2 and T3 and lower serum levels of cTn, CK-MB and BNP at T4 and T5.

CONCLUSIONUlinastatin offers effective perioerative cardiac protection in elderly patients undergoing major gastrointestinal surgery.

Aged ; Aged, 80 and over ; Cardiotonic Agents ; pharmacology ; Creatine Kinase, MB Form ; metabolism ; Digestive System Surgical Procedures ; Female ; Glycoproteins ; pharmacology ; Humans ; Intraoperative Period ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; metabolism ; Stroke Volume

Objective:To evaluate the prognostic value of combined detection of serum C-reactive protein(CRP), procalcitonin and lactic acid in elderly patients with community acquired pneumonia(CAP).Methods:Ninety-five elderly CAP patients in the emergency department of Shangqiu First People's Hospital were included as the case group, and 45 elderly healthy people in the emergency department of Shangqiu First People's Hospital were enrolled as the control group.Levels of blood lactic acid, procalcitonin and CRP were compared between the two groups.Meanwhile, blood levels of lactic acid, procalcitonin and CRP were compared between patients with different outcomes in the case group.The receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of CRP, procalcitonin and blood lactic acid in elderly patients with CAP.Results:Compared with the control group, blood levels of lactic acid, procalcitonin and CRP were increased in the case group( t=20.77, 26.03 and 31.27, all P<0.01). During a 12-month follow-up, 13 cases(13.68%, 13/95)died and 82 cases(86.32%, 82/95)survived in the case group.Blood levels of lactic acid, procalcitonin and CRP were higher in the death group than in the survival group( t=25.56, 8.30 and 13.56, all P<0.01). ROC curve analysis showed that the sensitivity and specificity of serum lactic acid, procalcitonin and CRP in predicting the prognosis of elderly CAP patients were 76.92% and 73.17%, 84.62% and 78.05%, and 69.23% and 70.73%, respectively.The sensitivity and specificity of combined detection of the three indicators were 92.31% and 89.02%, respectively, higher than those of the individual indicators. Conclusions:Serum levels of lactic acid, procalcitonin and CRP are increased in elderly patients with CAP.Combined detection of the three indicators can improve the prognostic value and therefore has important clinical significance.

Objective To study protective effect of ulinastatin on perioperative cardiac function in elderly patients undergoing major gastrointestinal surgery. Methods Sixty elderly patients (32 male and 28 female patients) aged 60-82 years scheduled for major gastrointestinal surgery were randomized into ulinastatin group and control group. The patients in ulinastatin group received 2 × 105 U ulinastatin rapidly administered via a intravenous pump immediately before operation with subsequent continuous infusion at the rate of 1 × 105 U until the completion of surgery, and those in the control group received the same amount of saline instead. In both groups, the mean arterial pressure (MAP), heart rate (HR), left ventricular ejection fraction (LVEF), and cardiac output (CO) were monitored immediately before surgery (T0) and at 1 h (T1), 2 h (T2) and 3 h (T3) after the start of surgery. The total dopamine dose used was recorded at the end of surgery, and blood samples were collected at T0 and at 6 h (T4) and 12 h (T5) after the operation for determination of serum levels of cTn, CK-MB and BNP. Results In both groups, MAP, LVEF and CO were significantly decreased at T2 and T3 (P<0.05) and serum levels of cTn, CK-MB and BNP significantly increased at T4 and T5 compared to those at T0 (P<0.05). Compared with the control group, the patients in ulinastatin group showed significantly higher MAP, LVEF and CO at T2 and T3 and lower serum levels of cTn, CK-MB and BNP at T4 and T5. Conclusion Ulinastatin offers effective perioerative cardiac protection in elderly patients undergoing major gastrointestinal surgery.

Objective To study the present situation and influence factors of pulmonary rehabilitation among COPD patients in community.Methods The present situation of pulmonary rehabilitation was investigated using questionnaire in 201 COPD patients,including one community in Guangzhou and three communities in Qingyuan,and the influencing factors were analyzed by Logistic regression.Results Total of 201 COPD patients,20.4％ COPD patients could insist on oxygen therapy,just one patient's oxygen time more than 15 hours;40.8％ COPD patients would increase the oxygen flow if exacerbation;17.9％ COPD patients could insist on respiratory exercising,and 75.5％ COPD patients took exercise in wrong way.50.7％ COPD patients took exercise in their life.3-4 times in hospital with a high rate of home oxygen therapy.Farmers and the course more than ten years with a high rate of exercising.Conclusions The cognition of COPD patients about pulmonary rehabilitation is poor,and also the compliance of pulmonary rehabilitation exercise is bad.The medical staff should strengthen the education of pulmonary rehabilitation of COPI patients in community,and pay attention to patients' hospitalization,occupation,and course of disease.

Objective To study protective effect of ulinastatin on perioperative cardiac function in elderly patients undergoing major gastrointestinal surgery. Methods Sixty elderly patients (32 male and 28 female patients) aged 60-82 years scheduled for major gastrointestinal surgery were randomized into ulinastatin group and control group. The patients in ulinastatin group received 2 × 105 U ulinastatin rapidly administered via a intravenous pump immediately before operation with subsequent continuous infusion at the rate of 1 × 105 U until the completion of surgery, and those in the control group received the same amount of saline instead. In both groups, the mean arterial pressure (MAP), heart rate (HR), left ventricular ejection fraction (LVEF), and cardiac output (CO) were monitored immediately before surgery (T0) and at 1 h (T1), 2 h (T2) and 3 h (T3) after the start of surgery. The total dopamine dose used was recorded at the end of surgery, and blood samples were collected at T0 and at 6 h (T4) and 12 h (T5) after the operation for determination of serum levels of cTn, CK-MB and BNP. Results In both groups, MAP, LVEF and CO were significantly decreased at T2 and T3 (P<0.05) and serum levels of cTn, CK-MB and BNP significantly increased at T4 and T5 compared to those at T0 (P<0.05). Compared with the control group, the patients in ulinastatin group showed significantly higher MAP, LVEF and CO at T2 and T3 and lower serum levels of cTn, CK-MB and BNP at T4 and T5. Conclusion Ulinastatin offers effective perioerative cardiac protection in elderly patients undergoing major gastrointestinal surgery.

Objective To evaluate the optimum compatibility of nabufine mixed with flurbiprofen for patient-controlled intravenous analgesia (PCIA) after gynecological laparoscopic surgery.Methods A total of 210 patients,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologist physical status Ⅰ or Ⅱ,scheduled for gynecological laparoscopic surgery under general anesthesia,were divided into 4 groups using a random number table method:sufentanil 2.0 μg/kg+flurbiprofen axetil 2.0 mg/kg group (SF group,n =55),nalbuphine 1.5 mg/kg+flurbiprofen axetil 2.0 mg/kg group (N1 F group,n=49),nalbuphine 2.0 mg/kg+flurbiprofen axetil 2.0 mg/kg group (N2F group,n =55) and nalbuphine 3.0 mg/kg +flurbiprofen axetil 2.0 mg/kg group (N3F group,n=51).PCIA solution was prepared correspondingly after surgery in each group.The PCA pump was set up to deliver a 1 ml bolus dose with a 15-min lockout interval and background infusion at 2.0 ml/h.Nalbuphine 5 mg or sufentanil 5 μg was intravenously injected as a rescue analgesic to maintain visual analogue scale score at rest ＜4 at 48 h after surgery in SF and N1 F-N3F groups.Ramsay sedation scores were recorded on admission to post-anesthesia care unit (T1),at the time of post-anesthesia care unit discharge (T2) and at 6,24 and 48 h after surgery (T3-5).The total pressing times of PCIA in 0-6 h,6-24 h and 24-48 h periods after surgery and requirement for rescue analgesics were recorded.The incidence of adverse reactions such as nausea and vomiting,drowsiness and shivering within 48 h after surgery was also recorded.Results Compared with group SF,the incidence of nausea and vomiting was significantly decreased in N1 F and N2F groups,the requirement for rescue analgesics was significantly decreased,and the total pressing times of PCIA was reduced in N2F and N3 F groups,and Ramsay sedation scores at T3,4 were significantly increased in group N3F (P＜0.05).Compared with group N1 F,the requirement for rescue analgesics was significantly decreased,and the total pressing times of PCIA was reduced in N2F and N3F groups,and the incidence of nausea and vomiting and Ramsay sedation scores at T3,4 were significantly increased in group N3F (P＜0.05).Compared with group N2F,the incidence of nausea and vomiting was significantly increased (P＜ 0.05),and no significant change was found in the requirement for rescue analgesics,total pressing times of PCIA or Ramsay sedation scores in group N3F (P＞0.05).Conclusion Nabufine 2.0 mg/kg mixed with flurbiprofen 2.0 mg/kg is the optimum compatibility when used for PCIA after gynecological laparoscopic surgery.

Objective To find an effective and convenient restraint band for the upper limb of the non-compression side for the patients in the lateral decubitus operation in the Neurosurgery Department. Methods From August 2017 to March 2018, patients in the lateral decubitus operation in the Neurosurgery Department,who from the Second Hospital of Hebei Medical University, were selected as the research objects. The self-made posture restraint belt was made of professional exercise shoulder, forearm sheath, binding band and magic stick. By using random number table produced by SPSS 22.0 edition, 160 patients who underwent lateral decubitus operation in the Neurosurgery Department were randomly divided into the control group and the observation group, with 80 cases in each group. In the control group, the conventional shoulder straps and wrist restraint bands were used, while the self-made lateral decubitus upper limb restraint band was used in the observation group. The differences of the time of lateral decubitus placement, the incidence of pressure sore in the non-compression side of the upper limb and the efficiency of restraint were observed and compared between the two groups. Results The time of lateral decubitus placement (365.97±42.08) s and the incidence of pressure sore in the non-compression side upper limb (10.0%) were higher than those of the observation group[ (302.69± 38.25)s, 1.3%]. The differences were statistically significant (P＜0.05). The efficiency (100.0%) of the non-compression side upper limb restraint in the observation group was higher than that in the control group (91.3%). The difference was statistically significant (P＜0.05). Conclusions The self-made upper limb restraint band for neurosurgery lateral position can effectively expose the surgical field, improve the comfort degree of patients, and improve the efficiency of posture placement and restraint.

Meridian theory plays an important role in the guidance of clinical practice of acupuncture and moxibustion. Since the publication of(), the meridian theory has been developed. In the paper, in view of complex science, the topological properties of acupoint-symptom network were analyzed quantitatively by taking acupoint as node and indication as the connection, such as high clustering coefficient and the small world effect. It was the first time to give the abstraction for the topological proof of the high efficiency information transmission property of acupoint-symptom network meridian system at different times. Its quantitative and digitalized significance was analyzed on the development of meridian theory under the complex scientific background so as to provide a new thought and method for the study of meridian theory and acupuncture modernization.

Probiotics can improve the microecological balance of the body and have special effects in promoting nutrient absorption, controlling intestinal infections, and regulating immune function. However, there are problems such as difficult colonization in the gastrointestinal environment and low oral bioavailability. Bacterial biofilms are organized bacterial cells that adhere to an abiotic or biotic surface and are enclosed in extracellular polymeric substances of exopolysaccharides (EPS), extracellular DNA (eDNA), proteins and lipids, with a three-dimensional spatial structure. Probiotics with the help of bacterial biofilms have obvious advantages over planktonic bacteria in stress resistance, combating pathogens and modulating the host's immune function, which provides a new research idea for the development of probiotics. This paper expounded on the advantages of probiotics with the help of bacterial biofilms, and focused on introducing substances that could promote the formation of probiotic biofilms and the mechanisms, and the safety of probiotic biofilms. Currently, research on probiotic biofilms is still in its infancy, and this paper is expected to provide references for future research in this field.
Bacteria ; Biofilms ; Extracellular Polymeric Substance Matrix ; Probiotics

Objective: To investigate the role of butyric acid-producing bacteria in long bone homeostasis in mice with periodontitis under a high-fat/high-sugar diet and to provide new insights for the prevention and treatment of periodontitis and related bone metabolic diseases. Methods: This study has been approved by the Animal Welfare and Ethics Committee of the Experimental Animal Center. Initially, 14 mice were randomly divided into the CON group (the control group) and the LIG group (the periodontitis group). Mice in the LIG group had experimental periodontitis induced by ligating the second maxillary molars bilaterally and were fed a high-fat and high-sugar diet. After 8 weeks, samples were collected. Micro-computed tomography (Micro-CT) was used to analyze alveolar bone resorption and various parameters of the proximal tibia trabecular bone, including bone mineral density (BMD), bone volume per tissue volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp). After decalcification, hematoxylin and eosin (HE) staining was performed on maxillary bone sections to assess periodontal tissue inflammation and connective tissue destruction. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect related genes in the distal femur and proximal tibia bone tissues, including osteocalcin (OCN), osteogenic transcription factor (Osterix), osteoprotegerin (OPG), tartrate resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), receptor activator of nuclear factor kappa-B (RANK), and receptor activator of nuclear factor kappa-B ligand (RANK-L). Subsequently, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + butyric acid-producing bacteria (BP) group, and LIG + BP group. The breeding, sampling, and sample detection methods remained the same. Finally, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + sodium butyrate (SB) group, and LIG + SB group. The breeding, sampling, and sample detection methods remained the same. Results: ①Periodontitis modeling was successful. Compared with the CON group, the LIG group exhibited significant alveolar bone resorption of the maxillary second molar, aggravated periodontal tissue inflammation, and connective tissue destruction. ②Periodontitis exacerbated long bone resorption in mice fed a high-fat high-sugar diet. Compared with the CON group, the LIG group had significantly lower BMD, BV/TV, Tb.N, and Tb.Th (P<0.05), and significantly higher Tb.Sp (P<0.05). HE staining of the proximal tibia showed that the trabeculae in the LIG group were sparse and disordered, with some areas showing fractures or dissolution. The expression of osteoblast markers (OCN, Osterix, OPG) was significantly lower in the LIG group (P<0.05), while the expression of the osteoclast marker TRAP showed an increasing trend (P>0.05). The ratio of RANK-L/OPG was significantly higher in the LIG group compared with the CON group (P<0.05). ③ Supplementation with butyric acid-producing bacteria alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BMD and Tb.Th were significantly higher in the LIG + BP group. HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + BP group compared with the LIG group. The expression of OCN and Osterix was significantly higher in the LIG + BP group, while the expression of osteoclast-specific genes (OSCAR, RANK, RANK-L) was significantly lower (P<0.05). ④ Supplementation with butyrate alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BV/TV and Tb.N were significantly higher in the LIG + SB group, and Tb.Sp was significantly lower (P<0.05). HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + SB group compared with the LIG group. The expression of Osterix, OPG, OSCAR, TRAP, and RANK was significantly lower in the LIG + SB group compared with the LIG group (P<0.05). Conclusion Periodontitis disrupts the long bone homeostasis of mice fed a high-fat high-sugar diet, aggravating long bone resorption. Supplementation with butyric acid-producing bacteria or butyrate can effectively alleviate the disruption of long bone homeostasis caused by periodontitis.