55 cases of severe multiple organ failure above 60 years old were treated from April 1977 to January 1987. Each case suffered from 2 to 11 kinds of chronic diseases with an average of 3.8 kinds, and an average of 3.3 organ failures. The average mortality rate was 90.9%. The main precipitating factors were pulmonary infection(72.7%), metastatic carcinoma (14.6%), cardiac arrhythmia (7.3%) and improper medication (5.5%). Low organ infusion, endotoxin and immunological insufficiency probably contributed to their development. Diagnosis, prognosis, therapy and prevention of MOF in the elderly were discussed.

M-mode and pulsed Doppler echocardiography was used to evaluate the changes in structure and function of the left ventricle in 30 patients with chronic renal failure (CRF).The left ventricular mass index (LVMI) and systolic function were unchanged in the early stage of the CRF cases as compared with those of the controls (n = 30). However, the decrement in VE (early peak filling velocity) and the increase in VA/VE (late to early peak velocity ratio) indicated damage of the diastolic function. After 13 months follow-up, the LVMI of the CRF group elavated significantly and the VE diminished further.The ejection fraction (EF), shortening fraction (FS) and circumferencial muscular shortening velocity (mVcf) were decreased as compared with those before the follow up. 47.7% of the patients showed left ventricular heart failure.

Essential hypertension (EH) is an escalating problem for developed and developing countries.It is currently seen as a 'complex' genetic trait caused by multiple susceptibility genes which are modulated by gene-environment and gene-gene interactions.Over the past 10 years,mitochondrial defects have been implicated in a wide variety of degenerative diseases,aging,and cancer.Recently several studies showed that human essential hypertension has excess maternal transmission which suggests a possible mitochondrial involvement.However,the exact pathophysiology of mitochondrial DNA mutation (mtDNA) in essential hypertension still remains perplexing.With the application of a variety of imaging approaches and successive mouse model of mitochonddal diseases we convince that these problems will be resolved in the near future.(J Geriatr Cardiol 2008;5(1):60-64)

Objective To observe the short-,mid-and long-term surgical complications of complex acetabular fractures treated by the Kocher-Langenbeck (K-L) approach combined with digastric trochanteric flip osteotomy (DTFO).Methods We reviewed the 40 cases of complex acetabular fracture that were treated at our department from December 2009 through December 2013.They were 34 men and 6 women,from 17 to 73 years of age (average,47.6 years).Of them,19 were treated by K-L approach combined with DTFO,including 17 males and 2 females,with a mean age of 44.7 ± 11.7 years.The other 21 controls were treated simply through the K-L approach,including 17 males and 4 females,with a mean age of 42.8 ± 14.4 years.The 2 groups were compared in terms of intraoperative results,postoperative outcomes and surgical complications like infection,sciatic nerve injury,heterotopic ossification,femoral avascular necrosis,and post-traumatic arthritis.Results The 40 cases were followed up for an average of 29.7 months (range,from 18 to 59 months).The operation time for the DTFO group (248.2 ± 123.2 min) was significantly shorter than that for the control group (276.1 ±50.6 min),the satisfactory reduction rate for the DTFO group (100.0％) was significantly higher than that for the control group (90.5％),the hip intorsion (19.7° ± 3.5°),hip extorsion (26.1° ±4.3°),and hip abduction (40.5° ±4.7°) at one year postoperation in the DTFO group were significantly superior to those in the control group (14.3°± 6.0°,21.0°± 7.2°,31.9°± 10.8°,respectively),and the hospital stay for the for the DTFO group (19.0 ±7.1 d) was significantly longer than that for the control group (13.6 ±4.9 d) (P ＜ 0.05).The intraoperative bleeding and transfusion for the DTFO group were insignificantly greater than those for the control group (P ＞ 0.05).Infection or iatrogenic sciatic nerve injury occurred in none of the patients.There were no significant differences between the 2 groups in terms of positive Trendelenburg test,hip function,heterotopic ossification,femoral avascular necrosis,or post-traumatic arthritis at the last follow-ups(P＞ 0.05).Conclusions In the surgical treatment of complex acetabular fractures,especially those involving the acetabular dome area and the femoral head,K-L approach combined with DTFO can obtain larger surgical exposure field,good fracture reduction and functional recovery,without obviously increasing surgical complications.This technique only slightly increases intraoperative bleeding and transfusion,and results in longer hospital stay.

After the following aspects of information resources digitalization in domestic TCM were described, in-cluding different types and contents of digital information resources, effectively developed ancient book resources, expanded team construction, and strengthened cooperation between departments. Measures were put forward for the digitalization of information resources in domestic TCM according to the existed problems, such as insufficient de-velopment, lack of audiovisual products, and low accessibility of TCM information resources.

Objective To investigate calcification of cultured aortic medial cells in vitro and acceleration by 25 hydroxycholesterol or ? glycerophosphate. Methods Aortic medial cells were obtained by explantation, and the calcification was observed by von Kossa staining. Insoluble calcium precipitation in cellular layer was determined by biochemical method , and osteocalcin in the media was analyzed with radioimmunoassay. Results Two different types of primary cells were shown from culture: one with parallel cellular growth and being negative by von Kossa staining, the other cell type formed cellular nodules with positive von Kossa staining. After 28 days of cell passages, cell growth appeared no nodule formation. However, many cellular nodules and positive von Kossa staining were observed in the passaged cells treated with 25 hydroxycholesterol or ? glycerophosphate, and both insoluble calcium 〔(57 80?18 50)?g/pool, (67 50?15 30)?g/pool〕and osteocalcin 〔(0 886?0 063)?g/L, (0 895?0 061)?g/L〕in the medium were significantly increased than that of the untreated cells. Conclusions Cultured aortic medial cells could be divided into two subtypes, one with the characters of smooth muscle cells, the other with the micro vascular pericytes which could calcify the extracellular matrix. 25 hydroxycholesterol and ? glycerophosphate promoted the in vitro calcification, and osteocalcin secretion was increased in the process of calcification of aortic medial, suggesting that osteocalcin might participate in the aortic calcification.

The head injury patients is very common in clinic and it is complicated to cure them.Furthermore,many ethical questions are involved during the treatment,which are discussed in the article.The aim is to be helpful to protect both patients'and medical staff's right,reduce medical disputes and form a good relationship between doctors and patients from the view of ethics.Accordingly,the patients of head injury will acquire better treatment.

To investigate the mechanism of aldosterone in the induction of hypertensive myocardial fibrosis, we compared the changes of the incorporation rate of 3H proline, the contents of cardiac tissue collagen, and the activities of the cardiac mitogen activated protein kinase (MAPK) in the spontaneous hypertensive rats (SHRs) untreated and treated with a competitive antagonist of the aldosterone receptorspironolactone (spiron), and also in normotensive rats. The results showed that the incorporation of 3H proline incubating with the myocardial tissue slices significantly increased at three time points (at 4,6,8 h), that the tissue collagen contents and the activities of tissue MAPK also increased in SHRs than in SHRs treated with spiron and in normotensive rats. It suggests that aldosterone stimulates the cardiac MAPK through specific recepter, thus increases the absorption of proline and synthesis of collagen in the cardiac fibroblasts, and in turn, is responsible for the myocardial fibrosis.

OBJECTIVE To investigate the distribution of drug resistance of Pseudomonas aeruginosa(PAE) among neonates and analyze the characteristic of the PAE infection.METHODS API system was used for the identification of 131 PAE clinical isolates and the resistance to 17 kinds antibiotics was determined by K-B method.RESULTS Most of 131 strains were isolated from sputum(42.0%) and gastric juice(32.8%).All strains were mainly isolated from neonate intensive care unit(NICU).The sensitivity to amikacin,levofloxacin,ofloxacin,ciprofloxacin,piperacillin/tazobactam,cefoperazone/sulbactam,imipenem and meropenem was respectively over 70.0%.PAE was inferior sensitivity to piperacillin,mezlocillin,cefoperazone,ceftriaxone,ceftazidime and aztreonam.CONCLUSIONS PAE is one of the most common pathogens causing nosocomial infection especially for neonates.Its susceptibility to antibiotics showed multidrug resistance.In order to reduce or prevent the occurrence of resistant isolate,we should rationally choose and use antibiotics combining with trait of neonate.

Objective The aim of the study is to explore the relationship of lung infection(LI)and multiple organ failure in the elderly(MOFE).Methods Consecutive patients ,who were admitted to the Institute of Geriatric Cardiovascular Diseases of the PLA General Hospital and the Endocardial Department of the Air Force General Hospital,withage≥65 years old were enrolled into 5 groups retrospectively by following criteria:acute LI alone,LI with the first presentation of acute lung edema,chronic bronchitis complicated with LI,chronic heart failure complicated with LI,and nic bronchitis and heart failure complicated with LI.Results Sixty-eight patients were selected of(72.5?7.6)years old ( 38 male).There were 4 cases of pure LI(4%),12 cases of LI firstly presented with the symptoms of acute lung edema(18%),16 cases of LI complicated with chronic bronchitis(24%),15 cases of LI based on chronic heart failure(22%)and 22 cases of LI complicated with chronic bronchitis and heart failure(32%).LI initiated MOFE in 25 cases(37%).Most of them were developed on the basis of chronic bronchitis and/or heart failure(34%).Mortality of secondary LI was higher than that of the primary LI(7.4% VS 0%,P