Objective To assess the risk of malnutrition in elder home-care patients through mini nutritional assessment (MNA) and study the correlations between total MNA score and 18 individual questions in this patient group.Methods In May 2011,62 elder home-care patients from our center answered the MNA questionnaire.And the results were used to analyze the correlations between total MNA score and individual questions and the correlations among MNA classifications and body mass index(BMI),mid-arm muscle circumference (MAMC) and calf circunference (CC).Results According to MNA,18％ were malnourished ( 11/62 ),47％ at risk of malnutrition ( 29/62 ) and 35％ well-nourished ( 22/62 ) ; BMI,independence,mobility,neuropsychological problems,ingesting method,MAMC,CC and selfperceived nutritional status,self-perceived health status showed strong correlations with total MNA score (0.601,0.600,0.666,0.611,0.627,0.618,0.726,0.612,0.672,P ＜0.05).And weight loss within a month,number of daily meals and intake of drinks showed weak correlations with total MNA score (0.35,0.319,0.288,P ＜ 0.05 ).Positive correlations existed among MNA classifications and BMI,MAMC,CC (15.45,19.85,31.89,P＜0.05).Conclusions The elder home-care patients have a high risk for malnutrition.Half of 18 individual questions are strongly correlated with total MNA score in this patient group.

Objective To investigate the role of Heme oxygenase-1 in the effect of hyperbaric oxygen preconditioning (HBOP) against the brain edema formation after experimental intracerebral hemorrhage in rats.Methods The study was carried out by animal experiment in two steps by using 54 Spradgue-Dawley rats weighting from 300-350 g.In the first step,rats were treated with HBOP (HBOP group,n =3) or with sham pre-conditioning (Sham pre-conditioning group,n =3).All the rats were sacrificed 24 h after the preconditioning,and basal ganglion of brain tissue was taken for detect HO-1 level by using western blot analysis.In the second step,rats were divided into 4 groups (n =12 in each group):HBOP +ZnPP group,in which rats had a micro-pump intra-peritoneally implanted containing a specific HO-1 inhibitor ZnPPⅨ (Zinc protoporphyrin IX,0.01 mg/kg),Sham pre-conditioning + Znpp group,HBOP + DMSO group,in which rats with a intra-peritoneal micro-pump containing 2 mL Dimethyl sulfoxide (DMSO,a solvent vehicle) and Sham pre-conditioning + DMSO group before HBOP.At 24 hours after the pre-conditioning,rats received an infusion of 100 μL autologous blood into the caudate nucleus to form a simulated intracerebrum hemorrhage (ICH),and were sacrificed 72 h later for brain water content measurements.All data were analyzed by using Stata 7.0 software and statistical analyses were carried out by two-tailed Student t test.Results Compared with the Sham pre-conditioning group,the HBOP group had significant higher level of HO-1.Compared with the Sham pre-conditioning + DMSO group,the HBOP + DMSO group had a significant lower level of water content in the ipsilateral basal ganglion [(81.4 ± 0.9) ％ vs.(82.6 ± 0.8) ％ (P ＜ 0.05)],however,peritoneal infusion of ZnPP Ⅸ before HBOP abolished HBOP-induced protection against brain edema formation after experimental ICH [(82.8 ± 0.9) ％ vs.(82.6 ± 0.7) ％ (P ＞ 0.05)].Conclusions Hyperbaric oxygen preconditioning attenuate brain edema formation after experimental ICH in rats,and this protection is attributed to the activation of HO-1.

Objective : To investigate the influencing factors for depression and anxiety in patients with dysphagia after stroke. Methods: From May 2017 to June 2018,patients with post-stroke dysphagia in the Department of Rehabilitation Medicine of Zhejiang Hospital were recruited to collect their height,weight,education level,serum nutritional indicators and feeding patterns. Self-Rating Anxiety Scale and Self-Rating Depression Scale were employed to assess the incidence of anxiety and depression. Multivariate logistic regression model was used to analyze the influencing factors for depression and anxiety. Results : Among 96 patients enrolled,43 suffered from anxiety and depression,with the incidence of 44.79%. The results of multivariate logistic regression analysis showed that normal albumin（OR=0.208,95%CI：0.054-0.800）was a protective factor for anxiety,while indwelling gastric tube（OR=5.789,95%CI：1.654-20.260）was a risk factor. Normal transferrin（OR=0.189,95%CI：0.042-0.860）was a protective factor for depression,while indwelling gastric tube（OR=13.977,95%CI：1.472-132.667）was a risk factor. Conclusion Normal albumin and transferrin are the protective factors for anxiety and depression in patients with dysphagia after stroke,and indwelling gastric tube is the risk factor for anxiety or depression.

Objective To investigate the effects and mechanism of IL-6 on invasion and metastasis of human pancreatic cancer cells. Methods IL-6 was added into the culture media of human pancreatic cancer cells Capan-2 and SW1990. Cell growth was measured by MTT assay. Western blot and immunocytochemistry were performed to detect Phosphorylated STAT3 (P-STAT3) protein. VEGF and MMP-2 mRNA and protein expression were examined using fluorescence quantitative polymerase chain reaction (RT-PCR) and Western blot, respectively. The invasion ability of SW1990 and Capan2 cells was determined by cell invasion assay in vitro. Results 100 ng/mL IL-6 significantly promoted growth and invasion ability of Capan-2 and SW1990 cells (P＜0.05). The use of IL-6 not only markedly increased the protein expression of P-STAT3, VEGF and MMP-2, but also greatly increased the mRNA expression of MMP-2 and VEGF. Conclusions STAT3 signal transducer pathway activation with IL-6 can promote the invasion ability of pancreatic cancer cells in vitro through up-regulation of MMP-2 and VEGF expression. STAT3 signal transducer may provide a novel therapeutic target for the treatment of pancreatic cancer.

Objective To study the accuracy of preoperative planning and postoperative satisfaction of prosthesis posi?tion by applying the personal surgical cutting guide (PSCG) to total knee arthroscopy (TKA) based on 3D printing technique. Meth?ods In this randomized study, 20 patients were selected from August 2014 to October 2015, who were randomly divided into two groups. In PSCG group, 4 males and 6 females were enrolled, with a mean age of 70.9±6.69 (from 59 to 78) years. In con?ventional instrumentation group, 2 males and 8 females were enrolled, with a mean age of 69.9 ± 6.35 (from 58 to 77) years. The conventional instrumentation group was treated with conventional TKA, while the PSCG group was treated with personal surgical cutting guides. Then the knee valgus angle of patients, the angle between prosthesis components on the coronal and the sagittal plane of two groups were evaluated. Subsequently the correlation of the actual osteotomy amount, the valgus angle, caster angle, external rotation angle between intra? and preoperative planning were compared in the PSCG group. Results Compared with the ideal value of each angle, the mean deviation of the hip?knee?ankle angle 0.77°±0.51°, frontal femoral compo?nent angle 0.37° ± 0.53° and frontal tibial component angle 0.11° ± 0.24° showed statistically significant difference between two groups (P<0.05). The mean deviation of the lateral femoral component angle and the lateral tibial component angle (respectively 8.26°±0.85°, 0.71°±0.77°) were smaller than that of the conventional instrumentation group, while the differences all had no statis?tically significant difference (P>0.05). The actual osteotomy amount, the valgus angle, caster angle, external rotation angle corre?lated well between intra?and preoperative planning (t=-2.547, 3.864, 0.537,-0.040,-1.290, P>0.05). Conclusion TKA assist?ed by PSCG can make lower extremity alignment and accuracy of prosthesis implantation more accurate compared with convention?al TKA, especially in hip?knee?ankle angle, frontal femoral component angle and frontal tibial component angle.

Aim To investigate the effect of polydatin on cardiomyocyte hypertrophy induced by high glucose (25.5 mmol·L -1 )and insulin (0.1 μmol ·L -1 ) (HGI)and its possible influence on peroxisome prolif-erator-activated receptor-β (PPARβ)/nuclear tran-scription factor-κB (NF-κB)/nitric oxide (NO)signa-ling pathway.Methods The cardiomyocyte hypertro-phy was characterized in rat primary cardiomyocytes by measuring the cell surface area,protein content,and atrial natriuretic factor (ANF)mRNA expression.The mRNA and protein expressions were measured by qRT-PCR and Western blotting,respectively.The activity of NO synthase (NOS)and NO content were measured by reagent kit through ultraviolet spectroscopy.Results HGI significantly induced cardiomyocyte hypertrophy which increased the cell surface area,protein content and ANF mRNA expression (P <0.01 ).Meanwhile, the expressions of PPARβmRNA and protein reduced while the NF-κB p65 and iNOS expressions increased significantly which occurred in parallel with rising NOS activity and NO concentration (P <0.01 ).Polydatin (0.1,1,10 μmol·L -1 )inhibited the cardiomyocyte hypertrophy induced by HGI (P <0.01 ),and re-versed the mRNA and protein expressions of PPARβ, NF-κB p65 and iNOS,and NOS activity,as well as NO content.These effects of polydatin were abolished by GSK0660 (1 μmol·L -1 ),a selective PPARβan-tagonist (P <0.05 ).Conclusion Polydatin resists HGI-induced cardiomyocyte hypertrophy,which may be mediated by PPARβup-regulation,and then NF-κB-iNOS-NO pathway inactivation.

Objective To evaluate femoral artery ligation for femoral artery pseudoaneurysm secondary to drug injection. Methods Clinical data of 32 drug addicts of femoral artery pseudoaneursysm caused by drug injection undergoing femoral artery ligation and local debridement were reviewed retrospectively.The blood supply of affected limb was evaluated by oxygen saturation of distal limb and its function.All the cases were followed up at 3,6,9,and 12months after the operation. Results Surgery was successful in all cases. There were no significantly difference of the limb oxygen saturation between postoperative and preoperative period (95.1％ ± 2.8％ vs.96.9％ ± 1.9％ ; t =1.26,P =0.25 ).White blood cells and neutrophils percentage significantly decreased after surgery.All patients were followed up for 1 year.Lower extremity ischemia after 6 hours of operation in one case treated by autologous saphenous vein bypass recovered. On 3 months mild claudication was observed in 5 cases. On 6 months claudication remained in only 2 cases,which disappeared on 9 months.All patients were able to maintain normal life.Conclusions Femoral artery ligation is a safe, effective and simple treatment modality for femoral pseudoaneurysms secondary to drug injection.

Objective To evaluate the feasibility,efficacy,and short to mid-term results of endovascular management of acute type B aortic dissection complicating visceral or lower limb malperfusion.Methods A retrospective study was conducted in 23 consecutive patients with acute type B dissection complicating visceral or lower limb malperfusion treated endovascularly at a single center between July 2001 to December 2012.Of the 23 patients identified [20 men,3 women; mean age (52 ±9) ranging 42-75]presented with clinical and imaging evidence of end-organ malperfusion:renal artary in 5 (21.7％),superior mesenteric artery in 9 (39.1％),celiac trunk in 3 (13％) and lower limb in 6 (20.1％),artary renal and lower limb in 2.Results All patients had stent-graft coverage of the proximal entry tear.11 (47.8％) patients needed additional branch vessel stenting.Successful correction of malperfusion was achieved in all the patients and the successful rate of operation and technology was 100％.In 1 patient,ischemia in the lower limb was resolved after a stent was implanted to the right iliac artery.In another patient,complicated with lower limb ischemic necrosis,amputation was performed after one stage stent-graft placement.The duration of follow-up was 6 months to 72 months,mean (21 ± 11)months.There was no migration of stent-graft and end-organ ischemia.No patients suffered from paraplegia in this group.Conclusions Endovascular coverage of the proximal entry tear in acute type B aortic dissections complicating end-organ malperfusion is a reasonable first line treatment.But some cases may need a combination branch vessel stenting.

Objective To investigate the clinical effect of total hip replacement in patients with hip fusion .Methods 31cases (43 hips) with hip fusion underwent total hip replacement from January 2006 to December 2012 ,To retro-spective analysis on clinical curative effect and operation related issues .Results The mean time of follow-up was 14 .2 months(12 to 72 months) in 26 cases (37 hips) .All patients had good relief postoperative on hip pain ,knee pain and low back pain ,and the gait was closed to normal ,and the activities of daily living improved in part of cases ,including 16 cases went back to work .The assessment of X-ray showed that had not found any complications ,such as dislocation ,Osteolysis and loosening ,the excellent rate was 89 .19% .Conclusion For pa-tients with hip fusion ,Total hip replacement can improve the function of the hip fusion and relieve pain .