Objective To investigate the high risk factors for severe complications after cardiopulmonary bypass cardiac surgery of patients aged 70 years and over. Methods 204 consecutive patients aged 70 years and over undergoing cardiopulmonary bypass cardiac surgery in our department were investigated.The patients′ characteristics,perioperative outcomes and the high risk factors for severe complications after surgery were analyzed.Results The overall mortality was 6.4%(13 of 204).A total of 40 cases with severe complications,including early death after surgery,were recorded.It was significantly higher than that in patients aged

Objective To investigate the predictive value of mnodified early warning score (MEWS) in predicting emergency potential in critically ill patients and its feasibility.Methods A total of 298 patients in the emergency department and emergency room were evaluated using the MEWS.The distribution of transfer to cadiopulmanary resuscitation (CPR),intensive care unit (ICU) and high dependency unit (HDU),length of hospital stay ( more than 1 month or not) and transferred to advanced hospital,death were recorded,and all patients were followed up.Results Patients with different MEWS were treated significantly differently ( x2=258.697,P ＜ 0.001 ),and their prognosis were also significantly different ( x2=115.938,P ＜ 0.001 ).the condition of patiens were significantly correlated with MEWS ( r=0.848,P ＜ 0.001 ).Conclusion The MEWS in the prediction of potential in critically ill patients in emergency department is feasible as a special emergency assessment system and is recommended for promotion.

Objective To explore the variation of the plasma high-sensitive C reactive protein (hs-CRP) levels and analyze the relationship between inflammation and malnutrition in the patients with stage V chronic kidney disease (CKD). Methods Ninety patients with stage V CKD were enrolled. The patients were divided into three groups according to their treatment, no dialysis (ND) group, hemodialysis (MHD) group and continuous ambulatory peritoneal dialysis (CAPD) group. Plasma hs-CRP, albumin and hemoglobin were detected. Results The levels of plasma hs-CRP were significantly increased in the patients with stage V CKD compared with normal individuals (P< 0.01). It showed a significant difference between MHD group, CAPD group and ND group (P < 0.05), while no significant difference was found between MHD group and CAPD group. The plasma hs-CRP levels increased in the patients with lower plasma albumin (< 35 g/L) or lower hemoglobin (< 90 g/L). Levels of plasma hs-CRP showed a negative relationship with plasma albumin and hemoglobin (r =- 0.535, P < 0.01 ;r =-0.220, P < 0.05). Conclusions Plasma hs-CRP levels increase in patients with stage V CKD, and there is a negative relationship between hs-CRP and plasma albumin and hemoglobin. Inflammation may be a factor of malnutrition in patients with CKD.

Cerebrovascular Disorders ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; methods

To study the chemical constituents of Veratrum dahuricum (Turcz.) Loes. f., a new aurone glycoside named as (Z)-7, 4'-dimethoxy-6-hydroxyl-aurone-4-O-β-glucopyranoside was isolated from the 95% ethanol extracts of the rhizomes and roots of Veratrum dahuricum (Turcz.) Loes. f. by repeated column chromatography on silica gel and recrystallization. Its structure was established by extensive spectroscopic analyses, and its cytotoxicities against HepG-2, MCF7 and A549 cell lines were measured in vitro.
Benzofurans ; isolation & purification ; Cell Line, Tumor ; Glycosides ; isolation & purification ; Humans ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Veratrum ; chemistry

BACKGROUND:Medical stuff have significant impacts on the development of organ donation and transplantation, however, medical students present insufficient knowledge and ambivalent attitude towards organ donation and transplantation. OBJECTIVE:To perform a systemic review on the effectiveness of educational program intervention on medical students’ knowledge and attitudes toward organ donation and transplantation. METHODS:PubMed, WILEY ONLINE LIBRARY, ProQuest Health, Medline, EMbase, CNKI, Wanfang and VIP databases were ful y searched for the published literature of medical students receiving an educational program intervention on organ donation and transplantation. According to the inclusion criteria, randomized control ed trials and quasi-experimental study were evaluated with the standard of Joanna Briggs Institute. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework was used to guide the assessment of the methodological quality of the studies. The outcomes were mainly medical students’ knowledge and attitudes toward organ donation and transplantation.
RESULTS AND CONCLUSION:Eight studies from three countries were summarized. The methods were employed in two studies of randomized control ed trials and quasi-experiment received a high quality rating, five studies received middle quality rating and one study received low quality rating. Educational program increased the knowledge in six studies, and changed the attitudes in six studies. Educational program intervention is a significant strategy to increase medical student’s knowledge about organ donation and transplantation. The majority of involved study are
quasi-experiment study, so more high-quality randomized control ed studies are needed.

Objective To evaluate the methods for the prevention of internal jugular vein malposition of peripherally inserted central catheter (PICC) in patient with limited neck motion.Methods 210 patients who underwent PICC placement using ultrasound-guided modified Seldinger technique were divided into observation group (n =106) and control group (n =104) with a random number table.Ultrasound probe compression on the internal jugular vein was used in the observation group,while finger compression was used in the control group.The 2 groups were compared in terms of incidence of internal jugular vein malposition,accuracy of PICC tip position in X-ray,and incidence of complications.Results Incidence of PICC malposition was significantly lower in the observation group than the control group [3 (2.8％) vs.36 (34.6％),P =0.000].The accuracy of PICC tip position in both groups was 100％.No complication was observed in the observation group,while the rate of complication in the control group was 4.8％,with a statistically significant difference (P =0.022).Conclusion The ultrasound probe compression method can significantly lower the incidence of internal jugular vein malposition of PICC and is safer than the finger compression method.

Objective To explore the incidence and risk factors of anti-tuberculosis (TB) drugs induced liver injury (ATDILI) and to discuss its impact on the treatment outcome of patients treated with first line anti-TB drugs.Methods Among the patients who received anti-TB treatment with directly-observed treatment strategy (DOTS),121 patients with ATDILI and 817 patients without ATDILI were included in this retrospective cohort study.Binary Logistic regression model was used to analyze the risk factors of ATDILI in univariate and multivariate analysis.The x2 test was used to compare the treatment success rates and drug resistant rates.Kaplan-Meier analysis and Log-rank test were used to compare the sputum smear/culture conversion rates and cavity closure rates.Results The incidence of ATDILI was 12.9％ (121/938) in this cohort.Multivariate Logistic regression showed that hepatitis B virus carrier with both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive (OR=4.29,95％CI:2.15-8.58,P＜0.01),complicated with systemic lupus erythematosus (OR=3.34,95％CI:1.46-7.63,P=0.004),serum albumin ≤25 g/L (OR=3.14,95％CI:1.50-6.58,P=0.002) and alcoholism (OR=1.79,95％CI:1.14-2.82,P=0.012) were independent risk factors of ATDILI.The treatment failure rate in patients with ATDILI was significantly higher than that in patients without ATDILI (19.1％[24/121] vs8.0％[65/817],OR=2.86,95％CI:1.71-4.78,P＜0.01).The drug resistant rates of two groups were not significant different (4.1％[5/121] vs 1.7％[14/817],P＞0.05).The sputum smear/culture conversion rate (85.4％[41/48] vs 94.0％ [298/317],x2 =38.912,P＜0.01) and cavity closure rate (84.6％[22/26] vs 93.0％[198/213],x2 =20.709,P＜0.01) in patients with ATDILI were both significantly lower than those in patients without ATDILI.Conclusions The incidence of ATDILI is relatively high in hospitalized patients treated with first line anti-TB drugs.ATDILI has negative effects on treatment outcome of TB patient.Hepatitis B carrier with positive HBsAg and HBeAg,systemic lupus erythematosus,albumin ≤25 g/L and alcoholism may increase the risk of developing ATDILI.

Objective The purpose of this study is to define the pollution level of CO2 pneumoperitoneum in operation room and its influence on the health of medical personnel,and put forward certain countermeasures.Methods This research consisted of four groups of experiments,and gradually proved that the use of pneumoperitoneum machine would lead to air pollution in the operation room,and the health of medical staff were influenced too.The four experiments were:the maximum CO2 gas leakage experiment;laparotomy and pneumoperitoneum surgery in the operating room CO2 gas concentration control experiment;CO2 gas concentration increase on the influence of the medical staff experiment; long-time pneumoperitoneum surgery operating room CO2 gas concentration change experiment.Results The maximum CO2gas leakage situation could cause the operation room CO2 gas concentration to increase(＞ l 000× 104); pneumoperitoneum machine in actual use process,could cause the increase of CO2 gas concentration in operation room; increase of CO2 gas concentration had an impact on the vital signs of the medical staff,the heart rate and blood pressure were statistically different before and after the operation; during pneumoperitoneum surgery for a long time,indoor CO2 gas concentration increased (＞1000× 10-6)and reduced quickly postoperation.Conclusions The use of C02 pneumoperitoneum machine in operation room influence the health of medical personnel.Effective protective measures dealing with gas pollution should be taken to reduce the chronic injury to medical staff.

Objective To observe the effects of long term injection sodium salicylate on the auditory brain-stem response(ABR)and expression of glutamic acid decarboxylase -67(GAD67) in rat inferior colliculus .Methods Eighteen healthy Wistar rats were randomly divided into three groups :the sodium salicylate group (intramuscular injection of 10% sodium salicylate ,175 mg/kg ,twice daliy for 28 days) ,the saline group (intramuscular injection with saline on same does at the same time) ,the control group (without any treatment) .The rats received ABR after modeling ,then were decapitated and inferior colliculus tissues were stripped .Western blot was used to study the dif-ferent expression of GAD67 protein levels in the three groups .Results Compared with the saline group and control group ,ABR thresholds of the sodium salicylate group were significantly elevated and latency of wave Ⅲ was aslo sig-nificantly prolonged(P<0 .01) ,while there was no significant difference between the saline group and the control group(P>0 .05) .The inferior colliculus GAD67 protein expression level of sodium salicylate group was significantly higher than the saline group and control group(P<0 .01) ,while there was no significant difference between the saline group and the control group(P>0 .05) .Conclusion Long term injection of sodium salicylate can cause a change in the inferior colliculus of GAD67 protein expression and the up regulation of GAD67 expression may occur as a com-pensatory response to increase inhibiting effect .The change of GAD67 protein expression is likely as a compensatory and regulatory mechanisms for sodium salicylate ototoxicity .