Objective To compare the serum microelement changes between patients aged ≥80years and adults aged ＜ 60 years,and to compare the levels of serum microelement,total protein,albumin,hemoglobin between the long term in-bed and non in-bed oldest patients.Methods Beijing Bohui BH5100 type atomic absorption spectrometer was used to determine serum microelement.Total protein,albumin,hemoglobin were also determined.Results The amounts of ferrum,zinc,calcium,copper,magnesium were (7.21 ± 1.21) mmol/L,(93.29 ± 10.96)mmol/L,(1.63 ± 0.21)mmol/L,(17.31±3.61)mmol/L,(1.49±0.20)mmol/L in people aged over 80 years,(8.91±1.25)mmol/L,(121.85±11.24)mmol/L,(1.51±0.23)mmol/L,(15.89±3.87)mmol/L,(1.51±0.21)mmol/L in people aged less than 60 years,respectively.The ratios of Ferrum deficiency were 42.9 ％,zinc deficiency 14.3％,calcium deficiency 21.4％,copper deficiency 14.3％ in oldest-old,whereas were 9.1％,13.6 ％,31.8％,27.3％ in people aged less than 60 years.The amount of ferrum was significantly lower in people aged over 80 years than in people aged less than 60 years (P＜0.01).Proportion of ferrum deficiency was higher in patients aged over 80 years (P＜0.01).The amount of calcium and copper was markedly lower in people aged less than 60 years than in people aged over 80 years (P＜0.01).The proportions of calcium,copper deficiency were higher in people aged less than 60 years (P＜0.01).The amounts of ferrum,zinc,total protein,albumin,hemoglobin of the patients aged over 80 years in long-term in-bed group were significant decreased as compared with those of people in non long-term in-bed group [(6.44±0.89)mmol/L vs.(8.16±1.16)mmol/L,(84.48±8.98)mmol/L vs.(103.62±10.31)mmol/L,(62.8±3.9)g/L vs.(66.3±1.7)g/L,(33.7±2.6)g/L vs.(36.7±l.8)g/L,(109.0±12.5)g/L vs.(132.0±5.2)g/L,all P＜0.01].The amount of calcium of people in none long-term group was much lower [(1.57±0.23)mmol/L vs.(1.71±0.19)mmol/L,P＜0.01].Ferrum,zinc,calcium and copper deficiencies were 60.9％,18.8％,13.0％,13.0％ in long-term in-bed group,21.1％,8.8％,31.6％,15.8％ in non long-term in-bed group.Proportion of ferrum deficiency was higher in long term in-bed group than non long-term in-bed group (P＜0.01).Proportion of calcium deficiency was higher in non long-term in-bed group than long-term in bed group (P＜0.01).There was no significant difference in the amount of copper between people in long term in bed group and non long-term in-bed group (P＞0.05).There was no absence of magnesium in both two groups.Conclusions There is more absence of ferrum,zinc,total protein,albumin,hemoglobin in the patients aged 80 years and over in long-term in-bed.There is more calcium and copper absence of people aged less than 60 years.So it is necessary to supply high ferrum food and nutrients in order to get well sooner,especially to patients aged over 80 years.

Objective To discuss the issue of the limb salvage versus the amputation of serious lower limb injury. Methods The history, the age, the clinical presentation, the treatment time and method of the 72 severe open fractures of the lower limb were studied. Following the patients admission, they were examined completely in emergency room and were sent to radiological department for taking X ray films. According to Gustilo and Andserson classification, there were 48 limbs of type ⅢB and 24 limbs of type ⅢC.16 limbs had multiple trauma as well as severe lower extremity injury. Among them, there were 7 (9.7%) limbs with head or spine injury, 5(6.9%) limbs had abdominal trauma, 4(5.6%)limbs had thoracic trauma. Results 16 limbs in 72 limbs were amputated, in which 7 limbs were type ⅢB and 9 limbs were ⅢC. 4 limbs in 8 limbs of more than 50 years old were amputated. The ratio of amputation was 50.0 %. 12 limbs in 64 limbs younger than 50 years old were amputated. The ratio of amputation was 18.8%.Their comparison has statistically significance(?2=4.018, P

Objective To explore serratus anterior muscle transplantation for the repair of soft tissue defects in foot and ankle. Methods Seventeen patients consisted of 11 males and 6 females aging from 13 to 58 years with the mean age of 35.2 years. The anatomical parameters of serratus anterior of 17 cases were measured, the thickness of the muscle was (1.24?0.65) cm, and the diameter of origin point of the nutrient artery to the muscle was (1.4?0.6) mm. There were two veins arising from the muscle, the diameter of larger one was (2.5?0.8) mm. The length of vascular pedicle was (8.31?1.48) cm. 17 patients with soft tissue defect of foot and ankle were treated with free serratus anterior muscle transfer and split skin graft overlying the muscle. The primary lesions were soft tissue defect around the ankle and Pilon fracture in 5 cases, non-union of distal tibial fracture in 3, Achilles tendon and soft tissue defect in 3, metatarsal fracture and soft tissue defect in 4, and calcaneal fracture with soft tissue defect in 2. All of the patients suffered from infection or exposure of bone or applied plate, the area of soft tissue defect ranged from 4.5 cm?6 cm to 11 cm?13 cm. Results The average operative time was (6.5?1.2) hours. The complications included local hematoma in 2 cases, superficial infection in 2, winged scapula without function loss in 1,scar pain in 2, and numbness of lateral thoracic wall in 1. Furthermore, weakness and decreased shoulder mobility were noted in 3 patients comparing with the contralateral side, but the condition improved half year following the operation. The transferred muscle flap appeared thinner and less bulky , and healed intimately with the adjacent foot tissue, the patients resumed good function in walking. Conclusion The serratus anterior muscle flap is a good choice for treatment of soft tissue defects in foot and ankle.

Objective To investigate the effect of persistent ST-segment elevation after successful direct percutanous coronary intervention (PCI) on the late phase of left ventricular (LV) systolic function in acute anterior wall myocardial infarction.Methods Serial electrocardiograms were record before PCI and 1 hour after reperfusion in 72 patients with acute anterior wall myocardial infarction. The reduction of ST-segment elevation after successful PCI more than 50% was defined as ST-segment resolution (ST reduction group). Persistent ST-segment elevation was defined as ≥50% of peak ST elevation (ST elevation group). Echocardiography was performed on 2 to 3 weeks (early phase) and 5 to 6 months(late phase)after PCI to evaluate the LV function and ventricular wall motion abnormality (VWMA). Results Fifty-three patients (74%) had early ST segment elevation resolution and 19 patients (26%) did not. The LV function and VWMA were similar in two groups during early phase. But during the late phase, ST elevation group patients had lower LVEF and higher LVEDVI, LVESVI, VWMA index compared with ST reduction group (P

Objective To analyze the monitoring data of the fever clinic during the epidemic period of COVID-19 in Xiangyang City, and to provide a scientific basis for the government to carry out the prevention and control of new coronavirus pneumonia in the next step. Methods Monitoring data from the "Symptom Monitoring System of Fever Outpatients in Xiangyang City" from February 11, 2020 to March 16, 2020 was obtained. The data combined with the confirmed cases was statistically analyzed. Results A total of 28 296 outpatients with fever were monitored and 38 confirmed cases were found. According to trend chi square test, the visit rate of the fever clinic (Z =629.11，P = 0.000＜0.005 ) decreased gradually from the second week. The analysis of the rate of the fever clinic visits (χ²=2819.54，P=0.000＜0.05 ) and the rate of confirmed cases in different areas ( χ²=7.80，P=0.005＜0.05) indicated that the diagnostic confirmation rate in the urban area was higher, while the rate of visits in counties was higher. The rate of visits to fever clinics (Z=2 261.99, P=0.000<0.008) and the rate of diagnostic confirmation (Z=10.69, P=0.001<0.008) in different age groups showed that the visit rate decreased with the increase of age, while the diagnostic confirmation rate increased with the increase of age. Conclusion The prevention and control of the new coronavirus in Xiangyang City had been effective. It is important to strengthen the screening of patients in fever clinics in key areas (urban areas) and key age groups (children and adolescents) in the next step.

Kidney plays an important role in maintaining the homeostasis as an important excretory and endocrine organ.The occurrence and development of kidney disease is closely associated with glomerular filtration barrier dysfunction and renal interstitial remodeling.Matrix metalloproteinase-9 (MMP-9),a major enzyme in the extracellular matrix (ECM),plays an important role in the process of kidney disease by regulating the ECM components and its interaction with cytokines.The paper reviews the pathophysiology of MMP-9 in glomerular filtration barrier dysfunction and renal fibrosis to provide a theoretical basis for clinical treatment of kidney disease.

Objective To analyze risk factors for acute kidney injury after aortic arch operation under deep hypothermic circulatory arrest.Methods Between January 2005 and June 2011,549 cases aortic arch replacement under deep hypothermic circulatory arrest were retrospectively analyzed.According to the occurrence of acute kidney injury they were divided into two groups.Univariate and multivariate analysis (multiple logistic regression) were used to identify the risk factors.Results AKI occurred in 102 cases (18.6％) and 27 cases(4.9％) had dialysis.Multiple logistic regression showed that body mess Index(OR =1.072,95％ CI:1.006-1.141,P =0.031),serum creatinin (OR =1.011,95％ CI:1.006-1.017,P =0.000),cardiopulmonary bypass time(OR =1.006,95 ％ CI:1.002-1.009,P =0.005) and the peak intraoperative glucose level (OR =1.007,95 ％ CI:1.002-1.011,P =0.003) were independent risk factors for AKI.Conclusion The higher BMI,serum creatinin level maybe indicate the occurrence of AKI,and AKI maybe can be reduced by controlling CPB time and intraoperative hyperglycemia.

Objective Retrospectively analyze 47 cases received reoperation with aortic disease after aortic valve replacement to deepen the understanding of aortic valve disease.Methods From January 2003 to June 2012,47 patients with previous aortic valve replacement received aortic root or other aortic operation because of new aortic disease.38 male and 9 female,the interval (6.0 ± 3.8) years. All cases with new aortic disease were diagnosed by cardiac ultrasound and aortic computed tomography.Bentall's procedure were operated on 14 patients,total aortic arch replacement with elephant trunk procedure on 14 patients,aortic root and aortic arch with elephant trunk procedure on 7 patients,ascending aortic replacement on 10patients,total thoracic and abdominal aorta replacement on 2 cases.All patients were followed by clinic interview or telephone.Results Aortic dissection and aneurysmal dilatation were occurred on ascending aorta,each account for 50％,in patients with previous aortic valve replacement because of rheumatic valve disease and bicuspid aortic valve; 3 cases with Marfan syndrome occurred ascending aortic dilatation and 4 cases occurred aortic dissection.Diameter in ascending aorta increased (5.2 + 7.1)mm per year and aortic sinus (3.3 ± 3.1)mm per year.The value of ascending aortic dilatation per year in patients with rheumatic disease was higher than patients with Marfan syndrome(P ＜ 0.05).47 patients were re-operated in fuwai hospital,1 patients died in operating room because aortic dissection seriously involved right coronary artery.7 patients have renal insufficiency after operation and all were cured by hemofiltration; neurological complication occurred in 14 patients including that 7 patients stroked and 7 patients had transient brain dysfunciotn.There were no postoperative spinal cord deficits occurred.All patients were followed up,the mean follow up time were(53.49 +33.79) months.8 cases were died during follow-up and threeyear survival rate was 83％.There were no cases received operation due to aortic disease during follow-up.Conclusion Deepening the understanding of aortic valve disease combine ascending aorta changes,especially pay attention to patients with previous aortic valve replacement because of Marfan syndrome and rheumatic disease during follow-up after first operation,all efforts should decrease the occurrence of aortic adverse events in long term.

The morbidity of inflammation-associated tumor is high .Prevention and treatment of inflammation play a positive role in delaying the occurrence and development of cancer .Antrodia camphorata, an endemic fungus in Tai-wan, possesses significant anti-inflammatory effect.So far, 35 anti-inflammatory active components from Antrodia camphorata have been identified , among which triterpenoids account for the most .Studies have revealed that triterpenoids , including ergostanes and lanostanes , have significant anti-inflammatory activities .Because of their structures , especially those of the ergostanes , are similar to the structures of cholesterol and steroid hormones , their anti-inflammatory mechanism may be related to mimic the steroid hormones or interfere with the effect of cholesterol .

Objective To evaluate the correlation between intracranial hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery(FLAIR) and the degree of the stenosis of internal carotid artery (ICA).The effect of carotid endarterectomy(CEA) on HVS was assessed.Methods A retrospective analysis of MR FLAIR sequence and cerebral-cervical computed tomography angiography(CTA) was performed in 1 total of 491 patients.Of the 491 patients,41 treated with CEA were evaluated using their pre-and post-operative image data.Patients were divided into ICA stenosis group and non-stenosis group according to the CTA imaging findings.The ICA stenosis group was subdivided into unilateral group and bilateral stenosis group.Furthermore,we measured and graded the ICA of the unilateral stenosis group into seven stenotic degrees,they were＜50％(n=40),50％-＜60％(n=15),60％-＜70％(n=17),70％-＜80％ (n=6),80％-＜90％ (n=7),90％-＜100％ (n=23),100％ (n=24),respectively.Chi square test was used to analyze the occurrence rates of HVS between ICA stenosis and non-stenosis group,and between ICA unilateral and bilateral stenosis group,respectively.Spearman rank correlation was performed to evaluate the correlation between the presence of HVS and stenotic degrees of the ICA.For the 41 patients who underwent CEA,pre-and post-operative image data were compared,focusing on the presence or disappearance of the HVS on MR FLAIR imaging.Results HVS on FLAIR images were observed in 81 of 177 patients(45.76％) with ICA stenosis,and in 59 of 314 patients(18.79％) without ICA stenosis.The occurrence rate of HVS was significantly higher in patients with ICA stenosis than those without ICA stenosis (x2=40.40,P＜0.01).There was no statistical significance in the occurrence rates of HVS between ICA unilateral stenosis group and bilateral stenosis group(x2=0.24,P＞0.05).The occurrence rates of HVS of ICA graded as the seven stenotic degrees were 22.00％(8/40),26.67％(4/15),35.29％(6/17),33.33％ (2/6),42.86％ (3/7),69.57％ (16/23),83.33％ (20/24),respectively.There was a significant positive correlation between the occurrence rates of HVS and the degrees of ICA stenosis(r=0.964,P＜0.01).HVS disappeared in 19(86.36％) out of 22 patients with HVS on pre-operative MR images after CEA in The remaining HVS in 3(13.64％) patients was attributed to the failure of completely recanalization of ICA.Conclusions A close relationship exists between HVS and ICA stenosis.The presence of HVS indicates a high probability of the existence of severe ICA stenosis.A further assessment for ICA stenosis is warranted.HVS disappearance after successful CEA indicates that HVS can be a useful marker for the the evaluation of consequence associated with CEA.