Objective To explore the incidence and risk factors for postoperative delirium patients over 60 years undergoing total knee arthroplasty.Methods Three hundred and sixty-nine patients (73 males,296 females,aged over 60 years,ASA Ⅰ or Ⅱ) undergoing unilateral total knee arthroplasty were chosen.Before induction of anesthesia,femoral nerve block by nerve stimulator was performed for all patients,25 ml of 0.4% ropivacaine was injected to the continuous femoral nerve catheter for postoperative analgesia,all patients received intravenous-inhalation anesthesia during the operative.The confusion assessment method-intensive care unit (CAM-ICU) was used twice a day to evaluate whether the postoperative delirium had happened for patients within 3 days after operation,and record the case of complication besides postoperative delirium.To analysis the perioperative indicators depend on whether the postoperative delirium had happened for patients,then to screen out the probable risk factors for postoperative delirium,which include the kind of intravenous anesthesia drugs during operation,gender,age group,level of education;preoperative hypertension,coronary heart disease,arrhythmia,stroke,respiratory disease,diabetes,abnormal renal function and the ASA grade;the bleeding and blood transfusion volume during operative and the total amount of blood transfusion;degree of postoperative pain and whether used pethidine after operative.Put all observed factors to be analyzed by the Logistic regression model.Results Sixty-two patients (16.8%) had delirium within 3 days after operation.The results of multi-factor Logistic regression analysis indicates that the patients` increasing age (OR=2.116,P=0.035),low level of education (OR=0.091,P<0.001),preoperative chronic obstructive pulmonary diseases (COPD) (OR=12.500,P=0.002),high ASA grade (OR=22.333,P=0.005),increasing total amount of blood transfusion (OR=4.500,P<0.001) and postoperative used pethidine(OR=22.372,P=0.001) were the independent risk factors for postoperative delirium.Conclusion The patients` age,level of education,preoperative COPD,high ASA grade,increasing total amount of blood transfusion and postoperative used pethidine are the independent risk factors for postoperative delirium.

AIM: To establish the quality standard for Jieeryin Effervescent Tablets (Fructus Cnidii, Folium Artemisiae Argyi, Radix Sophorae Flavescentis, Cortex Phellodendri, etc.). METHODS: Radix Sophorae Flavescentis、Cortex Phellodendri、Radix Scutellariae and Fructus Gardeniae in Jieeryin Effervescent Tablets were identified by TLC. The content of geniposide was determined by HPLC. RESULTS: The average recovery was 99% and relative standard deviation was 1.6%. CONCLUSION: The precision and reproducibility of the method are good. The method can be used for quality control of Jieeryin Effervescent Tablets.

Objective To investigate the changes of the serum level of IL-6 and IL-10 as well as their significance after coronary artery stent implantation. Methods The study involved 30 patients who underwent coronary artery stent implantation. Blood stamples were taken from the femoral arteries before and 24h after successful coronary stenting. Serum concentration of interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured and complications as well as the occurance of restenosis were observed after the procedure. Results The concentration of IL-6 in femoral aterial blood was significantly higher after 24 hours of stent-implantation (214.6?118.0 ng/L vs 175.8?81.8 ng/L, P 0.05, and the ratio of IL-6/IL-10 increased (3.2?1.9 vs 2.3?1.0, P

Objective The diagnosis and treatment of renal angiomyolipoma were studied. Methods A total of 72 cases of renal angiomyolipoma encountered and treated from Jan. 1983 to Dec. 1999 were reviewed. Results Of the 72 cases, 13 were misdiagnosed preoperatively.The positive diagnosis rate of ultrasonography was 73.6%(53/72) and that of CT 81.9%(59/72).10 cases( 13.9 %) had been misdiagnosed preoperatively with the combined use of ultrasonography and CT.Tumors smaller than 4 cm had a significantly higher misdiagnosis rate( P

Objective To explore the pathological basic of some common characteristic of papillary microcarcinoma of thyroid in ultrasound. Methods Totally 117 thyroid papillary microcarcinomas that were completed all thyroid ultrasound examinations before the surgical excisions were collected. Shape, border, internal echogenicity, halo, posterior echogenicity and calciifcation were observed in ultrasound. While the degree of inifltration of the tumor, the tumor’s internal structure as well as calciifcation was observed in pathology. Results IIrregular shape (87.18%, 102/117), unclear border (80.34%, 94/117), hypoechoic (90.60%, 106/117) and microcalciifcations (65.81%, 77/117) were recognized by ultrasound while the main pathological features were invasive growth (93.16%, 109/117), cell components internally (46.15%, 54/117) and calciifcation (56.41%, 66/117). Of the 109 neoplasms which were invasive growth in pathology, 102 (93.58%) nodules presented irregular shape in ultrasound while 91 (77.78%) presented unclear border. All of the 8 neoplasms which were not invasive growth in pathology showed regular shape in ultrasound. Thirteen nodules showed halos in ultrasound, and 8 of them showed visible ifbrous capsule surrounding the mass. Whatever the tumor’s internal structure was, most nodules presented hypoechoic. And the hyperechoic nodules were all found cell components internally. Of the 66 neoplasms which were found calciifcation by microscope, 35 (53.03%) nodules showed calciifcation in ultrasound and 31 (46.97%) did not. And of the 51 neoplasms in which calciifcation were not found by microscope, 42 (82.35%) nodules showed calciifcation in ultrasound and 9 (17.65%%) did not. Conclusions There is no doubt that all the performances of papillary microcarcinoma in ultrasound have bases in pathology. It is helpful to the judgment of a thyroid nodule if we could understand the correlation of performances in ultrasound and pathology.

Objective To evaluate the detection competence of HbA2 and HbF in Guangxi medical laboratories.Methods The external quality assessment(EQA) of HbA2 and HbF was conducted twice a year and five samples was detected each time during 2012 to 2016.The laboratories participated in EQA completed the samples' detection and submitted the detection results at specified time according to the requirements of EQA.The distribution of each detection system,the qualification rate of each laboratory,the variation degrees of each detection system and each detection method,and the variations of results for different levels of quality control(QC) materials during 5 years were analyzed based on the returned results.Results The application of high performance liquid chromatography (HPLC) and capillary electrophoresis(CE) increased year by year and their usage rates in 2016 reached up to 46.1％ (82/178) and 18.0％ (32/178),respectively.The qualification rates of HbA2 and HbF increased from 51.5％ (34/66) and 60.6％ (40/66) in 2012 to 93.3％ (166/178) and 92.1％ (164/178) in 2016,respectively.The average coefficient of variation(CV) of each detection system decreased year by year.There were good CVs for the results of high,medium and low levels of HbA2 QC materials detected by the Bio-Rad Variant Ⅱ and Sebia CAPILLARYS 2 systems,and they were less than 6.0％.HPLC and CE could quantitatively detect the HbA2 and HbF levels,and their total detection competence was superior to that of agarose gel electrophoresis.Conclusion EQA can assess the abihty of one laboratory detecting HbA2 and HbF,and quantitatively analyze the levels of HbA2 and HbF,which may provide the quality assurance and data support for the screening and prevention of thalassemia.

Objective To evaluate reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency. Methods The clinical data of 25 cases (29lower extremities) undergoing primary deep venous insufficiency from March 1998 to December 2006 were analyzed retrospectively. 25 eases(29 lower extremities) were treated with reformative encircling constriction combined with the retrograde venograms in operations. Results 25 eases were treated with reformative encircling constriction combined with the retrograde venograms in operations,the leg swelling improved and no deep vein thrombus occurred; all the varicose veins are welt controlled. Conclusion Reformative encircling constriction operations are eutherapeutic for severe femoral venous valve dysfunction, when combined with the retrograde venogram, it can be a guidance in encircling constriction of superficial femoral vein and number of femoral venous valves.

Objective To discuss the features of MRI and differential diagnosis of cerebral fat embolism syndrome(CFE).Methods The features of MRI of 4 final diagnosis cases of CEF were retrospectively analysed.Results MRI showed that there were spotty and patchy high T_2-weighted signals and some of them were low or equal signals on T_1-weighted.These signals were distributed in bilateral centrum semiovale,corona radiata,thalamus,deep part white matter of brain along the lateral ventricle,the cortex of brain of watershed,collose,brain stem and the hemisphere of cerebellum.The position of these abnormal signals was symmetric in the rough.The figure of the MRI signals in the midbrain liked the reverse Chinese number "eight".Brain swelling was showed in 2 of 4 cases.Conclusion There are some features of the CEF on T_2-weighted of MRI,but the history,the physical signal and the results of laboratory must be considered,and must be differential diagnosed with the diseases liking diffuse axonal injury,etc.

Objective To investigate the expression and clinical significance of platelet-derived growth factor A (PDGF-A) on placenta tissue from pre-eclampsia.Methods The expression of PDGF-A in the placenta of 38 pre-eclampsia patients and 22 normal pregnant women at third trimester was detected by immunohistochemistry method.Results (1)PDGF-A was mainly expressed in the cytomembrane and cytoplasm of cytotrophoblasts and the endothelial cell of capillary in placenta.(2) The rates of PDGF-A expression of cytotrophoblasts were 63% (24/38) in pre-eclampsia group and 32% (7/22) in normal pregnancy group,which exhibited significant difference (P ＜0.05).(3) The rates of PDGF-A expression of endothelial cell were 68% (26/38) in pre-eclampsia group and 27% (6/22) in normal pregnancy group,which also showed significant difference (P ＜0.01).(4)The rates of PDGF-A expression of cytotrophoblasts were 39% (7/18) in mild pre-eclampsia patients and 85% (17/20) in severe pre-eclampsia,which reached statistical difference (P ＜ 0.01).Conclusion The increasing expression of PDGF-A in cytotrophoblast and endothelial cell in placenta might confer the occurrence and progression of preeclampsia.

Objective To compare the influence of the continuous airway humidification with microp-ump and the discontinuous dripping technique on patients. Methods Randomized grouping method was adopted, 25 cases with tracheotomy in the observation group used continuous airway humidification with micro-pump, 24 cases in the control group used dripping technique via airway for airway humidification. The two groups were compared retrospectively. Results The oxygen saturation rate in the observation group increased compared with that of the control group, sputum callus formation, irritating cough, airway bleeding and pul-monary infection was significantly lower than those of the control group. Condusious The effect of continu-ous airway humidification with micro- pump is superior to the traditional method of inconsistent endotracheal dripping, the former can also decrease nursing workload of airway humidification.