Emergency Treatment ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; complications ; therapy ; Myocardial Infarction ; complications ; therapy ; Pancreatitis ; complications ; therapy ; Treatment Outcome

Objective To investigate the risk factors and treatment of postoperative delirium in patients with benign prostatic hyperplasia(BPH). Methods　For 256 postoperrative BPH patients in our department,the clinical parameters including age,hypoxemia,preoperative infection,postoperative pain,and introvert were analyzed,and the treatment were summarized. Results　The incidence of postoperative delirium was higher in patients aged≥75 years than＜75 years[17.4%(19/109)vs.5.4%(8/147),X2=8.307,P=0.0043,higher in patients with preoperative infection (pulmonary or urinary)versus without the infection[15.0%(17/113)vs.7.0%(10/143),X2=4.337,P=0.037],higher in patients with hypoxia versus without hipoxia[16.5%(16/97).vs.6.9%(111159),X2=4.885,P=0.027]and higher in patients with post-operative pain versus without the pain(16.9%(10/59)vs.1.2%(1/85),X2=10.146,P=0.0014].Hematocrit and hemoglobin in patients with postoperative delirium were lower after operation versus pre-operation[(0.29±0.04)vs.(0.42±0.04),t=12.2314,P＜0.001;(102.39±6.58)g/L vs.(114.58±8.36)g/L,t=5.9537,P＜0.001].All delirium patients were recovered after sedation treatment,improving the quality of sleep,controlling the infection and correcting electrolyte turbulence. Conclusions　Advanced age,hypoxemia,preoperative infection,postoperative pain are important risk factors for delirium.

Objective To investigate the safety and feasibility of electrocoagulation of gallbladder artery in laparoscopic cholecystectomy ( LC) . Methods A total of 376 patients with gallbladder benign diseases underwent LC in our hospital from May 2004 to September 2013.The gallbladder artery was treated by electrocoagulation . Results Because of unclear gallbladder triangle due to abdominal adhesion , conversion to laparotomy was performed in 9 patients.In the remaining 367 patients, three-port LC with electrocoagulation of the gallbladder artery was conducted successfully .Laparoscopic appendectomy was conducted simultaneously in 12 patients.An additional fenestration and drainage of the left renal cyst was performed in 1 patient.Postoperatively, a secondary bile duct exploration was conducted in 1 patient because of bile duct obstruction caused by common bile duct stones . Conclusion The electrocoagulation of gallbladder artery is safe and feasible in LC for the treatment of gallbladder benign diseases .

Objective To compare the inspiratory cycling-off synchronization with expiratory trigger sensitivity (ETS) setting during noninvasive pressure support ventilation (PSV) under the different conditions of respiratory mechanics. Methods Bi-level pressure ventilator was connected to a lung model (Hans Rudolph Series1101 simulator). And its mechanics was set to normal, obstructive and restrictive ventilation dysfunction. Tests were performed with pressure support levels of 10 (in normal condition, 1 cmH2O = 0.098 kPa) and 15 cmH2O, 5 cmH2O positive end-expiratory pressure (PEEP). The data including cycling delay time (Td), tidal volume (TV) and airflow were collected in the presence of air leaks (24-28 L/min). Results Significant performance on airflow was observed in various respiratory mechanics conditions. The peak inspiratory flow (PIF) and peak expiratory flow (PEF) were different, and the tidal volume, PEF and inspiratory time were increased after decreasing the ETS level. Premature cycling occurred frequently in normal and restrictive model. Delay cycling was found only when the ETS setting was at the lowest level (about 5% of PIF), at which Td were (15.20 ± 0.43) ms and (105.00 ± 15.82) ms. In obstructive model, PIF and PEF were significantly decreased, and delay cycling was always present. Td were increased after the ETS setting was changed from the most sensitive level to moderate level:(51.30 ± 12.63) ms vs. (162.40 ± 15.59) ms, as cycling-off criteria were reduced from (34.52 ± 3.36)% to (16.04 ± 2.58)% of PIF, and there were statistical differences (P<0.05). Severe delay cycling was found when the ETS level was at the lowest level. Conclusions There are significant differences in performances and cycling-off synchrony in various respiratory mechanics models during PSV. For Curative Flexo ST30 bi-level pressure ventilator, its flow cycling-off criteria range is about 5%-35%of PIF. The higher ETS level might be beneficial to improve patient-ventilator synchrony in patients with obstructive airway diseases, which could result in premature cycling in patients with restrictive disease.

Objective To investigate the echocardiographic features in patients with right atrial myxoma and thus evaluate the value of echocardiog?raphy in the diagnosis of right atrial myxoma. Methods The echocardiographic findings of 20 patients with right atrial myxomas were retrospectively analyzed,and the echocardiographic features of these patients were summarized. Results The main clinical symptoms of right atrial myxoma includ?ed chest tightness,shortness of breath,lower limb edema,and syncope. Of these 20 patients,the echocardiography showed that the average size of the right atrial myxomas was 3.11 cm × 2.90 cm to 7.44 cm × 4.52 cm. The myxomas were round or oval shape in 15 patients(75%)and lobulated shape in 5(25%). The myxomas were attached to the atrial septum in 15 patients(75%)and to right atrial free wall in 25%of the patients. The aver?age width of the basement was 1.62±0.30 cm,and the width was greater than 1 cm in 80%of the patients had the width over 1 cm. Some myxomas had internal areas of calcification and anechoic cystic areas. The percentages of patients with the blocking of right atrium,tricuspid and pulmonary hy?pertension were 70%,50%,and 10%,respectively. Conclusion The echocardiographic features of right atrial myxoma were specific. Echocardiog?raphy can accurately assess the tumor and identify the secondary changes in cardiac structure and hemodynamics and thus provide evidence for time?ly and accurate diagnosis of right atrial myxoma.

Objective To explore the technique of auxiliary partial orthotopic liver transplantation model in C57BL/6 mice.Method The donor portal vein and hepatic vein were anastomosed with Cuff and suture techniques respectively.The donor bile duct was implanted into recipient duodenum.Result The operation time of harvesting donor's liver and anhepatic phase and recipient was (30 ± 3),(6-± 1) and (58 ± 5) min respectively.The model success rate was 96％,and the 4-week survival rate was 88％.Conclusion The animal model was stable with high success-rate and can be used for the study of auxiliary partial orthotopic liver transplantation.

Aged ; Cyclosporine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Myelodysplastic Syndromes ; drug therapy ; Phytotherapy

As an interdisciplinary of stomatology and space medicine, space oral medicine focuses mainly on oral diseases happened under space environment. With the manned space technology stepping into the new era, space oral medicine has been put under the spotlight. This article will review the historical events on this subject, summarize the newly progress especially on craniomaxillofacial bone, tooth-derived stem cell and oral microbiology researches and still put forward future prospect.
Aerospace Medicine ; Biomedical Research ; Humans ; Mouth Diseases ; Oral Medicine ; Stem Cells ; Weightlessness

OBJECTIVETo explore the clinical effects of negative pressure wound therapy (NPWT) combined with artificial dermis grafting and autologous skin grafting on repair of open joint wounds and/or wounds with exposed bone fracture.

METHODSEleven patients with open joint wounds and/or wounds with exposed bone fracture, hospitalized from November 2008 to November 2014, were enrolled in the study. According to the differences of the first stage treatment, all patients were divided into experimental group ( n = 6, including 4 patients of open joint wounds, 1 patient of wound with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture), and control group ( n 5, including 2 patients of open joint wounds, 2 patients of wounds with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture). After debridement, the wounds in both groups were grafted with punctured artificial dermis, while NPWT was only used over the artificial dermis of experiment group for 1 week. In the operation at sacsod stage, autologous split-thickness skin was grafted on the vascularized artificial dermis in both groups. Results In 5 patients of open joint wounds in experimental group, the artificial dermis was vascularized well, autologous skin grafts survived, and wounds were healed. In 3 patients of open joint wounds in control group, the artificial dermis grafting all failed due to local infection, and then these wounds were repaired with local tissue flap grafting. Artificial dermis in 3 patients of wounds with exposed bone fracture in both groups was vascularized well after grafting, and the wounds were healed after autologous skin grafting, whether or not NPWT was used.

CONCLUSIONSNPWT combined with artificial dermis grafting and autolognus skin grafting can be used for repairing open joint wounds and/or wounds with exposed bone fracture.

Debridement ; Dermis ; transplantation ; Humans ; Negative-Pressure Wound Therapy ; methods ; Skin Transplantation ; methods ; Skin, Artificial ; Surgical Flaps ; Wound Healing

Objective To investigate the effect of metformin ( MET) on learning and memory behavior in HFD-induced insulin-resistant rats.Methods Thirty male Sprague-Dawley (SD) rats were divided into three groups to receive either a normal diet (Control group) or a high-fat diet (two HFD groups) for four weeks(HFD+MET).From two HFD groups, one received vehicle ( HFD group ) alone and other MET administration ( HFD+MET group ) .MET was dissolved in drinking water at a concentration of 2 mg/ml.All rats were subjected to the glucose tolerance test ( GTT) and behavioral tests using the elevated plus maze ( EPM ) , open field test ( OFT ) , Morris water maze ( MWM ) test and the step-through passive avoidance test ( PA) after four-week consecutive MET treatment .Blood samples were collected for determination of glucose. Results MET attenuated the glucose resistant condition and improved cognitive behavior in MWM and PA, vs the HFD group. Conclusion MET can improve the impaired learning and memory behavior in HFD-induced insulin-resistant rats.