Aged ; Asphyxia ; etiology ; mortality ; Female ; Humans ; Vocal Cord Paralysis ; complications ; mortality

Objective To evaluate the efficacy and safety of tropisetron for the prevention of postoperative nausea and vomi -ting (PONV) after general anesthesia .Methods We searched the PubMed ,EBSCO ,Cochrane ,CNKI and Weipu database to identi-fy randomized controlled trials (RCT ) about tropisetron in preventing PONV after general anesthesia .The methodological quality of the included RCT was assessed and data were extracted .The meta-analyses were performed by Rev Man5 .0 software .Results A total of 18 RCT met the inclusion criteria ,involving 2 901 patients .All RCT were randomized double-blind experiments .The results of meta-analyses showed that :(1)tropisetron could significantly decrease the incidence of PONV after general anesthesia ,[OR =0 .43 ,95% CI(0 .33 - 0 .57)] ,the efficacy in later period [OR = 0 .41 ,95% CI(0 .25 - 0 .65)] was better than that in earlier period [OR = 0 .66 ,95% CI(0 .44 - 0 .98)] ;(2)compared with tropisetron ,the combination of tropisetron and dexamethasone could signifi-cantly decrease the incidence of PONV [OR = 0 .37 ,95% CI(0 .22 - 0 .64)] ;(3)compared with granisetron or ondansetron ,tropise-tron could not significantly decrease the incidence of PONV ,the OR was [OR = 1 .08 ,95% CI(0 .68 - 1 .73)] and [OR = 0 .77 ,95%CI(0 .27 - 2 .21)] respectively ;(4)compared with dexamethasone ,tropisetron could not significantly decrease the incidence of PONV [OR = 1 .06 ,95% CI(0 .49 - 2 .30)] .Conclusion Tropisetron can significantly decrease the incidence of PONV after general anesthesia .It has also the advantage of decreasing incidence of the incidence of PONV combined with other non-5 HT-3 receptor in-hibitor such as dexamethasone .

Objective: To study the efficacy of purging the lung and removing phlegm and blood stasis method(泻肺化痰祛瘀法) on animal model of pulmonary hypertension induced by monocrotaline and explore its mechanism.Methods: The model of pulmonary hypertension induced by monocrotaline was established in rats.Sixty healthy and clean male Wistar rats were randomly divided into normal control group,model group,low and high dosage of traditional Chinese medicine(TCM) drugs for purging the lung and removing phlegm and blood stasis groups.From the 15 th day after model establishment,two dosage groups were treated with the drugs in the prescription containing the main ingredients as follows: 9 g prepared rhubarb(制大黄),(2 g)(prepared)(euphorbia) kansui(炙甘遂),15 g lepidium apetalum(葶苈子),9 g ligusticum(川芎) and 15 g(scutellaria)(黄芩) infused into the stomach once a day for 7 days.Normal control group and model group were given normal saline infused into the stomach.Mean right ventricular pressure(MRVP) and the mean(pulmonary) artery pressure(MPAP) of rats were measured by right cardiac catheterization,and the(pathological)(changes) of lung tissues were detected by hematoxylin and eosin(HE) stained sections.(Results:) The MRVP and the MPAP in high dosage group((13.37?4.22)mm Hg and(12.26?2.79) mm Hg,(1 mm Hg)=(0.133 kPa)) were lower than that in the model group((16.27?2.27) mm Hg and(14.77?(2.39) mm Hg),P

Objective To investigate the feasibility and effects of modified Stoppa approach in treatment of anterior pelvic ring fractures.Methods The therapeutic effects of 21 patients with anterior pelvic ring fractures treated through the modified Stoppa approach from June 2008 to August 2011 were summarized and analyzed.According to Tile classification,there were seven patients with type A2 fractures,six with type B2 fractures,five type B3 fractures and three type C2 fractures.Surgical treatment through the modified Stoppa approach included anterior pelvic ring plates for 14 patients,anterior pelvic ring plates and external fixators for four and anterior pelvic ring plates and sacroiliac joint compressed cannulated screws for three.The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively.Results The incision length of the modified Stoppa approach ranged from 10 to 12 cm ( average,11 cm).The operation time ranged from 70 to 120 minutes ( average,95 minutes).The intra-operative blood loss ranged from 400 to 1 000 ml (average,700 ml ).According to the Matta criteria,all 21 patients obtained sound reduction,of whom 15 patients had bony union after 8-20 months follow-up post-operatively.The Majeed score in all patients showed a gradual increase postoperatively.Conclusions The modified Stoppa approach is characterized by convenience and directness in making incisions,clear operation field,easy reduction,few complications and fast recovery and hence is an ideal choice in surgical treatment of anterior pelvic ring fractures.

Objective To evaluate the mitochondrial function of chondrocytes in Kashin-Beck disease (KBD) patients and its correlation with age.Methods Mitochondrial function was evaluated by analyzing the activities of respiratory chain enzyme complexes and citrate synthase (CS),intracellular adenosine triphosphate (ATP)contents, changes in mitochondrial membrane potential (ΔΨm),as well as the intracellular reactive oxygen species (ROS) contents.Correlation of mitodhondrial function and age was analyzed with linear regression.Results Activities of complexes Ⅱ (P = 0.001 ),Ⅲ (P = 0.005 )and Ⅳ (P = 0.005 )were reduced in KBD articular chondrocytes compared with cells from normal controls.However,the mitochondrial mass was increased in KBD samples. Cultured KBD chondrocytes had reduced cellular ATP level (P = 0.001 )and mitochondrial membrane potential (P =0.001),but increased citrate synthase activity (P =0.04)and intracellular ROS level (P <0.001).We found no correlation between mitochondrial function and donor age either in normal or in KBD chondrocytes. Conclusion Mitochondrial function is altered in articular chondrocytes of KBD,and no correlation was found between mitochondrial function and donor age.

Objective To investigate the NAD+ - dependent protein deacetylase SIRT1 expression in the cochlea of C57BL/6 mice ,a mouse model of age - related hearing loss(AHL) .Methods A total of 46 C57BL/6 mice were used ,and were divided into 2 groups ;according the age ,there were young group (1 ~ 2 months old ,23 mice) and old group (12 ~ 16 months old ,23 mice) .ABR measurements were performed on young and old C57BL/6 mice . The expression of SIRT1 in the cochlea was detected by qRT - PCR and immunofluorescence .Results The ABR thresholds in the old mice(4 kHz :82 .7 ± 7 .32 dB SPL ,8 kHz :80 .9 ± 7 .8 dB SPL ,16 kHz :89 .3 ± 5 .5 dB SPL ,32 kHz :89 .9 ± 4 dB SPL) were significantly higher than those in the young C57BL/6 mice(4 kHz :52 .1 ± 8 .3 dB SPL ,8 kHz :40 .5 ± 6 .1 dB SPL ,16 kHz :50 .7 ± 9 .4 dB SPL ,32 kHz :57 .6 ± 11 .9 dB SPL)(P < 0 .001) .SIRT1 mRNA expression was significantly decreased in the cochlea of old C57BL/6 mice in comparison with young mice ( P <0 .01) .SIRT1 protein was abundantly expressed in the inner hair cells ,outer hair cells ,supporting cells ,strial marginal cells ,strial intermediated cells ,and spiral ganglion neurons .The positive area and the average flourescence intensity of SIRT1 protein were reduced in old C57BL/6 mice(P< 0 .001) .Conclusion The down - regulation of SIRT1 mRNA and protein expression in the older C57BL/6 mouse cochlea may be correlated with the pathogenesis of AHL .

Objective To evaluate the feasibility of contrast material on image quality of coronary CT angiography (CCTA)by using double injection technology and iterative reconstruction.Methods 120 patients with suspected coronary heart disease who underwent CCTA were randomly divided into two groups.Then,60 patients with 30 kg/m2>BMI≥25 kg/m2 were averagely divided into A1 and B1 groups,and other 60 ones with BMI<25 kg/m2 were also averagely divided into A2 and B2 groups.The patients in group A were scanned with 120 kV tube output and iolromide 350 mg I/mL,and the images were reconstructed using filtered back projection (FBP).Meanwhile,the patients in group B were scanned with 80 kV or 100 kV tube output and 245 mg I/mL or 280 mg I/mL of contrast media (BMI≥25 kg/m2 )using double injection technology,and the images were reconstructed using adaptive iterative dose reduction 3D (AIDR 3D).The effective radiation dose (ED)of each patient was also calculated.CT attenuation of the main proximal vessels (ascending or descending aorta,pulmonary artery,RCA,LM,LAD and LCX)and the obj ective image quality (SD,CNR and SNR)were measured,and the subj ective evaluation was also assessed by an experienced radiologist.Results There was significant differences in mean image quality scores,SD,SNR and CNR of ascending aorta between group A1 and B1(P<0.05),but no difference in the SI of values (P>0.05).There was no significant difference in mean image quality scores between group A2 and B2 (P>0.05), however,there were significant differences in the SI,SD of values and SNR,CNR of ascending aorta (P<0.05).The values of BMI were negatively related to the values of CT in ascending aorta between two subgroups (r=-0.66 and -0.441,P<0.05).The values of weight were not related to the values of CT in ascending aorta (P>0.05).There was significant difference in effective dose between subgroups (P<0.05).Conclusion The method with a combination of iterative reconstruction and a contrast material of 245 mg I/mL using double inj ection technology can improve the contrast enhancement without impairing image quality.

Objective To prepare a redox-responsive doxorubicin-loaded nanoparticle,and to study its in vitro realease behavior and targeting effect on heptoma cells.Methods Cystamine was grafted on the side chains of hyaluronic acid with 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride/N-hydroxysuccinimide catalyst,and then β-cyclodextrin (β-CD) was conjugated on the amine groups of the cystamine by Schiff's base reaction to prepare β-CD modified hyaluronic acid (HACD).The HACD/DOX nanoparticles were prepared by encapsulating DOX into HACD using dialysis method.The drug loading,encapsulation efficiency,particle size and distribution,zeta potential and other physical and chemical properties,as well as in vitro drug release behavior of the HACD/DOX nanoparticles were characterized.The cytotoxicity of HACD/DOX nanoparticles to HepG2 cells was studied by cell counting kit-8 (CCK-8) method.The targeting effect of HACD/DOX nanoparticles on HepG2 cells was studied using flow cytometry and confocal laser scanning microscopy (CLSM).Results HACD were successfully synthesized,which could carry DOX to form uniform homogeneous nanoparticles.The drug loading of DOX in the nanoparticles was (16.1±0.2)％ and the encapsulation efficiency was (64.2±0.9)％.The transmission electron microscope images indicated that the shape of the HACD/DOX nanoparticles was homogeneous sphere.The results of granularity analysis showed that the average size of the HACD/DOX nanoparticles was (203.1 ±2.5) nm with a narrow size distribution (PDI =0.202).The zeta potential of the HACD/DOX nanoparticles was (-29.1±0.8) mV.The in vitro release behavior of the nanoparticles exhibited obvious redox-sensitivity.The results of in vitro cytotoxicity showed that the blank carrier material HACD had no obvious toxicity to hepatoma cells,and the HACD/DOX nanoparticles could effectively kill hepatoma cells with the 0.38 μg/ml half maximal inhibitory concentration (IC50) value at 48 h.Flow cytometry and CLSM results demonstrated that the HACD/DOX nanoparticles could target hepatoma cells through the mediating effect of hyaluronic acid.Conclusions The prepared HACD/DOX nanoparticles have suitable particle size,high drug loading and encapsulation efficiency,and can release DOX under the stimulation of reducing agent.These nanoparticles have obvious targeting effect on hepatoma cells,which is expected to be applied as the drug delivery system of hepatocellular carcinoma (HCC) therapy.

Objective To analysis the difference of lymph node cleaning and operative complication rate between thoracoscope surgery and routine thoracotomy on patients with thoracic segment esophageal cancer.Methods A summary of 62 patients with thoracic segment esophageal cancer in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from August 2012 to August 2014,who were carried with thoracoscope surgery,were randomly chosed and designed as the thoracosc0Pe group,and 62 patients with thoracic segment esophageal cancer over the same period,carried out with routine thoracotomy,were designed as the control group.All the clinical data of the two groups were collected.The total of thoracic lymph node cleaned and the group of thoracic lymph node cleaned were compared between the two groups.The operation time,intraoperative blood loss,chest tube placement time and postoperative hospital duration were collected and compared.All the patients were followed up at least for one year.The incidence of postoperative complications such as pulmonary infection,pneumothorax,atelectasis,recurrent laryngeal nerve injury and anastomotic leakage in the follow-up period were compared.The follow-up time,mortality and recurrence rate were compared.Results The total of thoracic lymph node cleaned(13.36±3.28) and the group of thoracic lymph node cleaned(3.35±0.84) in the thoracoscope group were lower then these of the control group ((14.22± 2.78) and (3.58±0.75)),but with no statistical difference (t =1.57,1.61,P＞ 0.05).The operation time of the thoracoscope group((314.63±38.72) min) were higher then that of the control((217.46±41.54) min),and the intraoperative blood loss ((205.73 ± 114.38) ml),chest tube placement time ((6.83 ± 1.92) d) and postoperative hospital duration((18.47±5.36) d) of the thoracoscope group were remarkably lower then these of the control ((345.72 ±175.62) m1,(10.04±2.41) d,(22.65±6.84) d,t=13.47,5.26,8.20,3.79,P＜0.05).The incidence of pulmonary infection (4.8％ (3/62)) and atelectasis (1.6％ (1/62)) of the thoracoscope group,were evidently lower then these of the control (17.7％ (11/62),1.3％ (7/62),x2 =5.15,4.81,P＜0.05).There was no significant difference in mortality and recurrence ratebetween the two groups during the follow-up period (3.2％ (2/62) vs.8.1％ (5/62),11.3％ (7/62) vs.14.5％ (9/62),x2 =1.36,0.29,P＞0.05).Conclusion There are no significant difference inlymph node cleaning between thoracoscope surgery and routine thoracotomy on patients with thoracic segment esophageal cancer,but thoracoscope surgery can shorten the length of hospital duration,reduce the intraoperative blood loss,chest tube placement time and postoperative complications.So the thoracoscope surgery is a safe and feasible operation for patients with thoracic segment esophageal cancer.