Objective To observe the effects of hyperbaric oxygen (HBO) on the apoptosis expression of intestinal mucosa during the different periods of ischemia-reperfusion injury in order to elucidate the underlying mechanisms. Method Rats were subjected to ischemia for 60 min by clamping superior mesenteric artery, and then had reperfusion for 60 min by unclamping. Rats were randomly divided into four groups: ischemia-reperfusion group (I/R), pre-emptive HBO or HBO treatment before ischemia (HBO-P) group, HBO treatment during ischemia period (HBO-I) group, and HBO treatment during reperfusion (HBO-R) group. After reperfusion for 60 min, samples of small intestine tissue were taken from the end portion of ileum for detecting the levels of ATP by using colorimetric method and the levels of caspase-3 by using immunochemistry. The levels of TNF-α in intestinal tissue were measured by using enzyme-linked immunosorbent assay method ( ELISA). All values were expressed in Mean ± Standard Deviation (x ± s). The different groups were compared among them with SNK- q test of OneWay analysis of variance (One-Way ANOVA plus SNK). Results The levels of TNF-α in HBO-I group were significantly lower than that in HBO-P group ( P ＜ 0.05), and significantly lower in HBO-P group than those in HBO-R or I/R groups ( P ＜ 0.05), and there was no significant difference in TNF-α between HBO-R and I/R group ( P ＞ 0.05). The levels of caspase-3 were significantly lower in HBO-I group than those in HBO-P group ( P ＜ 0. 05), and also significantly lower in HBO-P group than those in I/R or HBO-R groups ( P ＜ O. 05), and no significant difference caspase-3 was found between HBO-R and I/R groups. The ATP levels were significantly lower in HBO-I group than those in HBO- P group ( P ＜ 0. 05), and also significantly lower in HBO- P group than those in I/R or HBO-R group ( P ＜ 0.05), and no significant difference in ATP level between in HBO-R and I/R group. Conclusions There was a connection between HBO and small intestinal I/R injury as well as mucosal cell apoptosis. And HBO maintained ATP and aerobic metabolism, and inhibited the genesis of TNF-α, and thus in turn prevented intestinal mucosa cell from apoptosis. The best result was obtained when HBO was administered during ischemia period, and there was no effect found when HBO was employed during reperfusion period.

Objective To explore whether the patients aged over 65 years with obstructive sleep apnea hypopnea syndrome (OSAHS) are able to tolerate continuous positive airway pressure (CPAP)while compared with patients aged less than 65 years.And to investigate the factors that affect compliance to CPAP in OSAHS patients.Methods A total of 147 OSAHS patients diagnosed with overnight polysomnography (PSG) were divided into two groups:≥65 years old group (n=46),<65 years old group (n = 101 ).Clinical data and PSG parameters were included in a computerized database.The pressure level of CPAP,the duration of respirator use were followed up.Results Compared with <65 years old group,there were higher prevalences of COPD (16% vs.4%,P=0.02),cardiovascular disease (23% vs.10%,P=0.04),apnea (43% vs.26%,P=0.03),regular alcohol consumption (61% vs.38%,P=0.007) and lower incidence of snoring (31% vs.54%,P= 0.03),shorter total sleeping time (378 min vs.423 min,P=0.001),longer wake after sleep onset periods (162 min vs.115 min,P=0.004),lower sleep efficiency (69% vs.77%,P<0.001),higher percentage of stage 1 sleep (29% vs.20%,P=0.001),lower percentage of stage 3-4 sleep (6% vs.9%,P=0.016) and rapid eye movement (REM) sleep (12% vs.15%,P=0.001) in ≥65 years old group.The percentages of acceptance to CPAP at 3 months,6 months,1 year,2 years and 3 years were 91%,89%,84%,82% and 82% respectively in ≥65 years old group,and were 92%,86%,81%,72% and 67% in <65 years old group.Average use time of CPAP were (5.1±1.5) h/night in ≥65 years old group,and were (3.9±1.2) h/night in <65 years old group (P=0.022).By analysis of multivariate logistic regression,a high pressure CPAP was associated with higher objective CPAP compliance in OSAHS patients.Conclusions Compliance to CPAP in older OSAHS patients is not decreased when compared to younger adults.A high CPAP pressure is the only significant independent predictor of better CPAP compliance.

Objective To investigate the pharrnacodynamics of compound Chuanxiong granules in treating dysmenorrhea.Methods The effects of compound Chuanxiong granules on uterus contraction,anti-inflammatory,analgesia and hemostasis were researched by rat's uterine smooth muscle contraction test in vivo,the level of prostaglandins F2α effect test,mice torsion model induced by oxytocin test,mice auricle swelling model induced by dimethylbenzene test,and the coagulation time of mice test.Results Compared wAth the model control group,Chuanxiong granules may obviously inhibit smooth muscle constriction resulted from oxytocin (the average inhibition ratio in high-dose group,middle-dose group and low-dose group were 32.3％,27.2％,17.6％),decline the levels ofprostaglandins F2 [the value in high-dose group,middle-does group and low-dose group was (79.2±4.3)rig/L,(79.3 ±12.9) ng/L and (88.2±7.6) ng/L] inhibit twist times of mice (the value in high-dose group,middle-does group and low-dose group was 39.4％,46.8％,24.8％),inhibit the auricular swelling of mice caused by dimethylbenzene [the value in high-dose group,middle-does group and low-dose group were(31.7±21.0)％,(35.6±33.7)％,(59.3±35.0)％],and shorten the coagulation time [thevalue in high-dose group,middle-does group and low-dose group was(41.1±9.7)s,(43.3±10.1)s,(50.5±10.8)s respectively].Conclusion Compound Chuanxiong granules is a effective agent to relieve dysmenorrhea.

Objective To explore the characteristics of clinical features,diagnosis,treatment and prognosis in acute fibrinous and organizing pneumonia (AFOP) patients.Methods We described an 80-year-old woman who was diagnosed with AFOP and got better after treatment with glucocorticoids.Clinical data of 51 patients which have been published in literatures in China and abroad were retrospectively analyzed.The differences in characteristics of clinical features were compared between the elderly and non-elderly patients.Results The case reported herein,who was a 80-year-old female with latent autoimmune diabetes in adults (LADA),presented with fever,dry cough and progressive dyspnea.Chest CT scan showed bilateral multiple patchy consolidation.CT-guided needle aspiration was performed and the pathological examination finding was consistent with AFOP.The patient was treated with oral methylprednisolone and experienced a significant improvement in symptoms and imaging manifestations.But she presented with deterioration with relapsing clinical symptoms when she discontinued corticosteroid treatment by herself,and the clinical symptoms were improved by retreatment.Clinical data of 51 reported cases with AFOP including 27 males and 24 females aged 38 d to 80 years were enrolled and analyzed in the study.Patients aged 60 years and over accounted for 47.1％ (24 cases).No risk or predisposing factor was found in most of cases.Autoimmune diseases were the most common combined diseases in AFOP patients.The top three symptoms were dyspnea (80.4％,41 cases),cough (64.7％,33 cases) and fever (52.9％,27 cases).The incidence of dyspnea was lower in elderly patients than in non-elderly patients [66.7％ (16/24) vs.92.6％ (25/27),P＜0.05],and ground glass opacity in the chest image was also less in elderly patients than in non-elderly patients (P＜0.05).15 patients (29.4％) got definitive diagnosis by minimally invasive procedures including percutaneous lung puncture biopsy or transbronchial lung biopsy.Corticosteroids were the main drug treatment,and 39 cases (76.5 ％) received antibacterial drugs.The mortality rate of AFOP was 37.3％ (15 cases).The average time from symptom onset to final diagnosis was shorter in dead cases than in recovered patients (19 days vs.40 days,P＜0.05).The rate of using mechanical ventilation was higher in dead cases than in recovered patients [57.9 ％ (11/19) vs.9.4％ (3/32),P＜0.05].Conclusions There are no specific clinical and imaging features in AFOP,which is easily misdiagnosed as infectious diseases.AFOP is more common in elderly patients.Dyspnea and other symptoms can easily be ignored,and minimally invasive biopsy and pathological examination findings is helpful for diagnosis.The mortality rate of AFOP is high,and insufficient course of therapy is associated with the increased risk of AFOP relapse.Rapid progression of disease and the invasive mechanical ventilation predispose poor outcomes.

Objective To investigate the clinical features of glucose transporter 1 deficiency syndrome(GLUT1-DS) and summarize the characteristics of GLUT1-DS through reviewing related references.Methods The clinical data including manifestation,cerebrospinal fluid (CSF) glucose,electroencephalogram,MRI and gene mutation of a patient with GLUT1-DS was collected and the related literatures were reviewed.Results The patient was a 6 years old boy.The patient,whose seizures occurred at the age of 9 month-old and prolonged to 6 year-old,attacked before breakfast.Physical examination showed microcephaly with head circumference 47.5 cm.Laboratory tests showed that CSF glucose decreased (1.87 mmol/L) and CSF-serum ratio was 0.36.And meantime the MRI was normal and electroencephalogram showed general spike and slow wave complex paroxysm.Mutation of SLC2A1 gene,c.350_385del,was found in the patient.There were 219 cases with GLUT1-DS had been reported and the age of onset was 15.69 months.In 219 patients,159 cases (72％) suffered seizures,105 cases (47％) had motor abnormalities,61 cases (27％) suffered intellectual disability.The CSF glucose values were (1.92±0.31) mmol/L,CSF-serum ratio was 0.36±0.07.SLC2A1 gene mutations were detected in 183 patients(96％)in which missense mutation was the most mutation.Conclusion A wide range of phenotypes of GLUT1-DS include seizures,motor abnormalities,mental retardation.The diagnosis is confirmed when CSF glucose and CSF-serum ratio are continuously decreased which in the absence of meningitis.The SLC2A1 gene should be detected in suspicion of GLUTI-DS patients.Early diagnosis and treatment may improve the prognosis of those GLUTI-DS patients.

Objective To analyze the prevalence rate and risk factors for aspiration pneumonia in elderly inpatients,and to identify a high-risk population for aspiration pneumonia.Methods Totally 398 inpatients aged ≥ 60 years in Beijing Hospital from April 2014 to April 2015 were selected.A questionnaire survey was performed for aspiration risk factors,including gender,age,smoking and drinking history,swallowing function,basal diseases,medication history,activities of daily living(ADL),occurrence of aspiration pneumonia over the past year.The patients were divided into aspiration pneumonia group and non-aspiration pneumonia group,and the prevalence rate and risk factors for aspiration pneumonia were studied.Results 364 cases with complete data were collected,and 14.3％ (52/364)were identified definitively as aspiration pneumonia over the past year.The ADL score was (77.0± 33.9) scales in aspiration pneumonia group,and (88.0 ± 22.2) scales in non-aspiration pneumonia group,with statistically significant difference (P＜ 0.05).The incidence rate of aspiration pneumonia was increased along with the increase of the age of patients.Risk factors for aspiration pneumonia were different in different age group.The proportion of patients aged 60-69,70-79 and over 80 years were 23.1％ (12 cases),36.5％ (19 cases),40.4％ (23 cases)in the aspiration pneumonia group,respectively.Under the condition of a propensity score-matched case-control pair design on 104 subjects with versus without aspiration pneumonia,the logistic regression analysis showed that smoking history,coronary heart disease,Parkinson's disease,dementia,chronic obstructive pulmonary disease(COPD),gastro-esophageal reflux disease(GERD),long-term uses of theophylline,calcium antagonists,nitrates,diazepam,antidepressants,anti-Parkinson drugs were the risk factors for aspiration pneumonia in elderly(all P＜0.05).Conclusions Smoking history,basal diseases and medication history are associated with the incidence rate of aspiration pneumonia in elderly.Assessment of these risk factors for aspiration pneumonia should be emphasized,and preventive measures should be considered conscientiously to lower the incidence rate of aspiration pneumonia in elderly.

Objective To discuss the experience of using the new dressings in the treatment of refractory wounds in the department of orthopedics. Methods Wound care team gave the treatment and nursing to 7 cases of refractory wounds in the department of orthopedics, used the new type of wound dressings. Results Among 7 cases, 5 cases were cured and discharged. The granulation growth of the wound was good, and the wound was healed after the transfer surgery of the joint flap. One patient had reached the healing rate of 90% after discharging, and recovered after being followed up for 22 days. Conclusions The correct assessment of the wound, reasonable choice of the new dressing, a good job of anti-infection treatment and the skin protection around the wound can effectively promote healing of the refractory wound after fracture, reduce the cost of health care, and bring the satisfaction to the patients and their families.

Objective To investigate the effects of body-weight support treadmill training(BWSTT) on function of lower limbs.Methods 46 hemiplegic patients after stroke were randomly divided into the therapy group(n=23) and control group(n=23).The subjects of both groups were administered with standardized rehabilitation program.The therapy group was also given BWSTT in addition.Both groups were evaluated before and after treatment using Functional Ambulation Category(FAC),Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS).Results Before treatment,there was no significant difference between these 2 groups in terms of scores with FAC,FMA and BBS.After treatment,both groups were significantly improved regard to their scores with FAC,FMA and BBS(P<0.01),with the therapy group scored significantly better than the control group(P<0.01).Conclusion BWSTT can significantly improve walk ability and balance function of the hemiplegic patients after stroke.

Objective To study the risky factors related to postoperative mortality after surgical intervention for intra-ventricular hemorrhage (IVH).Methods The clinical data of 142 IVH patients aged from 19 to 86 years with 77 male and 65 female were collected from 2007 to 2010 for retrospective analysis with SPSS version 13.0 package.Multi-factorial Logistic regression analysis and mono-factorial x2 analysis were used to find out the risk factors related to post-operative death. Results Of 142 patients,48 (33.8％) died.Mono-factorial analysis demonstrated that the risk factors of death after surgical intervention to IVH were elderly age ( ＞ 65 years),history of hypertension,low GGS score,intra-ventricular diffuse bleeding,preoperative obstructive hydrocephalus and coagulation abnormality,postoperative central high pyrexia and central diabetes insipidus,postoperative hemorrhage of alimentary tract,pulmonary infection,and drainage after operation ≥7 days ( P ＜ 0.05 or P ＜ 0.01 ).Multi-factorial Logistic regression analysis,on the other hand,revealed the independent factors associated with postoperative IVH mortality were postoperative central high fever,preoperative obstructive hydrocephalus (P ＜ 0.01 ); drainage after operation ≥7 days,postoperative pulmonary infection,elderly age,low GCS score,intra-ventricular diffuse bleeding and history of hypertension ( P ＜ 0.05 ). Conclusions General condition of patients with IVH and CT findings are likely related to mortality,and active prevention against various complications is the crucial approach to lowering postoperative mortality and improving prognosis.