Objective: To explore characteristics and influencing factors for blood pressure variability (BPV) in aged patients with H type hypertension.Methods: A total of 100 patients with essential hypertension, who were treated in our hospital from Dec 2012 to Dec 2013, were selected.According to serum level of homocysteine (Hcy), patients were divided into pure hypertension group (n=42, Hcy<15.4 μmol/L) and H type hypertension group (n=58, Hcy≥15.4 μmol/L).All patients received 24h ambulatory blood pressure monitoring (24hABPM), and BPV indexes were recorded and compared between two groups.Correlation among BPV indexes and general data were analyzed, and multi-factor linear regression analysis was used to analyze influencing factors for BPV indexes.Results: Compared with pure hypertension group, there were significant rise in 24h systolic blood pressure standard deviation [24hSSD, (12.80±2.23) vs.(16.01±3.11)], daytime SSD [dSSD, (11.58±2.30) vs.(13.86±2.26)] and nighttime SSD [nSSD, (9.41±1.64) vs.(11.71±2.34)] in H type hypertension group, P<0.05 or <0.01.Pearson correlation analysis indicated that Hcy, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were significantly positively correlated with 24SSD, dSSD and nSSD (r=0.201~0.508, P<0.05 or <0.01).Multivariate linear regression analysis indicated that Hcy and TC were significantly positively correlated with 24SSD, dSSD and nSSD (B=0.194~0.546, P<0.05 or <0.01).Conclusion: Systolic blood pressure variability in aged patients with H type hypertension is significantly higher than that of patients with pure hypertension,their serum Hcy level, TC elevating level are significantly positively correlated with systolic blood pressure variability and are major influencing factors for BPV in these patients.

Objective To analyze and compare the HBV DNA contents in serum and breast milk after injection of hepatitis B im‐munoglobulin (HBIG) in different periods of pregnant and lying‐in women to provide the experimental basis for blocking the mater‐nal‐neonatal transmission(PMTCT) and breast feeding scheme .Methods 140 pregnant women carrying hepatitis B virus with HB‐sAg(+ ) by antenatal examination in the obstetric outpatient department of our hospital from June 2012 to June 2014 were selected and divided into the research group and the control group according to the voluntary and secretive principle .Among them ,75 cases in the research group were intramuscularly injected by high titer HBIG 200 U at 28 ,32 ,36 weeks of pregnancy ,while 65 cases in the control group were injected by HBIG at the end of pregnancy due to different causes .Serum HBV‐DNA content before injection and before delivery was detected in the two groups ,and which in neonatal serum and breast milk within 3-5 d also detected .The differences and correlation between the two groups were analyzed .Results The HBV‐DNA content <500 copies/mL ,500-1 × 106 copies/mL ,>1 × 106 copies/mL before HBIG injection in the research group were 28 cases ,17 cases ,30 cases respectively ,which before delivery were 35 cases ,20 cases ,20 cases respectively ;which in antenatal twice detection in the control group were 19 cases , 21 cases ,25 cases and 20 cases ,17 cases ,28 cases respectively ;neonatal serum HBV‐DNA positive in the research group and control group had 1 case(5 .3% ) and 5 cases (7 .7% ) respectively ;the breast milk HBV‐DNA positive in the two groups had 3 cases(4% )/and 8 cases(12 .3% ) respectively .Conclusion HBIG injection at late pregnancy in the pregnant women carrying HBV could influ‐ence the HBV replication ,thus reduces the probability of neonatal intrauterine infection ,at the same time reduces the HBV‐DNA positive rate of postpartum breast milk .

Objective To investigate the effects of ischemia reperfusion on the morphological changes of sinoatrial node(SAN) cells in rabbits in vivo . Methods Ninety healthy adult rabbits were randomly divided into 3 groups with 10 rabbits in control and every subgroup: control group [a suture passed under the root section of right coronary artery(RCA) without ligation], ischemia group(occluding the root section of RCA for 10, 30, 60 and 120 min respectively), ischemia reperfusion group(10, 30, 60 and 120 min ischemia after respectively followed by 4 hours′ reperfusion). Results ① Compared with control group, abnormal structure of SAN cells was not seen in 10 min ischemia group and 10 min ischemia reperfusion group with light microscopy, except slight mitochondrial swelling of SAN cells in former group with electron microscopy. ② There were morphological changes of SAN cells in 7, 6 and 8 rabbits in 30, 60 and 120 min ischemia group, presenting mainly as cellular swelling, karyopyknosis, and focal necrosis under a light microscope, and mitochodrial swelling, cristae disorganization or break under an electron microscope. The most severe cellular damages were found in 120 min ischemia group. ③ In ischemia reperfusion group, there were morphological abnormalities of SAN cells in 6, 8 and 7 rabbits in 30, 60 and 120 min ischemia reperfusion groups. The morphologic changes were similar to those in ischemia group, but injury degree was more severe than that in ischemia group with the same ischemic time. Conclusion Ischemia and ischemia reperfusion can induce morphological changes of SAN cells in a time dependent manner in rabbits in vivo , and the injury degree is more severe in ischemia reperfusion group than that in ischemia group with the same ischemic time.

Evidence-based anesthesia’s core thinking is to abide by evidence,which means clinical decision must be based on objective research result,personal experiences and patients` actual situation. The thinking of EBA will magnificently promote the conversion of model of clinical anesthediology education,and will make significant influence on clinical teaching,scientific research, and clinical practice. According to the current situation,try to give out new teaching model of evidence-based practice of anesthesiology and offer teaching methods and practical procedures.

ObjectiveTo assess the impact of nutrition education on the outcomes and dietary intake during pregnancy.MethodsFrom January 2007 to December 2008,240 healthy pregnant outpatients were selected from Jining First People's Hospital.Subjects were randomly and equally divided into the intervention group and control group,and the intervention group received nutrition education till labor.Through the comparison of two groups,the impact of nutrition education on the outcomes and dietary intake was assessed.ResultsBirth weight of the newborn infauts was significantly lower in the intervention group than the control group( (3.15 ±0.81 )kg vs (3.33 ± 0.56)kg,t =2.04,P ＜ 0.05).Compared with the control group,the incidence rate of anemia was lower in the intervention group (45.8％ vs 59.8％,x2 =4.56,P ＜0.05).The intervention group had higher proportion of supplementation in iron,folic acid and compound vitamins (P ＜ 0.05).Significant differences were also observed in the frequency of intake fried food,pork,poultry,milk,soybean milk and fresh fruits (P ＜ 0.05).ConclusionNutrition education can improve the outcomes and dietary intake during pregnancy.

Objective To investigate the clinical experiment of arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis. Methods From January 2001 to April 2005, 6 patients (4 males and 2 females), with a mean age of 33 years old (range, 28 to 44 years old) and mean duration of 13 months, received arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator. All patients had received at least 3 weeks standard drug treatment for tuberculosis before the operation. After thoroughly debridement under arthroscopy using anterolateral and anteromedial approaches, a half-ring sulcated external fixator was used to fix the ankle joint at the neutral position. 4 days (2-7 days) after the operation, patients could walk with partially weight bearing. All patients replied to our questionnaire and the average follow-up was 21.3 months, with a range of 6-42 months. Patients returned for a clinical and radiolographic evaluation every week before the tibiotalar joints union. The external fixator apparatus were removed after the joint fused. Results Fusion occurred in all patients, the average time to clinical and radiographic union was 12.5 weeks (9-17 weeks). 3 patients were graded as excellent: no pain with a stable fusion. The others were graded as good: mild pain, occasional limp with a stable fusion. There were no sinus or other complications occurred. Conclusion There are considerable advantages using arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis without serious bone defect, include: limited invasion, quickly recovery, thoroughly debriding the tuberculose focus. And the half-ring sulcated external compression fixator could achieve stable and elastic fixation with adjustable rigidity. And patients can walk earlier to promote ankle fusion and decrease related complications.

Objective To evaluate preventive and therapeutic effects of low dose of unfractioned heparin on severe sepsis. Methods 52 Patients with severe sepsis hospitalized in Intensive Care Units were randomly divided into control group and heparin group. On the basis of conventional therapy, patients with sepsis were given low dose of unfractioned heparin or isovolume physiologic saline by continuous intravenous drip infusion over 5 days. Acute Physiologic and Chronic Healthy Evaluation (APACHE-Ⅱ) score, blood platelet count(BPC), prothrombin time(PT), activated partial thromboplastin time(aPTT), thrombin time(TT), plasma fibrinogen(FDP) and D-dimer levels were assessed on admission, 3rd, 5th day after intervention. Incidence of disseminated intravascular coagulation(DIC) and 28-day mortality between heparin group and control group were compared. Results There were no significant difference in APACHE-Ⅱ, BPC, PT, aPTT, TT, and FDP levels, incidence of DIC, and 28-day mortality between heparin group and control group. D-dimer levels in both groups decreased along with time. D-dimer levels on 5th day after treatment in heparin group was markedly decreased than that of control group(740?135?g/L vs 853?179?g/L, P

60 years senile autopsy cases w as about half of that of western countries,most of latent carcinomas were well a nd moderate differentiated.HGPIN was closely associated with prostatic adenocar cinoma.

Objective To explore the regularity of dynamic morphologic changes of the sinoatrial node (SAN) cells of rabbits after the constitution was damaged by formaldehyde wet dressing. Methods Sixty rabbits were randomly divided into 6 groups (n=10 in each group): the control group and 5 experimental groups observed at 2 h, 1, 2, 3, and 4 weeks respectively after the operation. The SAN constitution of rabbits was damaged by 20% formaldehyde wet dressing. The constitutions of SAN were cut quickly at 2 h after wet dressing in the control group and at the corresponding time points in other experimental groups respectively. The specimens were made for light microscopical and electron microscopical observations. The apoptosis of SAN cells was detected by TUNEL method. Results Compared with those in the control group, SAN cells in all experimental groups were damaged at various degrees observed by light microscopy and electron microscopy. Distinct cell tumefaction, soak of grain cells, cytoclasis, hyperplasia of collagen fibers, and other pathological changes were detected. Electron microscopical observation showed distinct pathological changes of the super-micro construction of cells. Apoptosis was not detected in the control group, but various degrees of apoptosis in all experiment groups. The apoptotic rates in all experimental groups were significant as compared with that in the control group (P