Objective To investigate the relationship between postoperative cognitive dysfunc-tion and plasma cortisol levels in aged patients undergoing total hip replacement surgery. Methods Ninety patients aged 65-75 years old,scheduled for total hip replacement surgery under general anesthesia were enrolled in the present study.Cognitive state was tested by mini-mental state examination (MMSE).The patients were divided into two groups,POCD group and non-POCD group.Perioperative plasma levels of cortisol were determined on 2 d preoperative,2 d postoperative and 7 d postoperative.Results Incidence of POCD after 7 d in aged patients undergoing total hip re-placement surgery was 37.8%.Compared with day 2 d preoperative,plasma cortisol levels in POCD patients significantly increased on 2 d and 7 d post operation (P <0.01 or P <0.05).Compared with non-POCD patients,cortisol levels on the 2 d and 7 d postoperative day significantly increased in POCD patients (P <0.05).Plasma cortisol levels showed a negative correlation with MMSE scores on postoperative 2 d and 7 d(P <0.01).Conclusion Elderly patients have a relatively higher incidence of POCD after hip replacement surgery.POCD may be caused by high plasma cortisol levels in elderly patients following hip replacement surgery under general anesthesia.

Objective: To explore the risk factors for heart failure (HF) occurrence in patients with inferior or combining right ventricular myocardial infarction (MI).
Methods: A total of 143 patients with inferior or combining right ventricular myocardial infarction (MI) in our hospital from 2013-01 to 2015-06 were studied. Based on HF occurrence, the patients were divided into 2 groups:HF group, n=81 and Non-HF group, n=62. The risk factors related to HF occurrence as age, gender and hypertension were retrospectively studied and compared between 2 groups.
Results: Compared with Non-HF group, HF group had more patients with hypertension, female gender, higher blood levels of Hs-CRP and creatinine, more volume of lfuid input on the 3rd day of admission and the higher ratio of V4-6 ST segment depression in ECG; while obviously lower diastolic blood pressure (DBP) at admission. Multivariate Logistic regression analysis indicated that hypertension (OR=3.275, 95% CI 1.220-8.793), female gender (OR=13.236, 95% CI 3.476-50.405), Hs-CRP (OR=1.029, 95%CI 1.005-1.070), low DBP at admission (OR=0.945, 95%CI 0.911-0.979), serum creatinine (OR=1.053, 95%CI 1.029-1.078) and V4-6 ST segment depression in ECG (OR=4.118, 95%CI 1.395-12.154) were positively related to HF occurrence in relevant patients.
Conclusion: The incidence of HF has been relatively high in patients with inferior or combining right ventricular MI;hypertension, female gender, low DBP at admission, blood level of Hs-CRP, serum creatinine, V4-6 ST segment depression in ECG were the independent risk factor for HR occurrence.

Objective To optimize a W/O microemulsion formulation of troxerutin and evaluate its physical properties such as morphology, droplet size, stability and content of troxerutin. Methods The W/O microemulsion was optimized using a pseudoternary phase diagram and the area of the microemulsion region was used to screen and determine microemulsion components.HPLC assay was used for determination of the loading content. Results The optimal formulation contained lecithin, ethanol, isopropyl myristate and water (23.30:11.67:52.45:12.59).The microemulsion was physicochemically stable with round shape and uniform size, and the mean droplet size was about 50. 20 nm. Conclusion Microemulsion was developed successfully.It will expect to be the new preparation for troxerutin.

Objective To study the different expressions of neurotensin (NT) at gene and protein level in orthotopic model of prostate cancer . Methods The animal models of androgen dependent prostate cancer(ADPC,castrated for 3 days) and androgen independent prostate cancer(AIPC) were established by planting tumor tissue or undergoing surgical castra-tion. Affymetrix microarray technology was carried out to compare the gene expressions of NT. The result was verified by qRT-PCR. HE staining was used to observe the change of pathology. ELSIA and immunohistochemistry technology were fi-nally performed to detect protein expression of prostate-specific antigen(PSA) and NT in three different groups of prostate cancer tumor tissues. Results The expression of NT was 5.10 times higher in AIPC group than that in ADPC group. The ex-pression of NT was 0.33 times lower in castrated 3-day group than that in ADPC group. Results of RT-PCR and qRT-PCR showed that the expression levels of NT gene were 1.41 and 7.27 times respectively higher in AIPC group than that in ADPC group,but the expression levels of NT gene were 0.78 and 0.46 times respectively lower in castrated 3-day group than that in ADPC group (P<0.05). HE results showed that nuclear atypia and tumor structure in three groups. Immunohistochemistry and ELISA results showed that the values of PSA and NT were (0.48±0.03) and (0.031±0.008)μg/L in ADPC group;(0.17± 0.03) and (0.021±0.004)μg/L in castrated 3-day group,and (0.87±0.02) and (0.042±0.010)μg/L in AIPC group. There were significantly lower expressions of NT and PSA in castrated 3-day group that those of ADPC group (P<0.01). Conclusion In the transition from ADPC to AIPC, the over-expression of NT suggested that NT may be associated with prostate cancer progression. NT may be used as a new therapeutic target and specific diagnostic method of AIPC.

Objective To develop a special stool collector for paraplegic patients with constipation,and to observe the clinical effects. Methods 52 paraplegic patients with constipation were divided into group A(30 cases) and group B(22 cases ).Group A used type one stool collector and goup B chose type two stool collector. The time of dealing with defecation, exposure time, pollution area, the usage of urinal pad, toilet paper, clean water before and after the special toilets were observed between the two groups. Results Each indicator significantly changed after using two types of stool collectors in the two groups of patients and above were significantly decreased. Conclusions The special stool collector for the paraplegic patients with constipation can effectively avoid the soakage of the anal and buttocks skin, reduce the environment pollution of the odor, reduce labor intensity and lower care costs.

Aim To study the characteristics of the binding reaction of Troxetutin with bovine serum albumin (BSA) by fluorescence and ultra violet-visible absorption spectra.Methods The quenching mechanism of the fluorescence of BSA by troxerutin was studied with fluorescence.To determine the dynamic quenching constants and static binding constants,the Stern-Volmer equation and the double reciprocal Lineweaver-Burk equation were applied. The number of binding site was calculated with double logarithmic equation and the main binding force was discussed by thermodynamic equations. The binding distance and energy transfer efficiency between donor (BSA) and acceptor (troxerutin) were obtained effectively quenched fluorescence of BSA via static quenching processes. The binding constant Ka was calculated to be in the order of 106,indicating a strong interaction between Troxerutin and BSA. The number of binding site was approximately equal to 1,the binding distance was 1.97 nm,the energy transfer efficiency was 0.529,and the binding force was mainly hydrophobic force.Conclusion Troxerutin effectively quenchs the intrinsic fluorescence of BSA via static quenching mechanism,and the binding is mainly driven by the hydrophobic interaction.

BACKGROUND: The water molecules and biological macromolecules in human tissue may combine to form hydrate composite. Different types of macromolecules show different approaches to combine with water molecules. OBJECTIVE: To discuss the basic form of water molecules combined with biological macromolecules. METHODS: The theoretical hypothesis of texture composite hydration system was proposed. The relevant literatures were retrieved through the computer to discuss these issues. RESULTS AND CONCLUSION: According to the role of water in the hydrate composite, the composite ways can be divided into the following 4 groups. ①Surfaca composite: Hydrated membrane layers can form on the surface of globular protein or DNA molecules. The hydrated membrane layer shows that the speed of water molecular and hydrate density were reduced gradually from surface to inside. The hydrated layer makes the shape and physical state of the macromolecules stabilized, and it plays important role in forming of TCHS.②Swelling composite: As a result of the strong hydration of glycosaminoglycans, the hydrated proteoglycan often swells and shows high viscosity and hydrogel character. The hydrated proteoglycan play some mechanicalroles in connective tissue. For example, it can make the cartilage have a strong deformation-resistibility.③Hydrophobic composite: Hydr0phobic effect drives structural rearrangement, including the formation of bilayers (Bio-membrane). This hydrophilic-hydrophobic-hydrophilic "sandwich" structure is conducive to the self-stability in mechanics, combination with membrane protein and transmembrane transport. ④Slit composite: A lot of slit spaces with nano scale were existing inside and outside of the cells. Aqueous solution in the slit spaces shows some abnormal characters such as higher viscosity and lower ice point, because of the rearrangement of water molecules. Slit composite and surface composite have some universality, and it can be regarded the former as a special case of the latter. The classification way mentioned above has not any absolute connotations. However, the rational utilization of these hydration composite ways will be conducive to research the theory on textural composite hydrate system.

Objective To examine mycological profile of eryptococcal meningitis in patients with non-acquired immune deficiency syndrome (AIDS) during treatment and follow-up so that to support clinical therapy. Methods Data of 28 cuhure-confirmed cryptoeoccal meningitis patients with non-AIDS were retrospectively analyzed. Fungat smear, count, culture and latex agglutination test of cerebrospinal fluid (CSF) were done during treatment and follow-up. Initial treatment included intravenous amphotericin B plus oral flucytosine or f;uconazole for at least 6 weeks, and consolidation treatment included oral fluconazole and (or) itraeonazole for at least 2 months. All 28 patients were cured. The data were analyzed by rank-sum test. Results The positive rate of CSF fungal smear was 92.9% before treatment and gradually decreased, and the fungal count was significantly reduced over time after treatment. While fungal smears of some patients were still positive after initial treatment. Fungal growth time in culture was gradually extended, and fungal culture turned to be negative in all patients after 2 weeks of treatment. The positive rate of latex agglutination test of CSF was 100%. Cryptococcal antigen titer decreased steadily after treatment, which was not correlated with the decrease of fungal count. Conclusion Mycological tests of patients with eryptococcal meningitis should be interpreted comprehensively during treatment, and result of each test should be specifically analyzed.

ObjectiveTo discuss the characters and management of renal lymphangiectasia.MethodsThe clinical data of two cases of renal lymphangiectasia were reviewed. The first patient was a 37-year-old woman with the chief complaint of lumbago in the right flank for 8 days.B-ultrasound showed mixed echo in perinephric space. On CT, similar appearances of fluid collections were seen, but not conspicuous. Conservative treatment was taken for three weeks and the symptoms were relieved. Three month later the patient had right lumbago relapse. CT scan revealed a large amount of fluid collection under the capsule of the right kidney. Percutaneous drainage was carried out. Two months later B-ultrasound showed fluid collection in perinephric space and percutaneous drainage again the fluid was sent to pathology. The second case was a 32-year-old woman with the chief complaint of lumbago in the left flank for the past three years. Ultrasonography revealed hyperechoic surrounding the left kidney. CT scan showed a left perinephric collection of fluid attenuation and circumferentially draping around the kidney. Renal lymphangioma was diagnosed and the patient underwent surgery.ResultsNeedle aspiration of the perinephric fluid was carried out, and laboratory analysis showed most leucocytes were lymphocytes. The pathologic diagnosis of the first case was renal lymphangiectasia. There was no recurrence during follow - up of two months. The second case was diagnosed renal lymphangioma pathologically. Follow - up for nine years, revealed no relapse.ConclusionsUltrasonography and CT contributed to the diagnosis of renal lymphangiectasia. Needle aspiration bioposy and histology could confirm it. Treatment of asymptomatic cases is not required. When collections are very large and cause symptoms, percutaneous drainage may be carried out however there is a risk of relapse.

Objective To assess the feasibility and clinical efficiency of laparoscopic Madigan enucleation of the prostate for the treatment of benign prostatic hyperplasia (BPH) with large prostate.Methods From Nov.2008 to Jan.2010,24 eases of BPH patients with large prostate ( ＞90 g) were treated in our institute by laparoscopic Madigan enucleation.The average patient's age was 65.2 yrs,the average prostate weight were 132.3 ± 21.9 g,preoperative residual urine was 143.2 ± 23.2 ml,average IPSS was 28.6 ± 3.8,average QOL was 5.5 ± 2.4 and average MFR was 5.4 ± 2.3 ml/s.All patients accepted the laparoscopic Madigan enucleation of the prostate.The pre-surgery and three months post-operative IPSS,QOL,and MFR were compared and analyzed.Results All 24 patients successfully completed the surgery.The resected prostate tissue weight was 104.7 ± 23.3 g,blood loss was 112.5 ± 47.8 ml,postoperative hospital stay was 3.5 ± 0.8 d,bladder irrigation time was 1.3 ± 0.9 d,drainage time was 2.3 ± 0.5 d and catheterization time was 3.1 ±0.4 d.Three months after surgery,patient's IPSS was 4.5 ± 1.8,QOL was 19.9 ±3.1,and MFR was 18.5 ±2.9 ml/s.All the parameters significantly improved compared with the pre-surgery data ( P ＜ 0.05 ).Conclusions Laparoscopic Madigan enucleation of the prostate is a safe and effective method in the treatment of BPH with large prostate volume.