Vitamin D deficiency is common among the elderly,which may be an important pathogenic factor in Alzheimer's disease(AD).Vitamin D has multiple functions including immune regulation,anti-oxidation,regulation of neurotrophic factors/acetylcholine neurotransmitters,and clearance of amyloid beta peptide; meanwhile,it may be helpful to avoid hyperparathyroidism.Vitamin D supplementation among the elderly may prevent the loss of neurons and slow down the AD-related cognitive decline,and therefore may play a role in the multi-targeted therapies for AD.

Four cases of primary malignant fibrous histiocytoma of the thorax, arising from the mediastinum, trachea, esophagus and lung respectively are reported. Primary malignant fibrous histiocytoma is rare in those regions, but more commonly in deep fascia and skeletal muscles of the extremities and in the retroperitoneum. It is a distinct form of sarcoma and has been considered to be of primitive mesenchy-mal cell origin. Most of the tumors contain both fibroblast-like and histiocyte-like cells; some contain pleomorphic giant cells and inflammatory celts. They are often confused with other sarcomas. It is impossible to make correct diagnosis preoperatively. Excision is the treatment of choice for malignant fibrous histiocytoma. Radiation and chemotherapy appear to be useful adjuncts to surgical therapy.

Objective To investigate the relationship between preoperative anemia,low albumin,low body mass index and the prognosis of advanced gastric cancer.Methods Three hundred and seventeen patients diagnosed with advanced gastric cancer as well as complete clinical pathology data from January 2006 to January 2008 were retrospectively analyzed.The clinical pathologic factors including age,gender,tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth,lymph nodes metastasis.The single factor and multiple factors were analyzed.Results Tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth and lymph node metastasis were identified as influencing factors of the prognosis,while independent factors associated with the prognosis of gastric cancer were serum albumin (OR =1.546,95％ CI:1.069-2.237),infiltration depth (OR =1.933,95％ CI:1.182-3.162) and lymph nodes metastasis (OR =1.586,95％ CI:1.358-1.853).Conclusion Anemia and low body mass index are the influence factors but not the independent factors in the prognosis of gastric cancer,while low albumin concentration is the independent factor in the prognosis of gastric cancer.

[Objective]To analyze the early diagnosis and treatment of the popliteal artery injury associated with the dislocation and fracture of the knee.[Method]A total of 71 cases of popliteal artery injury associated with the dislocation and fracture of the knee were treated from March 1998 to May 2005.Properative(vascular examization) and operative(methods of arterial repair,venous repair-ligation,anticoagulation-thrombolytic therapy,fracture reduction and internal fixation,fasciotomy) treatment were studied.[Result]Totally 15 cases were primary amputation and 56 cases were performed vascular repair and the fractures and dislocations were reduced and fixed by internal or external fixation.Two cases had thrombosis at the repaired site confirmed by Doppler and had to perform second operation to remove thrombus and repair the popliteal by autograft of the saphena magna vein.At the follow-up,2 cases had chronic osteomyelitis and 2 cases had traumatic arthritis.[Conclusion]It is postulated that a rational and prompt diagnosis and treatment of popliteal artery injury associated with dislocation and fracture around the knee would decrease the adverse effects of ischemia and reduce the overall morbidity.

Objective To observe the therapeutic effect of injection of consciousness promoted drug through carotid artery on persistent vegetate state (PVS).Methods33 PVS cases were divided into the treatment group (n=15) and control group (n=18). All patients were treated with routine therapy, but the treatment group added with injection of consciousness-promoted drug through the carotid artery. The therapeutic effects of two groups were evaluated.ResultsAfter the treatment, the therapeutic effects of patients in two groups were better than that of before treatment (P<0.05), and the treatment group was better than control group(P<0.05).ConclusionInjection of consciousness-promoted drug through the carotid artery is effective to PVS patients.

10.3969/j.issn.2095-4344.2013.25.007

Objective To evaluate nasal carriage and antimicrobial resistance of bacteria in health care workers (HCWs)in an intensive care unit (ICU),and provide basis for making prevention and control measures of health-care-associated infection(HAI).Methods From April 2014 to March 2015,nasal swabs from HCWs in ICU were collected,carriage and antimicrobial resistance of bacteria were detected.Results A total of 450 nasal swab speci-mens were taken,137 strains were isolated,isolation rate was 30.44%.There were no significant difference in na-sal carriage rates of bacteria in HCWs with different genders,ages,types of work,length of service,and education-al level (P >0.05);nasal carriage rates in HCWs at different seasons were significantly different (P <0.05 ).82 strains (59.85%)were gram-negative bacteria,the major were Klebsiella pneumoniae (21 .16%)and Enterobacter aerogenes (18.98%);55 strains (40.15% )were gram-positive bacteria,the major were Staphylococcus aureus (18.98%)and Staphylococcus epidermidis (15.33%).38 (27.74% )strains were multidrug-resistant strains. 7.69% (2/26)of Staphylococcus aureus were methicillin-resistant strains,3.45%(1/29)of Klebsiella pneumoniae and 3.85%(1/26)of Enterobacter aerogenes were imipenem-resistant strains.Conclusion Nasal carriage rate of bac-teria and detection rate of multidrug-resistant organisms in HCWs in ICU is high.

Objective To study the mechanism of analgesic effects of the iontophoresis of aconitine on the rat with adjuvant arthritis. Methods Forty-five Wistar rats were randomly divided into a normal control group, a model group and a therapy group, with 15 rats in each group. The model of rat adjuvant arthritis(AA) was induced by injection of complete Freud′s adjuvant(0.1 ml) into the right ankle joint of the rats. The brain stem, hypothalami and local inflammation tissue of rats in the 3 groups were obtained after 1, 5 and 10 days of treatment, respectively. The concentrations of 5-HT, NE, ?-EP in brain stem, hypothalami and local inflammation tissue were detected with high performance liquid chromatography (HPLC) and radioimmunoassay (RIA). Results It was shown that the 5-HT content in the inflammatory tissues was not significantly different from that in the model group after 1 day of treatment, but significantly lower than that in the model group after 5 to 10 days of treatment (P0.05). After 5 to 10 days of treatment, the brain stem NE content in the therapy group was significantly higher than that in the model group(P

Objective To explore the expression and significance of Dickkopf-1 (Dkk-1) and cell lymphoma/leukemia-2 (Bcl-2) protein in sinonasal squamoucell carcinoma(SNSCC) .MethodThe immunohistochemical SP method and Western blomethod were adopted to determine the expression of Dkk-1 and Bcl-2 in 30 specimenof SNSC(SNSCgroup) ,38 specimenof sinonasal inverted papillomas(SNIP group) and 20 specimenof middle turbinate mucosa(control group) .ResultThe expression of DKK-1 protein in the SNSCgroup wasignificantly down-regulated compared with the SNIP group and the control group ,while the expression of Bcl-2 protein in the SNSCgroup wasignificantly up-regulated compared with the SNIP group and the control group;in the SNSCgroup ,the positive rateof DKK-1 protein and Bcl-2 protein in the high and middle differentiation group and the low differentiation group were 100 .00% ,68 .75% ,33 .33% and 50 .00% ,62 .50% ,100 .00% respectively ,the differencewere statistically significan(P＜0 .05) .Conclusion Dkk-1 protein may play an importanpromoting role in the developmenand pro-gression procesof SNSC,the expression of Dkk-1 protein hanegative correlation with the expression of Bcl-2 protein in SNSC,which may become new targespoof SNSCgene therapy .

Objective To investigate the efficacy and safety of tranexamic acid on bleeding in rheumatoid arthritis (RA) patients undergoing total hip arthroplasty (THA). Methods A retrospective study was performed in 197 RA patients (Steinbrock?er III-IV) following primary unilateral THA from June 2012 to June 2014. The patients were divided to three groups based on the regimen of tranexamic acid:68 patients received a single intravenous dosage of 15 mg/kg tranexamic acid 20 min prior to opera?tion (single dose group);74 patients received an intravenous dosage of 15 mg/kg preoperatively and a second dosage of 10 mg/kg 3 hours postoperatively (repeated dose group);the other 55 patients didn't receive tranexamic acid (control group). The primary out?comes were total blood loss, transfusion rate, the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE). The sec?ondary outcomes were postoperative drainage, hemoglobin (Hb) drop on third day postoperatively and other wound related compli?cations. Results There was less total blood loss (816.80 ± 245.09 ml vs 975.15 ± 216.33 ml vs 1 295.68 ± 263.85 ml), drainage (221.60 ± 70.05 ml vs 337.20 ± 113.10 ml vs 479.74 ± 120.66 ml), transfusion requirement (5.41%vs 10.29%vs 25.45%) and Hb drop (2.71±0.74 g/dl vs 3.18±0.62 g/dl vs 3.83±0.70 g/dl) in experimental group when compared with control group. And the effect was better in repeated dose group, with less total blood loss (816.80 ± 245.09 ml), less transfusion requirement (5.41%) and less postoperative drainage (221.60±70.05 ml). No episode of DVT or PE occurred in either group. There were 8 wound complications in single dose group, 6 in repeated group, and 8 in control group, and there were no statistically difference. Conclusion Intrave?nous administration of tranexamic acid was effective and safe on decreasing blood loss and transfusion requirement in RA patients following THA. Compared with a single dosage of tranexamic acid preoperatively, a second dosage of tranexamic acid 3 hours post?operatively was recommended.