Objective To provide evidences for fall prevention through environmental safety assessment of elderly patients admitted in different grade hospitals. Methods 24 different levels hospitals located in 10 cities in southwest of China were surveyed with assessment form of fall-related factors of hospital environment for elderly patients. Results Hospital public environment and ward public environment were assessed well by elderly patients which were 4.10 points and 4.06 points, but the scores for ground channel environment and toilet environment were lower which were 3.92 points and 3.65 points;Scores of tertiary-class hospitals were better than that in second-class hospitals, including ward facilities (t=-2.756, P<0.01), bathroom facilities (t=-3.752, P<0.01), public ward environment (t=-2.438, P<0.05) and public hospital environment (t=-2.263, P<0.05). As the ground-channel was concerned, there was no statistically significant different between them (P>0.05). Conclusions Public hospital environment and public ward environment got higher scores, and the scores of ground-channel environment and the bathroom environment were relatively lower. Environment in second-class hospitals need to improve in order to prevent fall of elderly patients. Assessment form of fall-related factors of hospital environment for elderly patients is helpful to disclose the unsafety factors of the hospital environment, and should be windely used in futher clinical practice.

The tumor metastasis is the major cause of the death of cancer patients.S-100A4 is a member of the S100 family of calcium-binding proteins and has been categorized as a metastasis-associated protein.S-100A4 is a candidate as a molecular marker for metastatic potential with high prognostic significance.An increase in S-100A4 protein expression has been correlated with poor prognosis of patients with breast,colorectal,gallbladder,bladder,esophageal,nonsmall-cell lung,gastric,medulloblastoma,pancreatic and hepatocellular cancers.The overexpression of S-100A4 protein can induce the increase of invasion and mobility of the tumor cells.It has been considered that S-100A4 is secreted by the tumor and stroma cells as a regulator of tumor metastasis.S-100A4 can regulate the progress of cell cycle,change cell adhesion,cell mobility and increase the survival ability of the tumor cells.

Objective According to the clinical imaging for mycoplasma pneumoniae pneumonia,lung CT imaging features of mycoplasma pneumoniae pneumonia were summarized in children.Methods The CT findings and clinical features of 66 patients were retrospectively reviewed(average age was 7 years with 30 males and 36 females) with confirmed pneumoniae pneumonia.The CT images were analyzed by two experienced pulmonologists.Results The most common finding in the mycoplasma pneumoniae pneumonia group was bronchial wall thickening with 69.9％,air bronchogram up 65.1％,over all age groups there was no significant difference;ground-glass-like changes up to15.1％,scattered patchy shadows up to 45.5％,more common in infants; lung consolidation accounted for 48.4％, tree bud accounted for 34.8％,the above results more common in older children.Conclusions Mycoplasma pneumoniae pneumonia HRCT imaging features include:bronchial wall thickening inflatable, the tree bud tree fog sign,ground glass-like changes,scattered patchy shadows,dense coalescent consolidation,and lung CT may improve the early diagnosis of mycoplasma pneumonia.

Objective To study the expression of estrogen receptor beta in the lung tissue of mice treaded with B[a]p alone or combined with estrogen (17 ?-estradiol, E2) in female Kunming strain mice and to explore the effect of estrogen in the lung cancer of mice induced by benzo[a]pyrene (B[a]P). Methods One hundred and twenty-five female Kunming mice were randomly divided into 5 groups: normal control group was group 1 ;group 2 was treated with subcutaneous injection of estrogen ( 900 ?g/kg); group 3 was given B[a]P(75 ?mol/kg) by gavage;the last two groups were given the same dosage of B[a]P (75 ?mol/kg)plus two different dosage of estrogen: 900 ?g/kg and 300 ?g/kg. After 8 weeks,there was a recovery period of 8 weeks. Then, the lung tissue was obtained by surgical resection. The expression of estrogen receptor-? gene and estrogen receptor-? protein of the lung tissue was detected by real-time PCR and Western blotting technology respectively. Results The expression of estrogen receptor-? protein and estrogen receptor-? gene in the B[a]P group and the B[a]P plus low dosage estrogen group was significantly higher than the normal group (P

Objective To explore the clinical characteristics,pathogens,inflammatory biomarkers,therapeutic methods and prognosis of necrotizing pneumonia (NP) in children.Methods The clinical data of children with NP who were admitted to the Department of Pediatrics of Shengjing Hospital of China Medical University from October 2010 to October 2015 were collected.The data included demographic data,laboratory test results,intrapulmonary complications,therapeutic methods and so on were analyzed,retrospectively.Results Forty-nine pediatric patients with NP were enrolled,31 cases were boys,18 cases were girls;the average age of the patients were 2.5 years (4 months-13 years).The average febrile time were (15.08 ± 5.92) d,and the hospital stay was (21.19 ± 10.83) d,respectively.The median value of peripheral blood leukocyte count was 17.7 × 109/L,the average of neutrophils ratio was (67.62 ± 18.52)％,and the median value of C-reactive protein (CRP) and procalcitonin (PCT) was 97.9 mg/L and 0.54 μg/L,respectively.Nineteen cases had Mycoplasma pneumoniae (MP) infection,16 cases with pneumonia chlamydia infection,9 cases complicated with MP and chlamydia pneumoniae infection,and 8 cases with positive bacterial culture,and 10 cases suffered from the intrapulmonary complications.Forty-seven cases got better prognosis with the treatment of antibiotics,glucocorticoids,intravenous immunoglobulin and other comprehensive therapeutic methods such as bronchoalveolar lavage with fiber bronchoscope and closed thoracic drainage.Conclusions NP is a severe complication of community-acquired pneumonia in children,and the occurrence of NP should be alerted in the children who have persistent high fever,higher inflammatory index and pleural effusion,but the great majority of patients do recover fully after comprehensive treatment.

Objective To compare the risk of tumor invasion and metastasis under paravertebral block (PVB) combined with general anesthesia versus general anesthesia in the patients undergoing radical resection for lung cancer performed via video-assisted thoracoscope in terms of plasma concentrations of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9).Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 30-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective radical resection for lung cancer performed via video-assisted thoracoscope,were randomly divided into 2 groups (n =20 each) using a random number table:general anesthesia group (group G) and PVB combined with general anesthesia (group PG).PVB of T4-7 was performed successfully with local injection of 0.375％ ropivacaine 5 ml before induction of anesthesia.Double-lumen endotracheal tube was placed after induction of anesthesia,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 1％-2％),and intravenous infusion of remifentanil 0.2-0.3 μg · kg-1 · min-1,and intermittent intravenous boluses of atracurium.Before anesthesia and at 24 h after surgery,the venous blood samples were collected for measurement of plasma concentrations of VEGF and MMP-9.Results The plasma VEGF and MMP-9 concentrations were significantly lower after surgery in group PG than in group G.Conclusion PVB combined with general anesthesia significantly decreases the risk of tumor invasion and metastasis in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope in comparison to general anesthesia.

Objective To investigate the effect of transcutaneous electric acupoint stimulation (TEAS)of Hegu-Neiguan-Houxi-Zhigou for preventing postoperative nausea and vomiting (PONV) in patients undergoing thoracoscopic lobectomy.Methods Sixty-four ASA physical status Ⅰ-Ⅲ pa-tients,aged 18-75 years,scheduled for elective thoracoscopic lobectomy were enrolled.Patients were randomly allocated into two groups (n =32):TEAS group (group E)and sham TEAS group (group C).TEAS at Hegu,Neiguan,Houxi and Zhigou was applied to patients before,during and after sur-gery in group E.The frequency was 2/100 Hz and the intensity was 2 times the threshold of sensation before and after surgery,and 30 mA during surgery.While sham TEAS with the intensity of sensory threshold was given to patients before and after surgery in group C.Patients in both groups received sufentanil,propofol and rocuronium for induction of anesthesia.Target controlled infusion of propofol and remifentanil was administered for maintenance of anesthesia.Patient-controlled intravenous anal-gesia (PCIA)was applied in both groups.No antiemetic was given to patients before and during sur-gery.Frequency of nausea or vomiting and any use of antiemetic for remediation were recorded after surgery.The postoperative Visual Analogue Scale (VAS)score and analgesic dosage were also docu-mented.Results Compared to group C,the incidence of nausea immediately after surgery,6 h after surgery,24 h after surgery and 48 h after surgery were significantly lower in group E.The incidence of vomiting 24 h after surgery was significantly lower in group E.The VAS score 6h and 24 h after surgery were significantly lower in group E.The analgesic dosage 48 h after surgery were reduced in group E.There were no significant differences regarding the use of antiemetic for remediation between the two groups.Conclusion TEAS at Hegu-Neiguan-Houxi-Zhigou is effective for preventing PONV in patients undergoing thoracoscopic lobectomy.

OBJECTIVE:To study the impacts of Zishenyutai pills on the ovarian tissue oxidative damage and Nrf2 protein ex-pression in rats exposed by electromagnetic radiation (EMR). METHODS:Accordiny to their weight,30 SD rats were randomly divided into normal group,radiated group and radiated-treated group with 10 rats in each group. Normal group were not radiated, and other 2 groups were exposed by 900 MHz radiation for 4 h every day;radiated-treated group was given Zishenyutai pills sus-pension [0.25 g intragstrically(medicinal materials)/ml] after radiation;normal group and radiated group were given constant vol-ume of normal saline intragastrically for consecutive 20 d. The rats were killed when they were at the estrum. The Nrf2 proteins ex-pression of ovary were detected by immunohistochemical method,the content of ovary MDA(malondialdehyde),and activity of to-tal superoxide dismutase (T-SOD) and superoxide dismutase (GSH-Px) were detected by biochemical method. RESULTS:Com-pared with the rats in normal group,the Nrf2 protein expression was higher in the rats of the radiated group;the content of ovary MDA was higher and activity of ovary T-SOD and GSH-Px were lower significantly(P<0.05). While compared with the rats in ra-diated group,the Nrf2 protein expression didn’t obviously change in the rats of the radiated-treated group(P>0.05),the content of ovary MDA was lower and activity of ovary T-SOD and GSH-Px were higher significantly (P<0.05). CONCLUSIONS:Zish-enyutai pills can prevent and cure ovary tissue oxidative injury induced by 900 MHz radiation,but have no effect on the expression of Nrf2 protein.

ObjectiveTo determine the correlation of real-time contrast-enhanced ultrasonography (CEUS) patterns and quantitative parameters with microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of breast tumors.Methods One hundred and five patients with 128 breast lesions(62 benign,66 malignant) underwent CEUS examination.CEUS patterns were analyzed and parameters were obtained by time-intensity curve analysis software.Immunohistochemical staining using anti-factor CD34 was performed to evaluated the MVD and VEGF expression was detected.Results All CEUS patternsweresignificantlyassociatedwithMVDandVEGFexpressionexceptboundary characteristics( P ＜ 0.05).The enhancement parameters showed that the time to peak was significantly faster in malignant tumors than that in benign lesions,and the peak intensity and area under the curve were significantly higher in malignant tumors than those in benign lesions( P ＜0.05).The time to peak,the peak intensity,area under the time-intensity curve were statistically correlated with MVD (P ＜0.05),the highest correlation was between the area and MVD( r =0.81,P ＜0.001).Only the area under the timeintensity curve was significantly associated with VEGF expression (P ＜ 0.05).Conclusions CEUS patterns and parameters of breast lesions are closely correlated with MVD,which can be used to evaluated the angiogenesis in breast tumors.

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.