Objective To investigate the correlative factors for osteoporosis among senile patients with multiple cardiovascular diseases and type 2 diabetes mellitus.Methods 206 patients were divided into osteoporosis (OP) group and non-osteoporosis (non-OP) group according to the diagnosis standards of osteoporosis.The general data were recorded.Clinical history of all kinds of cardiovascular diseases and type 2 diabetes mellitus were detected.Serum levels of hemoglobin (Hb),glucose (Glu),glucosylated hemoglobin (HbA1c),alkaline phosphatase (ALP),total serum protein (TP),albumin (ALB),BUN,creatinine (Cr),calcium (Ca),phosphonium (P),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) were detected.Dual-energy Xray absorptiometry was used to detect the bone mineral density (BMD) of bilateral femoral neck and lumbar spine.The related factors of BMD were analyzed.Results The morbidity of osteoporosis was much higher in elderly females than in elderly males (58.7％ vs.38.6％).The osteoporosis patients were older than non-osteoporosis patients in both males and females,although there was no significant difference.The body mass index (BMI) of both gender was much lower in osteoporosis group than in non-osteoporosis group (P＜0.05).In male patients,BMD was positively correlated with BMI significantly (P＜0.01).In female patients,TC and LDL C were higher in OP group than in non-OP group (P＜0.05).In female patients,BMD was positively correlated with BMI,and negatively correlated with TC and LDL-C.Logistic regression analysis showed that the lower BMI was an independent risk factor for osteoporosis in male patients; BMI and TC were independent risk factors for osteoporosis in female patients.Conclusions In both male and female,senile patients with lower BMI,multiple cardiovascular diseases and type 2 diabetes mellitus have higher risks for osteoporosis.In senile female patients,TC may be correlated with BMD.TC should be reduced to decrease the risks of cardiovascular diseases and osteoporosisin senile females.

ObjectiveTo investigate the clinical features of patients with primary biliary cirrhosis (PBC) in China. MethodsThe reported articles about clinical analysis of patients with PBC in China were searched. The quality of included studies was critically evaluated. Meta-analysis was performed using RevMan 4.2 software about controlled trials. Results① Ninety-one literatures including 2315 patients wuth PBC were included. ②The common symptoms in PBC were fatigue (54.54％). AMA was found in 74.1％～100％ of patients with PBC, as well as the prevalence rate of anti-M2 range from 45％ to 83％. ANA antibodies present in 20％～83.78％ of patients, the most common antinuclear patterns were nuclear-envelope(38.65％).Increased levels of IgM [(2.8±0.7)～(7.3±5.1) g/L], IgG [(16.5±4.9)～(20.5±5.9) g/L] were found in these patients, and the most common liver histologic classification was type Ⅱ (36.6％). Sjogren's syndrome occured significantly more frequently in PBC (1.96％～34.61％). To the end of follow-up period (five months to nintysix months ), 3.80％ of patients were dead. ③ Meta-analysis performed in several case control studies, showed no significant differences was found in liver tests including of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotrans ferase (AST), total bilirubin (TBil), or gamma-glutamyltransferase (GGT), IgG levels between AMA positive groups and AMA negative groups. However, lower levels of IgM presented in the latter. While it also showed that levels of ALP decreased after ursodeoxycholic acid (UDCA)therapy. The levels of TBil were lower in the elderly than in younger group, but the mortality ratio for liver diseases was higher in the former. ConclusionThe clinical characteristics of the present series in China are mostly similar to those reported in other countries. Because of the low quality and the small number of included studies, larger sample-size, randomized, double-blinded controlled trials are needed.

Objective To investigate the effects of extractum trametes robiniphila murr combinated with hydroxyurea on proliferation and apoptosis of K562 cells and whether the 2 drugs have synergistic effects,and to detect the antiproliferation and apoptosis ratio of cells in diffe-rent groups were detected.Methods K562 cells were cultured in vitro,and logarithmic phase cells were used for study.MTT-inhibitory test and cell morphological analysis were employed to examine the effects of extractum trametes robiniphila murr alone or in combination with hydroxyurea on proliferation of K562 cells.The effects of extractum trametes robiniphila murr alone or in combinated with hydroxyurea on apoptosis of K562 cells were examined by flow cytometry.The expressions of bcr-abl,bax and bcl-xl mRNA levels were detected by way of reverse transcription polymerase chain reaction(RT-PCR).Results Extractum trametes robiniphila murr could inhibit proliferation and induce apoptosis of K562 cells,and extractum trametes robiniphila murr combinated with hydroxyurea had a synergistic effects on cell prolife-ration and apoptosis.The RT-PCR displayed that either extractum trametes robiniphila murr alone or in combinated with hydroxyurea could down-regulate the expression of bcl-xl mRNA and up-regulate the expression of bax mRNA and the effect of the 2 drugs had a synergistic effect on bcl-xl and bax mRNA expressions.Extractum trametes robiniphila murr alone could also down-regulate the expression of bcr-abl mRNA,but hydroxyurea alone did not show any effect on the expression of bcr-abl mRNA and the 2 drugs had no synergistic effect.Conclusions The effect of extractum trametes robiniphila murr combinated with hydroxyurea on the proliferation and apoptosis of K562 cells has a synergistic effect.The mechanism of antiproliferation and inducing apoptosis of extractum trametes robiniphila murr is probably related to down-regulating the expression of bcl-xl and bcr-abl mRNA and up-regulating the expression of bax mRNA.The synergistic effect of antiproliferation and inducing apoptosis of extractum trametes robiniphila murr combinated with hydroxyurea on K562 cells is probably related to down-regulating the expression of bcl-xl mRNA and up-regulating the expression of bax mRNA.

Background and purpose: Preemptive analgesia is one of the strategies to treat postoperative pain by preventing the establishment of central sensitization. This study was designed to explore whether the method of flurbiprofen axetil injection combined with bilateral cervical plexus nerve block in thyroid carcinoma surgery as multimodal preemptive analgesia can serve as a better analgesia. Methods: Sixty patients with thyroid carcinoma were randomly divided into three groups. Patients in Group A were treated with flurbiprofen axetil injection combined with bilateral cervical plexus nerve block as multimodal preemptive analgesia. Patients in Group B were anesthetized with bilateral cervical plexus nerve block. General anesthesia alone was used in patients of Group C. The onset time of nerve block, operation time, extubation time and dosage of fentanyl were recorded. The VAS (visual analogue scale) was used to evaluate the pain level, the side effects of drugs were also analyzed. Results: The onset time of nerve block in Group A, Group B were (7.47±1.04) min and (8.75±1.36) min, repectively (P<0.05). The dosage of fentanyl n Group A, B and C were (0.36±0.04) mg, (0.40±0.06) mg and (0.45±0.07) mg, respectively (Group A vs Group B P<0.05; Group A vs Group C, P<0.01).VAS scores of patients in Group C were higher than both Group A and B at 4,8 h after operation. Moreover, patients in Group B got higher VAS scores than that of Group A at 8 h. The side effects of both Group A and B were much less serious than that of Group C. Conclusion: Flurbiprofen axetil injection combined with bilateral cervical plexus nerve block as multimodal preemptive analgesia during thyroid carcinoma surgery can supply better analgesia and opioid-sparing effects, with less side effects.

The paper uses computer multimedia technology to collect and switch audio and video signals, constructs the remote High Definition ( HD) surgery demonstration system which supports live broadcast, recorded broadcast, rebroadcast and video-on-demand depending on the network communication routing technology.It introduces functions, design scheme and composition of the system and points out that the system can realize HD video transmission and video talkback between the surgery scene and the classroom.Thus, tech-nical level of clinical surgery teaching can be enhanced.

ObjectiveTo evaluate arterial stiffness and its influencing factors in the elderly patients with hypertension and (or) type 2 diabetes mellitus.MethodsTotally 320 elderly patients were divided into four groups: control,diabetes mellitus,hypertension,coexisting hypertension and diabetes mellitus.Arterial stiffness in ankle and brachial artery was determined by brachial-ankle pulse wave velocity (baPWV).Other factors affecting baPWV were also collected and measured,including age,body mass index (BMI),sex,smoking,blood pressure,pulse pressure,mean arterial pressure,serum fasting blood glucose,lipid profile,glycosylated hemoglobin and hypersensitive C-reactive protein (hsCRP).ResultsbaPWV in the four groups were ( 1667.2 ± 279.3 )cm/s,(2158.6 ±386.9)cm/s,(1881.2±383.8) cm/s and (2165.9± 479.9)cm/s,respectively.The baPWV value was higher in groups of hypertension,diabetes mellitus,and the coexisting diseases than in controls (F=8.473,P＜0.05).Diabctic patients had a higher baPWV levels than those without diabetes.There was no difference in baPWV levels between diabetic patients with or without hypertension.Pulse pressure and hsCRP were higher in coexisting diseases group than in control group (P＜0.05).Stepwise backward regression analysis showed that fasting blood glucose,pulse pressure,mean blood pressure,hsCRP and low density lipoprotein cholesterin (LDL-C) were positively related to baPWV P ＜0.05). ConclusionsHypertension and (or) type 2 diabetes mellitus are important influencing factors for higher arterial stiffness. Hyperglycemia might play more important role in the elderly arterial stiffness.Serum fasting blood glucose,pulse pressure,mean blood pressure,hsCRP,LDL-C may be the independent risk factors of arterial stiffness.

Objective To analyze retrospectively the correlation between the difficult airway and thyromental height by three-dimensional reconstruction among the Chinese. Methods Eithty patients who had been scanned by helical CT in the head and neck were allocated into two groups according to Cormack-Lehane grading:paients with Ⅰ-Ⅱ grade were allocated into group 1, and paients with Ⅲgrade were allocated into group 2. Reconstructed images were obtained by AW4.4 workstation and the following parameters were recorded and analyzed:the length from the oral to the under jaw(a), the length from the under jaw to the skin of the neck (b), the vertical distance from the under jaw to the neck was equal to thyromental height(c), the vertical distance from the oral to the cervical vertebra(d), the angle with the under jaw as the vertices and with two lines (a and b) for edge (angle ofα). Results The c value in two groups had no significant difference:(3.97 ± 0.82) cm vs. (3.64 ± 0.62) cm, P>0.05. The d value in group 2 was significantly higher than that in group 1:(8.69 ± 0.48) cm vs. (8.25 ± 0.80) cm, P<0.05. The c/d value and c/a value in group 2 were significantly lower than those in group 1: 0.42 ± 0.07 vs. 0.48 ± 0.12, 0.80 ± 0.18 vs. 0.95 ± 0.25, P<0.05. Conclusions Thyromental height by three-dimensional reconstruction has no significant differences in evaluating the difficult airway among the Chinese. The ratio of the vertical distance from the under jaw to the neck and the vertical distance from the oral to the cervical vertebra, and the ratio of the vertical distance from the under jaw to the neck and the length from the oral to the under jaw shows negative correlation with difficult airway.

Background:Myopathy due to smooth muscle cells( SMC)abnormalities is involved in the pathogenesis of diabetic gastroparesis(DGP),however,the relationship between myopathy and advanced glycation end products(AGEs)is not fully clarified. Aims:To investigate the ultrastructural changes of gastric SMC in patients with diabetes mellitus( DM)and the relationship between expressions of contractile proteins and AGEs. Methods:Full-thickness gastric specimens from 30 gastric neoplasm patients undergoing gastrectomy from July 2012 to December 2012 at the First Affiliated Hospital with Nanjing Medical University were collected. Of them 15 patients had DM( DM group)and the other 15 patients without ( control group). Ultrastructure of SMC was observed by transmission electron microscopy. Expressions of three contractile proteins[ myosin heavy chains( MHC),α-actin and calponin]and Nε-carboxymethyllysine( CML),the key component of AGEs in gastric muscular layer were determined by Western blotting,and expressions of MHC,α-actin and calponin mRNA were determined by real-time PCR. Correlations of mRNA expressions of three contractile proteins with protein expression of CML were analyzed by Pearson correlation coefficient. Results:In DM group,significant ultrastructural changes were found in gastric SMC,including disruption of gap junction,swelling of mitochondria,occurring of lipofuscin in cytoplasm,increase in cell membrane alveolae,and thickening of basal lamina. Protein and mRNA expressions of muscular MHC,α-actin and calponin were significantly lower in DM group than in control group(P all ﹤0. 01),while protein expression of CML was significantly higher in DM group(P ﹤0. 01). In gastric muscular layer of DM group, negative correlations were found between expressions of MHC,calponin mRNA and CML protein(r= -0. 59,P=0. 02;r= -0. 63,P=0. 01),but no correlation was seen between α-actin mRNA and CML protein(r= -0. 49,P=0. 06). Conclusions:Disruption of SMC ultrastructure,decrease in contractile proteins and increase in AGEs are existed in gastric muscular layer of DM patients,and there is a negative correlation between contractile proteins and AGEs. These changes may cause impaired contractility of SMC,and subsequently lead to gastric motility disorders in diabetic patients.

Objective To investigate the effect of one-time anti reflux multi-function drainage bag in clinical application.Methods A total of 125 cases of benign prostate hyperplasis (BPH) were treated with transurethral resection of prostate (TURP) from October 2012 to March 2013 at our hospital of uropoiesis surgical department.All the cases were randomly divided into the control group (63 cases) and the experimental group(62 cases).The three cavities balloon catheter was connected with common drainage bag in the control group,and with one-time anti-reflux multi-function drainage bag in the experimental group.The urine in catheters and drainage bag of 3,5,7 days postoperatively in two groups was sampled for urine culture.The cases of daily urine tube plugging and daily drainage bag reflux in two groups were observed respectively.Results The cases of bacilluria significantly reduced in catheters of the experimental group compared with the control group and the drainage bag of the experimental group,respectively.The cases of bacilluria was significantly reduced in drainage bag compared with the control group.The cases of drainage bag reflux was significantly reduced compared with the control group.The cases of bacilluria in catheter and drainage bag had no significant difference in the control group.The cases of catheter plugging had no significant difference between two groups.Conclusions One-time anti reflux multi-function urine drainage bag can effectively prevent bacteria and reflux,and make the drainage system in a closed state.It has obvious advantage to prevent the happening of the retrograde infection compared with the common drainage bag.

AIM　The relation between lung collagen,lung elastin and anti-oxidative capacity was investigated in the experiment, and the aging model of mice was induced by D-galactose. METHOD　The aging mice treated with cistanche desertica polysacchrides (50,100 mg*kg-1*d-1) and determinate the modification of SOD、GSH-Px、Vit E、MDA in blood and lung. RESULTS　Cistanche desertica polysacchrides (CDP), which was isolated from Cistanche desertica cultivated in Xinjiang could enhance lung anti-oxidative capacity and inhibit the modification of lung elatic constitution induced by D-galactose. CONCLUSION　Cistanche desertica polysacchrides have anti-oxidative injury and anti-aging effects on lung.