Objective To evaluate the susceptibility to toenail fungal infection (FI) in the elderly. Methods Two hundred patients with toenail FI aged 60 years or older from 2005 to 2007 in our hospital were collected in our study, including one hundred elderly patients with toenail fungal infection (case group) and one hundred elderly patients without toenail fungal infection (control group). The clinical data of the patients in two groups were analysed. Results In case group, diabetes mellitus was the most common complication, accounting for 24% (24/100), while there were only 6 cases with diabetes mellitus (6%) in control group (P<0. 05). In case versus control group, there were 31 cases vs 12 cases with lower extremity varicose vein (P<0. 05), and 36 cases vs 19 cases with foot deformity, 11 cases vs 3 cases with toenail onychomychosis following trauma of their toes (P<0.05) ,32 cases vs 12 cases with history of wearing tight shoes (P<0. 05). In case group, 12 of 47 female patients used to wear high-heel shoes. Conclusions Toenail trauma, foot malformation, lower extremity varicose vein and diabetes mellitus are predisposing factors for toenail onychomycosis in the elderly.

Objective To analyze the clinical diagnosis and therapeutic effect of primary middle lobe lung cancer,in order to provide evidence for clinical diagnosis and treatment.Methods The clinical data of 45 cases of primary middle lobe lung cancer treated by surgery from January 2002 to January 2007 were ana- lyzed retrospectively.The operation style includes:simple middle lobectomy 12 cases(26.7 %),middle or up- per lobectomy 10 cases(22.2 %),right lung total resection 5 cases(11.1%).Chest exploration was done on 2 cases(4.44 %),palliative resection or vedged resection 2 cases(4.44 %).Results 1 case died from lung in- fection and respiratory failure(2.22 %).15 cases with arrhythmia (33.3 %), 1 case with chylothorax were cured after conservative treatment.The survival rate of 1,3,5 year were 82.1%,64.3 %,32.1% respectively. Conclusion The treatment of primary middle lobe lung cancer is dominated by regular lobectomy. It is difficult to perform middle lobectomy,so double or total lobectomy is done generally.Owing to the more postoperative complications, it should be cautious to perform sleeve resection.It should be avoided to do vedged resection for primary middle lobe lung cancer in order to lessen local recurrence.

Objective To investigate the expression and clinical significance of migration inhibitory factor ( MIF) and matrix metalloproteinase-9(MMP-9) in human gastric cancer tissue and corresponding adjacent normal tissue. Methods Selected surgery and pathologically confirmed 80 cases of gastric cancer as the experimental group, took another 80 cases of corresponding adjacent tissues as a control group. The expressions of MIF and MMP-9 were de-tected in 80 cases of gastric cancer patients cancer tissue and corresponding adjacent normal tissue by immunohisto-chemical SP method. Results ①The expression of MIF and MMP-9 of gastric cancer in varying degrees:The pos-itive rates of MIF and MMP-9 were 68. 8% and 67. 5%,which were higher than that in adjacent normal tissues, 32. 5% and 37.5% (P <0.05);② The expression of MIF was significantly associated with the clinical stage, depth of invasion,degree of differentiation,lymph node metastasis and TNM staging (P<0.05), nothing to do with other clinicopathological parameters;the expression of MMP-9 was significantly associated with the depth of inva-sion,degree of differentiation, lymph node metastasis and TNM staging (P<0.05), nothing to do with other clini-copathological parameters;③ There was positive correlation between the expression of MIF and MMP-9 in gastric cancer tissue (χ2 =9. 154, P<0. 01,r=0.338). Conclusion The expressions of MIF and MMP-9 show a posi-tive expression in gastric carcinoma, there maybe have a positive correlation between MIF and MMP-9. Their ex-pressions of varying degrees are closely related with the occurrence and development of gastric cancer, guidance gastric diagnosis, treatment and prognosis.

Objective To evaluate the clinical efficacy of 5-aminolevulinic acid-induced photodynamic therapy (ALA-PDT) in the treatment of condyloma acuminatum. Methods Thirty-six cases of condyloma acuminatum were treated with ALA-PDT. Results After the treatment, 33 (91.67%) patients were cured, 35 (97.22%) improved. Relapse occurred in 3 (8.33%) patients. Side effects were noted in 2 (5.56%) patients. Conclusions ALA-PDT is a relatively simple, effective and safe treatment with a lower recurrence rate for condyloma acuminatum, especially for small skin lesions or lesions at specific area. However, the high expense required for multiple treatments with ALA-PDT may restrict its application.

OBJECTIVETo evaluate therapeutic effects of Rigidfix cross pins combined with Intrafix pins for the reconstruction of anterior or posterior cruciate ligament under arthroscopy.

METHODSFrom January 2009 to June 2010,34 patients with anterior or posterior cruciate ligament injuries were divided into two groups : group A and group B. There were 24 patients in group A, including 19 males and 5 females,with an average age of (31.83±9.57) years old. The patients in group A were treated with anterior cruciate ligament reconstruction under arthroscopy; Rigidfix cross pins and Intrafix pins were used to fix femoral and tibial side respectively. Among the 10 patients in group B, 8 patients were male and 2 patients were female, with an average age of (27.20+7.59) years old. The patients in group B were treated with posterior cruciate ligament reconstruction under arthroscope; Intrafix pins and Rigidifix cross pins were used to fix femoral and tibial side sepectively. The drawer test and Lachaman test were used to evaluate postoperative knee stability. All the patients were followed up at least 18 months. Lysholm and Tegner knee scores were used to evaluate the clinical therapeutic effects.

RESULTSAll the 34 patients were followed up, and the duration ranged from 18 to 26 months,with an average of (20.79±2.39) months. All the patients obtained good pain relief and knee stability. In group A,Lysholm scores significantly increased from 43.04±7.57 preoperatively to 85.41±4.68, 92.50±3.05, and 93.45±2.57 at 6,12, and 18 months postoperatively; Tegner scores significantly increased from 2.62±0.92 preoperatively to 7.45±1.14, 8.58±0.77, and 8.95±0.55 at 6, 12, and 18 months postoperatively. In group B,Lysholm scores significantly increased from 46.20±8.27 preoperatively to 86.40±5.14,90.40±2.67,and 92.00±3.85 at 6,12,and 18 months postoperatively ;Tegner scores significantly increased from 2.00±0.66 preoperatively to 7.10±0.99, 8.60±0.84, and 8.80±0.42 at 6,12, and 18 months postoperatively. There were no differences in Lysholm and Tegner scores between group A and B at different times during follow-up. Lysholm scores of all patients significantly increased from 43.97±7.79 preoperatively to 85.70±4.76,91.88±3.06,and 93.02±3.01 at 6,12,and 18 months postoperatively. Tegner scores of all patients significantly increased from 2.44±0.89 preoperatively to 7.35±1.09, 8.58±0.78, and 8.91±0.51 at 6,12,and 18 months postoperatively. During the follow-up period,there were no serious immunological rejection and complications.

CONCLUSIONReconstruction of anterior or posterior cruciate ligament under arthroscopy with Rigidfix cross pins and Intrafix pins fixation is feasible therapy for anterior or posterior cruciate ligament injuries, and the fixation is rigid. The therapy restores knee stability and provides a satisfactory short-term results.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Bone Nails ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; instrumentation ; methods

Aim To study the effect of Baoxinbao film on endothelin(ET) and nitric oxide(NO) secretion in patients with stable angina pectoris(SAP).Methods 76 patients with SAP were randomly divided into two groups, with 40 cases in the baoxinbao group plastered with baoxinbao film and 36 cases in the isosorbide dinitrate group receiving isosorbide dinitrate. The levels of plasma ET and NO before and after treatment were observed. Results The concentrations of plasma ET were increased and plasma NO reduced significantly in the SAP patients respectively, as compared with those in the control group(all P

Objective To investigate the risk factors associated with the death of pediatric septic shock,for improving prognosis and decreasing mortality.Methods Sixty-four patients in intensive care unit diagnosed as septic shock were enrolled from Apr.2002 to Apr.2008.The factors such as age,sex,C-reacted protein,WBC,platelet count,blood glucose,procalcitonin(PCT),serum lactic acid,pediatric critical illness score(PCIS),ventilator using and complication of multiple organ dysfuction syndrome(MODS) were researched,these research factors were analyzed by univariate analysis,then to be analyzed by Logistic regression.Results The mortality was 59.38%(38/64 cases).Twenty patients with severe septic shock were all died.Thirty-four patients had breath failure and 26 cases had MODS,the mortality were 62.50%,76.92%,100.00% in patients complicated with 2,3,4 organs dysfunction.In the univariate analysis,variables significantly associated with death in septic shock were PCT,lactic acid,PCIS,MODS.In the Logistic regression,variables significantly associa-ted with death were PCT,lactic acid,PCIS and MODS.Conclusions The mortality of septic shock was high,and decreased PCIS,elevated serum lactic acid level and PCT,and multiple organ dysfuction are the risk factors associated with the death of septic shock.

Objective To explore the effect of nitric oxide (NO) on ?-aminobutyric acid B receptor (GABA_BR) subunits during recurrent febrile seizures (FS).Methods Twenty-four Sprague-Dawley rats aged 21 days were randomly divided into 4 groups: control group (37.0 ℃ water,n=8), FS group (45.2 ℃ water,n=8), FS + SNP group (45.2 ℃ water,n=8), FS+L-NMMA group (45.2 ℃ water,n=8). FS rats were induced 10 times in a warm-water bath, once every 2 days. The plasma level of NO was detected by the spectrophotometer. The expressions of GABA_BR subunit mRNA and c-fos gene were examined by in situ hybridization. The expressions of GABA_BR subunit and Fos protein were observed by immunohistochemistry. Results The plasma level of NO increased in FS + SNP group while decreased in FS+L-NMMA group compared with that in FS group. The expressions of GABA_BR_2 were down-regulated in FS+SNP group, while GABA_BR_1 hardly changed compared with those in FS group. In FS+L-NMMA group, both the expression of GABA_BR_2 and GABA_BR_1 up regulated compared with those in FS group. The expressions of c-fos gene and Fos protein were significantly enhanced after recurrent FS. SNP elevated the expressions of c-fos gene and Fos protein, while L-NMMA down regulated the expressions of them.Conclusion NO may play a regulatory role through modulating GABA_BR function in the pathogenesis of recurrent FS.

Objective To explore the influence of ?-aminobutyric acid B receptor(GABA_BR)on carbon monoxide (CO)/heme oxygenase(HO-1)system during recurrent febrile seizures (FS).Methods Sprague-Dawley rats aged 21 days were randomly divi- ded into 4 groups:control group and FS group,FS+baclofen group,FS+phaclofen group.FS in rats were induced 10 times in a bath of warm water, once every 2 days.The plasma level of CO was detected by the dual wave lengh spectrophotometer;the expressions of GABA_BR and HO-1 mRNA were examined by insitu hybridization;the expressions of GABA_BR and HO-1 protein were observed by immunohistochemistry.Results The plasma level of CO increased in FS+baclofen group,while decreased in FS+phaclofen group compared with FS group.The expressions of GABA_BR and HO-1 upregulated in FS+baclofen group,while decreased in FS+phaclofen group compared with FS group.There were significant difference (All P

Objective To analyze the prevalence and characteristics of skin diseases in elderly patients with type 2 diabetes mellitus (T2DM).Methods Clinical out patient records for both elderly and non-elderly individuals with T2DM were collected from the dermatology department of Beijing Hospital.Statistical comparisons were performed between the elderly group and the non-elderly group on the prevalence of common skin complications and disease characteristics.Analysis was performed in the elderly group to identify any association of common skin disorders with gender,age,duration of T2DM,or level of glycosylated hemoglobin (HbA1c).Results Among 679 elderly T2DM cases,pruritus was the most common complication (26.1％),followed by eczema (21.t ％) and tinea pedis/onychomycosis (18.3％).Pruritus was more prevalent in the elderly group (177 cases,26.1％) compared to the non-elderly group (34 cases,9.8％) (x2 =6.006,P＜0.01).On the other hand,tinea pedis/onychomycosis was less prevalent in the senior group (124 cases,18.3 ％) than in the non-senior group (112 cases,32.2 ％) (x2 =37.437,P＜0.01).In the senior group,pruritus was more prevalent among male patients (105 out of 358 cases,29.3％) than among female patients(72 out of 321 cases,22.4％) (x2 =4.181,P =0.041).On average,patients with eczema were older[(72.3 ± 2.2)years] and had a longer history of T2DM [(8.3 ± 0.3)years] compared with patients without eczema[age:(65.2±1.9)years,history of T2DM:(5.2±0.1)years] (t=1.250,P=0.023 for age;t=1.680,P=0.033 for disease duration).Patients with tinea pedis/onychomycosis had higher HbA1c levels (6.7 ± 0.4) ％ than patients without tinea pedis/onychomycosis (6.1 ± 0.3) ％ (t =0.790,P＜0.01).Conclusions Pruritus is the most common skin complication in elderly patients with type 2 diabetes and is more common in elderly patients and male patients.Risk factors for developing eczema in elderly patients with type 2 diabetes may include older age and long disease duration.High levels of glycosylated hemoglobin in elderly patients with type 2 diabetes indicates increased risk for foot fungi infections.