Cardiac Surgical Procedures ; adverse effects ; Circadian Rhythm ; physiology ; Cognition Disorders ; etiology ; Humans ; Hydrocortisone ; blood ; Melatonin ; blood ; Postoperative Complications ; etiology

Objectiv e To evaluate the mid-term and long-term clinical outcome of total hip re-pl ace ment in patients with hip congenital dislocation.Methods From June198 3to Decem ber1998,36hips in32patients di agnosed as congenital disloca tion of hip(CDH),aged22to69years old(with the mean of 48.5years), were treated with total hip replacement (THR).Thirty-one hips of 28patient s were fol lowed-up with the duration of 9.5years(3.5to18years).Ac c ording to our system,the congen ital dys-pla sia of hip was divid ed into th ree degrees:the first degree was subluxation in15hips,the second degree was in termedi ate dislo cation in11hips,and the third degree was high dislocatio n in5hips.The fixation of the prosthetic compo nents was as follows :10cup s and12stems with cement,21cups and19stems with un-cement.In acetab ula r preparation,most of the patients with subluxation(13hips)underwent deep ening of the acetabu lum and were installed with larger cups;deepening of the acetabulum,smaller cup and auto femoral grafting on the su perior lip fixed w ith screws were performed in2hips with subluxation and all of hips with interm e di ate and high dislocation.Results The complications included intra operativ e lesser trochanter fracture in1case,deep vein thrombosis and thromboembolism of femoral artery in1case re spec-tively,limb discrepancy in3cases,asepti c loosening in4cases(1with trochanteric nonunion and migration,1with stem l oosening and2with both stem and cup loosening).The Harrisscore was85in th e other27hips(48scores before surgery).Con clusion Total hip replacement in patients with congenital dislocation of hip could be some what difficult be cause of the liability to complications.The techni cal difficulties en coun-t ered during surgery in cluded the correction of the length of bilateral lower extremi ty,the balance of the abductor muscles,the re lease of the soft tis sue,the dealing of the su perior segmental defect of acetabulum and selectio n of the compo nents.

A 30-year-old woman presented with a 5-year history of recurrent nodular lesions in the left subaxillary region,which had rapidly grown for 7 weeks.Five years prior to the presentation,she received breast conservation surgery and radiotherapy for left breast cancer,thereafter,chronic radiation dermatitis developed in the left subaxillary region.Two years after the operation,three soybean-sized bright red nodules appeared in the lesions of radiation dermatitis,and slowly enlarged.Subsequently,the nodules were resected,but a local recurrence was observed 3 weeks after the resection.The recurrent masses underwent accelerated growth during her pregnancy,and the growth was obviously inhibited after the termination of pregnancy.Physical examination revealed a quasi-elliptic,dark or bright red plaque measuring about 18 cm × 14 cm with a smooth surface in left subaxillary region,and in the center of the plaque was a bright red,hemispheric,elevated lesion measuring 10 cm × 9 cm × 5 cm with erosions or pitchy crusts on the surface.Histopathology of the lesions showed that the tumor was located in the dermis and consisted of densely packed uniform spindle-shaped cells arranged in a characteristic storiform or whirlpool pattern.Some cell nuclei showed atypia,and few mitoses were observed.In some parts of the lesion,tumor cells were arranged in a herringbone pattern.Immunohistochemistry revealed that the tumor cells stained positive for vimentin(strongly)and actin(weakly),but negative for CD34.Based on these findings,a diagnosis of postradiation dermatofibrosarcoma protuberans(fibrosarcoma type)was made.

AIM:To establish the fingerprint analysis method of Yaotongning Capsule by HPLC-DAD.METHODS:This experiment used homogeneous design to optimize extract method.the analysis was performed on an Agilent C_ 18(4.6 mm?250 mm,5 ?m.)column with a acetonitrile-0.2 acetic acid,0.2% triethylamine.Detection time was 60 min.The flow rate was 1.0 mL/min and the wavelength was at 254 nm.Effect of solvents time and method of extract on experiment was studied,then calculated fingerprint similarities to evaluate,the samples' stability.RESULTS:15 peaks including strychnine,brucine,glycyrrhizic acid,ecdy sterone and ephephedrine,were separated on HPLC fingerprint in Yaotongning Capsule.CONCLUSION:The method is reliable,accurate and can be used as a quality control for Yaotongning Capsule.

Objective To investigate the relationship between age and biochemical markers of bone absorption and bone formation in old men. Methods Urinary deoxypyridinoline crosslinks (Dpd),calcium (Ca),serum bone g1aprotein (BGP),procollagen I C terminal peptides (PICP) and testosterone (Tes) were determined by ELISA. Urinary hydroxyproline (Hyp) was tested by HPLC,and bone specific alkaline phosphatase (BALP) was assayed by electrophoresis. The data from 210 old man were compared with those of postmenopausal women and young men. Results As the age increased in old men, the levels of bone absorption markers increased (Dpd:12.6%,Hyp:23.5%), and bone formation markers decreased (BGP:3.1%,PICP:45.9%).The average level of Dpd in old men was (4.53?1.34) nmol/mmolCre, lower than that of postmenopausal women [(7.90?3.27) nmol/mmolCre] and young men [(6.78?3.31) mol/mmolCre], t test P

Fracture is the most serious complication caused by osteopor osis. Vertebral fracture in osteoporosis is a strong risk factor for new fractur es as well as an important parameter in prognosticating new fractures. As a stro ng risk factor, vertebral fracture reflects the degeneration of the structure of bone and the reduction of bone mineral density (BMD). Therefore, it is more val uable in predicting the risk of refracture when the reduction of BMD and vertebr al fracture is reflected. It is more convenient and easier to evaluate vertebral fracture by radiographic grading and semiquantitative grading scheme without me asuring the vertebral height. To evaluate the drugs for osteoporosis objectively and accurately, their effects on both BMD and vertebral fracture should be take n into consideration. The ideal drug should be one that can increase BMD and red uce the risk of vertebral fracture.

Objective To explore the effect of RNA interference on the bionomics of Cathepsin L of hepatoma carcinoma cells. Methods In this study, the experimental group was the Cathepsin L RNA interference group. Control groups were the normal blank hepatoma carcinoma cell group (the blank group) and the Cathepsin LRNA interference blank group (the fluorescence control group). Observing times were ld,3d and 6d after RNA interference. Transfection efficiency in each group was observed. Expression of Cathepsin L of hepatoma cells was detected by immunofluorescence, RT-PCR and WB. Cell vigor was detected by MTT assay. Changes in the cell cycle and apoptosis were observed by flow cytometry. Transwell cabin was used to detect the changes of cell invasive power.Results In the experimental group, Cathepsin L mRNA level and protein level significantly decreased, the proliferation index significantly decreased and apoptosis index significantly increased. The invasive power also decreased. Conclusion RNAi interference can inhibit Cathepsin L expression, cell proliferation and cell invasive power efficiently.

Objective To explotr clinical application of impulse oscillation system(IOS)determining bronchodilator reversibility test and the impact of age factor on positive values of bronchoddilator reversibility test in children.Methods Two hundred and fifteen patients during asthma attack were recruited randomly for this study.They were divided into three groups according to their age(4-7 year-old group,8-11 year-old group and 12-16 year-old group).Mensurated MEFV and IOS lung function.Carried on the bronchial dilation test with the results.Forced expiratory volume in first second(FEV1),the sensitivity and specificity of IOS parameters,total respiratory impedance(Zrs),respiratory resistance at 5 Hz(R5)and 20 Hz(R20),reactance at 5 Hz(X5)and resonant frequency(Fres)for diagnosing asthma at different improvement levels after inhalation of bronchedilator were calculated respectively through using FEV1 as a "sold standard"in the different age groups.Results After inhalation of bronchodilator,Fres,Zrs,R5,X5 and R20 of IOS were improved significantly.The improvement of X5 was the most obvious,however the decline of R20 was the lowest.The improving rate of Fres,Zrs,R5 had very significant difference in the three age groups(P＜0.01).It displayed that the age factor was very important impact factor on the improving rate of Fres,Zrs,R5,however the improving rate of X5 was on difference in the three age groups(P＞0.05).In the three age groups,there were significantly positive correlations between X5,R5,Zrs and FEV1(P＜0.01).there wash't correlations between R20 and FEV1 in the 4-7 year-old group and the 12-16 year-old group(P＞0.05).Furthermore,when an increase of FEV1 equaling to or greater than 15% was used as reference for positive bronchial reversibility,the improve rate of Fres,Zrs,R5,and X5 equaled to or greater than 13%,23%,17%,31%,respectively in 4-7 year-old group,18%,26%,25%,32%,respectively in 8-11 year-old group,25%,28%,28%,36%,respectively in 12-16 year-old group. Conclusions IOS can be used to assess bronchodilator reversibility test in children,and age factors should be paid attention.

AIM: To analyze the application on frequency domain optical coherence tomography ( OCT ) technology of pathologic myopia optic disc neurosensory retinal thickness changes and its relationship with axis oculi, sex and age, and help for the early diagnosis of pathological myopia and primary open angle glaucoma.
METHODS:Collected 96 eyes of normal eyes ( axis oculi 23-24mm) and 153 eyes of pathologic myopia eyes ( axis oculi 25-27mm 80 eyes, >27mm 73 eyes). We measured the thickness of nerve fiber layer of the optic disc by OCT and analyzed their relationship with axis oculi, sex and age with multiple linear regression analysis.
RESULTS: The observation group showed significant smaller average thickness of peripapillary, superior, inferior, nasal than the control group ( P<0. 05 ); the difference in the temporal quadrant between the groups were no statistically significant differences (P>0. 05); The partial correlation coefficient of peripapillary average thickness of nerve fiber layer and axis oculi was -1. 31, gender was 5. 21, age was -0. 12.
CONCLUSION:The thickness of nerve fiber layer of the optic disc in the pathologic myopia eyes are decreased than normal eyes, axis oculi, sex and age are influenced factors. The pathologic myopia patients should use different index combined with optic nerve fiber layer thickness decreased to help for the diagnosis of early primary open angle glaucoma.

Objective To explore the clinical significance of urinary leukotriene E4(LTE4) in children with respiratory syncytial virus(RSV) bronchiolitis.Methods Forty infants with bronchiolitis were enrolled for the identification of RSV-Ag from the nasopharyngeal secretions.Forty cases who were found to be positive of RSV were put into RSV bronchiolitis group.According to the severity of illness,the infants in RSV bronchiolitis group were separated into 2 subgroups:mild illness group (24 cases) and moderate illness group (16 cases).Thirty healthy children were chosen as healthy control group.Urine of the patients in RSV bronchiolitis group was collected in acute phase (on the 1st day) and recovery phase (on the 7th day after the admission).Urine of children in control group was collected .Enzyme-linked immunosorbent assay was used to assay the level of urinary LTE4.Results The levels of LTE4 in healthy control group (M,Q) were 1.28 pmol?mmol-1,1.72 pmol?mmol-1,while the levels of LTE4 in acute phase in RSV bronchiolitis group (M,Q were 30.52 pmol?mmol-1,23.56 pmol?mmol-1,and the levels of LTE4 in recovery phase in RSV bronchiolitis group (M,Q) were 3.98 pmol?mmol-1,3.43 pmol?mmol-1.Urinary LTE4 levels in acute phase in RSV bronchiolitis group were significantly higher than those in healthy control group (P