Objective To investigate the risk factors for deep vein thrombosis (DVT) of lower limbs after laparoscopic surgery.Methods A total of 230 patients underwent laparoscopic surgery were selected in Huanggang Central Hospital from January 2014 to August 2016.The patients were divided into DVT group and non-DVT group according to DVT of the lower limbs,and the related risk factors for DVT of lower limbs after laparoscopic surgery were analyzed.Results In the 230 patients,there were 10 patients with DVT of lower limbs and 220 patients without DVT of lower limbs,the incidence of DVT of lower limbs was 4.35％ (10/230).Logistic regression analysis showed that age ≥40 years old,operation time ≥120 min,postoperative ambulation time ≥ 30 h,the intraoperative position of high-head and low-foot,plasma D-Dimer level ≥0.5 mg · L-1 were the independent risk factors for DVT of lower limbs after laparoscopic surgery (P ＜ 0.05).Conclusion There is a certain incidence of DVT of the lower limbs after laparoscopic surgery.The effective prevention measures should be taken to reduce the incidence of DVT after laparoscopic surgery according to the related factors of DVT.

Objective:To study the expression of IFN-γ,IL-4 and IL-17 in peripheral blood of patients with oral lichen planus(OLP). Methods:The level of IFN-γ,IL-4 and IL-17 in peripheral blood were detected by ELISA in 60 OLP patients(including 30 erosive ca-ses and 30 non-erosive cases)and 25 healthy volunteers(controls).Data were statistically analyzed by SPSS 13.0.Results:(1 )The level of IFN-γin serum of patients with non-erosive OLP and erosive OLP were significantly lower than that in the controls(P<0.01);while the level of IL-4 in the patients were significantly higher than that in the controls(P<0.01),and the IFN-γ/IL-4 ratio in non-ero-sive OLP and erosive groups were significantly lower than that in the control group(P<0.01);(2)The level of IL-17 in erosive OLP pa-tients was significantly higher than that in the controls(P<0.05),while no statistical difference was seen between non-erosive OLP group and the control group(P>0.05).Conclusion:The down-regulated level of IFN-γand up-regulated level of IL-4,which result in the decrease of IFN-γ/IL-4 ratio,might be one of the immune etiological factors of OLP,while the up-regulated level of IL-17 protein in OLP may be mainly related with the inflammatory processes of OLP.

Objective: To investigate the quality of life (QOL) and its influence factors in the scattered elderly in Shanghai, and to evaluate the effect of nutrition status on the QOL. Methods: Ninty-five randomly-selected elderly were investigated with QOL questionnaire, food frequency questionnaire and 24 h dietary recalls, their nutrition status were awarded by nutrient intake and medical examinations. Results: The percentage of poor, moderate and good QOL were 1.05%, 61.05% and 37.89%. The significant influence factors of QOL were health status, nutrition status, livelihood satisfaction, mentality health, family harmony, medical examination and income. The main nutrition intake of the 95 cases were sufficient, such as energy, protein, but the intake of diet fat and salt were overtaken. The rate of overweight and obesity were 26.3% and 40.0%. Conclusion: Nutrition status is the main influence factor of QOL in the elderly. To improve the QOL of the elderly, health education and balance nutrition guidance should be strengthened.

Objective To study the synthesis and degradation of collagen at the transcription level during liver fibrosis in rabbits with schistosomiasis japonica. Methods New Zealand rabbits infected with Schistosoma japonicum cercariae were served as animal models of liver fibrosis. The liver specimens were collected through operations at 4, 6, 8, 10, 12, 16, 20, 24 and 28 weeks after infection. TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels of liver tissue were detected by RT\|PCR plus dot blotting, and the size of egg granulomas and the degree of liver fibrosis were measured by histopathological examinations. Results TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased simultaneously in the early stage after the infection, mostly reaching their peaks at 10 weeks after infection. Compared with normal controls, type Ⅰ collagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased by 12\^0 , 11\^0 , 6\^6 , 10\^0 and 11\^0\|fold, respectively, coinciding with the changes of egg granulomas. Thereafter, both collagen and collagenase mRNA levels decreased. TypesⅠ, Ⅲ and Ⅳ collagen mRNA levels declined to 2\|fold to 3\|fold compared with normal controls ( P 0\^05) at 28 weeks. This study showed that the synthesis and degradation of collagen remained dynamic balance in the early stage of schistosomiasis, while in the later stage the metabolism of collagen synthesis was higher than that of collagen degradation. Conclusion It was confirmed at the transcription level that when the metabolism of collagen synthesis was higher than that of collagen degradation in rabbits with schistosomiasis japonica, liver fibrosis might be produced.

Humans ; Occupational Diseases ; prevention & control ; Occupational Health Services ; organization & administration ; Trichloroethylene ; adverse effects

Objective To analyze clinical outcome of anterior atlantoaxial transarticular screw fixation in treatment of atlantoaxial instability.Methods Thirty-two patients with atlantoaxial instability treated between March 2004 and June 2009 were enrolled in the study.The patients consisted of 21 males and 11 females,at age of 22-64 years (mean 49 years).Atlantoaxial instability was attributed to old odontoid fracture in 10 patients,free odontoid malformation in 16,transverse ligament rupture in two,and rheumatoid arthritis in four.Anterior atlantoaxial transarticular screw fixation under monitoring of cortical somatosensory evoked potential (CSEP) was performed for all patients.Operation time,intraoperative blood loss,and complications were recorded.Japanese Orthopedic Association (JOA) scoring system was used to evaluate neurologic function preoperatively and at one year postoperatively.Results Operation lasted for average 98 minutes and intraoperative blood loss averaged 110 ml.Injuries on esophagus,nerve and vertebral arteries as well as leakage of cerebrospinal fluid were not observed in operation.All patients received a follow-up of 12-31 months.JOA score was increased from preoperative 9.8 points to 15.8 points at one year postoperatively,with improvement rate of 83％.Bone fusion and satisfactory internal fgxation were achieved in all patients.Hypoglossal nerve injury symptom was found in two patients postoperatively and was recovered two months later.Conclusion Anterior atlantoaxial transarticular screw fixation is an effective treatment for atlantoaxial instability.

Objective To observe the effect of combined continuous femoral nerve blockade (CFNB)with epidural morphine postoperative analgesia on total knee arthroplasty (TKA)in elderly patients.Methods Eighty elderly patients scheduled to undergo TKA were randomly divided into two groups:groups FN and FNM.Groups FNM and FN were received 0.1% morphine 2 ml and normal saline 2 ml through epidural space respectively at the end of surgery.After surgery,all patients were implanted catheter around femoral nerve guided by ultrasound,and were infused 0.2% ropivacaine 25 ml.Continuous infusion of 0.2% ropivacaine for femoral never block was administrated at a rate of 5 ml/h for 48 hours to all patients.VAS scores and bending degree during rest,active and passive exer-cise were recorded at time point of postoperative 24,48,72,96 h.Ambulation status on the fifth day after operation were observed.Satisfaction of hospitalization were graded before hospital discharge. Results Compared with group FN,VAS scores during rest,active and passive excercise were signifi-cantly decrease at 24 h in group FNM (P <0.05 or P <0.01).The bending degree of knee joints in group FNM were significantly greater compared with group FN at 24 h after surgery (P <0.01).Am-bulation status on the fifth day after surgery were significantly better in group FNM compared with group FN (P <0.05).The level of patient satisfaction was much higher in group FNM (P <0.05). Conclusion After TKA,CFNB combined with single epidural morphine injection can provide better analgesia and bending degree with a high level of satisfaction.

Objective To compare different methods for developing rat model of the syndrome of cold fluid retention in lung ( CFRL) , so as to find an easier and more reliable modeling method for CFRL. Methods Twenty rats were divided into 4 groups, namely normal group, lipopolysaccharide (LPS) group, tobacco group, and cold bath group, 5 rats in each group. Lipopolysaccharide group was given intratracheal drip of LPS, tobacco smoking and cold bath, tobacco group was given tobacco smoking and cold bath, and cold bath group was given cold bath and intragastric gavage of cold water. The modeling time in the three groups lasted for 15 days. After the experiment, we compared the general health state, body weight, sputum volume and pathological changes in rats of the four groups. Results (1) Compared with the normal group, activities of rats in the three modeling groups were lowered, body temperature decreased, and the signs of panting, cyanotic nose and lips with excretion, and sneezing (cough) were obvious. (2) Compared with the normal group, the decrease of body weight was obvious (P<0.01), expelling sputum volume was increased (P<0.05) in the model groups. However, the differences among the three model groups had no statistical differences ( P>0.05). ( 3) The results of lung tissue slice examination showed that the injury of lung tissue was severe in LPS group, mild in tobacco group and slight in cold bath group. Conclusion Rat model of CFRL has been established successfully in all of the three modeling groups, and in consideration with all respects, the method for tobacco group is the best.

No. Ⅱ fluorocarbon blood substitute in divided doses was infused into the rats in a 12-day-period. Pathomorphological changes of the various organs of the animals were observed dynamically in the first year after the completion of the infusion. Fluorocarbon particles mainly accumulated in the organs with abundant reticulo-endothelial tissue particularly the liver and spleen. The changes of the weight of the liver and spleen and the existence of foam cells could be considered as the criteria to indicate the severity of the accumulation. It was found that at the end of the first year after the completion of No. Ⅱ fluorocarbon blood substhue infusion, the liver and spleen essentially resumed their normal weight but a small number of foam cells still existed, However, accumulated fluorocarbon particles exerted no harmful effects on the functions and structures of the organs observed.

Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) in Zhejiang and to analysis factors associated with outcomes for providing evidence on improving the success rate of cardiopulmonary resuscitation (CPR). Methods Clinical data of 493 patients with OHCA collected from the emergency department (ED) of Zhejiang Provincial People's Hospital, Ningbo Emergency Medical Service Center and Shaoxing Emergency Medical Service Center from January 2012 to August 2016 were analyzed retrospectively. All the data were recorded following the Utstein style included causes of arrest, location of arrest, first arrest rhythm, witnessed by bystanders, bystander CPR, pre-hospital defibrillation, pre-hospital intubation, pre-hospital epinephrine administration, emergency medical services (EMS) response time, return of spontaneous circulation (ROSC) at scene/enroute, ROSC at ED, admission to hospital, survival to hospital discharge and neurological outcomes at discharge. Factors associated with 30 days survival rate of patients with OHCA were analyzed. Results 493 patients were enrolled, of whom 342 were male and 151 were female. The average age was (58.8±21.4) years. The causes of arrests consisted of cardiac etiology (219 cases), trauma (155 cases), respiratory disease (22 cases), drowning (19 cases), electrocution (8 cases) and others (70 cases). Most of the events occurred at home (65.1%) and public places (22.7%). 55.2% patients were witnessed by bystanders while bystander CPR was performed in only 2.6% cases. Asystole was the predominant rhythm (78.7%) observed by the ambulance crew at the arrest site while only 5.5% first arrest rhythms were ventricular fibrillation/ventricular tachycardia (VF/VT). Only 6.9% patients underwent pre-hospital defibrillation. Pre-hospital intubations were attempted in 16.4% patients. Epinephrine was administered in 56.4% patients at scene or in ambulances. EMS response time was (13.6±8.0) minutes. 4.5% patients had ROSC at scene/enroute and 7.7% had ROSC at ED. Only 9.7% patients were admitted to hospital and 1.2% discharged alive. 0.8% patients were still in hospital on 30th day. The 30-day survival rate was 2.0% (10/493) and only 0.8% patients had neurologically favorable survivals [with the cerebral performance category (CPC) score of 1 or 2]. Witnessed by bystanders (3.31% vs. 0.45%), VF/VT as the first arrest rhythm (7.41% vs. 1.72%), bystander CPR (15.38% vs. 1.67%), pre-hospital defibrillation (8.82% vs. 1.53%) and EMS response time < 10 minutes (3.57% vs. 0.74%) could improve 30-day survival rate of OHCA significantly (all P < 0.05). Conclusion Resuscitation survival of OHCA in Zhejiang province was unsatisfactory. Improvements are required in series aspects of OHCA survival chain.