Objective To improve diagnosis of straight back syndrome.Methods 21 patients with straight back syndrome include 12 male and 9 female,and aged 15～36 years old(mean 21 years old).The standard P-A and left lateral chest film were taken and the A-P diameter and transverse diameter of the chest were measured,and the ratio between the both was calculated.Results The A-P diameter of the chest were 5.3 cm～8.5 cm(mean 6.6 cm)in male and 4.2 cm～8.1 cm(mean 6.2 cm)in female.the ratio between the A-P diameter and transverse diameter of the chest were 0.22～0.37(mean 0.34)in male,and 0.19～0.366(mean 0.31)in female.Conclusion The ratio between the A-P diameter and transverse diameter of the chest ≤0.37 is the diagnostic basis of the straight back syndrome.

Objective To measure the daily nursing workload by simplified therapeutic intervention scoring system and provide information for reasonable dynamic management of nursing manpower and improving nursing service satisfaction of patients in elderly ICU.Methods 113 patients in elderly ICU were selected from July 2012 to June 2013.The Therapeutic Intervention Scoring System 28(TISS-28) was used to measure the nursing workload,reasonably arranged the nursing staff according to the daily total nursing workload.The average daily working time and service satisfaction were compared before and after the application of dynamic management of nursing manpower.Results After the application of dynamic management of nursing manpower,the average daily working time of nurses decreased,satisfactory degree of patients with nursing service increased,and satisfactory degree of medical workers with nursing manpower management also increased.Conclusions Measurement of nursing workload by TISS-28 can provide the basis for the dynamic management of nursing manpower in elderly ICU and improve satisfaction degree of medical workers.

Objective To evaluate the effect of gender and treatment strategy on remote ischemic preconditioning (RIPC)-induced reduction of myocardial damage in patients undergoing cardiac surgery.Methods We systematically searched the literature in PubMed,EMBase,and Cochrane Library (from Feb 1990 to Feb 2012) using the related keywords.Randomized control trials (RCTs) published in English with report on postoperative biomarkers of myocardial damage concerning RIPC-induced myocardial protection in adult patients undergoing cardiac surgery were included.Standardized mean difference (SMD) was calculated.Publication bias and sensitivity analysis were used to evaluate the reliability of overall enzymatic estimate.Meta-regression analysis was performed to explore the potential sources of significant heterogeneity among results of studies.Data were analyzed using Stata 12.0.Results Thirteen RCTs involving 985 patients were included in our study.Compared with controls,RIPC significantly reduced postoperative serum levels of biomarkers of myocardial damage with significant heterogeneity (SMD=-0.539; 95％CI:-0.926to-0.152; P＜0.05; I2 =88.7％,P＜0.01).No evidence of obvious publication bias was observed (P =0.083,Begg' s test; P =0.077,Egger' s test).Sensitivity analysis showed that each individual study produced no effect on the direction and magnitude of the overall effect size (P ＜ 0.05).Meta-regression analysis revealed that male (％) (coefficient =0.02 ; 95 ％ CI:-0.002-0.042 ; P =0.070 ; adjusted R2 =19.61％) and total ischemic time (min) (coefficient=-0.08; 95％CI:-0.154-0.002; P =0.055; adjusted R2 =19.47％) were the two major influential factors.Conclusion Gender affects RIPC-induced reduction of myocardial damage after cardiac surgery in patients,RIPC-induced reduction of myocardial damage infemale patients is superior to that in male patients and a better efficacy can be achieved by prolonging the single ischemic time or by increasing the ischemic cycles.

Objective To investigate the effect of IH764-3 on the leukocyte-mediated hypoxia-reoxygention injury of human brain microvascular endothelial cell (HBM VEC). Methods MTT assay was used to detect the survival of HBMVEC; gelatin zymography was used to check the activity of MMPs. The level of reactive oxygen species (ROS) in leukocyte was determined via commercially available kit, and the indirect enzyme-linked immunosorbent assay (ELISA) was used to quantify the contents of TNF-α, IL-1α, IL-2 and INF-γ in leukocyte culture medium. Results Survival of HBMVEC was impaired by hypoxia-reoxygenation, which was aggravated by supernatant of activated leukocytes but was attenuated by IH764-3. Leukocytes produced high level of MMP-9, ROS and cytokines (TNF-α, IL-1α, IL-2, IFN-γ) after hypoxia-reoxygenation, the process was inhibited by IH 764-3. Furthermore, IH764-3 could effectively reverse hypoxia-reoxygenation injury of HBMVEC with supernatant of activated leukocytes. Conclusion IH764-3 can protect HBMVEC from leukocyte-involved hypoxia-reoxygenation injury by attenuating the activation of leukocytes and inhibiting the pathogenic effects of leukocytes products.

Objective To detect the gastric motility in patients with type 2 diabetes mellitus, and to explore the relationship between disorder of gastric motility in diabetes and the influential factors. Methods Sixty-five patients with type 2 diabetes mellitus and 30 health control subjects were collected. The gastric motility was tested with the signal processing device designed by Chongqing University of Posts and Telecommunications. The impedance and electrical signals were collected at the same time. Fasting blood glucose (FBG) was detected by oxidation enzyme method, while microcolumn method was adopted to test HbA1c. Results In the 65 patients with type 2 diabetes mellitus,the occurrence of abnormal gastric motility was 53.85% , they had several symptoms, such as abdominal distension, early satiety, and belching. The percentage of dominant frequency of impedance gastrogram in diabetes group was lower than that in the normal controls (P<0. 05 ). The percentage of dominant frequency of EGG in the abnormal HbA1c group( ≥6. 5% ) was significantly lower than that in the normal HbA1c group ( P<0. 01). The percentage of bradygastria in the elderly was higher than that in young and middle-aged subjects (P<0. 05), respectively. Disorder of gastric motility was not correlated with FBG and course of disease. Conclusions The incidence of disordered gastric motility is very high in patients with type 2 diabetes mellitus. Elderly patients and those with higher HbA1c are prone to suffer from disordered gastric motility. However, disorder in gastric motility is not correlated with FBG and duration of the illness.

Objective To investigate the effect of IH764-3 on the leukocyte-mediated hypoxia-reoxygention injury of human brain microvascular endothelial cell (HBMVEC). Methods MTT assay was used to detect the survival of HBMVEC; gelatin zymography was used to check the activity of MMPs. The level of reactive oxygen species (ROS) in leukocyte was determined via commercially available kit,and the indirect enzyme-linked immunosorbent assay (ELISA) was used to quantify the contents of TNF-?,IL-1?,IL-2 and INF-? in leukocyte culture medium.Results Survival of HBMVEC was impaired by hypoxia-reoxygenation,which was aggravated by supernatant of activated leukocytes but was attenuated by IH764-3. Leukocytes produced high level of MMP-9,ROS and cytokines (TNF-?,IL-1?,IL-2,IFN-?) after hypoxia-reoxygenation,the process was inhibited by IH 764-3. Furthermore,IH764-3 could effectively reverse hypoxia-reoxygenation injury of HBMVEC with supernatant of activated leukocytes. Conclusion IH764-3 can protect HBMVEC from leukocyte-involved hypoxia-reoxygenation injury by attenuating the activation of leukocytes and inhibiting the pathogenic effects of leukocytes products.

Objective To study the curative effect of transcatheter arterial chemoembolization( TACE) combined with conventional percutaneous ethanol injection therapy ( PEIT) in the treatment for primary liver cancer?Methods Forty cases patients with primary liver cancer(the diameter was equal or more than 8 cm) who were treat in the Third Hospital of Qinhuangdao from January 2007 to May 2013 were selected,and randomly divided into treatment group(20 cases) and control group(20 cases)?The control group underwent TACE,the treatment group were given TACE combined with PEIT, the clinical effect of the two groups were observed?Results The effective rate of the treatment group was 80%,significantly higher than that of the control group( 50%) ,the difference was statistically significant( P=0?04)?During the follow?up of 3 years,there were 3 cases of portal vein tumor thrombus,5 cases of hepatic metastasis,1 case of upper gastrointestinal bleeding and 2 cases of liver failure in the control group;there were 1 case of liver metastasis,1 case of liver failure and death in the treatment group?Conclusion The test of the curative effect of patients with huge hepatocellular carcinoma after combination therapy with TACE and PEIT proved combination therapy can increase the curative effect, decrease impairment of liver funvtion?It was a palliation road to treat huge hepatocellular carcinoma.

Objective: To study subclinical hypothyroidism (SCH) with its treatment in patients after coronary artery bypass grafting (CABG). Methods: A total of 1500 patients received CABG by the same surgical team in our hospital from 2010-06 to 2014-03 were retrospectively studied. According to thyroid function, the patients were divided into 2 groups: SCH group,n=107 and Normal group, n=1393. With 1:4 propensity score matching, there were 104 patients in SCH group and 416 patients in Normal group enrolled in our research. The rates of intra-aortic balloom pumping (IABP) implantation and peri-operational blood transfusion, mechanical ventilation time, new onsets of stroke, myocardial infarction and atrial ifbrillation, malignant arrhythmia, acute kidney injury and in-hospital mortality were observed. The outcome of treatment was assessed by single- and multi-factor analysis. Results: Compared with Normal group, SCH group showed increased mechanical ventilation time (23.3±47.9) h vs (15.0±5.5) h, P<0.05; more patients had mechanical ventilation time>12 h (89.4% vs 78.8%),P<0.05 and more patients had IABP implantation (3.8% vs 0.72%),P<0.05. SCH was related to mechanical ventilation time>12 h (OR=2.363, 95% CI 1.183-4.516) and IABP implantation (OR=6.126, 95% CI 1.190-31.537). The in-hospital death and other events were similar between 2 groups,P>0.05. Conclusion: Our research indicated that SCH was related to mechanical ventilation time and IABP implantation in patients after CABG.

Objective To evaluate the effects of sevoflurane postconditioning on ischemia-reperfusion injury in chronically-infarcted rat hearts.Methods Left anterior descending coronary artery was ligated to induce myocardial infarction in male Sperague-Dawley rats.Six weeks later,chronically-infarcted hearts were isolated and passively perfused in a Langendorff apparatus.Eighty chronically-infarcted hearts were randomized into 8 groups (n =10 each)∶ Ⅰ-Ⅷ groups.In group Ⅰ,hearts were continously perfused with Krebs-Henseleit (K-H) solution for 90 min.In group Ⅱ,hearts were subjected to 30 min of global ischemia,followed by 60 min of reperfusion.In groups Ⅲ to Ⅵ,hearts were exposed to 30 min of global ischemia,specific phosphatidylinositol-3-kinase (PI3K) inhibitor LY294002 15 μmol/L and mitogen-activated extracellular regulated kinase 1/2 (MEK1/2) inhibitor PD98059 20 μmol/L,0.02％ dimethyl sulfoxide,and K-H solution saturated with 3％ sevoflurane were administered,respectively,during the first 15 min of reperfusion,followed by perfusion with plain K-H solution for 45 min.In groups Ⅶ and Ⅷ,hearts were exposed to 30 min of global isehemia,K-H solution saturated with 3％sevoflurane was given during the first 15 min of reperfusion,LY294002 15 μmol/L and PD98059 20 μmol/L were simultaneously administered,respectively,followed by perfusion with plain K-H solution for 45 min.Coronary flow (CF),left ventricular developed pressure (LVDP),± dp/dt,left ventricular end-diastolic pressure (LVEDP) and heart rate (HR) were recorded after 20 min of equilibration (baseline,T0),immediately before ischemia (T1),and at 15,30 and 60 min of reperfusion (T2-4).The concentrations of lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) in the collected coronary effluent were determined at T0 and T4.Acute myocardial infarct size was determined at T4.Left ventricular tissue samples were collected at T2 to measure the phosphorylation of protein kinase B/Akt (PKB/Akt),and extracellular regulated kinase 1/2 (ERK1/2) and degree of mitochondrial permeability transition pore (rnPTP) opening.Results Compared with group Ⅰ,LVDP,± dp/dt,HR and CF were significantly decreased,LVEDP was increased,the acute myocardial infarct size was enlarged,and the concentrations of LDH and CK-MB in the coronary effluent and degree of mPTP opening were increased during reperfusion in groups Ⅱ-Ⅷ (P ＜ 0.05).LVDP,± dp/dt,HR and CF were significantly higher,LVEDP was lower,the acute myocardial infarct size was smaller,the concentrations of LDH and CK-MB in the coronary effluent were lower,the phosphorylation of PKB/Akt and ERK1/2 was higher,and the degree of mPTP opening was lower during reperfusion in group Ⅵ than in group Ⅱ (P ＜ 0.05).Conclusion Sevoflurane postconditioning protects chronically-infarcted rat hearts against ischemia-reperfusion injury by activating PI3K-PKB/Akt and MEK1/2-ERK1/2 and inhibiting mPTP opening.

ObjectiveTo investigate the effect of finasteride on hemorrhage in peri-operation of transurethral plasmakinetic enucleation of prostate (TUPKEP).Methods150 patients with benign prostatic hyperplasia (BPH) were randomly divided into 3 groups:control group without finasteride (n= 50),treatment groupl 1 with finasteride 5 mg daily for 7 days(n= 50) and treatment group 2 with finasteride 10 mg daily for 7 days(n= 50) before and after operation.All patients received TUPKEP and the data were recorded,including total blood loss,operation time,amount of washing fluid during operation,blood loss of per gram tissue,blood loss per minute,washing time after operation,amount of washing fluid after operation,and rebleeding rate within 3 months after operation.ResultsThe 150 patients successfully received TUPKEP.The total blood loss,amount of washing fluid during operation,operation time,blood loss per gram tissue,amount of washing fluid after operation,washing time after operation and rebleeding rate within 3 months after operation in treatment group 1 and 2 significantly reduced as compared with control group (P＜0.05).The blood loss per minute were (1.77±0.89) ml/min,(1.71±0.82) ml/min and (1.70±0.81) ml/min in 3 groups,respectively,and there were no significant differences among groups (P＞ 0.05).There were no significant differences between treatment group 1 and 2 in the total blood loss,operation time,amount of washing fluid during operation,blood loss of per gram tissue,blood loss per minute,washing time and amount of washing fluid after operation (P＞0.05).The rebleeding rate within 3 months after operation in treatment group 1 (8/35) and treatment group 2 (3/26) decreased as compared with control group (17/39) (x2= 3.544 and 7.523,P=0.016 and 0.025)and it was lower in treatment group 2 than in treatment group 1 (x2 = 1.293,P = 0.044).Conclusions The application of finasteride in peri-operation of TUPKEP can reduce hemorrhage.