OBJECTIVETo explore the perioperative cardiovascular dysfunction and its relevance to age in patients with silent coronary heart disease (or silent myocardial ischemia), and explore the clinical treatment and recovery of perioperative arrhythmias.

METHODSOne hundred and eighty cases were selected from selective surgery patients with silent myocardial ischemia (SMI). Among the cases, 130 patients older than 51 years old were divided into 51 - 60 year-old group, 61- 70 year-old group and 71 - 80 year-old group. Control group was set up by other 50 patients younger than 51 years old. Electrocardiogram data of 24 h before the operation, 24 h after the operation and 48 h after the operation were continuously monitored by dynamic electrocardiogram (DCG). The electrocardiogram data of ST shifting, arrhythmia incidences of different type and at different time were analyzed by professional doctors. At the same time, the treatment and recovery of perioperative arrhythmia were recorded.

RESULTSAs the age increase, the magnitude and duration of ST shifting appeared upward trend compared to the control group (P < 0.05, P < 0.01). The incidence of ST elevation in 71 - 80 year-old group was higher than the control group (P < 0.05). The ST depression duration in 61 - 70 and 71 - 80 year-old group and ST elevation magnitude in 71 - 80 year-old group were higher than 51 - 60 year-old group (P < 0.05). Compared to the control group, the incidence of accelerated idioventricular rhythm (AIR) in 61 - 70 year-old group and the incidence of sinus bradycardia (SB), ventricular premature beat (VPB), ventricular tachycardia (VT) in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). Compared to the 51 - 60 year-old group, the incidence of atrial fibrillation (AF) in 61 - 70 year-old group and the incidence of VP, VT, AF in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). The arrhythmia incidences in 24 h after operation were higher than 48 h after operation and 24 h before operation (P < 0.01). As the age increase, the recovery incidence by removing inducement was decreased, but the recovery incidences by drug and electric-shock treatment were increased (P < 0.05).

CONCLUSIONOld SMI patients have high levels of perioperative myocardial ischemia and arrhythmia, and 24 h after operation is the period of high incidence.

Aged ; Aged, 80 and over ; Cardiovascular System ; physiopathology ; Coronary Disease ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period

Objective To investigate symptom characteristics and their their prevalence in terminally ill patients with ovarian carcinoma.Methods A retrospective study was carried out based on clinical data of 98 terminally ill patients with ovarian carcinoma who died in our hospital during January 1995 to December 2004.Fifteen most common symptoms were analyzed with a focus on the followings:symptom incidence,survival time after symptom occurrence,regularity of symptom cluster,and common causes of death.Fifteen symptoms were:pain,cachexia,pleural effusion and ascites,dyspnea,fever,intestinal obstruction,renal failure,bone marrow depression,lung infection,hemorrhage,deep venous thrombosis (DVT),intestinal or pancreatic fistula,mycotic infection,jaundice and emergency conditions.Results (1)The most prevalent symptom was pleural effusion and ascites(63%),followed by pain(60%), cachexia(59%),dyspnea(52%)and intestinal obstruction(49 %).(2)The symptom which lasted longest survival time was mycotic infection(77 days),followed by intestinal or pancreatic fistula(75 days), intestinal obstruction(67 days),pain(60 days)and eachexia(60 days).Symptoms such as bone marrow depression,renal failure,dyspnea and emergency conditions were comparatively critical associated with shorter survival times(14,13,12,7 days,respectively).(3)Terminal symptoms occurred typically in clusters,with 4.9?1.5 symptoms per case.Of 98 cases,84 cases(86%)had 4 or more symptoms,with the median survival time of 63 days from the last day of anti-cancer therapy,and a slow death process.The remaining 14 cases(14%)with 3 or fewer symptoms survived only 25 days,of which 10 cases(71%)died of emergency diseases.The survival time for two groups was significantly different(P

Objective To compare effection of two kinds of bowel preparation for enteroscopy in aged patients. Methods 100 patients who would receive enteroseopy were divided into two groups. 50 cases in each group. Patients in experimental group received colon dialysis, patients in control group received oral medication. Observed the effectiveness of two kind of bowel preparations and adverse reaction. Results The effectiveness of colon dialysis was superior to oral medication(P <0. 05) ,there was no significant deviation the adverse reaction of two groups. Conclusions Colon dialysis is a suitable method in bowel preparation for enteroscopy in aged patients.

OBJECTIVETo investigate the effect and mechanisms of Compound Astragalus Recipe (CAR) for regulating cellular immune in patients with myasthenia gravis (MG).

METHODSSixty MG patients were equally assigned to two groups randomly, the test group administered with CAR and the control group with prednisone for 3 months. Changes of patients' symptoms and adverse reactions were observed. The peripheral lymphocyte subsets distribution was examined by flow cytometry, and the levels of immunoglobulins and complements in the peripheral blood were measured by immuno-turbidimetry before and after treatment.

RESULTSThe total effective rate in the test group after 12-week treatment reached 80% (24/30), while that of the control group reached 83.3% (25/30), difference between them showed no statistical significance (P > 0.05). CD4+ and CD4+/CD8+ ratio were lowered significantly in both groups, but the decrement of CD4+/CD8+ ratio in the test group was more significant than that in the control group, showing significance between groups (P < 0.05). While CD8+ in the test group after treatment was significantly increased as compared with that before treatment (P < 0.05), but with no significant difference in comparing with that in the control group (P > 0.05). Serum levels of IgM and IgA in MG patients were significantly higher than normal range (P < 0.01). Levels of C3 and C4 were significantly increased in both groups after treatment (P < 0.05). Moderate high level of ALT and AST revealed transiently at the 2nd week in 5 patients of the control group, while no adverse reaction was found in the test group.

CONCLUSIONOne of the mechanisms for CAR in playing its immuno-modulate effect may be its regulation on lymphocyte subsets distribution and humoral immune function.

Adolescent ; Adult ; Aged ; Astragalus membranaceus ; chemistry ; Child ; Complement System Proteins ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunoglobulins ; blood ; Lymphocyte Subsets ; drug effects ; Male ; Middle Aged ; Myasthenia Gravis ; drug therapy ; immunology ; Phytotherapy ; Young Adult

Objective To investigate the relation between recurrent hemorrhage and both ultrastructural features of vascular and expressions of angiopoietin 1 (Ang-l),CD68 and matrix metalloproteinase-9 (MMP-9) in intracranial cavernous hemangioma.Methods Thirty-five intracranial cavernous hemangioma samples,35 hepatic cavernous malformation samples and 4 normal brain tissues were chosen in our study; the ultrastructural features of vascular were observed with optical microscope and electron microscope; immunohistochemical methods were used to analyze the expressions of Ang-1,CD68 and MMP-9.Results The vascular wall was very thin in intracranial eavemous hemangioma samples,only with thin monolayer of endothelial cells and adventitia,but without basal lamina and elastic layer; gap junctions were obviously observed between endothelial cells; basement membrane showed unintelligible,and a large number of high electron density of sediment was presented at the surrounding blood vessels.Tissues from intracranial cavernous hemangioma obviously expressed higher levels of CD68 and MMP-9 than the normal brain tissues (P＜0.05); Rank correlation analysis indicated that the expressions of CD68 and MMP-9 had a high degree of positive correlation (r=0.870,P=0.000).Tissues from intracranial cavernous hemangioma expressed less Ang-1 than normal brain tissues without significant difference (P＞0.05).Conclusion The vascular structural and functional defection and instability in patients with cavernous hemangioma provide favorable conditions for the happaning of recurrent hemorrhage; and high expressions of CD68 and MMP-9 are closely related with recurrent hemorrhage.

Objective:The therapeutic approach of traditional chinese Medicine (TCM) in autism spectrum disorder (ASD) is a functional one.To study the efficacy,safety and functional brain change from the use of tongue acupuncture (TAC) on ASD children.Methods:21 autistic boys (3-16 years old) were randomly assigned to TAC group (TAC:n =12;receiving daily TAC for 8 weeks) or control (C:n =9;no acupuncture).Primary outcome mea-sures included Autism Treatment Evaluation Checklist (ATEC),Reynell Language Develop-mental Scale,Symbolic Play Test (SPT),Functional Independence Measure for Children(WeeFIM),Clinical Global Impression (CGI) Scale and Cerebral FDG Metabolism by PET.Results:There were significant improvement in speech domain of ATEC (p =0.030),Self-care domain of WeeFIM (p =0.021),cognition domain of WeeFIM (p =0.001) and Total score domain of WeeFIM (p =0.001) in TAC group compared to the C group.There were significant difference in positive clinical response between C and TAC group in language (p =0.0211),functional (p =0.0011),parental Impression criteria (p =0.0003) and overall cerebral glucose metabolism (p =0.0451) using ROC criteria.No significant association of PET Glucose Meta-bolism with Clinical response was found.None of the children developed any side-effects.Conclusion:A short course of TAC can improve specific functions in children with autism spec-trum disorder,especially speech and cognition function.No statistical significant association of PET Glucose Metabolism with Clinical response.Larger scale with more sample size trial should be done for further investigation.

BACKGROUNDRisk factors that contribute to younger patients with lung cancer are still relatively unknown. The aim of this study was to compare the clinical characteristics, histological types, stages at diagnosis, treatment modalities and survival rates between young and old patients with lung cancer.

METHODSThe study was designed as a retrospective review of all lung cancer patients admitted to the Third Affiliated Hospital of Harbin Medical University from 1998 to 2008. Survival analyses using univariate and multivariate approaches were performed to compare the survival rates between different age groups and to discover potential prognostic factors.

RESULTSThis research included 3320 patients with primary lung cancer, of whom 626 (18.8%) were 45 years old or younger at the time of diagnosis. The percentage of smokers and the male to female ratios between the young and old patient groups were 51.27% vs. 70.6% (P < 0.001) and 1.99 vs. 2.13 (P = 0.4801), respectively. The young patient group had a higher incidence of adenocarcinoma and fewer surgeries. The 1-year, 3-year and 5-year survival rates in the young patient group were generally lower than those of the old patient group, with significant differences (P = 0.0232). The clinical stage of the tumor was a prognostic factor for both non-small cell lung cancer patients (P < 0.0001) and small cell lung cancer patients (P = 0.0002). Symptoms, diagnostic method, histology, smoking, treatment modality and body mass index were shown to have significant relationships with the survival of lung cancer patients (P < 0.05).

CONCLUSIONSPatients with lung cancer who are younger than 45 years old might have a significantly poorer prognosis than that of older patients. Symptoms, diagnosis method, histology, smoking, treatment modality and body mass index can be independent prognostic factors for lung cancer.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung Neoplasms ; epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Smoking ; Survival Rate ; Young Adult

OBJECTIVETo investigate the safety and efficacy of close reduction and percutaneous needle fixation for the treatment of anterior dislocation of sternoclavicular joint.

METHODSA retrospective analysis was performed with 6 cases of anterior sternoclavicular dislocation by close reduction and percutaneous needle fixation with Kirschner wire treated from January 2001 to February 2009, including 5 males and 1 female aged from 19 to 45 with an average of 28.8 years old. Among the 6 cases, 4 were on right lateral and 2 were on left lateral. The time from injured to treatment was from 6 hours to 12 days (averaged 4.5 days). The clinical effects were evaluated according to Rockwood scoring and the complications were observed.

RESULTSAll 6 patients were followed-up for 3 to 13 months (averaged 6 months). According to Rockwood scoring,the preoperative score was (7.00 +/- 0.89) points, postoperative score was (13.17 +/- 1.72) points; the results showed excellent in 5 cases and good in 1 case. No local infection, postoperative pain,recurrent dislocation,broken needle, and other complications were observed in this study.

CONCLUSIONThe treatment of anterior sternoclavicular joint dislocation with Kirschner wire minimally invasive fixation is an easy, reliable fixation with less complications.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Radiography ; Sternoclavicular Joint ; injuries ; surgery

OBJECTIVETo study use of nasal lining flap in correction of the wide complete unilateral cleft lip.

METHODS78 patients with wide complete cleft lip were. operated, firstly to be sure. That the lip length on both sides was equal. Then the nasal lining flap was used to enhance the height of the lip on cleft side for keeping symmetry with the non-cleft side. The rest of procedures was the same as "Millard" method.

RESULTS84.6 percent of patients had good appearance at one and half years after surgery.

CONCLUSIONSIt is an effective way to take advantage of the nasal lining flap to correct the wide complete unilateral cleft lip.

Cleft Lip ; surgery ; Humans ; Infant ; Male ; Nose ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps

Objective To explore whether autoreactive antibody presents in patients with sporadic idiopathic hypoparathyroidism(sIHP).Methods The subjects including 26 patients with sIHP and 112 genealogical members as well as 60 age-and sex-matched healthy controls.Anti-parathyroid antibodies in the sera were assayed by indirect immunofluorescence.The levels of calcium,phosphorus and magnesium as well as intact parathyroid hormone(iPTH)in the sera were tested.Results Positive autoantibodies against parathyroid tissue were demonstrated in 10 patients(38%)with sIHP,significantly higher than that of in genealogical members(10%,?~2=13.42,P