Objective To know the preventive effects of using hammock firmness sheets for pa-tients with pressure ulcer.Methods Divided 98 patients into the application group (31 cases), the treatment group(30 cases) and the control group(37 cases) according to themselves condition.Hammock firmness sheets was used in the application group, while the routine preventive method of pressure ulcer was used in the control group.To know the preventive effects of pressure ulcer betweent the two groups.The patients in the treatment group was patients had pressure ulcer, hammock firmness sheets combined with local massage were used for them, observed the treatment effects for them.Results The condi-tion of preventive effect of pressure ulcer in the application group was better than those of in the control group.The cure rate of pres sure ulcer in the treatment group was 90%.Conclusions The hammock firmness sheets can prevent pressure ulcer effectively.

Objective To investigate the changes of visual evoked potentials (VEP) in patients with Parkinson’s disease (PD). Methods Pattern reversal checkerboard VEP and the unified Parkinson’s disease rating scale (UPDRS) were evaluated in 69 patients with PD and 61 healthy controls. The 69 patients and 61 healthy controls were divided into an aged group (≥60 years old) and a non aged group (0.05). Conclusions VEP reflected objectively the patients’ electrophysical changes of the visual pathway due to dopamine changes and it may be helpful in PD diagnosis.

Objective To investigate the clinical manifestations and possible reasons of the missed and inaccurate diagnosis of Fuchs syndrome. Methods The clinical data of 85 patients with Fuchs syndrome who were diagnosed and treated from June 1999 to December 2003 were retrospectively analyzed. The disease history of each patient was carefully recorded. Slit-lamp microscopy was performed on the patients. The character and distribution of keratic precipitates (KP), color of the iris, depigmentation, and complications were noted in detail. The data recorded in other hospitals were analyzed and the reasons of missed and inaccurate diagnosis were statistically analyzed. Results The age of the patients ranged from 13 to 72 years, and binocular involvement was noted in 76 patients. None of the patients showed ciliary congestion and iris synechiae. Middle-sized or stellated KP was found. Triangle-distributed KP was seen in 13 patients, and diffuse distribution behind the corneal or in the pupil area was in 72. Anterior-chamber flare was observed in all of the patients, while anterior-chamber cells were only noted in 42 patients. The iris with different degrees of depigmentation was found in all the patients. Complicated cataract and increased intraocular pressure occured in 44 and 19 patients, respectively. The diagnosis in other hospitals mainly included uveitis, anterior uveitis and complicated cataract. Conclusions Fuchs syndrome is characterized by depigmented iris and typical KP. Missed and inaccurate diagnosis is mainly due to the unawareness of its clinical features.

Objective To investigate the influence of panton-valentine leucocidin (PVL) on expression of Toll like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB) signals and IL-8,IL-6 in THP-1 macrophages,and to study the mechanism of PVL-related lung tissue damage.Methods THP-1 cells were cultured in the presence of 100 nmol/L phorbol-12-myristate 3-acetate (PMA) for 48 h to induce monocytemacrophage differentiation.rPVL-F and rPVL-S were induced and expressed from the recombinant plasmid,respectively purified with chromatographic column. After that,THP-1 macrophages were incubated with rPVL,and then ELISA was performed to test expression of IL-8 and L-6 in supernatants fluid; RT-PCR was performed to detect expression of IL-8,L-6 and TLR4 ; NF-κB was analyzed by Western blot and immunohistochemistry method.Results PVL was able to induce expression of IL-8 and IL-6 in THP-1 macrophages in time-and concentration-dependent manners.PVL could also significantly promote the activation of TLR4/NF-κB signals.Conclusion PVL can activate the expression of TLR4/NF-κB signals,and increased the high expression of inflammatory cytokines.Maybe it's the mechanism of action of PVL exerts the function of lung tissue damage.

Objective To evaluate the clinical significance of the axillary conservative surgery by sentinel lymph node biopsy (SLNB) using preoperative lymphoscintigraph technique with 99mTc-SC and methylene blue in early-stage breast cancer patients. Methods The sentinel lymph node (SLN) of 187 patients were located with preoperative lymphoscintigraph technique with 99mTc-SC and labeled with methylene blue during the operations. The metastasis of SLN was detected using frozen section technique. There were 51 patients whose SLN were positive having been carried with modified radical mastectomy of breast cancer and axillary lymph node dissection (ALND), 136 patients' SLN were negative,58 patients of those were carried with mammectomy or partial mastcctomy and ALND (group A),while 78 patients were carried out with mammectomy or partial mastectomy only (group B). The sentinel lymph nodes were detected with HE stain after surgery. All the patients were treated with chemotherapy,and the patients with partial mastcctomy must be treated with radiotherapy. There were 2 patients with micrometastasis in group B being treated with mammectomy or partial mastcctomy only,and carried out with ALND again. Results The number of cases with upper limb numbness, edema, dysfunction in group A were 36,8 and 45 cases, in group B were 2,0,0 case respectively. Group A compared with group B was increased significantly (P< 0.05). The number of local recurrence within 1, 3 and 5 years were 0,0,2 cases;lymphatic metastasis were 1,5,8 cases; the distant metastasis were 2,8,12 cases; the disease-free survival were 60,57,49 cases. In group B, the number of local recurrence within 1, 3 and 5 years were 0,0,6 cases, lymphatic metastasis were 3,8,12cases,the distant metastasis were 4,8,16 cases,the disease-free survival were 76,70,61 cases. There were not significant differences between the two groups(P> 0.05). Conclusion It is simple and accurate to carry out SLNB using preoperative lymphoscintigraph technique with 99mTc-SC combined with methylene blue,and the effect is reliable.

ObjectiveTo explore the role of polymorpbonuclear leukocyte (PMN) in PantonValentine leucocidin (PVL)-induccd acute lung inflammation and injury. Methods Fifteen New Zealand rabbits were divided into 3 groups with five rabbits in each group.The controls were treated with pbosphate buffer solution (PBS),the rabbits with normal granulocyte in rPVL group were treated with endotracheal instillation of rPVL,the granulocytopenia rabbits in vincristine (VCR) +rPVL group were firstly treated with VCR,thcn with endotracheal instillation of rPVL.Nine hours after injection,the peripheral blood and bronchoalveolar lavage fluid (BALF) were collected for counting PMN.The lactate dehydrogenase (LDH) activity in BALF,lung permeability index (LPI),PMN apoptosis and necrosis and the release of reactive oxygen species (ROS)in BALF were measured.After the rabbits sacrificed,the lung tissue samples were collcctcd for dctcrmining wet/dry (W/D) ratio and histopathological examination.The comparison among groups was done by t test.ResultsThe PMN count in the peripheral blood was (2.69=0.34) × 10 mL in rPVL group,which was significantly lower than control group [(3.63 ± 0.38) × 105/mL] (t =4.12,P＜0.05).The PMN counts in BALF in control group,rPVL group and VCR+rPVL group were (0.57±0.01 ) ×106/mL,(3.01±0.02) × 106/mL and (0.10±0.02) × 106/mL,respectively; that in rPVL group was significantly higher than those in control group (t=254.39,P＜0.05).The LDH activity,LPI and W/D ratio in rPVL group were all significantly higher than control group,while those in VCR+rPVL group were not significantly different from control group.The PMN apoptosis rate and necrosis rate in VCR+rPVL groupwere (1.17±0.24)％ and (1.13±0.17)％,respectively.The releases of ROS (meanfluorescence intensity) in rPVL group,control group and VCR+rPVL group were 1.56±0.39,0.41±0.03 and 0.39±0.02,respectively,and that in rPVL group was significantly higher (t=6.58,P＜0.05).Histopathological examination of the lung showed the diffuse infiltration of inflammatory cells,hemorrhage and edema in rPVL group,wbile there was only thimbleful infiltration of inflammatory cells observed in surrounding bronchia and alveolar septun in VCR-rPVL group.ConclusionsrPVL can induce lung inflammation and injury in rabbits with normal granulocyte,but not in neutropenic rabbirs.Lung inflammation and injury may be the result of recruitment,aggregation and subsequent lysis and/or activation of PMN,which can damage the lung by releasing the contents of cytotoxic granules and/or reactive oxygen metabolites.

Objective To explore the characteristics of intellectual impairment and event -related potential(ERP) in the elderly patients with asymptomatic cerebral infarction (ACI). Methods By using WAIS-RC and sensory event-related potential, VIQ, PIQ, FIQ, the latency of all the waves of ERP and the amplitude of P300 were measured in 53 elderly patients with ACI and 50 healthy controls. The 53 ACI patients were divided into a single-infarct cerebral lesion (30 cases) and multi-infarct cerebral lesion (23 cases). Results About 49.1%-58.5% of the patients with ACI showed some degrees of intelligence impairment, all score by WAIS-RC test was significantly lower in patients with ACI than that in healthy controls (P

Objective To evaluate the effectiveness and predictive value of high-resolution manometry(HRM) for POEM in treating achalasia. Methods A total of 84 achalasia patients categorized into subtypes by HRM, who also underwent POEM, were enrolled in our study. Eckardt score, Barium esophagogram and HRM were performed before, 6 months and 1 year after POEM. Results POEM was successfully performed in all 84 patients. No perforation occurred in any patient. The Eckardt scores and esophageal diameter after POEM significantly reduced compared with those before(P<0. 05). The 4s-IRP decreased from 33. 4±9. 0 mmHg (1 mmHg =0. 133 kPa) to 14. 6±3. 8 mmHg six months after POEM (P<0. 05) and to 16. 4±3. 9 mmHg one year after POEM (VS preoperate, P<0. 05). The LESP before treatment was 41. 8±15. 4 mmHg, decreasing to 18. 4±7. 1 mmHg six months after POEM (P<0. 05) and 20. 7±7. 6 mmHg one year after POEM (VS preoperate, P <0. 05) . When categorizing patients into 3 subtypes by HRM, 4s-IRP of type II showed the most dramatic decrease six months after POEM(62. 8%), followed by typeⅠ(53. 5%), while type III had the least decrease(41. 8%). The mean decreasing rate of LESP in type III was 42. 3% six months after POEM, followed by typeⅠ(55. 3%) , while type II showed the highest rate(57. 8%). Conclusion POEM is a safe treatment for achalasia and has significant short-term efficacy with Type II responding best to POEM. HRM plays a vital role in typing AC and predicting the effectiveness of POEM and can be useful in selecting an appropriate treatment.

ObjectiveTo explore the role of NF-κB signaling pathway protein and cytokines in Panton-Valentine leukocidin (PVL)-induced acute lung inflammation and injury.MethodsThirty rabbits were distributed randomly into two groups,each group had fifteen rabbits.Group rPVL were directly treated with endotracheal instillation of rPVL,normal control were treated with PBS.Then five rabbits chosen at random from each group were killed at 3,6,or 9 h postinfection.The lung was removed from the rabbits to determine histopathology studies.ELISA was performed to evaluate levels of IL-6,IL-8,IL-10 and TNF-α.NF-κB p65 protein of the lung tissue was assessed by immunohistochemistry method.ResultsIn group rPVL histopathology study showed symptoms of severe illness:diffuse infiltration of inflammatory cells,hemorrhage,edema and other manifestations of lung injury.Levels of IL-6,IL-8 and TNF-α were increased gradually,and the level of IL-10 was increased at 9 h postinfection.The expression of NF-κB p65 protein was increased gradually with the infection time.ConclusionNF-κB activation and cytokines release play an important role in PVL-related lung injury.It may be an important path to down regulate the counts of NF-κB activation.

Objective To explore the diagnosis value of 3D-power Doppler ultrasound in differentiating benign and malignant breast masses in elderly patients.Methods A retrospective study of 53 lesions in 45 patients was performed,and breast masses were divided into benign and malignant group by pathological diagnosis after operation.Display of cross,vertical and coronal plane of total 53 masses were automatically acquired by 3D-power Doppler examination before operation,and 3D imaging of masses were reconstructed by virtual organ computer-aided analysis.The vascular morphology inside and beside the breast neoplasm was observed by tomographic ultrasound imagine layer by layer in different sections.Vascular distribution characteristics were divided into penetrating,central,surrounding and few vessel type.Quantitative analysis of vascularization-flow index inside the breast neoplasm was measured by 3D-power Doppler histogram.Results The difference in vascular distribution characteristics by 3D-power Doppler ultrasound was statistically significant between 15 (28.3％) benign and 38 (71.7％) malignant lesions(x2=19.52,P＜0.01).The case number of presence of penetrating vessels was 26(68.4％)in the malignantuniors.The sensitivity and specificity of penetrating vessel diagnosed malignant breast tumor were 68.4％ and 86.7％.Vascular distribution characteristics of benign masses was mainly of surrounding vessel type(53.3％).Vascularization-flow index was higher in malignant group than in benign group [(1.32 ± 1.58) vs.(0.63 ± 0.53),t=2.187,P＜0.05].Conclusions 3D-power Doppler ultrasound completely presents the vessel stereoscopical distribution and shows quantificationally blood perfusion of breast neoplasm.The 3D-power Doppler ultrasound is superior to conventional ultrasound for enhancing differential diagnosis ability between benign and malignant breast tumors.