Objective To investigate effect of low molecular weight heparin (LMWH)on oxidative stress and renal function in elderly patients undergoing gastrectomy of stomach neoplasms. Methods 90 elderly patients undergoing radical surgery were randomly divided into LMWH group (Ⅰ group,n=45)and control group (Ⅱ group,n=45). Patients inⅠ group received a subcutaneous injection of LMWH(100 u/kg,1/d)from the time before anesthesia induction to postoperative 5 days,and patients in Ⅱ group were given equal volume of saline. Venous blood samples were collected to determine level of malondialdehyde(MDA),aldose reductase(AR)activity level,superoxide dismutase(SOD)activity level,catalase (CAT)activity level,creatinine(Cr)and blood urea nitrogen(BUN)before anesthesia induction(T0 ),at the end of the surgery(T1 ),on postoperative 1 day(T2),3 days(T3)and 5 days(T4)respectively;urine specimen were also collected to measured albumin(Alb)and N-acetyl-beta-D-amino glycosidase enzymes(NAG)at the same time points. Results There were obvious statistical differences in MDA,AR,SOD and CAT at different time points by intra-group comparison (P<0.05 ). MDA and AR rose first and then fell in two groups,and both reached the peak at T2 ,whereas SOD and CAT had the opposite trends. There were obvious statistical differences in MDA,AR,SOD and CAT at T1 ~T3 (P<0.05 ). MDA and AR inⅠgroup at T1 ,T2 and T3 was lower than those in groupⅡ(P<0.05 ),whereas SOD and CAT inⅠgroup at T1 ,T2 and T3 were significantly higher than those in group Ⅱ(P<0.05). Cr and BUN of both groups were found no significant statistical difference within the group and between groups(P>0.05).Alb/Cr of both groups at T1 and T2 were significantly higher than those at T0 (P<0.05 ),while Alb/Cr in Ⅰ group at T1 was obviously lower than Ⅱgroup(P<0.05 ).NAG/Cr in both groups at T1 ,T2 and T3 were significantly higher than those at T0 (P<0.05 ),while NAG/Cr inⅡ group at T4 was still higher than that at T0 (P<0.05 ),and NAG/Cr inⅠgroup at T1 ~T4 was obviously lower thanⅡgroup (P<0.05 ). MDA and AR in both groups at T1 ,T2 were positively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ),whereas SOD and CAT in both groups at T1 ,T2 were negatively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ). Conclusion Oxidative stress reaction resulted from radical surgery of elderly patients is associated with perioperative renal damage. LMWH could reduce oxidative stress in elderly patients,and alleviate the kidney damage,as well as protect the renal function.

QA(Quality Assurance)of CT offers dependable guarantee for the daily work of hospital.Slice width is an important characteristic of the all parameters.In this study,we gained a new method to detect slice thickness work by computer from the analysis of the CT image of the phantom named Catphan412 in a programmed way.

Animals ; Diet ; Fatty Acids, Monounsaturated ; administration & dosage ; Insulin Resistance ; Physical Conditioning, Animal ; Rats

ObjectiveTo explore a minimally invasive,reliable,and efficient method for endotracheal intubation to instill lipopolysaccharide (LPS) for preparation of acute lung injury (ALI) in mice.MethodsA total of 80 BALB/C mice was randomly selected into LPS group ( n =40) and control group (Normal saline,NS; n =40).After a successfully endotracheal intubation,each mouse was instilled by LPS (3 mg/kg) in LPS group,and NS ( 1.5 ml/kg) in NS group,respectively.The one-time success rate and final success rate of the endotracheal intubation,and survival rate were recorded.After 24 hours,the total number of cells in bronchoalveolar lavage fluid (BALF) of left lung was counted with light microscope.The cells were classified and counted after Wright's stain.Total protein concentration in BALF was assayed with a BCA kit.Wet/dry value was calculated after the lung became dry.Artery blood PaO2 was tested and the oxygenation index was counted.ResultsCompared to NS group,the LPS group had the one-time success rate 92.5％,and the final success rate 100％,survival rate 100％,the total number of cells [ ( 10.82±3.51) ×105/mlvs (0.72±0.52)×105/ml.t =-6.294 P ＜0 01]the rate of polymorphonulear leukocytes in total cells [ (93.93 ± 1.77) ％ vs (2.2 ± 0.91 ) ％,t =- 105.565,P ＜ 0.01 ],the rate of mononuclear leukocytes in total cells[ (6.07 ± 1.77)％ vs (97.8 ±0.91 )％,t =- 105.565,P ＜0.01 ],total protein concentration[ (0.49 ± 0.13 ) mg/ml vs (0.29 ± 0.11 ) mg/ml,t =- 2.823,P ＜ 0.05 ],W/D ratio(4.60 ±0.18 vs 4.16 ±0.25,t =-4.793,P ＜0.01 ),PaO2[ (68.57 -±7.23)％ vs(87.00 ±6.33 )％,t =4.571,P ＜ 0.01 ],and oxygenation index [ (326.53± 34.43 )mmHg vs (414.29 ± 30.16)mmHg,t =4.571,P ＜0.01 ].ConclusionsImproved method for endotracheal intubation has high success rate and minimal injury,and instillation of LPS (3 mg/kg)can induce mice ALI successfully.

Objective To explore the effects of one time loading of different doses of simvastatin before percutaneous coronary intervention (PCI)on post-PCI inflammation,oxidation stress and the endothelium function in (ACS) patients. Methods Totally 124 cases with ACS were randomly divided into two groups:high dose simvastatin group(40 mg,62 cases),low dose simvastatin group (20 mg,62 cases). Each group was given the same basic treatment. Blood samples were obtained from all the patients before and 12 h after PCI,and endothelin-1 (ET-1),nitric oxide (NO),interleukin-10(IL-10),high sensitive - C reactive protein(hs-CRP),superoxide dismutase (SOD) and malondialdehyde(MDA) were detected. Results The baseline information,distribution of sex,age,and implanted frames had no significant differences between the two groups (P＞0.05).Before PCI,the levels of ET-1,NO,IL-10,hs-CRP,SOD and MDA had no significant differences (P＞0.05) between the two groups.After PCI,ET-1,IL-10 and hs-CRP levels in simvastatin 40 mg group were significant lower while NO level was higher than in simvastatin 20 mg group[(4.4 ± 1.1)ng/L vs.(4.8±1.2)ng/L,t=2.03,P=0.044; (15.0±6.3) ng/L vs.(18.7±9.0)ng/L,t=2.68,P=0.008;(26.9±10.0)ng/L vs.(31.5± 11.7)ng/L,t=2.52,P =0.022;(51.9± 10.9)μmol/L vs.(47.1±11.8)μmol/L,t=2.37,P=0.020].There were no significant differences in MDA and SOD levels between the two groups.For safety,all the patients had no abnormality in liver and kidney function after treatment. Conclusions Compared with 20 mg simvastatin loading before PCI,the 40mg simvastatin loading may decrease the inflammatory cytokines and improve the endothelium function more effectively.

ObjectiveTo explore the effects of Jinyaodai on neurological behavior and Akt expression in the cortex of rats following spinal cord contusion injury.MethodsRats were randomly divided into control group,spinal cord contusion group and Jinyaodai group.The weight-drop device was employed to prepare the spinal cord injury(SCI) model.Jinyaodai was administrated every day by using a stomach tube.Rats were performed the BBB assessment,and the detection of Akt expression and count of Neun positive neurons in cortex following SCI.ResultsCompared with control group,deficit of motor function in hindlimbs was seen at 3 dpo following cord contusion,and partial functional recovery could be seen from 7 dpo to 1 m.Treatment of Jinyaodai greatly increased the BBB scores ( 14.1 ± 1.4 ) more than SCI group ( 7.8 ± 1.3 ) at 1 month (P ＜ 0.05 ) ; Simultaneously,compared with SCI rats,treatment of Jinyaodai significantly increased the expression of Akt (0.53 ± 0.05,0.68 ± 0.07,P ＜0.05 ) and the number of neurons ( 11 ± 2, 15 ± 1 ; P ＜ 0.05 ) in the lesion-induced cortex of rats.Conclusion Jinyaodai may play an essential roles in functional recovery after spinal cord injury,in which the underlying mechanism may be involved in the expression of Akt in cortex.

ObjectiveTo evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of laterally spreading tumors (LST).MethodsESD was applied to remove 32 colorectal LSTs larger than 2 cm.The characteristics of the tumors and clinical results including en bloc resection rate,procedure time,complication and recttrrence rates were retrospectively evaluated.Results The lesions ranged from 2.5 cm to 8.0 cm,with a mean diameter of 4.1 ± 2.1 cm.En bloc resection wasachieved in 29 patients (90.6％ ) with a mean operation time of 75.7 ±66.0 min.Immediate arerial bleeding occurred in 5 ( 15.6％ ) cases but was stopped successfully by clips or coagulations.Late bleeding occurred in 2 ( 6.2％ ) and perforations in 3 (9.4％ ),which were closed successfully by clips without surgery.Pathological diagnosis revealed low-grade intraepithelial dysplasia in 19 (59.4％ ),high-grade intraepithelial dysplasia in 6 ( 18.8％ ),and carcinomas in 7 (21.9％).The lesions were restricted in mucosal layer in 25 (78.1％ ),infiltrating into sm1 layer in 5 ( 15.6％ ) and sm2 layer in 2 (6.2％ ),and the later 2 were referred to surgery.Twenty patients were followed up for 3-12 months,and no local recurrence was found..ConclusionESD was an effective and safe therapy for colorectal LST larger than 2 cm.

Objective: To observe the clinical effect of Quyu-Huatan decoction combined with noninvasive positive pressure ventilation in treatment with moderate to severe obstructive sleep apnea hypopnea syndrome with phlegm dampness type. Methods: A total of 64 patients with moderate to severe obstructive sleep apnea hypopnea syndrome with phlegm dampness type were divided into observation group and control group according to the random number table method, with 32 cases in each group. The control group received routine clinical treatment combined with noninvasive positive pressure ventilation, while the observation group was treated with Quyu-Huatan decoction on the basis of the control group. After 4 weeks of treatment, the polysomnography (PSG) index (the apnea hypopnea index, AHI, the Oxygen saturation, SaO₂, the pulse pressure, PP, the longest apnea time), the degree of lethargy (Epworth sleepiness scale, ESS), the quality of sleep (Pittsburgh sleep quality index, PSQI) and the quality of life (Calgary mass index of life quality index, SAQLI) before and after the treatment of two groups were observed, and the clinical effect was compared. Results: The total effective rate of the observation group was 87.5% (28/32), which was significantly higher than that 68.8% (22/32) of the control group (Z=-3.187, P=0.000). After treatment, the AHI (8.59 ± 0.93 times/h vs. 18.62 ± 2.44 times/h, t=5.735), the PP (35.96 ± 4.02 mmHg vs. 43.33 ± 4.70 mmHg, t=5.083) and the longest apnea time (11.93 ± 1.86 s vs. 17.94 ± 2.43 s, t=4.863) of the observation group were significant lower than those of the control group (P<0.05), while the SaO2 content (93.07% ± 10.03% vs. 82.36% ± 9.37%, t=5.812) of the observation group were significant higher than those of the control group (P<0.05). After treatment, the ESS (5.33 ± 0.33 vs. 8.73 ± 0.96, t=4.682) and the PSQI (2.25 ± 0.31 vs. 5.68 ± 0.77, t=4.872) of the observation group were significant lower than those of the control group (P<0.05), and the SAQLI (6.12 ± 0.59 vs. 4.36 ± 0.53, t=4.631) of the observation group were significant higher than those of the control group (P<0.05). Conclusions The application of Quyu-Huatan decoction combined with noninvasive positive pressure ventilation in treatment with moderate to severe obstructive sleep apnea hypopnea syndrome with phlegm dampness type can improve sleep disordered breathing, relieve drowsiness, and improve sleep quality and quality of life.

AlM:To compare the differences of tilt and decentration of two aspheric posterior chamber intraocular lens ( PC-lOL) implantation by ultrasonic biomicroscope ( UBM) .METHODS:Thirty-seven patients ( 45 eyes ) underwent cataract surgery were distributed to two groups randomly. Group A was implanted with Akreos AO ( Bausch &Lomb; four-haptic ) while group B implanted with ZCB00 ( Abbott Medical Optics, lnc. AMO; two-haptic) . All eyes underwent standard phacoemulsification with intraocular lens implantation. Diameter of capsulotomy was recorded. One month postoperatively, vision, best-corrected visual acuity ( BCVA) assessment, slit lamp examination, and anterior chamber depth ( ACD ) measured by UBM were performed. Tilt and decentration were measured horizontally and vertically, and total tilt and decentration were calculated by geometry method.
RESULTS:No statistical difference was found in BCVA and diameter of capsulotomy between two groups ( P>0. 05). The mean ACD of group A and group B were 3. 86mm ± 0. 31mm and 4. 14mm ± 0. 31mm respectively, which showed it had statistically significant difference ( P<0. 05). Horizontal decentration, vertical decentration and total decentration of group A were 0. 15mm ± 0. 09mm, 0. 15mm ± 0. 12mm and 0. 22mm ± 0. 12mm respectively, while it were 0. 22mm ± 0. 21mm, 0. 14mm ± 0. 15mm, 0. 29mm±0. 22mm for group B. Horizontal tilt, vertical tilt and total tilt of group A were 0. 63°±0. 62°, 0. 89°±0. 85°and 1.22°±0.76°, while it were 1.36°±1.48°, 1.46°±1.62° and 2. 21°±1. 97° for group B. No statistically significance was found in tilt and decentration between group A and group B, no matter horizontally or vertically or totally (P>0. 05).CONCLUSlON:Two-haptic lOL shows no difference in tilt and decentration with four-haptic lOL postoperatively.

[ABSTRACT]OBJECTIVETo investigate the therapeutic effect of early combination treatment with intratympanic glucocorticoid injection for sudden sensorineural hearing loss(SSNHL).METHODSTotal of 178 patients with diagnosis of SSNHL, including 44 with hearing loss at middle-low frequencies,50 at high frequencies,44 at all frequencies and 40 at total deafness, were randomly divided into combination treatment group (CT group) and systemic oral prednisone group (OP group).CT group (82 patients) received intratympanic administration of methylprednisolone and oral prednisone in tapering doses. Pure-tone threshold audiometry (PTA) was performed at week 8 after beginning of therapy. RESULTSIn middle-low frequencies, the final PTA and PTA improvement were 26.14±24.82 dB and 42.23±1.61 dB in CT group respectively, and were 37.91±13.98 dB and 30.00±13.30 dB in OP group respectively (both P<0.05). In high frequencies, all frequencies and total deafness SSNHL group, the differences of the final PTA and PTA improvement were not statistically significant in both groups. The PTA improvement in CT group for total deafness (26.52±14.03) dB was more than that of OP group (22.06±11.17)dB (t=2.361,P<0.05). In middle-low frequencies, the recovery rate was 72.73%(16 cases) in CT group, and 40.91% (9 cases) in OP group, the difference was significant (χ2=4.539,P<0.05), but not in apparent effective rate, effective rate and total effective rate. In high frequencies, all frequencies and total deafness, there were no significant differences in therapeutic effect. The recovery rate of total CT group (40.24%) was significantly increased compared with that of OP group (26.04%)(χ2=4.061,P<0.05), the differences of apparent effective rate, effective rate and total effective rate were not statistically significant in both groups.CONCLUSIONFor low-middle frequencies SSNHL, the early combination treatment with intratympanic glucocorticoid injection leads to higher hearing recovery and therapeutic effect compared with traditional oral prednisone. Systemic application should be applied for high frequencies, all frequencies and total deafness of SSNHL.