Objective To identify the risk factors for postoperative cognitive dysfunction (POCD).in the elderly patients requiring general anesthesia.Methods Three hundred elderly patients,aged 65-80 yr,scheduled for thoracic or abdominal surgery under general anesthesia,were enrolled in this study.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 3 days after operation.The patients were diagnosed as having POCD if MMSE ＜ 21.The patients were assigned into POCD and non-POCD group.The general data,fasting plasma glucose,glycosylated hemoglobin (HbAlc) and blood pressure were measured.If there was no significant difference between the 2 groups,the factor was analyzed using logistic regression to select the risk factor for the incidence of POCD.Results Ninety-eight patients developed POCD (32.7 ％).Logistic regression model showed that older age,diabetes and hypertension were independent risk factors for POCD (P ＜ 0.05).Conclusion Older age,diabetes and hypertension are independent risk factors for POCD in the elderly patients requiring general anesthesia.

Objective: To study the relation of bile acid levels and fetal hypoxia and brain injury in Intrahepatic Cholestasis of Pregnancy (ICP). Methods: From May. 2006 to Sep. 2006, we selected 30 cases of ICP as the study group, and randomly selected 30 cases of normal pregnant women for delivery during the same period as the control group in our hospital. Color Doppler ultrasound was used to measure the peak systolic velocity to end-diastolic velocity (S/D) and the resistive index (RI) of fetal middle cerebral artery, and the automatic biochemical analyzer be used to detect the total bile acid (BA) in maternal blood, and BA, pH as well as lactate in umbilical arterial serum; neuron-specific enolase (NSE) in umbilical artery serum was detected by ELISA. The results were analyzed and compared. Results:①The BA concentration in maternal blood and newborn umbilical artery blood of the study group was significantly higher than that of the control group ( P<0.01). In the study group, the BA in maternal and newborn blood were positively correlated ( r=0.937, P< 0.01) ;②Lactate and the NSE Concentration in newborn umbilical artery of the study group was significantly higher than that of the control group ( P< 0.01). The pH value innewbom umbilical artery and The S/D, RI value of fetal middle cerebral artery in the study group was significantly lower than those of control group ( P< 0.01); ③ In the study group, the NSE concentration was positively correlated with BA and lactate concentration in newborn umbilical artery, while negatively correlated with the S/D and RI values of fetal middle cerebral artery and the pH value in newborn umbilical artery ( P<0.01). Conclusions: There is the existence of hypoxia and brain injury in fetus of ICP. By measuring the blood flow changes of fetal cerebral artery with Color Doppler and detecting pH, lactate as well as NSE levels in umbilical arterial blood, we could early predict the fetal hypoxia and diagnose the fetal brain injury in ICP.

Objective To investigate the influence of intraoperative posture intervention on drainage in patients after gynecological laparoscopic surgery. Methods A total of 1250 patients who were scheduled for gynecological laparoscopic surgery including laparoscopic-assisted salpingoplasty,oophorocystectomy,ectopic pregnancy,vaginal hysterectomy,myomectomy and appendectomy were randomly divided into two groups. The patients' posture was changed from Trendelenburg position to level lithotomic position during suction by the circulating nurses in the experimental group,while after surgery in the control group. The volume and time of drainage,and the length of stay after surgery were compared between the two groups. Results The volume and time of drainage,as well as the length of stay after surgery had significant differences between the two groups (P<0.05). Conclusions Intraoperative posture intervention is helpful for the treatment effect of drainage after gynecological laparoscopic surgery.

Objective To study the role of nicorandil in protecting myocardium of very old patients with non-ST segment elevation myocardial infarction.Methods Ninety-six very old patients with non-ST segment elevation myocardial infarction admitted to our hospital from March 2012 to July 2016 were randomly divided into experimental group (n=48) and control group (n=48).After 4 weeks of comprehensive treatment,the patients in experimental group were given oral nicorandil (5 mg,3 times a day).The serum cTnI level was measured in 2 groups before treatment and on days 1,3,7 and 10 after treatment.The ECG of 2 groups was observed before and after treatment.Results The serum cTnI level was significantly lower in experimental group than in control group on days 3,7 and 10 after treatment (3.24±4.31 μg/L vs 10.47±t4.72 μg/L,P＜0.05;0.53±0.31 μg/L vs 2.50±1.45 μg/L,P＜0.01;0.09±0.07 μg/L vs O.41±0.26 μg/L,P＜0.01).The ECG was significantly better in experimental group than in control group after treatment (P＜0.05).Conclution Oral nicorandil can protect the myocardium of very old patients with non-ST segment elevation myocardial infarction.

0.05), respectively. The remnant index(%) in group 1,2,3 and 4 was 56.7, 56.7, 80 and 50 respectively. Conclusion: In vitro study indicates that there is no difference in production of shear strength and tensile strngth between teeth and the tow kinds of brackets.

Objective To introduce the new technique of transperitoneal laparoscopic ureterovesical reimplantation and to evaluate its feasibility and clinical significance. Methods Overall,17 cases (5 men and 12 women) of ureterovesical obstruction (left,7 and right,10) were included.Of them,10 cases were diagnosed with simple congenital ureter outlet stricture;1 had calculi and polyp formation at right ureter outlet;2 had recurrent ureter outlet stricture after open ureterovesical reimplantation (1 of them had 2 calculi at lower part of the ureter);1 had double nephroureteral upper unit ureter outlet stricture with 2 calculi;2 had recurrent ureter outlet stricture after holmium laser section;1 with urinary TB had right ureter outlet stricture after left nephrectomy.Among the 17 cases,severe hydronephrosis occurred in 12,and moderate,in 5.Transperitoneal laparoscopic ureterovesical reimplantation was performed in the 17 cases (ureterovesical anastomosis in 15 and bladder flap ureterovesical reimplantation in 2). Results The operations were all successful in 17 cases with operating time of 90～160 min (mean, 112 min) and blood loss of 60～100 ml.The drainage tubes were removed 1～3 days after surgery without urine leakage.The urinary catheters were removed 1 week after surgery and double J stents,1 month after surgery. Six months after surgery cystography showed Ⅲ?urine reflux in 6 cases, Ⅰ?-Ⅱ? urine reflux in 5 and no reflux in 6.One year after surgery cystography showed Ⅲ? urine reflux in 3 cases, Ⅰ?～Ⅱ? urine reflux in 4 and no reflux in 10.During 3～24 months' follow-up, ultrasound B and IVU showed moderate hydronephrosis in 4 cases,mild,in 5 and no obvious hydronephrosis in 8. Conclusions Laparoscopic ureterovesical reimplantation is a feasible,less painful and minimally invasive alternative method for treatment of ureterovesical diseases.By comparison,bladder flap ureterovesical reimplantation has better anti-urine reflux effect but more complicated than ureterovesical anastomosis does.Long term efficacies of the methods need further observation.

Objective To study the correlation of NF-?B expression with the grade, the stage, the recurrence, the metastasis and PKC expression of bladder transitional cell carcinoma. Methods The expression of NF-?B and PKC was examined with SP immunohistochemical method in 54 cases of paraffin-embedded bladder transitional cell carcinomas tissues and 13 cases of normal bladder tissues. Results The positive expression rate of NF-?B P65 and PKC in bladder transitional cell carcinomas was 88 9% and 81 5% respectively. The expression rate of NF-?B decreased along with pathological grade and clinical stage increased, while its expression increased along with the rate of recurrence and metastasis elevated. There was a positive relationship between NF-?B and PKC expressions. Conclussion NF-?B may play a role at early stage of bladder transitional cell carcinoma. It probably serves as an index to evaluate the malignant extent and progression of bladder transitional cell carcinoma. PKC probably takes part in the activation process of NF-?B.

OBJECTIVE: To evaluate the efficacy and safety of standardized subcutaneous immunotherapy for dust mite in patients with allergic rhinitis. METHOD: Using self-control methods, 35 cases with allergic rhinitis were treated with specific immunotherapy for 2 years. Symptom score and visual analogue scale (VAS) score were observed before treatment and 1 years, 2 years after treatment respectively. RESULT: The symptoms, signs and VAS score of the 35 patients who were treated with specific immunotherapy after 1 year were significantly reduced than that before treatment, the differences were statistically significant (P < 0.05). The symptoms, signs and VAS score of the patients who completed 2 years' treatment, compared with that of pretreatment and 1 year treatment were significantly reduced, the differences were statistically significant (P < 0.05). CONCLUSION Standardized immunotherapy for dust mite is a safe, effective method for patients with perennial allergic rhinitis, which can be used as a routine treatment for allergic rhinitis. To further improve the therapeutic effect, immunotherapy should be continued for at least 2 years.
Adolescent ; Adult ; Allergens ; administration & dosage ; Child ; Female ; Humans ; Immunotherapy ; Male ; Middle Aged ; Rhinitis, Allergic ; therapy ; Treatment Outcome ; Young Adult

Objective To develop the job burnout scale for military personnel and examine the reliability and validity of this scale. Methods A total of 1000 military personnels were chosen by random cluster sampling to outline the Job Burnout Scale for Military Personnel, with the subjects divided into group A and group B, 280 of them were tested by this scale and Chinese Maslach Burnout Inventory simultaneously (CMBI), In group A ( n=500 ) Exploratory Factor analysis and Correlation analysis were used, and in group B ( n = 500) Confirmatory factor analysis was used. Results The results of correlation analysis indicated that the Cronbach'α of total scale was 0.917, and that of subscales was 0.719 ～ 0.847; split-half reliability coefficient of total scale was 0.920, and that of subscales was 0.723 ～ 0.867. The correlation coefficient of total scale scores and each factor was 0.731 ～ 0.808 (P＜0.01 ) ,and the correlation coefficient ranged from 0.386 to 0.627 between the factors(P ＜ 0.01 ). According to the results of exploratory and confirmatory factor analysis, the sample data fitted better to the hypothesized structure of theoretical model ( Sense of achievement, Somatization, Self-assessment, Human relation, Demotivation) and the indexes of Chi-Square was 771. 914, the degrees of freedom was 395, the probability level was 0.000, the relative Chi-Square was 1.954, the root mean square error of approximation (RMSEA) was 0.044, and the goodness of fit index ( GFI ), comparative fit index ( CFI ), incremental fit index ( IFI ) were 0.904,0.919, 0.920 respectively. The correlation was significant between this scale and CMBI. Conclusion The Job Burnout Scale for Military Personnel has good reliability and validity.

Objective Survival rates of pancreas cancer during the years 1972-2011,from a population-based cancer registry in Qidong,were analyzed in order to provide information for the prognosis assessment and control of this disease.Methods The deadline of the last follow-up for survival status of 3279 registered cases was April 30th,2012.DCO (death certificates only) cases were excluded,leaving 3272 cases for survival analysis.Cumulative observed survival rate (OS) and relative survival rate (RS) were calculated by the SURV3.01 software.Results The 1-,5-,10-,15-,20-,25-,and 30-year OSs were 12.69％,4.87％,3.76％,3.07％ 2.66％,1.94％ and 1.28％,respectively,and OSs in male were 12.39％,4.67％,3.41％,2.77％ 2.22％,1.35％,0.75％,and in female were 13.08％,5.12％,4.22％,3.45％,3.28％,3.00％ 2.40％.The 1-,5-,10-,15-,20-,25-,and 30-year RSs were 13.34％,6.30％,6.47％,7.34％ 9.27％,10.33％ and 10.65％,respectively;and the RSs in male were 13.06％,6.14％,6.06％ 6.91％,8.06％,7.44％,6.44％,and in female were 13.70％,6.47％,6.99％,7.88％,10.91％ 15.25％,19.12％.The 5-year OS rates at age groups of 15-34,35-44,45-54,55-64,65-74 and ＞75 were 17.81％,6.34％,8.32％,5.04％,3.75％ and 3.82％,respectively.The 5-year RSs were 17.97％,6.47％,8.65％,5.47％,4.68％ and 8.03％.Five-year OSs increased from 2.01％ in 1973-1977 to 5.11％ in 2003-2007.Conclusions The overall survival rate of pancreas cancer has increased during the past 40 years in Qidong,but the improvement is marginal.