Objective Toinvestigatethecorrelationofsmallvesseldisease(CSVD)causedacute lacunarinfarctionandurinemicroalbumin.Methods Theclinicaldataof136patientswithacutelacunar infarction admitted to the Department of Neurology,Shengjing Hospital of China Medical University from November 2012 to April 2014 were analyzed retrospectively. They were divided into either a CSVD group (n=72)or a cerebral large vessel disease (CLVD)group (n=64)according to their carotid artery color Doppler ultrasound and head magnetic resonance angiography findings. The levels of urinary microalbumin in both groups were observed and compared. SAS 9. 1 software was used to conduct statistic analysis. A Logistic regression analysis was used to determine the independent risk factors for CSVD caused acute lacunarinfarction.Results TheconcentrationofurinemicroalbuminoftheCSVDgroup(22±13mg/L) was significantly lower than (29 ± 14 mg/L)that of the CLVD group. There was significant difference (P<0.05). There was significant difference in the increased urine microalbumin levels between the CSVD group and the CLVD group (P<0. 01). There was an increasing trend for the proportion of patients with urine microalbumin concentration 10- <30 mg/L (56. 9%[41/72])in the CSVD group compared with the CLVD group (26. 6%[17/64]). Logistic regression analysis showed that the slightly increased microalbuminuria was associated with CSVD caused acute lacunar infarction (OR,3. 130,95%CI 1. 481-6.618;P<0.01).Conclusion Theslightlyincreasedmicroalbuminuriaisanindependentriskfactorfor CSVD caused acute lacunar infarction.

Objective The purpose of our research was to quantitative study the degeneration of lumbar intervertebral discs by using T2 mapping technology at 3.0T MR and research the correlation of biomechanics and lumbar disc degeneration.Methods 34 patients with low back pain or sciatica were enrolled.The correlation of T2 values of lumbar intervertebral discs and Pfirrmann grading,disc location,patient ages were analyzed.T2 values before and after loading were also analyzed.Results T2 values of nucleus pulposus were correlation with Pfirrmann scoring,disc location and,patient ages.Conclusion (1 )T2 mapping provides a non-invasive and quantitative way to diagnose lumbar discs degeneration.(2)The change of external pressure load can affect the T2 values of the intervertebral disc.

Objective To investigate expression and significance of matrix metalloproteinase-2(MMP-2),MMP-9 and tissue inhibitor of metalloproteinase-1(TIMP-1) in rats with glomerular sclerosis made by doxorubicin.Methods Forty Wistar male rats(8-week-old) were randomly assigned into 2 groups:sham operated and model groups.Rats in model group were nephrectomized after anesthesia and injected with adriamycin(5 mg/kg) after 1 week.Rats in sham operated group was subjected to sham operation and injected with normal saline after 1 week through the tail vein.All rats were killed in the 12th week.Immuno-histochemistry was performed on renal tissue to detect Collagen Ⅳ(Col-Ⅳ),fibronectin(FN),MMP-2,-9 and TIMP-1.Results Immunohistochemistry staining indicated that expressions of MMP-2,-9 in model group decreased significantly compared to sham operated group(Pa

Objective To study the expression of ?-smooth muscle actin(?-SMA)in glomerulosclerosis rats and its relationship with renal function.Methods Forty healthy Wistar rats were equally divided into 2 groups including sham operated group and model control group.Rats in model groups were uninephrectomized and injected with daunorubicin(5 mg/kg)after 1 week through the tail vein.Twenty-four hours of urinary protein excretion,serum creatinine(Scr),blood urea nitrogen(BUN)were measured at the 12th week.Renal pathology was evaluated.Immunohistochemistry(SupervisionTM)was performed on renal glomeruli tissue to detect the expression of ?-SMA.Reverse transcription polymerase chain reaction(RT-PCR)was used to examine the expression levels of ?-SMA mRNA in glomeruli.SPSS 13.0 software was used to analyze the two variables.Results In model control group,the urinary protein,Scr,BUN significantly increased(Pa

Objective To compare the activities of daily living(ADL) of the elderly in different styles of providing.Methods 662 subjects were in range of 60～100 years old living in the organization for the aged and 620 subjects were in the range of 60～98 years old living at home from Beijing urban. They were evaluated with the ADL rating scales and a self-designed health status questionnaire.Results The total scores of ADL were not significantly difference between the elderly living at home and living in the organization(t=-0.299, P＞0.05). But age (OR=3.05, 95%CI: 1.805～2.935), educational level (OR=2.01, 95%CI: 1.512～2.544), and physical health (OR=1.25, 95%CI: 1.524～2.012) were related to ADL. Conclusion Age is the important factor affecting ADL (OR=3.05, 95%CI: 1.805～2.935), but ADL of the elderly in different styles of providing is not significantly difference.

Objective To study the incidence of vitamin K deficiency in low-birth weight premature infants and its relationship with intraventricular hemorrhage.Methods We use emzymoimmunoelectrophoresis to detect prophrombin protein precursors(PIVKA-Ⅱ) in vein blood in premature infants

Objective To observe the effect of goal-directed fluid therapy on hemodynamic and regional cerebral oxygen saturation (rSO 2 )in the elder patient undergoing one-lung ventilation. Methods Fifty-eight patients scheduled for esophagus cancer resection(44 males,14 females,aged 65-79 years,ASA physical status Ⅱ or Ⅲ),were randomly divided into two groups (n =29 each)u-sing a random number table:conventional fluid therapy group (group C)and goal-directed fluid ther-apy group (group G).Implementing radial artery puncture and internal jugular vein puncture under local anesthesia in order to monitor BP and CVP.The Flotrac/Vigileo system was used to monitor cardiac output (CO),stroke volume variation (SVV)and cardiac index (CI)in the both group.As mentioned all above,group C received conventional fluid therapy based on MAP,CVP and urine vol-ume,whereas group G received goal-directed fluid therapy (GDFT)based on SVV with the goal of CI at 2.5-4.0 L·min-1·m-2 .Intraoperative continuous monitoring of rSO 2 was performed and the sur-gery rSO 2 average (rSO 2 ),the minimal surgery rSO 2 (rSO 2min )and the maximal percentage of the decreased rSO 2 compared to baseline values (rSO 2%max )were calculated in the both group.The varia-tion of MAP,HR,CVP,SVV and CI at the onset of the monitoring (T1 ),the momment before one-lung ventilation (T2 ),30 min after one-lung ventilation (T3 ),1 h after one-lung ventilation(T4 )and the end of the surgery (T5 )were recorded.The requirement for crystalloid and colloid,total volume of fluid infused,bleeding volume,urine volume,and requirement for vasoactive agents were recorded during operaton.Results Compared with group C,MAP at T3 ,T4 and CI at T3-T5 in group G were increased significantly,while CVP at T3-T5 and SVV at T2-T5 in group G were decreased (P <0.05). The rSO 2%max in group G was significantly lower than that in group C (P <0.05).No statistically sig-nificant difference was observed in the rSO 2 and rSO 2min between the two groups.Compared with group C,the requirement for crystalloid [(668±187)ml vs (1052±221)ml and total volume of fluid infused [(1212±318)ml vs (1519±329)ml],urine volume [(211±47)ml vs (278±54)ml]and vasoactive agents [4 cases (14%)vs 14 cases (48%)]were significantly decreased (P <0.05),the requirement for colloid were increased [(544±103)ml vs (467±94)ml,P <0.05].Conclusion The goal-directed fluid therapy based on SVV stabilizes the hemodynamic effectively,improves the CI and the perfusion of brain,and maintains the cereral oxygen metabolism in the elder patient undergoing one-lung ventilation.

Postoperative pancreatic leakage remains a persistent problem after pancreaticoduodenectomy.For patients with a soft and nonfibrotic pancreas,double binding continuous hemstitch suture is an optimal method for anastomosis.From January 2011 to June 2012,92 cases of periampullary carcinoma with a soft pancreas underwent pancreaticoduodenectomy,and then a modified technique of pancreaticogastrostomy was performed with 2 continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall,respectively.The median time for pancreaticogastrostomy was 12 minutes,and only 15 patients had postoperative complications.Two patients developed pancreatic leakage(1 grade A and 1 grade B)postoperatively.Pancreaticogastrostomy with double binding continuous hemstitch sutures is a simple and safe reconstruction procedure for patients with a soft and fragile pancreas who received pancreaticoduodenectomy.

Objective To observe the effect of flexible laryngeal mask (FLMA) in transnaso-sphenoidal microsurgery for pituitary adenoma on airway management and variation of stress response.Methods One hundred patients (71 males, 29 females, aged 18-65 years, BMI 21-28 kg/m2, ASA physical status Ⅰ or Ⅱ) undergoing transnaso-sphenoidal microsurgery for pituitary adenoma were randomly divided into two groups: the FLMA group (group F) and the reinforced endotracheal tube group (group T) using a random number table, 50 cases in each group.The plasma concentration of epinephrine and norepinephrine were measured before anesthesia induction (T0), at the time of inserting the FLMA or reinforced endotracheal tube (T1), 1 min (T2) and 5 min (T3) after insertion.The Berry scores of the preoperative and postoperative airway exposure by branchofiberoscope in group F were assessed.The time of removal of FLMA (endotracheal tube) and the occurrence of choking, laryngeal spasm, sore throat, hoarseness and other adverse reactions were recorded.Results The levels of epinephrine and norepinephrine were were significantly lower at T2 and T3 in group F than those in group T (P<0.05).There was no significant difference in airway Berry scores.The time of extubation was shorter in group F than that in group T [(9±3) min vs (17±6) min] (P<0.05).The incidence of choking (2% vs 22%) and sore throat (4% vs 30%) were significantly lower in group F than those in group T (P<0.05).Conclusion Compared with the reinforced endotracheal tube, FLMA can be applied safely and effectively to transnaso-sphenoidal microsurgery for pituitary adenoma, reduces stress respond associated with anesthesia and post-extubation complications, improves the recovery of patients.

Objective To compare the relative efficacy and quality of extraction of human fecal DNA using four methods.Methods Real-time PCR were utilized for analysis both quantification and quality of the fecal targeted bacteria(including gut all eubaeterium,Bacteriodes-PrevoteUa group,Bifidobacterium spp Enterobacteriaceae and Enterococcus spp)by using 16s rRNA gene-targeted genus or group-specific primer sets.Results The negative rat of PCR product from method 3(phenol-chloroform plus bead-beating) was about 40%(4/10)by using universal primers,the PCR inhibition disappeared after fecal DNA purified with column.The total fecal 16s rRNA gene copy numbers(per gram of wet weight of feces)as well as the numbers of Bacteriodes-Prevotella group from method 1(QIAamp~DNA stool mini kit)and 4(QIAamp~ DNA stool mini kit combined with bead-beating)was higher significantly than that from method 2(FastDNA ~Kit,Biol01)and 3(P