Objective To describe the survival status and to analyze the related factors of mortality among elderly patients with first-ever stroke.Methods Totally 1 96 elderly patients with first-ever stroke from January 2010 to January 2014 were enroll for the study.The survival status of all cases was attained through follow-up,and the deadline of follow-up was July 30,2014.The deceased patients because of stroke were divided into death group while the others were divided into survival group.Univariate com-parison and multivariate Logistic regression analysis were performed to screen out the related factors of death.Results The median follow-up time was 41 months,and 14 cases were lost to follow-up.The survival rate 28 d,1 year and 3 years after the onset were 73.47%,66.81% and 58.89%.Age,complication,Glasgow score,NIHSS score and blood WBC were the independent influence fac-tors of death (P <0.05).Conclusion The death among elderly patients with first-ever stroke are more concentrated in 28 d after the onset.Advanced age,complications,decrease of Glasgow score,increase of NIHSS score and blood WBC could increase the death risk.

[Objective]To introduce the effect of reversed sural neurofasciocutaneous flap with muscle repairing the soft tissue defect of foot and ankle.[Method]Reversed sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect simultaneous open fracture of tibia lower section 6 cases,the soft tissue defect simultaneous chronic osteomyelitis of tibia lower section 5 case,the soft tissue defect of sole of foot simultaneous calcaneus epicarp 3 case, the soft tissue defect of sole of foot simultaneous calcaneus osteomyelitis or dead space 2 case. The scope of the flap was 18 c m?13 cm～11 c m?7 c m and that of the gastrocnemius flap was 4 cm?3 cm～9 c m?6 cm,the thickness was 1～3 cm,the skin flap was bigger than the muscle flap.[Result]Muscle side of the muscle flap was errhysising actively and the skin flap was good circulation duing operation, the muscle flaps were used clinically in 16 patiens all survived completely after operation. All cases were followed up from 5 to 17 months ,incision of open fracture healed primarily, osteomyelitis without reoccurring, the muscle flaps were satisfactory in appearance,feel recovered and walk well.[Conclusion]Reversed sural neurofasciocutaneous flap with muscle has sufficient blood supply and high survival rate,so it is an effective and feasible method in repairing the soft tissue defect of foot, ankle and tibia lower section in special cases.

To explore the role of CDC25B in pathogenesis and development of colorectal cancer and to investigate the relation between the expression of CDC25B and the clinical pathological character of colorectal cancer and the prognosis of patients. The expression of CDC25B in 168 patients with colorectal cancer and 25 patients with adenoma, and normal colorectal mucosa from 20 individuals was assayed by immunohistochemistry (S-P method). The expression of CDC25B was not detected in adenoma and normal colorectal mucosa. The expression rate of CDC25B in colorectal cancer was 71.4%(120/168). The expression of CDC25B had a positive correlation with distant metastasis and the increase of CEA,while it had no relationship with the tumor stage, grade, lymph node metastases, gender, age or the size of tumor . The patients in whom expression of CDC25B was detected had a markedly low 5-year survival rate. The results suggested that expression of CDC25B in colorectal cancer might accelerate the transformation of cell cycle,which promoted metastasis to distant organ, indicating that the expression of CDC25B might play a role in the development of colorectal cancer. The expression of CDC25B was a risk factor of poor prognosis.

Objective To explore the features and treatment methods of osteoporotic vertebral compression fracture of elderly patients with cardiopulmonary diseases. Methods 18 cases of osteoporotic vertebral compression fracture of elderly patients with cardiopulmonary diseases teated by percutanteous vertebroplasty(PVP), and VAS(visual analogic scale) and mobility ability were measured before and after treatment. Results All 18 patients were punctured and operated successfully. The preoperitive and postoperative VAS was 7.6?1.2 and 3.7?1.3, respectively. There was obvious pain relief after operation (P

0 05).CD 34 , CD 31 and F VIII of the average counts of microvessels were (69 5?15 7), (65 3?14 5) and(58 3?16 3) respectively in the NSCLC with metastasis and (44 3?14 3), (40 5?12 6) and (36 5?15 8) respectively in those without metastasis,there was a significant difference (P

The article analyzed the system architecture design of the Shanghai municipal hospital clinical information sharing project, aiming to provide reference for system design of a regional medical information sharing system. This project is composed of the following: A universal medical card,hospital's internal information system, an inter-hospital network, a clinical information exchange and sharing platform, a data center, a decision support system and a public service portal. Key issues involved in the system design include the personal identity, the establishment of standards and specifications, the information sharing model, the information storage model, systems related to hospitals and personal privacy protection.

Objective To discuss the effect of expanded deltopectoral skin flaps in repairing scar contracture deformity of facio-cervical .Methods Twenty-four patients with scar contracture deformity of faciocervical were included into the study .We expanded the deltopectoral skin flap with dilator .8-10 weeks later ,the deltopectoral skin flap were transferred after resection of faciocervical scar .3-4 weeks later ,the pedicles were cut off ,and then the remaining wound were repaired .Results They had not exudation .Ex-pander exposure ,local hematoma and local infection respectively were 1 ,3 ,4 cases ,all did not affect operation effect by symptomatic treatment ,and obtain good postoperative effect .Deltopectoral flap was for 27 cases ,blood supply obstruction low temperature and skin flap necrosis respectively were 4 ,2 ,1 cases ,all get good healing after corresponding .Followed up for 0 .5 year ,all flaps were survived well ,no ectropion or mental cervical adhesion ,its color and texture were similar with surrounding normal skin appearance , so they were got high satisfaction .Conclusion Application of expanded deltopectoral skin flaps to repair scar contracture deformity of faciocervical can achieve good effect and may be an ideal method to repair ,which is worthy of clinical application .

Objective To investigate the changes of lipopolysaccharide binding protein(LBP) in serum and ascites in patients with liver cirrhosis and its clinical significance. Methods Ninety?six cases of liver cir?rhosis patients who were treated in the NO. 202 Hospital of People's Liberation Army from January 2013 to De?cember 2015 were selected as research subjects,and were divided into liver cirrhosis with spontaneous bacterial peritonitis(SBP) of 27 patients as SBP group,69 cases of patients with liver cirrhosis as non?SBP group accord?ing to the clinical diagnosis. The level of LBP in serum and ascites,routine blood test and liver function indica?tors of two groups were detected and comparative analyzed. Receiver operating curve( ROC) was drawn to select LBP diagnosis best critical value of SBP. Results The level of LBP in serum and ascites of SBP group were significantly higher than that of non?SBP group((43. 2±10. 6) μg/L vs. (19. 5±7. 5) μg/L,(280. 6±73. 9)μg/L vs. (127. 4±42. 0) μg/L),and the difference was statistically significant(t=12. 324,7. 892;P<0. 05) . ROC curve showed that the diagnosis of SBP sensitivity was 82. 30%,the specificity was 78. 36%,the area un?der ROC curve AUC value was 0. 821 when Cut?off value of LBP in ascites was 23. 5 g/L;the diagnosis of SBP sensitivity was 85. 59%,the specificity was 81. 24%,the area under ROC curve AUC value was 0. 856 when Cut?off value of LBP in serum was 152. 1μg/L. Conclusion LBP levels in serum and ascites in cirrhotic patients for the differential diagnosis of SBP has some clinical value.

Objective To discuss the method and clinical effect of bilobed DIEP flap for repair of degloving injuries of the hand.Methods From June, 2013 to January, 2015, the bilobed DIEP flap were designed to repair 6 cases of degloving injuries of hand, of which the small leaf flap repaired separately defect of thumb, larger leaf flap repair 2nd-5th finger and palm and dorsum.The bilobed DIEP flap design were based upon anatomic study on deep inferior epigastric artery, superior epigastric artery, intercostal artery and its anastomosis.Results The largest area of main flap was 35 cm × 12 cm, and the deputy leaves of flap was 10 cm× 7 cm.All of the 6 flaps survived.One of them experienced distal end necrosis of epidermis.But it was healed by dressing changes.All of the 6 cases were followed up for average of 12 months (range, 6-20 months).All flaps were seen with good appearance, fully recovered protectve sensation and the active motion of the thumb was recovery.Moreover, the donor sites were closed directly and the appearance were satisfactory.Conclusion The bilobed DIEP flap is a satisfying choice in repairing degloving injuries of the hand in that it has reliable blood supply, can obtain the larger area of skin and leaves small injuries in targeted area.

Objective To discuss the clinical application and evaluate the effect of repairing finger injuries using the perforator flap in forearm cubital fossa.Methods From July,2012 to December,2013,8 cases of finger injuries with totaled defect area of 2.5 cm × 4.0 cm-5.5 cm × 7.0 cm were reviewed.Among them,6 cases had phalangeal fracture,7 cases had neurovascular injury and 4 cases combined with tendon injuries.Cubital fossa flaps based on the inferior cubital perforator of radial artery were transplanted to repair the defects.Results All of the 8 flaps survived.One of them experienced distal end necrosis of epidermis and 1 cm long wound dehiscence.But it was healed by dressing change.All of the 8 cases were followed up for an average of 11 months (range,6-20 months).Sensory quality of （S） + was present in all of the flaps with two-point discrimination ranging between 7.5 mm and 9.8 mm with an average of 8.5 mm.All flaps were seen with good appearance,texture and colour.Moreover,function and appearance in donor sites were satisfactory.Conclusion The perforator flap in forearm cubital fossa is a satisfying choice in repairing small skin defects in fingers and other paas in that it is fixed,easy to dissect and leaves small injuries in targeted area.