Aged ; Amyloidosis ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Moxibustion ; methods ; Skin Diseases ; therapy

In the light of requirements of medical equipment simulation system, the overall framework of joint control system of medical equipment integrated support in the theater is designed in this paper. Such modules are developed with Delphi as communication module, module for equipment basic information, module for equipment video information and module for medical faculty information. A joint control system suiting integrated support simulation sand table for medical equipment is complteted,which provides a multidimensional informational platform for integrated demonstration of medical equipment.

Objective To investigate parameter changes for skin aging in murine model induced by D-galactose. Methods Sixty 3-month-old female mice were randomly divided into three groups: normal control group,low dose (80 mg/kg)and high dose (1000 mg/kg) D-galactose groups. After subcutaneous administration for 6 weeks, the aging models were established. Then, histochemical standards relating to aging were measured and morphologic alterations of surplus dorsal skin were observed under microscope and analyzed. Results In contrast with the control group, high dose D-galactose group showed that the thickness of dermis (624.5 ?48.5) ?m was significantly reduced (P

Objective To explore the applicative value of contrast enhanced ultrasound (CEUS) through rectumin the T-staging of rectal cancer.Methods 24 cases with rectal cancer were examined preoperatively by endorectal ultrasound (ERUS) and CEUS during May 2012 to November 2013 in our hospital.The characteristics of contrast enhanced ultrasound imaging in early and late phase of the rectal cancers were studied,and the imaging distribution and enhancement mode were observed.The preoperative staging diagnosis was conducted by consulting T staging criteria.The diagnostic results were compared with the postoperative pathologic diagnosis.Results The contrast enhanced time in rectal cancer began at 14-35s.The early tumor showed uneven nodular,ribbon or ring in high enhancement.At the advanced late,angiographic tumor showed homogeneous enhancement and continued to be observed during the whole time.Normal rectal wall ultrasonography showed spotty low enhancement or no enhancement.The overall accuracy of ERUS in T-staging was 66.7％ (16/24) and the overall accuracy of CEUS was 83.3％ (20/24) respectively.There was a significant difference in the overall accuracy between ERUS and CEUS (P＝0.018).The sensitivity,accuracy and positive predictive value of CEUS were 100.0％ (2/2),100.0％ (2/2),100.0％ (2/2) inT1 stage,83.3％ (10/12),83.3％ (10/12),100.0％ (10/10) in T2 stage,100.0％ (8/8),88.9％ (8/9),88.9％(8/9) in T3 stage,and 100.0％ (2/2),100.0％(2/2),100.0％ (2/2) in T4 stage,respectively.Conclusions As compared toroutine transrectal ultrasound,transrectal contrast enhanced ultrasound imaging on rectal cancer shows the typical sonographic characteristic imaging on microvascular focus size and borders,on characteristic infiltration zone.Therefore,contrast enhanced ultrasound improves the diagnostic accuracy of preoperative T-staging in rectal cancer surgery.

Objective To study the effects of sodium bicarbonate (SB) on resuscitation in swine model of asphyxiation cardiac arrest (CA).Methods Thirty-two healthy miniature pigs were randomized (ramdom number) into two groups,the SB group (n =16) and the control group (n =16).Animals in both groups underwent endotracheal tube clamping to induce CA.Once induced,CA left untreated for a period of 8 minutes.At the beginning of initiation of cardiopulmonary resuscitation (CPR),SB (1.0 mEq/kg,diluted to 40 mL) was injected in central venous in SB group and isopyknic normal saline solution was injected in control group.Two minutes following initiation of CPR,defibrillation was attempted until return of spontaneous circulation (ROSC) was achieved or animals died.To assess the SB effects on myocardial metabolism,positron emission tomography (PET) was performed at baseline and 6 after ROSC.To analyze 18F-FDG myocardial uptake identified in PET,the maximum standardized uptake value (SUV) was measured.Results ROSC was 10/16 successful in SB group and only 8/16 successful in control group.The average survival time of SB group was (3.63 ± 0.76) h and that of control group was (2.45 0.70) h.Myocardial metabolism imaging using PET demonstrated that myocardial metabolism injuries in control group were more severe than in SB group at 6 h after ROSC and SUVmax was more higher in SB group than in control group (6 hrs after ROSC:1.32 ± 0.20 vs.1.10 ± 0.14,P =0.035).Conclusions In swine model of asphyxiation CA,SB improve the myocardial metabolism and might raise the possibility of ROSC and have no hypernatronemia.

BACKGROUND:Because of osteoporosis, short-segment transpedicular fixation or screw-rod system fixation is prone to screw loosening depending on its poor anti-pul-out strength in patients with thoracolumbar fracture with ankylosing spondylitis.
OBJECTIVE:To probe the clinic outcomes of multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis.
METHODS:Eleven patients with ankylosing spondylitis combined with thoracolumbar fracture in the Fourth Department of Orthopedics, Meizhou Hospital, Sun Yat-sen University, China from January 2009 to December 2012 were selected. Al the patients underwent posterior reduction and multi-segment transpedicle spinal fixation, among whom, six cases were subjected to internal fixation through the pedicle of fractured vertebra.
RESULTS AND CONCLUSION:Al of the 11 patients were fol owed up for 13 to 36 months. Solid bone healing was achieved in al of the patients, and there were no complications related to the internal fixation systems such as loosening or breakage. Three cases of spinal cord injury achieved Frankel’s class E from class C recovery. Lumbodorsal pain rate achieved 100%according to the Japanese Orthopaedic Association scoring. Results confirmed that it is effective to treat thoracolumbar fractures with ankylosing spondylitis by posterior reduction and multi-segment transpedicle spinal fixation. Strong internal fixation and fracture union can be achieved by operation.

Objective To observe the effect of nutritional status change on hemodialysis patients of chronic renal failure and deficiency of spleen and kidney treated bytraditional Chinese medicine(TCM) of warming kidney and invigorating spleen. Methods In our center, 146 patients who were diagnosed chronic renal failure belonging to deficiency of spleen and kidney in TCM were received hemodialysis between Jun2012 and May2013. All patients were randomly divided into a treatment group (n=72) and a control group (n=74). 74 patients in the control groupreceived conventional hemodialysis and medicine treatment, and 72 patients in treatment group received conventional hemodialysis、medicine treatment and TCM treatment of warming kidney and invigorating spleen. The comprehensive nutritional assessment of all patients were treated by modified SGAN method (MQSGAN), anthropometric, biochemical and laboratory examination before and 6 monthsafter the treatment. Results The treatment group patients of modified SGAN(9.58±3.15), BMI (body mass index 19.34±0.52) Kg/m2, MAC(upper arm circumference 27.51±1.95)cm, TSF(tricepsskinfold thickness 12.92± 2.42) mm and MAMC(upper arm muscle circumference 23.64±1.96)cm were significantly improved compared with the control g roup(respectively data 13.23±3.14, 17.29±0.76) Kg/m2, (24.01±2.55, 10.58±2.71) mm, (20.71±2.04)cm, P<0.05,and treatment group patients with ALB(serum albumin 38.19±1.95)g/L, PA(prealbumin 2.23±0.16)g/L, TF(transferrin 0.21±0.04)g/L, CH(cholesterol 4.02±0.26)mmol/L, BUN(blood urea nitrogen 19.58±2.17)mmol/L and SCr (creatinine 869.54±79.15)mmol/L were significant improved also compared with the control group(respectively data 33.73±1.31)g/L, (1.67±0.25)g/L, (0.17±0.02)g/L, (3.22± 0.46)mmol/L, (16.27±1.12)mmol/L, (792.73±71.65)mmol/L, P<0.05. Conclusion Traditional Chinese medicine of warming kidney and invigorating spleen can improve the nutritional status and quality of life on patients with chronic renal failure belonging to deficiency of spleen and kidney type during hemodialysis.

Objective To investigate the safety of different intensity anticoagulation therapy of warfarin in preventing thromboembolism in octogenarian patients with nonvalvular atrial fibrillation (NVAF). Methods The 130 patients with persistent or permanent NVAF were randomly divided into three groups: low-intensity warfarin group (35 cases, international normalized ratio, INR (1.5-2.0), moderate-intensity warfarin group (32 cases, INR 2.1-2.5) and aspirin control group (63 cases). The rate of hemorrhagic events and the effect on renal function were observed. Results The incidence of hemorrhage was the lowest in low-intensity warfarin group compared to the other groups with slight bleeding in one case. life-threatening bleeding in one case, severe bleeding in one case and slight bleeding in four cases occurred in moderate-intensity warfarin group. Life-threatening bleeding in three cases, severe bleeding in two cases and slight bleeding in six cases occurred in aspirin control group. There were significant differences in bleeding incidence among the three groups (χ2=5.13,P＜0.05). The low-intensity warfarin group and moderate-intensity warfarin group were superior to the aspirin control group in the effect on renal function (P＜0.05). Conclusions It is safe that the dose of warfarin is maintained at low anticoagulation intensity between INR 1.5 and 2.0 in octogenarians with NVAF.

ObjectiveTo investigate the age distribution of serum prostate specific antigen (PSA) and explore its correlation with fasting blood glucose(FBG)and lipid in the male elderly.MethodsThe levels of FBG,triglyceride (TG),low-density lipoprotein (LDL-C),high density lipoprotein (HDL-C) and PSA were reviewed in 2903 elderly men (aged ≥ 60 years) in our hospital.The subjects were classified into 6 groups by age,and PSA levels were compared among groups.The correlations of FBG,TG,LDL-C,HDL-C with PSA were analyzed using multiple linear regression analysis.Results The level of PSA had the trend to increase with age.Positive association of TG,LDL with serum PSA level,but negative correlation between HDL and serum PSA level were noted in the group aged 60-64 years (r=0.10,0.15,0.12,P＜0.05).In the group aged 66-69 years,there was negative relationship between FBG and serum PSA(r= 0.10,P＜0.05).No relationship could be found in other groups (P＞0.05).ConclusionsPSA level may increase with age,but without relation with FBG,TG,LDL-C and HDL-C.

Objective To observe the clinical efficacy of staphylococcal protein A immunoadsorption plus nonmyeloablative chemotherapy with CD34+ autologous peripheral blood stem cell transplantation in the treatment of refractory systemic lupus erythematosus (SLE). Methods Three patients with active SLE were enrolled into this study. All patients were diagnosed with lupus nephritis by renal biopsy and poorly responded to routine therapy. Before transplantation, patients were given 6 sessions of immunoadsorption apheresis using columns of staphylococcal protein A-silica with an interval of 3 days; each session processed 3 L plasma and a total of 18 L plasma was processed over the 6 treatments. Three days following the immunoadsorption apheresis, the mobilization of stem cells was realized by intravenous cyclophosphamide at a dose of 2 g per square meter of body surface area and subcutaneous recombinant human granulocyte colony-stimulating factor (G-CSF) at a dose of 5 g per kilogram of body weight per day for 5 days. Then, peripheral blood raonoclonal cells were obtained by CS-3000 Cell Separator, and passed through the Clini Macs CD34+ cell selection device, with the final concentration of CD34+ cells being 2.6×106, 2.1×106 and 2.4×106 per kilogram of body weight respectively, and that of CD3+ cells being 3×105, 2.1×105, and 2.0×105 per kilogram of body weight, respectively, in these three patients. The conditioning regimen consisted of oral fludarabine of 50 mg/d for 5 days plus intravenous pig anti-human thymocyte immunoglobulin (ATG) at a daily dose of 90 mg/kg for 5 days. After 72-hour treatment with ATG, the frozen stem cells were infused back to the patients. Clinical manifestations and lupus-correlated immune parameters were compared in patients at baseline and after transplantation. Results Following immunoadsorption apheresis, an obvious decrease was observed in the level of serum anti-dsDNA, antinuclear antibody and IgG antibodies, while an increase in the level of serum complement 3. All patients achieved the reconstruction of hemopoiesis 2-3 days after the transplantation. Also, an apparent clinical remission was achieved with the SLEDAI score being less than 3. Six months after the transplantation, serum anti-dsDNA and antinuclear antibodies as well as urine protein were undetectable, the level of complement 3 reached the normal range, and renal function was restored. Conclusions Staphylococcal protein A immunoadsorption plus nonmyeloablative CD34+ autologous peripheral blood stem cell transplantation are effective and safe for refractory SLE, but the long-term effect remains to be connfirmed by further studies.