This study was aimed to discuss traditional Chinese medicine (TCM) factors of bone mineral density (BMD) in order to figure out the relation of BMD T-Score to the TCM syndrome of kidney-deficiency, qi-deficiency , and blood-stasis . It may provide the scientific basis for TCM treatment of osteoporosis . Patients were collected from August 2010 to April 2011 at the Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine . The assay of BMD was performed with the U . S . HOLOGIC dual-energy radia-tion . The BMD was measured and recorded in the form . All data were collected into the computer using Epi-Data3 . 02 software . Then , the data was analyzed by the SPSS15 . 0 statistical software . The results showed that through the Mann-Whitney U test , the BMD of patients with kidney-deficiency syndrome was worse compared to patients without kidney-deficiency syndrome ( P < 0 . 01 ); the BMD of patients with q i-deficiency syndrome was worse compared to patients without q i-deficiency syndrome ( P < 0 . 01 ); the BMD of patients with blood-stasis syndrome was worse compared to patients without blood-stasis syndrome ( P < 0 . 01 ) . It showed that the BMD of patients with kidney-deficiency , q i-deficiency and blood-stasis was worse compared to patients with-out syndrome of kidney-deficiency , q i-deficiency and blood-stasis . Under a variety of evidence-based BMD distribution , the chi-square test showed that there was significant difference ( P < 0 . 01 ) . It showed that differ-ent BMD had different TCM syndrome distributions . Among normal BMD cases , distributions of syndrome with-out kidney-deficiency, qi-deficiency and blood-stasis occupied the largest proportion. Among osteoporosis cas-es , the distribution of syndrome of kidney-deficiency , q i-deficiency and blood-stasis occupied the largest pro-portion . It was concluded that the syndrome of kidney-deficiency , q i-deficiency and blood-stasis maybe impor-tant factors to influence BMD . It may also be the risk factor of osteoporosis complication . The BMD are relat-ed to the syndrome of kidney-deficiency , q i-deficiency and blood-stasis and their combinations . Among bone mass reduction and osteoporosis cases , the proportion of combination of two or three types of syndromes was more than single one syndrome . It suggested that the combination of kidney-deficiency , q i-deficiency and blood-stasis had more influence on BMD .

Objective To analyze the effect of polydatin on cardiac function and mitochondrion of platelet in peripheral blood of patients with severe hemorrhagic shockpolydatin.Methods 60 patients with severe hemorrhagic shock from January 2010 to May 2015 in the hospital were selected.The control group adopted the intravenous therapy of normal saline and transfusion therapy and observation group adopted polydatin (10mg/kg) and transfusion therapy.After treatment, the cardiac function index including heart ejection fraction and and cardiac output, protein kinase C (PKC), ATP levels in mitochondria of platelet, platelet mitochondrial membrane potential and lipid peroxide ( LPO ) in platelet were compared between two groups.Results After treatment, the ejection fraction and cardiac output of two groups increased compared with pre-treatment ( P <0.05 ) , and the above indicators in observation group increased compared with control group (P<0.05).After treatment, PKC content in cell membrane and cytoplasm increased compared with pre-treatment (P<0.05), and the above indicators in observation group increased compared with control group (P<0.05). After treatment, the ATP level in two groups increased compared with pre-treatment (P<0.05), and the above indicator in observation group increased compared with control group ( P <0.05 ).After treatment, platelet cell rate of low mitochondrial membrane potential in observation group decreased compared with pre-treatment (P<0.05), but there was no significant difference in control group, the above indicator in observation group was lower than that in control group (P<0.05).After treatment, LPO content in observation group decreased compared with pre-treatment (P<0.05), but there was no significant difference in control group, the above indicator in observation group was lower than that in control group (P<0.05).Conclusion The injury of mitochondrion plays an important role in occurrence and development of severe hemorrhagic shockpolydatin.The function of peripheral blood platelet mitochondrion could be seen as a simple index of judging the state of shock.After the application of protective agent of mitochondrion, the function of mitochondrion is protected.The cardiac function is also improved.It has an important significance for the diagnosis of severe shock.

Objective To investigate the effect of miR-210 on angiogenesis of human renal clear cell carcinoma . Methods Detect the expression of miR-210 in 40 cases of renal clear cell carcinoma tissues , and analyze the rela-tionship between the expression of miR-210 and microvessel density ( MVD) .miR-210-ASO was lipotransfected in-to renal clear cell carcinoma cell line 786-O.RT-qPCR was used to verify the transfection effect .The effect of the supernatant of control group , negative control group and miR-210-ASO group tumor cells on the lumen formation of human umbilical vein endothelial cells ( HUVEC) was observed in a 3-D culturesystems .The transplantation tumor model of nude mice was established , and the effect of miR-210 on the formation of the transplanted tumor micro vessel was observed by endomucin and VEGF immunofluorescence staining under laser scanning confocal micro -scope.Results The expression of miR-210 was positively correlated with microvessel density in renal clear cell carcinoma ( P<0.05 ) .The expression of miR-210 was significantly decreased in 786-O cells transfected with miR-210-ASO( P<0.05 ) .The lumen formation of HUVEC cells co cultured with miR-210-ASO group cell supernatant was significantly less than that of control group and negative control group ( P<0.05 ) .The tumor volume of miR-210-ASO group was less than that of the control group , and the number of the micro vessel and the VEGF expres-sion were significantly less than that of the control group ( P<0.05 ) .Conclusions Inhibition of miR-210 can suppress blood vessel formation in renal clear cell carcinoma .

ObjectiveTo study the efficacy of fluoxetine on improving depressive symptoms and activities of daily living(ADL) in early poststroke depressive patients.Methods42 early poststroke depressive patients (within 14 days after first stroke) were randomly divited into fluoxetine treatment group and control group (without antidepressive drugs).Evaluation was conducted before the treatment and at 4 and 6 weeks after treatment,using the Hamilton Depression scale(HAMD)and Barthel Index(BI).ResultsThere was no significant difference in HAMD and BI scores between the two groups before the treatment(P>0.05).At 4 and 6 weeks after the treatment, compared with the control group, the fluoxetine treated group demonstrated significant reduced in HAMD scores (P<0.001) and significant improvement in BI scores (P<0.01).ConclusionsFluoxetine is an effictive drug in improving depressive symptoms and ADL in early postsroke depressive patients.

Objective To discuss the clinical value of subintimal angioplasty (SIA) in treating long segment occlusion of superficial femoral artery (SFA) in the elderly,and to observe the follow-up results.Methods Subintimal angioplasty was performed in 66 elderly patients with stage Ⅱ-Ⅳ long segment occlusion of SFA.The improvement of ankle-brachial index (ABI) and the long-term patency rates were observed and analyzed before and after treatment.Results Of 66 elderly patients,the surgery was successfully performed in 64 cases (97 ％).Skin temperature was improved,the claudication disappeared or a claudication distance was prolonged,the rest pain disappeared or relieved,foot infection was under control and turned into the dry gangrene in these patients.SIA was given up in 1 case because the wire failed to return to the true lumen and the distal outflow segment was occluded.One patient underwent bypass grafting instead of SIA because the wire failed to get into the subintimal.The ABI got obvious improvement before and after treatment (0.59±0.16 vs.0.84± 0.21,P＜0.01).The patency rates in 62 patients undergoing SIA at 6,12,24,36 months were 85.5％ (53/62),69.4％ (43/62),54.8％ (34/62) and 48.4％ (30/62) after surgery,and the 3-years limb salvage rate in 62 cases was 96.6％ (60/62).Conclusions Subintimal angioplasty is an effective method for treating long segment occlusion of superficial femoral in elderly patients,and it has the satisfactory long-term follow-up results.

Objective To evaluate the clinical significance of implanting an inferior vena cava filter to prevent pulmonary embolism.Methods Reviewed the causality of 180 cases,which was undertaken the ultrasound examination,patients were diagnosed as the deep vein thrombosis,male patients were 128 cases, female patients were 52 cases,median age was 65 years old,all received the transfemora] implantation of inferior vena cava filter implantation.Results All the operations were successfully conducted,filters were placed into inferior vena cava at 1-3 cm inferior of renal vein,without hematoma in the puncture position and thrombosis.One hundred and forty-nine cases (82.8%) were followed up at 1,6,12 months respectively, 55 cases(30.6%)were followed up more than 36 months, no filter drift,deformation and inferior vena perforation complications was observed.There was no fatal pulmonary embolism occurred for all the cases,the inferior vena unobstructed rate was 95.6%.Conclusion Vena cava filter is an effective and safe method which can prevent and cure pulmonary embolism.

Objective To observe the effects of 1,25-dihydroxyvitamin D3 on the expressions of transforming growth factor-β1(TGF-β1), fibronectin(FN),and vascular endothelial growth factor(VEGF) in rats with diabetic nephropathy(DN), and to elucidate the protective mechanism played by 1,25-dihydroxyvitamin D3. Methods DN models were estabolished by injecting streptozotoein ( STZ ) into male SD rats, which were divided into TGF-β1 overexpression group, TGF-β1 overexpression plus vitamin D3 group, TGF-β1 low-expression group, TGF-β1 low-expression plus vitamin D3 group, TGF-β1 normal-expression group, and TGF-β1 normal-expression plus vitamin D3 group. After 1,25-dihydroxyvitamin D3 treatment for 37 days, renal function and blood biochemical parameters were evaluated. The morphology and fibrosis of kidney tissues were observed. The expressions of TGF-β1, FN, and VEGF in kidney cortex were measured by immunohistochemistry, realtime PCR, and Western blotting. Results The levels of cholesterol, triglyceride, creatinine,plasma glucose, HbA1C , and 24 h urinary protein were lower in vitamin D3treated groups than those in corresponding control groups(P<0. 05). The degree of renal fibrosis was raised with the increased level of TGF-β1. Vitamin D3 treatment decreased the fibrosis in diabetic kidney. There were significant differences in the mRNA and protein expressions of TGF-β1 in three control groups(P<0. 05). With the increased levels of TGF-β1, the expressions of FN and VEGF were increased. The expressions of TGF-β1, FN, and VEGF were lowered by vitamin D3compared with the corresponding control groups(P<0. 05). Conclusion 1,25-dihydroxy-vitamin D3 may protect the renal tissure in diabetic rats via inhibiting the expressions of TGF-β1, FN, and VEGF in the kidney.

Objective To evaluate the muscle mass in elderly patients with inguinal hernia using CT scan.Methods 30 male (age 70-90 years) hospitalized patients scheduled to receive surgery for inguinal hernia were selected into study group, 10 male health volunteers (40-50 years) were involved in adult control group, and 10 men of the same age as the study receiving annual physical examination were enrolled as elderly control group.General information were recorded;CT scanning of the stomach muscles and thigh muscles were conducted, and the muscle area was calculated using a special software.Results The index of grip strength in the study group was significantly lower than the adult control group [(36.44 ± 14.15) kg vs.(77.30 ± 22.69) kg, P =0.001], the calf circumference in the study group was significantly less than the adult control group [(25.18 ±2.31) cm vs.(27.62 ±2.33) cm, P =0.006].There was no significant difference in L3 abdominal area, subcutaneous fat area, abdominal fat area, and vertical spinal muscular volume between the study group and the adult control group;while the L3 abdominal muscle area and vertical spinal muscular mass was significantly less in the study group than in the adult control group [(12 094.23 ± 1 970.30) mm2 vs.(17462.00±1 600.58) mm2, P=0.001;(1 642.60±266.90) mm2 vs.(2 003.50±350.91) mm2,P =0.007].L3 skeletal muscle index of the study group was 50.64 ±7.52 and 66.7％ (20/30) of the study group had sarcopenia (≤52.4％).The CT findings of abdominal muscle of the study group were not significantly different from those of the elderly control group.The thigh muscle mass in the study group was significantly less than that in the control group (P =0.001), but there was no significant inter-group difference in thigh fat and femur areas (P ＞ 0.05).Conclusion The muscle mass and strength in elderly patients with inguinal hernia are significantly lower than those of adult controls, for which CT scan can be applied for assessment.

Objective To explore the effects of L-carnitine on the plasma lipid profile and liver function in elderly patients receiving total parenteral nutrition after abdominal operations.Methods In this prospective blinded randomized controlled trial,24 eligible elderly patients were given 6-day total parenteral nutrition.They were further equally divided into L-carnitine group(administered with L-carnitine 50 mg/kg)and control group(without L-carnitine).The changes of lipid profile and liver function and the clinical outcomes were recorded and compared.Results The plasma triglyeride levels were lower in L-carnitine group than in control group on the 4th and 7th post-operative day,but there were not significant difference(P>0.05);There was a significant difference between the two groups in the change of the 4th post-operative day and pre-operative day(P<0.05).However,the liver function indicators were not significantly different between these two groups.Conclusion Administration of L-carnitine during total parenteral nutrition can improve the triglyeride metabolism in elderly patients after abdominal operations and may benefit the recovery of liver function.

ObjectiveTo investigate the prevalence of nutritional risk and malnutrition among hospitalized elderly abdominal surgical patients with malignant tumors.MethodsTotally 269 elderly patents ( ≥ 65 years) with malignant tumor who were hospitalized in our department of abdominal surgery from December 2009 to November 2010 were consecutively enrolled.Nutritional Risk Screening 2002 ( NRS 2002 ) was performed on the next morning after admission.Body mass index (BMI) lower than 18.5 kg/m2 was considered as malnutrition.Results The NRS 2002 was completed in all the 269 enrolled patients.The overall prevalence of malnutrition was 30.1％ (81/269) ; more specifically,37.5％ (21/56) among geriatric patients ( ≥80 years) and 17.6％ (43/245) among the other age groups (P =0.001 ).The overall rate of nutrition risk was 38.3％ (103/269) ; more specifically,57.1％ (32/56) among the geriatric patients and 29.3％ (72/245) among the other age groups (P ＜0.001 ).The rate of nutrition risk in patients with pancreas cancer was 58.3％,which was higher than other elderly patients; on the contrary,and the rate of nutrition risk in the patients with colorectal cancer was relatively lower.ConclusionThe rates of nutrition risk and malnutrition in hospitalized elderly abdominal surgical patients ( ≥ 65years) with malignant tumor are relatively higher than other age groups,especially among the geriatric patients.