Objective To investigate the timing of beginning dialysis in CRF patients and the factors that might contribute to dialysis.Methods 117 non-diabetic CRF patients starting their first-time dialysis in our hemodialysis center from 2001.1 to 2002.12 were surveyed.The creatinine clearance (Ccr),creatinine concentration (Scr),symptoms of uremia,comorbidity and the conditions during first hemodialysis sessions were recorded.Factors from the points of patient,society,and physician that might affect the timing of dialysis were further analyzed.Results (1)In this study,the average level of Ccr was 4.18?3.26ml/min. (2)87.18% of the patients experienced nausea or vomiting before dialysis,55% manifested worsened nutritional status.71.79% occurred with cardiac morbidity and/or neuropathy,27.35% needed urgent hemodialysis. (3)98 cases (83.76%) seemed to start dialysis too late.The predominant reason was late diagnosis of CRF (76.52%).Conclusion (1)The timing of dialysis in our patients is generally late.(2)Disease screening and medical care of chronic kidney disease are key factors that affect the timing of dialysis.

Dislocation of the acromioclavicular joint is a common injury seen by surgeons.Although many orthopaedic surgeons hold that injuries of Rockwood types Ⅰ and Ⅱ are usually treated nonoperatively and injuries of types Ⅳ to Ⅵ surgically,there is no consensus with regard to the treatment of type]Ⅲ injuries.There are mainly 2 disputes in the management of AC joint dislocations of Rockwood type Ⅲ concerning operative versus nonoperative treatments and different operative techniques.In this paper,we will outline the current progress in the management of acromioclavicular joint dislocation of Rockwood type Ⅲ.

[Objective] To observe the effect of heated needle on the pathological changes of articular cartilage in mice with experimental knee osteoarthritis (OA). [ Methods ] Sixty-four NIH mice were randomly divided into 4 groups: heated needle group, electro-acupuncture (EA) group, model group and normal control group, 16 mice in each group. The mice models with knee OA were made with Xie's method, and then were treated for 2 weeks according to the experimental design. [Results] After treatment, the movable angle of right back knee in mice was increased in heated needle group and EA group ( P

Objective: To study the quality of life of chronic elderly patients Method: 150 chronic patients aged 60 or above were assessed with SCL-90 (symptom checklist-90), SDSS (social deficit screening scale), ADL (activity of daily living) and QOL (quality of life), their demographic data were also collected Results: Men's social function was poorer than women's, but their quality of life had no significant difference to women's The quality of life in our sample differed with different age, educational degree, family conditions, occupations and incomes Conclusion: Life quality of chronic old patients is related to their demographic characters

Objective To explore the aberrant expressions of mammalian target of rapamycin (mTOR) and its activation form,pmTOR,in stage IIIB human colon cancer,and analyze the association of mTOR and pmTOR with clinicopathologic characteristics and patients' prognosis. Methods A total of 104 patients with stage IIIB (T 3-4 N1M0) colon cancer with available follow-up data were enrolled. The specimens of colon cancer and clinical data were acquired from these subjects. The expressions of mTOR and pmTOR in tumor tissues and matched normal tissues were detected with immunohistochemistry. The relationship and its significance between the expressions of mTOR and pmTOR and some clinicopathological features,such as gender,age,location of primary tumor,pathological stage and TNM stage,were analyzed. Results The mTOR and pmTOR were found to be expressed in cell membrane and cytoplasm of tumor tissues. Out of the total 104 specimens,positive rate of mTOR and pmTOR accounted for 75.9% (79/104) and 76.9% (80/104),respectively. No significant correlation was noted between the expressions of mTOR and pmTOR and the clinicopathological features by partial correlation analysis. Both univariate analysis and multivariate analysis showed that the expressions of mTOR and pmTOR threw no significant influence on the 5-year overall survival of patients. Nevertheless,subgroup analysis suggested that a high expression of pmTOR along tumor border was likely to contribute to higher risk of death in patients. Conclusion Aberrant expressions of mTOR and pmTOR are noted in patients with locally advanced colon cancer. High expression of pmTOR along the border of tumor tissue may suggest the possibility of invasion and metastasis.

Objective To investigate the effect of breathing filter(BF) on prevention of the respiratory tract infection in elder patients undergoing general anesthesia.Methods One hundred elderly who underwent the operation of gastrointestinal tumors were involved in the current study.They were randomly divided into control and experiment group and each for 50 cases.Patients in experiment group were given BF while in control group were not given.Bacteria on the tip of endotracheal tube and in the anesthesia machine circuits close to endotracheal tube were checked.The rate of the respiratory tact,infection of operative patients were recorded.Results After operation,a large number of bacterial growth in endotracheal catheter ends in both groups.The level of bacteria in the anesthesia machine circuits of control group was (305.2 ± 12.4) CFU/cm2,higher than that in experiment group ((10.2 ± 2) CFU/cm2 ; t =166.077,P ＜ 0.001).No patients in experimental group got respiratory tract infection in the follow up periods,but 5 patients (10.0％) in control group were infected,and the difference was significant (x2 =5.263,P ＜ 0.05).Conclusion BF can effective filtrate the bacterial in breathing circuit,significantly reduce the incidence rate of respiratory tract infection.

Objective To study the influences of psycho-social factors in the treatment of the aged patients with hypertension. Methods Aged in-patients with hypertension were divided into two groups according to their improvement: 148 reached the standard and 62 did not reach the standard. Their psycho-social factors were assessed by self-rating depression scale(SDS), self-rating anxiety scale(SAS), life events scale (LES) and social support scale. Results (1)The percentages of depression (7.4% vs 32.2%, P

Objective To detect the expressions of c-myc,Bmi-1,serum insulin-like growth factor-Ⅰ (IGF-Ⅰ) and insulin-like growth factor binding protein-3 (IGFBP-3) in diffuse large B-cell lymphoma (DLBCL),and to analyze their relations with clinical stages,efficacy and prognosis.Methods 102 cases of incipient patients with DLBCL and 60 patients or health examination volunteers were chosen as DLBCL group and control group,respectively.Immunohistochemical method was used to detect expressions of c-myc and Bmi-1 in DLBCL wax samples.Chemiluminescence immunoassay method was used to determine the levels of serum IGF-Ⅰ and serum IGFBP-3.The expression differences of these factors between DLBCL group and control group and their relations with pathological types,clinical stage,IPI and chemotherapy were analyzed.Results The positive rates of c-myc and Bmi-1 were 71.6 ％ (73/102) and 61.8 ％(64/102) in the tissues of DLBCL,respectively.The positive rates of c-myc and Bmi-1 in non-GCB group were higher than those in GCB group [c-myc:80.0 ％ (48/60) vs 59.5 ％ (25/42);Bmi-1:71.7 ％ (43/60) vs 50.0 ％ (21/42)].With the increase of IPI score,the expressions of c-myc and Bmi-1 were enhanced,but there were no statistical differences between Ⅲ-Ⅳ group and Ⅰ-Ⅱ group (P ＞ 0.01).The differences of 3-year progression free survival (PFS) rate and 3-year overall survival (OS) rate between c-myc gene or Bmi-1 gene normal and abnormal had statistical significance,and 3-year PFS rate and 3-year OS rate of double-hit of c-myc gene and Bmi-1 were lower.C-myc gene and Bmi-1 gene aberrant were the independent prognosis factors.The levels of serum IGF-Ⅰ and serum IGFBP-3 in DLBCL group were significantly lower than those in the control group (P ＜ 0.01),however,the levels were increased after chemotherapy (P ＜ 0.01).Serum IGF-Ⅰ and serum IGFBP-3 levels had no significant differences between non-GCB group and GCB group (P ＞ 0.01).Their levels in stage Ⅳ group or high risk group were significantly lower than those in other groups.Serum IGF-Ⅰ level and serum IGFBP-3 level had no significant differences between the c-myc gene or Bmi-1 gene abnormal group and normal group (P ＞ 0.01),but their levels were lower in both c-myc gene and Bmi-1 gene abnormal group than those in normal group.Conclusions C-myc and Bmi-1 are related with the biological characteristics and prognosis of DLBCL.Serum IGF-Ⅰ level and serum IGFBP-3 level reflect clinical stages of DLBCL and the efficacy in a certain degree.The expressions of c-myc and Bmi-1 have some correlation with the levels of serum IGF-Ⅰ and IGFBP-3 in DLBCL.

Objective To observe clinical curative effect of modified total cystectomy and Mainz Ⅱ neobladder. Methods Seventeen patients with bladder neoplasms were treated with modified total cystectomy and Mainz Ⅱ neobladder for urinary diversion. The paries posterior allantois with intestinum rectum and colon sigmoideum were taken 10 cm respectively, split the mesenterium edges, conduplicated and bilayer sutured from the junction of intestinum rectum and colon sigmoideum, bilateral ureters antireflux anastomosed respectively with colon sigmoideum and rectal papilla, then bilayer sutured paries anterior became Mainz allantois. Results There was no surgical mortality. The operative time was 340 ～ 420 mins (mean, 350 mins).Blood transfusion was 400 ～ 800 ml ( mean 600 ml). The follow-up was 4 ～ 18 months, urine and dejecta were shunt, uresis continence was fine and the operation had fewer severe complications. Conclusion Modified total cystectomy and Mainz Ⅱ neobladder to be an effective method for urinary diversion because of its simple operation, fewer severe complications, good uresis continence and high quality of life.

Objective To evaluate the clinical characters, management and prognostic factors of patients with differentiated invasive thyroid carcinoma (DITC). Methods The data were analyzed retrospectively for 114 DITC patients treated at Department of Head and Neck Surgery of Sun Yat-sen University Cancer Center. Survival analysis was performed by Kaplan-Meier method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model. Results After surgery, 68 patients were with tumor residue. The 5-year and 10-year overall survival rate were 91.9% and 80.1% respectively in all patients, while the 10-year overall survival rate were 88.5% 、78.5% and 53.1% in no tumor residue group, micro-residue group and grossresidue group respectively. This study failed to prove that radiotherapy might improve the survival rate in patients with postoperative tumor residue. Multivariate analysis indicated that age, invasion to esophagus and recurrence predict the prognosis. Conclusion DITC may be treated mainly by surgical operation. Radical resection is the key factor in the treatment of DITC. Patients with DITC have a relatively poor prognosis.Age, esophagus invasion and status of tumor residue are the most important factors affecting the prognosis.