Objective To explore the risk factors of cognitive impairment in rural elderly patients from Changzhi urban. Methods Totally 118 elderly patients were examined with minimental state examination (MMSE). The common data and histories of coronary heart disease,hypertension,diabetes and chronic obstructive pulmonary disease were collected. Results The prevalence of cognitive impairment was 14.4％.Multivariate analysis showed that MMSE scores was associated with age,stroke history,homocysteine and low density lipoprotein(LDL-C) (x2 =21.166,19.323,13.672,3.698,P＜0.01 or P＜0.05),and cognitive impairment was not associated with gender,alive spouse,hypertension,coronary heart disease, diabetes and chronic obstructive pulmonary disease(P＞0.05).Age(OR=0.853,95％ CI:0.765-0.951),stroke history(OR=0.764,95％ CI:0.629-0.929),LDL-C (OR =0.208,95％ CI:0.062-0.701 ) and activities of daily living (ADL)(OR=0.839,95％ CI:0.725-0.972)were independent risk factors of cognitive impairment in rural elderly patients. Conclusions Age,stroke and LDL-C are independent risk factors for rural elderly patients in the community.

Objective To investigate the trend of omtibacterial resistance rate of Acinetobater baumannii in our hospital from Jan.2000 to Jun.2005,and for the guidance of rational use of antibacterials.Methods A.baumannii strain was isolated and tested by K-B method from clinical samples and antibiotic resistance was analyzed and studied retrospectively.Results There was an elevated tendency of the resistance rates to common antibacterial in A baumanii for past six years. The resistance rate to imipenem was the lowest (3.6%) and to amikacin, cefoperazone/sulbactam was 29.5%-77.4%.Conclusion The resistance rates to common the antibacterial in A.baumanii are high and the resistance pattern is wide. It is important to select antibiotics according to the antibiotics sensitivity in vitro.

Objective To evaluate the necessity of concomitant bladder cuff and the possibility of distal ureter sparing surgery during radical nephroureterectomy of low-level upper urinary tract tumors. Methods Clinical data of 73 patients with low-level (Tis-T3 M0 N0 ) tumors of the proximal upper urinary transitional epithelial cancer treated in radical nephroureterectomy in our hospital from 2000 to 2007 were analyzed retrospectively. The medical charts and pathologic specimens of 35 patients with, and 38 patients without, concomitant bladder cuff were reviewed. Results In the 35 patients with concomitant bladder cuff resection, 8 cases (22.9%) recurrence was observed; in the 38 patients without concomitant bladder cuff resection, 8 cases (21.1%) recurrence was observed. There was no difference between both groups(P>0.05). In the 19 patients suffered renal pelvis tumors with concomitant bladder cuff resection, 4 cases (21.1%) recurrence was observed; In the 16 patients suffered ureter tumors with concomitant bladder cuff resection, 4 cases (25 %) recurrence was observed.There is no difference between patients of renal pelvis tumors and of ureter tumors with concomitant bladder cuff(P>0.05). In the 27 patients suffered renal pelvis tumors without concomitant bladder cuff resection, 3 cases (11.1 %) recurrence was observed; in the 11 patients suffered ureter tumors with concomitant bladder cuff, 5 cases (45.5%) recurrence was observed. There was significant different between patients of renal pelvis tumors and of ureter tumors without concomitant bladder cuff (P<0. 05). Conclusion Concomitant bladder cuff resection confers a favorable prognosis to the patients with ureter tumors, but not to the patients with renal pelvis tumors.

Objective To establish the method for determination of astragaloside Ⅳ in Fufang Buqi Yangxue Oral Solution by RP-HPLC.Methods The content of astragaloside Ⅳ was determined by a HPLC system under the following conditions:the chromatographic column was Agilent C18(150 mm? 4.60 mm,5? m),the mobile phase was acetonitrile-water(60:40),the flow rate was 1.0 mL? min-1,and the detection wavelength was at 203 nm.Results Astragaloside Ⅳ showed good linearity in the range of 0.34～ 3.40 ?g(r=0.999 9).The average recovery was 100.8 %,and RSD was 1.47 %(n=6).Conclusion The HPLC method is simple and reproducible,and can be used for quality control of Fufang Buqi Yangxue Oral Solution.

Objective To set up the isolated perfused rat liver model. Methods Rat livers were harvested after the cannulation of the portal vein and bile duct. The reperfusion solution was Krebs-Henseleit solution containing bovine albumin serum and sodium taurocholate. The original CZ-1 isolated perfused rat liver system contained two subsystems: recirculating perfusion system and heat-exchange system. Then we modified the original CZ-1 system and omitted the heat-exchange system.The modified CZ-1 system consisted of a thermostatically regulated water bath,a peristaltic pump,a 4-neck round-bottom flask, a flow meter, an in-line manometer, a glass organ chamber, an iron support and a set of recirculating pipe line. Then the livers were connected via the portal vein to the modified CZ-1 system for 120 min. After 120 min reperfusion, bile production was evaluated. Routine HE staining and electron microscopic examination of hepatic tissues were also performed. Results The was not significantly different from that reported by references. Hepatic tissues in reperfusion group were also morphologically normal Conclusion The CZ-1 isolated perfused rat liver system was cost-effective and reliable to use. It was easy to run and is the ideal model for investigation of organ preservation solution.

Objective To explore the effect of morning nursing round and direction for key patients in geriatric comprehensive surgery department.Method Four hundred and twenty-six patients from January to December,2012 were assigned to control group,where routine morning nursing round was carried out.Another 453 patients from January to December in 2013 were assigned to observation group,where the morning nursing round and direction for key patients was carried out.The two groups were compared in terms of the general nursing quality,the rate of nurses knowing the disease condition and the rate of professional knowledge acquisition. Result After the application of morning nursing round for key patients,the general nursing quality,the rate of nurses knowing disease conditions and the rate of professional knowledge acquisition in the observation group were all significantly higher than those the control group(all P<0.05).Conclusion The morning nursing round and directions for key patients may remarkably improve the rate of nurses’knowing the disease conditions and professional knowledge acquisition and general nursing quality so that their professional skills and comprehensive quality can be further upgraded.

Objective To investigate the changes in total and surface N-methyl-D-aspartate receptor (NMDAR) NR1,NR2A and NR2B subunits in spinal cord in a rat model of incisional pain(IP)-remifentanil-induced hyperalgesia.Methods Thirty-two male SD rate in which caudal vein catheter were successfully placed were randomly divided into 4 groups ( n =8 each):control group(group C),remifentanil group(group R),IP group (group I) and IP + remifentanil group (group R + I).In groups R and C remifentanil 1.2 μg· kg-1 · min-1 or the same volume of normal saline was infused intravenously for60 main.In groups R + I and I,a 1 cm longitudinal incision was made in the plantar surface of left hindpaw and remifentanil 1.2 μg· kg-1 ·min-1 or the same volume of normal saline was infused intravenously for 60 min.Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were measured at 24 h before and 2,6,24,48 h after remifentanil or normal saline administration.The animals were sacrificed after last pain threshold measurement.The L4-6 segment of the spinal cord was isolated for determination of the expression of the total and surface NMDAR NR1,NR2A and NR2B subunits in spinal cord by Western blot.The ratio of surface NR2B/NR2A was calculated.Results Compared with group C,PWT was significantly decreased,PWL shortened,the expression of the total and surface NMDAR NR1,NR2A and NR2B subunits up-regulated and the ratio of surface NR2B/NR2A increased in groups 1,R and R + I( P ＜ 0.05).Compared with groups R and I,PWT was significantly decreased,PWL shortened,the expression of the total and surface NMDAR NR1,NR2A and NR2B subunits up-regulated and the ratio of surface NR2B/NR2A increased in group R + I( P ＜ 0.05).There was no significant difference in the total and surface NMDAR NR2A subunits among the four groups( P ＞ 0.05).Conclusion The up-regulation of total and surface NMDAR NR1 and NR2B subunits and the increased percentage of surface NR2B subunits in rats spinal cord may be involved in the development of incisional pain- remifentanil- induced hyperalgesia.

Objective Antiangiogenesis therapy has been shown to prolong survival for patients with malignant tumor .However the present study has not been observed the clinical benefit of antiangiogenesis therapy combination with chemotherapy treated with gastric canc-er.Human recombinant vascular endothelial inhibition (endostar) as a multi-targeted anti-angiogenesis drug, the mechanism is different from other Antiangiogenesis drugs.It can block different pathways of signal transduction to inhibit angiogenesis .This study aimed to observe the effect of combined application of endostar and paclitaxel on biological behavior of gastric cancer cell lines . Methods MMT assay and Tr-answell invasion assay were respectively used to examine the inhibition rate of cell growth and invasion ability when cells were treated with va-rious concentrations of endostar and paclitaxel alone or in combination.The protein expressions of VEGF,MMP-2 and MMP-9 were examined by Western blot. Results Endostar or paclitaxel effectively inhibited the growth of MGC803 cells and the in vitro invasion of MGC803 cells in a concentration-dependent manner.The proliferation and invasion ability of combined treatment with endostar and paclitaxel was significantly lower than that of endostar or paclitaxel alone (P<0.05).Compared with con-trol group, the VEGF,MMP-2 and MMP-9 protein expressions were de-creased in experimental groups ( P <0.05).Compared with paclitaxel group, the VEGF, MMP-2 and MMP-9 protein expressions were relatively reduced in combination groups (P<0.05). Conclusion Endostar combined with paclitaxel can suppress the growth and invasion of MGC803 cells, and the decreasing VEGF , MMP-2 and MMP-9 expressions may be involved in the mechanism .

0.05). Conclusions When SD rats serve as both donors and recipients,the rejection is mild because of their good tissue compatibility.The rejection of Wistar-SD rat kidney transplants is rapid and severe, which can serve as good animal model of acute rejection.

[Objective]To evaluate the effects of sutureless technique in comparison to conventional techniques for repair of total anomalous pulmonary venous connection(TAPVC)with the method of propensity score analysis.[Methods]From October 2007 to December 2013,179 consecutive patients were enrolled in this study. Patients were operated with sutureless technique(n = 81)or Conventional technique(n=98),and followed up at an interval of 1 month,3 months,6 months and then once a year post-operation. During analysis,three type of propensity-score matching methods,including nearest neighbor caliper matching,Mahalanobis metric matching with propensity score ,optimal full matching were used to create balanced groups of patients receiving each treatment. Surgeons’performance difference was assessed with random frailty proportional hazards models with gamma. Composite endpoints was defined by postoperative death or late death or postoperative pulmonary venous obstruction(PVO),which was evaluated with Kaplan-Meier curve and multivariable Cox proportional hazard model,adjusted by Preoperative-PVO,age,gender,weight and TAPVC type.[Results]Nearest neighbor caliper matching method was the best choice during propensity score analysis. After matching ,sutureless group included 73 patients and Conventional group73 patients. In sutureless group,cardiopulmonary bypass(CPB)time(Z=2.18, P=0.030),cross-clamp time(Z=3.63,P<0.001),rate of composite endpoints(HR 95%CI=0.20(0.06~0.61),P=0.005),late death(HR 95%CI=0.03(0.01~0.55),P=0.017)were significantly better than that in Conventional group. In subgroup analysis ,for patients with pre-PVO,decreased composite endpoints was seen in sutureless group.[Conclusion]Comparison using thepropensity score analysis demonstrated that sutureless strategy for primary repair of TAPVC may associate with decreased mortality rate of post-PVO and CPB time and cross-clamp time.