Objective To investigate the risk factors of pressure ulcers in elderly patients with hip fracture. Method Single factor analysis was done to investigate the possible risk factor by looking into the clinical data of 147 elderly patients hospitalized in our hospital during January 2010 and December 2014 to find out the varieties with statistical significance were introduced onto Logistic regression model for multivariate analysis. Results During hospitalization, 55 patients contracted pressure ulcers, accounting for 37.4%. Seven factors including diabetes, malnutrition, conservative treatment like simple traction, obesity, pain score, hypertension and hypertlipemia, were related to the pressure ulcers in elderly patients with hip fracture. The high risk factors included malnutrition and obesity. Conclusion Malnutrition and obesity are closely related to pressure ulcers in elderly patients with hip fracture. It is indicated that we should attack importance to disease assessment and preparation to prevent the occurrence of pressure ulcers.

BACKGROUND: Laryngeal cancer can cause hoarse voice, dyspnea, and dysphagia, for which common surgical approaches or biotherapy hardly results when nodal metastases are present. Identification of the factors associated with laryngeal cancer metastases is a crucial task in the study of the malignancy, as such a revelation may help establish molecular markers for accurate assessment of metastases and develop biological agents to restrain the invasion and metastases.OBJECTIVE:To study the association of MMP-2, MMP-9, CD44v6, PCNA,nm23, VEGF, p53, Cath-D and E-cadherin with the metastasis of laryngeal cancer so as to provide evidence for clinical treatment of laryngeal cancer.DESIGN: An experimental study ofclinical specimens.PARTICIPANTS: All specimens of primary laryngeal cancer were obtained from patients receiving surgical treatment in the Department of Otolaryngology,Fourth Affiliated Hospital of Harbin Medical University from February 2002 to November 2003. Immunohistochemical examination of the specimens was conducted in the Third Affiliated Hospital of Sun Yat-sen University.INTERVENTIONS: The expressions of MMP-2, MMP-9, CD44v6, PCNA,nm23, VEGF, p53, Cath-D and E-cadherin were examined immunohistochemically in the specimens from 70 patients of laryngeal cancer. Logistic stepwise regression model was used to analyze the influence of the 9 clinicopathologic factors on lymph node metastasis.MAIN OUTCOME MEASURES: The expressions of MMP-2, MMP-9,CD44v6, PCNA, nm23, VEGF, p53, Cath-D and E-cadherin in laryngeal cancer specimens.RESULTS: Using the established equation to estimate lymph node metastasis, the frequency of lymph node metastasis was highest in patients with positive MMP-9 expression(Wald = 10. 350 1, P ＜ 0.05) . Lower E-cadherin expression was accompanied by higher frequency of lymph node metastasis, and nm23 expression in patients with lymph node metastases was significantly decreased in comparison with patients without metastases (Wald=6.189 6 and 6. 863 2, P ＜0.05).CONCLUSION: The expressions of MMP-9, E-cadherin and nm23 are useful indicators for preoperative prediction of lymph node metastasis of laryngeal cancer and provide valuable information for prognostic evaluation of the interventions.

BACKGROUND: Matrix metalloproteinases-7 (MMP-7) plays an important role in the invasion and metastasis of cancer and is related to prognosis of many carcinomas.OBJECTIVE: To investigate the significance of MMP-7 expression in the invasion and metastasis of laryngeal cancer and explore the relationship between MMP-7 expression and the prognosis of laryngeal squamous cell cancer (LSCC).DEGIGN: An open experimental study based on the cells.SETTING: Two otolaryngology departments of two university hospitals and one otolaryngology department of a municipal hospital.MATERIALS: The experiment was conducted in the Center Laboratory of Second Affiliated Hospital of Harbin Medical University from April 2002 to January 2003. The materials were laryngeal cancer and corresponding neighboring noncancerous tissues, MMP-7 antibody and immunohistochemical kit.METHODS: The expression of MMP-7 protein in 70 samples of paraffin-embedded LSCC and corresponding neighboring noncancerous tissues was detected with immunohistochemical technique. Reverse transcription-polymerase chain reaction(RT-PCR) and Western blot technique were used to examine the expression of MMP-7 in 35 frozen specimens of LSCC and corresponding neighboring noncancerous tissues.MAIN OUTCOME MEASURES: The relationship of MMP-7 mRNA expression with the invasion depth(T grade), neck nodal metastasis and prognosis of LSCC.RESULTS: Immunohistochemical staining of MMP-7 was observed in 77.1% (54/70) of cancer tissues and in 5.7% (4/70) of neighboring noncancerous tissues( P ＜ 0.01) . The mRNA expression of MMP-7 was detected in 74.3% (24/35) of cancer tissues and in 5.7% (2/35) of neighboring noncancerous tissues( P ＜ 0.01 ). The expression of MMP-7 was higher in T3-T4 group than that in T1-T2 group(P ＜ 0.01), and was positively correlated with nodal metastasis( P ＜ 0. 01 ). Western blot showed that both 28 ku (latent form of MMP-7) and 19 ku(active form of MMP-7)bands had close relationship with T grade and neck nodal metastasis. Kaplan-Meier survival curve showed that the group with high MMP-7protein expression had poorer prognosis than the group with weak or negative MMP-7 protein expression(Log-rank = 4. 755 9, 8. 951 3; P = 0. 029 2,0.002 8).CONCLUSION: MMP-7 is closely correlated with the invasion, metastasis,and prognosis of LSCC, and it may serve as a marker in estimating the invasive and metastatic potency and prognosis of LSCC.

Objective:To observe the clinical application of flexible endoscope assisted by general versus pillow-under-shoulder supine position in nasotracheal intubation of the patients with difficult airway, and to explore the influence of intubation position in the intubation effect.Methods: A total of 168 patients with difficult airway who underwent nasotracheal intubation and oromaxillofacial surgery under general anesthesia were randomly divided into general supine position (control group) and pillow-under-shoulder supine position (experimental group) with 84 cases in each group.The first-time and the total success rate of intubation, the intubation time, and the rate of direct glottis exposure of the patients in two groups were recorded.The mean arterial pressure(MAP), heart rate (HR), and complications of intubation of the patients in two groups before induction, before tracheal intubation, during intubation, 1 and 5 min after intubation, were also recorded.Results:The first-time success rate of intubation in experimental group (94.0 %, 79/84) was significantly higher than that in control group (71.4%, 60/84) (P<0.01);the total success rate of intubation (98.8%, 83/84) had no difference compared with control group (97.6 %, 82/84) (P>0.05);the intubation time (57 s±12 s) was significantly shorter than that in control group (146 s±29 s) (P<0.01);the rate of direct glottis exposure (47.6%, 40/84) when the flexible endoscope passed through the posterior nasal apertures was obviously higher than that in control group (15.5 %, 13/84) (P<0.01).The values of MAP and HR of the patients in two groups before and during intubation were decreased significantly compared with the baselines (P<0.01), and came back to the baselines 1 and 5 min after intubation (P>0.05).There were no significant differences in the MAP and HR between different time points (P>0.05).The incidence rates of complications including pharyngalgia, hoarseness and epistaxis had no differences between two groups (P>0.05).Conclusion: Flexible endoscope assisted by pillow-under-shoulder in nasotracheal intubation has a higher intubation success rate, shorter intubation time and it is a superior procedure for the patients with difficult airway.

Objective　To study the probability of using hepatitis D virus (HDV) ribozyme as a kind of anti-hepatitis-C-virus (HCV) gene thera-py drugs. Methods　The natural HDV genomic ribozyme′s stem Ⅳ was optimized and its substrate-binding region reconstructed, thus three recombinant HCV-specific HDV genomic ribozymes RzC1, RzC2 and RzC3 were obtained. HCV RNA 5'-noncoding region and 5'-fragment of C region (HCV RNA5'-NCR-C) were transcribed from plasmid pHCV-neo by T7 phage RNA polymerase in vitro, and radiolabelled at its 5'-end. The trans-cleaving reaction was performed by mixing the ribozymes and substrate at mol ratio 100∶1 under conditions as follows: 37℃, pH7.5, Mg2+ 20 mmol/L and deionized formamide 2.5 mol/L. Percentage of trans-cleaved products were calculated at different time points and used as the activity indicator of the three ribozymes. Results　RzC1, RzC2 trans-cleaved more substrate when the time extended, and got to 24.9%,20.3% after reac-ting for 90 minutes respectively; RzC3 was not able to trans-cleave its substrate. Conclusion　Recombinant HDV genomic ribozymes have the ability to trans-cleave HCV RNA, but the appropriate target sequence should be selected.

AIM: This study is based on the result of the study in HL and ALCL employing gene chip technique, in which writer found that there was distinctly different expression of caspase-4 between HL and ALCL cell lines at the level of mRNA. From the point of view, we try to identify at the level of protein whether there is different expression of this gene in HL and ALCL tissues as well. METHODS: HE staining, the monoclonal antibodies CD30 (BerH2), CD15 (C3D-1), CD20 (L26) and CD45RO (UCHL1) were used for selecting the cases of HL and ALCL. Specific high affinitive anti-caspase-4 polyclonal antibody was used by immunohistochemical staining to analyze the expression of caspase-4 in 18 cases of HL and 15 cases of ALCL. RESULTS: The expression of caspase-4 demonstrated a strong positive staining in all ALCL cases (15/15,100%), whereas negative in 16 HL cases (88 8%), while other two cases were weakly stained (11 2%), showing a distinct difference (P

Isolated freshly rat islets were transferred to 24-well plates and incubated with different concentrations of glucose or resveratrol for 1 or 24 h.The results showed that resveratrol dose-dependently inhibited glucose-stimulated insulin secretion from isolated rat islets after 1 h incubation,with 10%,35%,and 80% (P<0.05 or P<0.01) decrease at the concentrations of 1,I0,and 100 μmol/L.10 μmol/L resveratrol decreased the intracellular calcium concentration by 60% (P<0.05).After incubation for 24 h,resveratrol increased palmitatesuppressed insulin secretion to 75% (P<0.01) of control.These results suggest that resveratrol acutely inhibits insulin secretion from primary pancreatic islet via regulating intracellular calcium ion concentration,and in the long run resveratrol may protect β-cells from lipotoxicity.

The effect of troglitazone on glucose-stimulated insulin secretion (GSIS) in pancreatic β-cells and its mechanism were investigated.10 μmol/L troglitazone had no effect on basal insulin secretion,but significantly decreased GSIS and stimulated AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) phosphorylations (all P<0.01).These reactions were completely reversed by AMPK inhibitor compound C,suggesting that the troglitazone acutely inhibits insulin secretion via stimulating AMPK activity in beta cells.

Objective To detect the serum level of vitamin D in infants with atopic dermatitis (AD),and to investigate the relationship between the serum level of vitamin D and severity of AD in infants.Methods Clinical data were collected from patients with moderate to severe AD (AD group)through a questionnaire survey in Children's Hospital of Shanxi from February to April in 2016,and the severity of AD was evaluated by the SCORing atopic dermatitis (SCORAD) score.A total of 95 health checkup examinees served as the control group.Enzyme-linked immunosorbent assay (ELISA)was performed to detect the serum level of 25 (OH) D3 in the AD group and control group,as well as the total serum IgE level in the AD group.Blood cell analyzer was used to determine the proportion of blood eosinophils in the AD group.Results A total of 97 patients with AD were enrolled into the study,including 43 (44.3 ％) patients with moderate AD and 54 (55.7％) patients with severe AD.The serum level of 25 (OH) D3 was significantly lower in the AD group than in the healthy control group ([66.71 ± 21.07] nmol/L vs.[85.43 ± 14.87] nmol/L,P ＜ 0.01),as well as in the patients with severe AD than in the patients with moderate AD ([47.54 ± 29.36] nmol/L vs.[63.89 ± 26.67] nmol/L,P =0.006).The proportion of blood eosinophils was significantly higher in the severe AD group than in the moderate AD group (0.124 ± 0.094 vs.0.061 ± 0.060,P ＜ 0.001).There was no significant difference in the total serum IgE level between the moderate AD group and severe AD group (P =0.375).Among the patients with AD,the serum level of 25 (OH) D3 was negatively correlated with the proportion of blood eosinophils (r =-0.336,P ＜ 0.05),but there was no correlation between the serum level of 25 (OH)D3 and total serum IgE level (r =-0.174,P ＞ 0.05).The serum level of 25 (OH)D3 was significantly associated with breastfeeding and vitamin D supplementation (P ＜ 0.05),but unrelated to age,gender,course of disease and acute exudative phase (all P ＞ 0.05).Conclusion The serum level of 25 (OH) D3 is evidently decreased in infants with AD,and vitamin D deficiency is closely related to the severity of AD in infancy.

Objective To assess the myocardial blood flow and reserve function by rest and stress 13 N-NH3 PET myocardial perfusion imaging ( MPI) , and evaluate the diagnostic value of PET and risk fac-tors of non-obstructive coronary microvascular disease ( CMVD) type 1. Methods A total of 56 patients (28 males, 28 females;age:(52.0±7.6) years) with clinical suspected CMVD type 1 from April 2017 to December 2018 were prospectively enrolled. The coronary CT angiography, coronary angiography and other clinical data were recorded. All patients underwent one-day rest and stress 13 N-NH3 PET MPI. Images were analyzed and the absolute myocardial blood flow ( MBF) and coronary flow reserve ( CFR) were obtained. Patients were divided into CMVD type 1 ( CMVD) group and non-CMVD group. The differences between 2 groups were analyzed by two-sample t test and logistic regression. Results Among 56 patients, 20 patients were diagnosed as CMVD type 1, and 36 patients were excluded as non-CMVD group. The proportion of smoking and diabetes in the CMVD group was significantly higher than that in the non-CMVD group (χ2 val-ues:9.433 and 4.114, both P<0.05). The stress MBF ((2.37±0.61) vs (3.83±1.25) ml·min-1·g-1;t=-4.807, P<0.001) and CFR (2.67±0.60 vs 3.81±0.96;t=-4.751, P<0.001) were lower in smokers than those in non-smokers, and the stress MBF was lower in diabetes patients than that in non-diabetes patients ((2.63±0.98) vs (3.62±1.28) ml·min-1·g-1;t=-2.758, P=0.008). Smoking might be the risk factor for lower stress MBF (odd ratio (OR)=0.310, 95％ CI:0.114-0.880) and lower CFR (OR=0.278, 95％ CI:0. 080-0.894), and diabetes might be the risk factor for lower stress MBF (OR=0.254, 95％ CI:0.073-0. 887) . Conclusions PET MPI can be used for the diagnosis of CMVD type 1. Smoking and diabetes are likely to be associated with the onset of CMVD type 1.