Objective To investigate the risk factors of postoperative delirium in elderly patients with intertrochanteric facture.Methods This retrospective analysis was conducted on 256 patients aged over 65 years treated with internal fixation of intertrochanteric facture between January 2012 and December 2013.Incidence and risk factors of postoperative delirium were documented.Results Incidence of postoperative delirium was 14.8％ (38/256).Risk factors of postoperative delirium included body mass index (BMI) less than 20 kg/m2 (P ＜ 0.05),preoperative hemoglobin (Hb) less than 100 g/L (P ＜ 0.05),atrial fibrillation (P ＜ 0.05),low sodium (P ＜ 0.05),preoperative total protein less than 60 g/L (P ＜ 0.05),preoperative waiting time more than 4 days (P ＜ 0.05),preoperative cognitive impairment (P ＜ 0.05),operation time more than 2.5 hours (P ＜ 0.05),perioperation blood loss more than 1,000 ml (P ＜ 0.05),and more than two kinds of medical conditions (P ＜ 0.05).Logistic regression identified three independent factors for postoperative delirium:preoperative waiting time more than 4 days (P ＜ 0.05,OR =2.74),BMI less than 20 kg/m2 (P ＜ 0.05,OR =13.27),preoperative cognitive impairment (P ＜ 0.05,OR =4.47),and operation time more than 2.5 hours (P ＜ 0.05,OR =4.56).Conclusions Risk factors of postoperative delirium in elder patients with femoral intertrochanteric fracture are complicated.Therefore,overall situation should be taken into consideration and comprehensive and effective treatment should be formulated to prevent the occurrence of postoperative delirium.

Objective To investigate the therapeutic effects and adverse reaction of Gastrodin Injection combined with Fluoxitine (Prozac) in the treatment of post-stroke depression (PSD).Methods One hundred and two patients with PSD were randomly allocated into two groups:51 cases in the Gastrodin Injection and Fluoxitine combination group (treatment group),51 cases in Fluoxitine Group (control group).The treatment group was treated by intravenous injection of 600 mg/d Gastrodin (14 days) plus oral administration of 20 mg/d Fluoxitine (30 days).The control group was only treated by oral administration of 20 mg/d Fluoxitine (30 days).The therapeutic effects were evaluated by the observations of the changes of symptoms and signs and Hamilton Depression Scale (HAMD) respectively in the two groups.Results The cured,effective,improved and invalid rates were 9.8％ (5/51),52.9％ (27/51),27.5％ (14/51) and 9.8％ (5/51) respectively in the treatment group and 2.0％ (2/51),11.7％ (6/51),66.7％ (34/51) and 19.6％ (10/51) in the control Group.The total effective rate in the treatment and the control groups were 90.2％ (46/51) and 80.4％ (41/51) respectively.The therapeutic effect was better in the treatment group than in the control group,and there was significant difference observed between the two groups (x2 =13.03,P ＜ 0.05).The rate of adverse reaction was significantly lower in the treatment group than in the control group (3.92％ (2/51) vs.25.5％ (13/51),x2 =9.64,P ＜ 0.01).Conclusion Gastrodin Injection in combination of Fluoxitine,with low adverse reation rate,is an effective therapeutic method for the treatment of PSD.

Objective To investigate the change of apoptosis and drug resistance after multiple thermotherapy On the HepG2 Cell. Methods After HepG2 cell were treaded by ten repeated cycles of exposure at 43 degree C for 80 minutes twice a day，the sensibility of HepG2 cell to Adfiamyein was analyzed by MTr assay.The apoptosis Was detected by kit，and the expression of Bcl-2 or Bax protein and mRNA were detected by immunohistochemical method and RT-PCR respective.Results The drug resistance to Adfiamycin Was gained by HepG2 cell after multiple thermotherapy.The rate of apoptosis was decreased，the expression of Bcl一2 protein and mRNA Was strengthened，and the ratio of Bcl-2/Bax increased.Conclusions The resistance of heated HepG2 cell to chemotherapeutics Was related with the decreased rate of apoptosis，overexpression of Bcl-2 protein and mRNA，and increased ratio of Bcl-2/Bax.

Adolescent ; Adult ; Aged ; Cystitis ; etiology ; prevention & control ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Hemorrhage ; etiology ; prevention & control ; Humans ; Injections, Intravenous ; Male ; Mesna ; administration & dosage ; therapeutic use ; Middle Aged ; Transplantation Conditioning ; methods ; Young Adult

AIM: To construct recombinant adenovirus vector containing brain derived neurotrophic factor, (BDNF) gene using bacterial homogenous recombination, and investigate the expression in expanded rat mesenchymal stem cells (rMSC) in vitro. METHODS: BDNF gene and proBDNF gene were subcloned into adenovirus shuttle plasmid pAdTrack-CMV containing enhanced green fluorescent protein gene (EGFP) expression cassette, forming shuttle vector of pAdTrack-BDNF, and pAdTrack-proBDNF, and co-transformed into BJ5183 bacterial cells with adenovirus backbone vector pAdEasy-1 using chemical transformation. After the recombinant adenovirus vector was obtained, the identified recombinant adenovirus plasmid DNA was digested with Pac I and transfected to 293 cells to package recombinant adenovirus particles. rMSC were infected by recombinant adenovirus and EGFP expression was detected using fluorescent microscope. Infection efficiency was assessed by flow cytometrics. Western blotting identified expression of Ad -proBDNF and Ad-BDNF in rMSC. rMSC infected with Ad -proBDNF and Ad-BDNF were induced to differentiate into neuron-like cells. rMSC infected with Ad -proBDNF and Ad-BDNF were injected into nude mice and assessd in vivo. RESULTS: We successfully constructed the recombinant adenovirus Ad -proBDNF and Ad-BDNF that expressed in expanded rMSC in vitro.CONCLUSION: Recombinant adenovirus high-effectively mediates Ad -proBDNF and Ad-BDNF expression in expanded rMSC in vitro and in vivo.

Objective To explore the surgical management for arterial diseases. Methods The clinical data of 86 cases of arterial diseases were analysed retrospectively. These cases included:3 cases of thoracic aortic aneurysm,2 cases of descending aortic dissection with rupture and aneurysm formation,2 cases of abdominal aortic dissection with false aneurysm,1 case of abdominal aortic aneurysm(AAA)with duodenojejunal fistula and GI bleeding,5 cases of ruptured AAA with shock, 3 cases of traumatic rupture of abdominal aorta,21 cases of AAA combined with unilateral or bilateral iliac aneurysms,6 cases of iliac aneurysms,9 cases of popliteal aneurysms,21 cases of false aneurysm of iliac or popliteal artery,1 case of rupture of junction of subclavian and vertebral artery with false aneurysm,3 cases of rupture of subclavian artery with false aneurysm,2 cases of aneurysm of carotid artery and 7 cases of false aneurysm of carotid artery. Prosthetic vascular graft was performed in 71(cases),autologous vein graft in 3 cases and suture(repair) of arterial rupture in 12 cases.Results Operative (mortalty) was 3.5%(3/86)in this series.Seventy-one cases were followed-up for 1 month to 5 years, the results showed that all the patients were alive and well.Conclusions In the(management) of(appropriate) aortic diseases, the use of endoluminal technique is simple, microtraumtic, safe and has few complications. It also can shorten the hospital stay of the patient. Endovascular technique should be the first choice for patients with aortic diseases.

Objective To explore the elementary properties of LiF (Mg,Cu,and P) thermoluminescent dosimeter (TLD) in dosimetry for tumor radiotherapy,and to provide a reliable basis for thermoluminescent dosimetry in clinical radiotherapy.Methods 60Coγ-ray and 6 MV X-ray were used for evaluation of the dispersion,repeatability,and dose response of LiF TLD.To meet the requirement of clinical radiotherapy,the effects of energy,dose (50-600 cGy),radiation dose rate (50-600 MU/min),and the angle of incidence for accelerator gantry (0°-± 90°) on TLD were determined and the respective correction factors were calculated.Results The errors of repeatability and dispersion of TLD were less than ±3％.There was a linear relationship between readout and irradiation dose within a certain range of irradiation dose.The minimal relative deviation of 0.3％ was obtained when 6 MV X-ray was used with a dose rate of 300 MU/min and an angle of incidence of 0°.Conclusions LiF TLD shows excellent repeatability,low dispersion,high stability,and strong linear correlation.It meets the international criteria and can be used for dose measurement in tumor radiotherapy.

Objective To investigate the effect of fetal hemoglobin( HbF) in improving anemia of women who were β‐thalasse‐mia carriers at childbearing age .Methods 289 cases of women at childbearing age diagnosed as β‐thalassemia carriers in Shenzhen City were enrolled in this study .The high performance liquid chromatography (HPLC) was uesed for quantitative analysis of HbF , and the red blood cell parameters were detected by using the LH750 Automatic blood cell analyzer .The differences of red blood cell parameters between the HbF normal group and the HbF increased group were compared ,and the relationship between the high HbF expression rates and gene mutations were also analyzed .Results Comapred with the HbF normal group ,the hemoglobin (HGB) levels ,mean corpuscular volume (MCV) and the mean corpuscular hemoglobin (MCH) increased significantly ,while the red blood cell (RBC) count reduced ,there were significant differences between the two groups (P<0 .05) .No significant differ‐ences of the mean corpuscular hemoglobin concentration (MCHC) and RDW coefficient of variation (RDW‐CV) between the two groups were found(P>0 .05) .There were no significant differnces of rates of HBF high expression between different types of β‐globin gene mutations and the overall rate of HBF high expression (P>0 .05) .Conclusion Compared with the HbF normal group , anemia may improve more significantly in cases of women diagnosed as β‐thalassemia carriers at childbearing age in the HbF in‐creased group ,and there may be no relationship between gene mutations and high expression of HbF .

Objective To investigate the efficacy of initial polytherapy in the patients with newly diagnosed infantile spasm by evaluating the ambulatory electronecephalogram (EEG) profiles and serum neuron specific enolase ( NSE ) level.Methods Data from 108 cases of newly diagnosed infantile spasm from Sep.2007 to Nov.2010 in the Department of Pediatrics,the First Hospital of Jilin University,were respectively analyzed for the EEG profiles and serum NSE level.The patients were treated with multiple drugs.Results ( 1 )After treatment,EEG showed normal shape in 56 cases ( 62.2％ ),sporadic sharp and slow waves without hypsarrhythmia in 32 cases( 35.6％ ),and hypsarrhythmia in 2 cases (2.2％).The overall effective rate was 97.8％.(2) Serum NSE in 35 seizure-free cases were examined at the time points of hospital admission,48 hours and one month after seizure cessation,respectively.NSE level was significantly decreased at 48 hours after seizure control than that at hospital admission ( t =6.54,P ＜ 0.05 ) ; NSE at one month after seizure free was further decreased compared with that at admission point ( t =9.29,P ＜ 0.05 ).Conclusion Polytherapy for infantile spasms can ameliorate the abnormal EEGs.NSE level is decreased after seizure cessation.Intelligence is improved 6 months after seizure free and polytherapy may improve the prognosis of the children with infantile spasms.

Objective:The study was attempted to improve the manipulation and eliminate patient's fear for gastroscopy combined with intravenous injection.Methods:A total of 1350 patients wasrandomized into test group (n=1100 given intraveous protofol and midazolam)and the control (n=250,without anesthetics).Patient's feeling,heart rate,blood oxygen saturation,blood pressure,operative duration and operator' satisfaction were recored and analysed.Results:Data in test group showed less complaints,easier manipulation,high satisfaction and no difference in operative duration and blood oxygen saturation as compared with the control.After intravenous administration of protofol and midazolam,patient's heart rate and blood pressure (systolic and diastolic pressure) significantly decreased.Conclusions:With intravenous use of protofol and midazolam,gastroscopy can be achieved effectively,painlessly and safely.