Objective To identify etiological factors for non-ulcer dyspepsia (NUD) in elderly patients presenting to the emergency department.Methods A total of 97 elderly patients with NUD presenting to the emergency department from January 2011 to December 2013 were enrolled in the NUD group and 116 elderly people undergoing annual physical examinations served as the control group.Clinical data,including Helicobacter pylori (HP) infection,unhealthy living habits,anxiety,depression and regular intake,were collected and compared between the two groups.Results Compared with the control group,the NUP group showed a higher HP infection rate [70.1％ (68/97)vs.54.3％ (63/116),x2 =5.565,P＜0.05],a higher incidence of unhealthy living habits (unhealthy dietary habits,smoking,drinking,and lack of regular exercise) (P＜0.05),a higher incidence of suspect anxiety/anxiety and a higher incidence of regular intake [30.9％ (30/97) vs 10.3％ (12/116),x2=14.138,P＜0.05].SerumpepsinogenⅠ(PGⅠ) [(178.7±13.6) μg/L vs.(125.2±10.5)μg/L,t=1.971,P＜0.01] and serum pepsinogen Ⅱ(PG Ⅱ) [(28.8±5.3) μg/L vs.(14.7±3.8)μg/L,t=1.960,P＜0.01] levels were also higher in the elderly NUD patients than in the control group.Conclusions HP infection,unhealthy living habits,anxiety and/or depression,and regular intake are closely associated with NUD in the elderly.Serum PGⅠ and PGⅡ could be used as markers in screening for malignant lesions in elderly patients with dyspepsia.

OBJECTIVE:To develop an HPLC method for the determination of 5-ISMNconcerntrations in human plasma and study the pharmacokinetics of 5-ISMN orally disintegrating tablets and the reference tablets.METHODS:A single oral dose test capsule(orally disintegrating tablets)or reference capsule of 5-ISMN(60 mg)were administered by randomized crossover way in 20 healthy male volunteers with plasma 5-ISMN concentrations determined by HPLC.The pharmacokinetic parameters were calculated with 3p87 pharmacokinetic program and the bioavailability of the two preparations was evaluated.RESULTS:The main pharmacokinetic parameters of the test preparation vs.the reference preparation were as follows:Cmax:(613.42?73.83)vs.(368.64?38.66)?g?mL-1;tmax:(26.52?2.00)vs.(95.73?4.16)min;AUC0～∞:(73 872.24?543.89)vs.(77 978.47?646.37)ng?min?mL-1,respectively.CONCLUSION:The assay was proved to be sensitive,accurate and suitable for pharmacokinetic study of 5-ISMN.The results of pharmacokinetic study after oral administration of test and reference preparations of 5-ISMN showed that the two preparations were bioequivalent while the test preparation had a higher peak concentration and could reach peak level in less time,and the test preparation showed a rapid drug releasing behavior.

Objective To evaluate hepatic functional reserve and operational risks of primary hepatic carcinoma in Child A using functional CT.Methods In 128 cases of primary hepatic carcinoma of Child A undergoing hepatoectomy and identified by pathology, CT perfusion scanning and measurement of remannent hepatic volume were done before operation and whole patients were divided in-to acute hepatic failure group(AHF group,33 cases)and non-acute hepatic failure(non-AHF group,95 cases).All variables were ana-lyzed by one way analysis of variance(one-way ANOVA)firstly.The variables with significance (P<0.05)were analyzed with Step-wise Logistic regression further.Results One-way ANOVA result:There were significant difference between two groups in RHVS measured by CT,PVP,HBF,HBV,serum creatinine,thrombinogen activity,total bilirubin and intraoperative blood loss (P<0.05).The StepwiseLogistic regression analysis demonstrated that decreased RHVS and the lowed PVP were the independent risk factors of AHF complicated to hepatoectomy of primary hepatic carcinoma(P<0.01).Conclusion Hepatic functional reserve and operational risks of primary hepatic carcinoma could be j udged with functional CT before operation .

OBJECTIVE To investigate mycoplasma infection in ICU patients.METHODS Sixty-five samples from blood,respiratory tract and genitourinary tract of patients were collected respectively from Oct 2007 to July 2008 in ICU.Mycoplasma pneumoniae(Mp),Urealasma urealytium(Uu) M.fermentans(Mf) and M.penetrans(Mpe) were cultivated by modified mycoplasma fluid and solid medium.Mf and Mpe positive isolates were verified by nested polymerase chain reaction(rPCR),Mp and Uu were confirmed by fluorescent quantitative PCR.RESULTS It was found that the positive detection rate for Mp was 12.3%(8/65)in blood and 35.4%(23/65) in respiratory tract excreta and for Mu 1.5%(1/65) and 26.2%(17/65) in blood or Genitourinary tract,respectively.Mpe and Mf did not detected.CONCLUSIONS The state of mycoplasma infection is very severe,and often accompanies bacterial infection.It is necessary to consider mycoplasma when chose antibiotics.

BACKGROUND:The treatment of severe rigid idiopathic scoliosis is the difficulty of clinical treatment. The studies in recent years have shown that the three-stage correction is a safe and effective treatment method. OBJECTIVE:To explore the efficacy of three-stage correction in the treatment of severe rigid scoliosis. METHODS:Retrospective analysis was performed on 10 severe rigid scoliosis patients undergoing three-stage correction, the mean age of the patients was 12 years. The average Cobb angle in the coronal plane was 140° (ranged 110°-180°), the average Cobb angle in the sagittal plane was 75° (ranged 50°-100°). The treatment was divided three stages:anterior release, Halo-plevic traction and third step with posterior osteotomy and fixation. RESULTS AND CONCLUSION:Al of the patients underwent the surgery safely without severe complications. After anterior release and Halo-plevic traction, the Cobb angle in the coronal plane was 90°, and the mean correction rate was 35.7%;the Cobb angle in the sagittal plane was 50° with correction rate of 33.3%. The mean Cobb angle in the coronal plane was 40° with the correction rate of 71.4%after osteotomy, and the Cobb angle in the sagittal plane was 35° with the correction rate of 53.3%. The results show that three-stage correction is a safe and effective method for the treatment of severe rigid scoliosis.

Objective:To evaluate the clinical effects of problem solving therapy on the elderly patients with depression by Meta-analysis.Methods:Randomized controlled trials articles regarding the effects of problem solving therapy on the elderly patients with depression were searched from the database of PubMed, EMbase, Medline, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Database and Wanfang Data electronically. SMD was used as the post merger response, and its 95% CI was calculated. Results:Ten articles were recruited and a total of 1 005 patients were included, 501 patients in the intervention group and 504 patients in the control group. Meta-analysis showed that problem solving therapy was significantly better than the control group in the treatment of depressive symptoms in the elderly patients with depression ( SMD =-0.64, 95% CI -0.98 - -0.31, P<0.05); during the follow-up within 3 months and 6 months after the intervention, the improvement of depression in the intervention group was better than that in the control group ( SMD=-0.62, 95% CI -1.00 - -0.25, P<0.05) and ( SMD =-0.79, 95% CI -1.03 - -0.55, P<0.05), respectively. Compared with the control group, the intervention group had an effect on the improvement of dysfunction ( SMD=-1.28, 95% CI -2.22 - -0.35, P<0.05). Conclusions:Problem solving therapy can improve the depressive symptoms of the elderly patients with depression and the clinical effect remains stable for a certain period of time; problem solving therapy has an improvement effect on the dysfunction of the elderly patients with depression.

Aged ; Female ; Humans ; Kidney ; pathology ; surgery ; Kidney Transplantation ; Male ; Middle Aged ; Nephrectomy ; methods ; Ureter ; pathology ; surgery ; Urinary Bladder Neoplasms ; pathology ; surgery

In order to investigate the effects of electric pulses on cancer cells, we carried out the experiments with exposing HepG2 and L02 to electric pulses (1 kV/cm, l00 micros, 1 Hz) for different lengths of time (8 s, 15 s, 30 s, 60 s). Annexin V-FITC Kit and Flow cytometry were used to study the apoptosis of treated cells. The results showed that the electric pulses of 1 kV/cm, l00 micros, 1 Hz for 8 s could not induce tumor cells apoptosis. Apoptosis was observed when tumor cells were stimulated for 15 s and longer, and the apoptosis percentage increased with the increase of stimulation time. Furthermore, tumor cells were more sensitive than normal cells in response to electrical pulses. Rhodamine 123 and Laser Scanning Confocal Microscope (LSCM) were used to make a real-time study of mitochondrial transmembrane potential (Deltapsim) when the tumor cells were exposed to electric pulses for 60 s. No significant change of Deltapsim was observed within 30 s stimulation. After that, the Deltapsim increased sharply and declined later, suggesting that the mitochondrial pathway may be one of the apoptosis mechanism induced by electric pulses.
Apoptosis ; radiation effects ; Electromagnetic Fields ; Hep G2 Cells ; Humans ; Membrane Potential, Mitochondrial ; physiology ; radiation effects ; Time Factors

In order to deal with the shortage of medical talents in Tibet, medical group assistance to Tibet is started as an innovative move in a new era, not only providing high-quality medical resources to Tibet, but also training local medical personnel by drawing on the "Master-Apprentice" model in traditional Chinese medicine. During the past three-year, the Shanghai Medical Team took advantage of medical group assistance to Tibet, enriched the types, methods and contents of teaching and mentoring tasks, and highlighted the role of "experts leading the backbone" and "team leading the team" in the "Master-Apprentice" model. The total amount and quality of local medical talents have thus been significantly improved. On the basis of summarizing experience, this study proposes a number of measures to optimize the current "Master-Apprentice" training model, evaluate the implementation process, and improve the feedback and quality management, so as to speed up the construction of the Tibetan medical talent team.

Objective:To conduct meta analysis to compare the effect of complete resection with or without postoperative radiotherapy (PORT) on survival in stage Ⅲ(N 2) non-small cell lung cancer (NSCLC). Methods:Relevant studies of the efficacy of PORT for stage Ⅲ(N 2) NSCLC were searched from Wanfang Data, PubMed, and Cochrane Library from January 2006 to January 2022. Literature screening, extraction of information and assessment of the risk of bias of the included literature was carried out by two independent researchers. Meta analysis was performed using R4.0.3 software. Results:A total of 12 publications consisting of 2992 patients were included, 1479 cases in the PORT group and 1513 cases in the control group. PORT improved the overall survival (OS) and disease free survival (DFS) compared to the control group. Fixed-effects model meta analysis of 6 randomized controlled trials showed that PORT did not significantly reduce the risk of death ( HR=0.98, 95% CI: 0.80-1.20). Fixed-effects model meta analysis of 6 retrospective studies showed that PORT improved prognosis ( HR=0.68, 95% CI: 0.59-0.79). PORT could improve OS of patients with multiple (station) metastasis of ipsilateral mediastinum and / or submandibular lymph nodes ( HR=0.89, 95% CI: 0.80-0.99). Conclusions:PORT could improve OS and DFS in stage Ⅲ(N 2) NSCLC. A trend towards benefit can be observed in the subgroup with multiple/multi-station N2 metastasis.