OBJECTIVE:To explore the effect of olmesartan on NT-proBNP and high-sensitive C- reactive protein(hs-CRP) and left atrial diameter (LAD) in elderly hypertensive patients with paroxysmal atrial fibrillation (PAF). METHODS:188 cases of elderly hypertensive patients with PAF from May 2011 to May 2013 were divided into control group(n=94)and observation group (n=94),both groups received the treatment of amiodarone,observation group were additionally given olmesartan on the basis of conventional treatment,the treatment cycle was 12 months in two groups. NT-proBNP,hs-CRP,LAD changes and atri-al fibrillation(AF)recurrence were compared between 2 groups before(T0)and after 1 month(T1),3 months(T2),6 months (T3)and 12 months(T4)treatment;related factors for recurrence of atrial fibrillation were analyzed. RESULTS:NT-proBNP and hs-CRP in observation group were lower than control group at T3-T4,with significant difference(P<0.05);LAD improvement in observation group was better than control group,with significant difference (P<0.05). After treatment,the decent range of NT-proBNP and hs-CRP in observation group were higher than that control group,with significant difference(P<0.05);AF re-currence in observation group were lower than control group at T3-T4,with significant difference(P<0.05);Multiple stepwise re-gression analysis showed that NT-proBNP and hs-CRP were positively related with LAD,with significant difference (P<0.05);multi-factor logistic regression analysis showed that the NT-proBNP level,hs-CRP,LAD were positively correlated with AF re-currence,NT-proBNP drop and hs-CRP drop were negatively correlated with AF recurrence. CONCLUSIONS:Serum NT-proB-NP and hs-CRP levels are closely related to LAD and AF recurrence in elderly hypertensive patients with PAF,and olmesartan can decrease the plasma NT- proBNP CRP levels,reduce inflammation response and improve left atrial remodeling so as to re-duce the AF recurrence.

Objective To observe the application effect of fast track surgery(FTS)in the perioperative period of elderly patients with colorectal cancer. Methods A total of 153 colorectal cancer patients admitted in our hospital from March 2011 to July 2015 were chosen as the research ob?jects. Those patients were assigned to younger age group(<65 years,n=77)and older age group(≥65 years,n=76). Then,35 patients of younger age group(FTS1 group)and 37 patients of older age group(FTS2 group)were randomly selected and received FTS treatment ,and others were given traditional treatment measures(TC1 group and TC2 group). All patients underwent surgical treatment by the same experienced surgical team. The differences between the pairs of groups in different age ranges were compared with respect to the postoperative recovery index ,complica?tions,and medical costs. Results Compared with the TC1 group,the FTS1 group experienced earlier postoperative flatus,a shorter postoperative hospital stay,lower medical costs,and decreased incidence of postoperative complications(P<0.05). Compared with the TC2 group,the FTS2 group had a shorter hospital stay(P<0.05),but no significant difference in others(P>0.05). Conclusion The application of FTS can signifi?cantly improve postoperative rehabilitation,shorten hospitalization time,and decrease medical costs for<65 aged colorectal patients;However, there is no significant difference in benefits for aged patients(≥65)underwent the FTS procedure. Our results suggested that we should consider whether the FTS procedure is suitable for elderly patients with colorectal cancer cautiously.

Objective To evaluate the relationship between protein kinase B (AKT) and protein kinase (PKCθ) and morphine-induced inhibition of differentiation of T helper (Th) cells.Methods Peripheral venous blood samples were taken from 20 healthy volunteers..Peripheral blood mononuclear cells (PBMCs) were extracted by density gradient centrifugation method.CD4+ T lymphocytes extracted were purified by magnetic bead separation.CD4+ T lymphocytes were randomly assigned into 5 groups (n =3 each) using a random number table.CD4 + T lymphocytes were incubated routinely in group C.CD4 + T lymphocytes were incubated in the presence of PMA 25 ng/ml + ionomycin 1 μg/ml (group PI),PMA 25 ng/ml + ionomycin 1 μμg/ml + morphine 50 μμg/ml (group M),or PMA 25 ng/ml + ionomycin 1 μμg/ml + morphine 50 μg/ml + naloxone 50 μμg/ml (group N).The cells were incubated for 4 h in the incubator containing 5％ CO2 at 37 ℃.The expression of interferon (IFN)-γ and interleukin-4 (IL-4) was detected by flow cytometry.The expression of IFN-γ and IL-4 was used to reflect the percentage of Th1 and Th2 cells,respectively.The ratio of Th1/Th2 was calculated.The expression of AKT,phosphorylated AKT (p-AKT),PKCθ and phosphorylated PKCθ (p-PKCθ) was detected by Western blot,and the ratio of p-AKT/AKT and p-PKCθ/PKCθ was calculated to reflect the activities of AKT and PKCθ,respectively.Results Compared with group C,the percentage of Th1 and Th2 cells and ratio of Th1/Th2 were significantly increased in PI,M and N groups,the activities of AKT and PKCθ were increased in PI and N groups,and the activity of PKCθ was increased in group M (P ＜ 0.05).Compared with group PI,the percentage of Th1 cells,ratio of Th1/Th2 and activity of AKT were significantly decreased in group M,the ratio of Th1/Th2 was decreased in group N (P ＜0.05),and no significant change in the activity of PKCθ was found in M and N groups (P ＞ 0.05).Compared with group M,the percentage of Th1 cells,ratio of Th1/Th2 and activity of AKT were significantly increased (P ＜ 0.05),while no significant change in the activity of PKCθ was observed in group N (P ＞ 0.05).Conclusion The mechanism by which morphine inhibits the differentiation of Th cells through activating opioid receptors is related to inhibition of AKT activation,but not related to PKCθ.

OBJECTIVETo compare the effect on surgical indicators and functional outcome between preoperative skeletal traction and skin traction for adult femoral fracture and guide the choice of preoperative traction method of adult femoral fractures.

METHODSFrom February 2008 to September 2012, 68 patients aged greater than 18-year-old with femoral fractures were treated and randomly divided into two groups according hospitalization order,the odd with skeletal traction of tibial tubercle (group A) and the even with skin traction (group B). In group A, there were 25 males and 9 females with an average age of (36.3±9.9) years old,including 11 cases with transverse fracture, 15 cases with oblique fracture, 8 cases with spiral fracture. In group B, there 26 males and 8 females with an average age of (37.1±11.0) years old,including 10 cases with transverse fracture, 13 cases with oblique fracture,11 cases with spiral fracture. The operative time,blood loss,the number and amount of blood transfusion ,fracture healing time, hemoglobin, pain scores and functional scores between two groups were analyzed and compared. Results:All patients were followed up, the follow-up time was (33.5±6.5) months in group A, (31.3±7.5) months in groupB. In group A,the operation time was (108.8±14.2) min and the intraoperative blood loss was (383.1±117.1) ml and the postoperative blood transfusion was 14 cases and the blood transfusion was (350.0±122.5) ml and the average bone healing time was(15.0±3.3) weeks. In group B, the operation time was (111.6±12.7) min and the intraoperative blood loss was (392.0± 116.7) ml and the blood transfusion was 11 cases and the blood transfusion was(327.3±129.1) ml and the average healing time was (15.5±3.4) weeks. These obseration indicators had no significant difference between two groups. There was no significant difference between two groups in terms of Hemoglobin, the pain scores before and after traction, the femoral fractures efficacy score,knee function score and knee range.

CONCLUSIONPreoperative skeletal traction does not reduce surgery time, blood loss and pain and so on. The bone healing time and limb functional outcomes were also not significantly improved.

Adult ; Blood Loss, Surgical ; Bone and Bones ; surgery ; Dermatologic Surgical Procedures ; Female ; Femoral Fractures ; physiopathology ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Male ; Middle Aged ; Preoperative Period ; Traction ; Young Adult

Objective To evaluate the relationship between GATA-3 and T-bet and inhibition of the differentiation of human T helper cells by morphine.Methods Ten healthy volunteers,aged 20-50 yr,weighing 50-70 kg,were enrolled in the study.Peripheral venous blood samples were taken in the early morning.Peripheral blood mononuclear cells (PBMCs) were isolated and assigned into 5 groups (n=10 each).PBMCs were incubated routinely (group C).PBMCs were incubated in the presence of PMA and ionomycin (group P),morphine 50 μg/ml (group M),morphine 50 μg/ml + naloxone 50 μg/ml (group MN) or naloxone 50μg/ml (group N),and were then stimulated with PMA and ionomycin for another 4 h.The percentage of Th1 and Th2 cells was detected by flow cytometry.The Th1/Th2 ratio was calculated.Interferon (IFN)-γ and interleukin (IL)-4 concentrations in the supematant were determined using ELISA.The activities of GATA-3 and T-bet were analyzed by EMSA.Results Compared with group P,the percentage of Th1 and Th2 cells,Th1/Th2 ratio,IFN-γand IL-4 concentrations in the supernatant,and GATA-3 and T-bet activities were significantly decreased in group M,the percentage of Th1 cells,Th1/Th2 ratio,and IFN-γ concentration in the supernatant were significantly decreased in group MN (P ＜ 0.05 or 0.01).Compared with group M,the percentage of Th1 and Th2 cells,Th1/Th2 ratio,IFN-γ and IL-4 concentrations in the supernatant,and GATA-3 and T-bet activities were significantly increased in group MN (P ＜ 0.05 or 0.01).There was no significant difference in the indexes mentioned above between groups N and C (P ＞ 0.05).Conclusion Morphine inhibits the differentiation of human T helper cells by activating opioid receptors,which may be related to the inhibition of GATA-3 and T-bet activities.

The medical records of 197 patients on linezolid therapy were collected retrospectively.The prevalence and risk factors for linezolid-induced reduction of hemoglobin were identified.The incidence of linezolid-induced reduction of hemoglobin was 31.98％.The patients with reduction of hemoglobin had older age [(68 ± 14) vs.(59 ± 18) years,P =0.000] and lower creatinine clearance (CCr) [(72 ±42)vs.(98 ± 52) ml/min,P =0.000].Multivariate logistic regression analysis showed that age ≥65 years,treatment duration ≥ 15 days,CCr ＜ 65 ml/min and pre-treatment hemoglobin value ＜ 95 g/L were significant risk factors for linezolid-induced reduction of hemoglobin.

Objective With the sole object of glycyrrhizic acid products,the methods were investigated for Glycyrrhiza uralensis genomic DNA transformation into Hansenula anomala by nitrogen and argon ion implantation.Methods The genomic DNA from G.uralensis was randomly transferred into H.anomala by nitrogen and argon ion bombardment.The recombined yeasts were cultured by the slant and liquid cultivation,in which the contents of glycyrrhizic acid and glycyrrhetic acid were determined by acetic anhydried-H2SO4 qualitative test and RP-HPLC determination.Results Five recombined yeast strains that produced glycyrrhizic acid and glycyrrhetic acid were obtained.After cultured in liquid medium for 96 h,the highest content of glycyrrhizic acid in the cultivation liquid was 114.49 mg/L and that of 18?-glycyrrhetic acid and 18?-glycyrrhetic acid were respectively 0.56 and 0.81 mg/L by RP-HPLC.A kind of unknown red component was found in the cultivation liquid of one recombined strain by TLC.Conclusion The recombined yeast strains of producing glycyrrhizic acid could be obtained G.uralensis genomic DNA transformation into yeast mediated by the ion implantation.

Objective To evaluate the clinical and stenting relating risk factors on the in-stent restenosis. Methods One hundred and thirty seven patients whose data were available were enrolled in this study, and the patients were divided into the groups of in-stent restenosis and non in-stent restenosis according to the results of coronary angiograms. Then the clinical and stent relating factors affecting in-stent restenosis were analyzed. Results There were no statistical differences in age and prevalence of smoking, drinking, hypertension and diabetes mellitus between two groups. Narrowing of target coronary vessels before the procedures in the group of in-stent restenosis was more severe than that in the group of non in-stent restenosis ( vs , P=0.033). The average diameter of stents used in the group of in-stent restenosis was obviously smaller than that used in the group of non in-stent restenosis ([3.19?3.90]mm vs mm, P=0.005), the average length of stents, however, used in the group of in-stent restenosis was apparently longer than that used in the group of non in-stent restenosis ([21.91?8.98]mm vs [18.20?6.07]mm, P=0.011). The total duration of stent inflation in the group of in-stent restenosis was obviously shorter than that in the group of non in-stent restenosis ([22.74?19.56]s vs [29.12?25.72]s, P=0.026). There was no statistial difference between the two groups in the inflation times and pressure of stents implantation. Conclusion The results suggested that the rate of in-stent restenosis was not significantly influenced with age, smoking, drinking, hypertension, diabetes mellitus and inflation times and pressure of stent implantation, but the narrowing of target vessels before procedures and the lengths of the stents were positively related to in-stent restenosis, while stent diameters and total inflation durations of stent were negatively related to in-stent restenosis.

Objective To understand the water quality of centralized water supply in Shanghai and provide the scientific data for further improvement of the health inspection and management of centralized water supply. Methods The management situation of centralized water supply, the water quality of water source, product water and tap water were investigated by using the methods in Analytical Methods for Water and Sanitary Standard for Drinking Water Quality (2001) in Shanghai in 2006. Results The current situation of management of 165 units of centralized water supply including 19 self-supply water plants in Shanghai was satisfactory. The analysis of drinking water showed that COD and total coliform in source water exceeded the standard limit remarkably(the eligible rates were 63.93% and 22.95% respectively), the eligible rates of COD, turbidity and manganese in product water and tap water were 25.45%, 18.18%, 27.88% and 18.06%, 13.89%, 11.81% respectively. Conclusion The results of the present investigation show that in Shanghai the main problems about the water quality are water source contamination by organic pollutants and the undeveloped water treatment.

Objective To review the experience of closure of recalcitrant bronchopleural fistula using the transsternal transpericardial approach. Methods 3 patients with recalcitrant bronchopleural fistula underwent transsternal transpericardial closure of a bronchopleural fistula and drainage by open thoracostomy. Results All patients were survived and there was no recurrence of bronchopleural fistula. Conclusion Transsternal transpericardial approach seems to be a safe and effective method in cases of bronchopleural fistula complicated with empyema. It has the added advantage of less recurrent fistula formation.