Objective To investigate the clinical features of acute mesenteric ischemia (AMI) in the elderly and provide evidence for early prevention,diagnosis and treatment of AMI for elderly patients.Methods A retrospective analysis was performed in 104 patients with AMI in our hospital,who were divided into two groups:the elderly group (aged≥60 years) and the non-elderly group (aged ＜ 60 years).Clinical manifestations,misdiagnosis rate,laboratory data,underlying diseases,treatment and prognosis were compared between the two groups.Results Acute superior mesenteric artery thromboembolus (ASMATE) was the main cause of AMI in the elderly group and acute mesenteric venous thrombosis (ASMVT) was the main cause of AMI in the non-elderly group.Elderly patients were more prone to misdiagnosis as compared with the non-elderly group (P =0.007).Abdominal pain (100.0％) was the most common clinical manifestation of AMI patients,followed by vomiting (58.7％).Nausea and vomiting were strongly associated with AMI in the elderly (P＜0.05).In laboratory data,serum creatinine,lactate dehydrogenase and uric acid were higher and the D-Dimer level was lower in elderly patients than in non-elderly patients (P＜0.05).Hypertension,atrial fibrillation,arteriosclerosis,ischemic heart disease,cerebral infarction and chronic renal insufficiency were more common in the elderly with AMI (all P＜0.05),while history of alcohol intake was higher in the non-elderly group (P=0.042).Hypertension,arteriosclerosis and cerebral infarction were independent relevant factors for elderly-onset AMI (P =0.000,OR =4.057;P =0.001,OR=4.585;P=0.007,OR=4.269).The number of patients with colon necrosis was higher in the elderly group than in the non-elderly group (P=0.038),and the prognosis was worse in the elderly group than in the non-elderly group (P=0.001).Conclusions ASMATE is the main cause of AMI in elderly patients.Nausea and vomiting are the main clinical manifestations,together with impaired renal function.Hypertension,arteriosclerosis and cerebral infarction are the independent relevant factors for elderly-onset AMI.Elderly patients are more prone to misdiagnosis,show more severity and have worse prognosis.

ObjectiveTo investigate the effects of sex hormones( 17 β-estradiol and testosterone)on human omental preadipocytes proliferation and differentiation and on leptin and adiponectin secretions in adipocytes.Methods Omental preadipocytes were cultured and then differentiated into mature adipocytes in vitro.The proliferation and differentiation processes of preadipocyte were observed.The preadipocytes were incubated in the presence of sex hormones and were detected the contents and gene expressions of leptin and adiponectin.ResultsHuman preadipocytes were primarily cultured successfully.Estradiol stimulated preadipocytes proliferation (0.823±0.059 vs 0.276 ±0.032,P＜0.05 ),and inhibited lipid accumulation in cell differentiation ( P＜0.05 ).Testosterone had no significant effect on proliferation of preedipocytes,but inhibited adipogenic differentiation ( P＜0.05).Leptin could be detected during proliferation and differentiation of preadipocytes.Estradiol increased the leptin secretion,whereas testosterone reduced it ( all P ＜ 0.05 ).The adiponectin only could be detected during differentiation.Sex hormones reduced the adiponectin secretion.17β-estradiol stimulated leptin mRNA expression and suppressed adiponectin mRNA expression in adipocytes.Testosterone suppressed the mRNA expressions of leptin and adiponectin (all P ＜ 0.05 ).ConclusionIn vitro,17β-estradiol increases the leptin secretion and mRNA expression whereas reduced the adiponectin secretion and mRNA expression.Testosterone reduced the adiponectin and leptin secretion and mRNA expression.

Objective To study the influencing factors,treatment and prevention of venous thromboembolic (VTE) in elderly patients with malignant tumor.Methods The clinical findings in forty elderly patients with malignant tumor combined with VTE from our hospital within 5 years were analyzed retrospectively.The risk,site,time,prevention and treatment of VTE in these tumor patients were analyzed and summarized.Results After active treatment,the positive efficacy response was obtained in 26 cases (65.0％),no-response in 14 cases (35.0％).Specifically,14 cases died,7 cases cured,and 19 cases were improved.Besides cancer and aging,the elderly tumor patients were considered as the high-risk group because of the risk factors including hypertension,diabetes,hyperlipidemia,pulmonary infection,surgery,radiation,chemotherapy and so on.D-dimer level was significantly increased in elderly malignant tumor patients with VTE.Venous thrombosis could occur at any stage.Venous thrombosis was found before tumor in 1 case.The most common site of DVT was the lower limbs,especially the left lower extremities (14 cases,35％).Most of internal carotid vein and upper limb vein thrombosis were associated with peripherally inserted central catheter (PICC) Conclusions The elderly patients with malignant tumor is the extremely high risk groups for venous thrombosis,and their quality of life and survival will be seriously impacted.Anticoagulant therapy through the whole process of treatment in patients with VTE is beneficial.The prevention and treatment of VTE play an important role in the tumor patients with risk factors such as chronic diseases,high D dimer level,radiation and chemotherapy,which should attract the attention of clinicians.

Based on the review of status of schistosomiasis transmission and surveillance in P.R. China,this article analyzed the present challenges in the surveillance on schistosomiasis. The focus on schistosomiasis surveillance and the needs for improv-ing surveillance system after the achievement of transmission control of schistosomiasis were explored.

Objective: To examine the microbial flora within the root canals with failed root canal therapy by PCR test, to identify detection rate of bacteria and the predominant bacteria species, and to determine the association of the various species with clinical features. Methods: Forty roots with failed root canal therapy were selected for this study. According to clinical features the roots were divided into three groups: pain, fistula and symptomless. After removal of the root filling material, the microbial samples were taken from the canal and detected by PCR test. Results: The microbial flora within root canals of teeth with failed root canal therapy was found to be mixed, six kinds of bacteria were detected. Enterococcus faecalis was the most commonly recovered bacteria species. Significant associations were observed between Prevotella nigrescens and pain, while dependablity was observed between Actinomyces israelii and fistula. Conclusion: The main cause of root canal treatment failure is the persistent microorganisms. The composition of bacteria in teeth with failed root canal therapy has its own specificity.

_ Objective_ To observe the effect of vaspin on the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells in rats and its potential mechanism. Methods Bone marrow mesenchymal stem cells( BMSCs) from 4 weeks aged rats were isolated and cultured. The BMSCs were treated with osteogenic induction medium and different concentrations of vaspin and Wnt signaling pathway inhibitor DKK1. The proliferation was detected by CCK8 method at 24, 48, 72 h. After 7 days, the mRNA expressions of ALP, Runx2,β-catenin were detected by realtime qPCR. The expression levels of Runx2 and β-catenin protein were detected by Western blot. After 21 days, alizarin red stained mineralized nodules and quantitative detection were performed. Results Vaspin had no effect on the proliferation but promoted the expression of osteogenic differentiation gene ALP, Runx2, and also increasedβ-catenin mRNA and expression of Runx2 and β-catenin protein. Mineralized nodules were brown and increased, OD value of vaspin group was higher than control group. After adding the DKK1, the expression of ALP, Runx2,β-catenin mRNA and Runx2, β-catenin protein were significantly decreased(all P<0. 05). Conclusion Vaspin can promote BMSCs into osteogenic differention through the Wnt/β-catenin signaling pathway.

OBJECTIVETo evaluate therapeutic effects of Rigidfix cross pins combined with Intrafix pins for the reconstruction of anterior or posterior cruciate ligament under arthroscopy.

METHODSFrom January 2009 to June 2010,34 patients with anterior or posterior cruciate ligament injuries were divided into two groups : group A and group B. There were 24 patients in group A, including 19 males and 5 females,with an average age of (31.83±9.57) years old. The patients in group A were treated with anterior cruciate ligament reconstruction under arthroscopy; Rigidfix cross pins and Intrafix pins were used to fix femoral and tibial side respectively. Among the 10 patients in group B, 8 patients were male and 2 patients were female, with an average age of (27.20+7.59) years old. The patients in group B were treated with posterior cruciate ligament reconstruction under arthroscope; Intrafix pins and Rigidifix cross pins were used to fix femoral and tibial side sepectively. The drawer test and Lachaman test were used to evaluate postoperative knee stability. All the patients were followed up at least 18 months. Lysholm and Tegner knee scores were used to evaluate the clinical therapeutic effects.

RESULTSAll the 34 patients were followed up, and the duration ranged from 18 to 26 months,with an average of (20.79±2.39) months. All the patients obtained good pain relief and knee stability. In group A,Lysholm scores significantly increased from 43.04±7.57 preoperatively to 85.41±4.68, 92.50±3.05, and 93.45±2.57 at 6,12, and 18 months postoperatively; Tegner scores significantly increased from 2.62±0.92 preoperatively to 7.45±1.14, 8.58±0.77, and 8.95±0.55 at 6, 12, and 18 months postoperatively. In group B,Lysholm scores significantly increased from 46.20±8.27 preoperatively to 86.40±5.14,90.40±2.67,and 92.00±3.85 at 6,12,and 18 months postoperatively ;Tegner scores significantly increased from 2.00±0.66 preoperatively to 7.10±0.99, 8.60±0.84, and 8.80±0.42 at 6,12, and 18 months postoperatively. There were no differences in Lysholm and Tegner scores between group A and B at different times during follow-up. Lysholm scores of all patients significantly increased from 43.97±7.79 preoperatively to 85.70±4.76,91.88±3.06,and 93.02±3.01 at 6,12,and 18 months postoperatively. Tegner scores of all patients significantly increased from 2.44±0.89 preoperatively to 7.35±1.09, 8.58±0.78, and 8.91±0.51 at 6,12,and 18 months postoperatively. During the follow-up period,there were no serious immunological rejection and complications.

CONCLUSIONReconstruction of anterior or posterior cruciate ligament under arthroscopy with Rigidfix cross pins and Intrafix pins fixation is feasible therapy for anterior or posterior cruciate ligament injuries, and the fixation is rigid. The therapy restores knee stability and provides a satisfactory short-term results.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Bone Nails ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; instrumentation ; methods

Objective To discuss the risk factors and prognosis of gynecologic cancer patients with deep venous thrombosis(DVT). Methods Data from gynecologic cancer patients diagnosed by cytology or histopathology in Affiliated Tumor Hospital of Guangxi Medical University between Jan. 1994 and Sep. 2014 were collected,including 106 cases in the DVT group, according to 1:1 proportion by the computer random method to selecting patients without DVT as the control group. The follow-up deadline was March 31, 2015. The median follow-up time of DVT group was 27.0 months (range, 1 to 169 months), while the control groupwas 33.5 months (range,1 to 125 months). Univariate analysis was performed by two independent sample t test or χ2 test. Multivariate analysis was performed by logistic regression analysis. The Kaplan-Meier curve was used to estimate the survival analysis. Results (1) The univariate analysis showed that body mass index (BMI), hypertension, diabetes, history of thrombosis, tumor stage, blood transfusion, stimulating factor, white blood cell (WBC), platelet (PLT), prothrombin time (PT) and fibrinogen (FIB) were statistically significant associated with DVT (P<0.05). Multivariate analysis showed that tumor stage, stimulating factor, WBC, PT and FIB may be the independent risk factors of gynecologic cancer with DVT (P<0.05). (2) The median survival time in DVT group was 66 months, while the control group was 102 months(χ2=7.039, P=0.008). The overall survival and progression-free survival in the DVT group were statistically significant lower than those in the control group (P<0.05). The tumor stage, the scope of DVT (whether with pulmonary embolism) and the treatment of DVT were the effective factors influenced the prognosis of gynecologic oncology patients with DVT (P<0.05). Cox regression model showed that tumor stage and the scope of DVT were the independent risk factors (P<0.01). Conclusions Gynecologic cancer with DVT is the common effect of various risk factors. We should identify the risk factors for high-risk patients and take preventive measures actively to reduce the deep venous thromboembolism, then improve the survival of patients and their prognosis.

Objective To compare the effectiveness of medicated γintrauterine device (IUD) and medicated genefix IUD inserted immediately after abortion. Methods A multicenter clinical trail was performed for the study from Mar. 2012 to Jan. 2013. Totally 840 women who volunteered to participate were randomly allocated to γ-group (medicated γ IUD) or genefix-group (medicated genefix IUD) immediately after abortion. While 464 abortion women who had not used IUD or steroids contraceptive methods were chosen as control group. The effectiveness of the IUD were followed up for 1 year. All women were required to record the number of vaginal bleeding days and blood volume of vaginal bleeding within 3 months after abortion. Results At the 12th month, the expulsion was the most common reason for termination. The expulsion rates of genefix-group and γ-group were 2.48/100 women years and 3.12/100 women years, respectively (P>0.05). For the expulsion reasons, IUD moving down could account for more than seventy percent. The removal rate for IUD usage of two IUD groups were almost equal (3.91/100 women years verus 4.35/100 women years), the differences were not statistically significant (P>0.05). At the 90th day after abortion, comparing with control group, the bleeding and (or) spotting days of genefix-group and γ-group extended by 3.9 and 2.6 days respectively, the differences had statistical significance between the three groups (P<0.05). Among the bleeding and (or) spotting days, spotting days prolonged significantly. At the 12th month, spotting days of genefix-group andγ-group were (9.2±5.9) days and (8.5±4.6) days respectively, more than (5.2 ± 4.0) days of control group. The differences had statistical significance between IUD with control group (P<0.05), and had not between the two kinds of IUD (P>0.05). Conclusion The insertion of medicated genefix IUD and medicated γ IUD immediately after abortion is safe, feasible, has slight side effects and could be effective contraception.

Objective To explore the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma of the breast (IMPC),and the distinction between IMPC and invasive ductal carcinoma of the breast (IDC).Methods From February 2004 to November 2013,195 IMPC patients and 420 IDC patients were analyzed retrospectively.Results There were significant differences in mammilla invasion,lymph vessel invasion,orange peel sign,soft tissue encroachment,neoadjuvant chemotherapy,radical mastcctomy,lymph node metastasis,clinical stages,tumor size,lymph node staging,estrogen receptor (ER),progestin receptor (PR),human epidermal growth factor receptor 2 (HER2),molecular subtyping,ratio of radiation,ratio of endocrine therapy,disease-free survival (DFS),overall survival (OS)between the two groups,all P ＜0.05.Patients with IMPC had lower 5-year DFS and OS rates (68.2％ and 73.8％,respectively) than IDC patients (85.7％ and 88.6％,respectively),all P ＜ 0.05.In IMPC patients with positive ER/PR,HER2-negative,smaller tumor volume,less lymph node metastasis,negative nipple invasion,negative lymphatic vessel tumor thrombus,negative orange peel change had higher 5-year DFS and OS rates than those with negative ER/PR,HER2 overexpression,larger tumor volume,more lymph node metastasis,positive nipple invasion,positive lymphatic vessel tumor thrombus,positive orange peel change,all P ＜ 0.05.Besides,the patients with pathologic stage Ⅰ had higher OS than those with stage Ⅲ (P ＜ 0.05).Cox regression analysis found that orange peel change,lymph vessel invasion and HER2 were the independent risk factors for the survival time of patients with IMPC.Conclusions IMPC patients have lower DFS and OS compared with IDC.