Objective To investigate the effects of different doses of penehyclidine hydrochloride on postoperative cognitive function in the elderly patients.Methods Ninety-three ASA Ⅰ or Ⅱ elderly patients,aged ≥65 yr,weighing 55-71 kg,were randomly divided into 3 groups (n =31 each):penehyclidine hydrochloride 0.010 mg/kg group (group A),penehyclidine hydrochloride 0.015 mg/kg group (group B) and atropine 0.010 mg/kg group (group C).Their preoperative Mini-Mental State examination (MMSE) scores were ＞ 27.At 30 min before anesthesia,groups A,B and C received intramuscular penehyclidine hydrochloride 0.010 mg/kg,penehyclidine hydrochloride 0.015 mg/kg and atropine 0.010 mg/kg,respectively.The cognitive function of the patients was assessed within 72 h after operation using MMSE.Diagnostic criterion of postoperative cognitive dysfunction (POCD) was defined as MMSE score ≤27.POCD and the degree were recorded within 72 h after operation.Results Compared with group A,postoperative cognitive function was significantly decreased at each time point after operation and the incidence of POCD was significantly increased in group B (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group C (P ＞ 0.05).Compared with group B,postoperative cognitive function was significantly enhanced at each time point after operation and the incidence of POCD was significantly decreased in group C (P ＜ 0.05).Conclusion Penehyclidine hydrochloride can depress postoperative cognitive function and the effect is related to the dose.

Objective To investigate the clinical characteristics of Kennedy disease with secondary mitochondrial dysfunction and glutaric aciduria typeⅡ.Methods The clinical data of 1 case Kennedy disease with secondary mitochondrial dysfunction and glutaric aciduria typeⅡwas retrospectively analyzed.Results The patient presented muscle weakness in proximal limbs, fasciculation, bulbar palsy, amyotrophy, postural tremor, sensory disturbance, gynaecomastia, impotency.The level of serum creatine kinase and urinary glutaric acid were elevated. Electromyogram and nerve and muscle biopsy supported mixed damage in peripheral nerves, as well as neurogenic and secondary myogenic pathologic changes in muscles.Gene sequencing indicated trinucleotide CAG repeated amplification for 47 times in chromosome X.Diabetes was diagnosed at 7 years after onset.Conclusions The pathogenesis of Kennedy disease is very complex, which may involve myogenic factor.The treatment to the secondary mitochondrial and lipid metabolic disturbance in muscle can improve the muscle weakness to a certain extent.

Adolescent ; Adult ; Amnion ; transplantation ; Blood Transfusion, Autologous ; Eye Burns ; therapy ; Humans ; Male ; Middle Aged ; Occupational Injuries ; therapy ; Young Adult

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Histiocytosis, Sinus ; pathology ; surgery ; Humans ; Immunoglobulin G ; blood ; Paranasal Sinus Diseases ; pathology ; surgery ; Paranasal Sinuses ; pathology ; S100 Proteins ; metabolism ; Sclerosis ; pathology

Objective: To investigate the effect of fucoidan on multiple myeloma U266 cells and its possible molecular mechanism. Methods: The multiple myeloma U266 cells were treated with 10, 25 and 50 μg/mL fucoidan for 24, 48 and 72 h, respectively. The growth inhibitory rate of U266 cells was determined by cell counting kit-8 (CCK-8) assay. The apoptosis rate was measured by flow cytometry. The expression levels of RAS, p38, phospho-p38, sonic Hedgehog (Shh) and glioma-associated oncogene homolog 1 (GLI1) were detected by Western blotting. Results: The growth of multiple myeloma U266 cells treated with different concentrations of fucoidan (10, 25 and 50 μg/mL) was inhibited only in a dose-dependent manner. The apoptosis rates of U266 cells treated with 10, 25 and 50 μg/mL fucoidan for 24 h were (6.73±2.30)%, (9.12±1.90)% and (20.13±2.10)%, respectively, which were higher than that of the U266 cells without fucoidan intervention [control: (4.08±1.60)%; P < 0.05). The expression levels of RAS, phospho-p38, Shh and GLI1 proteins in U266 cells treated with fucoidan were significantly lower than that of the control (P < 0.05). Conclusion: Fucoidan inhibits proliferation and induces apoptosis of U266 cells by inhibiting Ras-p38MAPK and Shh-GLI1 signaling pathways. Copyright © 2013 by TUMOR.

Objective To investigate the prevalence of nutritional risks and malnutrition as well as the application of nutritional support in the department of geriatrics.Methods Elderly inpatients in the Geriatric Department of Peking University People's Hospital were consecutively enrolled from July 2010 to June 2011.Nutritional Risk Screening 2002 ( NRS 2002) was performed on the second day after admission,and nutritional support was investigated on the 14th day or the discharge day.The relationship between nutritional risk and nutritional support was analyzed.Results A total of 445 patients were enrolled,and 423 patients (95.1％ ) underwent NRS 2002.The overall prevalence of undernutrition was 4.7％ and nutritional risk was 13.2％.In 230 patients with overweight/obesity,the prevalence of nutritional risk was 6.1％.Nutritional support was provided to 15 patients (26.8％ ) with NRS2002≥3 and 14 patients (3.8％) with NRS 2002 ＜3.The average parenteral nutrition:enteral nutrition ratio was 1.6∶1.Conclusions A large proportion of elderly inpatients are at nutritional risk or suffer from undernutrition in the geriatric department in Beijing.The application of nutritional support currently is somehow inappropriate.Evidence-based guidelines are required to improve this situation.NRS2002 is not applicable for elderly inpatients with overweight/obesity.

Objective To assess the effect of ongoing health education compared to a single comprehensive health program on nutritional knowledge,attitudes and practices(KAP) of hospitalized diabetes patients to provide a basis for improving health education for these patients.Methods Newlyhospitalized patients with diabetes were randomly classified into Group 1 ( Conventional Education Group; 50 cases) and Group 2 (Intensive Education Group; 58 cases).A single comprehensive health program was conducted for Group 1,and an ongoing health program was provided for Group 2. A self-designed questionnaire was administered to the two groups before and after the health education,and nutritional KAP of these patients were compared.ResultsIn both groups,after health education,the nutritional KAP of the newly enrolled inpatients were substantially improved.For control of total energy intake,control of salt intake and food exchanges,the improvement rates of Group 2 [ 88.4％ ( 38/43 ),84.6％ ( 33/39 ),60.9％ (28/46),respectively] were higher compared to Group 1 [71.1％ (27/38),65.6％ (21/32),40.0％ (16/40),respectively ].The differences were significant ( x21 =4.75,x22 =4.83,x23 =4.37,respectively,P ＜ 0.05).For importance of health education,the improvement rate of Group 2 [ 95.8％(23/24) ] was significantly higher than that of Group 1 [65.2％ ( 15/23),x2 =14.90,P ＜0.01 ].For therapeutic diet,the improvement rate of Group 2 was 14/14,significantly higher than that of Group 1 (5/13; x2 =44.40,P ＜ 0.01 ).Conclusion Health education is an effective way to improve the nutritional KAP of inpatients with diabetes.An ongoing health program should have a more significant role in health education for these patients than a single program.

One hundred and twenty elderly inpatients (average aged 78) were randomly sampled from the Department of Geriatrics, Peking University People's Hospital for a questionnaire survey on the knowledge, attitude and practice (KAP) before and after receiving nutritional education. The results showed that the average score for nutrition knowledge of the subjects was 46 ± 21 and 85 ± 18 before and after nutrition education respectively (P ＜0. 01 ); the progress for patients aged over 80 was more remarkable:nutrition knowledge score increased to 83 ± 18 from 41 ±21 on the admission ( P ＜0. 01 ). Before nutritional education, the rates of treatment diet implementation, ordinary diet implementation and hospital repast were 48.9%, 57.7% and 50. 8%, respectively, which reached to 93. 6%, 100. 0% and 95.0% after nutritional education (P ＜0. 01 ). The results indicate that the nutrition education is an effective approach to improve nutritional KAP among elderly inpatients. We propose to implement nutrition education in elderly inpatients as a routine clinical treatment measures.

Objective To observe the difference in serum level of oxidative stress between first diagnosed type 2 diabetes mellitus (T2DM) patients and healthy person with normal glucose,compare the difference in serum level of oxidative stress between T2DM patients with continuous subcutaneous insulin injection (CSII) and multiple subcutaneous insulin injection (MSII),and further explore the possible mechanism of CSII superior to MSII.Methods Sixty patients with first diagnosed T2DM were divided into CSII group and MSII group by random digits table,with 30 patients in each group and given 14 days treatment of CSII and MSII respectively.Thirty healthy person were selected with age and sex matched in same period as control group,then fasting plasma glucose (FPG),2-hour postprandial blood glucose (2 h PG),glycosylated serum protein (GA),fasting insulin (FINS),superoxide dismutase (SOD),reduced glutathione (rGSH) and malondialdehyde (MDA) before and after treatment was measured and analyzed.Results The FPG,2 h PG,GA,HOMA model of insulin resistance (HOMA-IR) and MDA before treatment in CSII group and MSII group was higher than that in control group [FPG:(13.81 ± 3.14),(13.58 ±2.10) mmol/L vs.(5.21±0.42) mmol/L; 2 h PG:(21.72 ±4.43),(22.07 ±3.86) mmol/L vs.(6.19 ± 0.47) mmol/L;GA:(28.74 ± 4.40),(28.83 ± 5.01) mmol/L vs.(13.24± 1.26) mmol/L;HOMA-IR:0.45 ±0.13,0.43 ±0.12 vs.0.20 ±0.15;MDA:(4.37 ± 1.13),(4.44 ± 1.07) mmol/L vs.(2.37 ±0.58) mmol/L] (P ＜ 0.01),and the HOMA model 3 cell function index (HOMA-β),SOD and rGSH was lower than that in control group [HOMA-β:0.98 ±0.17,0.96 ±0.12 vs.1.91 ±0.19;SOD:(29.63 ±9.29),(28.07 ±9.62) mU/L vs.(41.00 ± 12.89) mU/L;rGSH:(157.03 ±46.58),(165.23 ±45.66) ng/L vs.(212.00 ± 61.67) ng/L] (P ＜ 0.01).There was no significant difference between CSII group and MSII group (P ＞ 0.05).The FPG,HOMA-β,SOD and MDA after treatment in CSII group was no significant difference compared with that in control group (P ＞ 0.05).But the FPG and MDA after treatment in MSII group was higher than that in control group(P＜ 0.01 or ＜ 0.05),and the HOMA-β and SOD was lower than that in control group (P ＜ 0.01).The FPG,2 h PG,GA and MDA after treatment in CSII group was lower than that in MSII group (P ＜ 0.01 or ＜ 0.05).The HOMA-β was higher than that in MSII group (P ＜ 0.01).Multi-factor analysis results showed that the HOMA-β and FPG (r =-0.919,P ＜ 0.01),2 h PG (r =-0.904,P ＜ 0.01),GA (r =-0.830,P ＜ 0.01) and MDA (r =-0.653,P ＜ 0.01) was negatively correlated,and SOD (r =0.454,P ＜ 0.01) and rGSH (r =0.394,P ＜ 0.01) was positively correlated.Conclusions Oxidative stress level of first diagnosed T2DM is significantly higher than that of healthy people.Two intensive insulin treatment for first diagnosed T2DM can reduce blood glucose level,oxidative stress levels and improve insulin resistance and β cell function.CSII can effectively reduce blood glucose,reduce the level of lipid peroxidation and improve β-cell function compared with MSII.

Objective To evaluate the value of dual Doppler ultrasonography in the diagnosis of fetal atrial extrasystoles.Methods Seven thousands and thirteen fetuses were examined by fetal echocardiography.If fetal arrhythmias were found,information of pulsed wave Doppler signals in hepatic vein (HV) and descending aorta (DAo) using dual Doppler were colleted simultaneously.The detected times were compared between using general Doppler and dual Doppler in 20 cases.Results On dual Doppler examination,28 of the fetuses showed signals of atrial extrasystoles,14 fetuses atrial extrasystoles conducted to ventricle,8 fetuses atrial extrasystoles non-conducted to ventricle,6 fetuses with part of the extrasystoles conducted to ventricle and part of the extrasystoles non-conducted to ventricle.No case had congenital heart disease.Twenty-six fetuses with atrial extrasystole were converted to normal rhythm within the third trimester of pregnancy,and the others' were converted to normal rhythm during the first 3 days postnatally.The detected time of dual Doppler was shorter than that of general Doppler(P ＜0.05).Conclusions Dual Doppler ultrasonography of simultaneous recordings in HV and DAo is an easy,rapid method of assessing fetal atrial extrasystoles,which should allow precise diagnosis of atrial extrasystole.