Objective: To eplore the effective measure to prevent postopelative deep vein thrombosis (DVT).Methods:510 cases of hospitalzed surgical patients from January 2005 to December 2007 were divied into observation group(without any preventive measure) and control group(including physiotheragy group,elastic socks with gradient pressure group and intermittent pressure device group).To observe the patients changes in 10 days after operation.Results:There were 6 cases of DVT in 125 cases of observation group(with the occurrence rate of 4.8%).In control group,there was I case of DVT in 125 cases of physiotherapy group(with the occurrence rate of 0.8%) and no cases of DVT in the other two observation groups.Conclusion:The elastic soks with gradient pressure and the intermittent pressure device can effectively prevent the occurrence of postoperative DVT.

Objective: To discuss the effects of nursing intervention in the rebleed rate of the cirrhosis patients after endoscopic esophageal varix ligation.Methods:60 cirrhosis patients with endoscopic esophageal varix ligation were randomly divided into intervention(n=30)and control group(n=30).Both groups received usual care and the intervention group did additional nursing intervention as psychological nursing health education relaxation training,effective coping strategy,familial and social support system.Resets:The rebleed rate was significantly lower.the time of hospital stay shorter and the hospital expense less in the intervention than in the control group(P<0.05). Conclusion:The nursing intervention in the patients with endoscopic esophageal varix ligation can obviously decrease the rebleed rate, abate reduce their economic burden and improve their quality of life.

Objective: To explore the clinical value of color Doppler ultrasound in evaluation of carotid artery before and after treatment of diabetes cases.Methods:A total of 80 cases of Type 2 Diabetes were examined with color Doppler ultrasound before and after treatment in Carotidor. Their carotid artery wall,lumen,intima-media thickness and plaque size,and flow conditions were analyzed respectively, ResuLts: In 80 cases of type 2 diabetes detection rates of carotid artery atherosclerotic plaque after treatment were lower than those before treatment,and the carotid artery diameter,Intima-media thickness and resistance index were reduced too. Conclusion:Using color Doppler ultrasound in carotid artery,can be directly observe large vascular wall and luminal lesions,and has a important clinical value in the prevention of diabetic carotid atherosclerosis and formulation the means of intervention,and it has broad application prospects in suppression of diabetic macrovascular disease development.

Objective: To investigate the relationship between glycated albumin levels and diabetic nephropathy in patients with type 2 diabetes mellitus.Methods: From January 2006 to June 2009,78 patients with type 2 diabetes mellitus in our hospital were enrolled in the study. We used liquid enzymatic to detect glycated albumin,and compare with 50 cases of healthy in the same period as the control group.Results: The glycated albumin was different between the control group and the diabetic nephropathy groups(F=8.953,P=0.000). Glycated albumin in each diabetes group was higher than that in the control group;glycated albumin in diabetic nephropathy groups was higher than that in non-diabetic nephropathy group;glycated albumin in end-stage diabetic nephropathy group was higher than that in the rest of groups.The severity of diabetic nephropathy and level of glycated albumin were related,rs was 0.754(t=6.547,P=0.008).Logistic regression showed that glycated albumin was an independent risk factor impacting on the incidence of diabetic nephropathy and the severity of the disease,multi-adjusted OR value was 2.326,and 95%CI was 2.114-2.538.Conclusions:Glyeated albumin plays an important role in the pathogenesis of diabetic nephropathy ,and it is closely related to the phases of diabetic nephropathy.

Objective: To discuss the effect of bone marrow mobilization on chemotaxis of aggregation of macrophages in venous thrombosis. Methods:SD adult rats were divided randomly into normal group,sham operation group,thrombus group and rhG-CSF group.Peripheral blood was harvested at 30min before operation and on the 7th and 14th day after operation.Level of MCP-3 in peripheral blood was detected by ELISA.Inferior vena cava specimens of thromus group and rhG-CSF group were collected at postoperative 7th and 14th day. With the application of RT-PCR,expression of MCP-3mRNA in thrombus was detected.Results:The level of MCP-3 in peripheral blood of rhG-CSF group was significantly higher than that before operation and also higher than the levels of MCP-3 in peripheral blood of sham operation group and thrombus group on the 14th day after operation(P<0.05),and the difference was significant.On the 7th and 14th day after operation,compared with thrombus group,the expression of MCP-3 mRNA in rhG-CSF group remarkablely increased,and the difference Was significant beween these two groups(P<0.01).Conclusion:Brone marrow cell mobilization enhances the chemotaxis of MCP-3 on macrophages.

Objective: The aim of this study was to investigate the immune function and prognosis for patients with primary hepatic cancer who implemented the perioperative enteral immunonutrition support for hepatectomy.Methods: 58 cases of patients with primary hepatic cancer in our hospital in 2003 treated with liver resection were randomly divided into nutritional support fur immune nutrition group and conventional control group.Immune function was detected on admission,1st day and 7th after surgery;5-year follow-up was performed to compare the prognosis of the two groups. Results: Concentration level of CD3+,CD4+,CD8+and CD4+ICD8+in preoperative hepatectomy were the same between the two groups. On the first day after surgery,CD3+,CD4+,CD8+content decreased significantly; there was no difference between the two groups. On the 7th day after surgery,CD3+,CD4+,CD8+content increased;and the intervention group increased more significantly.1,2,3,4,and 5-year survival rates in intervention group and control group were 82.8%,70.2%, 39.6%,22.6%.20.6%and 74.6%,50.1%,25.4%,21.5%,19.5%.The survival rate was higher in the intervention group than the control group at 1-year,2-year and 3-year,while the 4 and 5-yearsurvival rate of the two groups was same,and the intervention group had better overall survival compared with the control group(X~2=3.547,P=0.025).The OR value for enteral immunonutrition support impacting postoperative survival was 0.649 after multivariate analysis adjusted.with 95.0%CI of 0.614-0.686.Conclusion:Enteral immunonutrition support can ameliorate immune suppression in hepatectomy for patients with primary liver cancer during perioperative period,and it also Can improve postoperative survival.

Objective:To assess the appliance value of combined sternohyoid muscle flap in laryngeal funtion reconstruction after partial laryngectomy.Methods:46 patients who underwent partial laryngectomy were reviewed.The laryngeal function was reconstructed using combined sternohyoid muscle flap.Results:All the patients rehabilitated deglutition in 10 to 14 days after surgery.Postoperative decannulation rate is 97.83%.functions of respiration,deglutition and phonation are good.5-year survival rate was 86.96%(40/46).Conclusion:Combined sternohyoid muscle flap is a ideal material for laryngeal fuctional reconstruction after partial laryngectomy.

Objective:To investigate the effect of brain tissue extract of hypoxia-preconditioned mice (BHP) on tolerance of NGF-induced differentiated PC12 cells to hypoxia and the optimal concentration for protective effect.Methods:The mice model of acute repetitive hypoxia was reproduced and BHP was prepared.BHP was added into the cultures of 4～5 day differentiated PC12 cells and the final protein concentrations of BHP were 1.0、10.0、100.0?g/ml(BHP groups) respectively.Brain tissue ex- tract of normal mice(BN) at the same three protein concentrations were used as controls(BN groups) and PBS solvent control groups were also prepared in which only PBS was added(PBS groups).Then differentiated PC12 cells were cultured in hypoxia (2%O_2).After 24,48,72 hours'hypoxia,colorimetric method(OD_(570nm)) of tetrazolium salt MTT staining was adopted to determine cell viability and lactate dehydrogenase(LDH) leakage assays were also conducted at the same time.Besides,apoptotic per- centages at late stage(72 hours' hypoxia) were detected.Results:After 24 hours' hypoxia,OD_(570nm) values of BHP groups with protein concentrations being 10.0、100.0?g/ml were significantly higher,but their LDH leakage percentages were significantly lower than those of BN groups with the same protein concentrations and of hypoxic PBS group.With hypoxia prolonging,BHP gradually lost the protective effect.At the time point of 72 hours' hypoxia,OD_(570nm) values of only BHP group at 100.0?g/ml protein concentration was significantly higher than that of the corresponding BN groups,its LDH leakage percentage and apop- totic percentage was significantly lower than those of the hypoxic PBS group.Conclusion:The effects of BHP on tolerance of differentiated PC12 cells to hypoxia depend on its concentrations and on its treating time.Besides,BHP at final concentration of 100.01?g/ml protein showed steady,prolonged protective effect.

A follow-up study of the dynamic changes with multiple parameters of blood coagulation and plasma limulus assay was carried out in 20 patients with decompen-sated hepatic cirrhosis.It was found that the levels of endotoxin in peripheral blood and factor VIII-related antigen increased significantly, prothrombin time and kaolin partial thromboplastin time prolonged, whereas fibrinogen, factor II, hepaplastin test, antithrombin-III and fibronectin decreased.Our data suggested that( 1 )both the coagulation abnormalities and endotoxemia were coexisted and correlated progressively with the disease process. ( 2 )the incidence and severity of endotoxemia were closely correlated with the degree and severity of hepatic decompensation; ( 3 )dynamic charges of endotoxemia and coagulation abnormalities were of some prognostic significance in decompensated hepatic cirrhosis

This paper presents the application of Cox regression model in survival analysis of lung cancer for the first time in China.By using Cox model,a multivariate analysis was made on 191 patients with lung cancer treated by operation. Among the twenty three factors, only pathological sort, the size of tumor,lymph node metastases,type of operai ions, infiltra -ing across the end of tumor,and complications showed a high significance with prognostic relationship. Of those factors influecing postoperative survivaltime,lymph node metastases, is detrimental for patients, squamasum carcinoma and lobectomy are preferable. From survival curves of groups of different harzad groups,fit in the model and survival rale in the interclass was calculated, Therefore it showed advantages using Cox regression model in multivariate survival analysis