Objective To explore the blood sugar controlling for elderly patients with fracture and diabetes mellitus. Methods Twenty patients with fracture complicated with diabetes were managed with mental education and diet controlling. Meanwhile nursing measures were done to prevent infections, bedsores and deep vein thrombosis (DVT). Results The fasting blood sugar levels of the 20 elderly patients were well controlled below 7.8 mmol / L. There were no related complications. Conclusion Such nursing measures as psychological counseling and diet control are helpful for a steady maintenance of blood sugar for feasibility of surgical operation, to ensure successful manipulation of the surgical operation. Prevention of infection, bedsore and DVT is critical for ensuring the success of operations.

Nursing experiences on 4 children with organic acidemia were summarized. The nursing care focused on correct collection of samples for early diagnosis,prompt opening of an effective intravenous route to manage water,electrolyte,acid-base and metabolic imbalances,special medication nursing,strict diet control to prevent relapse,health education to keep normal growth and development. Three children were followed up for 1 month,7 months and 1 year respectively with disease controlled and a child was withdrawn treatment from.

OBJECTIVE: To study the causes of false-positive hyoid fractures and forensic identification. METHODS: Twelve cases of false-positive hyoid fractures were collected and analyzed. RESULTS: Improper dissection technique (4 cases) and congenital separation (8 cases) were the main reasons for false-positive hyoid fractures. CONCLUSION True fractures can be differentiated from false-positive hyoid fractures. False-positive hyoid fracture caused by improper dissection technique can be identified through examination of peripheral muscle, soft tissue hemorrhage, and the characteristics of fracture end.
Autopsy ; Cell Differentiation ; Diagnostic Errors ; Fractures, Bone/diagnosis* ; Humans ; Hyoid Bone/injuries* ; Muscles

AIM:To investigate the effect and mechanism of liver ischemia/reperfusion(I/R)injury on the changes of cardiac energy metabolism and structure.METHODS:48 healthy Wistar male rats were randomly divided into 6 groups as follows(n=8 in each group):control group(CTL),simply ischemia for 30 min without reperfusion(I group);reperfusion following ischemia for 30 min(I/R group);2 h reperfusion following ischemia for 30 min(I/R 2 h group);4 h reperfusion following ischemia for 30 min(I/R 4 h group)and 6 h reperfusion following ischemia for 30 min(I/R 6 h group).The level of serum endotoxin was measured.The levels of insulin and insulin antibody in heart were detected by radioimmunoassay.The contents of MDA,MPO and lactic acid in heart were also determined.RESULTS:During the process of liver I/R injury,the level of endotoxin increased in I group and I/R group and declined gradually for long time during reperfusion,but was still longer than that in CTL group(P0.05).CONCLUSION:During the process of liver I/R injury,endotoxin is absorbed from intestine and impairment of liver detoxication leads to endotoxemia,which might play a role in the changes of the energy metabolism and structure in heart.

Objective To investigate effects of Kanglaite injection on proliferation, cycle and apoptosis of human breast cancer MCF-7 cells;To discuss its relevant mechanism. Methods Logarithmic growth phase cells were divided into control group and Kanglaite-treatment group (10, 20, 40μL/mL). Cells were cultured in RPMI-1640 for 24 h before drug treatment. The inhibition rate of Kanglaite injection on proliferation of human breast cancer MCF-7 cells was detected by MTT assay. Apoptosis and cell cycle of MCF-7 cells were detected by flow cytometry. Changes in cell nucleus were determined by Hochest staining assay. Protein expressions of Bcl-2 and Bax were detected by ELISA and Western blot. Results Kanglaite injection for 12 h, 24 h or 48 h resulted in a significant inhibition of MCF-7 cells proliferation (P<0.05, P<0.01);Compared with the control group, Kanglaite injection-treated cells showed increased percentage in G2/M and G0/G1 phases (P<0.001, P<0.01), but showed decreased percentage in S phase (P<0.01), and apoptosis rate increased (P<0.05, P<0.001). Kanglaite injection significantly decreased protein expression of Bcl-2, and enhanced protein expression of Bax of MCF-7 cells (P<0.01, P<0.001). Conclusion Kanglaite injection can inhibit the proliferation of human breast cancer MCF-7 cells, decrease cell cycle and induce apoptosis, the mechanism is related with decreasing protein expression of Bcl-2 and enhance the protein expression of Bax.

Objective To analyze the prevalence of the various hematological malignancies (HM) in Harbin.Methods Study data was collected from January 2010 to December 2011.All cases were diagnosed and classified on the basis of blood test,bone marrow puncture,histochemical staining and typing and classified by the French American British classification.The age and sex distribution of HM and its subtypes were analyzed.Results Of 2214 Chinese people diagnosed with HM,acute myeloid leukaemia (AML) (33.5 ％) and myelodysplastic syndromes (MDS) (29.9 ％) were the most prevalent and of 742 AML,the most frequent subtypes were M3.With the growth of age,the rates of chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) were increased,but in acute lymphocytic leukemia (ALL),this trend was reversed.The distribution of HM increased with age between 0-60 years old,in above 60 years old,the frequency of some chronic HM including CLL,chronic myelomonocytic leukemia (CMML),chronic neutrophilic leukemia (CNL) and MM were continued to rise,but other HM subtypes were decrease,lower than in 41-60 years old groups.This study also revealed that M0 and MPAL were more common in 0-20 years as well as ALL.For patients never drinking alcohol and drinking for at least 10 years maybe associated with acute leukemia [OR =1.53 (95 ％ CI 1.05-2.23)],while smoking wasn' t a substantial risk factor for acute and chronic leukemia (P =0.20,0.48).Conclusions The epidemiology of HM in Harbin indicates that AML is the most prevalent,followed by MDS.Prevalence of CLL and MM increases with the age in patients above 60 years old.Drinking for at least 10 years maybe associated with acute leukemia.

Objective To compare the hypnotic effects of propofol administered by target-controlled infusion (TCI in daytime and nighttime,in order to explore the effect of circadian rhythm on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients,aged 18-55 years,with the body mass index (BMI) of 18.5-24.9 kg/m2,undergoing emergency minor hand surgery were divided into two groups according to the time of the day when they received TCI of propofol:daytime group (from 07:01 to 19:00) and nighttime group (from 19:01 to 07:00).The pharmacokinetic parameters proposed by Schnider et al.which suggested the effect-site concentration (Ce) was used.Four Ces of propofol were set at 0.8,1.2,2.0 and 4.0 μg/ml,respectively.Ce was increased step by step and each Ce was maintained for 5 minutes.The level of sedation at each Ce was assessed by bispectral index (BIS) and observer's assessment of alertness/sedation (OAA/S) scores.BIS values and Ces of propofol were recorded and compared between the two groups when the patients lost consciousness (OAA/S score =2).Results There were 28 and 30 patients in daytime and nighttime groups,respectively.When Ces were 1.2 and 2.0 μg/ml,the BIS values were significantly lower in the nighttime group than in the daytime group.There was no significant difference in BIS values between the two groups when Ces were 0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the two groups,but Ce was significantly lower in the nighttime group than in the daytime group.Conclusion The hypnotic effect of propofol is greater during night time than during day time.

Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.

Objective To validate cystatin (Cys C)-based equations for evaluation of residual renal function (RRF) in patients on continuous ambulatory peritoneal dialysis (CAPD).Methods Fifty patients on CAPD from our department were enrolled in the study.Eight patients with residual urine volume ≤ 100 ml/d and 42 patients with residual urine volume ＞ 100 ml/d were enrolled into anuria group and non-anuric group respectively.The clinical and laboratory status of each group were compared and equations (Hoek' s,Yang' s and abbreviated MDRD equations) were validated in the non -anuric group by comparing with the arithmetic average of residual renal creatinine clearance rate and residual renal urea clearance rate which was considered as the golden standard for RRF.Results (1) Anuric group had significantly higher serum Cys C than the non-anuric group [(7.73±1.13) mg/L vs (6.46± 1.15) mg/L,t =2.39,P =0.02)].(2) RRF estimated by each equation was correlated well with measured RRF (r =0.56,0.56 and 0.39,all P ＜ 0.05).(3) Yang' s equation [0.10 ml· min1· (1.73 m2)-1]was least biased,followed by Hoek' s equation [-0.73 ml· min-1 · (1.73 m2) 1] and abbreviated MDRD equation [3.15 ml· min-1 · (1.73 m2)-1].(4) The precision of Yang' s equation was equivalent to that of Hoek' s equation and both of them were better than abbreviated MDRD equation [6.2 and 6.1 vs 8.4 ml· min-1 · (1.73 m2)-1].(5) 50％ accuracy according to Yang' s equation and Hoek' s equation revealed an elevated results in comparison to that according to abbreviated MDRD equation (59.5％ and 54.8％ vs 23.8％,respectively,all P ＜ 0.01).Conclusions Serum Cys C-based prediction equations are better than the abbreviated MDRD equation in bias,precision and 50％ accuracy.For patients undergoing CAPD,the use of Cys C-based equation to estimate RRF may be a clinically acceptable alternative.

Objective To compare the hypnotic effect of propofol administered by target-controlled infusion (TCI) during day-time and night-time,in order to explore the effect of circadian rhythms on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing emergency minor hand surgery were divided into 2 gorups according to the time of the day when they received propofol TCI:day-time group (from 7:01 to 19:00) and night-time group (from 19:01 to 7:00).The pharmacokinetic parameters proposed by Schnider which predict effect-site concentration (Ce) were used.Four effect-site concentrations of propofol were set:0.8,1.2,2.0 and 4.0 μg/ml.Ce was increased step by step and each Ce was maintained for 5 min.The level of sedation at each Ce was assessed by BIS and OAA/S scores.BIS value and Ce of propofol were recorded and compared between the 2 groups when the patients lost consciousness (OAA/S score =2).Results There was 28 and 30 patients in day-time and nighet-time groups respectively.When Ce =1.2 and 2.0 μg/ml,the BIS values were significantly lower in night-time group than in day-time group.There was no significant difference in BIS value between the 2 groups when Ce =0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the 2 groups,but Ce was significantly lower in night-time group than that in daytime group.Conclusion The hypnotic effect of propofol is greater during night-time than during day-time.