Objective: To determine if different methods of anesthesia and analgesia will influence the incidence of early postoperative cognitive dysfunction (POCD) after non-cardiac surgery in the elderly. Methods: One hundred and three elderly patients undergoing elective abdominal surgery were randomly allocated to receive either general anesthesia followed with postoperative intravenous analgesia (general anesthesia group, 53 cases) or combined general-epidural anesthesia followed with postoperative epidural analgesia (combined general-epidural anesthesia group, 50 cases). Cognitive function was assessed preoperatively and 7 days postoperatively using a battery of nine neuropsychological tests. A postoperative deficit in any test was defined when decline by more than or equal to 20% of the preoperative value of that test occurred. Any patient showing deficit in 2 or more tests was defined as having postoperative cognitive dysfunction. Results: Ninety-two patients completed both preoperative and postoperative neuropsychological tests. On day 7, POCD occurred in 20/45 patients (44.4%) in the general anesthesia group and in 23/47 patients (48.9%) in the combined general-epidural anesthesia group. No significant difference was found between the two groups. Logistic regression analysis showed that short duration of education and operation of general surgery were independent risk factors of the occurrence of early POCD. Conclusion: Early POCD occurred in 46.7% of the elderly patients undergoing abdominal surgery. However, there was no significant difference between the effects of two different methods of anesthesia and postoperative analgesia on the incidence of POCD. Short duration of education and operation of general surgery were risk factors of early POCD.

Objective To study the induction of IL-6 on expression and activity of tissue factor (TF)in peripheral blood monocytes(PBMCs).Methods rhIL-6 100 ng/L and rhIL-6 100 ng/L+ rhIL-6 MoAb 10?g/L were used respectively to stimulate the PBMCs for 24 h,PBMCs without any stimulation as control group,to study the changes of antigen content,mRNA expression and the ac- tivity of the TF.Results The antigen content,mRNA expression and activity of TF were increased significantly in 100 ng/L rhIL-6 group as compared with rhIL-6 100 ng/L+rhIL-6 MoAb 10?g/L and control groups(P＜0.01).Conclusions rhIL-6 can induce the increase of antigen expression,activity and mRNA expression in PBMCs,and these effects can be suppressed successfully by rhIL-6 MoAb. This study demonstrated that there was potential relations between cytokines and thrombogenesis, which may play an important role the pathogenesis of chronic rejection.

The relationship between vascular endothelial growth factor-C (VEGF-C)/vascular endothelial growth factor receptor 3 (VEGFR-3) expression and clinicopathologic features of the patients with non-small cell lung cancer (NSCLC) was investigated. The expression of VEGF-C and VEGFR-3 was assessed in 65 patients with NSCLC by immunohistochemistry. The significance of VEGF-C and VEGFR-3 expression was analyzed statistically. The results showed that VEGF-C and VEGFR-3 were highly expressed in cytoplasm and membrane in lung cancer tissues with the positive rate being 55.4 % and 52.3 % respectively, while there was no expression in the normal lung tissues. The expression of VEGF-C was significantly increased in adenocacinoma as compared to other types of NSCLC (P<0.05). The VEGFR-3 expression was closely related with lymph node metastasis (P<0.01) and TNM stage (P<0.05). There was a positive correlation between the VEGF-C and VEGFR-3 expression in NSCLC patients (r=0.658, P<0.01). It is suggested that VEGFR-3 plays an important role in the lymphatic metastasis of NSCLC. The interaction between VEGF-C and VEGFR-3 may be deeply involved in the mechanism of lung cancer metastasis.

Nuclear factor(NF)-κB is widely expressed in various types of tissue cells. Abnormal activation of NF-κB signaling pathway can lead to the initiation and progression of asthma,chronic ob?structive pulmonary disease(COPD)and other lung inflammatory diseases,but inhibition of its activity can effectively alleviate the occurrence and development of these diseases. In this paper ,we review biological characteristics of NF-κB,role of NF-κB signaling in asthma,COPD and other inflammatory lung diseases,and potential application of NF-κB inhibitors in clinical treatment of these inflammatory lung diseases. It will provide a valuable reference for further study on pathogenesis,prevention,and control of lung inflammatory diseases.

Female ; Humans ; Leukemia, Myeloid, Acute ; complications ; etiology ; Middle Aged ; Myelodysplastic Syndromes ; complications ; etiology ; Uterine Cervical Neoplasms ; complications ; drug therapy ; radiotherapy

This study aimed at exploring the economic operation and developing trend of county-level public TCM hospitals in Guangxi Province,promoting the comprehensive reform of county-level public hospitals with feasible countermeasures and suggestions.In this study,forty-seven county-level public TCM hospitals were involved in the analysis of their economic operations and benefits by constituent ratio analysis,ratio analysis and trend analysis.As a result,the average gross income of the hospitals exceeded the total expenditure with a slight surplus.Drug income contributed the biggest share of the medical income,while the ratio of Chinese drug income to the medical income was increasing year by year.The debt ratio increased from 38.7％ in 2009 up to 44.6％ in 2013,being over 30％ in this period.In conclusion,it was demonstrated that problems were found in the lack of financial assistance,the low efficiency of economic management and the increasing average medical charges,which should be addressed by increasing investments to TCM hospitals,strengthening the performance appraisal and adjusting the charges of TCM medical services.

Objective To detect the intervened effect of the compound of Polygonum caspidatum to the NAFLD rat models and analyze its mechanism at the level of gene expression.Methods The Wistar rats were fed with high fatty chow to induce NAFLD and intervened with the compound of Polygonum caspidatum.The mRNA relative level of leptin,adiponectin,tumor necrosis factor ?,resistin and uncoupling protein 2 in the adipose tissue of the intervenient and control rats was detected with RT- qPCR method.The data differences between two groups were analyzed in t-test.Results Comparing to the control group,the relative level of leptin mRNA in the intervenient group was significantly increased(P0.05).At the same time,the resistin and UCP2 mRNA didn’t been detected in all samples of these two groups.Conclusion Metformin hydrychloride can adjust the adipose metabolism in liver and improve the steatosis and inflammatory reaction in liver cell.

Objective: To discuss the methods and items for clinical linear accelerator (Clinac) and 3D treatment planning system (TPS)/intensity modulated radiotherapy(IMRT) system based on 2D ionization chambers array(2D-ICA). Methods: The 2D-I-CA laid on the anthropomorphic phantom with five centimeters and which was put on another five centimeters same phantom.All data have gained as following conditions: the SAD is 100 cm and the SSD is 90 cm; the fields' size are 2 cm, 5 cm, 10 cm,15 cm ,20 cm respectively and 2 cm×10 cm ,5 cm×20 cm ,20 cm×5 cm, MU=100 cGy;the Clinae and TPS were verified by some special items for checking their dose accuracy, such as, square fields, rectangular fields, and rectangular fields with 600 wedge or 300 wedge, which were measured for verification their flatness and symmetry. And some measured items were only for checking multileaf collimator (MLC) and TPS calculated accuracy. So, we developed moveable MLC fields and IMRT plans and compound fields to evaluate leafs side effects and leafs end effects and transmission effects. Results: The flatness value of square and rectangular fields was 100.07%～102.66%,and their symmetry value was 0.10%～1.49%; and these irradiate fields' size were compared with light fields' sizes, which the X direction deviation was-1.5%～0.7% ,the Y direction deviation was-1.4%～1.0%,and their average value was-0.47%.To verify calculated data for TPS ,we developed Gamma value and ab-solute value (<4%)to evaluate their accuracy. For square and rect-angular fields, The Gamma value was 92.02%～96.35%.In com-pound fields Which were composed with two half fields (X1 = 5 cm, X2 =0 cm, Y= 10 cm and X1 = 0 cm,X2 = 5 cm, Y=10 cm),the maximum deviation was about 5%.And five fields (2 cm×10 cm) composed one fields (10 cm×10 cm),the maximum deviation was about 10% in the joint place. The Gamma value of one fields was 96.6%, another was 93.2% in the moveable fields. Conclusions: To dollop 2D ionization chambers array to verify the dose for Clinac and TPS, it was so quick and simple, and it was important that it bring more accurate dose evaluation and more clinical quality assurance and quality control methods.

Objective To investigate the role of human cytomegalovirus (CMV) in the occurrence of drug eruptions.Methods Peripheral blood samples were collected from 44 patients with drug eruptions (including 13 severe cases) and 50 healthy human controls.Taqman fluorescent real-time quantitative PCR (RT-PCR) was performed to determine the positive rate and load of CMV DNA in peripheral blood mononuclear cells (PBMCs).Enzyme-linked immunosorbent assay (ELISA) was conducted to detect anti-CMV IgM antibodies in sera.Results The positive rate of CMV DNA was significantly higher in the patients than in the controls (65.91％ (29/44) vs.28.00 ％ (14/50),x2 =13.552,P ＜ 0.05),significantly different among patients with severe drug eruptions (11/13),patients with mild drug eruptions (58.06％ (18/31)) and the controls (x2 =16.153,P ＜ 0.05).In addition,patients with severe drug eruptions showed a higher positive rate of CMV DNA compared with patients with mild drug eruptions (x2 =13.817,P ＜ 0.05) and the controls (x2 =7.237,P ＜ 0.05).CMV DNA load was significantly higher in the patients than in the controls ((28 183.829 ± 19 527.654) vs.(3 019.952 ± 1 760.952) copies,t' =8.517,P ＜ 0.05).No significant difference was found in CMV DNA load between patients with severe drug eruptions ((554 813.389 ± 722 642.498) copies),patients with mild drug eruptions ((13 290.558 ± 14 082.356) copies)) and the controls (P ＞ 0.05).The positive rate of anti-CMV IgM antibodies was similar between the patients and controls (13.64％ (6/44) vs.6.00％ (3/50),P ＞ 0.05),but significantly different among patients with severe drug eruptions (4/13),patients with mild drug eruptions (6.45％,2/31) and the controls (x2 =7.832,P ＜ 0.05),and significantly higher in patients with severe drug eruptions than in the controls (x2 =6.409,P ＜ 0.05).Conclusions CMV infection exists in patients with drug eruptions,and might be a factor associated with the initiation and aggravation of drug eruptions.

Based on a correct understanding of the related concepts and system of the evaluation of human resources for military medical sciences ( EHRMMS), this thesis established a three-dimension model of EHRMMS that is composed of the evaluation goal, evaluation subject and evaluation object, and analyzed the factors that affect the crucial parameters in the model.We also analyzed the features and regularity of the evaluation model, and tentatively explored the application of the model.