With the population ageing, the number of elderly patients with end-stage renal disease(ESRD)is increasing, and the proportion of elderly patients undergoing hemodialysis is also increasing year by year.The elderly patients undergoing hemodialysis are susceptible to frailty due to the comorbidities, polypharmacy, chronic inflammation, malnutrition and other factors.In addition, frailty can lead to a variety of adverse prognosis such as falls, fractures, cognitive decline, all-cause hospital readmissions and all-cause death in elderly patients undergoing hemodialysis.

Adult ; Dust ; analysis ; Female ; Humans ; Male ; Middle Aged ; Neural Networks (Computer) ; Occupational Exposure ; Silicosis ; diagnosis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods

Objective To investigate the clinical effects of continuous 3-in-1 femoral nerve block with stimulating catheters for patient controlled regional anesthesia(PCRA) in elderly patients after unilateral total knee replacement (TKR)surgery.Methods Thirty ASA Ⅰ - Ⅱ elderly patients wererandomly divided into two groups: FB group and Ⅳ group.FB group received continuous 3-in-1 femoral nerve block for postoperative analgesia with 0.2% ropivacaine plus 0.1 μg/ml sufentanil continuous infusion at 5 ml/h plus PCA boluses (1.0 ml/15 min).Ⅳ group received continuous intravenous analgesia with 1 μg/ml sufentanil plus 0.04 mg/ml tropisetron hydrochloride at 2 ml/h plus PCA boluses (0.5 ml/15 min).All patients were maintained analgesia for 48 hours.Results In FB group, the visual analogue scale(VAS) scores were 1.3 ±1.1, 1.2 ± 1.0, 1.1±0.9, 1.1 ± 1.0,1.0±0.9 at 4, 8, 12, 24, 48 hours after surgery under rest status respectively and were 3.04±1.4,2.3±1.3 at 24, 48 hours after surgery in active function training.These parameters in Ⅳ group were 4.0±1.6, 3.5±1.6, 3.2±1.4, 3.0±1.3, 2.5±1.2, 4.7±1.5 and 3.3±1.5 respectively, which were significantly different compared with FB group (t=5.358, 4.707, 4.852, 3.784, 3.743, 3.254,1.932,all P<0.05 or P<0.01).The incidence of nausea was higher in IV group than in FB group(P = 0.0022).Postoperative satisfaction ratings was higher (χ2 =41.1 ,P<0.01) and the total morphine use for 48 hours after operation was less(uc=2.412, P<0.01) in FB group than in Ⅳ group.Conclusions After TKR surgery, the continuous 3-in-1 femoral nerve block with stimulating catheters is an effective method with better pain relief,fewer side effects and higher satisfaction ratings in the elderly.

Adipose Tissue ; cytology ; physiology ; Animals ; Humans ; Leptin ; physiology ; Stromal Cells ; physiology

Objective To appraise the diagnosis value of pleural membrane biopsy on pleural effussion.Meth- ods 218 patients with pleural effusion who were had pleual menbrane biopsy were retrospectively analyzed.Among them 165 cases were done only once,42 cases were done twice,11 cases were done three times.They were done 271 times of biopsies.Results The pleural membrane biopsy always masculine gender rate was 72.0%,1 pleural mem- brane biopsy succeeds the masculine gender rate was 59.6%,after the masculine gender rate which 2 pleural mem- branes biopsies succeeds was 69.7%.The illness complication formation rate was 8.7%.Conclusion Pleural mem- brane biopsy is a simply,safe and higher diagnosing-rate method.The different spot pleural membrane biopsy may cnhance diagnosis rate.

Objective To evaluate the significance of standardized ultrasound examination of fetal structures in the ifrst trimester (11-13+6 weeks). Methods The ultrasound data of 29 858 fetuses who underwent the ifrst trimester screening were analyzed retrospectively in Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2010 to December 2012 and followed up the cases with structural abnormalities and increased nuchal translucency (NT). Results Among 29 858 fetuses, 328 structural defects were detected in 284 fetuses (0.95%) by ultrasound in the first trimester, including fetal hydrops (124 cases), choroid plexus cysts (36 cases), exencephaly (32 cases), gastroschisis (24 cases), exomphalos (22 cases), cardiac defects (19 cases), megacystis (14 cases), spine abnormalities (10 cases), meningoceles/encephaloceles (9 cases), alobar holoprosencephaly (8 cases), hydrocephaly (7 cases), abnormalities of extremities (7 cases), acrania (6 cases), amniotic band syndrome (4 cases), abdominal cyst (3 cases) and conjoined twins (3 cases). Pregnancy was terminated in all cases (115) with exencephaly, gastroschisis, exomphalos, meningoceles/encephaloceles, alobar holoprosencephaly, hydrocephaly,abnormalities of extremities, acrania, amniotic band syndrome and conjoined twins, and the defects were verified by the gross appearance of fetuses. Two cases of megacystis were turned out to be normal during follow-up while 1 case was proved to be aneuploid and 1 other case progressed to multiple abnormalities during the second trimester. Most choroid plexus cysts, except 1 case of aneuploid, were normal during the second and the third trimester follow-ups by ultrasound. Thirteen cases of fetal hydrops were found to be aneuploids and 4 hydrops cases were proved to be complicated with other structural defects during the second and the third trimester. NT was increased in 422 cases (1.41%), among which 122 cases (28.91%) were complicated with structural defects and/or fetal hydrops. Ninty-nine cases with increased NT underwent chromosomal examination and 38 cases were found to be aneuploides. During the follow-up of 298 cases with increased NT who continued pregnancy, 21 structural abnormalities were found, including cardiac defects (14 cases), neural abnormalities (4 cases) and diaphragmatic hernia (3 cases). Conclusion The standardized fetal ultrasound in the first trimester is a effective tool for the screening of aneupolides and major structural abnormalities.

An HPLC method has been developed to determine polydatin in giant knotweed rhizome. In order to systematically validate the method, specificity, precision, linearity of reference solution and test solution, repeatability, reproducibility, accuracy, stability and robustness were measured. In the robustness test, a one-variable-at-a-time procedure was applied to evaluate the influence of slight variations in method factors, including the flow rate, the column temperature, the extraction time, and etc., on the assay result of polydatin. No significant differences were found when the process parameters changed during the experimental domain. And system suitability test limits were defined based on the robustness test. Results showed that the developed method was accurate, reproducible and robust.

Objective To observe the levels of Th1 and Th2 type cytokines of peripheral blood CD+4 T lymphocytes at different stage of treatment of colonic cancer,in order to find out the laboratory evidence of tumor immunotherapy.Methods The peripheral blood lymphocytes were stimulated by stimulator in order to enhance the expression of cytokines.Then specific fluorescent-conjugated monoclonal antibodies were added to combine with its specific antigens.Cytokines were detected by flow cytometry.Results At different stage of treatment of colonic cancer,the levels of Th1 type cytokines of each stage was significant.The levels of Th2 type cytokines at each stage were not significant.The IFN-γ//IL-4 ratio were significantly different during tumor immunothempy.Conclusion At different stage of treatment of colonic cancer,the levels of Th,type cytokines were obviously associated with treatment.The levels of Th2 type cytokines had no association with treatment.Among them,the changes of Th1/Th2 ratio (IFN-γ/IL-4) had more correlation with tumor immunotherapy.So the reasonable immunotherapy can reverse Th1/Th2 ratio and immune inhibition.

ObjectiveDahl salt-sensitive (Dahl/SS) rats are hereditary salt-sensitive hypertensive rats.Its pathogenesis is similar to that of human primary hypertension,CPB established in Dahl/SS rats provides an animal model for the study of CPB in patients with primary hypertension.MethodsMale 14-16 weeks old Dahl/SS rats weighing 360-390 g were fed with high salt (8％ NaCl) diet for 4 weeks before the experiment.Ten Dahl/SS rats were randomly divided into 2 groups ( n =5 each) according to the CPB time:groups Ⅱ and Ⅲ underwent CPB for 120 and 75 min respectively.Another 7 male 14-16 weeks old ordinary SD rats weighing 410-490 g undergoing CPB for 120 min were used as control group (group Ⅰ ).Anesthesia was induced with isoflurane inhalation.Orotraeheal intubation was performed.The animals were mechanically ventilated.Right jugular vein and tail artery were cannulated for venous drainage and arterial inflow from CPB circuit.Blood was oxygenated with a customized mini-oxygenator.Blood gases were analyzed and blood glucose concentration was determined.MAP was recorded before (baseline) and at 30 and 60 min of CPB and 30 and 90 min after CPB.The rate of changes in MAP and blood glucose concentration and survival rate at 7 d after termination of CPB were recorded.ResultsThere was no significant difference in blood gases among the 3 groups.The rates of change in MAP and blood glucose concentration were significantly higher during and after CPB in Dahl/SS rats than in control SD rats in a duration of CPB dependent manner.The survival rate at 7 d after CPB was 7/7 (in group Ⅰ ),1/5 (in group Ⅱ ) and 4/5 (in group Ⅲ ) respectively.ConclusionA model of 75 min CPB is established successfully in Dahl/SS rats.

Objective To analyse the kidney damage situation of the elderly health examination people,and identify its characteristic.Methods A cross-sectional study was held which enrolled 1088 elderly health examination people.Urine routine,random urine albumin/creatinine ratio (ACR),serum creatinine,urea nitrogen were detected by biochemical analyzer,and estimated glomerular filtration rate (GFR) with CKD-EPI formula.Kidney structure change was examined by Color doppler ultrasound detector.Results The prevalence of hypertension,hyperlipemia,diabetes mellitus was 61.5％,62.1％,11.6％,respectively.The abnormal detection rate of urine routine was 19.0％,including 2.6％ proteinuria,14.1％ hematuresis and 5.4％ leucocyturia.The abnormal detection rate in the people with was higher than those without (P＜0.01).However,the albuminuria detection rate with random urine ACR was 25.1％,obviously higher than that of urine routine (P＜0.01).The ultrasound results showed that 6.8％ of the total were examined with elderly characteristic kidney change,the proportion of renal cyst was the highest,accounted for 21.8％.70.7％ of all people were in the level of eGFR more than 60 ml· min-1 · 1.73 m-2.The level of eGFR＜60 ml· min-1 · 1.73m-2 in the people with was higher than those without (P＜0.01).eGFR was declined with age.When age increased every 10 years,eGFR was decreased 7 ml · min-1 · 1.73 m-2.Conclusions No matter in structure or function,the elderly people's kidney damage has its characteristic.We should make it clear to correctly diagnose and cure elderly kidney disease.