OBJECTIVE To investigate the clinical features of nosocomial acquired pneumonia in elderly patients with apoplexy.METHODS A retrospective study was carried out to investigate the clinical data of 724 elderly patients with apoplexy in Department of Neurology during Jan 1st,2003 to Dec 31st,2005.RESULTS The nosocomial acquired pneumonia rate was 12.26%.The nosocomial infection rate in patients with cerebral hemorrhage and cerebral infarction was 23.79% and 6.48%,respectively.The incidence rate of nosocomial acquired pneumonia was related positively to long time in hospital,underlying disease severity,consciousness,swallow,preventive antibiotic therapy and diabetes.CONCLUSIONS More attention should be paid in clinical treatment and nursing care in order to lowering the occurrence of the nosocomial acquired pneumonia.

AIM: To investigate the anti-proliferative and apoptosis-inducing effect of honokiol on U937 cell line in vitro. METHODS: Proliferation of U937 cells and PBMCs were analyzed by MTT assay. Flow Cytometry and cell morphological observation were performed to find out whether honokiol could affect cell cycle and induce apoptosis of U937 as well as PBMCs in vitro. RT-PCR and Western blotting techniques were used to detect the changes in mRNA expression and protein production of bcl-2 and bax in U937 cells after treated with honokiol. RESULTS: Honokiol could significantly inhibit the proliferation of U937 cells at IC_ 50 concentration of 11.8 ?g/mL, but slightly inhibit the proliferation of PBMCs, at IC_ 50 concentration of 40.3 ?g/mL, respectively. Most honokiol-treated cells were arrested at G_0/G_1 phase. CONCLUSION: Honokiol could inhibit the proliferation and induce apoptosis of U937 cells, while has little effect on the proliferation and survival of PBMCs. Bax might be involved in the gene regulation related to honokiol-induced apoptosis.

Objective To evaluate the clinical application of fecal elastase test in exocrine insufficiency of pancreatic disease. Methods The fecal elastase 1 was detected by ELISA method in 55 patients with chronic pancreatitis, 21 with pancreatic cancer and 25 with nonpancreatic digestive disease, and the urine BT PABA was measured by DACA method simultaneously. Results The fecal elastase 1 and urine BT PABA excretion in patients with chronic pancreatitis and pancreatic cancer were much lower than those in patients with nonpancreatic disease ( P

Objective The survey is based on status of sexual health and sexual needs for male patients with acute myocardial infarction and Percutaneous Transluminal Coronary Angioplasty (PTCA) plus stent implantation.The survey data provides the basis for guiding patients' health education.Methods General questionnaire,sexual knowledge status questionnaire and sexual health knowledge demand questionnaire were used to carried out the investigation in 214 cases of patients with PTCA plus stent implantation.Collected data entered into a database for statistical analysis.Results The overall score of sexual health of 214 patients was (8.79±2.52) points.There was a statistically significant difference in different education levels,occupation and monthly income.There was no statistically significant difference in different ages.The overall score of knowledge of sexual health demand was (29.40 ± 6.47) points.There was a statistically significant difference in different ages,education levels and occupations.There was no statistically significant difference in different monthly income.Conclusions The sexual knowledge cognitive level of patients with PTCA plus stent implantation is low,but they have higher demand of sexual health knowledge,the medical personnel should strengthen the knowledge of sex education for patients to improve the quality of sex.

Objective To detect the correlations of miR -106 a expression with clinical features of pa-tients with colon cancer ,and to explore the significance of miR -106 a as a prognostic factor .Methods One hun-dred and five patients with primary colon cancer were retrospectively enrolled in this study including their clinical information and slices of FFPE.miR-106a expression was detected by qRT -PCR,and analyzed the correlation between the level of miR -106a and clinical features and survival .Results The level of miR -106a in tumor tissue was higher than adjacent normal tissue (1.142 vs.0.685,P<0.001).miR-106a was correlated with TNM stage and lymphnode metastasis .The higher miR -106a expression,the poorer survival patients were .The hazard risk was increased 3.390 folds(95%CI for HR:1.028 ~11.178)when compared high expression group with the low.Conclusion The aberrant expression of miR -106a may be associated with colon cancer .It will po-tentially be a therapeutic target and prognostic factors .

Objective To review and discuss the changes of diagnostic techniques and therapeutic modalities of pheochromocytoma during the past fifty years. Methods The clinical data of 362 patients (196 men and 166 women; age range,7-75 years;mean age,38 years) with pheochromocytoma from January 1955 to July 2004 were retrospectively analyzed.The disease course ranged from 20 d to 20 years with a mean of 3.9 years.According to the premedication,the past 50-year period was divided into 3 stages;and the diagnostic techniques,premedication, anesthetic skills,surgical procedures and perioperative death rate were compared among the 3 stages. Results There were 60 patients in the first stage (1955-1975) and their diagnoses were made on urine VMA and retroperitoneal air-contrast imaging.They had no premedication except for tranquilizers.The therapeutic modality was open surgery of resecting tumors under peridural anesthesia.The perioperative mortality was 8.3% (5/60).The second stage (1976-1994) included 105 patients and they were diagnosed mainly by 24-h urine catecholamine, ultrasonography and CT.Phenoxybenzamine was taken as the regular premedication and open surgery general anesthesia was used; the mortality decreased significantly to 1.0% (1/105).The third stage (1995-2004) consisted of 197 cases.In addition to 24-h urine catecholamine,ultrasonography and CT, 131I-MIBG scan was used as the specific diagnostic technique for pheochromocytoma widely.The premedication was phenoxybenzamine and urapidil.The microcirculation imaging analysis was used to judge the volume expansion preparation. Laparoscopic resection of the tumor under general anesthesia was adopted as the regular means.The perioperative mortality was 0.5% (1/197). Conclusions The diagnostic techniques for pheochromocytoma have become enriched and mature.The premedication has been standardized and included more medicines.The microinvasive surgery has become the current method for resecting tumors,and the perioperative mortality has become significantly decreased.

Aged ; Case-Control Studies ; Cerebral Hemorrhage ; etiology ; Cerebral Infarction ; etiology ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; metabolism ; Male ; Middle Aged ; Plasma ; chemistry ; Polymorphism, Genetic

Objective To explore the influence of levothyroxine(L-T4) in the treatment of primary hypothyroidism on myocardial enzymes and lipids.Methods 78 patients with primary hypothyroidism were selected and treated with L-T4 for 12 weeks.The fasting serum levels promote thyroid hormone(TSH),free T3 (FT3),free T4 (FT4),total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C),aspartate aminotransferase enzyme (AST),creatine kinase (CK) and its isoenzyme (CK-MB),lactate dehydrogenase(LDH) were monitored and analyzed before and after treatment.Results After L-T4 treatment for 12 weeks,compared with before treatment,TSH,TC,TG,LDL-C,CK,CK-MB,LDH,AST were significantly decreased or restored (t =10.5223,26.8498,22.7699,16.2735,22.9329,13.1910,32.0907,22.9597,all P ＜ 0.01).The FT3 was negatively correlated with TG (r =-0.3782),LDL-C(r =-0.3506),AST(r =-0.2843),LDH(r =-0.2974),CK(r =-0.3726) (all P ＜ 0.01)and CK-MB(r =-0.2559) (P ＜ 0.05).FT4 was negatively correlated with TC (r =-0.2660),TG (r =-0.4661),LDL-C(r=-0.5119),LDH(r=-0.5936),CK(r=-0.4877),CK-MB(r=-0.5463) (all P＜0.01)and AST(r =-0.2328) (P ＜0.05).TSH was positively correlated with TC(r =0.5341),TG(r =0.7567),LDL-C(r =0.8240),AST (r =0.3923),LDH (r =0.8073),CK (r =0.9661),CK-MB (r =0.7336) (all P ＜0.01).TSH had,the best correlationship with CK (r =0.9661).Conclusion L-T4 can significantly improve the thyroid function and reduce the blood lipids,myocardial enzymes levels of patients with primary hypothyroidism.

Objective To investigate the effects of penehyclidine hydrochloride combined with ulinastatin on lung injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).Methods Sixty ASA Ⅱ or Ⅲ patients of both sexes,aged 33-64,weighing 47-81 kg,NYHA class Ⅱ or Ⅲ ,scheduled for cardiac valve replacement,were randomly divided into 4 groups(n = 15 each): control group(group C),ulinastatin group(group U),penehyclidine hydrochloride group(group P)and penehyclidine hydrochloride + ulinastatin group(group PU).Group U,P and PU received iv injection of ulinastatin 20 000 U/kg,penehyclidine hydrochloride 0.05 mg/kg and ulinastatin 20 000 U/kg + penehyclidine hydrochloride 0.05 mg/kg 30 min after the end of CPB,respectively,while group C received equal volume of normal saline.Then PEEP was increased to 8 cm H2O in all groups.Blood samples were taken at 30 min,3 and 6 h after the end of CPB and 12 and 24 h after operation for determination of PaO2 and serum concentrations of TNF-α,IL-6,IL-8 and IL-10.Airway peak pressure and airway plateau pressure were recorded at the corresponding time points.Oxygen index(OI)and pulmonary compliance(CL)were calculated.Lung injury was scored at 6 h after the end of CPB and 12 and 24 h after operation.Results OI and CL were significantly increased and lung injury score was significantly decreased in group U,P and PU compared with group C(P ＜ 0.05 or 0.01),and in group PU compared with group U and P (P ＜ 0.05).Serum concentrations of TNF-α,IL-6 and IL-8 were significantly lower and the serum IL-10 concentration was significantly higher in group U,P and PU than in group C(P ＜ 0.05 or 0.01),and in group PU than in group U and P(P ＜ 0.05).There was no significant difference in the indices mentioned above between group U and P(P ＞ 0.05).Conclusion Penehyclidine hydrochloride combined with ulinastatin can attenuate lung injury by inhibiting inflammatory response in patients undergoing cardiac valve replacement with CPB.

Objective To investigate the effects of L-Arginine(L-Arg) on microcirculation perfusion after banked-blood transfusion in rabbits with hypovolemia.Methods Thirty healthy male New Zealand white rabbits weighing 2.0-2.5 kg were randomly divided into 3 groups (n =10 each): groups Ⅰ-Ⅲ.Hypovolemia was induced by blood letting (20％ of blood volume) and the equal volume of banked-blood was transfused 30 min later in groups Ⅰ and Ⅲ.25％ L-Arg 300 mg/kg was injected iv 5 min before blood letting in group Ⅲ,and the equal volume of normal saline was injected in group Ⅰ.Group Ⅱ only received 25％ L-Arg 300 mg/kg.MAP,CVP and tip perfusion index (TPI) were recorded at before (T0) and after blood letting (T1),end of banked-blood transfusion (T2),1 h ( T3 ) and 2 h (T4) after banked- blood transfusion,and blood samples were taken for determination of plasma lactate and nitric oxide (NO) concentrations.Results TPI was higher at T2-T4,plasma lactate concentration lower at T1 -T4 and plasma NO concentration lower at T3,T4 in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜0.05).There was no significant difference in MAP between groups Ⅱ,Ⅲ and group Ⅰ ( P ＞ 0.05).MAP was lower at T1 in group Ⅲ than in group Ⅱ (P ＜ 0.05).There was no significant difference in CVP among the 3 groups( P ＞ 0.05).Conclusion Pretreatment with L-Arg can increase microcirculation perfusion,and has no effect on hemodynamics in rabbits with hypovolemia after banked-blood transfusion.