Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Dental Implantation ; methods ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged

Objective To select properly the esophageal metallic stent to treat the dysphagia and strictures of advanced esophageal cancer. Methods To place esophageal metallic stent for 72 cases of advanced esophageal cancer. Results Dysphagia were markedly improved or completely alleviated together with esophageal and mediastinal fistula sealed completely after the procedure. Conclusions The complications will be reduced by the proper selection of esophageal metallic stent and also for resuming of food intake.

OBJECTIVETo explore the therapeutic efficacy of unilateral multiple channels approach in percutaneous vertebroplasty (PVP) for osteoporotic vertebral fractures.

METHODSA retrospective review (from March 2003 to October 2012) was conducted on 685 consecutive patients, a total of 885 vertebrae were involved. Eighty-two cases (99 vertebrae) with bone cement leakage when less than 0.3 ml bone cement was injected to fill the fracture were given PVP procedure by unilateral multiple channels approach. 38 cases were male (45 vertebrae) and 44 cases were female (54 vertebrae). The average age was 75.4 years old (from 69 to 92). The operation time, amount of injected bone cement and complications were recorded. Rate of excellent and good outcomes was studied by measuring the cement distribution on the X-ray film. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function respectively at preoperation and 1 hour, 1 month, 3 months and 6 months after operation.

RESULTSAll these ninety-nine vertebrae were treated in 82 cases with PVP of unilateral multiple channels approach. The average operation time was 33 minutes. The rate of excellent and good outcomes of cement distribution was 98.8%. The VAS score was (8.40 +/- 0.73) before surgery,and (2.50 +/- 0.43), (2.00 +/- 0.33), (1.80 +/- 0.28), (2.10 +/- 0.17) at 1 hour, 1 month,3 months and 6 months respectively after operation. ODI was (40.94 +/- 2.72) before surgery, (9.64 +/- 2.60) at 1 month after surgery, (8.52 +/- 2.30) at 3 months after surgery and (7.77 +/- 2.15) at the final follow-up. The differences of the VAS and ODI between pre-operation and post-operation had statistical significance (P<0.01). No spine or nerve injuries occurred intraoperatively.

CONCLUSIONThe unilateral multiple channels approach in percutaneous vertebroplasty can obviously relieve the pain and effectively improve the functional activity, provide a satisfied cement distribution in vertebral body with cement leakage after a small amount infusion.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Osteoporosis ; surgery ; Retrospective Studies ; Spinal Fractures ; surgery ; Treatment Outcome ; Vertebroplasty

Objective: To evaluate the value malnutrition-inflammation score(MIS) for the nutritional status in patients with maintenance hemodialysis.Methods: Eighty patients with maintenance hemodiaqlysis were selected in this study.MIS was used to access the nutritional status in these patients.At the same time,the laboratory indexes including serum albumin(ALB),transferrin(TRF),hemoglobin(Hb),serum creatinine(Scr),blood urea nitrogen(BUN),C-reactive protein(CRP),serum calcium(Ca) and phosphorus(P) were measured,and Kt/v,urea reduction ratio(URR) and protein catabolic rate(PCR) were calculated.The body composition was also measured by bioelectrical impedance analysis after postdialysis,including body weight(WT),body mass index(BMI),fat mass(FAT MASS),fat-free mass(FFM) and total body water(TBW).Results: The abnormal rates of these nutritional marker were: protein malnutrition(ALB1.8 mmol/L) 70.0%,respectively.All patients were mild or moderate malnutrition by MIS.MIS showed a significant correlation with WT,BMI,ALB,TRF,Hb and CRP(P﹤0.001,P

OBJECTIVE To get knowledge of the drugs resistance change of Pseudomonas aeruginosa in intensive care unit (ICU) from 2001 to 2006, so as to offer the first-hand information to the clinical preventive and therapeutic countermeasures. METHODS The P. aeruginosa antimicrobial susceptibility tests to 15 commonly used antibiotics were performed from 2001 to 2006. RESULTS The most frequent isolates were P. aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii in 2001-2004. Staphylococcus aureus was more than A. baumannii in 2006, and became the major isolated pathogen in the sputum of the ICU patients. The multi-resistant P. aeruginosa increased yearly, and drugs susceptibility to carbapenem had decreased sharply in the past 6 years. CONCLUSIONS It was showed that P. aeruginosa is the major pathogen in the ICU, and the pathogens show the high drug resistance. Doctors should pay more attention to analyze the bacterial resistance profile in order to decrease the incidence of drug resistance and use the antibiotics properly.

Objective To explore the effect of suledexide on renal injury and podocalyxin expression of podocytes in STZ diabetic desoxycorticosterone acetate (DOCA)-hypertensive rats. Methods Wistar rats were subjected to subcutaneous injection of streptozotocin(STZ), followed by uninephrectomy and subcutaneous administration of DOCA. Diabetic and hypertensive rats were randomly allocated to treatment with sulodexide or a combination of sulodexide and telmisartan for 8 weeks. Blood pressure (BP), 24-hour urinary albumin were measured every 2 weeks. Blood and urinary samples were collected to detect biochemical indexes of plasma and urinary β-acetyl-β-D-glucosaminidase (NAG) at the end of the study. Immunohistochemistry (IHC), RT-PCR and Western blot were performed to examine the expression and distribution of podocalyxin. Results STZ +DOCA-treated rats progressively developed hypertension, albuminuria and hyperglycemia. Hyperlipidemia and hypoinsulinemia were found in diabetic and hypertensive rats compared with controls. Albuminuia was significantly reduced in sulodexide group at week 8 and sulodexide plus telmisartan group at week 6 and week 8. Blood pressure decreased in sulodexide plus telmisartan group. No significant effects on lipid and glucose metabolism were observed in all treated groups. Histopathological index increased in STZ+DOCA-treated rats, but was significantly lower in sulodexide group as well as sulodexide plus telmisartan group. The number of podocytes on glomerular cross-section of the four groups were comparable. Segmental loss and down-regulation of podocalyxin were detected in STZ+DOCA-treated rats, which were greatly attenuated by sulodexinde, meanwhile, combination treatment preserved more podocalyxin expression in glomeruli than sulodexide monotherapy. Conclusion Sulodexide effectively reduces albuminuria, prevents loss of podocyte podocalyxin and alleviates renal damage in STZ diabetic DOCA-hypertensive rats.

Objective To explore the risk factors affecting prognosis of invasive fungal infection .Methods The clinical data of 208 hospitalized patients diagnosed with invasive fungal infection in Sun Yat-sen memorial hospital from 2007 to 2011 were reviewed . The factors affecting prognosis were determined by univariate and logistic regression analysis .Results The fatality rate of adult inpa-tient with invasive fungal infection was 21%.The univariate analysis showed that difference of seven indicators was significant between the survive group and death group:advanced age (over 60 years old), hospitalization time,fasting plasma glucose level, hypoalbumin-emia, using more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome ( MODS) .Binary logistic regression showed that the difference of five indicators was significant between the two groups:advanced age (over 60 years old), hypoalbuminemia, using more than two kinds of broad spectrum antibiotic for more than two weeks, kinds of invasive operations , and multiple organ dysfunction syndrome .Conclusions The indicators such as advanced age (over 60 years old), hypoalbuminemia, the use of more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome might be independent risk factors of death in patients with invasive fungal infection.Early medical intervention should be made in clinical work , in order to reduce fatality rate of patients with invasive fungal in-fection.

Objective To study the preventive effects of erythropoietin (EPO) on acute tubular necrosis of kidney in rats. Method The rat models of acute renal tubular necrosis were established with injecting glycerol in dose of 10 mL/kg. Thirty Wistar rats were randomly (random number) divided into control group, model group and EPO treatment group. EPO was administered intravenously into rats of treatment group in a dose of 1000IU/kg. Levels of blood urea nitrogen (BUN) and serum creatinine (Scr), urine osmolality, urine N-acetyl-D-glucosaminidase (NAG), urine β2-microglobulin (β2-MG), tissue MDA and SOD of rats in the three groups were assayed after the experiment. Renal histological examination was also performed. Results Compared with model group, the levels of BUN and Scr, urine osmolality, NAG,β2-MG and tissue MDA in EPO treament group were significantly lower, but urine osmolality and tissue SOD of rats remarkably increased in comparison with model group. EPO also lessened the histological changes in treatment group. Conclusions EPO has some protective effects on acute renal tubular necrosis in rats, which is probably through preventing oxygen free radical damage and elevating endogenous antioxidation potential.

Objective:To study the inhibition of astragaloside on the proliferation of human keloid fibroblasts. Methods: Com-pared with that of normal skin, the expression of transforming growth factor-β( TGF-β) and its transduction factors Smad in the human keloid fibroblasts was detected. The optimal concentration was screened by MTT after HFF-1 human skin fibroblast was infected with astragaloside at different concentrations. The mRNA expression of Smad2, Smad3, Smad4 and Smad7 in the fibroblasts was studied by using real-time. The protein expression of TGF-βRⅡ, Smad2, Smad3, Smad4 and Smad7 in the fibroblasts was detected by using Western blot. Results: Compared with that of normal skin tissue, the expression of Smad protein was significantly increased ( P <0. 05) in the human keloid fibroblasts, and there was no significant difference in the TGF-βRⅡ expression (P>0. 05). The optimal concentration of astragaloside was 0. 5μg·ml-1 . The expression level of Smad2 protein in the two groups was significantly increased, and the level of Smad3 expression was significantly decreased (P<0. 05). Conclusion:Astragaloside can inhibit the formation of fi-broblast possibly through Smad2 over-expression and Smad3 inhibition in the TGF-β/Smad signal transduction pathway.