Objective: To improve the safety of anesthesia of the neonates at high risk during surgical operation. 　Methods:Before the operation, Anisodamine, Ketamine and Vecuronium bromide were injected intravenously with dosage of 0.06mg, 2mg*kg-1 and 0.08-0.1mg*kg-1, respectively. Tracheal cannula or topical anesthesia using 1% of lidocaine hydrochloride was performed. The tracheal cannulation was performed after administration of sodium hydroxybutyrate and Ketamine by injection with dosages of 50-80 mg*kg-1 and 2mg*kg-1 body weight. Anesthesia apparatus and combinative anesthesia were used. The concentrations of SpO2 were monitored during the operation. A dosage of 1-2mg*kg-1 body weight was used for resuscination of the patients after the operation. 　Results: A total of 100 cases of operation were performed using the regime of anesthetic intervention described above. A 100% of success rate was achieved and no death occurred during the operation. 　Conclusion:Significant improvement of safety in anesthesia of the neonates at high risk during surgical operation can be achieved with sufficient preoperational preparation, adequate monitoring during the operation and rational use of anesthetics as well as restrict selection of suitable anesthetical interventions.

Objective To develop the Elderly Frailty Assessment Scale and test its reliability and validity.Methods The primary item pool was formulated through literature review,compounding existing instruments measuring elderly frailty and group meeting.The items were selected by expert consultation.Totally 420 elderly adults were selected to test the reliability and validity and SPSS 20.0 was used to analyze data.Results The Elderly Frailty Assessment Scale consisted of 35 items;the exploratory factor analysis identified four principal factors which explained 72.685％ of the total variance.The item content validity index ranged from 0.824 to 1,and the scale content validity index was 0.932.The Cronbach's α coefficient of the scale was 0.952 and test-retest reliability was 0.937.Conclusion The Elderly Frailty Assessment Scale is reliable and valid,which can be used to evaluate elderly frailty.

Objective To investigate the mechanism of the permeability change in the blood brain barrier(BBB)at early stage of infectious brain edema which was pretreated with LPS.Methods PMNs were isolated and purified.The concentration of Glu was measured in the supernatant without cells.The rat BMECs were primarily isolated and cultured.The permeability of BMECs waB evaluated by measuring the passing rate of 125 I-BSA via γ ray counter.The expression of NMDAR1 on BMECs was evaluated.Results The concentration of Glu in the LPS preconditioning PMNs subgroup at 5 rain time point was highest.In each group conditioned for 240 min,the permeability index of Bake average of the LPS preconditioning PMNs extract group was highest(P＜0.01).The expression of NMDARI increased in the LPS preconditioning PMNs extract group was more than that in other groups.Conclusions The research showed for the first time that the concentration of Glu increased after LPS preconditioning and the Glu excreted by PMNs can promote the permeability of BMECs and change the function of BBB,which possibly may be related the mechanism of NMDAR1 expression increased in BMECs.

Objective To evaluate effect of construction with dual plates via olecranon osteotomy approach in treatment of type C distal humeral fractures.Methods The study involved 19 patients with type C distal humeral fractures treated by olecranon osteotomy and double plate fixation between July 2008 and April 2010,including 11 males and 8 females at a mean age of 49.2 years (range,27-71 years).Fractures were causes by traffic accidents in 10 patients,tumble in seven and fall from height in two.According to Association for Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification,there were nine patients with type C2 and 10 with type C3 fractures.Besides,two patients were complicated by ulnar nerve injuries and one by radial nerve injury.Results Primary wound healing was achieved in all patients after operation.All patients were followed up for average 15.9 months (range,12-20 months).X-ray films revealed that both fracture and olecranon osteotomy sites were healed in average 12 weeks (range,8-18 weeks).No fixation failure,myositis ossificans,malunion,delayed union or disunion occurred during the follow-up.Average Mayo elbow performance score (MEPS) was 94.8 points (range,75-100 points) at the last follow-up,which showed excellent results in 14 patients,good in three,and fair in two,with excellence rate of 90％.Conclusions Double plate fixation via olecranon osteotomy gains advantages of solid fixation and early functional exercise in treatment of comminuted intercondylar fractures of humerus.Moreover,postoperative outcome is satisfactory.

BackgroundRevascularization and statin therapy are routinely used in the management of stable coronary artery disease. However, it is unclear whether the estimated high-density lipoprotein (HDL) particle size (eHDL-S), the ratio of HDL cholesterol (HDL-C) to apoprotein A-I (apoA-I), is associated with the clinical outcomes of diabetic patients with stablecoronary artery disease (CAD).MethodsWe per-formed a prospective cohort study of 328 patients diagnosed with stable CAD by coronary angiography. Patients were followed up for a mean duration of 12 months. The patients were divided into three groups by the tertiles of eHDL-S: low eHDL-S (< 0.71,n= 118); interme-diate eHDL-S (0.71-0.79,n= 111); and high eHDL-S (> 0.79,n= 99). The associations between the baseline eHDL-S and short-term out-comes were evaluated using the Kaplan-Meier method and Cox proportional regression.Results The low eHDL-S group had higher trig-lyceride, hemoglobin A1c, uric acid, and leukocyte count than the other groups. During the follow-up period, 47/328 patients experienced a pre-specified outcome. According to the Kaplan-Meier analysis, the incidence of pre-specified outcomes was lower in the high eHDL-S group (P = 0.04). However, eHDL-S was not independently associated with adverse outcomes in Cox proportional hazards regression (haz-ard ratio (HR): 0.23, 95% confidence interval (95% CI): 0.01-11.24,P = 0.493).ConclusionAlthough the eHDL-S was associated with inflammatory biomarkers, it was not independently associated with the short-term prognosis of diabetic patients with stable CAD in the era of revascularization and potent statin therapy.

Objective To describe the status quo of Aged care willingness among nursing undergraduates,and to explore its influencing factors. Methods A total of 382 nursing undergraduates were enrolled by convenience sampling method. They were investigated with a self-designed questionnaire about the demographic data, the Kogan′s Attitudes toward Old People Scale, the Palmore′s Facts on Aging Quiz Scale and College Students′ Gratitude Trait Questionnaire. Results The overall aged care willingness score for nursing undergraduates was 17.75 ± 3.62. Appreciation, old training, happiness, retribution and living with the older people entered the multiple regression equation. Conclusions The Aged care willingness level of 382 nursing undergraduates is at medium level. Appreciation, old training, happiness, retribution and living with the older people are important influencing factors.

BACKGROUND: Previous studies have shown that the complex of polyethylene glycol diacrylate and chitosan is biodegradable, has the anti-inflammation effect and can promote wound healing, with good biocompatibility.However, the composite material is brittle, and thus, it is necessary to develop a mechanical support material due to the anatomy of the nasal cavity.OBJECTIVE: To study the cytocompatibility of a novel degradable absorbable nasal packing material made of polyethylene glycol diacrylate composite hydrogel.METHODS: In our experiment, the composite hydrogel was formed by the combination of different ratios of polyethyleneglycol diacrylate, chitosan and polyvinyl alcohol using photo-crosslinking method. According to the international standard of medical devices, we used direct and indirect international standard experimental methods to evaluate the cytotoxicity of the materials. (1) Direct contact method: the polyethylene glycol acrylate composite hydrogel and mouse fibroblasts L929 were co-cultured for 24 hours to observe the morphological changes of cells. (2) Indirect extraction: mouse fibroblasts L929 were cultured in polyethylene glycol diacrylate composite hydrogel extracts (100, 50 μL) and RPMI1640 medium (100 μL), respectively, for 3 days to observe the proliferation and cytotoxicity by cell counting kit-8 assay.RESULTS AND CONCLUSION: (1) Direct contact method: the cells around the material formed a flat structure with fusiform or stellated protrudes. The material was confirmed to have good biocompatibility depending upon the presence of adherent cell growth, full and strong refraction, and the overall growth trend. (2) Indirect extraction method: with the increase of time, the number of cells in the hydrogel extract group increased, the relative proliferation rate of cells increased gradually, and the cytotoxicity was 0 to 1. To conclude, these experimental findings indicate that the polyethylene glycol acrylate composite hydrogel material has good cytocompatibility.

Objective To observe the role of chronic inflammation in the development of atherosclerosis (AS) by analyzing the expression of TLR4 and NF-κB in artery endothelium. Methods To construct the atherosclerotic animal model, the balloon catheter was used to injure common carotid artery and rabbits were fed the high cholesterol diet. All the rabbits were divided into three groups: control group with the normal diet, high cholesterol diet-fed group and model group (balloon-injured common carotid artery and the high cholesterol diet fed rabbits). The rabbits were sacrificed after 8 weeks and their tissues were collected. Then morphological changes of rabbit common carotid artery were observed by light microscope. The expression of TLR4 and NF-κB in endarterium was displayed using immunochemistry method. Results Both hyperlipidemia and exterior inflammatory stimulation promoted the expression of TLR4 and NF-κB in vascular endothelium (P ＜ 0.01 ). And when both of them were present, the level of TLR4 and NF-κB expression would get higher even than that affected by one of them( P ＜ 0.01 ). Conclusion Both hyperlipidemia and chronic inflammatory process can improve the expression of TLR4 and NF- κB in vascular endothelium in different degree; the inflammatory stimulation would promote the atherosclerosis to some extent; TLR4/ NF-κB would play a role as a bridge between the internal environment changes and the arterial morphological changes.

Objective To investigate the relationships and clinicopathologic features of the expressions of cytochrome P450 2E1 (CYP2E1) and PC cell-derived growth factor (PCDGF) in esophageal squamous cell carcinoma (ESCC),and to determine the role of CYP2E1 and PCDGF in angiogenesis.Methods The expression levels of CYP2E1 and PCDGF in 42 surgical cancer specimens and 20 adjacent normal esophageal mucosa specimens from patients with ESCC were detected by immunohistochemistry.Results The positive expression rates of CYP2E1 and PCDGF in ESCC were 83.3 ％ (35/42) and 88.1％ (37/42),respectively,which were obviously higher than those of normal mucosa (P ＜ 0.05).Expression of PCDGF was correlated with the degree of histological differentiation (r =0.444,P ＜ 0.05),depth of tumor invasion (r =0.332,P ＜ 0.05),lymph node metastasis (r =0.476,P ＜ 0.05),and TNM classification (r =0.450,P ＜ 0.05).The expression of CYP2E1 was negatively correlated with tumor tissue differentiation (r =-0.518,P ＜ 0.05),and positively correlated with depth of invasion in ESCC (r =0.388,P ＜ 0.05).The expression of CYP2E1 was related to that of PCDGF in the tumor (r =0.483,P ＜ 0.05).Conclusion The expressions of CYP2E1 and PCDGF are synergistically involved in tumor growth,infiltration andmetastasis.Overexpression of CYP2E1 and PCDGF can be used as the important predictors for evaluating the biological behavior of ESCC and predicting prognosis of patients.

Objective To observe the 2-year survival situation of high intensity focused ultrasound(HIFU) treatment in unr esectable advanced pancreatic carcinoma.Methods Thirty-eight patients with unresectable pancreatic cancer received HIFU treatment.After treatment,the changes of laboratory tumor markers examination results,pain score,life quality score and survival situation were recorded.Results Among 35 patients with pain symptom before HIFU treatment,pain was relieved after HIFU treatment in 28 cases,the remission rate was 80.0％.The CA19-9 and CEA levels after HIFU therapy were obviously reduced compared with before treatment.The imaging examination showed the coagulation necrosis in HIFU-treated area.It was found the tumor volume was obviously shrunk during follow-up period.The median survival period was extended to (12.9 ± 6.6) months.Conclusion The HIFU treatment can effectively improve the life quality in the patients with unresectable pancreatic cancer and extends their survival period.