BACKGROUND: Radix astragali has the effect of protecting cells from damage in ischemic reperfusion, whether pre-treatment with radix astragali can protect myocardial eells from apoptosis in ischemic reperfusion ? OBJECTIVE: To investigate the effect of pre-treatment with radix astragali on apoptosis and its relative genes in rats with ischemic myocardial reperfusion DESIGN: A randomized and controlled trial taking Wistar rats as experimental subjects.SETTING: The Basic Medical Department of Chengde Medical College and the Geriatric Department of the Affiliated Hospital.MATERIALS: The experiment was completed in the Imunnohistochemical Laboratory of Basic Medical Institute in Chengde Medical College from February to December in 2004. A total of 30 healthy male Wistar rats were selected, and at random classified as groups of radix astragali pre-treated (radix astragali), ischemic reperfusion and psuedo-operated (control), 10 rats for each group.METHODS: Radix astragali injection was given peritonealy for rats in radix astragali pre-treated group before operation, and the equivalent normai saline was given for those in ischemic reperfusion and psuedo-operated groups. One week later, the model of ischemic reperfusion was set up. After operation the myocardia in marginal zone of ischemic reperfusion were sampled, and the myocardia of the corresponding zone were taken for control group. The method of terminal (TdT)-mediated dUTP-biotin nick end labeling (TUNEL) was used for assay of myocardial apoptosis rate, and the ABC immunohistochemical method was used for assay of myocardial bcl-2 (inhibiting apoptosis gene) and bax (promoting apoptosis gene).MAIN OUTCOME MEASURES: Apoptosis rates, and expression of bcl2 and bax genes of myocardia RESULTS: ① Apoptosis rate of myocardial cells: The rate in radix astragali group was decreased compared with that in ischemic reperfusion group [ (14.06 ±9.97) ％, (19.34±12.30) ％, t = 1.863, P ＜ 0.05].② Expression of bcl-2: There was no significant difference between radix astragali and ischemic reperfusion groups[(9.14±4.46) ％, (8.99±4.54) ％, P ＜ 0.05].③ Expression of bax: The expression in radix astragali group was decreased compared with that in ischemic reperfusion group [(12.65 ±7.23)％,(18.12±7.92) ％, t = 2.096, P ＜ 0.05]CONCLUSION: Pre-treatment with radix astragali can down-regulate the expression of promoting apoptosis gene so as to reduce the rate of myocardial cell apoptosis, hence it can protect the myocardial cells in ischemic reperfusion.

Objective To analyze perioperative management and risk factors for the prognosis of hip fracture surgery in elderly patients.Methods The present study included 112 elderly patients (aged ≥65 years) who received hip fracture surgery from January 2009 to January 2013 in our department,and their clinical data were retrospectively analyzed.Results The percentage of cases with concomitant diseases before operation was 91.0 ％,and the postoperative complications rates were 35.7％.One-year mortality after operation was 21.4％.The percentage of survival cases with daily living activities fully restored to pre injury status was 47.6％.Logistic regression analysis revealed that independent risk factors for the one-year mortality included general health before injury (OR=13.36,P =0.047),pulmonary disease (OR =18.33,P =0.007),number of postoperative complications (OR=15.14,P=0.025),and renal failure (OR=11.26,P=0.034).Conclusions Elderly hip fracture patients have many different concomitant diseases.By applying the qualified levels of perioperative management,anesthetic and operative methods,and postoperative rehabilitation measures according to the conditions of the patient,the incidence of perioperative complications and one year mortality can be decreased,and qualified surgical outcomes can be obtained.The independent risk factors for the one-year mortality include general health before injury,pulmonary disease,number of postoperative complications and renal failure.

D ue to the negative autopsy and w ithout cardiac structural abnorm alities, unexpected sudden cardiac death (U SC D ) is alw ays a tough issue for forensic pathological expertise. U SC D m ay be asso-ciated w ith parts of fatal arrhythm ic diseases. T hese arrhythm ic diseases m ay be caused by disorders of cardiac ion channels or channel-related proteins. C aveolin can com bine w ith m ultiple m yocardial ion channel proteins through its scaffolding regions and plays an im portant role in m aintaining the depolar-ization and repolarization of cardiac action potential. W hen the structure and function of caveolin are af-fected by gene m utations or abnorm al protein expression, the functions of the regulated ion channels are correspondingly im paired, w hich leads to the occurrence of m ultiple channelopathies, arrhythm ia or even sudden cardiac death. It is im portant to study the effects of caveolin on the functions of ion channels for exploring the m echanism s of m alignant arrhythm ia and sudden cardiac death.

Objective T o explore the genetic variation sites of caveolin (C A V ) and their correlation w ith sudden unexplained death (SU D ).Methods The blood sam ples w ere collected from SU D group (71 cases), coronary artery disease (C A D ) group (62 cases) and control group (60 cases), respectively. T he genom e D N A w ere extracted and sequencing w as perform ed directly by am plifying gene coding region and exon-intron splicing region of CAV1 and CAV3 using PC R . T he type of heritable variation of CVA w as con-firm ed and statistical analysis w as perform ed. Results A total of 4 variation sites that m aybe significa-tive w ere identified in SU D group, and tw o w ere new found w hich w ere CAV1: c.45C>T (T 15T ) and CAV1:c.512G>A (R 171H ), and tw o w ere SN P loci w hich w ere CAV1:c.246C>T (rs35242077) and CAV3:c.99C>T (rs1008642) and had significant difference (P<0.05) in allele and genotype frequencies betw een SU D and control groups. Forem entioned variation sites w ere not found in C A D group. Conclu-sion T he variants of CAV1 and CAV3 m ay be correlated w ith a part of SU D group.

Objective To evaluate the clinical outcomes and feasibility of multi-modality adjuvant chemotherapy and radiation, which was conducted as postoperative chemotherapy, radiation, and consolidation chemotherapy (CRC) mode for the treatment of advanced endometrial cancer. Methods A retrospective analysis of 124 patients with International Federation of Gynecology and Obstetrics (FIGO) stages Ⅲ and Ⅳ endometrial cancer from Jan. 2004 to Oct. 2012 was conducted in Peking University People′s Hospital and Beijing Obstetrics and Gynecology Hospital. Inclusion criteria were comprehensive staging procedure including hysterectomy, bilateral salpingo-oophorectomy, and (or) selective pelvic aortic lymphadenectomy, and treatment with adjuvant chemotherapy and (or) radiation. The average age of these patients was (55.9 ± 8.4) years old (range from 23 to 79 years old). According to different postoperative adjuvant treatment modes, the patients were divided into CRC group, chemotherapy-radiotherapy (CR) group and single chemotherapy (C) group. The survival and side effects of the three groups were compared. Results (1) One hundred and twenty-four patients with advanced stage endometrial cancer were identified and received postoperative adjuvant therapies.Sixty-one (49.2％, 61/124) cases of them received postoperative CRC fashion, 19 (15.3％, 19/124) received postoperative CR and 44 (35.5％, 44/124) cases received C. The age, stage, grade and type of surgery of the three groups were not significantly different (all P>0.05);while, the pathology, chemotherapy cycles and chemotherapy regimens differed significantly (all P<0.05). (2) The progression-free survivals (PFS) of the patients with CRC, CR, and C group were (121±7), (68± 15), and (100±11) months, respectively. The 3-year PFS rates were 87.9％, 43.7％, and 61.4％, respectively. The 5-year PFS rates were 82.2％, 36.4％, and 61.4％, respectively. The above indicators were significantly higher in the CRC group than in the CR group (all P<0.01), and there was no difference between the CRC group and the C group (P=0.037). The overall survival (OS) of patients with CRC, CR, and C group were (128 ± 6), (80 ± 12), and (99 ± 10) months, respectively. The 3-year OS rates were 87.8％, 72.4％, and 67.1％, the 5-year OS rate were 84.2％, 54.3％, and 64.1％, respectively. The above indicators were significantly higher in the CRC group than those in the CR group and C group (all P<0.01). (3) There was no difference in the frequency of adverse effects either chemotherapy, such as severe bone suppression or radiotherapy;hepatotoxicity,blood transfusion, dose modifications;or cycle delays between the CRC, CR and C group (all P>0.05). (4) In the univariate analysis shown that, stage, the fashion of postoperative adjuvant therapy and type of surgery were risk factors for tumor progression in patients with advanced endometrial cancer (P<0.05). After adjusted for FIGO stage and type of surgery, the tumor progression hazard ratio (HR) was 3.931 (95％CI:1.734-8.914, P=0.001) for the CR group and 2.188 (95％CI:1.010-4.741, P=0.047) for the C group, compared to the CRC group. Conclusion Sequential CRC delivered in a"sandwich"fashion for the treatment in advanced endometrial cancer could significantly improve the 3-year and 5-year OS rates and have a similar adverse effect profile compared with other sequencing modalities.

Objective:To design and evaluate a new type of clothes for patients with reconstruction after oral cancer resection.Methods:According to the characteristics of patients after oral tumor resection and reconstruction, a new type of patient clothing was designed. From January 2018 to June 2018, 79 patients with oral malignant tumor radical resection combined with reconstruction were selected as the control group, using traditional patient clothing. 64 patients with the same operation were selected as the experimental group from July 2018 to December 2018, and the new patient clothing was used. The time of changing clothing, wearing comfort and privacy protection, the convenience for medical staff to observe and change wound dressing were to evaluate.Results:The clothing change time of the patients was (124.00±23.35) s in the experimental group, and (156.09±25.66) s in the control group,the difference was statistically significant( t value was 14.97, P<0.01). The scores of clothing comfort and privacy protection were 8.23±0.91, 7.17±0.94 in the experimental group, and 4.78±0.94, 5.50±0.89 in the control group, the difference were statistically significant( t values were -15.21, -9.95, P<0.01). The scores of medical staff observing wounds and changing wound dressings were 7.88±0.89, 7.87±0.83 in the experimental group, and 4.15±0.78, 4.15±0.78 in the control group, the difference was statistically significant( t values were -18.98, -17.75, P<0.01). Conclusions:The new clothes is effective for patients with reconstruction after oral cancer resection. It can be popularized in patients with oral cancer resection and reconstruction.