Objective To investigate the clinical effect of flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of irritable bowel syndrome with constipation (IBS-C) in elderly patients. Methods Fifty paients aged from 65 to 95 years with IBS-C were randomly divided into 2 groups: control group (23 patients) and treatment group (27 patients). The patients in treatment group received flupentixol and melitracen tablets (1 tablets, once a day) combined with macrogol 4000 powders (1 bag/time, 2 times a day) , while the patients in control group received macrogol 4000 powders alone. The treatment period was 4 weeks. The curative effect, the scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) and adverse reaction were compared between two groups. Results At the improvement of depressive symptoms, the effective rate in treatment group and control group was 88.9%(24/27) and 39.1%(9/23), and there was significant difference (P<0.01). At the improvement of anxiety symptoms, the effective rate in treatment group and control group was 74.1%(20/27) and 26.1%(6/23), and there was significant difference (P<0.01). The total effective rate in treatment group and control group was 88.9%(24/27) and 65.2%(15/24), and there was significant difference (P<0.05). Conclusions Flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of aged IBS-C patients have more distinguished therapeutic effect in improving constipation symptoms, stools times, anxiety and depression.

Objective To investigate the expression of extracellular matrix metalloproteinase inducer (CD147), nuclear factor kappa B (NF-κB) in esophageal squamous cell carcinoma tissue and probe their relationship to invasion and metastasis of esophageal carcinoma. Methods Immunochemical staining was performed to detect the expression of CD147 and NF-κB protein in 40 cases of esophageal carcinoma tissues and 40 cases of normal control. Results The positive rate of CD147 and NF-κB in esophageal carcinoma tissues and in adjacent noncancerous tissues were 77.5%/87.5% Vs 25%/42. 5%, P＜0.05.The positive rate of their prophase and metaphase-advanced stage esophageal carcinoma tissues were 33.3%/90.3% Vs 55.6%/96.8%, P＜0.05..The positive rate of non-metastatic and metastatic esophageal carcinoma tissues were 28.6%/87.9% Vs 42.9%/97%, P＜0.05.Conclusions Our results suggested that the increased expression of CD147 and NF-κB contributed to tumor angiogenesis in esophageal squamous cell carcinoma, which might be through the common pathway.

Objective To evaluate the effect of nitroglycerin (NTG)-induced hypotension on cognitive function after endoscopic sinus surgery performed under isoflurane anesthesia in elderly patients.Methods Forty ASAⅠ or Ⅱ patients aged 65-85 yr weighing 40-75 ks undergoing endoscopic nasal sinus surgery for chronic sinusitis under isoflurane anesthesia were randomly divided into 2 groups(n=20 each):control group(group C) and controlled hypotension group(group H).Anesthesia was maintained with isoflurane inhalation in both groups.In group H controlled hypotension was induced and maintained with continuous iv infusion of NTG at function was assessed 1 day before(baseline)and at 6,12,24 and 72h after surgery using Minimental State examination (MMSE) and scored.Results The MMSE scores were significantly decreased after surgery from 6h to 24h in both groups and were significantly lower in group H than in group C.There was no significant difference in MMSE scores between the 2 groups at 72h after surgery.The incidence of cognitive deficit was significantly higher in group H(55%) than in group C(25%).Conclusion Controlled hypotension induced by NTG may aggravate transient cognitive deficit after isoflurane anesthesia in elderly patients.

Objective To explore the influence of corporate governance at public hospitals on their nature of public welfare,in order to provide reference for promoting the reform of public hospital corporate governance.Methods Hypotheses of such impacts were raised by means of literature review. 460 questionnaires were collected from site survey,and four factors of public hospital corporate governance were used as independent variables,and five factors of the public welfare performance as dependent variables,for a correlation analysis and multiple linear regression analysis.Results A clear correlation is found among medical service level,and decision-making mechanism,the mechanism of key employees recruit/evaluation/incentive and their constraints (P < 0.05 ).Completion status of public health services is significantly correlated with the mechanism of recruit/evaluation/incentive and constraint,and their supervision mechanism as well(P <0.05).Medical technology level and cost of medical services are significantly correlated with decision-making mechanism.Conclusions In consideration of public hospital corporate governance,such mechanisms as decision-making,supervision,recruit,evaluation,incentive and constraint for key employees play a key role for public welfare performance.It is recommended to promote the hospital corporate governance reform from the above aspects.

Objective To study the role of HMGA2 in the occurrence and the progression of uterine leiomyomas.Methods Fifty cases of uterine leiomyomas who met the inclusion criteria(aged 30-50 years old,free from hormone at least for 6 months before surgery,no other diseases,postoperative pathological diagnosis as uterine leiomyoma) admitted to our hospital from January to July 2003 were studied.The expression of HMGA2 mRNA in uterine leiomyomas and neighbour normal myometrium was detected by ISH.Results HMGA2 mRNA was strongly expressed in 30 cases of uterine leiomyomas but not expressed in neighbour normal myometrium.There was no difference in HMGA2 mRNA between proliferative stage and progestational stage.Conclusion The increased expression of HMGA2 in uterine leiomyomas may be important in the occurrence and the progression of uterine leiomyomas.

Objective To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone(FSH) in polycystic ovarian syndrome (PCOS) patients. Methods Base on the ratio of LH/FSH,total 95 patients with PCOS were divided into two groups,including 49 cases in higher ratio group (LH/FSH≥2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay(ELISA). Ovarian sexual hormones,fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression. Results (1) AMH: the serum level of AMH were (7.2±4. 3) μg/L in higher LH/FSH group, (5. 2±3. 8) μg/L in normal LH/FSH group and (3.7 ±2. 2) μg/L in control group, which all reached significant difference among those 3 groups(P < 0. 01). (2) The correlation between AMH and biological metabolic index: estradiol (E2) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0. 318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0. 493,0. 362,0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0. 301), but negatively correlated with E2 (r = -0. 429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0. 428). Conclusion The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.

Objective To explore the relationship among resilience, general self-efficacy and coping styles of inpatients with tibia and fibula fracture. Methods Totally 104 inpatients with tibia and fibula fracture who met the conditions were investigated with General Self-Efficacy Scale, Connor-Davidson Resilience Scale and Medical Coping Modes Questionnaire. Results The total score of resilience with tibia and fibula fracture inpatient was 52.36 ± 9.56, which had a positive relationship with general self-efficacy and self-improvement coping style. Educational level, general self-efficacy, facing coping and yielding coping styles were influencing factors of resilience in patients with tibia and fibula fracture. Conclusions The level of resilience in patients with tibia and fibula fracture needs to be improved. Health care workers should pay attention to improve patient′s general self-efficacy, focus on patient′s coping styles and strengthen psychological health education of lower degree patients.

ObjectiveTo investigate the association between nucleotide polymorphisms ofGRIN3A gene and clinical characteristic of Kawasaki disease (KD) in children in Han population in central Chinese.MethodsA case-control study was performed. A total of 191 children with KD were recruited and 217 healthy children were served as controls. The distribution of SNP was determined by PCR-RFLP. Arterial lesions were detected by echocardiographic.ResultsThe distribution of three genotypes (CC, CG, GG) in SNP (rs7849782) was statistically difference between KD and control groups (P=0.034), and C allele was associated with KD susceptibility (OR=1.46, 95%CI: 1.10-1.92,P=0.007). In children with KD, the polymorphism of SNP loci was signiifcantly associated with oral mucosa lesions and coronary artery lesion (P<0.05), but not associated with conjuncti-val hyperemia, hand-foot edema, rash, and lymphadenopathy (P>0.05). The polymorphism of SNP loci was also associated with the levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (P<0.05).ConclusionThe ploymorphism of SNP loci ofGRIN3A gene (rs7849782) was associated with the susceptibility of KD. The C allele was the risk factors. The poly-morphism of SNP was associated with oral mucosa lesions and coronary artery lesion, and may affect the levels of ESR and CRP.

Objective: To analyze the correlation between third molar agenesis and craniofacial morphology by studying the location and number of congenital missing third molars and results of craniofacial cephalometric measurement. Methods: A total of 123 patients were included, including 64 patients in the control group without congenital third molar absence and 59 patients in the absence group with at least one third molar absent. Cephalometric measurements included FMA, IMPA, AR-Go, GoGn-Sn, Co-A, Co-Gn, ANS-Me, Go-Me, SN-MP, Ar-Go-Me, SNA, SNB, ANB, Y-axis angle, Y-axis length, Ar-Go, Go-Me, MP-OP, FH-PP, FH-OP, a total of 18 bone tissue indicators, U1-SN, U1-L1, U1-NA, L1-NB, U1-APo and L1-APo, a total of 6 dental indicators, and UL-EP, LL-EP and nasolabial angle, a total of 3 soft tissue indicators. The correlation between congenital agenesis of third molars and craniofacial morphology was analyzed. Results: The most common missing location of the third molar occured in the upper jaw and the most common number of missing teeth was one. In control group, Ar-Go-Me and SN-MP were larger (P<0.05), U1-SN, U1-NA, L1-NB, UL-EP and LL-EP were larger (P<0.05), and U1-L1 was smaller (P<0.01). There were no significant differences in Ar-Go and Go-Me between the two groups(P>0.05). Conclusion Patients with four third molars are more likely to have backward and downward rotation of the mandible and are more likely to develop into a convex facial type than patients with missing third molars, which has a higher correlation with hyperdivergent growth pattern and convex facial type.

Objective To investigate the serum levels of CD147 and MMP-2 and the relationship between these proteins and colorectal tumor differentiation, Dukes stage. Methods Serum levels of CD147 and MMP-2 in 44 patients with colorectal carcinoma,28 polyp intestinal patients and 36 normal subjects were measured by ELISA. Results Serum levels of CD147(103.59±40.74pg/ml)and MMP-2(14.92±2.02ng/ml)in the cancer patients were significantly higher than those of the polyp intestinal(66.27±16.91;10:96±1.71)and normal control(63.84±18.71;10.49±1.61)(P＜0.05).The levels were associated with tumor differentiation and Dukes stage. Patients with poor differentiation had significantly higher levels of MMP-2 than those of patients with well differentiation. And Dukes C and D stage tumors had significantly higher levels of CD147 than Dukes A and B stage tumors(P＜0.05).The levels of CD147 and MMP-2 declined remarkably after one month of radical operation. Conversely, it decreased illegibly after palliative operation. The serum levels of CD147were positively correlated with MMP-2 in patients with colorectal cancer. Conclusion Elevated CD147 and MMP-2 serum levels are associated with tumor differentiation, invasion, metastasis. Dynamic alterations of serum CD147 and MMP-2 may be used as the indicators of diagnosis, the choice of operative method and the judgment of prognosis in patients with colorectal cancer.