[Objective] To evaluate the clinical efficiency of refratory edema based on daytime prelonged Online-HDF.[Methods] Six patients include four females and two males whose age ranging from 28 to 74 years old and average 55 years old.Online-HDF treatment for 3-9 times,vascular access was percutaneous femoral or internal jugular catheterization.One patient's temporary access was changed to permanent access because who needed continous hemodialysis.The machine version was Ganbro AK-100S.To filter by u2000 and replace fluid online for 6-10 hous,blood flow was 200-250ml/min,uf 1200-8600,the total fluid used for replacement was 20-42 liter,during the process,regular heparin or low molecular was used for anticoagulation.[Results]Three patients' clinical symptoms resulted from edema resolved,one patient accepted continous hemodialysis treatment for inpaired kidney function,one patient left hospital for expensive medical cost,one patient accepted ventilation treatment for respiratory failure in ICU.[Conclusion]Daytime prelonged Online-HDF is effective on the trentment of refratory edema,especially effective on dyspnea,tachypnea,chest distress that resulted from edema.

0.05),while the activities of SOD of bone tissue were lower(P

Objective:To study the gene regulatory network during the osteogenic differentiation process of dental follicle stem cells (DFSCs)with bioinformatic analysis.Methods:The differentially expressed genes during the osteogenic diffrentiation process of DF-SCs were selected from the GEO Datasets.Then the relationship among the genes were analysed using DAVID and GeneMANIA data-base.Results:Numerous differentially expressed genes during the osteogenic differentiation process of DFSCs were obtained,289 genes with significance of different expression(P <0.05)were enriched into “cell differentiation”,“cell proliferation”,“skeletal sys-tem development”and “calcium signaling pathway”subgroups.ALPL,CTSK,TUFT1 ,TGFBR2,FHL2,ROR2,STC1 ,POSTN, ZBTB1 6,FRZB,PRELP and IGFBP5 were enriched into the “skeletal system development”subgroup.The 1 2 genes exhibited interac-tions,including co-expression,co-localization,genetic interaction and signal pathways.Conclusion:There is a complex molecular regulatory network among the differentially expressed genes during the osteogenic differentiation process of DFSCs.It is necessary to an-alyse the osteogenic differentiation process of DFSCs as a whole from WNT,TGFbeta,MAPK siganal pathyways,Homeobox transcrip-tion factors and osteogenic differentiation marker genes.

Objective To study the method of preparation and blood sugar lowering effect of oral chitosan-insulin nanoparticles (INS-NPs) in streptozotocin-induced diabetic Wistar rats. Methods The INS-NPs were prepared by an ionic gelation method. The changes in the morphology and size of the INS-NPs were observed with transmission electron microscope and Zetasizer 3000HS, respectively. The blood sugar lowering effect of the INS-NPs was evaluated by monitoring the blood glucose levels in healthy and streptozotocin-induced diabetic rats. Results INS-NPs were spherical in shape with a mean size of 220.6±15.9nm. Entrapment efficiency of INS-NPs was 75.4%±3.2% and the loading efficiency of INS-NPs was 19.5%±2.6%. In vivo blood sugar lowering study showed that the levels of blood glucose of healthy Wistar rats were significantly reduced from 6h to 12h after oral administration of INS-NPs(25U/kg). The blood glucose level of diabetic rats were significantly reduced at 6h after oral administration of INS-NPs (25U/kg), and this effect was maintained for more than 9h, and the levels of blood glucose were kept in normal range for 7h. Conclusion The INS-NPs prepared by ionic gelation method has the blood glucose lowering effect in streptozotocin-induced diabetic Wistar rats.

Objective: To analyze the drinking practice of people in China. Method: The data of 2002 China National Nutrition and Health Survey was used for this study. 159 117 subjects aged 15 years and over were involved. The information on drinking practice was collected using interview-administrated questionnaire. Results: The overall current drinking rate of people in China was 21.0%, 39.6% for male and 4.5% for female, respectively. The current drinking rates in urban and rural areas were 20.9% and 21.0%, respectively. The 45 to 59 years age group reached the highest. The rate of onset age of drinking younger than 18 years old was 8.8% in current drinkers. 39.9% male and 29.5% female current drinkers drank at least once a day. Distilled spirits was the first choice for 50.3% current drinkers. 58.2% male drinkers and 77.3% female drinkers consumed 100-150g and 50-100g distilled spirits, respectively. Conclusion: Alcohol drinking has become a public health problem in China, it is necessary to carry out further surveys to reveal the influencing factors.

Objective To investigate the effects of intervertebral bridging ossifications in patients of osteoporotic vertebral compression fracture (OVCF) on bone fracture healing.Methods A total of 170 patients of thoracolumbar vertebral endplate fracture who were admitted into our hospital were selected.Divided these patients into the observation group,namely 60 patients with nonunion of vertebral endplate after 3 months of conservative treatment,and the control group, including 110 patients with well healed vertebra after 3 months of conservative treatment.Compared the distribution of intervertebral bridging ossifications of the two groups 3 weeks after injury.Results The incidence of bridging ossification at levels of T9 to T10,T10to T11,T11to T12 in the observation group were significantly higher than that in the control group.And it showed a significantly higher incidence of bridging ossification at the second proximal intervertebral segment in the observation group than that of the control group.There was a significantly greater sagittal wedge angle in the observation group compared with the control group.Conclusion Conservative treatment may increase the risk of nonunion of osteoporotic vertebral compression fractures when there is a bridging ossification at the second proximal intervertebral level or the sagittal wedge angle was greater than 14.2°in a fresh osteoporotic vertebral compression fracture.It should be a careful choose whether to take conservative treatment or surgical intervention.

BACKGROUND:Three-dimensional visualization technique has been widely used in clinical treatment. Preoperative visualization technique al ows safe demonstration on the complex spine fracture models, and also prepare screw placement scheme according to three-dimensional model of patients.
OBJECTIVE:To discuss the clinical result of treating short-segment lumbar vertebrae fracture with pedicle screw visualization.
METHODS:A total of 32 patients with lumbar vertebrae fracture were treated with 182 pedicle screws. Before the screw implantation, the structure of bilateral pedicle was observed using Mimics software and the implantation parameters were measured. The operation methods and related complications were told to the patients through the reconstructed three-dimensional images. The satisfaction of the patients, operation time, and the position of pedicle screws by postoperative CT scan were assessed. The percentages of anterior vertebral height and Cobb’s angle were measured before operation, 2 weeks after operation and 8 months after operation.
RESULTS AND CONCLUSION:The excellent satisfaction rate of the patients was 100%, the mean operation time was 185 minutes, and 173 pedicle screws (95.1%) were total y inserted within the pedicle. Al patients were fol owed up for 7-22 months. The results showed that the fracture healed wel . The percent of anterior vertebral height and Cobb’s angle at 2 weeks after operation were significantly decreased compared with them before operation (P<0.05). There were no significant difference about the percent of anterior vertebral height and Cobb’s angle between 2 weeks and 8 months fol ow-up (P>0.05). Single-segment lumbar vertebrae fracture was wel treated by the pedicle screw visualization technique. This method assists to make up preoperation plan, increase the rate of patients’ satisfaction, shorten operation time, and increase the accuracy of pedicle screw insertion.

Objective To investigate the correlation of plasma interleukin ( IL)-17 level and IL-17 receptor (IL-17R) expression in the thymus of patients with myasthenia gravis (MG).Methods The blood samples of 63 patients (38 with glucocorticoid treatment, 25 with thymus removal) who admitted to Henan Provincial People′s Hospital between 2010 and 2014 were collected at three different stages: pre-treatment, 1 week post-treatment and 1 month post-treatment.The blood samples of 42 healthy controls were also collected.Enzyme linked immunosorbent assay was used to evaluate the levels of IL-17 in plasma.Twenty-five thymus tissues from MG patients and another 12 thymus tissues from patients with congenital heart disease who had surgery therapy were also collected.Reverse transcription polymerase chain reaction was used to evaluate the mRNA levels of IL-17R.The possible correlation between the expression of IL-17 and IL-17R with MG was analyzed.Results Before treatment, the levels of IL-17 in the plasma were much higher in all the MG patients ( both ocular and generalized) when compared to the healthy controls ( controls (3.2 ±0.7) pg/ml, MG patients (8.5 ±1.7) pg/ml, t =2.450, P <0.01; generalized type patients (9.7 ±1.4) pg/ml, t =2.532, P <0.01).In the patients with glucocorticoid treatment, IL-17 levels began to reduce after 1 week treatment and a statistically significant difference was found when compared to the pre-treatment samples (pre-treatment (8.3 ±1.2) pg/ml, 1 week after treatment (6.3 ±0.7) pg/ml, t=2.052, P<0.05) and healthy controls (t =1.933, P<0.05).One month after the glucocorticoid treatment, the levels of IL-17 decreased to the normal level (1 month after treatment (3.9 ±0.6) pg/ml, t=2.630, P <0.01, compared to the pre-treatment; t =1.395, P >0.05, compared to the healthy controls).In the surgery therapy cases, the IL-17 levels were also reduced after the thymus removal ( pre-surgery (8.8 ±1.4) pg/ml, 1 week after surgery (5.3 ±0.7) pg/ml, t=1.950, P<0.05;1 month after surgery (3.0 ±0.4) pg/ml, t=2.683, P<0.01).In the thymus tissues of the MG patients, the mRNA levels of IL-17R were much higher than that of the controls ( relative level 2.31 folds, t =2.682, P <0.01).Meanwhile, a positive correlation was found between the plasma IL-17 levels and the relative IL-17R levels in thymus tissues ( r =0.945 4, P <0.01 ).Furthermore, IL-17 was positively correlated with quantitative myasthenia gravis scores (QMGS) either pre-treatment (r =0.798 1, P <0.01) or post-treatment (r=0.906 5, P<0.01).And IL-17R was positively correlated with QMGS pre-treatment (r=0.775 5, P<0.01).Conclusions IL-17 is increased in the plasma of MG patients (both ocular and generalized) , and is decreased upon the glucocorticoid treatment or surgery therapy, suggesting that it can be used as a parameter to determine the therapeutic effects.IL-17R is increased in the thymus tissues of MG patients, suggesting that it can potentially be used as a pathological diagnosis parameter.

Objective To investigate the effect of dexmedetomidine on postoperative cognitive function in elderly patients undergoing general anesthesia.Methods A total of 100 elderly patients undergoing elective surgery were enrolled.The patients were randomly divided into observation group and control group,with 50 patients in each group.The observation group was given dexmedetomidine + 0.9％ sodium chloride injection before induction anesthesia.The control group was given 0.9％ sodium chloride injection.The remaining anesthesia induction and maintenance time were same in the two groups.The cognitive function and postoperative cognitive dysfunction(POCD) were evaluated by MMSE scale.The blood pressure and heart rate before and after operation and at the end of the operation,the levels of serum tumor necrosis factor α(TNF-α) before operation,at the end of the operation and postoperative 3,7 days were measured.Results At postoperative 1 day and 3 days,the MMSE scores of the observation group were (24.6 ± 0.7) points and (27.2 ± 1.1) points,respectively,which were significantly higher than those of the control group [(22.4 ± 0.6) points,(27.2 ± 1.1) points,t =3.64,3.97,all P ＜ 0.05].And 6 cases in the observation group occurred cognitive dysfunction,which was significantly lower than 20 cases of the control group (x2 =5.38,P ＜0.05).At the end of the operation and postoperative 3 days,the serum levels of TNF-α in the observation group were (28.52 ± 3.73) ng/L,(28.82 ± 4.13) ng/L,respectively,which were significantly lower than those in the control group[(37.14 ± 3.62) ng/L,(38.27 ± 3.47) ng/L,t =5.21,4.89,all P ＜ 0.05].At the beginning of the operation,the systolic blood pressure,diastolic blood pressure,heart rate of the observation group were (124.53 ±3.84) mmHg,(79.32 ± 4.38) mmHg,(70.45 ± 5.32) times/min,respectively,which were significantly lower than those of the control group [(145.36 ± 4.72) mmHg,(93.17 ± 3.82) mmHg,(86.79 ± 4.26) times/min],the differences were statistically significant(t =5.83,4.97,4.58,all P ＜ 0.05).Conclusion In the elderly patients undergoing general anesthesia,the use of pumped dexmedetomidine has little effect on the postoperative cognitive function.The mechanism may be related to stabilizing the blood flow dynamics,decrease the high expression of TNF-α,which is worthy of clinical application.

Objective: To understand the gender disparity and influencing factors for in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) at secondary hospitals in China. Methods: A total of 5525 in-hospital STEMI patients from 99 secondary hospitals of 15 provinces or autonomous regions between 2011-09 to 2014-06 were recruited including 1649 female and 3876 male. The in-hospital mortalities were compared between 2 genders and the relevant inlfuencing factors were studied by multiple Logistic regression analysis. Results: There were about 29.8% female and 70.2% male STEMI patients were studied. The in-hospital mortalities in female and male were 13.2% and 5.9%,P<0.01; gender disparity was obviously existing regardless of age, history of MI, hypertension and diabetes mellitus. The mortality in female was higher than male even without diseases history and cardiovascular risk factors. Compared with male gender, female patients were usually having elder age and likely complicated with cardiovascular risk factors; they were with lower incidence to receive ECG, drug therapy and thrombolysis within 10 minutes of admission. With adjusted confounding factors, multiple regression analysis presented that female STEMI patients had the higher mortality than male (OR:1.7, 95% CI:1.4-2.0). Conclusion: The in-hospital mortality for STEMI patients was higher in female than male at secondary hospitals in China. Female patients were usually having elder age, complicated with more cardiovascular risk factors, while with less chances to receive ECG, drug therapy and thrombolysis within 10 minutes of admission.