Objective To investigate the risk factors of wound healing 30 days after treatment in patients with pressure ulcer. Methods Two hundred and forty-five hospitalized patients with pressure ulcer between January 2015 and October 2016 were selected. They were divided into the healed group and the unhealed group 30 days after the treatment. The influencing factors 13 indexes including age, gender, edema, the number of diseases, the number of pressure ulcer, the size of pressure ulcer, PUSH score (Pressure Ulcer Scale Healing), hemoglobin, serum albumin, low density lipoprotein cholesterol and blood homocysteine underwent single factor and Logistic regression analysis. Results Single factor analysis of 12 indicators of risk factors affecting healing were age, Hb, Alb, Hcy, area of ulcer and PUSH scores of the 6 indicators in the regression equation (Z=3.11-6.63, All P < 0.01), gender also entered the regression equation (χ2=0.19, P<0.01);further multivariate regression analysis showed that there were statistically significant differences in PUSH score index (χ2=10.47, P<0.01, OR=0.001, 95%confidence interval were 0.001-0.037). Conclusions Age, gender, Hb, Alb, Hcy and PU area were the risk factors of pressure ulcer healing.

OBJECTIVE:To observe the clinical efficacy and safety of sodium hyaluronate combined with glucosamine in the treatment of knee osteoarthritis. METHODS:1 220 patients with knee osteoarthritis were randomly divided into observation group and control group. The patients in control group were treated with Sodium hyaluronate injection alone,once a week;while the ob-servation group was additionally and orally treated with Glucosamine hydrochloride capsules two tablets,three times a day. The course of treatment was 5 weeks in both groups. The relevant physicotherapeutics and oral medication in the treatment of the dis-ease should be stopped. The clinic efficacy,visual analog scale(VAS)and lysholm knee score before and after treatment,and inci-dence of adverse reaction were observed. RESULTS:Total effective rate of observation group was significantly higher than control group,with statistically significant difference(P<0.05). After treatment,VAS and lysholm knee scores in both groups were signifi-cantly lower than before,and observation group was lower than control group,with significant differences(P<0.05). There were no severe adverse reactions during treatment. CONCLUSIONS:Sodium hyaluronate combined with glucosamine has more signifi-cant clinical efficacy in the treatment of knee osteoarthritis than sodium hyaluronate alone,with good safety.

Objective To explore the relationship between the CHADS2 score and short-term prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation. Methods Consecutive ischemic stroke patients with nonvalvular atrial fibrillation who were hospitalized within 7 days after stroke were registered.Patients were divided into 3 groups on the basis of CHADS2 pre-stroke score (0 to 1,2,3to 6).And recovery was assessed by modified Rankin Scale (mRS) at 3 months follow-up (mRS ≤ 2reflected good prognosis,and mRS ≥ 5 implicated unfavorable outcome).After screening the risk factors affecting prognosis using univariate analysis,the relationship between CHADS2 score and prognosis was estimated using logistic regression model.Results Of 203 patients enrolled,the CHADS2 score of 0-1,2,3-6 were present in 72,53 and 78 respectively.Patients with the higher CHADS2 score had a higher initial NIHSS score (9.8,12.6,13.0,F =3.404,P =0.008 ),more likely to receive nosocomial pulmonary infection( 12.5％,34.0％,39.7％,x2 =14.643,P =0.001 ),negatively related to good prognosis (x2 =28.542,P =0.000 ) and positively related to unfavorable outcome ( x2 =23.575,P =0.000 ).Logistic regression model results suggested that CHADS2 score was an independent predictor of good prognosis and unfavorable outcome. Compared with CHADS2 score 3-6, CHADS2 score 0-1 was independently associated with good prognosis ( OR =5.018,95 ％ CI 2.055-12.560 ).And compared with CHADS2 score 0-1,CHADS2 score 3-6 was independently associated with unfavorable outcome ( OR =6.197,95％ CI1.670-22.996 ).Conclusions CHADS2 pre-stroke score appears to be useful in prediction of stroke outcome for patients with nonvalvular atrial fibrillation.After acute ischemic stroke,the patients with the lower CHADS2 score (0-1) are more likely to achieve good prognosis,inversely,the patients with the higher CHADS2 score (3-6) are more likely to achieve unfavorable outcome.

Background: The side effects of glucocorticoid in treatment of systemic lupus erythematosus (SLE) have been the focus of debate, and our preliminary study indicates that ginsenosides can enhance the efficacy of dexamethasone. Objective: To observe the effects of ginsenosides combined with prednisone in SLE patients. Design, setting, participants and interventions: A total of 60 SLE patients from Department of Rheumatology and Immunology, Changhai Hospital, Second Military Medical University, were randomly divided into treatment group and control group, with 30 patients in each group. Patients in the treatment group were given routine treatment with prednisone plus ginsenosides, while those in the control group were given routine treatment with prednisone plus placebo. They were all treated for 3 months. Main outcome measures: After three-month treatment, syndrome score in traditional Chinese medicine (TCM), total response rate and symptom improvement rate were measured and evaluated. Results: Twenty-eight cases in treatment group and twenty-seven cases in control group were included in analysis. The total response rates in the treatment group and control group were 89.28% and 66.67% respectively, and there was a significant difference between the two groups (P<0.05). After treatment, the TCM syndrome scores in the two groups were lower than those before treatment (P<0.01), and prednisone plus ginsenosides was better in decreasing the TCM syndrome score than prednisone plus placebo (P<0.05). The symptoms were improved in the treatment group as compared with the control group (P<0.05). Conclusion: Prednisone combined with ginsenosides can increase the clinical effective rate and improve the clinical symptoms of SLE patients.

Objective To analyze the correlation between clinical features and renal dysfunction in patients of acute lacunar infarction with progressive cerebral microbleeds (CMBs). Methods Two hundred and sixty-five patients with first-episode acute lacunar infarction were selected. The serum creatinine was measured within 24 h of admission and the estimated glomerular filtration rate (eGFR) was calculated. The brain MRI (including gradient-echo images) was examined within 2 d of admission and after 1 years of follow-up, respectively. The progressive CMBs was assessed with microbleeds anatomical rating scale (MARS), and the patients were divided into progressive CMBs group (progressive group, 42 cases) and non progressive CMBs group (non progressive group, 223 cases). The clinical features of 2 groups were compared and the correlation between progressive CMBs and renal dysfunction was analyzed. Results The age, 24 h pulse pressure, incidences of renal dysfunction and CMBs in progressive group were significantly higher than those in non progressive group: (69.8 ± 5.8) years vs. (61.5 ± 4.9) years, (63.3 ± 3.1) mmHg (1 mmHg=0.133 kPa) vs. (51.8 ± 4.2) mmHg, 69.0％(29/42) vs. 39.9％(89/223) and 57.1％(24/42) vs. 25.1％(56/223), and the platelet was significantly lower than that in non-progression group:(168 ± 35) ×109/L vs. (189 ± 40) ×109/L, and there were statistical differences (P<0.05 or<0.01). The Logistic regression analysis result showed that renal dysfunction and CMBs were Independent risk factors of progressive CMBs (OR = 1.571 and 1.054, 95％ CI 1.042 - 2.493 and 1.010 - 1.142, P<0.05). Conclusions The rate of renal dysfunction is higher in patients of acute lacunar infarction with progressive CMBs, and progressive CMBs are associated with renal dysfunction.

Objective:To explore the influence of total alkaloids of Corydalis Ochotensis(TAOCO) on the behavior and pathomorphology of brain tissue of the rats with Alzheimer's disease(AD) induced by β-amyloid protein 25-35(Aβ25-35),and to clarify its therapeutic effects on the AD rats.Methods:The Wistar rats were divided into mormal control group(treated with 0.5 mL·100 g-1 distilled water) (n=9),model group(treated with 0.5 mL·100 g-1 distilled water)(n=9),positive drug group(treated with 1.75 mg·kg-1 donepezil hydrochloride)(n=9),and low,middle and high doses (treated with 2.0,4.0 and 8.0 mg·kg-1) of TAOCO groups(n=8,n=9,n=9).The rat AD models were made by injecting Aβ25-35 into hippocampus.On the 14th day after operation,the rats were administered for 7 d.Morris water maze test was used to detect the spatial learning and memory ability of the rats;dark avoidance task was used to observe the passive avoidance ability of the rats;the pathomorphology of the cerebral cortex and hippocampus of the rats were detected.Results:The Morris water maze test results showed that compared with model group,the latency to platform of the rats in low dose of TAOCO group was decreased on the 4th and 5th days(P<0.05);the latency and swimming distance to reach the platform of the rats in middle dose of TAOCO group were decreased on the 5th day(P<0.05),and the starting angle of the rats was reduced on the 3th day(P<0.05);the latencies to reach the platform of the rats in high dose of TAOCO group were decreased on the 2nd and 5th days(P<0.05),and the starting angle of the rats was decreased on the 6th day(P<0.01).Compared with model group,on the 7th day,the time of staying on platform,distance of staying on platform,time of staying on platform/total time,distance of staying on platform/total distance of the rats in different doses of TAOCO groups were all increased significantly(P<0.05) within 1.5 min.Compared with model group,the times of crossing platform and time of staying in effective area of the rats in low and high doses of TAOCO groups were significantly increased(P<0.05).The dark avoidance task results showed that compared with model group,the error latencies and the error times of the rats in different doses of TAOCO groups had no significant differences on the 2nd day(P>0.05).Compared with model group,there was no obvious improvement of the cerebral cortex and hippocampus injury of the rats in low and middle doses of TAOCO groups.In high dose of TAOCO group,the cerebral cortex and hippocampus injury of the rats were significantly improved.Conclusion:TAOCO can improve the learning and memory function of the AD rats and reduce the pathological injury of brain tissue of AD rats.

Objective To investigate the relationship between different topographic locations and neurological deteriorations (ND) in patients with acute new isolated pontine infarction.Methods One hundred sixty-eight patients with acute new isolated pontine infarction during arch 2012 to March 2016 were identified by diffusion weighted imaging (DWI) for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:The upper,middle,and lower ones,and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 168 patients,26.8％ (45/168) were diagnosed with ND,and 73.2％ (123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio [62.2％ (28/45) vs 41.5％ (51/ 123)],smoking ratio [13.3％ (6/45) vs 26.0％ (32/123)],mean length of hospital stay [(22.83 ± 7.12)d vs (19.31 ± 7.65)d],ratio of worse short-term clinical outcomes [77.8％ (35/45) vs 33.3％ (41/123)],and ratio of lower pontine infarction [55.6％ (25/45) vs 26.0％ (32/123)] between two groups (P ＜ 0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (OR =1.953,95％ CI:1.092-3.535,P =0.029).Conclusions Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.

Objective To investigate the effects of post-operative analgesia with oxycodone or morphine for patients undergoing colon cancer radical surgery on platelet activation and cellular immunity.Methods Forty colon cancer patients scheduled for radical surgery, 23 males and 17 females, ASA physical status Ⅰ or Ⅱ, were randomly divided into 2 groups (n=20 each): oxycodone group (group O) and morphine group (group M).Patient-controlled intravenous analgesia (PCIA) was used for post-operative analgesia.PCIA solution contained oxycodone 1 mg/kg and tropisetron 6 mg in 100 ml normal saline in group O or morphine 1 mg/kg and tropisetron 6 mg in 100 ml normal saline in group M.Blood samples were obtained from the patients at 5 min before anesthesia induction (T0), 4 h after surgery (T1), 24 h after surgery (T2) and 48 h after surgery (T3).The levels of glycoprotein (GP)Ⅱb/Ⅲa, P-selection (CD62P), natural killer (NK) cells, NKT cells, and natural Treg (nTreg) cells were detected.The platelet aggregation rate (PAR) was determined.Results Compared with T0, the levers of GPⅡb/Ⅲa, CD62P, PAR and nTreg cells were significantly higher at T1 in group O and at T1, T2 in group M (P<0.05).Compared with T0, the levels of NK and NKT cells were decreased significantly at T1 in group O and at T1-T3 in group M (P<0.05).The levels of GPⅡb/Ⅲa, CD62P, PAR and nTreg cells at T2 and T3 in group O were decreased significantly as compared with group M (P<0.05).The levels of NK cells, NKT cells at T2 and T3 in group O were significantly higher than those in group M.Conclusion Post-operative analgesia with oxycodone for patients undergoing colon cancer radical surgery exhibits a more significant effect of decreasing platelets activity and presents a less disturbance on cellular immunity as compared with morphine.

Objective To evaluate the effects of sevoflurane on invasion and migration of mouse lung cancer cells induced by hypoxia.Methods Mouse Lewis lung cancer cells were inoculated in the culture plate.After being cultured for 24 h,the cells were randomly divided into 3 groups (n=18 each) using a random number table:control group (group C),hypoxia group (group H) and hypoxia+ 2％ sevoflurane group (group HS).Cells were exposed to 95％ air-5％CO2 (2 L/min) for 4 h in group C.Cells were exposed to 94％ N2-5％CO2-1％ O2 for 4 h in group H.In group HS,cells were exposed to 2％ sevoflurane and 94％ N2 (2 L/min) for 4 h.The invasion of cells was determined by Transwell assay,and the invaded cells were counted.The migration of cells was evaluated by wound healing assay,and cell migration rates were calculated.The expression of Beclin 1 and LC3 Ⅱ protein in cells was detected by Western blot.Results Compared with group C,the number of invaded cells and cell migration rates were significantly increased,and the expression of Beclin Ⅰ and LC3 Ⅱ was up-regulated in H and HS groups.Compared with group H,the number of invaded cells and cell migration rates were significantly decreased,and the expression of Beclin 1 and LC3 Ⅱ was down-regulated in group HS.Conclusion Sevoflurane can inhibit the invasion and migration of mouse lung cancer cells induced by hypoxia,and inhibition of autophagy is involved in the mechanism.

Objective:To observe the efficacy, median progression-free survival (PFS) and adverse reaction induced by rh-endostatin injection (Endostar) plus platin-based chemotherapy for advanced non-small cell lung cancer (NSCLC).Methods:Fifty five histologically or cytologically confirmed advanced NSCLC patients received Endostar combined with platin-based chemotherapy for more than 2 cycles. The evaluated parameters included PFS, response rate (RR), clinical benefit rate (CBR) and adverse reaction. Results:Of the 51 patients who can be evaluated for response, 15 (29.4%) achieved partial response (PR), 27 (52.9%) had stable disease (SD), 9 (17.6%) had progressive disease(PD), no patient had complete response(CR). The overall RR was 29.4% (15/51) and CBR was 82.4% (42/51). The median PFS was 6.3 months. There were no significant differences in the short-term efficacy and PFS between the patients who had different pathological features (P=0.037), those had naive or relapsed diseases (P=0.101), or those received different chemotherapeutic regimens (P=0.232). The total white cells and platelets decreased by 72.7% and 54.5%, respectively. The frequency of grade Ⅲ or Ⅳ neutropenia and thrombocytopenia were 36.4% (20 caces) and 21.8% (12 cases), respectively. Four patients stopped the therapy for adverse reaction. One died of gastrointestinal hemorrhage; one had uncontrolled grade Ⅲ hypertension; one had superventricular arrhythmia; one had grade Ⅳ hepatic dysfunction. Conclusion:The combination of Endostar and platin-based chemotherapy increased the CBR and prolonged the PFS of the patients with advanced NSCLC. The toxicities were tolerable.