Objective To discuss nicardipin′s influence on post operation cognitive dysfunction (POCD) in senior patient after hip joint replacement operation.Methods 180 senior patient, who received selective unilateral hip joint replacement operation between October 2015 and October 2016 under the condition of combined spinal-epidural anesthesia (CSEA) were randomly divided into Group A (with nicardipine) and Group B (without nicardipine).Nicardipine was only appropriately pumped into vein in time in Group A.MAP was observed and recorded 30 minutes after starting the operation and at the end of the operation.Mini-mental state examination (MMSE) was applied to score the patient one day before, one day, three days and five days after operation, and the number of POCD was recorded.Results Compared with Group B, Group A was obviously lower in MAP level (P<0.05) after 30 minutes.MMSE score of Group A was obviously higher (P<0.01) one day after operation.The number of POCD in Group A was 8 (8.89%) significantly lower than than that of Group B (19, 21.11%).Conclusion Nicardipine could maintain hemodynamic stability of senior patients receiving selective unilateral hip joint replacement operation under the CSEA and prevent POCD to a certain extent.

Objective To understand the situation of iodine deficiency disorders of Cangzhou city, Hebei province, in order to provide the scientific basis for prevention and control of iodine deficiency disorders. Methods From 2007 to 2009, dynamic monitoring of iodine deficiency disorders was carried out in low iodized salt coverage places Hejian city and Xian county. Nine towns were randomly chosen in each county, 4 administrative villages were randomly selected in each town, 8 household salts were tested in each village. Every year, 1 - 3 copies of residents water samples were collected for determination of iodine; more than 100 students age 8 - 10 years old were checked the situation of goiter and urinary iodine, more than 40 students selected were measured iodine content of salt from their home; more than 50 women of childbearing age 18 - 40 years were tested of urinary iodine. Thyroid was examined with palpation; water iodine and urine iodine concentration were measured with arsenic-Ce catalytic spectrophotometry; salt iodine was detected by direct titration. Results From 2007 to 2009,median household salt iodine were 4.3,15.9,3.6,18.4,4.6,11.7 mg/kg in Hejian city and Xian county, respectively,iodized salt accounted for 34.03% (98/288), 78.82% (227/288), 29.86% (86/288), 84.72% (244/288), 37.15%(107/288),49.31% (142/288), respectively, the consuming rate of iodized salt were 27.08% (78/288),36.46%( 105/288 ), 28.13% (81/288 ), 49.31% ( 142/288 ), 37.15 % ( 107/288 ), 30.90% ( 89/288 ), respectively. Ten samples of drinking water were tested, water iodine were 5.5 - 34.4 μg/L. From 2007 to 2009, the goiter rate of students aged 8 - 10 years old was below 5%, the median of urinary iodine were 138.1,176.6,112.0 μg/L, ＜ 100 μg/L ratio were 31.6% ( 65/206 ), 25.0% ( 52/208 ) and 44.4% (91/205 ). The median of urinary iodine of child-bearing age women were 167.3,164.2,78.1 μg/L, ＜ 100 μg/L ratio were 28.7%(29/101 ), 19.2%(20/104) and 60.0%(60/100).Conclusions In areas with low coverage of iodized salt, iodine nutrition level are affected, the child-bearing age

Objective To investigate the efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin versus cisplatin for patients with middle-advanced stage uterine cervical carcinoma.Methods 180 patients with middle-advanced stage uterine cervical carcinoma were randomized into concurrent chemoradiotherapy with nedaplatin group (nedaplatin group) and concurrent chemoradiotherapy with cisplatin group (cisplatin group).The short-term efficacy and the toxicity were observed.Results In the nedaplatin group,the short-term response rate、the one-year relapse-free surviva l、one-yea metastasis-free survival、the two-year relapse-free survival、the two-year metastasis-free survival were 98.85％、89.66、86.21％ 、85.06％ 和 80.46％,But in the cisplatin group,the short-term response rate 、the one-year relapse-free surviva l、one-yea metastasis-free survival、the twoyear relapse-free survival、the two-year metastasis-free survival were 97.60％ (x2 =3.07,P ＞ 0.05) 、81.93％(x2 =3.07,P ＞0.05) 、83.13％ (x2 =0.31,P ＞0.05) 、78.31％ (x2 =1.30,P ＞0.05) 和 80.72％ (x2 =0.00,P ＞ 0.05),so there was no significant difference.The incidences of nausea and vomiting in the cisplatin group were 52.27％ (grade Ⅰ ～ Ⅳ toxicities),12.50％ (grade Ⅲ ～ Ⅳ toxicities),which were higher than those in the nedaplatin group 27.27％ (grade Ⅱ ～ Ⅳ toxicities),6.82％ (grade Ⅲ ～ Ⅳ toxicities) (P ＜ 0.05),while there were no significant difference in the other toxicities such as anemia,granulocytopenia,thrombocytopenia,diarrhoea between the two groups (x2 =12.18,P ＞ 0.05).Conclusion The efficacy of concurrent chemoradiotherapy with nedaplatin is the same as that of concurrent chemoradiotherapy with cisplatin,and its toxicity is well-tolerated.

Objective To observe the expression of P21 and CDK6 in cervical squamous cell carcinoma,and to investigate the relationship between their expression and cervical squamous cell carcinoma.Methods The expression of CDK6 and P21 in 100 cases of cervical squamous cell carcinoma,20 cases of cervical CIN lesions and 20 cases of normal cervical tissues were detected by immunohistochemical ABC method,and the relationship between them and tumor differentiation,invasion depth,lymph node metastasis and clinical stage were analyzed.Results The expression rates of P21 and CDK6 in cervical squamous cell carcinoma tissues were significantly higher than those in CIN lesions and normal cervical tissues;The low expression of P21 was associated with the depth of tumor invasion,lymph node metastasis and clinical stage (P＜0.05),and was not associated with the degree of tumor differentiation (P＞0.05);The high expression of CDK6 was associated with tumor differentiation,invasion depth,lymph node metastasis and clinical stage (P＜0.05).Conclusion The abnormal expression of P21 and CDK6 may play an important role in the occurrence and development of cervical squamous cell carcinoma,and the two may have a certain significance in the prognosis of cervical squamous cell carcinoma.

OBJECTIVETo investigate the clinical effects and prevent the complications of posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure.

METHODSFrom 2008 January to 2011 December, 17 patients with cervical anterior internal fixation failure were treated with posterior and anterior decompression and internal fixation. There were 12 males and 5 females, aged from 26 to 68 years old with an average of 44.1 years. The lower screw loosening was found in 6 cases, the upper screw loosening in 5 cases, titanium mesh caving in 3 cases, the upper screw breakage in 2 cases, the lower screw breakage in 1 case. Informations of bone fusion were observed by X-ray, CT, MRI. Clinical effects were evaluated by modified JOA score.

RESULTSAll the revision operations were successfully completed. One case with poor blood coagulation function before operation resulted in postoperative hematoma and occurred neurological symptoms; after hematoma removal and fresh frozen plasma infusion later, neurological symptoms of the patient disappeared. All patients were followed up from 6 to 38 months with an average of (22.4±10.0) months. Postoperative at 2 weeks, 3 months, and final follow-up, JOA score had obviously improved and respectively was 13.1±1.6, 13.4±1.6, 14.2±1.5. All internal fixation locations were good after revision,and obtained bone fusion at 10 months after operation, with an average fusion time of 6 months.

CONCLUSIONThe combined posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure is safe, can achieve thoroughly decompression, maintain the cervical curvature, reconstruct the three column stability, and it may be used for the patients of cervical anterior fixation failure.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

Objective To observe the efficacy and toxicities of RF transparent heating (RTH) combined with transcatheter hepatic arterial chemoembolization (TACE) in the treatment of advanced primary hepatic carcinoma. Methods In a randomized manner, 69 patients with advanced primary hepatic carcinoma were divided into two groups: study group (TACE+RTH) 34 cases and control group (TACE alone) 35 cases, the control group were treated with DDP 80mg, FU 1000mg and E-ADM 60mg, E-ADM was used with iodized oil embolism 10ml. Results The total effective rate in the near future were 70.59% and 45.71%, the overall survival rates of 0.5, 1.0, 1.5, 2.0 years were 82.35%, 73.53%, 58.82%, 38.24% in study group and 74.29%, 75.14%, 45.71%, 22.86% in control group, respectively. Toxicities were similar comparing with the two groups. Conclusions RTH combined with TACE in the treatment of advanced primary hepatic carcinoma is better than TACE alone, at the same time TACE +RTH method is no increasing toxicity and is an effective safe combined one.

This study was performed to investigate the chemical constituents in the twigs and leaves of Harrisonia perforate. Six compounds were isolated from the 95% EtOH extract of the twigs and leaves of Harrisonia perforate by silica gel, ODS, Sephadex LH-20 column chromatographies and preparative HPLC. On the basis of chemical properties and spectra data, these compounds were identified as harriperfin E (1), kihadanin A (2), kihadanin B (3), 6α-acetoxyobacunol acetate (4), gardaubryone C (5), and β-sitosterol methyl ether (6), respectively. Compound 1 is a new chromone, and compounds 2-6 are isolated from this plant for the first time.

OBJECTIVESTo investigate the influence of combined thoracoscopic and laparoscopic esophagectomy for early postoperative pulmonary function, and to study the relative factors for postoperative pulmonary complications.

METHODSFrom September 2009 to December 2010, 61 patients with esophageal cancer had undergone esophagectomy surgery, of which 32 patients had undergone combined thoracoscopic and laparoscopic esophagectomy (CTLE group), and 29 patients had undergone open three-field esophagectomy (open group). Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)) were measured on the 1(th) preoperative day, 5(th) and 10(th) postoperative day, and arterial blood gas analyses were performed during the same period. Meanwhile, pain scores and other potentially relevant factors were recorded as well.

RESULTSPreoperative pulmonary function and arterial blood gas analysis, including FEV(1)%, FVC%, PaO2 in two groups had no significant difference (t = -1.608 to 0.709, P = 0.113 to 0.481). On the 10(th) postoperative day, FEV(1)%, FVC%, PaO2, and SaO2 of two groups were significantly different (FEV(1)%: 77% ± 17% vs. 53% ± 13%, t = 6.241, P = 0.000; FVC%: 78% ± 13% vs. 57% ± 16%, t = 5.549, P = 0.000; PaO2: (87 ± 9) mmHg vs. (79 ± 14) mmHg, t = 2.477, P = 0.017; SaO2: 96% ± 3% vs. 94% ± 2%, t = 2.313, P = 0.024; 1 mmHg = 0.133 kPa). Pain score of CTLE group was lower than open group, and the scores of two groups had significant difference before the 5(th) day after surgery (t = -4.398 to -1.815, P = 0.000 to 0.049). Postoperative pulmonary complications of CTLE group was lower than open group (6/32 vs. 12/29, χ(2) = 3.745, P = 0.049).

CONCLUSIONSCombined thoracoscopic and laparoscopic esophagectomy has advantages on early postoperative pulmonary function. It can relatively reduce the incidence of pulmonary complications after surgery.

Aged ; Esophageal Neoplasms ; physiopathology ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Laparoscopy ; Lung ; physiopathology ; Male ; Middle Aged ; Postoperative Complications ; Postoperative Period ; Respiratory Function Tests ; Thoracoscopy

OBJECTIVETo investigate the feasibility and efficacy of neoadjuvant chemoradiotherapy followed by combined thoracoscopic and laparoscopic esophagectomy (CTLE) in the treatment of advanced esophageal carcinoma.

METHODSFrom June 2011 to February 2012, 11 patients with locally advanced esophageal carcinoma underwent neoadjuvant chemoradiotherapy followed by CTLE (clinical stage IIB-IIIA). NP (vinorelbine pin and cisplatin) or TP (program paclitaxel-pin and cisplatin) were applied as preoperative chemotherapy. During the same period, conventional fractionated radiotherapy was used with the radiation dose of 40 Gy/20 F. At four to six weeks after CRT, 11 patients received three-incision CTLE.

RESULTSDuring chemoradiation, 9 patients developed bone marrow suppression. The interval between completion of chemoradiation and surgery was (49.6±15.4) d. Intraoperative findings revealed local fibrosis in one patient (75 days after chemoradiation) while operative difficulty was not increased in the remaining 10 patients. Compared to 15 patients who received surgery alone, operative time was shorter [(242.3±27.0) min vs.(280.5±27.2) min, P=0.002] and intraoperative blood loss was less [(168.2±95.6) ml vs. (244.5±84.8) ml, P=0.042], the number of removal lymph nodes was similar [(19.5±5.8) vs. (20.5±7.1), P=0.683], postoperative hospital stay was prolonged [(18.9±10.3) d vs. (12.5±4.6) d, P=0.020]. The postoperative complication rate was 36.4% including cervical anastomotic leak with pulmonary infection (n=1), cervical anastomotic fistula and hoarseness (n=1), pulmonary infection with pleural effusion (n=2). Follow up ranged from 1 to 9 months, and no recurrence was found.

CONCLUSIONThe neoadjuvant chemoradiotherapy followed by combined thoracoscopic and laparoscopic esophagectomy in the treatment of locally advanced esophageal carcinoma is safe, feasible, and the short-term outcomes are favorable.

Adult ; Aged ; Esophageal Neoplasms ; surgery ; therapy ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Male ; Middle Aged ; Neoadjuvant Therapy ; Preoperative Care ; Thoracoscopy ; Treatment Outcome

Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP).Methods MR imaging was performed in 12 patients with AIP proved histopathologically or clinically,of them CT was scanned in 10 patients and endoscopic retrograde cholangiopancreatography (ERCP)in 3.All imaging data were reviewed retrospectively.Results All 12 patients had enlargement of the pancreas either diffusely(n=9)or focally(n=3).The swollen pancreas was hypointense on T_1-weighted images and mildly hyperintense on T_2-weighted images.It also demonstrated decreased enhancement on artery phase of dynamic imaging and moderate enhancement on delayed phase images. Capsule-like enhanced rim was found around the swollen pancreas in 11 patients.Stricture of the distal common bile duct was found in 9 patients,and ERCP showed diffuse and irregular narrowing of the main pancreatic duct in 3 cases.At follow-up,pancreatic abnormalities and common bile duct stricture resolved after steroid therapy in 7 patients.Conclusion AIP showed some characteristic imaging findings,and imaging examinations will play an important role in the diagnosis of AIP.