Artificial femoral head replacement is commonly performed in elderly patients with femoral neck fracture. However, the patients are always complicated by other diseases and their major organ functions are low, which increases risks of anesthesia and replacement. The anesthesia methods for artificial femoral head replacement include epidural anesthesia, combined spinal-epidural anesthesia, and general anesthesia. Respiratory system and nervous system complications, bleeding and transfusion complications, deep venous thrombosis and lung embolism, and bone cement-associate complications are common complications in anesthesia for femoral head replacement. Therefore, appropriate anesthesia pattern, rigid monitoring, and proper treatment can reduce anesthesia risks.

Objective To study the X-ray and CT findings of pneumocystis carinii pneumonia(PCP)in AIDS.Methods 18 cases with PCP in AIDS proved by clinic and pathologically were collected.HIV antibody was positive in all cases.Chest radigraphy and CT scan were taken in all cases.The imaging findings were analysed.Results The typical features of PCP on radiography and CT included unsymmetric diffuse mesh or reticulo-nodular changes,symmetric ground-glass opacification and many more even lobar consolidations which distributed in bilateral hilar regions and middle-lower lung fields.The atypical manifestations included cystic lesions,lobar consolidation,hilar and/or mediastinal adenopathy,pleural effusion,pneumothorax,atelectasis,mass and cavity-mass.Conclusion Plain chest film and CT scan are of important value in diagnosis of PCP.It is possible to diagnose PCP in patients with typical imaging manifestations positive HIV and in combination with clinical data.

Objective To understand the influence of nursing intervention in community on hypertension pa-tients′life style and behaviors.Methods 183 hypertensive patients admitted registered in Donghu Street community were selected for nursing intervention for 18 months, from whom effect evaluation was made through pre -and post -intervention.Results Nursing intervention had significant influence on hypertension patients′life style such as smoking, drinking, salt restriction and exercise (p <0.01).With improvement of notable knowledge on hypertension and its risk factors, control rate of blood pressure and medicine taking compliance all increased significantly (p <0.01), but illegible improvement was found respecting weight control, high fat diet and patients′emotion (p >0.05).Conclusion In some way community nursing intervention can alter hypertension patients′life style and help to improve their health status and quality of life.

Child ; Chronic Disease ; Cough ; diagnosis ; etiology ; therapy ; Humans ; Practice Guidelines as Topic

Objective To study the methods and benefits of exposure of recurrent laryngeal nerve(RLN) in thyroid surgery Methods In this study, 2148 patients admitted in our hospital from July 1993 to July 2003 were divided randomly into two groups: RLN exposure group (936 cases) and RLN non exposure group (1212 cases) RLN was dissected around the inferior thyroid artery, thyroid cartilage, and cervical vagus Results Two cases (0 21%) suffered from RLN injury in exposure group and 5 cases (0 41%) suffered from RLN injury in non exposure group ( P

Objective To investigate the methods and evaluate their efficacy of pseudoaneurysms by color Doppler ultrasound guided compression and injection treatment.Methods Twenty patients with seventeen femoral artery pseudoaneurysms and three subclavian artery pseudoaneurysms underwent compression and injection treatment with color Doppler ultrasound guided.Results Simple compression method presented a successful rate of 86%(12 out of 14 patients).Two with subclavian artery pseudoaneurysms were injected with medical OB glue,as a result,one had a hard knot in the lesion after treatment,the other was thrombosed in the remote artery.Thrombin injection achieved the rate of success 100%, 4 in 4 patients.Conclusions Color Doppler ultrasound guided compression and thrombin injection is a simple,safe and effective method for the treatment of postangiographic pseudoaneurysms,but medical OB glue injection may bring about complications.

Objective To establish a desirable quantitative assay system to evaluate the correlation between surgical manipulation and micrometastasis in primary esophageal cancer patients.Methods 118 pe- ripheral blood samples from 40 esophageal cancer patients undergoing radical resection were collected before surgery(B-1),immediately after surgery(B0)and at the third day postoperatively(B+3).Based on real-time quantitative reverse transcription-PCR,carcinoembryonic antigen(CEA)mRNA gene was used in the detec- tion.12 patients with benign tumor and 13 healthy volunteers were collected as negative control groups.Re- sults The median of CEA mRNA copies at B-1,B0 and B+3 were 1592,13 314 and 6221 copies/ml blood, respectively.CEA mRNA expression levels were found to be significantly higher at both B0 and B+3 than that of B-1(P=0.0001 and 0.0209,respectively).No significant difference was found between B0 and B+3(P= 0.4396).Conclusion Surgical manipulation on esophageal cancer patients increases the probability of mi- crometastasis.Therefore,adjuvant therapy is needed during perioperative stage.

Objective To estimate the influence of 1,25(OH)2D3 on the proliferative ability of and methylation levels of genomic DNA and proliferation-associated gene promoter in human HaCaT keratinocytes.Methods Some cultured HaCaT cells were treated with 1,25 (OH)2D3 of 10-6,10-7 and 10-8 mol/L for 24 hours,then,methyl thiazolyl tetrazolium (MTT) assay was carried out to evaluate the proliferative activity of cells,and a global DNA methylation quantification kit was used to determine the global DNA methylation level.Real-time PCR was conducted to quantify the mRNA expression of DNA methyl transferases (DNMTs) and methyl-DNA binding domain (MBD) proteins,and methylation-specific PCR (MS-PCR) to evaluate the methylation status of promoter region in the programmed cell death 5 (PDCD5) and tissue inhibitor of metalloproteinase 2 (TIMP2) genes,in HaCaT cells after 24-hour treatment with 1,25 (OH)2D3 of 10-6 mol/L.The HaCaT cells receiving no treatment served as the control.Results Compared with the untreated HaCaT cells,those treated with 1,25(OH)2D3 of 10-6 mol/L showed significantly down-regulated proliferative activity (0.152 ± 0.027 vs.0.290 ± 0.017,P ＜ 0.01),global DNA methylation level (0.187 ± 0.071 vs.0.316 ± 0.049,P ＜ 0.05),DNMT3a and DNMT3b mRNA expression levels (P ＜ 0.01 or 0.05),but markedly upregulated mRNA expression levels of MECP2,MBD2,PDCD5 and TIMP2 (P ＜ 0.01 or 0.05).Moreover,the DNA methylation levels within the promoter region of PDCD5 and TIMP2 genes were significantly lower in HaCaT cells treated with 1,25 (OH)2D3 of 10-6 mol/L than in the control cells (0.38 ± 0.135 vs.0.72 ± 0.121,0.46 ± 0.172 vs.0.68 ± 0.133,both P＜ 0.05).Conclusions 1,25(OH)2D3 may down-regulate the global genomic DNA methylation level of,and modulate the expression of DNA methylationmodifying genes in,HaCaT cells.Furthermore,1,25 (OH)2D3 can decrease the promoter methylation levels but induce the overexpression of PDCD5 and TIMP2 genes,and decelerate the proliferation of HaCaT cells.

Objective To discuss the CT characteristics of AIDS's brain common disease,so that to improve the diagnostic level.Methods CT features of brain lesions in 25 patients with AIDS were retrospectively analyzed.Results Acute HIV encephalitis(n=6),CT features included low density at the basis festival area and the ventriculi laterals,no enhancement on contrast-enhanced scan in 1 case.Subacute HIV brain illness(n=5),CT images showed different degree of atrophy.Toxoplasmosis(n=4),CT images showed iso-dense tubercles with edema in the deep part of brain white matter or iso-dense circle at the edema area.Cytomegalovirus encephalitis(n=3),CT images showed symmetrical low density at bilateral cerebral occipital lobe,internal capsule and thalamus.Progressive multifocal leukoencepathy(n=3),CT showed multiple low density at the inferior surface of brain cortex,the gyri close of focus was clearer,and far of tapetum room system.Mixed infectious(n=4),mixed CT characteristics.Conclusion CT is beneficial in the differential diagnosis of brain disease in AIDS.

Objective To evaluate DSA and MRI in diagnosing focal nodular hyperplasia(FNH) of the liver.Methods DSA and MRI findings in seven patients with pathologically-proved FNH were retrospectively analyzed.Selective hepatic arteriography with DSA,and both plain and dynamic contrastenhanced MR scans were performed in all patients.The imaging findings were retrospectively evaluated and analyzed.Results On DSA examination,all FNH lesions were hyper-vascular,which were characterized by thickened and tortuous feeding arteries.And the feeding arteries,after entering the lesions,branched off peripherally in a radiation pattern and the lesions were evenly dyed with sharp borders.In venous phase,hepatic vein drainage was demonstrated in 6 cases.On dynamic contrast-enhanced MRI,marked enhancement of the lesions was observed,which lasted until to delayed phase when the lesions still showed hyper-intensity or iso-intensity signals.Scar signal in the lesion's center was seen in three cases,which started to enhance at portal vein phase and maintained to delayed phase.Conclusion On DSA imaging,FNH lesions are characterized by thickened and tortuous feeding arteries that branch off peripherally in a radiation pattern after entering the lesions.And the hepatic vein drainage is also a common finding in venous phase.Dynamic contrast-enhanced MRI can well display the abnormal signal of the central scar of FNH.The combination use of DSA and MRI can effectively improve the diagnostic accuracy for FNH.