Objective To study the influence analysis of patients with anxiety and depression in elderly patients with hypertension antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets.Methods 60 elderly patients with hypertension accompanied by anxiety and depression in our hospital from January 2014 to December 2016 were selected as the subjects.They were randomly divided into the control group and the experimental group, with 30 patients in each group.The control group was treated with conventional antihypertensive treatment, the experimental group were given psychological intervention combined with treatment of Flupentixol and Melitracen Tablets.The clinical indexes of the experimental group and the control group were compared and analyzed.Results After the corresponding treatment, the effective rate of antihypertensive treatment in the experimental group was 28 cases, and the effective rate of depressurization was 93.3%.The effective rate of antihypertensive treatment in the control group was 21, and the effective rate of antihypertensive treatment was 70%.After treatment, the HAMD score and HAMA score of the experimental group were significantly lower than those before the treatment, and the score of the experimental group was significantly lower than that of the control group, with statistical difference(P<0.05).Conclusion The treatment of elderly hypertensive patients with anxiety and depression in patients with better antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets, can improve the depression and anxiety of patients in a large extent, high safety, is further applied in clinical significance.

OBJECTIVE:To observe the effects of epalrestat combined with lipoic acid on nerve function,oxidative stress and inflammatory reaction in patients with diabetic peripheral neuropathy(DPN). METHODS:From Jan. 2013 to Jan. 2016,150 pa-tients were selected from our hospital and then divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lipoic acid injection 600 mg,ivgtt,qd;group B was given Epalrestat tablet 50 mg,po,tid;group C was given lipoic acid+epalrestat,same usage and dosage as above. TSS score,MNCV,SNCV,oxidative stress indexes (SOD and MDA)and inflammatory indexes(TNF-α and IL-6),as well as blood pressure,blood lipid and blood glucose indexes were compared among 3 groups before and after treatment. The occurrence of ADR were observed. RESULTS:Before treatment, there was no statistical significance in above indexes among 3 groups (P>0.05). Compared to before treatment,TSS score, MDA,TNF-α and IL-6 levels of 3 groups were decreased significantly after treatment;MNCV and SNCV were speeded up signifi-cantly,and SOD level was increased significantly;each index of group C was better than that of group A and B,with statistical significance(P<0.05),but there was no statistical significance between group A and B(P>0.05). SBP and FPG after treatment of 3 groups were decreased significantly than before treatment,while HDL-C was increased significantly,with statistical signifi-cance(P<0.05);there was no statistical significance among 3 groups(P>0.05). No obvious ADR was found in 3 groups. CON-CLUSIONS:Epalrestat combined with lipoic acid can effectively improve nerve function in DPN patients by inhibiting oxidant stress and inflammatory reaction with good safety. The effect of drug combination is better than single drug.

Objective To investigate the value of nuchal translucency(NT) thickening in the fetal chromosome abnormality screening.Methods The 14 881 pregnant women received NT measurement in 11-13 +6 weeks at Beijing Obstetrics and Gynecology Hospital from January 2010 to August 2012.The 118 fetuses whose NT≥2.5 mm were recruited.One hundred and eight (91.5％,108/118)of them accepted invasive procedure and karyotype analysis.Results (1) Chromosome karyotype analysis:113 singleton pregnancies (95.8％) and 5 twin pregnancies (4.2％) whose NT thickened from 2.5 mm to 11.0 mm were advised karyotype analysis.The 108 pregnant women accepted karyotype analysis.Among them,88 had normal chromosome karyotype,and 20 had chromosome abnormalities.The detection rate was 18.5 ％ (20/108).(2) The sensitivity,specificity,false positive rate,false negative rate,total consistent rate,positive predictive value and negative predictive value of prenatal screening of chromosome abnormalities for NT ≥ 2.5 mm were 44％,99％,1％,56％,99％,19％ and 100％,respectively.(3) Among the 88 fetuses who had normal karyotype,72 (82％) had isolated thickened NT,while 16 (18％) had fetal structural malformation or intrauterine demise.(4) Among the 10 pregnant women who did not accept fetal karyotype analysis,8 terminated pregnancy because of fetal structural malformation,and the other 2 fetuses died in uterus.(5)All of the 5 twin pregnancies were dichorionic twins,and one of the twins had thickened NT.Among the 5 twin pregnancies,one fetus was trisomy 21 and others had normal karyotype.3 twin pregnancies who had normal chromosomes gave live birth.And the other had a gastroschisis and exstrophy deformity fetuse.This fetuse died in uterus and remaining fetuse had full-term live birth.(6) 35 (29.7％) pregnant women received second trimester Down's syndrome serum screening.One was high risk and was proved a trisomy 21 pregnancy.Thirty-four were low risk and had normal chromosome karyotype.Conclusion NT thickening may indicate fetal chromosome abnormalities or other structural malformations.It is a useful prenatal screening indicator.

Objective To investigate the effect of nitric oxide synthase(NOS) inhibitors and L-arginine(L-Arg) on the prognosis of traumatic shock in rats. Methods Traumatic shock models of Sprague-Daulay rats were made and randomly devided into control group (n=24),L-NAME treatment group (n=24),AG treatment group (n=24) and L-Arg treatment group (n=24). Serum nitric oxide(NO) levels and oxygen partial pressure in tissues include skeletal muscles,liver and small intestine were detected at 1h,3h,5h after resuscitation. Meanwhile, hemodynamic data of the rats and their survival rates of 12h and 24h were monitored and recorded. Results Serum NO concentration was statistically lower after resuscitation in L-NAME group than that in control group, while there were no statistical significance of tissues oxygen partial pressure and survival rate in 12、24h between the two groups. AG could decrease serum NO levels only at late stage of traumatic shock,but no effect on the synthesis and relase of NO at early stage of traumati shock.AG could improve tissues oxygen partial pressure of the liver and small intestine, and prolonged the mean survival time. L-Arg could increase serum NO levels, and improve oxygen partial pressure of intestine and significantly increase the survival rate at 12h and 24h in rats with traumatic shock. Conclusions Treatment with AG and L-Arg can improve the prognosis of traumatic shock rats much better than that with L-NAME.

Objective To investigate the effect of different amplification methods and probes with various length on the results of comparative genomic hybridization (CGH) analysis of pre-implanted single blastomere and to establish the basis for preimplantation genetic diagnosis.Methods Twenty blastomeres of embryo at 6-8 cells stage were randomly divided into A and B group with 10 in each.Twenty peripheral blood lymphocytes from a healthy man were similarly divided into C and D group with 10 in each.Degenerate oligonucleotide primed polymerase chain reaction (DOP-PCR) was used to amplify whole genomic DNA in group A and C,and multiple displacement amplification (MDA) was used in group B and D for whole genome amplification (WGA).The specificity of resultant products was confirmed by amplification of TBX1 gene exon 2.CGH was performed respectively with 250-750 bp and 750-2000 bp probes prepared from the amplified whole genomic DNA.The result of CGH was verified by sex-determining region of Y (SRY).Results (1) Nine of the 10 samples in group A and all in group C were amplifiable by DOP-PCR,but there were multiple non-specific bands in the amplification of TBX1 exon 2 when WGA products were used as templates.When 250～750 bp probe was used in CGH,1 of the 5 blastomeres was failed and another one had different karyotype from that analyzed by SRY.(2) All samples in group B and D were successfully amplified by MDA,and the non-specific bands were significantly less in the amplification of TBX1 exon 2.All 5 blastomeres were successful in CGH with the 250～750 bp probe.Moreover,the karyotype was in agreement with that of SRY.(3) When 750 ～ 2000 bp probe was used,the CGH results were suboptimal.Conclusions In WGA of single blastomere,MDA is superior to DOP-PCR in the stability and specificity.The karyotype image detected by CGH with the 250～750 bp probe is clear and homogenous.

OBJECTIVE: To investigate the surgical effect and complications of arytenoid resection in bilateral vocal cord fold paralysis(BVFP) patients via endoscopic laser approach and external cervical approach. METHOD: A total seventy-eight BVFP patients who underwent arytenoid resection surgery via endoscopic laser approach (laser group, n=30) or external cervical approach (external cervical group, n=48) were enrolled in this study. Videostroboscopy, vocal perception evaluation, maximum phonation time (MPT) text were preformed in all patients both preoperatively and postoperatively. The decannulation rate was also calculated. RESULT: Videostroboscopy showed that vocal fold on the operated side in both groups could abduct to various extent postoperatively, which showed significant difference when compared with preoperative abductive movements (P<0. 05). Postoperative glottal closure showed various increment in both groups. However, when with preoperative glottal closure, external cervical group showed significant difference (P < 0. 05), while laser group showed no significant difference (P> 0. 05). Postoperative videostroboscopy showed no significant difference in vocal fold position and glottal closure between these two groups(P>0. 05). Vocal perceptual evaluation(RBH score) showed a significant deterioration in voice quality postoperatively in both groups respectively (P<. 05). Postoperative MPT values showed no significant difference between the two groups (P>. 05). However, they were significantly shorten/shorter than preoperative ones in these two groups respectively (P<0. 05). The overall decannulation rate were 90. 0% and 95. 8% for laser group and external cervical group respectively. In Both groups, patients presented aspiration symptoms postoperatively, except one patient of external cervical group who developed pneumonia due to recurrent aspiration. CONCLUSION Arytenoid resection surgery via both endoscopic laser approach and external cervical approach can both enlarge glottic area so as to solve respiration problems, in BVFP patients. Two kinds of surgery have obvious voice damage.
Arytenoid Cartilage ; surgery ; Endoscopy ; methods ; Humans ; Lasers ; Neck ; surgery ; Postoperative Complications ; Postoperative Period ; Vocal Cord Paralysis ; surgery ; Vocal Cords ; physiopathology ; Voice Quality

Objective To investigate the value of detecting methylated SEPT9 gene (mSEPT9) in serum and stool in screening colorectal cancer in elderly people.Methods Subjects were divided into three groups, the colorectal cancer group (n=82), the colorectal polyps group (n=80) and the healthy control group (n=100).Real-time quantitative polymerase chain reaction (PCR) was used to detect mSEPT9 in peripheral blood and feces.The relationship between mSEPT9 and clinical and pathological characteristics of colorectal cancer was analyzed.The agreement between serum and stool results was analyzed.Results The positive rate of serum mSEPT9 was 73.2％ in the colorectal cancer group, 6.3％ in the colorectal polyps group and 4.0％ in the healthy control group, with statistical significance between the colorectal cancer group and the other two groups (P＜0.01).The sensitivity and specificity for plasma mSEPT9 detection in screening colorectal cancer were 73.2 ％ and 95.6％, respectively.The positive rate was higher in patients with tumor maximum diameter over 3.0 cm, invasion of the entire serosa layer, lower differentiation or advanced clinical staging (P＜0.05).The detection results of plasma mSEPT9 were in complete agreement with those of stool mSEPT9 from the same patients.Conclusions The expression of mSEPT9 is high in elderly patients with colorectal cancer and has a high sensitivity and specificity for PCR detection.Complete agreement can be seen in results from plasma and feces.Detecting mSEPT9 can be a valuable approach to screening colorectal cancer in the elderly.

ObjectiveTo investigate the relationship between fractional exhaled nitric oxide (FeNO) and bronchopulmonary dysplasia (BPD) in extremely/very low birth weight infant (ELBWI/VLBWI). MethodsThirty-five ELBWI/VLBWI (gestational age <34 weeks at birth and birth weight <1 500 g), who were admitted to neonatal intensive care unit of Peking University Third Hospital from October 2014 to March 2015 with respiratory distress soon after birth, were enrolled into the study, and divided into BPD group (n=11) and non-BPD group 1 (n=24) according to the diagnosis at discharge. One day before they left the hospital, FeNO level was determined with Exhalyzer D, an equipment for pulmonary function test. Difference of FeNO and nitric oxide (NO) production between the two groups was compared witht-test or Fisher exact test, and the value of FeNO in predicting BPD was tested by receiver-operating characteristic (ROC) curve.ResultsThe mean gestational age at birth in BPD group was significantly less than that in non-BPD group [(29.7±1.9) vs (32.0±1.5) weeks,t=4.005,P=0.000], and the duration of invasive ventilation [(53.0±91.3) vs (15.0±30.2) h, t=1.598,P=0.002] and oxygenation was longer [(42.1±7.8) vs (8.2±6.4) d,t=13.567,P=0.000]. There were more babies required surfactant treatment, prenatal cortisone administration, and inhalation of cortisone and bronchodilator during hospital stay in BPD group than in non-BPD group[10/11 vs 38%(9/24), 11/11 vs 58%(14/24) and 11/11 vs 21%(5/24), Fisher exact test, allP<0.05]. The age and body weight of the babies at the time of FeNO determination in BPD group were older or higher than those in non-BPD group [(46.4±16.3) vs (20.9±11.7) d,t=5.278,P=0.000; (2 090±164) vs (1 892±153) g,t=3.498,P=0.001], but the corrected gestational age was similar [(36.3±3.1) vs (35.0±2.3) weeks,t=1.407,P=0.169]. Both the mean FeNO level and NO production in BPD group were significantly higher than those in non-BPD group [(13.6±6.9) vs (8.0±3.6) ppb (1 ppb=1×10-9 mol/L), (25.6±10.1) vs (18.1±9.0) nl/min,t=2.967 and 2.478,P=0.006 and 0.018]. The area under the ROC curve was 0.749 (P=0.021, 95%CI: 0.539-0.953) which implied that FeNO provided medium power for discrimination of ELBWI/VLBWI with BPD from those without, with a sensitivity of 72.7% and specificity of 75.0% at the cut-off value of 11.55 ppb.ConclusionsFeNO and NO production in BPD infants are significantly higher than non-BPD infants. Measurement of FeNO for ELBWI/VLBWI through mask before discharge is a simple, safe and invasive procedure to objectively evaluate pulmonary function early after birth.

Objective To investigate the clinical outcomes of using modified antegrade digital artery island flap for the treatment of the severely flexion contracture of the burned finger.Methods Between August,2013 to August,2015,21 patients (21 fingers) with severely flexion contracture of the burned finger were hospitalized for treatment.According to the Stren classification standard for the interphalangeal joint flexion contracture,all the patients were rated as type Ⅲ.The volar soft-tissue defect with exposed tendons,nerves,vessels or bone ranged from 1.0 cm × 2.0 cm to 2.5 cm × 4.0 cm after scar relaxation.The artery and the nerve defect were 1.5 to 4.5 cm and 2.0 to 4.2 cm,respectively.The wound were reconstructed with the modified antegrade digital artery island flap.The dorsal branches of the proper digital nerve of the flap were anastomosised with the proper digital nerve of the wound.The flap donor site was resurfaced with full-thickness skin grafting from inner aspect of the forearm.All the cases were called back for postoperative follow-up.Results All the reconstructed fingers and flaps survived completely without vascular problems.The donor skin graft survived and wound healed by first intention.All the patients were followed up with 11.5 months (range,6-22 months).The finger appearance was satisfactory.The texture and color of flaps in all cases were good.There was no pigmentation and contraction relapse.The contracted fingers received no cold intolerance.At the final examination,the average values of static 2-point discrimination were 5.2 mm (range,4.3-6.5 mm) of the flap.In the series,based on the Michigan Hand Outcome Questionnaire,18 patients were strongly satisfied with the injured finger appearance and 3 patients satisfied with the appearance.Conclusion The modified antegrade digital artery island flap,which is easy to raise with large flap size and can result with the good finger appearance and function,is an ideal technique for reconstruction of the severe flexion contracture of the burned finger.