Objective To evaluate the academic quality and characteristics of edition of the Chinese Journal of Geriatrics. Methods Within the database of Chinese Medical Citation Index(CMCI), the citation analysis was used to analyze the number and its distribution of the cited original articles published in the Journal 1999-2004. Results The average freguency for a single article cited by other researchers was 2.82, and there were more articles cited than other journals. The authors of these articles were distributed in the 30 province and municipalities, among which Beijing, Guangdong Province, Shanghai were in the front of Geriatrics research. There were 514 cited journals, and self-citing rate was 6.07%. Conclusions The Chinese Journal of Geriatrics has published high quality articles, and has its own edition characteristics to keep its steady level of research. It is one of the most important information resources for the geriatrics researchers and one of the most important medical journal.

Objective To evaluate the academic level and the popularity of Chinese Journal of Hepatobiliary Surgery.Method According to the information of Chinese Medical Citation Index(CMCI),I statistically analyzed the amount and distribution of the originals in Chinese Journal of Hepatobiliary Surgery cited by the journal included by CMCI.Result The average of original articles cited by other researchers is 2.93,and there are more articles cited than other journal.The authors of these articles are from the 30 province,Beijing Shanghai and Guangdong Province are in the front of Hepatobiliary Surgery research.There are 355 citing journals,and self-citing rate is 11.89%.Conclusion With the unique style and character Chinese Journal of Hepatobiliary Surgery is the main medical core periodical and one of the most important information resourses in the field of Medical Hepatobiliary Surgery in China.

Objective To learn the effects of crude herb moxibustion combined with rehabilitation training on the recovery of pulmonary functions and quality of life of patients with stable-stage chronic obstructive pulmonary diseases (COPD) in Nanning communities. Methods Two hundred patients with stable-stage COPD, sampled from Nanning communities and used as the subjects of this study, were divided into the experiment group and the control group by the random number table method. Patients in the control group were given conventional medication and community health care education and guides;Patients in the experiment group were not only offered the same treatment as mentioned above, but treated during dog days and the coldest days of winter with moxibustion medicine cakes which were applied accurately on selected acupuncture points, together with moxibustion with moxa cone done on the cakes. Treatment was done 6 times in each course of treatment, and 2 courses were given, combined with rehabilitation training. Examination of pulmonary functions was conducted for all patients before and after the treatment and St. George′s Respiratory Questionnaires (SGRQ) were distributed to them. Results Forced vital capacity patients, forced expiratory volume in first second, the percentage of forced expiratory volume in first second and forced vital capacity of experimental group before the intervention were (2.27 ± 0.36) L, (1.56 ± 0.30) L, (44.81 ± 5.35) %, while six months after the intervention were (3.36 ± 0.42) L, (2.25 ± 0.27) L, (65.38 ±8.08)%. The difference was statistically significant (t=18.90, 16.40, 20.36, P<0.01);The above indexes of control group respectively before intervention were (2.28±0.43) L, (1.58±0.33) L, (45.17 ± 4.97) %, while six months after the intervention were (2.57 ± 0.57) L, (1.71 ± 0.35) L, (46.94 ± 8.42)%. Difference was not statistically significant (t = 1.81, 2.04, 1.70, P > 0.05). Differences between two groups before intervention had no statistical significance (t = 0.17, 0.43, 0.47, P > 0.05), and differences between two groups after the intervention were statistically significant (t=10.62, 11.62, 14.99, P < 0.01). In the experimental group,before intervention the total score of SGRQ and the part scores of symptom, the activity ability and the influence of the disease were (16.56 ± 1.76) points, (10.44 ± 1.57) points, (18.55±2.17) points, (45.73 ± 2.53) points, 6 months after the intervention the scores were (10.77 ± 1.56) points, (7.28±1.23) points, (14.33 ±1.66) points, (32.98 ± 2.35) points. The difference was significant (t=14.82-35.50, P<0.01);In the control group before intervention the total scores of SGRQ and the part score of symptom, the activity ability and the influence of the disease were (16.47 ±1.81) points, (10.39 ± 1.66) points, (18.52 ± 2.16) points, (45.79 ± 2.49) points, 6 months after the intervention the scores were (16.12 ±1.36) points, (9.89 ±1.38) points, (16.96 ±1.58) points, (42.15±2.34) points. The lower score was not obvious, there was no statistically significant difference (t=1.45-2.17, P > 0.05). Intervention before comparing differences between two groups had no statistical significance (t=0.09-0.34, P > 0.05). Intervention after comparing differences between two groups was statistically significant (t=10.88-26.22, P<0.01). Conclusions Clinically, crude herb moxibustion combined with rehabilitation training is to some extent conducive to delaying the decrease in pulmonary functions, reducing complications, and improving the quality of life of patients with stable-stage COPD.

Objective To detect the expression of hypoxia-inducible factor 1α (HIF-1α) and bcl-2 ovarian serous carcinoma and their clinical significances. Methods Paraffin specimens including 61 cases of ovarian serous carcinoma and 50 normal ovarian tissues were selected. The expressions of HIF-1α and bcl-2 proteins were detected by immunohistochemical EnVision method and their relationship between them was analyzed. Results The positive rate of HIF-1α and bcl-2 proteins expression in 61 ovarian serous carcinoma was 68.9%and 54.1%, respectively. There was a significant difference between the two groups (χ2=55.381, P< 0.05; χ2= 38.493, P< 0.05). The clinical pathological parameters showed that the positive expression of HIF-1αand bcl-2 proteins were not related with the age (P>0.05). HIF-1αpositive expression was correlated with tumor grades, the state of lymph node metastasis and FIGO stages (χ2=4.931, 25.008, 5.610, P<0.05). Bcl-2 was significantly associated with tumor grades and lymph node metastasis (χ2= 6.956, 33.869, P<0.05), but not with FIGO stages (χ2=3.391, P>0.05). The expression of bcl-2 was positively correlated with HIF-1α in ovarian serous carcinoma (r= 0.304, P= 0.017). Conclusions The expressions of HIF-1α and bcl-2 play a synergic role in the progression of ovarian serous carcinoma. The combined detection of HIF-1αand bcl-2 is effective for patients'prognosis judgment.

With the further research of spinal cord injury treatment, a series of new drugs have been used in experiment and clinic. This article is to review the current developments of drugs combination in spinal cord injury.

Objective To assess the safety, efficacy, temporary side effects and feasibility of oral ibuprofen suspension in the treatment of patent ductus arteriosus (PDA) with hemodynamic significance in premature infants. Method A randomized controlled trial including seventy-four premature infants with PDA was performed from February 2007 to May 2008. Infants were randomly assigned to two groups: testing group (36 patients) received three doses of oral ibuprofen suspension (10 mg/kg at 24-hour intervals) and control group (38 patients) did not receive such treatment. The cure rate of PDA, relative side effects of ibuprofen and complications during treatment were recorded.Results The closure rate of ductus arteriosus in the testing group was 52.8% (19/36), which was higher than that of control group (18.4%, 7/38) (χ2=9.575, P=0.002). The severe side effects did not occur in testing group, such as oliguria, renal impairment, prone of bleeding, gastrointestinal perforation and novel appearing or deteriorative of intraventricular hemorrhage (IVH). Compared with the infants in control group (26.3%, 10/38), the morbidity of abdominal distension or gastric retention in testing group (33.3%, 12/36) was higher, while there was no statistically significant difference (χ2=0.436, P=0.509). The hospital stay [(22.8±14.8) d vs (24.1±17.1) d], mechanical ventilation rate [5.6% (2/36) vs 2.6% (1/38)] and oxygen supplement time [(8.3±9.3) d vs (8.8±8.3) d] between the testing and control groups remained no significant difference (P>0.05). Conclusions Oral ibuprofen suspension could be effective in closing PDA of preterm infants; no significant complications and side-effects occurred during oral ibuprofen treatment. It is suggested that oral ibuprofen suspension treatment was safe, effective and well tolerated for preterm infants with PDA.

Objective To identify the clinical phenotypic diagnosis and gene mutation detection of two kindreds with PS deficiency. MethodsPS: A was measured by chromogenic substrate method;TPS:Ag, FPS: Ag levels were measured by ELISA method; PS gene(PROS1 gene)was detected by amplifying 15 exons and flanking intron sequences from the propositus with PCR method. PCR products were purified and directly sequenced. Results For propositus 1,PS: A was 48.6% ,TPS: Ag was 136 mg/L, FPS : Ag was 41 mg/L, PROSI gene exon 2 was in c. Heterozygous base substitutions was detected in C121T locus, which led to Arg-1Cys (R-1C) heterozygous roissense mutation encoded in PS proteins. For propositus 2, PS: A was 29.2%, TPS: Ag was 83 mg/L, FPS: Ag was 26 mg/L, PROSI gene exon 14 was in c. Heterozygous base substitutions was identified in CI687T locus, in which Gln.522Stop heterozygous nonsense mutation was encoded in PS proteins. Conclusions c. C121T is a novel mutation locus detected in PROS1 gene. This heterozygous mutation could lead to type Ⅱ PS hereditary deficiency, while c. C1687T heterozygous mutation could bring about type Ⅰ PS hereditary deficiency.

Objective: To summarize the major post-operative complication of modiifed extended Morrow procedure in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to explore the major factors affecting its prognosis. Methods: We retrospectively analyzed 139 consecutive HOCM patients who received the procedure by same surgeon in our hospital from 2012-06 to 2014-07. There were 87 male and 52 female patients with the age of (10-67) years, body weightof (26-105) kg and pre-operative left ventricular outlfow tract peak gradient (LVOTPG) of (84.48 ± 44.75) mmHg. Concomitant operations were performed with known cardiac disease as necessary. Pre- and post-operative echocardiography, ECG and chest X-ray were examined to assess the adequacy of resection and mitral valve structure and function. Results: There was no peri-operative death. 73/139 (53%) patients received simple modiifed expanded Morrow procedure, the other 66 (47%) patients received concomitant surgery including 21 patients with coronary artery bypass grafting, 15 mitral valve plasty, 7 mitral valve replacement, 10 tricuspid valve plasty, 2 aortic valve replacement, 3 modiifed Maze procedure, 2 unblock of right ventricular outlfow tract, 2 sub aortic membrane resection, 1 ventricular aneurysm resection. The mechanical ventilation time was (24.05±36.74) hours, post-operative ICU and in-hospital stays were (2.85±3.18) days and (10.11±4.57) days; the complications included arrhythmia in 108 cases, pleural effusion in 25 cases, secondary intubation in 1 case, tracheotomy in 1 case, hemoifltration in 1 case, intra-aortic balloon pump in 1 case, back into ICU in 3 cases; no pneumothorax, secondary thoracotomy/operation. The post-operative left atrial diameter, LVOTPG, inter-ventricular septal thickness and LVEF were all decreased; mitral valve closed well or with mild regurgitation, systolic anterior motion (SAM) basically disappeared. The major factors for delayed ICU stay included age≥55 years, female, CPB time≥120 min, AOC time≥90 min, the patients combining with arrhythmia and right ventricular dysfunction. Late follow-up presented that the patients were almost without the symptoms, NYHA classiifcation at (I-II), no late death, complication or re-operation. Conclusion: Modified expand Morrow procedure has good surgical and short/late post-operative effects, concomitant operation does not increase the complication and mortality; correction of arrhythmia and improving right ventricular function at peri-operative period are important for treating the relevant patients.

Objective To study the GPⅡb/Ⅲa gene mutations of eight glanzmann thrombasthenia(GT) pedigrees. Methods Responses of eight probands to different agonists were observed by platelet aggregation test and the amount of αⅡb and β3 was determined by flow cytometry. All the exons of Ⅱb and Ⅲ a genes were amplified by PCR followed by sequencing for mutational screening. Further analysis of the normal population excluded the possibility of mutational sites as a polymorphism. Results Eight probands showed normal PLT counts, dispersion of the platelet particles without aggregation, prolonged bleeding time and severely reduced platelet aggregation in response to the physiological agonists- ADP, epinephrine, and collagen, but relatively normal aggregation of PLT in response to ristocetin. Flow cytometry showed that all probande were Ⅰ type GT, except that proband 2 was Ⅲ type GT and proband 6 was Ⅱ type GT. The sequencing results showed that twelve different types mutations were present in eight probands, including GIOA, Gl412T, GII99A, 1525deiC, G2223T, C2671T, 2930delG, IVSI5 (-1) delG, A2334C, C1750T, 69-79del and CA70A. We were not able to detected any mutations in GP Ⅱb/Ⅲa gone on proband 3. Conclusions GT is mainly caused by GPⅡb/Ⅲa gene mutations. G10A, 69-79del, C470A,G1412T, G2223T, C2671T and 1525delC were the novel mutations causing GT.

Objective To compare the efficacy of dexmedetomidine versus remifentanil in combination with sevoflurane for gynecological laparoscopy. Methods Forty ASA Ⅰ or Ⅱ patients aged 18-64 yr with body mass index of 18-30 kg/m2 undergoing gynecological laparoscopy were randomly assigned to one of two groups ( n =20 each): dexmedetomidine group (group D) and remifentanil group (group R). Starting from 5 min before induction of anesthesia, dexmedetomidine was infused at 0.05 μg · kg - 1 · min- 1 in group D and remifentanil at 0.1 μg· kg- 1· min-1 in group R for 10 min, then dexmedetomidine infusion rate was increased to 0. 3 μg· kg-1 · h-1 and remifentanil infusion rate was increased to 0.15 μg· kg-1 · min-1 . Anesthesia was induced with propofol 1.5-2.0 mg/kg and fentanyl 2 μg/kg. Tracheal intubation was facilitated with cis-atracurium 0.15 mg/kg. Anesthesia was maintained with sevoflurane and fentanyl 1 μg/kg and intermittent iv boluses of cis-atracurium. Narcotrend index was maintained at 40-50. Blood sample was taken from external jugular vein for blood gas analysis and determination of serum concentrations of corticosteroid, norepinephrine and epinephrine before administration, at 5 min after intubation, at 10 min of aeroperitoneum and at 5 min after extubation. The pH value and concentrations of lactic acid and glucose were recorded. The time for recovery of spontaneous breathing, eye-opening time, extubation time, orientation time and perioperative side-effects were recorded. Numeric rating scale was used to assess the intensity of pain during 2 h after operation. The analgesics used were also recorded. Results The serum concentrations of norepinephrine and epinephrine were significanfly lower at 10 min of aeroperitoneum, the time for recovery of spontaneous breathing was shorter, eye-opening time longer and the incidence of shivering and nausea and vomiting lower, the percentage of patients requiring rescue opioids lower in group D than in group R ( P ＜ 0.05). Conclusion The efficacy of dexmedetomidine combined with sevoflurane anesthesia is better than remifentanil combined with sevoflurane anesthesia for gynecological laparoscopy.