55 cases of severe multiple organ failure above 60 years old were treated from April 1977 to January 1987. Each case suffered from 2 to 11 kinds of chronic diseases with an average of 3.8 kinds, and an average of 3.3 organ failures. The average mortality rate was 90.9%. The main precipitating factors were pulmonary infection(72.7%), metastatic carcinoma (14.6%), cardiac arrhythmia (7.3%) and improper medication (5.5%). Low organ infusion, endotoxin and immunological insufficiency probably contributed to their development. Diagnosis, prognosis, therapy and prevention of MOF in the elderly were discussed.

M-mode and pulsed Doppler echocardiography was used to evaluate the changes in structure and function of the left ventricle in 30 patients with chronic renal failure (CRF).The left ventricular mass index (LVMI) and systolic function were unchanged in the early stage of the CRF cases as compared with those of the controls (n = 30). However, the decrement in VE (early peak filling velocity) and the increase in VA/VE (late to early peak velocity ratio) indicated damage of the diastolic function. After 13 months follow-up, the LVMI of the CRF group elavated significantly and the VE diminished further.The ejection fraction (EF), shortening fraction (FS) and circumferencial muscular shortening velocity (mVcf) were decreased as compared with those before the follow up. 47.7% of the patients showed left ventricular heart failure.

Essential hypertension (EH) is an escalating problem for developed and developing countries.It is currently seen as a 'complex' genetic trait caused by multiple susceptibility genes which are modulated by gene-environment and gene-gene interactions.Over the past 10 years,mitochondrial defects have been implicated in a wide variety of degenerative diseases,aging,and cancer.Recently several studies showed that human essential hypertension has excess maternal transmission which suggests a possible mitochondrial involvement.However,the exact pathophysiology of mitochondrial DNA mutation (mtDNA) in essential hypertension still remains perplexing.With the application of a variety of imaging approaches and successive mouse model of mitochonddal diseases we convince that these problems will be resolved in the near future.(J Geriatr Cardiol 2008;5(1):60-64)

To investigate whether the calcium channel blocker amlodipine could inhibit macrophage matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) expression and secretion. Methods Peritoneal macrophages were isolated from BALB/C mice and incubated with low (5μg/L), middle (15μg/L) and high (305μg/L) concentrations of amlodipine, or in the medium alone (controls) for 24 hours, and the expression and secretion of MMP-2 and MM-9 of the cells were analyzed by RT-PCR and gelatin zymography. Results Compared with controls, amlodipine at low concentration had no significant effects on the expression and secretion of either MMP-2 and MMP-9 (P＞0.05);at middle concentrationit it could inhibited MMP-2 and MMP-9 expressions completely and significantly reduced the secretion of MMP-9 (P＜0.05); but it had no effect on the secretion of MMP-2. At high concentration it also inhibited MMP-2 and MMP-9 expression completely. Conclusion Amlodipine at 15 ìg/L inhibited the expression of MMP-2 and MMP-9 and reduced the secretion of MMP-9, suggesting that amlodipine may stabilize atherosclerotic plaque.

Objective To observe the short-,mid-and long-term surgical complications of complex acetabular fractures treated by the Kocher-Langenbeck (K-L) approach combined with digastric trochanteric flip osteotomy (DTFO).Methods We reviewed the 40 cases of complex acetabular fracture that were treated at our department from December 2009 through December 2013.They were 34 men and 6 women,from 17 to 73 years of age (average,47.6 years).Of them,19 were treated by K-L approach combined with DTFO,including 17 males and 2 females,with a mean age of 44.7 ± 11.7 years.The other 21 controls were treated simply through the K-L approach,including 17 males and 4 females,with a mean age of 42.8 ± 14.4 years.The 2 groups were compared in terms of intraoperative results,postoperative outcomes and surgical complications like infection,sciatic nerve injury,heterotopic ossification,femoral avascular necrosis,and post-traumatic arthritis.Results The 40 cases were followed up for an average of 29.7 months (range,from 18 to 59 months).The operation time for the DTFO group (248.2 ± 123.2 min) was significantly shorter than that for the control group (276.1 ±50.6 min),the satisfactory reduction rate for the DTFO group (100.0％) was significantly higher than that for the control group (90.5％),the hip intorsion (19.7° ± 3.5°),hip extorsion (26.1° ±4.3°),and hip abduction (40.5° ±4.7°) at one year postoperation in the DTFO group were significantly superior to those in the control group (14.3°± 6.0°,21.0°± 7.2°,31.9°± 10.8°,respectively),and the hospital stay for the for the DTFO group (19.0 ±7.1 d) was significantly longer than that for the control group (13.6 ±4.9 d) (P ＜ 0.05).The intraoperative bleeding and transfusion for the DTFO group were insignificantly greater than those for the control group (P ＞ 0.05).Infection or iatrogenic sciatic nerve injury occurred in none of the patients.There were no significant differences between the 2 groups in terms of positive Trendelenburg test,hip function,heterotopic ossification,femoral avascular necrosis,or post-traumatic arthritis at the last follow-ups(P＞ 0.05).Conclusions In the surgical treatment of complex acetabular fractures,especially those involving the acetabular dome area and the femoral head,K-L approach combined with DTFO can obtain larger surgical exposure field,good fracture reduction and functional recovery,without obviously increasing surgical complications.This technique only slightly increases intraoperative bleeding and transfusion,and results in longer hospital stay.

Objective To evaluate the feasibility, and clinical efficacy of combined interventional procedure (CIP) in composite cardiovascular diseases (CCD). Methods Twenty one consecutive patients were diagnosed as CCD before the procedures. The algorithm of CIP were individualized by the operators and physicians. The criteria for a successful procedure were defined before the operation. The counterplan for predictable complications was also established beforehand. The successful rate, short and long term efficacy, the incidence of complications and adverse reaction associated with contrast medium and X-ray were observed. All the patients were followed up through special out-patient clinic, telephone, or letters. Results Seven cases accepted electrophysiological testing(EPT) + radiofrequency catheter ablation (RFCA)+coronary angiogram (CAG)+percutaneous transluminal coronary angioplasty (PTCA)+stent implantation (SI). Four cases accepted CAG+PTCA+SI+EPT. Three cases accepted EPT+RFCA+CAG. Six cases accepted CAG+PTCA+SI+peripheral artery angiogram (PAG). One cases accepted pacemaker implantation (PI)+CAG+PTCA+SI+percutaneous transluminal septal myocardial ablation (PTSMA). The symptoms of arrhythmia disappeared or alleviater in 19 cases during hospiatalization. Arrhythmia recurred in 2 cases 12 hours after the procedure and accepted RFCA again. No severe complications and adverse reaction occured. The successful rate was 90.5 percent. Two cases suffered from recurrent angina during the follow-up period and one of them had in-stent restenosis proved by CAG and accepted PTCA+SI again. The other patient received medicine therapy. Conclusion Combined interventional procedure operated by experienced interventional cardiologist in a conditioned catheterization laboratory is safe and feasible. The short-term outcomes are satisfied. The long-term outcomes will be proved by accumulating more cases' data. Individualized approaches, counterplans for complications and cautious operation are important to a successful procedure.

OBJECTIVE To investigate the distribution of drug resistance of Pseudomonas aeruginosa(PAE) among neonates and analyze the characteristic of the PAE infection.METHODS API system was used for the identification of 131 PAE clinical isolates and the resistance to 17 kinds antibiotics was determined by K-B method.RESULTS Most of 131 strains were isolated from sputum(42.0%) and gastric juice(32.8%).All strains were mainly isolated from neonate intensive care unit(NICU).The sensitivity to amikacin,levofloxacin,ofloxacin,ciprofloxacin,piperacillin/tazobactam,cefoperazone/sulbactam,imipenem and meropenem was respectively over 70.0%.PAE was inferior sensitivity to piperacillin,mezlocillin,cefoperazone,ceftriaxone,ceftazidime and aztreonam.CONCLUSIONS PAE is one of the most common pathogens causing nosocomial infection especially for neonates.Its susceptibility to antibiotics showed multidrug resistance.In order to reduce or prevent the occurrence of resistant isolate,we should rationally choose and use antibiotics combining with trait of neonate.

Objective The aim of the study is to explore the relationship of lung infection(LI)and multiple organ failure in the elderly(MOFE).Methods Consecutive patients ,who were admitted to the Institute of Geriatric Cardiovascular Diseases of the PLA General Hospital and the Endocardial Department of the Air Force General Hospital,withage≥65 years old were enrolled into 5 groups retrospectively by following criteria:acute LI alone,LI with the first presentation of acute lung edema,chronic bronchitis complicated with LI,chronic heart failure complicated with LI,and nic bronchitis and heart failure complicated with LI.Results Sixty-eight patients were selected of(72.5?7.6)years old ( 38 male).There were 4 cases of pure LI(4%),12 cases of LI firstly presented with the symptoms of acute lung edema(18%),16 cases of LI complicated with chronic bronchitis(24%),15 cases of LI based on chronic heart failure(22%)and 22 cases of LI complicated with chronic bronchitis and heart failure(32%).LI initiated MOFE in 25 cases(37%).Most of them were developed on the basis of chronic bronchitis and/or heart failure(34%).Mortality of secondary LI was higher than that of the primary LI(7.4% VS 0%,P

Thirty-six patients with acetabular fracture undergoing Kocher-Langenbeck approach surgery in Beijing Jishuitan Hospital between January 2001 and December 2005 were selected.All patients underwent tibial tubercle or femoral upper condyle traction before surgery.People with traumatic arthritis or other lower limb injury on postoperative X-ray were excluded.Using Biodex system to test the abduction and extension muscle at 60( ?)/s and 180( ?)/s.Peak torque,total work,and mean power were used for evaluation.The difference between bilateral limbs ≤ 10% was normal,≥ 20% was abnormal and 11%-19% was suspected.The muscle strength in fast test was more than the slow test(t=2.21,P

After the following aspects of information resources digitalization in domestic TCM were described, in-cluding different types and contents of digital information resources, effectively developed ancient book resources, expanded team construction, and strengthened cooperation between departments. Measures were put forward for the digitalization of information resources in domestic TCM according to the existed problems, such as insufficient de-velopment, lack of audiovisual products, and low accessibility of TCM information resources.