OBJECTIVE To study the risk factors of pulmonary infection and prognosis in elderly cerebral apoplectic patients. METHODS A retrospective survey on 541 elderly cerebral apoplectic patients was analyzed to investigate the rate of pulmonary infection,the type and the severity of cerebral apoplexy,the underlying disease,disturbance of consciousness,invasive operation and the prognosis. RESULTS The most of the pulmonary infections in elderly cerebral apoplectic patients were nosocomial infection.The rate of infection was high and related to many factors. CONCLUSIONS The result showed that the pulmonary infection in elderly cerebral apoplectic patients is caused by many risk factors.Controlling the rate of pulmonary infection can help us to succeed in treating cerebral apoplexy.

Objective To observe the effects of different levels of stroke volume variation(SVV) directed fluid therapy on prognosis in elderly surgery patients. Methods One hundred and fifty-six patients (ASA gradeⅠorⅡ) having underwent abdominal surgery were selected, and the patients were divided into 3 groups according to the level of SVV with 52 cases each:low SVV group (SVV 3%-6%), middle SVV group (SVV 7% - 10%) and high SVV group (SVV 11% - 14%). Each group accepted different fluid therapy strategy. The intraoperative index, postoperative recovery index and complications were compared. Results The volume of crystalloid and volume of colloform in low SVV group and middle SVV group were significantly higher than those in high SVV group: (2 365 ± 517) and (2 080 ± 378) ml vs. (1 820 ± 579) ml, (1 105 ± 220) and (898 ± 239) ml vs. (559 ± 166) ml, and those in low SVV group were significantly higher than those in middle SVV group, and there were statistical differences (P<0.05). The urine volume in low SVV group was significantly higher than that in high SVV group:(717.4 ± 289.0) ml vs. (511.8 ± 326.3) ml, and there was statistical difference (P<0.05). The first exhaust time in high SVV group was significantly shorter than that in low SVV group:(81.2 ± 27.5) h vs. (98.9 ± 32.5) h, and there was statistical difference (P<0.05). The first level and above nursing time, postoperative hospital stay and total length of hospital stay in middle SVV group were significantly shorter than those in high SVV group and low SVV group: (4.4 ± 2.8) d vs. (5.3 ± 3.2) and (6.4 ± 3.7) d, (13.8 ± 5.2) d vs. (17.7 ± 8.4) and (19.5 ± 8.9 ) d, (22.7 ± 10.4) d vs. (26.8 ± 13.1) and (30.6 ± 10.3) d, and there were statistical differences (P<0.05). The incidence of stomal leak in high SVV group was significantly higher than that in low SVV group: 17.3% (9/52) vs. 3.8% (2/52), the incidences of postoperative infection in high SVV group and middle SVV group were significantly lower than that in low SVV group: 5.8% (3/52) and 5.8% (3/52) vs. 26.9% (14/52), and there was statistical difference (P<0.05). Conclusions The SVV 3% - 6% in elderly surgery patients may increase the risk of postoperative infection and prolong the time of hospitalization. But the SVV 7% - 10% may have a better postoperative recovery, and this level could be a better goal of perioperative fluid therapy in elderly surgery patients.

Objective: To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance. Methods: Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model. Results: Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck. Conclusions The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.

AIM: To evaluate the effect of TDF withdrawal time on changes of serum HBV-M, HBV DNA and ALT level in the mother-to-child blocking of the maternal population. METHODS: A prospective, randomized and controlled study was conducted. The 120 pregnant women with HBV who took TDF during 24 to 28 weeks of gestation were randomly divided into group A (withdrawal at delivery) and group B (withdrawal at 4 weeks postpartum), levels of HBV-M, HBV DNA, and ALT at different times were detected. The results were statistically analyzed by Wilcoxon Rank-sum test and χ