Objective: To investigate the prevalence of postoperative delirium(PD)and its risk factors in patients aged 80 and over with hip fracture treated with total hip arthroplasty(THA). Methods: Clinical history and perioperative data of patients aged 80 years and over with hip fractures who underwent THA in our hospital from Sep.2017 to Mar.2019 were analyzed.Patients were divided into delirium group and non-delirium group.The prevalence of postoperative delirium of THA and its risk factors were analyzed by multiple Logistic regression. Results: A total of 90 patients were eligible for inclusion for this study.Of them, 27 patients(30.0%)were diagnosed as PD and 63(70.0%)did not experience PD.Multivariate stepwise Logistic regression analysis showed that a history of stroke(OR=17.702, 95%CI: 1.514-207.034, P=0.022), preoperative lower serum albumin(OR=1.524, 95%CI: 1.132-2.051, P=0.005), Mini-Nutritional Assessment short-form score(MNA-SF)(OR=1.481, 95%CI: 1.045-2.099, P=0.027)were independent risk factors for PD. Conclusions The prevalence of postoperative delirium of THA is higher in patients aged 80 years and over with hip fractures.Prevention and correction of risk factors, such as malnutrition, may help prevent the postoperative delirium.

OBJECTIVETo investigate the relationship between extracapsular spread (ECS) of cervical metastatic lymph node and the recurrence in patients with oral squamous cell carcinoma (OSCC).

METHODSThe medical records of 74 OSCC patients with histologically confirmed cervical lymph node metastasis were reviewed. They were divided into 2 groups, ECS positive (ECS+) and ECS negative (ECS-). The treatment results were followed up. Statistical analysis, with chi-square test, and multiple logistic regression was conducted.

RESULTSThe overall recurrence rates for pN+/ECS- and pN+/ECS+ patients were 47.6% and 75.0%, respectively, and the cervical recurrence rates for pN+/ECS- and pN+/ECS+ patients were 9.5% and 46.9%, respectively (P < 0.001). Multivariate analysis showed that ECS was one of the independent prognosis factors for cervical recurrence.

CONCLUSIONSExtracapsular spread significantly increased both overall and cervical recurrence rates, and ESC may be a prognosis factor for OSCC patients.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; Neck ; pathology ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies

OBJECTIVETo appraise the effect of single- and two-layer Percoll density gradient centrifugation in sperm separation.

METHODSTwenty semen specimens underwent single-(50%) and two-layer (90% and 45%) density gradient centrifugation, respectively. The sperm class analyzer (SCA) was used to analyze sperm density, motility and dynamic parameters and round cell density before and after the treatment.

RESULTSAfter separation, the sperm recovery rate of the single-layer method was (65.5 +/- 12.8)%, significantly higher than that of the two-layer method (P < 0.01). The percentages of grade a sperm of the single- and two-layer method were significantly higher than pre-treatment (P < 0.05, P < 0.01), that of the single-layer was significantly lower than that of the two-layer method (P < 0.05), but the percentage of grade c sperm of the former was significantly higher than that of the latter (P < 0.05). Compared with pre-treatment, the percentage of grade a + b sperm of the two-layer method was significantly higher (P < 0.05), while that of the single-layer method showed no significant difference (P > 0.05), and the round cell density of both the methods was significantly lower (P < 0.05, P < 0.01), with no significant differences between the two methods (P > 0.05).

CONCLUSIONThe single-layer method yields a higher rate of sperm recovery and causes little change in the sperm motility, while the two-layer method effects a lower rate and significantly improves sperm motility. Both the methods can efficiently separate sperm from round cells, and each has its own advantages and its application value in in vitro treatment of sperm.

Cell Separation ; methods ; Centrifugation, Density Gradient ; methods ; Humans ; Male ; Povidone ; Silicon Dioxide ; Sperm Count ; methods ; Spermatozoa ; cytology

Objective To analyze the clinical features of melioidosis,explore its diagnosis and treatment methods.Methods 35 patients who were with pathogenic evidence of melioidosis and admitted in a hospital between March 2012 and February 2017 were analyzed retrospectively.Results Of 35 patients at admission,2 (5.7％) were with confirmed culture result of melioidosis in the other hospitals,3 (8.6％) highly suspected patients had relatively typical clinical features,30 (85.7％) were misdiagnosed,suspected patients were all confirmed melioidosis through the cultured result of Burkholderia pseudomallei from all kinds of specimens.Through treatment of anti-infection,surgical drainage (11.4％) and operation (20.0％),26 cases (74.3 ％) were improved or recovered,2 (5.7％) abandoned treatment,and 7 (20.0％) died.The most common initial symptom was fever (88.6％),followed by cough (34.3％),shortness of breath(28.6％),abdominal pain (14.6％),extremity pain (11.4％),and joint pain (5.7％);the top five infection sites were blood (85.7％),lung (54.3％),spleen (20.0％),skin and soft tissue (20.0％),and liver (14.3％);85.7％ of Burkholderia pseudomallei were isolated from blood culture,37.1％ and 20.0％ were isolated from all kinds of puncture fluid and sputum respectively.Conclusion Clinical features of melioidosis are diverse,misdiagnosis rate is high.Early,timely,rational,and enough treatment course can reduce the mortality and recurrence rate of melioidosis.

Postoperative delirium involves attention and cognitive impairment and is a common, serious and often fatal condition in the elderly.This review summarizes the definition, diagnosis, pathogenesis, risk factors, prevention and treatment of postoperative delirium in elderly patients with hip fractures.

OBJECTIVETo explore the changes of CD(14)(+) monocyte human leucocyte antigen DR (HLA-DR) and their relationship with multiple organ dysfunction syndrome (MODS) in severe sepsis.

METHODSNinety-one patients with a definite diagnosis of severe sepsis in the intensive care unit (ICU) were included. CD(14)(+) monocyte HLA-DR levels were detected by flow cytometry on the first, 4th and 7th days of the study, and Marshall scores and prognosis on day 28 were evaluated.

RESULTSThirty-four patients died within 28 days following the onset with a mortality rate of 37.4%. Persistently lowered levels of HLA-DR were detected and significantly increased Marshall scores were found in the fatal cases at all the time points (P<0.001). In the surviving patients, the levels of HLA-DR were significantly increased (P<0.01) and Marshall scores were gradually decreased (P<0.001). During the observation period, the levels of HLA-DR decreased significantly as the number of dysfunctional organs and Marshall scores increased (P<0.001). The levels of HLA-DR were significantly increased in severe sepsis patients with 2-4 dysfunctional organs and Marshall score of 5-12 (P<0.05 or P<0.001). No changes in HLA-DR levels in severe sepsis patients with 5-6 dysfunctional organs and Marshall scores of 13-22. The levels of HLA-DR showed a significant inverse correlation to Marshall scores (r=-0.368, P<0.001).

CONCLUSIONIn patients with severe sepsis, persistent low CD(14)(+) monocyte HLA-DR levels predicts high mortality. The levels of HLA-DR are significantly correlated to the severity of organ dysfunction.

Adult ; Aged ; Aged, 80 and over ; Female ; HLA-DR Antigens ; metabolism ; Humans ; Lipopolysaccharide Receptors ; Male ; Middle Aged ; Monocytes ; immunology ; metabolism ; Multiple Organ Failure ; pathology ; Sepsis ; immunology ; metabolism

OBJECTIVEThe ratio of psychological to organic ED changes with aging. This study aimed to analyze the results of nocturnal electrobioimpedance volumetric assessment (NEVA) for ED patients of different age groups and their significance in the diagnosis of ED.

METHODSA total of 83 ED patients were divided into 4 age groups (< or = 29 yr, 30 -39 yr, 40 -49 yr and > or = 50 yr) and detected for nocturnal penile tumescence (NPT) by NEVA.

RESULTSThirty-four of the cases were diagnosed as organic ED, and the other 49 as psychological ED. With the increase of age, the former was increased from 30.3% in the < or = 29 yr group to 60.0% in the > or = 50 yr group, while the latter decreased from 69.7% to 40.0%.

CONCLUSIONThe percentage of organic ED tends to grow with the increase of age, while that of psychological ED is just the opposite.

Adult ; Aging ; Electric Impedance ; Erectile Dysfunction ; diagnosis ; physiopathology ; Humans ; Male ; Middle Aged ; Penile Erection

OBJECTIVETo separate and identify human testicular embryonal carcinoma proteomics using two-dimensional electrophoresis (2-DE) and mass spectrometry.

METHODSImmobilized pH gradient two-dimensional polyacrylamide gel electrophoresis was used to separate the total proteins of the samples. After silver staining, PDQuest 7.30 image analysis software was applied to analyze the 2-DE images. Three of the proteins highly expressed in human testicular embryonal carcinoma were identified by matrix-assisted laser adsorption/ionization-time of flight-tandem mass spectrometry (MALDI-TOF-MS/MS).

RESULTS2-DE effectively screened the differentially expressed proteins in the carcinoma tissues. Three proteins highly expressed in the carcinoma were successfully identified.

CONCLUSIONThe proteins of human testicular embryonal carcinoma can be effectively separated and analyzed using 2-DE and mass spectrometry. Proteomic analysis offers a new means for further study of this carcinoma.

Adult ; Biomarkers, Tumor ; analysis ; metabolism ; Carcinoma, Embryonal ; genetics ; metabolism ; pathology ; Electrophoresis, Gel, Two-Dimensional ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Mass Spectrometry ; Proteomics ; methods ; Testicular Neoplasms ; genetics ; metabolism ; pathology ; Young Adult

OBJECTIVETo explore the effect of electroacupuncture (EA) on the pathomorphology of the sciatic nerve and the role of P2X3 receptors in EA analgesia.

METHODSThe chronic constriction injury (CCI) model was adopted in this study. A total of 32 rats were randomly divided into four groups: sham CCI, CCI, CCI plus contralateral EA (CCI + conEA) and CCI plus ipsilateral EA (CCI + ipsEA). Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured. EA began at day 7 after the CCI operation and was applied to the Zusanli (ST 36) and Yanglingquan acupoints (GB 34). At day 14, the pathomorphologic changes of the operated sciatic nerve were demonstrated by hematoxylin and eosin staining. In addition, dorsal root ganglion (DRG) neurons isolated from rats were examined by electrophysiological recording to determine if the P2X3 receptor agonists, adenosine 5'-triphosphate disodium (ATP) and α,β-methylen-ATP (α,β-meATP) evoked inward currents.

RESULTSPain thresholds in the CCI group were obviously decreased post CCI surgery (P<0.01). In the EA groups, thermal and mechanical threshold values were increased after the last EA treatment (P<0.05, P<0.01). There was no significant difference in light microscopic examination among the four groups (P>0.05). Current amplitude after application of ATP and α,β-meATP in DRG neurons were much larger in the CCI group compared to those obtained in sham CCI (P<0.05). ATP and α, β-meATP invoked amplitudes in the CCI + EA groups were reduced. There was no signififi cant difference between the CCI + conEA group and the CCI + ipsEA group (P>0.05).

CONCLUSIONEA analgesia may be mediated by decreasing the response of P2X3 receptors to the agonists ATP and α,β-meATP in the DRG of rats with CCI. No pathological changes of the sciatic nerve of rats were observed after EA treatment.

Adenosine Triphosphate ; analogs & derivatives ; pharmacology ; Animals ; Constriction, Pathologic ; Electroacupuncture ; Ganglia, Spinal ; drug effects ; metabolism ; pathology ; Hyperalgesia ; pathology ; Ion Channel Gating ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley ; Reaction Time ; drug effects ; Receptors, Purinergic P2X3 ; metabolism ; Sciatic Nerve ; injuries ; metabolism ; pathology ; Staining and Labeling

The chigger mite Leptotrombidium sialkotense is one of the 6 main vectors of scrub typhus in China. Before present study, L. sialkotense was found in some parts of Hunan province, China with a narrow geographical distribution. During field investigation 2016-2017, we found L. sialkotense in Jingha, southern Yunnan, China. Of 15 small mammal host species, L. sialkotense were collected from 6 species of the hosts. Rattus brunneusculus was a dominant host of L. sialkotense, from which 98.3% of the mites were collected. The chigger mite showed a relatively high infestation prevalence (PM=11.7%) and mean abundance (MA=0.5) in comparison with the rest 5 host species. These results reveal a certain host specificity of L. sialkotense to a rat R. brunneusculus. The mite L. sialkotense showed an aggregated distribution on the host (P<0.05). A positive correlation observed between L. sialkotense and the body length of hosts. There was a positive interspecific association between L. sialkotense and 2 other dominant vectors, L. deliense and L. scutellare.