Objective The purpose of this study was to evaluate the perioperative management of patients with recent myocardial infarction (MI) undergoing non-cardiac surgery.Methods Twelve patients underwent general or thoracic surgery on the 72th to 175th day after acute MI. Their mean age was (67?4 ) years old. All patients received epidural block or epidural block combined with general anesthesia. Epidural catheter was left in place for postoperative analgesia.Results All patients underwent operation smoothly. During operation ECG monitoring showed no ischemic ST-T changes. Postoperative pain relif was satisfactory. No acute heart failure or myocardial reinfarction occurred during their stay in hospital.Conclusions In patients who had recent MI the time interval between the first MI and surgery should not be the only factor in the risk assessment. Other factors such as urgency of surgery, the severity of coronary artery disease, exercise tolerance and complexity of surgery should also be considered. Adequate preoperative evaluation and preparation and maintenance of cardiac function during perioperative period are crucial to the safety of surgery. Epidural block combined with general anesthesia is the anesthesia of choice for patient with recent MI undergoing non-cardiac surgery.

and each of the resistant strains was resistant at least to 5 antibiotics.13 strains out of the 28 harbored plasmids ranging from 1 to 6 in number and 105 Md to 2.7 Md in molecular weight.The plasmid with 50 Md was the most popular one in this study,which may be the epidemic plasmid in the urologic unit.It was also found that 2 different species of bacteria isloated from the patients with infection of the urinary tract showed identical plasmid profile,which indicates that these 2 patients may be associated with each other.

Objective To explore the clinical value of serum inhibin B in predicting ovarian stone.Methods 158 patients were divided 3 groups:73 premature ovarian failure(POF) group and 55 decreasing ovarian stone(DOS) group,while 30 nomal women were taken as the control group,their basal serum inhibin B(INHB),estradiol(E2),follicle stimulating hormone(FSH),resistance index(RI),ovary follicle(OVF),ovary diameter(OVD),and symptom point were detected.Results Comparde with the control group,the level of INHB decreased significantly in the POF group and DOS group(P

Student awareness of rehabilitation medicine theory was still weak after learning for some time. We tried to impart rehabilitation concepts and thoughts to students during the course of rehabilitation technique. Following one controlled and randomized study, the Results of treatment group was more significant than that of controls.

Objective:To investigate if downregulation of two mitotic checkpoint proteins, MAD2 and p55CDC, is a frequent event in human prostate cancer and whether decreased expression of these two proteins are associated with progression of prostate cancer. Methods: Using immunohistochemistry technique, the expressions of MAD2 and p55CDC proteins are examined in 46 benign prostate hyperplasia (BPH) and 65 prostate cancer tissues. Differential expressions were compared first between BPH and prostate cancer specimens, and then among prostate cancer samples with different Gleason grades. Results: We found that down regulation of MAD2 and p55CDC expressions was significant in prostate cancer (96% and 83%, respectively) compared to BPH (19.5% and 4.3%, respectively) ( P

OBJECTIVE: To investigate feasibility and effectiveness of pedicle screw bi-cortical fixation in lumbar spondylolisthesis or destabilization of aged people. METHODS: The statistical significance of the distance between the anterior edge of vertebral body and the anterior major blood vessels at the level of pediculus arcus vertebrae by CT scan at random were measured and analyzed. 82 cases of lumbar spondylolisthesis or destabilization, aged 65 years (range 51 to 75 years), including 35 males and 47 females, were treated pedicle screw bi-cortical fixation, with the anterior edge of the vertebral body penetrated by one screw thread. The function was evaluated by Macnab backleg pain scale standards. RESULTS: There was significant difference in the distance of the anterior edge and the major vessels between the old and the young (P< 0.05). All the 82 cases were operated successfully, and the mean time was 145 minutes and the mean amount of bleeding was 530 mL. The 43 cases including 15 males and 28 females were followed up for 18 months (range 3 to 53 months). There was one case of rupture of the spinal dura mater with no sequela after the suture. There were 3 cases of transient paralysis and pain of lower limbs, which were alleviated after 2 months' treatment. No complications of nerve root or vessel injuries were found. All incisions healed well at the primary stage. The lumbocrural pain of all 43 cases was alleviated to a certain content. There were 31 cases of excellent, 10 of good, and 2 of fair; the excellent and good rate was 97%. CONCLUSION: It is feasible and safe to treat the lumbar spondylolisthesis or destabilization in the old with the pedicle screw bi-cortical fixation.

ObjectiveTo explore the influence of early enteral nutrition (EEN) on the immune function and outcome in patients with severe traumatic brain injury.MethodsTotally 131 patients with severe traumatic brain injury who were admitted to the Intensive Care Unit of our hospital between March 2010 and March 2011 were enrolled in this study.Among them,69 were in EEN group and 62 were in control group.On day 7,humoral immune function was measured using automatic biochemistry analyzer,and the peripheral blood lymphocyte subset proportions were measured using flow cytometry.The complications were recorded in the initial 7 days after trauma.ResultsCompared with the control group,the EEN group had significantly lower incidences of complications including glucose metabolism disorder,diarrhea/stomach intestine distend,infection,multiple organ dysfunction syndrome,and stress ulcer on day 7 ( P =0.000,0.002,0.001,0.004,and 0.002).Hospital mortality in the EEN group was also significantly lower than that in control group ( P =0.028).The serum levels of IgM and IgG in EEN group were significantly higher than in control group ( both P =0.000),whereas the serum levels of C3 and C4 in the EEN group were significantly lower ( both P =0.000).IgA showed no significant difference between these two groups (P =0.144).The serum levels of CD3 + CD4 + T lymphocytes,CD4 +/CD8 + T lymphocytes,and CD19 + lymphocytes in the EEN group were significantly higher than in control group (all P =0.000),while CD3 + CD8 + T lymphocytes showed no significant difference ( P =0.070 ),The serum level of CD16+ CD56+ T lymphocytes in the EEN group was significantly lower than that in control group (P =0.026).ConclusionPatients with severe traumatic brain injury have good tolerance of EEN,which may enhance the immune function and improve the outcome of the patients.

OBJECTIVE:To evaluate the efficacy and safety of new agent zaleplon in treatment of insomnia.METHODS:A randomized,double-blind,controlled and dosage-adjusted clinical trial was conducted.The subjects had been treated with zaleplon5～10mg/d and zopicolone7.5～15mg/d for14days,respectively.RESULTS:The scores of sleep dysfunction rating scale at endpoint were significantly reduced as compared with the baseline in both groups(P

BACKGROUND: Both Allergic rhinitis and bronchial asthma are allergic diseases of respiratory tract. They frequently coexist in the same patients.OBJECTIVE: To study the incidence of allergic rhinitis in patients with bronchial asthma in Nanjing, and to analyze the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.DESIGN: The questionnaire survey.SETTING: Department of Otorhinolaryngology-Head and Neck Surgery and Department of Respiratory, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: A total of 134 patients with bronchial asthma including 73 males and 61 females were selected form Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from February 2001 to April 2005. Their ages ranged from 3 to 72 years. Severity of asthma of all patients was classified based on Global Initiative for Asthma (GINA). The diagnostic criteria of allergic rhinitis were established referred to the guideline of Haikou Meeting (November, 1997). All patients provided the confirmed consent.METHODS: The questionnaire survey of 134 bronchial asthma patients from the city of Nanjing was conducted. Their age, classification, severity, treatment status, and the family history of all 134 patients were investigated in details. Differences of age, age at onset, and course of disease between rhinitis and asthma of all patients were examined by two independent t tests. The correlation between clinical characteristics of allergic rhinitis and bronchial asthma was analyzed by Spearman rank correlation.MAIN OUTCOME MEASURES : Incidence of allergic rhinitis in patients with bronchial asthma and the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.RESULTS：Of all 134 bronchial asthma patients，82(61．2％,82/134)were accompanied with allergic rhinitis．There were 45 males and 37 females．Of 82 patients with allergic rhinitis accompanying with bronchial asthma，severity was classified into grade Ⅰ (mild pause,n=56)，grade Ⅱ (mild persistence，n=21)，grade Ⅲ (moderate persistence，n=4)，and grade Ⅳ (severe persistence，n=1)．In addition,allergic rhinitis was classified into periodicity (n=65) and persistence(n=17)．According to the classification and seventy system recommended in ARIA,63 patients had mild symptoms and 19 had moderate and severe symptoms．Severity of allergic rhinitis was positively related to that of bronchial asthma(r=0.689,P＜0．01)．CONCLUSION: The morbidity of allergic rhinitis combining with bronchial asthma is high in Nanjing, China. While, their classification and severity are highly coherent.

Objective To study the effects of high volume hemofiltration (HVHF) according to pulse-indicated continuous cardiac output (PiCCO) on patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomly controlled trial was conducted.163 patients with ARDS admitted to Taizhou People's Hospital,Medical College,Nantong University,between February 2011 and January 2014,were enrolled.The patients were randomly divided into conventional therapy group (n＝ 50),HVHF group (n =55),and PiCCO + HVHF group (n＝58) by random number table.The patients in conventional therapy group received routine treatment including mechanical ventilation and drug treatment according to ARDS treatment guideline.The patients in the HVHF group received HVHF treatment of 18 hours per day on 1,3,5,7 days on the basis of conventional therapy.Patients in the PiCCO + HVHF group received HVHF treatment according to PiCCO.The indexes of lung function and PiCCO monitoring were recorded at intensive care unit (ICU) admission (before) and 4 days and 7 days after treatment.The serum levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were determined by enzyme linked immunosorbent assay (ELISA),and the prognosis of patients was recorded.Results In three groups,oxygenation index (PaO2/FiO2),static lung compliance (Cs) were gradually increased,and respiratory rate (RR),lactic acid (Lac) were gradually decreased.The indicators in HVHF and PiCCO + HVHF groups were significantly improved compared with conventional therapy group.The indexes in PiCCO + HVHF group were significantly increased or decreased compared with those in HVHF group,and the statistical differences were found on the 7th day after treatment [PaO2/FiO2 (mmHg,1 mmHg=0.133 kPa):189.3 ± 36.8 vs.166.3 ± 36.1,Cs (mL/cmH2O):76.7 ± 18.9 vs.67.0 ± 18.2,RR (times/min):16.4 ±5.2 vs.19.2 ± 5.4,Lac (mmol/L):1.20 ±0.41 vs.1.41 ±0.43,all P＜0.01].In PiCCO +HVHF group,cardiac index (CI) was gradually increased,and extra vascular lung water index (EVLWI) and intra thoracic blood volume index (ITBVI) were gradually decreased.There were significant differences in the indexes 4 days and 7 days after treatment compared with those before treatment [CI (L·min-1·m-2):4.62 ± 1.13,4.83 ± 1.10 vs.4.01 ± 1.02,EVLWI (mL/kg):7.6 ± 2.7,6.5 ± 2.6 vs.12.4 ± 2.9,ITBVI (mL/m2):801.3 ± 120.9,785.4 ± 118.7 vs.980.1 ± 168.6,all P＜0.01].After treatment,the serum levels of TNF-α and IL-1β in three groups were gradually decreased.Compared with the conventional therapy group,the serum levels of TNF-α and IL-1β on 4 days and 7 days in the HVHF and PiCCO + HVHF groups were significantly decreased,and the statistical differences were found on 7 days [TNF-α (ng/L):68.35 ± 12.63,67.54 ± 12.90 vs.85.35 ± 13.70; IL-1β (ng/L):424.6 ± 142.9,412.2 ± 140.2 vs.895.2 ± 187.7,all P＜0.01].Compared with the HVHF group,the serum levels of TNF-α and IL-1β in the PiCCO + HVHF group were slightly decreased without statistical differences.Compared with the conventional therapy group,the number of organ failure,duration of mechanical ventilation,the length of stay in ICU and hospital mortality in HVHF group and PiCCO + HVHF group were lowered,and the statistical differences were found in PiCCO + HVHF group compared with HVHF group [number of organ failure:2.41 ± 0.79 vs.2.72 ± 0.80,duration of mechanical ventilation (days):4.8 ± 2.0 vs.5.7 ± 2.1,the length of stay in ICU (days):11.5 ± 3.4 vs.13.1 ± 3.6,hospital mortality:31.0％ (18/58) vs.41.8％ (23/55),all P＜0.05].Conclusions Levels of inflammatory factors in patients with ARDS could be reduced by HVHF.The oxygenation and compliance of lung can be improved,the number of organ failure can be lowered,the duration of mechanical ventilation and the length of stay in ICU can be shortened,and the hospital mortality could be declined by PiCCO guided HVHF.