Objective To investigate the detection of central venous oxygen saturation ( ScvO2 ) whether can be alternative mixed venous oxygen saturation ( SvO2 ) in elderly patients with acute left ventricular failure.Methods 42 elderly patients with acute heart failure were detected by central venous oxygen saturation and mixed venous oxy-gen saturation before the treatment and 1h,2h,4h after treatment.Then the parameters index changes were analyzed according to the prognosis.Results Whatever the prognosis of the patients were,the trend of ScvO2 and SvO2 was the same.Before the treatment,the blood oxygen saturation detected by the ScvO2 with patients was no statistical differ-ence with the ScvO2(t=0.867,P>0.05),and after treatment of 4h the change trend detected of both has also the consistency,no statistical difference (t=0.681,P>0.05) The correlation coefficient r=0.998,and the relationship between ScvO2 and SvO2 confirmed the same clinical significance.Conclusion Considering the factors of trauma, complications,costs and so on,ScvO2 can be used to replace SvO2 in elderly patients with acute left heart failure.

Objective To assess the value of exercise treadmill testing (bruce protocol) in diagnosing early atherosclerotic lesions of the lower limb. Methods Between March and September 2008, 173 outpatients with high risks of peripheral arterial disease (PAD) were enrolled randomly from the cardiology clinic of Chinese PLA General Hospital. The patients were subjected to exercise treadmill testing (Bruce protocol) and ankle-brachial index (ABI) determination, as well as lower limb artery ultrasonography within one week. Using ultrasonic findings as diagnostic criteria, the diagnostic sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of exercise treadmill testing for early atherosclerotic lesions of the lower limb were analyzed, and the diagnostic value of exercise treadmill testing was assessed using the ROC curve. Results After exercise, ABI decrement (R value) increased in subjects with high risks for PAD with atherosclerotic lesions of the lower limb aggravating. Using the presence of large atherosclerotic plaques (area > 20 mm2 ), atherosclerotic plaques and atherosclerotic lesions in lower limb arteries as positive diagnostic criteria, the area under curve of ROC was 0. 80 (95% CI: 0.72-0.88), 0.78 (95% CI: 0.71-0.85) and 0. 60 (95% CI: 0.44-0.76), respectively. Using the presence of large atherosclerotic plaques in lower extremities as positive diagnosis, R value was 0.80, with a sensitivity of 54. 0%, a specificity of 96. 7%, a LR+ of 16. 4, and a LR- of 0. 58, meanwhile, R value was 0. 85, with a sensitivity of 70.0%, a specificity of 91.9%, a LR + of 8.64, and a LR- of 0.33. Conclusions Exercise treadmill testing (Bruce protocol) in combination with ABI determination is a safe, accurate, objective tool for detecting early atherosclerotic lesions of the lower limb. Immediately after exercise, 0.85 is the cut-off R value appropriate for diagnosing large atherosclerotic plaques of the lower limb (area > 20 mm2).

Objective: To study the influence of Ruhuang(Rhubarb and Lactohacillin) preparation to endotoxin and intestinal defence function of cirrhotic rats.Methods:88 male Wister rats were randomly divided into normal group,model group,prevention group,prevention of control group,model treatment group and model treatment of control group.Liver cirrhosis model was induced by CCl4 combined with other factors,Ruhuang preparation was used for the prevention and treatment,lactulose was used as positive control drug.The level of plasma endotoxin,intestinal mucosal S-IgA and serum D-lactic acid were detected.Results : The blood plasma endotoxin level of Ruhuang prevention group and model treatment group is lower than that of model group obviously(P

Objective To observe the clinical effects of ultra-sound guided lumbar plexus and sciatic plexus nerve block combined with general anesthesia on elderly patients undergoing hip replace-ment surgery.Methods Eighty elderly patients scheduled for unilateral hip replacement surgery were randomly divided to lumbar plexus and sciatic plexus nerve block combined with general anesthesia group (group N)and general anesthesia group (group G).The airways of all the patients were con-trolled by laryngeal mask airway (LMA)in both groups.The bispectral index (BIS)of patients in both groups was maintained in the range of 45-55.The dosage of sulfentanyl,visual analogue scale (VAS)at 2,4,8 and 24 h after surgery,and the dosage of patient controlled analgesia (PCA)drugs were recorded.The period from end of surgery to extubation,off-bed activity and discharged from hospital,mortality in 30 days after surgery were recorded.Meanwhile,postoperative delirium (POD) and postoperative cognitive dysfunction (POCD),and severe cardiovascular and pulmonary complica-tions were evaluated.Results No patient died in 30 days after surgery in both two groups.One patient suffered from severe pulmonary infection in group G.The dosage of sulfentanyl of group N was less than the value of group G (P <0.05),the periods from end of surgery to extubation,off-bed activity and discharged from hospital of group N were shorter than those in group G (P <0.05 ).The VAS scores and incidence of POD and POCD in group N were lower than those in group G (P < 0.01 ). Conclusion In elderly patients undergoing hip replacement surgery,ultrasound-guided lumbar plexus and sciatic plexus nerve block combined with general anesthesia could help reduce usage of opioids during operation,offer better analgesia effect,shorten the period of off-bed activity and discharged from hospital and reduce incidence of POD and POCD in elderly patients.

The epidemic characteristics and genotype of Bacillus anthracis strains in Liaoning Province ,China was analyze in this study .Six Bacillus anthracis strains from 2001 to 2011 were studied with multiple‐locus variable‐number tandem repeat analysis (MLVA) .BioNumerics4 .0 software was used to analyze the DNA fingerprint of statistics ,and cluster analysis results were obtained .Clustering analysis found that the 6 strains could be divided into two genotypes .For anthrax outbreaks ,the ge‐netic markers of multiple‐locus variable‐number tandem repeat were highly similar .It's suggested that MLVA is quite useful for investigation of strain relatedness in regions of outbreaks .

Objective To evaluate the clinical outcome of cervical laminoplasty using titanium miniplate ( AO arch) for the treatment of multisegmental cervical spondylotic myelopathy (MCSM).Methods 21 patients with MCSM were operated by cervical posterior unilateral open-door laminoplasty combined with titanium miniplate internal fixation.The JOA score,sagittal diameter of the spinal canal in the midline (SD) and cervical curvature index according to the measurement of Penning method before surgery and at postoperative follow-up intervals were measured and compared by one-way analysis of variance.Results All patients were followed up for 9 ～48 months.There were no severe adverse events.CT sean showed bony fusion at hinge side since six months after operation.According to the JOA score evaluation system,al final follow-up period,9 cases were excellent,7 good,3 ordinary and 2 cases bad.Recovery rate was 62.5 ％ at final follow-up interval.Cervical SD before surgery and in posloperative one month were (9.2 ± 1.1 )mm,(13.5 ± 1.4) mm,respectively.The difference was significant between them( t =3.02,P ＜ 0.01 ),but there was no improvement since one month postoperatively ( P ＞ 0.05 ).Cervical curvature index was ( 12.6 ± 14.7 ) ° preoperatively,it was ( 17.1 ± 12.4 ) ° at final follow-up interval,indicating that cervical curvature index made obvious progress at final follow-up interval ( t =8.26,P ＜ 0.01 ),but there was no significant change within six months postoperatively ( P ＞ 0.05 ).Conclusions Cervical laminoplasty combined with titanium miniplate can enlarge and maintain cervical SD,ameliorate cervical curvature and neurological function,and it is an ideal alternative treatment for MCSM.

Objective:Rosin alcohol two glycosidase (pinores inoldiglucoside, PDG) effect on the improvement of the osteoporosis in mice and the possible mechanism of action.Methods:A mouse model of osteoporosis was established by removing bilateral ovaries. According to the random number table method, 50 mice were divided into model (MOD) group (equal volume of normal saline), positive control (PC) group (0.2 mg/kg estradiol), PDG-low dose (L) group (5 mg/kg) PDG), PDG-high dose (H) group (10 mg/kg PDG by gavage) and PDG-H+ML385 group (10 mg/kg PDG by gavage after intramuscular injection of 30 mg·kg-1 ML385), 10 mice in each group; Another 10 mice without any ovarian treatment were selected as sham group (intragastric administration of the same amount of normal saline). After 3 weeks of drug intervention, the serum alkaline phosphatase (ALP), tartrate resistant acid phosphatase (TRAP), interleukin-6 (IL-6) and tumor necrosis factor were detected by enzyme-linked immunosorbent assay (ELISA) -α (TNF-α). The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by dual energy X-ray. The mRNA and protein expression levels of nuclear factor related factor 2 (Nrf2), oxidase heme oxygenase 1 (HO-1), quinone oxidoreductase 1 (NQO1) were detected by real-time fluorescence quantitative PCR (qRT-PCR) and Western blot, respectively.Results:The serum ALP levels in Sham, MOD, PC, PDG-L, PDG-H and PDG-H + ML385 groups were (25.88±3.42), (47.42±5.32), (36.20±3.37), (38.95±3.24), (29.66±2.64), (39.57±2.06) U/dL, respectively; The serum trap levels were (2.18±0.40), (4.69±0.83), (3.58±0.38), (3.67± 0.48), (2.93±0.26), (3.81±0.49) U/L, respectively; BMD (153.04±12.96), (86.25±6.71), (126.53±8.99), (119.77±8.84), (139.18±15.94), (92.09±4.17) mg/cm 2; The expression levels of Nrf2 mRNA were 1.00±0.00, 0.35±0.04, 0.67±0.05, 0.54±0.03, 0.82±0.08 and 0.48±0.04, respectively; The expression levels of HO-1 mRNA were 1.00±0.00, 0.25±0.03, 0.56±0.03, 0.47± 0.03, 0.71±0.04 and 0.37±0.04, respectively; The expression levels of nqo1mrna were 1.00±0.00, 0.38± 0.02, 0.63±0.03, 0.58±0.04, 0.79±0.05 and 0.44±0.03, respectively; Nrf2 protein expression levels were 0.98±0.08, 0.26±0.04, 0.52 ±0.06, 0.46±0.03, 0.86±0.07, 0.45±0.05. HO-1 protein expression levels were 0.39±0.02, 0.09±0.01, 0.15 ±0.03, 0.17±0.03, 0.26±0.03, 0.12±0.02. NQO1 protein expression levels were 0.53±0.03, 0.21±0.02, 0.38±0.04, 0.29±0.02, 0.55±0.03, 0.24±0.04, respectively; The levels of serum IL-6 were (104.25±11.35), (515.38±74.48), (351.78± 65.12), (364.73±36.64), (246.18±17.52), (408.93±32.56) pg/ml, respectively; The levels of serum TNF-α were (33.79±3.55), (170.11±19.24), (76.09±8.99), (84.95±6.12), (66.98±3.73), (119.04±9.75) pg/mL, respectively; The serum SOD levels were (258.47±19.25), (72.15±8.12), (187.60±14.63), (152.61±12.36), (204.22±19.65), (138.01±13.62) U/mL, respectively; The serum MDA levels were (2.02±0.27), (4.75±0.73), (3.19±0.46), (3.7±0.49), (2.91±0.42), (4.10 ±0.25) μmol/L respectively. There were significant differences between MOD group and Sham group, or PC, PDG-L, PDG-H, PDG-H+ML385 group and MOD group,or PDG-H+ML385 group and PDG-H ( P<0.05) . Conclusion:PDG can reduce bone inflammation and oxidative stress by activating Nrf2 pathway and improve the state of osteoporosis.

Objective To investigate the effect of Shenxiong glucose injection on platelet reactivity during aspirin treatment in patients with acute ischemic stroke.Methods A total of 263 patients with acute ischemic stroke admitted to 12 hospitals from January 2014 to December 2016 were enrolled prospectively.They were randomly divided into aspirin group and aspirin + Shenxiong glucose injection group.The changes of platelet maximum aggregation rate induced by 4 platelet aggregating agents (arachidonic acid,adenosine diphosphate,collagen and platelet activating factor) were detected before and after the treatment.Results There were no significant differences in the demographic data and baseline clinical characteristics between the aspirin group (n =132) and the Shenxiong glucose injection + aspirin group (n =131).At baseline,the maximum aggregation rate of platelet induced by arachidonic acid and platelet activating factor in Shenxiong glucose injection + aspirin group was significantly higher than that in the aspirin group (all P ＜0.05).On the 6th day after treatment,the maximum aggregation rate of platelets induced by the 4 aggregating agents in the Shenxiong glucose injection + aspirin group was significantly lower than that in the aspirin group (all P ＜ 0.001).Conclusion Shenxiong glucose injection had a significant inhibitory effect on platelet reactivity during aspkin treatment in patients with acute ischemic stroke.

Objective To investigate the correlation between the infarction location and progressive motor deficits (PMD) occurrence.Methods The patients with middle cerebral artery(MCA) infarction within 24 h of onset without thrombolytic therapy were included.The National Institutes of Health Stroke Scale(NIHSS) motor item score increase ≥2 points of the base line within 7 d after stroke onset served as the PMD diagnostic criteria.The differences in clinical and laboratory data,and infarction location were compared between the PMD group and non-PMD group.The multivariate Logistic regression analysis predicted the risk factors of PMD occurrence.Results A total 121 patients with MCA acute cerebral infarction were included in the study and divided into the PMD group (45 cases) and non-PMD group (76 cases).The internal watershed infarction occurrencerate in the PMD group was higher than that in the non-PMD group (26.7 ％ vs.5.3％,p=0.001).The occurrence rate of penetrating arterial infarction (PAI) had no statistical difference between the PMD group and non-PMD group(42.2％ vs.35.5％,P=0.463).PAI was further divided into perforating branch atheromatous disease (BAD) and lipohyalinitic degeneration (LD).The occurrence rate of BAD in the PMD group was significantly higher than that in the non-PMD group (28.9％ vs.9.2％,P=0.005).The stepwise Logistic regression analysis indicated that watershed infarction [odds ratio (OR):9.750,95 ％ confidence interval(CI):2.828-33.612,P=0.000] and BAD lesion (OR:6.036,95 ％ CI:2.119-17.190,P =0.001) were the independent risk factors contributing to PMD.Conclusion Internal watershed infarction and BAD lesion may predict the PMD occurrence.The infarct location is conducive to find the high risk population of cerebral infarction progress.