Objective To identify etiological factors for non-ulcer dyspepsia (NUD) in elderly patients presenting to the emergency department.Methods A total of 97 elderly patients with NUD presenting to the emergency department from January 2011 to December 2013 were enrolled in the NUD group and 116 elderly people undergoing annual physical examinations served as the control group.Clinical data,including Helicobacter pylori (HP) infection,unhealthy living habits,anxiety,depression and regular intake,were collected and compared between the two groups.Results Compared with the control group,the NUP group showed a higher HP infection rate [70.1％ (68/97)vs.54.3％ (63/116),x2 =5.565,P＜0.05],a higher incidence of unhealthy living habits (unhealthy dietary habits,smoking,drinking,and lack of regular exercise) (P＜0.05),a higher incidence of suspect anxiety/anxiety and a higher incidence of regular intake [30.9％ (30/97) vs 10.3％ (12/116),x2=14.138,P＜0.05].SerumpepsinogenⅠ(PGⅠ) [(178.7±13.6) μg/L vs.(125.2±10.5)μg/L,t=1.971,P＜0.01] and serum pepsinogen Ⅱ(PG Ⅱ) [(28.8±5.3) μg/L vs.(14.7±3.8)μg/L,t=1.960,P＜0.01] levels were also higher in the elderly NUD patients than in the control group.Conclusions HP infection,unhealthy living habits,anxiety and/or depression,and regular intake are closely associated with NUD in the elderly.Serum PGⅠ and PGⅡ could be used as markers in screening for malignant lesions in elderly patients with dyspepsia.

Objective To evaluate the clinical value of radionuclide pulmonary perfusion imaging in diagnosing acute pulmonary embolism.Methods Radioactive pulmonary perfusion imaging was performed in 25 patients clinically suspected for acute pulmonary embolism,meanwhile,imaging of deep veins of lower limb was taken.Results Multiple segments of abnormal blood perfusion were found in 23 of 25 patients,among them,radioactivity defects were found in 41 segments,radioactivity rarefied areas were found in 84 segments.Deep venous thrombosis was detected in 6 patients.Conclusion Radionuclide pulmonary perfusion imaging is a non-invasive and effective method in diagnosing acute pulmonary embolism.

Objective To analyze the therapeutic effect ofShengji-Yuhong ointment in the treatment of patients with pressure ulcer.Methods 86 patients of pressure ulcer were randomly divided into a control group and an observation group, with 43 cases in each. After debridement, the wound was covered with vaseline gauze in the control group, whileShengji-Yuhong ointment in the treatment group. 10 days constituted 1 course of treatment, and both groups were treated for 3 courses. The blood supply of the whole blood viscosity, plasma viscosity, erythrocyte aggregation index detection; white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) were observed in order to observe the control condition of the patients with wound infection.Results The total effective rate was 95.3% (41/43) and 74.4% (32/43) in the observation group and control group respectively, with significant difference between two groups (χ2=5.800,P=0.016). After treatment, the whole blood viscosity (high-shea) (4.06 ± 1.38 mPa?svs. 4.74 ± 1.62 mPa?s,t=2.095), the whole blood viscosity (medium-shea) (3.71 ± 1.22 mPa?svs. 4.34 ± 1.41 mPa?s,t =2.216), blood reduction viscosity (1.13 ± 0.22 mPa?svs.1.44 ± 0.51 mPa?s,t=3.660), the whole blood viscosity (medium-shea) (4.16 ± 0.48 mPa?svs. 4.51 ± 0.89 mPa?s,t=2.270) obviously compared with group before treatment decreased (P<0.05). The patients in the observation group in the whole blood viscosity (medium-shea) (3.71 ± 1.22 mPa?svs. 4.16 ± 0.48 mPa?s,t=2.251), and blood reduction viscosity (1.13 ± 0.22 mPa?svs. 1.32 + 0.31 mPa?s,t=3.278) in the observation group were  obvious better than the control group (P<0.05). After the treatment the WBC, CRP, ESR in the observation group were decreased significantly than the control group (t=5.947, 7.198, 12.064,P<0.01).ConclusionShengji-Yuhong ointment can effectively control the PU infection in the wound, improve wound tissue under the blood circulation, and promote wound healing.

Objective:To evaluate the clinical effects of ball attachment and Locator attachment for implant-supported overdenture.Methods:67 cases with edentulous jaw were treated with 150 Straumann and Bego implants and implant-supported overdentures using ball attachments Locator attachments,respectively.All cases were followed up regularly,biological and mechanical complications were observed,the patient satisfaction after restoration was compared between groups.Statistical analysis was performed using SPSS 17.0 software.Results:Follow-up was completed in 58 cases,25 with ball attachment,26 with Locator attachment and 7 with ball changed by Locator.Biological complications comparison showed that the incidence of gingival hyperplasia in the ball group was higher than that in the Locator group(P ＜ 0.05).There was no statistical difference of mechanical complications between the 2 groups (P ＞ 0.05),but the incidence of all kinds of mechanical complications in the Locator group was less than those in the ball group,the average repair frequency of the ball and Locator group was 1.9 times and 0.9 times respectively.Patients'satisfaction on chewing and retention was higher in the Locator attachment group than that in the ball attachment group(P ＜ 0.05).No statistical difference was found in patients' satisfaction between genders (P＞0.05),and no correlation of satisfaction was found with patients' age and follow-up time.Conclusion:The clinical effects of implant-supported overdenture using the Locator attachment is superior to that using the ball attachment.

Objective To evaluate the effect of sevoflurane preconditioning on the left ventricular function in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅱ or Ⅲ patients,aged 42-70 yr,with body height 152-181 cm,weighing 43-78 kg,scheduled for elective CABG under CPB,were randomly divided into 2 groups (n =15 each) using a random number table:control group (group C) and sevoflurane preconditioning group (group SP).Group SP inhaled sevoflurane with the end-tidal concentration corresponding to 1 MAC for 30 min after endotracheal intubation.Before sevoflurane preconditioning (T0) and at 60 min after termination of CPB (T1),mean arterial pressure (MAP),stroke volume index (SVI),pulmonary artery obstruction pressure and the TEE variables including left ventricular ejection fraction (LVEF),peak E wave velocity (E),systolic wave velocity (S),and diastolic wave velocity (D),and low propagation velocity (Vp) were recorded.S/D ratio and E/Vp ratio were calculated.Extubation time and duration of ICU stay were also recorded.Results Compared with the baseline value at T0,HR was significantly increased at T1 (P ＜ 0.05 or 0.01),and no significant change was found in the other parameters of the left ventricle function in the two groups (P ＞ 0.05).There was no significant difference in the parameters of the left ventricle function,extubation time and duration of ICU stay between SP group and C group (P ＞ 0.05).Conclusion Preconditioning with inhalation of sevoflurane with the end-tidal concentration corresponding to 1 MAC before CPB does not produce myocardial protection in terms of the left ventricular function or exerts little effect on the short-term outcomes.

Objective To analyze the sensitivity and specificity of several volume parameters regarding volume responsiveness.The studied volume parameters include pulmonary artery obstruc-tion pressure (PAOP),central venous pressure (CVP),right ventricular end-diastolic volume (RV-EDV)measured by Swan-Ganz pulmonary artery catheter and left ventricular end-diastolic area (LVEDA),inferior vena cava diameter (IVC)measured by transesophageal echocardiography (TEE). Methods Twelve patients with ASA Ⅱ or Ⅲ,scheduled for coronary artery bypass grafting were studied.After anesthesia induction,the TEE probe was put into the esophagus and Swan-Ganz cathe-ter was placed in right internal jugular venous.Measurements were made at the time before cutting the skin (T0 ),20 min after divorcing from cardiopulmonary bypass or finishing vascular anastomosis in off-pump surgery(T1 ),10 min after rapid infusion (T2 )and 30 min after rapid infusion (T3 ),re-spectively.Results The values of PAOP,IVC,LVEDA,COLVOT at time T2 increased significantly compared to those at time T1 (P <0.01).No obvious correlation (r=-0.298 5、r=-0.091 8、r=-0.243 6)was observed between △CVP、△PAOP、△RVEDV and △COLVOT (the difference between T2 and T1 );Meanwhile,△IVC and △LVEDA were well correlated to △COLVOT (r= 0.445 0、r=0.612 0).Using more than 1 5% change of COLVOT after volume expansion as definition of positive re-sponse,the areas under the receiver operating characteristic curves of CVP,PAOP,RVEDV,IVC and LVEDA were 0.389 (95% CI 0.035-0.743 ),0.458 (95% CI 0.109-0.807 ),0.333 (95% CI 0-0.671 ), 0.903 (95% CI 0.701-1.000 ) and 0.889 (95% CI 0.661-1.000 ), respectively. Conclusion PAOP,IVC,LVEDA,CO are more sensitive to the change of volume;while CVP and RVEDV have weak responses to volume changes.This indicates that IVC and RVEDA have more ad-vantage to estimate cardiac output increase and guide volume therapy.

Objective To evaluate the feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.Methods Forty ASA physical status Ⅱ or Ⅲ patients,aged 67-81 yr,weighing 47-65 kg,scheduled for extremity artificial vascular graft between femoral artery and deep femoral artery,were randomly divided into 2 groups (n =20 each) using a random number table:spinal anesthesia group (group S) and lumbar plexus block group (group L).In group S,0.5 ％ hyperbaric ropivacaine 3 ml was injected into the subarachnoid space.In group L,lumbar plexus block was performed with 30 ml of 0.5 ％ ropivacaine under the guidance of a nerve stimulator.The onset time and duration of sensory block,anesthetic efficacy,and requirement for ephedrine and volume of fluid infused during operation,and development of lumbar plexus block-related adverse events were recorded.Results Compared with group S,the onset time and duration of sensory block were significantly prolonged,the requirement for ephedrine and volume of fluid infused during operation were decreased,and no significant change was found in anesthetic efficacy in group L.No lumbar plexus block-related adverse events developed in group L.Conclusion Lumbar plexus block can be used for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.

Objective To evaluate the changes in the right ventricular systolic and diastolic function during the early period after cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG).Methods Eighteen ASA physical status Ⅱ or Ⅲ patients of both sexes,with coronary heart disease (NYHA Ⅱ or Ⅲ),aged 50-80 yr,weighing 51-96 kg,with left ventricular ejection fraction≥50％,scheduled for elective CABG under CPB,were enrolled in this study.Before splitting of sternum and at 5 min after termination of CPB,the parameters of hemodynamics,cardiac output (CO)and variables of right ventricular function (using transesophageal echocardiography) including tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (RVFAC),tricuspid annular peak velocity during isovolumic contraction (IVV),peak velocity during ejection phases (St),early diastolic peak velocity (Et),late diastolic peak velocity (At),E/Et ratio and Et/At ratio were recorded.Results Compared with the baseline value before splitting of sternum,TAPSE,IVV,St,RVFAC,CO,E,Et and At were significantly increased,and no significant change was found in the parameters of hemodynamics and E/Et and Et/At ratios at 5 min after termination of CPB.Conclusion For the patients undergoing CABG,the right ventricular systolic function is significantly enhanced,and there is no obvious improvement in the right ventricular diastolic function during the early period after CPB.

Objective To evaluate the changes in early left ventricular myocardial diastolic function after cardiopulmonary bypass (CPB) in the patients undergoing mitral valve replacement.Methods Twenty patients of both sexes,aged 40-70 yr,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅱ or Ⅲ),with left ventricular ejection fraction (LVEF) ≥ 45 ％,scheduled for elective mitral valve replacement with CPB,were enrolled in the study.Global and regional left ventricular diastolic function was measured by using TEE.After splitting of sternum and at 30 and 90 min after termination of CPB,HR,mean arterial pressure,central venous pressure,cardiac index,LVEF,early diastolic transmitral velocity (E),early diastolic tissue velocity (Ea),right ventricular early myocardial velocity (Em) and right ventricular late myocardial velocity (Am).E/Ea and Em/Am ratios were calculated.Results There was no significant difference in the parameters of hemodynamics and left ventricular diastolic function at each time point before and after CPB.LVEF was greater than 50％ and E/Ea ratio was greater than 20 at each time point in the patients.Conclusion There is no further damage to the early left ventricular myocardial diastolic function after CPB in the patients undergoing mitral valve replacement.

Objective To evaluate the effects of sevoflurane on right ventricular systolic function after cardiopulmonary bypass in patients undergoing coronary artery bypass grafting(CABG). Methods Eighteen patients with coronary heart disease,13 males,5 females,ASA Ⅱ or Ⅲ,aged 50-80 years,measuring 1 50-182 cm in height,weighing 5 1-96 kg,scheduled for CABG under CPB were enrolled in this study.Anesthesia was maintained with intravenous anesthesia, and 1 MAC sevoflurane inhalation lasted for 60 min after CPB.Hemodynamic indicators such as HR,MAP, CVP,cardiac output (CO),Systemic vascular resistance (SVR)and right ventricular parameters in-cluding tricuspid annular plane systolic excursion (TAPSE)and velocity (TAPSV)were recorded be-fore sternotomy (T2 ),30 min after CPB (T3 ),60 min after CPB (T4 ).Results Compared with T1 , CO was increased at T2 (P <0.05);compared with T2 ,CO was decreased at T3 and T4 (P <0.05 or P <0.01),with a statistical significance;compared with T1 ,TAPSE and TAPSV were increased at T2 (P <0.05 or P <0.01);compared with T2 ,TAPSE and TAPSV were decreased at T3 and T4 (P<0.05);with a statistical significance in TAPSE and TAPSV.Conclusion For the patients undergo-ing CABG under CPB,1 MAC sevoflurane inhalation after CPB can reduce right ventricular systolic function,which,however,is within the normal ranges.