Objective To study the influence of general anesthesia and epidural anesthesia on postoperative short-term cognitive function in the elderly patients undergoing orthopedics surgery.Methods 120 patients with hip joint displacement or internal fixation after femur fracture and American Society of Anesthesiology Ⅰ and Ⅱ were randomly divided into general anesthesia and epidural anesthesia groups(n=60 for each group).Artery blood pressure(ABP)and heart rate were recorded before operation,pre-operation after anesthesia,during 30 min operation,during main operation and at operation end.Cognitive function was detected by mini-mental state(MMS)before induction of anesthesia and 6 h,12 h,24 h and 72 h after anesthesia.Results There were no differences in ABP and heart rate during operation between the two groups(P＞0.05).The scores of MMS in general anesthesia group at 6 h(26.5±0.5),12 h(25.4±0.7)and 24 h(27.4±0.3)were decreased as compared with pre-induction of anesthesia(29.5 ± 0.3)(P＜ 0.05),while no difference was found at 72 h(29.3±0.3).The scores of MMS in epidural anesthesia group at 6 h(26.6±0.4)and 12 h(25.6±0.8)were lower(P＜0.05),while had no difference at 24 h(29.1±0.4)and 72 h (29.5±0.4)(P＞0.05)as compared with pre-induction of anesthesia(29.4±0.4).At 24 h after anesthesia,the MMS scores were higher in epidural anesthesia group(29.1±0.4)than in general anesthesia group(27.4±0.3)(P＜0.01).Conclusions General anesthesia may contribute to more obvious influences on cognitive function than epidural anaesthesias within 12h after operation in the elderly patients undergoing orthopedics surgery.

Objective To explore the effect of dexmedetomidine for the dosage of drug of pain pump of the patients postoperative.Methods From April 2013 to July 2015,86 patients with intestinal obstructionwhich come to our hospital for surgical treatment were divided into observation group and control group according to the lottery method,each had 43 cases.The patients of control group were given pain pump for pain treatment ; and the patients of observation group were given dexmedetomidine on the base of control group for treatment.The heart rate,systolic arterial pressure(SAP),arterial oxygen pressure(PaO2),analgesia satisfaction,visual analogue scale/score(VAS)pain score,sleep quality score,sufentanil dosage,the number of self-administration,adverse reactions,postoperative anal exhaust time.Results 36h and 72h,SAP,PaO2 in the observation group were significantly better than those in the control group after treatment(P<0.05); The total satisfaction of analgesia was significantly higher than that of control group(P<0.05); VAS pain score was significantly lower than the control group(P<0.05); The sleep quality score was significantly higher than that of the control group(P<0.05); The dosage of sufentanil and the times of administration were significantly lower than those of the control group(P<0.05); Anal exhaust time was significantly shorter than the control group(P<0.05); The incidence of adverse reactions was significantly lower than that of the control group(P<0.05).Conclusion By using dexmedetomidine on the base of pain pump can improve the analgesic effect postoperative,reduce the dosage of pain pump medication and the adverse reactions.

Objective To investigate curative efficacy of ginkgo biloba extract dripping pills in treatment of acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI) and its effects on platelet aggregation rate(PAR), activated clotting time(ACT) and antithrombin(AT)Ⅲ. Methods 90 patients of ACS treated with PCI who received therapy from January 2014 to October 2016 in Zhejiang green town cardiovascular hospital were selected and randomly divided into the observation group and the control group , 45 cases in each group.The control group was treated with routine treatment after PCI, while the observation group was combined with ginkgo biloba extract dripping pills.After treatment of seven days, the changed of PAR, ACT, ATⅢ and adverse cardiovascular events were compared, after treatment three months, the seattle angina scale were compared. Results After treatment, the levels of PAR in the observation group were significantly lower than that of the control group, and the levels of ACT and ATⅢ were significantly higher than that of the control group, the difference was statistically significant (P<0.05), the total incidence of adverse cardiovascular events in the observation group was significantly lower than that of the control group , the difference was statistically significant ( P<0.05), in the seattle angina scale, the scores of stable state of angina pectoris, the attack of angina pectoris, physical activity limitation, treatment satisfaction in the observation group were significantly better than that of the control group, the difference was statistically significant (P<0.05). Conclusion Ginkgo biloba extract dripping pill is well for ACS after PCI, which can effectively relieve clinical symptoms, to improve the expression of PAR, ACT and ATⅢ, helps to reduce the incidence of adverse cardiovascular events.

Objective To investigate the effect of labor induction of full-term pregnancy use of oxytocin,and the incidence of adverse reactions of mode of delivery of cervical dilatation balloon with pubeisheng.Methods The clinical data of full-term pregnant women who were delivered in our hospital from October 2014 to November 2015 were retrospectively analyzed,According to the induction of labor is divided into the way of pubeisheng group and cervical dilation balloon group.The differences of delivery mode,oxytocin utilization,maternal and neonatal outcomes and adverse reactions were observed between the two groups.Results Cervical dilatation balloon group vaginal delivery rate was 90.38％,higher than that of pubeisheng group(P<0.05); oxytocin use rate of 11.54％,lower than that of pubeisheng group(P<0.05); Cervical dilatation balloon group first,second and third labor time is shorter pubeisheng group(P<0.001); The cervical dilation balloon group bleeding more than pubeisheng group(P<0.001),two groups of infection,urinary retention complication rate had no significant difference.Two groups of neonatal aspiration pneumonia incidence rate had no significant difference after the birth of 1min Apgar score difference,and cervical dilatation balloon group after the birth of 5min Apgar was higher than that of pubeisheng group(P<0.05).Conclusion The application of cervical dilation balloon in the induction of labor in term pregnancy is better,which can significantly improve the rate of vaginal delivery,reduce the use rate of oxytocin and shorten the labor process,and has the value of clinical application.

Objective To analyze the risk factors of the patients with gestational diabetes mellitus(GDM),to explore the effect of GDMon pregnancy outcome,and provide reference for early clinical prevention and intervention. Methods Randomly selected 220 GDMpatients who were treated from January 2014 to January 2016 as the observa-tion group,and collected 236 cases of non -diabetic pregnant women in our hospital during the same period as control group.Retrospectively analyzed the risk factors of GDM and the effect of GDM on pregnant women and neonates by questionnaires and clinical data.Results Single factor analysis and Logistic regression analysis showed that the age, history of diabetes,body mass index(BMI)before pregnancy,BMI before 1 week of childbirth and weight of oral glucose tolerance test(OGTT)were the risk factors of GDM(OR =2.988,5.684,4.255,3.765,3.051;P =0.003, 0.000,0.000,0.024,0.021 ).The incidences of phydramnion,postpartum hemorrhage,pregnancy period hyperten-sion,premature rupture,premature birth,cesarean section and ketoacidosis in the observation group were higher than the control group,and the differences were statistically significant (χ2 =5.539,11.338,14.103,4.527,8.160, 4.719;P =0.019,0.001,0.000,0.033,0.004,0.030).The incidence of newborn malformation,asphyxia,fetal distress and macrosomia in observation group were higher than the control group,and the differences were statistically significant(χ2 =4.929,5.539,4.163,5.950;P =0.026,0.019,0.041,0.015).Conclusion The age,history of diabetes,BMI before pregnancy,BMI before 1 week of childbirth and weight of OGTT were the risk factors of GDM, which should pay close attention to these people and take corresponding treatment measures,so as to improve the adverse outcome of maternal and infant in clinic.

Objective To investigate the therapeutic effect of levosimendan on acute decompensated heart failure and its effect on SDNN and SDANN values.MethodsThe clinical data of patients with acute decompensated heart failure treated in Zhejiang Greentown Cardiovascular Hospital from January 2014 to August 2016 were retrospectively analyzed.According to their treatment methods, they were divided into control group and observation group.There were 49 cases in the control group and 71 cases in the observation group.The control group was given conventional drug treatment, the observation group was given levosimendan treatment on the basis of the control group.The therapeutic effects of the two groups were observed.The difference of cardiac function, SDNN, SDANN value and adverse reaction between the two groups were compared before and after treatment.ResultsAfter treatment, the observation group efficiency was 98.59%, significantly higher than the control group;the observation group LAD, RAD, LVESD, LVEDD and BNP lower than the control group, the level of LVEF was higher than the control group, the difference was statistically significant (P<0.05);the observation group SDNN, SDANN, RMSSD and PNN50 (%) was higher than that of the control group, the difference was statistically significant (P<0.05).ConclusionLevosimendan has good therapeutic effect on acute decompensated heart failure, can significantly improve the level of SDNN, SDANN, and the incidence of adverse reactions is low.

Heart rate variability (HRV) is a reliable, innocuous and sensitive new index to measure cardiac autonomic nervous function. Anxiety disorder is often accompanied by autonomic nerve dysfunction and its main sign is abnormal HRV. Acupuncture can affect HRV indices, correct abnormal HRV and improve cardiac autonomic nerve dysfunction to relieve anxiety. This article sorts out and analyzes recent years’ studies on abnormal HRV in anxiety disorder, the effect of acupuncture on HRV and acupuncture regulation of abnormal HRV in anxiety disorder to provide a therapeutic basis for clinical acupuncture intervention in abnormal HRV in anxiety disorder.

Objective To explore the value of contrast-enhanced ultrasound in the diagnosis and classification of traumatic spleen rupture , as compared with enhanced CT. Methods The manifestations of contrast-enhanced ultrasound on surgically or clinically confirmed spleen rupture in 40 patients were retrospectively analyzed. The performance of contrast-enhanced ultrasound on diagnosis and classification was compared with that of enhanced CT. Results For 40 patients with traumatic spleen rupture , the of accuracy of enhanced CT and contrast-enhanced imaging in the diagnosis of traumatic spleen rupture was 97.5%, with no significant statistical differences (chi-square = 0, P = 1). On contrast-enhanced ultrasound examination, 14 patients were diagnosed as true splenic rupture , 9 as subcapsular spleen rupture , and 16 as central splenicrupture, with a accuracy rate of 92.5% (37/40); and accuracy rate for enhanced CT was 90.0% (36/40), there was no significant statistical difference (chi-square = 1.97, P > 0.05). Conclusions Contrast-enhanced and enhanced CT have good consistency in the diagnosis and classification of traumatic spleen rupture. Contrast-enhanced ultrasound can accurately determine the scope and degree of spleen damage , resulting in more accurate classification; and it has values in the diagnosis of traumatic spleen rupture and choice of therapies.

Objective:To study the immunotherapy effects of different doses of human peripheral blood γδT cells on human hepatoma cells (SMMC-7721) xenograft model.Methods: (1)The nude mouse model of liver cancer was established by inoculated BALB/c mouse subcutaneous with human hepatoma cell line (SMMC-7721).(2)The mononuclear cells in healthy human were extracted from peripheral blood,and specific amplification γδT cells in vitro.(3) The nude mouse model divided into 5 groups by random.The positive control group was 5-Fu,negative control group was normal saline(NS).The treatment group was injected different doses of γδT cells(1×105,5×105 and 25×105)by nude mice tail vein.The positive control group injected 5-Fu by enterocoelia,negative control group injected NS by tail veins.The inhibition effect of different dose γδT cells on tumor was observed,including weight,food intake and growth conditions,etc.and the changes of tumor volume (TV),relative tumor volume (RTV)and relative tumor appreciation rate[T/C(%)] were compared with positive control group and negative control group.Results: Different dose of γδT cells had different degree of inhibition on nude mouse xenograft growth.RTV compared with saline negative control group was statistically significant (P<0.05).Compared with the positive control group of 5-Fu,the TV growth was significantly lower than the 5-Fu,degree of inhibition was similar in RTV each dose group,and all slightly higher than the 5-Fu positive control group.The each dose group of T/C (%)was slightly lower than the relative tumor proliferation rate of the control group of 5-Fu,but had no significant difference.Conclusion: The γδT cells from peripheral blood had significant inhibitory effect on nude mice transplanted liver tumor and it may be used as a new treatment for liver cancer immunotherapy provide experimental data.

OBJECTIVE: To investigate osteopontin (OPN) expression in plasma and tissue of patients with layngeal squamous cell carcinoma and analyze its role in invasion, metastasis, and clinical significance in laryngeal quamous cell carcinoma. METHOD: Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to detect expression of OPN in plasma and tissue of 60 cases of laryngeal squamous cell carcinoma, 20 cases of adjacent normal laryngeal tissue and 20 cases of plasma from healthy subjects. RESULT: The expression of plasma OPN was closely correlated with clinical stage and cervical lymphatic metastasis in laryngeal squamous cell carcinoma (P < 0.05), but no significant correlation with the tumor location, pathological grade, gender and age (P > 0.05). The expression of OPN increased in plasma during cancer development: laryngeal squamous cell carcinoma (38.089 ± 9.225) ng/ml, healthy subjects (18.563 ± 9.308) ng/ml. There was a significant difference between the groups (P < 0.05). The expression of OPN in tissue was closely correlated with clinical stage (P < 0.05), pathological grade (P < 0.05) and cervical lymphatic metastasis (P < 0.05) in laryngeal squamous cell carcinoma adjacent atypical hyperplastic epithelium and carcinoma. The expression of OPN increased in tissue during cancer development: laryngeal squamous cell carcinoma (56.67%), adjacent normal laryngeal tissue (15.00%). There was a significant difference between the groups (P < 0.05). Elevated expression of plasma OPN is positively correlated with the expression of OPN in tissue in laryngeal squamous cell carcinoma patients (r = 0. 871, P < 0.05). CONCLUSION OPN plays an important role in the infiltration, metastasis and carcinogenesis in laryngeal squamous cell carcinoma. Combination of serum OPN, tissue OPN detection can be used as diagnostic and surveillance indicators for laryngeal squamous cell carcinoma infiltration and metastasis.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Case-Control Studies ; Enzyme-Linked Immunosorbent Assay ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Hyperplasia ; pathology ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; Larynx ; pathology ; Lymphatic Metastasis ; Neck ; Osteopontin ; metabolism ; Squamous Cell Carcinoma of Head and Neck