Objective To investigate the effect of surgical decompression on lumbar spinal stenosis in senile people. Method 175 senile patients with lumbar spinal stenosis were admitted from Jan. 1997 to Dec. 2003. Among them, the data of effect of surgical decompression in 106 cases, including 49 males and 57 females, age ranged from 70 to 82 years, all of them having a disease history of 4-10 years, and followed-up for 2-6 years after the operation. Their data were analyzed retrospectively. All the patients had been treated conservatively. 42 patients were complicated by one internal disease, and 55 complicated by at least 2 internal diseases. In all the patients continuous movement could not last longer than 15 min before operation. Lamina decompression was done in 95 patients, and a combined operation of lamina decompression, pedicle fixation and post-lateral bone grafting in 11 patients. Result All the patients survived the operation. Complications occurred in 38 cases, and the patients recovered after effective treatment. During follow-up, lumber complaint was improved in 37 cases, numbness in both legs was improved in 63 cases, and no satisfactory improvement was seen in 6 cases. In 66 cases the Oswestry score was lower than 20%, and in 34 cases it was lower than 10%. The result of surgical decompression was satisfactory in 94% of cases, and the average continuous movement was prolonged to over 30 min after operation. Conclusion Based on the effective control of complicated disease, the operative treatment of lamina decompression with fusion or no fusion played an important role in the recovery of neurological function in senile patients with lumbar stenosis.

Objective To study the ways which ensure the delivery of enough tidal volume to patients under various conditions close to the demand of the physician. Methods The volume control ventilation model was chosen,and the simulation lung type was active servo lung ASL 5000 or Michigan lung 1601. The air resistance,air compliance and lung type in simulation lungs were set. The tidal volume was obtained from flow analyzer PF 300. At the same tidal volume,the displaying values of tidal volume of E5,Servo i,Evital 4,and Evital XL ventilators with different lung types of patient,compliance of gas piping,leakage,gas types,etc. were evaluated. Results With the same setting tidal volume of a same ventilator,the tidal volume delivered to patients was different with different lung types of patient,compliance of gas piping,leakage,gas types,etc. Reducing compliance and increasing resistance of the patient lungs caused high peak airway pressure,the tidal volume was lost in gas piping,and the tidal volume be delivered to the patient lungs was decreased. If the ventilator did not compensate to leakage,the tidal volume delivered to the patient lungs was decreased. When the setting gas type of ventilator did not coincide with that applying to the patient,the tidal volume be delivered to the patient lungs might be different with the setting tidal volume of ventilator. Conclusion To ensure the delivery of enough tidal volume to patients close to the demand of the physician, containable factors such as the compliance of gas piping,leakage,and gas types should be controlled.

Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Severe Acute Respiratory Syndrome ; drug therapy ; prevention & control

Objective We conducted a systematic review and meta-analysis of the published literature to evaluate the efficacy of prophylactic antibiotics in the prevention of incisional infection of inguinal tension-free hernioplasty.Methods Articles of randomized controlled trials about the efficacy of prophylactic antibiotics in the prevention of incisional infection in the inguinal tension-free hernioplasty published from January 1975 to October 2012 was retrieved and systematically reviewed.Results A total of 11 randomized controlled trials meeting the inclusion criteria were screened.Among the 4159 cases of patients,130 cases had wound infection,and the infection rate was 3.13％.In the prophylactic antibiotics group of 1845 cases,wound infection occurred in 45 cases; the infection rate was 1.94％.In the control group of 2314 cases,85 cases had incision infection; the infection rate was 3.67％.The preventive use of antimicrobial drugs reduced surgical site infection of inguinal tension-free hernioplasty (OR 0.55,95％ CI 0.38-0.80,P =0.002).Conclusions The use of prophylactic antibiotics can effectively reduce the incisional infection in the inguinal tension-free hernioplasty.

Objective To investigate the clinical characteristics between elderly and non-elderly patients with ulcerative colitis (UC) in order to provide the base for diagnosis and management of the disease.Methods Two hundred and four patients with UC admitted to Shengjing Hospital from January 2009 to December 2011 were enrolled in this study.The patients were divided into elderly group (≥60 years of age) and non-elderly group(＜ 60 years of age).The clinical manifestation,laboratory examination indices and endoscopic feature were recorded and analyzed.Results Among the 204 cases with UC,33 (16.2％,33/204) were elderly patients,and 171 (83.8％,171/204) were non-elderly patients.Onset peak of U C was ranged from 30-39 years old.There was no significant difference in terms of other indices of clinical presentations,extraintestinal manifestations,complications,clinical and endoscopic score between two groups.The rate of abdominal distension,constipation,difficult defecation,alteration of intestinal flora,hypokalemia and hypoproteinemia in elderly group were 36.4％,9.1％,6.1％,66.7％,45.5％,36.4％ respectively,higher than that in in nonelderly group (14.6％,1.2％,0.6％,48.0％,14.0％,20.5％ respectively),and there was significant differences between groups (x2 =8.808,7.260,5.724,3.876,17.660 and 3.942 respectively,P ＜ 0.05).Endoscopic examination revealed that the colonic lesion parts in elderly patients was limited in left-side colon and protosigmoid,which was different from that of no-elderly group (P =0.044).Conclusion The elderly patients showed a similar clinical manifestation with non-elderly patients.However,the colonic lesion parts in elder group was limited to left-side colon and protosigmoid.They also had the higher rate of hypoproteinemia,hypokalemia and alteration of intestinal flora,which needed to pay more attention.

AIM: To investigate the repair mechanism associated with cholesterol synthesis regulated by silent information regulator 1 (SIRT1) in rat model of optic nerve damage.METHODS: Preparation of optic nerve damage in 70 rats was randomly divided into normal group (10 rats), resveratrol treatment group ( experimental group 30 rats) and PBS buffer control group ( 30 rats ) . The experimental group and control group was further divided into 3 subgroups ( each group 10 rats ) , respectively. After 7, 14, 21d injected resveratrol or PBS, optic nerve injury were observed, then the rats were sacrificed. Retina was segregated; the surviving retinal ganglion cell ( RGCs ) was counted. Dissection of optic nerve, cholesterol content of them were tested; RT-PCR was used to detect mRNA expression of SIRT1, SREBP2 and HMGCR; Western blot assay was used to test the protein expression levels of SIRT1, cholesterol regulatory element binding protein 2 (SREBP2) and HMGCR.
RESULTS:The numbers of RGCs and cholesterol levels of rat model with optic nerve injury decreased significantly (P<0. 01). The mRNA and protein expression levels of SIRT1, SREBP2 and HMGCR were all decreased in a time-dependent manner (P<0. 05). Three components of the three time points, with time injuries were aggravated, and the extent of damage was significantly reduced in the treatment group compared with the control group. But in resveratrol treatment group, the cholesterol levels and mRNA or protein expression of SIRT1, SREBP2, HMGCR in optic nerve were significantly restored in a time-dependent ( P<0.05 ) . The number of surviving RGCs restored significantly in resveratrol treatment group (P<0. 01) in a time-dependent manner.
CONCLUSION:Up-regulating the expression of SIRT1, SREBP2 and down- regulating HMGCR by resveratrol could repair the injury of optic nerve through promoting the synthesis of cholesterol in neurons and retinal ganglion cells in the repair process. SIRT1 may be as a promising new target for treatment on optic nerve damage.

Melanin is formed by oxidative polymerization of phenolic compounds,basically different kinds of melanin come from different organisms.DOPA melanin and DHN melanin have same physical and chemical characters although they have different biosynthetic pathway.DHN melanin is common in plant fungi and plays an important role on infection.The melanin accumulates in the fungal cell walls and prevents organic and inorganic molecules penetrating out,that insures appressorium's pressure and infection ability.This paper has reviewed the kinds and characters,especially discussed the role of melanin during pathogen infection based on our some research.

Aim To research the protective effect and mechanisms of taurine on myocardial ischemia and reperfusion injury in rats. Methods Myocardial ischemia reperfusion models were established in SD rats. The effects of taurine on the size of myocardial infarction and the changes of activity of SOD , and the levels of MDA and NO in myocardium and plasma of rats with myocardial ischemia and reperfusion injury were observed. Results In rats with myocardial ischemia and reperfusion injury, the taurine could reduce the size of myocardial infarction (P

Objective To explore the activity and its possible neural mechanism of brain default mode network by using resting state functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI). Methods The 20 amnestic MCI patients and 25 healthy controls were included in this study, and all subjects underwent mini-mental state examination (MMSE), auditory verbal learning test (AVLT) and fMRI. The data were analyzed by amplitude of low frequency fluctuation (ALFF), and the enhanced and weakened regions of ALFF were observed and compared in both MCI patients and healthy controls. Results MMSE and AVLT tests showed that the memory function was seriously impaired in MCI patients compared with healthy controls, which is based on the short and long delayed episodic memory impairment (2.4±1.7 vs. 6.6±1.4, t=3.70, P＜0.01; 2.1±1.6 vs. 6.7±1.5, t=4.16, P＜0.01). The resting state fMRI showed that MCI patients had significant decreases of ALFF in hippocampal formation, parahippocampal cortex and lateral temporal cortex as compared with health controls (t=2.58, 2.43 and 1.75, all P＜0.01), which were closely relevant to the episodic memory. And they had significant increases in temporal-parietal joint and inferior parietal lobule (t=3.14 and 2.77, both P＜0.01). Conclusions MCI patients show significant decreased active intensity of some DMN nodes that is related to episodic memory in resting state. Increased active intensity in MCI patients would be some type of compensation.

Objective To evaluate the potential activity ofSaccharomyces boulardii as an adjuvant to triple therapy for Helicobacter pylori infection,so as to forecast the probable effectiveness of Saccharomyces boulardii in the eradication of Helicobacter pylori and the adverse reaction.Methods A total of 120 patients who received gastroscopy and tested positive for Helicobacter pylori infection were divided into standard triple therapy group and Saccharomyces boulardii group with 60 cases each by random digits table method.Patients were randomized to receive one week standard triple therapy,supplemented with Saccharomyces boulardii in Saccharomyces boulardii group.Saccharomyces boulardii was taken 500 mg per day for one week.All adverse reactions were recorded during the treatment period.13C or 14C urea breath test was performed at four weeks after the end of triple therapy to evaluate the situation of Helicobacter pylori eradication.Results Helicobacter pylori eradication rate in Saccharomyces boulardii group was higher than that in standard triple therapy group [80.00％ (48/60) vs.73.33％ (44/60)],but there was no significant difference (P =0.542).Five adverse reactions including epigastric discomfort,nausea,diarrhea,taste disorder and liver injury were recorded during the treatment period.The incidence of adverse reactions such as epigastric discomfort and diarrhea in Saccharomyces boulardii group was significantly lower than that in standard triple therapy group [13.33％ (8/60)vs.43.33％(26/60),3.33％(2/60) vs.26.67％(16/60)],and there was significant difference (P ＜ 0.05).Conclusion Saccharomyces boulardii as an adjuvant to triple therapy can not improve Helicobacter pylori eradication rate,but can decrease the incidence of adverse reactions during the treatment period and improve the complicance of Helicobacter pylori eradication treatment.