Objective To study the influence of anesthesia methoda on early postoperative cognitive function in elder orthopedics patients. Methods Fifty patients aged more than 65 years old with fractured femur randomly received general anesthesia(group G, 28 cases) or unilateral combined spinal epidural anesthesia(group E,22 cases). The assessment of postoperative cognitive {unction referred to the scores that achieved in neuropsychological testing with mini mental state examination (MMSE) by special psychological person on the day before and the first day after surgery. It was considered to he postoperative cognitive dysfunction (POCD) when the score was ≥1 standard deviation(SD). Results The score of MMSE was lower in group G than that in group E on the first day alter surgery(P<0. 05). The incidence of POCD on the first day after surgery was higher in group G than that in group E(42.9% vs. 13. 6%) (P<0. 05). Conclusion Compared to combined spinal epidural anesthesia, more POCD takes place in the eldedy underwent orthopedic surgery under general anesthesia.

Objective To explore the protective effect of Zhenbao pill on acute spinal cord injury of rat and its possible mechanisms.Methods 64 Wistar rats were randomly divided into a injury group and a drug group, with 32 rats in each group, A T10 acute incomplete spinal cord injury model was produced by using modified Allen technique in the two groups,Zhenbao pill mixed suspension of 0.6 g/kg was given by gavage method daily in the drug group 30 min after moding, the same amount of saline was given in the injury group. Behavior detection were conducted in the first day, third day, and the seventh day after modeling to each 8 rats of the two groups. Spinal cord specimens was got centered about the damage points after rats were executed. histopathological changes were observed under HE staining, the MDA content were determined by thiobarbituric acid spectrophotometer and the apoptotic cells were marked by TUNEL method.Results After 1, 3, 7 d, compared with the injury group, the MDA level in the rat spinal cord tissue in the drug group (15.12 ± 1.27 nmol/mgvs.19.71 ± 1.29 nmol/mg, 20.42 ± 1.33 nmol/mgvs.24.65 ±1.36 nmol/mg, 10.46±1.49 nmol/mg vs.15.46 ± 1.44 nmol/mg) decreased(P<0.05); the apoptosis rate of drug groups (19.61% ± 1.49%vs.26.61% ±1.52%, 21.49% ± 1.37% vs.32.37% ± 1.24%, 13.04% ±  1.30%vs.18.35% ± 1.27%)decreased (P<0.05); the BBB score of drug groups (6.52 ± 1.27vs. 2.63 ± 1.27), (12.68 ± 1.32 vs.6.17 ± 1.34), (15.47 ± 1.27 vs.11.57 ± 1.29) was higher than the injury group (P<0.05). Conclusion Zhenbao pill can significantly improve the histopathological examination,reduce the MDA content in the injured spinal cord specimen of the rat and the rate of neuronal apoptosis, which may promote recovery of neurologic function in the rat suffered from ASCI.

OBJECTIVE To summarize the use of intraoperative neuromonitoring system for monitoring and protection of recurrent laryngeal nerve during thyroid surgery. METHODS There were 21 cases in this study, included 5 cases with thyroid cancer, 9 cases with thyroid benign tumor and 7cases with hyperthyroidism. Intraoperative neuromonitoring system includes the host monitor, stimulus detection pin of recurrent laryngeal nerve, special EMG endotracheal intubation tube which contacts vocal cord, grounding conductive circuit electrode, and anti-jamming probe. Operation method: a "three-step method" was adopted. First we revealed the cervical vagus nerve trunk and tested our instruments, and then dissected and protected the recurrent laryngeal nerve, followed by removal of thyroid tissue. RESULTS In all 21 patients, operative side recurrent laryngeal nerve were exposed from lower thyroid blood vessels to the larynx. All patients were phonated as well as before operation, and without drinking cough. CONCLUSION The intraoperative neuromonitoring system can avoid damage of the recurrent laryngeal nerves when we exposed the recurrent laryngeal nerve before resection of the thyroid tissue and tumor.

Objective To investigate the effects and mechanism of visfatin on matrix metalloproteinases-9(MMP-9)expression and invasive activity in macrophages.Methods THP-1 monocytes were induced into macrophages.To investigate the effects of visfatin on MMP-9,cells were divided into 2 groups:①macrophages+visfatin 12 h;②macrophages+visfatin 24 h.The concentrations of visfatin in each group were:0(control),50,100,200,400 ng/mL.MMP-9 mRNA and protein expression were analysed by RT-PCR and Western blotting,and MMP-9 invasive activity was assayed by gelatin zymography.To investigate the mechanism of visfatin on MMP-9,cells were divided into 5 groups:①macrophages without stimulation(control);②macrophages pretreated with MAPK p38,ERK1/2,JNK pathway inhibitor for 1 h,then stimulated with visfatin(200 ng/mL)for 24 h;③macrophages pretreated with retinoid X receptors(RXR)nature ligand or peroxisome proliferators-activated receptor ?(PPAR?)natural/synthetic ligand for 1 h,then stimulated with visfatin(200 ng/mL)for 24 h;④macrophages stimulated with visfatin(200 ng/mL)for 24 h;⑤macophages+visfatin(200 ng/mL)for different time(5,10,15,30,60 min).MMP-9 expression,PPAR? expression,and the effect of visfatin on MAPK phosphorylation were analysed by Western blotting.Results Visfatin not only significantly enhanced MMP-9 mRNA and protein expression in macrophages(P

Objective To investigate the basis of ultrasound microbubble technology enhanced thermal ablation effect.Methods All 48 rabbits bearing hepatic tumors were averagely randomly divided into four groups:only laser group,sham,destruction + laser group,and blank group.The filling defect area changes of before and after treatment were observed and the differences between groups were compared.Results Pathology confirmed ablation of tumor tissue could produce coagulation necrosis for experiment group.The conventional ultrasound showed there was no significant variation in the maximum diameter and area in the pre and post treatment of experiment group and control group(P ＞0.05).There was no change for the control group.Ultrasound imaging showed an area of filling defect were:laser treatment alone group (0.83 ± 0.06) cm2,microbubbles false break combined with laser therapy group (0.65 ± 0.05) cm2,microbubbles break combined with laser therapy group (2.40 ± 0.16)cm2,blank control group (0.01 ± 0.01) cm2.The filling defect area of the treatment group,which was combined with ultrasound microbubble break technology and laser ablation was increased,there was significant variation in the each group (P ＜0.05).Conclusions Microbubble burst combined laser ablation could expand the single needle laser ablation area of rabbit VX2 liver tumor and increase the therapeutic effect.

Objective To compare the prophylactic effect of laminar closure between titanium miniplate and anchor fixation in open-door cervical laminoplasty.Methods Between January 2010 and December 2010,63 patients with cervical spondylotic myelopathy were treated by open-door laminoplasty.Of them,30 patients underwent laminoplasty by titanium miniplate fixation and 33 by anchor fixation.During follow-up,multi-detector CT was performed preoperatively,at 1 week and 6 months after surgery.At each level,the anteroposterior diameter (APD) of the spinal canal and opening angle (OA) were measured.And the spinal canal expansion rate are calculated.MRI was performed preoperatively and 1 year after surgery to evaluate the severity of cord compression.Results All incisions healed by first intention.The incidence of postoperative axial symptoms in miniplate fixation group and anchor fixation group were 33.3％ (10/30) and 39.4％ (13/33),respectively.The OA,APD,and the spinal canal expansion rate of patients in both groups improved significant postoperatively,but differing from miniplate fixation group.The OA,the APD and the spinal canal expansion rate in anchor fixation group after 6 months were reduced than one week after surgery,and the difference between the groups was statistically significant.Lamina close in two groups was not found.CT images at 6 months showed complete fusion of the hinge area by mature bone or callus in two groups,by cervical sagittal MRI assessment.The severity of spinal cord compression was improved after 1 year.Preoperative and 1 year after the surgery,the severity of spinal cord compression between the two groups showed no significant difference.The severity of spinal cord compression after 1 year in both groups were no more than three grade.Conclusion Open-door cervical laminoplasty by anchor fixation or titanium miniplate can effectively prevent the occurrence of postoperative lamina closure,which can help patients to do functional exercises early,but improvement of spinal cord compression has no significant difference between both of them.However,titanium miniplate fixation for maintenance of the expansive spinal canal is better.

Objective To analysis the molecular epidemiology characteristics of human Bocavirus1-4 ( HBoV 1-4) in children for diarrhea in Urumqi area.Methods Feces samples were collected from 315 in-patient and out-patient children with diarrhea at People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Province,China,all through the year of 2011.Using nested PCR,which amplified NS1(518 bp) fragments.Human Bocavirus1-4 were screened. Results The overall frequency of HBoVs was 8.57％ (27/315),of which 2 were HBoV1,22 were HBoV2,and 3 were HBoV3.HBoV4 was not detected.Except XJ1378,the rest of 26 strains shared 98％-100％ nucleotide sequence identity with different reference strains,but 3 HBoV3 all shared 92％ nucleotide sequence identity with gorilla BGoV12009( HM145750.1 ).Phylogeny showed that NS1 fragments of HBoV3 were closer to that of HBoV1.HBoV infection was distributing throughout the year,there was no significant seasonal.There was no difference in gender,age and ethnic.Conclusion HBoV1-3 were detected throughout the year in Urumqi area,Xinjiang,HBoV2 was dominant.

Objective To determine the prognostic value of fight ventricular end-diastollc diameter (RVDD)in patients with chronic heart failure(CHF).Methods The clinical data of the in-hospital patients diagnosed as CHF were analyzed retrospectively.Telephone follow-up was carried out for all participants.The patients were divided into the survival group and death groups according to their clinical outcomes.The relationship between RVDD and death was evaluated by independent t-test and multivariate Logistic regression analysis.Results 1552 in-hospital patients were enrolled into the study.The mean age was 64.62 ± 10.45 years old,with 879(56.64％)male.After 3 years' follow-up,439(28.29％)patients died.Comparison of baseline data showed that gender,age,SBP,NYHA classification,the serum level of creatinine,LVEF,LVDD and RVDD were significantly different between the two groups(P ＜ 0.01);Multivariable logistic analysis showed that RVDD(OR=1.11,95％ CI:1.07-1.14,P ＜0.01),age(OR =1.03,95％ CI:1.02-1.05,P ＜0.01),creatinine(OR =1.02,95 ％ CI:1.01-1.04,P ＜ 0.01),LVEF(OR =0.93,95 ％ CI:0.92-0.97,P ＜ 0.01),LVDD(OR =1.13,95％ CI:1.09-1.17,P ＜0.01)and NYHA classification(OR =1.17,95％ CI:1.12-1.24,P ＜ 0.01)were independent predicting factors for the death of CHF patients.The power of RVDD to predict mortality was examined by ROC curves.The area under the curve was 0.805(95％ CI:0.798-0.812,P ＜ 0.01).Conclusion RVDD increases the risk of death in patients with CHF.RVDD is a significant independent predictor for death among patients with CHF.

Objective To study the relationship between tyrosine kinase receptor B (TrkB)expression and anoikis-suppression and invasion in OVCAR3 ovarian cancer ceils. Methods The expression of TrkB mRNA in OVCAR3 ovarian cancer cells under two culture conditions :adhesive cells and ceil-spheroids were evaluated by RT-PCR and real-time PCR.The relationship between TrkB expression and anoikis-suppression of OVCAR3 ovarian cancer ceils was examined by RNA interference (RNAi) technic,anchorage independent culture and fluorescence-activated ceil sorting analysis.The difference in invasion and metastatic ability of OVCAR3 cells under two culture conditions and with or without TrkB silenced by small interfering RNA (siRNA) was investigated by matrigel invasion assay and in vivo studies.Results The expression of TrkB mRNA was highest in OVCAR3 ovarian cancer ceils,0.0240 ~ 0.0017,compared with the other three cell lines,0.0030±0.0006,0.0027±0.0009 and 0.0087±0.0003 respectively,andthe expression in OVCAR3 multicellular spheroids was significantly higher than that in ceils under monolayer adhesive culture,0.0437±0.0021 versus 0.0240±0.0017 (P＜0.01) . TrkB mediated anoikissuppression in OVCAR3 ovarian cancer ceils.OVCAR3 multiceilular spheroids had a higher invasion ability than OVCAR3 cells under monolayer adhesive culture,and the penetrating cells of the two groups were 71.8± 0.8 and 47.7±0.8 respectively (P＜0.01 ).The metastatic ability of OVCAR3 cells was attenuated when TrkB was silenced,and the volume of the tumors developed by OVCAR3 adhesive cells and OVCAR3 adhesive cells with TrkB silenced were (16.3±4.7) mm3 and(6.0±1.4) mm3 respectively (P＜0.01).Conclusion As an anoikis-suppressur,TrkB may increase the invasion and metastasis of OVCAR3 ovarian cancer cells.

One hundred and forty-four medical students were enrolled in the study, the participants were randomly divided into experimental group and control group with 72 in each. All students attended the theoretical lecture of general medicine. Students in experimental group took part in the extracurricular teaching activities including the nutritional course and practice, the clinical case study and problem based learning ( PBL), students in control group did not have the extracurricular activities. The results showed that although there was no difference in general testing scores between two groups, the problem solving ability and assay-writing ability of experimental group were significantly higher than those of control group.