Congenital heart disease often lost the opportunity of radical sureryfor secondary pulmonary hypertension.pulmonary hypertension is pathologicallycharacterizzed by pulmonary vascular remodeling,including the vascular smooth musclecell' s proliferation,migration and extracelluar matrix deposition,Recently,someresearchers have found that connective tissue growth factor can bind with somesurface receptors of vascular smooth muscle cells,causing some biological behaviorchanges such as proliferation,migration and extracellular matrix abnormaldeposition,and activating crresponding gene expression through this signaltransduction pathway.Pulmonary vascular remodeling may be one of the molecularpathogenesis in pulmonary hypertension.

Objective To study feasibility and effects of early enteral nutrition(EEN) after total gastrectomy in elderly patients of gastric cancer. Methods Sixty-six cases of gastric cancer underwent total gastrectomy were divided into two groups randomly. One group was treated with EEN, another with parenteral nutrition(PN). Results The difference of nutritional status and incidence of posteroprative complications between EEN and PN group had no statistical significance, but the EEN group had earlier recovery of intestinal function and shorter hospital stay when compared with PN group. Conclusions EEN is an effective way of postoperative nutritional support in elderly patients of gastric cancer, which is safe, reliable, simple and clinically valuable.

This article summarized the application of Quality of Life in Parkinson's disease such as in therapy or nurse assessment, and discussed how it can be used to assess the effect of Traditional Chinese Medicine on Parkinson's disease, which suggest that a Sinicized Patient Reported Outcome (PRO) measure should be advanced.

Objective To compare the effects of sevoflurane versus propofol on a tourniquet-induced lower extremity ischemia-reperfusion (I/R) injury in patients undergoing orthopedic operation.Methods Fifty-four ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 44-85 kg,scheduled for elective orthopedic operation,were randomly assigned into 3 groups (n =18 each)∶ control group (group C),propofol group (group P) and sevoflurane group (group S).After lumbar plexus-sciatic nerve block,the laryngeal mask airway insertion was facilitated with propofol 2-4 mg/kg and anesthesia was maintained with infusion of propofol at 2-4 mg· kg-1 · h-1 during operation in group P.In group S,8 ％ sevoflurane was inhaled,the laryngeal mask airway was inserted and anesthesia was maintained with inhalation of 2％ sevoflurane during operation.A tourniquet was applied and inflated (300 mm Hg)during 15-20 min after administration of propofol or sevoflurane in groups P and S,and a tourniquet was also applied at the same time point in group C.The tourniquet was released at the end of operation.Postoperative analgesia was performed with oral meloxicam or intramuscular pethidine and VAS score was maintained ＜ 3.Blood samples were taken after admission to the operating room (T1) and 30 min after tourniquet release (T2) to determine the plasma concentrations of MDA and TNF-α.The changing rate of MDA and TNF-α concentrations was calculated.The tourniquet-related adverse events and amount of analgesics consumed within 24 h after operation were recorded.Results No tourniquet-related adverse events occurred in all the patients.Compared with group C,the plasma concentrations of MDA and TNF-α and changing rate were significantly decreased at T2 in groups P and S (P ＜ 0.05).There were no significant differences in the plasma concentrations of MDA and TNF-α and changing rate between group S and group P (P ＞ 0.05).Compared with the baseline value at T1,no significant change was found in the plasma concentrations of MDA and TNF-α at T2 in groups P and S (P ＞ 0.05),and the plasma concentrations of MDA and TNF-α were significantly increased at T2 in group C (P ＜ 0.05).There was no significant difference in the amount of analgesics consumed within 24 h after operation between the three groups (P ＞ 0.05).Conclusion Both sevoflurane and propofol can reduce a tourniquet-induced lower extremity I/R injury in patients undergoing orthopedic operation and the efficacy is comparable.

Cheek ; pathology ; Head ; pathology ; Humans ; Keratosis ; diagnosis

Objective To study the effects of lentiviral vector of microRNA targeting IGF1R gene on growth of liver cancer cells.Methods The complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed,synthesized and cloned into the pPRIME vector,named pPRIME-IGFIR-miR30-shRNA.The viruses were propagated on 293T cells.Viruses were purified by CsCI gradient according to standard techniques,and functional PFU titers were determined by plaque assay on 293 cells.The effect of pPRIME-IGFIR-miR30-shRNA on IGFIR expression of Hep3B、SMMC7721 cells was detected by RT-PCR and Western blot.The antitumor potential of PRIME-IGFIR-miR30-shRNA to Hep3B、SMMC7721 cells was evaluated by CCK-8 assay and Tunel.Results PRIME-IGFIR-miR30-shRNA was constructed successfully.Functional PFU titers of pPRIME-IGFIR-miR30-shRNA were 4.58?109PFU/ml.PRIME-IGFIR-miR30-shRNA inhibited IGFIR expression and the proliferation of Hep3B、SMMC7721 cells.Conclusions PRIME-IGFIR-miR30-shRNA expressing IGFIR-siRNA can inhibit IGFIR expression and may be used for further investigation of gene therapy of liver cancer.

Alloys ; adverse effects ; Cobalt ; adverse effects ; Dust ; Humans ; Occupational Exposure ; adverse effects ; Tungsten ; adverse effects

Objective To investigate the clinical characteristics of peptic ulcer in young and middle-aged patients and old-aged patients,and to improve the awareness of clinicians.Methods A retrospective analysis was performed in 351 cases (old-aged group) and 351 cases (young and middle-aged group) of peptic ulcer in our hospital from Jan,2012 to Jan,2013.The clinical data were compared between the two groups,including clinical symptoms,complications,ulcer site,size,concomitant diseases,treatment and outcome.Results (1) Clinical symptoms:the symptoms were not typical in old-aged group compared to young and middle-aged group (80.3％ vs 73％),complications as the initial symptom was more common (46.7％ vs 29.6％,P＜0.001),typical upper abdominal pain were lower than those in the young and middle-aged group (19.7％ vs 37％,P＜0.001);(2) Common complications:old-aged patients with complications was significantly higher than in the young and middle-aged group (46.7％ vs 29.6％,P＜0.05),in which bleeding,perforation and obstruction were common;(3) Ulcer site:gastric ulcer,elevation ulcer werw more common in old-aged patients than young and middle-aged patients (P＜0.05);(4) Ulcer size:giant ulcer (more than 2.0 cm) was more common in old-aged patients than young and middle-aged patients (15.1％ vs 4.3％,P＜0.05);but there was no difference in the infection rate of Helicobacter pylori (HP) between them (90.3％ vs 90.9％,P＞0.05);(5) Concomitant diseases:the incidence of concomitant diseases was higher in old-aged patients,including diabetes,cardiovascular disease,gallstones,cholecystitis,gout (47％ vs 15.7％,P＜0.05);(6) Treatment and outcome:the mortality of old-aged patients with complications was significantly higher than those in the young and middle-aged group (14％ vs 3.8％,P＜0.05).Conclusion The clinical manifestations of peptic ulcer in old-aged patients are atypical,with characteristics of high morbidity,high incidence of complications,high mortality.Early diagnosis and treatment is essential to improve the prognosis and reduce mortality.

ObjectiveTo investigate rational surgical therapy for patients aged at 70 and up suffering from cardiac cancer. Methods 79 cases admitted from 1991 to 2000 were treated by transabdominal total gastrectomy with a radical resection rate of 73% and palliative resection rate of 19%. Results The average age was 74 6 years with a ratio of male to female of 4 6∶1. The average course of the disease was 3 1 months, and only 1 (2%) case got early diagnosis,while the misdiagnosis rate was 54%. Postoperative complication rate was 38%, mortality rate was 3%. Conclusions With the preoperative concurrent disease properly managed and the operation appropriately performed senile patients with cardiac cancer could also be managed successfuly as young patients .

Objective Pulmonary artery atresia (PAA) with intact ventricular septum (IVS) is an anatomically heterogeneous entity. A variety of surgical strategies is possible. We sought to evaluate the clinical results of various surgical corrections of PAA with IVS. Methods A retrospective review of our surgical database revealed 17 patients with PAA and IVS operation between January 1992 to August 2004. There were 9 males and 8 females. The age ranged from 15 days to 12 years [(25.5?7.9) months]. The body weight was 3.5 to 28.0 kg [(7.8?5.4) kg]. Radical operation was performed in 10 cases with the Z score -2.3～1.2 (-0.78?0.34), the pulmonary artery index (PAI) 149.53～297.89 mm~2/m~2 (206.35?82.15 mm~2/m~2). Two infants received BT shunt operation for the severe hypoxia at first postoperative day. Palliative operation was performed in 6 cases with the Z score -6.1～0.2 (-2.7?0.92), the PAI 39.88～218.29 mm~2/m~2 (131.85?72.93 mm~2/m~2), including bi-directional Glenn bypass (2 cases), systemic-to-pulmonary arterial (BT) shunt (1 case), right ventricular outflow tract (RVOT) reconstruction and BT shunt (3 cases). One patient accepted one and a half ventricular repair, first underwent bi-directional Glenn bypass operation, two years later ,underwent ASD occulsion、PDA occlusion and RVOT reconstruction. Results 3 patients(16.7%) died at perioperative time [two patients who had the radical operation, but next day, had the BT shunt operation, one patient had the right ventricular outflow tract (RVOT) reconstruction and BT shunt]. The rest recovered smoothly. The main complications included low cardiac output in 3 patients, hypoxemia in 3 patients, hydrothorax in 1 patients and right heart failure in 3 patients. Conclusion Surgical outcome for patients with the PAA with IVS maybe satisfactory, strategries are to be chosen according to the anatomic subtypes such as the tricuspid valve diameter, right ventricular size, pulmonary artery index and coronary anatomy.