Alzheimer Disease ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Rhodiola

0.05),PD and AL were decreased in 1 year(P

Objective To observe the effects of pulsed electromagnetic field (PEMFs) or/and exercise on the area bone mineral density (aBMD) and volume bone mineral density (vBMD) of rats with osteoporosis induced by tretinoin gastric perfusion.Methods 100 female SD rats were randomly divided into 5 groups with 20 rats in each group： PEMFs group, exercise group, PEMFs plus exercise group, osteoporosis group and healthy control group. Except for the healthy control group, the osteoporosis models of other 4 groups were built by tretinoin gastric perfusion. After the building of models, each group was intervened with different treatment. In the 4th, 6th and 8th week after treatment, relevant Results of aBMD and vBMD were tested.Results Compared with the osteoporosis group, the BMD of the rats of PEMFs group, exercise group, PEMFs plus exercise group significantly increased significantly ( P＜0.05) in the 6th week, 4th week and 4th week after treatment respectively. In the 6th and 8th week, there was no significant differences among the PEMFs plus exercise group, the exercise group and the PEMFs group ( P>0.05).Conclusion PEMFs can increase the BMD of the rats with osteoporosis as well as exercise. PEMFs takes effect slower than exercise.

Objective To investigate the risk factors for hip fracture in elderly people in Ningbo,in order to provide the basis for prevention and treatment of hip fracture.Methods A case-control study were conducted in study on 450 cases of hip fracture patients aged over 60 years in Ningbo and 450 subjects of control as 1 ∶ 1 matched case control study.A univariate analysis of hip fracture was performed by x2 test.Risk factors for hip fracture were analyzed by logistic regression.Results Poor self-care ability (OR=5.05),light manual labor occupation (OR=4.10),history of cerebrovascular events (OR=2.59),smoking (OR=2.14) were the risk factors for hip fracture in elderly men,while poor self-care ability (OR=11.36),light manual labor occupation (OR=2.41),osteoporosis (OR=3.19),early menopause (OR=6.89),low body mass index (OR=5.05) were the risk factors for hip fracture in elderly women.The protective factors for hip fracture was milk uptake (OR=0.29) Conclusions Early interventions for hip fracture risk factors,and prevention and treatment of osteoporosis can help reduce the occurrence of hip fracture.

Objective To investigate the efficacy of small-axillary-incision esophagectomy combined with mechanical esophagogastric anastomosis for esophageal carcinoma.Methods From April 2005 to April 2007,56 patients with esophageal cancer underwent small-axillary-incision esophagectomy combined with mechanical esophagogastric anastomosis in our hospital.After thoracotomy was performed via a small axillary incision,the stomach and esophagus were separated.Circular stapler was used for esophagogastric anastomosis after esophagectomy.The anastomotic segment was then enveloped and placed at the esophageal bed.Results The average length of the axillary incision was(13.2?1.6)cm(10-15 cm).No anastomotic leak and hemorrhage,injury to the laryngeal nerve,or chylothorax occurred in this series.53 of the patients were followed up for 4-16 months(mean,7.8 months),during which 1(1.9%)patient developed slight anastomotic stenosis,and 4(7.5%)had gastroesophageal reflux.Conclusions Small axillary incision causes less trauma to the patients leading to a quick recovery.By using mechanical cervical anastomosis,man-mad injuries to the anastomotic segment are avoided,resulting in a low rate of postoperative complications.

Objective To investigate the correlation between cerebral artery stenosis (MCAS) and mild cognitive impairment (MCI).Methods Continuous selected 636 cases of 50-80 years old inpatients or outpatients who examined by transcranial color Doppler ultrasound (TCD) in April 2012 to April 2013 in our hospital.Keep the mini-mental state examination (MMSE) and clinical dementia rating (CDR) as the evaluation of cognitive function.Results Detected 124 cases of MCAS patients (MCAS group) and 512 cases of non-MCAS patients (non-MCAS group).Forty-four cases MCI were detected in MCAS group with the prevalence rate was 35.5％(44/124),and 114 cases of patients with MCI were detected in non-MCAS group with the prevalence rate was 22.3％ (114/512),the difference was statistically significant (P ＜ 0.05).Single factor analysis showed that there were no significant difference between two groups in waist circumference,hypertension,coronary heart disease,hyperlipidemia,smoking,diastolic blood pressure and total cholesterol,uric acid,fasting glucose,C-reactive protein (P ＞ 0.05); There were significantly different between two groups in age,gender,education level,MCAS,history of diabetes,systolic blood pressure and triglyceride,low density lipoprotein-cholesterol,high-density lipoprotein-cholesterol(P ＜ 0.05).Multiple factors analysis showed that the MCAS (OR =1.899,95％ CI 1.224-2.946),history of diabetes (OR =1.764,95％ CI 1.191-2.612),systolic blood pressure(OR =1.012,95％ CI 1.003-1.022),gender (OR =0.558,95％ CI 0.380-0.821),and age (OR =1.029,95％ CI 1.010-1.049) was the independent risk factor for MCI.Conclusion The MCAS related with MCI occurrence and development.

Objective To verify the validity and feasibility of national early warning score (NEWS) in evaluation of death risk in elderly patients with critical illness,in order to find out which scoring method is more suitable for elderly critical illness patients.Methods A prospective case-control study was conducted.The critical illness patients aged over 60 years old with the length of hospital stay over 24 hours,and admitted to Department of Emergency of Qingdao Municipal Hospital from January to December 2015 were enrolled.The clinical data including in emergency and the actual outcome of patients were collected,and the patients were divided into death group and survival group according to 30-day outcome.Patients in the two groups were assessed by using NEWS and risk classification according to the first results of vital signs monitoring.Multivariate logistic regression model was used to analyze the relationship between the NEWS classification and the risk of death in elderly critical ill patients.Results 1 950 emergency elderly patients with critical illness were enrolled,with 78 cases (4.0％) dead within 30 days and 1 872 survived (96.0％).Compared with the survival group,patients in death group were older (years:79.8 ± 10.8 vs.75.3 ± 8.9,t =4.335,P ＜0.001),and had higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (22.9± 4.6 vs.18.2 ± 4.8,t =8.487,P ＜ 0.001),lower Glasgow coma scale (GCS) score (12.2 ± 4.5 vs.13.4 ± 5.2,t =-2.007,P =0.045),higher incidence of respiratory system diseases (29.5％ vs.17.9％,x 2 =12.742,P =0.013),higher NEWS score (11.2 ± 5.5 vs.3.9 ± 2.7,t =22.063,P ＜ 0.001),as well as higher proportion of patients with NEWS classification of high risk and very high risk (65.4％ vs.15.8％,x 2 =263.125,P ＜ 0.001).With the increase of NEWS risk classification,mortality rate was also increased,and the mortality rate in the patients with low,medium,high and very high risk were 0.81％ (9/1 108),3.63％ (18/496),5.83％ (13/223),30.89％ (38/123),respectively,with statistically significant difference (x 2 =179.741,P ＜ 0.001).It was showed by logistic regression analysis that the NEWS score of elderly patients with critical illness were positively correlated with 30-day death.The 30-day death risk of patients with middle risk,high risk and very high risk was 4.600,9.052 and 54.598 folds of the patients with low risk respectively.Conclusion NEWS score can be used to assess the risk of death in emergency elderly patients with critical illness.NEWS risk classification can quantify and classify the risk of death in the elderly patients with critical illness.

OBJECTIVE:To optimize the ultrafine pulverization technology in Chaige tuire powder;to compare the content and microcharacteristics between ultrafine powder and ordinary powder. METHODS:Using contents of 3 active ingredients(puera-rin,glycyrrhizin and baicalin)and powder d(0.5)as main indexes,bulk density,angle of repose and microcharacteristic as refer-ence indexes,orthogonal test was designed to optimize the initial particle size,moisture and pulverized frequency in ultrafine pul-verization technology. Contents of 3 active ingredients of ultrafine powder and ordinary powder(over 65/80 mesh sieve)and obser-vation results of calcium oxalate crystal under microscope were compared. RESULTS:The optimized technology was as follow as over 65 mesh sieve,moisture of 2.5%preliminary powder in 60 Hz of frequency for pulverization. In verification test,d(0.5)aver-age value of 3 ultrafine powder samples was 31.5 μm(RSD=0.45%,n=3);contents of puerarin,glycyrrhizin and baicalin were 0.232 mg/g(RSD=1.31%,n=3),0.212 mg/g(RSD=1.62%,n=3),8.962 mg/g(RSD=0.89%,n=3),respectively,which were increased about 30%-40% than in ordinary powder(0.158,0.15669,6.140 mg/g). There were no or little bundles of calci-um oxalate crystal that is common in ordinary powder. CONCLUSIONS:Optimized ultrafine pulverization technology is stable and feasible;contents of 3 active ingredients in Chaige tuire ultrafine powder are higher and calcium oxalate crystal are litter than ordi-nary powder,which possibly reduces the adverse reactions in clinical application.

Objective To assess the effect of continuous renal-replacement therapy (CRRT) dose on the outcome of acute renal failure (ARF) patients with meta-analysis of randomized controlled trials (RCTs). Methods Studies were identified by systematic search of peer-reviewed publications in Medline, EMBASE and Cochrane library database through June 2010. All the RCTs that compared the incidence of clinical outcome such as mortality, need for chronic dialysis between standard and low dose CRRT were eligible. The pooled relative risk (RR) for clinical outcome was compiled using a random-effects model. Heterogeneity was evaluated by means of subgroup and sensitivity analysis. Results Six eligible studies were identified. By meta-analysis, standard dose CRRT was associated with non-significant 13% mortality risk reduction (RR 0.87, 95%CI 0.70-1.07, P=0.19)and 13% composite outcome risk reduction of chronic dialysis dependence and mortality (RR 0.87, 95%CI 0.69-1.09, P=0.21), but the trend toward increased chronic dialysis dependence risk among survivors (RR 1.43, 95%CI 0.94-2.18, P=0.09). The overall test for heterogeneity among cohort studies was significant (P=0.001, I2=76.2%). The risk of mortality was modality was significantly lower in some studies of which delivered dose was moer than 35 ml·kg-1·min-1,modality was continuous venous-venous hemofiltration (CVVH) and major cause was non-sepsis treated with standard dose CRRT. Conclusions Standard dose CRRT in patients with ARF does not improve survival, renal recovery and composite outcome, but decreases mortality in important subgroups including those with higher delivered dose, CVVH and non-sepsis.

Objective To discuss perioperative features, operative approach and surgical effects of spinal tuberculosis in older patients. Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal tuberculosis ranging in age from 61 to 78 years (average, 67 years). The lesion was located in thoracic vertebrae in 9 patients, thoracolumbar vertebrae in 14, lumbar in 16, and lumbosacral in 6. Preoperative Frankel grades were B in 7 cases, C in 21, D in 11 and E in 6. Among them, 21 had cardio-cerebrovascular disease, 10 had diabetes mellitus. With preoperative medicine and chemotherapy for 2-3 weeks, all patients were treated surgically. The surgical procedures included: 1) Posterior focus debridement, bone grafting and one-stage posterior transpedicular screw system fixation in thoracic vertebrae (T2-T7). 2) Anterior debridement, bone grafting and one-stage posterior transpedicular instrumental fixation in lumbosacral vertebrae (L5-S1). 3) Anterior focus elimination, bone grafting and one-stage anterior plate fixation in the other vertebrae. Results Forty-five patients were followed up for 24 to 40 months, with the average of 28.5 months. No severe complication occurred during and after operation. Forty-four cases had recovered and 1 recurred. Spinal fusion occurred 12-18 months after operation. Frankel neurological grades improved significantly. Conclusion With the effective management of comorbidities in perioperative period,the elderly could tolerate surgical treatment. The appropriate approaches, thorough debridement and reasonable bone grafting with internal fixation are key to therapeutic success.