Objective To identify the risk factors for postoperative cognitive dysfunction (POCD).in the elderly patients requiring general anesthesia.Methods Three hundred elderly patients,aged 65-80 yr,scheduled for thoracic or abdominal surgery under general anesthesia,were enrolled in this study.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 3 days after operation.The patients were diagnosed as having POCD if MMSE ＜ 21.The patients were assigned into POCD and non-POCD group.The general data,fasting plasma glucose,glycosylated hemoglobin (HbAlc) and blood pressure were measured.If there was no significant difference between the 2 groups,the factor was analyzed using logistic regression to select the risk factor for the incidence of POCD.Results Ninety-eight patients developed POCD (32.7 ％).Logistic regression model showed that older age,diabetes and hypertension were independent risk factors for POCD (P ＜ 0.05).Conclusion Older age,diabetes and hypertension are independent risk factors for POCD in the elderly patients requiring general anesthesia.

Objective To explore the factors influencing the mild cognitive impairment(MCI)in elderly Uyghur patients with diabetes mellitus and their possible interactions.Methods The crosssectional study was undertaken on 510 elderly Uyghur patients with diabetes mellitus.Based on using a variety of neuropsycholological rating scales for evaluating MCI,the patients were divided into the mild cognitive impairment group (n =182,MCI)and the normal cognitive group (n =328,NMCI),and 200 healthy subjects matched by nation,age and gender served as non-diabetes control group.The collecting of relevant medical history,biochemical examination,evaluation of cognitive function and diabetic complication were performed.Risk factors for cognitive function impairment were determined by single factor analysis and multivariate Logistic analysis.The interactions between factors were analyzed by additive effects model.Results Multiple regression analysis showed that the risk factors for cognitive function decline were ageing,long diabetes duration,higher glycated hemoglobin,lacunainfarction,leukoaraiosis,diabetic microangiopathy (P ＜ 0.05 or P ＜ 0.01).Diabetic microangiopathy had an interaction with cerebral small vessel disease(lacunarinfarction,leukoaraiosis),their percentages of effects of responsibility attribution were 69.9％ and 33.8％,and relative risk ratios of renewable energy research laboratory(RERI)were 10.67 and 7.52 respectively.Conclusions Age,diabetic duration,glycosylated hemoglobin,diabetic microangiopathy and cerebral small vessel disease may be the main risk factors for cognitive dysfunction.Diabetic microangiopathy has a positive interaction with lacunarinfarction and leukoaraiosis in elderly Uyghur type 2 diabetes mellitus with mild cognitive impairment.

Objective:To evaluate the computer aided detection system on the diagnosis of pulmonary nodules. Methods: 120 cases of examined patients with solitary lung nodules up to 9-30 mm in diameter were evaluated. All nodules had been verified by means of biopsy. 120 cases of healthy patients were selected as control group on the basis of confirmation on the chest CT. All chest radiograph in the two group were obtained with a digital radiography system. Five experienced chest radiologists and five residents detected the chest radiograph with or without CAD output images. The scales of performance were evaluated with receiver operating characteristic curve(ROC curve). Results: The average area under the curve value increased significantly from 0.762 without to 0.825 with CAD output images(P

Objective To explore the roles of cytokines in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS). Methods Double-antibody sandwich ELISA was used to determine serum interleukin (IL)-6, urine tumor necrosis factor (TNF), IL-6 and IL-8 levels in 56 patients with HFRS. Results Serum IL-6, urine TNF, IL-6 and IL-8 concentrations in HFRS patients were significantly higher than those in control group, respectively (P＜0.001). The concentrations increased at fever stage, then continued to increase during hypotension stage and peaked at oliguria stage. The concentrations of serum IL-6, urine TNF, IL-6 and IL-8 increased in accord with the severity of the disease and differed greatly among different types of the disease. Serum IL-6 had remarkable relationships with serum specific antibodies. It was positively related to serum β2-microglobulin (β2-MG), blood ureanitrogen (BUN) and creatinine (Cr). Significant positive relationships were also found both between urine IL-6 and TNF, and between IL-6 and IL-8 (r=0.5768, P＜0.05; r=0.3760, P＜0.01). Conclusion TNF, IL-6 and IL-8 activated during the course of the disease. IL-6 is associated with the immunopathological lesions caused by the hyperfunction of humoral immune response. IL-6, IL-8 and TNF are involved in the renal immune impairment. Determining them might, in certain extent, be used in predicting the prognosis and outcome of patients with HFRS.

Objective: To study the cytocompatibility of nanophase alumina ceramics with osteoblasts. Methods: Alumina ceramics were prepared via wet chemistry techniques. The grain size of alumina of interest in the present study was determined by scanning electron microscopy and atomic force microscopy with image analysis software. Primary osteoblast culture was established from rat calvaria. Protein content, synthesis of alkaline phosphatase(ALP) and deposition of calcium-containing mineral by osteoblasts cultured on nanophase alumina ceramics and conventional alumina ceramics for 7, 14, 21 and 28 d were respectively examined. Results: The average surface grain size of the nanophase and conventional alumina compact formulations was 60 nm and 1.80 ?m respectively.Synthesis of ALP and deposition of calcium-containing mineral were significantly greater by osteoblasts cultured on nanophase than those on conventional ceramics after 21- and 28- day culture. Conclusions: Nanophase alumina may stimulate ALP synthesis and calcium deposition of osteoblasts.

Objective To investigate the clinical effect of methotrexate combined with dilatation and curettage on the treatment of cesarean section scar pregnancy and the effect on HCG (chorionic gonadotropin). Methods 130 cases with cesarean section scar pregnancy admitted in Taizhou hospital from January 2016 to March 2017 were randomly divided into two groups. The control group wasreceived dilatation and curettage. The study group was given methotrexate combined with dilatation and curettage.The effect and the influence to HCG in the two groups were compared. Results The effective rate in the study group was significantly higher than that in the control group (P<0.05). There was no significant difference in HCG level between the two groups before treatment. The levels of HCG in the study group were significantly lower than that in the control group (P<0.05). Conclusion Methotrexate combined with curettage on the treatment of cesarean scar pregnancy, can improve the therapeutic effect, reduce postoperative bleeding and hospitalization time, reduce the level of HCG.

BACKGROUND:Recently,with the rapid development of material science and bioscience,the technology of dental implant has made great progress,especially the immediate implant technology.But the size and shape of implant are usually not fit for tooth extraction wound,so it is an important factor that leads to failure when implant and tooth extraction wound can not form close tangency.Guided bone regeneration or bone grafting materials are usually used to solve this problem.OBJECTIVE:To study the effects of nano-hydroxyapatite/collogen (nHAC) with recombinant human bone morphogenetic protein-2(rhBMP-2) and titanium (Ti) membrane on repairing peripheral bone defects of instant implant.DESIGN,TIME AND SETTING:A randomized,controlled animal study was performed at the Central Laboratory,the Fourth Military Medical University of Chinese PLA between January 2005 and January 2006.MATERIALS:Ti screw implants (diameter 2 mm,length 10 mm,and pitch 0.4 mm) without the part that went through gum were offered by Nonferrous Metal Academy in Baoji,China.The nonabsorbable Ti membranes (2 cm×2 cm) were offered by Zhongbang Biomaterial Limited Company in Xi'an,China.The nHAC materials were gifted by professor Cui Fu-zhai from Material Science and Engineering Department of Tsinghua University and fabricated into 0.5 mm×0.5 mm×0.5 mm small blocks.rhBMP-2 was offered by the Academy of Military Medical Sciences in Beijing,China.rhBMP-2 was dissolved with hydrochloric carbamidine and then nHAC was immersed in it.Vacuumization,freeze-drying,and Ekibon degermation were followed.Each gram of nHAC compounds required approximately 1 mg rhBMP-2.METHODS:Four healthy purebred male dogs were included in this study.According to the methods to repair bone defects rhBMP-2+Ti membrane,nHAC composited with rhBMP-2 was implanted,covering Ti membrane.Six defects were made on the mandible on each side.MAIN OUTCOME MEASURES:At 6 and 12 weeks after implantation,new bone formation and the correlation of new bone to Ti implant were investigated by radiography,bone density measurement and histological examinations.RESULTS:All the bone wounds were full of new bone at 12 weeks,the Ti implants were steady and the osseointegration was good.In the nHAC+rhBMP-2 and nHAC+rhBMP-2+Ti membrane groups,new bone formed and maturated earlier.In the nHAC +Ti membrane,blank control,and nHAC + rhBMP-2 +Ti membrane groups,new bone formed well below Ti membrane and the alveolar crest was plump.In the nHAC + rhBMP-2 +Ti membrane group,new bone formed earliest with the most quantity and the alveolar crest was the plumpest.By 12 weeks,the bone density had achieved the same level as the autologous cancellous bone transplantation,but the alveolar crest was plumper compared to the positive control group.In addition,bone mass was much more.Bone formed slowest in the blank control group and fastest in the positive control group with the crest of ridge being slightly absorbed.CONCLUSION:nHAC is a new good bone graft material in repairing peripheral bone defects of instant implant,especially compositing with rhBMP-2 and/or Ti membrane.A round method to repair the surrounding bone defect of instant implant should be selected according to the specific situation in the clinic.

Basal Cell Nevus Syndrome ; complications ; Child ; Humans ; Hypertension ; complications

In the light of such basic concepts as yin-yang, Sanjiao, five elements, and eight trigrams in TCM, the left forearm is selected as the treatment area to enhance treatment results. This method is extensively accepted by both doctors and patients.

Objective To investigate the risk factors and preventive strategies of patients with diffuse axonal injury(DAI) with deep veins thrombosis in lower limbs (LDVT).Methods One hundred and thirty cases of diffuse axonal injury patients with lower limb vascular were divided into LDVT group(22 cases) and non LDVT group(108 cases) based on ultrasound.The information including long-term bed,plasma fibrinogen level,varicose veins,hypertention,sex,age,smoking,alcohol drinking,diabetes,obesity,Glasgow Coma Scale (GCS) were collected.Results There were significant different between LDVT and non-LDVT group in terms of longterm bed time,hypertension,smoking,diabetes,high plasma fibrinogen,age,low GCS score correlated with LDVT (x2 =7.08,5.99,5.17,4.70,3.55,12.72,t =27.80,P ＜ 0.05).Gender,drinking,obesity,varicose vein factors had no correlation with LDVT(P ＞ 0.05).Conclusion Diffuse axonal injury in patients with LDVT is more common in patients with older age,hypertension,low GCS score,the higher the plasma fibrinogen.