Anemia, Aplastic ; mortality ; pathology ; therapy ; Child ; Disease-Free Survival ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Risk Factors ; Severity of Illness Index ; Tissue Donors ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors

[Summary] The basic data and serum targets of 3 349 residents were collected by multi stage stratified cluster random sampling and analyzed by correlation and regression analysis to access its association with cardiovascular risk factors. The result showed that morbidity of hyperuricemia was 18. 85% . The risk of hyperuricemia was raised in people with high triglycerides, high low-density lipoprotein-cholesterol ( LDL-C), low high-density lipoprotein-cholesterol(HDL-C), and low estimated glomerular filtration rate(eGFR). The people with hyperuricemia are usually accompanied with many cardiovascular risk factors.

Objective To explore the relationship of serum uric acid level with estimated glomerular filtration rate (eGFR) of elderly patients with hypertention based on a retrospective cohort study.Method The subjects included 465 cases who had a readmission after 3 years of follow-up in an original cohort of 1648 patients with diagnosis of essential hypertension in Fujian Provincial Hospital from August 2007 to September 2009.Multiple regression analysis was performed to examine the effect of serum uric acid level on renal function.Results Four hundred and sixty-five subjects were followed up for an average of 3.9 years.Mean patient age was 68.3 ± 9.7 years.There was no significant difference in uric acid between the baseline and 3 years later (P ＞ 0.05).Multiple regression analysis showed that after adjustment for age,gender,diabetes,body mass index,blood pressure etc,each 100 μmol/L-higher uric acid at baseline was associated with 4.40 ml· min-1· (1.73m2)-1 decrease in eGFR[95％ confidence interval (CI):-6.25--2.55,P ＜ 0.01].According to the alteration of the serum uric acid,all patients were divided into the group with decreased uric acid and the group with increase uric acid.The eGFR was lower in patients with increased uric acid than that in patients with decreased uric acid 3 years later [(70.63±21.54) ml· min-1 · (1.73m2)-1 vs (79.62±21.16) ml· min-1· (1.73 m2)-1,P ＜ 0.01] and there was no significant difference at baseline between the two groups (P ＞ 0.05).Multiple logistic regression analysis showed that after adjusting for aging,gender,diabetes,alteration of blood pressure etc,baseline uric acid was associated with a higher risk for eGFR decreasing more than 10 ml· min-1· (1.73 m2)-1 3 years later [hazard ratio (HR)=2.11,95％CI:1.24-3.59,P ＜ 0.01]; increased uric acid 3 years later resulted in a higher risk for renal function deterioration (HR=2.60,95％ CI:1.67-4.07,P ＜ 0.01).Conclusions Elderly hypertensive patients with baseline hyperuricemia have a lower eGFR,resulting an increased risk of chronic kidney disease.While the patients with declined uric acid had a lesser imparied renal function.It suggests that the improvement of uric acid may help to slow down the deterioration of renal function in elderly hypertensive patients.

Objective To study the characteristics of its pathologic and neurophysiologic changes of a ani-mal model of cervical spinal cord compression, and to explore the relationship between the severity of spinal cord inju-ry and its functions. Methods Thirty-two rabbits were divided into 4 groups randomly. A catheter was inserted intothe vertebral canal and a balloon was inflated to compress spinal cord in epidural space. According to the diameter ofballoon, the animals were divided into 4 groups (A, B, C, D group), Each group consisted of 8 rabbits. The corti-cal somatosensory evoked potential (CSEP) and motor evoked potential (MEP) were used to assess neurologicalfunction. Motor function behavior was scored before and on 1, 3, 7 and 14 days after surgery. Histological observa-tions were performed, pathological changes were observed by light and electron microscope. Results Spinal cordcompression resulted in a gradual increase of the peak latency and significant decrease of the peak amplitude. The la-tency and amplitude of MEP were changed more dramatically than those of CSEP. The result indicated that MEP wasmore sensitive than CSEP to the compression. Analysis also revealed that the severer the pathologic changes, the lon-ger the latency and the lower the amplitude of the evoked potentials. Conclusion The animal model presented inthis paper was simple and standardized. Evoked potentials as a noninvasive technique have great value in monitoringspinal cord function. The variance of amplitude and the latency in significantly correlate with the degree of compres-sion of the spinal cord.

Objective To investigate the clinical value of preventive analgesia in patients with radical gastrectomy for gastric cancer.Methods The clinical data of 161 patients undergoing radical gastrectomy for gastric cancer at the Xijing Hospital from July 2012 to June 2013 were prospectively analyzed.A single-blind,randomized,controlled study was performed in the eligibe patients who were randomly divided into the preventive analgesia group and the control group based on a random number table.All the patients received major gastrectomy + Billroth Ⅱ anastomy or total gastrectomy + esophagojejunastomy,and then they received vein combined anesthesia and tracheal intubation.In the preventive analgesia group,10 mg dexamethasone and 200 mg parecoxib were administered by intravenous infusion before operation,7-8 mL ropivacaine (0.5％) were injected at the incisional site and transversus abdominis infiltration at open and close surgery and celecoxib was taken orally for 3 days.In the control group,vein analgesia pump was used after operation.The visual analogue scale (VAS),proportion of patients with postoperative out-off-bed activity time ＞ 8 hours,time of flatus,time of defecation and duration of hospital stay were recorded between the 2 groups.The measurement data with normal distribution were presented as x ± s.The comparison between groups was evaluated with the t test and repeated measures ANOVA.The data with skew distrubution and ordinal data were analyzed by the analysis of variance,and the count data were analyzed using the chi-square test.Results All the 161 patients who were screened for eligibility were randomly divided into the preventive analgesia group (87 patients) and the control group (74 patients).The scores of the VAS at postoperative day 1,2 and 3 were 2.8 ± 0.6,2.6 ± 0.4 and 1.8 ± 0.4 in the preventive analgesia group,and 5.3 ± 0.5,4.2 ± 0.6 and 2.4 ± 0.3 in the control group,with a significant difference between the 2 groups (F =4.25,P ＜ 0.05).The proportion of patients with postoperative first abmulation time ＞ 8 hours at postoperative day 1,2 and 3 were 8,17 and 20 in the preventive analgesia group,and 0,3 and 11 in the control group,with a significant difference between the 2 groups (x2 =7.60,10.26,3.16,P ＜ 0.05).The time of flatus,time of defecation and duration of hospital stay were (51 ± 24) hours,(61 ± 24) hours and (5.5 ± 3.0) days in the preventive analgesia group,compared with (71 ± 23) hours,(83 ± 30) hours and (6.3 ± 2.1) days in the control group,showing a significant difference between the 2 groups (t =5.32,5.04,0.17,P ＜ 0.05).All the patients in the 2 groups normally survived after surgery without respiratory depression,incision infection and adverse drug reaction.Conclusions Preventive analgesia in the perioperative treatment of patients with radical gastrectomy for gastric cancer could relieve the postoperative pain of patients,improve the bowel function and enhance the recovery of patients.Registry This study was registered with the Chinese Clinical Trial Registry with the registry number of ChiCTRTRC-11001440.

Objective To evaluate the clinical value of pulmonary embolism severity index (PESI) in non high-risk acute pulmonary thromboembolism (APTE) patients treated with sequential anticoagulation.Methods Non high-risk APTE patients treated with sequential anticoagulation were divided into two groups according to PESI:high-value group and low-value group.Prognosis and treatment response was compared between two groups.Results There were 82 cases in high-value group,and 76 cases in low-value group.The rate of adverse events in high-value group was significantly higher than that in low-value group [23.2％(19/82) vs.7.9％ (6/76)] (x2 =5.0698,P =0.009),and 30 days cumulative hazard was also significantly higher than that in low-value group (P ＜ 0.05).The sensitivity of predicting adverse events by PESI was 76.0％,specificity was 52.6％,positive predicting value was 64.6％,and negative predicting value was 65.9％.The mortality in high-value group was significantly higher than that in low-value group [9.8％(8/82) vs.1.3％ (1/76)] (P =0.022).After 30 days of anticoagulation,the pulmonary artery systolic pressure,internal diameter of right ventricle in high-value group was significantly higher than that in low-value group [(39.4 ± 8.1) mm Hg (1 mm Hg =0.133 kPa) vs.(27.2 ± 5.5) mm Hg,(33.0 ± 7.8) mm vs.(21.7 ± 4.6) mm] (P =0.034,0.021),and arterial oxygen partial pressure was significantly lower than that in low-value group[(75.15 ± 12.41) mm Hg vs.(86.36 ± 9.22) mm Hg](P=0.016).Conclusions PESI can effectively predict short-term prognosis of non high-risk APTE patients treated with sequential anticoagulation.At least some of these patients might need treatment other than sequential anticoagulation.

Objective To compare the clinical safety and efficacy of simultaneous bilateral total knee arthroplasty (TKA) and staged bilateral TKA in treatment of both knee osteoarthritis.Methods A total of 119 patients (14 males,105 females) with both knee osteoarthritis who underwent TKA from March 2005 to March 2012 were retrospectively analyzed.Their ages ranged from 30 to 81 years with the average age of 65.23±6.33 years.The patients were divided into three groups according to different treaments:simultaneous bilateral TKA group,staged bilateral TKA group during the same hospitalization period and staged bilateral TKA group in two separate hospitalization periods.All the procedures were performed by the same surgeons and the same type of prostheses (LPS-Flex,Zimmer,US) were implanted.Differences of preoperative factors (age,height,body mass in dex and complications),treatment factors (preoperative hemoglobin,operation time,drainage volume,blood transfusion volume,total hospitalization time and total hospitalization costs) and postoperative curative effects (HSS scores,WOMAC scores and ROM)among three groups were compared.The analysis of viariace,LSD-t test and x2 test were used for data analysis.Results The differences of gender composition,body mass index,preoperative hemoglobin were not statistically significant among three groups (P＞0.05).The patientsin simultaneous bilateral TKA group were younger,and havelower incidence ofpreoperative complications (P＜0.05).The differences of post-operative HSS scores,WOMAC scores and ROM were not statistically significant among the three groups (P＞0.05).Although the total hospitalization time,operation time were shorter,and the hospitalization costs were significant ly lower in simultaneous bilateral TKA group,the total drainage volume,the total blood transfusion volume and incidence of postoperative complication rate were higher in this group than those of the other two grops (P＜0.05).Conclusion Due to great impact on patients' physiological conditions,more postoperative complication occurrence and high risk of periprosthetic infection,the decision of simultaneous bilateral TKA should be made cautiously.

Objective: To evaluate the characteristic and explore the mechanism of microwave extraction (MAE) in extracting Chinese medicines by comparing with conventional extractions on Radix et Rhizoma Rhei. Methods : The sum of anthraquinone was determined by spectrophotometry and aphrostase in paraffin section was observed by microphotography. Results : Among the four methods, the efficiency of MAE was significantly the highest, which was 3.5 times of supersonic extraction and 1.5 times of Sohlex extraction and 1.5 times of decocting by water, respectively. The time of MAE was the shortest. MAE could destroy the cell organization to pick up the speed of dissolving. Conclusion : MAE is efficient, saving energy and time in extracting Chinese medicines.

AIM: To evaluate the characteristic and explore the mechanism of MAE on Semen Cassiae by comparing MAE with commonly used extraction method. METHODS : The amount of anthraquinone was determined by spectrophotometer. The surface and cross section of Semen Cassiae were observed by microphotography. RESULTS : Among the four methods,the efficiency of MAE is 16 times that of ultrasonic extraction,3 times that of Sohlex extraction and 1.1 times of decocting by water,respectively. Micrographs taken after extraction differed markedly indicated that the degree of damage varied considerably. CONCLUSION : The MAE method is more advantageous than other traditional extraction methods (Soxhlet extraction and ultrasonic extraction) with regard to the extraction yield and the time and cost of the procedure.

Object To explore the regularity of microwave extraction (ME) on Chinese medicines in different morphological structure and different polar compositions. Methods Anthraquinone in Radix et Rhizoma Rhei (RRR), Semen Cassiae (SC), cholorogenic acid in Flos Lonicerae, baicalin in Radix Scutellariae were determined as index compositions by HPLC. The extraction rate was measured by orthogonal design. Results ME selectivity to different anthraquinone in RRR is not significant, while at the same temperature, the extraction rates of emodin, chrysophanol, physcion in RRR are higher than those in SC. Conclusion The ME selectivity to the different morphological structure of Chinese medicines is obvious, but to the different polar compositions is not distinct.