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Background Emergence delirium (ED) is a common phenomenon occurring in the recovery period. The aim of this study was to investigate the incidence, risk factors, and consequences of ED in adults after elective brain tumor resection. Methods We retrospectively analyzed the data of a prospective cohort performed in a tertiary university hospital. Adult patients admitted to the intensive care unit (ICU) immediately after elective brain tumor resection were consecutively enrolled. Level of consciousness was assessed using the Richmond Agitation–Sedation Scale and ED was assessed using the Confusion Assessment Method for the ICU. Risk factors for ED were determined by multivariable logistic regression. Results A total of 659 patients met the inclusion criteria, of which 41 patients with coma were excluded. Among the remaining 618 patients, 131 (21.2%) developed ED. Independent risk factors for ED were: age, education level, use of anticholinergic and mannitol, Glasgow Coma Score and arterial partial pressure of oxygen postoperatively, postoperative pain, malignant tumor, and frontal approach craniotomy. ED was associated with increased postoperative delirium, longer length of hospital stay, and higher hospitalization costs. There was no significant difference in the neurological function deficits (modified Rankin Scale score) between ED and non-ED groups. Conclusions ED has a high incidence and is associated with poor outcomes in adults after elective brain tumor resection. Early screening and prevention for ED should be established in perioperative management of this population.

Summary Studies on melatonin and melatonergic agents (MMA) for the prevention of postoperative delirium (POD) have produced inconsistent findings. We conducted a meta-analysis to assess the effect of perioperative MMA on the prevention for POD. This meta-analysis is registered in the PROSPERO (CRD42020164900). We searched PubMed, Embase, and Cochrane Library through August 1, 2020 to identify randomized placebo-controlled trials (RCTs) that assessed MMA for the prevention for POD in adult patients undergoing surgery. The primary outcome was POD. Relative risk (RR) with 95% confidence interval (CI) was pooled using a random-effects model. Nine RCTs with 1452 patients were included. The incidence of POD was 23.8% (173/726) and 24.4% (177/726) in the MMA and placebo groups, respectively. Compared with placebo, MMA did not reduce the occurrence of POD (9 trails, 1452 patients, RR 0.93, 95% CI 0.70–1.24), with modest heterogeneity (I2 = 40%). Sensitivity analyses suggested that MMA also did not reduce the occurrence of POD in elderly patients (age ≥65 years) (6 trails, 810 patients, RR 0.71, 95% CI 0.38–1.32), patients given melatonin (4 trails, 806 patients, RR 0.78, 95% CI 0.43–1.41) or ramelteon (4 trails, 345 patients, RR 0.89, 95% CI 0.44–1.78), and patients undergoing general anesthesia (4 trails, 681 patient, RR 1.02, 95% CI 0.82–1.28). Based on the current evidence, perioperative MMA may have no effect on the prevention of POD.

Background: Postoperative delirium (POD) is a significant clinical problem in neurosurgical patients after intracranial surgery. Identification of high-risk patients may optimise individual perioperative management, but an adequate and simple risk model for use at super early phase after operation has not been developed.Methods: Adult patients were admitted to the ICU after elective intracranial surgery under general anaesthesia. The POD was diagnosed as Confusion Assessment Method for the ICU positive on postoperative day 1 to 3. Multivariate logistic regression analysis was used to develop the early prediction model (E-PREPOD-NS) and the final model was validated with 200 bootstrap samples.Results: Among 800 patients included in the study, POD occurred in 157 cases (19.6%). We identified nine variables independently associated with POD in the final E-PREPOD-NS model: age > 65 years [odds ratio (OR) = 3.336, 95% confidence interval (CI) = 1.765-6.305, 1 risk score point], education level < 9 years (OR = 2.528, 95% CI = 1.446-4.419, 1 point), history of smoking (OR = 2.582, 95% CI = 1.611-4.140, 1 point), history of diabetes (OR = 2.541, 95% CI = 1.201-5.377, 1 point), supra-tentorial lesions (OR = 3.424, 95% CI = 2.021-5.802, 1 point), anesthesia duration > 360 min (OR = 1.686, 95% CI = 1.062-2.674, 0.5 point), GCS P = 0.593).Conclusions: The E-PREPOD-NS model based on nine perioperative risk factors can predict POD in patients admitted to the ICU after elective intracranial surgery with fairly good accuracy. External validation is needed before use in clinical practice.

Chunmei Wang,1,2,* Jun Liu,3,* Xiaoye Shi,1 Shaoze Ma,1 Guangqin Xu,1 Tingwei Liu,1 Tingting Xu,3 Bo Huang,3 Ying Qu,4 Xiaozhong Guo,1 Xingshun Qi1 1Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China; 2Graduate School, Jinzhou Medical University, Jinzhou, People’s Republic of China; 3Military Joint Teaching and Research Office, The 32684 Troop of Chinese PLA, Shenyang, People’s Republic of China; 4Department of Health Care, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xingshun Qi; Xiaozhong GuoDepartment of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, Liaoning Province, 110840, People’s Republic of ChinaTel +86-24-28897603Fax +86-24-28851113Email xingshunqi@126.com; guo_xiao_zhong@126.comPurpose: Helicobacter pylori infection is an important cause of peptic ulcer disease and gastric cancer. Current knowledge regarding epidemiology of H. pylori infection in military personnel has insufficiently been updated. This cross-sectional study aimed to estimate the prevalence of H. pylori infection in military personnel and to compare the prevalences in military and civilian groups.Patients and Methods: We retrospectively enrolled the subjects who underwent 14C-urea breath tests at the Department of Gastroenterology of the General Hospital of Northern Theater Command between January 2017 and July 2020. Subjects were divided into military and civilian groups. H. pylori infection and major endoscopic findings were reviewed.Results: Overall, 23,496 subjects were eligible, including 2282 subjects in the military group and 21,214 subjects in the civilian group. In the overall analysis, the prevalence of H. pylori infection was not significantly different between military and civilian groups (33.9% versus 34.4%, P=0.592). In the population aged 17– 25 years, the prevalence of H. pylori infection was significantly higher in the military group than in the civilian group (35.6% versus 25.9%, P=0.001). Both 14C-UBT and endoscopy were performed in 547 inpatients, including 83 military inpatients and 464 civilian inpatients. There was a significantly higher prevalence of H. pylori in inpatients with peptic ulcer and/or gastric cancer than in those without (65.5% versus 41.4%, P=0.001).Conclusion: Among the adolescent population, H. pylori infection may be more common in military personnel as compared to the civilians. Well-designed prospective studies should be required to validate such a high prevalence and to explain its potential causes.Keywords: Helicobacter pylori, prevalence, military, epidemiology, endoscopy

Background Postoperative delirium (POD) has been confirmed as an important complication after major surgery. However, neurosurgical patients have usually been excluded in previous studies. To date, data on POD and risk factors in patients after intracranial surgery are scarce. Objectives To determine the incidence and risk factors of POD in patients after intracranial surgery. Design Prospective cohort study. Setting A neurosurgical ICU of a university-affiliated hospital, Beijing, China. Interventions Adult patients admitted to the ICU after elective intracranial surgery under general anaesthesia were consecutively enrolled between 1 March 2017 and 2 February 2018. Delirium was assessed using the Confusion Assessment Method for the ICU. POD was diagnosed as Confusion Assessment Method for the ICU positive on either postoperative day 1 or day 3. Patients were classified into groups with or without POD. Data were collected for univariate and multivariate analyses to determine the risk factors for POD. Results A total of 800 patients were included. POD was diagnosed in 157 patients (19.6%, 95% confidence interval 16.9 to 22.4%). Independent risk factors for POD included age, nature of intracranial lesion, frontal approach craniotomy, duration of surgery, presence of an episode of low pulse oxygenation at ICU admission, presence of inadequate emergence and emergence delirium, postoperative pain and presence of immobilising events. POD was associated with adverse outcomes and high costs. Conclusion POD is prevalent in patients after elective intracranial surgery. The identified risk factors for and the potential association of POD with adverse outcomes suggest that a comprehensive strategy involving screening for predisposing factors and early prevention of modifiable factors should be established in this population. Trial registration ClinicalTrials.gov NCT03087838.

BACKGROUND: The incidence of left ventricular thrombus (LVT) is 4% to 15% in patients with anterior acute ST‐segment elevation myocardial infarction (ant‐AMI) in the era of primary percutaneous coronary intervention (PPCI). And patients with LVT have higher in‐hospital mortality. HYPOTHESIS: There is a relationship between LVT formation and 1‐year major adverse cardio‐cerebrovascular events (MACCE) in patients with ant‐AMI treated by PPCI. METHODS: Our study population included 1488 consecutive patients with ant‐AMI. The primary endpoint was the incidence of MACCE within 1 year after AMI. The secondary endpoint was the thrombosis disappearance. RESULTS: A total of 106 (7.1%) patients were diagnosed with LVT and 1382 (92.9%) patients without LVT. Patients with LVT had a higher incidence of MACCE than in patients without LVT (21.7%vs10.3%; P < 0.001). Univariate analysis showed LVT was associated with an increase in MACCE risk (odds ratio [OR] = 2.40; 95% confidence interval [CI] [1.37‐4.21]; P < 0.001). When examining MACCE components individually, LVT was only associated with the incidence of congestive heart failure (OR = 2.41; 95% CI [1.29‐4.58]; P = 0.001). After adjustment for principal confounders, LVT remained an independent risk factor for MACCE (HR = 2.28; 95% CI [1.12‐6.38]; P = 0.020). Other independent predictors include 24‐hour LVEF, creatine kinase peak value, and age. Further analysis found patients with LVT in international normalized ratio (INR) ≥ 2 group had lower MACCE risk and higher thrombus disappearance than in INR < 2 group (13.5%vs29.6%; P = 0.044; 90.4%vs74.1%; P = 0.029). CONCLUSION: For patients with ant‐AMI treated by PPCI, LVT is an independent predictor of 1‐year MACCE events. Treatment with vitamin K antagonist in the therapeutic range (INR ≥ 2) has the potential to reduce MACCE risk and promote disappearance of thrombus.

Background Preoperative frailty is associated with poor outcomes in major surgery. Postoperative delirium is common after neurosurgery. To date, the association of preoperative frailty with postoperative delirium after neurosurgery has not been established. We aimed to determine the association between preoperative frailty and postoperative delirium in patients undergoing elective brain tumor resection. Methods We retrospectively analyzed the data of a prospective cohort, consecutively enrolling adult patients admitted to the intensive care unit after elective craniotomy for brain tumor resection under general anesthesia in a tertiary hospital in China from March 1, 2017 to February 2, 2018. Preoperative frailty was evaluated using the modified frailty index. The primary outcome was postoperative delirium, assessed using the Confusion Assessment Method for the Intensive Care Unit. Univariate and multivariable regression analyses were performed to examine the association. Results 659 patients met inclusion criteria for our analysis. There were 398 (60.4%) non-frail (modified frailty index = 0), 237 (36.0%) pre-frail (modified frailty index = 1–2), and 24 (3.6%) frail (modified frailty index ≥ 3) patients. Of these, 124 (18.8%) developed postoperative delirium. In adjusted analyses, frailty was independently associated with postoperative delirium (odds ratio 1.7, 95% confidence interval 1.0–2.7, P = .032). Frail patients had longer length of hospital stay and higher total costs than non-frail patients. Conclusion Preoperative frailty is associated with postoperative delirium, length of hospital stay, and total costs in patients undergoing elective brain tumor resection. Preoperative frailty assessment and appropriate management strategies should be involved in the perioperative management of postoperative delirium.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Microvascular decompression (MVD) is an effective and safe approach for treating hemifacial spasm (HFS). Postoperative complications may include facial nerve palsy, hearing loss, intracerebral haematoma, and brainstem infarction. The occurrence of intracranial cyst following MVD is extremely rare, with few cases documented in the literature. Herein, the cases of two patients with HFS who developed ipsilateral cerebellar cyst following MVD are reported. The first patient was a 50-year-old male presenting with a 6-year history of HFS on the right side of his face. MVD was performed, and 12 days postoperatively he developed dizziness and nausea. Magnetic resonance imaging (MRI) showed a cyst in the ipsilateral cerebellum. Antibiotic treatment provided no benefit, and the cyst was drained. The second patient was a 44-year-old female presenting with a 4-year history of HFS on the right side of her face. MVD was performed, and 18 days following surgery, she developed dizziness and nausea. MRI showed an ipsilateral cerebellar cyst. Conservative treatment was applied and the cyst shrunk. At the 2-month follow-up appointment, symptoms were completely resolved in both patients. Cerebellar cyst is a rare complication following MVD. Timely diagnosis and appropriate treatment should be emphasized, and surgical treatment may be unnecessary.

This study aimed to explore thrombolysis therapy based on ultrasound combined with urokinase and Arg–Gly–Asp sequence (RGDS)-targeted microbubbles by evaluating the histological changes in a thrombotic rabbit model. Forty-two New Zealand rabbits featuring platelet-rich thrombi in the femoral artery were randomized to (n = 6/group): ultrasound alone (US); urokinase alone (UK); ultrasound plus non-targeted microbubbles (US + M); ultrasound plus RGDS-targeted microbubbles (US + R); RGDS-targeted microbubbles plus urokinase (R + UK); ultrasound, non-targeted microbubbles and urokinase (US + M + UK); and ultrasound, RGDS-targeted microbubbles and urokinase (US + R + UK) groups. Diagnostic ultrasound was used transcutaneously over the thrombus for 30 min. We evaluated the thrombolytic effect based on ultrasound thrombi detection, blood flow, and histological observations. Among all study groups, complete recanalization was achieved in the US + R + UK group. Hematoxylin and eosin staining showed that the thrombi were completely dissolved. Scanning electron microscopy examination demonstrated that the fiber network structure of the thrombi was damaged. Transmission electron microscopy showed that the thrombus was decomposed into high electron-dense particles. Histology for von Willebrand factor and tissue factor were both negative in the US + R + UK group. This study revealed that a thrombolytic therapy consisting of diagnostic ultrasound together with RGDS-targeted and urokinase coupled microbubbles.

Background Spinal cord infarction (SCI) is rarely caused by vertebral artery dissection (VAD), which is an important cause of posterior circulation stroke in young and middle-aged patients. We report the case of a middle-aged patient without obvious risk factors for atherosclerosis who had SCI from right VAD. Case presentation An otherwise healthy 40-year-old man presented with acute right-sided body weakness. Six days earlier, he had experienced posterior neck pain without obvious inducement. Neurologic examination revealed a right Brown-Séquard syndrome. Magnetic resonance imaging (MRI) of the head was normal. Further, cervical spine MRI showed spinal cord infarction (SCI) on the right at the C1-C3 level. Three-dimensional high-resolution MRI (3D HR-MRI) volumetric isotropic turbo spin echo acquisition (VISTA) scan showed evidence of vertebral artery dissection (VAD). The patient was significantly relieved of symptoms and demonstrated negative imaging findings after therapy with anticoagulation (AC) and antiplatelets (AP) for 3 months. Conclusions The possibility of vertebral artery dissection (VAD) should be considered in the case of young and middle-aged patients without obvious risk factors for atherosclerosis. Furthermore the VISTA black blood sequence plays an important role in the pathological diagnosis of vertebral artery stenosis. Early correct diagnosis and active therapy are crucial to the prognosis.

Construction project managers (CPMs) with different types of personalities make various assessments in risky situations and draw up different risk management strategies. This research presents the findings of an empirical study in China that investigated whether and how CPMs with different personality traits differed in the way they perceived project risk. A conceptual model was developed and four hypotheses were proposed concerning the relationships among personality traits, risk propensity, and risk perception using the Big Five personality model. The Partial Least Squares Structural Equation Modeling analyses of a sample of 152 imply that 1) Extraversion, Agreeableness, and Conscientiousness significantly influence risk propensity; 2) risk propensity negatively affects risk perception; 3) Extraversion, Agreeableness, and Conscientiousness have significant effects on risk perception; and 4) risk propensity fully mediates the relationship between personality traits and risk perception. The results were complemented by qualitative evidence from 5 semi-structured interviews with project managers. This research contributes to a better understanding of how CPMs perceive risk.

Background: Fabry disease is rare, and the diagnosis is often delayed. Here, we describe a case of Fabry disease resulting in vasculopathy of the central nervous system. Magnetic resonance (MR) black-blood sequence (three-dimensional T1 volumetric isotropic turbo spin echo acquisition), with the unique advantage of imaging the vascular wall, facilitated a clear identification of the vasculopathy. Case presentation: A 27-year-old man visited our hospital for the treatment of " double vision 6d." After a series of examinations, the patient was diagnosed with Fabry disease, which caused vasculopathy of the central nervous system. Subsequently, the patient was treated with corticosteroids and his symptoms were attenuated. Two months after the initial treatment, the initial lesion in the vascular vessel disappeared, however, a new lesion appeared. Similarly, four months after the initial treatment, although the previous lesion disappeared, a new lesion appeared. Conclusions: This case highlights that clinicians should use MR black-blood sequence scan in a timely manner in case of young patients with migratory lesions of brain. In case of detection of a vascular lesion in combination with other systemic lesions, the possibility of Fabry disease should be considered.

In patients with acute coronary syndrome (ACS), treatment using ticagrelor demonstrated significant ischemic benefits over clopidogrel; however, it was associated with increased bleeding complications leading to frequent de-escalation to clopidogrel. The objective of the present study was to investigate the efficacy and safety of de-escalation in early and late phase after percutaneous coronary intervention (PCI). We performed a retrospective study of 4678 ACS patients from March 2016 to April 2017 who initially received ticagrelor then de-escalated to clopidogrel and categorized them into Group 1: early phase (1-30 days) and Group 2: late phase (30 days-1 year) switching groups. The primary efficacy endpoints included cardiovascular death, definite/probable stent thrombosis, myocardial infarction, unplanned revascularization, and stroke. The safety endpoint was Bleeding Academic Research Consortium classification 3 or 5 bleeding events within 1 year after PCI. The incidence of switching occurred in 1019 patients; 380 (37.3%) in Group 1 (median 14 days, interquartile range 4-30 days) versus 639 (62.7%) in Group 2 (median 180 days, interquartile range 90-270 days). The ischemic endpoints occurred in 53 (13.9%) patients in Group 1 versus 35 (5.4%) in Group 2 (HR 1.93,95%CI 1.22-3.08, p .0001). There were no significant differences of major bleeding events (HR 0.91; 95%CI, 0.58-1.43, p = .90) seen between the groups. The main cause for switching between the two groups was due to BARC 1 or 2 bleeding types. Early de-escalation from ticagrelor to clopidogrel during the initial 30 days after ACS was associated with higher risk of ischemic events when compared with switching beyond 30 days.

Hepatocellular carcinoma is one of the leading causes of malignancy-related death in China. Its therapy in clinics is a big challenge. Ginsenoside Rh2 is one of the most notable cancer-preventing components from red ginseng and it has been reported that ginsenoside Rh2 exhibited potent cytotoxicity against human hepatoma cells. Rh2 exists as two different stereoisomeric forms, (20S)-ginsenoside Rh2 and (20R)-ginsenoside Rh2. Previous reports showed that the Rh2 epimers demonstrated different pharmacological activities and only (20S)-ginsenoside Rh2 showed potent proliferation inhibition on cancer cells in vitro. However, the in vivo anti-hepatoma activity of (20R)-ginsenoside Rh2 and (20S)-ginsenoside Rh2 has not been reported yet. This work assessed and compared the anti-hepatoma activities of (20S)-ginsenoside Rh2 and (20R)-ginsenoside Rh2 using H22 a hepatoma-bearing mouse model in vivo. In addition, hematoxylin and eosin staining, the deoxynucleotidyl transferase dUTP nick-end labeling assay, and the semiquantitative reverse transcriptase polymerase chain reaction method were used to further study the apoptosis of the tumors. The results showed that both (20S)-ginsenoside Rh2 and (20R)-ginsenoside Rh2 suppressed the growth of H22 transplanted tumors in vivo, and the highest inhibition rate could be up to 42.2 and 46.8 %, respectively (p 0.05). Further, hematoxylin/eosin staining and the deoxynucleotidyl transferase dUTP nick-end labeling assay indicated that both (20R)-ginsenoside Rh2 and (20S)-ginsenoside Rh2 could induce H22 hepatoma tumor cell apoptosis, with apoptosis indexes of 3.87 %, and 3.80 %, respectively (p 0.05). Moreover, this effect was accompanied by downregulating the level of Bcl-2 mRNA. In conclusion, both (20S)-ginsenoside Rh2 and (20R)-ginsenoside Rh2 can suppress the growth of H22 hepatomas without causing severe side effects, and this effect is associated with the induction of apoptosis.

Punica granatum possesses strong antitumor properties. In this study, a nude mouse model with a subcutaneous xenograft of human prostate cancer cells (PC-3) was established to observe the in vivo antiproliferative and apoptotic effects of pomegranate peel polyphenols (PP). Levels of the cytokines tumor necrosis factor α (TNF-α) and vascular endothelial growth factor (VEGF) were detected by enzyme-linked immunosorbent assay. Quantitative analysis of ellagic acid, gallic acid, and punicalagin in active fraction was conducted using reverse phase high-performance liquid chromatography with a photo-diode array (HPLC/PDA). PP decreased tumor volume and weight in tumor-bearing nude mice, and significantly increased the rate of apoptosis (p

We measured serum levels of 25-hydroxy vitamin D (25(OH) D) in 79 preterm neonates (?32 wk), and correlated it with serum ionized calcium (Ca++) levels at 48-72 h and serum phosphorus and alkaline phosphatase levels at 2-3 weeks of age. The mean (SD) 25 (OH)D level was 14.8 (7.0) ng/mL. 25(OH)D levels had a weak positive correlation with Ca++ (r=0.299) and phosphorus (r=0.186), and a negative correlation with alkaline phosphatase (r=-0.523).

BACKGROUND: Stress index provides a noninvasive approach to detect injurious ventilation patterns and to personalize ventilator settings. Obtaining the stress index (SI), however, requires quantitatively analyzing the shape of pressure-time curve with dedicated instruments or a specific ventilator, which may encumber its clinical implementation. We hypothesized that the SI could be qualitatively determined through a visual inspection of ventilator waveforms. METHODS: Thirty-six adult subjects undergoing volume controlled ventilation without spontaneous breathing were enrolled. For each subject, 2 trained clinicians visually inspected the pressure-time curve directly from the ventilator screen. They then qualitatively categorized the shape of pressure-time curve as linear, a downward concavity, or an upward concavity at the bedside. We simultaneously recorded airway pressure and flow signals using a dedicated instrument. A quantitative off-line analysis was performed to calculate the SI using specific research software. This quantitative analysis of the SI served as the reference method for classifying the shape of the pressure-time curve (ie, linear, a downward concavity, or an upward concavity). We compared the SI categorized by visual inspection with that by the reference. RESULTS: We obtained 200 SI assessments of pressure-time curves, among which 125 (63%) were linear, 55 (27%) were a downward concavity, and 20 (10%) were an upward concavity as determined by the reference method. The overall accuracy of visual inspection and weighted kappa statistic (95% CI) was 93% (88–96%) and 0.88 (0.82–0.94), respectively. The sensitivity and specificity to distinguish a downward concavity from a linear shape were 91% and 98%, respectively. The respective sensitivity and specificity to distinguish an upward concavity from a linear shape were 95% and 95%. CONCLUSIONS: Visual inspection of the pressure-time curve on the ventilator screen is a simple and reliable approach to assess SI at the bedside. This simplification may facilitate the implementation of SI in clinical practice to personalize mechanical ventilation. (ClinicalTrials.gov registration NCT03096106.)

Background. Previous studies have shown that P2Y12 receptor inhibitors might prevent ventricular arrhythmias and cardiac dysfunction in patients with coronary artery disease. However, few studies have focused on comparison of the efficacy of novel oral potent P2Y12 receptor inhibitors with clopidogrel on these outcomes. Methods and Results. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that were published in electronic databases of MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, and ClinicalTrials.gov before June 20, 2018. We compared the effect of prasugrel and ticagrelor with clopidogrel on outcomes of ventricular tachycardia (VT), ventricular fibrillation (VF), heart failure (HF), and cardiogenic shock (CS). Data were combined using both the fixed-effects models and the random-effects models, and the heterogeneity was assessed with the I2 statistic. Nine RCTs (6 with prasugrel and 3 with ticagrelor) with 45,227 patients were included. Patients receiving prasugrel were associated with a lower risk of combined VT and VF (rate ratio [RR]: 0.72, 95% confidence interval [CI]: 95% CI: 0.52-0.99, p=0.043), as well as combined HF and CS (RR: 0.81, 95% CI: 0.70-0.94, p=0.005), compared with clopidogrel. Patients receiving ticagrelor were also associated with a reduced risk of VT and VF (RR: 0.85, 95% CI: 0.72-1.02, p=0.077), although without statistical significance, but not of HF and CS (RR: 0.96, 95% CI: 0.81-1.13, p=0.620). Conclusions. This meta-analysis of RCTs shows that, compared with clopidogrel, novel oral P2Y12 inhibitors, especially prasugrel, might have better effect on improving ventricular rhythm and cardiac function.

Aim This study examined the predictors of loss to follow-up in long-term supportive periodontal therapy in patients with chronic periodontitis. Methods A total of 280 patients with moderate to severe chronic periodontitis in a tertiary care hospital in China were investigated and followed over the course of study. Questionnaires on clinical and demographic characteristics, self-efficacy for oral self-care and dental fear at baseline were completed. Participants were followed to determine whether they could adhere to long-term supportive periodontal therapy. Binary logistic regression analysis was used to examine the association between clinical and demographic characteristics, self-efficacy for oral self-care, dental fear and loss to follow-up in long-term supportive periodontal therapy. Results The loss to follow-up in long-term supportive periodontal therapy was significantly associated with age [adjusted OR = 1.042, 95% confidence interval (CI): 1.012–1.074, p = 0.006], severe periodontitis [adjusted OR = 4.892, 95%CI: 2.280–10.499, p

In this manuscript, a new type of planar metamaterial lens is designed that possesses the optical properties of conventional curved lenses, such as convex and concave lenses. In addition, this study demonstrates that the lens configuration and optical characteristics, such as the focal length and polarity, can be modulated when the planar meta-lens is combined with negative-index media.

a Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-related Cardiovascular Diseases, Ministry of Education, Department of Atherosclerosis, 2 Anzhen Road, ChaoYang District, Beijing 100029, China b Department of Radiology, The China–Japan Friendship Hospital, Beijing 100029, China c Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing 100029, China d Department of Imaging, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing 100029, China e Department of Emergency, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing 100029, China f National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun 130024, Jilin, China g Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100029, China

Objective We performed a comprehensive review and meta-analysis to evaluate the diagnostic values of serum single and multiplex tumor-associated autoantibodies (TAAbs) in patients with lung cancer (LC). Methods We searched the MEDLINE and EMBASE databases for relevant studies investigating serum TAAbs for the diagnosis of LC. The primary outcomes included sensitivity, specificity and accuracy of the test. Results The systematic review and meta-analysis included 31 articles with single autoantibody and 39 with multiplex autoantibodies. Enzyme-linked immunosorbent assay (ELISA) was the most common detection method. For the diagnosis of patients with all stages and early-stage LC, different single or combinations of TAAbs demonstrated different diagnostic values. Although individual TAAbs showed low diagnostic sensitivity, the combination of multiplex autoantibodies offered relatively high sensitivity. For the meta-analysis of a same panel of autoantibodies in patients at all stages of LC, the pooled results of the panel of 6 TAAbs (p53, NY-ESO-1, CAGE, GBU4-5, Annexin 1 and SOX2) were: sensitivity 38% (95% CI 0.35–0.40), specificity 89% (95% CI 0.86–0.91), diagnostic accuracy 65.9% (range 62.5–81.8%), AUC 0.52 (0.48–0.57), while the summary estimates of 7 TAAbs (p53, CAGE, NY-ESO-1, GBU4-5, SOX2, MAGE A4 and Hu-D) were: sensitivity 47% (95% CI 0.34–0.60), specificity 90% (95% CI 0.89–0.92), diagnostic accuracy 78.4% (range 67.5–88.8%), AUC 0.90 (0.87–0.93). For the meta-analysis of the same panel of autoantibodies in patients at early-stage of LC, the sensitivities of both panels of 7 TAAbs and 6 TAAbs were 40% and 29.7%, while their specificities were 91% and 87%, respectively. Conclusions Serum single or combinations of multiplex autoantibodies can be used as a tool for the diagnosis of LC patients at all stages or early-stage, but the combination of multiplex autoantibodies shows a higher detection capacity; the diagnostic value of the panel of 7 TAAbs is higher than the panel of 6 TAAbs, which may be used as potential biomarkers for the early detection of LC.

Research output and impact metrics derived from commercial citation databases such as Web of Science and Scopus have become the de facto indicators of scholarly performance across different disciplines and regions. However, it has been pointed out that the existing metrics are largely inadequate to reflect scholars' overall peer-mediated performance, especially in the social sciences and humanities (SSH) where publication channels are more diverse. In this paper alternative metrics exploring a variety of formal and informal communication channels were proposed, with the aim of better reflecting SSH scholarship. Data for a group of SSH scholars in Taiwan on these metrics were collected. Principal component analysis revealed four underlying dimensions represented by the 18 metrics. Multiple-regression analyses were then performed to examine how well each of these dimensions predicted the academic standing of the scholars, measured by the number of public grants awarded and prestigious research awards received. Differences in the significance of the predictors were found between the social sciences and humanities. The results suggest the need to consider disciplinary differences when evaluating scholarly performance.

Objective To objectively evaluate the effectiveness of psychological interventions for improving health-related quality of life in patients with systemic lupus erythematosus (SLE). Design and review methods Databases including Ovid-Medline, PubMed, Web of Science, EBSCOhost, the Cochrane Library and Embase were electronically searched to identify randomized controlled trials published from inception through November 2013 involving psychological intervention in SLE patients. Studies that measured physiological function, life vitality, depression, pain degree, disease activity, severity of fatigue, and physical and mental component summaries as outcomes were included. Trials involving patients with multiple diseases or received simultaneous psychological interventions or combinations of other interventions were excluded. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted and quantitative analysis was performed with RevMan software (version 5.2). Results A total of six randomized controlled trials comprising 394 participants were included in the study. Meta-analyses showed that psychological interventions significantly reduced the degree of depression (standard mean difference = −0.44, 95% confidence interval [CI]: −0.78–0.10; P = 0.01] and improved the status of the physical health component summary (mean difference = 8.85, 95%CI: 3.69–14.00; P = 0.00] in SLE patients. However, there was no significant effect of psychological intervention on disease activity, degree of pain, fatigue or the mental health component summary. Conclusions The results show that psychological interventions can effectively improve the health-related quality of life in patients with SLE. The full benefit and clinical performance of psychological care requires further investigation by a series of multicenter, large-sample size randomized controlled trails.

A large area of agricultural non-point source pollution which was caused by higher input of fertilizer and pesticide, lower availability of fertilizer, soil erosion and serious destruction of ecological balance in black soil region of northeast China has attracted the national attention and raised the relevant scholars’concern. This paper mainly summarizes the research on mechanism exploration, quantitative of pollution load and model simulation and controlling measure of the black earth region of northeast conducted by domestic scholars, which based on the instruction of general situation of agricultural non-point source pollution in black soil region of northeast China, and then put forward the shortcomings in the present study and direction of future development.

Research achievements of the ASTP Policy-Oriented cannot generate directly economic benefit, social benefit and ecological benefit. It would realize benefit of ASTP only if the outputs can be transformed practical productive forces. In this paper, the mechanism and pathway of achieving benefit of ASTP is analyzed deeply based on the logical framework model. Then the empirical studies shows that the inputs (research investment) have positive correlation with outputs (research achievement), extension and outcomes (changes in productivity). Although the inputs have a certain influence to agricultural economics, it mainly affects indirectly agricultural development by research achievements and extension. Therefore, the benefits of ASTP should not be evaluated according by inputs/outputs methods. We must analyze and assess the anticipated chain of cause/effect relationships of ASTP based on the program “theory-driven” approach. It can promote agricultural research and extension projects to integrated closely, at the same time the benefit of ASTP can be improved greatly.

Transformation electromagnetics reveals that electromagnetic fields can be manipulated in almost any desired manner using specially tailored transformation media. The equivalent scattering property of an arbitrary target changes when it is embedded in such media. This study focuses on this phenomenon and provides a general description that any target embedded in transformation media can map to another object in free space through inverse spatial transformation. The structure and material parameters of the free object are analyzed in detail. A field expander is then obtained as a specific example to demonstrate that the embedded target and the corresponding free object have the same scattering pattern. A cloak with a fissure in the shell is also used to illustrate that the said equivalent scattering is helpful in designing illusion devices and in rigorously evaluating the deviation of scattering cross-section caused by the imperfect structures or parameters of the systems.

In this paper the AC power 50Hz power interference, we use IIR digital notch filter method for industrial frequency interference filter. From the design of IIR digital filter method proceed with, on the IIR digital notch filter simulation, the algorithm deduced, on the fixed-point DSP programming method and overflow handling problems made elaborate incisively, and in digital audio signal processing system has been applied.

A C/T polymorphism (rs11614913) was identified in the microRNA (miRNA) 196a2 (miR-196a2) gene and was implicated in the susceptibility to cancer. Numerous studies have investigated its association with the risk of colorectal cancer (CRC). However, the results were inconsistent and inconclusive. The present meta-analysis was conducted based on the results of six published case-control studies comprising 1,754 cases and 2,430 controls (up to November, 2012). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for the allelic and genotypic comparisons following the co-dominant, dominant and recessive genetic models. The Chi-square-based Q-test was used to assess heterogeneity. Egger's test and inverted funnel plots were used to investigate publication bias. Subgroup analysis was also performed. The results demonstrated that almost all the genetic models (except the model of CT vs. TT) indicated a significant association between rs11614913 polymorphism and CRC risk. The subgroup analysis in an Asian population also demonstrated similar results. However, there was no significant association of miR-196a2 rs11614913 polymorphism with the clinical characteristics of CRC patients. Our results confirmed the association of the polymorphism rs11614913 with the risk of CRC, but not with tumor stage and grade.

This paper proposes a new automatic detection method of Interictal Epileptiform Discharges (IED) based on the merger of the increasing and decreasing sequences (MIDS) to improve IED detection rate. Firstly, increasing and decreasing sequences as well as complete and incomplete waves are reviewed to highlight the characteristics of clinical visual detection of IED. The sequence merging rules and algorithms are consequently proposed for time-domain electroencephalogram (EEG) signals. Experimental results demonstrate that the performance MIDS detection on rhythm waves and slow waves are very close to clinical visual detection. Secondly, the MIDS detection method is applied to IED fragments according to IED features in the time-domain. The results show that most IED fragments are recognized, although with some false detection of non-IED fragments. To reduce such false detection rate, Support Vector Machine (SVM) was applied with 17 characteristics and a training over 232 fragments from 3 patients' EEG recordings. With the SVM improvement, out-of-sample clinical EEG recordings of 32 suspected epilepsy patients were analyzed and 95.9% of the IED fragments marked by clinicians were successfully detected. The results show that the proposed algorithm performs well in IED detection and is a promising candidate in assisting clinicians' epilepsy diagnosis.

Parasitic infection profile in China has been changed greatly with the rapid economic development in China since the 1980s, such as the tremendous decreased infection rate of the soil-borne helminthiasis, the elimination of filariasis, the control of malaria, and the initiation to eradicate malaria in 2020. Some food-borne parasitic infections have increased such as Clonorchiasis, Cysticercosis, and Echinococcosis, probably because of the increased chances of eating out. This trend directly affected the status of Human Parasitology teaching in medical universities, such as the shorten length of this course, re-adjusted contents structure and teaching manners, even the change of the name of this course. In this paper, we analyzed the current status and challenges of Human Parasitology teaching in medical universities, and discussed the requisite contents and manners in course delivery and measures to improve the quality of Human Parasitology teaching in China.

Objective Pleural lavage cytology (PLC) is considered as a possible tool for assessing prognosis of lung cancer patients. We aimed to comprehensively review the prognosis value of PLC in patients undergoing surgical resection. Methods We searched 4 electronic databases for relevant studies comparing positive PLC and negative PLC. The primary outcomes included survival rate and recurrence rate at maximum follow-up. Results The meta-analysis included 28 studies, with a total of 20,714 patients. For the overall survival rate of all stages, the results demonstrated that positive pre-resection, post-resection and pooled PLC were associated with unfavorable survival: hazard ratio (HR) 2.89 (95% confidence interval [CI] 2.48-3.37), 2.70 (1.90-3.83), and 2.89 (2.52-3.31), respectively. For the stage I survival rate, the combined results also suggested that positive pre-resection, post-resection and pooled PLC were associated with unfavorable survival: HR 3.29 (95% CI 2.55-4.25), 4.85 (2.31-10.20), and 3.16 (2.53-3.94), respectively. Furthermore, a meta-analysis of 14 studies included 14,279 patients showed that positive pre-resection, post-resection and pooled PLC were associated with an increased risk of overall recurrence: risk ratio (RR) 2.45 (95% CI 1.91-3.15), 2.37 (1.11-5.09), and 2.37 (95% CI 2.00-2.80), respectively. Positive PLC was also associated with a high pleural recurrence (RR 4.77; 95% CI 3.13-7.26) or distant recurrence (RR 2.33; 95% CI 1.65-3.29). Conclusions Both positive pre- resection and post-resection PLC are associated with not only higher tumor recurrence but also unfavorable survival outcomes in patients with lung cancer resection. This technique can therefore act as a strong prognostic factor for tumor recurrence and adverse survival rates.

Neuregulin-1 (NRG-1), an endogenously produced polypeptide, is the ligand of cardiomyocyte ErbB receptors, with cardiovascular protective effects. In the present study, we explored whether the cardioprotective effect of NRG-1 against I/R injury is mediated by inhibiting myocardial endoplasmic reticulum (ER) stress. In vitro, NRG-1 directly inhibited the upregulation of ER stress markers such as glucose-regulated protein 78, CCAAT/enhancer binding protein homologous protein and cleaved caspase-12 induced by the ER stress inducers tunicamycin or dithiothreitol in both neonatal and adult ventricular myocytes. Attenuating ErbB signals by an ErbB inhibitor AG1478 or ErbB4 knockdown and preincubation with phosphoinositide 3-kinase inhibitors all reversed the effect of NRG-1 inhibiting ER stress in cultured neonatal rat cardiomyocytes. Concurrently, cardiomyocyte ER stress and apoptosis induced by hypoxia-reoxygenation were decreased by NRG-1 treatment in vitro. Furthermore, in an in vivo rat model of myocardium ischemia/reperfusion (I/R), intravenous NRG-1 administration significantly decreased ER stress and myocardial infarct size induced by I/R. NRG-1 could protect the heart against I/R injury by inhibiting myocardial ER stress, which might be mediated by the phosphoinositide 3-kinase/Akt signaling pathway.

Background. The present study aimed to evaluate the prevalence and prognosis of residual lipid abnormalities in statin-treated acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI).Subjects and Methods. A total of 3,047 ACS patients who underwent PCI and received statin therapy were included. Plasma concentrations of LDL-C, HDL-C, and TG were measured. For the follow-up study, major adverse cardiovascular cerebrovascular events (MACCE; including total death, cardiovascular death, myocardial infarction, and revascularization) were documented.Results. A total of 93.14% of all individuals were followed up for 18.1 months (range, 0–29.3 months). Of all 3,047 patients, those with a suboptimal goal were 67.75%, 85.85%, and 33.64% for LDL-C, HDL-C, and TG levels, respectively. Multiple Cox regression analysis revealed there were significant increases in cumulative MACCE of 41% (HR = 1.41, 95% CI [1.09–1.82],p=0.008), and revascularization of 48% (HR = 1.48, 95% CI [1.10–1.99],p=0.01) in low HDL-C patients with ACS after PCI, but not the high TG group at the end of study.Conclusions. Our results showed there is high rate of dyslipidemia in Chinese ACS patients after PCI. Importantly, low HDL-C but not high TG levels are associated with higher MACCE and revascularization rates in ACS patients after PCI.

The aim of this study was to assess the effectiveness of cardiac resynchronization therapy (CRT) by intracardiac delay optimization using echocardiography. Sixty-five patients were implanted with a CRT device randomly assigned to receive simultaneous biventricular pacing or echo-optimized sequential CRT. Forty-two patients were defined as responders and 23 patients were classified as non-responders. During a 12-month follow-up period, the positive response rate, QRS duration, New York Heart Association class, mitral insufficiency grade, left ventricular end-systolic volume and LV end-diastolic volume were similar in the optimized and non-optimized groups (P>0.05), whereas 6-minute walking distance, quality-of-life score, left ventricular (LV) ejection fraction and aortic velocity time integral were significantly improved in the optimized group (P0.05), whereas heart failure aetiology, clinical and echocardiographic measurements showed significant differences (P

The diagnosis of several neurological disorders is based on the detection of typical pathological patterns in electroencephalograms (EEGs). This is a time-consuming task requiring significant training and experience. A lot of effort has been devoted to developing automatic detection techniques which might help not only in accelerating this process but also in avoiding the disagreement among readers of the same record. In this work, Neyman–Pearson criteria and a support vector machine (SVM) are applied for detecting an epileptic EEG. Decision making is performed in two stages: feature extraction by computing the wavelet coefficients and the approximate entropy (ApEn) and detection by using Neyman–Pearson criteria and an SVM. Then the detection performance of the proposed method is evaluated. Simulation results demonstrate that the wavelet coefficients and the ApEn are features that represent the EEG signals well. By comparison with Neyman–Pearson criteria, an SVM applied on these features achieved higher detection accuracies.

In this article, making use of FIX industrial control soft, introduce the test principle signal data processing and property analyzing of the hydraulic cylinder by the help of the computer.It has greatly enhanced the speed and accuracy of detection for hydraulic components and hydraulic system, and also given a promise to assure the design and maintenance successfully.

The grey control theory is used to predict electric power demand in this paper. Original data is processed by the Generation Method. Many unimportant factors affecting electric power demand are removed,and useful information is extracted from original data. The differential fitting equation is set up,and grey prediction model modified by slip average method is presented with residual modification. The current year data is possessed with high weight,which avoids excessive fluctuation. Predicting results show that the model is effective to improve the predict precision.

To minimize the influence of experiential factor and guarantee the software quality from the design phase, with the aid of unified modeling language (UML), an object-oriented design method for PLC program is presented. With UML as design tool, class diagram and state machine diagram are chosen respectively to describe the static structure and dynamic behavior of the PLC based control system, and PLC ladder diagram is acquired from state machine diagram subsequently. With the combination of object-oriented technology, UML and classic PLC design technology, the software reliability of PLC based control system is promoted, and the application area of object-oriented technology and UML is extended.

Ignition timing control is of great importance in homogeneous charge compression ignition engines. The effect of hydrogen addition on methane combustion was investigated using a CHEMKIN multi-zone model. Results show that hydrogen addition advances ignition timing and enhances peak pressure and temperature. A brief analysis of chemical kinetics of methane blending hydrogen is also performed in order to investigate the scope of its application, and the analysis suggests that OH radical plays an important role in the oxidation. Hydrogen addition increases NOx while decreasing HC and CO emissions. Exhaust gas recirculation (EGR) also advances ignition timing; however, its effects on emissions are generally the opposite. By adjusting the hydrogen addition and EGR rate, the ignition timing can be regulated with a low emission level. Investigation into zones suggests that NOx is mostly formed in core zones while HC and CO mostly originate in the crevice and the quench layer.

Background and objectives The mechanisms that trigger gallbladder evacuation dysfunction, the key risk factor for gallstone formation, have not yet been fully elucidated. The sphincter of Oddi (SO) plays important roles in the regulation of gallbladder evacuation and maintenance of normal hydraulic pressure of the biliary tract The aim of our study was to investigate the effects of hypercholesterolemia on the motility function of SO and the underlying mechanisms of SO dysfunction (SOD). Methods Forty New Zealand white rabbits were divided randomly into the control group fed with standard chow and the experimental (Ch) group fed with a high-cholesterol diet for 8 weeks. Changes in the maximal gallbladder emptying rate, gallbladder evacuation with cholecystokinin-octapeptide (CCK-8) stimulation and SO functions of both groups were measured in vivo; B ultrasound examination was used for dynamic observation of peristaltic movements in vivo; SO pressure was measured using manometry; morphological characteristics were observed by electronic microscope; laser scanning confocal fluorescence microscopy was used to identify changes in [Ca 2+ ]i and Ca 2+ oscillation in primary SO smooth muscle cells (SMCs). Results Gallbladder cholestasis was observed during early stages of gallstone formation in Ch rabbits. CCK-8 could not improve the gallbladder cholestatic state in Ch group. Passive dilation of SO significantly improved the cholestatic state in Ch rabbits (P

In order to recognize parts’ pose on Coordinate Measuring Machine (CMM) correctly and fast, based on the translation of CMM, A single camera stereo vision measurement method for feature points’ 3D coordinate on the measured parts is proposed. According to the double cameras stereo vision principle, a image of the part to be measured is captured by A CCD camera, which is driven by CMM along its X or Y axis, on two different position correspondly. Thus, the part’s single camera stereo vision measurement is realized with the proposed image matching method, which is based on the centroid offset of image edge, on two images of the same feature point on the part, and each feature point’s 3D coordinate in the camera coordinate system can be obtained. The measuring system is set up, and the experiment is conducted. The feature point’s coordinate measuring time is 1.818s, and the difference value, which is between feature points’ 3D coordinate calculated with the experiment result and that measured by CMM in the machine coordinate system, is less than 0.3mm. This measuring result can meet parts’ pose real-time recognization requirement on the intelligent CMM, and also show that the method proposed in this paper is feasible.

Acute kidney injury (AKI) frequently occurs after catheter-based interventional procedures and increases mortality. However, the implication of AKI before thoracic endovascular aneurysm repair (TEVAR) of type B acute aortic dissection (AAD) remains unclear. We aimed to determine the incidence

Objective. To evaluate the beneficial and adverse effects of Wenxin Keli (WXKL), either alone or in combination with Western medicine, on the left ventricular ejection fraction (LVEF) and plasma brain natriuretic peptide (BNP) in the treatment of heart failure (HF).Methods. Seven major electronic databases were searched to retrieve potential randomized controlled trials (RCTs) designed to evaluate the clinical effectiveness of WXKL, either alone or in combination with Western medicine, for HF, with the LVEF or BNP after eight weeks of treatment as main outcome measures. The methodological quality of the included studies was assessed using criteria from the Cochrane Handbook for Systematic Review of Interventions, Version 5.1.0, and analyzed using RevMan 5.1.0 software.Results. Eleven RCTs of WXKL were included. The methodological quality of the trials was generally evaluated as low. The risk of bias was high. The results of the meta-analysis showed that WXKL, either alone or in combination with Western medicine, was more effective in LVEF and BNP, compared with no medicine or Western medicine alone, in patients with HF or HF complicated by other diseases. Five of the trials reported adverse events, while the others did not mention them, indicating that the safety of WXKL remains uncertain.Conclusions. WXKL, either alone or in combination with Western medicine, appears to be more effective in improving the LVEF and BNP in patients with HF and HF complications.

The aim of this study was to investigate whether Huisheng oral solution (HSOS) has an inhibitory effect on the development of pulmonary thrombosis and metastasis in mice with Lewis lung carcinoma (LLC), and to explore the possible mechanisms involved. A mouse model of LLC was developed, and model mice were divided into either a treatment group or a control group to undergo treatment with HSOS or normal saline. Normal mice treated with saline were used as normal controls. On day 25 after treatment, blood samples were drawn from the eyes of half the mice in each group to determine blood cell counts and plasma levels of D-Dimer and vascular endothelial growth factor (VEGF), while heart blood samples were collected from the remaining mice to measure the rate of thrombin-induced platelet aggregation. For all mice, pathological analyses of the cerebrum, lung, mesentery, femoral vein, external iliac vein and spleen were performed. Tumors were weighed to assess the impact of HSOS treatment on tumor growth, and the number of thrombi, metastatic nodules and neovessels in the tumor tissue were counted. In addition, 24 normal New Zealand rabbits were divided into two groups and treated with either HSOS or normal saline to determine the rates of ADP-, collagen- or thrombin-induced platelet aggregation. Compared with the model group, HSOS treatment decreased the incidence of pulmonary thromboembolism and metastasis, the number of metastatic nodules, the plasma levels of D-dimer and VEGF, the rate of collagen-induced platelet aggregation in rabbits and the numbers of leukocytes and tumor neovessels (P

Objective: To analyze the tolerance of lung cancer patients with moderate pulmonary hypofunction to open-chest operation. Methods: The postoperative complications of 31 patients with moderate pulmonary hypofunction (study group) and 62 patients with normal pulmonary function (control group) were reviewed. Statistical t test and χ2 test were set to examine the data, and logistic regression was performed to find the associated factors. Results: In patients with moderate pulmonary hypofunction, hypoxemia (41.9%), arrhythmia and cardiac dysfunction (25.8%), and pulmonary inflammation (25.8%) were common postoperative complications, and respiratory failure and cardiac failure (9.2%) severe complications. In-hospital mortality rate was 3.2%. In the control group, the incidence of the above 4 postoperative complications was 16.1%, 8.1%, 9.6% and 3.2% accordingly, and no case died in hospital. Regression analysis showed that age and resection range were associated with the occurrence of the complications. Conclusion: Common postoperative complications (hypoxemia) in patients with moderate pulmonary hypofunction are remarkably higher than those in control group, but severe complications and in-hospital mortality rate are not significantly high. Patients with older age and larger resection range undergo higher complication rate.

This study aimed to investigate the role of real-time B-mode ultrasound in posterior decompression and reduction and to observe the signal changes in spinal cord blood flow in a thoracolumbar burst fracture (TBF). Between February 2004 and December 2008, 138 patients with TBF were divided into group A (108 cases) and group B (30 cases). In group A, under the assistance of real-time B-mode ultrasound, posterior decompression and fracture piece reduction were performed, and we observed the signal changes in spinal cord blood flow. In group B, posterior fenestration was combined with pushing the fracture piece into the fractured vertebral body using an L-shaped operative tool. Presurgical and postsurgical recovery of neurological function was evaluated according to American Spinal Injury Association (ASIA) standards, and the range of spinal decompression was determined by measuring the proportion of encroached fracture piece in the spinal canal (spinal stenosis rate) on the computed tomography (CT) image. In group A, 12 patients had a grade A spinal injury according to the Frankel grading system, and there were six cases without neurological recovery. In the other patients, neurological function increased by 1–3 grades. There were no aggravated spinal cord injuries or other serious complications. In group B, three patients were categorized as grade A and there were two cases without neurological recovery. In the other patients, neurological function increased by 1–3 grades. In groups A and B, the postsurgical spinal stenosis rate was significantly lower than the presurgical stenosis rate (P0.05). Real-time B-mode ultrasound is an effective method for posterior decompression and reduction and to observe signal changes in spinal cord blood flow in TBF.