[Risk factors associated with delirium for patients with hip fracture under the orthogeriatric unit mode].

Objective: To explore postoperative delirium (POD)risk factors for geriatric patients who suffered hip fracture under the care of orthogeriatric unit mode. Methods: Patients aged 65 years or older, who were admitted to the orthogeriatric unit in Beijing Jishuitan Hospital from April to October 2017 for hip fracture surgery, were eligible for this prospective cohort study. After univariable analysis, significant risk factors associated with POD were further evaluated with multivariable analysis, to establish independent risk factors associated with POD. Results: A total of 203 patients with an average age of 80(65-96)years were enrolled in the study. The overall incidence of POD was 9.4%(19/203)in which hyperactive and hypoactive type accounting for 84.2%(16/19)and 15.8%(3/19), respectively. Significant difference was found between POD and non-POD groups in patients' age (P=0.003), albumin(P=0.006), TSH(P=0.018), PaCO(2) level(P=0.003), visual analogue scale (VAS )both at rest (P=0.013)and movement(P=0.010) on post-operative day 1.The further Logistic stepwise regression analysis showed that significant differences existed between groups in age(P=0.027), albumin(P=0.003), PaCO(2)(P=0.014)and VAS at rest(P=0.002). Conclusion: The independent risk factors of POD in geriatric patients undergoing hip fracture under the orthogeriatric unit mode include patients' age, pre-operative albumin as well as PaCO(2) level and post-operative VAS at rest.

The cardiovascular macrophage: a missing link between gut microbiota and cardiovascular diseases?

The prevalence of cardiovascular diseases is on the rise. Interventions that would aid prevention or treatment of these diseases are essential. The microbes residing in the gut, collectively called "gut microbiota", produce a plethora of compounds that enter the bloodstream and affect the cardiovascular system. Signals ascending from gut microbiome are believed to modulate differentiation and functional activity of macrophages residing in perivascular tissue, atherosclerotic plaques, and perivascular areas of the brain. Cardiovascular macrophages may be the key players that transform the signals ascending from gut microbiome into increased predisposition to cardiovascular diseases. The present review summarizes the knowledge to date on potential relationships between gut microbiota, cardiovascular macrophages, and cardiovascular diseases.

[Efficacy and safety of ultrasound-guided or neurostimulator-guided bilateral axillary brachial plexus block].

Objective: To explore the efficacy and safety of bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator. Methods: From February 2012 to April 2014, 120 patients undergoing bilateral hand/forearm surgery in Beijing Jishuitan Hospital were enrolled and anaesthetized with bilateral axillary brachial plexus block. All patients were divided into two groups randomly using random number table: the ultrasound-guided group (group U, n=60) and the neurostimulator-guidedgroup (group N, n=60). The block was performed with 0.5% ropivacaine. Patients' age, sex and operation duration were recorded. Moreover, success rate, performance time, onset of sensor and motor block, performance pain, patient satisfaction degree and the incidence of related complications were also documented. Venous samples were collected at selected time points and the total and the plasma concentrations of ropivacaine were analyzed with HPLC. Results: The performance time, the onset of sensor block and the onset of motor block of group U were (8.2±1.5), (14.2± 2.2)and (24.0±3.5)min respectively, which were markedly shorter than those in group N( (14.6±3.9), (19.9±3.8), (28.8±4.2)min, respectively), and the differences were statistically significant(t=11.74, 10.09, 6.73, respectively, all P<0.01). The performance pain score of group N was (25.5± 13.2), which was obviously more serious than group U (31.7± 11.2) and a significant statistical difference was detected (t=2.856, P<0.05). The patient satisfaction degree of group U was 95.0%, which was significantly higher than group N (83.3%) and a markedly statistical difference was detected (χ(2)=4.227, P<0.05). Fifty min after performance, the total plasma concentration of ropivacaine of group U was(1.76±0.48)mg/L, which was significantly lower than group N (1.88±0.53)mg/L and a significant statistical difference was detected (t=2.43, P<0.05), while no significant differences were detected at the other time points between two groups (P>0.05). No analgesic was superadded and no other anesthesia methods were applied. No complications were detected perioperatively. Conclusions: The bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator are both effective and safe for bilateral hand/forearm surgery. However, the ultrasound-guided block may be more clinically beneficial because of its shorter performance time, rapid onset and higher patient satisfaction degree.

Acaroid mites (Acari: Astigmata) in Chinese traditional medicines.

Almost 2000 samples of the dried plants and animals used in Chinese traditional medicine were collected from a storehouse in Huainan city, Anhui province, China, where they had been kept for at least 6 months. When examined, every sample was found to contain acaroid mites. The mites included representatives of 44 species belonging to 22 genera and seven families. It seems that samples of Chinese traditional medicine frequently become severely infested with mites while in storage. More importance should be attached to protecting the medicines against mite infestation and to protecting against acariasis those who ingest or simply handle the medicines.

[Effect of combined drug-acupuncture anesthesia on hypothalamo-pituitary-adrenocortical axis response and glucose metabolism in open-heart surgery patients].

OBJECTIVE: To study and evaluate the effect of electroacupuncture (EA) on hypothalamo-pituitary-adrenocortical (HPA) axis response and glucose metabolism in open-heart surgery patients undergoing cardiopulmonary bypass (CPB). METHODS: Thirty patients with atrial septal defect were divided into 3 groups, the general anesthesia group (A), the acupuncture anesthesia group (B) and the general anesthesia combined EA group (C). Peripheral blood samples were collected at the time before anesthesia, before CPB and 30 min after CPB to determine plasma beta-endorphin, adrenocorticotropic hormone (ACTH), serum cortisol and blood glucose. RESULTS: Plasma beta-endorphin, ACTH and serum cortisol increased significantly in Group A and B 30 min after CPB but without significant change in Group C. Blood glucose increased in all the 3 groups 30 min after CPB but the increment in Group C was the lowest. CONCLUSION: Group A and B showed no significant inhibitory effect on HPA axis response and glucose metabolism in open-heart surgery patients undergoing CPB, but Group C could obviously inhibit those responses. Assessment from the viewpoint of stress, the general anesthesia combined with EA is the better approach for anesthesia in open-heart surgery with CPB.

[Clinical observation on verrucous gastritis with combined therapy of traditional Chinese and Western medicine].

Controlled study of verrucous gastritis treated with combined therapy of TCM-WM was compared with that of WM only. The result showed that the total effective rate and the cured rate of former were 97.83% and 84.78%, while that of latter were 77.14% and 22.86% respectively. The TCM-WM revealed better results than WM alone. Follow-up was done after six months, the recurrence rates of the two groups were 9.10% (2/22) and 43.75% (7/16) respectively, the difference was significant (P < 0.05). There was no side effect in combined therapy and the therapy was convenient for use.

[In vitro culture of premature seeds of Dendrobium huoshanense Tang et Cheng].

The premature seeds of D. huoshanense collected in September or October can develop normally in MS or Kundson media with BAI and NAA 0.5 mg/L and form complete plantlets. The premature seeds cultured in dark for 22 days and then in low light intensity give the highest germination percent age(91%). The suitable temperature for the germination of D. huoshanense premature seeds is 25-27 degrees C.

An improved method for semen alpha-L-fucosidase typing--distribution in the Wuhan population of China.

An improved method for the separation of the genetic variants of alpha-L-fucosidase in human semen is described. The method involves, isoelectric focusing in ultrathin-layer PAG containing a mixture of ampholines, pH 5-7 and pH 3.5-9.5, and separator HEPES. The Fu pattern obtained is simple, easy to interpret, and reproducible. The occurrence of fucosidase phenotypes in 189 semen samples from the population of Wuhan was investigated, and the frequencies of the Fu alleles were calculated.