This review firstly introduces sixty h type indices which are categorized in order to overcome the drawbacks of the Hirsch index,especially the advantages and limits of the h type indices when comparing with h index.Moreover,the review gives a list to show the main characteristics of h type indices.Lastly,some illustrative researches are shown to present the applicability of some h type indices.

Objective To evaluate effect of preventing ventilator associated pneumoia (VAP) of patients with oral cavity endotracheal intubation by air impulse clearing away secretion drainage. Methods 348 patients with oral trachea cannula and mechanical ventilation (MV) in intensive care unit (ICU) were divided into control group (n=174) and observational group (n=174). The control group adopted conventional airway management methods without the subglottic secretion drainage while the observational group adopted conventional airway management methods on the basis of combining air impact method remove stranded on airbags. Other treatment and care for all of patients were basically the same. The MV time, duration in ICU and incident rate on VAP were compared between the two groups. Results The average of MV time in control group was (5.25±1.18) days, (5.62±3.20) days in ICU and the rate of VAP was 10.34%(18/174). In observational, it was (8.96 ±5.43) days, (10.43 ±4.96 ) days and 34.48%(60/174), respectively. The MV time, duration in ICU and incident rate on VAP were significantly different (P<0.05), with statistical significance. Conclusions The air impact method to remove airbags retentate could shorten time of MV and during time in ICU, and could reduce the rate of VAP.

Objective To observe the high-flow nasal cannulae can reduce indoor postoperative intensive care patients with tracheal intubation in offline acute respiratory failure after extubation reintubation rates. Methods 53 cases of postoperative acute hypoxia type patients with respiratory failurein the ICU in offline after extubation were divided into two groups, control group of 24 patients, 29 cases of observation group patients. Control group patients in the event of a failure after using non-invasive mechanical ventilation (NIMV) and observation group of patients using HFNC. All other patients with same treatment and nursing. Compare two groups of patients reintubation rates. Results Observation group of reintubation rate was 20.69%(6/29), the control group was 45.83%(11/24), reintubation rate difference of two groups of patients were statistically significant (χ2=3.81, P < 0.05). Conclusions HFNC can reduce postoperative extubation after weaning reintubation rates in patients with acute respiratory failure.

Objective To investigate the effect of different ratios of ginsenosides(GS) and panax notoginsenosides(PNS),which are extracted from Qi-strengthening herbs of Radix Ginseng and blood-activating herbs of Radix Notoginseng respectively,on rats peritoneal mesothelial cells(PMCs) in peritoneal dialysis solution(PDS).Methods PMCs were isolated from rat peritoneal membrane by trypsin digestion method,and then a stable PMCs culture model was established.PMCs were pre-exposed in 4.25% PDS for 3 hours,and then respectively grew in culture solution with different ratios of GS or PNS for 6 hours.The capacity of proliferation of rat PMCs was assessed by methyl thiazolyl tetrazolium(MTT) assay.Results GS 100?g/mL and PNS 80?g/mL showed protective effect on the proliferation of injured PMCs in PDS(P 0.05).Conclusion The combination of GS and PNS,which are extracted from Qi-strengthening herbs of Radix Ginseng and blood-activating herbs of Radix Notoginseng respectively,exerts certain protective effect on PMCs in peritoneal dialysis solution.

Objective To investigate the effect of exogenous interleukin-10 (IL-10) on liver regeneration in rats with biliary obstruction.Methods Male Wistar rats were divided randomly into either a sham operation (SO) group,obstructive jaundice (OJ) group,or IL-10 treated group.Rats in OJ and IL-10 treated groups underwent ligation and division of the common bile duct,while only the SO group had division of the common bile duct.Rats in the IL-10 treated group received daily intraperitoneal injection of IL-10 at a dose of 4 μg/kg after the operation.Quantitative fluorescence real-time PCR was performed to detect hepatic TGF-β1 mRNA expression.Immunohistochemistry for hepatic proliferating cell nuclear antigen (PCNA) labeling index was used to evaluate and epitope of IL-10.The serum levels of total bilirubin (T Bil),direct bilirubin (D Bil),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also measured.Results Hepatic TGF-β1 mRNA,PCNA labeling index and serum levels of ALT and AST in OJ group rats were significantly higher than SO group rats at days 3 and 7 after the operation (P＜0.05).Compared to the OJ group,the IL-10 group had significantly lower hepatic TGF-β1 mRNA and serum levels of ALT and AST.Conversely the IL10 group's hepatic PCNA labeling index was significantly increased as compared with those in OJ group 7 days after operation (P＜0.05).Conclusion Exogenous IL-10 could enhance liver regeneration and alleviate hepatic dysfunction by down-regulating hepatic TGF-β1 expression in rats with biliary obstruction.

Objective Proximal humerus fracture is the most common upper-arm osteoporotic fracture in elderly patients and the result of treatment directly affects the physiological function of the shoulder .This article discusses the clinical effect of the locking proximal humeral plate ( LPHP) combined with anti-osteoporosis drugs in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients . Methods This study included of 47 elderly osteoporotic patients with comminuted proximal humerus fractures treated from April 2009 to March 2012 and with complete follow-up data.According to the Neer classification , the patients were divided into groups A (LPHP treatment, n=23, including 13 cases of three-part fractures and 10 cases of four-part fractures) and B (LPHP+anti-osteoporosis drugs, n=24, including 13 cases of three-part fractures and 11 cases of four-part fractures). Results All the patients were followed up for 14 to 38 (mean 23.6) months.The postoperative healing time was significantly shorter in group B than in group A ([96.57 ±2.59]d vs [115.91 ±2.73]d, P<0.05), and the excellence rate was remarkably higher in B than in A (91.7%vs 78.3%,P<0.05). Conclusion With the advantages of short healing time and high excellence rate , LPHP+anti-os-teoporosis drugs is superior to simple LPHP in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients.

This article elaborated the theory of chronic and complex disease treatment based on collaterals. It put forward that complex virtual evil stasis was the common pathogenesis of chronic and complex disease treatment. Combined with articles published in recent 5 years, from the perspective of cytokines and genes, it summarized traditional Chinese medicine (TCM) compound targets in chronic and complex disease treatment. It put forward the transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), vascular endothelial growth factors (VEGFs), matrix metalloproteinases/tissue inhibitor of metalloproteinase (MMPs/TIMPs) were its high-frequency targets. It provided a basis for future experiment design on chronic and complex disease treatment based on collaterals as well as new drug development.

Pancreatic tuberculosis (PTB) is a rare,chronic,specific and infectious disease which is generally secondary to tuberculosis at the common sites of pancreas,and it has a high misdiagnosis rate due to the hidden onset and nonspecific symptoms of PTB.A patient with PTB was admitted to the First Affiliated Hospital of Zhengzhou University in June 2014.Before operation,the space-occupying lesions of the head of pancreas were detected by preoperative imaging examination,and the patient was regarded as with pancreatic cancer.Intraoperative exploration showed cystic duct involvement,and the granulomatous inflammation was detected by rapid pathological examination using frozen section technique,after that the patient received granuloma resection+cholecystectomy according to suspected PTB.The diagnosis of PTB was confirmed by postoperative pathological examination,and the patient received liver-protective and anti-tuberculosis treatments after discharge.

Objective To observe the effects of ilexonin A (IA) on IL-6 and M-CSF following ballon angioplasty in rabbit common carotide artery to provide experimental basis for percutaneous coronary interventions. Methods 30 Japanese rabbits were fed with high cholesterol food for 4 weeks. Then they were divided into three groups randomly. Each group had ten rabbits. ①Control group: the incision was sew directly after right carotide artery of the rabbit was seeked. ②Balloon dilation group:the proximal of the carotide artery was cuted,the ballon was delivered and distended,after it was drawn repeatly,the incision was closed. ③IA therapy group: operation was the same to the balloon dilation group,then IA was administered in vein.All of them were fed with high cholesterol diet for 4 weeks and the blood samples were collected 1 d before the operation and 1 d,1,2,4 weeks after the operation. The serum IL-6 and M-CSF levels were determined with radioimmunoassay.The pathological changes of injuried artery were observed. Results ①The IL-6 level in balloon dilation group was higher than that in IA therapy group after the operation (P

Objective To determinate whether the first post-operative day serum parathyroid hormone (PTH) is more effective than serum calcium in predicting hypocalcemia after total thyroidectomy.Methods According to PTH level on the first post-operative day,104 patients after total thyroidectomy were divided into different groups.Patient's serum calcium was measured,the number of patients who developed hypocalcemia and the time for calcium supplement were recored.Results Serum PTH was more accurate in predicting hypocalcemia than serum calcium.There were 26 patients whose PTH value was ＜ 5 pg/ml,among whom 7 patients had transient hypocalcemia and symptoms,while 5 of them developed hypocalcemia for long time and needed long-term calcium supplement.The positive predictive value of group PTH value ＜ 5 pg/ml was 28％,and the accurate rate was 46％,higher than other groups.Besides,the positive predictive value and the accurate rate of PTH value ＜ 5 pg/ml was higher than serum calcium.Conclusion Serum PTH is more effective in determining hypocalcemia after total thyroidectomy than serum calcium,and PTH value ＜ 5 pg/ml on the first post-operative day is a reliable marker in predicting hypocalcemia after total thyroidectomy.