Background:Inflammatory bowel disease(IBD)is a chronic,non-specific,relapsing inflammatory bowel disorder. Prediction of prognosis and relapse is of great importance for disease control. Aims:To analyze the characteristics and related factors for relapse in IBD patients. Methods:Four hundred and seventy-nine hospitalized patients diagnosed as ulcerative colitis(UC,n = 301)or Crohn’s disease( CD,n = 178)from Jan. 2004 to Jun. 2014 were enrolled and divided into relapse group and non-relapse group. The clinical characteristics were collected and univariate and multivariate analysis were performed to identify the influencing factors for relapse. Results:The relapse rates for UC and CD were 52. 49% and 77. 53% ,respectively. In stepwise Logistic regression analysis,younger onset age( < 40 years old,OR =0. 825,95% CI:0. 777-0. 876,P = 0. 000),longer disease duration(OR = 1. 186,95% CI:1. 089-1. 291,P = 0. 000) and extensive colitis(OR = 16. 993,95% CI:2. 670-108. 170,P = 0. 003)were independent risk factors for relapse of UC,while younger onset age( < 40 years old,OR = 0. 944,95% CI:0. 915-0. 974,P = 0. 000)and poor medication adherence(OR = 31. 074,95% CI:10. 456-92. 343,P = 0. 000)were independent risk factors for relapse of CD. Conclusions:Patients at high risk for relapse of IBD can be identified by referring to the related risk factors. Early identification and intervention,persistence for maintenance therapy and improving medication adherence by health education may reduce the clinical relapse of IBD.

Objective To explore the persistent cerebrospinal fluid drainage and intrathecal injection of urokinase in prevention and treatment of cerebral vasospasm after aneurysm surgery.Methods The effect of prevention and treatment of cerebral vasospasm after aneurysm surgery in 40 patients, using the method combined with intrathecal injection of urine kinase for persistent cerebrospinal fluid drainage, and classified as the observation group;the other 40 cases patients with persistent cerebrospinal fluid drainage intervention, and classified as the control group, two groups of patients were in Shandong Provincial Hospital from January 2016 to January 2017.Results The incidence of rebleeding in two groups had no significant difference in observation of cerebral vasospasm in patients with the incidence was significantly lower than the control group, the observation The incidence of cerebral vasospasm group was 15.0%, 37.5% in the control group, compared two groups of patients with the prognosis, the obvious observation group of patients with good prognosis, comparison between groups showed significantly(P<0.05).Conclusion Persistent cerebrospinal fluid drainage and intrathecal injection of urokinase on the clinical study of postoperative cerebral vasospasm aneurysm found the simple, compared with continuous drainage of cerebrospinal fluid, can improve the clinical condition of patients, and promote the recovery of patients, reduce cerebral vascular spasm, so it is worthy of reference.

Objective To investigate clinical efficacy of epirubicin joint docetaxel for triple -negative and non -triple -negative breast cancer,to provide reference for clinical treatment.Methods A retrospective analysis of 80 cases with breast cancer was conducted,26 patients with triple -negative breast cancer were set as study group, and 54 patients with non -triple negative breast cancer were set as control group.All patients used epirubicin docetax-el chemotherapy,the curative effect,survival rate,toxicity were compared between the two groups.Results The chemotherapy response rate of triple -negative breast cancer group was 84.62%,which was significantly higher than 53.70% in non -triple -negative breast cancer group (χ2 =6.45,P <0.01).The 5 -year disease -free survival rate,overall survival rate of triple -negative breast cancer group were 50.00%,73.08%,which were significantly lower than those of non -triple -negative breast cancer group (χ2 =5.89,P <0.01;χ2 =4.19,P <0.01).The inci-dence rates of constipation,nausea,vomiting,leukopenia,neutropenia Ⅲ -Ⅳ degrees reaction were 13.75%, 10.00%,15.00%,13.75%,and the overall incidence rates were 41.25%,42.50%,41.25%,43.75% respective-ly.Conclusion Epirubicin joint docetaxel adjuvant chemotherapy has good short term efficacy for triple negative breast cancer,but its long -term efficacy is poor to non -triple -negative breast cancer.

Objective:To investigate the sleep quality and relative factors of the people aged 18years or over in Tianjin Municipality.Methods:The participants came from the Tianjin Mental Health Survey conducted from Ju-ly to December in 2011.Total of 11618 residents aged 18 years or over were selected randomly among the general population and finished the Pittsburgh Sleep Quality Index (PSQI)for assessment of sleep quality and General Health Questionnaire (GHQ-12)for screening out the individual with possible mental disorders.The PSQI total score >7 was defined as poor sleep quality.Chi-square test and Wilcoxon rank sum test was used to conduct univa-riable analysis,and logistic regression was used to analyze the related factors to poorer sleep quality.Results:In this sample,980 people had poorer sleep quality,with the adjusted prevalence rate in Tianjin was 6.6%.Logistic regres-sion analysis showed risk factors to poorer sleep quality were female (OR =1.47,95%CI:1.19 -1.82),older age (30 -39 years old,40 -49 years old,50 -59 years old,60 -69 years old,70 years or older,OR =1.72(95%CI:1.10 -2.69),2.55(95%CI:1.66 -3.91),4.41 (95%CI:2.85 -6.83),5.34(95%CI:3.32 -8.59),5.40(95%CI:3.21 -9.08),at his/her own expense on medicare (OR =1.52,95%CI:1.15 -2.00),unemployment (OR =1.46,95%CI:1.05 -2.03)or retirement (OR =1.45,95%CI:1.02 -2.06),smoking (OR =1.49,95%CI:1.22-1.83),difficulty to engage in daily work or activities due to physical illness (OR =2.30,95%CI:1.85 -2.85), and GHQ -12 score ≥ 4 (OR =6.51,95%CI:5.46 -7.46).Conclusion:Although the prevalence rate of poorer sleep quality in the people aged 18 years or over in Tianjin is lower,the problem is common and should not to be ignored.

[Objective]To evaluate the long-term clinical results of Herbert screw in the treatment of intra-articular fractures by retrospective analysis.[Method]From 1991 to 2006,fifty-five patients of different parts of intra-articular fracture treated with Herbert screw were followed up effectively,including scaphoid fracture group of 19 cases,the radial head fracture group of 25 cases,the femoral head fracture group of 11 cases.[Result]After an average follow-up time of 5 years and 11 months(ranged,1-13 years),the good-to-excellent rates were 94.7%,96%,72.7% according to the modified Mayo score,the Broberg-Morrey score and the Tompson-Epstein score.[Conclusion]The Herbert screw can provide strong fixation and stability in the long-term follow-up.It is an ideal material in treating intra-articular fractures.

Objective To investigate the classification and its application in one-stage repair of massive posttraumatic bone defects which are infection-induced and refractory in lower extremities. Methods From March 2002 to December 2008, we treated 42 patients with massive posttraumatic refractory infection-induced bone defects in lower extremities. We classified the defects into 3 types: simple massive infection-induced bone defects (type Ⅰ), massive infection-induced bone and soft-tissue defects (type Ⅱ) and massive infection-induced bone defects plus limb shortening (type Ⅲ). After thorough debridement, various types of vascularized fibular grafts were used to repair the 3 kinds of defects accordingly. Simple fibular grafts were used in 6 cases, transplantation with fibular and skin flaps was used in 31 cases, fibular grafts combined with anterior lateral thigh flap in 4 cases, and one-stage limb lengthening and fibular graft in one. Results The follow-ups of 6 to 41 (average, 26. 3) months revealed that the refractory bone defects were repaired successfully in 38 cases, amputation due to necrosis of fibular grafts in 2 cases and uncontrolled infection in 2 cases. In the 38 cases, infections were controlled effectively, circulation of the traumatic limbs was good,contour and function were restored satisfactorily, and no obvious complication was found in donor limbs. By Johner-Wruhs evaluation, 17 cases were excellent, 18 cases good, 3 cases fair and 4 cases poor, with a total excellent and good rate of 83.33%. Conclusions Refractory and massive posttraumatic infection-induced bone defects in lower extremities can be classified into 3 types. They can be repaired using various types of vascularized fibular grafts according to the defect types at one-stage.

Objective To investigate the roles of c-reactive protein (CRP) in the onset of dysthymia and its effects on the therapeutic efficacy. Methods Ninety six patients with dysthymia (male:37, female: 59) were examined using Hamilton depression scale (HAMD) to determine their status of depression at 2 months before and after treatment with fluoxetine. Another 50 normal subjects were employed as the controls. CRP levels were measured by scatter turbidimetry by TurboxR special protein analysis system (Finland) in all subjects. Results All depression scores of normal subjects according to HAMD depression scale were under 17 and their serum CRP concentrations were at a basic level. The prevalence rate of increase of serum c-reactive protein in dysthymia was 43.8%(42/96). The average serum CRP level in patients with dysthymia was significantly higher than that in normal subjects (P0.05). Conclusion Serum CRP concentration maybe an important evoking factor of dysthymia. It may not increase the severity of depression but may impede the early improvement of symptoms.

Objective To observe the effects of hyperventilation on jugular bulb pressure and optic nerve sheath diameter during RALRP. Methods Twenty patients undergoing elective RALRP were enrolled in this study. After hyperventilation of General anesthesia,we monitored and recorded changes of Heart rate(HR),mean arterial pressure (MAP),end-tidal carbon dioxide (ETCO2),arterial oxygen tension (PaO2),arterial carbon dioxide tension(PaCO2),peak airway pressure(PIP),JBP and ONSD in 5 minutes after intubation(T0),Trendelenberg posture in 15 minutes (T1),the established pneumoperitoneum in 30,60,90 minutes (T2,T3,T4) and termination of pneumoperitoneum in 15 minutes in supine position(T5)respectively. Results Compared with T0, JBP increased at T1 ~ T5(P < 0.05). ETCO2 and PaCO2 of T1 ~ T5 were lower than those of T0(P < 0.05)during hyperventilation. After establishment of Trendelenburg posture and pneumoperitoneum,PIP values increased at T1~T4 than that at T0 (P < 0.05),However,ONSD increased from T3 to T5 compared with T1 to T2 (P < 0.05). Conclusion Through over-ventilation,pneumoperitoneum and Trendelenburg posture,JBP and PIP can increase, and ONSD becomes wider evendually.

Objective To explore the anticoagulating active components in water extraction, alcohol sedimentation and fraction separated by gelfiltration chromatography of Bombyx Batryticatus. Methods Anticoagulating active fractions were prepared by the methods of water extraction, 70% alcohol sedimentation and gelfiltration chromatography. Components (such as porteins or polypeptide, amino acids, oxalic acid ammonium) in each fraction were determined by chemical reaction indentification, Kjeldahl method, conductance, UV and HPLC. Results Polypeptide, amino acids and oxalic acid ammonium were the main components in anticoagulating active fractions, content of which reached more than 80%. The content of oxalic acid ammonium decreased about 52% processed by alcohol sedimentation, while the content of polypeptide and amino acids only decreased about 8%. The content of peptides and amino acids increased about 28% purified by gelfiltration chromatography compared with the one in water extraction and about 39% compared with the one in alcohol sedimentation. The content of oxalic acid ammonium was the same as the one in alcohol sedimentation, but decreased about 1 time compared with the one in water extraction. The content of 15 kinds of amino acids were 40%～50% in the solids of each fractions, which maked up to 60%～76% of the content of proteins determined by Kjeldahl method. Molecular weight range of peptides is 1.0～4.4 kDa. Conclusion This study provides a experimental basis for further separation and purification of anticoagulating active components from Bombyx Batryticatus.

Argon-helium cryosurgical system has been widely used in the treatment of solid tumors.The basic mechanism of this technique is that the ultra low temperature(below 140℃ ) can act on the diseased tissues, resulting in the formation of ice crystals both inside and outside of the cells and causing the rupture of the cells, which will further produce a series of physical and chemical changes and finally bring about the necrosis of tumor cells.This paper aims to introduce the argon-helium cryosurgical system, focusing on its guiding mode, freezing extent and time, freezing immunity, curative effect and combination of treatments.