Objective To explore the clinical effects of three nail and plate systems in treating femoral intertrochanteric fracture.Methods The clinical data of 75 patients with femoral interochanteric fiactures treated by internal fixation were analyzed.According to different treatment methods,75 patients were divided into three groups:DHS group(treated with dynamic hip screw) 26 cases,PFN group(treated with proximal femoral nail) 15 cases,LCP group (treated with anatomical proximal femoral locking plate) 34 cases.Fracture union time,complications and hip function scores according to Harris's scoring were recorded.Results All patients were followed up for 18 to 36 months.Four patients appeared coax vara in DHS group and one case appeared coax vara in PFN group,three case appeared coax vara in anatomical proximal femoral locking plate (LCP.) There was no significant difference in fracture union time and the excellent and good rate of hip function scores among the three groups (F =2.25,χ2 =0.032,all P ＞ 0.05).Conclusion The effects of three nail and plate systems in treating femoral intertrochanteric fracture is similar,but they have their own characteristics and indications.And the reasonable treatment should be selected according to different fracture types.

Objective:To study the diagnostic value of combined detection of IAA,ICA and GADA in the classification of diabetes mellitus.Methods:30 cases of patients with type 1 diabetes who were treated in our hospital from June 2015 to June 2016 were selected as A group,60 cases of patients with type 2 diabetes were selected as B group,50 cases of healthy people were selected as C group.The IAA,ICA and GADA of the three groups were detected by ELISA,and the positive rate of the three groups were compared.Results:The fasting glucose of A group was (10.12± 3.68) mmol/L,B group was (11.23± 3.26) mmol/L,A group and B group were significantly higher than that of C group (P＜0.05),but there was no significant difference between A group and B group (P＞0.05);the positive rates of GADA,ICA and IAA in A group and B group were significantly higher than those in C group (P＜0.05),and the positive rates of GADA,ICA and IAA in A group were significantly higher than those in B group (P＜0.05);the sensitivity and specificity of combined detection of IAA,ICA and GADA in type 2 and type 1 diabetes mellitus were significantly higher than that in the single test (P＜0.05).Conclusions:The combined detection of IAA,ICA and GADA has a high diagnostic value in the classification of diabetes mellitus,which is worth clinical application.

Objective To investigate the characteristics of the microbiota of colonic lavage fluid from patients with diarrhoea-predominant irritable bowel syndrome (D-IBS).Methods From August 2014 to March 2015,at the Department of Gastroenterology Shanxi Provincial People's Hospital,39 patients with D-IBS were enrolled and during the same period 39 patients with self-reported symptoms such as occasional abdominal discomfort or abdominal pain but were excluded from the diagnosis of irritable bowel syndrome (IBS) were selected as control group.The colonic mucosal tissues and colonic lavage fluid of two groups of patients were collected.DNA was extracted from tissues and colonic fluid.Ten dominant bacteria,including Bacteriodes prevotella,Bacteroidetes,Clostridium,Bifidobacterium,Dialister pneumosintes,Enteropathogenic Escherichia coli,Faecalibacterium prausnitzii,Firmicutes,Lactobacillus and Salmonella,were analyzed by real-time fluorescence quantitative polymerase chain reacticn (RT-PCR).T test and Spearman correlation analysis were performed for statistical analysis.Results The numbers of Bacteriodes prevotella in colonic lavage fluid and the descending colon mucosal tissues of patients in D-IBS group were 3.096 ± 1.462 and 4.278 ± 0.290,respectively,which were lower than those of control group (4.842 ± 1.032 and 5.341 ± 0.433,respectively),and the differences were statistically significant (t =6.093 and 12.657,both P ＜ 0.01).Correspondingly,the numbers of Bacteroidetes were 3.259 ± 0.607 and 3.698 ± 0.554,respectively,which were lower than those of control group (4.085 ± 0.504 and 4.339 ± 0.263,respectively),and the differences were statistically significant (t =6.538 and 6.528,both P ＜ 0.01).The numbers of Clostridium were 5.254 ± 0.522 and 4.471 ± 0.690,which were lower than those of control group (5.949 ± 0.505 and 4.950 ± 0.604,respectively),and the differences were statistically significant (t =5.976,P ＜ 0.0l;t =3.262,P =0.002).The number of Faecalibacterium prausnitzii from colonic lavage fluid of patients in D-IBS group was 2.238 ± 1.845,which was lower than that of control group (3.222 ± 1.450),and the difference was statistically significant (t =2.619,P =0.011).The Firmicutes (r =0.678,P =0.012),Lactobacillus (r =0.358,P =0.034),Bifidobacterium (r =0.418,P =0.042) and Faecalibacterium prausnitzii (r =0.568,P =0.022) from colonic mucosal tissues were all positively correlated with those from colonic lavage fluid.However,Salmonella (r =-0.638,P =0.012) and Enteropathogenic Escherichia coli (r =-0.343,P =0.025) were negatively correlated with those from mucosal tissues.Conclusions An imbalance of the microbiota in colonic lavage fluid is found in D-IBS patients.The numbers of Bacteriodes prevotella,Bacteroidetes,Clostridium and Faecalibacterium prausnitzii significantly decrease.

Backgrounds::Inadequate sleep duration is associated with a higher risk of type 2 diabetes and the relationship is nonlinear. We aim to assess the curve relationship between night sleep duration and the incidence of type 2 diabetes in China.Methods::A cohort of 11,539 participants from the REACTION study without diabetes at baseline (2011) were followed until 2014 for the development of type 2 diabetes. The average number of hours of sleep per night was grouped. Incidence rates and odds ratios (ORs) were calculated for the development of diabetes in each sleep duration category.Results::Compared to people who sleep for 7 to 8 h/night, people with longer sleep duration (≥9 h/night) had a greater risk of type 2 diabetes (OR: 1.27; 95% CI: 1.01-1.61), while shorter sleep (<6 h/night) had no significant difference in risk of type 2 diabetes. When the dataset was stratified based on selected covariates, the association between type 2 diabetes and long sleep duration became more evident among individuals <65 years of age, male, body mass index <24 kg/m 2 or with hypertension or hyperlipidemia, no interaction effects were observed. Furthermore, compared to people persistently sleeping 7 to 9 h/night, those who persistently slept ≥9 h/night had a higher risk of type 2 diabetes. The optimal sleep duration was 6.3 to 7.5 h/night. Conclusions::Short or long sleep duration was associated with a higher risk of type 2 diabetes. Persistently long sleep duration increased the risk.