Objective To investigate effects of cemented hip arthroplasty applied to treat intertrochanteric fracture of aging patients.Methods 21 cases of clinical data of patients with intertrochanteric fracture treated with cemented hip arthroplasty were retrospectively analyzed,and hip functions were evaluated according to Harris grading.Results The mean time of surgery was (42.2 ± 8.6) main,mean blood loss was (597 ± 83) ml,mean time of hospital stay(specialist hospital stay not included) was (16.5 ± 1.7) days,all cuts were primary healing,and mean time of healing was (15.7 ± 0.2)days.After operation 5 parents had respiratory tract infection and improved by symptomatic anti-inspection therapy.3 cases had deep vein thrombosis and improved by inferior vena cava filter input and thrombolysis therapy.1 case had dislocation after cemented hip hemiarthroplasty and improved by legs brace booth outside fixed for 3month.21 cases had following up for 6 months after operation.All fractures were cured,without any osteolysis,loosening of the prosthesis or heterotopic ossification.65 ～ 89 scores by Harris hip function grading,and the mean score was 74.1.13 cases were good,7 cases less than ideal and 1 case poor.Conclusion Cemented hip arthroplasty is an effective method to treat intertrochanteric fracture of aged patients.After operation,the patients can do early activity and have long-term good function recovery.

Objective To explore the effect of parenting style and behavior on children with allergic asthma.Methods From July to December in 2016,a total of 60 children with allergic asthma,who were from Jiangsu Province Hospital of Traditional Chinese Medicine and Jiangsu Research Institute of Traditional Chinese Medicine,were selected as the asthma group.Another 60 normal children from kindergarten and primary school were selected as the healthy group.Achenbach child behavior checklist (CBCL) and parenting style questionnaire were used to evaluate the behavior and parenting style of the two groups.The Fractional exhaled nitric oxide (FeNO) of the two groups were also collected.Results (1) The scores of dotage,autocracy,inconsistence of parenting style in asthma group ((14.95±4.95),(22.23±4.69),(13.43±3.80))were higher than those in healthy group((11.68±3.69),(16.47±4.16),(11.07±3.32))and the differences were significant (all P＜0.05).The scores of democracy,indulgence in asthma group ((38.92 ± 5.37),(18.12± 4.54)) were lower than those in healthy group((41.35±3.62),(19.88±3.41)),and the differences were statistically significant(all P＜0.05).(2) The scores of attention,socialization,aggression and withdrawal of child behavior in asthma group ((7.35±3.55),(3.85±2.17),(11.57±5.30),(3.40±2.65))were higher than those in healthy group((3.38±2.81),(2.52± 1.52),(6.98±4.77),(2.02± 1.63)),the differences were statistically significant(all P＜0.01).There was no significant difference between the two groups in the dimension of discipline(P＞0.05).(3) The FeNO index of asthma group((32.27± 14.27) × 10-9 mol/L) was higher than that of healthy group ((11.10± 1.88) × 10-9 mol/L) and the differences were statistically significant (P＜0.01).(4)Logistic regression analysis showed that the attention(B=0.38,OR=1.47,95％ CI =1.27-1.70,P＜0.01),dotage(B=0.19,OR=1.20,95％ CI =1.06-1.37,P＜0.01) and autocracy(B=0.24,OR=1.27,95％ CI =1.14-1.42,P＜0.01)had significant effects on allergic asthma.Conclusion Attention,dotage and autocracy are the risk factors to influence the control level of allergic asthma.This should arouse the attention of clinicians and parents.

Objective To analyze the perioperative complications and prognosis of surgical treatment of pancreatic ductal stones.Methods 60 patients diagnosed to have pancreatic ductal stones and were admitted into our hospital from January 2009 and December 2014 were enrolled into this retrospective study.There were 47 males and 13 females.The average age was (44.1 ± 12.0).Results All patients underwent surgical operation and there was no perioperative death.Perioperative complications occurred in 7 patients (11.7％), including pancreatic fistula in 4 patients, delayed gastric emptying in 1 patient, abdominal infection in 1 patient, anastomotic bleeding in 1 patient.Eight patients developed elevated amylase levels.The fasting time was 3.4 ± 1.2 days and the hospital stay was 10.0 ±4.0 days.The follow-up rate was 88.3％ (53/60), at a mean follow-up of 27 months.In 51 patients who presented with abdominal pain, 43 patients (84.3％) had complete pain relief and 7 patients (13.7％) had partial pain relief.In 14 patients with preoperative diabetes mellitus, 1 patient had improvement and 2 patients recovered from diabetes.Two additional patients were diagnosed to have diabetes two years after the operation.Of the 2 patients who were shown to have pancreatic cancer on histopathological study, 1 patient was lost to follow-up while another patient died at 27 months after the operation.The patients diagnosed to have epithelial dysplasia were followed-up and none developed pancreatic cancer.Conclusions The relationship between chronic pancreatitis and pancreatic ductal stones was very close.Chronic pancreatitis also caused exocrine and endocrine dysfunction.Surgical operation plays an important role in symptomatic relief and in delaying pancreatic dysfunction.

Objective To investigate the effects of transcutaneous electro acupuncture stimulation (TEA) on esophageal motility of patients with refractory gastroesophageal reflux disease (RGERD) by high resolution manometry (HRM),and to provide a new treatment option for RGERD.Methods From February 2014 to June 2015,a total of 45 patients with RGERD were enrolled.TEA instrument was used for electro acupuncture stimulation at the points of Zusanli and Neiguan.HRM was carried out before and after treatment.The changes of HRM parameters such as lower esophageal sphincter pressure (LESP),distal contractile integral (DCI),and amplitude of 3 cm,7 cm above lower esophageal sphincter (LES),esophageal body velocity and contractile front velocity (CFV) were also compared.The paired-samples t test was performed for statistical analysis.Results According to LESP value,45 patients were divided into low LESP group (10 patients) and normal LESP group (35 patients).According to parameter of esophageal motility function,patients were divided into esophageal dysmotility group (25 patients) and normal esophageal motility group (20 patients).After TEA treatment,the LESP of lower LESP group was (14.83± 4.17) mmHg (1 mmHg =0.133 kPa),which was higher than that before treatment ((9.54 ±2.42) mmHg),and the difference was statistically significant (t=4.92,P=0.001).LESP of esophageal dysmotility group was (19.04±5.91) mmHg,which was higher than that before treatment ((16.20±6.09) mmHg),and the difference was statistically significant (t=4.92,P=0.001).There was no statistically significant difference in LESP of normal LESP group and normal esophageal motility group before and after treatment (both P＞0.05).After treatment,DCI of esophageal dysmotility group was (530.76±215.53) mmHg· cm· s,which was higher than that before treatment ((363.92 ± 279.17) mmHg · cm · s),and the difference was statistically significant (t=2.86,P＜0.05).There was no statistically significant difference in esophageal body velocity,amplitude of 3 cm,7 cm above LES andCFV before and after treatment (all P＞0.05).There was no statistically significant difference in all of the esophageal motility parameters in normal esophageal motility group before and after treatment (all P＞0.05).Conclusion TEA can increase LESP and DCI in RGERD patients with esophageal motility dysfunction,improve contraction of entire esophagus and raise esophageal clearance capacity.

[Summary] The aim of this study was to detect the levels of serum miR-130b expression in patients with type 2 diabetes mellitus and to analyze their correlation with diabetic renal damage. 243 patients with type 2 diabetes mellitus were divided into three groups according to urinary albumin/creatinine ratio ( UACR ): normoalbuminuria group (UACR<30 mg/g, n=103), microalbuminuria group (UACR 30-300 mg/g, n=86), and macroalbuminuria group(UACR>300 mg/g, n=54). The levels of serum miR-130b were validated by realtime polymerase chain reaction. Serum transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α(TNF-α) were determined by enzyme-linked immunosorbent assay ( ELISA) in all patients and 59 healthy volunteers. Compared with control group, the level of serum miR-130b in the type 2 diabetes mellitus group were significantly decreased, gradually with the increases of UACR. The level of serum miR-130b was inversely correlated with blood urea nitrogen ( r=-0. 295, P<0.05), serum creatinine(r=-0. 316, P<0. 05), UACR(r=-0. 463, P<0. 05), but positively related to the estimated glomerular filtration rate(r=0. 367, P<0. 01). The level of serum miR-130b was also negatively correlated to homeostasis model assessment for insulin resistance, triglyceride, low density lipoprotein-cholesterol, TNF-α, and TGF-β1 (r=-0. 257,-0. 345,-0. 242,-0. 562,-0. 622, all P<0. 01). The present study indicates that serum miR-130b might be a potential new biomarker for early diagnosis of diabetic nephropathy. Serum miR-130b might be involved in the pathogenesis of diabetic nephropathy.

Objective To analyze the clinical characteristics of patients with acute pancreatitis (AP) in Jiangxi Province.Methods From 2007 to 2012,the data of 2 625 hospitalized patients diagnosed as AP were retrospectively analyzed.The changes of composition in gender,age and etiology during 2007-2009 time period and 2010-2012 time period were compared.Mann Whitney U test was performed for non-normal distribution measurement data analysis and x2 test was for count data analysis.Results Among the 2 625 patients with AP,from 2007 to 2009 there were 1 028 cases and 1 597 cases in the period 2010 to 2012.The ages of the patients in these two period were 50(38,61) and 50 (40,63) years old,respectively.There was statistically significant difference in the age distribution between these two period (U=783 635.5,P＜0.05).Biliary factor was the most common cause of AP in the two time period 2007 to 2009 and 2010 to 2012,which accounted for 55.9％ (575/1 028) and 62.9％ (1 005/1 597),respectively,and the difference was statistically significant (x2=12.778,P＜ 0.01).Alcoholic AP accounted for 1.9％ (19/1 028) and 7.3％ (117/1 597),respectively,hyperlipidemic AP were 14.0％ (144/1 028) and 17.7％ (283/1 597),and idiopathic AP were 22.0％ (226/1 028) and 5.9％ (94/1 597),all the differences were statistically significant (x2 =38.204,6.330 and 151.416,all P＜0.05).In male patients,biliary AP accounted for 52.4％ (732/1 398),which was lower than that of female patients (69.1％,848/1 227),and the difference was statistically significant (x2 ＝76.524,P＜0.01).Alcoholic AP and hyperlipidemic AP accounted for 9.0％ (126/1 398) and 21.4％ (299/1 398) in male patients,which were significantly higher than those of female patients (0.8％,10/1 227; 10.4％,128/1 227),and the differences were statistically significant (x2 89.396 and 57.585,both P＜0.01).Biliary AP accounted for 79.9％ (631/790) in elderly group,which was higher than that of non elderly group (51.7％,949/1 835),and the difference was statistically significant (x2＝182.720,P＜0.01).In elderly group hyperlipidemic AP and alcoholic AP accounted for 2.5％ (20/790) and 1.3％ (10/790),which were significantly lower than those of non-elderly group (22.2％,407/1 835; 6.9％,126/1 835),and the differences were statistically significant (x2 =156.524 and 35.262,both P＜0.01).Conclusions The middle-aged and elderly people are the vulnerable population of AP.Biliary factor is the most common cause of AP,especially in the female and elderly.The proportions of hyperlipidemic AP and alcoholic AP both significantly increase,in the male higher than that of the female and in the non-elderly higher than that of the elderly.The proportion of idiopathic AP significantly decreases.

Objective To make contrast analysis of sleeve lobectomy and wedge resection in lung cancer treatment by observing the clinical curative effect.Methods 100 patients with lung cancer using random table method, all the patients were divided into the observation group ( 50 cases, treated with sleeve resection ) , control group (50 cases,treated with wedge resection),follow-up after treatment lasted respectively for 3 years.Results In the two groups,anastomotic fistula incidence and mortality rates of the observation group were 4%,6%;6% and 8% in the control group,there were no statistical difference (χ2 =0.00,0.00,all P>0.05);the positive rate of stump cancer cell bronchial in the observation group was 4%,it was obviously less than 16% in the control group,and the differ-ence was obvious (χ2 =4.00,P<0.05) .The anastomotic scar tissue hyperplasia and recurrence rate of the observa-tion group during the follow-up period were 2%,2%;which were lower than 16%,18% of the control group (χ2 =4.40,7.11,all P<0.05).The 1,3 year survival rates of the observation group were 92%,64%,which were higher than 62%and 42%of the control group (χ2 =12.70,4.86,all P<0.05).Conclusion Taking sleeve resection for bronchogenic carcinoma can effectively control the positive rate of bronchial stump with cancer cells,inhibit anasto-motic scar tissue hyperplasia,reduce the recurrence rate,and the curative effect is very good,which is worth of clinical application.

Objective To explore the risk factors affecting prognosis of invasive fungal infection .Methods The clinical data of 208 hospitalized patients diagnosed with invasive fungal infection in Sun Yat-sen memorial hospital from 2007 to 2011 were reviewed . The factors affecting prognosis were determined by univariate and logistic regression analysis .Results The fatality rate of adult inpa-tient with invasive fungal infection was 21%.The univariate analysis showed that difference of seven indicators was significant between the survive group and death group:advanced age (over 60 years old), hospitalization time,fasting plasma glucose level, hypoalbumin-emia, using more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome ( MODS) .Binary logistic regression showed that the difference of five indicators was significant between the two groups:advanced age (over 60 years old), hypoalbuminemia, using more than two kinds of broad spectrum antibiotic for more than two weeks, kinds of invasive operations , and multiple organ dysfunction syndrome .Conclusions The indicators such as advanced age (over 60 years old), hypoalbuminemia, the use of more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome might be independent risk factors of death in patients with invasive fungal infection.Early medical intervention should be made in clinical work , in order to reduce fatality rate of patients with invasive fungal in-fection.

Objective To investigate the relationship between blood vessel invasion (BVI) and clinicopathologic features and prognosis in patients with gastric cancer,and analyze related factors affecting the prognosis of patients.Methods The clinicopathological data of 206 patients with gastric cancer who were admitted to the Nanjing Hospital Affiliated to Nanjing Medical University from January 2007 to December 2010 were retrospectively analyzed.The BVI of surgical tumor specimens in all patients was detected by immunohistochemical staininng.All the patients were followed up via outpatient examination and telephone interview up to March 2014.The count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method.The survival analysis and univariate analysis were done using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The BVI rate of 206 patients was 27.67％ (57/206).The BVI rate of tumor tissues,tumor differentiation,perineural invasion,T stage,N stage and TNM stage in all patients with gastric cancer were compared,showing significant differences (x2=14.396,9.569,15.579,43.453,30.732,P ＜ 0.05).After operation,188 patients were followed up for 6.0-60.0 months (median,34.0 months),with the follow-up rate of 91.26％ (188/206).Among 188 patients with follow-up,the median survival time and 5-year cumulative survival rate in patients with BVI and with negative BVI were 32.4 months and 19.6％,40.7 months and 42.0％,respectively,with a significant difference in the survival of patients (x2 =9.364,P ＜ 0.05).The results of univariate analysis showed that the diameter of tumor,tumor differentiation,perineural invasion,BVI,T stage,N stage and TNM stage were factors affecting the prognosis of patients with gastric cancer (x2=9.241,17.486,11.243,9.364,27.666,216.745,49.887,P ＜ 0.05).The results of multivariate analysis showed that the diameter of tumormore than 5 cm,BVI,stage T4,stage N3 and stage Ⅲ were independent risk factors affecting the prognosis of patients with gastric cancer (HR =0.502,0.456,0.052,0.001,0.735; 95％ confidence interval:0.334-0.754,0.289-0.720,0.004-0.664,0.000-0.006,0.159-3.398,P ＜ 0.05).Conclusions BVI in patients with gastric cancer is associated with the progression of tumors.The diameter of tumor more than 5cm,BVI,stage T4,stage N3 and stage Ⅲ are independent risk factors affecting the prognosis of patients with gastric cancer,and BVI may be a predictor of poor prognosis of patients with gastric cancer.

Fragmented QRS (fQRS) complex drew a large number of research interests recent years.It said to be prevalent in patients with coronary artery disease and myocardial infarction.Researchers also found fQRS was a sign of myocardial scarring,myocardial focal necrosis and substandard perfusion in patients suffered acute myocardial infarction,and the relationship of fQRS with malignant arrhythmia and cardiovascular events in these patients was also investigated lately,patients with fQRS were said to have an unfavorable prognosis.We summarized the definition,pathogenetic mechanism of fQRS and the relationship with ventricular arrhythmia in this article to figure out the cardiovascular event's predictive value of fQRS in patients suffered with acute myocardial infarction.