Objective To study the clinical characteristics of elderly sleep apnea syndrome (ASA). Methods 329 SAS patients diagnosed by 7-hour polysomnography(PSG) were classified into the aged and the middle aged groups. Results Both the body mass index(BMI) and neck circumference were significantly lower in the aged group than those in the middle aged group(P

Objective To explore the value of three-vessel and trachea(3VT) view plus aortic arch coronal section in ultrasonic diagnosis and classification of fetal right aortic arch(RAA).Methods Echocardiography data and follow-up results of 44 fetuses with RAA were retrospectively analyzed.Sonographic features on 3VT view and aortic arch coronal section were summarized.Results Among 44 fetuses with RAA,27 cases(61.36%) were RAA with aberrant left subclavian artery(ALSA) and the left ductus arteriosus(LDA) connecting the ALSA and U-shaped vascular ring was formed;17 cases(38.64%) were mirror right aortic arch(MRAA).Among 17 cases with MRAA,3 cases were with LDA connecting the descending aorta(DAO) and U-shaped vascular ring was formed;1 case was with LDA connecting the left innominate artery(LINA),8 cases were with absent ductus arteriosus(ADA),5 case were with right ductus arteriosus(RDA),no vascular ring was formed.Parts of MRAA were combined with other complex intracardiac abnormalities.RAA-ALSA-LDA were rarely combined with intracardiac abnormalities.Conclusions 3VT view is simple and intuitive for diagnosing RAA.Aortic arch coronal section has great clinical value in determining the concrete type of RAA.

In February, 2019, a patient with a defect of open dorsal cartilage and bone in the first metatarsal head, including the defects of soft tissue, tendon and joint capsule, was treated in our department. After multiple debridement, the vascularised medial femoral condyle osteochondral chimeric tissue flap was transferred to repair the composite tissue defect in the metatarsal head at the second stage. After 18 months of follow-up, the patient felt no pain in the foot and walking, and there was no sign of lameness and discomfort at donor sites. The postoperative functional recovery was satisfactory.

Objective To screen and diagnose obstructive sleep apnea-hypopnea syndrome (OSAHS) in elderly males by obesity index using receiver operating characteristic(ROC) curves. Methods Data of 402 consecutive elderly male patients who underwent polysomnography from 2001 to 2008 were collected. The relationship between apnea hypopnea index(AHI) and obese indexes such as body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) were analyzed by Pearson's correlation. ROC curves were used to determine the best cutoff values to screen and diagnose OSAHS, and their priority was compared by area under curve (AUC). A two-tailed P value less than 0.05 was considered statistically significant. Statistical analysis was carried out with SPSS version 13.0. Results (1) AHI was positively correlated with BMI (r=0.241,P<0.001), NC(r=0.201,P<0.001), WC(r=0.210,P<0.001) and WHR(r=0. 097,P>0.05)) in elderly male patients. The area under curve (AUC) of BMI, NC, WC and WHR was 0.61, 0.58, 0.51 and 0.45 respectively, and P value was 0.001,0.060,0.840 and 0. 250 respectively. Only BMI was competent in screening and diagnosing OSAHS in elderly male adults; (2) The optimal value of BMI was 22.0 kg/m~2 in screening OSAHS with specificity 90% and rate of missed diagnosis 10%; (3) The optimal value of BMI was 29.0 kg/m~2 in diagnosing OSAHS with specificity 90% and rate of missed diagnosis 10%. Conclusions BMI more than 22.0 kg/m~2 could be the reference standard to screen OSAHS and BMI more than 29.0 kg/m~2 to diagnose OSAHS in elderly men.

Objective To assess oral health knowledge and behaviors of self-care among HIV infected patients in Yunnan, China. Methods Questionnaire survey was performed to collect the information about behaviors of oral self-care and seeking medical advice and diets of 216 HIV-infected patients who came from the Third Hospital of Kunming. The data were then statistically analyzed. Results Half of the patients were diagnosed over six months. The smoking of the HIV-positive were serious and the gingival bleeding was less, but there was obvious discomfort in oral cavity when eating. In addition,the standard method of cleaning teeth was below 20%, less of 50%patients could clean the oral cavity in time after diet and they didn't replace their toothbrushes timely. Over half of patients asked artificial tooth and exodontias on treatment. Conclusion It is necessary to pay more attention to the oral health knowledge and self-care behaviors of HIV-infected patients so as to improve the quality of life.

Background:Acute-on-chronic liver failure( ACLF)is a commonly seen liver failure in China,and lacking an animal model that can effectively simulate the dynamic change of immune status of ACLF. Aims:To establish an animal model that can simulate dynamic change of immune status of ACLF by repeated administration of concanavalin A(ConA). Methods:Mice were randomly divided into normal control group and ConA repeated administration group. Mice in ConA repeated administration group were injected with ConA 15 mg/ kg through retrobulbar angular vein every 48 hours for 5 times,and mice in control group were injected with same volume of 0. 9% NaCl solution. Serum levels of IL-6,IL-10,IL- 12,TNF-α,IFN-γ,MCP-1 in peripheral blood were assessed by CBA assay,and the ratio of IL-10/ TNF-α was calculated. The expression of HLA-DR,number and proportion of CD4+ T cells and the expression of PD-1 of monocytes in peripheral blood were detected by flow cytometry. Results:Peripheral blood cytokines changed from predominated proinflammatory cytokines into predominated anti-inflammatory cytokines with the increasing in time of administration in ConA repeated administration group. Compared with control group,HLA-DR expression of monocytes in peripheral blood was significantly decreased(P <0. 05),number and proportion of CD4+ T cells were significantly decreased(P <0. 05), and PD-1 expression was significantly increased( P < 0. 05)in ConA repeated administration group. Conclusions:An animal model of ACLF immune status from systemic inflammatory response syndrome( SIRS) to compensatory antiinflammatory response syndrome(CARS)induced by repeated ConA stimulation is successfully established.

Objective:To explore the effect of cupping therapy on regulating phlegm dampness constitution of elderly patients with hypertension in the community.Methods:From August to November in 2019, 120 elderly patients with phlegm dampness hypertension were randomly divided into control group and intervention group, 60 cases in each. The control group was given traditional Chinese medicine (TCM) health care in the community, and the intervention group was given cupping therapy intervention on this basis, to evaluate the changes of the scores of TCM phlegm wet body mass table, the total score reduction rate of TCM phlegm wet body mass, the conversion rate of TCM phlegm wet body mass, blood pressure, body mass index and waist circumference between the two groups before the intervention, 1 month, 2 months, 3 months after the intervention.Results:Finally, there were 51 cases in the intervention group and 57 cases in the control group. The TCM phlegm dampness constitution sub-scale and total scores of the comparison between groups at four different time points showed that except for the dimension of abdominal hypertrophy, the sub-scale and total scores of TCM phlegm-dampness constitution scale in the two groups were lower than before, and the differences were statistically significant ( F values were 3.450-94.995, P<0.05). The total score reduction rate of phlegm dampness constitution in the intervention group was 0.17 ± 0.10, higher than that in the control group (0.12 ± 0.09), and the difference was statistically significant ( t value was - 2.773, P < 0.05). The transformation rate of phlegm-dampness constitution was 47.1% (24/51) in the intervention group, which was higher than that in the control group (33.3%,19/57). The value of systolic blood pressure was lower in the intervention group [(135.10±2.64) mmHg,1 mmHg=0.133 kPa] than that in the control group [(138.88±2.42) mmHg] after 2 months of intervention, and the difference was statistically significant ( F value was 6.586, P<0.05). The value of diastolic blood pressure was lower in the intervention group [(80.75±3.03) mmHg] than that in the control group [(78.14±3.43) mmHg] after 3 months of intervention, and the difference was statistically significant ( F value was 6.758, P<0.05). Conclusions:On the basis of TCM physical nursing in the community, the effect of cupping therapy on reducing the score of phlegm and dampness physical fitness of elderly hypertension patients in the community, promoting the transformation of phlegm and dampness physical fitness of elderly hypertension patients in the community, and reducing the blood pressure level of elderly hypertension patients in the community is better than that of TCM physical nursing in the community, which is worth being promoted in the community.

Objective To investigate the prevalence,subtypes and infected population of influenza (flu) viruses in Xuzhou city from 2010 to 2015,providing scientific supports for influenza prevention and control.Methods Molecular detection and virus isolation were carried out with the throat swab samples collected from influenza-like illness(ILI) cases of national sentinel hospitals and the flu outbreaks.Results The influenza has obvious epidemic characteristics seasonally,two concentrated outbreaks in every December to next March and August to September.The positive rates were different among age groups,the highest was in less than ten years old group (64.36％),then 10-19 years old group (10.69％),and the lowest was in 50-59 years old group (3.77％).A total of 15 245 swab specimens were collected in which 1 459 strains were detected and identified for influenza viruses with total positive rate of 9.57％.Among these positive samples,593 samples were H3 subtype (40.64％),627 samples were B subtype (42.97％),237 samples were H1 N1 subtype (16.24％).Four hundred and fouty strains were isolated fromMDCK cells the relatively isolate rate was 30.16 ％ (440/1 459),fifty nine strains from embryonated chicken (13.78％).Conclusions The epidemic types of influenza in Xuzhou from 2010 to 2015 were alternation between H3 and B.There were epidemic peaks of H1N1occurred occasionally and unstably.

Objective To summarize the prenatal ultrasonographic characteristics of unroofed coronary sinus( URCS) for improving the prenatal echocardiography diagnostic accuracy of URCS . Methods The retrospective review for prenatal ultrasonogram of 7 fetuses was applied ,which were diagnosed as URCS . The prenatal ultrasonographic characteristics of 7 fetuses with URCS were reviewed and comparatively analyzed with postpartum autopsy findings or postnatal echocardiography . The relevant literatures referring to the prenatal diagnosis of URCS were reviewed . The experience of prenatal diagnosis of URCS were summarized . Results In 7 cases with URCS ,5 cases of completely URCS were associated with right atrial isomerism syndrome and confirmed by postpartum autopsy ,and 2 cases of partially URCS were only with persistent left superior vena cava and confirmed by postnatal echocardiography . The karyotype analysis of 2 cases of partially URCS on amniotic fluid was normal . Conclusions There are some characteristic signs in ultrasonic features of URCS . URCS can be diagnosed by prenatally ultrasonography . A long axial section of the coronary sinus is the most important view for prenatal ultrasonic diagnosis of U RCS .

Objective To summarize the prenatal ultrasonographic characteristics of anomalous origin of one pulmonary artery from the aorta( AOPA ) ,and describe the diagnostic and clinical outcomes of fetal AOPA . Methods Echocardiographic characteristics of 3 fetuses with AOPA were reviewed . The ultrasonographic features were comparatively analyzed with postpartum autopsy findings . The relevant literature were reviewed and the experience of prenatal diagnosis of AOPA were summarized . Results In 3 cases with AOPA ,2 cases were the proximal type and anomalous origin of right pulmonary artery from the aorta ,of them ,one was accompanied with coarctation of the aorta , the other was accompanied with aortopulmonary window . One case was the distal type and anomalous origin of left pulmonary artery from the left innominate aorta ,it was only associated with mirror right aortic arch and right ductus arteriosus . Ultrasound characteristics were no bifurcation in distal pulmonary artery ,main trunk of pulmonary artery extends directly to one branch ,the other branch originated from the ascending aorta or left innominate artery . Three cases were confirmed by postpartum autopsy . Conclusions There are some characteristic signs on ultrasonic features of AOPA . Prenatal ultrasound has important value for diagnosis of AOPA .