Objective To explore the clinical effect of laparoscopy in treatment of elderly patients with cholelithiasis. Method The clinical data of 120 elderly patients with cholelithiasis were retrospectively analyzed,which were divided into observation group and control group. Result The operation time, hemorrhage amount of operations,length of stay and recurrence rate after operation of the observation group were lower than that of the control group, and the stone clearance rate in the observation group had significantly higher than that of the control group ,the difference was statistical significance( all P ＜ 0. 05). Conclusion The clinical curative effect of laparoscopy in treatment of elderly patients with cholelithiasis was good.

[Objective] To search Zhang Taiyan’s prentice of medicine,study his effect of academic thought and academic method. [Method] Complete collection of periodicals in the Republic of China, with the research methods of philology, based on the academic history.[Result]Many famous disciples of Zhang Taiyan are from Jiangsu and Zhejiang,such as Lu Yuanlei,Xu Hengzhi,Zhang Cigong,Chen Cunren,Zhang Polang,Yu Yunxiu,Sun Shiyang. They inherited Zhang Taiyan’s effect of academic thought and academic method,such as widely collecting prescriptions and verifying,canoniz Changsha school,referring Chinese medicine in Japan,paying attention to the textual research.[Conclusion]Zhang Taiyan’s prentice of medicine made outstanding contributions to Chinese medicine. To search Zhang Taiyan and his prentice of medicine is helpful to study the medicine history of Wu and Yue area.

Objective To investigate the progress and effectiveness of water-improving defluoridation projects comprehensively in control of fluorosis in drinking-water-borne endemic fluorosis areas in Hubei Province,and to provide a scientific basis for making strategies in prevention and control of endemic fluorosis.Methods All villages affected by fluorosis in drinking-water-borne endemic fluorosis areas were selected in Hubei Province,in which the progress and effectiveness of water-improving and defluoridation projects were investigated in 2015.Those villages were chosen to determine fluoride content of drinking water,and to check the prevalence of dental fluorosis of children 8 to 12 years old.Water fluoride content was tested with fluoride ion-selective electrode,and dental fluorosis was diagnosed by the Dean method.Results The water improvement projects were completed in 197 villages in the 30 disease affected counties (cities) with accomplishment rate 100.00％ (197/197),geometric mean of water fluorine 0.36 mg/L,qualified rate of water fluorine 100.00％ (197/197) and normal operation rate of the water-improvement projects 95.94％ (189/197).Totally 14 856 children aged 8-12 were examined their dental fluorosis.The prevalence rate was 1.78％ (265/14 856) and the dental fluorosis index was 0.04,which meant epidemic strength was negative.Totally 29 out of the 30 disease affected counties (cities) had met the disease control standards.Conclusion The prevalence of drinking-water-borne endemic fluorosis in Hubei Province has been under control,but management and monitoring of the water improvement projects still should be strengthened.

Objective: To study influence of glycosylated hemoglobin A1c (HbA1c) on major adverse cardiovascular events (MACE) in patients with diabetes mellitus (DM) complicated coronary heart disease (CHD) after percutaneous coronary intervention (PCI).Methods: A total of 100 DM+CHD patients after PCI were selected from our hospital.According to HbA1c level, they were divided into HbA1c<6.5% group (n=48) and HbA1c≥6.5% group (n=52).Levels of C reactive protein (CRP), tumor necrosis factor α (TNF-α), erythrocyte sedimentation rate (ESR) and interleukin (IL)-6 before PCI, incidence rate of MACE on six and 24 months after PCI were compared between two groups.Results: Compared with HbA1c<6.5% group before PCI, there were significant rise in serum levels of CRP[(18.5±6.2) mg/L vs.(25.8±4.2) mg/L]and TNF-α[(32.4±12.3) ng/L vs.(48.3±11.8) ng/L]in HbA1c≥6.5% group, P<0.01 both.On six months after PCI, incidence rate of myocardial infarction in HbA1c≥6.5% group was significantly higher than that of HbA1c<6.5% group (9.62% vs.0, P=0.028);24 months after PCI, compared with HbA1c<6.5% group, there were significant rise in incidence rates of myocardial infarction (2.08% vs.15.38%) and diseased vessel restenosis (12.50% vs.32.69%) in HbA1c≥6.5% group (P<0.05 all).Conclusion: In DM+CHD patients after PCI, those with lower HbA1c level possess better prognosis.

Objective To know the changing characteristics of residents' iodine nutritional status after eating salt with different iodine concentrations in Hubei Province,according to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD provide a scientific standard for appropriate iodine concentration in edible salt.Methods According to inhabitants' salt and urine surveillance of Hubei in 2010,Xinzhou District,Tianmen City and Changyang County were selected for trial.Salt with two kinds of iodine content was used in 3 trial areas in 4 months for the study of community intervention.Before the intervention,3 months and 4 months after the intervention,urine samples of observed participants(40 from 8-10 old children,40 from pregnant women or lactating women and 40 from adults aged older than 18) were collected and tested.The urinary medians of different groups of people and at different times were calculated and compared.Results Three months and 4 months after the intervention,in those towns using iodized salt of (15 ± 3) mg/kg,the urinary medians of children,declined from 294.2 μg/L to 185.6,195.7 μg/L,respectively.The urinary medians of pregnant women or lactating women dropped from 269.0 μg/L to 141.7,176.1 μg/L.For adults aged 18 and older,the urinary medians changed from 304.9 μg/L to 199.7,202.2 μg/L.In those trial towns of using (25 ± 3)mg/kg iodized salt,the urinary medians of children,pregnant women or lactating women and adults older than 18 all went down from 301.1 μg/L to 229.7,253.8 μg/L,from 261.4.0 μg/L to 196.6 and 206.5 μg/L and from 379.7 μg/L to 244.3,237.4 μg/L,respectively.Conclusions According to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD and the decreasing of urinary iodine median and per capita daily salt intake,salt with 25 mg/kg iodine is suitable as the average level of salt iodine concentration after the adjustment in Hubei Province.

Objective To explore the reconstructive methods of benign bone tumor defects in proximal joint. Methods Operative treatment was performed in 11 cases with benign bone tumor defects in proximal joint, a-mong whom 4 cases were treated by curettage,cauterization of wall and bone grafting,3 cases were treated by filling branch through segment fibula transplantation with vascular,2 cases were treated by fibula head transplantation with vascular to reconstruct the glenohumeral joint and rediocarpal joint, and 2 cases were treated by artificial joint re-placement. Results The follow-up ranged from 1.5 to 6 years. All of cases got excellent bone unioned without re-lapse and 2 cases of them developed with little limitation in joint function. Conclusion The importance and recon-structive achievement of fibula transplantation in treating the benign bone tumor defects in proximal joint should be thought fully. The indication of artificial tumor prosthesis replacement should be strictly mastered.

Objective To investigate the role of miR-203 in radiation-induced thymic lymphoma (RITL).Methods A 60Co irradiator was used for total-body irradiation.MicroRNAs(miRNAs) level was assayed by qRT-PCR.Cell proliferation was assayed by MTT assay.Cell apoptosis was examined by fluorescence activated cell sorter (FACS).Dual luciferase reporter assay system was used to detect the 3'UTR reporter.Results MiR-203 was down-regulated in RITL tissues.Overexpression of miR-203 strongly inhibited the proliferation of both NIH3T3 cells and EL4 cells and vice versa.MiR-203 inhibited cells proliferation and induced apoptosis via TANK-binding kinase (TBK1),SLUG (SNAI2) and Cyclin D1 (CCND1).Conclusions Radiation down-regulated the level of miR-203 in thymic,which promoted radiation-induced thymic lymphoma by targeting TBK1,SNAI2 and CCND1.

Objective Through the dynamical monitoring of the water improvement projects operation,we intend to understand the prevalent trends of endemic fluorosis of children aged 8 to 12 in Hubei,to evaluate the effect of control measures and to provide the basis for making preventive measures.Methods In Hubei,ten surveillance counties were selected,and three epidemic villages were selected as fixed monitoring villages in each county from 2010 to 2014.In those villages,the operation situation of water improvement projects and the fluoride content in drinking water were detected,and the dental fluorosis of children aged 8 to 12 was diagnosed.Results From 2010 to 2014,the normal operation rate of water improvement projects was 75.61％-100.00％,the average of water fluorine content did not change,the differences were not statistically significant (F =2.00,P ＞ 0.05).The numbers of water improvement projects with water fluorine content in excessive amount was increased in the past five years which was only one project in 2010-2012 and was increased to two projects in 2013 and 2014.In 2010-2014,the dental fluorosis prevalence rate of whole children was 9.45％ (525/5 557),the dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was 42.40％ (92/217),the dental fluorosis prevalence rate of qualified villages was 8.11％ (433/5 340).The children's dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was higher than that in qualified villages;the differences were statistically significant (x2 =282.60,P ＜ 0.05).Conclusions The operation rate of water-improving projects is mostly higher than 90％,and so is the qualification rate of fluoride content in drinking water.The operation condition and water quality of the water-improving projects in Hubei need to be improved.The prevalence of children dental fluorosis of affected villages has dropped significantly after low fluoride water is provided continuously.

Objective To investigate and analyze the examination and acceptance results for coalburning-borne endemic fluorosis control and elimination in Hubei Province.Methods A county-level selfinspection and a provincial-level spot-check were conducted to investigate the status of improved-stove usage,the situation of correctly drying corn and chili,and the dental fluorosis prevalence among children aged 8 to 12 in 501 historic coal-burning-borne endemic fluorosis villages of 6 counties (cities) in Hubei Province from 2012 to 2014.The endemic areas were selected according to the Control Standards of Endemic Fluorosis in Endemic Areas (GB 17017-2010) and Eliminating Standards of Coal-burning Type Endemic Fluorosis.Results The results of county-level inspection showed that the qualified rates of improved stoves,the correct-usage rates of qualified stoves,and the correctly drying rates of corn and chili were all higher than 98％ in targeted villages,and the prevalence rate of dental fluorosis of children was 7.73％ (2 319/30 003).The results of provincial-level recheck were more than 99％ and 8.25％ (353/4 277),respectively.The results of county-level inspection were of good consistency with those of provincial-level recheck (88.89％,48/54).Five counties (cities) but one had met the standard of fluorosis control or elimination.Conclusion Coal-burning-borne endemic fluorosis scope in Hubei Province is narrowed greatly and the prevalence rates are decreased significantly.

Objective This study aims to explore the impact of patient gratitude on nurse creativity and examine the me-diating role of job satisfaction and the moderating role of safety climate.Methods In May 2023,a questionnaire survey was con-ducted among all nurses in two county-level public hospitals in Yangquan City,using the Patient Gratitude Scale,Creativity Scale,Job Satisfaction Scale,and Safety Climate Scale.A total of 448 valid questionnaires were collected.Mediation and moder-ation effects were tested using SPSS 20.0 and Model 4 and Model 7 in the Process v3.0 plugin.Results Patient gratitude showed a significant positive correlation with job satisfaction and creativity(r=0.558,0.591,P<0.01),and job satisfaction showed a significant positive correlation with creativity(r=0.581,P<0.01).Job satisfaction partially mediated the relationship between patient gratitude and creativity(mediation effect value=0.1850,95%confidence interval[0.1190:0.2484]),ac-counting for 34.76%of the total effect.Safety climate moderated the relationship between patient gratitude and job satisfaction(β=-0.048,P<0.05).Conclusion Patient gratitude has a positive impact on nurse creativity through job satisfaction.Ad-ditionally,safety climate moderates the relationship between patient gratitude and job satisfaction.