Objective To study the influence analysis of patients with anxiety and depression in elderly patients with hypertension antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets.Methods 60 elderly patients with hypertension accompanied by anxiety and depression in our hospital from January 2014 to December 2016 were selected as the subjects.They were randomly divided into the control group and the experimental group, with 30 patients in each group.The control group was treated with conventional antihypertensive treatment, the experimental group were given psychological intervention combined with treatment of Flupentixol and Melitracen Tablets.The clinical indexes of the experimental group and the control group were compared and analyzed.Results After the corresponding treatment, the effective rate of antihypertensive treatment in the experimental group was 28 cases, and the effective rate of depressurization was 93.3%.The effective rate of antihypertensive treatment in the control group was 21, and the effective rate of antihypertensive treatment was 70%.After treatment, the HAMD score and HAMA score of the experimental group were significantly lower than those before the treatment, and the score of the experimental group was significantly lower than that of the control group, with statistical difference(P<0.05).Conclusion The treatment of elderly hypertensive patients with anxiety and depression in patients with better antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets, can improve the depression and anxiety of patients in a large extent, high safety, is further applied in clinical significance.

OBJECTIVE:To observe the effects of epalrestat combined with lipoic acid on nerve function,oxidative stress and inflammatory reaction in patients with diabetic peripheral neuropathy(DPN). METHODS:From Jan. 2013 to Jan. 2016,150 pa-tients were selected from our hospital and then divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lipoic acid injection 600 mg,ivgtt,qd;group B was given Epalrestat tablet 50 mg,po,tid;group C was given lipoic acid+epalrestat,same usage and dosage as above. TSS score,MNCV,SNCV,oxidative stress indexes (SOD and MDA)and inflammatory indexes(TNF-α and IL-6),as well as blood pressure,blood lipid and blood glucose indexes were compared among 3 groups before and after treatment. The occurrence of ADR were observed. RESULTS:Before treatment, there was no statistical significance in above indexes among 3 groups (P>0.05). Compared to before treatment,TSS score, MDA,TNF-α and IL-6 levels of 3 groups were decreased significantly after treatment;MNCV and SNCV were speeded up signifi-cantly,and SOD level was increased significantly;each index of group C was better than that of group A and B,with statistical significance(P<0.05),but there was no statistical significance between group A and B(P>0.05). SBP and FPG after treatment of 3 groups were decreased significantly than before treatment,while HDL-C was increased significantly,with statistical signifi-cance(P<0.05);there was no statistical significance among 3 groups(P>0.05). No obvious ADR was found in 3 groups. CON-CLUSIONS:Epalrestat combined with lipoic acid can effectively improve nerve function in DPN patients by inhibiting oxidant stress and inflammatory reaction with good safety. The effect of drug combination is better than single drug.

Objective To investigate the value of nuchal translucency(NT) thickening in the fetal chromosome abnormality screening.Methods The 14 881 pregnant women received NT measurement in 11-13 +6 weeks at Beijing Obstetrics and Gynecology Hospital from January 2010 to August 2012.The 118 fetuses whose NT≥2.5 mm were recruited.One hundred and eight (91.5％,108/118)of them accepted invasive procedure and karyotype analysis.Results (1) Chromosome karyotype analysis:113 singleton pregnancies (95.8％) and 5 twin pregnancies (4.2％) whose NT thickened from 2.5 mm to 11.0 mm were advised karyotype analysis.The 108 pregnant women accepted karyotype analysis.Among them,88 had normal chromosome karyotype,and 20 had chromosome abnormalities.The detection rate was 18.5 ％ (20/108).(2) The sensitivity,specificity,false positive rate,false negative rate,total consistent rate,positive predictive value and negative predictive value of prenatal screening of chromosome abnormalities for NT ≥ 2.5 mm were 44％,99％,1％,56％,99％,19％ and 100％,respectively.(3) Among the 88 fetuses who had normal karyotype,72 (82％) had isolated thickened NT,while 16 (18％) had fetal structural malformation or intrauterine demise.(4) Among the 10 pregnant women who did not accept fetal karyotype analysis,8 terminated pregnancy because of fetal structural malformation,and the other 2 fetuses died in uterus.(5)All of the 5 twin pregnancies were dichorionic twins,and one of the twins had thickened NT.Among the 5 twin pregnancies,one fetus was trisomy 21 and others had normal karyotype.3 twin pregnancies who had normal chromosomes gave live birth.And the other had a gastroschisis and exstrophy deformity fetuse.This fetuse died in uterus and remaining fetuse had full-term live birth.(6) 35 (29.7％) pregnant women received second trimester Down's syndrome serum screening.One was high risk and was proved a trisomy 21 pregnancy.Thirty-four were low risk and had normal chromosome karyotype.Conclusion NT thickening may indicate fetal chromosome abnormalities or other structural malformations.It is a useful prenatal screening indicator.

Objective To investigate the effect of nitric oxide synthase(NOS) inhibitors and L-arginine(L-Arg) on the prognosis of traumatic shock in rats. Methods Traumatic shock models of Sprague-Daulay rats were made and randomly devided into control group (n=24),L-NAME treatment group (n=24),AG treatment group (n=24) and L-Arg treatment group (n=24). Serum nitric oxide(NO) levels and oxygen partial pressure in tissues include skeletal muscles,liver and small intestine were detected at 1h,3h,5h after resuscitation. Meanwhile, hemodynamic data of the rats and their survival rates of 12h and 24h were monitored and recorded. Results Serum NO concentration was statistically lower after resuscitation in L-NAME group than that in control group, while there were no statistical significance of tissues oxygen partial pressure and survival rate in 12、24h between the two groups. AG could decrease serum NO levels only at late stage of traumatic shock,but no effect on the synthesis and relase of NO at early stage of traumati shock.AG could improve tissues oxygen partial pressure of the liver and small intestine, and prolonged the mean survival time. L-Arg could increase serum NO levels, and improve oxygen partial pressure of intestine and significantly increase the survival rate at 12h and 24h in rats with traumatic shock. Conclusions Treatment with AG and L-Arg can improve the prognosis of traumatic shock rats much better than that with L-NAME.

Objective To investigate the morphology change of posterior cricoarytenoid muscle myofiber in patients with idiopathic vocal fold paralysis and to provide experimental evidence for the clinical treatment of idio‐pathic vocal cord paralysis .Methods Thirty -nine cases of vocal fold paralysis patients were recruited into and di‐vided into 2 groups :idiopathic vocal cord paralysis group(n=16) ,and traumatic vocal cord paralysis group(n=23) . Both groups were further divided into 3 subgroups:0 .5~1 year(5 cases and 7 cases) ,>1~2 years(5 cases and 10 cases) ,>2 years(6 cases and 6 cases) .Part of posterior cricoarytenoid muscle(PCAM ) were acquired from all of vo‐cal cord paralysis patients .Normal human posterior cricoarytenoid muscles were treated as the control group (n=5) . They were all stained with Masson three-color staining ,the fiber crosssectional area of muscle tissue and collagen connective tissue were quantitatively analyzed with the image pro plus analysis system .Differences of two observa‐tion indexes were compared with each other among groups and subgroups .Results The number of myofibers was decreased ,but the numbers of the collagen fibers was increased with the onset time course extension ,the ratio of cross sectional area of myofibers to those of collagen fibers was progressively decreasd with increased time course of denervation and more decrease within 1 year .There was obvious difference between the control group and 0 .5~1 year ,>1~2 years ,>2 years subgroup of idiopathic vocal cord paralysis (P<0 .05) .Although without no signifi‐cant difference between >1~2 years subgroup and >2 years subgroup ,the trend of shrinking still existed .Com‐pared two observation indexes of traumatic vocal cord paralysis with the same period subgroup indexes of idiopathic vocal fold paralysis ,there was no significant difference about these two observation indexes (P>0 .05) .In some special cases with 10 years duration in idiopathic vocal cord paralysis group ,the posterior cricoarytenoid muscle at‐rophy fibrosis was not serious .However ,in some case which the course lasted for only 1 .5 years ,the muscle atrophy was very obvious .There were great individual differences among idiopathic vocal cord paralysis patients .Conclusion If there is no recovery after half year treatment ,for PCA muscle function recovery ,the recurrent laryngeal nerve injury repair surgery could be considered to carry out within 1 year .In some cases with long disease duration (>2 years) ,they may still have the muscle morphological basis for nerve repair .

Objective To assay the clinical effect of proximal dorsal digital artery pedicled island flap in treatment and sensory reconstruction of adjacent finger soft-tissue defect.Methods The study enrolled 21 cases of soft-tissue defect in 21 fingers treated from January 2013 to January 2014.All the defects were covered with the proximal dorsal artery pedicled island flaps raised from the adjacent finger.Index finger was injured in 7 patients,middle finger in 9 patients,ring finger in 4 patients,and little finger in 4 patients.Defect and flap dimensions varied from 1.9 cm × 1.5 cm to 4.3 cm × 2.3 cm and from 2.0 cm × 1.7 cm to 4.5 cm × 2.5 cm respectively.Donor site was resurfaced with a fullthickness skin harvested from medial side of the upper arm.Postoperative flap appearance and two-point discrimination were evaluated.Total active motion (TAM) of the finger was evaluated after operation.Results All the flaps and skin grafts survived after operation.Duration of the follow-up was 6-18 months (mean,14.7 months).Through the final follow-up,appearance and function of the flap were satisfactory,donor site healed well,and two-point discrimination was 5-9 mm (mean,6.3 mm).TAM evaluation was excellent in 19 patients and good in 2 patients with the excellent-good rate of 100％.Conclusion The proximal dorsal artery pedicled island flap raised from the adjacent finger is an ideal choice in finger soft-tissue reconstruction,for the technique has advantages of high survival rate,satisfactory appearance and sensory function as well as few complications.

Objective To estimate the excess relative risk coefficients of stomach cancer for Chinese population attributable to ionizing radiation.Methods The excess relative risk and excess absolute risk coefficients of stomach cancer were estimated based on Life Span Study by using risk models developed by BEIR Ⅶ committee (Biological Effect of Ionizing Radiation).Guided by transportation methods from Life Span Study to Americans,we determined that transportation method for Chinese population includes both multiplicative and additive models with a weight of 0.7 and 0.3 respectively,on an arithmetic scale.Besides,curve fitting was used to obtain sex-age-specific stomach cancer baseline incidence based on Chinese cancer annual report.Then,Chinese excess relative risk coefficients of stomach cancer were obtained by substituting excess relative risk,excess absolute risk of Life Span Study and Chinese baseline incidence rate into risk transportation model.Results Excess relative risk coefficients of stomach cancer for Chinese population are 0.26/Sv for male and 0.64/Sv for female,whose exposure age is 30 years old and cancer age is 60 years old.Coefficients increase with decreased exposure age and cancer age.Conclusions Excess relative risk coefficients of stomach cancer for Chinese population are by larger higher than that of Life Span Study,and their sex-age tendency are similar.

Objective To estimate the averaged excess relative risk(ERR) in Chinese population based on the radiogenic cancer risk of leukemia in Japanese atomic bomb survivor cohort,and to discuss proper method suitable for risk transfer between populations.Methods Based on BEIR Ⅶ radiogenic cancer model and population transfer model,and the 2009 Chinese leukemia baseline rates given in 2012 Chinese Cancer Registry Annual Report,comparison was made of population incidences in seveal countries to adjust the weighting factors.Results The ERR of three subtypes of leukemia as a whole was obtained,and the weighting factors for risk transfer model was assumed.The additive factor for male was 0.2,and the multiplicative factor was 0.8,while the additive factor for female was 0.15,and the multiplicative factor was 0.85.Conclusions For the risk transfer between populations,weighting factor was adjusted as a whole to obtain the ERR value for estimating the risk to Chinese population.The risk transfer method suitable for Chinese population was obtained by using the incidence rate available for Chinese population to directly transfer radiation-induced leukemia risk to Chinese from Japanese.

Objective To investigate the effect of patients′ health education needs analysis on health education . Methods One hundred and sixty-four type 2 diabetic patients who met the inclusion criteria and participated diabetes education management voluntarily into the control group and the observation group randomly with 82 cases in each group and the control group lost 2 patients and the observation group lost 3. The control group received traditional education. Based on the control group, the observation group also received patients′ health education needs analysis . The two groups were compared in terms of blood glucose level , diabetes knowledge scale score and self-care behavior. Results After 6 months′management, the patients in the observation group were better than the control group in terms of the blood glucose level, diabetes knowledge scale scores and self-care behavior(P<0.05). Conclusion Patients′health education needs analysis before education can enhance their diabetes knowledge and better self-care behavior , improve diabetic patients′control over blood glucose .

Objective To investigate the value of detecting methylated SEPT9 gene (mSEPT9) in serum and stool in screening colorectal cancer in elderly people.Methods Subjects were divided into three groups, the colorectal cancer group (n=82), the colorectal polyps group (n=80) and the healthy control group (n=100).Real-time quantitative polymerase chain reaction (PCR) was used to detect mSEPT9 in peripheral blood and feces.The relationship between mSEPT9 and clinical and pathological characteristics of colorectal cancer was analyzed.The agreement between serum and stool results was analyzed.Results The positive rate of serum mSEPT9 was 73.2％ in the colorectal cancer group, 6.3％ in the colorectal polyps group and 4.0％ in the healthy control group, with statistical significance between the colorectal cancer group and the other two groups (P＜0.01).The sensitivity and specificity for plasma mSEPT9 detection in screening colorectal cancer were 73.2 ％ and 95.6％, respectively.The positive rate was higher in patients with tumor maximum diameter over 3.0 cm, invasion of the entire serosa layer, lower differentiation or advanced clinical staging (P＜0.05).The detection results of plasma mSEPT9 were in complete agreement with those of stool mSEPT9 from the same patients.Conclusions The expression of mSEPT9 is high in elderly patients with colorectal cancer and has a high sensitivity and specificity for PCR detection.Complete agreement can be seen in results from plasma and feces.Detecting mSEPT9 can be a valuable approach to screening colorectal cancer in the elderly.