Percutaneous endoscopic lumbar discectomy belongs to minimally invasive spine operation Its superiority includes smalleroperation wound,less bleeding,shorter hospital day,and earlier return to function,conpared with the traditional operation.At the same time,percutaneous endoscopic lumbar discectomy has complications,as the open operation.This paper reviews its common complications,diagnosis,prevention and control.

The role of insulin pump in the treatment of diabetes is becoming more and more significant. Based on the systematic literature review, collation and analysis, this article introduces the management of insulin pump outside the hospital from the development trend of insulin pump, application and common problems. In order to enhance the therapeutic satisfaction of patients and improve their quality of life, our aims are to put forward the strategy of standardized management and provide a reference for establishing and improving the standardized management system of insulin pump therapy outside hospital.

Objective To verify the relationship between personality traits and clinical nurse competence in five third-A level hospitals in Shenyang. Methods A total of 1559 clinical nurses from five tertiary-level hospitals in Shenyang were recruited into this study. Two self-report questionnaires, the Nurse Competence Scale (NCS) and the Tridimensional Personality Questionnaire (TPQ), were used to collect data. Results The average score of NCS was 71.97 ± 13.25.Nursing competence increased with the increase of working years (β=0.272, P<0.01) and RD (β=0.134, P<0.01). Practicing nurses with the lower HA appear to have a higher level of competence (β=-0.117, P<0.01). Conclusions The overall level of nurses' competencies good in third-A level hospitals in Shenyang. The predicting factors of nursing competence are work experience, HA and RD. More psychological courses should be provided in fundamental nursing education and continuing nursing education for helping nurses shape their good personality traits.

Objective To summarize the clinical efficacy of interventional treatment for lower extremity arteriosclerosis obliterans and its complications.Methods We analyzed sixty-nine patients with lower extremities arteriosclerosis obliterans undergoing interventional treatment from October 2011 to January 2013.During the same period,three patients were referred to us who suffered from the complications of interventional treatment.In these patients,eight were TASC ⅡA type,twenty-one were TASC Ⅱ B,twenty TASC Ⅱ C,and twenty-two TASC Ⅱ D lesions.All patients received CTA or DSA.Seventy patients were treated by interventional treatment,and two who had fractured stent underwent external iliacsuperficial femoral artery bypass grafting using artificial grafts.Results The technique success rate was 100％.The symptoms disappeared after surgery.During interventional treatment,one iliac artery ruptured,one patient suffered from arterial perforation and three patients suffered from distal embolization.Sixty-eight patients were followed-up for 9 ± 4 months.Conclusions Endovascular treatment has good early clinical efficacy.In order to reduce the incidence of complications,indication of interventional treatment should be controlled strictly and manipulation should be careful.

Objective To develop a simple high-resolution melting ( HRM) analysis method for differentiation of Pc and P2 variants in class 1 integron.Methods DNA fragments containing Pc and P2 variants were amplified from plasmids pACW ( PcW ) and pACWP2 ( PcW-P2 ) respectively , then these purified PCR products and P 2 promoters were analyed full-length amplicon by HRM .Eight DNA fragments containing different Pc promoters were amplified and site-specific mutated from plasmids pACS ( PcS ) , pACH2 ( PcH2 ) , pACH1 ( PcH1 ) , pACW ( PcW ) , genomic DNA of Klebsiellar pneumonia HS07-68 (PcWTGN-10)and HS05-1792(PcH2TGN-10)respectively.The purified PCR products and eight Pc variants were characterized by HRM analyses of an unlabeled probe and full-length amplicon.This assay was applied to the differentiate Pc and P2 variants in 109 class 1 integrons from 95 urine clinical Escherichia coli isolates in Huashan Hospital during 2004 -2007.The differentiation results were compared with that determined by direct sequencing .Results P2 promoter with a significant higher melting temperature ( Tm ) can be identified by HRM analysis clearly .P2 promoters were identified in 2 class 1 integrons and consistent with direct sequencing results .Eight Pc variants were classified into three groups: PcS, PcSTGN-10 , PcW, PcWTGN-10, PcH1, PcH1TGN-10.Using direct HRM analysis.PcH2, PcH2TGN-10 were classified into four groups:PcS, PcH1, PcH2, PcW, PcSTGN-10 , PcH1TGN-10 , PcH2TGN-10 , PcWTGN-10 according to the melting curves of the unlabeled probe .Combined the HRM analyses of the whole amplicon and unlabeled probe , the eight Pc variants can be differentiated from each other .Five different Pc variants, PcS, PcW, PcH1, PcH2TGN-10 and PcWTGN-10 , were identified and consistent with direct sequencing results .Conclusions This developed a simple Pc and P 2 variants differentiation method via simultaneous HRM analyses of an unlabeled probe and full-length amplicon .This method is cost-effective and accurate , could be used in differentiation of Pc and P2 variants of class 1 integrons in clinical isolates .

Objective To study the early response and acute/subacute adverse effects after particle radiation therapy for adenoid cystic carcinoma (ACC) of the head and neck.Methods Between May 2015 and March 2016,a total of 8 patients with ACC of the head and neck were treated using proton and/or carbon-ion radiation therapy.Three patients had early stage and 5 had locally advanced disease.Five patients had an R2 and three achieved an R1 resection.Results Seven patients received intensitymodulated proton therapy (IMPT) followed by intensity-modulated carbon-ion therapy (IMCT) boost.One patient received IMPT only.Among the five patients who had an R2 resection,2/3 patients had partial response (PR)/stable disease (SD) at the end of radiation,0/3 achieved PR/complete response (CR) at 1-month follow-up,and 1/2 achieved PR/CR at 3-months' follow-up after the completion of radiation,respectively.Two patients experienced Grade Ⅲ mucositis during radiation therapy.No patient experienced moderate or severe skin reactions.At the time of this analysis,all patients are alive and no patient had disease progression or recurrence.Conclusions The short-term outcomes indicated that particle therapy is safe and potentially efficacious in the management of head and neck ACC.However,longer follow up is needed to assess late toxicities and long-term efficacy.

Atherosclerosis(AS) is the basic pathological process of many cardiovascular and cerebrovascular diseases. Particularly, the rupture of vulnerable plaques is a major cause of disability and death among middle-aged and elderly people. It's crucial to find out some reliable serummarkers for diagnosis, treatment and prognosis of AS. This study aims to summarize some newly reported miRNAs which can control the development of AS by regulating the biological function of endothelial cells, smooth muscle cells and macrophages.We also enumerated some target genes and signal pathways that they may act on, and thus provide some new ideas for the treatment of AS and to provide theoretical basis for finding serum biomarkers which can evaluate the occurrence and stability of AS plaque.

Objective To compare comfort of topical versus sub-Tenon's anesthesia in small -incision extracapsular cataract excision surgery.Methods A total of 200 patients were divided into sub-Tenon's group (received infiltration with 2％ lignocaine,n =100) and topical anaesthesia group (received topical anaesthesia with 0.5％ proparacaine drops,n =100).Patients were given Visual Analog Scale to record the pain in different stage (intraoperative,postoperative and 30 min after operation).And operative complications were recorded.Results Sub-Tenon's anesthesia group had lower pain scores intraoperative,postoperative and 30 min after operation,and control ability in eye movement,pressure on the eyelids and overall satisfaction scores showed significant differences in two groups.Conclusion Sub-Tenon's anaesthesia had better anesthesia efficacy for patients with small-incision extracapsular cataract excision surgery under topical anesthesia.

Objective To compare comfort of topical versus sub-Tenon's anesthesia in small -incision extracapsular cataract excision surgery.Methods A total of 200 patients were divided into sub-Tenon's group (received infiltration with 2％ lignocaine,n =100) and topical anaesthesia group (received topical anaesthesia with 0.5％ proparacaine drops,n =100).Patients were given Visual Analog Scale to record the pain in different stage (intraoperative,postoperative and 30 min after operation).And operative complications were recorded.Results Sub-Tenon's anesthesia group had lower pain scores intraoperative,postoperative and 30 min after operation,and control ability in eye movement,pressure on the eyelids and overall satisfaction scores showed significant differences in two groups.Conclusion Sub-Tenon's anaesthesia had better anesthesia efficacy for patients with small-incision extracapsular cataract excision surgery under topical anesthesia.

Objective To investigate the correlation between serum vitamin D level in human body and Chlamydia trachomatis (Ct) genitourinary tract infection. Methods This study enrolled 174 outpa-tients (male: 95, female: 79, 20-49 years) infected with Ct and 380 healthy subjects (male: 211, female:169, 20-49 years) in Tianjin from November 1, 2016 to March 15, 2017. Blood samples were collected from all subjects after fasting overnight and the time points for sample collection in the Ct infection group were before and after a course of antibiotic treatment. Serum 25-hydroxyvitamin D [25-(OH)D] levels were measured with enzyme-linked immunosorbent assay (ELISA). PCR assay was used to assess the recovery in those patients one month after a course of treatment. Two case-control studies were respectively conducted, in which 161 patients and 161 healthy subjects as well as 41 uncured patients and 41 cured patients were randomly selected and matched for gender and age. Statistical analysis was performed using SPSS19. 0. Re-sults The two case-control studies showed that vitamin D deficiency was a risk factor for both Ct genital tract infection and poor efficacy, of which the adjusted ORs were 2. 281 (95％ CI: 1. 438, 3. 619) and 7. 266 (95％ CI: 2. 551, 21. 036). Among all subjects aged 20-39, male patients had lower 25-(OH)D level in serum than healthy men [(40. 10±17. 93) nmol/ L vs (53. 72±18. 00) nmol/ L, P< 0. 01] and fe-male patients also had lower 25-(OH)D level in serum than healthy women [(35. 71±19. 99) nmol/ L vs (45. 42±16. 08) nmol/ L, P<0. 01]. The levels of 25-(OH)D in uncured male and female patients were re-spectively lower than those in cured male and female patients [(30. 50±14. 53) nmol/ L vs (41. 32±17. 24) nmol/ L; (29. 47±16. 66) nmol/ L vs (41. 37±21. 03) nmol/ L; both P<0. 05]. Conclusion Vitamin D deficiency related to Ct infection in human genitourinary tract and poor prognosis. Lower serum vitamin D levels might increase the risk of Ct genitourinary tract infection and reduce the efficacy of treatment.