Objective To explore the correlation between the length of peristaltic break (LPB) and the severity of the symptoms in patients with non-erosive reflux disease (NERD) and negative pH monitoring.Methods A total of 35 patients with NERD and negative pH monitoring were enrolled,and at same time 10 healthy individuals were selected as controls.The LPB of esophageal body of both groups was measured by high resolution manometry (HRM).Meanwhile,the symptom of NERD patients with negative pH monitoring was scored.The LPB of esophageal body between the two groups was compared by t test.The correlation between the LPB and the severity of the symptoms in NERD patients with negative pH monitoring was analyzed by Pearson correlation analysis.Results The average LPB of esophageal body of NERD patients with negative pH monitoring was (3.3±0.9)cm,which was longer than that of healthy controls ((1.2 ± 0.4) cm),and the difference was statistically significant (t=9.17,P＜0.01).The symptom score of NERD patients with negative pH monitoring was 21.6± 7.8.There was a positive correlation between the LPB and NERD symptom score (r=0.894,P＜ 0.01).Conclusion The LPB of esophageal body is a kind of expression of esophageal motility dysfunction,which is correlated with the symptom of NERD.

Objective:To study the treatment effect of zoledronic acid and letrozole on life quality of postmenopausal women with breast cancer operation. Methods:Totally 26 patients were in the control group,and given letrozole,and 23 patients were in the treat-ment group with zoledronic and letrozole. The patients in the two groups were assessed bone mineral density ( BMD) of hip and lumbar vertebrate before the treatment and the 6th and 12th month after the treatment. BALP, CTX, VAS, FACT-B and adverse reactions were also assessed at the 6th and 12th month after the treatment. Results:Improvement of BMD and FACT-B in the treatment group was sig-nificantly better than that in the control group. BALP, CTX and VAS in the treatment group were all decreased more significantly than those in the control group (P<0. 05 or P<0. 01). There was no significant difference in the metastasis between the two groups (P>0. 05). Conclusion:By preventing bone loss and increasing BMD, the combination of zoledronic acid and letrozole can effectively im-prove the life quality of postmenopausal women with breast cancer operation.

Objective To construct nursing service quality evaluation index system for abdominal operation patients. Methods Based on the service quality(SERVQUAL)model, a total of 33 nursing experts were selected by Delphi method for two turns of consultation. All the consultation experts have got senior professional title and 90.9%(30/33) have been working for more than 20 years. Finally, we calculated the questionnaire response rates, the authority coefficient, the mean and standard deviation, the coefficient of variation and the harmony coefficient. Results The response rates of questionnaires was 91.89% and 100% respectively, while the authority coefficient of experts was 0.91. The harmony coefficient of first and second and third indictors was 0.43, 0.47 and 0.53 respectively in the second consultation. Combined with selection of indicators and expert opinion, the final evaluation index system includes 6 first grade indexes, 14 second grade indexes and 49 third grade indexes. Conclusions There is a high level of authority and team coordination in experts. The results of the study can provide a reference for evaluating the nursing service quality of abdominal operation patients.

Objective To discuss the safety and the application of the self-designed multifunctional inflatable pelvis and hip-joint fixator (MIPHF) in damage control in pelvic fracture patients.Methods The MIPHF was subjected to pressure test and quality inspection.From September 2016 to June 2017,61 pelvic-fracture patients were treated with our self-designed MIPHF as pre-hospital first-aid care according to the concept of damage control orthopedics (DCO) (MIPHF group).The control group consisted of 69 pelvic-fracture patients who had not received pre-hospital first-aid care with the self-designed MIPHF from December 2015 to August 2016.There were no statistically significant differences between the two groups in gender,age,types of pelvic fracture,and preoperative injure severity score (ISS).The study compared the two groups for the case fatality rate,volume of blood transfused during surgeries,early complication rates,fracture reduction (Matta standards),and long-term efficacy (Cole scores).Results The pressure test showed that the MIPHF had a good fixation effect on the pelvis.And the quality inspection showed that the material used for the MIPHF was in line with national standards and the safety was guaranteed.The MIPHF group had 1 death (1.6％) and the control group had 8 deaths (11.6％),which was a significant difference (x2=4.979,P=0.026).All survival patients in both groups were followed up.The MIPHF group (61 cases) received 3.0 to 18.0 months follow-up,with an average of 9.0 months.And the control group (69 cases) had 18.0 to 30.0 months follow-up,with an average of 21.9 months.In the MIPHF group,23 cases were treated conservatively,and 37 cases were treated with surgery.Among them,3 cases were fixed with external fixator,20 cases with anterior open reduction and internal fixation,9 cases with posterior open reduction and internal fixation,and 5 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 20 days after injury,with an average of 4.1 days.The volume of blood transfused in the MIPHF group during surgery was 200 to 1500 ml,with an average of 628.6 ml.In the control group,27 patients were treated conservatively,and 42 patients were treated with surgery.Among them,2 cases were fixed with external fixator,24 cases with anterior open reduction and internal fixation,10 cases with posterior open reduction and internal fixation,and 6 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 15 days after injury,with an average of 3.l days.The volume of blood transfused in the control group during surgery was 200 to 4000 ml,with an average of 1 707.1 ml.There was a significant difference between the two groups in intraoperative blood transfusion(Z=-2.330,P=0.020).The MIPHF group had 10 (16.4％) cases of early serious complications and the control group had 22 (31.9％) cases,which had a significant difference (x2=4.187,P=0.041).According to the criteria proposed by Matta et al.,the good rate of results for treating fractures was 82.0％ in the MIPHF group and 60.9％ in the control group,which got a significant difference (x2=6.967,P=0.008).The MIPHF group and the control group also differed significantly in their mean long-term Cole scores (27.2±4.0 versus 25.1 ±5.6,t=2.457,P=0.015).Conclusion MIPHF,which reflects the DCO concept,may be recommended as pre-hospital first-aid care for patients with pelvic fracture because it can lessen bleeding and prevent secondary pelvic injury,thus reduce case fatality rate and the incidence of complications.It can also improve the success rate of treating pelvic fracture,which will positively affect long-term outcomes.

Objective To investigate the role of peripheral CD14+monocyte-macrophages in the recognition of phosphorylated antigen by γδ T cells and its relationship with treatment outcome. Methods Three kinds of γδ TCR tetramers were used to stain PBMC collected from patients with tuberculosis ( TB) and neonatal umbilical cord blood samples. The proportions of various TB-specific antigen presenting cells (APC) in peripheral blood were analyzed, and their relationships with treatment outcome were assessed based upon clinical data. Results CD14+monocyte-macrophages both in tuberculosis patients′ peripheral blood and neonatal umbilical cord blood were the strongest binding cells to CD277 antibody and γδ TCR tet-ramers. The median (P50) of CD14+monocyte-macrophages reached the highest peak after taking anti-tu-berculosis treatment for about one month and patients′condition was improved obviously during this period. Conclusion This study elucidated that CD14+monocyte-macrophages accounted for the largest proportion of APC when γδ T cells recognized phosphorylated antigens, which provided reference data for further study on the mechanism of γδ T cells restrictively recognizing phosphorylated antigen and their significance in innate and adaptive immunity.