Objective To explore the surgery and conservative treatment for obstructive sleep apnea hypop -nea syndrome of PSG parameters .Methods According to the treatment method , 60 cases of obstructive sleep apnea syndrome patients for the study were divided into observation group and control group ,the control group were used for non-surgical treatment ,the research group were treated by surgery .PSG monitoring equipment were used to detect the AHI,AHTI,AHT,SAT90%,minimum and average SaO2 so SaO2.Results After treatment,patients were significant-ly lower SAT90%were (38.4 ±13.4)%,(17.5 ±12.5)%,the lowest Sa(O2) were(79.6 ±12.4)%,(83.7 ± 11.2)%,significantly higher average SaO 2 were (85.4 ±16.3)%,(90.8 ±12.4)%,increased significantly com-pared with before treatment difference was statistically significant (t=10.13,22.42,4.76,9.76,3.65,6.65,all P<0.05).And the control group improved more significantly (t=17.32,3.76,3.76,all P<0.05).After treatment,pa-tients were AHI,AHT and AHTI were (22.4 ±3.4)times/h,(14.5 ±2.5)times/h,(9.6 ±2.4)min,(5.7 ±1.2) min,(1.4 ±0.3)min,(0.8 ±0.4)min,significantly reduced compared with before treatment difference was statisti-cally significant(t=9.63,12.12,7.51,19.27,21.42,10.63,all P<0.05).And the control group decreased more significantly,the difference was statistically significant (t=8.97,9.76,6.57,all P<0.05).Conclusion Obstructive sleep apnea syndrome treated by surgery ,each of PSG parameters improved significantly superior to conservative treat-ment,which should be used as their preferred method of treatment .

Objective To investigate the efficacy and safety of low-dose and standard-dose intravenous alteplase for acute ischemic stroke. Methods The patients with acute ischemic stroke treated with intravenous alteplase from August 2012 to January 2016 were analyzed retrospectively. According to the dosage of the drug, the patients were divided into either a low-dose group (0. 6-0. 8 mg/kg) or a standard-dose group (0. 9 mg/kg). The efficacy was evaluated with the modified Rankin Scale (mRS) at 90 days, and a favorable functional outcome was defined as mRS 0-1. The safety was evaluated by the mortality at 90 days and the incidence of symptomatic intracerebral hemorrhage (SICH) within 7 d after onset. Results A total of 790 patients were enrolled, including 612 in the low-dose group and 178 in the standard-dose group. There was no significant difference in each baseline clinical data between the 2 groups. Compared with the standard-dose group, there was no significant difference in the good outcome rate of the small-dose group at day 90 (35. 6% vs. 37. 6% ; χ2 = 0. 872, P = 0. 35) and mortality (5. 1% vs. 6. 2% ;χ2 = 2. 173, P = 0. 14), but the incidence of SICH was significantly lower (1. 8% vs. 5. 1% ; χ2 = 5. 875, P =0. 015). Conclusion The efficacy of low-dose intravenous alteplase for acute ischemic stroke is equivalent to the standard-dose and the safety is better.

Objective To investigate the epidemiological features and trends of humeral intercondylar fractures at our hospital from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the patients with humeral intercondylar fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender,fracture site and AO classification were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 303 humeral intercondylar fractures were recorded,accounting for 5.29％ of the distal humeral fractures,3.39％ of the elbow fractures and 0.24％ of the total fractures at the same period.They involved 197 males and 106 females,with a male/female ratio of 1.86∶ 1.The high-risk age group was adolescent and middle-aged adults,accounting for 63.70％.The high-risk type was type 13-C2,accounting for 44.00％.There were 171 and 132 cases in group A and group B,accounting for 5.40％ and 5.17％ of the contemporary distal humeral fractures,3.72％ and 3.05％ of the contemporary elbow fractures,and 0.26％ and 0.22％ of all the contemporary fractures,respectively,showing no significant differences between the 2 groups(P ＞ 0.05).In groups A and B respectively,the male/female ratios were 1.44∶1 and 2.67∶ 1,the proportions of adolescents and the middle-aged 58.48％ and 70.45％,the proportions of type 13-C1 35.83％ and 18.10％,and the proportions of type 13-C3 14.17％ and 44.76％,showing significant differences between the 2 groups in all the above comparisons (P ＜ 0.05).Conclusion The humeral intercondylar fractures were common in the adolescent and middle-aged patients,with a male predominance (about twice more in males).Compared with the first five years,the latter 5 years witnessed increased proportions of males,adolescent and middle-aged patients,and type 13-C3 but a decreased proportion of type 13-C1.

Objective To investigate the epidemiological features and trends of adult fractures at the base of the first metacarpal bone in The Third Mfiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The data of human fractures treated between January 2003 to December 2012 at our hospital were collected through the PACS system and case reports checking system.Adult fractures at the base of the first metacarpal bone were included in the present study and assigned into 2 groups,group A containing the data between 2003 and 2007 and group B the data between 2008 and 2012.Comparison and analysis was done with analytic items of gender,age and fracture type.Results A total of 378 adult fractures at the base of the first metacarpal bone were included,accounting for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures involved 311 males (82.28％) and 67 females (17.72％).The youth group had 254 fractures with the highest constituent ratio (67.20％).The right side was involved in 286 cases (75.66％) and the left side in 92 (24.34％).There were 198 cases of extra-articular fracture with the highest constituent ratio (52.38％).Group A had 200 fractures,a male to female ratio of 6.14∶ 1,a median age of 34 years,the highest constituent ratio in youth (73.50％) and in type A1 fractures (53.50％);group B had 178 fractures,a male to female ratio of 3.56∶ 1,a median age of 40 years,the highest constituent ratio in youth (60.11％) and in type A1 fractures (51.12％).Compared with group A,group B had a higher constituent ratio of females,older ages,a higher constituent ratio of elderly patients,a lower constituent ratio of youth,and a lower constituent ratio of type C1 fractures.All these differences between the 2 groups were statistically significant (P ＜ 0.05).Conclusions During the 10 year,the adult fractures at the base of the first metacarpal bone accounted for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures occurred mostly in men and in the age range of 16 to 44 years.About 3/4 of them occurred on the right side.Compared with the first 5 years,the latter 5 years witnessed increasing trends of female and elderly patients and decreasing trends of young patients and type C1 fractures.

Objective To investigate the epidemiological features and trends of supracondylar humeral fractures from 2003 to 2012 at The Third Affiliated Hospital to Hebei Medical University.Methods The data of the patients with supracondylar humeral fracture who had been treated between 2003 and 2012 at our hospital were collected through the PACS system and case reports checking system.The data between 2003 and 2007 were classified as group A and those between 2008 and 2012 as group B.The data concerning gender,age and fracture type were statistically analyzed and compared between the 2 groups.Results Atotalof3,111 supracondylar humeral fractures were treated,accounting for54.4％ (3,111/5,723) of the distal humeral fractures,34.8％ (3,111/8,932) of the elbow fractures and 2.5％ (3,111/126,479) of the total fractures.They were 2,018 males (64.9％) and 1,093 females (35.1％).The age range from 1 to 10 years obtained the highest constitute ratio for both genders,77.0％ (1,554/2,018) for males and 78.2％ (854/1,093) for females.The extension type and flexion type had 2,693 (86.6％) and 418 (13.4％) cases,respectively,and their male to female ratios were 2.0:1 and 1.2:1 respectively,all showing significant differences (P ＜ 0.001).There were 1,902 cases in group A and 1,209 cases in group B,accounting for 60.0％ (1,902/3,168) and 47.3％ (1,209/2,555) of the distal humeral fractures,41.4％ (1,902/4,199) and 27.9％ (1,209/4,333) of the elbow fractures,and 2.9％ (1,902/65,267) and 2.0％ (1,209/61,212) of the total fractures,respectively,all showing significant differences between groups (P ＜ 0.001).The male to female ratio was 1.9:1 for group A and 1.8:1 for group B,showing an insignificant difference (P ＞ 0.05).The age range from 1 to 10 years had a constitute ratio of 75.0％ (1,426/1,902) for group A and that of 81.2％ (982/1,209) for group B,showing a significant difference (P ＜ 0.001).The proportion of extension type was 85.4％ (1,624/1,902) for group A and 88.4％ (1,069/1,209) for group B,showing a significant difference (P ＜ 0.05).Conclusions The current investigation has revealed the epidemiological features and trends of supracondylar humeral fractures which had been treated between 2003 and 2012.They were mostly seen in children from 1 to 10 years old.The extension type predominated.Compared with the first 5 years,the proportion of age range from 1 to 10 years and the extension type increased in the latter 5 years.

Objective To investigate the epidemiological features and trends of adult carpal fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the adult patients with carpal fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender and fracture type were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 1,181 carpal fractures were collected,accounting for 5.99％ (1,181/19,712) of the hand fractures and 1.10％ (1,181/107,648) of the total fractures in the same period.They involved 967 males and 214 females,with a male/female ratio of 4.52∶ 1.The high-risk age group was from 21 to 30 years (33.28％);the high-risk type was scaphoid fracture (72.99％).In group A of 453 cases,the male/female ratio was 6.68∶1,the median age 29 years and the high-risk type scaphoid fracture (83.89％).In group B of 728 cases,the male/female ratio was 3.70∶ 1,the median age 34 years and the high-risk type also scaphoid fracture (66.21％).Group B had a significantly lower male/female ratio,a significantly lower proportion of scaphoid fractures and a significantly older median age than group A (P ＜ 0.05).Conclusions In the 10 years at our institute,adult carpal fractures accounted for 5.99％ of the hand fractures and 1.10％ of the total fractures in the same period.They mostly occurred in males and during the age from 21 to 30 years.Of all the carpal bones,the scaphoid was the most often fractured.The latter 5 years witnessed significantly increased median age,proportion of females and proportion of scaphoid fractures compared with the former 5 years.

Objective To compare and analyze the epidemiological features of fractures at the base of the first metacarpal bone between East and West China.Methods We retrospectively analyzed the clinical data of the patients with fracture at the base of the first metacarpal bone who had been treated from January 2010 to December 2011 in 63 hospitals in the east and west areas of China.The data from 35 hospitals in East China were classified as group A while the data from 28 hospitals in West China as group B.The analytic items included gender,age,age distribution and fracture classification.Results A total of 890 cases were collected.The total male/female ratio was 4.56∶ 1.The youth accounted for the highest proportion and the high-risk type of fracture was type Ⅲ (44.49％,396/890).The male/female ratio was 4.59∶1 in group A of 621 patients and 4.49∶1 in group B of 269 patients,showing no statistic between-group difference (P ＞ 0.05).The median age in group A was 39 years,significantly older than that in group B (35 years) (Z =-3.687,P ＜ 0.001).In both groups,the youth accounted for the highest proportion and there were more right-side fractures than left-side ones.Group A had a significantly lower proportion of the youth and a significantly higher proportion of the middle-aged than group B (P ＜ 0.05),but there was no statistic difference in proportions of the children and the aged (P ＞ 0.05).Type Ⅲ was the high-risk type in both groups;group A had significantly more fractures of type Ⅰ and significantly fewer fractures of type Ⅱ than group B (P ＜ 0.05),but there was no statistic difference in proportions of type Ⅲ and type Ⅳ between the 2 groups (P ＞ 0.05).Conclusions Fractures at the base of the first metacarpal bone mostly occurred in the young males.There were more fractures at the right side than at the left side.The most frequent type was type Ⅲ.The proportion of type Ⅰ fractures in East China was higher than in West China while the proportion of type Ⅱ fractures in East China lower than in West China.

Objective To investigate the association and interaction of heat shock proteins B1 (HSPB1) gene rs2868371 and tumor-suppressor protein p53 (TP53) gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers (i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo [a] pyrene-diolepoxide (BPDE)-albumin adducts and the lymphocytic micronucleus (MN) frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR (ABI Prism 7900HT), and the corresponding frequency ratios (FR) with 95%confidence intervals (CI) were computed for all assays. Results In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+CC genotype carriers ((3.88 ± 2.88)‰, (4.00 ± 2.66)‰, and (3.91 ± 2.83)‰, respectively) than in rs2868371 GG genotype carriers ((3.52±2.67)‰;FR=1.10, 1.13, and 1.11;95%CI:1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency (Ptrend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers ((3.63±2.61)‰and (3.66±2.61)‰, respectively) than in TP53 rs1042522 CC genotype carriers (3.95 ± 3.06)‰(FR=0.87 and 0.90;95%CI:0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers (P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged>40 years (FR=1.07, 95% CI: 1.01-1.12), those working >20 years (FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m2 (FR=1.07, 95% CI: 1.01-1.13), drinkers (FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels (FR=1.07, 95% CI: 1.01-1.13) (Ptrend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years (FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m2 (FR=0.94, 95% CI:0.88-0.99), and drinkers (FR=0.94, 95% CI: 0.88-1.00) (Ptrend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency (P=0.030 and 0.013, respectively). Conclusion In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.

Objective To investigate the association and interaction of heat shock proteins B1 (HSPB1) gene rs2868371 and tumor-suppressor protein p53 (TP53) gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers (i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo [a] pyrene-diolepoxide (BPDE)-albumin adducts and the lymphocytic micronucleus (MN) frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR (ABI Prism 7900HT), and the corresponding frequency ratios (FR) with 95%confidence intervals (CI) were computed for all assays. Results In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+CC genotype carriers ((3.88 ± 2.88)‰, (4.00 ± 2.66)‰, and (3.91 ± 2.83)‰, respectively) than in rs2868371 GG genotype carriers ((3.52±2.67)‰;FR=1.10, 1.13, and 1.11;95%CI:1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency (Ptrend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers ((3.63±2.61)‰and (3.66±2.61)‰, respectively) than in TP53 rs1042522 CC genotype carriers (3.95 ± 3.06)‰(FR=0.87 and 0.90;95%CI:0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers (P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged>40 years (FR=1.07, 95% CI: 1.01-1.12), those working >20 years (FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m2 (FR=1.07, 95% CI: 1.01-1.13), drinkers (FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels (FR=1.07, 95% CI: 1.01-1.13) (Ptrend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years (FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m2 (FR=0.94, 95% CI:0.88-0.99), and drinkers (FR=0.94, 95% CI: 0.88-1.00) (Ptrend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency (P=0.030 and 0.013, respectively). Conclusion In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.

Objective: To introduce a combined operation for treating chronical peroneal tendon dislocation and to evalu-ate the clinical outcomes of patients. Methods: Data of 12 ankles in 12 patients (male 9, female 3) with chronical peroneal ten-don dislocation who underwent the fibular groove deepening procedure with transposition of the peroneal longus muscle from June 2006 to August 2013 were retrospectively analyzed. The mean age was 24.6±4.3 years (range, 18-34 years), and there were 3 cas-es on left side, 9 on right side. The mechanism of peroneal tendon injury consisted of sports injuries in 8 and sprains in 4. There were 8 cases of flat fibula sulcus and 4 cases of convex. All patients met the inclusion criteria of a painful snapping or popping sen-sation or palpable clicking and positive provocation maneuver and without fracture and were treated with peroneal sulcus deepen-ing and peroneal longus tendon transposition. The duration of preoperative popping and pain symptoms ranged from 12 to 23 weeks, with an average of 16.9±4.0 weeks. All cases were treated conservatively 3-4 weeks before operation and were not effec-tive. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, visual anologue scale (VAS). Results: Twelve patients were followed up with an average period of 37.3±7.0 (range, 25-50) months. The mean VAS scale score of all patients reduced from 5.6±0.9 to 0.5±0.7 at the latest follow-up. The mean AOFAS scale score improved from 61.4±5.6 to 92.6±4.2 at the latest follow-up. The difference between preoperative and postoperative was statis-tically significant. (t=16.250,-18.475; P=0.000). According to the evaluation of symptom and function scoring system, 10 cases were excellent and 2 cases were good, with an excellent rate of 100%. The mean postoperative return-sport time was 26.42±3.06 weeks (range, 23-32 weeks). All patients healed primarily and no infection, skin necrosis and residual redislocation occurred. The osteotomy healed completely without displacement, which was confirmed by imaging examination in three months postoperation. No patients had intractable pain after surgery, and they were able to perform daily activities at 3 months and physical exercise at 6 months after surgery. No slip occurred in all patients at the latest follow-up. Conclusion The fibular groove deepening procedure with transposition of the peroneal longus muscle can effectively treat chronical peroneal tendon dislocation and obtain good medi-um-term results.