Objective To study the association between NT-proBNP and elevated nocturnal blood pressure in male elderly primary hypertension patients.Methods Five hundred and ninety male elderly primary hypertension patients,admitted to our hospital from January 2009 to December 2012,were divided into non dipper hypertensivon group (n=418) and anti-dipper hypertension group (n =172).Their clinical data,laboratory test parameters and ambulatory ECG findings were recorded.Results The age was older,the serum levels of creatinine,HbAlc and NT-proBNP were higher in anti-dipper hypertension group than in non-dipper hypertensivon group (81.47± 9.25 years vs 77.81±11.10 years,P=0.000;113.18±99.70 μmol/L vs 93.35±84.49 μmol/L,P=0.017;7.34％±8.35％ vs 6.37％±1.05％,P=0.001;551.16±991.72 ng/L vs 355.12±934.89 ng/L,P=0.009).Multivariate regression analysis showed that average day systolic blood pressure was independently associated with NT-proBNP (P=0.004).Conclusion The loss of rhythmia is more noticeable and the target organ damage is more serious in anti-dipper hypertension patients than in non-dipper hypertensivon patients.The serum NT-proBNP level plays a certain role in regulating blood pressure.

Objective Investigation of the Hexi Corridor in Gansu Province in the pathogenesis of esophageal cancer risk factors, prevention and treatment for esophageal cancer provide the basis. Methods Based on the hospital case control study, a survey of the region' s incidence of esophageal cancer risk factors. Results The single factor, multi factors and Logistic regression analysis found that Large quantities of alcohol, eating less fresh vegetables and less meat,eggs and fish, hot drink and diet, family history of esophageal cancer, history of significant mental trauma and low education level factors and esophagus cancer incidence closely related to the incidence of esophageal cancer in the Hexi Corridor is the main risk factors. At the same time, smoking, eating fast, eating sauerkraut was not related to the incidence of esophageal cancer. Conclusion After the investigation discovered this local esophagus cancer morbidity dangerous factor and locality special living conditions factor related, mainly displays in diet aspects and so on habits and customs and energetic factor. These factor function is by no means independent, but is affects mutually, affects mutually forms.

Objective To evaluate the therapeutic effect and application value of laparoscopy combined with holmium laser in the treatment of intrahepatic and extrahepatic bile duct stones.Methods Retrospectively analyzed the clinical data of 22 cases with intrahepatic and extrahepatic bile duct stones who treated with laparoscopy choledo-choscopy combined with holmium laser lithotripsy(the observation group),and 21 cases who treated with laparoscopy combined with choledochoscopic lithotomy(the control group).The clinical curative effect was compared between the two groups.Results In the observation group,the residual stones completely removed in 21 cases(95.4%),the mean operation time was (130 ±13)min,the intraoperative bleeding volume was (85 ±20)mL,the average hospitali-zation time was (8.3 ±2.0)days,without conversion to open surgery,no incision infection,1 case had residual stones after operation,through T tube sinus tract choledochoscopy took a stone again.In the control group,took net calculi in 13 cases(61.9%),the average operation time was (135 ±20)min,the intraoperative hemorrhage volume was (70 ± 15)mL,the average hospitalization time was (14.5 ±2)days,6 cases converted to laparotomy,incision infection in 2 cases,8 cases had residual stones after operation,through T tube sinus combined with choledochoscopy again take stone,which 2 secondary mirror lithotomy in 6 cases,3 cases of 2 stones.The differences of the two groups in stone from the net rate,conversion rate,average hospitalization time were statistically significant(χ2 =2.203,2.897,t =4.293,P =0.033,0.006,0.017).The differences of mean operation time,intraoperative hemorrhage had were not statistically significant(t =1.176,1.629,P =0.246,0.111).Conclusion It is safe,effective and minimally invasive for the treatment of intrahepatic and extrahepatic bile duct stones with holmium laser combined with endoscopic holmi-um laser.

Objective To compare and discuss the clinical application effect of the end-to-end anastomosis of pancreatic and intestinal anastomosis,binding type of pancreatic and intestinal anastomosis,end-to side pancreatic duct anastomosis and modified pancreatic duct jejunum anastomosis.Methods Collected pancreatoduodenectomy in 95 cases,the end-to-end pancreatico duodenal sleeve type anastomosis in 23 cases,binding type pancreatic enteric anastomosis in 18 cases,end to side pancreaticojejunostomy anastomosis in 28 cases,improvement of the pancreatic duct jejunum end to side anastomosis in 26 cases,compared with four groups of patients with pancreatic enteric anastomosis time and postoperative complications.Results Anastomosis time:A group (34.0 ± 4.6) min,B group (31.0±5.8) min,C group (32.0 ±6.3) min,D group (14.0 ±4.2) min(P=0.037,P＜0.05).And the incidence rate of postoperative pancreatic fistula,bile leakage,abdominal cavity or digestive tract bleeding had no significant difference (P ＞ 0.05).Improvement of the pancreatic tube jejunum end to side coincident with a low incidence of pancreatic fistula,but different pancreatic enteric anastomosis way pancreatic fistula rate difference was not statistically significant,improvement of the pancreatic duct and jejunum mucosa end side group pancreatic enteric anastomosis anastomosis time significantly shorter in the three groups,the difference was statistically significant (P ＜ 0.05).Conclusion Improvement of pancreatic duct jejunum end to side anastomosis with short operation time,low incidence of pancreatic fistula,and the operation is simple and practical,safe.

The purpose of this study was to investigate and analyze the high frequency electrocardiogram (HFECG) for middle-aged and elderly people.138 subjects were chosen in our study.The mean age was 60.38 years.Among them,72.1 per cent were between 50 and 69 years.The results showed that (1) the differences were not significant between male and female groups in the mean number of high frequency notches (HFN).(2) For an increase in high frequency notches in the leads V1 and V2,we should consider the possibility of pathological changes of the anterior medial wall of heart,which was supplied by the dessending rami of the right anterior coronary artery,on the one hand,and it might remind us to pay great attention to posteromedian wall of heart,on the other hand.(3) Looking at all age groups in this study,we preliminarily found that the age peak of ischemic heart disease was between 50 and 70 years,according to the number of high frequency notches in the leads of HFECG.(4) The sensitivity of HFECG for diagnosing ischemic heart disease is 40 per cent higher than that of the conventional ECG.(5) In addition,nine leads were used in this examination,which not only preserved sensitivity of six leads but also could provide a localizing value for the diagnosis of heart disease.

Objective: To evaluate the association of smoking with the risk of ankylosing spondylitis (AS) using a Mendelian randomization (MR) approach. Methods: A total of 16 383 186 AS-associated single nucleotide polymorphisms (SNPs), 378 smoking initiation associated SNPs and 126 lifetime smoking score-associated SNPs were collected from three large-scale genome-wide association studies (GWAS). The association of smoking phenotypes with the risk of AS was examined using inverse-variance weighted (IVW) with AS as a outcome variable, smoking initiation and lifetime smoking score as exposure factors and SNPs with strong associations with smoking as instrumental variables, and sensitivity analyses were performed with maximum likelihood-based method, MR pleiotropy residual sum and outlier (MR-PRESSO) test and MR-Egger regression analysis. Results: A 33.5% increased risk of AS was found among genetically predicted smokers relative to non-smokers (OR=1.335, 95%CI: 1.059-1.682), and an increase in predicted lifetime smoking by per standard deviation resulted in a 101.4% increased risk of AS (OR=2.014, 95%CI: 1.341-3.024). The maximum likelihood-based method and MR-PRESSO test showed consistent correlated effect estimations and MR-Egger regression analysis identified no evidence of pleiotropy. Conclusion It is genetically predicted that smoking is associated with an increased risk of AS.

Objective To observe the effects of electro-acupuncture ( EA ) on learning, memory and the morphology of hippocampal neural tissues in rats with a model of chronic cerebral ischemia.Methods One hundred and twenty male Sprague-Dawley rats were used. Chronic cerebral ischemia models were successfully established in 104 of them, and those rats were randomly divided into an EA group and a model group with 52 rats each. These were further subdivided into 1,2, 4 and 6 week subgroups with 13 rats in each. The EA group was given EA. The changes in spatial learning and memory ability were observed using a Morris water maze. The morphological changes in hippocampal nerve tissue were observed by HE staining.Results The escape latency in the EA group was significantly different from the model group at the 2nd, 4th and 6th week. The nerve cells in the dentate gyrus were more tightly and consistently lined-up and had rich layers, and the structures in the EA group were better than in the model group.Conclusions EA can improve spatial learning and memory and promote the repair of injury after cerebral ischemia.

Purpose To compare the difference of the genotype and allele of endothelial cell protein C receptor (EPCR)gene rs9574 C/G between Guangxi population and other ethnic groups.Methods The rs9574 C/G polymorphisms of EPCR in 130 cases of Guangxi population were detected by PCR and DNA sequencing.The distribution frequency of allele and genotype was compared with the other four ethnic groups (HapMap-CEU,HapMap-HCB,HapMap-JPT,HapMap-YRI),which was published by the human genome project.Results Three genotypes of CC,CT and TT were found in rs9574 C/G with the frequencies of 39.2％,46.2％,14.6％ respectively.the allele frequencies of C,T were 62.3％ and 37.7％.No significant difference was observed in the frequency of genotype and allele between male and female (P ＞ 0.05).There were significant differences in the genotype distribution among Guangxi population,HapMap-CEU and HapMap-YRI (P ＜ 0.05).Significant differences of allelic frequency were found among Guangxi population,HapMap-CEU,HapMap-JPT and HapMap-YRI.Condusion The polymorphisms of rs9574C/G in 3'-noncoding region of EPCR gene in Guangxi population were different in different regions and ethnic groups.

Objective To detect the mutations of GJB2 and GJB6 genes in the first Chinese case of keratitis, ichthyosis and deafness (KID) syndrome. Methods Genomic DNA was extracted from the patient with KID syndrome and his family members. All encoding exons and adjacent splice sites of the GJB2 and GJB6 genes were amplified by PCR. Mutation scanning was carried out by direct bidirectional DNA sequencing. Results No mutation was found in GJB6. A G148A mutation was found at exon2 of GJB2 in the patient, which caused a change from aspartic acid to asparagine at codon 50(D50N). Conclusion This case of KID syndrome may be caused by the mutation in GJB2.

This research focused on the doctors' changes based on the performance-payment reform from a district public hospital of Chongqing.The work compared the doctors' work efficiency,medical quality,scientific research,new technology and new project,cost control and patients burden.Performance-payment reform significantly activated doctors' self-study initiative and quality.The main running quotas of hospital,including stuff's positivity,work efficiency,medical quality,scientific research,new technology and new project,presented a better improvement trend.This not only reduced the patient cost burden,relieved the doctor-patient relationship,but also improved the hospital personnel cohesion,and strengthened the core competitiveness of the hospital.