Objective To study the deep vein thrombosis (DVT ) in lower extremities of patients with or without cardiovascular disease after fracture .Methods Five hundred and eighty-four frac-ture patients were divided into cardiovascular disease (CVD) group (n=235) and non-cardiovas-cular disease (NCVD) group (n=349) .Patients in CVD group were further divided into subgroup A (with essential hypertension) ,subgroup B (with CHD) ,and subgroup C(accompanying essen-tial hypertension and CHD) .Incidence of DVT in CVD group ,NCVD group ,subgroups A-C at different ages after fracture was compared .Results The incidence of DVT was significantly high-er in CVD group than in NCVD group (P<0 .01) ,in two groups on days 0-7 after fracture than on days 8-14 or >14 after fracture ,and in patients with their age ≥60 years than in those with their age <60 years .Conclusion DVT is easier to occur in CVD patients with their age ≥ 60 years than in those with their age <60 years after fracture .DVT usually occurs within 1 week af-ter fracture .Importance attached to high risk population and measures taken as soon as possible against it can reduce DVT after fracture .

Objective To systematically review the correlation between polymorphisms of CYP2D6 genotypes and concentrations of tamoxifen and its activity in Chinese breast cancer patients.Methods Such databases as Cochrane Library, PubMed, EMBase, CNKI, CBM, WeipuData and WanfangDate,from January 1995 to October 2014 were searched on line for the studies about the correlation between polymorphisms of CYP2D6 genotypes concentrations of tamoxifen and its activity in Chinese breast cancer patients.And references about it were checked.The meta-analysis was performed with RevMan 5.3 software.Results A total of 4 articles involving 438 patients were included.The results of meta-analysis showed that,the concentrations of HTAM and endoxifen in patients who had CYP2D6*10/*10 genotypes were lower than the other genotypes ( P<0.0001 ) .The concentration of tamoxifen in patients who had CYP2D6*10/*10 genotypes was lower than CYP2D6Wt/Wt ( P<0.05 ) .There was no significant difference between CYP2D6Wt/Wt and CYP2D6Wt/*10.Conclusion We concluded that CYP2D6 polymorphisms may influence concentrations of tamoxifen and its activity in Chinese breast cancer patients.

Objective To compare the efficacy of different doses of ropivacaine for ultrasound-guided axillary brachial plexus block in children.Methods One hundred and twenty ASA Ⅰ or Ⅱ children,aged 5-12 yr,scheduled for elective surgery for hand injury,were equally and randomly divided into 4 groups according to the doses of ropivacaine:0.35,0.3,0.25 and 0.20 ml/kg groups.The children received oral midazolam 30 min before surgery.Propofol was given by target-control infusion after admission to the operating room.When the pediatric patients lost consciousness and had no response to verbal command,axillary brachial plexus block was performed under the guidance of ultrasound.0.25 ％ ropivacaine 0.35,0.3,0.25 and 0.20 ml/kg were injected to block the radial,median,ulnar,musculocutaneous and medial antebrachial cutaneous nerves.Additional ketamine was given when needed during operation.The duration of block and consumption of general anesthesia and complications were recorded.The degree of sensory block of the region innervated by each nerve and effectiveness of block were assessed.Results The rate of effective block of the radial nerve,median nerve and musculocutaneous nerve was significantly lower,the number of patients requiring ketamine was larger and the duration of block was shorter in group 0.2 ml/kg than in 0.35,0.30 and 0.25 ml/kg groups (P ＜ 0.05).There was no significant difference in the parameters mentioned above between 0.35,0.30 and 0.25 ml/kg groups (P ＞ 0.05).No pediatric patients developed block-related complications in each group.Conclusion Ultrasound-guided axillary brachial plexus block with 0.25 ％ ropivacaine 0.25 ml/kg can provide better block in children.

Objective To analyze the clinical value of ultrasound-guided percutaneous Lauromacrogol Injection sclerotherapy in the treatment of simple renal cyst. Methods A total of eighty patients with simple renal cyst, who were divided into 40 groups according to the random number table, were divided into two groups from February 2016 to April 2017. The traditional group used traditional open renal cyst unroofing decompression. Ultrasound guided ultrasound guided percutaneous Lauromacrogol Injection sclerotherapy was performed in the ultrasound guided group. The therapeutic effect, operation time and the rate of successful puncture were compared between two groups of simple renal cysts. It needs to compare the volume of the cyst and the quality of life before and after the intervention. Results Ultrasound guided group simple renal cyst treatment effect was higher than the traditional group (P<0.05). The operation time of the ultrasound guided group was shorter than that of the traditional group, and the success rate of the one shot puncture was higher than that of the traditional group(P<0.05). Before the intervention, the volume and quality of life of the two groups were similar. In the ultrasound guided group, the volume and quality of life in the ultrasound guided group were better than those in the traditional group(P<0.05). Conclusion Ultrasound guided percutaneous Lauromacrogol Injection sclerotherapy is of high clinical value in the treatment of simple renal cysts. The utility model can improve the success rate of one puncture, shorten the operation time, and the exact effect can speed up the regression of symptoms and reduce the volume of the cyst. Therefore, this method can improve the quality of life of patients.

This article was aimed to study the effect of Baohe granules for patients with chronic heart failure (CHF) of traditional Chinese medicine (TCM) syndrome and the effect of gastrointestinal hormone secretion. Patients with CHF were used as the object of study. A total of 80 selected patients were divided into 2 groups. The control group was treated with western medicine anti-heart failure therapy. The treatment group was treated with the combination of Baohe granules. All patients were compared in aspects of TCM efficacy, symptom score and serum gastrin, motilin secretion after two-week medication. The results showed that both treatments can significantly improve the TCM syn-drome and symptom total score of CHF patients. And the effect of the treatment group with Baohe granules was bet-ter. The TCM single symptom integral was also obviously improved in the treatment group combined with Baohe granules, which included heart palpitations, shortness of breath, abdominal distension, and loss of appetite. The GAS and MTL levels of CHF patients were significantly increased in the treatment group. It was concluded that the treat-ment combined with Baohe granules can improve CHF patients with TCM syndromes, symptoms and gastrointestinal hormone secretion. Thus, it contributed to the stability of the disease condition. It can slow the disease progression and improve prognosis. So it is worth using widely in the clinical practice.

Objective To compare the efficacy and tolerability of nateglinide with those of acarbose in Chinese type 2 diabetes mellitus (T2DM) patients.Methods This multi-center,randomized,double-blind,parallel-arm study compared the efficacy and tolerability of nateglinide( 120 mg,3/d,n = 119) and those of acarbose( 100 mg,3/d,n = 118) during a 12-week treatment in T2DM patients uncontrolled by diet with glycosylated haemoglobin (HbA1c) 6.5% - 11.0% .Results Monotherapy with nateglinide (120 mg,3/d)or acarbose (100 mg,3/d)decreased HbA1c to a similar extent during 12-week treatment.The mean change from baseline to end-point in HbAlc was ( -0.90±0.98)% and ( -0.83±0.81 )% in patients receiving nateglinide and acarbose,respectively,with no significant difference between the two groups (P>0.05).The decrease in fasting plasma glucose (FPG)was similar between nateglinide and acarbose (P > 0.05).The mean change in 2-hour postprandial plasma glucose ( PG2h ) was ( - 1.45 ± 2.74) mmol/L and ( -2.20±2.21 ) mmol/L in patients receiving nateglinide and acarbose(P =0.0017).Body weight was significantly decreased in both groups at the end-point ( P < 0.05 ),although the decrease was more with acarbese than nateglinide [( -0.66±1.79)kg vs (-2.06±2.00) kg,P=0.0000].And the proportion of patients experiencing any presumed drug related adverse events was not significantly different between the two groups.Conclusions Nateglinide ( 120 mg,3/d) is effective and well tolerated in T2DM patients uncontrolled by diet,demonstrating similar HbA1c reductions as compared with acarbose (100 mg,3/d).

Objective To preliminarily investigate the safety and feasibility of intra-arterial cold saline infusion combined with intravascular reperfusion for acute ischemic stroke with large artery occlusion. Methods From March 2016 to March 2018, consecutive acute ischemic stroke patients with large artery occlusion within 8 h after onset admitted to the Department of Neurology, the People's Hospital of Longhua District, Shenzhen and recanalized successfully after endovascular treatment were enrolled. After recanalization, cold saline was infused through the guiding catheter via the ipsilateral guilty vessel (10 ℃, 33 ml/min for 30 min). Results A total of 20 patients were enrolled, including 15 males. Their median age was 67 years (interquartile range, 53-80 years). Fifteen patients were treated with thrombolysis. A median onset-to-needle time was 300 min (interquartile range, 260-360 min). During the infusion of cold saline, the lowest rectal temperature was only decreased 0. 1 ℃, but within 5 min after completion of perfusion, it returned to the temperature before perfusion. Complications associated with intra-arterial hypothermia were not observed. The median National Institutes of Health Stroke Scale score was significantly decreased from 21 (interquartile range 15-55) before needle to 15 (interquartile range 10-16; Z = -4. 549, P < 0. 001) at discharge. Conclusion Selective intra-arterial cold saline infusion combined with intravascular reperfusion for acute ischemic stroke with large artery occlusion is safe and feasible.

Objective To investigate the effect of HCV RNA on virological and immunological response to highly active antiretroviral therapy (HAART),liver function and blood lipid levels in HIV/HCV co-infected patients.Methods In a cohort study,275 HIV/HCV co-infected former blood donors receiving HAART were followed up every six month in Henan province in China.HCV RNA,HIV RNA,CD+4 T cell counts,indexes of liver function and lipid levels were periodically tested.The differences of HIV viral load suppression,immunological response,liver injury and blood lipid levels between HCV RNA positive group and negative group were compared by x2 test and two independent-samples tests.Result There was no significant difference of HIV viral load suppression between HCV RNA positive group and HCV RNA negative group six-month treatment (45.6% vs.38.5% ,X2=1.150,P>0.05) and CD+4 T cell counts before (286 cells/μ1 vs.209 cells/μ1,Z=0.734,P=0.463)and after 6-month (310 cells/μ1 vs.362 cells/μl,Z=0.562,P=0.574) ,12-month(378 cells/μ1 vs.289 cells/μ1,Z=1.091,P=0.275),18-month(363 cells/μ1 vs.288 cells/μl,Z=1.435,P=0.151) ,24-month(413 cells/μ1 vs.348 cells/μ1,Z=0.939,P=0.348) HAART.The mean levels of serum ALT (55.0 U/L vs.29.5 U/L,Z=6.789,P<0.01),AST(46.0 U/L vs.33.0 U/L,Z=4.890,P<0.01)、TBIL(9.3 mmol/L vs.7.2 mmol/L,Z=3.748,P<0.01)were significantly higher in HCV RNA positive group than that in HCV RNA negative group.HCV RNA was the independent variables associated with liver injury after HAART (aOR=3.8,P<0.01).The serum triglyceride level was higher in HCV RNA positive group than that in HCV RNA negative group(1.2 mmoL/L vs.1.4 mmol/L,Z=1.936,P=0.043) .The serum HDL level was higher in HCV RNA positive group than that in HCV RNA negative group (1.5 mmol/L vs.1.3 mmol/L,Z=2.251,P=0.024).Conclusions HCV RNA does not affect HIV virological responses to HAART and CD+4 T recovery.HCV RNA is an independent risk factor associated with liver injury in HIV/HCV co-infected patients receiving HAART,but appears to provide significant protection against HAART-ieduced hyperlipidemia.

Objective To explore the serum levels of VILIP-1 and Cav-1 in cases with severe craniocerebral injury undergoing decompression and their effects on the prognosis.Methods 108 patients with severe craniocerebral injury who were treated in our hospital from July 2019 to July 2022 were selected as the study group,and 120 healthy people who came to our hospital for physical examination were selected as the health group.All cases were followed up for 6 months,and were divided into good prognosis group(GOS=4-5 points,n=82)and poor prognosis group(GOS=1-3 points,n=26)according to GOS.The levels of serum VILIP-1 and Cav-1 were detected by ELISA.The diagnostic value of serum VILIP-1 and Cav-1 on the prognosis of patients was evaluated by the ROC curve.Multivariate logistic regression analysis was used to explore the prognostic factors of patients.Results The levels of serum VILIP-1 and Cav-1 in study group were higher than those in healthy group(P＜0.05).The levels of serum VILIP-1 and Cav-1 in case with poor prognosis were higher than those in cases with good prognosis(P＜0.05).The AUC(95％CI)of serum VILIP-1 and Cav-1 to predict the prognosis of patients was 0.848(0.797～0.899)and 0.817(0.766～0.868).The AUC(95％CI)of the combined detection was 0.905(0.854～0.956).The time from injury to admission,admission GCS score,history of diabetes,admission pupillary reaction,preoperative brain midline displacement and postoperative complications in good prognosis group were different from those in poor prognosis group(P＜0.05).Preoperative midline displacement≥5 mm(OR=2.467,95％CI:1.619～3.760),postoperative complications≥ 2(OR=2.321,95％CI:1.544～3.489),VILIP-1≥10.37 ng/ml(OR=3.367,95％CI:2.087～5.432),and Cav-1≥32.28 μg/L(OR=2.770,95％CI:1.786～4.298)were risk factors for prognosis in patients(P＜0.05).Conclusion Serum VILIP-1 and Cav-1 can be used as biological indicators to predict the prognosis of patients with severe brain injury after decompression,and the increase of serum VILIP-1 and Cav-1 levels are risk factors for prognosis.

Objective To compare the safety and efficacy of insulin degludec (IDeg) with those of insulin glargine (IGlar) in insulin-naive subjects with type 2 diabetes (T2DM).Methods This was a 26-week,randomized,open-label,parallel-group,treat-to-target trial in 560 Chinese subjects with T2DM (men/women:274/263,mean age 56 years,mean diabetes duration 7 years) inadequately controlled on oral antidiabetic drugs (OADs).Subjects were randomized 2:1 to once-daily IDeg (373 subjects) or IGlar(187 subjects),both in combination with metformin.The primary endpoint was changes from baseline in glycosylated hemoglobin(HbA1c) after 26 weeks.Results Mean HbA1c decreased from 8.2％ in both groups to 6.9％ in IDeg and 7.0％ in IGlar,respectively.Estimated treatment difference (ETD) of IDegIGlar in change from baseline was-0.10％ points (95％ CI-0.25-0.05).The proportion of subjects achieving HbA1c ＜ 7.0％ was 56.3％ and 49.7％ with IDeg and IGlar,respectively [estimated odds ratio of IDeg/IGlar:1.26 (95 ％ CI 0.88-1.82)].Numerically lower rateof overall confirmed hypoglycaemia and statistically significantly lower nocturnal confirmed hypoglycemia were associated with IDeg compared with IGlar,respectively [estimated rateratio of IDeg/IGlar 0.69 (95％ CI 0.46-1.03),and 0.43 (95％ CI 0.19-0.97)].No differences in other safety parameters were found between the two groups.Conclusions IDeg was non-inferior to IGlar in terms of glycaemic control,and was associated with a statistically significantly lower rate of nocturnal confirmed hypoglycaemia.IDeg is considered to be suitable for initiating insulin therapy in Chinese T2DM patients on OADs requiring intensified treatment.Clinical trail registration Clinicaltrials.gov,NCT01849289.