Objective To observe the clinical efficacy of percutaneous minimally invasive plate osteosynthesis(MIPPO) in treatment of senile proximal humeral fractures(SPHF).Methods The clinical data of 41 SPHF patients treated by MIPPO were analyzed retrospectively.The effect of surgery was evaluated by Neer scoring system.Results 41 patients were follow-up for 5 to 19 months (mean 11.6 months).Based on the Neer scoring criteria:the turn of excellent,good,fair or poor were 25 cases,12 cases,3 cases,1 case,the excellent rate was 90.2％.Never happened avascular necrosis of the humeral head,plate and screw fracture,nerve injury,fractures unhealed or delay healing and other negative phenomena.Conclusion The application of MIPPO in treatment of SPHF is easy to operate,little nerve damage,good fixed performance,high reliability,which is worthy of clinical application.

Objective To investigate the women during pregnancy because of various reason caused by the impact of diabetes on perinatal outcome.Methods The delivery 24-28 weeks pregnant or first diagnosed more than 28 weeks after the gynecology clinic diagnosis with diabetes in 125 singleton pregnant women and newborns were selected as the research object of study.Except giving birth to the same period 95 cases of normal of diabetes single fetus of pregnant women and their newborn for the control group.The complications of pregnancy and gestational age,birth and neonatal intrauterine nutrition status,mode of delivery,neonatal asphyxia,hypoglycemia and jaundice,case analysis,comparison.Results The two groups in the average age,average number of pregnancy pregnancy and intrauterine nutrition(group GDM,PI =2.717,control group 2.469) and the rate of neonatal asphyxia were not statistically significant(P ＞ 0.05).GDM group of 71 cases of cesarean section,natural childbirth in 54 cases,31 cases of control group difference and 64 cases,very significant differences between the two groups (x2 =12.678,P ＜ 0.01),group GDM,the incidence of neonatal jaundice neonatal hypoglycemia respectively 18.4%,24%,and 7.4% in the control group,there was significant difference compared with 12.6% (x2 =4.500,5.577,all P ＜0.05).Conclusion Gestational diabetes is the important reason which caused by adverse perinatal outcome.

The side effects of cesarean with the increasing rate section began to attract the attention of pediatricians in recent years. Previous studies reported that the incidence of neonatal pnermothorax by full-term cesarean section, especially selective cesarean section, was significantly higher than vaginal birth or non-selective cesarean section. In addition, with an extensive establishment of NICUs in China and widely use of mechanical ventilation, the rate of successful neonatal rescue was improved obviously, but the incidence of pneumothorax was increasing. Studies suggested that the incidence of neonatal iatrogenic pneumothorax was highly relevant with selective cesarean section and mechanical ventilation. The indications for cesarean section and mechanical ventilation should be carefully considered.

ObjectiveTo investigate the psychological state and care measures for patients undergoing pereutaneous coronary intervention (PCI). Methods300 patients treated with PCI from December 2009 to June 2011 in our hospital were chosen as the research object.The factors arousing psychological disorders for PCI patients were taken for comparison.And then the appropriate nursing measures were discussed. ResultsThe most evident negative emotion of PCI patients was depression.The factors arousing negative emotion included the factors of family members and undesirable environment by many people going in and out. ConclusionsEffective measures can avoid the psychological barriers of PCI patients and improve the quality of postoperative recovery for patients.

Objective To explore the value of the application of hemorheology test in diagnosis and treatment of malignant tumor .Methods A total of 100 patients suffered from malignant tumors selected as study group ,and divided as distant metastasis subgroup and no distant metastasis subgroup ,meanwhile 50 healthy persons were selected into control group .Test results of hemo‐rheology were compared .Results The whole blood viscosity ,erythrocyte aggregation index ,fibrinogen levels in the distant metasta‐sis subgroup were significant higher than those of the no distant metastasis group ,and the hematokrit level was significant lower than that of the no distant metastasis group ,the differences were statistical significant(P< 0 .05) .The parameters of hemorheology in the distant metastasis subgroup were significant different with that of the control group(P< 0 .05) .Except for erythrocyte aggre‐gation index ,other parameters of hemorheology were also significant different with those of the control group(P < 0 .05) .After treatment the whole blood viscosity ,packed cell volume and plasma viscosity had improved significantly comparing with before treatment(P< 0 .05) .Conclusion In the process of diagnosis and treatment of malignant tumors ,test indicators in hemorheology are constantly changing with the progress of the disease ,which has important application value .

Objective To discuss the influence of atorvastatin and rosuvastatin on carotid intima-media thickness(CIMT) of patients after percutaneous coronary intervention (PCI).Methods 142 patients after PCI with CIMT increasing were randomly divided into Lipitor group (n=71) and Crest group (n=71).The Lipitor group was given atorvastatin(20mg) orally once a day.The Crest group was given rosuvastatin(20mg) orally once a day.The changes of low density lipoprotein,high density lipoprotein,liver function and CIMT before and after 12 weeks treat-ment were observed in two groups.Results After treatment for 6 months, the levels of LDL-C, CIMT in Lipitor group were lower than before treatment with statistical difference[(3.37 ±1.20)mmol/L vs (2.0 ±0.29)mmol/L, (1.29 ±0.06)mm vs (0.91 ±0.23)mm](t=4.032,3.523,all P<0.05);the levels of LDL-C,CIMT in Crest group were lower than before treatment with statistical difference[(3.38 ±1.21)mmol/L vs (1.8 ±0.15)mmol/L, (1.30 ±0.16)mm vs (0.81 ±0.15)mm](t=4.700,3.892,all P<0.05).The decreasing degree of LDL-C, CIMT was significantly lower in Crest group than that in Lipitor group with statistical difference( t=3.668,3.002,all P<0.05 ) .The level of HDL -C in Lipitor group was higher than before treatment with statistical difference [(1.01 ±0.36)mmol/L vs (1.10 ±0.31)mmol/L](t=3.801,P<0.05).The level of HDL-C in Crest group was higher than before treatment with statistical difference[(1.03 ±0.32)mmol/L vs (1.15 ±0.35)mmol/L](t =3.722,P<0.05).The decrease degree of HDL-C was significantly higher in Crest group than that in Lipitor group with statistical difference(t=3.568,P<0.05).Conclusion Rosuvastatin has better effect than atorvastatin on the reversal of atherosclerosis process.

Nutritional therapy constitutes the basis for the integrated treatment of diabetes.It is essential for diabetic dietary management to be an individualized and balanced diet pattern based on total calorie control Carbohydrates is the main dietary ingredient to affect postprandial blood glucose levels.Dietary structure,way of eating,and physical exercise all contribute to the control of postprandial blood glucose levels.

Objective To investigate the application value of cataract extraction surgery in the treatment of primary angle-closure glaucoma and cataract.Methods 132 patients of primary angle-closure glaucoma and cata-ract were randomly selected,these patients were divided into lensectomy treatment group(A group,n=66) and laser peripheral iridotomy treatment group(B group,n=66) according to the treatment method.The visual acuity,intraocu-lar pressure,anterior chamber depth,and complications of the two groups were analyzed statistically.Results In A group,the visual acuity <0.1 was in 0 case,0.1-0.3 in 12 cases,>0.3-0.4 in 20 cases,>0.4 in 34 cases, accounting for 0.00%,18.18%,30.30%,51.52%.In B group,the visual acuity <0.1 was in 5 cases,0.1-0.3 in 14 cases,>0.3-0.4 in 19 cases,>0.4 in 28 cases,accounting for 7.58%,21.21%,28.79%,42.42%.A group of visual acuity <0.1 proportion of patients was significantly lower than B group(χ2 =5.02,P<0.05) ,the propor-tion of patients >0.4 was significantly higher than B group(χ2 =7.38,P<0.05),but the differences of the propor-tion for 0.1-0.3,>0.3-0.4 vision between the two groups were not significant(χ2 =2.71,4.61,all P>0.05). The differences of the intraocular pressure and anterior chamber depth before surgery between the two groups were not significant(t=1.532,1.447,all P>0.05),the anterior chamber depth after surgery in group A was significantly lon-ger than B group(t=2.571,P<0.05),but the difference of IOP between the two groups was not significant(t=1.032,P>0.05).A group had corneal edema in 1 case,a transient high IOP in 4 cases,2 cases in hyphema,the postoperative complication rate was 10.61%.B group had corneal edema in 1 case,a transient high IOP in 4 cases, 2 cases in hyphema,the postoperative complication rate was 10.61%,the incidence rate of postoperative complica-tions in A group was significantly lower than B group(χ2 =9.35,P<0.05).Conclusion The application value of cataract extraction surgery in the treatment of primary angle -closure glaucoma and cataract is higher than laser peripheral iridotomy,which can more effectively improve visual acuity, prolong anterior chamber depth, reduce inci-dence of complications of patients,so it is more safe and effective,and worthy of promotion.