Objective To investigate the effect of compound Lactobacillus acidophilus on the levels of serum SP , VIP, 5-HT, IL-6 and TNF-αin patients with diarrhea-predominant irritable bowel syndrome ( IBS) .Methods 82 cases of patients with diarrhea -predominant irritable bowel syndrome ( IBS) from November 2015 to November 2016 in our hospital were selected,and randomly divided into two groups.30 patients in observation group were treated with compound Lactobacillus acidophilus tablets and 52 patients in control group were treated with trimebutine maleate capsule.The levels of serum SP, VIP, 5-HT, IL-6 and TNF-α,quality of life score,clinical curative effect and adverse reaction were observed and compared before and after treatment.Results After treatment,the diarrhea, abdominal distention, defecation frequency and abnormal rate of stool were significantly lower than those before treatment(P <0.05), the levels of SP,VIP,5-HT,IL-6 and TNF-αin serum were significantly lower than those before treatment(P <0.05),and the treatment group were lower than those of the control group.After treatment, the mental status, emotional control and work status scores of the observation group were higher than those of the control group,and the effective rate of the observation group 86.7%was significantly higher than the control group 61.5%,the differences between the two groups were statistically significant (P <0.05).There was no significant adverse events were observed during the treatment.Conclusion Compound Lactobacillus acidophilus is effective in the treatment of diarrhea-predominant irritable bowel syndrome.It can restore the levels of serum SP, VIP, 5-HT, IL-6 and TNF-αin patients with diarrhea-predominant irritable bowel syndrome and improve the quality of life .

Objective To observe the recent clinical effects and toxicity in advanced gastric carcinoma by neo-adjuvant chemo-therapy FOLFOX and XELOX .Methods A total of 81 patients with Ⅱ ~ Ⅲ level of gastric cancer underwent neo-adjuvant chemo-therapy before curative resection were collected ,and divided into two groups ,as XELOX group(n=26) and FOLFOX group(n=25) .30 patients who just underwent surgical treatment did not received neo-adjuvant chemotherapy were taken into control group(n=30) .The curative resection rate and complications were compared in three groups .Results There were no obvious differences be-tween XELOX group and FOLFOX group in recent clinical effect (P>0 .05) ,but FOLFOX group had higher toxic reaction rate (P<0 .05) .The curative resection rates of XELOX group and FOLFOX group were higher than that of control group (P<0 .05) . The complication rates in three groups showed no significant difference (P>0 .05) .Conclusion Neo-adjuvant chemotherapy could increase the curative resection rate of advanced gastric cancer ,which does not increase the complications ,and the program XELOX had less toxic reaction .

Objective To investigate the relationship between self-efficacy and positive degree in patients with cervical spondylosis.Method A questionnaire survey was conducted among 98 patients with cervical spondylosis.Results The self-efficacy score was 6.30±1.56,the score on the positive degree was 53.76 ±12.53.The self-efficacy and positive degrees were positively correlated (r=0.531,P＜0.001).Conclusions The patient's self-efficacy and positive degree are at medium level.Nursing staff should take corresponding measures to improve self-efficacy of cervical spondylosis patients,in order to improve its positive degree and achieve the purpose of effective self-management and health promotion.

Objective To evaluate the prognosis influencing factors of early non-small cell luny cancer (NSCLC) after radiotherapy.Methods 81 early NSCLC patients received definitive radiotherapy and were eligible.Among these patients,60 were diagnosed as squamous cell carcinoma,16 were adenocarcinoma and 5 were diagnosed through imaging instead of pathology.45 patients received conventional radiotherapy,36 patients received three dimensional conformal radiotherapy (3D-CRT),All of them received a total dose of 50-96 Gy with a median dose of 67.8 Gy. Kaplan-Meier survival curves and Cox regression model analysis were applied to evaluate the survival and prognostic factors. Results The median survival time was 34 months.The 1-,3- and 5-year survival rates (OS) were 88.7 ％,41.9 ％,21.8 ％,respectively.Karnofsky performance status≥80,Clinical stage, diameter≤4 cm and the therapeutic effect were associated with improving overall survival.Cox hazards model showed that Karnofsky performance status≥ 80 and diameter≤4 cm were likely to be independent positive prognostic factors. Conclusion Karnofsky performance status and tumor diamater can be used to evaluate the prognosis of early NSCLC after radiotherapy.

Objective To evaluate the feasibility and clinical effectiveness of arthroscopic femoral osteoplasty for cam-type femoroacetabular impingenent(FAI).Methods From October 2007 to April 2009,31 patients with cam-type FAI underwent hip arthroscopy,including 12 males and 19 females with an average age of 34.1 years(range,18-45).Physical examination,X-ray,3D-CT scans were carried out preoperatively to make the definite diagnosis.All patients were treated with hip arthroscopic debridement and femoral osteoplasty.The patients were followed-up at 1 month,3 months,6 months,1 year,and every year post operation.Outcomes were measured with pain visual analogue scale(VAS),ROM of hip,impingement tests,α angle and modified Harris hip score at final follow-up.Results All patients were followed up for average 22.7 months(range,18-36).At final follow-up,impingement tests among all patients were negative,the range of flexion increased from 101.0°±14.2° to 121.0°±11.7°,the range of internal rotation in a position of 90° flexion increased from 5.0°±9.8° to 30.1°±12.7°,α angle decreased from 74.2°±10.7° preoperatively to 44.7°±8.3°,VAS pain score decreased from 6.1±1.1 preoperatively to 0.9±0.7,modified Harris hip score improved from 41.2±5.7 preoperatively to 73.6±4.1,all differences were statistically significant.Conclusion Arthroscopic femoral osteoplasty for cam-type FAI can win the satisfactory achievements for complete excision of bony prominence at anterior-lateral femoral head-neck junction,restoration of the femoral offset,significant relief of clinical symptoms and improvement of hip range of motion.

Objective To compare the clinical results of anterior cruciate ligament(ACL)reconstruction using anterior tibial muscle tendons allograft and hamstring tendons autograft.Methods According to the graft used for ACL reconstruction,60 patients with chronic ruptures of ACL were divided into group A(30 patients,using anterior tibial muscle tendons allograft)and group B(30 patients,using semitendinosus and gracilis tendons autograft).The average follow-up periods after surgery were 29.4 and 31.6 months respectively.Lysholm,Tegner,IKDC clinical rating scales and KT2000 were used for evaluation pre-and post-operation.The muscle strength of the extension,flexion,internal rotation and external rotation of knees was evaluated by the isokinetic tester.Results There were statistically significant differences in Lysholm,Tegner,IKDC clinical rating scales and KT2000 results between pre-and postoperation(P<0.01).However,there were no statistically significant differences between group A and group B after operation(P>0.05).The Isokinetic muscle strength tester showed that the knee muscle strength of the internal rotation and flexion were decreased post-operative in group B,rather than group A,which showed no significant differences between pre-and post.operation(P<0.05).Conclusion For ACL reconstruction under arthroscopy,anterior tibial muscle tendons allograft was a favorable substitute for autograft materials for its convenience,satisfactory clinical effect and less complications.

BACKGROUNDTo explore the characteristics of exercise cardio-pulmonary function and its possible influencing factors in patients with lung cancer.

METHODSThe pulmonary function, ECG and exercise cardio-pulmonary function were measured in 198 patients with lung cancer and 20 healthy controls.

RESULTS1. Compared with healthy group, VO₂%P, VO₂/kg, AT, VO₂/HR%, VE and VT/VC significantly decreased in lung cancer patients with normal resting pulmonary ventilation, however, BR remarkably increased (P < 0.05 or P < 0.01). 2. In patients with normal resting pulmonary ventilation, there was no significant difference of exercise cardio-pulmonary function between the central and peripheral lung cancer groups. 3. The exercise cardio-pulmonary function was closely related to the TNM stages (P < 0.05 or P < 0.01). 4. W%, VO₂%P , AT and VO₂/HR% in patients with great vessel invasion were remarkably lower than those without great vessel invasion (P < 0.05 or P < 0.01).

CONCLUSIONSThe results suggest that exercise ventilation is impaired in lung cancer patients with normal resting ventilation. And the decrease of exercise cardio-pulmonary function may be related to TNM stage and to great vessel involvement.

BACKGROUNDTo evaluate the clinical significance of predicting post-operative respiratory failure in patients with lung cancer using cardiopulmonary exercise test (CPET).

METHODSBefore operation, 260 patients with lung cancer underwent CPET with incremental protocol. W%, VO₂%P, VO₂/kg, AT, MET, O₂ pulse, VTe, BF and VE were measured in the end of load exercise.

RESULTS(1) In patients after pneumonectomy, the values of the above indexes of CPET in the respiratory failure group were significantly lower than those in the non-respiratory failure group ( P < 0.05 or P < 0.01) except VTe. In patients after lobectomy, the values of 9 indexes of CPET in the respiratory failure group were similar to those in the non-respiratory failure group ( P > 0.05). However, when the patients after lobectomy were further divided into groups of upper and lower lobectomy, W% in the respiratory failure group was remarkably lower than that in the non-respiratory failure group after lower lobectomy ( P < 0.05). (2) Chi-Square test showed that abnormality of CPET indexes in different degrees was related to the morbidity of respiratory failure after pneumonectomy. Logistic regression showed that O₂ pulse < 80% and BF < 30/min correlated with the morbidity of post-operative respiratory failure. (3) For predicting post-operative respiratory failure, the sensitivity and specificity of VO₂%P < 60%, BF < 30/min, VE < 35 L/min were all more than 60% and their negative predictive values were all more than 90%.

CONCLUSIONSCPET is suitable to predict post-pneumonectomy respiratory failure. As a comprehensive index indicating cardiopulmonary function during exercise, VO₂%P < 60% should be selected to predict respiratory failure and evaluate indication of lung resection for patients with lung cancer.

Objective: To analyze the clinical features of inpatients infected with influenza A virus, and then to provide evidence for the diagnosis, treatment and prevention of influenza A in primary hospital. Methods: The clinical data of inpatients with influenza A in one district hospital from Dec 2016 to Mar 2017 were collected to analyze retrospectively. Results: A total of 21 665 patients were admitted to hospital from Dec 2016 to Mar 2017. Among them 647 flu-like cases accepted influenza A nucleic acid detection, and 203 cases were positive, the positive rate was 31.4%. The median age of influenza A positive patients was 64.25 years, and 20.2% were 0 to 4 years, 49.26% were 65 years of age or older. 58.13% patients had at least one underlying medical condition. Fever, Cough and Sputum were the most symptoms of patients infected with influenza A. Compared with the patients under 60 years old, non-fever symptoms were more common in those 60 years or older, the difference was statistically significant (χ²=15.43, P<0.001). Laboratory examination indicated that lymphocytopenia were detected in 54.27% of patients, and increased level of C-reactive protein and procalcitonin (PCT) in 74.83% and 11.76% of patients respectively. Moreover, 75.58% of patients had high erythrocyte sedimentation rate (ESR), 8 patients (97.3%) had findings consistent with pneumonia. 78.33% of patients received anti-viral treatment with oseltamivir, the rate of antibiotic utilization was as high as 85.22%. The median of hospitalization expense of patients infected with influenza A was 4 280 (interquartile range 2 792-9 565) yuan, and the cost of inpatients who had combined underlying diseases were higher than that in inpatients who had no coexisting medical conditions, the difference was statistically significant (Z=7.106, P<0.01). No death occurred in this study. Conclusions Children and old people were at high risk for influenza A infection. Fever, cough and lymphocytopenia were the common clinical features of patients infected with influenza A. It is especially noteworthy for the patients who were 60 years of age or older with flu-like symptoms but without fever, or the patients who had one or more underlying medical conditions, and such patients should receive influenza virus nucleic acid tests as early as possible.

Objective:To investigate the effects and the impact on maternal and infant outcome of Tianma-Gouteng Decoction combined low-dose aspirin for high-risk patients with pre-eclampsia (PE). Methods:A total of 94 high-risk patients who met the diagnose cretieria of PE from January 2017 to January 2019 in our hospital were divided into two groups by the random number table method, each group 47 cases. The control group based on symptomatic treatment, received daily 75 mg of aspirin enteric-coated metformin hydrochloride additionally; and the observation group took Tianma-Gouteng Decoction based on the control group. Both groups stopped taking medicine after 28th week of gestation. Immune turbidimetric method was used to detect D-dimer (D-D), the Claus method was used for detecting fibrinogen (Fib). The blood pressure meter was used to measure systolic blood pressure (SBP) and diastolic blood pressure (DBP). The poor maternal and infant outcomes were recorded. Results:After the treatment, the plasma D-D (0.50 ± 0.12 μg/L vs. 0.60 ± 0.30 μg/L; t=2.122, P=0.037), Fib (2.37 ± 0.22 g/L vs. 4.43 ± 0.56 g/L; t=23.473, P<0.01) in the observation group were significantly lower than the control group. The SBP (83.43 ± 4.01 mmHg vs. 96.30 ± 5.34 mmHg, t=13.212), DBP (113.77 ± 3.90 mmHg vs. 126.52 ± 4.43 mmHg, t=14.810) in the observation group were significantly lower than the control group ( P<0.01). The incidence of fetal and neonatal adverse outcomes in the observation group was 10.6% (5/47), the control group was 25.5% (12/47), and there was statistically significant between two groups ( χ2=3.519, P<0.05). The incidence of adverse outcome in the observation group was 31.9% (15/47), the control group was 55.3% (26/47), and there was statistically significant between two groups ( χ2=4.326, P<0.01). Conclusions:Tianma-Gouteng Decoction combined low-dose aspirin enteric-coated metformin hydrochloride can improve coagulation function, lower blood pressure, improve clinical efficacy, reduce the occurrence of advers outcomes for high-risk patients with PE.