Objective To estimate the effect of low molecular weight heparin (LMWH) combined with conventional treatment on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Literature on randomized control trials( RCTs) with AECOPD treated by LMWH combined with conventional methods was collected in PubMed.The studies were selected according to inclusive and exclusive criteria.The data were extracted,the quality was assessed, and meta-analysis was conducted with RevMan 5.2 software.Results There were twelve RCTs including 879 patients with AECOPD in the current study.The results of meta-analysis showed that:①LMWH could obviously improve PaO2 and PaCO2 of patients with AECOPD as compared with the control group.②There was no statistically significant difference between the LMWH-treated group and control group in the improvement of FEV1 or hematocrit.Conclusion LMWH can significantly improve arterial blood gas analysis in AECOPD, but does not improve FEV1 or hematocrit.

Objective To investigate the value of rosuvastatin in alleviating early inflammatory reaction and in preventing early recurrence of persistent atrial fibrillation (AF) after catheter ablation treatment. Methods A total of 84 patients with persistent AF who had received catheter ablation were enrolled in this study. The patients were randomly and equally divided into group A (n = 42, study group) and group B (n = 42, control group). Rosuvastatin therapy (10 mg/d, 42 patients) was employed in the patients of group A, while no medication was used in the patients of group B. One month after the ablation treatment, the serum lipid level, hs-CRP and IL-6, as well as the recurrence rate of all kinds of arrhythmia were determined. The preoperative and postoperative levels of inflammatory markers were also determined, the results were compared between the two groups, and its correlation with the early recurrence of AF was evaluated. Results One month after the ablation treatment, the levels of inflammatory markers, including hs-CRP and IL-6, in the study group were significantly lower than those in the control group, as well as lower than those determined before treatment, while in the control group the serum hs-CRP and IL-6 levels became significantly higher than the preoperative ones. Sinus rhythm was successfully maintained in 29 cases (69%) of the study group and in 25 cases (59.5%) of the control group, while the difference was not statistically significant (P = 0.362). The patients of the study group were further divided into non-recurrence sub-group (n = 29) and recurrence sub-group (n = 13). The reduction in inflammatory marker level in the non-recurrence sub-group was greater than that in the recurrence sub-group although the difference was not statistically significant. Conclusion There is remarkable inflammatory reactions during the early period after catheter ablation. Rosuvastatin can effectively relieve the degree of inflammatory reaction, although it has only a slight effect in reducing the early recurrence rate after catheter ablation of AF. The greater the inflammatory markers levels are reduced, the lower the recurrence rate of AF will be, although the difference is not statistically significant.

Objective To investigate the effect of treadmill running pretreatment on the expression of CyclinA and CyclinE protein in hippocampus of rats after global cerebral ischemia and reperfusion.Meth-ods 60 healthy male wister rats were randomly divided into control group, model group and experiment group.Global cerebral ischemia reperfusion model was generated by improved four-vessel occlusion as de-scribed according to the description of Pulsinelli's method.Rats in the experiment group were performed treadmill running for 2 weeks before injury.The water maze test was performed at 24 h and 48 h respectively after injury to determine the spatial memory ability of rats.Morphological changes of hippocampus were ob-served by HE staining ( hematoxylin-eosin staining) at 3 h,6 h,24 h,48 h after injury and the expression of CyclinA and CyclinE were detected by immunohistochemical staining.Results Compared with control group,the survival rate of neurons in the model group was significantly decreased at each time point.Morris water maze test showed that the escaping latency of rats in the model group was significantly prolonged( 24 h (24.35±3.99)s,48 h(33.08±5.85)s),and the frequency of crossing the platform was decreased(24 h(6.80 ±0.79),48 h(4.00±0.67)).The expression of CyclinA was increased significantly in the model group ((8.40±0.52)/high view,(11.70±1.06)/high view,(15.50±0.53)/high view,(22.40±0.52)/high view) as well as the expression of CyclinE((20.30±0.48)/high view,(15.20±0.63)/high view,(10.00± 0.82)/high view,(7.70±0.68)/high view) (P<0.05).Compared with model group,the survival rate of neurons in the model group was significantly increased at each time point.Morris water maze test showed that the escaping latency of rats in the experiment group was significantly shorten(24 h(13.21±2.73) s,48 h (24.20±4.66)s),and the frequency of crossing the platform was increased(24 h(9.70±0.95),48 h(6.30± 1.16)).The expression of CyclinA was significantly increased in the model group((10.60±0.84)/high view),(16.70± 0.68)/high view),(24.50±0.53)/high view),(36.20±1.40)/high view) as well as the expression of CyclinE((31.60 ±0.70)/high view),(24.50±0.70)/high view),(16.80±0.63)/high view),(9.10±0.74)/high view) (P<0.05).Con-clusion The treadmill running pretreatment improves the function of spatial memory after global cerebral ischemia and reperfusion,potenlially mediated by regulating the expression for cell cycle proteins,which have a protective effect on cerebral brain tissue.

Objective To analyze the investigation data of the national schistosomiasis surveillance sites in 2015,so as to provide scientific evidences for schistosomiasis control,elimination and surveillance. Methods According to National Schisto-somiasis Surveillance Programme(version 2014),457 surveillance sites were selected,and the investigation data in residents, floating population,domestic animals and Oncomelania hupensis snails were collected and analyzed from four types of endemic counties. Results A total of 4468 seropositive cases were detected from 133350 residents,among which 4457 residents with seropositive results received the etiological tests,and 71 of them were identified with positive results. Most of them were fisher-men and farmers in the middle and old-aged group. The schistosomiasis infection rate was 0.05% in local population. Totally 977 seropositive cases were examined from 85047 migrant individuals,and 16 positive cases were found out from 966 individuals who took etiological tests,which showed the schistosomiasis infection rate was 0.02% in floating population. Imported cases were found among floating people in four provinces,namely Zhejiang,Hunan,Hubei and Anhui provinces. No acute schistoso-miasis cases were reported. A total of 13406 head of cattle received examinations and only 5 were determined as stool positives. The cattle infection rate was 0.04%. The snail survey covered an area of 22295.13 hm2 and snails were found in an area of 7426.63 hm2,including 3.47 hm2 newly detected area with snails. No schistosome-infected snails were found. Conclusions Based on the collected data from 457 national schistosomiasis surveillance sites of China,the Schistosoma japonicum infection rate is 0.05% in local population which maintains a stably descending trend. In floating population,there are imported schistosome-in-fected persons. Cattle are still a vulnerable species infected with schistosome. Although no infected snails are found,snails are widely distributed in endemic areas. Some provinces detect areas with snails for the first time or the reproduction of snails. The staff in endemic provinces should carry out the surveillance work according to National Schistosomiasis Surveillance Programme (version2014)to improve the surveillance system,and enhance the sensibility and effectiveness of surveillance work.

BACKGROUND:During ordinary plate fixation, the soft tissues around the fracture of the proximal humerus are nearly stripped to impact blood supply, and moreover, an ordinary steel plate cannot meet with the fixed requirements for severe osteoporosis, large bone defects and comminuted fractures. OBJECTIVE: To observe the functional recovery and complications in middle-aged patients with proximal humeral fractures undergoing stainless steel locking plate implantation. METHODS:From March 2011 to March 2014, 48 patients with proximal humeral fractures were treated in the 306th RESULTS AND CONCLUSION: The 48 patients were folowed up for 6-17 years, and the mean healing time was (15.3±1.2) weeks. At the last folow-up, the Neer scores were excelent in 12 cases, good in 22 cases, fair in 11 cases and poor in 3 cases, with an excelent-good rate of 71%. After internal fixation, there was one case of Hospital of PLA, including 20 males and 28 females, with an average age of 58 years. Of the 48 cases, there were 9 cases of Neer 2 fractures, 26 cases of Neer 3 fractures, and 13 cases of Neer 4 cases, al of which belonged to closed injuries. Al the patients were subject to locking plate implantation for repair of fractures of the proximal humerus, and evaluated based on Neer scores. soft tissue infection, two cases of traumatic arthritis, and no bone ununion and osteomyelitis. These findings suggest that the stainless steel locking plate implantation for repair of fractures of the proximal humerus can achieve a good anatomic reduction under minimaly invasive conditions and produce a stable rehabilitation environment for the soft tissue around the shoulder joint by internal fixation. Hence, the factures can recover faster with less complications. The stainless steel locking plate implantation can obtain good achievements in the repair of proximal humeral fractures of Neer 2, 3 as wel as Neer 4 in young patients with good bone quality.

ObjectiveTo explore the effect of the calcium phosphate cement (CPC) /calcium polyphosphate fiber (CPPF) composites mixed with different proportion of minimal morselized bone on repair of bone defect in vivo. MethodsA total of 36 New Zealand white rabbits were completely randomly designed into A, B, C, D groups and their bilateral radial bone defect model was prepared. The minimal morselized bone (300-500 μm in diameter) was made from the iliac of those rats. The CPPF and CPC were evenly mixed into CPC/CPPF composites which were divided into four groups in accordance with the CPPF weight O, 10％, 30％ and 50％ in CPC/CPPF composite. The CPC/CPPF composites of the four groups was mixed with the minimal morselized bone with ratio of 6:4 and then the mixture was implanted the bone defect of the rabbits in four groups. The gross, X-ray and histological observations were done at four and eight weeks. The biomechanical test was performed at eight weeks. Results When CPPF occupies 30％ of the CPC/CPPF composite, the maximum compressive load and bending loads were better than those in the other groups ( P ＜ 0.05 ), when the histological observation showed the most tight link between the artificial composite and the bone interface and the closest similarity between material degradation rate and the ossification rate, with the best osteogenesis and the optimal ratio.ConclusionThe repair of bone defect can attain the optimal outcome through adding a certain ratio of minimal morselized bone into the CPC/CPPF to adjust the degradation rate of composites.

Objective To investigate the risk factors for early rebleeding after esophageal variceal ligation (EVL) through a multicenter retrospective study.Methods A total of 3289 patients who were hospitalized and underwent EVL in 17 upper second-class hospitals or hospitals of higher classes from January 1999 to May 2015were collected and screened according to the exclusion criteria.A total of 2531 patients were screened out,and a retrospective analysis was performed for their clinical data including age,sex,endoscopic findings,and results of laboratory examination (liver function,biochemical results,routine blood test,and coagulation function) to collect related data.According to the presence or absence of rebleeding within 1 month after EVL,the patients were divided into rebleeding group and non-rebleeding group.SPSS22.0 software was used for independent t-test and one-way analysis of variance,and P ＜ 0.05 was considered statistically significant.Results In the 2531patients who underwent EVL,the rate of early rebleeding after EVL was 6.6％,and the mortality rate was 12.0％.The results showed that sex (P =0.014),number of veins with varices (P =0.203),prothrombin time (P =0.001),prothrombin activity (P=0.014),albumin (P =0),total bilirubin (P =0.011),aspartate aminotransferase (P =0.004),white blood cell count (P =0.342),hepatic encephalopathy (P =0.021),ascites (P =0.027),Child-Pugh class (P =0),Child-Pugh score (P =0),glue injection for gastric varices (P =0.521),gastric varices (P =0.32),shunt (P =0.174),number ofligation points (P =0.001),number of ligation times (P =0.024),number of times of hematemesis before treatment (P =0),number of times of tarry stool (P =0.008),and volume of blood in hematemesis before treatment (P =0) were risk factors for early rebleeding after EVL.The regression analysis showed that male sex,a Child-Pugh score of ＞7.2,and volume of blood in hematemesis before treatment were independent risk factors for early rebleeding after EVL,while an albumin concentration of ＞ 31.5 g/L was the protective factor.Conclusion EVL has a good therapeutic effect in esophageal variceal rebleeding.Among all the factors analyzed,male sex,a Child-Pugh score of ＞ 7.2,and volume of blood in hematemesis before treatment are independent risk factors for earlyrebleeding after EVL,and an albumin concentration of＞ 31.5 g/L is a protective factor.

To study the clinical and pathological characteristics and prognostic factors of primary breast diffuse large B-cell lymphoma (PBDLBCL). Methods: Clinical and pathological data of 62 patients with PBDLBCL from January 2006 to December 2016 were retrospectively analyzed. The Kaplan-Meier method was used for univariate analysis and the Cox regression model for multivari-ate analysis. Results: The 62 patients analyzed included women aged 26-71 years, with a median age of 47 years. Patients were fol-lowed up from 6 to 105 months; the 3-year overall survival (OS) rate was 71.0%, and 5-year OS rate was 51.0%. The univariate analysis showed statistically significant differences in the clinical stage, lactic acid dehydrogenase level, International Prognostic Index score, Myc/Bcl-2 protein expression, and chemotherapy regimen at 3 and 5 years associated with OS rates. The multivariate analysis showed that Myc/Bcl-2 protein expression was an independent prognostic factor of OS. Conclusions: Comprehensive treatment with chemo-therapy and radiotherapy is appropriate for PBDLBCL. Myc/Bcl-2 protein expression is an independent adverse prognostic factor for PB-DLBCL.

Aortic stenosis(AS)is a structural change in aortic valve caused by congenital or acquired factors,and its incidence increases with age.Transcatheter aortic valve replacement(TAVR)is a safe and feasible minimally invasive treatment for severe AS.Since it was first approved by FDA in 2011 for severe AS which cannot be treated surgically,its indications have been extended to AS patients with low to moderate surgical risk.The placed prosthetic valves could compress the atrioventricular conduction system at the aortic root,leading to the development of postoperative cardiac conduction abnormalities,for which permanent pacemaker implantation(PPMI)is a treatment option.And post-TAVR PPMI is closely related to the prognosis of AS patients.Therefore,this article reviews predictors of conduction dysfunction and PPMI after TAVR.

Objective? To summarize the experience on data collection during community nursing research. Methods? We analyzed the characteristics and difficulties of data collection in community by combining working experience of data collection during clinical nursing research in community medical institutions and in community nursing research. Results? From the perspective of postgraduates, we shared information, such as the prerequisite of effective data collection, characteristics and difficulties of community data collection, methods of data collection (time, place of data collection, selection and appointment of subject investigated, influencing factors of evaluation results, considerations of data collection). Conclusions? Effectiveness and reliability of data collection is critical. In community nursing research, thinking and summarizing experience and skills actively about data collection can promote the smooth development of community nursing research.