Objective:To study the sleep conditions, the prevalence of insomnia and the treatment problems in Jinuo People.Methods: 126 Jinuo People were investigated with “questionnaire of sleep conditions" which was designed for this study. Results: Sleep duration of Jinuo people decrease as they get old. The rate of siesta in people under 30-year-old was significantly higher than that of over 30-year-old. Among 126 Jinuo people,43 suffered from insomnia (34.12%). Psychiatric diseases(41.86%)and alcohol dependence(30.23%) were the two most common causes of insomnia. Among the patients with insomnia, 11(25.58%) sought for treatment. Conclusion: Compared with the general population, the prevalence of insomnia in Jinuo people was relatively higher. In view of the sampling bias and small sample, this results need to be validated by further study.

Objective To evaluate the therapeutic effect of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation for the treatment of lower thoracic disc herniation.Methods From June 2000 to June 2010,36 cases of lower thoracic disc herniation were treated with method of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation,including 23 males and 13 females,with an average of 42 years old(range,22-61 years old).The courses of disease were from 21 days to 69 months,with an average of 22 months.The lesion locations were T10-11 for 12 cases,T11-12 for 15 cases and T12L1 for 9 cases.Each of the patients underwent X-ray and MR examination,31 of them underwent CT scanning.Twenty-five cases were central protrusion type,7 cases were para-central protrusion type,4 cases were lateral protrusionstype.The clinical results were evaluated by Otanni scored system.Results The operative time was 135-220 min,with average of 155 min.The blood loss was 350-800 ml,with average of 460 ml.All patients were successfully operated without neurological symptoms aggravation and accidents.Cerebrospinal fluid leakage occurred in 12 cases,which was treated by continuous suture or dura patch repair.Two cases with giant disc herniation suffered from muscle strength decrease of lower limbs after surgery,which gradually recovered after drug treatment of hormones,dehydration,high-pressure oxygen and nerve nutrients.Postoperative X-ray examinations showed that there were no internal fixation loosening.The followed-up period was 14 days to 48 months,mean 4 months.According to Otani scored system,there were excellent results in 12 cases,good results in 18 cases and poor results in 1 case.The clinical satisfaction rate was 83.3%.Conclusion Posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation is a safe and effective surgical procedure for the treatment of lower thoracic disc herniation.

Objective To investigate the efficacy of surgical treatment for hepatolithiasis in patients of advanced age.Methods The clinical data of 196 patients of advanced age (≥80 years) and with hepatolithiasis who were admitted to the Kailuan General Hospital from January 2009 to October 2012 were retrospectively analyzed.All the 196 patients received surgical treatment.Patients were followed up via phone call or out-patient examination till May 2013.Results Fifty-eight patients received emergent operation within 24 hours after admission,and the other 138 patients received operation 7.4 days (range,1.0-18.0 days) after admission.Fifty patients received laparoscopic surgery,including 43 received cholecystectomy + choledocholithotomy + T tube drainage,7 received choledocholithotomy + T tube drainage.One hundred and forty-six patients received open surgery,including 78 received cholecystectomy + choledocholithotomy + T tube drainage,43 received choledocholithotomy + T tube drainage and 25 received choledocholithotomy + T tube drainage + partial hepatectomy.The operation time was (78 ± 16)minutes,and the volume of intraoperative bleeding ranged between 15 mL and 300 mL.One hundred and ninety-four patients were cured and 2 patients died.Thirty-seven patients had complications after operation,with the morbidity of 18.88％ (37/196).A total of 163 patients were followed up,with the follow-up rate of 83.16％ (163/196).The median time of follow-up was 26 months (range,7-52 months).Twelve patients had hepatolithiasis recurrence,and the recurrence rate was 7.36％ (12/163).Conclusion Surgical treatment for hepatolithiasis in patients of advanced age has the advantages of high cure rate,low incidence of complications and recurrence,and the clinical efficacy is satisfactory.

Objective To discuss the role of assistance of intraoperative uitrasonography in ret-roperitoneal laparoscopic nephron-sparing surgery for renal tumors. Methods The intraoperative laparoscopic ultrasonography was applied in retroperitoneal nephron-sparing surgery for 20 patients, of whom 11 were men and 9 were women. The average age was 53(range 33 to 73) years. There were 12 patients with renal cell carcinoma and the mean tumor size was 2.9(range 1.4 to 4.6)cm in diame-ter. All of them were staged as T1 N0 M0. Seven patients had angiomyolipoma and the mean tumor size was 4.5(range 1.8 to 8.0)cm in diameter and 1 patient had a 3.1 cm oncocytoma in diameter. The ul-trasonography was used to locate the tumor, observe the bloodstream and detect whether there were small satellite tumors. The surgical time, time of renal artery occlusion and operative effect were ob-served. Results Laparoscopic surgery was successful in all cases without conversion to open surger-y. Mean operative time was 115 (range 85 to 270) min, mean time of renal artery occlusion was 28 (range 22 to 50) min. During the mean followup of 16(range 4 to 30) months, no patients with renal cell carcinoma had local or port site recurrence or metastatic disease. Conclusion In retroperitoneal laparoscopic nephron-sparing surgery, the intraoperative uhrasonography is helpful to locate the tumor in the surgery, to estimate whether the renal artery is occluded completely and to excise the tumor pre-cisely.

Objective To explore a new technique to treat the benign stricture at hilar bile duct of plastic anastomosis, so as to obtain the theoretical basis and the feasibilities of practical application in treating the benign stricture at hilar bile duct with plastic anastomosis through the animal experiments. Methods 30 miniature pigs were randomly divided into three groups. Group A (control group):2 centimeters of the bile duct above the duodenum was isolated;Group B:The same separation of bile duct with group A, then making physical injury on it with the clamps and electric heat;Group C:Making bile duct injury model in group C as group B,and then monitoring of the diet, feces, urine, ALT, AST and bilirubin etc. When the bile duct stricture was formed, taking the plastic anastomosis operation in this group. After all the operations, we observed the diet, mental state and the color of the urine of animals in all the three groups, and tested ALT,AST,T-BIL and D-BIL levels on the pre- and post-day and every 7 days after surgery respectively. After three months of the surgery,we executed all the pigs,picked up part of the liver tissue,then preserved them by liquid nitrogen for pathological examination. Results From the day before operative-day to the 30 days after operation, there was no significant change in ALT, AST, T-BIL and D-BIL in group A,while the relative indicators of group B and C had obvious changes ( <0.05) . The indicators of group B were significantly increased 21 days after surgery, compared with pre-operation and 14 days after operation respectively ( <0.05) . In group C, the indicators were significantly declined 14 to 21 days after the plastic anastomosis compared with pre-operation (<0.05) . Conclusions Treating benign stricture at hilar bile duct of miniature pigs by plastic anastomosis is feasible and practicable. This study provides an experimental basis for clinical application of plastic anastomosis in treatment of benign stricture at hilar bile duct.

Objective To explore the clinical results and complications of the traditional skeletal traction through olecranon on treating the irreducible humeral supracondylar fracture in children with of ulna.Methods Ninety-eight children patients of humeral supracondylar fracture with failure of reduction manipulation were selected as our subjects.The towel clamp-skeletal traction through olecranon of ulna was applied as the additional treatment methods.Meanwhile 5-24 months' follow-up were performed.Results According to Flynn elbow joint function evaluation standard.The curative effect was as followed.71 patients (74.7％) got the excellent outcome,17 patients (17.9％) for good outcome and 7 patients for improved utcome(7.3％).Therefore,the ratio of excellent operation reached to 92.6％.Conclusion The towel clampskeletal traction through olecranon of ulna might be an effective method to treat reliable fixation regarding of its high curing rate and simple process of performance.

Objective To investigate the relationship between the catechol-O-methyl transferase (COMT) gene polymorphism and the clinical efficacy and cognitive function of risperidone in the treatment of schizophrenia.Methods 105 cases of Han Chinese patients with schizophrenia who were treated with risperidone for 12 weeks and healthy controls of 168 cases were collected.The effect of the drug therapy with the PANSS,digit vigilance test,Raven Standard Progressive Matrices,forward and backward subtests of the digit span test were evaluated,and then the rs 165599,rs4680,rs6267,rs737865 loci in COMT gene were detected.Results (1)rs737865 was not the polymorphic locus in this sample.(2) There was statistically significant between schizophrenia patients and controls in the distribution of allele frequency and genotype frequency in rs4680 (x2=8.16,P=0.02).Haplotype GA in rs165599-rs4680 was statistically significant in schizophrenia patients and controls (x2 =4.35,P =0.04).(3) After treatment,the total score ((47.64±5.75) points),subscale scores (positive symptoms (11.66±2.90) points,negative symptoms (13.79±3.18)points,general psychotic symptoms (22.09±3.59) points) and scores of five factors model in PANSS decreased and the difference was significant (P＜0.05);the scores of digital cancellation test increased significantly compared with those before treatment(t value respectively were 12.34,10.17,4.34,all P＜0.05);the scores of forward and backward subtests of the digit span test were significantly increased compared with those before treatment (t=-5.57,P=0.00) and Raven standard reasoning test scores had increased significant (t=-19.05,P=0.00).(4) The difference of instantaneous memory score changes among rs 165599 genotypes was statistically significant after treatment (F=4.06,P=0.02).(5) The difference of negative syndromes of PANSS among rs 165599 genotypes was statistically significant after treatment (F=3.11,P=0.049).(6) The difference of negative symptoms (F=4.64,P=0.01),cognitive impairment (F=3.21,P =0.045) and instantaneous memory (F=4.86,P=0.03) among rs 6267 genotype were statistically significant after treatment.Condusion Risperidone can effectively improve the psychotic symptoms of schizophrenia patients,and promote the recovery of cognitive function.Rs165599-rs4680 haplotype GA might be risk factor for the onset of schizophrenia.

Objective e the effect of community standardized management in control of glycosylated hemoglobin and complications in patients with type 2 diabetes.Methods Totally 128 patients with type 2 diabetes were randomly divided into control group and study group,64 cases in each group.Both groups were treated with routine medication guidance,and on this basis,the community standardized management was carried out in study group.The glycemic indexes [glycosylated hemoglobin (HbA1c),fasting blood glucose (FPG),postprandial 2 h blood sugar (2 hPG)] and awareness of knowledge about disease before and after intervention were compared,and the incidence of chronic complications and compliance behaviors were compared as well.Results The HbA1c,FPG and 2 hPG levels after intervention in the study group were significantly lower than the control group,macrovascular and microvascular complications were significantly lower than the control group (P ＜ 0.05).In the study group,the ratios of self monitoring of blood glucose,taking medication,reasonable diet,regular visits,weight control,adhere to the rule of medication were significantly higher than the control group (P ＜ 0.05).Awareness score of disease knowledge in the study group was significantly higher than the control group (P ＜ 0.05).Conclusion Implementation of immunity standardized management for patients with type 2 diabetes can reduce blood sugar level,reduce the incidence rate of complications,improve patients'ompliance behavior and improve their mastery of disease and self-management behavior.

Objective To study effect of community seamless chain service management on blood pressure indicators and complications in middle-aged and elderly patients with chronic hypertension.Methods A total of 226 middle-aged and elderly patients with chronic hypertension enrolled in this community service center were divided into control group and study group according to the random number table method,with 113 cases in each group.The control group was treated with conventional hypertension management,and the study group was given community-based seamless chain service management intervention model on the basis of control group.The changes of blood pressure level,quality of life and the incidence of complications were compared between the two groups before and after management.Results After 6 months of management,the diastolic blood pressure and systolic blood pressure of the two groups were lower than management before,and study group was much lower (P ＜ 0.05).The quality of life of the two groups was better than management before,and the study group was better than the control group (P ＜ 0.05).The overall incidence of complications in the study group was significantly lower than that in the control group (7.1％ vs.16.8％,P ＜0.05).Conclusion Community seamless chain service management model in middle-aged patients with chronic hypertension has significant effect,and it can effectively control the patient's blood pressure level stability,reduce the incidence of complications,improve the quality of life of patients,so it is worth promoting.

Objective e the effect of community standardized management in control of glycosylated hemoglobin and complications in patients with type 2 diabetes.Methods Totally 128 patients with type 2 diabetes were randomly divided into control group and study group,64 cases in each group.Both groups were treated with routine medication guidance,and on this basis,the community standardized management was carried out in study group.The glycemic indexes [glycosylated hemoglobin (HbA1c),fasting blood glucose (FPG),postprandial 2 h blood sugar (2 hPG)] and awareness of knowledge about disease before and after intervention were compared,and the incidence of chronic complications and compliance behaviors were compared as well.Results The HbA1c,FPG and 2 hPG levels after intervention in the study group were significantly lower than the control group,macrovascular and microvascular complications were significantly lower than the control group (P ＜ 0.05).In the study group,the ratios of self monitoring of blood glucose,taking medication,reasonable diet,regular visits,weight control,adhere to the rule of medication were significantly higher than the control group (P ＜ 0.05).Awareness score of disease knowledge in the study group was significantly higher than the control group (P ＜ 0.05).Conclusion Implementation of immunity standardized management for patients with type 2 diabetes can reduce blood sugar level,reduce the incidence rate of complications,improve patients'ompliance behavior and improve their mastery of disease and self-management behavior.