Objective To study the change and clinical significance of serum sex hormone levels in patients with Alzheimer's disease(AD).Methods The 1:1 case-control study,male AD group in 25 cases,control group in 25 cases,female AD group in 25 cases,25 cases in the control group.The serum sex hormone levels were measured by chemiluminescence immtmoassay in the two groups,and the data were analyzed.Results There was statistically significant difference in estradiol level between female patients and the control group[(40.820 ± 23.249) pmol/L vs.(153.700 ±113.900) pmol/L,t =4.85,P ＜ 0.001].There were statistically significant differences between male patients and the control group,in estradiol[(99.243 ± 34.657) pmol/L vs.(124.t00 ± 38.432) pmool/L],testosterone [(7.904 ±3.944) nmol/L vs.(19.142 ±7.882) nmol/L] levels (t =2.40,6.37,all P ＜0.05).No significant difference was observed in testosterone level in the female groups (P ＞ 0.05).The promoting follicle stimulating hormone and luteinizing hormone,progesterone,prolactin levels between the male group and female group had no statistically significant differences (all P ＞ 0.05).In patients with simple intelligent screening scale (Mini-Mental State Examination,MMSE),the score was significantly correlated with the level of estradiol (r =-0.281,P ＜ 0.05).Conclusion The level of women's estrogen decline is related to factor in the pathogenesis of AD,estradiol,testosterone levels of male decline is related to factor in the pathogenesis of AD.Estradiol level is low,the severity of the disease moreand more heavy.

Objective:To observe the application value of dizocine sedation in brachial plexus nerve block.Methods:From January 2016 to December 2018, 80 patients with brachial plexus block anesthesia in the Second People's Hospital of Tongxiang were selected and divided into two groups according to the random number table method, with 40 cases in each group.The control group was not given sedation intervention, while the observation group was given dizocine sedation.The heart rate, mean arterial pressure, blood oxygen saturation and Ramsay scores at different time points were compared between the two groups.The anesthetic effect of the two groups was analyzed.Results:The onset time of sensory block in the observation group[(8.86±0.92)min] was significantly shorter than that in the control group[(11.43±1.08)min]( t=11.457, P<0.05). The duration of sensory block[(729.95±54.43)min] and the duration of analgesia[(879.96±165.52)min] in the observation group were significantly longer than those in the control group[(600.73±49.86)min, (750.27±261.19)min]( t=11.072, 2.653, all P<0.05). There were no statistically significant differences in the mean arterial pressure, heart rate and blood oxygen saturation at each time point between the two groups before operation (all P>0.05). The mean arterial pressure and heart rate of the observation group were significantly lower than those of the control group at 15 min, 30 min after operation and at the end of operation (all P<0.05). The Ramsay score between the two groups had no statistically significant difference before operation ( P>0.05). At 15 min, 30 min after operation and at the end of surgery, the Ramsay scores of the observation group were (4.08±0.54)points, (4.15±0.37)points, (2.96±0.19)points, respectively, which were significantly higher than those of the control group [(1.79±0.27)points, (1.77±0.16)points, (1.93±0.14)points], the differences were statistically significant ( t=23.989, 37.341, 27.602, all P<0.05). Conclusion:After dizocine sedation is used in brachial plexus block patients, the vital signs fluctuate slightly and the sedation effect is obvious.

Objective To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin,sNGAL) and cardiovascular events in patients with chronic kidney disease(CKD).Methods 300 patients with CKD were divided into two groups according to the level of sNGAL:high sNGAL group (n=158) and low sNGAL group (n=142).The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve,and the correlation between sNGAL and cardiovascular risk factors,cardiovascular events in patients with chronic renal disease was analyzed.Influencing factors of cardiovascular events in CKD patients was analyzed.Results There were significant differences in the data about BMI,diabetes proportion,CKD staging,eGFR,hsCRP,24h proteinuria,HDL,iPTH,phosphate and blood calcium between the two groups (P＜0.05).The 3-year cumulative survival rate of high sNGAL group(77.2％) was significantly lower than that of low sNGAL group(96.5％),and the 3-year incidence of cardiovascular events (37.9％) was significantly higher than that of low sNGAL group (9.8％) (P＜ 0.05).AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR(0.636),age (0.504),serum calcium (0.545),HDL(0.594) and LDL (0.508,all P＜0.05).There was a significant correlation between sNGAL and eGFR,HDL,BMI,hs-CRP,iPTH and phosphate (P＜ 0.05).Both univariate and multivariate fact ors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P＜0.05),((HR=1.976 and 1.588,95％ CI=1.443-2.724 and 1.144-2.143,respectively,P=0.O00 and 0.000)).Conclusions The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased.sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease.