Objective To investigate the relationship of serum IL-6 levels with cognitive dysfunction among patients with obstructive sleep apnoea syndrome (OSAS).Methods Patients diagnosed with OSAS by polysomnography (PSG) received assessment of cognitive function with Montreal Congnitive Assessment (MoCA).According to the result of MoCA assessment,patients were divided into two groups,without cognitive dysfunction group (n =47) and with cognitive dysfunction group (n =55);30 health volunteers were used as control.Serum IL-6 levels were detected by enzyme-linked immunosorbent assay (ELISA) in three groups;according to the apnea hypopnea index (AHI),OSAS patients with cognitive dysfunction were divided into three groups,light group (n =15),moderate group (n =16),and severe group (n =24),and differences in MoCA scores and serum IL-6 levels were analyzed among three groups.The correlation of serum IL-6 levels and MoCA scores were analyzed in OSAS patients with cognitive dysfunction.Results Serum levels of IL-6 in OSAS patients with cognitive dysfunction [(197.3 ± 72.58) pg/ ml] were significantly increased than those without cognitive dysfunction [(155 ± 39.3)pg/ml] as well as health control [(87.39 ±33.44)pg/ml] (P ＜0.01).For OSAS patients with cognitive dysfunction,MoCA scores were decreased and the level of serum IL-6 was increased among patients with poor AHI grade,with statistically significant difference.Pearson correlation analysis showed serum IL-6 levels were significantly negatively correlated with MoCA scores among OSAS patients with cognitive dysfunction (r =-0.65,P ＜ 0.01).Conclusions Serum levels of IL-6 in OSAS patients with cognitive dysfunction were significandy increased and correlated with the cognitive dysfunction.OSAS patients with cognitive dysfunction experiencing sever AHI grade have more serious cognitive dysfunction and the higher serum levels of IL-6.

Objective To compare the safety and clinical outcome between minimally invasive internal fixation and open reduction in treatment of calcaneus fracture based on Meta analysis.Methods A computer-based online search of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese biomedical literature database,PubMed,Ovid database and all was performed for clinical trials regarding minimally invasive internal fixation and open reduction in treatment of calcaneus fracture.Meta analysis was used to analyze the postoperative local soft tissue,calcaneal last follow-up Bohler angle and Gissane angle.Results A total of 17 studies were included(used Jadad quality grading,one is 7 points,two is 4 points,four is 3 points,ten is 2 points),involving 1138 patients,including 569 patients used minimally invasive internal fixation and 569 used open reduction.Meta analysis showed that the incidence of postoperative local soft tissue poor healing used minimally invasive internal fixation is lower than used open reduction about,the difference was statistically significant [OR =0.26,95％ CI:(0.14,0.47),P ＜ 0.01].Meta analysis showed that the calcaneal last follow-up Bohler angle of minimally invasive internal fixation was lower than open reduction,the difference was statistically significant [WMD =-1.29,95％ CI:(-2.39,-0.19),P =0.02].There were no statistically significant differences in the calcaneal last follow-up Bohler angle between minimally invasive internal fixation and open reduction[WMD =1.01,95％CI:(-3.02,5.04),P =0.62].Conclusions Regardless of the calcaneal fracture type,minimally invasive internal fixation or open reduction,the postoperative Bohler angle and Gissane angle at the calcaneus mechanical recovery characteristics are the same.However,the postoperative soft tissue healing of minimally invasivc internal fixation is less better than open reduction.

Objective To compare the safety and the clinical outcomes between proximal femoral nail antirotation (PFNA) and InterTan nail in treatment of femoral intertrochanteric fracture using a Meta analysis.Methods A computer-based online search was performed of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese Biomedical Literature Database,PubMed,Ovid database for clinical trials regarding PFNA and InterTan nail in the treatment of femoral intertrochanteric fractures.A Meta analysis was done to compare operation time,intraoperative bleeding,time for fracture healing,postoperative Harris hip score,and postoperative complications between the 2 groups using statistical software RevMan 4.2.Results A total of 7 studies were included (one of 7 points and 6 of 2 points by Jadad quality grading),involving 491 patients (all one-sided).PFNA was used in 266 patients and InterTan nail in 225.The operation time in the PFNA group was significantly shorter than in the InterTan nail group [WMD=-15.58,95％ CI (-21.60,-9.56),P ＜0.001].The Harris hip score at the last follow-up was significantly lower in the PFNA group than in the InterTan nail group[WMD =-2.33,95％ CI (-4.14,-0.53),P =0.01].There were no statistically significant differences between the 2 groups in bleeding volume [WMD =-33.89,95％ CI (-71.88,4.11),P =0.08],bone healing time [WMD =1.60,95％ CI (-2.32,5.52),P =0.42],or postoperative complications [OR =1.90,95％ CI (0.98,3.69),P =0.06].Conclusions Although InterTan nail may lead to longer operation time than PFNA,the risk of surgery may not be much increased and the former has an advantage of better hip functional recovery than the latter.

Objective To evaluate the effect of tourniquet on incisional infection based on animal model,and evaluate the effect of ischemia preconditioning on incisional infection,so as to provide experimental basis for the ra-tional use of tourniquet in clinic.Methods 100 BALB/c mice were randomly divided into 4 groups,with 25 mice in each group.Group A:tourniquet+methicillin-resistant Staphylococcus aureus (MRSA)incisional infection;group B:ischemic preconditioning+ MRSA incisional infection ;group C :MRSA incisional infection;group D:blank control.The survival rates,temperature,routine blood testing,and change in soft tissue beside femoral incision were compared among 4 groups.Results During observation period ,the survival rate in group A was 68%,in group B,C,and D were all 100%,group A was lower than group B,C,and D (P <0.05).The temperature at each time point was significantly different among group A,B,and C (P <0.01 );temperature curves of 4 groups were significantly different (P <0.01 );except basal body temperature,temperature at the other time points among 4 groups were significantly different(all P <0.01);routine blood testing results (white blood cell count,total granu-locyte count,and total lymphocyte count)among 4 groups on the third,and seventh day were significantly different (all P <0.05);on the seventh day,routine blood testing results of 4 groups all returned to normal level,but group A was slightly higher than group B,C,and D.Section of epithelial tissue revealed that epithelial tissue in group A was not healed,inflammatory response of peripheral tissue was most serious;epithelial tissue in 10 mice in group B was healed,partial peripheral tissue revealed inflammatory response;epithelial tissue in 4 mice in group C was healed,most peripheral tissue revealed inflammatory response.Conclusion Mice incisional infection will be aggrava-ted by using lower limb tourniquet,incision healing and body function recovery time will be delayed,even lead to death.Ischemic preconditioning before making an incision model can reduce the severity of incisional infection,and shorten wound healing time.

BACKGROUND:In osteoarthritis cartilage degeneration, connective tissue growth factors as the important effector molecules play an important role in chondrocyte proliferation and differentiation. Clinical application of diacerein for the treatment of osteoarthritis has achieved good effect, but the exact mechanism of the treatment is unclear. OBJECTIVE:To observe the effect of different concentrations of diacerein on the expression of connective tissue growth factor in the articular cartilage induced with interleukin-1βin vitro. METHODS: Chondrocytes of Sprague Dawley rats were culturedin vitro, and then the chondrocytes were induced with recombinant human interleukin-1β to prepare the osteoarthritis model. Rats in the normal control group received no treatment; rats in the model group were treated with recombinant human interleukin-1β; rats in the experimental group were treated with different concentrations of diacerein+10 μg/L recombinant human interleukin-1β. The proliferation of chondrocytes was observed withMTT assay, and Western blot was used to detect the expression of connective tissue growth factor. The experiments above were repeated for three times. RESULTS AND CONCLUSION:The MTT assay results showed that compared with the normal control group, the diacerein could promote the proliferation activity of chondrocytes, and more significant in the concentration of 10-5 mol/L (P < 0.01); the proliferation capacity of chondrocytes in the experimental group was decreased after induced with interleukin-1β (P < 0.05), but when compared with the normal control group, the diacerein with the concentrations of 10-4 mol/L and 10-5 mol/L could promote the MTT proliferation capacity of chondrocytes with or without interleukin-1β (P < 0.05). Western blot results showed that interleukin-1β could reduce the expression of connective tissue growth factor (P< 0.01), and 10-5 mol/L diacerein could significantly promote the expression of connective tissue growth factor induced with interleukin-1β, and the effect was significantly higher than that in the model group (P < 0.01). Diacerein can promote expression of connective tissue growth factor induced with interleukin-1β, it may be one the mechanism of diacerein for promoting chondrocytes differentiation and proliferation and the treatment of osteoarthritis.

Objective To study the histocompatibility of tissue engineered skin with the observation of the effects of selectins E and P on the immunological rejection after skin allograft in rats. Methods Tissue engineered skin was prepared as follows: The materials obtained from the neonatal SD rats were cultured and then grafted onto the adult Wistar rats. The expression of selectins E and P in the grafted skin was determined with immunohistochemical staining. Results The expression of selectins E and P was significantly higher in the rats with allograft than in the rats with the grafts of tissue-engineered material. Conclusion Selectins E and P play an important role in the immunological rejection after allograft of skin but the tissue-engineered skin graft possesses favorable histocompatibility and shows no obvious immunological rejection.

Objective To isolate and determine the structures of chemical constituents from the roots and rootstalks of Rheum emodi.Methods The chemical constituents were isolated and purified by silica gel and polyamide column chromatography.Chemical methods and spectroscopic methods,such as 1H-NMR,13C-NMR,and MS spectra were used for the structure identification.Results Eighteen compounds were obtained.Sixteen of them were identified as:chrysophanol(1),physcion(2),?-sitosterol(3),emodin(4),aloe-emodin(5),rheumin(6),daucosterol(7),d-catechin(8),piceatannol(9),piceatannol-4'-O-?-D-glucopyranoside(10),piceatannol-4'-O-?-D-(6″-O-p-coumaroyl)-glucopyranoside(11),chrysophanol-8-O-?-D-glucopyranoside(12),physcion-1 and 8-O-?-D-glucopyranoside(13a and 13b),emodin-8-O-?-D-glucopyranoside(14),and sucrose(15).Meanwhile,one compound structure simi-lar to rhein was detected.Conclusion Compound 11 is a new compound named rheoside,compounds 13a and 13b are obtained from R.emodi for the first time.

This paper introduces some experiences on how to perform teaching reformation of reproductive medicine.

Objective To understand the job burnout status of bank staff and analyse the relationship between job burnout and self-efficacy,job satisfaction.Methods The job burnout,self-efficacy and job satisfaction of 8 942 bank staff was surveyed by Maslach burnout inventory-general survey(MBI-GS),general self-efficacy scale (GSES) and job satisfaction scale (JSS) respectively.Results A total of 8 942 questionnaires were issued and 7 486 valid questionnaires were returned.The score of self-efficacy in male was significantly higher than that in the female(P ＜0.05).There was no significant difference in job satisfaction score between male and female(P ＞ 0.05).The score of emotional exhaustion (EE) in female was significantly higher than that in male,while the score of reduced personal accomplishment(RPA) was significantly lower than that in male (P ＜ 0.05);there was no significant difference in depersonalization (DP) score between male and female (P ＞ 0.05).The EE,DP and PAL scores of bank staff with post-graduate education were significantly lower than those with high school/secondary school and junior college/undergraduate (P ＜ 0.05);the DP and PAL scores of bank staff with junior college/undergraduate were significantly lower than those with high school/secondary school(P ＜ 0.05);there was no significant difference in EE score of bank staff between junior college/undergraduate and high school/secondary school(P ＞ 0.05).The EE score of age ＞ 50 years old bank staff was significantly lower than that of age ＜ 30 years old,30-40 years old and 41-50 years old (P ＜0.05);there was no significant difference in EE score among age ＜30 years old,30-40 years old and 41-50 years old bank staff (P ＞ 0.05).The DP score of 41-50 years old bank staff was significantly higher than that of age ＜ 30 years old (P ＜0.05);there was no significant difference in DP score among age ＜30 years old,30-40 years old and 41-50 years old bank staff (P ＞ 0.05).There was no significant difference in PAL score among all age groups (P ＞ 0.05).The three dimensions of job burnout had significant negative correlation with self-efficacy and job satisfaction (P ＜ 0.05).Conclusion Bank staff have a certain degree of job burnout.Age,sex,and education level maybe the influence factors of job burnout.Improvement of self-efficacy and job satisfaction may help to reduce the job burnout.

Objective To describe and analyze the distribution of medical expenditure of Liaoning province in 2014 in terms of population beneficiary based on the System of Health Accounts 2011(SHA 2011).Methods By means of multistage and stratified sampling, a total of 252 medical institutions were selected from four cities in Liaoning province according to their economic status and geographical distribution.Macro data including the outpatient income and hospitalization income were taken into account, to calculate the beneficiary population of the province in 2014 according to SHA2011.Results GBD classification found that the highest medical expenditure category was non-communicable diseases, accounting for 63.02% in total medical expenditure.ICD classification found that respiratory disease as consuming the highest medical expenses (43.76%).The average medical expenditure of the elderly population was the highest per person, up to 3 041.70 yuan per person.Conclusions Medical expenses of non-communicable diseases, respiratory disease and elderly population were still high.Thus we need to emphasize disease prevention, and take efficient measures against such key diseases to curb the medical expenses.The elderly population calls for specific and effective measures to reduce their medical expenses.