Objective:To investigate the relationship between body mass index (BMI) and invasive mechanical ventilation time in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:Medical records of 72 patients with AECOPD admitted to Zhejiang Xin′an International Hospital from June 2018 to December 2019 were retrospectively analyzed. According to BMI, they were divided into the low body mass group (BMI<18.5 kg/m 2), the normal body mass group (18.5 kg/ m 2 ≤ BMI < 24.0 kg/m 2), and the obesity and overweight group (BMI ≥ 24.0 kg/m 2). According to the time of invasive mechanical ventilation of patients, they were divided into invasive mechanical ventilation time>7 d group and ≤ 7 d group. The changes of baseline data in each group were compared, and the risk factors of invasive mechanical ventilation time of patients with AECOPD were analyzed. Results:The incidence of hypertension and diabetes in the obesity and overweight group were higher than those in the low body mass group: 11/15 vs. 31.8(7/22), 8/15 vs. 13.6%(3/22), P<0.05. Before intubation, the level of ALB in the obesity and overweight group was higher than that in the normal body mass group and the low body mass group: (34.77 ± 5.11) g/L vs.(33.02 ± 4.86), (29.13 ± 3.64) g/L, the level of ALB in the normal body mass group was higher than those in the low body mass group , and there were significant differences ( P<0.05). The time of invasive mechanical ventilation in the obesity and overweight group was shorter than that in the normal body mass group and the low body mass group:(9.51 ± 1.38) d vs. (11.03 ± 1.91), (14.11 ± 2.36) d, the time of invasive mechanical ventilation in the normal body mass group was shorter than that in the in the low body mass group, and there were significant differences ( P<0.05). But there were no statistically significant differences in gender, age, smoking, complicated gastrointestinal bleeding, abdominal distension, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, exudation, ventilator modes, pH values, arterial partial pressure of carbon dioxide (PaCO 2) before intubation and arterial partial pressure of oxygen (PaO 2) before intubation of patients in the three groups ( P>0.05). Complicated diabetes mellitus, gastrointestinal bleeding, abdominal distension, BMI<18.5 kg/m 2, the rate of exudation and APACHEⅡscore in the invasive mechanical ventilation time ≤ 7 d group were lower than those in the invasive mechanical ventilation time>7 d group. Before intubation, ALB levels in the invasive mechanical ventilation time ≤ 7 d group were higher than those in the invasive mechanical ventilation time >7 d group ( P<0.05). The Logistic regression analysis results showed that complicated gastrointestinal bleeding, abdominal distension, BMI<18.5 kg/m 2, APACHEⅡscore > 10 points, before intubation, ALB< 30 g/L were independent risk factors of invasive mechanical ventilation time of patients with AECOPD ( P<0.05). Conclusions:In addition to the mechanical ventilation related complications and high APACHEⅡscore, malnutrition is an important risk factor affecting invasive mechanical ventilation time of patients with AECOPD before intubation.

OBJECTIVE:To observe the adjunctive efficacy of allicin for restenosis of geriatric myocardial infarction (MI) after percutaneous coronary intervention (PCI). METHODS:From Jan.to Dec.2007,150 geriatric MI patients after PCI were divided into 2 groups (n=75 each),i.e. conventional therapy group and allicin group (allicin 40 mg tid plus conventional therapy). After treatment for 1 year,plasma levels of restenosis markers including endothelin-1,CRP,NO were tested; Coronary arteriography was carried out to reveal the restenosis situation; Angina attack frequencies were also recorded. RESULTS:66 cases in allicin group vs.57 in conventional therapy group had no recurrence of angina,with the effective rate being 88% in allicin group vs.76% in conventional therapy group,showing significant differences between the two groups (P

Objective To explore the value of the combination of endoscopic sphincterotomy (EST) and laparoscopic cholecystestomy (LC) in the treatment of Cholecystolithiasis with extraheptatic bile duct stones. Methods 62 cases with cholecystolithiasis combined with extraheptatic bile duct stones were underwent LC following EST. Results Two cases were treated with common bile duct exploration after the failure of EST. 60 cases were executed sucessfully by EST and LC. No case occured serious complications. 8 patients with transient hyperamylasemia and 4 cases with intestinal bleeding after operation were cured by means of conservative therapy. Conclusion Combination of EST and LC is a safe and effective method in the treatment of cholecystolithiasis with extraheptatic bile duct stones.

BACKGROUND:In China there is no norm to assess anxiety disorders in children.The Chinese urban norm for screening child anxiety related emotional disorders is applicable to assessing anxiety problem in Chinese children and assisting clinical diagnosis,research and epidemiological investigation. OBJECTIVE:To develop the norm for screening child anxiety related emotional disorders(SCARED) in Chinese cities,and test the reliability and validity of this scale. DESIGN:A sampling survey taking the students of Grade 2 and up in elementary schools and junior middle schools in 14 big and medium sized cities in China and children with anxiety disorders who visited children's mental clinics in Changsha,Jinan and Shenzhen cities from October 2001 to April 2002,as the subjects. SETTING:The psychiatric department of a provincial specialized mental hospital. PARTICIPANTS:A total of 2 019 subjects(1 012 males and 1 007 females) with the mean age of(11± 2) years old were selected from 14 cities in China(Beijing,Tianjin,Taiyuan,Siping,Wuhan, Changsha,Xi'an,Shenzhen,Mianyang,Jinan,Fuzhou and Yichun) from October 2001 to April 2002.The students and their parents(norm group) filled in SCARED,and meanwhile,90 children with anxiety disorders who visited children's mental clinics in Changsha, Jinan and Shenzhen were taken as anxiety group. INTERVENTIONS:The children completed one copy of SCARED in the classroom during regular classes after informed consent was obtained, and then the questionnaires were collected on the spot. Another copy of SCARED was taken home by the children to be completed by the parents.Meanwhile,in Changsha,the parents filled in the child behavior checklist(CBCL) while their children completed the Piers Harris children's self concept scale(PHCSS).The reliability and validity of SCARED were determined. MAIN OUTCOME MEASURES:Reliability and validity of SCARED. RESULTS:The test retest coefficients of SCARED ranged from 0.567 to 0.608,split reliability of SCARED was 0.88,and Cronbach alpha(α ) coefficients were 0.43 to 0.89,with good reliability. Significant correlations were found between the total scores and anxiety indexes of SCARED and Achenbach CBCL(r=0.564,0.603,P< 0.05).The children in anxiety group scored higher in SCARED than those in norm group(t=8.06 to 12.89,P=0.000). Sensitivity and specificity of diagnosis of anxiety disorder were 0.74 and 0.79,respectively. CONCLUSION:The reliability and validity of SCARED are good, suggesting that the norm is applicable to assessing anxiety disorders in Chinese children.

[Objective]To discuss the effects of DHS and compression screw application on femoral intertrochanteric fracture.[Method]Internal fixation was performed with DHS,DHS and compression screw,Ender nail and proximal femoral anatomical plate in 185 patients with femoral intertrochanteric fracture.The main outcome measures were operation duration,coxa adducta rates and postoperative Sanders scoring.[Result]All patients were followed up for 9-48 months.Operation duration was similar in the four groups.There were significant differences in coxa adducta rates and postoperative Sander's scores.According to the Sander's scores,the excellent to good rates in DHS and compression screw,DHS,Ender nail and proximal femoral anatomical plate groups were 94.6%,85.3%,75.4% and 80.6%,respectively.The coax adducta rates were 2.4%,9.5%,22.2% and 19.2%,respectively.[Conclusion]All the four kinds of internal fixation can be used for femoral intertrochanteric fracture,but DHS and compression screw is the best one for its good restoration of joint function and has no or little complication.

Objective To develop a quick, simple and sensitive method for determination of sulfuric acid mist in the air by ion chromatography. Methods The samples were collected by Nillipore filter, Na2CO3-NaHCO3 solution was used and the samples were analyzed by using ion-chromatography as well as external standard curve. Results The linear range of the method was 0.5-10.0 ?g/ml and the correlation coefficient was 0.999 8. The RSD for the test accuracy and variation of repeat tests within one day or between the different days was

Objective To investigate the role of imaging characteristics of cerebral infarction in different regions in predicting the progressive cerebral infarction (PCI). Methods Patients with cerebral infarction were selected in the De?partment of Neurology of Hefei third People’s Hospital from January 2010 to June 2014. Brain MRI were examined the location of cerebral infarction. Patients were then classified into four groups accordingly:cortical infarction, basal gangli?on infarction, coronaradiata infarction and posterior infarction. Patients were further divided into PCI group and non-PCI group according to their clinical manifestations. MRI imaging features and risk factors were analyzed and compared be?tween PCI group and non-PCI group. Results A total of 150 patients with cerebral infarction were enrolled, including 99 cases of non-PCI and 51 cases of PCI. According to the Brain imaging classification, there were 46 cases of cortical in?farction, 25 cases of coronaradiata infarction, 47 cases of basal ganglion infarction and 32 cases of posterior infarction. There were significant differences in subtype cerebral infarction between PCI group and non-PCI group(χ2=19.239,P=
0.001). The percent of cortical infarction were significantly higher in PCI group compared to the non-PCI group. Cortical infarction was correlated to PCI and the value of R and P was 0.170 and 0.026, respectively. Logistic regression revealed that Imaging of subtypes of cerebral infarction was correlative with PCI (P=0.002). The frequency of progression was sig?nificantly increased in cortical infarction than in other subtypes of cerebral infarction (P=0.002). The trend was still sig?nificant even after adjustment for age and blood glucose, (P=0.014). Conclusion The location of cerebral infarction is closely correlated to PCI in which cortical infarction is more likely to develop PCI.

BACKGROUND:In recent years, the morbidity of chronic pancreatitis has been increasing dramaticaly with lifestyle changes. Fortunately, endoscopic pancreatic stenting for patients with chronic pancreatitis shows favorable clinical prospects.OBJECTIVE:To introduce the advantages and disadvantages of various stent materials and to review the development and clinical application of pancreatic stents.METHODS: With the key words of chronic pancreatitis, pancreatic stent in Chinese and English, respectively, a computer-based search was performed for articles published in CNKI and PubMed databases from January 2005 to November 2016. After the initial screening, articles related to endoscopic pancreatic stenting usedin vitro,in vivo or in clinic were included.RESULTS AND CONCLUSION: Endoscopic pancreatic stenting has become a recognized treatment for chronic pancreatitis in recent years. Therefore, the development and application of the materials of pancreatic duct stents appear to be particularly important. According to different materials, pancreatic duct stents can be classified into plastic stents, fully covered self-expandable metal stents, and biodegradable stents. The complications, including stent migration and secondary surgery, frequently appear in the clinical use of plastic pancreatic duct stents and self-expandable metal stents, although they have been widely used in clinical practice. Biodegradable pancreatic duct stents can be degraded completely in the pancreatic duct within the expected time, and thereby avoid several complications. Consequently, the exploitation and application of biodegradable pancreatic duct stents have become an issue of concern.

K-ras gene is one of oncogenes in non-small cell lung cancer,and it can promote tumor cells growth after mutations by several signaling pathways.K-ras mutations frequently occur in lung adenocarcinoma patients with smoking history.In the present study,K-ras mutations are associated with resistence to targated therapy and may be a marker of poor prognosis in patients with non-small cell lung cancer.

The incidence of upper limb dysfunction of stroke patients was high, and the recovery was difficult, which seriously impact-ed their activities of daily living and quality of life. This article reviewed the new techniques and methods for hemiplegic patients after stroke. The main techniques and methods includeed bilateral isokine-matic training, mirror neuron system, gymnastics rods training, music therapy, motor imagery, upper limb rehabilitation robot, virtual reality, constraint induced movement therapy, functional electrostimulation, electromyographic biofeedback therapy, transcranial magnetic stimulation, neurophyisological therapy and so on.