Objective To study the clinical efficacy of fondaparinux sodium in the treat of deep vein thromboembolism after the surgery on lower limbs.Methods 83 cases of patients with lower extremity surgery from Jan 2013 to May 2015,were randomly divided into experimental group(42 cases) and control group(41 cases),the patients in experimental group were injected subcutaneously with fondaparinux sodium 2.5 mg,one time a day,for five days and the patients of control group administrated orally with rivaroxaban 10 mg, one time a day, for five days.All patients accepted the ultrasonic examination by Doppler’ s method before the experiment, seven days and one month later after the experiment.The occurrence of deep vein thromboembolism of all patients was counted,including Proximal thrombosis,Distal thrombosis and Total venous thrombosis,and recorded the occurrence of adverse reaction-subcutaneous hemorrhage.Results One case(2.38%)of deep vein thrombosis was appeared in the experimental group,and that was significantly lower than that of the control group seven case ( 17.07%, P <0.05 ) .Meanwhile, there was no patient observed adverse reaction in experimental group, while two cases were observed in control group ( P <0.05 ) .Conclusion Fondaparinux showed better clinical efficacy than rivaoxaban,and caused fewer adverse reaction.We can conclude that it is safe and effective for the treatment of deep vein thrombosis in patients accepting the lower limbs surgery.

Objective To probe the clinical values of the human serum glycoprotein profiles for the diagnosis of common gynecological tumors. Methods A total of 123 clinical serum samples which included 31 breast cancer, 24 cervical cancer, 19 ovarian cancer and 49 healthy individuals were collected. A lectin microarray consisting of 15 lectins with different glycan binding specificities was used to determine the glycoprotein profiles of serum sam-ples. Stepwise discrimination analysis method was adopted to establish function model of clinical serum samples classification with SPSS 15. 0 software. Results Two grades of diagnostic discrimination function models were es-tablished. The first grade discrimination function could differentiate gynecological tumors from healthy individuals, the diagnostic accuracy rates of retrospective inspection were 85. 7% and 83. 8% respectively, and the total diag-nostic accuracy rate was 84.6%. The second grade discrimination function was used to differentiate breast tumor, cervical tumor and ovarian tumor, the diagnostic accuracy rates of retrospective inspection were 96.8%,75.0%and 78.9% respectively, and the total diagnostic accuracy rate was 85.1%. Conclusion The human serum gly-coprotein profiles are associated with gynecological tumors, and the established discrimination function models based on lectin microarray data have a helpful reference value for the clinical diagnosis of gynecological tumors.

Objective To analyze the distribution and esophageal motility characteristics of patients with non obstructive dysphagia (NOD).Methods From June 2010 to June 2012,ninety seven patients with a sense of obstruction when swallowing were selected and patients with esophageal organic stenosis was excluded through endoscopic examination and upper gastrointestinal radiography.While nine healthy volunteers were recruited as healthy control.High-resolution esophageal manometry was performed with high-resolution multi-channel Netherlands CTD Synectics gastrointestinal function monitoring system (Pcpolygraf polysomnography recording system) and MMS digestive power detection system.The observation parameter included upper esophageal sphincter pressure (UESP),upper esophageal sphincter relaxation rate (UESRR),the length of the lower esophageal sphincter (LESL),lower esophageal sphincter pressure (LESP),intergrated relaxation pressure (IRP),lower esophageal sphincter relaxation rate (LESRR),esophageal subordinate segments pressure and esophageal effective peristalsis ratio.The rank sum test was performed for comparison between groups.Results Among 97 patients with NOD,the percentage of achalasia,nonspecific esophageal motor disorder andgastroesophageal reflux disease (GERD) was 41.2％ (40/97),39.2％ (38/97)and 19.6％(19/97),respectively.Among patients with nonspecific esophageal motor disorder,the percentage of abnormal peristalsis,absent peristalsis,normal pressure and distal esophegesl spasm was 39.5％(15/38),36.8％(14/38),15.8％(6/38) and 7.9％(3/38),respectively.The differences in lESL,LESP,LESRR,esophageal subordinate segments pressure and esophageal effective peristalsis ratio among achalasia,GERD,nonspecific esophageal motor disorder and healthy control were statistically significant (F 6.143,57.490,50.559,10.155 and 22.046,all P＜0.05).LESP oF patients with achalasia was higher than that of healthy control,however LESRR,esophageal subordinate segments pressure and esophageal effective peristalsis ratio were all lower than those of healthy control and the differences were statistically significant (F 2.276,11.113,-8.036 and -14.663,all P＜0.05).LESL and LESP of achalasia were both higher than those of GERD group,LESRR,esophageal subordinate segments pressure and esophageal effective peristalsis ratio were all lower than those of GERD group and the differences were statistically significant (F=4.325,15.983,-19.235,-3.410 and-4.351,all P＜0.05).LESL and LESP of achalasia group both were higher than those of nonspecific esophageal motor disorder group,LESRR and esophageal effective peristalsis ratio were both lower than those of GERD group and the differences were statistically significant (F=2.376,7.668,2.873 and-3.873,all P＜0.05).LESRR of GERDgroup was higher than that of healthy control group,LESL,LESP,esophageal subordinate segments pressure and esophageal effective peristalsis ratio were all lower than those of healthy control group and the differences were statistically significant (F=5.931,-2.483,-14.618,-3.071 and-4.516,all P＜0.05).LESL and LESP of GERD group were both lower than those of nonspecific esophageal motor disorder group,LESRR was higher than that of nonspecific esophageal motor disorder group and the differences were statistically significant (F =--2.113,6.578 and 10.979,all P ＜ 0.05).LESP,LESRR,esophageal subordinate segments pressure and esophageal effective peristalsis ratio of nonspecific esophageal motor disorder group were all lower than those of healthy control group and the differences were statistically significant (F=-6.313,-3.580,-3.511 and-8.150,all P＜0.05).IRP of 40 patients with achalasia were all beyond the normal range.Conclusions NOD mainly included achalasia,nonspecific esophageal motor disorder and GERD.The reduction of effective esophageal peristalsis may be an important pathophysiological mechanism of NOD.

Objective To discuss the relationship between bone mineral salt metabolism index change and bone density in different stage of chronic kidney disease (CKD).Methods Three hundred and forty-five non-dialysis patients with CKD were enrolled in this study.According to the serum creatinine (SCr),glomerular filtration rate (GFR),they were divided into stage 1-5.CKD 1 had 75 cases,CKD 2 had 65 cases,CKD 3 had 65 cases,CKD 4 had 65 casès,CKD 5 had 75 cases.The level of blood calcium (Ca),phosphorus (P) and SCr were detected by ion selective electrode method.The level of urea nitrogen (BUN) was detected by picric acid method.The level of intact parathyroid hormone (iPTH) and 1,25 (OH)2VitD3 were detected by chemiluminescence.Results With the decline of renal function,the level of iPTH and blood P increased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(289.6578 + 187.7945),(482.0667 + 232.2065) μ g/L vs.(77.8431 + 52.9760) μ g/L and (1.6938 + 0.1960),(2.6034 ± 0.5986) mmol/L vs.(1.3833 ± 0.4068) mmol/L,P ＜ 0.05].The level of blood Ca and 1,25 (OH)2VitD3 decreased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(1.9185 +0.4633),(1.8293 ± 0.3075) mmol/L vs.(2.0893 + 0.2245) mmoi/L and (10.0892 + 0.2638),(7.6058 +0.4356) ng/L vs.(18.0036 + 0.3218) ng/L,P ＜ 0.05].With the decline of renal function,the proportion of osteoporosis also gradually increased,especially in stage CKDS,and compared with stage CKD 1 and CKD 2,there was significantly difference [60.00％ (45/75) vs.20.00％ (15/75),23.08％ (15/65),P ＜ 0.05].Conclusion With the decline of renal function,the level of blood P and iPTH increase,and blood Ca,1,25(OH)2VitD3,bone density decrease,especially in stage CKD 4 and CKD 5 patients.

Objective To compare the serum thyroid hormones level in patients with pre-diabetes,newly diagnosed type 2 diabetes mellitus(T2DM)and healthy people,and to investigate the association of glucose metabolism with thyroid function.Methods Sixty newly diagnosed T2DM patients(T2DM group),60 pre-diabetes patients(pre-diabetes group),and 60 healthy people(healthy group) from outpatient departments were randomly enrolled in the study.Their thyroid peroxidase antibodies(TPOAb),thyroglobulin antibodies(TGAb),thyrotropin receptor antibodies(TRAb),and thyroid color dopplar ultrasound were all normal.Thyroid hormones was measured.Glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),glycated albumin(GA) was additionally measured in T2DM patients.We compared the difference of thyroid hormones among the 3 groups and investigated the factors that influence thyroid hormones level in each T2DM patients.Results There was no significant difference found on thyroid hormones level between the pre-diabetes group and healthy group(P＜0.05).T3 and FT3 level were(1.34±0.24)nmol/L and(3.88±0.51)pmol/L in the T2DM group,respectively,which were significantly lower than those in the pre-diabetes group([1.48±0.29]nmol/L and [4.12±0.55]pmol/L,t=-0.135 and -0.145,respectively,Ps＜0.01＝ and in the healthy group([1.49±0.26]nmol/L and [4.13±0.55]pmol/L,t=-0.240 and -0.260,respectively,P＜0.05 or 0.01) .In the T2DM group,T3 and FT3 were negatively correlated with FPG,GA,HbA1c(For T3:r=-0.275,-0.318 and -0.453,respectively,Ps＜0.05;For FT3:r=-0.280,-0.291 and -0.336 ,respectively,Ps＜0.05).Conclusion In patients with abnormal glucose metabolism, thyroid hormone was influenced only when the glucose metabolism level reached a certain abnormal degree.

ObjectiveTo estimate the effect of azithromycin on lung function and transforming growth factor β1(TGF- β1) in patients with idiopathic pulmonary fibrosis (IPF). MethodsOne hundred and ten patients with IPF were divided into two groups by random digits table. Patients in azithromycin group(60cases) were treated by azithromycin tablets and thoee in placebo group ( 50 cases) were treated by placebo tablets, and they were observed for 12 weeks. Lung function was detected at beginning and after 6,12 weeks' treatment. TGF- β1 was tested by ELISA, meanwhile patient's condition was observed. ResultsAfter 6 and 12 weeks' treatment, the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), carbonmonoxide diffusion capacity (DLCO) in the two groups had no significant differences compared with those at beginning of treatment (P ＞ 0.05). After 12 weeks' treatment, the level of TGF- β1 in azithromycin group was significantly decreased compared with that at beginning and after 6 weeks' treatment (P ＜ 0.05) ,but there was no significant difference in placebo group (P ＞ 0.05). The ratio of acute exacerbation admission and infection was 8.3％(5/60) and 60.0％(3/5) in azithromycin group, 22.0％( 11/50) and 81.8％(9/11 ) in placebo group,and there were significant differences between the two groups(P ＜0.05 or ＜0.01). Conclusion Azithromycin may reduce the ratio of acute exacerbation admission and infection, decrease TGF- β 1 expression in patients with IPF by taking orally for a long time, but it may have no obvious effect on lung function.

Objective To explore the diagnostic value of electroneurophisology in patients with charcot-Ma-rie-Tooth disease(CMT).Methods Electromyogram(EMG),Motor nerve conduction velocity(MCV),Sensory nenre conduction velocity(SCV) and F wave were measured in 31 cases with Charcot-Marie-Tooth disease(CMT).Resuits The abnormality rate of EMG was 90%,MCV was 100%,SCV was 90%,and F wave was 34%.Conclu-sion The electroneurophysiology is very practical and valuable in diagnosing Charcot-Marie-Tooth disease.

Objective To explore the diagnostic value of electroneurophisology in patients with charcot-Ma-rie-Tooth disease(CMT).Methods Electromyogram(EMG),Motor nerve conduction velocity(MCV),Sensory nenre conduction velocity(SCV) and F wave were measured in 31 cases with Charcot-Marie-Tooth disease(CMT).Resuits The abnormality rate of EMG was 90%,MCV was 100%,SCV was 90%,and F wave was 34%.Conclu-sion The electroneurophysiology is very practical and valuable in diagnosing Charcot-Marie-Tooth disease.

Objective To investigate and analysis the clinical effect of pramipexole in Parkinson's disease with depression.Methods The patients with Parkinson disease patients with depression were selected in a total of 100 as the research object,and were randomly divided into two groups,the observation group and the control group with 50 cases in each group.The control group was taken conventional treatment,the observation group was given pramipexole based on the conventional treatment methods,the the effects of treatment were observed and compared. Results The MIHD score of the observation group after treated for 12 month (8.26 ±1.96)was lower than the score before treatment (24.91 ±4.6),and the score of the control group after treated for 12 month (11.15 ±2.10)was also lower than the score before treatment (24.48 ±5.34),the difference were all statistically significant(P<0.05). After treated for 12 month,the score in the observation group was lower than that in the control group,and the total effective rate in the two group were 94% and 80% respectively(P<0.05 ).The UPDRS score of the observation group was lower than in the control group,but the difference was not significant(χ2 =14.756,P<0.05).Conclusion Give pramipexole has notable curative effect on the depression disease in patients with Parkinson disease on the basis of conventional therapy method,and has the value of popularization.

Objective To survey the status of the clinical competence and meta-cognitive ability of college nursing students, to explore the correlation between the two factors, and analyze the influencing factors of baccalaureate nursing students′ clinical skills, then explore the approach of improving the clinical competence of nursing students. Methods Totally 184 nursing students from Taishan Medical University were investigated by General Information Questionnaire, Clinical Competence Test Scale, University Students Meta Cognitive Ability Scale. Results Nursing students′ average score of meta cognition was 80.48 ± 11.97, the average score of clinical competence was 121.22 ± 22.74. The meta cognitive ability and clinical competence of nursing undergraduate students both maintained at the middle level. Meta cognitive ability was positively correlated with clinical competence. To some extent, enhancing the meta cognitive ability could help students improve the clinical competence. Conclusions To understand the status and correlation between meta cognitive ability and clinical competence can guide students to learn effectively, can help teachers play a good role in teaching effectively.