Degree of Confidence(?),Validity(E),Item Difficulty(P) and Item Discrimination(D) used in Software System for Paper Quality Analysis play an important role in evaluating the qualities of items and papers.Their usages and meanings are discussed in detail here,and an example is given to illustrate their significance and important roles in items analysis and papers analysis.

Paper analysis plays an important role in teaching improvement as well as in its quality enhancement.We have developed a set of software for analyzing paper qualities,which will make paper analysis efficient,practical and standardizing.

Objective To compare open reduction and internal fixation (ORIF) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the operative treatment of complicated proximal humeral fractures.Methods From January 2014 to October 2015,55 complicated proximal humeral fractures were treated at our department.They were 32 men and 23 women,from 21 to 81 years of age (average,51 years).According to Neer classification,34 cases belonged to three-part fractures and 21 ones to four-part fractures,14 of which were complicated with dislocation.Of them,35 received ORIF and 20 underwent MIPPO.The 2 groups were compared in terms of operation time,intraoperative blood loss,incision length and Neer scoring of the shoulder function at the final follow-ups.The 2 groups were compatible without significant differences in preoperative demographic data (P ＞ 0.05).Results The 55 patients were followed up for 6 to 12 months(mean,9 months).The operation time (100.5 ± 10.2 min),intraoperative blood loss (80.0 ± 10.5 mL),and incision length (7.5 ± 3.2 cm) in the MIPPO group were significantly better than those in the ORIF group (120.0±10.1 min,200.5±10.2mL,and10.5±5.3cm,respectively) (P ＜0.05).According to the Neer scoring of the shoulder function at the final follow-ups,the good to excellent rate was 71.4％ (25/35) in the ORIF group and 85.0％ (17/20) in the MIPPO group,showing a significant difference (P ＜ O.05).The incidence of humeral head necrosis was 15 in the ORIF group,significantly higher than that (3) in the MIPPO group (P ＜ 0.05).Conclusion In treatment of complex proximal humeral fractures,compared with ORIF,MIPPO may lead to less damage to local blood supply,less trauma,and quicker functional recovery due to early functional exercise.

Objective To investigate the effect of Urinarykallid for different ages patients with acute cerebral infarction cases.Methods Ninety-five cases with acute cerebral infarction were divided into high age group(n=48) and middle age group(n=47).Patients in the two groups were both given the Urinarykallid therapy combined with routine treatment.After 1 courses of treatment(3 weeks),American National Institutes of Health Stroke Scale(NIHSS) were performed before and after the treatment.The adverse reactions occurred in the process of scoring were compared.Results The total effective rate in the high age group was 83.33％,lower than the middle age group(89.36％),but the difference was not statistically significant(P=0.391).The NIHSS scores of patients in the two group after treatment were both significantly reduced compared with that in before treatment (high age grou:(9.81±2.37) vs.(6.79± 0.82),middle age group:(9.75 ± 2.46) vs.(3.04±0.58;P=0.004,P=0.001).Meanwhile,the NIHSS in the middle age group decrease significantly than the high age group(P=0.000).No obvious adverse reactions occurred in both two groups,the treatment was proved with safe and reliable.Conclusion Urinarykallid treatment is showed with better therapy effect on acute cerebral infarction patients with different age,and it is safety with improving patients NIHSS score level.Meanwhile,the better efficacy is showed in patients with lower age.

A new NK cell subset with antigen presentation function was recently found and called as interferon-producing killer dendritic cells (IKDC cells).These cells co-express surface markers of NK cells and DCs;functionally,they can secrete interferons,kill target cells and have antigen-presenting ability.IKDCs extensively exist in almost all lymphoid tissue or organs with similar phenotype,but recent studies indicated that IKDCs were developmently not from DC cells but from NK cells,the conclusion of which is still in its early stage.The discovery of IKDC will be help to understand the link between innate and adaptive immunity.

Objective To compare the effects of volume preloading with crystalloid and colloid fluid to prevent hypotension associated with thoracic epidural block combined general anesthesia.Methods Ninety ASA Ⅰ～Ⅱ grade patients,scheduled for elective upper abdominal surgery,were randomly allocated to three groups(30 patients in each group).A,B and C group respectively received 1000ml lactated Ringer's solution,500ml and 1000ml polygeline injection for volume preloading in 40min before general anesthesia induction.During volume preloading,epidural catheter was placed at T_ 8～9 and blocked with mixed solution of 1.6% lidocaine and 0.2% dicaine.Results Systolic blood pressure(SBP) and diastolic blood pressure(DBP) were significantly lower in group A and B than those in group C after epidural block,general anesthesia induction and intubation(P

OBJECTIVE To investigate clinical status,distribution of the genera,and risk factors of pneumonia caused by fungi in hospitalized senile patients.METHODS The notices of hospitalized senile patients from Jan 2000 to Apr 2003 were analyzed according to Diagnosis Standard of Nosocomial Infection published by National Ministry of Health.RESULTS Totally 135 cases were collected.The isolating ratio of Candida albicans ranked first(54.8%),followed by C.tropicalis(20.0%).The risk factors included underlying diseases,invasive surgical procedure,and prolonged hormones and antibiotics therapy.CONCLUSIONS To prevent and control pneumonia caused by fungi in hospitalized senile patients,the measures such as curing the underlying diseases,reducing invasive surgical procedures,and using antibiotics reasonably should be adopted.

Objective To investigate the clinical effectiveness of interventional therapy for deep venous thrombosis(DVT) in the lower limbs.Methods A total of 38 patients with DVT were treated by intravenous thrombolysis;12 of them received percutaneous transluminal balloon angioplasty and intravascular stenting after the thrombolysis.According the evaluation criteria of our hospital,the outcomes of the patients were classified as cure(angiography showed complete lysis of the thrombus and smooth venous wall),markedly improved(the deep vein was patent with intravascular mural thrombi,the inner radius was reduced by less than 1/3),improved(angiography showed residual thrombi in the deep vein,and the inner radius was reduced by more than 1/3),and failure(the vein was still obstructed).Results After the treatments,cure was achieved in 22 patients,markedly improved in 14,and improved in 2.No severe complications occurred during the operations.Thirty-four of the patients were followed up for 3-24 months(3-6 months in 7 cases,7-12 months in 12,and 13-24 months in 15).Two patients had recurrence during the follow-up and were cured by intravenous thrombolysis.Conclusion Interventional therapy is continent,effective,and safe for DVT.

Natural killer (NK) cells have long been considered the only representative of lymphocyte lineages among the innate immune system ,but recent studies have revealed that several types of innate lymphoid cells ( ILC ) exist in both humans and mice.These newly identified ILC populations were mainly distributed at mucosal barriers ,regardless of their rarity ,they play important roles in the defense against pathogens and in the maintenance of tissue or organ homeostasis .In the early stages of ILC development ,a common ILC lineage-restricted progenitor exists and under the control of different transcription factors ,the progenitor can later give rise to different ILC subsets with distinct phenotypes and functions.Different ILC subsets exhibit distinct cytokine secretion profiles ,based on the categorization of helper T cell subsets , ILC family has been further classified into three groups.The finding of diverse ILC extremely enriches the content of innate immunity ,and also provides new insights into links between innate and adaptive immunity .

Objective To explore the curative effect of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy (ICP) and the effect on total bile acid (TBA) in post partum fetal umbilical venous blood .Methods 30 patients with intrahepatic cholestasis of pregnancy who were admitted into the Hospital Affiliated to Sichuan Medical University during January 2014 to December 2014 were selected as the research objects and randomly divided into observation group and control group ,15 cases in each group.The observation group were given ursodeoxycholic acid tablets while control group were injected with ademetionine butanedisulfonate .The curative effect of two kinds of drugs in treatment of intrahepatic cholestasis of pregnancy was observed and the effect on total bile acid in post partum fetal umbilical venous blood was analyzed .ResuIts After treatment , the TBA and ALT of observation group were significantly lower than those pre-treatment and those of control group (P<0.05).There were no significant differences of TBIL and ALP between two groups and within groups.TBA and TBIL in post partum fetal umbilical venous blood of observation group were significantly lower than those of control group (P<0.05).There was no significant difference of ALT level between two groups .There were two cases of abnormal perinatal outcomes in observation group while seven cases in control group (χ2 =3.97, P<0.05).ConcIusion Ursodeoxycholic acid could effectively reduce the total bile acid levels in maternal and fetal umbilical vein blood, reduce the mortality rate of the fetal and improve the perinatal outcomes , with high security.