Objective To investigate the feasibility and efficacy of iliofemoral endovascular therapy for the treatment of chronic ischemia of lower extremities due to arterial atherosclerosis. Methods During the period of September 2005-January 2009 percutaneous endovascular angioplasty and stent implantation were performed in 15 consecutive patients with CTA-proved chronic occlusive iliofemoral artery disease. The patients included 11 males and 4 females with a mean age of (72.1 ± 5.9) years (ranged from 61 to 82 years). Before the procedure, all patients underwent clinical and imaging assessments, including Fontaine classification, ankle-brachial pressure index (ABI), and lower limb computed tomography angiography (CTA). According to the length, morphology and location of the occlusive segment, different types of stents were employed together with pereutaneous transluminal angioplasty (PTA) to treat the occluded lilac or superficial femoral artery. At the end of the procedure, distal angiogram was performed to assess the success of the procedure and to exclude thromboembolism or dissection complications. After PTA, the residual stenosis < 30% and/or pressure gradient < 10 mmHg were defined as technical success. Clinical success was identified when patient's clinical symptoms were improved by one or more grade according to Fontaine classification. Results Technical success was totally achieved in all patients with no occurrence of complication. Recanalization of the occluded artery was performed preferably by retrograde ipsilateral femoral artery approach in 5 patients and by contralateral access using the crossover aorta technique in 10 patients. PTA was performed in all patients after stent release to open the occluded vessel to its normal diameter. The mean length of the lilac arterial segment covered with 8 stents was (7.6 ± 1.4) cm (ranged from 6 cm to 10 cm). The mean diameter ± SD of the iliac stents was 9.5 mm ± 1.4 mm (ranged from 8 mm to 12 mm). The mean length of 5 superficial artery implanted stents was (4.5 ± 1.1) cm (ranged from 4 cm to 6 cm). The mean ABI before treatment and six months after treatment was 0.64 (range 0.41 to 0.89) and 0.76 (range 0.50 to 0.95), respectively. The difference in ABI between pre-interventional and post-interventional procedure was statistically significant (t = -4.64, P < 0.01). Clinical improvements according to Fontaine classification were obtained in all patients, in whom technical success was achieved (100%). Conclusion Endovascular interventional procedure is a safe and effective treatment for iliofemoral arterial occlusive disease due to arterial atherosclerosis. PTA combined with subsequent stent implantation can well improve the patient's quality of life as well as the hemodynamics of lower extremities, which is very important for preserving the diseased limb for a long period of time.

Objective:To explore therapeutic effect of Fasudil combined Salmeterol Xinafoate and fluticasone propio‐nate powder for inhalation (Seretide) on patients with chronic obstructive pulmonary disease (COPD) combined pul‐monary arterial hypertension (PAH ) .Methods :A total of 120 patients ,who hospitalized in our department from Jan 2013 to Oct 2014 and conformed to diagnostic standards of COPD and PAH ,were selected .According to ran‐dom number table ,they were equally divided into routine treatment group (received routine therapeutic measures ) , Fasudil group (received Fasudil based on routine treatment group ) and combined treatment group (received Fasudil combined Seretide based on routine treatment ) . Pulmonary function indexes , mean pulmonary arterial pressure (mPAP) ,pulmonary arterial systolic pressure (PASP) ,6min walking distance (6MWD) and blood gas indexes were observed and compared among three groups before and after treatment .Results:Compared with routine treatment group after treatment ,there were significant reductions in mPAP [(54.1 ± 10.3) mmHg vs .(51.3 ± 9.5) mmHg vs . (48.5 ± 10.5) mmHg] and PASP [ (72.4 ± 9.7) mmHg vs .(63.4 ± 9.3) mmHg vs .(61.6 ± 9.1) mmHg] ,and sig‐nificant rise in 6MWD [ (259.4 ± 37.0) m vs .(274.2 ± 36.5) m vs .(288.3 ± 47.5) m] ,forced expiratory volume in one second [FEV1 ,(1.44 ± 0.32) L vs .(1.59 ± 0.38) L vs .(1.87 ± 0.34) L] and FEV1/forced vital capacity (FVC) [ (47.2 ± 11.9)% vs .(50.3 ± 12.1)% vs .(54.6 ± 11.7)% ];significant rise in partial pressure of oxygen in artery [PO2 ,(64.3 ± 9.8) mmHg vs .(68.9 ± 8.2) mmHg vs .(76.9 ± 9.5) mmHg] and saturation of arterial blood oxygen [SaO2 ,(65.0 ± 8.2)% vs .(71.0 ± 9.8)% vs .(76.8 ± 9.4)% ] ,and significant reduction in partial pressure of carbon dioxide in artery [PCO2 ,(63.6 ± 9.5) mmHg vs .(58.5 ± 9.6) mmHg vs .(51.3 ± 7.9) mmHg] in Fasud‐il group and combined treatment group ,and those of combined treatment group were significantly improved com‐pared to those of Fasudil group , P<0.05 or <0.01. Actual base excess of combined treatment group was signifi‐cantly higher than the other two groups , P<0. 01 both . Conclusion:Fasudil combined Seretide can significantly im‐prove pulmonary function reduction ,improve PAH ,quality of life and prognosis in COPD + PAH patients .

Objective To investigate the detectable rate and correlative factors of behavior problems among Hui nationality left-behind children in Ningxia rural area.Methods 1394 children,between 6 and 15 years old,of which 282 were Hui nationality children and 112 were Hui left-behind children,were selected from six primary schools and two junior middle schools using cluster random sampling method in Yongning,Ningxia.All of them were assessed by the Achenbach 's Child Behavior Checklist (CBCL) and self-designed General Information Questionnaire.Logistic regression method was used to analyze the correlative factors of behavior problems.Results The detectable rate of behavior problems among Hui nationality children between 6 and 15 years old was 31.25％,which was higher than the Han nationality left-behind children' s(17.84％) and Hui nationality nonleft-behind children' s (14.12％).Among the Hui left-behind children,those who between 6 and 11 years old,had been left alone between 5 and 7,and whose parents exchanging ideas with teachers less than one time a month had higher detectable rates (x2 =14.904,6.327,7.904,P ＜ 0.05).Among the Hui ethnic children,the detectable rates of those who between 6 and 11 yeas old were higher than that of the non-left-behind children' s(P ＜ 0.05).Logistic regression analysis showed that Hui ethnic left-behind children between 12 and 15 years old (OR =0.179) and those whose parents contacted with their teachers frequently(OR =0.362) had less possibilities to attach behavior problems.Conclusion The detectable rate of behavior problems among Hui nationality left-behind Children between 6 andl5 years old in Ningxia is higher,and the correlative factors are complex.

Objective: To explore mechanism of fasudil combined salmeterol and fluticasone propionate powder for inhalation (Seretide) in treating chronic obstructive pulmonary disease (COPD) complicated pulmonary artery hypertension (PAH).Methods: A total of 120 patients accorded with diagnostic standards of COPD and PAH, who hospitalized in our department from Jan 2013 to Oct 2014, were selected.According to random number table method, patients were randomly and equally divided into routine treatment group, fasudil group (received intravenous drip of fasudil based on routine treatment group) and combined treatment group (received additional Seretide therapy based on fasudil group).Levels of nitric oxide (NO), endothelin-1 (ET-1), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured and compared among three groups before and after treatment.Results: Compared with before treatment, after two-week treatment, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in three groups, P<0.05 or<0.01;compared with routine treatment group after treatment, there were significant reductions in levels of CRP[(14.8±3.3) mg/L vs.(12.9±3.6) mg/L vs.(11.4±3.4) mg/L], ESR[(37.3±8.9) mm/h vs.(32.9±8.8) mm/h vs.(29.3±5.6) mm/h]and ET-1[(63.1±11.2) ng/L vs.(57.5±8.1) ng/L vs.(53.1±8.9) ng/L], and significant rise in NO level[(70.2±10.7) μmol/L vs.(76.0±8.0) μmol/L vs.(80.5±11.3) μmol/L]in fasudil group and combined treatment group, P<0.05 or<0.01;compared with fasudil group, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in combined treatment, P<0.05 all.Conclusion: Fasudil hydrochloride combined Seretide can significantly reduce levels of ESR, CRP and ET-1, and increase NO level in COPD + PAH patients.It may improve prognosis in these patients, which is worth extending.

Objective:To evaluate the efficiency of ResNet50-OC model based on deep learning for multiple classification of color fundus photographs.Methods:The proprietary dataset (PD) collected in July 2018 in BenQ Hospital of Nanjing Medical University and EyePACS dataset were included.The included images were classified into five types of high quality, underexposure, overexposure, blurred edges and lens flare according to clinical ophthalmologists.There were 1 000 images (800 from EyePACS and 200 from PD) for each type in the training dataset and 500 images (400 from EyePACS and 100 from PD) for each type in the testing dataset.There were 5 000 images in the training dataset and 2 500 images in the testing dataset.All images were normalized and augmented.The transfer learning method was used to initialize the parameters of the network model, on the basis of which the current mainstream deep learning classification networks (VGG, Inception-resnet-v2, ResNet, DenseNet) were compared.The optimal network ResNet50 with best accuracy and Micro F1 value was selected as the main network of the classification model in this study.In the training process, the One-Cycle strategy was introduced to accelerate the model convergence speed to obtain the optimal model ResNet50-OC.ResNet50-OC was applied to multi-class classification of fundus image quality.The accuracy and Micro F1 value of multi-classification of color fundus photographs by ResNet50 and ResNet50-OC were evaluated.Results:The multi-classification accuracy and Micro F1 values of color fundus photographs of ResNet50 were significantly higher than those of VGG, Inception-resnet-v2, ResNet34 and DenseNet.The accuracy of multi-classification of fundus photographs in the ResNet50-OC model was 98.77% after 15 rounds of training, which was higher than 98.76% of the ResNet50 model after 50 rounds of training.The Micro F1 value of multi-classification of retinal images in ResNet50-OC model was 98.78% after 15 rounds of training, which was the same as that of ResNet50 model after 50 rounds of training.Conclusions:The proposed ResNet50-OC model can be accurate and effective in the multi-classification of color fundus photograph quality.One-Cycle strategy can reduce the frequency of training and improve the classification efficiency.

Objective: To investigate the expression and clinical significance of long-chain non-coding RNA brain cytoplasmic RNA 1 (BCYRN1) in serum of patients with non-small cell lung cancer. Methods: 74 patients with non-small cell lung cancer (NSCLC) diagnosed and treated in our hospital were selected as the experimental group, and 50 healthy subjects were selected as the control group. The expression of BCYRN1 in serum of NSCLC and control group was detected by real-time quantitative polymerase chain reaction (qRT-PCR). The patients′ clinical pathology data were collected and followed up. To analyze the relationship between the expression of serum BCYRN1 and clinicopathological parameters of NSCLC patients, and the relationship between BCYRN1 expression in the diagnosis and prediction of NSCLC prognosis. Results: The relative expression of BCYRN1 in serum of NSCLC patients was 2.84±0.95, which was significantly higher than that of healthy controls (1.16±0.50) (P<0.05). The level of serum BCYRN1 in patients with NSCLC with tumor size >3 cm was significantly higher than that in patients with tumor size ≤3 cm (P<0.05). The level of BCYRN1 in patients with tumor node metastasis (TNM) Ⅲ+ Ⅳ was significantly higher than that in patients with stage Ⅰ+ Ⅱ (P<0.05). Patients with low differentiation and positive lymph node metastasis had higher serum BCYRN1 than those with moderate to high grade and lymph node metastasis (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that the area under the curve was 0.847 (95% CI: 0.772-0.922, P=0.000), and the sensitivity and specificity were 68.9% and 88.0%, respectively. The median progression free survival (PFS) (15 vs 21 months) and overall survival (OS) (19 vs 28 months) of patients with high and low expression of BCYRN1 were statistically significant (P<0.05). High expression of BCYRN1 was an independent risk factor for overall survival in patients with NSCLC. Conclusions BCYRN1 is highly expressed in the serum of NSCLC patients, and high expression of BCYRN1 is closely related to the poor prognosis of patients with NSCLC. It can be used as a novel biomarker and diagnostic target for NSCLC.

Objective: To understand epidemiological characteristics of the pathogens and evolution of the genotype associated with infectious diarrhea epidemic caused by norovirus in Hebei Province. Methods: A total of 8 infectious diarrhea outbreaks caused by norovirus were reported from Jan 2015 to Dec 2016, of which epidemic treatment materials and specimens were collected at the same time. Norovirus nucleic acid was detected by using real-time PCR, and the partial ORF2 of the all positive specimens were amplified by RT-PCR and sequenced. Phylogenetic tree was constructed by using Mega5.2 based on partial ORF2 sequences of norovirus to perform phylogenetic analysis. Results: A total of 8 norovirus outbreaks, involving 265 cases who were mainly for residential inhabitents, children and students, were reported during this period, and the overall attack rate ranged from 0.70% to 8.13%. The overall positive detection rate of norovirus was 66.25%. The PCR products were sequenced, and sequencing result were obtained for 28 samples, which included GⅠ.3, GⅡ.2, GⅡ.4, GⅡ.13 and GⅡ.17. Conclusions Multiple genotypes of infectious diarrhea outbreaks caused by norovirus were found in Hebei province.

Objective: To analyze the application of accelerated rehabilitation surgery in elderly patients with gastric cancer surgery and its influence on inflammation and nutritional indicators. Methods: From October 2017 to October 2018, 80 elderly patients with gastric cancer who underwent gastrectomy in Shaoxing People's Hospital were selected.According to random number table method, they were randomly divided into traditional control group and ERAS group, with 40 cases in each group.The traditional control group was treated by traditional perioperative treatment + operation, while ERAS group was treated with ERAS perioperative treatment + operation.The recovery and complications, inflammation and nutritional changes before operation, 1 day after operation and 3 days after operation, and the improvement of quality of life after operation were compared and analyzed between the two groups. Results: In the ERAS group, the first exhaust time[(2.3±0.8)d] and defecation time[(2.5±0.4)d]were shorter than those in the traditional control group[(3.5±0.5)d and (3.7±0.6)d], and the incidence rate of complications (7.5%) was lower than that in the traditional control group (35.0%), the differences were statistically significant (t=8.72, 10.52, χ²=9.04, all P<0.05). On the first day after operation, the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6(IL-6) in the ERAS group were (28.3±4.9)μg/L and (23.1±5.8)μg/L, respectively, which were lower than those in the traditional control group[(39.8±6.7)μg/L and (34.5±8.1)μg/L](t=8.76, 7.24, all P<0.05). The serum TNF-α and IL-6 levels in the ERAS group on the 3rd day after operation were (18.4±6.2)μg/L and (18.3±3.2)μg/L, respectively, which were lower than those in the traditional control group[(26.2±5.1)μg/L and (26.5±4.8)μg/L](t=6.14, 8.99, all P<0.05). The serum levels of albumin (Alb) and prealbumin (PRE) in the ERAS group on the first day after operation were (31.1±0.7)g/L and (161.3±7.2) mg/L, respectively, which were lower than those in the traditional control group[(30.2±0.9)g/L and (154.3±4.8)mg/L](t=4.99, 5.12, all P<0.05). The serum levels of Alb and PRE in the ERAS group on the 3rd day after operation were (33.4±0.5)g/L and (172.1±5.0)mg/L, respectively, which were lower than those in the traditional control group[(31.9±0.8)g/L and (165.3±3.2)mg/L](t=10.06, 7.24, all P<0.05). The WHOQOL-BREF score of the ERAS group[(91.4±6.5)points]was higher than that of the traditional control group[(80.3±7.8)points](P<0.05). Conclusion Accelerated rehabilitation surgery has good effect for elderly gastric cancer surgery.It can maintain the inflammation and nutritional status of patients after operation.It is worthy of clinical reference.

Objective: This study aimed to investigate the prevalence of externalizing behavior problems (EBPs) and its influencing factors among Hui left-behind children (LBC) in rural China. Methods: A cross-sectional study was conducted among school students from the southern rural areas in Ningxia, China (2012–2013). The general self-made questionnaire, Egma Minnen av Bardndosna Uppforstran, Eysenck Personality Questionnaire (for Children), Piers-Harris Children’s Self-Concept Scale, and Achenbach’s Child Behavior Checklist (for parents) were used to investigate the related information. Binary logistic regressions were conducted. Results: The prevalence of EBPs in boys Hui LBC was significantly higher than that of non-LBC (12.37% vs. 6.84%, χ2=4.09, and p=0.04). Multivariate logistic regression analysis showed that low self-awareness of behavior (odds ratio [OR]=29.78), introversion (OR=21.67) and intermediate personality (OR=15.83), poor academic performance (OR=11.65) and both parent migrating (OR=2.73) were the risk factors for the EBPs of Hui LBC, while middle and high father refusal and denial (OR=0.11, OR=0.09) were their protective factors. Conclusion Our findings suggest that both parent migrating is a potential risk factor for EBPs among Hui LBC. Hui boys LBC should be paid more attention when formulating relevant policies.

Objective To investigate the effects of matrine on proliferation and apoptosis of human Tenon capsule fibroblasts (HTFs) in.vitro.Methods After treated with 0,0.3,0.6 and 0.9 g/L matrine in vitro,cell counting kit-8 (CCK-8) method was used to assay the proliferation of HTFs at 24,48 and 72 hours,Western blot and PCR were performed to evaluate the expression of apoptosis-associated factor caspase-3 on both protein and RNA levels.Results The activity of human Tenon capsule fibroblast at 48 hours and 72 hours after treated with 0.3,0.6,0.9 g/L matrine was significantly inhibited when compared with the 0 g/L matrine group,and the inhibitory effect was dose-dependent and time-dependent (F ion =1 019.51,P =0.00;Ftime =5 848.66,P =0.00;Fi ion =147.45,P=0.00).After treated with 0,0.3,0.6 and 0.9 g/L matrine,the early apoptosis rate of HTFs was (2.68±0.30)％,(5.08±0.47)％,(6.97±0.69)％ and (10.30±1.20)％,the grey value ofcaspase-3 protein was 1.00±0.13,1.90±0.19,2.50±0.30 and 2.67±0.30,the relative expression of caspase-3 mRNA was 0.98 ±0.12,2.01 ±0.34,6.15 ± 0.60 and 11.40 ± 1.12,respectively,with significant differences among them (F =55.74,66.01,154.50;all at P＜0.01),the early apoptosis rate of HTFs,the grey value of caspase-3 protein and the relative expression of caspase-3 mRNA were all increased significantly as the concentration of matrine increased,with significant differences between any two groups (all at P＜0.05).Conclusions Matrine can inhibit the proliferation of HTFs and induce the apoptosis of HTFs in a time-and dose-depended manner.