Objective To survey the incidence of sleep disorders among patients with industrial injuries and analyze the relevant factors.MethodsA total of 112 depressed patients ( male 106,female 6; aged 22-79 years,course of disease 35 d-25 years) were assessed by a professional psychologist using life satisfaction index A,the type A behavior pattern scale,the Pittsburgh sleep quality index (PSQI) and the Barthel index.ResultsThe incidence of disordered sleep was 40.18％ (45/112),of whom mildly depressed patients were 34.29％,moderately depressed patients 42.86％ and severely depressed patients 85.71％.The incidence of sleep disorders increased with increasing depression severity.The incidence of disordered sleep was significantly higher among the severely depressed patients than among those mildly or moderately depressed,but there was no significant difference in incidence between moderately and mildly depressed patients.PSQI scores among the severely and moderately depressed patients were significantly higher than among those mildly depressed,but there was no statistically significant difference in average PSQI scores between the severely and moderately depressed patients.The sleep disorder group suffered significantly poorer sleep quality and took significantly longer to get to sleep.There were no significant differences in average age,educational level,marital status,social relations,family and social support,gender distribution or course of disease between the two groups.There were,however,significant differences in family income,life satisfaction,character type and disease species between the groups.ConclusionThe incidence of disordered sleep among depressed patients after industrial injury is correlated with the severity of depression,family income,life satisfaction,the type of injury and the patient's character.

Objective To explore the clinical value of portal exposure in laparoscopic treatment of children with type Ⅲ biliary atresia (BA).Methods From June 2013 to October 2017,30 infants with type Ⅲ BA who treated with laparoscopic portoenterostomy in Huai'an Women and Children's Hospital were selected.A percutaneous suture was used to snare the round ligament and retract the liver,other percutaneous stay sutures were then introduced and fundus and neck of gallbladder were sutured to elevate the liver to expose the portal hepatis.The fibro cord and hepatic vessels were mobilized,and then two rubber bands were put around the left and right portal veins and hepatic arteries.The portal hepatis was exposed by laterally stretching the two elastic rubber bands.The fibro cord was removed and then laparoscopic portoenterostomy was accomplished.In 20 cases,the liver was enlarged,part of hepatic lobus quadratus was removed laparoscopiclly for exposure of the portal hepatis.Results There were 30 cases in this group,2 cases were converted to open surgery by a micro transverse incision.There was no surgical death.Time of laparoscopic procedure varied from 210 to 280 min.All cases survived the surgery without any intraoperative complications.Blood loss during operation was minimal,without necessity for blood transfusion.One case died of respiratory failure one week after surgery.Two cases were lost follow-up.Twenty-five cases were followed up for 3～51 months(mean 22.4 months).Three cases died because of repeated cholangitis and liver failure at 10,16,35 months postoperatively.Nineteen patients' total bilirubin had dropped to normal,three others' bilirubin levels dropped significantly after surgery.Conclusion The technique of laparoscopic hepatic porta exposure can help to complete hepatic portoenterostomy successfully,reduce the conversion rate of laparoscopic surgery,and improve the surgical effect.

Objective To analyze the detection results of apolipoprotein B (ApoB) and serum uric acid (SUA) in patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of150 NAFLD patients admitted to our hospital were selected as study group, and 150 healthy people with physical examination in the same period were as the control group. Low density lipoprotein cholesterol (LDL-C), triglyceride (TG), alanine aminotransferase (ALT), waist-hip ratio (WHR), body mass index (BMI), total cholesterol (TC), ApoB, creatinine (Cr), SUA levels were measured in the two groups. The correlation between SUA, ApoB and NAFLD was analyzed by multiple Logistic regression analysis. At the same time, smoking, coronary heart disease, diabetes and hypertension were compared between the two groups. Results The levels of LDL-C, TG, ALT, WHR, TC, BMI, SUA and ApoB in the study group were higher than those in the control group (P ＜ 0. 05). The levels of Cr in the study group were significantly lower than those in the control group (P ＜ 0. 05). The results of multiple Logistic regression analysis showed that the levels of SUA and ApoB were independently and positively correlated with NAFLD and were independent risk factors for NAFLD. The incidences of smoking, coronary heart disease, diabetes mellitus and hypertension were significantly higher than that of the control group (P ＜ 0. 05). Conclusion The levels of SUA and ApoB are positively correlated with NAFLD. The higher the levels of SUA and ApoB are, the higher the incidence of cardiovascular disease is. Therefore, blood lipid intervention should be carried out in time to control the development of NAFLD.

Objective To analyze the detection results of apolipoprotein B (ApoB) and serum uric acid (SUA) in patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of150 NAFLD patients admitted to our hospital were selected as study group, and 150 healthy people with physical examination in the same period were as the control group. Low density lipoprotein cholesterol (LDL-C), triglyceride (TG), alanine aminotransferase (ALT), waist-hip ratio (WHR), body mass index (BMI), total cholesterol (TC), ApoB, creatinine (Cr), SUA levels were measured in the two groups. The correlation between SUA, ApoB and NAFLD was analyzed by multiple Logistic regression analysis. At the same time, smoking, coronary heart disease, diabetes and hypertension were compared between the two groups. Results The levels of LDL-C, TG, ALT, WHR, TC, BMI, SUA and ApoB in the study group were higher than those in the control group (P ＜ 0. 05). The levels of Cr in the study group were significantly lower than those in the control group (P ＜ 0. 05). The results of multiple Logistic regression analysis showed that the levels of SUA and ApoB were independently and positively correlated with NAFLD and were independent risk factors for NAFLD. The incidences of smoking, coronary heart disease, diabetes mellitus and hypertension were significantly higher than that of the control group (P ＜ 0. 05). Conclusion The levels of SUA and ApoB are positively correlated with NAFLD. The higher the levels of SUA and ApoB are, the higher the incidence of cardiovascular disease is. Therefore, blood lipid intervention should be carried out in time to control the development of NAFLD.

Objective:To explore the possibility of laparoscopic simple oblique duodenoduodenostomy in the management of congenital duodenal obstruction in neonates.Methods:The clinical data of neonates with congenital duodenal obstruction undergoing laparoscopic simple oblique duodenoduodenostomy at Huaian Women and Children′s Hospital from February 2015 to February 2018 were retrospectively reviewed.By a lower-pressure pneumoperitoneum of 5-8mmHg and a suspending suture for right liver elevator, the procedure was performed using 4 ports: a transumbilical 5-mm port for the camera and another three 3-mm ports for instruments.After kocherizing of the proximal and distant part of the duodenum, the lower duodenum was incised longitudinally 0.5-1cm distal to the blocked end, the upper duodenum incision was placed 0.5cm away from the blocked end extended downward obliquely.The duodenoduodenostomy was performed as a " simple" " oblique" anastomosis with 5-0 PDS suture.Results:Fifteen patients were identified with a median age at operation of 2 days.Of all the cases, 4 cases were duodenal atresia (type Ⅲ), 11 cases were annular pancreas, and 7 cases of them were annular pancreas complicated with congenital intestinal malrotation.All cases were treated with laparoscopic simple oblique duodenoduodenostomy.Ladd procedure was accomplished in 7 cases with congenital intestinal malrotation in the meantime.The average operative time was (115.0±25.5) min (70-145 min). Feedings were started on postoperative 4-10d (mean 6.0d), without abdominal distention and vomit, all patients were discharged in good health with a median postoperative hospital stay of 7-14d(mean 10.6d). There was no mortality rate, no conversion to laparotomy, and no intraopertive complications in the group.The cases were followed-up for 2-36 months (mean 15.6 months), and all cases were doing well.Conclusion:Laparoscopic simple oblique duodenoduodenostomy is safe and efficacious in neonatal period, and can be a viable option in the treatment of neonates with congenital duodenal obstruction.