Objective To evaluate clinical importance of high ligation combined with endovenous laser treat-ment(EVLT)for great sapenous varicose veins patients with diabetes,to provide a reference for clinical treatment. Methods 65 great sapenous varicose veins patients with diabetes were selected,and they were set as the observation group with treatment of high ligation combined with EVLT;while 50 great sapenous varicose veins patients without diabetes were selected during the same period,they were set as the control group under the same treatment.Clinical effect and complication were compared between the two groups.Results The wound cure rate of the observation group was 96.92%,surgery time was (42.94 ±7.93)min,hospital stay time was (6.87 ±1.74)d,there were no statistical differences compared with the control group (χ2 =1.003,P =0.174;t =0.994,P =0.254;t =0.883,P =0.317);The complication rate of the observation group was 18.46%,that of control group was 18.00%,there was no statistical difference between the two groups(χ2 =1.114,P =0.097).Conclusion With control of blood sugar,high ligation combined with endovenous laser treatment can get a good result and safety performance for great sapenous varicose veins patients with diabetes.

Objective:To investigate the intervention effect of vitamin C for the treatment to diabetes patients with diabetes and gastric ulcer.Methods: 53 cases of patients with diabetes combined with gastric ulcer were selected as the research subjects, and were divided into a control group(23) and a intervention group(30). The patients in two groups were given the treatment of reducing blood sugar and anti-HP triple therapy. The intervention group was given additionally diet intervention via eating vitamin C. The blood sugar, blood lipid levels, gastric ulcer index and inflammatory markers of the two groups were reviewed six months later by helicobacter pylori type detector. And the statistical analysis was performed.Results: After treatment, the blood sugar, blood lipid levels, gastric ulcer index and inflammatory markers of the two groups were significantly improved (t=1.23,t=1.35,t=2.63,t=1.07,t=0.77,P<0.05), except for the HP cure rate (P>0.05). Other indexes of the intervention group are significantly better than the control group (t=1.45,t=1.67,t=2.33, t=1.55,P<0.05).Conclusion:Vitamin C play a very good role in the treatment and prevention for the blood sugar, the blood lipids, gastric function and inflammation of patients with diabetes and gastric ulcer, and helicobacter pylori type detector can simplify the detection of helicobacter pylori.

Health education is not only the first step to health management,but also an important health intervention.It has an important significance for promoting the development of health management because it runs through the whole process of health management.However,because the health management has just started in our country,it faces many challenges when putting the health education into effect in the health management process.From the organizational structure,management system,resources,education content and method of the implementing body,this paper summarized eight problems existing in the implementation.This paper tried putting forward corresponding countermeasures,and hoped to be helpful to the further development of health education.

Objective To explore the effectiveness of bilevel positive airway pressure(Bipap)ventilation via nasal/ mouth mask in patients with respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases(COPD).Methods 40 patients were randomly submitted either to standard therapy(consisting of medical,oxygen and physical therapy)plus BiPAP or to standard therapy.Clinical manifestation were comparatively analyzed before and after 4 hours and 7 days of treatment in each group.Results After 4 hours and 7 days of treatment by BiPAP,patients showed a significant improvement in PaCO_2,and clinical manifestation,and there was a significant difference between the two groups.Conclusion Bipap ventilation is effective in patients with respiratory failure during acute exacerbation of COPD.

Objective To investigate the value of prevention of cerebral ischemia with multi-modality neuroelectrophysiological monitoring in intracranial aneurysm embolization. Methods The clinical data of 44 patients with intracranial aneurysm treated with endovascular embolization from May 2013 to June 2014 were analyzed retrospectively. The patients were divided into two groups according to whether they used intraoperative neuroelectrophysiological monitoring. There were 21 patients in a monitoring group and 21 in a non-monitoring group. According to the site of the aneurysms,somatosensory evoked potential ( SEP),motion evoked potential( MEP),scalp electroencephalogram,and brainstem auditory evoked potential (BAEP)were monitored,and at one day after procedure,their newly developed neurological deficits and the follow up observation after 3 months in both groups were compared and analyzed. Results The intraoperative SEP,MEP,and scalp EEG changes in the monitoring group were observed in 9,3 and 4 patients,respectively. Timely preventive measures were taken for 9 of the patients with cerebral ischemia revealed by neuroelectro-physiological monitoring. At the first day after procedure,the incidence of patients with new neurological deficit was 17. 4%(4/23)in the monitoring group,and that was 47. 6%(10/21)in the non-monitoring group. There was significant difference between the 2 groups(χ2 =4. 623;P<0. 05). There was significant difference in the good prognosis rates(87. 0%[20/23]vs. 57. 1%[12/21])after 3-month follow-up (χ2 =4. 919;P<0. 05)between the 2 groups. There were no deaths in both groups. Conclusion Multimode in combination with neuroelectrophysiological monitoring may decrease ischemic complications in aneurysm interventional treatment and improve the safety of procedure.

Objective To investigate the histological injury as well as the risk factors for the course of HBeAg-negative chronic hep-atitis B virus( HBV)-infected patients with persistently normal alanine aminotransferase ( ALT) levels ( PNAL) . Methods Ninty four patients of HBeAg-negative chronic HBV-infected with PNAL were performed liver puncturing. The ALT, HBV markers, and liver histo-logical changes were detected. The gender, age, family history, HBV-DNA and HBsAg levels were compared between different patients with liver inflammation and fibrosis. And the Logistic model was used during the analysis of independent risk factor. Results Among 94 cases, patients with inflammatory necrosis classification≥G2 accounted for 74. 5%, fibrosis grading≥S2 accounted for 27. 7%. Patients in the group of inflammatory necrosis classification≥G2 was older than the group of < G2, and the ALT level of≥G2 group was higher, as well as a higher HBV-DNA. What is more,Patients in the group of inflammatory necrosis classification ≥G2 were mainly male, and were associated with a family history of hepatitis B. Patients in the group of fibrosis stage ≥S2 was older than < S2 group, and the ALT level of fibrosis stage ≥S2 group was higher. And those patients were often associated with a family history of hepatitis B, but there was no significant difference among the HBV-DNA level and gender constitution. HBV-DNA and family history were the independent risk fac-tors of liver inflammation necrosis≥G2, and family history was the only independent risk factor of fibrosis stage≥S2. Conclusion The patients of HBeAg-negative chronic HBV-infected with PNAL, regardless of the ALT and HBV-DNA, must have a liver biopsy. The pa-tients with high level of HBV-DNA and with a family history of hepatitis B should be performed liver puncturing accordingly.

Objective To investigate the diagnostic value for rheumatoid arthritis(RA) by using combined detection of anti‐cy‐clic citrullinated peptide antibody (anti CCP ) ,anti keratin antibody (AKA ) and the antiperinuclear factor (APF ) in serum . Methods A total of 110 RA patients(RA group) ,50 patients with other autoimmune diseases(non RA group) and 110 healthy subjects (control group) were enrolled in the study .The concentrations of AKA ,APF were detected by using indirect immunofluo‐rescence assay and anti CCP by using ELISA .Results The positive rates of anti‐CCP ,AKA ,APF in RA group were higher than those in non RA group and control group(P<0 .05) .In the series detection of the three indicators ,the sensibility and specificity were 44 .55% and 99 .38% respectively ;in the parallel detection of the three indicators the sensibility and specificity were 93 .64%and 85 .63% respectively .Conclusion Anti CCP detection exhibits relatively higher sensitivity and specificity in the diagnosis of RA .Series detection of the 3 indicators can improve the specificity ,reduce the rate of misdiagnosis;parallel detection of the 3 indica‐tors can improve the sensitivity ,reduce the rate of misdiagnosis .The Combined detection of anti CCP ,AKA and APF has better di‐agnostic efficiency than single detection .

Objective To evaluate the diagnostic values of enzyme‐linked immunosorbent assay (ELISA ) and colloidal gold im‐munochromatographic assay in detecting serum anti‐cyclic citrullinated peptide(anti‐CCP) antibody .Methods Colloidal gold immu‐nochromatographic assay and ELISA were used to detect serum anti‐CCP antibody in 110 RA patients and 110 healthy cases . Results The data were analysed with the paired Chi‐Square Test (χ2 = 174 .354 ,P < 0 .01) ,the difference was significant .The K ap pa value was 0 .890(P< 0 .01) ,indicating that the coincidence between the two kinds of methods was good .The sensitivity , speciality of ELISA were 83 .64% and 92 .73% respectively .Conclusion In detecting serum anti‐CCP Antibody ,there was dife‐rence between colloidal gold immunochromatographic assay and ELISA according to statistics analysis .The sensitivity and speciality of ELISA were higher than those of colloidal gold immunochromatographic assay .

[Objective] To investigate the height change of intervertebral space after anterior cervical fusion and its relation to neck axial symptoms.[Method]Totally 122 patients receiving anterior cervical fusion were followed up for 2 to 5 years,average 3.9 years.The height change of intervertebral space of the fused segment on X-rays were evaluated before,3 months and 2 years after operation.All patients were classified into 3 groups by means of the postoperative height change of intervertebral space.The axial symptoms after operation were observed and analyzed during follow-up.[Result]The incidence of neck axial symptoms was 54.55%,25.84% and 45.45%,respectively.There were significant differences in statistical analysis in group A group B,group B to group C(x2=7.18,P0.0125).[Conclusion]There is significant relation between height change of intervertebral space and neck axial symptoms after anterior cervical fusion.

[Objective]To analyze and compare the results of the posterolateral entrance and posterior laminectomy in treating thoracic disc herniation.[Method]From Nov.1998 to Feb.2006,fifty-one cases were treated with posterolateral entrance combined with the facet disectomy(Group A),and 26 patients were treated with the vertebral disectomy instead of the thoracic disc tissue disectomy.Complications occurring in the follow-up time were investigated and the improving rates were calculated.Otanni Systems was used to evaluate the clinical results.The SPSS 13.0 was used for statistic work.[Result]The operation time was 130～185 min(mean 162 min) for Group A,145～205 min(mean 168 min) for Group B.No difference existed(P=0.062).The blood lost was 400～600 ml(mean 485 ml),while in group B,it was 500～800 ml(mean 646 ml),tbere was significant difference(P=0.013).The clinical satisfaction rate of group A was 86.3%,26 patients returned to perfect results,with 18 in good,6 in fair and 1 in poor results.In group B,the clnical satisfaction rate was 69.2%.There was significant difference between 2 groups(P=0.025).Seven out of the 51 patients had complications in group A.Two patients of neurological dysfunction showed no improvement.One patient was found having spinal cord reactive edema.Internal fixation system was removed in 2 patients because of loosening and paresthesia.Anterior spinal artery syndrome was found in 1 patient.Leakage of CSF was observed in 1 patient.While in the Group B,six patients neurological dysfunction showed no improvement.One patient was found having spinal cord reactive edema.Internal fixation system was removed in 1 patient.Anterior spinal artery syndrome was found in 1 patient.Leakage of CSF was observed in 2 patients.There were obvious difference(P=0.034).[Conclusion]Posterolateral entrance is effective in treating thoracic disc herniation.Comparing with the posterior laminectomy,this operation method is safer,more effective and has less complications.