Objective To analyze the correlation of discomfort experience and factual recollection (FR) in patients of intensive care unit (ICU). Methods Fifty-five ICU patients and 63 ward patients par-ticipated in the study. Standardized questionnaires were used to evaluate all patients" FR and the results underwent analysis. Results The prevalence of recollection of any type of discomfort in the ICU patients was 64%. The presence of an endotracheal tube, pain and hallucinations were identified as sources of dis-comfort.The median score for FR in the ICU patients was 7.25. The median score for FR in the ward pa-tients was 13.50. The difference between them was highly significant (t =3.34, P < 0.01 ). Logistic analysis revealed that discomfort, especially discomfort caused by the presence of an endotracheal tube, pain and hallucinations, was positively related to FR, 0R95%CI (1.2～2.1), P < 0.01. Conclusions The presence of an endotracheal tube, pain and hallucinations were most frequently reported as sources of discomfort in ICU patients and their memory was often impaired. FR and recollection of discomfort appear to be related significantly in ICU patients.

LabVIEW is applied to the realization of virtual oscilloscope, and such functions are fulfilled as waveform display, parameter measurement, filter, spectral analysis, data storage and playback.

Objective: To discover and prevent diabetes early in high-risk group. Methods:Chose 323 records of type 2 diabetes or IFG,IGT patients with first course which come from a large hospital in Lanzhou between 2009 January to 2014 March; Use Apriori algorithm and the SPSS Clementine 12 software design;Set up prediction model of type 2 diabetes. Results:A total of 10 strong association rules are formed. The strong association rules contain some associations between factors and type 2 diabetes. Conclusion: Through the association rules, the initial judgment on the high-risk group of diabetes is simple and accurate.

Objective To investigate the treatment of perinail refracture after surgery of proximal femoral fracture.Methods From January 2010 to January 2015,we treated perinail fractures in 31 patients who had undergone surgery for proximal femoral fracture.They were 11 men and 20 women,with an average age of 75.6 years (range,from 24 to 87 years).On average,their refracture occurred 9.4 months after primary fixation (range,from 3 to 60 months).With reference to the Vancouver classification of peri-prosthestic refractures in the proximal femur and the position and bone quality of perinail refractures,we tried to classify the perinail fractures and chose different treatment protocols accordingly.In our cohort,6 were type A,5 type B,15 type C,and 5 type D.Type A cases were treated conservatively,and types B and C cases with locking compression plate or less invasive stabilization system.In one case of type D,dynamic hip screws were implanted to fixate the femoral neck fracture after removal of the original intramedullary nail,and hip replacement was conducted in the other 4 after removal of the original intramedullary nail.Results The operation time averaged 2.1 hours (range,from 1.6 to 3.0 hours) and intraoperative bleeding 600 mL (range,from 150 to 800 mL) in this cohort.Of them,27 were followed up for an average of 15 months (range,from 12 to 24 months),giving a follow-up rate of 87.1％ (27/31).Six type A fractures obtained bone union after protected weight-bearing walking for 12 weeks.All the 16 fractures of types B and C healed after an average period of 4.2 months (range,from 3 to 6 months).Of the 5 type D fractures,one obtained bone union 12 weeks after change into dynamic hip screwing and 4 had fine functional recovery after hip replacement.No infection,nonunion,or implants failure occurred.Conclusions We have set an exploratory classification system for the perinail refractures at the proximal femur with reference to the Vancouver classification of peri-prosthestic refractures.Our classification can provide effective guidance for the treatment of perinail refracture after surgery of proximal femoral fracture.

Objective To investigate the distribution of antiphospholipid antibodies(APA) in patients with systematic lupus erythematosus (SLE) and normal controls and its significance. Methods Six kinds of APA were detected by enzyme linked immunosorbent assay(ELISA). The examined sera were collected from 82 cases of normal controls and 32 cases of SLE. Results ①The positivity rate of IgG type aCL, aPI, aPA, aPE, aPS and aPC in the serum from normal controls was 6.10%, 6.10%, 7.32%, 7.32%, 3.66% or 3.66%, respectively. ②The positivity rate of IgM type aCL, aPA, aPC, aPS, aPE aPI in serum from normal controls was 2.44%, 3.66%, 3.66%, 6.10%, 6.10% and 4.88%, respectively. ③Compared with normal controls, the A values and positivity rate of IgG type of aCL, aPA, aPS, aPC and aPI in SLE patients were significantly higher. ④Compared with normal controls, the A values and positivity rate of IgM type of aCL, aPA, aPS, aPE and aPC in SLE patients were significantly higher. ⑤The total positivity rate of IgG type and IgM type APA was 68.75% or 71.88%, respectively. Conclusion ①There is lower titer of APA in normal controls, with some relationships between different types of APA and they appear at the same time.②the measurment of APA in sera of SLE might be benefit to the diagnosis of antiphospholipid syndrome. [

Objective To compare the effects of different methods of getting out of bed for the first time in patients receiving lumbar disc herniation operations.Methods Totally 60 patients receiving lumbar disc herniation operations were divided into the experimental group and the control group with 30 patients in each group.The patients in the experimental group got out of bed with prone position.The patients in the control group got out of bed with lateral position.The pain scores and degrees of comfort were recorded.Results The experimental group scored 5.4±1.3 in pain degree,and the control group scored 6.1±1.8,t=0.37,P ＞ 0.05,the difference was not significantly different.The experimental group scored 85.7±10.9 in comfort degree,and the control group scored 70.6±11.5,t=4.21,P ＜ 0.05,the difference was significantly different.Conclusions The method of getting out of bed with prone position can reduce negative emotions of patients receiving lumbar disc herniation operations and improve degrees of comfort.

Objective To study the long-term results of using an autologous vascularized pedicled flap of gastric tissues in the repair of traumatic bile duct strictures.Methods From 2002 to 2016,38 patients with traumatic bile duct strictures underwent repair using an autologous vascularized pedicled flap of stomach tissues.The postoperative morbidity,mortality,long-term clinical results,liver function and the rate of biliary stricture recurrence were studied.Results The overall complication rate was 18.4％ (7/38).A delay in healing of the incision wound occurred in 4 patients,biliary fistula in 2,and ascites in 1.Two patients died of malignant tumor.The median follow-up was 92 (61 ～ 107) months and the follow-up rate was 100％.Excellent results were obtained in 97.2％ (35/36) of patients.Abnormal liver function was detected in 1 patient which improved with treatment using choleretic drugs.The remaining 35 patients had normal liver functions with absence of abdominal pain.Conclusions To repair traumatic bile duct strictures using an autologous vascularized pedicled flap of stomach tissues was safe and reliable,and good long-term outcomes are available.

Objective To investigate the distribution of measured value and the expected value of spirometry parameters in healthy children aged 5-14 years old in Beijing,and to provide evidence for clinical interpretation precisely.Methods Four hundred healthy children (198 boys and 202 girls) aged 5 to 14 years from the kindergartens and the primary schools in Beijing were selected as subjects.All of the parameters were measured by using Jaeger Masterscreen spirometry machine(Germany).Pulmonary function parameters including forced vital capacity(FVC),forced expiatory volume in 1 second (FEV1),FEV1/FVC,peak expiratory flow(PEF),forced expiratory flow at 50% of vital capacity(FEF50),forced expiratory flow at 75% of vital capacity(FEF75),and the maximal midexpiratory flow(MMEF) were collected for analysis.The expected values of the 7 parameters above were calculated according to Zapletal prediction equations(4-18 years old).The measured value vs.the expected value was calculated.Results Children aged 5 to 12 years had similar height and weight between boys and girls,and the differences were not significant(all P>0.05);while boys were taller and heavier than girls in 13-<14 years old group and 14 years old group,and the diffe-rences were significant(t=3.35,2.05,5.99,2.67;all P<0.05).The mean measured value vs.the expected value of PEF,FVC,FEV1,FEV1/FVC of children in different gender and age groups ranged between 105.0%-114.7%,95.4%-106.8%,104.6%-115.4% and 105.8%-112.6%,respectively.The mean measured value vs.the expected value of small airway function parameters FEF50,FEF75,MMEF was as follows respectively:79.7%-103.7%,70.2%-110.5%,and 81.6%-114.7%.The low limit of normal(LLN) measured value vs.the expected value of the 7 pulmonary function parameters was as follows:PEF 85.0%,FVC 84.7%,FEV1 92.4%,FEV1/FVC 98.4%,FEF50 67.7%,FEF75 60.1%,and MMEF 71.0%.Conclusions The pulmonary function parameters of the healthy children in Beijing are higher than those of the Zapletal prediction.The measured value vs.the expected value of FEV1 92.4%,FEV1/FVC 98.4%,PEF 85.0%,FVC 84.7%,FEF50 67.7%,FEF75 60.1%,and MMEF 71.0% can be used as LLN in 5-14 years old children.

Objective To compare the clinical efficacy and prognosis between classical infra-patellar (IP) and supra-patellar (SP) intramedullary nailing in the treatment of tibial shaft fractures.Methods A retrospective analysis was conducted of the 68 patients with tibial shaft fracture who had been treated from June 2012 to December 2014 and completed follow-ups.They were 59 males and 9 females,18 to 87 years of age (mean,43.7 years).Of them,38 were treated through the SP approach and 30 through the IP approach.The 2 groups were compared in terms of surgery-related indexes,The Hospital for Special Surgery (HSS) knee function score and Johner-Wruhs evaluation for clinical efficacy at 1,3,6,and 9 months postoperation.The 2 groups showed no significant differences regarding preoperative general data(P ＞ 0.05).Results The 68 patients obtained an average follow-up of 6 months (range,from 1 to 9 months).Intra-operative accumulative fluoroscopy time in the IP group(2.1 ± 1.1 s) was significantly less than in the SP group(3.3 ± 1.8 s) (P ＜ 0.05).The number of limited open reduction (1),intra-operative bleeding volume (128.6 ± 164.1 mL) and number of second intra-operative shifting (4) in the SP group were significantly smaller than in the IP group(7,216.2 ± 195.9 mL and 10,respectively) (P ＜ 0.05).The HSS score in the SP group at 9 months (80.8±7.Spoints) was significantly higher than in the IP group (74.0±5.4points)(P ＜0.05).The clinical good to excellent rate at 9 months for the SP group (97.4％) was significantly higher than for the IP group (70.0％) (P ＜ 0.05).There were also significant differences between the 2 groups in postoperative adverse events like knee pain(P ＜ 0.05).No wound infection,limb shortening,internal fixation loosening or rupture,fracture nonunion or mal-union happened in either of the 2 groups.Conclusions In the treatment of tibial shaft fractures with intramedullary nailing,the supra-patellar surgical approach may effectively reduce the incidence of postoperative knee pain so that it can prevent degenerative changes of the knee joint in the long term.It may also lower the incidence of intraoperative second shifting.It also has the advantages of limited incision,simplicity,and limited scaring.In short,it may be superior to the classical infra-patellar approach.

Objective To explore the effects of Pannexin1 (Px1) channel protein on osteogenic differentiation of mesen?chymal stem cells (MSCs) under mechanical stress stimulation. Methods Bone marrow was extracted from Sprague Dawley (SD) rats (3 weeks, weighing 100-120 g) and cultured following 1st generation cellular technology. The safe dose of CBX (an inhibitor of Px1 channel protein) on MSCs was determined by CCK8 method and 100 μmol/L was used. The MSCs were cultured by the whole marrow culture method. When the cell was passaged to 3-4 generation, high purity of the MSCs were harvested. MSCs were divided into three groups:control group, stress?stimuli group (4 000μstrain) and stress stimuli+CBX group. The duration of stress was 15 min and CBX pre?treatment time point was 3 h, 6 h, 12 h, and 24 h, respectively. The alkaline phosphatase (ALP) activity, type I collagen expression, intracellular calcium ion (Ca2+) concentration, and Px1 channel protein, p?p38MAPK and p?ERK ex?pression were determined. Results ALP activities were highest in the stress group, and it was reduced by pretreatment of CBX. Similarly, stress increased the expression of type I collagen, concentration of Ca2+, and expressions of Px1 channel protein and p?p38MAPK was reduced by CBX. p?ERK was down?regulated by stress but not affected by CBX treatment. Conclusion Mechani?cal stress could promote osteogenic differentiation of MSCs and this promotion was inhibited by pretreatment of CBX, which might result in regulation of p?p38MAPK.