Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on the sleep disorder and examination results of recruits.Methods At a training base,the Pittsburgh Sleep Quality Index(PSQI)was used to screen the recruits with sleep disorders(total score of PSQI>7).The recruits were randomly assigned to rTMS group or sham rTMS group.Both groups received cognitive and behavioral intervention therapy,including sleep health education and relaxation training.Moreover,the rTMS group was treated with rTMS at the right posterior parietal lobe by continuous theta burst stimulation(cTBS)twice a day at an interval of at least 50 min for 5 consecutive days as a course of treatment with an interval of 2 days for a total of 2 courses of treatment.The coil position and stimulus intensity of sham rTMS group were consistent with the rTMS group,but the head of subjects was perpendicular to the coil plane and there was no effective stimulation.Before and after treatment,PSQI,self-rating depression scale,generalized anxiety disorder-7 and health questionnaire-15 were used to evaluate the sleep,mood and physical state of the recruits.The training result was assessed one month after treatment.The total effective rate of PSQI improvement and examination results were compared between the two groups.The independent influencing factors of excellent examination result were analyzed.Results Among 351 recruits,83 with sleep disorders completed treatment and follow-up.There were 40 patients in the rTMS group and 43 patients in the sham rTMS group.There was no significant difference between the two groups at baseline.After treatment,the total effective rate of PSQI improvement in the rTMS group was higher than that in the sham rTMS group(77.50%vs 53.49%,P=0.022).The average examination score and excellent rate of the rTMS group were higher than those of the sham rTMS group(91.58±3.19 vs 89.47±4.67,P=0.020;85%vs 65.12%,P=0.037).Logistic regression analysis showed that the treatment mode(rTMS group)was the independent influencing factor of excellent examination results(P=0.032).Conclusion rTMS can effectively and safely improve the sleep disorders and examination results of recruits.rTMS may play a positive role in improving the learning and training effect of recruits,which needs to be further proved.

Objective:To explore the risk factors for nonunion or malunion after internal fixation of femoral neck fracture.Methods:A retrospective analysis was done of the 140 patients with femoral neck fracture who had been admitted to Department of Traumatology and Orthopedics, Weifang People's Hospital from January 2013 through June 2019. They were 61 males and 79 females, aged from 18 to 65 years (average, 51.3 years). All patients received "inverted triangle" internal fixation with 3 hollow nails after reduction. The univariate analysis was conducted of the 9 factors: age, gender, fracture side, Garden classification, injury-to-operation time, reduction quality, postoperative ambulation with crutches but no weight-bearing, preoperative bone density, and preoperative 25-hydroxyvitamin D3 concentration. Multivariate logistic regression analysis was used for the factors with P<0.05 to identify risk factors. P<0.05 was considered statistically significant. Results:This cohort of 140 patients obtained follow-up for 6 to 12 months (average, 10.8 months). Nonunion or malunion occurred in 25 cases of them (17.86%). The multivariate logistic regression analysis showed that Garden types Ⅲ&Ⅳ ( OR=2.873, 95% CI: 1.027~8.039, P=0.044), non-anatomic reduction ( OR=4.678, 95% CI: 1.133~19.310, P=0.033), postoperative ambulation time with crutches but no weight-bearing <3 months ( OR=0.230, 95% CI: 0.072~0.737, P=0.013), and preoperative 25-hydroxyvitamin D3 concentration<30 ng/mL ( OR=3.718, 95% CI: 1.337~10.341, P=0.012) were the risk factors for nonunion or malunion after internal fixation of femoral neck fracture. Conclusion:The risk factors for nonunion or malunion after internal fixation of femoral neck fracture may be the Garden types Ⅲ&Ⅳ, non-anatomic reduction, postoperative ambulation time with crutches but no weight-bearing <3 months, and preoperative 25-hydroxyvitamin D3 concentration < 30 ng/mL.

Ultrasound-based measurement of relative blood volume can be used to assess patient's dry weight during hemodialysis. The results of relative blood volume were calculated from the ultrasonic transmission time measurement in the arteriol pot, and the accuracy of transmission time measurement is directly related to the reliability of the results of relative blood volume. There are various factors which influence the travel time, this article analyzed patients themselves, measuring device and the external factors, and advised appropriate counter measures.

OBJECTIVE: To evaluate the safety and effect of foley catheter traction for hemorrhage after postmicrochannel percutaneous nephrolithotomy (mPCNL). METHODS: Eighty-eight patients with upper urinary calculi were collected prospectively at the Department of Urology of Xiangya Hospital of Central South University from November 2010 to June 2011. The patients underwent mPCNL, and were divided into 2 groups randomly: 45 patients with 16F foley catheter but without traction served as the control group, and the other 43 patients with 16F foley catheter traction served as the experiment group. Blood loss was estimated by the mass of hemoglobin in the draining liquid and urine during postoperative duration through the HiCN. The blood loss and bleeding time were compared in the 2 groups, and analyzed by Wilcoxon rank sum test. RESULTS: There was statistical difference in the average blood loss between the control group (13.830 g) and the experiment group (7.959 g, P<0 .001). The mean bleeding time was 4 and 3 days in the control group and the experiment group respectively. CONCLUSION Foley catheter traction for mPCNL can reduce the blood loss, suggesting that Foley catheter traction is safe, effective and feasible.
Adolescent ; Adult ; Aged ; Blood Loss, Surgical ; prevention & control ; Child ; Female ; Hemostatic Techniques ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; adverse effects ; methods ; Postoperative Hemorrhage ; therapy ; Prospective Studies ; Traction ; Ureteral Calculi ; surgery ; Urinary Catheterization ; Young Adult

OBJECTIVETo investigate the genetic variation and typing of hepatitis B virus (HBV) in patients with chronic hepatitis B in relation to HBeAg status.

METHODSFluorescence quantitative polymerase chain reaction (PCR) was employed to detect serum HBV DNA in patients with chronic hepatitis B negative for HBeAg. Real-time fluorescent PCR and PCR-reverse dot blot hybridization were used to detect HBV genotypes and mutations, respectively.

RESULTSOf the 389 patients, 214 (55.01%) were positive and 175 (44.99%) were negative for HBV DNA; 102 (26.22%) had a HBV DNA copy number of 1×10(3), and 41 (10.54%) had a copy number of 1×10(4) (Χ(2)=226.6729, P<0.001). Of the 21 patients with a HBV DNA load of 1×10(5), 15 (71.43%) were found to have precore mutations, and 11 (52.38%) had basic core promoter (BCP) mutations; a higher HBV-DNA load was associated with an increased incidence of HBV mutations. In the 214 patients positive for HBV DNA, HBV genotypes A, B, C, D and the mixed type were found in 6 (2.80%), 84 (39.25%), 106 (49.53%), and 7 (3.27%), and 11 (5.14%) patients, who showed precore mutation rates of 16.67% (1 case), 36.90% (31 cases), 44.34% (47 cases), 0, and 0, and BCP mutation rates of 0, 19.05% ( 16 cases), 26.42% (28 cases), 0, and 0, respectively, demonstrating significant differences in HBV mutations between the genotype groups (P<0.001).

CONCLUSIONHBeAg-negative and HBV DNA-positive patients with chronic hepatitis B have a relatively low HBV replication level, and HBV DNA load is associated with HBV mutations. The B and C genotypes are more likely to have HBV mutations in HBeAg-negative patients.

DNA, Viral ; blood ; Female ; Genotype ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; classification ; genetics ; Hepatitis B, Chronic ; blood ; virology ; Humans ; Male ; Mutation ; Promoter Regions, Genetic ; Viral Core Proteins ; genetics ; Viral Load

Objective To prepare the coating of dexamethasone-eluting intravascular stent and observe the features of its delayed release in vitro.Methods Spray painting and dipping coating were used respectively to prepare stent coating,and then high performance liquid chromatography(HPLC)was used to detect the drug loading.The stents prepared by dipping coating were set in a flow of 50 ml PBS buffer at a velocity of 20 ml/min,and 0.5 ml buffer was collected at 6 h and 1,2,4,6,8,10,12,15 d respectively with another 0.5 ml fresh PBS being added immediately.The drug content of the 0.5 ml buffer was detected by HPLC for drug sustained release in vitro.Results The drug loading of stents prepared by spray painting was(24.26?5.23)?g,while that stents prepared by dipping coating for 4 d was(93.15?7.83)?g.Drugs were released slowly and the release rate reached 84% at 15 d.Conclusion The dipping coating-prepared stents have evident effect of sustained release.

Objective To analyze frequent causes of serious complications of laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on the diagnosis and treatment of 10 cases of serious complications out of 986 cases of LC. Results The complications included 2 cases of bile leakage caused by the detachment of titanic clips, 1 case of subphrenic Abscess, 3 cases of common bile duct injury, 2 cases of residual stones in the common bile duct, 1 case of duodenal injury, and 1 case of jejunal perforation caused by the Veress needle. No severe outcomes were seen after treatment. Conclusions Causes leading to complications in LC include local adhesion, serious inflammatory edema, serious intraperitoneal adhesion around the umbilicus, anatomic variations of the gallbladder, and lack of experience and proficiency in surgical performance.