Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective To evaluate the predictive value of HEART and GRACE scores for risk stratification and 30-day major adverse cardiovascular events (MACE) in patients with acute chest pain in emergency department.Methods This is a prospective observational study.Patients with acute chest pain aged 18 years or older who were first diagnosed in our emergency department were enrolled from January 1,2016 to September 1,2017.The clinical data were collected,and HEART and GRACE scores were calculated.All causes of MACE in each patient were followed up for 30 days.Results This study included 1004 patients with acute chest pain for analysis.Finally this study enrolled 600 patients with an age range of 20-98 years (mean 63.28±15.47 years),351 males (58.5％) and 249 females (41.5％).The age,past history (smoking,coronary heart disease and diabetes),GRACE score and HEART score in MACE patients were significantly higher than those in non-MACE patients (P＜0.05).The area under the ROC curve of HEART and GRACE scores were 0.817 (95％ CI 0.771-0.863) and 0.739 (95％ CI:0.687-0.791),respectively.The percent of patients with 30-day MACE with GRACE score and HEART score were 6.2％ vs 4.1％ in low-risk stratification,19.7％ vs 15.1％ in medium-risk stratification,and 35.1％ vs 56.5％ in high-risk stratification,respectively.Conclusions The HEART score is superior to the GRACE score in predicting 30-day MACE in patients with acute chest pain in emergency department.

Objective To compare the effects of remifentanil and fentanyl in urologic surgery under endoscopic anesthesia and the incidence of adverse reactions in patients.Methods A total of 170 patients undergoing urological surgery admitted to the Second People 's Hospital of Jinzhong from February 2015 to April 2016 were randomly divided into the study group and control group according to the digital table ,with 85cases in each group. Remifentanil and fentanyl was used in the study group and control group respectively .The preoperative anesthesia was performed in the patients who received anesthesia before and after tracheal intubation and before and after tracheal intubation,and the time of induction of anesthesia ,the operation time and the time of postoperative wakefulness were compared between the two groups.Pressure and heart rate changes ,the incidence of adverse reactions were recorded and compared between the two groups.The amount of anesthesia ,anesthesia surgery costs and the amount of bleeding during surgery were compared.Results The induction time of anesthesia in the study group was significantly shorter than that in the control group (9.8min vs.6.9min,t＝12.029,P＜0.05).The mean arterial pressure and heart rate in the study group were significantly larger than those in the control group ( all P＜0.05).The incidence rate of adverse reactions in the study group was significantly lower than that in the control group (5.9% vs.12.9%,χ2＝7.935,P＜0.05).The cost and blood loss of the study group were significantly lower than those of the control group (2 871.4 CNY vs.3 014.9 CNY;23.4mL vs.32.7mL,t＝20.391,17.907,all P＜0.05).Conclusion The application of remifentanil in preoperative anesthesia of urologic surgery can save time ,reduce the economic burden of patients and the incidence of adverse reactions in patients.It is worthy of widely recommended in clinic.

Objective To explore the HEART risk score in predicting 30-day major adverse cardiovascu-lar events (MACE)for the patients presenting to Emergency Department (ED) with acute chest pain. Methods Patients presented in our ED with acute chest pain were enrolled from January,2016 to April,2016. All cause MACE of each patient were followed up at 30 days by Health insurance information management System and call . Results Total 209 patients were enrolled(mean age 65.28 ± 16.85 years;52.63%male). The age,hypertension, ratio of ACS,SpO2,in-patient number HEART score in MACE subject were significantly higher than that in non MACE patients(P<0.05). The blood pressure at admission of MACE patients was significantly decrease than that in non MACE patients(P<0.05). The MACE within 30 days was 5.74%. The respective areas under the curve (AUC)for 30-day MACE(95% CI)was 0.908(0.846 ~ 0.974). The percent of patients with 30-day MACE with HEART scores between 0% and 3,4 ~ 6,and 7 ~ 10 was 0%,2.5%,and 27%,respectively. Conclusion HEART score can be simple,rapid and accurate prediction of emergency department of patients with acute chest pain within 30 days of MACE,effective elimination of low-risk patients with MACE,it plays a very important role for disease assessment and diagnosis and treatment process in emergency department.

A glassy carbon electrode (GCE) modified with gold nanoparticles loading on the reduced graphene oxide (rGO)-multi-walled carbon nanotubes (MWCNTs) composite film was fabricated by a two-step procedure.Firstly, rGO-MWCNTs composite were prepared by in-situ chemical reduction method with hydrazine as a reducing agent.Then, AuNPs were deposited on the surface of rGO-MWCNTs using simple cyclic voltammetry.This modified electrode was characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS) and electrochemical methods.Furthermore, the electrochemical behavior of bisphenol A (BPA) was also investigated using this modified electrode.The results showed that the modified electrode had high electrochemical activity for the oxidation of BPA.In 0.10 mol/L phosphate buffer solution (PBS, pH 7.0), the linear range for the determination of BPA with differential pulse voltammetry (DPV) was in the range of 5.0 × 10-9 -1.0 × 10-7 mol/L and 1.0 × 10-7-2.0 × 10-5 mol/L.The detection limit was 1.0 × 10-9 mol/L (S/N=3).The as-prepared modified electrode was successfully used to determine BPA in river water and the shopping receipt samples with recovery ranges of 97%-110% and 98%-104%, respectively.

Objective To observe the interference of glucose-6-phosphate dehydrogenase (G6PD) deficiency on glycated hemoglobin (HbA1c) detected by three measurement systems.Methods A total of 286 cases of blood and serum samples were collected at Zhongshan Hospital of Sun Yat-Sun University from August 2012 to April 2016.The blood samples were divided into healthy control group (122 cases),diabetes group (82 cases),glucose-6-phosphate dehydrogenase deficiency group (61 cases) and diabetes with G6PD deficiency group (21 cases).The levels of HbA1 c were detected by three measurement systems,including Primus Ultra2,Variant lⅡ Turbo 2.0 and Modular P.The results of HbA1c were converted into the estimated average blood glucose concentration (eAG).The values of A eAG-FPG in different groups were calculated and statistical analysis was performed for evaluation of the differences from the three measurement systems.Results The HbA1c results measured by the three systems and AeAG-FPG values in G6PD deficiency group were all lower than healthy control group(all P ＜0.05).The measured results were similar in both diabetes group and diabetes with G6PD deficiency group.Conclusion G6PD deficiency may cause false H-bA1c results detected by three measurement systems.In the case of HbA1c for evaluating blood glucose control,the interference of G6PD deficiency should be noticed.

Objective To explore the relationship between semen leukocyte and liquefaction and sperm motility through the anal‐ysis of routine semen examination results .Methods Retrospectively analyze on 8 666 cases of routine semen examination .Accord‐ing to the leukocyte count the semen samples which had sperms were divided into three groups ,Group A :white blood cells≤1 × 106/mL ,Group B:(1-4)× 106/mL ,Group C :>4 × 106/mL .Then compare the liquefaction time and sperm motility of these three groups .Results Among the 8 666 cases of semen analysis ,there were 164 cases of azoospermia(accounting for 1 .9% ) and 8 502 fine cases(accounting for 98 .1% ) .There were 7 419 ,1 014 and 69 cases in Group A ,B ,C respectively .In the three groups ,there were 5 323 ,740 and 50 cases of normal sperm motility respectively ;there were 2 096 ,274 and 19 cases of the abnormal motility ca‐ses respectively .In the three groups ,the normal cases of semen liquefaction time were 4 593 ,608 and 43 respectively ;the abnormal were 2 826 ,406 and 26 cases respectively .Statistical analysis showed no significant correlation between semen leukocyte and lique‐faction(P=0 .712) ,and between semen leukocyte and sperm motility(P=0 .486) .There were 1 217 cases of normal sperm motility and 4 027 cases of abnormal sperm motility in normal liquefaction group;there were 1 172 cases of normal sperm motility and 2 086 cases of sperm motility in abnormal liquefied group .There was statistically significant difference between the two groups(P=0 .000<0 .05) .Conclusion There were no correlation between semen leukocyte count and liquefaction or sperm motility ,but sperm mo‐tility and liquefaction are correlated .

Objective To study the gas analysis of umbilical cord artery blood and radial artery blood on predicating the prognosis of asphyxia neonate?Methods From September 2014 to September 2015, 328 neonates were divided into groups by Apgar score:290 patients in the control group and 27 patients in the mild asphyxia group,11 patients in the severe asphyxia group?After birth,umbilical artery blood,radial artery blood gas analysis was perfomed, oxygenation index was calculated, Outcome of neonatal behavioral neurological assessment ( NBNA) in neonates with asphyxia was regular follow?uped,the relationship between pH value and umbilical artery blood gas analysis was analyzed?Results The pH, PO2, PCO2 and oxygenation index of umbilical cord blood and radial artery blood in the severe asphyxia group was(7?11±0?25,(73?93±23?35) mmHg,(51?36±16?37) mmHg,206?23±98?12),significant different than the mild group(7?24±0?05,(86?35 ±12?56) mmHg,(45?89± 9?21) mmHg,411?22±57?94) and the control group(7?28±0?08,(87?80±12?07) mmHg,(43?68± 6?45) mmHg,426?23±73?30)(P<0?05)?The pH,PO2,PCO2 and oxygenation index of umbilical cord blood and radial artery blood in the severe asphyxia group was(7?25±0?18,(74?66±24?09) mmHg,(51?42±17?83) mmHg,332?03±65?19),significant different than the mild group(7?31±0?09,(87?24 ±11?75) mmHg,(45?73±10?21) mmHg,405?67±82?65) and the control group(7?32±0?06,(87?99±11?81) mmHg,(42?84± 9?32) mmHg,439?89±60?76)(P<0?05)?The NBNA scores of the severe asphyxia group was (34?09±5?02) points,lower than the mild group(36?62±2?04)(F=21?65,P<0?05)?The NBNA scores showed significant relationship with umbilical cord blood pH in the severe asphyxia group( r=0?877,P<0?01)?Conclusion The pH,PO2 and oxygenation index of umbilical cord blood and radial artery blood was lower while PCO2 was markedly high in the severe asphyxia group than other groups?For neonates, there is a correlation between umbilical cord blood pH and NBNAs core, neonates borned with hypoxia and acidosis should monitor blood gas analysis and oxygenation index dynamically

The impact of maintenance therapy on progression?free survival and overall survival as well as quality of life of Chi?nese patients with metastatic colorectal cancer has long been under discussion. Recently, some phase III clinical trials have revealed that maintenance therapy can signiifcantly prolong the progression?free survival while maintain an acceptable safety proifle. Based on this evidence and common treatment practice in China, we now generated one Expert Consensus on Maintenance Treatment for Metastatic Colorectal Cancer in China to further specify the neces?sity of maintenance therapy, suitable candidates for such treatment, and appropriate regimens.

Objective To investigate the interference of hyperlipidemia and hyperbilirubinaemia to HbA1c measurements by ion‐exchange high‐performance liquid chromatography(IE‐HPLC) method .Methods Fresh whole‐blood samples collected with EDTA‐K2 anticoagulant tubes were divided into four groups :control group(HbA1c<6 .2% ) ,diabetes group(HbA1c≥6 .2% ) ,hyperlipi‐demia group(TG 3 -20 mmol/L);hyperbilirubinaemis group (TBIL 21 -549 μmol/L) .HbA1c of these samples were measured with affinity chromatography(AC‐HPLC) and IE‐HPLC respectively .Results When HbA1c≤18 .7% ,r=0 .993 ;95% confidence interval(CI) of HbA1c results by using IE‐HPLC method was -0 .71 -0 .89 ;coefficient of variation was -5 .8% -6 .8% ;P=0 .198 and the difference was not statistically significant .When HbA1c< 16 .3% ,r= 0 .997;95% CI of HbA1c results with IE‐HPLC method is -0 .31-0 .67;coefficient of variation was -5 .8% -4 .3% .P=0 .000 and the difference was statistically signifi‐cant .No interference was detectded with the results ;When HbA1c was 16 .3% -18 .7% ,positive bias was observed with the re‐sults .When TG≤20 .78 mmol/L ,r=0 .995;95% CI of HbA1c results with IE‐HPLC method was -0 .26-0 .50 ;coefficient of var‐iation was -5 .5% -5 .8% .P=0 .000 and the difference was statistically significant .No interference was detectded with the re‐sults;When TBIL≤549 .3 μmol/L ,r=0 .990 ;95% CI of HbA1c results with IE‐HPLC method was -0 .08 -0 .63;coefficient of variation was -14% -4 .1% .P=0 .000 and the difference was statistically significant .When TBIL≤342 .1 μmol/L ,r= 0 .994 ;95% CI of HbA1c results with IE‐HPLC method was -0 .09-0 .50;coefficient of variation was -5 .5% -4 .1% .No interference was detectded with the results .When TBIL was 380 .7-549 .3 μmol/L ,negative bias was observed with the results .Conclusion Our data indicated that HbA1c measurement with IE‐HPLC method could resist the interference of hyperlipidemia;When TBIL≤380 .7 μmol/L and HbA1c<16 .3% ,the results could meet the needs of general clinical detection .Clinical staff should choose more specific HbA1c measurement method according to the patient's condition .