Objeetive To investigate the effects of timisartan on microinflammation state in maintenance bemodialysis patients.Methods In 40 maintenance hemodialysis patients and 20 healthy control subjects, the levels of C-reactive protein(CRP),interlukin-6(IL-6),tumor necroais factor alpha(TNF-α)were measured,the 40 maintenance bemodialysis patients were randomly divided into 2 groups to receive timisartan 80 mg daily or non-timisartan theraphy.All above parametes were assayed again after 24 weeks.Results Compared with healthy people,the serum CRP,IL-6,TNF-α were elevated significantly in patients with maintenance hemodialysis.After 24 weeks treatment,the levels of CRP,IL-6,TNF-α in Timisartan group was lower than before,and the levels of CRP, IL-6, TNF-α were much lower in timisartan group than non-timisartan group(P<0.01).Conclusions Timisartan can relieve the microinflammation state in maintenance hemodialysis patients.

Objective To investigate an effective method of autologous arteriovenous fistula formation for the elderly uremic patients with diabetic nephropathy.Methods The nest in the elbow above the median cubital vein at the curved incision 1-2 cm,inline high Fistula,namely arm cephalic vein and brachial artery bifurcation of the upper portion of the distal radioulnar side anastomosis in 20 cases over 75 years elderly uremic patients with diabetic nephropathy.And compared the effect of 16 cases of patients with similar conventional fistula.Results Twenty cases over 75 years elderly uremic patients with diabetic nephropathy were successful in all high dynamic fistula intravenous,blood flow was (1 007±131) ml/m,the immediate opening rate of 16 patients similar to conventional instant fistula was 12.5％,and a year after the opening rate was 6.25％ Conclusion High fistula are more easy to shape conventional,easy mature,full blood flow characteristics comparing with commom fistula,so elderly uremic patients with diabetic nephropathy fistula making difficult situation has been effectively improved.

Objective To study the clinical effect of minimally invasive treatment of 24 patients with hemor-rhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,ther-apeutic results of minimally invasive treatment were studied retrospectively.Results 24 patients with hemorrhagic moyamoya disease spontaneous intracerebral hematoma who need to acutely remove the hematoma were examined by CT angiography ( CTA) .Emergency minimal invasive puncture was performed according to the result of CTA,and the role of CTA in operation was analyzed.In all 24 patients,most of them were cerebral hemorrhage breaking into ventri-cles,5 cases with intracranial aneurysm.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AchA and P-CoM were observed in 9 patients,superficial temporal artery.Conclusion Minimally invasive treat-ment of hemorrhagic moyamoya disease scheme is simple,practical and effective,the maneuverability is strong.

Objective To explore the clinical characteristics of thyroid disease in patients with primary Sj(o)gren's syndrome (pSS).Methods A total of 81 pSS patients were retrospectively investigated for thyroid dysfunction and the presence of anti-thyroid peroxidase antibody (TPOAb),antithyroglobulin antibody (TGAb).Sex,age,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),white blood cell count,and serum immunoglobulins were also analyzed.Results Thirty-one patients were identified as having thyroid dysfunction,including 3 with hyperthyroidism,18 with hypothyroidism,and 10 with subclinical hypothyroidism.There were no significant differences in the incidences of some clinical manifestations between patients with or without thyroid dysfunction,such as dry mouth,dry eyes,joint pain,Raynaud's phenomenon,palpable purpura,peripheral neuropathy,interstitial lung disease,liver involvement,and renal tubular acidosis.Differences were not statistically significant for ESR and CRP between two groups.Also,the titers of anti-nuclear antibody,anti-SSA antibody,antiSSB antibodies,and rheumatoid factor between two groups showed no significant differences.However,white blood cell count [(5.65 ± 0.49 vs 7.22 ± 0.48) × 109/L,P＜0.05] and hematoglobin [(110.50 ± 3.64 vs 122.80 ± 3.02) g/L,P＜0.05],as well as the titers of TGAb [(587.30 ± 204.30 vs 58.76 ± 13.78) U/ml,P＜0.05] and TPOAb [(213.70 ± 39.64 vs 29.57 ± 8.49) IU/ml,P ＜ 0.05] were significantly different between the two groups.Conclusions Thyroid diseases are frequently associated with pSS.Therefore,extended screening for existing thyroid diseases during the routine assessment of pSS patients is recommended.

Objective To study the anticoagulation effect of low molecular weight heparin ( LMWH) on hemodiafiltration by different forms of administration. Methods Twenty-four uremic patients undertook hemodiafiltration were divided into ia and iv group randomly, acecepted single injection of LMWH. LMWH was administered to 12 patients by arterial injection ( predialyzer), while in the other 12 patients by venous injection (postdialyser). The APTT were measured before treatment and at 1 h,2 h,3 h time points after treatment in all patients. The dialysis fluid and blood levels of LMWH were measured at 2 minutes,5 minutes,1 h,2 h,3 h time points after the treatment started. Results The LMWH levels during hemodiafiltration were significantly higher in iv group than ia group (0.457 ± 0.073 ) U/ml vs. (0. 217 ± 0. 053 ) U/ml, t = 9. 702, P = 0. 001 ). However there were no significant APTT, dialyzer residual substance differences between two groups (P ＞ 0. 05 respectively )Conclusions Different ways of drug administration resulted in significantly different blood levels of LMWH, but did not affect the anticoagulant effect during hemodiafiltration, which would be related to LMWH absorption on dialysis membrant.

Female ; Humans ; Maternal Health Services ; Maternal Mortality ; Pregnancy

Objective To explore the clinical features,diagnosis and treatment of solid-pseudopapillary tumor(SPT)of pancreas.Methods The clinical data of 19 patients with SPT treated in 8 years were studied retrospectively,included 3 males and 16 females.Results The type of operation was decided by the size and location of tumor.Pancreatic leakage was a familiar complication,there were 9 cases.Patients were followed up from 3 to 70 months,and no recurrence or metastsis was found.Conclusion Pancreas SPT is a rare type neoplasm of pancreas.Pancreas SPT is affecting primarily young women,complete resection results in excellent prognosis.

Objective To investigate the teaching effects of Sandwich teaching mode applied in clinical oncology teaching.Methods Totally 72 clinical medicine undergraduates were divided into two groups randomly:Sandwich teaching group and traditional teaching group.Sandwich teaching mode was introduced to Sandwich teaching group while traditional teaching mode was carried out in traditional teaching group.Questionnaires and test paper were analyzed between the two groups and two teaching modes were evaluated.Examination results were statistically analyzed by t test.Results According to the questionnaires,more than 80 percent of the students thought that the initiative and enthusiasm were fully mobilized by the Sandwich teaching mode.Studying efficiency was improved significantly and skills of independent thinking,comprehensive analysis and problem-solving were trained,meanwhile,Sandwich teaching mode can improve the ability of expression and communication.Test score of students in Sandwich teaching group was higher than those in traditional teaching group (P＜0.05).Conclusions Sandwich teaching mode has obvious advantages in improving teaching quality of clinical oncology and it may help to cultivate high quality oncology specialists.

China has a large number of hepatocellular carcinoma patients, and more than half of the new cases and deaths of hepatocellular carcinoma in the world occur in China every year. The chemosensitivity of hepatocellular carcinoma is relatively low. Targeted therapy with antiangio-genic drugs are main treatment options for advanced hepatocellular carcinoma, but the effective rate and survival prolonging effect are very limited. Recently immune checkpoint inhibitors have exhibited promising efficacy in hepatocellular carcinoma, which is changing the pattern of hepatocellular carcinoma treatment. However, challenges still exit. Biomarkers commonly used in clinical practice including programmed death ligand-1, tumor mutational burden and mismatch repair proteins have limited clinical value in hepatocellular carcinoma. Compared with other etiology related liver cancer, hepatitis B related hepatocellular carcinoma in China harbors unique gene mutation map, but the individualized treatment strategy based on molecular typing has not yet been established. More effective and diversified systematic treatment methods can promote the comprehensive treatment of hepatocellular carcinoma into a new era, and the relevant diagnosis and treatments need to be further explored and established. Based on relevant literatures and combined with clinical practices, the authors investigate the progress and consideration of immunotherapy strategy for hepatocellular carcinoma.

Objective::To preliminarily investigate the values of failure mode and postoperative radiotherapy in non-small cell lung cancer (NSCLC) patients with chest wall invasion.Methods:A total of 69 T 3 stage NSCLC patients who underwent thoracic surgery in our hospital from 2010 to 2018 and presented with postoperative pathological findings of chest wall invasion were recruited. The outcomes between the post-operative radiotherapy and non-radiotherapy groups were assessed by propsensity matching analysis. Kaplan- Meier survival analysis and Cox’s model prognostic factors analysis were performed. Results:The median survival time of 69 patients was 25 months and the median progression-free survival was 8 months. Thirty-six cases were diagnosed with primary stage M 0 including 28 cases (78%) of R 0 resection and 33 cases (48%) were diagnosed with stage M 1a and received non-R 0 resection because of pleural metastases. In total, 53 cases (77%) suffered from disease progression, and 26 cases (38%) experienced local recurrence including 58% of mediastinal lymph node recurrence and 36% of chest wall tumor bed recurrence. Distant metastases were observed in 50 cases (73%) including 43% of pleural metastases. Univariate analysis showed that age, pathological staging, range of primary lesion invasion, postoperative radiotherapy and postoperative targeted therapy were significantly associated with overall survival (all P<0.05). The overall survival in the postoperative radiotherapy group was better than that in the non-radiotherapy group. No statistical difference was observed in the progression-free survival, local recurrence-free survival and distant metastasis-free survival between two groups (all P>0.05). Conclusions:For NSCLC patients with chest wall invasion, distal metastasis failure is the main cause, while local failure mainly consists of mediastinal lymph node and chest wall recurrence. Postoperative radiotherapy may improve survival. Nevertheless, the combination and benefit degree of postoperative comprehensive treatment need to be further confirmed by prospective studies.