Arteriovenous fistula stenosis developed in 32 patients who received hemodialysis from April 2014 to April 2016, including 24 cases of autologous arteriovenous fistula ( AVF) and 8 cases of artificial vessel arteriovenous fistula ( AVG).In AVF patients, there were 20 cases with blood flow decreasing and 4 cases of venous hypertension , while in AVG patients there were no cases with blood flow decreasing and 8 cases with venous pressure increasing (χ2 =17.77, P<0.001).All patients underwent percutaneous transluminal angioplasty ( PTA ) . In all patients the vascular diameter was increased significantly after PTA treatment [(3.6 ±0.2) vs.(1.2 ±0.1) mm, t=18.52, P<0.001].The blood flow during hemodialysis was increased significantly after PTA treatment in patients with anastomoti stenosis [(265.4 ±21.5) vs.( 150.5 ±23.1 ) ml/min, t =21.81, P <0.001 ]; however, there were no significant changes in venous pressure [(68.6 ±8.7) vs.(69.3 ±6.1) mmHg(1 mmHg=0.133 kPa), P>0.05].The blood pressure was decreased after PTA treatment [( 71.2 ±7.9 ) vs.( 170.4 ± 15.7) mmHg, t=34.62, P<0.001] in patients with venous outflowtract stenosis , however, there were no significant changes in the blood flow [(264.1 ±15.2) vs.(260.7 ±17.3) ml/min, t=1.04, P>0.05].

Objective To evaluate the diagnostic value of combined test of C-reactive protein,amylase and lipase for acute pan-creatitis patients in early stage,and its practicability in assessment of disease severity.Methods 71 cases of acute pancreatitis pa-tients in the hospital from March 2012 to March 2014 were enrolled in the study,including 60 cases of mild pancreatitis patients,11 cases of severe pancreatitis patients.Meanwhile,30 cases of non-acute pancreatitis patients were enrolled as Control Group A,and 50 cases of adults who underwent conventional examination and proved to be healthy were enrolled as Control Group B.Detection of C-reactive protein,amylase and lipase of these samples were performed and the results were recorded,compared and analyzed.Re-sults The serum amylase level of acute pancreatitis patients was (759.42±721.63)U/L,and serum lipase level were (1 624.34± 1 598.25)U/L,which were significantly higher than people in Control Group A and Control Group B,with statistical significance (P <0.05).However,C-reactive protein level of acute pancreatitis patients were (44.61±34.21)mg/L,which were not statistical-ly different compared with Control Group B.Combined test of the three indicators demonstrated that the sensitivity was 95.9%, specificity was 100% and accuracy was 96.9%,all of which were higher than other test combinations or singe test with statistical significance(P <0.05 ).Conclusion The combined test of C-reactive protein,amylase and lipase for acute pancreatitis patients doesn′t only improve early diagnostic efficiency,but also is helpful in disease severity judgment.

Tumor markers play an important role in tumor mass screening, diagnosis and differential diagnosis of tumor, tumor staging, therapeutic evaluation and prognosis assessment. According to the nature,tumor markers can be classified as follows: embryonic antigen, carbohydrate antigens, proteins, enzymes, hormones, and so on. And tumor markers have been used in clinical widely.

Objective To evaluate the effects of hypothermic cardiopulmouary bypass(CPB) on depth of anesthesia measured by BIS and auditory evoked potential index(AEPI) monitoring and cerebral O_2 and glucose metabolism. Methods Twenty-eight ASA Ⅱ-Ⅲ patients of both sexes(15 males, 13 females) aged 29-55 yrs undergoing elective cardiac valve replacement under hypothemic CPB were studied. Patients were excluded from the study if they had hearing disturbance, hepato-renal dysfunction, diabetes melhtus, hypertension, cerehro-vascular or mental diseases. The patients were premedicated with intramuscular morphine 0.15 mg?kg~(-1) and scopolamine 0.3mg. Anesthesia was induced with midazulam 0.05-0.1 mg?kg~(-1), fentanyl 10 ug?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with intermittent ⅰ.ⅴ. boluses of fentanyl, diazepam and pancuronium. Radial artery was cannulated for BP monitoring and blood sampling. A CVP catheter was inserted into right internal jugular vein and advanced in a cephalad direction until jugular bulb for blood sampling. BP, HR, T℃(naso-pharyngeal), BIS and AEPI were continuously monitored during operation. Arterial and jugular bulb blood samples were obtained before CPB(T_1), T℃ was lowered to 33℃(T_2)during stable hypothermia(T_3) during rewarming at 33℃(T_4) and 30 min after termination of CPB(T_5) for blood gas analysis and determination of glucose and lactate concentrations. Cerebral oxygen extraction rate(O_2 ER) cerebral glucose extraction rate(GER), arterial-jugular bulb venous lactate difference(DLa-jv) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) were calculated. Results Blood glucose and lactate concentrations were significantly increased, while arterial blood pH and DLa-jv did not change significantly during CPB. Cerebral oxygen extraction rate(O_2ER), cerebral glucose extraction rate(GER) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) decreased while jugular bulb venous oxygen saturation (SjvO_2) increased with decreasing body temperature. BIS and AEPI values decreased with decreasing T℃ and both were well correlated with T℃. AEPI was positively correlated with O_2 ER and negatively correlated with Ca-jvO_2 whereas BIS was positively correlated with PaO_2. Conclusion Cerebral metabolism is decreased during hypothermic CPB which also deepens anesthetic depth measured by BIS and AEPI monitoring.

Objective:To investigate the clinical effects and safety of triple therapy based on ipratropium bromide inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary diseases ( AECOPD) . Methods:Totally 150 patients with acute exac-erbation of AECOPD were randomly divided into control group (75 patients) treated with budesonide combined with salbutamol by in-halation, and treatment group (75 patients) treated with ipratropium bromide inhalation additionally. The clinical effects, dyspnea score, pulmonary function index and blood gas analysis index before and after the treatment and the incidence of adverse reactions of the two groups were compared. Results:The clinical effects of the treatment group was significantly better than that of the control group (P<0. 05). The dyspnea score, pulmonary function index in and blood gas analysis index in the two groups after the treatment were significantly better than those before the treatment(P<0. 05), and the improvement of the treatment group was significantly better than that of control group (P<0. 05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0. 05). Conclusion:Triple therapy including ipratropium bromide inhalation in the treatment of acute exacerbation of AECOPD can ef-fectively alleviate clinical symptoms and signs and improve the lung ventilation function without increased risk of adverse reactions.

Objective:To observe cardiovascular events and risk of tumor in aged patients with diabetes mellitus (DM) .Methods :A total of 2743 DM patients ,who visited to our department of endocrinology from 2004 to 2010 , were enrolled as DM group ,another 2642 people without glucose metabolic disorder ,who visited to our hospital dur‐ing the same period with the same age ,were regarded as normal control group .Incidence rates of cardiovascular dis‐eases and morbidity of malignant tumor ,levels of tumor markers were compared between two groups (both groups were followed up for 2~7 years) .Results:Follow‐up found that cardiovascular disease rate in DM group was signif‐icantly higher than that of normal control group (21.47% vs .6.43% , P<0.05 );tumor marker CA19‐9 level in DM group was significantly higher than that of normal control group [ (17.89 ± 3.61) kU/L vs .(9.78 ± 2.64) kU/L ,P=0.001] ,and incidence rate of malignant tumor was significantly higher than that of normal control group (18.34% vs .8.18% , P=0.001) .Conclusion:Incidence rate of cardiovascular events and tumor in aged patients with diabetes mellitus is significantly higher than that of people without glucose metabolic disorder of same age .

BACKGROUND:The chronic wounds, also cal ed non-heading wounds, can seriously affect the quality of life of patients and has brought heavy burden to patients, as wel as health care professionals. celltherapy is a new method for promoting wound healing and plays an important role in the repair of chronic wounds.
OBJECTIVE:To summarize the progress of researches on the chronic wound healing mechanism and celltherapy, and to provide evidences for the clinical management of chronic wounds and relative basic researches.
METHODS:A computer search of CNKI database from 2005 to 2012, PubMed database from 1995 to 2012 and Foreign Medical Journal Ful-Text Service database from 2000 to 2012 was performed using“non-healing wounds, diabetic foot ulcer, wound healing, celltherapy”in Chinese and English as the key words to retrieve articles about chronic wound healing mechanism and the application of celltherapy. Total y, 42 articles meeting the inclusive criteria were included in result analysis.
RESULTS AND CONCLUSION:The wound healing is a complex biological process, involving multiple celltypes, extracellular matrix and cytokine factors. The delayed healing of refractory wound seriously affects the quality of life of patients and has brought heavy economic burden to patients. At present, many methods have been employed to promote wound repair, such as local hyperbaric oxygen therapy, surgical treatment, herbal Chinese medicine, application of various growth factors, celltherapy and gene therapy. celltherapy is noninvasive and those delivered cells can adapt to their environment, are able to release growth factors and cytokines, and more importantly, are able to deliver the growth factors for the wound healing process due to cellsignaling capabilities. Currently, cells used for the treatment of chronic wound cells mainly include bone marrow stem cells, bone marrow-derived mesenchymal stem cells, cord blood stem cells, peripheral blood stem cells, epidermal stem cells, skin-derived progenitor cells, adipose stem cells, fibroblasts and platelets.

Small molecule inhibitors of Bcl-2 are a novel class of anticancer drugs that target anti-apoptotic proteins. In recent years,small molecule inhibitors such as ABT-737 ,ABT-263, gossypol, apogossypol,TW-37,obatoclax, HAl4-1 have attracted much reseach attention. Preclinical trials have shown that the inhibitors have cancer killing effect on some tumors when used alone and exhibit striking synergistic effect when combined with radiotherapy and/or chemotherapy.

Objective]To introduce professor YU Jingmao’s experience in treament of children with adenoid vegetation. [Methods]To select 3 effective cases of adenoid vegetation diseases, clarify professor YU Jingmao’s features of treatment based on syndrome differentiation, stage therapy and drug characteristics, and then analyze and expound the clinical experiences of professor Yu Jingmao. [Result]Professor YU Jingmao in infantile adenoid vegetation body therapy, treats in three stages:the early cure dispelling wind pathogens to clear heat reducing swelling;medium-term plans to raise Yin and moisture lung, promoting blood circulation to remove blood stasis;late to invigorate qi for consolidating superficies, nourish yin to clear away heat,often obtains better effect. [Conclussion]Professor YU Jingmao’s dialectical claim of in treatment of adenoid vegetation,stage therapeutics,purgation-tonifying and cultivste vital qi are worth learning.