Objective To investigate the effect of carvedilol combined with spironolactone in the treatment of elderly patients with chronic heart failure clinical efficacy and to provide reference for clinical treatment of formulation. Methods 104 elderly patients with chronic heart failure were randomly divided into observation group and control group,52 cases were randomly divided into observation group and control group.Control group intervention in accord-ance with the conventional treatment of chronic heart failure program,the observation group in the conventional scheme based on,combined with oral carvedilol and spironolactone therapy.6 months after treatment,clinical efficacy was compared between the two groups.The results of echocardiography before and after treatment in two groups were compared.The adverse reactions in the treatment process were compared.Results The effective rate in the observation group was 59.62%,the total effective rate was 96.15%,which were significantly higher than those of the control group (χ2 =4.10,9.82,all P <0.05);After treatment,LVEDD and LVESD of the two groups were significantly lower than those before treatment[(51.89 ±7.06)mm,(41.39 ±6.85)mm,(60.71 ±7.43)mm,(51.02 ±7.95)mm], LVEF[(52.31 ±9.02)% and (41.64 ±7.73)]were significantly higher than that before treatment,there were statistifically significant differences between the two groups(t =4.92,5.10,5.45,2.87,2.98,3.03,all P <0.05);After treatment,LVEDD[(51.89 ±7.06 )mm],LVESD [(41.39 ±6.85 )mm]of the observation group were significantly lower than those of the control group,and LVEF(52.31 ±9.02)% were significantly higher than that of the control group,there were statistifically significant differences between the two groups (t =3.02,2.98,2.97,all P <0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P >0.05).Conclusion Carvedilol combined with spironolactone can significantly improve the clinical effect of the treatment of elderly patients with chronic heart failure,effectively improve the left ventricular remodeling in patients with,improve myocardial contractility in patients and has good security.

OBJECTIVE:To study the clinical features of adverse drug reactions(ADR)in our hospital.METHODS:A total of 95 ADR cases reports collected in our hospital in 2006 were analyzed statistically and retrospectively.RESULTS:Of the 95 ADR cases,adults aged 19～60a took the lead(52.6%),intravenous drip(51.6%)took the lead,65.3% were caused by antibacterials,lesions of skin and the appendants were the most common manifestations,accounting for 41.1%.CONCLUSION:Great importance should be attached to the monitoring of ADR and publicizing of ADR knowledge to improve rational drug use level.

OBJECTIVE:To establish a method for preparation and quality control of compound dexamethasone liniment.METHODS:The compound dexamethasone liniment were prepared with dexamethasone acetate and vitamin E,the contents were determined by HPLC.RESULTS:The calibration curves of dexamethasone acetate and vitamin E were linear in the range of2～40?g/ml and80～800?g/ml respectively,and their average recoveries were100.5%(RSD=0.82%)and98.6%(RSD=0.59%)respectively.CONCLUSION:The preparation is reasonable in formula,simple and accurate in quality control.

Objective: To observe the effect of carboxyl-amino-polysaccharide on the gastric ulcer. Methods: Various rat models of gastric ulcer were established respectively by ethanol, aspirin, hydrochloric acid, acetic acid and bound stress in water bath. Results: Inhibitory rates of carboxyl polysaccharide in the dose of 0.5, 0.33, 0.17g/kg were 42.09%, 35.55%and 33.53%for the ethanol-induced model; 53.65%, 49.48%, and 49.76%for the aspirin-induced model; 51.48%, 44.09%, and 33.64%for the hydrochloric-acid-induced model, 49.44%, 46.23%, and 45.10%for the acetic-acid-induced model and 50.12%, 44.63%and 41.92%for the bound-stress-induced model respectively. Conclusion: Carboxyl-amino-polysaccharide can prevent and treat gastric ulcer. Its effect is similar to that of denol, famotidine and cimetidine.

To explore the role of CDC25B in pathogenesis and development of colorectal cancer and to investigate the relation between the expression of CDC25B and the clinical pathological character of colorectal cancer and the prognosis of patients. The expression of CDC25B in 168 patients with colorectal cancer and 25 patients with adenoma, and normal colorectal mucosa from 20 individuals was assayed by immunohistochemistry (S-P method). The expression of CDC25B was not detected in adenoma and normal colorectal mucosa. The expression rate of CDC25B in colorectal cancer was 71.4%(120/168). The expression of CDC25B had a positive correlation with distant metastasis and the increase of CEA,while it had no relationship with the tumor stage, grade, lymph node metastases, gender, age or the size of tumor . The patients in whom expression of CDC25B was detected had a markedly low 5-year survival rate. The results suggested that expression of CDC25B in colorectal cancer might accelerate the transformation of cell cycle,which promoted metastasis to distant organ, indicating that the expression of CDC25B might play a role in the development of colorectal cancer. The expression of CDC25B was a risk factor of poor prognosis.

Objective To explore the cell-mediated immune function in patients with colon cancer undergoing minilaparotomy or laparoscopic assisted right hemicolectomy. Methods From January 2009 to August 2014, the colon cancer patients receiving right hemicolectomy were retrospectively analyzed. According to the operation mode, the patients were divided into minilaparotomy group and laparoscopic-assisted group. The clinical and pathological data was analyzed. Cell counts of total CD3, CD4, CD8, CD19 as well as NK cells in venous blood samples were compared between 1 day before surgery and postoperative days (POD) 1 and 5. Measurement data with normal distribution was compared using the t test or Q test. Count data was analyzed usingχ2 test or Fisher exact probability. Results There were 408 patients with colon cancer undergoing right hemicolectomy, 26 patients of whom were excluded. The remaining 382 patients were recruited in the research, which were divided into minilaparotomy group (182 cases) and laparoscopic-assisted group (200 cases). There was no significant difference in the age, gender, body mass index, TNM staging, histological type, blood loss, return of bowel function, tumor location, hospital stay and postoperative complications between the two groups (all P> 0.05). The operating time in minilaparotomy group [(131.53 ± 22.57) min] was shorter than that in laparoscopic-assisted group [(167.53 ± 22.04) min], and there was significant difference (t=15.76, P= 0.00). Compared with prior to surgery, cell numbers of CD3, CD4, CD8, CD19 and NK cells were lower on POD 1 and POD 5 (all P< 0.05), but there was no difference between minilaparotomy group and laparoscopic-assisted group (all P>0.05). Conclusion The minilaparotomy and laparoscopic-assisted right hemicolectomy have same effect on cellular immune function of patients with colon cancer.

Objective To investigate the expressions of ER? protein and ER? isoform mRNA in sigmoid colon of female slow transit constipation patients. Methods RT-PCR and Western blot were used to detect the expression of ER? protein and ER? isoform mRNA of 20 patients with STC and 20 age-matched controls. Results ER? protein and ER?1, ER?2 and ER?5 mRNA were detected in the two groups lower in STC group than that in control group (P

[Objective]To introduce the effect of reversed sural neurofasciocutaneous flap with muscle repairing the soft tissue defect of foot and ankle.[Method]Reversed sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect simultaneous open fracture of tibia lower section 6 cases,the soft tissue defect simultaneous chronic osteomyelitis of tibia lower section 5 case,the soft tissue defect of sole of foot simultaneous calcaneus epicarp 3 case, the soft tissue defect of sole of foot simultaneous calcaneus osteomyelitis or dead space 2 case. The scope of the flap was 18 c m?13 cm～11 c m?7 c m and that of the gastrocnemius flap was 4 cm?3 cm～9 c m?6 cm,the thickness was 1～3 cm,the skin flap was bigger than the muscle flap.[Result]Muscle side of the muscle flap was errhysising actively and the skin flap was good circulation duing operation, the muscle flaps were used clinically in 16 patiens all survived completely after operation. All cases were followed up from 5 to 17 months ,incision of open fracture healed primarily, osteomyelitis without reoccurring, the muscle flaps were satisfactory in appearance,feel recovered and walk well.[Conclusion]Reversed sural neurofasciocutaneous flap with muscle has sufficient blood supply and high survival rate,so it is an effective and feasible method in repairing the soft tissue defect of foot, ankle and tibia lower section in special cases.

BACKGROUND:There is no clear conclusion on whether the lung cancer stem cels can induce to spheroid formation and have tumorigenicity. OBJECTIVE: To observe the spheroid formation induced by human lung adenocarcinoma cel line SPC-A1 and the tumorigenic ability of lung cancer stem cels. METHODS:SPC-A1 at proliferating phase was cultured in serum-free DF12 culture medium, and then recombinant human insulin-like growth factor-1, recombinant human epidermal growth factor, and recombinant human fibroblast growth factor-10 were added to induce spheroid cels. Immune fluorescence detection and PCR amplification were done to understand the expression of stem cel associated markers. NOD-SCID immunodeficient mice were subcutaneously implanted with lung spheroid cels to observe the tumor growth.In vivo fluorescence imager was used for radiography. RESULTS AND CONCLUSION:After 5-10 days, lung spheroid cels were harvested. RT-PCR results showed that lung spheroid cels were positive for CD24, CD221, CCSP and SP-C. In addition, the lung spheroid cels and purified CD24+, CD221+ lung cancer stem cels were both positive for TTF-1 of lung stem cels, OCT4 and Nanog of embryonic stem cels and TTF-1 of Bmi-1 lung stem cels. The fluorescence detection showed that over 80% lung spheroid cels expressed CCSP and OCT4; SPC-A1 cels had the characteristics of alveolar type II cels, and also expressed SP-C protein, but only about 5% of the cels expressed CCSP and OCT4. At 50 days after subcutaneous implantation of lung spheroid cels, in vivo fluorescence imaging showed that the diameter of tumor in mice was 1 cm, indicating human lung adenocarcinoma cel line SPC-A1 can induce the spheroid formation, and lung cancer stem cels rich in the cel spheres have the tumorigenic ability.

Objective To discuss the method and clinical effect of bilobed DIEP flap for repair of degloving injuries of the hand.Methods From June, 2013 to January, 2015, the bilobed DIEP flap were designed to repair 6 cases of degloving injuries of hand, of which the small leaf flap repaired separately defect of thumb, larger leaf flap repair 2nd-5th finger and palm and dorsum.The bilobed DIEP flap design were based upon anatomic study on deep inferior epigastric artery, superior epigastric artery, intercostal artery and its anastomosis.Results The largest area of main flap was 35 cm × 12 cm, and the deputy leaves of flap was 10 cm× 7 cm.All of the 6 flaps survived.One of them experienced distal end necrosis of epidermis.But it was healed by dressing changes.All of the 6 cases were followed up for average of 12 months (range, 6-20 months).All flaps were seen with good appearance, fully recovered protectve sensation and the active motion of the thumb was recovery.Moreover, the donor sites were closed directly and the appearance were satisfactory.Conclusion The bilobed DIEP flap is a satisfying choice in repairing degloving injuries of the hand in that it has reliable blood supply, can obtain the larger area of skin and leaves small injuries in targeted area.