Diabetes Mellitus, Type 2 ; complications ; diagnosis ; therapy ; Humans ; Liver Diseases ; complications ; diagnosis ; therapy

Objective To compare the changes of serum hepcidin,hemoglobin and other indexes of pure hemodialysis and hemodialysis combined with hemodiafiltration in treatment of maintenance hemodialysis patients,and to investigate the effect of hemodialysis combined with hemodiafiltration therapy on serum hepcidin clearance,the improvement of anemia and the relationship between them of maintenance hemodialysis patients.Methods Twenty-two patients with maintenance hemodialysis patients were collected from Shengjing Hosphal Affiliated to China Medical University from January 2015 to February 2017.This study was self-controlled study,before enrollment all patients were given only regular hemodialysis,after enrollment all patients were given hemodialysis combined with hemodiafiltration therapy for 3 months,compared the changes of serum hepcidin,hemoglobin,reticulocyte percentage,ferritin,serum iron,transferrin saturation and EPO of pure hemodialysis(before treatment) and hemodialysis combined with hemodiafiltration treatment for 3 months of patients,and analyzed the correlationship between serum hepcidin and other indexes.Results After hemodialysis combined with hemodiafiltration therapy for 3 months,compared with pure hemodialysis serum hepcidin levels were significantly lower((77.61±3.31) μg/L vs.(89.49±7.87) μg/L,t=9.660,P<0.01),hemoglobin levels were increased((112.73±11.02) g/L vs.(88.32±11.83) g/L,t=-11.957,P<0.01).The correlations between serum hepcidin and other indexes show that serum hepcidin and hemoglobin and ferritin were related,serum hepcidin was negatively correlated with hemoglobin(r=-0.851,P<0.01)and positively correlated with ferritin(r=0.385,P<0.05),and found no correlations between hepcidin and reticulocyte percentage(r=-0.151,P=0.328),serum iron(r=0.123,P=0.427),transferrin saturation(r=0.211,P=0.170) and EPO(r=-0.173,P=0.261).Conclusion To compare with pure hemodialysis,hemodialysis combined with hemodiafiltration therapy can more effectively remove hepcidin and improve anemia,and they are related.

Objective To investigate the safety and efficacy of percutaneous nephrolithotomy ( PCNL ) combined with ureteroscopy in supine anterolateral lithotomy position for the management of complicated upper ureteric calculi . Methods From January 2009 to October 2012, 67 patients underwent PCNL combined with ureteroscopy in supine position under general anesthesia . Renal calculi was treated with PCNL , and then ureteroscopy was used to break and wash out the residual calculi . Results All the 67 surgeries were completed successfully .Operation time was 46 -106 min ( average, 76 min); stone clearance rate was 92.5%(62/67);residual stone was found in 5 cases and were completely removed two weeks after ESWL .No massive hemorrhage , ureteral avulsion, pleura, abdominal organ injury or other complications occurred . Conclusions PCNL combined with ureteroscopy in supine anterolateral lithotomy position for the treatment of complicated upper ureteric calculi is safe and effective .It has shorter operative time and is convenient for the patients .

Objective To determine the protein expression level of p-STAT1 and STAT1 in thyroid cancer and its correlation with clinical pathological parameters,especially with lymph node metastasis and relapse-free survival.Methods p-STAT1 and STAT1 protein were measured by immunohistochemical staining in 80 cases of primary thyroid carcinoma and matched normal controls.All samples were selected from the pathological storage in the Jiangdong 22nd Zone,of Zhuji People's Hospital.The correlation between p-STAT1,STAT1 and patients clinical pathological parameters was analyzed.74 out of 80 patients were followed up over 3 years to analyze the potential relationship between expression of p-STAT1 and STAT1 and relapse-free survival.Results The positive expression of p-STAT1 and STAT1 was 28.8％ and 90.0％ in thyroid cancer tissue versus 85.0％ and 50.0％ in normal thyroid tissue.The difference was statistically significant(P ＜ 0.05).The positve expression of p-STAT1 in stage Ⅲ and Ⅳ thyroid cancers was significantly lower than in stage Ⅰ and stage Ⅱ thyroid cancer(P ＜ 0.05).There was negative correlation between the expression of p-STAT1 and tumor stage and lymph node metastasis,while the expression of STAT1 was irrelevant.Furthermore,the relapse-free survival was 100％ in p-STAT1 positive patients,and 92.65％ in STAT1 positive group.Conclusion p-STAT1 protein level,negatively correlating with tumor stage and lymph node metastasis,down regulates in primary thyroid cancers,and may be a novel biomarker for thyroid cancer metatstasis.

Objective To explore the expression of Excision repair cross -completion 1 in non-small cell lung cancer and to analyze its clinical significance .Methods ERCC1 protein expression was detected by IHC method in 160 cases of non-small cell lung cancer tissue .We analyzed relationship between the ERCC 1 ex-pression and clinicopathological parameters of non -small cell lung cancer ,as well as its correlation between ER-CC1 expression and the prognosis .At the same time ,160 cases of intraoperative specimens were primarily cul-tured.The relationship between ERCC1 expression and the drug sensitivity of DDP was analyzed .Results ER-CC1 protein was mainly expressed in the nucleus .ERCC1 protein expression in lung cancer tissue showed no rela-tionship with age,gender,tumor size and pathological types .ERCC1 protein expression was associated with TNM stages and lymph node metastases .High expression of ERCC1was significantly correlated with poor prognosis in pa-tients,indicating that ERCC1 is the independent factor of NSCLC patients .MTT results showed that the positive ex-pression rate of ERCC1 in DDP sensitive groups was higher than in DDP resistant groups .Conclusion ERCC1 is an independent factor influencing the prognosis of non -small cell lung cancer ,and associated with DDP resistance .

Objective To observe the clinical efficacy of treatment of diabetic nephropathy with Shuxuening injection combined with benazepril.Methods 60 cases from January 2014 to January 2015,were randomly divided into observation group and control group of 30 patients.the control group were given benazepril treatment,observation group were based on Shuxuening injection treatment,patients were followed up and record changes related indicators.Results The urinary β2-MG and hs-CRP were after treatment(0.38±0.08,6.29±1.40)mg/L,than the control group(0.48±0.10,7.74±1.36)mg/L,and the difference was significant sex(P<0.05); after treatment observation group 24H urine protein quantitative detection of(0.69±0.50)g/24h,than the control group(1.04±0.63)g/24h,and the difference was statistically significant(P<0.05); After the observation group patients,low-density lipoprotein,serum creatinine value were(359.2±50.3mg/L,2.40±0.63mmol/L,95.6±22.3mol/L),were better than the control group(379.8±48.3mg/L,3.44±0.76mmol/L,108.5±34.2mol/L),and the difference was statistically significant(P<0.05); observation group total effective rate was 90.0％,higher than 73.0 percent,and the difference was statistically significant(P<0.05).Conclusion Shuxuening injection combined with benazepril clinical treatment of diabetic nephropathy exact,no significant side effects,is worthy of further research and application.

Objective To investigate the effects of astragalus membranaceus parenteral solution combined with recombinant human erythropietin (rHuEPO) on erythrocyte immunity function in patients with hemodialysis. Methods Fifty-one patients of chronic renal failure(CRF) with hemodialysis were divided into 2 groups randomly according to whether treated with astragalus membranaceus parenteral solution or not(therapeutic group, was 26 cases and control group was 25 cases). IgG, IgA, IgM, RBC-C3b,RR,RBC-ICR, erythrocyte percentage of CD35 positive and SOD was measured before treatment and 8 weeks after treatment. Results After 8 weeks' treatment, IgG,IgA,IgM levels in therapeutic group and IgG,IgA levels in control group were higher than those before treatment(P < 0.01 ). IgM [ (2.03±0.73 ) g/L ] was higher than that in control group (P< 0.05). RBC-C3B,RR, erythrocyte percentage of CD35 positive and SOD were higher and RBC-ICR was lower than those before treatment in two groups (P < 0.05 ) ;compared with that in control group, RBC-C3b, RR was higher [(10.85±2.31 )% ] and RBC-ICR was lower [(5.34±1.91 )% ] (P < 0.05 ).Conclusion Astragalus membranaceus parenteral solution combined with rHuEPO is superior to improve CRF patients' levels of immune globulin and erythrecyte immunity function.

Objective To set up the experimental animal model of the filial rats exposed clozapine in the pregnant clay and expect to know what is the effect on the offspring exposed the antipsychiatrie in gestation.Methods Female Wister rats were divided into both the control group (n=17)and elozapine group (n=2.5) which were intraperitoneally injected saline and clozapine respectively from pregnant day 6 to day 15,and their pup rats were examined development indexes such as the physical growth ,neural reflex,neural behavior and the expression of MAPK44/42 in brain in neonatal stage.Results it was shown that clozapine- exposed in pregnant day lead to the retardation of the weight of filial rats in earlier age such as postnatal day 4 (PND4) and PND7(F=12.56/7.51,P=0.001/0.008).As for neural reflex,the time of cliff avoidance of rats was significantly delayed in PND 3 and day 9 (F=4.969/4.348 ; P=0.03/0.041),and the ratio of positive response of air righting decreased compared with the control group in PND13 and PND15 (F=7.959/6.475,P=0.007/0.016).There was no difference between two groups on the behavior of the filial rats in the open field of filial rats.The expression of PhoMAPK44/42 in hippocampi of exposed-clozapine offspring in PND15 was significantly lower than the control' s(F=18.729/23.824,P=0.001) ,however,no difference was demonstrated on the expression of MAPK44/42 in hippocamaias well as the expression of both Pho-MAPK44/42 and MAPK44/42 in forehead cortex in two groups.Conclusion The resuits suggest the aberration of both physical and mental development of filial rats exposed clozapine in gestation.

Objective To study clinical characteristics and CT features of cerebellar hemorrhage in the elderly patients in order to make early diagnosis and treatment. Methods The clinical characteristics, CT scan, sites and causes of hemorrhage, as well as the treatment and the prognosis of 32 elderly patients with cerebellar hemorrhage were analysed. Results The main clinical symptoms were vomiting, vertigo and headache and were observed in 32(100.0%), 26(81.2%) and 18(56.2%) cases, respectively. High motality rate was observed in hemorrhage volume≥25 ml, patients aged over 70 years and accomanied with cerebral hernia and multi-organ failure. Conclusions The clinical manifestations of cerebellar hemorrhage were not typical in the elderly. Cerebral hernia and multiple organ failure were the main causes of death. Hypertension and artherosclerosis were the main etiologies of cerebellar hemorrhage. The early diagnosis is necessary for the treatment of cerebellar hemorrhage. The prognosis was related to the quantity and site of hemorrhage.

Objective To summarize the experiences of reoperations on Ebstein's anomaly. Methods Clinical data of 17 cases of Ebstein's anomaly (6 males and 11 females, aged from 3 to 54 years old, averaged 23) were analyzed retrospectively. All the patients felt short breath and palpitation after exertion, and cyanosis was found in two patients. In the first operation, downwards displaced tricuspid valve leaflet was suspended and atrialized right ventricle was replicated in 14 cases, tricuspid anuloplasty and atrial septal defect were repaired in 2 cases, and tricuspid valve was replaced in 1 case. The interval time between two operations was 1-20 years in an average of 8 years. Before second operation, the cardiac function was NYHA Ⅱ in 6 cases, NYHA Ⅲ in 11 cases. Eight cases received Ebstein's anomaly anatomic correction, including transplanting downward displaced tricuspid valve and excising atrialized right ventricle. Seven cases received tricuspid valve replacement. Two cases received tricuspid valveplasty. All of operations were performed on arrested heart with moderate hypothermic cardiopulmonary bypass. The time of cardiopulmonary bypass was 70-287 (89.3?11.1)min, the time of aorta clamping was 70-287 (64.0?8.6)min. The transesophageal echocardiography was routinely performed before the operations and after the hearts rebeating. Results No case died in hospital, and all the patients were followed up for 1-3 years. Transesophageal echocardiography showed the tricuspid valve was closed well (non-reflow in 9 cases, mild reflow in 1 case) in 10 cases which received Ebstein's anatomic correction and tricuspid valveplasty. The cardiac function states of patients were significantly improved (NYHA Ⅰ-Ⅱ). Conclusion Most of patients with reoperations on Ebstein's anomaly can received anatomic correction. Tricuspid valve replacement is available if the pathology of tricuspid valve is severe.