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

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 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.

9.0 mmol/L, and well controlled group if FPG0.05). However, in each group, the incidence rate of different algesic severity decreased with the increasing algesic severity. Conclusion EIP will occur in DM patients within a week after RCT. Well controlling of the blood glucose can reduce the incidence rate of EIP.

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 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.

112.33mmHg).PaO2 of group B was significantly higher than those of group A after 30 minutes of reperfusion(54.42-118.87mmHg vs 112.33-183.73mmHg,P

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 study the clinical effect of tacrolimus combined with small dose of prednisolone in treatment of IgA nephropathy.Methods 84 cases with IgA nephropathy were randomly divided into study group and the control group in accordance with the digital table method.The control group was given simple hormone treatment, while the study group was treated with tacrolimus combined with small dose of prednisolone.The clinical efficacy and safety were compared between the two groups.Results The treatment effective rate (100.00%)and complete remis-sion rate (73.81%)of the study group were significantly higher than those in the control group (76.19%, 23.81%),and the differences were statistically significant (χ2 =21.01,11.35,P <0.05 ).After treatment,24h urinary protein level was significantly decreased compared with before treatment.24h urinary protein level[(0.54 ± 0.41)g/L]of the study group was significantly lower than the control group[(1.06 ±0.62)g/L],and the difference was statistically significant (t =4.01,4.58,3.87,all P <0.05).In addition,before and after treatment,the serum creatinine,blood sugar,white blood cells,cereal third transaminase,SBP and DBP levels between two groups had no significant differences (P >0.05).When patients lighter (Lee's Ⅱ level),the team for complete response rate was significantly higher than the control group,and the difference was statistically significant (χ2 =5.01,P <0.05 ). However,with the aggravation of pathological damage (Lee),the effective rate and complete remission rate of the study group and the control group showed a downward trend.The effective rate and complete remission rate of the study group were higher than those in the control group,but the differences were not statistically significant (χ2 =1.03,2.11,1.20,1.20,all P >0.05).The incidence rate of adverse reactions in the study group (19.05%)was not significantly different from that of the control group (16.67%)(χ2 =0.08,P >0.05 ).Conclusion Tacrolimus combined with small dose hormone for the treatment of IgA nephropathy has high clinical value,it can significantly reduce the level of IgA nephropathy 24h nephropathy,and adverse reactions.