Objective To explore the clinical effects of diabetic nephropathy treated with enalapril and Yinxingdamo injection. Methods 80 patients were randomly recruited into a control group and a treatment group. The control group was treated with enalapril, and the treatment group was treated with Yinxingdamo injection on the basis of the control group. Results Comparing with the control group, the treatment group could be seen a obvious decrease of 24h UAE, BUN and Cr(P<0.01). Conclusion The therapeutic effects of combined using enalapril and Yinxingdamo injection is better than only using enalapril in treating diabetic nephropathy.

Objective To investigate the clinical significance of the plasma adrenomedullin(ADM) and endothelin(ET-1) concentrations in patients with serious injuries complicated by hemorrhagic shock.Method Plasma ADM and ET-1 concentrations were measured by radioimmunoassay in 38 hemorrhagic shock patients(A group)and 36 non-hemorrhagic shock patients(B group)among 74 serious injury patients in the early stage and 30 age-sexmatched healthy(C group) control subjects.Results Plasma ADM and ET-1 concentrations in B group and A group,including mild(A_1 group),middle(A_2 group) and serious(A_3 group) hemorrhagic shock patients were significantly higher than those of C group.The plasma ADM and ET-1levels were greatly higher in A group than in B group.Their levels in A_1,A_2 and A_3 groups were progressively increased.There were statistical differences between A_1 and A_2 group,A_1 and A_3 group,A_2 and A_3 group respectively.There were similar increases of the plasma ET-1/ADM ratio in A group,and the ratios in A_1,A_2 and A_3 group were progressively increased also.There were positive correlations between increased plasma ADM levels and the increased plasma ET-1 levels in both A group and B group patients(r=0.492,0.438,P

Objective To analyse the CT features of solitary bronchioalveolar carcinoma(SBAC) so that to improve the CT diagnostic accuracy.Methods CT findings of 39 cases with SBAC proved by operation and pathology were studied,and an analysis as compared with 48 cases other type of peripheral pulmonary carcinoma.Results CT findings included lobulations in 32,spiculation in 33,pleural tags in 25,bronchovascular bundles in 14,vacuole or/and bronchiologram in 18 and ground glass changs in 8 cases.Conclusion The characteristic CT manifestations of SBAC are:(1)Vacuole or/and bronchiologram;(2)Long spiculation;(3)Ground-glass.It is important to recognize the CT appearances of SBAC in order to improve diagnostic ability.

Objective To investigate the necessity of primary neurorrhaphy (direct end-to-end anastomosis) when the recurrent laryngeal nerve(RLN) is severed during thyroid surgery.Methods 15 patients who suffered from iaotmgenic unilateral complete RLN injury or whose unilateral RLN had to be sacrificed because of disease invasion had a primary repair of RLN by direct end-to-end anastomosis.In control group,26 patients who did not have a nerve repair were enrolled into this study.Subjective evaluation of aspiration and voice quality were based on patient reports and hearer reports for all patients.9 patients with neurorrhaphy and 12 patients without nerve repair were followed with videolaryngoscopic examination.Results 14 patients undergoing neurorrhaphy restored normal voice at 2-5 months postoperatively.Although there were no significant functional motion of the vocal fold,slight adductory movement of the affected arytenoid was found with good tension vocal cords and symmetric arytenoids of the glottis during phonation.Only 2 patients without nerve repair had nearly restored normal voice.The patients with hoarseness had stiff arytenoids and atrophic folds resulting in glottal gap.Conclusions Neurorrhaphy is a simple and effective method to restore the normal aspiration and voice quality of patients with unilateral complete recurrent laryngeal nerve injuries.

Objective: To discuss the strategy of therapeutic management of T3 supraglottic carcinoma. Methods: A retrospective analysis of 459 patients with T3 supraglottic carcinoma treated in our hospital was performed. We evaluated the results of different managements, including surgery alone, preoperative radiotherapy, postoperative radiotherapy and radiotherapy alone. The extent of the lesion was also put into analysis. Statistical analysis of the overall survival (OS), cause-specific survival (CSS), local control (LC), regional control(RC), function-conservation (FC) were performed with the statistical package from SPSS. Results: In all patients, the rates of 5-year OS, CSS, LC, RC and FC were 64.2%, 71.2%, 87.8%, 78.8% and 64.5% respectively. The OS, LC and FC of the patients treated by surgery alone, preoperative radiotherapy and postoperative radiotherapy had no significant difference, and were remarkably better than that of patients treated by radiotherapy alone (P<0.001). In 412 patients treated by surgery, 300 patients received function-conservation laryngectomy. 209 patients (50.7%, 209/412) survived and maintained well-function of larynx for 5 years, which was significantly better than those in the radiotherapy alone group (27.7%, 13/47). The patients with the lesion invading the pre-epiglottic space but limited in supraglottic area had better OS (70.2%), LC (93.5%) and FC (85.1%). The rate of 5-year neck lymphatic metastasis was 56.2%(258/459), and the 5-year OS of patients with N0, N1, N2 and N3 stage were 76.0%, 66.2%, 50.5% and 13.0% respectively. Conclusions Surgical treatment was the best therapeutic approach for T3 supraglottic laryngeal carcinoma. Most patients with T3 lesions are suitable for function-conservation laryngectomy. Surgical procedure was determined by tumor invaded location and extension. The combined therapy of surgery and radiotherapy had no significant advantage.