Objective To explore the angiographic characteristic of lower extremities of patients with diabetic foot. Methods The angiographic results of 35 lower extremities of diabetic patients, the characteristics of respective clinical stages and the stenosis degree at different arterial segments were undergone statistical analysis. Results (1) A lotal of 210 arterial segments were divided into the above-knee and the below-knee section. There was significant difference in stenosis degree between the two sections (P

or =70years of age) with advanced non-small-cell lung cancer. Single agent vinorelbine should be selective chemotherapy in elderly patients with advanced non-small-cell lung cancer.

Objective To investigate the effect of Naoxintong on nuclear transcription factor-κB ( NF-κB ) , matrix metalloproteinase-9(MMP-9)and TNF-αin the brain of ischemic rat models.Methods One hundred and ten healthy male SD rats were randomly divided into sham operated group ( n=30 ) , model control group ( n=40 ) and Naoxintong treatment group(n=40).Each group was further divided into five sub group by 0.5d, 1 d, 3 d, 5 d and 7 d after ischemia-reperfusion.The middle cerebral artery occlusion ischemia reperfusion rat models were prepared by Zea Longa method;meanwhile the MRI and the Bederson score were used to select the successful models .In order to observe the changing process of the ischemic brain tissue after given Naoxintong capsule , six rats in each group each timepoint were examined by MRI .The expression levels of protein and mRNA of NF-κB, MMP-9 and TNF-αwere detected respectively by western blot and real time PCR .Results Cerebral infarction volume of Naoxintong treatment group was significantly reduced compared with the model control group .The mRNA and protein levels of NF-κB, MMP-9 and TNF-αof the Naoxintong treatment group decreased significantly compared with the model control group (P <0.05).The mRNA and protein levels of NF-κB, MMP-9 and TNF-αhad no significant difference between the sham group and Naoxintong treatment group .Conclusion Naoxintong has a neuroprotection effect on cerebral ischemia via alleviating the inflammatory factors in the ischemic area .

Objective To investigate the effect and safety of a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone on treatment of moderate and severe IgA nephropathy (IgAN).Methods Fifty-seven patients with IgAN confirmed by biopsy combining with clinical presentations were enrolled,with their ages ranged from 15 to 55,proteinuria excretion ≥ 1.0 g/24 h,serum creatinine (SCr) ≤ 265.20 μmol/L,grade Ⅲ or above in Hass histologic grading systems for renal biopsy.The patients were randomly divided into trial group( n =28 ) and control group( n =29 ) and received treatment for six months.The patients in trial group were treated with a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone,while those in control group were treated with prednisone and fosinopril.Results ( 1 ) After 6 months of treatment,the rates of complete remission (CR) and partial remission (PR) were 52.0％ and 40.0％ respectively in trial group,and 20.8％ and 54.2％ respectively in control group.The total remission rate(TR)and CR in trial group were significantly higher than those in control group ( TR x2 =0.47,P ＜ 0.05 ; CR x2 =5.11,P ＜ 0.05 ).( 2 ) The SCr level was decreased in trial group ( [ 115.83 ± 16.78 ] μmol/L v.s.(93.29 ±12.41 ) μmol/L,P ＜ 0.05 ),while increased in control group ( [ 112.79 ± 12.79 ] μmol/L v.s.( 136.99 ±25.97 )μmol/L,P ＜ 0.05 ).The two groups had significant difference on SCr clearance rate after treatment( P ＜0.05).There was no significant difference between the two groups on the endogenous creatinine clearance rate (Ccr) ( P =0.52 ),and no significant difference within trial group ( [ 79.34 ± 6.09 ] ml/min v.s.[ 85.12 ±12.26] ml/min,P =0.05)and within control group( [80.18 ±6.51 ] mi/min v.s.[84.22 ±8.39] ml/min,P =0.67 ).The levels of 24-hour proteinuria excretion after 6 months were decreased in both groups ( trial group:[1.93 ±0.55]g/24 hv.s.[0.78 ±0.42]g/24 h,P＜0.05;control group:[1.85 ±0.51]g/24 h v.s.[1.30±0.35 ] g/24 h,P ＜ 0.05 ),and the treatment effect was better in trial group ( P =0.04 ).Conclusion Treatment of moderate and severe IgA nephropathy with low-dosed urokinase combined with fosinopri plus leflunomide and prednisone is effective and safe by improving renal function and decreasing proteinuria.

Objective To investigate the incidence and influencing factors of aldosterone escape in patients with non-diabetic nephropathy by RASI-therapy. Methods A total of 104 patients with non-diabetic nephropathy were treated with ARB or combination therapy of ACEI and ARB in a mean follow-up period of 12 months. Aldosterone escape was determined according to the change of plasma aldosterone concentration before and after treatment during 6-month and 12-month ACEI/ARB treatment, while the influencing factors of aldosterone escape in patients with non-diabetic nephropathy was also analyzed after therapy with RASI . Results In 12 months, the incidence of aldosterone escape was significantly higher than that in 6 months (26.92% vs. 14.42%, P = 0.007). After 12-month treatment, the difference was statistically significant in incidence of aldosterone escape among different stages of CKD (P = 0.027). Compared with 6-month incidence of aldosterone escape in the losartan group, 12-month incidence increased evidently (P = 0.020). The Ald level was positively correlated with urinary protein excretion and the Scr level (r = 0.431, P = 0.003 and r = 0.336, P = 0.009, respectively), and negetively correlated with levels of the eGFR (r = -0.275, P = 0.006). Univariate Logistic regression demonstrated that risk factors of aldosterone escape included pre-treatment values of the urinary protein excretion (OR = 3.671, P = 0.028) and the eGFR (OR = 0.972, P = 0.019). Multivariate Logistic model revealed pre-treatment values of the eGFR was positively associated with aldosterone escape (OR = 0.970, P = 0.012). Conclusion The incidence of the aldosterone escape increases along with the time of treatment. Renal function has correlated with aldosterone escape and pre-treatment value of the eGFR is an independent risk factor of aldosterone escape.

Objective Analyse the causes,diagnosis and treatment for delayed hemorrhage after distal radical gastrectomy.Methods Retrospective study on 45 patients combined with intro-abdominal hemorrhage after distal radical gastrectomy from January 2008 to June 2013.Results Thirteen patients combined with delayed hemorrhage in these 45 patients,all of 13 patients had intro-abdominal hemorrhage in 1week to 4 weeks after operation.And 5 of the 13 patiens were intermittent intro-abdominal hemorrhage 1 week after operation,these patients were demonstrated the blood come from gastroduodenal artery pseudoaneurysm fracture by CT and DSA examine,and they were cured by interventional embolization.Other 8 patients were marginal ulcer hemorrhage diagnosed by gastroscope,and they stoped bleeding with the help of gastroscope.Conclusions The causes of delayed hemorrhage after distal radical gastrectomy were complicated,and CT,DSA and endoscope can use for diagnosis.What was more,interventional embolization and endoscope were helpful for curing the intro-abdominal hemorrhage,avoiding re-operation.

BACKGROUND: In China, although microscope-assisted anterior cervical decompression has been performed by many spine surgeons in recent years, the application of microscope still needs to be further promoted in China. Therefore, it is necessary to systematically evaluate and analyze the clinical efficacy of cervical spondylopathy by comparing patients under microscope-assisted anterior cervical approach to traditional anterior cervical approach. As a result, it can provide the evidence for clinical decision in these cervical spondylopathy patients. OBJECTIVE: To systematically evaluate the effect between microscope-assisted anterior cervical approach and traditional anterior cervical approach in cervical spondylopathy patients. METHODS: Databases such as Medline, Embase, PubMed, Web of science, CBM, Wangfang databases, VIP, and CNKI were searched from inception to July 2019 to find literature related to microscope-assisted anterior cervical approach and traditional anterior cervical approach in treatment of cervical spondylopathy. Two investigators evaluated the researches independently and compared the operative time, intraoperative blood loss, the preoperative and postoperative Japanese Orthopedic Association score, neurological success rate, the preoperative and the postoperative visual analogue scale score, and the complication rates between two groups. The quality of the included literature was evaluated by the modified Jadad scale, the modified Newcastle Ottawa score and the methodological index for non-randomized-studies. The correlative clinical outcome in inclusive research was analyzed systematically by using Stata 12.0 Software. RESULTS AND CONCLUSION: (1) Twelve studies were accorded with the inclusion criteria, containing 892 cases (438 cases in the microscope-assisted group, while 454 cases in the traditional group). (2) There were no significant differences in the preoperative Japanese Orthopedic Association score (WMD=-0.100, 95%C/(-0.459, 0.259), P=0.585), operative time (WMD=6.852, 95%C/(-0.446, 14.149), P=0.066), the preoperative and postoperative visual analogue scale score (WMD=0.293, 95%C/(-0.023, 0.608), P=0.069; WMD=-0.T\8, 95%C/(-1.495, 0.059), P=0.070) between two groups. (3) Postoperative Japanese Orthopedic Association score (WMD= 1.310, 95%C/(0.621, P < 0.001), the rate of neurological success (WMD-4.639, 95%C/(0.294, 8.984), P=0.036) in the microscope-assisted group were higher than those in the traditional group. The intraoperative blood loss (l/MMD=-18.068, 95%C/(-24.504, -11.632), P< 0.001) and the rate of complication (RR=1.068, 95%C/(1.012,1.126), P=0.002) in the microscope-assisted group were significantly lower than those in the traditional group. (4) Performing anterior cervical approach under microscope has a better clinical effect than using traditional anterior cervical approach in the treatment of cervical spondylopathy, but more high-quality clinical studies are needed to verify it.

The arterial lesions of lower extremities in patients with diabetic foot ulcers were extensive.The majority of below-knee arteries showed severe stenosis, even complete occlusion.Interventional therapy of femoral artery was effective in improving arterial blood perfusion and remission of the pain and numbness.After therapy, the skin temperature and ankle brachial index (ABI) were increased, healing of ulcer was enhanced and intermittent claudication was ameliorated.Percutaneous transluminal angioplasty of femoral artery was effective in improving arterial blood perfusion of the lower extremities with foreseen curing efficacy.

Objective To evaluate the clinical efficacy and safety of capecitabine continuous maintenance in treatment of re-currence of triple-negative breast cancer,which had responded to combined chemoradiotherapy.Methods The triple-negative breast cancer was defined as negative of ER,PR and HER2.A total of 46 patients of triple-negative breast cancer were divided into the treatment group (23 patients)and the control group (23 patients).The treatment group was given capecitabine continuous mainte-nance after 6 cycles of chemotherapy.The control group was given 6 cycles of combined chemotherapy only.The clinical efficacy and safety was evaluated between the two groups.Results The PR,PD,RR,and DCR in the treatment group were significantly higher than those in the control group(P <0.05).The acute toxic effects (except for hand-foot syndrome)were similar in two group(P >0.05).Conclusion Capecitabine continuous maintenance after combined chemoradiotherapy in treatment of recurrence of triple-neg-ative breast cancer is more effective,lower toxicity and tolerable.

ObjectiveTo evaluate the efficacy and safety of spironolactone in treatment NYHA (New York Heart Association) class Ⅰ - Ⅱ heart failure patients. MethodsEighty eight patients with NYHA classⅠ- Ⅱheart failure were randomized to sprionolactone or placebo groups.Patients were assessed by echocardiography and 6-minute walking test (6MWT) ,plasma aldosterone and NT-proBNP were measured before and 6 months after treatment; serum potassium and creatinine were monitored through the study. ResultsThe E/A and E/E' in spironolactone group were significantly lower than those of control group (1.2±0.7 vs. 1.7±0.6, P=0.007;15.2±2.3vs. 17.7±3.0, P=0.000). No differences were observed in left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)between two groups after treatment. Left ventricular mass index (LVMI) in spironolactone group decreased after theatment [(117 ±27) g/m2 vs.(112 ± 19) g/m2,P = 0.044]. Plasma aldosterone level in spironolactone group after treatment was significantly lower than that of control group [ ( 157 ± 16) ng/L vs.( 165 ± 16) ng/L, P =0. 021 ]. Although there were no differences in plasma NT-proBNP level between two groups after treatment, it decreased significantly comparing with that of before treatment ( P = 0. 000). No differences were observed in serum potassium and creatinine between two groups after treatment. However serum potassium and creatinine in spironolactone group increased significantly after treatment [ ( 83 ± 18 )pmol/Lvs. (87 ± 22) μmol/L, P =0.047; (4.4 ±0.4) mmoL/L vs. (4.5 ±0.6) mmol/L, P =0. 012]. ConclusionSpironolactone can alleviate cardiac remolding and diastolic function in NYHA classⅠ - Ⅱ heart failure patients.