Objective to observe the effects of ulinastatin(UtI)and xuebijing on treatment of burns sepsis after coagulation and systemic inflam-mation. Methods A total of 103 patients diagnosed of sepsis in burn department of our hospital during 2009-01 - 2014-01 were recruited for the study and randomly divided into 2 groups. the control group(51 cases)received conventional fluid resuscitation,mechanical ventilation,renal re-placement,wound dressing or operation,metabolic nutrition support;the treatment group(52 cases)received vein infusion of xuebijing 100 mL, bid on the basis of conventional therapy,ulinastatin 400 000 U intravenous drip,bid,for 10 d. the blood routine,blood coagulation function and in-flammatory reaction index and plasma lipopolysaccharide(LPS),tumor necrosis factor-alpha(tNF-alpha),interleukin-6(IL-6),interleukin-10 (IL-10),C- reactive protein(CRP)and procalcitonin(PCt)of the patients in each group were respectively detected before treatment and after treatment in the 1,3,7,10 days. Results After treatment of coagulation,indexes of blood fibrinogen degradation product(FDP),plasma fibrino-gen(FIB),blood concentration of two D- dimer(D-Dt),platelet and inflammatory reaction index compared were significantly improved compare with those before treatment in both two groups(P < 0.01). In addition,the treatment group showed significantly better effects than the control group, and the difference was statistically significant(P < 0.05). 7 d after treatment inflammation index levels in treatment group decreased more significant-ly compared with the control group,and the difference was significant(P < 0.05). Conclusion Combined application of xuebijing,ulinastatin with auxiliary treatment of post-burn sepsis can reduce the systemic inflammatory response,improve blood hypercoagulable state.

Objective To study the therapeutic effects of mycophenolate mofetil(MMF) in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods 16 refractory ITP patients were treated with MMF (1.0～1.5g/d),which were given in divided doses for three months as one course;the patients with significant therapeutic effect were given the dose for another three months and reduced by degree.Results Very effective results were obtained in 4 cases,striking improvement in 7,partial response in 1 and no response in 4.The total efficacy was 68.75%.The main side effect was observed as light digestive malaise.Conclusion MMF has striking therapeutic effect in treating refractory ITP with little side effect and can be used as an effective way of treatment.

A field transfusion device without support is designed.It is in shape of cuboid,and the idler wheels of mean axis disc are driven by motor to push transfusion liquid into human body.A disc with 6 idler wheels on the edge is set in the motor axis.When motor starts,idler wheels take turns to extrude liquid from transfusion pipe to human body with transfusion speed decided by motor rotate speed.Besides,an adjustable transfusion controller,sensor for liquid pressure and transfusion alarm system are equipped.When the set transfusion volume is finished,it gives alarm.

With the availality of new nucleotides (acid) analogues,the experience of anti-virus treatment has been continuously enriched.However,the problem of drug resistance becomes increasingly significant and the concern of individualized strategies,duration and endpoints of therapy as well as drug-resistance prevention for nucleoside (acid) analogues treatment has become a hot issue.Thus,the European Association for the Study of the Liver updated their guideline on diagnosis and treatment of chronic hepatitis B based on the principles of evidence-based medicine,so as to make it more flexible and practical.We briefly review and compare the updated content of this new guideline,and make analysis combined with the clinical practice,so as to promote the standardization of diagnosis and treatment of chronic hepatitis B.

Objective To discuss the application valueof the multi-slice spiral CT indiagnosing breast cancer. Methods The images of scanning, enhancing and reconstruction were analyzed in 71 cases of breast cancer proved by clinical pathology. Results All the 71cases were the type of mass. The shapes of the tumor in 57 cases were irregular, burrs can be seen in 48 cases , the skin in 8 cases changed, the nipples in 4 cases sunk, the tissue around the tumor was invaded in 12 cases; The CT value of the tumor rised greatly after enhancement, theranges of value was form 18 to 83 HU. Axilla lumph nodes were detected in 32 cases, Wecan find the lumph node in mediastinum and lung metasis; The tumor and tissue around it can be shown well in multi-orientations through images reconstruction. Conclusions The multi-slice spiral CT has the evident application value in pualitative diagnosing breast cancer.

Objective To evaluate left atrial function by velocity vector imaging (VVI) in patients with rheumatic mitral stenosis(RMS). Methods Thirty eight patients with RMS and 42 normal controls were studied with VVI analysis software. Peak systolic strain (S), systolic strain rate(SRs), early diastolic strain rate(SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured,and also the SRa peak time delay(Td-SRa). Results Comparing to the controls group, the S, SRs and SRe of all segments were significantly lower(P<0.05). Except the base latero-aorta's SRa, the other segments' SRa were lower (P<0.05). In patients with atrial fibrillation(AF),56% segments had no SRa,and 18.6% had irregular low amplitude movement at late diastole, while 25.4% had discernible positive peak. The base and middle inferior SRa of patients with AF were lower (P<0.05 ) than those of the patients with sinus rhythm. While the Td-SRa of patients was longer than that of control group,especially what of the patients with AF. Conclusions The segmental and globe left atrial function of patients with RMS can be evaluated with VVI.

Objective To assess global systolic function of left ventricle (LV) using speckle tracking echocardiography in patients who are left volumetric overload and to establish the correlativity between strain and left ventricle end-diastolic volume index (LVEDVI). Methods Seventy-seven patients who were left volumetric overload and 30 normal volunteers were enrolled in this study. Respective 3 high frame rate (＞ 100 frames/s) 2D images were recorded from the left ventricular short axis views: the levels of mitral valve annulus, papillary muscle and apex. Three global peak systolic radical strain and strain rate were measured using 2D strain imagirg. LVEDV was obtained by two-plane Simpson method and LVEDVI was obtained by normalized LVEDV with surface body area. Patients were divided into 6 groups: transitionalgroup,group A (LVEDVI:90- 120 ml/m2),group B (LVEDVI: 121 - 150 ml/m2 ),group C (LVEDVI:151 -180 ml/m2),group D (LVEDVI: 181 - 210 ml/m2),and group E (LVEDVI＞210 ml/m2). Patients were divided into two groups by left ventricular ejection fraction (LVEF): group Ⅰ (LVEF≥ 50 % ), group Ⅱ (LVEF＜50％). Results①Compared with normal control group,GRS,GRSr in transitional group showed no change at three short axis levels (P ＞0.05). The above parameters in group A, B and C were significantly higher than those in normal control group( P ＜0. 01 ). In transitional group,group A,B and C,GRS, GRSr of three short axis gradually increased with LVEDVI augmentation. Compared with group A, B,C,D and normal control group,the above parameters of 3 short aixs in group E were decreased( P ＜0. 01 ),which gradually decreased in group C, D, E with LVEDVI augmentation. ②GRS,GRSr of 3 short axis views in group Ⅰ were more significantly high than those in group Ⅱ and normal control group. The parameters above were significantly low in group Ⅱ ( P ＜0.01). ③In group A,B,C,GRS of papillary muscle and apex levels were correlated positively to LVEDVI ( rpapillary muscle = 0.55,0.64,0.76 and rspex = 0. 74, 0. 79,0.71,P ＜0.05) ; In group D, there was no correlativity between GRS of papillary muscle and LVEDVI( r =- 0.35, P ＞ 0.05) while negative correlativity was established in apex level( r = - 0.73, P ＜ 0. 05). In group E,the negative correlativity was found between GRS of papillary muscle and LVEDVI( r = -0. 70,P ＜0.05) while no correlativity was established in apex level( r = - 0.39, P ＞0. 05). GRS of mitral valve annulus was correlated positively to LVEDVI in group A, B( r = 0.79, 0.77, P ＜ 0.05) and had no correlativity in group C,D. The negative correlativity between them was found in group E( r = - 0. 54, P ＜0.05). At LVEDVI: 180- 190 ml/m2 ,GRS of papillary muscle and apex level reach the peak point about 93% and 62% ;GRS of mitral valve annulus level reach the peak about 63% at LVEDVI 150 - 160 ml/m2.Conclusions Radial strain,strain rate change periodically with LV volume overload. Wall motion of left ventricle can be evaluated accurately by speckle tracking echocardiography, which provide useful modality for evaluation cardiac systolic function.

Emergence and broad spread of chloroquine resistance urge human beings to change drug policy in malaria control and to find more effective new drugs. Nevertheless, chloroquine is still used in the treatment of falciparum malaria in some poor endemic regions due to economic and development reasons. It should be of great significance to un-derstand the mechanism of chloroquine resistance and find the way to reverse it in order to bring chloroquine with high efficacy and low cost back to the first line of the combat to malaria. Advent and development of resistance reversal agents provide a new clue for this purpose. When used together with chloroquine, it can partly restore the efficacy of chloroquine in resistant Plasmodium falciparum. The article summarizes the research progress on chloroquine resistance in P. falciparum and resistance reversers.

Objective To study the potentiation of chloroquine activity and mechanism by ketotifen and cyproheptadine in in vitro cultured Plasmodium falciparum Fcc SM1/yN strain. Methods In vitro cultured Fcc SM1/yN strain was added to pre-prepared drug plates at 50 ?l/well after synchronization to make final concentration of 0.312 5-2 560 nmol/L for chloroqine and of 9.80-5 000 nmol/L for ketotifen or cyproheptadine. After 34 hours' culture in 37 ℃, the number of schizonts with 3 or more nuclei was calculated among 200 parasites under microscope. Calculated half inhibitive concentration ( IC50 ) of chloroquine and every drug combination to parasite as well as chloroquine activity enhancement index ( AEI) of ketotifen (or cyproheptadin) . Time dependency of potentiation was studied. All data were analyzed statistically with SPSS 13.0. After 20 hours' action of one optimal combination dose of chloroquine/ketotifen or chloroquine/cyproheptadine, RNA of the Fcc SM1/yN strain was extracted and real-time PCR was used to determine the expression level of pfcrt and pfmdr1 genes. Results The best potentiation effect was observed with ketotifen or cyproheptadine of 625 nmol/L, with IC50 of 74.53 nmol/L for chloroquine/ketotifen and 89.7 nmol/L for chloroquine/cyproheptadine respectively, and activity enhancement index (AEI) of 0.42 for chloroquine/ketotifen and 0.30 for chloroquine/cyproheptadine respectively. Combination of 625 nmol/Lketotifen or cyproheptadine with 5 nmol/L chloroquine showed the highest potentiation potency. 6-7 hours during which ketotifen or cyproheptadine was added after chloroquine showed the highest effect, with IC50 of 67.70 nmol/L for chloroquine/ketotifen and 81.53 nmol/L for chloroquine/cyproheptadine respectively, and the AEI was 0.47 for chloroquine/ketotifen and 0.37 for chloroquine/cyproheptadine respectively. After action of chloroquine/ketotifen or chloroquine/ cyproheptadine at one optimal combination dose, expression level of pfcrt gene increased by 91% and that of pfmdr1 gene decreased by 14% respectively. Conclusion Appropriate combination of chloroquine/ketotiphen or chloroquine/ cyproheptadine potentiates chloroquine against in vitro cultured P. falciparum. 6-7 hour period is an optimal time when ketotifen or cyproheptadine was added after chloroquine. Potentiating activity of ketotifen and cyproheptadine may be related to the expression level of pfcr t and pfmdr1 genes.

OBJECTIVE To explore the clinical characteristics of hospital infection in diabetic nephropathy(DN). METHODS To retrospectively analyze the incidence rate of hospital infection,the infection sites,pathogenic bacteria,and predisposing factors in 348 cases with diabetic nephropathy,and to compare the index above with the homeochronous 466 diabetic patients without DN. RESULTS Sixty two cases occurred hospital infection from 348 cases with DN,the infection rate was 17.82%,the infection sites were most frequently in respiratory tract(37.10%),then urinary tract(24.19%) and digestive tract(19.35%),the major predisposing factors were out of control of blood glucose,renal sufficiency,advanced age,and longer stay in hospital. CONCLUSIONS The incidence rate of hospital infection is higher,the valid measures to control the hospital infection are to control the blood glucose effectively,to improve the renal function and timely to use the method of anti-infection with forcefulness.