Objective To observe the changes of plasma renin activity (PRA)in cirrhotic patients with ascites after portacaval shunt. Method Portal vein, artery,and peripheral vein PRA levels were measured in 16 cirrhotic patients with ascites during perioperative period of portacaval shunt. Results were compared with that in 16 cases of GI tract carcinoma.Results Z] (1)Measured at postshunt day 7,the portal venous pressure (PVP) was significantly lower than that preoperatively〔(26?4)?cm?H 2O vs. (36?4)?cm?H 2O, P

Objective To analyze the risk factors related to adult patients of primary immune thrombocytopenia with infection,so as to provide basis for control and prevention of infection. Methods From January 2015 to December 2017,the clinical data of 166 adult patients of primary immune thrombocytopenia in the People's Hospital of Shaoxing-were retrospectively analyzed. Statistical analysis was performed by SPSS21. 0 statistical software. Results The infec-tion rate was 24. 70％ (41 / 166). The risk factors related to infection were age(OR = 1. 290,P = 0. 011),the number of bone marrow megakaryocytes(OR = 1. 220,P = 0. 022),diabetes(OR = 2. 163,P < 0. 001) and glucocorticoid (OR =2. 203,P <0. 001). There were 45 strains of pathogenic bacteria detected in 41 patients,gram negative bacteria accounted for 51. 11％ (23 / 45),gram positive bacteria accounted for 44. 44％ (20 / 45),and fungi accounted for 4. 44％ (2 / 45). Conclusion A variety of factors are related to infection in adult primary immune thrombocytopenia patients. It is necessary to take effective prevention measure,which will help reduce the incidence of infection.

Objective To study the dietary nourishment of adult patients with leukemia and compare acute leukemic patients with chronic leukemic patients. Methods Adopting dietary review of 24 hours and seven consecutive days of dietary records method to obtain the food category and quantity of 122 patients with acute leukemia and 10 patients with chronic leukemia. Using statistic software SPSS11.0 to calculate the patients'intake of various kinds of nutfiments. and the difiences between acute and chronic leukemic patients were analyzed. Results The rate of most ontrients of patients'intake reaches RNI/AI is lower,especially vitamin A,vitamin C and caleium.There's a tendency that intake diet,energy and nourishments of acute leukemic patients is lower than that of those chronic leukemic patients. Conclusion There is a tendency of unbalanced dietary intakes in leukemic patients.including the low intakes.There is the tendency that nutritional status of acute leukemic patients iS poorer than that of chronic leukemic patients.

Objective:To investigate the clinical application of cervix-uterine internal target volume (ITV) in volume-modulated arc therapy (VMAT) for cervical cancer under different bladder filling conditions, aiming to obtain more accurate planning target volume (PTV).Methods:Sixty-two patients with cervical cancer receiving radiotherapy rather than surgery were selected and randomly divided into the study ( n=31) and control groups ( n=31). In the study group, individualized ITV, PTV and PTV margin were obtained under three bladder filling status by localization CT scan to compare the VMAT. The target area and organs at risk (OARs) within the target area were statistically compared between two groups. The target missing rate in CBCT, adverse events and short-term efficacy of radiotherapy were analyzed in two groups. Results:There was no significant difference in the volume of target area and OARs in the target area between two groups (both P>0.05). In the study group, the target missing rate and target missing volume were significantly lower compared with those in the control group (both P<0.05). There was no significant difference in the incidence of acute radiation-induced adverse events between two groups ( P>0.05). The 1-, 2-year overall survival and progress-free survival did not significantly differ between two groups (all P>0.05). One patient in the study group had uterine recurrence and 2 cases in the control group. Conclusion:Application of individualized cervix-uterine ITV and PTV in definitive VMAT under different bladder filling conditions can improve the accuracy of target area contouring and improve the local control rate in cervical cancer patients.

Objective The echocardiography of patients with chronic Keshan disease (CKD) in the plateau and plain areas was compared,to analyze the specific manifestations of echocardiography in patients with high altitude CKD,to provide a reference for imaging diagnosis.Methods From October 2014 to December 2016,34 patients with CKD were selected in the Tibet Autonomous Region [18 males,16 females,aged (44.5 ± 5.6) years old] as plateau group;45 patients with CKD were selected in Shandong Province [21 males,24 females,age (47.3 ± 6.9) years old] as a plain group.Echocardiography was performed on the observed subjects,and cardiac morphology,hemodynamics and cardiac function were analyzed.Results The left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),and left ventricular mass (LVM) of the plateau group were (39.2 ± 4.8),(56.5 ± 6.3) mm and (232.4 ± 40.2) g,respectively,which were lower than those of the plain group [(48.3 ± 5.7),(65.2 ± 7.8) mm,(283.7 ± 38.3) g,t =-7.52,-5.30,-5.74,P ＜ 0.01].The right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD) and right ventricular lateral wall thickness (RVWT) of the plateau group were (47.6 ± 8.5),(50.4 ± 7.3) and (4.8 ± 1.1) mm,respectively,which were higher than those of the plain group [(42.3 ± 7.2),(42.7 ± 6.8),(3.3 ± 0.7) mm,t =2.99,4.81,7.36,P ＜ 0.01].The early diastolic filling velocity (E),the early diastolic peak velocity of the mitral annular (Em) of the plateau group were lower than those of the plain group,E/Em of the plateau group was higher than that of the plain group (t =-2.64,-2.35,2.07,P ＜ 0.05).The fractional area change (FAC) of right ventricular,tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S') of the plateau group [(24.9 ± 2.8)％,(13.2 ± 1.2) mm,(6.8 ± 1.0) cm/s] were lower than those of the plain group [(26.3 ± 3.2)％,(14.5 ± 1.3) rmm,(7.5 ± 1.2) cm/s,t =-2.02,-4.53,-2.74,P ＜ 0.05 or ＜ 0.01].The tricuspid annular diastolic velocity (e') of the plateau group was lower than that of the plain group,and tricuspid annular blood flow early diastolic filling velocity maximum (e)/e'was higher than that of the plain group (t =-2.07,2.09,P ＜ 0.05).The systolic pulmonary artery pressure (SPAP) of the plateau group [(48.5 ± 12.3) mmHg,1 mmHg =0.133 kPa] was higher than that of the plain group [(41.6 ± 13.3) mmHg,t =2.34,P ＜ 0.05].Conclusion Compared with CKD patients in plain area,CKD patients in plateau area have showed more obvious right heart enlargement and right ventricular failure,and combined with higher SPAP.

Objective To investigate the effect of ultrasound debridement combined with vacuum sealing drainage on the treatment of diabetic foot ulcer and the potential mechanism. Methods Eighty-one patients with diabetic ulcer were randomly divided into two groups:ultrasound debridement combined with vacuum sealing drain-age as the experimental group,routine debridement combined with vacuum sealing drainage as the control group. The clinical curative effect,the reduction rate of the wound,the rate of blastocyst and the rate of bacterial clear-ance and blood flow were detected.Results The clinical curative effect in the experimental group was significantly better than that in the control group(P < 0.05). The rates of wound reduction and granulation were significantly higher than those in the control group(P<0.05).After 14-day treatment,the blood perfusion in the experimental group was significantly higher than that in the control group(P<0.05),and the expression of HIF-1α and VEGF in the ulcer tissue was significantly higher than that in the control group(P<0.05).Conclusions Ultrasound de-bridement combined with vacuum sealing drainage can improve the clinical efficacy,wound reduction rate,granu-lation coverage rate and bacterial clearance rate,and increase ulcer tissue blood flow. The potential mechanism is related with the increases of HIF-1α and VEGF in ulcer tissue.