Objective To compare the therapeutic effect of routine dose of calcitriol and large dose impulsion therapy on hemodialysis patients with secondary hyperparathyroidism(SHPT). Methods 48 uremic hemodialysis patients were divided into group A(routine group, n = 22) and group B(control group, n = 21 ). In group A,22 pa-tients were administered with calcitriol for 6 months at the dosage of 0.25～0.5μg/d,adding calcium agents simul-taneously;the patients in group B were not given calcitriol for economic reason. In group C,21 patients were given calcitriol twice a week at the dosage of 2μg/time after hemodialysis for 3 months. Results Comparing to group B,serum PTH,AKP in group A had no significant difference,but serum hypocalcium and hyperphasphate were partly corrected,symptoms of bone pain, muscular convulsion and akin pruriter were improved. Comparing to group A,serum hypocalcium and hyperphasphate in group C were corrected, serum PTH, AKP were significantly decreased( t=2.031,P<0.05;t =3.317,P<0.001),and no hypercalcium oecurred. Conelosion Routine dose of calcitriol can not control uremic-SHirr,while impulsion therapy with lower dose oral calcitriol is effective and safe.

The process of liver metastasis of colorectal cancer includes tumor cells invasion,survival in blood stream,extravasation to the liver and proliferation. It is involved in series of molecular markers,among which vascular endothelial growth factor and endothelial growth factor receptor are the major targets.

OBJECTIVE To investigate the significance of diagnosis of tempanosclerosis by HRCT combined with pure tone audiometry. METHODS 176 patients(181 ears) with chronic suppurative otitis media in stationary phase were recruited in Guizhou Medical University Affiliated Hospital between January 2014 to December 2015. Temporal bone HRCT combined with pure tone audiometry were applied to all patients before operation to diagnose tempanosclerosis. Intraoperative exploration results was the gold standard to observe sensitivity, specificity, positive likelihood ratio and the difference of accuracy of two diagnostic methods. RESULTS 1. The sensitivity, specificity, positive likelihood, negative likelihood ratio and accuracy of tympanosclerosis diagnosed only by temporal bone HRCT were 58.55%, 93.10%, 8.49, 0.46 and 64.09% respectively. 2. The sensitivity, specificity, positive likelihood, negative likelihood ratio and accuracy of tympanosclerosis diagnosed by HRCT combined with pure tone audiometry were caculated as 94.08%, 89.66%, 9.09, 0.01 and 93.37% respectively. Type I diagnostic accordance rate was 89.66%, type II was 87.50%, type III was 84.62%and type IV was 82.14%. The total diagnosis coincidence rate was 86.18%. The diagnostic efficacy increased significantly by the combined method than by the temporal bone HRCT alone. CONCLUSION Temporal bone HRCT combined with pure tone audiometry is valuable in diagnosis of tympanosclerosis. It can provide theoretical basis for making optimal operation scheme in suspect tympanosclerosis patients.

Objective To investigate the effect of three kinds of skin external use in the prevention and treatment of radiation dermatitis in patients with nasopharyngeal carcinoma. Methods 120 patients with nasopharyngeal carcinoma who were treated form August 2014 to October 2015 were divided into three groups by random number table method, namely, aloe vera gel group, triethanolamine cream group, radiation treatment of skin protectants (lifuning) group. Except for different medications among the groups, the other conditions remained relatively consistent. 3 groups were compared in the radiotherapy classification, area, local pain score, and topical drug costs during the radiotherapy and the radiation dose when radiation dermatitis occurred the first time. Results Three kinds of skin external use had a preventive effect, but the effect was different. Three groups′ patients with radiation dermatitis incidence was 100%, but occurred at different levels. Aloe vera gel cream group and triethanolamine group were mainly for gradeⅡradiation dermatitis, grade IV radiation dermatitis occurred in 2 cases and 4 cases, lifuning group were mainly for grade Ⅰ and grade Ⅱ radiation dermatitis, grade Ⅲ radiation dermatitis only occurred 2 cases, noⅣgrade radiation dermatitis occurred. Comparison among the three groups, the difference was statistically significant (H=8.758,P<0.05). 3 groups of patients after treatment all suffered pain, 12 patients in triethanolamine cream group , 7 patients in lifuning group , only 2 cases in aloe vera gel group (H=8.586,P<0.05). The average cost of skin external used in 3 groups was different, triethanolamine cream group was 546.0 yuan, lifuning group was 458.2 yuan, and aloe vera gel group was 157.5 yuan. Among the three groups pairwise comparison, the differences in triethanolamine cream group and aloe vera gel group were statistically significant in pain (χ2=9.62,P<0.05), aloe vera gel group was better than the group of triethanolamine cream, the differences among radiation dermatitis grade, size and radiation dose of radiation dermatitis occurred the first time were not statistically significant (P>0.05). The difference between in lifuning group and triethanolamine cream group in pain had no statistically significant (χ2=2.47,P>0.05), other indexes had significant differences (P < 0.05). Lifuning was better than the triethanolamine cream to reduce and delay the onset and deterioration of radiation dermatitis and could prevent a widening of the area of radiation dermatitis;aloe vera gel group and lifuning group had a significant difference in radioepidermitis grade (χ2=6.32,P<0.05). Lifuning was better than the aloe vera gel and was more conducive to reduce and delay the occurrence of radiation dermatitis, other indexes differences had no statistically significant (P>0.05). Conclusions Considering the efficacy, pain and price three aspects which skin external use prevention and treatment radiation dermatitis patients with nasopharyngeal carcinoma, lifuning as the mixture of triethanolamine and aloe can effectively reduce and delay the chance of radiation dermatitis, reduce the radiation field experience of local pain, and affordable, the patients are more acceptable, it′s worthy of clinical use.

Objective To study the clinical and genetic features of Lowe syndrome. Methods The clinical data and test results of OCRL gene from two children with Lowe syndrome were analyzed. The related literatures were reviewed. Re-sults Two male patients all presented with low molecular proteinuria, hypercalciuria, rickets and nephrolithiasis. Patient 2 had renal tubular acidosis, glycosuria and cryptochism. Patient 1 was found to have abnormal vision and congenital cataract soon after birth and treated surgically. Patient 1 also had psychomotor retardation and the cranial magnetic resonance ima-ging (MRI) showed agenesis of the corpus callosum. Patient 2 did not have obviously extra-renal symptoms, but was found to have mild cataract by a meticulous ophthalmological examination. MRI showed cerebral hypoplasia and myelination delay and mental retardation was gradually appeared during follow-up. Two OCRL gene mutations were detected. A splice site mutation NG_008638.1:g.46846-46848delTAA/insC was found in patient 1 and a frame shift mutation NM_000276.3:c.321delC in exon 5 was found in patient 2. Both mutations were not reported previously. Conclusions The diagnosis of Lowe syndrome is mainly by clinical manifestations and test of OCRL gene. Lowe syndrome needs to be included in the differential diagnosis of a patient with congenital cataract and renal tubulopathy. Two novel mutations in the OCRL gene were identiifed.

BACKGROUND:Chitosan hydrogel has good biocompatibility, biodegradability and antibacterial property, which can promote tissue healing and induce bone formation. As a scaffold carrying growth factors, it can ensure the efficient and slow release of exogenous growth factors.
OBJECTIVE: To observe the effect of injectable nano/chitosan/bone morphogenetic protein-2 composite to promote periodontal tissue regeneration in rats.
METHODS:Fifty-four Wistar rats were randomized into three groups, and then chronic periodontitis model of the second molar was established. After modeling, injectable nano/chitosan/bone morphogenetic protein-2 composite was implanted into the periodontal tissue of the second molar in the experimental group; injectable nano/chitosan hydrogel was implanted in the control grouop; and nothing was implanted in the blank group. At 3, 6, 9 weeks after surgery, gingival bleeding index, probing depth, and tooth mobility were detected. X-ray and histopathological observations were carried out.
RESULTS AND CONCLUSION:At 9 weeks after surgery, the probing depth and tooth mobility were both lower in the experimental group than the other two groups (P < 0.05). In the experimental group, the alveolar bone height was restored at the root bifurcations, bone trabeculae were arranged densely and evenly, the newly formed periodontal ligament and alveolar bone tissues were dense and equaly distributed in the bone defect area at 9 weeks after surgery, indicating a better restoration effect than the control and blank groups. These findings suggest that the injectable nano/chitosan/bone morphogenetic protein-2 composite has an anti-inflammatory role and can guide periodontal tissue regeneration.

High intensity focused ultrasound (HIFU) is a new and exciting medical treatment. Cavitation is the focus in the field of HIFU research. Cavitation and the relationship between cavitation, echo and the thermal effects of HIFU treatment were reviewed in this article.

Objective To analyze the pathogenesis,initially diagnosed symptoms and clinical manifestations of children with chronic kidney disease (CKD) at stage 2 to 5.Methods The data of 108 children who were hospitalized in Children's Hospital Affiliated to Capital Institute of Pediatrics from September 2007 to April 2016 with CKD stage 2 to 5 were retrospectively analyzed.The etiologies,clinical manifestations and examinations were summarized,and the clinical manifestations were compared between the congenital hereditary urinary diseases group and the acquired urinary diseases group.Results (1) In the 108 cases collected,66 cases were male,42 cases were female,aged from 3 months to 15 years and 1 month old.Twenty-four cases were diagnosed at stage 2,26 cases at stage 3,35 cases at stage 4,and 23 cases at stage 5.(2) Twenty-eight kinds of illness were involved in the cause of CKD.Among them,57 cases (52.8％) had congenital anomalies of the kidney and urinary tract,5 cases(4.6％) had hereditary kidney diseases,41 cases (38.0％) had other primary or secondary kidney diseases,and in 5 cases (4.6％) the causes of disease were unknown.(3) For the initially diagnosed symptoms,29 cases(26.9％) were due to complaints associated with kidney disease,36 cases (33.3％) were of other outside kidney symptoms,and 43 cases (39.8 ％) were of negative symptoms.The results of urinary ultrasound were abnormal in 79 cases(73.1％) and 87 cases(80.6％) showed abnormality in urinary analysis.There were 105 cases (97.2％) with abnormal manifestations either in urinary tract ultrasound or in urinary analysis.(4)The ages on diagnosis as CKD in children with congenital hereditary urinary diseases(5.89 years old) were younger than that of children with acquired urinary diseases (9.20 years old),and the difference was significant(Z =-3.434,P =0.001).The frequency of cases with short stature or lower-weight in group of congenital hereditary urinary diseases[66.1％ (41/622 cases),64.5％ (40/62 cases)] were significantly higher than those of the acquired urinary diseases group[43.9％ (18/41cases),43.9％ (18/41 cases)],and the differences were statistically significant(x2 =4.983,4.263,P =0.026,0.039).Conclusions The causes of CKD are complicated,and the congenital anomalies of kidney and urinary tract are the major causes of CKD at stage 2 to 5 in the cases.The initially diagnosed symptoms of CKD are insidious and atypical.The children with congenital hereditary urinary diseases tend to have more serious growth retardation.Urinary analysis and ultrasound may have an important significance for early diagnosis of CKD in children.

Objective To provide theoretical basis for clinical treatment of all-ceramic crown prosthodontics,the influence of cement thickness on the stress distribution in all-ceramic crowns under load was studied numerically.Methods The finite element analysis(FEA) model of a standard mandibular first molar was established using spiral CT and CAD software,and then it was applied to analyze the stress distribution of all-ceramic crowns under vertical loading using FEA software.Results Stress concentration was found in mesial and distal cement;the stress distribution at the cement upper and lower interface was found to be similar,and the stress magnitude discrepancy between the two interfaces was small;the stress of the model with 0.15 mm cement in the cervix was lower about 30% than the one of the 0.05 mm model.Conclusions The cement thickness plays an important role in the stress distribution of all-ceramic restoration system.The model with 0.15 mm cement shows a better resistance to destruction among the three models investigated.

Objective To explore efficiently treatment of advanced stage superior segment esophageal cancer.Methods The 30 cases with advanced stage superior segment esophageal cancer were randomly separated two groups:Treatment group 14 cases were local chemotherapy treated by gastroendoscopy,comminute with radication;Control group 16 cases were treated by surgical operative treatment,combinate with vadication.Results The treatment group and conerol group remission rates were 85.71% and 68.75%,1 year's survival rates were 71.42% and 50%.Conclusion Superior segment advanced stage esophageal cancer is local chemotherapy treated by gastroendoscopy,cuvative efficavy is distimction.