Objective To assess the long-term efficacy and safety of mid-dosage (13～15 mg?kg-1?g-1) ursodeoxycholic acid (UDCA) treatment for primary biliary cirrhosis (PBC). Methods A systematic review of all randomized controlled trials (RCT) comparing UDCA with placebo was performed. Results Seven trials including 1038 patients were assessed. UDCA could significantly improve liver biochemistry, but had no effect on pruritus and fatigue. In the patients with initial stage Ⅰ-Ⅱ, there was a significant decrease in the histologic progression after treatment with UDCA for 2 years compared with the placcebo group(P=0.03), but there was no significant difference between the two groups when considering overall patients with initial stage Ⅰ-Ⅳ (P=0.08). Meta-analysis showed no significant difference in the incidence of death (odds ratio 0.99, 95% confidence interval 0.62-1.58), liver related death (1.05, 0.53-2.05), liver trans-plantation (0.87, 0.53-1.41), death and/or liver transplantation (0.92, 0.64-1.31) and liver decompensation (0.94, 0.60-1.49) between the UDCA and placebo groups. Conclusions The analysis of RCTs of UDCA versus placebo shows improvement of liver biochemistry, but not improvement of clinical symptoms and survival. UDCA may slow down liver histologic progression in the early-stage patients with PBC.

The establishment of induced pluripotent stem cells(iPSCs)has been a major breakthrough in the field of stem cell research since 2006,and it made possible for the use of stem cells in treating retinal degenerative diseases.Research showed that fibroblast,B lymphocytes,neural stem cells,hair corneous cells,pancreatic cells,mesenchymal cells of umbilical cord stroma and amniotic membrane can be reprogrammed as iPSCs,and they are capable of differentiating into specific types of cells.Some novel developments in iPSCs study in ophthalmology also were observed over the past few years.Induced iPSCs can differentiate into retinal pigment epithelial cells,photoreceptors and other retinal cells,which lay a foundation for the therapy of retinal degenerative diseases.Differented from traditional treatment of stem cells,the generation of iPSCs makes it possible to utilize somatic cells derived from patients for stem cell therapy without provoking ethical and immunological problems.The generation of iPSCs,the current research about iPSCs in the ophthalmic field,the limitations of iPSCs in the clinic and their future development and application were reviewed.

Objective To study on the CDKN2/P16 gene in primary osteosarcoma.Method By using molecular biological methods that inclued genome DNA extraction from paraffined tissue and PCR SSCP analysis technique, we studied alternations of CDKN2/P16 gene in 25 primary osteosarcomas.Results (1)The deletions frequency in differentiation degree of osteosarcomas was① bone brood cell, 16.7% ;② cartilage brood cell,12.5% ;③ Fiber brood cell:20% ,(P >0.05).(2)The deletion frequency in male patients was 17.6% , female patients 12.5% ,(P >0.05).(3)In early metastatic osteosarcomas the deletion rate was 33.3% ,which was significantly higher than that of the control group with the rate of 10.5% (P< 0.05).(4)The deletion rate was 16% and the mutations were not found.Conclusion (1)The deletion rate was 16% and the mutations were not found.This suggests that the deletions of CDKN2/P16 gene were closely related to the genesis of primary osteosarcoma and that the main type of the alternation of CDKN2/P16 gene was deletion.(2)In early metastatic osteosaarcomas the deletion rate was 33.3% , which was significantly higher than that of the control group with the rate of 10.5% .This indicates to great extend that the deletions of CDKN2/P16 gene were closely related to the metastatic ability.(3)The deletions frequency had no significant relationship with differentiation degree of osteosarcomas, so was with the sex of the patient.

Objective To evaluate the clinical effects of platelet-rich plasma in treatment of DeepⅡburn wounds. Methods Sixty eight cases of inpatients with Deep Ⅱburns were selected, whose age were from 1 to 65 years and their burn areas were between 5%~62%of total body surface area (TBSA). Deep gradeⅡburn of each sample was divided into two parts. Part A was the treatment group and part B was the control group.The burn wounds in the treatment group were treated with platelet-rich plasma and the counterpart in the control group were treated with SD-Ag. Healing time ,recovering rate and the frequency of dressing changes,frequency of changing the most innerlayer gauze and the rate of wound infection were also analyzed. Finally the laboratory abnormalities and adverse effect were monitored regularly. Results The healing time of the treatment group (16.5±3.1 ) d was shorter than that of the control group (19.5±3.8 ) d. The recovering rate of the treatment group was higher than that of the control group on the 14th and 17th day after treatment. There were statistically sig?nificant differences between these two groups (P<0.05). After two weeks’treatment, the internal and external dressing per?meability into wet gauze layers were 20.6 ± 1.7, which were significantly decreased than that in the control group 23.3 ± 5.9. The frequency of dressing changes was(7.2±1.1)times in treatment group versus(9.2±1.4)times in control group and the frequency of changing the inner most layer gauze was( 2.3±0.6)times in the treatment group versus(5.3±1.3)times in con?trol group. There were 5 inflammation reaction cases in the treatment group, but 13 cases in the control group. However, there was no statistic significance between the two group in the outcomes of bacterial culture, the laboratory abnormalities and the adverse effect. Conclusion Platelet-rich plasma can remarkably shorten the healing time,improve healing rate,re?duce frequency of dressing change and promote wound healing for deepⅡburn wound. PRP is a potential safety reagent in treating deepⅡburn wound.

One case with fulminant type 1 diabetes during the third trimester of pregnancy was reported.If a patient manifests abrupt onset of hyperglycemia,nausea,vomiting,and bellyache during pregnancy or immediately after delivery,fulminant type 1 diabetes should be considered.

Objective To evaluate the performance of an improved skin prick test in the screening for allergens.Methods A total of 475 patients with chronic urticaria who aged from 3 to 81 years were enrolled in this study,and classified into the control group (n =235) and research group (n =240).Traditional and improved skin prick test were conducted in the control and research group respectively.The allergen detection rate was compared between the two test methods.Results The allergen detection rate was 65.4％ and 67.2％ respectively for the improved and traditional skin prick test,respectively (P ＞ 0.05).House dust mites were the most common sensitizing agent.Conclusion The improved skin prick test can offer reliable evidence for chnical diagnosis with a relatively convenient and safe procedure.

Objective To investigate the serum retinol-binding protein 4 (RBP4) level in olanzapinetreated schizophrenia with non-alcoholic fatty liver disease (NAFLD) via a case-control study and to explore its relationship with NAFLD.Methods Schizophrenia receiving olanzapine treatment,with or without NAFLD were enrolled as cases (n=60) or controls (n=60).The serum retinol-binding protein 4,metabolic syndrome component including body mass index (BMI),waist-to-hip ratio (WHR),fasting plasma glucose (FPG),total cholesterol (TG),total glycerin (TC) and blood pressure were assayed.TyG index,CT value ratio of liver and spleen were used for insulin resistance or NAFLD diagnosis and severity assessment respectively.Results The serum level of RBP4 was significantly higher in cases than that in controls ((70± 13)mg/L vs (52±12)mg/L ; t =4.943,P＜0.01) and the same result was showed after influencing factor adjustment thru covariance analysis (F=16.797,P＜0.01).Moreover,cases had significantly higher TyG index,BMI,WHR,FPG,TG and systolic pressure (t=2.383-4.300,P＜0.05-0.01).Cases with severe or moderate NAFLD had significantly elevated serum RBP4 level compared with mild cases((79± 16) mg/L,(72±8) mg/L vs (63t9) mg/L,d =16.2,9.9 ; P＜0.01,0.05).A significantly negative correlation between RBP4 level and the CT value ratio of liver and spleen (r=-0.244,P＜0.05),and a significantly positive correlation between RBP4 level and TyG index,BMI,WHR,TG(r=0.197-0.244,all P＜0.05) were observed.The partial coefficient between RBP4 level and CT value of liver and spleen was significant with influence adjusted(r=-0.453,P＜0.01).Logistic regression showed that serum RBP4 level(β3=0.105,P＜0.01)and TyG index,hyperlipidemia,obesity,central obesity or high blood pressure (β =1.288-9.711,P＜ 0.05-0.01) were closely associated with NAFLD.Conclusion A heighten serum RBP4 level may be one of NAFLD risk factors in schizophrenia treated with olanzapine.

OBJECTIVE:To study the effect of losartan on heart rate variability of essential hypertensive patientsMETHO_DS:The heart rate power spectral density and time-domain in 24-hour dynamic EKG were analyzed in 50 healthy subjects and in 90 patients with hypertension before and after giving losartanRESULTS:The low frequency and total frequency and ratio between low frequency and high frequency of hypertensive patients were significantly higher than those of controls,the high frequency and standard deviation of normal-to-normal intervals(SDNN) and standard deviation of the average of RR intervals(SDANN) for each five-minute period of the 24-hour eletrocardiographic recordings were significantly lower than those of controlsThe SDNN and high frequency of grade Ⅲ hypertension were significantly lower than those of grade Ⅱ hypertensionThe low frequency and ratio between low frequency and high frequency of grade Ⅲ hypertension were significantly higher than those of grade Ⅱ hypertension,and so were the grade Ⅱ than those of the grade Ⅰ It showed that vegetative nerve functi_onal damage was positively related with hypertensive gradeThe severer the illness,the greater the changeAfter losartan treatment,in addition to lowing the blood pressure,the SDNN,SDANN and high frequency of hypertensive patients were significantly increasedThe low frequency,total frequency and ratio between low frequency and high frequency of hypertensive patients were significantly decreasedCONCLUSION:When losartan lowers blood pressure,it can significantly improve the heart rate variability of essential hypertensive patients

Objective: To study the effects of long chain PUFA, AA and/or DHA on the fatty acid composition, growth and development of the newborn rats hippocampal neurons in culture. Methods: The primary culture of the hippocampal neurons was carried out in vitro by using serum free medium and supplementing 4 ? mol/L AA, DHA, or AA and DHA, of which the total concentration were 4 ?mol/L, the ratios of AA∶DHA from 1∶2 to 16∶1, in medium. The hippocampal neuronal fatty acid composition was analyzed by gas chromatogram, and the neuronal size and length of hippocampal neurite were measured by image analysis. Results: There were significant positive correlations between the ratios AA∶DHA in medium and the AA percentage and the ratios AA∶DHA in hippocampal neurons. The soma area? body maximum? minimum diameter and process length of hippocampal neurons in the group, which the total concentration of AA and DHA was 4 ?mol/L, and the ratio AA∶DHA in medium was 2∶1 or 4∶1,were higher significantly than other groups and groups with other ratios of AA∶DHA. Conclusion: AA and DHA could promote the growth and development of hippocampal neurons in culture..

Objective To compare and analyze the supply of blood collection and clinical blood demand in Hangzhou during 2011-2016,and to put forward some countermeasures and suggestions.Methods The related data of blood collection in blood center and the indexs of clinical blood demand in all hospitals in Hangzhou were collected during 2011-2016,and the growth rates of both of them were compared and analyzed.Results 1) The data of blood collection and supply was the lowest in 2012,and then increased year by year.The average annual growth of platelet collection and supply was 8.09％ and 8.47％,respectively,and the other indicators grew relatively gently.In 2016,the rate of blood donation reached 18.28 per thousand people.At the same period,the number of staff in institutions was basically stable.2) During 2011-2016,the blood demand of all hospitals in Hangzhoa maintained rapid growth.In Hangzhou,the number of hospitals increased by 10.65％ annually,and until 2016,there was an increase of 65.87％ over 2011.The average annual growth of the number of beds,the number of emergency patients and the number of inpatients increased by 10.21％,6.09％ and 11.40％ respectively.The growth rate of number of inpatients was higher than that of outpatient and emergency departments.Hospital employees remained at an average annual growth rate of nearly 10％.3) The clinical demand for blood increased significantly more higher than the growth of blood collection and supply.Conclusion Speed up the pace of the construction of blood supply,and keep pace with the construction of hospitals.Strengthening the publicity,health education and promotion models,in order to encourage more people,who are eligible for blood donation,to join the blood donation.And also strengthening personnel team building,improving overall work efficiency and level.