[Objective]To explore the effective method for eczema on hand and foot of children.[Method]Apply Compound Indometacin Tincture(CIT) to 48 cases of eczema on hand and foot of children.[Result]30 cases were cured,8 cases had marked effect,5 effective,5 cases no effect,the total effective rate was 89.58%.[Conclusion]CIT has good therapeutic effect on eczema on hand and foot of children.Its effect is similar to that of steroid hormone.

Abdominal compartment syndrome(ACS)is an important factor contributing to the multiple organ dysfunction syndrome which is commonly seen in patients with severe acute pancreatitis(SAP).As a life-saving procedure,decompressive laparotomy is widely applied to patients with SAP complicated with ACS,especially to patients with edema of the visceral tissues caused by massive fluid resuscitation at the early stage of the disease.However,decompressive laparotomy should be adopted with caution since it is associated with enteroatmospherie fistula,intraabdominal infection,postoperative ileus,third space losses,hypothermia and hemia.Therefore,decompressive laparotomy should only be considered after conservative management had failed.The indications for decompressive laparotomy are as follows:(1)intraabdominal pressure＞25 nnn Hg;(2)adequate ventilation of the patient is difficult;(3)pereutaneous drainage of ascites is not helpful.Timely temporal abdominal closure is helpful in preventing complications.Infected peripanereatie necrosis is the indication for peripancreatic exploration or necroseetomy.A thorough knowledge of decompressive laparotomy is essential for individualized management of patients with SAP complicated with ACS.

Altering the natural history of disease has been the goal of medical therapy for Crohn's Disease (CD) in recent years. The conventional approach has been thestep-up therapy. With the introduction of biological agents (such as infliximab) , there is growing evidence that the top-down approach is justified in a subgroup of high-risk patients. The new algorithms is not only associated with superior clinical remission rates, but also may have the potential to alter the natural history of the disease, including inducing mucosal healing, reducing the rate of complications, surgeries and mortality. Further study will have to determine which subgroup of patients will benefit most from this early aggressive biological therapy approach.

Objective To explore the relationship between cytogenetics with therapy and prognosis in myelodysplastic syndrome.Methods 124 cases of myelodysplastic syndrome from September 2005 to October 2009 were reviewed.124 cases contained 79 males and 45 females,aged 14 to 79 years,median age was 57 years old.26 cases were diagnosed as RA,13 cases as RAS,21 cases as RCMD,29 cases as RAEB-Ⅰ,35 cases as RAEB-Ⅱ.According to the karyotype,124 cases were divided into two groups,79 cases of normal karyotype and 45 cases of abnormal karyotype.Patients were followed up for three years in order to analyze the incidence of myelodysplastic syndrome changed into acute leukemia.Results In 39 patients diagnosed as RA and RAS,32 cases were with normal karyotype and 7 cases (17.9 ％) with abnormal karyotype.15 of 32 cases with normal karyotype achieved hematologic remission after treatment while only 1 of 7 cases with abnormal karyotype achieved remission.1 case with abnormal karyotype changed into acute leukemia after 2 years.In 85 patients diagnosed as RCMD,RAEB-Ⅰ and RAEB-Ⅱ.Difference of the lower incidences of RA and RAS changed into acute leukaemia during 3 years in normal karyotype and abnormal karyotype groups was statistically insignificant (P ＜ 0.05).The incidences of RCMD,RAEB-Ⅰ and RAEB-Ⅱ changed into acute leukemia were higher,especially in the abnormal karyotype group with 42.1 ％.Conclusion Myelodysplastic syndromea with abnormal karyotype is associated with poorer efficacy of therapy,higher incidence of changing into acute leukaemia.The patients can take early allogeneic hematopoietic stem cell transplantation to improve the prognosis.

Altering the natural history of disease has been the goal of medical therapy for Crohn's Disease(CD) in recent years.The conventional approach has been the "step-up" therapy.With the introduction of biological agents (such as infliximab),there is growing evidence that the "top-down" approach is justified in a subgroup of high-risk patients.The new algorithms is not only associated with superior clinical remission rates,but also may have the potential to alter the natural history of the disease,including inducing mucosal healing,reducing the rate of complications,surgeries and mortality.Further study will have to determine which subgroup of patients will benefit most from this early aggressive biological therapy approach.

With the increasing understanding of the pathogenesis of Crohn's disease and the advent of biological therapy,the therapeutic strategies of Crohn's disease have changed a lot in recent years.In this review,we concerned the progress in the management of active disease,maintenance of medically induced remission,and surgical options of Crohn's disease.The new concept of "top-down" approach to the treatment of Crohn's disease evolved recently was also discussed.

Objective To study the clinical efficacy and plasma concentrations of tacrolimus in renal transplant patients. Methods Kidney transplant patients were randomly divided into experimental group and control group. Control group was treated with cyclosporin A, experimental group was treated with tacrolimus. Clinical efficacy of two groups was compared,and plasma concentrations of tacrolimus the experimental group were tested at different periods. Results Compared with the control group,experimental group D-BILI and the concentration of T-BILI significantly lower,rate of acute rejection and infection significantly reduced,the differences were statistically significant (P <0.05) ;At the same time,in the experimental group,blood concentration of FK506 in patients at different periods after surgery were different. Conclusions . Tacrolimus was expected to develop ithe main immunosuppressant, its blood concentration factors of further research would be beneficial for to provide a reasonable regimen the clinical organ transplant patients.

Objective To explore the value of maternal serum triple markers screening,consisted of AFP (α-fetal protein),β-human chorionic gonadotropin (β-hCG) and free estriol (uE3),for Down's syndrome,in second trimester.Methods We searched published literatures from PubMed,MEDLINE,China National Knowledge Internet (CNKI) and Wanfang Database from January 1990 to August 2014 and articles met the following criteria were collected:(1) The report was of a screening test;(2) The research purpose was to study the efficiency ofAFP,hCG and uE3 (triple markers) screening for Down's syndrome;(3) The research subjects were pregnant women in second trimester;(4) All of the studied cases were confirmed by amniocentesis and chromosome karyotyping;(5) The pregnant outcomes must be available;(6) Each report should have at least one case of Down's syndrome identified;(7) The literature could be retrieved by Science Citation Index or Chinese core periodicals;(8) When assessed by QUADAS (quality assessment of studies of diagnostic accuracy included in systematic reviews) Quality Assessment Scale,the score should be ≥ 8.Information were extracted,including name of the first author,publication time,sample size,sensitivity,specificity,maternal age,gestational age,cutoff value,β-hCG type and others.MetaDiSc 1.4 software was applied for meta-analysis.I2 was used for heterogeneity,and the fixed or random effects model for calculation of the combined sensitivity,specificity,diagnostic odds ratio (DOR) and the 95％CI.The summary receiver operating characteristic (SROC) curve was drawn.Deek's test in Stata Software was used to validate publication bias.Results A total of 49 literatures were recruited in this study with a total sample size of 960 245.Deck's funnel plot analysis showed that the correlation coefficient and the standard error of bias were-1.067 and 3.64 (t=-0.290,P=0.771).The correlation coefficient and the standard error of the slope were 3.578 and 0.26 (t=13.740,P=0.000).The random effects model showed the pooled sensitivity of the 49 literatures was 0.72 (95％CI:0.70 0.74),the pooled specificity was 0.92 (95％CI:0.92-0.93),and DOR was 33.80 (95％CI:25.03-45.65).The area under the SROC was 0.900 7.DOR of younger age group (including three literatures) was 14.38 (95％CI:3.67-56.42) and 26.64 (95％CI:19.49-36.41) for the older age group (two literatures).For two literatures determining the gestational age based on ultrasonography,the DOR was 50.22 (95％CI:26.91-93.71),and DOR was 33.09 (95％CI:17.33-63.19) for those based on last menstrual period in these two literatures.For eight literatures applied the cutoff value of 1:270,12 applied 1:250 and four applied mixed cutoff value,the DOR was 10.94 (95％CI:3.04-39.38),54.34 (95％CI:42.19-70.01) and 36.37 (95％CI:31.19-42.40),respectively.DOR of total β-hCG group (12 literatures) was 22.06 (95％CI:16.46-29.58) and that of free β-hCG group (ten literatures) was 37.15 (95％CI:30.00-46.02).Conclusions Triple regimen of second trimester maternal serum screening for Down's syndrome is much more efficient.The detection rate could be further improved by determination of the gestational age with ultrasound,and application of 1:250 as the risk cutoff value and free β hCG as a screening marker.

Objective To observe the intervention effect of Wuxing-Jiangu exercise for different syndrome types of elderly patients with chronic low back pain.Methods A total of 199 patients who met the criteria of chronic low back pain (CLBP) were divided into a Wuxing-Jiangu exercise group (86 cases), a control group (85 cases) and a health education group (28 cases). On the basis of health education, theWuxing-Jiangu exercise group was given Wuxing-Jiangu exercise; the control group was treated with the warm type frequency therapeutic instrument; health education group was only given health education guide. The changes of the score of CLBP patients before and after treatment with different syndrome types were observed.Results After 3 months of treatment, the score of the kidney deficiency syndrome and spleen deficiency syndrome in the Wuxing-Jiangu exercise group, the control group and the health education group had significant differences (H were12.554, 8.014, respectively;all P<0.01); After 3 months of treatment, the score of kidney deficiency syndrome and spleen deficiency syndrome in the Wuxing-Jiangu exercise group reduced than before the treatment (Z were -5.975,-5.025, respectively)and 1 month after the treatment(Z were -5.976,-5.026, respectively) (all P<0.01).Conclusion Wuxing-Jiangu exercise can reduce the score of the kidney deficiency syndrome and spleen deficiency syndrome and improve clinical syndrome.

OBJECTIVE:To optimize extraction technology of saponins from Paris polyphylla. METHODS:Using paris sapo-nin Ⅰ,paris saponin Ⅱand Paridis total saponin as dependent variables,using ethanol volume fraction,extraction time and sol-vent amount as independent variables,through multiple linear regression and binomial fitting,the extraction technology was opti-mized with response surface method and predicted. RESULTS:The optimized extraction technology of saponins from P. polyphylla was as follows as 10-fold of 80% ethanol,2 times reflux extraction,100 min each time. Under the extraction technology,the ex-traction rates of paris saponinⅠwere 85.4%,82.7% and 87.1%;those of paris saponinⅡwere 85.9%,81.3% and 83.6%;and those of Paridis total saponin were 89.5%,92.1% and 90.3%(all RSD<2.0%). Measured value was 0.964 9,predicted value was 0.986 0 and deviation rate was 2.14%. CONCLUSIONS:The central composite design-response surface method is simple and reliable for the optimization of extraction technology of saponins from P. polyphylla.