Objective To evaluate the clinical effect of levocarnitine in the treatment of continuous blood purification and its effect on matrix metalloproteinase-2(MMP-2),interleukin-18(IL-18)and heart function.Methods 118 patients with continuous blood purification were randomly divided into the control group(n=59)and treatment group group(n=59).Two groups were treated with hemodialysis treatment.Control group was given folic acid,vitamin B and alpha keto acid,treatment group intravenous given levocarnitine injection 20mg/kg+0.9％NaCl 20mL on the basis of control group.A cycle of treatment was 28 days,and treated for 3 cycles.Serum levels of MMP-2 and IL-18,heart function,clinical effect and adverse drug reaction were compared between the two groups.Results After treatment,the total effective rate in control group was 84.74％,lower than 94.92％in treatment group(P<0.05).After treatment,serum MMP-2,IL-18,left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),ventricular septal thickness(IVST),left ventricular volume index(LVMI)in two groups were lower than pre-treatment(P<0.05),and the indexes in treatment group were more lower than control group(P<0.05).The E/A and left ventricular ejection fraction(LVEF)in two groups were all increased after treatment,and those in treatment group were higher than control group,the differences were significant(P<0.05).There was no significant in the incidence rate of adverse drug reactions between two groups.Conclusion Levocarnitine in the treatment of continuous blood purification was effective,and significantly reduce the serum MMP-2,IL-18 level and improve the heart function.

Objective To analyze the clinical and pathological characteristics of thyroid carcinoma in patients from Qilu Hospital of Shandong University in last 7 years,and to explore the changes in disease spectrum.Methods Records of 772 patients with thyroid carcinoma,who underwent thyroidectomy and pathological examination,were reviewed from January 2005 to December 2011.Results (1) Individuals suffering from thyroid carcinoma have increased rapidly during these 7 years.(2) The high incidence of the disease resided in the age group of 30-59 for both men and women,with a male-to-female ratio of 1 ∶ 2.73.(3) The proportion of papillary microcarcinoma showed a growing trend,the rising trends were also apparent in papillary thyroid cancer (PTC) coexisting with nodular goiter or Hashimoto's thyroiditis (HT).Papillary microcarcinoma accounted for27.27％ of all PTC in 2005 and reached 54.22％ in 2011.Coexistence of PTC and HT accounted for 12.38％ of the cases with a male-to-female ratio of 1 ∶ 6.Conclusion The occurrence of thyroid carcinoma,especially papillary microcarcinoma has been increasing in recent years.The coexistence of PTC with nodular goiter or HT showed a trend to increase.

Objective:To explore the therapeutic effect of monoclonal anti EGFR antibody leading chemotherapy to human tumors.Methods:To prepare immunoconjugate of chemotherapy drugs with anti EGFR antibody and apply to clinic,and to observe it′s therapeutic effect and side effect. Results: This conjugated method could relief clinic symptoms and reduce side effect of tissues and organs significantly.Conclusion:Conjugates of monoclonal therapy of anti EGFR antibody and drug attached chemotherapy is a new and effective way for treatment of human tumors, and it can reduce side effect of the drugs meanwhile.

OBJECTIVE To analyze the factors influencing endoscope disinfection,in order to take the effective measure,improve endoscope disinfection work and prevent nosocomial infection.METHODS According to Instructions for Technical Procedures of Endoscope Cleaning and Disinfection published by Ministry of Health,42 samples of disinfected endoscopes from 18 000 were randomly selected.RESULTS The work for rinse and disinfection of endoscope in our hospital came to be standardized procedure gradually.We already achieved qualified by 100 percent according to Instructions.CONCLUSIONS The standardized management for rinse and disinfection of endoscope is the assurance for preventing nosocomial infection.

[Objective]To explore the anatomical structures,depth and direction of needling at Chengqi (ST1).[Methods] Forty-eight adult orbital specimens were observed by dissection.[Results] When a needle was vertically inserted into Chengqi (ST1),the needle tip would pass through the skin,subcutaneous tissue,orbicularis muscle,orbital adipose body,inferior obliges and inferior rectus.[Conclusion] The acupuncture of the Chengqi (ST1) should select straight sting needling back-upwards.The depth should not exceed 25.0mm.

Objective To investigate the effect of surgical treatment for giant primary liver cancer.Methods One hundred and forty-six cases of giant primary liver cancer received surgical treatment in recent 11 years ware analyzed retrospectively. Of them, 99 cases underwent irregular hepatectomy ,28 hemihepatectomy and 4 right hepatic trisegmentectomy .Including 19 cases received secondary resection after preoperative TACE, meanwhile 6 cases were underwent portal venous cancer thrombus extraction, 15 cases received biopsies and DDS only, Interoprative DDS were performed in 105 cases. Result The postoperative complications was 10.3 %, the postoperative mortality was 1.4%.The 1-,3-,5- and 10year survival rates were 56.6 %, 30.2% ,14.4% and 2.1% respectively. Conclusions The main treatment of giant liver cancer is hepatcctomy.Combination with TACE,portal thrombus extraction and DDS can improve the long-term survival.

Objective To investigate the effection of Shenfu Injection (Ginseng-radix aconitum Injection)to the blood coagulation system and its prognosis in the patient of multiple trauma complicated with shock.Methods We prospectively studied 90 patients of multiple trauma complicated with shock,who came from the emergency center of the Second Affiliated Hospital of Medicine' s college of Zhe-Jiang University and emergency department of Lishui People' s Hospital from February 2007 to December 2011,and excluded those suffered with the dysfunction of coagulation system and uncontrolled ongoing bleeding before trauma.And then these eligible patients were randomly divided into two groups:treatment group ( 45 cases ) and control group (45 cases),the control group were received the routine treatment,the treatment group were received Shenfu Injection in early stage based on the routine treatment.The two groups were measured the platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fibrinogen (FIB) before treatment and 3,7 days after treatment.Results The differences of the PLT,PT,APTT,TT,FIB between the treatment group and control group at 3,7 d after the treatment was statistically significant (P ＜ 0.05 ). Conclusions Shenfu Injection has positive regulation to the coagulation system in the patient of multiple trauma complicated with shock.

Objective To determine the functional motif of the recombinant Ricin B(rRicin B) in Vibrio vulnificus cytolysin (VVC) and understand its molecule pathogenic mechanism.Methods The motif of VVC was predicted through bioinformatics analysis and cloned into a procaryotic expression vector pET28a-rRicin B.The recombinant plasmid was transformed into E.coli BL21 (DE3) and induced by IPTG to express rRicin B.The expressed protein was further analyzed by SDS-PAGE and purified by Ni2+-NTA agarose.Renaturation of the rRicin B were also carried out for further analysis.ELISA assay and confocal microscope was applied to identify the activity of the rRicin B on human Hela cells.Results Ricin B motif located in the 336-465 amino acids of Vibrio vulnificus cytolysin with a relative molecular weight of 20×103.The result of ELISA showed that the antigenicity of rRicin B was 28.71 U/L after renaturation.FITC labeled rRicin B could bind to the cell membrane and enter the cytoplasm of human Hela cells.Conclusion The Ricin B motif in Vibrio vulnificus cytolysin bearing the similar ability with the natural Ricin B can bind to the cell membrane and enter the cytoplasm.This feature may play an important role in the activity of pore-forming and the cytotoxicity of Vibrio vulnificus cytolysin.

OBJECTIVE:To systematic review the relationship between CYP4F2 gene polymorphism and warfarin maintenance dose in Chinese population,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane library,PubMed,EMBase,CJFD,VIP and Wanfang database,studies about the relationship between CYP4F2 gene polymorphism and warfarin maintenance dose in Chinese population were collected,and Meta-analysis was performed by using Rev Man 5.0 statis-tics software. RESULTS:A total of 13 studies were included,involving 2 958 patients. The type of gene was type TT,type CT and type CC. Results of Meta-analysis showed the relationship between 3 gene polymorphism and warfarin maintenance dose was type TT>type CT>type CC,and there were significant differences among groups. CONCLUSIONS:CYP4F2 gene polymorphism in Chinese population has significant correlation with warfarin maintenance dose. However,due to the limit of methodological quali-ty,large-scale and high quality studies are required for further validation of the conclusions.

Objective To observe the efficacy of liposomal doxorubicin combined with cyclophosphamide, vincristine and prednisone in the treatment of refractory Non-Hodgkin’s lymphoma.Methods Liposomal doxorubicin (40mg/m2) was given by intravenous drip in the 1st day. Cyclophosphamide (750mg/m2) was given by intravenous injection in the 1st day. Vincristine (2mg) was given by intravenous injection in the 1st day. Prednisone (100mg/m2) was given orally from the 1st to the 5th day. A cycle was repeated every 3 to 4 weeks. Every patient took at least 2 cycles of the regimen.Results A total of 13 patients were assessed in the group. Among them, 7 were completely release (53.8), 4 were partially release (30.67) and 2 remained the same (15.35). The B symptom of 7 patients in the 9 with that disappeared, and that of the other 2 patients was improved obviously. The most common adverse effects were slight gastrointestinal reactions and the grade Ⅲ bone marrow suppression in a few patients. Conclusion The regimen of liposomal doxorubicin combined with cyclophosphamide, vincristine and prednisone is effective in the treatment of refractory Non-Hodgkin’s lymphoma with tolerable toxicity. It may be a salvage chemotherapeutic regimen deserving further study.