Objective:To observe the effect of high-flux polyethersulfone dialysis membrane to inflammatory mediators and nutritional status in patients with maintenance hemodialysis, and to explore its mechanism.Methods: Ninety six patients with low-flux maintainance hemodialysis were recruited after changing to a high-flux hemodialysis. Hs-CRP, IL-1, IL-6,ALB, Hb,β2-MG were tested before treatment, 6 months and 12 months after treatment, at the same time single chamber urea clearance index (spKt/V) was recorded. Results:①The compare results among high-flux polysulfone membrane dialysis treatment for 6 months and after 12 months, and before treatment, hs-CRP andβ2-MG significantly decreased (F=6.53,P<0.05), spKt/V was significantly higher(F=4.35, P<0.05), and IL-6 significantly decreased at 12 months after treatment, compared with before treatment, the difference was statistically significant (F=7.21,P<0.05).②There was significantly negative correlation between hs-CRP and ALB (r=-0.463,r=-0.396,r=-0.402;P<0.05). Inflammatory mediators may participate in the occurrence and development of its hypoalbuminemia in MHD patients, and elevated hs-CRP levels may be a risk factor for hypoalbuminemia. Conclusion:High-flux polysulfone membrane hemodialysis can effectively reduce micro-inflammatory state MHD patients and improve their nutritional status, improve the quality of life and long-term survival.

Objective:To explore the application value of central venous indwelling catheter guided by ultrasound in temporary hemodialysis patients.Methods:Seven hundred and eight cases of hemodialysis patients were choosed as the respondents who were divided into control group(n=386) and ultrasound group(n=322), sex ratio, average age, disease distribution, platelet count(Plt), prothrombin time(PT), systolic blood pressure (SBP), neck circumference was no statistical difference in two groups. In control group, indwelling catheter of the right internal jugular vein were implemented in the triangle area formed by sternocleidomastoid clavicular head, sternum, clavicle by using surface anatomic mapping. In ultrasound group, position, the diameter and blood flow filling situation of the right internal jugular vein by using ultrasound scan, the veins were punctured and indwelled catheter under the guided by ultrasound. The success rates and times of indwelling catheter, as well as complications were compared between two groups.Results: One-time success rate of indwelling catheter guided by ultrasound group was obviously higher than that of control group, the rates were statistically significant difference (x2=118.82,P<0.01), and the indwelling time was significantly shorter than that of control group, The difference was statistically significant (t=7.03,P<0.01). The puncture comfort score of ultrasound group was significantly higher than that of control group, The difference was statistically significant (t=6.29,P<0.01). The complication rate of ultrasound group was lower than that of control group, the difference was statistically significant (x2=28.24,P<0.01).Conclusion: Ultrasound help to understand the position, diameter and blood flow filling situation of the right internal jugular vein, improve the success rate of indwelling catheter and reduce the occurrence of complications.

Objective To observe the effects of intravenous injection of fentanyl and tramadol on postoperative analgesia in laparoscopic cholecystectomy of clinical efficacy.Methods 80 cases treated with laparoscopic cholecystectomy were randomly divided into the fentanyl group (group F) and tramadol group (group Q).VAS score,adverse reaction incidence and patient satisfaction,were observed after the administration of 0.5,1,2,4,8,12h.Results In group F after administration of 0.5,1,2h,VAS score was better than that of group Q; group F after administration of the drug 4,8 h VAS score was inferior to group Q;two groups of patients in postoperative 12h VAS scores showed no significant difference in group F;the overall incidence of adverse reactions was higher than that of group Q,patients' satisfaction was higher than that of group Q.Conclusion Intravenous fentanyl in laparoscopic cholecystectomy operation postoperative overall are superior to the analgesic effect of tramadol,with high patient's satisfaction.

Regional saturation technique has been applied in MR scaning widely. It is possible to obtain MRA or MRV by putting the REST slab on one side of slice or another. REST eliminates artifacts caused by motion or blood flow and minimizers wrap artifacts along the phase encoding and high quality of images can be provided.

ObjectiveTo investigate the effect and medical cost of different revascularization strategies for acute myocardial infarction (AMI) patients with multi-vessel disease (MVD).Methods A prospective randomized controlled trial (RCT) was conducted. From January 2009 to June 2012, patients with AMI and MVD undergoing primary percutaneous coronary intervention (PCI) were enrolled. They were randomly assigned to group A [staged PCI for non-infarction related artery (non-IRA) within 7-10 days after AMI] and group B (subsequent PCI for non-IRA recommended only for those with evidence of ischemia). All of patients were given optimized medical therapy according to clinical guideline, and they were followed up for 24 months at regular intervals. Major adverse cardiovascular events(MACE) including recurrence of myocardial infarction and death due to cardiac ailments were recorded. Meanwhile, re-hospitalization from cardiac causes, recurrence of angina, heart failure, and re-PCI, number of stents, total hospital stay days, and total medical expenditure were recorded.Results A total of 428 patients accomplished the 24-month follow up. All the patients underwgennt PCI for non-IRA in group A (215 patients), while 62 patients in group B (213 patients) undergone PCI for myocardial ischemia, and 51 patients received non-IRA treatment. There was no significant difference in MACE incidence between group A and group B [8.4% (18/215) vs. 10.8% (23/213),χ2= 0.727,P = 0.394]. The difference of death rate due to cardiac causes (5.1% vs. 6.6%), recurrence of myocardial infarction (4.2% vs. 6.6%), and heart failure (4.2% vs. 7.0%) were not significantly different between groups A and B (allP> 0.05). The rate of recurrence of angina (14.4 % vs. 32.9%), re-hospitalization from cardiac causes (14.4% vs. 33.8%), and re-treatment of implanting stents (12.6% vs. 29.1%) were significantly lower in group A than group B (allP< 0.01), and the rate of revascularization was significantly higher in group A than group B (10.7% vs. 5.2%,P< 0.05). The total number of stents (610 vs. 366), mean number of stents per patient (2.83±0.91 vs. 1.72±0.91,t = 12.725,P = 0.000), and total cost per patient (kRMB: 63.7±12.6 vs. 51.5±12.3,t = 10.107,P = 0.000) in group A were significantly higher than those in group B. Total hospital stay days in group A was significantly less than group B (days: 8.21±2.45 vs. 9.89±3.23, t = 6.071,P = 0.000). Because non-IRA-vascular reconstruction rate was low in group B, the rate of usingβ-blocker and anti-anginal agents during the 24-month follow up in group B was significantly higher than group A [59.2% (126/213) vs. 47.0% (101/215),χ2= 6.371,P = 0.012; 56.3% (112/213) vs. 17.6% (36/215),χ2 = 64.704,P = 0.000]. Conclusions In patients with AMI and MVD undergone emergency PCI, staged PCI within 7-10 days for non-IRA cannot decrease the incidence of myocardial infarction and death due to cardiac causes, recurrence of angina and rehospitalization for cardiac causes was diminished, and it may increase the number of stents and medical cost significantly.

Objective:To investigate the variation characteristics and influencing factors of HIV/AIDS subtypes in Wuxi city of Jiangsu Province from 2014 to 2016.Methods:HIV/AIDS population in Wuxi city in 2014 was selected as the research object, and the HIV molecular epidemiology and follow-up study were carried out. Collect epidemiological information, extract DNA from blood samples, amplify pol gene fragment by nest-PCR and sequence, use ChromasPro 1.6 software and MEGA 7.0 software to construct the HIV-1 sequence database, and use FastTree2.1.10 software to construct the phylogenetic tree to confirm the subtype; in 2016, the same population was followed up, and the HIV subtype variation was analyzed, and the influencing factors of subtype variation were explored by multivariate logistic regression. Results:A total of 612 HIV/AIDS cases in 2014 and 2016 were collected. The age of the subjects was mainly 30 years old or above (85.46%, 523/612), and the proportion of people over 50 years old was higher (228/612, 37.25%). The main route of transmission was homosexuality, accounting for 49.67%. A total of 1224 samples were detected and CRF01 _ AE、CRF07_ BC、B、CRF08_ BC、CRF67_ 01B、CRF55_ 01B、CRF68_ 01B, 7 subtypes of HIV-1 and 5 unique recombinant types (URFs) was detected. CRF01_ AE and CRF07_ BC was still the main genotype in Wuxi, Jiangsu Province, accounting for 66.75%. There were 29 cases (3.56%) of URFs recombinant strains. During 2014-2016, the variation rate of subtypes was 14.63%, and the most common variation was CRF01_ AE changes to CRF07_ BC(13.95%). Marital status (OR=0.363, 95% CI: 0.137-0.964) and baseline CD4 level (OR=0.414, 95% CI: 0.192-0.891) were associated with subtype variation.Conclusions:The HIV-1 subtypes of HIV/AIDS patients in Wuxi city are diverse and complex, the proportion of recombinant subtypes is rising, the URFs that are difficult to determine the genotype increase significantly, and the variation rate of HIV-1 subtypes among HIV/AIDS infected people is high. It is necessary to strengthen the monitoring of HIV-1 subtypes.

Objective To analyze the application value of modified anterior pelvic floor reconstruction operation in pelvic organ prolapse.Methods A retrospective analysis was adopted.A total of 141 patients with pelvic floor reconstruction surgery in the obstetrics and gynecology department of Chongqing Municipal Ma-ternal and Child Health Care Hospital from January 2020 to December 2021 were included.The patients were divided into the observation group(modified anterior pelvic floor reconstruction operation,n=78)and control group(classic anterior pelvic floor reconstruction operation,n=63)according to the operation methods.The perioperative indicators,pelvic organ prolapse quantitation(POP-Q)score before and after operation,objective cure rate after operation,recurrence situation and pelvic floor quality of life score before and after operation were compared between the two groups.Results There was no significant difference in the surgical time,bleeding volume,duration of antibacteriakl drug use,and length of hospital stay between the two groups(P＞0.05).The POP-Q scores after surgerynin the two groups were signbificantly increase compared with before operation,and the objective cure rate in postoperative 12 months in the observation group was significantly higher than that in the control group at 12 months after surgery(91％.0 vs.81.0％,P＜0.05).There was no recurrence in the observation group after one year follow-up,while there were two cases of recurrence in the control group.The scores of the pelvic floor distress inventory short form 20(PFDI-20),pelvic floor impact questionnake,short form 7(PFIQ-7),and pelvic organ prolapse/incontinence sexual function questionnaire-12(PISQ-12)in 1 month after surgery in the two groups had statisticallyu significant differences compared with those before surgery(P＜0.05).After one year of follow-up,the patient global impression of improvement(PGI-I)score in the observation group was significantly lower than that in the control group(P＜0.05).Con-clusion The modified anterior pelvic floor reconstruction operation can effectively improve the quality of life in the patients,moreover the patients are not easy to relapse,so which is a new type of operation worthy of promotion.

Two new compounds, named lyciumlignan D () and lyciumphenyl propanoid A (), along with seven known compounds, were isolated from the root bark of. Their structures were elucidated using spectroscopic data (UV, IR, HR-ESI-MS, 1D and 2D NMR, CD), as well as by comparison with those of the literature. Compounds-were isolated from this genus for the first time. In theassay, compounds,, andexhibited stronger anti-inflammatory effects than the positive control curcumin at a concentration of 10 μmol/L.