OBJECTIVE:To discuss the use of allopurinol for the reduction of serum uric acid level in patients with chronic kidney disease complicating hyperuricacidemia so as to delay the progression of chronic renal disease.METHODS:A total of 47 patients with chronic kidney disease complicating hyperuricacidemia were randomly divided into treatment group and control group:the treatment group was given allopurinol 100～200mg?d-1 in addition to the antihypertensive therapy as adopted in the control group or the common therapy for 12 months.RESULTS:As compared with the control group,serum creatinine level was lower and the rate of renal function deterioration was significantly decreased in the treatment group(P

Objective To compare the effect of methotrexate combined with laparoscopic surgery on pregnancy outcome of patients with tubal pregnancy treated with conservative treatment.Methods 96 patients who were diagnosed of tubal pregnancy,fertility requirements and no clinical data given birth were analyzed retrospectively.Depending on the method of treatment was divided into 46 cases of methotrexate and laparoscopic group of 50 patients.Postoperative intrauterine pregnancy,ectopic pregnancy and secondary infertility situation again were compared.Results Laparoscopic group in intrauterine pregnancy rate was 70.0％,which was significantly higher than that in the methotrexate group(47.8％),and the difference was statistically significant(x2 =13.229,P ＜ 0.05) ;laparoscopic ectopic pregnancy rate was 14.0％ against 17.4％ with methotrexate group,the difference was not statistically significant(x2 =2.037,P ＞ 0.05) ; methotrexate group was 34.8％ of secondary infertility was significantly higher than thatin the laparoscopic group (16.0％),the difference was statistically significant (x2 =12.784,P ＜ 0.05).Conclusion Laparoscopic surgery after conservative treatment of tubal repregnancy outcome is better than methotrexate.

Objective To explore and classify the subjective opinions of nurses on whistle- blowing, and identify the subjective characteristics of each type. Methods This study applied Q -methodology, protocols which could determinate subjective opinions of nurses on histle-blowing were set up and underwent interview investigation, data of the interviews went through Q-factor analysis. Results Most nurses had a positive attitude toward whistle - blowing because it could prevent any nursing activity not based on expertise and professional ethics from causing disadvantages for patients. At the same time, however, they requested the creation of a legal framework in which whistle-blowing was done in a way to increase trust among colleagues. Meanwhile, some nurses showed resistance to whistle - blowing. Conclusions Whether whistle - blowing can reach its aims depends on nurses' attitude toward it. Most Korean nurses support whistle-blowing. Nursing activity not based on expertise and professional ethics and causing disadvantages for patients can be avoided if a legal framework is established for whistle-blowing.

Combined Modality Therapy ; methods ; trends ; Heart Defects, Congenital ; therapy ; Humans

Murine thymocytes can be induced to proliferate and differentiate into cytotoxic effector cells when stimulated with Con A and provided with various cytokines. We have analysed the requirements for a range of cytokines in this system and, i n particular, the role of transforming growth factor ? (TGF-P) in regulating the cellular response to optimal concentration of the cytokines in combination. It was found that Con A+IL-2 (?)ed to marked proliferation and t hi s was augmented with IL-6, TGF-? inhibited the prolifera tion induced by IL-2+IL-6, the presence of TGF-?from the beginning of culture inhibited the development of cytotoxic effector cells and such effects were dose-related and could be reversed with antiserum to TGF-? but not. by a range of cytoki nes including IL-2, IL-4, IL-5, IL-6, TNF-a or ?-IFN. Phenotypic analysis indicated that TGF-? preferentially inhibited the expression of IL-2 receptor and the growth of ly2~+ cells.

Objective To investigate the effect of Shuxuetong injection on anticoagulation of nephrotic syndrome.Methods 42 patients were randomly divided into 2 groups:Shuxuetong group and control group.The Shuxuetong group were injected Shuxuetong injection while the control group were injected low molecular dextran and Danshen injection.Hemorheology and clotting index were detected before and after treatment.Results Hemorheology and clotting index of the two groups were improved.Hemorheology and clotting index of the Shuxuetong group were improved better than that of the control group.Conclusions The results suggested that the Shuxuetong injection was a safe and effective anticoagulation drug for the treatment of nephrotic syndrome.

BACKGROUND:Methylene blue can hinder abnormal pain conduction via the sensory nerve, and its mechanism is to block bradykinin-induced hyperalgesia and eliminate pain caused by local tissue inflammation.
OBJECTIVE:To observe the influence of methylene blue solution on the lumbar spinal cord and spinal ganglia function of rats, and to investigate whether methylene blue is safe for treating discogenic low back pain.
METHODTotal y 120 Wistar rats were randomly divided into five groupthree experimental groups, a saline control group and a blank control group, n=24 in each group. Lumbar segmental dura was exposed in rats. In the three experimental groups, 0.2, 1, and 2 mL methylene blue were injected epidural y, respectively. The saline control group was subjected to the epidural injection of 1 mL saline. In the blank control group, there was no treatment. Six rats from each group were selected randomly and perfused at 30 minutes, 2 hours, 24 hours, 72 hours after injection, respectively. Then, the corresponding segments of the spinal cord and ganglions were removed. Hematoxylin eosin staining was used for comparing histological and structural changes under light microscope.
RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that at 30 minutes, 2 hours, 24 hours and 72 hours after injection of methylene blue, the spinal dorsal side exhibited the structural integrity, clear boundaries between the white matter and gray matter, dense nerve fibers in the white matter, and round or oval nuclei of glial cells among fibers;dense nerve fibers in the posterior horn of gray matter;light-colored neuronal nuclei with prominent nucleoli;a bundle of nerve fibers among cellpopulations. There was no significant change in tissue structure of lumbar spinal cord and spinal ganglia between the experimental groups and the saline control group or between the experimental groups and the blank control group. Thus, the epidural injection of 1%methylene blue has no significant effect on the spinal cord and spinal nerve structures.

Objective To explore the risk factors for hospital acquired pneumonia (HAP) in patients with neural-intensive care unit (NICU).Methods The clinical data were analyzed retrospectively for 207 patients in NICU ≥ 5 d,to determine possible risk factors with HAP.Results The incidence of HAP was 14.01％(29/207).Correlation analysis showed that old age,disturbance of consciousness,dysphagia,vomiting,low pre albumin,NICU residence time ≥ 30 d,indwelling nasogastric tube,the use of the acid-blocking drugs,tracheal intubation,tracheal incision,mechanical ventilation and deep bronchoscopic suctioning were the related factors of HAP (P ＜ 0.05 or ＜ 0.01),but blood glucose,sedative drugs were unrelated with HAP (P ＞ 0.05).Conclusion There is a high incidence of NICU in patients with HAP,taking comprehensive measures actively,reduce risk factors,can effectively control the occurrence of HAP in NICU.

Objective To determine the factors influencing the indication for tracheostomy following cervical spinal cord injury.Methods A retrospective study was performed to analyze the 118 patients who had been treated for cervical fracture/dislocation along with cervical spinal cord injury from July 2004 to June 2014 and whose abbreviated injury scale score (AISS) was lower than 3.They were 96 men and 22 women,19 to 68 years of age (average,45.2 years).The patients were divided into a tracheostomy group (n ＝ 28) and a non-tracheostomy group (n =90).The 2 groups were compared in terms of gender,age,presence or absence of complete spinal cord injury at admission,injured segment,injury mechanism,smoking history,injury severity score (ISS),motor AISS,systolic pressure at admission,hospital stay,and ICU stay to determine the factors influencing allocation of tracheostomy.Results Compared with the non-tracheostomy group,the tracheostomy group had a higher rate of complete spinal cord injury at admission,a higher rate of smoking,a higher ISS at admission,a lower motor AISS,and longer hospital and ICU stay,with statistically significant differences (P ＜ 0.05).There were no significant differences between the 2 groups in gender,age,injured segment,injury mechanism,or systolic pressure at admission (P ＞ 0.05).Increased severity of cervical spinal cord injury was associated with significantly decreased motor AISA,increased rate of tracheostomy and increased ISS (P ＜ 0.05).Conclusion The influencing factors for indication of tracheostomy after cervical spinal cord injury are complete cervical spinal cord injury irrespective of the level of injury,ISS,motor AISS,and history of smoking.

Objective Toexplore the effect of Bcl2 and Ercc1 gene on apoptosis by RNA interference of Bcl2 and Ercc1 gene expression in non-small cell lung cancer cell line. Methods shRNA targeting Bcl2 and Ercc1 gene were cloned into vector to construct recombinant adenovirus plasmids which were transfected into HEK293 cells. High titer adenovirus was obtained after package and amplification. H460 cells were infected with the adenovirus and apoptosis rate was detected by flow cytometry. Results The results of restriction endonuclease digestion showed that recombinantadenovirus vector adsiBcl2-Ercc1 was successfully constructed. The positive 1 200 bp amplification bands could be seen in PCR analysis , and the titer of the adenovirus was 5 × 1011/mL. The apoptosis rate of AdsiBcl2-Ercc1 was higher than that of the two single silenced gene groups. Conclusions The recombinant plasmids and recombinant adenovirus were successfully constructed. Silencing of Bcl2 and Ercc1 through shRNA promotes the apoptosisin lung cancer cells.