ObjectiveTo observe the effect of simvastatin combined with valsartan in treatment of chronic heart failure(CHF) and its affection on brain natriuretic pepfde(BNP) and heart function.Methods Ninety-six cases of CHF patients were classified into two groups by random digits table,which control group of 48 cases were treated with normal therapy,and observation group of 48 cases were treated with simvastatin combined with valsartan at the base of normal therapy.The clinical effect,BNP and heart function between two groups were compared.ResultsThe clinical effective rate in observation group and control group was 85.4％ (41/48) and 70.8％ (34/48) (P ＞ 0.05).The levels of BNP,left ventricular end-systolic dimension (LVESD),left ventricular end-diatolic dimension(LVEDD) and left ventricular ejection fraction (LVEF)after treatment were (0.72 ± 0.14) μ g/L,(36.14 ± 3.92) mm,(46.85 ± 4.11 )mm and (44.62 ± 3.38)％ in observation group,while ( 1.21 ± 0.22 ) μ g/L,(41.32 ± 4.22 ) mm,(54.31 ± 4.96 ) mm and (41.28 ± 2.25 )％in control group.After treatment,the levels of BNP,LVESD and LVEDD were significantly decreased,LVEF was significantly higher in both groups (P＜ 0.05).Moreover,the levels of BNP,LVESD and LVEDD in observation group were significantly lower than those in control group (P＜ 0.05),LVEF was significantly higher than that in control group (P＜ 0.05 ).ConclusionSimvastatin combined with valsartan in treatment of CHF can enhance the clinical effect,decrease BNP level and improve heart function,which can be applied in clinic.

Objective To explore the clinical effect of surgical treatment of stricturing Crohn's disease (CD).Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients with stricturing CD who were admitted to the First Affiliated Hospital of Zhejiang University School of Medicine between June 2013 and April 2016 were collected.After improving the patients' nutritional status by preoperative corresponding treatment and optimizing the risk factors of complications,patients received individualized therapy according to their conditions.The intestinal one-stage resection and anastomosis or ostomy were performed at the stenotic locus causing sypmtoms,and no treatment or angioplasty for stenosis was performed at the gentle stenotic locus.Patients received regularly postoperative outpatient reexaminations.The medication was used to prevent recurrence according to the individual conditions.Observation indicators:surgical procedures (open or laparoscopic surgery),operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,length of intestine resected,anastomosis methods,angioplasty for stenosis,duration of postoperative hospital stay,postoperative complications and follow-up.Follow-up using outpatient examination,telephone interview and wechat was performed to detect the abdominal pain,diarrhea,symptoms of clinical recurrence and endoscopic recurrence situations up to July 2016.Results All the 28 patients with stricturing CD underwent the selective operations,including 8 undergoing laparoscopic surgery (3 receiving conversion to open surgery) and 20 undergoing open surgery.Of 28 patients,2 underwent partial upper jejunum resection,10 underwent partial terminal ileum resection,15 underwent right hemicolectomy and 1 underwent colectomy.Operation time and volume of intraoperative blood loss were 33-288 minutes with an average time of 122 minutes and 50-650 mL with an average volume of 200 mL,respectively.One patient had intraoperative blood transfusion.Length of intestine resected of 28 patients was 10-150 cm,with an average of 54 cm and a total length of 1 510 cm.Of 28 patients,26 received the side-to-side anastomosis using linear closures (1 received the end-to-side anastomosis using pipe stapler,1 with multiple lesions and rectovaginal fistula received colectomy and ileostomy).Two patients with multiple stenosis of the small intestine underwent intestinal resection combined with angioplasty for stenosis in 3 loci.Duration of postoperative hospital stay was 7-45 days,with an average duration of 15 days.No patient died of surgery.Three patients had postoperative complications,including wound infection,incisional hernia and anastomotic leakage.Twenty-one patients were followed up for 3 months to 2 years,with a median time of 11 months,and there was no recurrence during the follow-up.Conclusions Surgical treatment should be performed to the patients with non-symptom,chronic and fibrous stricturing CD and anastomotic stenosis after ineffective medical treatment,with a satisfactory outcome.Meanwhile,it need follow the principle of minimally invasive.And optimizing high risk factors of complications before operation is a key point for preventing postoperative complications.

0.05), yet it correlated with RE incidence (P2.6 ,high risk ),obesity( OR=1.7～ 2.5,moderate risk ),over ingestion and intake of coffee and sweets ( OR=1.2～ 1.6,low risk ). Conclusion RE is frequently seen in adult population around Xi’ an area with a variety of risk factors.

Objective To investigate the role of central and peripheral sensitization in remifentanil-induced hyperalgesia in a rat model of inflammatory pain. Methods Twenty-one male SD rats weighing 200-300 g were used in this study. Inflammatory pain was induced by intraplantar injection of 1 % carrageenan 100 fd in the left hindpaw in all animals. The animals were then randomly divided into 3 groups ( n = 7 each): control group (group C) and two remifentanil groups (group R1 , R2) . In R1 and R2 groups remifentanil was infused iv at a rate of 10 and 30 μg-kg-1·min-2 respectively starting from 5 min before till 25 min after carrageenan injection, while in group C normal saline was infused iv instead of remifentanil. Bilateral paw withdrawal threshold to mechanical stimulation with von Frey filament (PWT) was measured before (baseline) and at 1 h, 3 h and 1-7 d after carrageenan injection. Bilateral paw withdrawal latency to noxious thermal stimuli (PWL) was measured before and at 2 h, 4 h and 1-7 d after carrageenan injection. The thickness of the plantar surface of left hindpaw was measured before and at 1 h, 4 h and 1-7 d after carrageenan injection. Results Bilateral PWT was significantly lower at day 1 after carrageenan injection in R, and R2 groups than in group C. The right PWT was significantly lower at 2 d and 4-7 d after carrageenan injection in group R2 than in group R, . There was no significant difference in PWL and thickness of the plantar surface of left hindpaw among the 3 groups. Conclusion Central sensitization is involved in developing and maintaining the remifentanil-induced hyperalgesia in a rat model of inflammatory pain, while peripheral sensitization is not.

OBJECTIVE To investigate distribution status and drug-resistance pathogens from infected urinary tract and offer scientific evidence for reasonably clinical usage of antibiotics.METHODS A total of 286 strains of pathogenic bacteria isolated from urinary tract were identified by common methods.Antibiotic susceptibility tests were performed by K-B methods.RESULTS Escherichia coli rated the top one,accounting for 62.2%.Results of susceptibility test showed that all pathogens were resistant to the many antibiotics in different degrees except for 100.0% sensitive to vancomycin in Gram-positive cocci and to imipenem in Gram-negative bacilli.The detection rate of extensive-spectrum beta-lactamases(ESBLs) producers in E.coli and Klebsiella pneumoniae was 36.5% and 40.9%,respectively.The average detection rate of meticillin-resistant staphylococci(MRS) was 35.7%.CONCLUSIONS The drug-resistance of pathogenic bacteria from infected urinary tract is quite serious in the local area.We should adopt effective measurement to control its prevalence.

Objective To investigate whether acid fibroblast growth factor (aFGF)can augument the number of endothelial progenitor cells ( EPCs), enhance their biological function and inhibit their apoptosis.Methods Mononuclear cells(MNCs) from human umbilical cord blood were isolated by Ficoll density gradient centrifugation,and cultured in vitro. After cultured six days, the attached cells were identified by flow cytometry and confocal laser scanning microscope. The cells were added with aFGF(2, 5, 10 μg/L) for 24 hours. Meanwhile, the attached cells in the group (aFGF 5 μg/L group)of the most obvious effects on EPCs was cultured for 6,12,24,48 h respectively ,accordingly, to explore the relationship between time and effect of aFGF 5 μg/L group. EPCs proliferation was assayed with CCK-8 kit assay. EPCs migration was assayed by modified Boyden chamber assay. EPCs adhesion assay was performed by replating cells on fibronectin-coated dishes,and then adherent cells were counted. Flow cytometry was uesd to detect cell apoptosis. Results Compared with control groop, aFGF can argument the number of EPCs and enhance the biological function of proliferation, migration, adhesion. In addition, aFGF can inhibit apoptosis of EPCs ( P ＜ 0. 05 ). The increase and inhibition ratio of apoptosis reached the maximum 24 h after administration of 5 μg/L( P ＜ 0.05 ). Conclusion The results of the present study define a novel mechanism of the action of aFGF: aFGF can augment the number of EPCs, enhance the functional activity and inhibit apoptosis in vitro.

Objective To investigate the effect of stoma skin care powde combined with skin protective mem-brane in prevention and treatment of secondary eczema after anal fistula surgery. Methods Eighty-three patients after anal fistula operation were divided into test group and control group. On the basis of routine treatment,the pa-tients in test group were used stoma skin care powder combined with skin protective membrane to protect the peri-anal skin. While the patients in control group were treated routinely. The degree of pruritus,the onset time,the number of skin lesions,the area of eczema and the healing time of eczema were observed in two groups 4 d,14 d and 24 d post-operation. Results Patients in test group had lowerdegree of pruritus,later onset time after dressing, less skin lesions,samller area of eczemaand shorter healing time of eczema than patients in control group in the 3 time nodes (all P<0.05). Conclusion Stoma skin care powder combined with skin protective membrane could effec-tively isolatepostoperative wound secretions and anus polyrrhea,and have preventive and therapeutic effects on sec-ondary perianal eczema after anal fistula surgery.

Objective To establish a benign esophageal stricture model and observe the effect of 32P radioactive isotopes on benign esophageal stricture scarring with intracavitary irradiation so as to provide experimental evidence for inhibiting scar hyperplasia and preventing esophageal restenosis after endoscopic dilation for benign esophageal stricture.Methods Benign esophageal stricture models were established in 18 healthy adult rabbits by annular incision and anastomosis.Then the rabbits were randomly divided into control group,hormone group and irradiation group,with six rabbits in each group.On day 2 after surgery,we measured inner diameter of the anastomotic stoma;then the control group received saline intervention,the hormone group was given dexamethasone,and the irradiation group was given 32P radioactive isotopes.The rabbits were observed for two weeks for their general condition and weight.After the intervention,we measured inner diameter of the anastomotic stoma.Liver functions (ALT and AST) were tested again before modeling and after intervention.Then the rabbits were put to death and had tissue in the esophageal stricture area removed for pathological examination and esophageal HE staining.We determined hydroxyproline (HYP) content of esophageal tissue around the anastomotic stoma.Restlts Benign esophageal stricture model was established successfully.After 2 weeks,the rabbits' appetite was obviously diminished in control group and relatively poor in hormone group;obviously improved in irradiation group.The rabbits' weight increased in radiation group compared with the other two groups (P＜0.05).The esophageal inner diameter in irradiation group widened obviously compared with the other two groups (P ＜ 0.05).In irradiation group,the number of fibroblasts decreased obviously,collagen fiber and granulation tissue were not obvious;HYP content was lower than that in the other two groups,and was close to that in a normal esophagus (P＞0.05).ALT and AST did not differ before and after intervention in all groups (P＞0.05).Conclusion ① We can establish benign esophageal stricture model successfully through the surgery.② 32Pradioactive isotopes radiation therapy can be used to prevent early scar formation in esophageal benign stricture,and is superior to dexamethasone therapy.

OBJECTIVE:To evaluate the efficiency and safety of Hydroalcoholic gel of osthol for subacute eczema. METHODS:By a randomized,parallel controlled clinical trial,a total of 243 patients with subacute eczema were assigned to either group A(n=116) or group B(n=127).The patients in group A were applied locally with Hydroalcoholic gel of osthol in the morning and evening for 2 weeks,and those in group B with Hydrocortisone butyrate cream in the morning and evening for two weeks.The total scores for the target sites and adverse reactions were evaluated after the completion of the 2- week treatment.RESULTS:There were no significant differences between the two groups in effective rate(84.48%for group A vs. 81.10%for group B),however,the itching- relieving efficacy in group A was significantly better than in group B(P

OBJECTIVETo observe differences of immediate effect of twirling reinforcing-reducing manipulation at head acupoints on muscle force in patients with acute ischemic stroke.

METHODSA total of 126 patients who met the inclusive criteria were randomly divided into a twirling reinforcing group, a mild reinforcing-reducing group and a twirling reducing group, 42 cases in each one. The lines between Baihui (GV 20) and bilateral Taiyang (EX-HN 5) were selected and treated with successive insertion of three needles. The twirling reinforcing method was used in the twirling reinforcing group, and mild reinforcing-reducing method was used in the mild reinforcing- reducing group, and twirling reducing method was used in the twirling reducing group. Each needle was manipulated for 1 min, which was repeated once every 10 min. The needles were retained for 30 min. Muscle force was evaluated immediately after treatment.

RESULTS(1) Muscle force of upper limb: after acupuncture, the muscle force of proximal and remote ends were all improved significantly in three groups (all P < 0.05), which was more obvious in proximal end (all P < 0.05). The improvement of the muscle force of proximal end in the twirling reinforcing group was superior to those in the mild reinforcing-reducing group and twirling reducing group (both P < 0.05); the differences of the muscle force of remote end were not significant among three groups (all P > 0.05). (2) Muscle force of lower limb: after acupuncture, the muscle force of proximal and remote ends was all improved significantly in the three groups (all P < 0.05). The improvement of the muscle force of proximal end was superior to that of remote end in the twirling reinforcing group and mild reinforcing-reducing group (both P < 0.05).

CONCLUSIONThe twirling reinforcing manipulation at head acupoints is superior to mild reinforcing-reducing and twirling reducing manipulation for muscle force in patients with acute ischemic stroke, which is more significant in proximal end of limbs.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Ischemia ; therapy ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Stroke ; physiopathology ; therapy ; Treatment Outcome ; Upper Extremity ; physiopathology