Humans ; Phosphorus Compounds ; toxicity ; Poisoning ; therapy

Objective To investigate the clinical efficacy of nifedipine sustained-release formulation(SR)and nifedipine controlled-release(GITS)in the treatment of essential hypertension.Methods 160 patients with essential hypertension were randomly divided into two groups.The SR group was treated with SR 20 mg twice a day;GITS group was treated with GITS 30 mg once a day.All patients were given ambulatory blood pressure monitoring(ABPM)and observed the 24-hour average blood pressure,heart rate,changes in the trough/peak(T/P)values,and adverse reactions before and after treatment in two groups.Results The T/P value of systolic blood pressure(SBP)and diastolic(DBP)in the GITS group was 68.5％,74.6％,respectively,which were higher than those of SR group(57.2％,61.1％)(x2=6.32,7.05,all P＜0.05);GITS group was significantly lower than the SR group in heart rate(t=4.17,P＜0.05);Adverse reactions between two groups had no significant difference(x2=0.16,P＞0.05).Conclusion SR and GITS can effectively lower blood pressure,but GITS is more efficient,stable,safe,small impact on the heart rate.

Objective To evaluate the clinical value of cerebrospinal fluid ADA,IL-23 joint detection in the diagnosis of tuberculous meningitis related diseases.Methods 253 cases with tuberculous meningitis related diseases were selected as the research subjects.According to the diagnosis,they were divided into tuberculous meningitis group (meningitis group,138 cases ),tuberculous meningitis complicated with hydrocephalus group (hydrocephalus group,35 cases)and control group(80 cases).All patients after admission received lumbar puncture, the part of cerebrospinal fluid specimens were inspected,the cerebrospinal fluid ADA,IL -23 joint test was conducted.Meningitis group and hydrocephalus group were given anti -TB drugs (INH,RFP and PZA +sm ) combined with chemotherapy.3 months after treatment,the meningitis group and hydrocephalus group received lumbar puncture cerebrospinal fluid ADA,IL -23 joint test again.The levels of ADA,IL -23 in cerebrospinal fluid were compared.Results Before treatment,cerebrospinal fluid ADA,IL-23 levels in the meningitis group were (12.64 ± 5.54)u/L and (48.38 ±10.78)pg/mL,those in the hydrocephalus group were (15.81 ±6.92)u/L and (77.21 ± 13.42 mm)pg/mL,which in the control group were (3.21 ±2.20)u/L and (9.05 ±3.89)pg/mL,ADA,IL-23 levels in meningitis group and hydrocephalus group before treatment were significantly higher than the control group (F=117.24,724.97,P<0.001).Spearma analysis showed that each group of cerebrospinal fluid ADA and IL-23 had no correlation.After treatment,the cerebrospinal fluid ADA,IL-23 levels in the meningitis group were (3.79 ± 3.13)u/L and (13.46 ±6.62)pg/mL,which in the hydrocephalus group were (6.42 ±4.35)u/L and (25.42 ± 8.54)pg/mL,the meningitis group before and after treatment had statistically significant differences in cerebrospinal fluid ADA,IL-23 (t=16.34,32.43,all P<0.001);hydrocephalus group before and after treatment had statistically significant differences in cerebrospinal fluid ADA,IL-23 (t=6.80,19.26,all P<0.001 ).Conclusion Cerebro-spinal fluid ADA,IL-23 joint detection in the early diagnosis of tuberculous meningitis related diseases and clinical observation has high clinical value.

Objective To explore the clinical significance of application of trans-abdominal Heller combined with Dor fundoplication for esophageal achalasia in the elderly.Methods Clinical data of 9 patients with esophageal achalasia undergoing trans-abdominal Heller combined with Dor fundoplication from Oct.2009 to Dec.2013 were collected.The postoperative effects and complications were analyzed.Results The operations were successful in the 9 patients with no conversion to open operation and no complications.The maximum esophageal diameter was reduced to (1.94 ± 0.76) cm from (3.69 ±-1.34) cm (P＜ 0.05).Rest lower esophageal sphincter pressure declined by 12.18 mmHg in average (1 mmHg=0.133 kPa,P＜0.05).Dysphagia score fell to 2.49 points from 7.88 points (P＜0.05).There were no retrosternal pain and dysphagia,stenosis and food retention in the lower esophagus and cardia place,and obvious expansion in esophageal.There were statistically significant differences in the above indexes.Conclusions The trans-abdominal Heller combined with Dor fundoplication can significantly improve the symptoms of esophageal achalasia in elderly patients,and effectively prevent postoperative gastroesophageal reflux,and has the characteristics being minimally invasive and fast,and fewer complications.

BACKGROUND:Traumatic soft tissue defects of the limbs are usual y accompanied with the exposure of tendon, joint capsule, bone or internal fixator, which can be reconstructed by skin flap. Previous research has shown that it is an important method to repair traumatic tissue defects with flaps. However, rarely research reports perioperative management about flap bed so far. OBJECTIVE:To explore the perioperative strategy for repairing traumatic soft tissue defects with revascularized flaps. METHODS:Total y 94 cases undergoing secondary skin flap repair were enrol ed. Intraoperative debridement using tourniquet was performed, and the wound was washed with mass of physiological saline. Whether the tissues, including bone, tendon, joint capsule and internal fixator, were reserved or not depended on their viability, and then the flaps were harvested to repair defects, and drainage was placed properly at last. RESULTS AND CONCLUSION:The flaps survived in al cases. Exudation occurred in 5 cases with the exposure of bone, and 28 cases with the exposure of tendon or joint capsule healed normal y. No complications were associated with the reservation of the internal fixators, but delayed-union occurred in three cases and nonunion in one case. These findings indicate that the perioperative treatment of the application of skin flap is worthy of attention. Careful debridement, advisable choice of the flap, efficient drainage and using antibiotic normatively are al keys. Treatment of the bone, tendon, joint capsule and internal fixator which are exposed should not only weigh the advantage and disadvantage, but also relax the indication of reserving them.

Based on a survey of community health service organization in several cities, community health service model based on the family clinic was compared with state-owned community health service model, and status quo, advantages and problems of family community health service organization were analyzed. Furthermore, policies for the management of community health service organization based on the family clinic were put forward.
China ; Community Health Services/*methods ; Community Health Services/*organization & administration ; Data Collection ; Delivery of Health Care/organization & administration ; Hospitals, Community/*organization & administration

Objective To observe the therapeutic effects and comphcations of treatment by using transcatheter arterial chemombolization(TACE) combined with functional splenic embolization(FSE) on patients with primary hepatocelluar carcinoma (HCC) combinded with hypersplenism.Methods Eighty HCC patients with hypersplenism were randomly divided into two groups by computer program.Observation group was treated with TACE and FSE,while control group was treated by only TACE.The iodine oil deposition,blood routine parameters and related complications were observed.Results (1) After one-month' s treatment,abdominal CT scan showed that 38 cases(79.17％) of patients in the observation group and 27 cases (84.38％) of patients in control group had iodine oil deposition in over 50％ of the tumor area.(2) The white blood cell counting in observation group were (7.65 ± 2.3) × 109/L,(5.89 ± 1.9) × 109/L,(5.02 ± 1.7) × 109/L in the follow-up examination 1 week,1month and 3 month after splenic embolization,respectively,which were significantly increased from the preoperative level of (2.21 ± 1.1) × 109/L(P ＜ 0.05).Platelets counting were (93 ± 29)× 109/L,(127 ± 32) × 109/L and (119 ± 26) × 109/L in observation group at 1 week,1 month and 3 month after splenic embolization,respectively,which were significantly higher than the preoperative level of (39 ± 20)× 109/L (P ＜ 0.05).In the control group,there were no statistically significant difference between the preoperative and postoperative levels (P ＞ 0.05).(3) Both of the the two groups showed no serious complications.Conclusion TACE combined with FSE is a safe and an effective method to treat hypersplenism combined in HCC patients.

BACKGROUND: High-strength titanium alloy can be prepared bY using powder metallurgy technique, but there are still some problems such as containing toxic elements or high elastic modulus in prepared alloys.OBJECTIVE: A new Ti-Mg alloy with non-toxic and elastic modulus which is close to human bones and strengths satisfy the requirements for human body implants was successfully prepared by means of powder metallurgy technology, and the effects of magnesium content on the microstructure and mechanical properties of Ti-Mg alloy were systematically studied.METHODS: The Mg powder and 17 powder in different mass ratios were prepared by powder metallurgy process to get a new integrated medical Ti-Mg alloy with excellent comprehensive properties. The porosity, fracture surface morphology and phase constituents of samples were observed by optical microscopy, scanning electron microscopy and X-ray diffraction, and the mechanical properties including bending strength, impact toughness and hardness of the alloys were measured,RESULTS AND CONCLUSION: Magnesium mass increasing firstly decreased and then increased admissible strain. When magnesium mass was 10%, admissible strain was 0.97%, which was highly closed to 0.67% of cortical bone. The porosity decreased from 18.3% to 3.8%, the holes became more tact and distributes more uniform, with the increased of mass ratio of magnesium. And with the increased of mass ratio of magnesium, the hardness, bending strength and elastic modulus of alloys with similar pattern of change, there were little changed when the mass fraction of magnesium less than 10%, they decreased significantly and then tended to stable with the continued to increased of magnesium mass fraction. While the admissible strain firstly decreased and then increased, with the increased of the mass fraction of magnesium. When the mass fraction of magnesium was 10%, the hardness, bending strength, impact toughness satisfied the mechanical requirements for human body implants, and the bending strength and admissible strain were close to human bones, which indicated well biomechanical compatibility.

Purpose To prepare streptavidin-tagged mouse interleukin-4(mIL-4-SA)bifunctional fusion protein and to study on its bioactivity.Methods The mIL-4 gene was cloned by RT-PCR and cloned into pET21 vector to get mIL-4-SA-pET21 expression plasmid.The mIL-4-SA fusion protein was expressed in BL21 (DE3)host bacteria and purified through the Ni-NTA affinity chromatography and refolded by dilution and dialysis.The effect of mIL-4-SA fusion protein on mouse thymocytes proliferation was evaluated by MTY.Flow cytometric analysis was performed to detect the mIL-4-SA fusion protein on the biotinylated B16F10 tumor cells.Results The mIL-4-SA-pET21 vector was successful by constructed and the mIL-4-SA fusion protein was expressed in BL21(DE3)at about 35%of total bacterial proteins.The purity of mIL-4-SA Was about 95% through Ni-NTA.The mIL-4-SA fusion protein exhibited bifunctional activities,i.e.,stimulative effect for mouse thymocyte proliferation and SA-mediated high-affinity binding to biotinylated cell surfaces(anchoring modified rate Was about 96.69%).Conclusion The mIL-4-SA fusion protein was expected to be developed for the treatment of tumors.

Objective To investigate the relation between coagulation disorders and sepsis severity of infected patients.Methods In this retrospective study,75 patients,51 males,24 femalse,with age(55.8± 18.1),were included from January 2010 to March 2011.They were clinically diagnozed as infection,and had Thromboelastography(TEG)and routine coagulation test within 24 hours after admission to emergency department.They were divided into 3 groups based on SIRS and SOFA score within 24 hours after admission:a)infection group,patients without SIRS; b)sepsis group,patients with SIRS and SOFA score less than 5; c)severe sepsis group,patients with SOFA score greater than or equal to 5.LSD was used to compare between two groups if one-way ANOVA of three groups comparasion showed significant differences.Results In comparasion to sepsis group(n =29)and infection group(n =27),D-dimer elevated significantly in severe sepsis group(n =19)(F =3.388,P =0.004),and platelet count decreased significantly(F =3.839,P =0.026),INR and KPTT showed an increase trend without significant difference (F =2.657,P =0.077 ; F =2.782,P =0.069); TEG showed MA obviously decreased(F =5.841,P =0.004),while there were nostatistically significant differences among other data.Conclusions The extent of coagulation disorders and sepsis severity of infected patients is closely correlated to each other.