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

Objective To study the differential expression of matrix metalloproteinase-9(MMP-9) and tissue inhibitors of metalloproteinase-1(TIMP-1) in serum and decidua tissue from missed abortion and normal first trimester pregnancy,and to explore their function in early pregnancy .Methods The expression of MMP-9,TIMP-1 in serum was determined using enzyme-linked immunosorbent assay ( ELISA) ,and in decidua by immunohistochemical method . Results The MMP-9 serum level from missed abortion women was higher than that from normal first trimester preg -nancy women [(154.60 ±28.69)ng/mL vs.(135.75 ±18.35)ng/mL,t=3.50,P=0.001].The TIMP-1 serum level from missed abortion women was lower than that from normal first trimester pregnancy women [(253.03 ± 29.90)ng/mL vs.(323.15 ±33.62) ng/mL,t=9.86,P=0.000].The MMP-9 positive expression rate in decidua tissue was higher in missed abortion women than that in normal first trimester pregnancy women (82.5%vs.42.5%,χ2 =13.65,P=0.000).The TIMP-1 positive expression rate in decidua tissue was lower in missed abortion women than that in normal first trimester pregnancy women (87.5%vs.62.5%,χ2 =6.67,P=0.010).Conclusion The expression of MMP-9 and TIMP-1 in serum and decidua may be assosiated with missed abortion .

Objective To investigate the level of serum cartilage oligomeric matrix protein (COMP) and its relationship with vascular calcification in diabetic nephropathy (DN) patients .Methods COMP was tested in 54 (DN) group and 28 matched healthy persons (healthy group) .DN group was divided into vascular calcification group (VC) and non‐vascular calcification (non VC) group .DN group was also divided into cardiovascular disease group (CVD‐y) and without cardiovascular disease group (CVD‐n) in view of the company of cardiovascular disease .Serum COMP levels was compared between the DN group and the control group ,the VS group and the non VS group ,and the CVD‐y group and the CVD‐n group .The correlations between COMP level and the occur‐rence of cardiovascular disease ,the incidence of vascular calcification were estimated by Wald analysis of the application of Wald test .Results Serum COMP in DN group was significantly higher than the control group;Aortic arch calcification accounted for 75 .9% of the DN group .The serum COMP in VC group was higher than that of non VC group ,CVD‐y group had higher COMP than CVD‐n group old respectively with every 10 ng/mL increased in concentration of serum COMP .Conclusion The higher of concentration of serum COM P ,the more risk of vascular calcification and CVD .

[Summary] With the rapid development of economy ,obesity and type 2 diabetes (T2DM ) have become a serious social problem in China. Metabolic surgery was started to carry out in late 20th century in our country . Currently ,there were many deficiencies in the selection of operation indication ,surgical pattern and procedure ,prevention and treatment of complications ,perioperative management and postoperative follow‐up. Therefore ,to standardize nationwide surgical treatment of obesity and diabetes ,to reduce the incidence of postoperative complications ,Chinese Society for Metabolic & Bariatric Surgery (CSMBS) ,surgeon branch of Chinese Medical Doctor Association called domestic famous experts together to jointly draft a practical manual :Guide to Surgical Treatment of Obesity and Type 2 Diabetes in China (2014). With the spread of this guide ,the number of metabolic surgery increased significantly ,the procedure and management of surgery were further standardized.

The current situation is that the study of blood system diseases is difficult, and the students lack both the initiative and enthusiasm to learn. Clinical teachers' energy is limited because of other clini-cal, management and research roles, so the quality of teaching varies greatly. Meanwhile, teaching quality has nothing to do with personal reviews. Furthermore, the relationship between doctors and patients is in trouble in current medical environment. All of these above affect the quality of clinical practice in hematology department. Aiming at these problems, we improve the teaching quality significantly by raising the students' interests, enhancing their initiative, improving teachers' teaching level and enthusiasm, carrying out the in-ternship system, and strictly enforce the elimination system.

Objective To study the possible relationship between mitochondrial DNA(mtDNA)and hereditary ataxia(HA).Methods Polymerase chain reaction(PCR)was used to amplify 4 mtDNA segments of 30 patients with HA、some of their relatives and 35 volunteers.The point 3243、8993、8344 and point 11778 lied in the 4 mtDNA segments respectively.For the PCR products of point 3243 and 8993,restriction fragment length polymophism(RFLP)was performed to search for A3243G、T8993G or T8993C point mutations.For point 8344 and 11778 PCR products,single strand conformation polymorphism(SSCP)was executed to detect mutations.The HA patients’ results of SSCP were compared with their relatives and volunteers’.Sequencing would be carried out to find out exact mutations in those subjects whose SSCP results were abnormal.Results We had not found the A3243G、T8993G or T8993C point mutations in our study.All subjects’ mtDNA segments of point 8344 had not been found mutations.However,a new mtDNA point mutation-A11893G-was identified in 2 patients and 1 relative without symptoms from pedigree 1.Conclusion This new point mutation of mtDNA might be related to HA.

Objective:To explore effectiveness of Russell Barkley's parent training in children with comorbid attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD),and to evaluate its applicability in mainland China.Methods:Parents of 30 DSM-Ⅳ ADHD+ODD children were given 10 weekly trainings.Results:Total numbers of symptoms,symptoms of ADHD,symptoms of inattention,hyperactivity/impulsivity and ODD declined significantly(P