Chronic kidney disease (CKD) is a global public health problem with a high mortality and case fatality, and multiplies the risk for complications of cardiovascular disease and huge medical costs. Integrated traditional Chinese and Western medicine is effective in preventing and treating CKD with less adverse, however there are a lot of questions that we don't know well. Strategies and approaches of the integrated traditional Chinese and Western medicine in preventing and treating CKD are: (1) enhance the study of optimized scheme for single entity; (2) accelerate the step of new drug exploitation; (3) augment the study of action mechanism of traditional Chinese medicine in treating CKD; (4) strengthen the study of the mechanism of Chinese crude drug which is poisonous to kidney and its prevention and cure; (5) utilize the systems biology to study the essence of kidney; (6) establish a guideline for integrated traditional Chinese and Western medicine in prevention and treatment of CKD; (7) preach up the general knowledge of CKD, pay attention to mass screening and early prevention of CKD. It is expected to improve diagnosis and treatment of CKD with integrated traditional Chinese and Western medicine by carrying out these strategies and methods mentioned above.

Objective To analyse the effect of ursodeoxycholic acid on serum levels of cholyglycine ( CG ) , conjugated bile acid ( CBA ) and soluble vascular cell adhesion molecules (sVCAM-1) in patients with intrahepatic cholestasis of pregnancy.Methods 56 patients who were diagnosed with intrahepatic cholestasis of pregnancy in our hospital were collected.All patients were randomly divided into experimental group and control group, 28 cases in each group. The control group were treated with dexamethasone, and the experimental group were treated with the treatment of ursodeoxycholic acid, after 7d of treatment, the serum levels of glucocholic acid , CBA, ALT, AST and sVCAM-1 were detected in all patients. Results After treatment, compared with control group, the serum CG,TBA,ALT,AST and sVCAM-1 levels were significantly lower in the experimental group,and the difference was statistically significant (P<0.05).Conclusion The ursodeoxycholic acid can significantly reduce the serum CG,TBA, ALT,AST and sVCAM-1 levels in patients with intrahepatic cholestasis of pregnancy,improve pregnancy outcome,with guidance significance for clinic.

Objective To investigate the clinical effect of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGBD) in the treatment of acute cholecystitis.Methods A retrospective analysis was performed for the clinical data of 81 patients with acute cholecystitis who underwent ultrasound-guided PTGBD in General Hospital of Lanzhou Petrochemical Company from March 2013 to February 2016.The changes in related parameters after the placement of drainage tube were analyzed.The t-test was used for comparison of continuous data between groups.Results All the 81 patients underwent a successful one-time puncture.After the surgery,1 patient experienced tube dislodgement and 2 experienced obstructed bile drainage,while no patient experienced serious complications such as bleeding,bile leakage,and hemopneumothorax.Within 12 hours after surgery,there was a significant improvement in pain in the right upper quadrant and significant reductions in the major axis and radial width of the gallbladder (t =13.28 and 9.54,P =0.023 and 0.041),as well as significant reductions in white blood cell count and neutrophil count (t =8.70 and 8.03,P =0.028 and 0.034).Of all patients,38 achieved symptom remission after the placement of drainage tube and refused selective surgical treatment,and 43 underwent cholecystectomy within 3 months after surgery.Conclusion PTGBD is simple,convenient,visible,and safe and can effectively reduce patients' pain,increase the success rate of the treatment of acute cholecystitis,improve patients' clinical outcomes,and reduce the incidence of complications.It also provides the conditions of selective surgery for critically ill patients with acute cholecystitis,and therefore,it holds promise for clinical application.

Objective Understand shunde Uistrict Foshan City,Guangdong Province in the incidence of breast cancer in women.Methods The joint selectivity ductoscopy examination of the clinical breast examination screening,breast X-ray radiography examination from March 2011 to January 2013,Shunde District,FoShan City,Guangdong Provice,3 600 bladder than 40 years old woman with breast cancer screening.Results Three thousand six hundred women were found in 10 cases of breast cancer,the detection rate of 278/100 000 (10/3 600).Breast clinical examination found 1 313 cases of breast abnormalities,142 cases of breast lumps,nipple discharge line fiberoptic ductoscopy to cheek the 100 cases,X-ray radiography examination of four and more than 72 cases,accounted for a total of 45.19％ of the screening population (1 627/3 600).Conclusions Joint ductoscopy X-ray radiography examination of breast cancer screening in the normal population can help to detect early breast cancer,and to provide the basis for early clinical treatment.

BACKGROUND: Kyphoplasty-assisted bone cement augmentation can be used in lumbar pedicle screw fixation of osteoporotic patients.OBJECTIVE: To assess the fixation strengths of loosened sacral screws augmented with kyphoplasty-assisted and traditional bone cement techniques.METHODS: Fresh sacra were harvested from nine osteoporotic cadavers. After testing bilaterally placed unicortical and bicortical pedicle screws, two unicortical pedicle screws with the traditional and kyphoplasty-assisted cement augmentations were established on the same sacrum. Following 2000 cyclic compression loading to screw head on a MTS machine, their maximum pull-out forces were recorded and compared. RESULTS AND CONCLUSION: The bone mineral densities of nine specimens were ranged from 0.61 to 0.77 g/cm2 (0.71 g/cm2 in average). The mean maximum pull-out forces of unicortical and bicortical screws, and traditional and kyphoplasty-assisted cement screws were 203, 325, 437, and 565 N, respectively. The pull-out force was significantly higher in bicortical screw compared with unicortical (P < 0.05); however, these two fixations exhibited markedly lower pull-out strength compared with two cement augmentation techniques (P < 0.05). The pull-out strength was significantly higher in kyphoplasty-assisted cement augmentation group compared with traditional bone cement technique (P < 0.05). In addition, a significant positive correlation was exhibited between bone mineral density and pull-out force for the four fixations (P < 0.05). Results demonstrated that traditional and kyphoplasty-assisted cement augmentations can serve as the salvage technique for loosening sacral screw. However, kyphoplasty-assisted augmentation can provide higher stability.

Objective To assess the effects of MRI-positive and interictal epileptic charges(IEDs) dominance on the memory of the patients with drug-resistant medial temporal lobe epilepsy (MTLE). Methods Fifty right-handed patients(age ranging from 16 to 60 years old)diagnosed as drug-resistant MTLE in our hospital with normal intelligence between September 2006 and April 2007 were investigated. All patients were classified as left MRI-positive(MRI(+)),right MRI(+),MRI(-),bilateral MR[ (+)by high-quality MR[protocol.The EEG was defined as dominant IEDs if≥75%independent IEDs was confined to one temporal lobe in all EEG recordings.Clinical memory scale was administered as memory assessment of MTLE.ANOVA and non-parametric statistics were used to analyze the data in SPSS 12.0. Results The distribution of age,sex,education,occupation,living condition,course,seizure and treat among left MRI(+),right MRI(+),MRI(-),bilateral MRI(+)groups was similar.All scores in the patients with MTLE was significantly lower than normal(P＜0.05).Right MRI(+)MTLE patients had deftcits in nonsense graphics recognition(9.42±7.46)compared to left MRI(+)and MRI(-) groups((16.26±4.43)and(18.26±5.49),F=4.281,P＜0.05).Among MRI(-)patients,left IEDs,right IEDs and bilateral IEDs groups displayed not significantly different impairment in memory. Conclusion Right MRI(+)MTLE has more severe impairment in non-verbal memory,and nonsense graphics recognition can be used to detect the deficit.

AIM: To evaluate the pulmonary function in patients with type 2 diabetes mellitus in order to identify whether the lung is a target organ of chronic pathologic changes in diabetes mellitus. METHODS: Pulmonary ventilation function and diffusion capacity were studied in 107 patients with type 2 diabetes mellitus and 61 healthy subjects matched for age and sex. Glycosylated hemoglobin (HbA1c), urine albumin excretion rate (AER), fundus examination and nerve conduction velocity were included as parameters of glycemic control and diabetic microangiopathies. RESULTS: Pulmonary ventilation function was similar in type 2 diabetic group and the control. Compared with the control, carbon monoxide diffusion capacity (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were significantly lower in type 2 diabetic group (P<0.05). DLCO and DLCO/VA were inversely correlated with microangiopathy score (r: -0.291, -0.324, respectively, P<0.01). Furthermore, DLCO/VA was negatively correlated with age and duration of diabetes mellitus (r: -0.269, -0.236, respectively, P<0.05). CONCLUSIONS: Pulmonary ventilation function is normal in patients with type 2 diabetes mellitus, but their diffusion capacity is impaired. It suggests that the lung may also be the target organ of the chronic pathologic changes of diabetes mellitus.

Objective To compare the classification rate of three classifications of epilepsy syndromes proposed by International League Against Epilepsy(ILAE),and analyze their stuctural changes.Methods All patients with epilepsy who consecutively visited the epilepsy center of Peking Union Medical College Hospital between Aug.1st,2007 and Mat.31st.2008 were included.Thtee classifications of epilepsy syndromes were used in order.Results In this study,we could categorize 75.5 % of 1356 patients by applying the 1989 international classification of epilepsy syndromes.89.0 % of them by the 2001 proposed diagnostic scheme and 88.1 % of them by the 2006 report.In this aspect,the 2001 and 2006 classifications were better than the 1989 classification(x2=116.3,P<0.01).However,only 11.6 % (157),12.O % (162)and 11.9 % (160)of patients with specific epilepsy syndromes were identified from the 1356 epileptic patients by three classifications.respectively.This data based on the 2001 and 2006 classifications did not change markedly in comparison with the 1989 classification(x2=0.09,P>0.05).Conclusions The 2006 report involve mole scientific mode of classification and systematic evaluation,and can classify more patients with epilepsy.It can be ased in clinical and scientific research.which can not only accumulate data for developing more scientific classification but also stimulate research especially in the fields of genetics and functional morphology.

Objective To evaluate the safety and efficacy of Zonisamide(ZNS) as adjunctive therapy in patients with refractory partial seizures receiving other antiepileptic drags (AEDs).Methods This was a randomized,double-blind,placebo-controlled study conducted at multi-centers.All 240 subjects were randomized to either the ZNS group or the placebo group in a 1:1 ratio.The double-blind treatment phase included a titration phase during which zonisamide dose inereased from 100 mg/day to 300 mg/day over 4 weeks and then a 12-week fixed-dose phase.The primary efficacy endpoint was,the median % reduction from baseline in all pattial seizure frequency(CPS+SPS+SGS)during the fixed-dose phase.The important secondaw endpoint wag the responder rate.Safety profiles and tolerance were also evaluated.Results The FAS analysis showed the median reduction from baseline in the ZNS group was greater than in the placebo group(48.4%vs 26.6%),the difference was significant for ZNS compared with placebo(F=4.904,P=0.028);The responder rates for all partial seizures(48.6%vs34.9%,X2=4.046,P=0.044)and for complex seizures(52.2% vs 33.3%,X2=5.607,P=0.018)were significantly higber in the ZNS group than in the placebo group in the FAS population.The overall adverse events(AEs)profile was comparable between the two groups.The most frequent AEs considered to be related to zonisamide by the investigator were headache,dizziness,somnolence,anorexia,nausea,etc.Conclusions ZNS is superior to placebo in reducing the frequency of partial seizures and well-tolerated.ZNS could be a choice of adjunctive therapy in patients with refractory partial seizures.

Objective To observe the effects of hyperoxia on Notch 1 receptor of alveolar epithelial type Ⅱ cells (AEC Ⅱ), in a hetcrocellular culture of alveolar epithelial type Ⅱ cells and lung flbroblasts(LF), in order to explore Notch signaling in hyperoxic induced lung injury and thus make theoretical basis for prevention and treatment of a acute/chronie neonatal lung injury. Method Twelve Spragne Dawkey female rats with 200～220 g and 3 Spragne Dawkey male rats with 220～250 g were offered from experimental animal centre of Tongji Medical Colleege, Huazhong University of Science and Technology. The AEC Ⅱ/ LF co-culture system was established successfully. AEC H s from premature rats were randomly assigned to 2 groups: air control group and hyperoxia group. Air control group was kept in room air 50% ml/L CO2 enviromnent at 37°C, while hyperoxia group was exposed to 950 ml/L O2 + 250 ml/L CO2. Immuno-histochemistry was taken to detect Notch 1. Fluorescent quantitafive PCR was used to quantify the Notch 1 mRNA. MTT method was taken to assess cen proliferation viability.Flow eytometry double label method was used to detect cell percentages. Results In hyperoxia group:Notch 1 activation was inhibited, and Notch 1 mRNA decreased to 0.43,0.29,0.11,0.03 fold of control (95% confidence limit). AEC Ⅱ percentage descended predominantly[ 24 h hyperoxia group vs. control group: (68.92±6.88)%vs. (90.35±4.01)%, P =0.006;48 h hyperoxia group vs. control group: (38.03±3.27) vs. (61.47±4.81)%, P =0.000;72 h hyperoxia group vs. control group:(20.13±4.45)% vs. (52.05±3.35)%, P =0.000;96 h hyperoxia group vs. control group:(8.17±1.99)% vs. (52.59±2.93)%, P =0.0001 while that d AECI rised[24 h hyperoxia group vs. contrd group:(0.11±0.03)% vs. (0.01±0.01)%, P=0.006;48h hyperoxia group vs. control gnmp:(49.73±3.45)% vs. (16.13±2.13)%, P =0.000;72 h hyperoxia group vs. control group: (52.43±3.14) % vs. (5.98±0.95) %, P = 0.000;96h hyperorxia group vs. control group:(19.85±3.26)% vs. (29.03±3.16)%, P =0.007]. Comclusions Hyperoxia may inhibit Notch signaling pathway, which can weaken proliferation and disdifferentiation of AEC Ⅱ s. Investigations on how to control Notch signaling will provide fresh thoughts for alveolar epithelium repairing.