Objective To observ the curative effect of combined with Chinese and Western medicine in treatment gouty nephropathy.Methods 200 cases with gouty nephropathy were divided into integrative medicine group(treatment group,n=100)and allopurinol treatment group(control group,n=100).The renal function before and after treatment in two groups were observed.Results The total effective rate was 88.0％ in treatment group which was significantly higher than 76.0％ in control group(x2=5.90,P＜0.05);The levels of Bun,Scr,serum uric acid in the treatment group were lower than the control group(t=5.26,4.27,6.01,all P＜0.05).Conclusion Integrative medicine treatment of gouty nephropathy could delay the course of the disease,and had a good effect.

Objective To explore the correlation between the elder brain atrophy and calcification score at siphon segment of internal carotid artery.Methods The brain CT examination was detected in 327 elders.The brain atrophy occurrence were observed, and the calcification score at siphon segment of internal carotid artery were determined and calculated.Accroding to the calcification score, all the cases were divided into calcification 0 score group, calcification 1-199 score group, calcification 200-399 score group, calcification 400-599 score group and calcification ≥600 score group.The situation of brain atrophy were compared among these groups.And the correlation between the brain atrophy and calcification score were analyzed.Results Accroding to the calcification score, there were 63 cases in calcification 0 score group, 133 cases in calcification 1-199 score group, 72 cases in calcification 200-399 score group, 28 cases in calcification 400-599 score group and 31 cases in calcification ≥600 score group.There were 13 cases ( 20.63%) of brain atrophy in calcification 0 score group, 64 cases (48.12%) in calcification 1 -199 score group, 51 cases (70.83%) in calcification 200 -399 score group, 23 cases (82.14%) in calcification 400-599 score group and 28 cases (90.32%) in calcification≥600 score group;the differences of the brain atrophy rate among these groups were statistical significant ( all P<0.05 ) .The brain atrophy was mainly mild-moderate in calcification 0 score group and calcification 1 -199 score group;which was mainly severe in calcification 200 -399 score group;and mainly moderate-severe in calcification 400 -599 score group and calcification≥600 score group (all P<0.05).Spearman rank correlation analysis showed that the degree of brain atrophy were positive correlated with calcification score at siphon segment of internal carotid artery ( r=0.717, P<0.05) .Conclusions The elder brain atrophy is significantly correlated with calcification score at siphon segment of internal carotid artery.The calcification score higher, the brain atrophy rate higher and the degree more severe.Calcification score can be used as an important indicator of the elder brain atrophy.

Objective To analyze the clinical feature,pathogenesis and treatment of autoimmune hemolytic anemia (AIHA) in patients after orthotopic liver transplantation.Method A retrospective analysis was conducted on 7 patients who developed AHA after orthotopic liver transplantation.The clinical feature,pathogenesis and treatment of AIHA were reviewed.Result The incidence of AIHA was 0.98％ (7/713).AIHA occurred (7.9-± 4.0) (3-14) days after transplantation.All patients were characterized by progressive anemia and jaundice.Laboratory examination showed lower hemoglobin and platelet count,higher lactate dehydrogenase,higher indirect bilirubin and higher reticuloeyte count.The causes of AIHA included ABO-incompatible liver transplantation,infection and repeated transfusion.Conclusion AIHA is a rare and serious complication after liver transplantation.The most cause is ABO-incompatible liver transplantation.The patients can be successfully cured if the diagnosis is clarified and the treatment is definitive.

Objective To explore the relationship between serum magnesium (Mg) levels and glucose metabolism disorders in the elderly.Methods The data of health examination of 126 elderly people were collected in our hospital.There were 50 patients with type 2 diabetes,35 patients with impaired glucose regulation (IGR) and 41 people with normal glucose.The clinical data of the three groups were compared and analyzed.Results (1)There were no significant differences in age,body mass index (BMI) and blood lipid level among the three groups.The mean serum Mg level was lower in normal glucose group [(0.84±0.1) mmol/L] than in diabetic group [(0.75±0.11) mmol/L,P＜0.01] and IGR group [(0.78±0.12) mmol/L,P＜0.05].(2)The prevalence of hypomagnesemia was higher in diabetic group and IGR group than in normal glucose group (24%,28.6% vs.7.3%,P＜ 0.01 ).(3)The correlation study showed that the serum magnesium level was negatively associated with fasting plasma glucose and HbA1c (r= - 0.343,- 0.271,P＜0.01 ),but not associated with age and BMI.Conclusions The low serum magnesium level is associated with glucose metabolism disorders in the elderly.

AIM: To investigate the causes and features of anxiety for further understanding of this disorder.METHODS: The theories of anxiety introduced by Freud, Karen Homey and Harry S. Sullivan were analyzed and assessed.RESULTS: Anxiety was emotional experience occurred when an individual anticipated that his/her self-respect was threatened by internal and external stimulus but he felt that he could not cope with such threats. Whereas, it was up to the cognitive evaluation to determine whether such internal and external stimulus threatened self-respect and to identify whether one could handle such threats.CONCLUSION: Stimulation, self-respect, cognitive evaluation and ability are the key factors that determine the anxiety. Treatment of anxiety should not based on medicine, but also carefully consider psychological treatment. Patients should be informed with the nature of this disease so that they have certain self-awareness to improve their ability to handle the threats,correct any misunderstanding, and rebuild cognition.

Objective To assess the effectiveness of the urinary potassium to serum potassium ratio and urinary potassium to(serum potassium)2 ratio in the screening for primary aldosteronism(PA)from the patients with hypertension.Methods We analyzed all the 55 patients with PA,50 patients with essential hypertension(EH)matched with age and body mass index(BMI).We compared the urinary potassium to serum potassium ratio(UPP)and urinary potassium to(serum potassium)2 ratio(UPPP)with the serum aldosterone-to-renin ratio(ARR)between PA and EH groups.Results(1)UPP,UPPP and ARR in PA group were higher than in EH group(P

Femtosecond laser has been widely used in ophthalmology for its high precision, safety and minimal damage to tissues, and now its application in the corneal refractive surgery, corneal stromal ring implantation and cataract surgery has been more mature.In recent years, it has been actively developed and applied in penetrating keratoplasty, anterior lamellar keratoplasty and corneal endothelial transplantation, and some achievements have been obtained in experimental research and clinical application.While femtosecond laser promotes the development of corneal transplantation surgery, there are still some problems such as limited indications, uncertain efficacy, expensive equipment, lack of big data support and intelligence in personalized design.Continuous optimization and improvement are still needed to ensure postoperative vision, reduce postoperative complications, simplify parameter design and reduce consumption costs.In this paper, the indications, parameter design, clinical effect and limitations of femtosecond laser in keratoplasty were reviewed.

Objective To investigate the effect of indirect gentle moxibustion on serum IL-1 and TNF-?contents in patients with knee osteoarthritis and explore the mechanism of its action. Method A randomized controlled trial was conducted according to the patient's condition. Besides acupuncture as basic treatment, the treatment group received indirect gentle moxibustion and the control group, thermotherapy plus cupping. Pre-treatment and post-treatment serum IL-1 and TNF-?contents and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were analyzed in the patients and compared between the two groups. Result There were statistically significant pre-/post-treatment differences in serum IL-1 and TNF-? contents and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score in the two groups (P<0.05). After treatment, serum IL-1 and TNF-?contents and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were lower in the treatment group than in the control group. Conclusion Indirect gentle moxibustion can effectively decrease serum IL-1 and TNF-?contents in patients with knee osteoarthritis. That provides a certain molecular cytobiological and bio tissue engineering basis for the mechanism of its action in reducing inflammatory stimulation.

In 669 newly diagnosed T2DM patients the positive rate was 10.9% for GAD-Ab, 10.5% for ICA, 4.2% for both antibodies and 13.0% for anyone of the two antibodies. BMI was higher in antibodies-positive adult diabetic patients than that in control.

Twenty six patients with fracture of tibial plateau was under arthroscopy assisted reduction, the joint surface of bone graft, and USES the steel plate fixation treatment. Average surgery time was 65 min (70-120 min), average fracture healing time was 15 weeks (12-17 weeks), joint surface anatomical reattachment rate was 92.9%. Using break knee function criteria evaluation of curative effect: 18 cases great 6 cases wed, 2 cases ok, fine rate was 92.3%. No infection, deep venous thrombosis and small leg fascia chamber syndrome and other complications. Conclusion is that treatment of tibial plateau fractures under arthroscope has advantages of small trauma, check intuitively and reset accurately, functional recovery of patients are satisfied, the treatment has certain clinical application value.
Adult ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult