OBJECTIVE:To observe the efficacy and safety of methylprednisolone combined with entecavir in the treatment of primary nephrotic syndrome with hepatitis B virus infection. METHODS:23 primary nephrotic syndrome patients with hepatitis B virus infection were given 0.5 mg/times Entecavir tablet,orally,once a day,for 2 weeks,and added 0.8mg/(kg.d)Methylpredniso-lone tablet,orally,once a day,for 8 weeks,then the dose was maintained for 2-3 months every other day,and then decreased 4 mg for 4 weeks every other day,and the dose was decreased 4 mg every 2-4 weeks,until drug withdrawal. Entecavir tablet was used in the whole process of Methylprednisolone tablet,the dose was adjusted and gradually stopped based on HBV-DNA within 3 months of Entecavir tablet withdrawal. Liver and renal efficacy,24 h urine protein excretion,serum albumin(ALB),alanine ami-notransferase(ALT),aspartate aminotransferase(AST)levels before and after treatment of 2,6,12 and 15 months,and the inci-dence of adverse reactions of all patients were observed. RESULTS:The liver and renal efficacy were 100%;after treatment of 2, 6,12 and 15 months,24 h urine protein,ALT and AST were significantly lower than before and gradually decreased by time, ALB was significantly higher than before and gradually increased by time,the differences were statistically significant(P<0.05);the incidence of adverse reactions was 43.48%,and there were no obvious adverse reactions and no renal dysfunction. CONCLU-SIONS:Methylprednisolone combined with entecavir has significant efficacy in the treatment of primary nephrotic syndrome with hepatitis B virus infection,with good safety.

Objective To compare the effect of ureteroscopic pneumatic lithotripsy(URL) and extracorporeal shock wave lithotripsy(ESWL) for ureteral stones.Methods 90 patients with ureteral stones were randomly divided into group A( URL group),group B( ESWL group),each group 45 cases.The effect of surgical treatment was compared between the two groups.Results The one-time success rate of gravel,stone free after 4 weeks of A group was significantly higher than that of group B( x2 =9.680,5.414,all P ＜0.05),but there was no significant difference in the surgical time and hospital stay of the two groups( t =1.010,0.909,all P ＞ 0.05 ).The postoperative renal colic,fever and other complications of group A were significantly lower than that of group B ( x2 =6.049,5.075,all P ＜0.05),but the gross heraturia and ureteral injury of group A was higher than that of group B(x2 =5.874,3.873,all P ＜ 0.05 ).Conclusion The ureteroscopic pneumatic lithotripsy and extracorporeal shock wave lithotripsy in the treatment of ureteral stones all have good effect,but ureteroscopic pneumatic lithotripsy and stone rubble drain success rate are significantly higher than extracorporeal shock wave lithotripsy,and postoperative complications are relatively less than extracorporeal shock wave lithotripsy.

Objective To investigate the application effect of comprehensive intervention on rehabilitation of schizophrenia patients in remission stage and residual period.Methods 300 patients with schizophrenia in the acute phase were divided into the observation group and the control group,the control group was given atypical antipsychotic drug treatment,the observation group was given mental health treatment based on the control group.Compliance,curative effects,side effects were compared between the two groups.234 patients were in remission and residual period were divided into comprehensive intervention treatment group and simple drug treatment group,quality of life,social function and cognitive function were compared between two groups.Results The total effective rate and compliance rate in the observation group were significantly higher than those of the control group(x2 =3.78,3.15,all P ＜ 0.05).Side effects scale(TESS) score in the observation group was significantly lower than that in the control group(t =2.58,P ＜ 0.05).In the remission phase and residual phase,the score of life quality,cognitive function score in comprehensive intervention group were significantly higher than those in the control group,the social function defect score was significantly lower than that in the control group(t =8.97,2.27,all P ＜ 0.05).Conclusion Comprehensive intervention is beneficial to reduce social function defects of schizophrenia patients,improve the therapeutic effect,and promote the recovery of cognitive function and quality of life.

Objective To study the clinical effect of diazepam and phenobarbital in children with febrile convulsion.Methods Seventy cases of febrile convulsion patients were divided into control group (phenobarbital treatment,35 cases) and experiment group (diazepam combined with phenobarbital,35 cases) by random digits table method,and compared the efficacy and complications.Results Two groups were cured within 1 h.The effective rate within 30 min in experiment group was significantly higher than that in control group [88.6％ (31/35) vs.74.3％ (26/35)] (P ＜ 0.05).The recurrent rate in experiment group was significantly lower than that in control group [2.9％ (1/35) vs.14.3％ (5/35)] (P ＜ 0.05).The complications had no statistically significant differences between two groups(P ＞ 0.05).Conclusions Diazepam combined with phenobarbital are very effective for children with febrile convulsion,can greatly improve clinical efficacy,decrease recurrent rate,and won't produce adverse reaction and complications,are the ideal treatment in the clinical treatment.

Objective To discuss the curative effect of small incision thyroidectomy on thyroid nodule . Methods 94 patients with thyroid nodule were selected and divided into the small incision group and control group according to different modes of operation ,47 cases in each group .The patients in small incision group were given small incision thyroidectomy ,while the patients in control group were given the traditional big incision thyroidectomy .The curative effect and security in the two groups were observed and compared .Results The operation time,intraoperative amount of bleeding ,length of incision and length of hospital stay in the small incision group were (48.76 ±10.37) min, (39.57 ±7.68)mL,(3.57 ±0.68)cm(4.89 ±1.13)d,which were significantly less than those in the control group [(54.07 ±11.64)min,(64.16 ±7.98)mL,(6.88 ±0.65)cm,(5.47 ±1.32)d](t=2.13,3.12,3.96,2.14,P<0.05 or P<0.01).The incidence rate of adverse reactions in small incision group was 10.6%,which was significant-ly lower than 29.8%in control group (χ2 =5.34,P<0.05).Conclusion Compared with traditional mode of opera-tion,small incision thyroidectomy has following advantages on thyroid nodule ,smaller operation wound ,less intraopera-tive amount of bleeding ,quicker postoperative recovery ,better cosmetic effect ,less adverse reactions ,etc.

Objective To explore the outcomes of radiotherapy and zoledronic acid in patients with bone metastasis.Methods 48 cancer patients with bone metastasis,were divided into two group,control group received radiotherapy only,therapy group received radiotherapy and zoledronic acid.Remission of ostalgia was evaluated after 3-6 months.Results The total effective of remission of ostalgia had no significant differences between two group(83.3 ％ vs 79.2％,P ＜ 0.05).But rate of complete remission therapy group was higher than that of control group(50.0％ vs 33.3％,P ＜ 0.05).The adverse reaction aer resemble between the two group.Conclusion The outcomes of radiotherapy and zoledronic acid in patients with bone metastasis is effectiveness for cases with bone metastasis,is worth spreading.

Objective To investigate the clinical effects of different dose of remifentanil with double-tube type laryngeal mask airway (LMA) ventilation in the aged patients undergoing total hip-arthroplasty (THA).Methods Sixty ASA class Ⅰ-Ⅱ grade patients undergoing THA were enrolled in the study.The patients were divided into three groups according to remifentanil dose with 20 cases each,0.2 μ g/ (kg· min)group,0.3 μ g/(kg· min) group and 0.4 μ g/(kg· min) group.Heart rate and mean arterial pressure (MAP)were measured immediately before anesthesia induction,immediately after anesthesia induction,immediately after inserting LMA,the set of operation,15 min during operation and discontinuation of anesthetic.Results All patients were successfully operated without intraoperative awareness.In 0.2 μ g/(kg·min) group,the patients suffered from the heart rate and MAP fluctuations,the high incidence of body movement (45.0％,9/20),and the maximum amount of propofol [(82.4 ± 21.6) mg].In 0.3 μg/(kg· min) group,heart rate and MAP had the better fluctuation,and patients might wake up faster postoperatively.In 0.4 μ g/(kg· min) group,heart rate and MAP significantly decreased,the amount of efedrina [(5.2 ± 4.3) mg] was the largest in the three groups,the recovery time [(5.2 ± 1.3) min] was the longest Conclusion Remifentanil 0.3 μg/(kg·min) compound with propofol with double-tube type LMA can be used for total intravenous anesthesia in the elderly patients with THA,with hemodynamic stability,fewer complications,and reliable ventilation.

Objective To analyse the clinical value of aspartate aminotransferase mitochondrial isoenzyme (m‐AST ) determina‐tion in patients with alcoholic liver disease .Methods 61 cases of patients with alcoholic liver disease (observe group) receiving treatment in this hospital from March 2013 to March 2015 and 61 cases of healthy individuals(control group) were enrolled in this study ,and serum levels of m‐AST ,alanine amino transferase(ALT) ,aspartate amino transferase(AST) and γ‐glutamyl transferase (GGT) were detected .Results Compared with the control group ,serum levels of of m‐AST ,ALT ,AST and GGT were increased in the observe group ,there were statistically significant differences (P<0 .05) .In patients with alcoholic liver disease ,after treatment , serum levels of m‐AST ,ALT ,AST and GGT were different among patients with hepatic adipose infiltration ,patients with hepatitis and patients with liver cirrhosis ,there were statistically significant differences(P<0 .05) .Conclusion Combined with ALT ,AST and GGT ,m‐AST could be utilized as an indicator for diagnosing alcoholic liver disease ,which has clinical significance .