With the development of the dialysis technology,the survival time of patients with chronic renal failure is prolonged,while more complications which affect the quality of life or even threat the life of patients are followed.Secondary hyperparathyroidism(SHPT)with a certain incidence and mortality is one of the common complications,and its main characteristic performances ale hyperphosphatemia,hypocalcemia and high level of parathyroid hormone.Most patients Can be cured by the treatment of medicine while surgical treatment is still required by some cases in which the disorder of the parathyroid function can not be well regulated through medicine treatment.The purpose of this paper is to make a review of the recent studies of surgical treatment in patients with SHPT.

BACKGROUND: Some researches report that diffusion-weighted imaging (DWI) can appear abnormal signal in minutes after cerebral ischemia.OBJECTIVE: To investigate the manifestation and regularity of diffusion coefficient in middle cerebral artery occlusion (MCAO) of rats after cerebral ischemia.DESIGN: Randomized controlled study.SETTING: Neurological Department of Clinical College of ChongqingMedical University.MATERIALS: The experiment was conducted at the Radiological Department of the First Affiliated Hospital of Chongqing Medical University from April to July 2004. Totally 18 adult Wistar rats with clean grade were randomly divided into three groups: control group, sham operation group and cerebral ischemia group with 6 rats in each group.METHODS: The origin of right middle cerebral artery was blocked with filament into right internal carotid. In the sham-operated group, the filament was just inserted into the common carotid artery not into the origin of middle cerebral artery, rats in normal control group were not treated with anything after anesthesia. MRI experiments were performed on a 1.5 T GE signa Highspeed NMR spectrometer to obtain DWI and ADC values at the time-point of 7, 15, 30, 60 minutes, 3,6, 12, 24 hours, 3, 7, 15 days, 1 and 2 months after operation.MAIN OUTCOME MEASURES: Changes of ADCs in infarct hemisphere and contralateral hemisphere.RESULTS: There was no significant change in MRI T1-and T2-weighted imaging in rats at 7 minutes post-infarction, but abnormal high intensity was emerged during the period of 1 hour to 3 hours, and enlarged over time. Finally, the infarction area located the right basal ganglia and the frontal-parietal lobes at 12 hours and increased less significantly later.Focal abnormal high signal was noted in DWI 7 minutes after cerebral ischemic insult, and the ADC values was decreased at the same time,reduced gradually after significant recover at 30 minutes, dropped to the lowest level at 12 hours and again increased at 24 hours, since then all the ADC values were remained high throughout follow-up, which increased by 5 times at 2 months than that at 12 hours. Correspondingly,rADC values showed the contrary pattern of evolution.CONCLUSION: It is reflected that ADC is highly sensitive not only to onset of cerebral ischemia but also to chronic cerebral ischemia.

The Proposal for the Standardization of Urinary Sediments Examination and the expert consensus have provided effective and timely instruction on urinalysis normalization,but there are still some puzzles about the methods and requirements on quality improvement for urinalysis normalization.This paper is discussing about some issues referring to American and European urinalysis guidelines,which include establishment of examination procedure,specifications and methods of testing system evaluation,specimen stability,the influence of sample centrifugation,the usage of sample staining,confirmation tests,requirements on result reporting,internal quality control and external quality assessment.These discussions will contribute to the quality improvement of urinalysis in clinical laboratories.

Object To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods Textual researches of materia medica were carried out and their history in clinical application were traced. Results T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

Objective To develop an assay of HPLC for the content determination of dryocrassine in Guanye Jinsitao drop pills. Methods The column was Kromasil-C18 (150 mm×4.6 mm, 5μm);mobile phase was acetonitrile-chloroform-isopropanol-0.1% phosphoric acid (52∶8∶30∶10);flow rate was 1.0 mL/min;UV detection was performed at 285 nm;detected drift tube temperature was set at 25 ℃. Results The calibration curves were linear in the range of 0.236-2.124 μg for dryocrassine (r=0.999 9). The average recovery rate of dryocrassine was 99.64% (RSD=1.90%). Conclusion The method is simple and accurate. It is suitable for the determination of dryocrassine in Guanye Jinsitao drop pills.

Objective To observe the influence of intensive insulin therapy on inflammatory fac-tors and prognosis in severe multiple trauma patients.Methods A total of 53 cases of severe multiple trauma were randomly divided into the treatment group(n =27)and the control group(n =26).Besides basic treatment,patients in the treatment group received additional intensive insulin therapy by micro-pump.The level of blood glucose in the control group was controlled under 11.1 mmol/L.Levels of TNF-α,IL-1β,IL-6,and CRP were tested before and after treatment.Multiple organ dysfunction syndrome,noso-comial infection rate,and mortality rate were also observed.Results The levels of TNF-α,IL-1β,IL-6, and CRP in the treatment group were significantly lower than those of the control group(P <0.05 or P <0.01).The incidence of multiple organ dysfunction syndrome,nosocomial infection,and mortality rate in the treatment group was lower(P <0.05).Conclusion Intensive insulin therapy can effectively decrease the expressions of inflammatory factors in patients with severe multiple trauma,improve the prognosis,re-duce the incidence of nosocomial infection and mortality.

Objective To evaluate the risk factors of gallstone occurrence after gastrectomy for gastric cancer.Methods Relevant documents published from 1990 to 2014 were retrieved through Pubmed,Cochrane Library,Embase,Web of Science CNKI,Wan Fang and VIP databases search.The Meta-analysis was applied with RevMan 5.3 software for Odds ratio and 95％ CI.Results 24 studies were selected for this Meta-analysis which included 3 randomized controlled trials,13 cohort studies and 8 case-controlled studies.These 24 studies included patient number which ranged from 32 to 893.The pooled OR (95％ CI) and P values of OR (95 ％ CI) for physiologic digestive tract reconstruction were 0.53 (0.44 ～ 0.65,P ＜ 0.05) ;amount of resection of stomach,1.98 (1.29 ～ 3.04,P ＜ 0.05) ; lymphadenectomy,0.38 (0.21 ～ 0.72,P ＜ 0.05) ; vagotomy,0.24 (0.13 ～ 0.45,P ＜ 0.05) ; and pylorus preservation,0.70 (0.48 ～ 1.02,P ＞ 0.05).Conclusions Physiologic digestive tract reconstruction and vagus nerve preservation reduced occurrence of gallstones after gastrectomy.On the other hand,total gastrectomy and extensive lymph node dissection increased the occurrence.There was no significant difference in the occurrence of gallstones whether there was pylorus preservation or not.

Punicalin is an important ellagic tannin in Pericarpium Granati with the pharmacological effects such as antioxidation,anti-bacteria,antivirus and anti-inflammation.The studies on Pericarpium Granati at home and abroad were reviewed in the paper,and the extraction,separation,content determination,pharmacological activities and metabolism of punicalin were also summarized to provide theoretical basis for the development and application of punicalin.

OBJECTIVE:To systematically review the procalcitonin(PCT)-guided therapy in patients with sepsis. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CJFD,Wanfang Datebase,related trails about PCT-guided therapy(test group)versus conventional treatment group(control group)in the treatment of sepsis were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 5 studies were enrolled,involving 826 patients. Results of Meta-analysis showed,use time of antibiotics in test group was significantly shorter than control group, with statistical significance [MD=-2.52,95%CI(-3.07,-1.98,P<0.001];there were no significant differences in the mortality rate [OR=1.14,95%CI(0.83,1.56),P=0.42],ICU treatment days [MD=-0.22,95%CI(-1.40,0.96),P=0.72] and total hospi-talization [MD=-1.81,95%CI(-4.37,0.76),P=0.17]. CONCLUSIONS:PCT-guided therapy can effectively reduce the use of antibiotics and shorten treatment time in the treatment of patients with sepsis.It can be considered as inflammatory markers for guid-ing rational use of antibiotics in clinic.

Objective To investigate the influence of early postoperative enteral nutrition on the immunologic function and inci-sion infection in the patients with colorectal cancer .Methods 81 postoperative cases of colorectal cancer were randomly divided into the early parenteral nutrition(41 cases) ,and the early enteral nutrition(40 cases) by the random number table method .The anal ex-haust time ,ambulation time and occurrence situation of incision infection ,etc .were compared between the two groups ,and the im-munological indexes changes were also compared .Results Postoperative anal exhaust time ,bed activity time and the occurrence rate of incision infection in the early enteral nutrition group were significantly lower than those in the early parenteral nutrition group (P<0 .05);Th1/Th2 and lymphocyte count in the early enteral nutrition group were significantly higher than those in the early parenteral nutrition group(P<0 .05) .Conclusion The early postoperative enteral nutrition support in the patients with colorectal cancer can effectively improve the body's immune function and is an ideal method of nutritional support .