The secondary hyperparathyroidism is one of the complications of chronic renal failure (CRF) and end stage renal failure (ESRD), and becomes more serious with the development of the primary disease. Parathyroid hormone (PTH) is considered as one of the biomarks of the development of renal failure. The purpose of this article will expound the physiological effects of the PTH, the causes and clinical significances of PTH rising in CRF and ESRD patients, the determination of PTH level, and the relationships between the increase of PTH and the polymorphism of CYP2D6, GSTT1,GSTM1.

non-skeletal actions,including immunoregulation,anti-tumor effect,and protecting from central nervous system diseases and metabelie syndrome.

Objective To investigate the clinical efficacy of acupuncture plus Jisheng Shenqi pills in treating patients with diabetic neurogenic bladder. Method Patients with diabetic neurogenic bladder were allocated, using a random number table, to treatment and control groups. The treatment group received acupuncture plus Jisheng Shenqi pills and the control group, oral administration of Western medicine. Both groups of patients were treated for four weeks as a course. Post-treatment clinical total efficacy rates, pre-treatment and post-treatment postvoid residual urine volumes, and adverse reactions during treatment were compared between the two groups. Result The total efficacy rate was higher in the treatment group (93.8%) than in the control group (68.8%) (P<0.05). The postvoid residual urine volume decreased significantly in both groups of patients after treatment compared with before (P<0.05). Post-treatment postvoid residual urine volume was lower in the treatment group than in the control group (P<0.05). The adverse reaction rate was lower in the treatment group than in the control group (P<0.05). Conclusion Acupuncture plus Jisheng Shenqi pills is remarkably effective in treating patients with diabetic neurogenic bladder. It can effectively decrease postvoid residual urine volume in the patients, has higher safety and is worthy of clinical popularization.

Objective To evaluate the scales of psychological distress and pain in patients with advanced cancer and the impact of pain on the anxiety and depression.Methods Seventy-four patients with advanced cancer were observed.The hospital anxiety and depression(HAD)scale and the brief pain inventory(BPI)were completed either by patients or under the assistance of the investigator.Results HAD-A(anxiety)and HAD-D(depression)scores were(7.68±4.09)and(7.19±3.38),respectively.Significant correlations were found between pain severity and HAD-A or HAD-D(P＜0.001)by univariate correlation analysis.Furthermore,significant associations were shown between HAD-A and six"pain interference in the patients'functional ability"items(P＜0.001),and between HAD-D and pain interference to"mood"or"relations with other people"(P＜0.01).Conclusions Quantitative analysis of psychological distress have shown that patients with advanced cancer are doubtful cases for both anxiety and depression and need psychological management.Anxiety and depression is not only associated with pain intensity directly,but also with pain interference in the patients'functional ability indirectly.

Objective:To observe the effect of Tangshenning on renal function and LOX-1 mRNA expression in the kidney of early diabetic nephropathy rats model. Methods:Early diabetic nephropathy rats model was made with high fat diet, STZ and unilateral ne-phregtomy. After the 12-week drug intervention, the rats were sacrificed, the kidneys were removed and the mRNA expressions of LOX-1 in the kidney were observed by the method of RT-PCR. Results:Early diabetic nephropathy rats model was successfully made by the triple-modeling method. The mRNA expression of LOX-1 in the kidney was significantly increased, and Tangshenning could low-er the expression of LOX-1 in the kidney in a dose-dependent manner. Conclusion:The abnormal expression of LOX-1 could be one of the mechanisms for diabetic nephropathy. Tangshening has good kidney protective effect through decreasing LOX-1 abnormal expression in the kidneys, which deserves further research.

Objective To observe the effect of Tanggankang on the expression of CREB in diabetic-fatty liver rats;To investigate the mechanism of Tanggankang. Methods STZ and feeding high fat forage induced diabetic rats were randomly divided into model group, Huganning group, Tanggankang high dose group, Tanggankang medium dose group, Tanggankang low dose group, 10 rats in each group, with 10 normal rats as control. After 12 weeks of drug intervention, rats were killed, the livers were removed, and the expression of CREB was detected by Western blot. Results Compared with normal group, the level of CREB of model group was significantly decreased (P<0.01). Compared with model group, Tanggankang low, medium and high dose group significantly decreased the level of CREB (P<0.01). Conclusion Tanggankang may play an active role in glucose and lipid metabolism by affecting the expression of CREB.

Objective To investigate the clinical effect of combined treatment of children allergic purpura with traditional Chinese and western medicine and preventive effect on renal damage ,and provide the basis for clinical therapy.Methods According to the different treatment methods ,96 children with allergic purpura were divived into the treatment group and the control group ,each group in 48 cases.The treatment group treated by combined western and Chinese medicine ,the control group was treated with western medicine ,the symptoms disappear time observation of treatment of the two groups of children,urinary N -acetyl -D beta glucosidase(NAG),urine albumin(mALB) changes,compared two groups of children with renal damage occurrence time and the incidence .Results The treat-ment group purpura disappearance time ,joint pain and swelling disappeared time ,abdominal pain disappeared time were (5.15 ±2.26)d,(3.12 ±0.81) d,(2.06 ±0.16) d,the control group respectively were (8.03 ±3.08) d, (5.13 ±1.09)d,(4.76 ±1.04)d.The difference between the two groups had statistical significance (t =2.01, 11.03,24.54,all P<0.05);After three months of treatment,the treatment group abnormal urine rate,NAG,mALB were 16.7%,(5.46 ±3.20) u/L,(7.24 ±7.62) mg/L,the control group were 37.5%,(7.58 ±4.32) u/L, (19.40 ±3.48)mg/L,the difference between the two groups was statistically significant (χ2 =6.67,t=2.72,10.13, all P<0.05).The treatment of renal damage occurred time [(36.4 ±12.4) d] later than that of the control group [(22.1 ±10.6)d](t=6.08,P<0.05),the incidence of renal damage in treatment group (16.7%) was lower than that in the control group (41.2%) (χ2 =7.26,P<0.05).Conclusion Compared with simple western medicine treatment,the treatment of children allergic purpura with combination of TCM and western medicine can reduce the symptoms disappeared time,reduce the content of NAG,mALB,reduce the incidence of renal damage ,and prevent kidney damage .

ObjectiveTo review surgical management of the complications caused by iatrogenic endoscopic sphincterotomy(EST).MethodsEleven patients with complications of EST were surgically treated, including 4 patients with hemorrhage, 3 patients with perforation, 3 patients with perforation plus hemorrhage, and one patient with perforation plus severe pancreatitis. ResultsTwo patients with perforation plus hemorrhage and the patient with perforation plus severe pancreatitis died, other patients survived.ConclusionEarly diagnosis and surgical intervention was very important to lower the mortality. For patients suffering from perforation and hemorrhage or pancreatitis, it′s very important to make an unobstructed peritoneal drainage as well as other maneuvers.

In this paper, the needs of community care for diabetic patients were studied, and the existing problems were summarized and analyzed. "Four drawbacks" on community care were pointed out, namely, lack of knowledge, insufficient service resources, deficiency of professional nursing staff, and inadequate management. There were also "four lacks" on diabetic patients, namely, lack of confidence, lack of attention, lack of knowledge and lack of compliance. Seven measures of community health care for diabetic patients were pointed out in this paper, which were to enhance the quality of personnel, to strengthen health education, to emphasize on psychological counseling, to enhance behavioral modification, to carry out medical consulting, and to implement the specific medical care and comprehensive intervention.

Cancer of digestive system is one of the most common worldwidely cancers and seriously threats to human health. However its etiology and pathogenesis are still not clear. Toll-like receptor (TLR), a newly discovered transmembrane receptor, plays an important role in innate immunity. Recent researches suggested that TLRs had extensive relationship with inflammation, autoimmune diseases and cancer. A large number of researches indicated that TLRs not only participated in the occurrence, development and immune escape of cancer, but also acted in immunotherapy in digestive system. Further investigation of TLRs may re-veal the effects of TLRs in the development of malignant tumors of digestive system, moreover may find new therputic target for the treatment of cancers. We reviewed the relationship between TLRs and cancers of di-gestive system.