In total, 106 patients with maintenance hemodialysis (MHD) were divided into two groups based on their valsartan administration, and 53 healthy controls were recruited in the study. Plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), resistin and high sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA) before and after valsartan treatment. Plasma levels of resistin, IL-6, TNF-α and hs-CRP were all significantly increased in patients with MHD as compared to those in healthy controls (P＜0. 05). Among patients with MHD the plasma levels of resistin, IL-6 and hs-CRP in valsartan group were lower than those in non-valsartan group (P＜0. 05).

Objective To investigate the therapeutic effect of esomeprazole,a new type 0f proton pump inhibitor(PPI),on patients with reflux esophagitis(RE).Methods 80 cases with RE diagnosed by endoscope were randomly divided into treatmeat group(n=40)and control group(n=40).The treatmeat group was treated with esomeprazole 20 mg bid,compared with the control group famotidine 20mg bid.The two courses of treatment both persisted for four weeks and included mosapride 5mg tid.At the end of therapy,the rate of relief of heartburn,acid reflux and substernal burning symptom,and the total effective rate confirmed by endoscope were recorded.ResuIts The clinical symptoms relief rates were 92.5%in the treatment and 62.5%in the control group raspectively and had obviously statistical difference(P＜0.05).The total effective rate was confirmed by endoscope were 82.5%and 55.0%respectively in two groups(P＜0.05).Conclusion Esomeprazole is a type of effective drug for patients with RE.

Objective To observe and study the therapeutic effect of ctreotide combined with omeprazole in the treatment of liver cirrhosis with upper gastrointestinal bleeding.Methods 76 cases of patients with upper gastrointestinal bleeding caused by liver cirrhosis were selected in our hospital from January 2013 to December 2014 to be separated into the observation group and control group randomly, with each group having 38 patients.Patients in two groups were all given symptomatic treatment first.Patients in control group were given 0.1 mg octreotide dissolved 20 mL 0.9% sodium chloride solution by intravenous injection in the first administration.And the rest octreotide was given by intravenous drip at the speed of 25μg/h.The treatment lasted for 72 h.On the base of control group, patients in observation group were given 40 mg omeprazole dissolved 100 mL 0.9%sodium chloride solution additionally, twice daily, for 3 d.Then the therapeutic effect, hemostatic time, blood transfusion, rebleeding rate and adverse reactions of patients in two groups were observed.Results The total effective rate of observation group 89.47%was much more than control group 63.16% (P<0.05).And the apparent rate of observation group 55.26%was also more than control group 31.58% ( P <0.05 ) .Both the hemostatic time and blood transfusion of observation group is less than control group ( P <0.05 ) .Besides, the rebleeding rate of observation group 5.26% is much less than control group 21.05% ( P<0.05 ) ., Incidence rates of adverse reactions in two groups were 10.53% and 7.89%, with no statistically significant difference. Conclusions Treatment of octreotide combined with omeprazole on patients with upper gastrointestinal bleeding caused by liver cirrhosis can improve the therapeutic effect, shorten the hemostatic time and decrease the blood transfusion with low rebleeding rate and few adverse reaction.

Objective To evaluate the efficacy and safety of consolidation chemotherapy after thoracic radical concurrent chemoradiotherapy for patients with oligometastatic non?small cell lung cancer ( NSCLC) . Methods Sixty?six NSCLC patients with more than five metastases from 2008 to 2013 were enrolled, and image?guided radiotherapy with conventionally fractionated or hypofractionated doses were performed for these patients. Platinum?based doublets chemotherapy was applied for both concurrent chemoradiotherapy and consolidation chemotherapy. Short?term outcome, adverse reactions, and survival rate were assessed for the patients after treatment. Results Sixty?four patients completed the treatment. The median biologically equivalent dose for planning target volume of thoracic primary tumor lesions was 72 Gy, with a median number of chemotherapy cycles of 4. The objective response rate for thoracic lesions was 70%. The follow?up rate was 97%. The 1?, 2?, and 3?year overall survival ( OS) rates were 72%, 53%, and 31%, respectively, with a median OS time of 25 months;the 1?, 2?, and 3?year progression?free survival ( PFS) rates were 56%, 26%, and 7%, respectively, with a median PFS time of 14 months. The incidence of grade 2?3 acute radiation pneumonitis and radiation esophagitis was 1% and 17%, respectively, and the incidence of grade 3?4 decreases in leukocytes, hemoglobin, and platelet count was 39%, 11%, and 16%, respectively. Conclusions Radical radiotherapy combined with concurrent and consolidation chemotherapy for oligometastatic NSCLC can achieve good short?term outcome and long?term survival, with tolerable adverse effects.

Objective To explore the clinical characteristics of the neuromyelitis optica spectrum disorders (NMOSD) with the area postrema syndrome as the initial symptom.Methods A total of 14 cases were enrolled in the study with the diagnose of NMOSD and the area postrema syndrome as the initial symptom.All the clinical data and imaging profiles by the contrasted magnetic resonance imaging (MRI) of the head and spinal cord were collected and analyzed.Results The median age of onset was (38.1 ± 17.0)years old and the gender ratio of female to male was 10:4.The serum aquaporin-4 (AQP4)-IgG was positive in 11 subjects and several autoimmune antibodies was positive in 7 subjects.The lesions revealed by MRI of the head mainly located in the area postrema and ependymal periphery which often presented as the linear medullary lesion,while linear lesions over three pieces of vertebra were shown by MRI of the spinal cord which mainly in the grey matter and with aH shape around the spinal central canal.Misdiagnose happened in 11 subjects with seven of gastroesophageal reflux disease,two of neurogenic vomiting,one of spinal cord tuberculosis and one of stroke.Conclusions NMOSD should be considered in patients with unexplained intractable nausea,vomiting and/or hiccups lasted for 48 hours or above,especially in those with positive nervous signs.Contrasted MRI and serum AQP4-IgG need to be performed in the suspected patients.Early detection is crucial for patients with NMOSD.

Purpose Recently the incidence of bone and joint degeneration is increased,with the increasing of cardiovascular disease complication.This study aims to utilize realtime three-dimensional echocardiography (RT-3DE) in evaluating left ventricular remodeling index (LVRI),to guide treatment and improve the survival rate.Materials and Methods Fifty-seven cases of healthy volunteers (normal control group) and sixty-seven patients with bone and joint degeneration (research group) were respectively divided into two subgroups according to the age.Both groups underwent conventional echocardiography and RT-3DE.The LVRI,left ventricular end diastolic volume index (LVEDVI),left ventricular mass index (LVMI),left ventricular end systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF) measured by different methods were analyzed,and the differences and correlations between groups and within each group were compared.Results The age of normal control group and research group was not significantly different (P＞0.05).The LVMI and LVRI in research group were significantly higher than those in the normal control group with same age (P＜0.05).The LVEDVI,LVMI and LVRI measured by two-dimensional echocardiography and M-mode echocardiography were higher than those measured by RT-3DE,and the difference was statistically significant (P＜0.05).Bland-Altman agreement analysis showed good agreement of measured LVRI using 2D echocardiography and RT-3DE.Conclusion Patients with bone and joint degeneration have left ventricular remodeling.RT-3DE can accurately assess LVRI with the advantages of convenience and lack of radiation,which can be widely used in clinic.

Objective To explore the efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis.Methods 106 cases with esophageal varices in control group was treated with drugs alone;study group had 113 cases, was given endoscopic therapy add drugs, The study group randomly divided into two groups, one was treated with endoscopic variceal ligation all the time (EVL group), another was treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy (sequential group). After the treatment, the rate of removal of varicose veins, the rate of rebleeding, the number of total treatment,mortality and intra-operative complications and postoperative complications were compared. And compared rebleeding rate and mortality with the control group and study groups with different CTP and MELD, analyze the factors of prognosis, and evaluate their prognostic value.Results Rebleeding, rate in control group, EVL group and sequential group were 41.51%,10.53% and 10.64%,sequential group was significantly better than control group (P = 0.000); mortality in control group, EVL group and sequential group were 15.09%, 5.26% and 2.13%, sequential group was also significantly better than control group (P = 0.001); rate of recurrence in EVL group and sequential group within half a year were 73.68% and 44.68%, sequential group was significantly better than EVL group (P = 0.021). In all control group and EVL group and the sequential group, rebleeding rate and mortality of the liver function Child-Turcotte-Pugh (CTP) class C was significantly higher than that of calss A; In MELD model, AUC area under the ROC curve of rebleeding rate in control group and sequential group were 0.944 and 0.851, mortality of the two groups were 0.881 and 0.984, while the rate of recurrence in the EVL group and sequential group were respectively 0.914 and 0.765, the MELD score has the important value to the prediction of rebleeding and death.Conclusion The rebleeding rate and mortality in cirrhotic patients with esophageal varices treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy were significantly decreased and the recurrence rate was lower than that of the patients with endoscopic variceal ligation all the time. Liver function Child-Turcotte-Pugh (CTP) score and the MELD score have important value in prediction of rebleeding and death, ligation and sclerosing sequential therapy can significantly reduced rebleeding and mortality in CTP class B and C, and improve the MELD threshold of rebleeding and death.

Objective To construct a collagen matrix-based skin model that can last a long time in vitro for potential application of subsequent tests and studies.Methods The porcine collagen and normal human skin fibroblasts were mixed and seeded into the culture dish,which were cultured for 3-4 days to obtain a dermal structure.Then,the third-to seventh-passage normal human keratinocytes were seeded onto the dermal surface and cultured for 14 days to obtain a double-layer skin model.Hematoxylin and eosin (HE)staining and Masson staining were performed to evaluate the morphology and structure of the skin model,and electron microscopy was conducted to observe the ultrastructure of the skin model.Immunohistochemical study and immunofluorescence staining were conducted to determine the expression of major markers in each layer of the skin model.Results HE and Masson staining showed that the skin model and normal human skin tissues showed very similar dermal and epidermal structures.After harvest of the skin model,it can be cultured in vitro for another 14 days with favorable and stable dermal and epidermal structures.Electron microscopy showed lipids in the stratum corneum,keratohyalin granules in the stratum granulosum,corneodesmosomes,desmosomes and basal membrane in the skin model.Immunohistochemical and immunofluorescence staining showed the consistent expression of transglutaminase,filaggrin,keratin 10 and Ki67 in the epidermis in both the skin model and normal skin.Moreover,the expression of type Ⅳ collagen and laminin-5 in the basal membrane,as well as that of type Ⅰ collagen,type Ⅲ collagen and fibrillin in the dermis were both consistent between the skin model and normal skin.Conclusion The constructed three-dimensional (3D) skin model is highly analogous to normal human skin in the aspect of tissue structure and various protein expression,and the skin model can be stably cultured in vitro for at least 14 days after harvest.

Objective: To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR). Methods: Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed. Results: The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes. Conclusions RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.

Objective To investigate the diagnostic value of IL-27, ADA and TB-Ab in TB pleurisy. Methods The data of 74 TB pleurisy cases and 45 non-TB pleurisy cases were screened randomly from June 2017 to July 2018 in Dalian Tuberculosis Hospital. Value of IL-27, ADA and TB-Ab in blood and pleural fluid of the two groups of cases was detected, and diagnostic value of these biomarkers in TB pleurisy was compared. Results The value of IL-27, ADA and TB-Ab in blood and pleural effusion of patients with TB pleurisy were higher than those of control group (P < 0.05). ROC curve analysis showed that areas under the blood IL-27, ADA and TB-Ab curves were 0.820, 0.744 and 0.589 (P<0.05) respectively, while those under the pleural effusion curves were 0.921, 0.876 and 0.708 (P<0.05) respectively. The area under the curve of IL-27 and ADA ROC curve was 0.921 (P<0.05), but 95% CI was higher than that of pleural effusion ADA (0.804-0.930) and IL-27(0.857-0.962). Conclusions Detection of IL-27 and ADA in pleural effusion is of great value in the diagnosis of TB pleurisy. The combined detection of IL-27 and ADA in pleural effusion would improve the diagnostic value.