Objective To use the genetic diagnosis technique to perform the gene detection in the patients with thalassemia for understanding the main gene mutation types and their gene frequencies .Methods Totally 5 500 outpatients and individuals un‐dergoing physical examination in the hematology department of the Huizhou Municipal Central People′s Hospital from January 2010 to October 2014 were taken as the research subjects .The GAP‐PCR and membrane reverse hypridition technology were adopted to conduct the gene analysis of α‐andβ‐thalassemia .Results A total of 1 604 cases ofα‐globin gene change were detected ,accounting for 29 .16% of the total detected subjects ;1 096 cases ofβ‐globin gene change were detected ,accounting for 19 .93% of the total de‐tected subjects ;119 cases of αβ‐complex thalassemia were detected .Conclusion The gene screening of α‐ and β‐ thalassemia pro‐vides the valuable basic data for conducting the marital and fertility instructions .

[Objective] To compare and analyse the clinical effect of tiny incision blind-cut suck-erasion on unhairing and preserving armpit hair in bromhidrosis.[Method] Select 429 cases of 851 sides in our hospital, divide them into treatment group(blind-cut suck-erasion+unhairing) 308 cases with 609 sides, and control group(blind-cut suck-erasion+preserving armpit hair) 121 cases with 242 sides. Make statistics and compare their complications in recent and forward stages, also the recurrence and residual of peculiar smel after 1 year. [Result] For the treatment group, 38 sides had the recent compli-cation of hematoncus, 30 sides had partly skin necrosis, 12 had bad cut cure, 70 had early slight hardening and contracture skin; for the forward complica-tions: 27 sides had focal slight scar, 3 severe scar, 23 focal subcutaneous sac lump with infection, 3 peculiar smel residual and recurrence. To the control one, for the recent complications, 11 sides had hematoncus, 9 partly skin necrosis, 5 bad cut cure, 13 early slight hardening and contracture skin; for for-ward complications, 8 sides had focal slight scar, 1 severe scar, 3 focal subcutaneous sac lump with infection, 38 peculiar smel residual and recurrence. By comparison, on early slight hardening and contracture skin and focal subcutaneous sac lump with infection, the treatment group was higher than control one;other complications had no difference of statistical meaning;on radical cure rate, the treatment group was obviously more than control one, with dif-ference of statistical meaning. [Conclusion] The tiny cut blind-cut suck-erasion is definite in treating bromhidrosis, the operation removes subcutaneous apocrine sweat gland, meanwhile removes the hair fol icle and sebaceous gland complexus, the therapy is very thorough, with better cure effect, less recur-rence, without increasing complications.

BACKGROUND:Epimedium has been used in the treatment of osteoporosis and repair of bone defects. OBJECTIVE:To explore the effects of epimedium on the osteogenic differentiation of bone marrow mesenchymal stem cells.
METHODS:A database search was performed to retrieve literatures addressing epimedium effects on the osteogenic differentiation of bone marrow mesenchymal stem cells. Then, the papers meeting the criteria were selected for in-depth analysis. During the osteogenic differentiation induced by epimedium, alkaline phosphatase, osteocalcin, osteopontin, transforming growth factorβ, bone morphogenetic proteins, osteocalcin, bone sialoprotein were detected in the bone marrow mesenchymal stem cells to understand the underlying mechanism of epimedium in proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.
RESULTS AND CONCLUSION:Epimedium effects on bone marrow mesenchymal stem cells are shown in a dose-dependent manner. During the early induction, icari n can increase cellphosphatase activity;in the late induction, icari n can increase calcified nodules, promote osteocalcin secretion, significantly improve the expressions of transforming growth factorβ1, bone morphogenetic protein 2, insulin-like growth factor-1, osteopontin and bone sialoprotein. Epimedium, which can be used as an excellent osteoinductive factor, improves the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.

BACKGROUND:Animal and cel studies have shown that the Kidney Recipe can prevent and treat osteoporosis and improve bone metabolism, but this recipe is complicated. Recent studies on compound Chinese medicine mainly focused on serum drug metabolism and pharmacokinetics, which has limitations, and the effective ingredient and pharmaceutical material basis are uncertain. OBJECTIVE:In the different concentrations and time, by using different compatibility proportion of active ingredients of Kidney Recipe, osteoblasts from neonatal Sprague-Dawley rats were subjected to culture intervention. The proliferation and differentiation of osteoblasts were determined so as to identify time-effect and dose-effect relationship of Kidney Recipe on osteoblasts and to provide experimental evidences for prevention and treatment of osteoporosis. METHODS:Primary neonatal 24-hour osteoblasts of Sprague-Dawley rats were cultured in vitro. Herbs“tonic”and“cathartic”active chemical components of different proportion were used. The experiment contained three groups:Tonics Medicine (T)>Cathartic Medicine (C) group, TC group and TC group (P<0.05). At mass concentration of 20μg/L, no significant difference was detected in the T>C and TC group (P<0.05), and the proliferation became weak at 72 hours. At mass concentration of 10μg/L and 72 hours of culture, alkaline phosphatase secretion could be promoted in the T>C group. At mass concentration of 20μg/L and 24 hours of culture, the promoting effect on alkaline phosphatase secretion was most significant in the TC group (P<0.05). Results confirm that active ingredients of Kidney Recipe compatibility proportion can promote osteoblasts proliferation and differentiation most strongly in the T>C group in the time-effect and the dose-effect relationship.

BACKGROUND:Drug treatment is the main method for the treatment of diabetes currently, but the development of the disease and occurrence of related complications are the chal enges to the effect of drugs. OBJECTIVE:To investigate the effect and feasibility of co-transplantation of bone marrow mesenchymal stem cells and islet cells for the treatment of diabetes. METHODS:The rat bone marrow mesenchymal stem cells were separated and purified, and cultured in vitro to establish the diabetes models. The rat diabetes models were injected with bone marrow mesenchymal stem cells, co-cultured mixture of bone marrow mesenchymal stem cells and islet cells, and normal saline or phosphate buffer (control). The effect of transplantation was evaluated through observing the blood glucose levels, insulin secretion, and pathological changes of pancreatic tissue in the rat diabetes models. RESUTLS AND CONCLUSION:In the diabetes rats treated with bone marrow mesenchymal stem cel transplantation, the C-peptide levels were significantly increased after transplantation, while the blood glucose levels were significantly decreased, but not lower than the normal level, and the blood glucose levels were increased again with the time prolonging. In the diabetes rats treated with co-transplantation of bone marrow mesenchymal stem cells and islet cells, the blood glucose levels were decreased significantly and lower than the normal level which was maintained in a certain time, and the decreasing degree was larger than that in the rats treated with simple bone marrow mesenchymal stem cel transplantation. Co-transplantation of bone marrow mesenchymal stem cells and islet cells is feasible for the treatment of diabetes with a certain effect.

BACKGROUND:Diabetes mel itus is a common complication after kidney transplantation. OBJECTIVE:To investigate the risk factors for diabetes mel itus after kidney transplantation diabetes mel itus risk factors and clinical treatment based on integrative medicine. METHODS:Literatures concerning diabetes mel itus after kidney transplantation were retrieved in the database, and the articles that met the study criteria were analyzed. In this paper, we analyzed the risk factors for diabetes mel itus and concluded the therapies for diabetes mel itus after kidney transplantation. RESULTS AND CONCLUSION:Diabetes mel itus after kidney transplantation is an abnormal glucose metabolism caused by multiple factors, which is related to age, body mass index, lipid levels, immunosuppressant program, frequency of acute rejections, and cumulative dose of glucocorticoid. Periodic monitoring of blood glucose after kidney transplantation contributes to the earlier detection of the occurrence of diabetes mel itus. Integrative medicines that can lower blood glucose level and immunosuppressant adjustment can be effective for the treatment of diabetes mel itus after kidney transplantation.

Objective To investigate the reliability of Narcotrend for monitoring the depth of sedation [the observer's assessment of alterness/sedation(OAA/S) scale] with midazolam and correlation between the depth of sedation and Narcotrend index.Methods 0 ASA Ⅰ-Ⅱ status patients scheduled for elective lower limb operations underwent spinal anesthesia,who were given target-controlled infusion of midazolam.Target plasma concentration was 50ng/ ml at first and increased by 10 ng/ml each grade until OAA/S scale became 1 point.Each target concentration infusion was maintained for 5min.Observe the patient the OAA/S scale to be 5 points.If the operation was not over yet,regulated the appropriate depth of sedation until the end of operation.The Narcotrend index of different OAA/S scale and heart rate,mean arterial pressure,respiration were recorded.Results In the deepening or recovery phase of sedation,OAA/S scales were correlated with Narcotrend index (Spearman' s r =0.786,0.652,all P ＜ 0.05).Conclusion Narcotrend is a good index to guide target controlled infusion of midazolam,the index is closely related with the depth of sedation of midazolam.

ObjectiveTo investigate the feasibility and safety of Proseal-laryngeal mask airway(PLMA) for anesthesia in endoscopic thyroidectomy.MethodsForty ASA class Ⅰ or Ⅱ patients underwent endoscopic thyroidectomy via breast approach were randomly divided into laryngeal mask venting group( Group P,n =20) and endotracheal tube venting group( Group T,n =20).Both groups were used the same anesthesia induction,maintenance and breathing parameter adjustment.The HR and MAP in both groups were recorded respectively before intubation,while intubation,2 min after intubation,before and after head back out center position,before extubation and 2 min after exbutation.The adverse effects of respiratory tract were recorded respectively.ResultsThere were no significant changes in HR and MAP in Group P before and after intubation,as well as before and after extubation( all P ＞ 0.05 ) ;In Group T,the HR and MAP while intubation,2 min after intubation are higher than that before intubation (all P ＞ 0.05).The HR and MAP in Group T,2 min after exbutation are higher than before extubation(all P ＞ 0.05 ).The incidence rate of sore throat and hoarse postoperatively were lower in Group P than in Group T( all P ＞ 0.05 ).ConclusionPLMA could be safely and effectively used in the anesthesia of endoscopic thyroidectomy.

To fully understand the characteristics of international students and importance, practicality and usefulness of internal medicine, many targeted measures were taken, including im-proving language level of teachers and students, applying case-based learning method and evidence-based medicine and strengthening the cultivation of humanistic spirit and professional ethics. Quality of internal medicine for international students was improved , which provided new ideas for clinical teaching reform.

OBJECTIVE To discuss the clinic presentation,imaging characteristics and surgical management of the external auditory canal cholesteatoma (EACC) with invasion of the tympaniccavity and the mastoid. METHODS This was a retrospective study including the clinical data of 14 cases of EACC invading tympanic cavity and mastoid from 1998 to 2003 . RESULTS All 14 cases showed different bone erosion in the four walls of external auditory canal with extention to the mastoid . Pars flaccida perforation were found in 4 cases with invasion of the cholesteatoma into the tympanic cavity, the ossicular chains were compressed or destroyed. The bony mastoid segment of facial canal was destroyed in 3 cases . Cerebral plate destruction and congenital stenosis of external auditory canal were found in one case respectively. According to the extent of disease, modified radical mastoidectomy was performed in 8 cases and radical mastoidectomy in 5 cases , meatoplasty in one case. The post-operative hearing of 10 cases with intact ossicula chains were normal.One case with compression,shift of ossicules also got normal audition after the operation. The hearing threshold of the air condition in 3 cases with ossicular disruptions got 15 to 20dB of improvement among the language frequency after reconstruction of ossicular chain. The 14 cases were followed-up from 18 months to 5 years and no recurrences were found. CONCLUSION The exact etiology of EACC still remains unclear. There is some difficulty in diagnosing external auditory canal cholesteatoma (EACC) invading the tympanic cavity and the mastoid because of its untypical clinic presentation . High-resolution temporal bone CT scan could help to find out the primary lesion and determine the range of the pathological changes, and choose the proper surgical approach.