OBJECTIVE: To explore the therapeutic effect of prostaglandin E1 lipid drug-loaded microcapsules(Lipo PGE1) on the earlier diabetic nephropathy (DN). METHODS: 72 cases with early DN were randomly divided into treatment group and control group. The control group were assigned to receive routine hypoglycemic agent,blood pressure controlling, and symptomatic treatment, while the treatment group were given another drip infusion of Lipo PGE1 20ug plus NS100ml q.d besides the routine therapy as in the control group. Both groups received 3 weeks’ course of treatment. The changes of urinary albumin excretion rate(UAER), urinary transferrin(TRF), urinary microglobulin(?1MG)and so on in the 24h urine of the 2 groups before and after treatment were observed.RESULTS: There was great decrease in UAER, TRF and ?1MG in the 24h urine in the treatment group after treatment(P

Objective To study the therapeutic effects of mycophenolate mofetil(MMF) in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods 16 refractory ITP patients were treated with MMF (1.0～1.5g/d),which were given in divided doses for three months as one course;the patients with significant therapeutic effect were given the dose for another three months and reduced by degree.Results Very effective results were obtained in 4 cases,striking improvement in 7,partial response in 1 and no response in 4.The total efficacy was 68.75%.The main side effect was observed as light digestive malaise.Conclusion MMF has striking therapeutic effect in treating refractory ITP with little side effect and can be used as an effective way of treatment.

Objective To discuss the differences of immunofluorescence pathological test results in four types of syndromes for lupus nephritis(LN) patients. Methods A retrospective study was carried out in 116 LN patients who had performed renal biopsy. The patients were differentiated into four syndrome patterns of excessive heat-toxicity, liver-kidney yin deficiency, qi-yin deficiency, and spleen-kidney deficiency. The results of immunofluorescence pathological tests were recorded for the analysis of the differences among the four patterns. Results (1)Of 116 LN patients, 59 were classified into spleen-kidney deficiency, 30 into excessive heat-toxicity, 14 into liver-kidney yin deficiency, and 13 into qi-yin deficiency. (2)The positive expression rate of IgA, IgG, IgM, C3, and Fi fluorescen ce antibody differed in the 4 syndrome patterns of LN patients(P<0.05), IgA and C3 had higher positive expression rate, while Fi had the lowest expression rate. (3)The percentage of“full-house” immunofluorescence staining(5 kinds of antibodies simultaneously showing positive immunofluorescence staining) differed in the 4 syndrome patterns of LN patients(P<0.05), and excessive heat-toxicity syndrome had the highest percentage. (4)The differences of positive rate of immunofluorescence staining were insignificant in the 4 syndrome patterns of LN patients(P>0.05). Conclusion The immune complex deposition in LN patients is dominated by IgA and C3 antibodies deposition, and the“full-house” immunofluorescence staining is commonly seen in the syndrome of excessive heat-toxin type. But the results of immunofluorescence pathological tests can not be used as the evidence to tell the differences in the 4 syndrome patterns of LN patients.

OBJECTIVE To explore the clinical characteristics of hospital infection in diabetic nephropathy(DN). METHODS To retrospectively analyze the incidence rate of hospital infection,the infection sites,pathogenic bacteria,and predisposing factors in 348 cases with diabetic nephropathy,and to compare the index above with the homeochronous 466 diabetic patients without DN. RESULTS Sixty two cases occurred hospital infection from 348 cases with DN,the infection rate was 17.82%,the infection sites were most frequently in respiratory tract(37.10%),then urinary tract(24.19%) and digestive tract(19.35%),the major predisposing factors were out of control of blood glucose,renal sufficiency,advanced age,and longer stay in hospital. CONCLUSIONS The incidence rate of hospital infection is higher,the valid measures to control the hospital infection are to control the blood glucose effectively,to improve the renal function and timely to use the method of anti-infection with forcefulness.

Objective To compare the morphology and histology about the chronic atrophic gastritis (CAG) narrow-band imaging (NBI),in order to improve the rate of final diagnosis.Methods The clinical data of 100 CAG patients who diagnosed by NBI from September 2011 to December 2012 were analyzed retrospectively.The morphological diagnosis by NBI and histodiagnosis by endoscopy were compared.Results In 100 patients,94 patients were diagnosed by histodiagnosis among whom 28 patients were with mild dysplasia,8 patients were with moderate dysplasia,7 patients were with severe dysplasia.In the NBI mode,gastric pits were divided into 6 kinds of types,dysplasia mainly expressed for Ⅳ and Ⅴ 1 type.In 7 severe dysplasia patients,2 patients of microvascular morphology were regular,the others were anomalism,and found neovascularization.Conclusions Endoscopic NBI technology has the advantage of simple operation,and can clearly observe the gastric pit and microvascular morphology after amplification.It can help to improve the accuracy rate of CAG and dysplasia targeted biopsy.

Some aspects of hernia and abdominal wall surgery in China have come up to an international advanced level,such as number and quality of operation.The latest issue of The Lancet gave a high score of 99 points on diagnosis and treatment of inguinal hernia in China,which has far outstripped the other developed countries of the world,with China in fourth place globally.The journal commented that,considering the treatment of inguinal hernia rely mainly on surgery,the reason Chinese surgeon performed well recalled for the great number of patients,surgery of huge quantity and the strong operation ability of the doctors in China.But there is still a wide gap on comprehensive strength between Chinese and international levels,and quality control standard is one of major aspects.If hernia and abdominal wall surgery wants to develop further,perfect quality control system is a crucial step.

Objective To evaluate acellular tissue matrix mesh in inguinal hernioplasty in young male patients.Methods Clinical outcome and sexual function were evaluated on 12 young male inguinal hernia patients undergoing inguinal hernioplasty by ACTM mesh.Results The mean operation time was 62 minutes.Postoperative analgesics were needed for an average of 1.45 days (range,0 -4 days).The average postoperative hospital stay was 3.9 days,and patients were able to return to normal activity,after a mean 11.8 days.All patients were followed-up for a mean duration of 9.54 months(range,6 - 16 months).Two patients complained pain one month after surgery and the pain disappeared later without any medical treatment.There was no hernia recurrence and foreign body feelings,nor sexual and reproductive problems.Conclusions The ACTM mesh is a safe and effective material for inguinal hernioplasty,especially in young male patients.

Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.

Objective To expolre the clinical characteristic of hospital acquired acute renal failure(HA-ARF).Methods To retrospectively analyse the clinical datas of 103 patients who were suffered from acute renal failure in the duration of hospital stay within 5 years,which was compared with the homeochronous community-acquired acute renal failure(CA-ARF).Results In the 103 cases of HA-ARF,the incidence rate was 32.04% in the major age range from 60 to 74 years old,infection was the most important factor(33.01%),then other factors were cardial and cerebrovascular diseases(17.48%),acute hypovolemia(14.56%) and operation(9.71%);The complicating other organ nonfunction(34.95%),and the mortality rate was 39.80%,all the factors in HA-ARF were higher than that in CA-ARF.Conclusion The main factors of origin in HA-ARF are infection,cardial and cerebrovascular disease,acute hypovolemia and operation.The mortality rate of this disease is higher.Etilogical treatment promptly and dialysis regimen are the main means to rescue these patients.

Objective To develop a clinical laboratory information system to execute information sharing.Methods The system realized information sharing between the third-party clinical laboratory facility and HIS with Oracle 10g database and Powerbuilder 9.0.Results The system implemented information sharing and informatized storing of the delivery specimen clinical laboratory results in the hospital.Conclusion The system fulfills seamless interface between the third-party clinical laboratory information system and HIS so as to provide the doctor and patient access to information and enhance the accuracy and timeliness of diagnosis.