Objective To explore the clinical curative effect of combination of Tripterygium glycosides and Valsartan on chronic Glomerulonephritis complication with hypertension and the influence on inflammatory cytokines.Methods 90 cases of patients with chronic glomerulonephritis complication with hypertension in our hospital were selected from January 2015 to January 2016,To adopt randomized single blind controlled design methods,were divided into the treatment group Tripterygium glycosides combined with Valsartan,and the control group Tripterygium glycosides,each group were 45 cases,continuous medication for 24 weeks.Before and after treatment respectively observe the changes in blood pressure,24h urinary protein,endogenous creatinine clearance rate(Ccr),blood urea nitrogen(BUN),serum creatinine(Scr),glomerular filtration rate(GFR),inflammatory cytokines such as tumor necrosis factor-α,hypersensitive C-reactive protein,interleukin-6 as reference indicators.Results All the patients were observed for 24 weeks,no adverse effects were found.The effective rate of the treatment group was 95.55%,significantly higher than 75.55%of the control group(P<0.05).After treatment,systolic blood pressure(SBP),diastole blood pressure(DBP),24h urinary protein,SCr and BUN were all decrease,while Ccr and GFR were improved,and inflammatory cytokines such as tumor necrosis factor-α,hypersensitive C-reactive protein,interleukin-6 were reduced in the treatment group and the control group,the difference was statistically significant(P<0.05).Compared with the control group,blood pressure,24h urinary protein,Ccr, Scr,GFR,TNF-α、hs-CRP were improved in the treatment group(P<0.05).Conclusion Tripterygium glycosides combined with Valsartan treatment has good clinical curative effect,It can effectively relieve the symptom of chronic Glomerulonephritis complication with hypertension.

Objective To compare the diagnostic accuracy of intraductal ultrasonography(IDUS) and endoscopic retrograde cholangiography(ERC) on extrahepatic bile duct stones. Methods 30 patients with suspected extrahepatic bile duct stones by B Ultrasonography, CT,or MRI,were allocated into this study. ERC was performed first by the use of Fujinon duodenal endoscopy ( ED-410XT, ED-410XU) and then followed IDUS by inserting the Fujinon miniprobe (PL2220-15 or PL2226-15) through endoscopic working channel to detect extrahepatic bile duct, finally the substance in extrahepatic bile duct was proved by endoscopic sphincterotomy(EST)and stone extraction. Results Among 30 cases, the diagnoses by ERC were stone 26 cases,floccule 1 cases and misinterpreted 2 cases so the accuracy and sensitivity of ERC were 26/30(86.7%) and 26/28(92.9%)respectively. For IDUS, the diagnoses were totally in accordance with the results of EST and stone extraction.So the accuracy and sensitivity of IDUS in the diagnosis of extrahepatic bile duct stones were 30/30(100%) and 28/28(100%) respectively. Conclusion (1) IDUS was superior to ERC in the diagnosis extrahepatic bile duct stones. (2) IDUS can compensate the misinterpretation of ERC on extrahepatic bile duct stones.

Objective To investigate the role of endoscopic color Doppler ultrasonography (ECDUS) in the preoperative localization of insulinomas. Methods Seven patientsd woman) with biochemically diagnosed insulinoma underwent abdominal US, spiral CT and ECDUS in an attempt to precisely localize the tumor before surgery. Surgical and pathological results were considered as the definite localization of tumor. The role of ECDUS in the preoperative localization of insulinomas was compared with that of abdominal US and spiral CT. Results Ten tumors were detected by surgery and pathology. The sensitivity of ECDUS in identifying insulinomas was 8/10 compared with 1/10 for CT and 0/10 for abdominal US. Two tumors not detected by ECDUS had a size below 0. 5cm. Conclusions ECDUS is superior to spiral CT or abdominal US, and should be served as the first choice in the detection of pancreatic isulinomas. ECDUS identification depends on the size of the tumor and 'is hard to detect the tumors smaller than 0. 5cm.

Objective To explore the feasibility of orthotopic spleen-p re served operation characterized of taking advantage of collateral circulation.Methods 12 cases with severe injuries of the spleen and its pedicle underwent splenic pedicel ligation and irregular subtotal splenectomy.R esults All patients had good operative and postoperative results and no postoperative complications.Ultrasonography and CT scanning showed that the remn ant of spleen had no infarct and secondary hemorrhage.Conclusion Orthotopic spleen-preserved operation using collateral circulation is useful i n treating severe traumatic rupture of spleen accomplied by destruction of sple nic pedicles.

Three-parent test tube baby technology is important to solve the mitochondrial genetic disease.Once available,it raises greatly ethical controversy such as breaking traditional family values,hitting the religious belief,existing unknown risks,correctly handling the failed embryo,as well as the influence on the social status of the babies.Regarding these controversy,we can discuss it from several aspects.Because the development of ethics is behind the progress of science and technology,we should affirm the value of three-parent test tube baby technology and balance the development of science and technology with respecting the religious beliefs.Strict supervision system and standard application system reflect our respect for life.Incomprehension to the unknown things should become the motivation of our inquiry.We should face up to our fear of three-parent test tube baby technology,and thus to strengthen research and deepen understanding.Based on the above argument,this paper puts forward the ethical principles that should be followed in the development of three-parent test tube baby technology,namely respect,benefit,no harm and justice.

Objective To observe the application of endoscopy combined with 125I seed implantation in the pancreatic cancer palliative surgery in elderly patients.Methods A total of 78 elderly patients with pancreatic cancer who can not be treated with radical operation were divided into observation group and control group (n=39 each group).All patients were treated with stent intervention.Patients in the ation group were treated with 125I seed implantation guided by CT or ultrasonangraphy additionally.The clinical symptoms were compared between groups.The survival time and complications of the patients were recorded during the follow-up.Results The clinical symptoms of patients in both two groups were greatly improved (x2 =0.06,P＞0.05).Compared with the control group,the pain remission was better and the incidence of pain caused by pancreatic cancer was lower in the observation group (46.2％ vs.76.9％,x2 =7.80,P＜0.05).There was a significant difference in the average of survival time between the observation group and control group [(13.7±3.4) months vs.(8.4±3.8) months,t=3.73,P＜0.01],but no statistical difference was found in the long-term survival rate between groups.There was no significant difference in the incidence of complications between the two groups (10.3％ vs.7.7％,x2=0.15,P＞0.05).Conclusions Endoscopy combined with 125Ⅰ seed implantation is an effective treatment for elderly patients with advanced pancreatic cancer,which can effectively relieve the clinical symptoms,proiong the survival time,reduce the pain and complications.

Objective To evaluate the feasibility and safety of the modified panceaticojejunostomy called Kissing panceaticojejunostomy by animal experiment,and to explore the pathological process of primary healing between the pancreatic duct and the jejunal mucous.Methods The tolerance pressure at the anastomotic intestine was measured during surgery to ensure close contact suture of Kissing panceaticojejunostomy.Exploratory laparotomy,pancreatic ductography and pathology was performed at 2,4 weeks after panceaticojejunostomy.Results Kissing panceaticojejunostomy was performed successfully on 6 Beagle dogs.Tolerance pressure in all dogs was 90 cm H2O and above.No bleeding、fistula or contrast extravasation was found,and healing anastomosis was identified by laparotomy and pancreatic ductography.Cicatricial healing was found between pancreatic duct and jejunal mucosa 4 weeks after anastomosis.Conclusions Kissing panceaticojejunostomy is easy to perform,ensuring close-up cicatricial healing without hydrops or abscess between pancreatic duct and jejunal mucosa.

Objective This study aims to evaluate the effect of joint training on professional core competencies of Intensive Care Unit (ICU) nurses.Methods Nurses enrolled in Joint Training Program (the experimental group) between 2007 to 2009 were interviewed with questionnaire and compared with those received general training (the control group).Data were collected before and after 10 months of training.Scores of ICU nurse core competencies from the two groups were analyzed and compared.Restults Comparing with the control group,scores of the experimental group showed statistical differences on total score,theory dimension,technical dimension and 54 items.Conclusions Joint training could improve the professional core competencies of ICU nurses,especially the competences of management and application of nursing to critically ill patients and ICU special skills.

Objective:To investigate if in vitro chemotherapy can induce the EMT progress in gastric cancer (GC) cells. Method:The GC cell line, SGC7901, was treated using 5-Fu at a concentration of 30 μg/mL. The residual cells after four cycles of 5-Fu therapy were named as SGC7901/Fu. The morphological changes and malignant biological features, including the invasiveness and clone formation ability and the characteristics of cancer stem cell and biomarkers of EMT between SGC7901 and SGC7901/Fu, were compared. Results:The SGC7901/Fu cells displayed a mesenchymal appearance, decreased the expression of epithelial markers, and increased the expression of mesenchymal markers. The 50% inhibitory concentrations in the SGC7901/Fu and SGC7901 cells were (43.8 ± 7.2) and (64.6 ± 5.5)μg/mL, respectively. The number of cells that migrated through the basement-membrane of the Transwell chamber was 51.4 ± 8.7 and 93.2 ± 9.5, respectively. The rate of clone formation was 5.2%± 1.0%and 13.2%± 2.2%, respectively. The portions of the CD44+/CD24-cells were 4.13%±0.81%and 7.97%±0.50%, respectively. All differences were statistically significant (P<0.05). Conclusion:The residual GC cells underwent EMT progress after 5-Fu treatment, with increased chemoresistance and ability of invasiveness and acquired the property of cancer stem cells.

Objective To explore the effects of Kangshuaiyizhi capsule on ChAT/AchE and NE, DA and 5-HT levels in the brain tissue of aging model rats, and explore its effect of protecting cerebral function. Methods Totally 72 rats were randomly divided into normal group and model group. The subacutely aging model rats were made by injecting D-gal (0.125 g/kg) into abdominal cavity continually, then aging rats were divided by random number table into model group, Naofukang group and Kangshuaiyizhi high-, low-dose group. After intervented with correspongding drugs for 60 days, activity of ChAT and AchE, cerebral cortex NE, DA, and 5-HT levels were detected. Results Activity of AchE was much higher (P<0.05), but level of ChAT, NE, DA and 5-HT in model group were significantly downregulated compared with normal group (P<0.05). After treated with Kangshuaiyizhi capsule, activity of AchE was downregulated, ChAT, NE, DA and 5-HT levels were significantly upregulated (P <0.01, P <0.05). Conclusion Kangshuaiyizhi capsule can regulate cholinergic and monoamine neurotransmitter levels in the brain tissue of aging model rats, and play a very important role in protecting cerebral function.