Objective To investigate the efficacy and safety of using adsorption method combined with warm saline in heparin- free dialysis for patients with high risk bleeding tendency in order to reduce blood ag-glutination in the dialyzer and pipeline. Methods 60 patients with high risk bleeding tendency who were to undergo long- term hemodialysis (HD) were divided into the experimental group and the control group with 30 eases in each group,they both adopted heparin- free dialysis.The control group used saline washing of room temperature, while the experimental group adopted adsorption method combined with warm saline during washing. The completion of dialysis as well as the agglutination in the dialyzer and pipeline were ob-served. Results Number of patients who completed the dialysis were more, the completion rate of dialysis was higher and agglutination of dialyzer and pipeline decreased in the experimental group than those in the control group. Conclusions Agglutination of dialyzer and pipeline can be reduced and the aim of safe and effective heparin- free dialysis can be reached when using adsorption method combined with warm saline.

T),resulting in His to Leu(CAT→CTT) substituted at codon 435(H435L).No mutation was identified in the patient's parents.HT occurred in the patient during following-up.Conclusion H435L mutation in exon 10 of TR? gene leads to resistance to thyroid hormone.Meanwhile,consistent RTH might lead to HT.

ObjectiveTo study the multiple electrodes radio-frequency in treating complications of liver tumor and its prevention and treatment. Methods 114 patients of liver tumor were treated with multiple electrodes radio-frequency for 170 times,clinical complication and its prevention and cure were observed. ResultsThe rate of complication was 9.6%. The complications included 1 case of colon perforation, 4 cases of skin burn, 5 case of hydrothorax, 1 case of subcutaneous hemorrhage, but no patient died from these. ConclusionThe rate of complications of multiple electrodes radio-frequency treatment for liver tumor is low and the complications can be prevented and cured.

Objective To explore the clinical features and endoscopic manifestations of eosinophilic gastroente-ritis(EG)in children.Methods A retrospective analysis was conducted of the clinical manifestation,laboratory examination,endoscopy(upper and/or colonoscopy)performance,diagnosis and treatment of 49 cases of patients who were diagnosed as EG in Children's Hospital of Nanjing Medical University from July 2013 to July 2015.Results The common clinical manifestations of EG in children were hematochezia(23 cases),diarrhea(20 cases),vomiting(18 cases)and abdominal pain(15 cases).The ages of children admitted to hospital for the first time ranged from 1 month and 7 days old to 13 years and 7 months old,and the mean age was 59.4 months old,in which most patients were younger than 1 year old,accounting for 38.77％(19 cases)of all.Peripheral blood eosinophilia was present in 20 cases(40.82％)of the patients,and only 6/18 cases(33.33％)of the patients had elevated serum IgE.Upon endoscopic analysis,the lesions involved esophagus(4 cases),stomach(14 cases),duodenum(20 cases),small intestine(15 cases),colon(28 cases)and rectum(6 cases),and the most common manifestation under gastroscopy was mucosal hyperemia edema(27 cases)and erosion(9 cases),while the most common manifestation under colonoscopy was mucosal hyperemia edema(25 cases)and nodular hyperplasia(24 cases).All patients improved with food restriction,in which 8 cases were treated with glucocorticoid while 9 cases with oral Singulair and 9 cases with oral Loratadine.All children with symptoms were alleviated somewhat,but 5 cases of them relapsed after drug withdrawal.Conclusions The clinical manifestations of EG in children varied and were mainly hematochezia,vomiting,diarrhea and abdominal pain.Some patients had the elevated peripheral blood eosinophilia and serum IgE.The most common manifestations under gastroscopy were mucosal hyperemia edema and erosion while the most common manifestations under colonoscopy were mucosal hyperemia edema and nodular hyperplasia.

Objective:To analyze the mistakes in the application of tuina therapy in the rehabilitation of stroke,in order to elevate the clinical effects in the treatment of stroke by tuina.Methods:The issues are found out by searching and analyzing the relevant articles on tuina treatment of stroke.Results:In the tuina treatment of stroke,mistakes exist in the intervening time of the treatment,in the emphasis of tuina with negligence of rehabilitation,in the assessment of therapeutic effects,in the selection of the manual techniques and acupoints,and in the negligence of health education.Conclusion:In the tuina treatment of stroke,it is advisable to start treatment in the early stages,use the manual techniques in different phases,to cooperate with rehabilitation at the proper time and to emphasize health education,in order to avoid or reduce the occurrence of misuse syndrome,and eliminate the appearance of disuse syndrome,for displaying the unique advantage of tuina therapy fully and promoting the innovation and development of TCM rehabilitative techniques.

Objective Investigate the effect of EC50 of propofol target-injection in the different TCM (traditional Chinese medicine) physique types of patients who are in unconscious phase. Methods Depend on the standard protocol of TCM physique types sort and determination, we sorted 60 patients into three groups:Ping He (group A), Yang Xu (group B) and Yin Xu (group C), 20 patients per group. We applied the sequential experiment to measure the minimal EC50 and NI values of propofol when the patients were in the unconscious phase. Results The EC50 of propofol of group A, B and C are 3.85 μg/mL, 4.12 μg/mL and 3.43 μg/mL respectively. 95% confidence intervals of group A, B and C are 3.64 ~ 4.07 μg/mL, 3.92 ~ 4.33μg/mL and 3.26 ~ 3.60 μg/mL respectively. Conclusion There is a correlation between the different TCM physique types and the dosage of propofol target-injection.

BACKGROUND:Abnormal hippocampal neurogenesis during aging has been reported to result in learning and memory dysfunction. But its mechanism is unclear.
OBJECTIVE: To understand the changes of mouse neurogenesis in the hippocampal subgranular zone during aging.
METHODS:C57BL/6 mice 2, 6 and 20 months of age were used. Immunochemistry was used to count the number of neural stem cels (nestin+), neuroblasts (Doublecortin+, DCX+), and proliferative cels (proliferating cel nuclear antigen+, PCNA+) in the hippocampal subgranular zone. mRNA expressions of aging-related genes, p19Arf and p21Cip1/Waf1, in the hippocampus were detected by reverse transcription-PCR.
RESULTS AND CONCLUSION: Compared with the young and middle age groups, the number of PCNA+ cels, nestin+ and DCX+ cels in the hippocampal subgranular zone of the aged group decreased dramaticaly; the expression of p19Arf and p21Cip1/Waf1 mRNA increased in the aged group. Proliferation activity, the number of neural stem cels and neuronal differentiation al decreased. These findings indicate that the decline of hippocampal neurogenesis may be associated with increased expression of aging-related genes p19Arf and p21Cip1/Waf1 in the p19Arf-Mdm2-p53-p21Cip1/Waf1pathway.

0.05),but there was significant difference between group A and group C,the rate of hypoglycemia of group A was less than group C(P

Objective To determine the impact of uric acid changes on kidney function in middle-aged and elderly women with normal renal function.Methods Serum uric acid and estimated glomerular filtration rate(eGFR) were studied by prospective cohort analysis in 1152 middle-aged and elderly Dalian women with serum uric acid<7 mg/dl, estimated glomerular filtration rate(eGFR)≥90 ml·min-1·(1.73 m2)-1, and age>45 years old.Results The analysis of variance (ANOVA) of clinical indices between baseline and follow-up data showed that an eGFR was decreased after three years in both middle-aged and elderly women even with normal serum uric acid.Compared with those in the lowest guartile subgroup, a significant drop of eGFR to less than 90 ml·min-1·(1.73 m2)-1 was seen in those with the highest guartile of baseline serum uric acid group (OR=1.707, 95%CI 1.192-2.443, P=0.003).Furthermore, there were positive correlations between changes in the levels of serum uric acid and eGFR, and linear regression analysis showed that, as the change level of serum uric acid increased, the change level of eGFR declined(β=1.562, 95%CI 1.050-2.075, P<0.01], and the changing degree of uric acid increase is independent risk factors refor eGFR reductions.Conclusion Reduction in eGFR level is inversely related to serum uric acid in perimenopausal and postmenopausal women.However, our study showed that, women with serum uric acid level ranging from normal, slight increase, and relatively high levels, the increasing degrees of uric acid are independent risk factors responsible for the changing degree of eGFR reduction.

Objective: To explore the application value of color Doppler ultrasound-guided percutaneous dilational tracheostomy with dilatation forceps in patients with head and neck burns complicated with upper respiratory tract obstruction. Methods: From July 2013 to June 2018, 17 patients with head and neck burns complicated with upper respiratory tract obstruction, including 15 males and 2 females, aged 19-63 years, were hospitalized in our unit and treated with color Doppler ultrasound-guided percutaneous dilational tracheostomy with dilatation forceps. Before operation, the trachea was examined by color Doppler ultrasonography to specify condition of trachea and peribronchial tissues and organs for comprehensive assessment, so as to confirm optimal incision site of puncture and pathways as well as specify distance from anterior cervical skin to intima of anterior tracheal wall. Then, under real-time guidance of color Doppler ultrasound, percutaneous dilational tracheostomy with dilatation forceps was performed. The position, shape, inner diameter, and intraluminal abnormalities of trachea of patients before operation, abnormal location of peribronchial vessels and thyroid, distance from anterior cervical skin to intima of anterior tracheal wall, success rate of puncture, surgical time (from skin disinfection to successful catheterization), success rate of catheterization, intraoperative blood loss, heart rate, blood pressure, respiration, percutaneous oxygen saturation, and presence or absence of complications such as vascular/thyroid injury, emphysema, pneumothorax, suffocation, postoperative hemorrhea, wound infection after operation were observed and detected. Results: (1)Preoperative color Doppler ultrasonography showed that the trachea of one patient deviated from the anterior median line of neck 13 mm to the right; 17 patients had edema of different degrees in the cervical soft tissue and more secretions in the trachea; 3 patients had the trachea changed from round to oval with reduced anteroposterior diameter; 1 patient had a small artery obstruction at the conventional puncture point; 2 patients had the trachea covered by the congestive and swollen isthmus of the thyroid between the first and the third tracheal cartilage rings; 16 patients had a distance from anterior cervical skin to anterior tracheal wall intima of 17-33 mm, and 1 patient had a distance from anterior cervical skin to anterior tracheal wall intima of 47 mm. (2) Puncture for 17 patients was successful at one time, and success rate of puncture was 100%. The operation time was 5-11 min, with an average of 7 min, and the success rate of catheterization was 100%. (3) Intraoperative blood loss of patients was less, all not exceeding 8 mL. Intraoperative percutaneous oxygen saturation was maintained between 0.90 and 0.99. The heart rate, blood pressure, and respiration were stable. (4) No complications such as vascular/thyroid injury, emphysema, pneumothorax, suffocation, postoperative massive hemorrhage, or wound infection occurred in any patient. Conclusions Applying color Doppler ultrasound-guided percutaneous dilational tracheostomy with dilatation forceps in patients with head and neck burns combined with upper respiratory tract obstruction can not only open up the airway quickly and effectively, but also reduce the complications related to the operation. It is expected to improve the success rate of rescue and improve the prognosis, making it of good application value.