Objective: To verify the feasibility and reliability of the pilot process of irbesartan and hydrochlorothiazide tablets. Methods:Three batches of the tablets were produced according to the determined formula and process, and the key parameters in the pilot production were verified. Results:All the indices for each batch of irbesartan and hydrochlorothiazide tablets conformed to the re-quirements of the quality standard. Conclusion: The pilot process of irbesartan and hydrochlorothiazide tablets is feasible, and the technological process and parameters can ensure the product quality with promising reliability and stability.

Objective To study the correlation between blood lactic acid level and PCIS scroing system.To study the relationship between dynamic lactic acid monitoring indexes and prognosis of critical patients.Methods Differences of mortality,incidence of MODS and shock,PCIS score between two groups were compared.The patients were divided into 3 groups by PCIS score to compare pathogenetic conditions prognosis, then to study the were divided into death group and survival group by the hospital prognosis. Differences of their lactic indexes and other clinical indicators which reflected organ/system status were compared, prognostic-significant lactic indexes were selected by mu fti-variable logistic analysis. Results Patients with elevated lactic acid level had more incidence of shock and MODS, higher PCIS scores and higher mortality, the differences had statistical significance compared with the normal lactic acid group. There were significant linear correlation between ICU lactic acid level, peak lactic acid level and PCIS scores respectively. For the patients with elevated lactic acid level, peak lactic acid level, 12h lactic clearance had significant correlation with prognosis. Conclusion PCIS scoring system had a significant linear correlation with lactic acid level. For the patients with elevated lactic acid level,peak lactic acid level,12h lactic clearance were good indicators to evaluate patients' prognosis.

Objective To evaluate the clinical and biochemical characteristics of type 2 diabetics with hyperuricemia and to investi-gate the association between serum uric acid and the number of metabolic syndrome components. Method In the cross-sectional study of 547 type 2 diabetics, we recorded body mass index (BMI), systolic blood pressure(SBP), diastolic blood pressure (DBP), and collected blood samples to measure serum uric acid (UA), fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), creatinine (Cr) and blood lipid profile, including tfiglyceride (TG), total cholesterol (TC), low-density cholesterol LDL-C) and high-density cholesterol (HDL-C). Results Compared with the normal UA group, the diabetic patients in the high UA group had significantly increased levels of BMI, SBP, DBP, FPG, Cr, TG, TC and HbA1c (P <0.05, P <0.01, P <0.05, P <0.01, P <0.01), and decreased level of HDL-C(P < 0.05). There was no significant difference in the level of LDL-C between the two groups (P > 0.05). According to their possession of 1, 2, 3 or 4 components of metabolic syndrome, 547 cases were divided into four groups (MSI, MS2,MS3 and MS4). There were significant difference in the levels of UA, BMI, SBP, DBP, Cr, TG, TC, LDL-C and HDL-C among MSI, MS2, MS3 and MS4 (All P < 0.05). Multiple regression analysis showed that UA concentration was positively correlated with sex, TG and Cr (Beta:0. 088,0. 350, 0. 124; P < 0.05, P <0.01, P <0.01) and negatively correlated with HDL-C and HbA1 c(Beta: -0.107, -0.124 ; P <0.01, P <0.01). The con-centration of UA was strongly correlated with serum TG. Conclusions Serum UA level in type 2 diabetics was significantly elevated as the number of metabolic components increased. Abnormal TG had great influence on serum UA. Hyperuricemia was considered to be a dangerous factor of the metabolic syndrome.

Objective To investigate the factors that influence the patients to understand the stroke they suffering from.Methods 61 stroke patients were investigated with a questionnaire designed by ourselves.ResultsThe age,sex and educated level affected the stroke patients' understanding,but the time after onset,the degree of locomotory injured and hemiplegic side did not.ConclusionDistinguishing direction of rehabilitation should be established according to the age,sex and educated level of patients.

[Summary] Radical prostatectomy, external beam radiation and active surveillance are the main treatments for localized prostate cancer. However, many patients are difficult to accept the psychological burden of active surveillance and the distress caused by potential side effects of radical therapy, including incontinence and erectile dysfunction, which make them limited. With the development of minimally invasive techniques, such as brachytherapy, cryoablation, high-intensity focused ultrasound, photodynamic therapy, and irreversible electroporation, novel procedures are playing an increasingly important role in the treatment of localized prostate cancer with their effective, minimally invasive, and safe advantages. This article mainly reviewed the above several minimally invasive treatment methods.

The clinical characteristics, therapeutic effects and complications of 32 incipient patients with acute Vogt-Koyanagi-Harada ( VKH) syndrome admitted in Wuxi Second Hospital during October 2010 to September 2013 were retrospectively analyzed.There were 15 males and 17 females with a mean age of (41.3 ±14.1) years (22 -71 years), the time from the disease onset to treatment ranged from 3 to 20 days.Among 32 cases, 30 ( 94%) had premonitory symptoms. The multifocal bullous neurosensory detachment, optic disk hyperemia and edema in posterior pole of fundus were found in all cases, and exudative retinal detachment was found in 4 cases (6 eyes).The results of optical coherence tomography ( OCT) showed the macula neurosensory detachment, thick retinal neuroepithelial layer and wavy RPE layer in all patients.Fundus fluorescein angiography ( FFA) showed that scattered hyperfluorescence dots and cystic fluorescein reservoir was observed in early phase and later period respectively.Patients received intravenous methylprednisolone with the onset dose of 80 mg per day for 3-7 days and oral administration followed, which would gradually decrease later;the average treatment duration was (52.9 ±14.6) weeks. The visual acuity of 40 eyes (22 cases) was recovered to more than 0.8, and no blindness occurred after the treatment.During the treatment hair loss, depigmentation of skin and hair were found in 12 cases (38%) , and 2 cases showed short-term elevated intraocular pressure.These symptoms disappeared after drug therapy ceased.And no recurrence was found during the follow-up of 6 months.However, sunset glow fundus was found in 13 patients (26 eyes).The study shows that the diagnosis of VKH syndrome is based on the typical signs of the fundus presented on OCT and FFA.Early and systemic administration of glucocorticoids is important treatment for patients with VHK syndrome, which could decrease systemic and local complications effectively.

Objective To investigate the effect of the dihydroartemisinin (DHA) on the human low-differentiated lung adenocarcinoma cell line A549 and to explore its mechanism. Methods The A549 cells at logarithmic growth phase were divided into control group and DHA group. The cells in the control group were incubated with conventional reagent, and the cells in DHA group were incubated with 500 nmol/L of DHA. After incubation for 72 hours, methyl thiazolyl tetrazolium (MTT) assay was used to examine the proliferation of A549 cells in the two groups. Gene expression of p85, Akt, Bax and Bcl-2 was detected by real-time fluorescence quantitative polymerase chain reaction (PCR) . The protein expression of p85, Akt, p-p85, p-Akt, Bax and Bcl-2 was detected by Western blotting method. The activity of Caspase3 was measured by Caspase3 colorimetric assay kit. Results Compared with the control group, the proliferation rate of A549 cells in DHA group was significantly decreased ( P<0.01) . The RT-PCR results showed that the mRNA expression levels of p85 and AKT had no obvious difference between the two groups, but the mRNA expressien level of Bax was increased ( P<0.001), and the mRNA expressien level of Bcl-2 was decreased ( P<0.05) . The Western blotting results showed that there was no significant changes of p85 and Akt proteins between the two groups (P>0.05), but p-p85, p-Akt and Bcl-2 protein expression levels were significantly decreased ( P<0.01) , and Bax protein expression was increased ( P<0.01). Moreover, the activity of Caspase3 was also enhanced ( P<0.001). Conclusion DHA can reduce the proliferation of A549 cells and increase the apoptosis of A549 cells, and its mechanism probably has relationship with the inhibition of PI3K/Akt signaling pathway.

Objective To investigate angiographic manifestations and interventional treatment of renal arteriovenous fistulas. Methods Renal arterial angiographies were performed in 20 patients from multiple hospitals.These patients suffered from repeatedly intermittent hematuria,but ultrasound,KUB,IVU,CT and endoscopy could not contribute to the diagnosis.The angiographic manifestations and treating procedure were analyzed. Results All the 20 cases were diagnosed as renal arteriovenous fistula by means of angiography.According to the image manifestations,these cases were classified into three types:(1)deformed branches and shunt in 11 cases;(2)high discharge shunt without deformed banches in 4;(3)concealed shunt showed by superselective segmental artery angiography but negative by renal artery angiography in 5.All fistulas of the 20 cases were successfully embolized with different materials including gelfoam,sodium morrhuate,ethanol,PVA,TH-glue,coils,etc. Conclusions Superselective renal angiography and embolization are the most important and effective tools for diagnosis and treatment of renal arteriovenous fistula.

Chronic obstructive pulmonary disease (COPD) is the leading death cause of pulmonary diseases, ranking the fourth of global death causes. Self-management program is able to gradually improve the Airways of COPD patients with ventilation, reduce the degree of lung failure, elevate the health status as well as promoting self-efficacy, which is the key process to effectively control COPD relapse. In recent years, more and more domestic and foreign academic employ the widely-used network technology and carry out a large number of information study on COPD self-management intervention. This article reviewed literatures about the intervention methods on self-management of patients suffered from COPD, aimed at providing a better basis for exploring more effective self-management.

Objecive To explore the effect of interleukin-10(IL10) on tumor necrosis factor-?(TNF?)- induced expression of intercellular adhesion molecule 1 (ICAM-1 )and related transcription pathway in human renal tubular cells. Methods Human renal proximal tubular cell line HK-2 cell was used as target cell. ICAM-1 was measured by cell ELISA and Northern blot in protein and mBNA levels. Activities of transcriptional factors nuclear factor GB(NFkB) and activator protein 1 (AP-1) were determined by electrophoresis mobility shift assay. Results TNF?-induced ICAM-l expression in HK-2 cells was increased in both protein and mNRA levels(P