Objective To observe the effect of sulodexide and tripterygium glycosides on the idiopathic membranous nephropathy in stage Ⅰ ~Ⅱ.Methods 52 adult patients with idiopathic membranous nephropathy (pathologic stage Ⅰ -Ⅱ stage,24 h urinary protein 4 -8 g/d)were randomly divided into the control group and observation group,with 26 cases in each group.The cases in the control group were treated by conventional treatment and tripterygium glycosides tablet,and the observation group were treated with sulodexide based on the therapy of con-trol group.Six months was a course.24 h urinary protein excretion(24hUpro),serum creatinine(CR),alanine amin-otransferase(ALT),albumin(ALB),activated partial thromboplastin time(APTT),fibrinogen(Fbg)and total choles-terol(TC)were compared before and after treatment.The clinical efficacy and adverse reactions of the two treatments were observed.Results After 6 months of treatment,24hUpro,Fbg and TC of the two groups were significantly decreased than those before treatment(control group:t =3.754,2.096,3.781,observation group:t =5.412,5.043, 6.200,all P <0.05),while serum ALB was significantly higher(control group:t =2.519,observation group:t =4.672,P <0.05).CR and ALT had no significant difference between before and after treatment(all P >0.05).APTT was significantly longer than that before treatment(t =5.115,P <0.05).After treatment,ALB and APTT of the obser-vation group were (30.2 ±3.6)g/L and (36.1 ±2.7)s,which were significantly higher than (27.8 ±4.1))g/L and (33.8 ±3.1)s of the control group(t =2.243,2.853,all P <0.05),while 24hUpro,Fbg and TC were significantly lower than those of the control group(t =2.176,4.072,2.555,all P <0.05).The clinical effect of the observation group was 53.8%,which was significantly higher than the control group's 26.9%(χ2 =5.042,P >0.05 ).Both groups had no serious adverse reactions.Conclusion The clinical efficacy of sulodexide and tripterygium glycosides tablet may be more precise than alone tripterygium for IMN,which is safety.

Objective To study the effect of ultrasound guided curettage after methotrexate and mifepristone in the treatment of endogenous caesarean scar pregnancy.Methods A retrospective analysis was performed on 43 patients of endogenous caesarean scar pregnancy undergoing treatment of ultrasound guided curettage after methotrexate and mifepristone.Results 39 cases were successful,4 cases were transformed to laparotomy because of intraoperative blood loss,7 cases of bleeding after curettage were successful by uterine carity placed double lumina Foley catheter. Conclusion Ultrasound guided curettage after methotrexate and mifepristone is a safe,effective,little trauma and low cost method in the treatment of endogenous caesarean scar pregnancy,it especially adapts to primary hospital.

Objective To investigate the effect of resveratrol ( Res ) on the expression of survivin, p27 protein in human renal cell carcinoma 786-0 cells. Methods The cell cycle and apoptosis of 786-0 cells were detected by flow cytometry, and the expression of survivin and p27 protein of 786-0 cells was detected by Western blotting at time point of 12, 24 and 48 h after human renal cell carcinoma 786-0 cells were cultured with Res ( 25μmol·L-1 ) and blank medium, respectively. Results The ratio in G1 phase [(64.87±3.76)%] and G2 phase [(9.91±0.82)%] in the experimental group decreased significantly (P<0.05), and the ratio of S phase [(25.05±3.12)%] increased significantly (P<0.05).The apoptosis rate of experimental group at 12, 24 and 48 h [(5.12±0.64)%, (5.71±0.49)%, (5.84±0.30)%] was significantly higher than that of the control group [ ( 0. 72 ± 0. 27 )%, ( 0. 93 ± 0. 25 )%, ( 1. 12 ± 0. 21 )%, P<0. 05 ] . The expression of survivin protein in experimental group was significantly higher than that of the control group ( P<0. 05 ) , and the expression was significantly increased with time prolonging (P<0.05).The expression of p27 protein in experimental group was significantly lower than that of the control group (P<0.05), and the expression level was significantly decreased in time-dependent manner (P<0.05).There was a negative correlation between the expression of survivin and p27 protein in the experimental group ( P<0.05) . Conclusion Res could inhibit the expression of p27 protein and up-regulate survivin expression level, and promote the apoptosis of renal cell carcinoma 786-0 cells.

Objective:To evaluate the effect of enteral rehabilitative therapy in improving graft structure recovery in rat small bowel transplantation.Methods:Fourty eight recipients of rat allogeneic heterotopic small bowel transplantation(SD→Wistar rat)were dvided into 4 groups randomly according to the presence or absence of glutamine or rhGH in TPN regimen.Cyclosporine A was used as the immunosuppressant.The morphological mucosal indices of transplanted gut were observed and compared.Results:The application of rhGH and glutamine-enriched TPN,especially the enteral rehabilitation therapy which composed both these two agents,can promote the recovery of graft structure significantly compared with standard TPN support.On the postoperative day 14,in the enteral rehabilitation therapy group,all the morphological indexes of transplanted gut recovered to the preoperative state.Conclusion:Enteral rehabilitation therapy is appropriate to the host metabolic status,so it can improve the graft structure recovery more effectively.

Objective The purpose of this study is to evaluate the results of double-bundle anterior cruciate ligamen (ACL) reconstruction with remnant preservation and tensioning in acute stage. Methods Fifty-six cases of acute ACL injury were treated with double-bundle ACL reconstruction and tibial remnant preservation and tensioning. The double-bundle reconstruction is performed in a four-tunnel manner with eight-strands of hamstring tendon graft. The tibial remnant was tensioned with PDS sutures pulling through the femoral tunnel for the deep bundle. Fifty-three were followed up for a minimum of two years and evaluat-ed according to IKDC and Lysholm rating scale. Results At the last follow-up, all patients had negative Lachman test. KT-1000 examination in 25° knee flexion showed an average side-to-side difference of anterior laxity of (-0.44±1.53) mm compared with (8.01 1.83) mm before surgery (t=37.03, P=0.0001). Twenty-nine (54.7%) patients showed less than 0 mm side-to-side difference, which indicate a more stable or tight status of the injured knee compared with the normal side; 24(45.3%) patients showed 0 to 2 mm laxity. All patients showed negative pivot shift test. Forty-eight patients showed normal range of motion; 2 patients had 5° flexion deficit, 1 patient had less than 5° flexion deficit and 2 patients had 5° hyper-extension loss. In IKDC e-valuation 51 patients (96.2%) were graded as normal and 2 patients (3.8%) were graded as nearly normal. The IKDC subjective score was 95.6±3.1, and the Lysholm score was 94.8±2.9. The average Tegner score was 7.3 before injury and 7.1 at last follow-up. Conclusion Double-bundle ACL reconstruction with rem-nant preservation and tensioning in acute stage could get 96.2% normal and 3.8% nearly normal rates ac-cording to the IKDC scale at a minimum of two year follow-up.

Objective To study the effect on aiding treatment of patients with dysmenorrhea through psychological intervention.Methods Sixty patients with dysmenorrhea were randomly divied into the intervention group and the control group with 30 cases in each group.The contrd group were treated with allopathy and normal care.On the base of such ineasures,the intervention group were treated with psychological interventions like congnitive regulation,emotion regulation and behavioral regulation.Results The average pain degree of the control group was Ⅱ-Ⅲ.The average pain degree ofthe intervene group Was Ⅰ-Ⅱ.The results ofthe two groups were eonpred.P＜0.01 and the difference was significant.The average dose of Atuopin in the control group was 0.60mg.and the average dose of Atuopin in the intervention group was 0.43 mg.P＜0.01 and the difference of the two groups is obvious.The average time being in bed in the control group was 5.85 hours,and the average time beingin bed in the intervene group was 3.2.5 hours.The results of the two groups were compared,P＜0.01and the difference is significant.Conclusion The intervention can apparently improve patients' symptoms of pain.

0 05).Conclusion:Intraoperative lymphatic mapping with methylene blue is easily performed in early breast cancer patients.To determine the sentinel lymph node and status of axillary lymph node metastasis by pathological examination of the stained lymph nodes,there was hight false negative rate and unacceptable rate of misdiagnosis.So,its feasibility need further evaluation.[

Objective To evaluate the effects of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral stenosis (MS) and MS associated with aortic regurgitation (AR) of mild to moderate degree. Methods The results of PBMV in the Group A of 26 patient with MS associated with AR of mild to moderate degree and the group B of 34 patient with MS without AR were analyzed and compared.Results In group A, the mean left atrial pressure (MLAP) was 23.5?4.6 mm?Hg and 11.2?2.9 mm?Hg ( P

Objective To explore the related risk factors of central lymph node metastasis ( CLNM) of papillary thyroid microcarcinoma ( PTMC) and the application value of central lymph node dissection ( CLND) . Methods Totally 251 patients who were confirmed as PTMC by pathological biopsy were selected as the research object, and they were divided into the metastasis group (n=42) and the non-metastasis group (n=209) according to the status of lymph node metastasis. The general datum of the two groups were retrospectively analyzed, and the indexes with significant differences after univariate analysis were analyzed by non-conditional Logistic regression analysis. Treated the patients with lymph node metastasis through CLND, and the occurrence rate and recurrence rate of related complications were recorded during the 1 to 3 years of follow-up. Results The comparison of the location of the tumor, complicated adenoma, Hashimoto’ s thyroiditis, nodular goiter, and hyperthyroidism between the two groups was not statistically significant (P>0. 05). In the metastasis group, the rate of patients aged less than 45 years old and the percentage of male patients were both significantly higher than the non-metastasis group, and the difference was of statistical significance (P<0. 05). There were 25 cases (59. 5%) whose tumor diameter were 5~10 mm, 12 cases (28. 6%) with multiple lesions, and 22 cases (52. 4%) breaking through the envelope in the metastasis group, which were significantly higher than 70 cases (33. 5%), 23 cases (11. 0%) and 67 cases (32. 1%) in the non-metastasis group, and the differences were statistically significant (P<0. 05). In the metastasis group after operation, there was 1 cases (2. 3%) of hoarseness, 6 cases (14. 3%) of local numbness, 1 case (2. 3%) of nerve invasion, and 2 cases (4. 8%) of vascular invasion, and there was no choking cough report. During the period of 1 to 3 years of follow-up, there were only 2 cases of recurrence and the recurrence rate was 4. 8%. Conclusion Central lymph node metastasis mostly occurs in the male patients with PTMC who are less than 45 years old. And the main characteristics are diameter of tumor over 5 mm, multifocal lesions, with envelope penetration symptom and so on. In clinic, patients who meet the above-mentioned condition should be taken as the primary concern and given related prevention measures to reduce the occurrence risk of central lymph node metastasis. To treat patients with papillary thyroid microcarcinoma through central lymph node dissection can receive good curative effect and effectively improve the prog-nosis quality, and it is worthy of clinical promotion.

Objective To compare the outcomes of arthroscopic coracoacromial ligament augmentation and clavicular hook plating in treatment of acromioclavicular joint dislocation.Methods From March 2008 to March 2012,47 patients with acute closed type Ⅲ-Ⅴ acromioclavicular joint dislocations underwent an arthroscopic repair with coracoacromial ligament augmentation and suture (ligament augmentation group,23 patients) and with AO clavicular hook plate (hook plate group,24 cases).Mean age of the patients (32 males and 15 females) was 34.8 years (range,17-45 years).There were 32 left and 15 right injuries.Postoperative outcome was assessed through radiographic examination,American Shoulder and Elbow Surgeon (ASES) score and Karlsson scoring method.Results Mean period of follow-up was 18 months (range,12-24 months).In ligament augmentation group ASES score improved from (28.7 ± 7.3) points preoperatively to (96.3 ± 6.9) points postoperatively (t =51.34,P ＜ 0.05).In hook plate group ASES score improved from (29.3 ± 7.6) points preoperatively to (83.6 ± 8.5) points postoperatively (t =43.78,P ＜ 0.05).Postoperative radiographic examination showed well joint reduction of all patients.Good and excellent results with the Karlsson score accounted for 96％ (22/23) in ligament augmentation group and 71％ (17/24) in hook plate group (x2 =9.05,P ＜0.05).Conclusions Efficacy of coracoacromial ligament augmentation and suture for the treatment of acromioclavicular joint dislocation is better than clavicular hook plate.Coracoacromial ligament augmentation and suture are associated with lower incidence of shoulder pain and shoulder activity limitation,shorter recovery time,fewer complications and early activities.