Objective To investigate the effect of L-carnifine on the anemia of renal anemia and its effect on endothelin and left ventricular remodeling in maintenance hemodialysis patients.Methods 206 patients with uremia who underwent hemodialysis for more than 6 months from November 2010 to November 2014 were randomly divided into study group and control group (n =103),control group (n =103).Patients in the study group were treated with intravenous injection of levocarnitine injection on the basis of the control group.After 6 months of treatment,the clinical curative effect of the two groups was observed.Results After treatment,the levels of Hb and HCT were significantly increased,ET levels were significantly reduced,in which the change of patients in the study group was significantly better than the control group (P ＜ 0.05);LAD,LVDs and LVDd of the two groups were different (P ＜ 0.05).The difference between the two groups was statistically significant (P ＜ 0.05).Conclusion L-carnitine combined with erythropoietin in the treatment of renal hemodialysis patients with renal anemia can improve the therapeutic effect,reduce plasma endothelin levels,effectively improve or inhibit the occurrence and development of left ventricular remodeling,effective prevention of heart failure,The effect is remarkable,can promote the use.

OBJECTIVE: To research the content of alkaloids and polysaccharides in different varieties of Aconitum carmichaeli. METHODS: The contents of total alkaloids, diester diterpenoid alkaloids and polysaccharides were measured by acid dye colorimetry, HPLC and sulphuric acid-anthrone colorimetric method respectively. RESULTS: In different varieties, the differences of total alkaloids and diester diterpenoid alkaloids were significant. However, the difference of polysaccharides wasn’t significant. The content of total alkaloids and diester diterpenoid alkaloids in processed A. carmichaeli reduced significantly while the content of polysaccharides increased slightly. CONCLUSION: The results of study could provide a scientific basis for rational breeding of A. carmichaeli.

Objective To investigate the therapeutic effects of retinal angioma. Methods The clinical data of 16 cases(20 eyes) were retrospectively analyzed, and the patients included 5 males and 11 females of 23.3 yeras old on average. Four cases in this series affected by bilateral retinal angiomas were identified as von Hippel-Lindou disease. The retinal angiomas were divided into 5 stages according to their degrees of developmnet from simple angiom without vessel dilation to feeder vessel dilation and intraretinal exudates, local retinal detachemnt, massive retinal detachment and complication occurrence in proper order. The methods of treatment were laser photocoagulation, trans-scleral cryotherapy and vitreoretinal surgery. The patinets were followed up for 37.8 months on average. Results There were 10 eyes(2 in stage 1, 7 in stage 2, 1 in stage 3)treated with laser photocoagulation, and all of the angiomas were controlled after the treatment. The visual acuity improved in 2 eyes, decreased in 4 eyes, and remained unchanged in 4 eyes. Cryotherapy was performed on 7 eyes(5 in stage 3, 2 in stage 4). The visual deteriortion was found in 5 eyes; and the state of illness was stable in 3 eyes in stage 3 and aggravating in 4 eyes (2 in stage 3, 2 in stage 4). Vitreoretinal surgery was performed on 4 eyes including 2 which had been gi ven photocoagulation, and the visual acuity improved in 2 eyes, decreased in 1 eye, and was unimproved in 1 eye. The visual acuity decreased to no light perception in an untreated eye after 1.5-year follow-up. New angiomas occurred in 3 eyes with Von-Hippel-Lindou disease in the follow-up period. Conclusion Laser photocoagulation is effective in treating the angiomas from stage 1 to 3. Cryotherapy can cause massive exudation and proliferation, and it is only suitable for a few patients in stage 3. The visual prognosis is more favorable in vitreoretinal surgery than other therapies for the patients in stage 4.

Purpose To investigate the expression and significance of MCM5 and p16INK4A in cervical carcinoma and cervical intraepithelial neoplasia (CIN 1,CIN 2 ～ 3) with different degrees of HPV 16 infection.Method RT-PCR and immunohistochemistryof SABC method were used to detect the expression of mRNA and protein in HPV 16 infected normal cervix,CIN 1 tissue,CIN 2 ～3 tissue and cervical squamous cell carcinoma and analyzed the clinical significance.Result The expression of p16INK4A and MCM5 mRNA in cervical cancer tissues were significantly higher than that in normal tissues (x2 =-6.589,P ＜0.001,x2 =-4.349,P ＜0.001).The degree of cervical lesions increased gradually (x2 =57.141,P ＜ 0.001,x2 =47.628,P ＜0.01).Expression of mRNA MCM5 was correlated with pathological grade and clinical stage.Ⅰ a-Ⅰ b period was significantly lower than that of Ⅱ a-Ⅱ b (x2 =-4.93,P ＜0.01),the expression decreased with the decrease of pathological grade (x2 =-4.017,P ＜0.01).The expression of p16INK4A mRNA in cervical cancer decreased with the decrease of pathological grade (x2 =8.560,P ＜ 0.01).The most obvious expression of p16INK4A and p16INK4A mRNA in squamous cell carcinoma.Expression of MCM5 protein and p16INK4A protein in cervical squamous cell carcinoma was positively correlated (r =0.497).Conclusion There is high expression of MCM5 and p16INK4A in cervical carcinoma.MCM5 can be a better reaction of cervical malignant hyperplasia,and p16INK4A joint detection for the improvement of CIN classification and prognosis of the significance of the judgment.

Objective To investigate the preoperative biliary drainage on the effect of surgical treatment for hilar cholangiocarcinoma patients.Methods A total of 52 hilar cholangiocarcinoma patients who underwent resection operation in Renmin Hospital of Wuhan University from January 2005 to December 2015 were divided into preoperative biliary drainage group (24 cases) and non-preoperative biliary drainage group (28 cases).To compare the operation time,intraoperative blood loss,hospital stay,perioperative changes in liver function,and incidence of postoperative complications,tumor recurrence rate,1-,3-,and 5-year survival rate and some other indicators.The data was analyzed using SPSS 19.0 software.The patients of two groups were followed up by telephone,out-patient review and hospital examination.Patients were followed up for 8-60 monthes.Results The hospital stay for biliary drainage group was longer than that in non-preoperative biliary drainage group and the difference was statistically significant (P ＜ 0.05).The differences of operation time,intraoperative blood loss,postoperative tumor recurrence rate,postoperative complications (including bile leakage,blooding,fever,pleural effusion,abdominal infection,wound infection,pulmonary infection,liver failure and some others) and 1-,3-,and 5-year survival rate were not statistically significant (P ＞ 0.05).Alanine aminotransferase,aspartate aminotransferase,total bilirubin and direct bilirubin in preoperative biliary drainage group before biliary drainage were(98.0 ± 51.7) U/L,(94.2 ± 44.2) U/L,(177.5 ± 64.1) μmol/L and (160.2 ± 61.9) μmol/L,respectively,and after biliary drainage were (71.2 ± 13.8) μmol/L,(60.0 ± 12.1) μmol/L,(93.5 ± 20.7) μmol/L and (76.3 ± 18.1) μmol/L,respectively.The differences of the above parameters before and after biliary drainage were statistically significant (P ＜ 0.05).However,the changes of albumin before and after biliary drainage were not significant (P ＞ 0.05).The follow-up patients of biliary drainage group were 21 cases and the follow-up patients of non-preoperative biliary drainage group were 25 cases.The differences of 1-,3-,and 5-year survival rate between the two groups were not statistically significant (P ＞ 0.05).Conclusions Preoperative biliary drainage for hilar cholangiocarcinoma patients may improve the liver function to a certain extent.However,preoperative biliary drainage cannot improve the prognosis of the hilar cholangiocarcinoma patients.Therefore preoperative biliary drainage is not suggested for patients with good general conditions.

Objective To evaluate the clinical features of 18 cases of juxtapapillary capillary hemangioma. Methods In 18 cases of juxtapapillary capillary hemangioma, the clinical data of 19 eyes, the results of fundus fluorescein angiography (FFA) of 16 eyes, and the follow-up observation of 7 eyes were retrospectively analyzed. Results In 18 cases, the sex ratio of male and female is 1∶2 with the average age of 28.9 years. Peripheral retinal angioma was found in 3 cases (4 eyes). In 19 eyes, the center of hemangioma was located beyond the rim of optic, most of which was in inferotemporal quadrant of the optic (7/19) with the size of 1-2.5 disc diameter (DD). Most of the tumors were red in color (12/19). In the result of FFA of 16 eyes, wash-out at the late phase was found in 13 eyes. Decreased acuity was found in all 7 cases that were followed up more than 12 months (including 5 cases treated by laser photocoagulation). Retinal detachment didn′t occur in 6 cases without exudative retinal detachment after being followed-up for 54.5 months of the average term. Conclusions Most of the juxtapapillary capillary hemangioma are orange or red oval tumors. The center of hemangioma are located beyond the rim of the optic. The patients often complain gradually decreased visual acuity when they are in prime of their life with exudation and edema in different degree around the tumor. FFA is helpful for the diagnosis and differential diagnosis of this disease.

Objective To explore the clinical value of high-frequency color Doppler ultrasound in the diagnosis of isolated calf muscle vein thrombosis (ICMVT). Methods Sonographic features of 175 patients with isolated calf muscular venous thrombosis were analyzed retrospectively and outcome of anticoagulant therapy in 1, 3, and 6 months was followed up. Diagnosis was established with high-frequency color Doppler ultrasound examination. Results One hundred and seventy-ifve patients presenting with 190 calf muscle vein thrombosis were included. One hundred and iffty-eight cases with 173 calf muscle vein thrombosis were diagnosed by high-frequency color Doppler ultrasound, 7 cases of misdiagnosis, missed diagnosis in 10 cases. The accuracy rate was 91.1%(173/190). Seven cases were misdiagnosed with 1 euroifbromatosis, 1 mixed hemangioma, 5 gastrocnemius hematoma. After diagnosis of ICMVT, all patients prescribed thrombolysis and anticoagulation therapy. High-frequency color Doppler ultrasound for 1, 3, 6 months after treatments revealed partial or complete recanalization without calf deep vein thrombosis. Typical sonographic features included:calf muscle venous lumen dilation, tortuous anechoic lumen or hypoechoic iflling, with tubular or branched shape in the longitudinal view and oval or round shape in the transversal view. Conclusion High-frequency color Doppler ultrasound is an accurate and reliable method in the diagnosis of the isolated calf muscular venous thrombosis.

From both doctors and patients′different perspectives , this paper analyses the causes of conflict of doctor-patient communication , and from the subjective and the objective , the history and reality , individual and social aspects of light on the restricting factors for good doctor -patient communication , and puts forward strengthe-ning the consciousness of active , rule execution , achieving full coverage , explore ways to standard mode , rich di-verse ways and other countermeasures .

Objective To review the experience on screening,diagnosis and treatment for neonatal congenital hypothyroidism (CH)in Xuancheng City,Anhui Province.MethodsFrom Jan 2008 to Dec 2014,peripheral blood samples from the heel were collected among 83787 neonates and the blood samples were sent to the screening center to test the level of thyroid stimulating hormone (TSH).Neonates with abnormal level of TSH were admitted to our hospital for further TSH and free tetraiodothyronine (FT4 )tests. Neonates with CH diagnosis were given standard treatments of levothyroxine and their thyroid function, physical and intelligence development were evaluated on a routine basis.Results Among the 106 neonates with abnormal TSH level ,68 were diagnosed CH.The prevalence of CH in Xuancheng City was 0.8 ‰.All 68 patients with CH received levothyroxine treatment and 6 cases were lost during follow-up.44 patients received physical examination and their bone ages were normal. 53 patients received intelligence assessment.Only 1 of them was diagnosed of mental retardation, and 3 with suspicious mental retardation.Conclusion Neonatal screening is necessary for the early diagnosis and treatment of CH. Neonates with CH can have normal physical and mental development if they receive standard treatment as early as possible and followed up regularly.

Objective To evaluate the value of monitoring circular blood interleukin(IL)-17 for predicting 60 d mortality rate in premature infants with necrotizing enterocolitis(NEC).Methods A total of 85 neonates with surgically or medically treated NEC were retrospectively included.Serum IL-17 level was detected in diagnosing NEC and before preparing operation for evaluating its predictive value.Results The mortality rate after 60 d was 20 ％ (17/85),in which 5 (10 ％)was in the medical treatment group and 12(34％) in the surgical treatment group.The IL-17 level was significantly correlated with mortality rate after 30 d [odds ratio (OR):1.38;CI:1.14-1.67;P=0.001].The preoperative IL-17 level in the surgical treatment group was 27-7 500 pg/mL(median 2 625 pg/mL),which was significantly higher than mean 156 pg/mL in the medical treatment group.The difference in the area under curve(AUC)between the medical treatment group and surgical treatment group was 0.82(CI:0.74-0.90).The critical value of IL-17 for detection significance was 1 783 pg/mL(sensitivity was 90.5％,specificity was 59.2％).Conclusion Serum IL-17 level is correlated with the mortality rate after 60 d.