OBJECTIVE:To observe the clinical efficacy and safety of nitroprusside combined with dopamine in the treatment of acute heart failure(AHF). METHODS:96 patients with AHF were randomly divided into control group and research group. All patients were given ACEIs,digoxin,diuretics,statins,aspirin and other conventional treatment. On this basis,control group was given nitroprusside 12.5-25.0 mg,adding into 5% Glucose solution 50 ml by micro pump and started at 6.25 μg/min,and then maintained at 12.5-50.0 μg/min based on the blood pressure adjustment;research group was given dopamine 100 mg based on the treatment of control group,adding into 5% Glucose solution 50 ml at rate of 2 μg/(kg·min)by pump,and maintained at 2-10 μg/(kg·min). The course of both was 5-7 d. The clinic data was observed,including clinical efficacy,hemodynamic parameters(cen-tral venous pressure,pulmonary artery systolic pressure,heart rate and cardiac output index)before and 0.5,3,12,24 and 48 h af-ter treatment,renal functions(serum potassium,blood urea nitrogen,serum creatinine and 24 h urine)before and 24,48 and 72 h after treatment,and the incidence of adverse reaction. RESULTS:The total effective rate in research group was significantly higher than control group,with significant difference(P<0.05). The central venous pressure,pulmonary artery systolic pressure,heart rate,serum sodium and potassium in 2 groups at different time points were significantly lower than before;cardiac index,blood uric acid nitrogen,creatinine and 24 h urine were significantly higher than before,with significant difference(P<0.05). However, there were no significant differences on the hemodynamic parameters and renal functions at different time points between 2 groups (P>0.05). There were no significant differences in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Nitroprusside combined with dopamine has more obvious efficacy than only nitroprusside in the treatment of AHF,and can obviously reduce the cardiac stress,increase cardiac output and improve renal function,with similar safety.

Objective To Search for the induced factors and therapeutic strategies for ovarian hyperstimulation syndrome(OHSS).Methods 38 cases with OHSS were retrospectively analyzed.Results All cases had symptoms of stomach and intestine,hcmachrosis and ascitic fluid.Human serum albumin through intravenous dripping was one of the most successful treatment as plasma expanders through restoration of effective blood volume.Paracentesis was necessary for critical OHSS patients with severe ascites and hydrothorax.Herus could decrease the cost of albumin significantly.Conclusions OHSS was the severe complication of ovarian stimulation.All patients with OHSS got completely recovered through intense care and effective treatment.

Objective To study the expression of KAI1mRNA in cervical carcinoma and its clinical significance.Methods The transcription-polymerase chain reaction(RT-PCR) method was applied to detect the expression of KAI1mRNA in 53 fresh freezing cervical tissues.The findings were compared with the clinicopathological data.Results The expression of KAI1mRNA was (0.309?0.093) in normal cervix,(1.608?0.289) in cervical intraepithelial neoplasia(CIN),(0.948?0.910) in cervical carcinoma respectively.The relative densitometric value of KAI1mRNA decreased in late stage of cervical cancer in local cervical cancer with lymphatic metastasis(P

Objective:To investigate the quality of Herba Leonuri Preparations sold in market. Methods: The alkaloid content in preparations was determined according to the determination method in China Pharmacopoeia (1995). Results: There were significant differences among Herba Leonuri Preparations from different pharmaceutical factories, place of origin and batches. Conclusions: It is suggested that the determination item of stachydrine hydrochloride be added.

Objective To investigate the protective effects of ω-3 polyunsaturated fatty acids on severe sepsis patients with myocardial injury.Methods Thirty-one patients with severe sepsis were divided into treatment group (17 cases) and control group (14 cases) by random digits table.All patients received partial enteral nutrition and partial parenteral nutrition with equivalent nitrogen and calorie values for 5 days.The control group was given routine therapy and the treatment group was given routine therapy and ω-3 polyunsaturated fatty acids emulsion.The serum malondialdehyde (MDA),superoxide dismutase (SOD),cardiac troponin Ⅰ(cTnI),N-terminal pro-B urine sodium peptide (NT-proBNP) levels and acute physiology and chronic health evaluation (APACHE) Ⅱ score was compared between two groups before and after treatment.Results There was no difference in indicators before treatment between two groups (P ＞ 0.05).The MDA,cTnI,NT-proBNP and APACHE Ⅱ score in two groups after treatment 5 days was lower than that before treatment 1 day,and the SOD was higher than that before treatment (P ＜ 0.05).The MDA,SOD,cTnI and NT-proBNP after treatment 5 days in treatment group was better than that in control group [(7.50 ±2.06) mmol/L vs.(9.24 ± 1.79) mmol/L,(89.22 ± 16.21) mU/L vs.(76.60 ± 15.13) mU/L,(0.65 ± 0.34)μ g/L vs.(1.03 ± 0.62) μ g/L,(1267.13 ± 279.26) ng/L vs.(1532.47 ± 375.73) ng/L],and there was significant difference between two groups (P ＜ 0.05).The APACHE Ⅱ score was no significant difference between two groups after treatment 5 days.Conclusion ω-3 polyunsaturated fatty acids can reduce the oxidative stress and myocardial injury,decrease cTnI and NT-proBNP levels and improve heart function in the patients with severe sepsis.

Objective To explore the safety and feasibility of controlled hypotension with urapidil and nitroglycerin esmolol-three drugs combination in endoscopic surgery. Methods Forty patients who were received endoscopic surgeries were randomly divided into two groups, 20 cases in each group, urapidil-esmolol-nitroglycerin controlled hypotension group (A group) and non controlled hypotension group (B group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded at the following points: before anesthesia (basal, T1), immediate before surgery (T2), 30 minutes after the start of surgery (T3), end of the operation (T4), 10 minutes after the end of surgery (T5). We recorded blood loss, operative time, transfusion volume, urine. At last the parameters were compared between the two groups. Results The difference of SBP, DBP, MAP at the points of T2, T3, T4 in the two groups was statistically significant (P < 0.05) comparing with the control group (group B). The vital signs of patients during anesthesia in A group had more stable than that of the B group , and the operation time of the A group was significantly shorter than that of the B group. Meanwhile, the blood loss in A group was significantly decreased(P < 0.05). Conclusion It has synergistic antihypertensive effect, and can reduce both side effects and the risk of anesthesia and surgery for us to use urapidil-esmolol-nitroglycerin three antihypertensive drugs in combination. It is a safe and reliable method for clinical application.

Objective To observe the effect of non-ablative treatment combined intense pulse light (IPL) and Q switched Nd :YAG laser on hyperpigmented skin diseases. Methods Total 250 cases of Fitzpatrick skin types Ⅲ and Ⅳ with hyperpigmented skin disorders received 4 treatments with combined 560nm IPI. and 532 nm Q switched Nd :YAG laser. The interval between two treat-ments was I month. After 3 months the effect of IPL was observed. If it was not good, we used the Q switched Nd :YAG laser. Efficacy and adverse effects were evaluated 3-6 months after the final treat-ment. Results 3-6 months after the last treatment, 50%-70% of patients had their telangiectasia, enlarged pores, hyperpigmentation and wrinking of facial photoaging improved. The degree of im-provement was more than 60 %. Common side effects were minor blistering and erythema. Conclusion Combined IPI. and Q switched Nd :YAG laser treatment is an idea non-ablative therapy for telangi-ectasia, enlarged pores, hyperpigmentation and wrinking of facial photoaging in Fitzpatrick skin types Ⅲ and Ⅳ in Asian.

OBJECTIVE:To explore the method and efficacy of occlusion with medicinal albumin gel for esophageal fistula. METHODS:Over the recent 5 years,a total of 11 patients with esophagus -respiratory fistula or esophagus-neck fistula confirmed by iodine imaging and / or gastroscopy were occluded with medicinal albumin gel under endoscope. RESULTS:The occlusion with medicinal albumin gel for esophageal fistula was successful in all the 11 cases,and 9 out of 11 were completely healed after one time occlusion treatment and the other 2 cases were completely healed after the second occlusion treatment. The average hospital stay was 27 days and the average cost was 24,500 yuan. There was no recurrence after follow-up of 3 to 6 months,nor was there any adverse complication. CONCLUSION:Compared to the conventional conservative treatment,occlusion with medicinal albumin gel for esophageal fistula under endoscope can reduce the length of hospital stay and the cost of hospitalization.

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.

Objectives To investigate the expression of mTOR signaling pathway in pancreatic cancer and export its signification. Methods 6 samples of pancreatic cancer and its paracancerous tissues specimens confirmed by surgery and pathologic examination were selected. RNA was extracted and expression profiles experiment was performed by using Agilent human whole genomic oligonucleotide microarrays. The expression of mTOR signaling pathway in pancreatic cancer was analyzed by bioinformatics. Results Totally 1276 differential gene were selected, and 691 were up-regulated in cancer tissue, while 585 were down-regulated.The highest score of KEGG pathway's Enrichment and gene count was hsa04150 in mTOR signaling pathway,with its Enrichment of 4.5622519 and gene count of 9, and the percentage of gene count was 1.15%, the EASE Score P value was 6.23 E-04, which had the most biological significance. Among those, there was significantly difference of expression of nine key genes including ULK2, PIK3R3, PDPK1, EIF4EBP1, PGF,VEGFB, ULK3, RICTOR and PIK3 R5 (P ＜ 0.05). Conclusions The pathogenesis of pancreatic cancer is related to the activation of the mTOR signaling pathway.