Objective To study the clinical efficacy and safety of leflunomide combined with irbesartan in the treatment of lupus nephritis . Methods 80 cases of patients with lupus nephritis in Yueqing Hospital Affiliated to Wenzhou Medical University from May 2014 to May 2016 were selected and randomly divided into leflunomide group ( leflunomide combined with irbesartan group ) and cyclophosphamide group ( cyclophosphamide combined with irbesartan group),40 cases in each group.The urine indexes and blood indexes levels,clinical curative effect,adverse reaction of the two groups were statistically analyzed.Results The 24h urine protein,urine beta 2-MG,urine red blood cell count,blood beta beta2-MG,ESR,Cr levels of the leflunomide group were significantly lower (P<0.05),the serum albumin,C3 levels were significantly higher (P<0.05),the total treatment efficiency 97.5%was significantly higher than the cyclophosphamide group 82.5%(P<0.05),the incidence of adverse reactions 5.0%was significantly lower than the cyclophosphamide group 22.5%(P<0.05).Conclusion Leflunomide combined with irbesartan is safe and effective in the treatment of lupus nephritis.

OBJECTIVE:To investigate the dissolubility of commercial metformin hydrochloride tablets from different manufactories.METHODS:The in vitro dissolubility of 14 kinds of commercial metformin hydrochloride tablets was determined by basket method and the dissolution parameters were analyzed with variance analysis method.RESULTS:The in vitro dissolubility of 14 kinds of metformin hydrochloride tablets fitted to the request of ChP2000,but the dissolution parameters were different.CONCLUSION:The statistical results indicate that there are significant differences between products from different factories(P

Objective To summarize the safety and clinical therapeutic effect of advanced aged coronary heart disease(CHD) patients with angina recurrence after coronary artery bypass grafting (CABG).Methods The clinical data,arteriography and the interventional results of 9 aged patients with angina recurrence treated by CABG were retrospectively analyzed .Results There were 8 patients received intervention ,among them 5 patients received coronary artery intervention , another 3 patients received graft vessels intervention .During operation and hospitaliza-tion,angina recurrence,acute myocardial infarction,revascularization,complication and mortality were not observed in 8 patients who received intervention .All patients were followed up for 12 months,there were 3 patients had angina recurrence and cured by drugs , but had no acute myocardial infarction and revascularization .Conclusion The intervention for advanced aged patients after CABG is a safe and effective treatment .The advanced aged patients with angina recurrence need receive arteriography quickly and receive coronary artery interventional treatment or graft vessels interventional treatment .

Objective To study the effect of the deferoxamine mesylate on the prognosis of patients with intracerebral hemorrhage(ICH) after one year. Methods From February 2013 to May 2014,spontaneous ICH patients diagnosed by computed tomography ( CT ) within 18 hours of onset in Mancheng District Hospital of Baoding were evaluated. Patients were randomly divided into experimental group and control group. The treatment of the two groups was similar except that the experimental group received deferoxamine mesylate. Patients were e?valuated by CT and neurology scale( NIHSS scale,GCS scale) at the time of admission and followed up for the first year by the RANKIN( mRS) scale. All clinical data of the two groups were compared. Results Forty?two patients were included in the study, including 21 cases in the experimental group and 21 cases in the control group,there was no significant difference in baseline data between the two groups at admission. There were 6 pa?tients with mRS ≥3 in the experimental group, and 6 patients with mRS ≥3 in the control group after one year. There was no statistically significant difference in the distribution of mRS score between the two groups after one year admission( P=1. 000) . Conclusion There may be no helpful on the prognosis of patients with intrace?rebral hemorrhage by intravenous infusion of deferoxamine mesylate,the further study is needed.

Objective To investigate the multi-drug resistance of Klebsiella strains and its mechanism.Methods Twenty strains of Klebsiella were isolated from the Affiliated Hospital of Medical College,Ningbo University from October 2009 to March 2011,in which 18 isolates were Klebsiella pneumonia and 2 were Klebsiella planticola. Drug sensitivity was determined by K-B tests. Drug resistant genes gyrA,parC (chromosome mediated) and aac( 6′)-I b-Cr,qnrA,qnrB,qnrS,qepA (plasmid mediated) were amplified by PCR and verified by direct automated fluorogenic sequencing. Results Resistance to β-1actams,aminoglycosides and quinolones was observed in 20 strains,and resistant rates were all above 80％.Klebsiella planticola strains were sensitive to imipenem and meropenem.Mutations of gyrA and parC genes existed in 18 strains (90％),and the positive rates of aac (6') -I b-C r,qnrB and qnrS were 60％ (12/20),20％ (4/20) and 20％ (4/20),respectively.Conclusion The mutations ofgyrA and parC genes may be the main cause of the resistance to quinolones in these strains.

Objective To evaluate the effects of sevoflurane preconditioning on postoperative cognitive dysfunction in aged rats.Methods One hundred and twenty healthy male Sprague-Dawley rats,aged 18 months,weighing 400-450 g,were randomly divided into 3 groups (n =40 each) using a random number table:control group (group C),operation group (group O),and sevoflurane preconditioning group (group Sev).In group C,the rats were only anesthetized with pentobarbital sodium and did not undergo operation.In group O,the rats were anesthetized with pentobarbital sodium and underwent 30 min of exploratory laparotomy.In group Sev,the rats inhaled 2.4％ sevoflurane for 30 min and then inhaled air for 30 min,and the other procedures were similar to those previously described in group O.At 30 min before operation and on 1st,3rd,5th and 7th days after operation,Morris water maze test was performed to record the escape latency,time of staying at the original platform quadrant and frequency of crossing the original platform.At 30 min before operation and on 1st and 7th days after operation,10 rats in each group were sacrificed and hippocampi were isolated to detect the apoptotic rate and intracellular [Ca2 +] i (using flow cytometry) and the ultrastructure of hippocampal neurons was observed with transmission electron microscope.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased,and the apoptotic rate and intracellular [Ca2 +] i were increased after operation in O and Sev groups (P ＜0.05).Compared with group O,the escape latency was significantly shorten,the time of staying at the original platform quadrant was prolonged,the frequency of crossing the original platform was increased,and the apoptotic rate and intracellular [Ca2+]i were decreased after operation in group Sev (P ＜ 0.05).Microscopic examination showed no abnormality in the ultrastructure of hippocampal neurons in group C,and the pathological changes of the ultrastructure of hippocampal neurons were obvious in group O,and were significantly attenuated in group Sev.Conclusion 2.4％ sevoflurane preconditioning can reduce postoperative cognitive dysfunction in aged rats,and regulation of imbalance of calcium homeostasis and reduction of cell apoptosis are involved in the mechanism.

AIM: To investigate combination principle of Gegenqinlian Decoction through experiment of anti-diarrhea. METHODS: Propelling rate of mouse's small intestine was selected as index on the condition of ink as colour reagent, diarrhea frequence served as second index for orthoganal design on the basis of mouse's diarrhea induced by senna. RESULTS:Coptis chinensis franch and Glycyrrhiza uralensis fisch and reduce drive rate. Scutellaria baicalensis Georgi and Pueraria lobata(wild) ohwi had counteracter against Coptis chinensis franch's effect, while Glycyrrhiza uralensis fisch could enforce Coptis chinensis franch's effect.as to DI, Coptis chinensis franch had anti-diarrhea effect. Scutellaria baicalensis Georgi had counteracter against Coptis chinensis franch's effect, Pueraria lobata(wild) Ohwi could enforce Scutellari, baicalensis Georgi effect, but Glycyrrhiza uralensis fisch could enforce Coptis chinensis's effect after compounding with Scutellaria baicalensis Georgi. CONCLUSION: ~Among the combinantion of Gegenginlian Decoction, as to the pharmcological effects on anti-diarrhea, the best compound is Coptis chinensis franch and Glycyrrhiza uralensis fisch.

Objective To describe the clinical application of microvascular anastomotic device in head and neck reconstruction.Methods From July,2013 to November,2013,microvascular free flaps were transferred to reconstruct the defects simultaneously after tumor resection of head and neck region in 12 cases in Department of Oral and Maxillofacial Surgery,Peking University School of Stomatology.Microvascular anastomotic coupling devices (MACD) were used in vascular anastomosis.The clinical data were collected and analyzed,including the selection of free flap,diameter of donor and recipient vessels,type of MACD,time of anastomosis,instant patency of anastomosis.The flap was monitored closely after operation and the final survival rate was calculated.Results Twelve microvascular free flaps were done in this series,including 6 fibula flaps,4 forearm flaps and 2 anterolateral thigh flaps.Totally 17 MACD were used by end-to-end anastomosis in this series,including 5 arterial anastomosis and 12 venous anastomosis.The anastomose time using MACD was from 4 to 10 minutes,with a median time 6.8 minutes.The instant patency rate of anastomosis was 100％.There were some blood leakages near the anastomotic stoma in 1 arterial anastomosis using MACD.It was resolved successfully by changing a new MACD.Conclusion Our primary clinical experience showed that the MACD was well suited to the microvascular reconstruction of head and neck defect.The feasibility and reliability was confirmed by our clinical cases.It should be recommended as a safe,fast and reliable adjuvant anastomotic instrument for free tissue transfer.

BACKGROUND:The mechanism underlying orthodontic-induced external root resorption is not yet clear, and it differs individual y. Kidney deficiency has been proved to be related to bone diseases which mediated by different cytokines. Interleukin-17 is an important cytokine involved in external root resorption. So figuring out whether kidney deficiency and interleukin-17 are related to root resorption wil be helpful for etiological research.
OBJECTIVE:To explore the relationship between kidney deficiency physique, interleukin-17 and root resorption during orthodontic treatment in rats.
METHODS:Thirty-six Wistar rats were selected and equivalently randomized into two groups, fol owed by modeled into kidney deficiency (kidney deficiency group) or injected with normal saline (control group), respectively. Afterwards, the right maxil ary of each rat served as an orthodontic force model, and the left maxil ary as a non-orthodontic force model. Al rats were respectively sacrificed under general anesthesia at the 3, 7 and 14 days after given orthodontic force. Then, the mesial surface of the root of maxil ary first molars and the expression level of interleukin-17 were observed through hematoxylin-eosin staining and immunohistochemical method.
RESULTS AND CONCLUSION:Histological observation showed that significantly increasing root resorption in a time-dependent manner could be observed, and there were various absorbed lacunae of osteoclasts on the enamel in the kidney deficiency orthodontic force group. The alveolar bone resorption and widened periodontal membrane appeared in the control orthodontic force group. While no remarkable root and alveolar bone resorptions were found in the other two non-orthodontic force groups. The expression level of interleukin-17 in the kidney deficiency orthodontic force group was higher than that in the control orthodontic force group;the expression level of interleukin-17 in the kidney deficiency non-orthodontic force group was higher than that in the control non-orthodontic force group. In conclusion, kidney deficiency patients are easy to develop root resorption, the mechanism of which is maybe relevant to the upregulation of interleukin-17.

Objective To explore effect of 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 on IL -17,IL -23 expression of recurrent condylomata acuminata patients.Methods 140 patients with recurrent condylomata acuminata were randomly divided into 3 groups.53 cases in observation group were treated by 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5,42 cases in control group 1 were treated by 5 -aminolevulinic acid -photodynamic therapy,and 45 cases in control group 2 were treated by thymopen-tin -5.24 healthy subjects were served as normal controls.IL -17,IL -23 levels were determined by enzyme linked immunosorbent assay before and after the clinical therapy.Results IL -17,IL -23 levels in the patients with recur-rent condylomata acuminata were significantly lower than those in healthy subjects(t =28.10,P <0.01;t =11.10, P <0.01).There were significant differences in IL -17,IL -23 between recurrent condylomata acuminata patients and healthy persons before treatment.There was significant difference after treatment(t =61.17,P <0.01;t =28.02, P <0.01).Conclusion 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 in the treat-ment of recurrent condylomata acuminata inhibited IL -17,IL -23 expression,so as to achieve therapeutic effect.