OBJECTIVE:To observe the efficacy and safety of alprostadil combined with tanshinone ⅡA in the treatment of pa-tients with early chronic kidney disease(ECKD). METHODS:138 ECKD patients were randomly divided into group A,group B and group C,46 cases in each group. On the basis of conventional treatment,group A received 40 mg TanshinoneⅡA sodium sulfonate in-jection,adding into 250 ml 0.9% Sodium chloride solution,ivgtt,qd+10 μg Alprostadil injection,adding into 100 ml 0.9% Sodium chloride solution,ivgtt,qd;group B received the same dose with Alprostadil injection;group C received the same dose with Tanshi-noneⅡA sodium sulfonate injection. All patients were treated for 14 d. Clinical efficacy,laboratory indexes [24 h urine protein,serum creatinine(SCr),total cholesterol(TC),triglyceride(TG),blood urea nitrogen(BUN),uric acid(UA)] in 3 groups before and af-ter treatment were observed,and the incidence of adverse reactions was compared. RESULTS:The total effective rate in group A was 97.83%,which was significantly higher than group B(80.43%)and group C(76.09%),the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in 24 h urine protein,SCr,TC,TG,BUN and UA among 3 groups (P>0.05);after treatment,all above-mentioned indexes significantly reduced,and group A was lower than group B and group C,the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reac-tions among group A(10.87%),group B(6.52%)and group C(8.70%)(P>0.05). CONCLUSIONS:Alprostadil combined with tanshinoneⅡA shows good efficacy in the treatment of ECKD,it can improve renal function in patients with good safety.

With the improvement of China's population aging and health care consciousness, female pelvic floor dysfunction gets increasing attention in society. Modern TCM scholars conclude TCM doctors’ theories about etiology and pathogenesis of pelvic floor dysfunction, summarized as debility of Chong Ren meridians and inability to lift, and then they advocated invigorating qi and elevating yang, with a purpose to protect pelvic floor stability. This article conducted relevant discussion on the significance of rehabilitation of pelvic floor dysfunction based on TCM adjusting qi activity.

Asthma is a common disease in children. Adherence to inhaled glucocorticoid therapy directly affects the outcome of asthma. The article mainly reviews the adherence status, assessment method, patient barriers to non-adherence and intervention strategy,so as to provide references for clinical practices and scientific research of nursing staff.

With the intensified aging problem, the study of age-related diseases is becoming more and more significant. Alzheimer's disease is a kind of dementia, with senile plaques and neurofibrillary tangles as the main pathological features, and has become one of the major diseases that endanger the health of the elderly. This review is concentrated on the research of the early assessment of Alzheimer's disease. The current situation of early diagnosis of the disease is analyzed, and a prospect of the future development of early assessment means of the disease is also made in the paper.
Aged ; Aging ; Alzheimer Disease ; diagnosis ; pathology ; Early Diagnosis ; Humans ; Neurofibrillary Tangles ; pathology ; Plaque, Amyloid ; pathology

Objective:To explore the role of T lymphocytes activation co-stimulation pathway in asthma pathogenesis and the ability of therapy asthma with Anti-CD86mAb.Methods:The blood samples were taken from 28 asthma children( including 18 male and 10 female, age 1 year-8.08 years) and 15 normal children( including 7 male and 8 female, age 3.25 years-10 years).ELISA was used to detect the levels of IL-4、IL-13、IFN-? in culture supernatants of PBMC stimulated with PHA and treated with mouse anti human CD86mAb. Results:①When treated control PBMC with anti-CD86mAb, the level of IL-4 in control group(13.30?4.66 pg/ml) was lower than that of mouse IgG control group (15.20?5.22 pg/ml,P

AIM:To treat the chemotherapy-induced premature ovarian failure ( POF) rats with the methods of tonifying kidney yin and yang by observing the indicator changes in apoptosis of ovarian granulosa cells and related cyto -kines before and after medication .METHODS:SD rats ( n=36) were chronically given intraperitoneal injection of cyclo-phosphamide ( CTX) for 15 d in order to establish the animal model of POF .The rats were randomly divided into control group, CTX group, CTX+kidney yin group and CTX +kidney yang group.The levels of tumor necrosis factor alpha (TNF-α) and interferon gamma ( IFN-γ) in the peripheral blood were detected by ELISA .The apoptosis of ovarian granulosa cells was observed by TUNEL method .The levels of apoptosis related proteins were determined by Western blot .RE-SULTS:After modeling , the levels of TNF-αand IFN-γin the peripheral blood were significantly increased .The protein expression of Bax was up-regulated and Bcl-2 was down-regulated .The apoptosis of ovarian granulosa cells was significantly induced with a deep staining .After treatment with tonifying kidney yin and yang , the levels of TNF-αand IFN-γin the pe-ripheral blood were decreased , the protein expression of Bax was down-regulated and Bcl-2 was up-regulated, and the apop-tosis of ovarian granulosa cells was reduced .CONCLUSION:The reserve function of the ovarian can be recovered by pre-scriptions of tonifying the kidney yin and yang via regulating the expression of TNF -α, IFN-γ, Bax and Bcl-2, and inhibi-ting the apoptosis of ovarian granulosa cells .

Objective To evaluate the advantages and disadvantages of various methods for the treatment of aortic dissection involving aortic arch. Methods The clinical data of 56 patients with aortic dissection involving aortic arch were analyzed retrospectively. All the patients were treated with throacic endovascular aortic repair (TEVAR) combined with chimney technique and hybrid operation to reconstruct partial vessels of the aortic arch according to the different morphology sites of aortic disease. Results Among 56 patients, 29 cases received TEVAR combined with chimney technique of left subclavian artery, and 27 cases received TEVAR combined with hybrid operation. Six cases had typeⅠendoleak. Among them, 2 cases improved by compliant balloon dilatation, and 4 cases were not treated. There was no death in perioperative period. The patients were followed up for 3-70 (22 ± 3) months, and all the branches of the artery were unobstructed during middle and long term follow-up. Conclusions Combined endovascular treatment is a safe and effective method for aortic dissection involving the aortic arch. In the meantime, strict preoperative evaluation and suitable operation method is also important.

Objective To study the curative effect of transcatheter arterial chemoembolization( TACE) combined with conventional percutaneous ethanol injection therapy ( PEIT) in the treatment for primary liver cancer?Methods Forty cases patients with primary liver cancer(the diameter was equal or more than 8 cm) who were treat in the Third Hospital of Qinhuangdao from January 2007 to May 2013 were selected,and randomly divided into treatment group(20 cases) and control group(20 cases)?The control group underwent TACE,the treatment group were given TACE combined with PEIT, the clinical effect of the two groups were observed?Results The effective rate of the treatment group was 80%,significantly higher than that of the control group( 50%) ,the difference was statistically significant( P=0?04)?During the follow?up of 3 years,there were 3 cases of portal vein tumor thrombus,5 cases of hepatic metastasis,1 case of upper gastrointestinal bleeding and 2 cases of liver failure in the control group;there were 1 case of liver metastasis,1 case of liver failure and death in the treatment group?Conclusion The test of the curative effect of patients with huge hepatocellular carcinoma after combination therapy with TACE and PEIT proved combination therapy can increase the curative effect, decrease impairment of liver funvtion?It was a palliation road to treat huge hepatocellular carcinoma.

Objective To Summary the first 40 cases underwent robotic atrial septal defect (ASD) closure or atrial septal defect closure combined bicuspid valve plasty (TVP) using da Vinci S surgical System on beating heart. Methods 40 cases of atrial septal defect or combined sever tricuspid valve regurgitation were repaired using da Vinic S surgical system on beating heart from March 2009 to December 2010 in cardiovascular department of PLA general hospital. The average age was (38 ± 13) yeas old. 23 cases were female and 17 cases were male. All patients were ostium atrial septal defect with or without pulmonary hypertension. The atrial defect diameter was 1.5 -3.5 cm, and the mean diameter was(2. 8 ±1.3)cm. 9 patients had sever tricuspid valve regurgitation. Without sternotomy, the extracorporeal circulation was established through groin artery,groin vein and internal jugular vein cannulation with the guidance of transeophageal echocardiography. 3 ports of 8 mm and 1 working port of 2 cm were made in the right chest wall. After da Vinci S syetem was set up, with the assistant of bed-side surgeon, the surgeon completed the atrial septal defect closure or combined tricuspid valve plasty in the surgeon console with three dimensions visualization. During the operation, without cardioplegia administrated and aortic occlusion, the procedure was completed through right atriotomy. The pleural space was insufflated with carbon dioxide to avoid the air embolism. The direct suturing was used in 22 cases and pericardial patch were used in 18 cases. 9 patients accepted concurrent De Vega tricuspid valve plasty. The transesophageal echocardiography were used to evaluate the result of atrial defect closure or tricuspid valve repair. The operation time, robotic using time and cardiopulmonary time were compared with totally robotic atrial defect repair in arrested heart. Results All cases were accomplished successfully without complication. There was no residual shunt and air embolism. The operation time, robotic using time and cardiopulmonary time were less than the arrested group. Conclusion Robotic atrial septal defect closure or combined tricuspid valve repair on beating heart can avoid aortic ocllusion and can be utilized effectively and safely.

Objective:To explore the effect of different hemoperfusion times on the recovery of serum cholinesterase (ChE) in patients with severe acute oral organophosphorus pesticide poisoning (AOPP).Methods:This was a retrospective case-control study. Patients with severe AOPP admitted to our hospital were identified between January 2010 and December 2019. The clinical information of patients with severe AOPP was collected between January 2010 and December 2019, the patient's ChE vitality levels were collected on admission, at 1, 3 and 5 days after admission, and the sex, age, oral poison volume, and related treatments were recorded as well. The relationship between ChE, different HP treatment times and patients without HP treatment was analyzed by generalized estimation equations and multiple comparisons afterward.Results:A total of 159 patients with severe AOPP were included in our study. Among them, 60 (37.74%) patients were male and 99 (62.26%) were female, with a median age of 33 years old (range 13-75 years old). The median oral dose of OPs was 75 mL (range 15-500 mL). Multivariate analysis results showed that in the unadjusted generalized estimation equation, compared with patients without HP treatment, the average ChE value of patients with single HP treatment was 745.6 U/L higher (95% CI: 467.09 - 1024.1; P<0.01), the average ChE value of patients with 2 times HP treatment was 565.81 U/L higher (95% CI: 384.25-747.36; P<0.01), and the average ChE value of patients with 3 times HP treatment was 43.86 U/L higher (95% CI: 420.71-1 067.01; P<0.01), the differences were all statistically significant. After adjusting the amount of oral OPs at admission, age and PSS score in the multiple generalized estimation equations, the results showed that whatever single HP treatment or multiple HP treatment, the recovery rate of ChE was significantly faster than those without HP treatment. And the multiple comparison results of multiple models showed that the difference between 3 times HP treatment and 1 to 2 times HP treatment was not statistically significant, and the average difference between 2 times HP treatment and single HP treatment was also not statistically significant. Conclusions:Hemoperfusion therapy can accelerate the recovery rate of ChE in AOPP patients; Whatever single HP treatment or multiple HP treatments, the recovery rate of ChE in AOPP patients has no significant difference.