the GGT level.Increased GGT and TG may be risk factors for diabetes mellitus.

Objective To observe the effects of intensive insulin therapy on C-reactive protein (CRP) ,interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α ) in the patients of critical illness complicated with hyperglycemia and its incidence of side effect. Methods Two hundred and nine patients of critical illness complicated with hyperglycemia were randomly divided into intensive insulin therapy group (106 patients,blood glucose maintained at a level of 4.4-6.1 mmol/L) and conventional insulin therapy group ( 103 patients, blood glucose maintained at a level of 9.0-11.1 mmol/L). Serum levels of CRP,TNF- α and IL-6 were determined on 0,24,48,72 h respectively after ICU admission. Results The levels of blood glucose of both groups reached the target level. The incidence rates of the hypoglycemia had no significant difference between two groups [6.60 % (7/106) vs. 4.76% ( 3/63 ),P > 0.05]. After 72 h treatment, serum level of CRP in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 24,48 and 72 h treatment, serum level of IL-6 in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 48 and 72 h treatment, serum level of TNF-αin intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05). Conclusion Intensive insulin therapy can significantly decrease the levels of non-specific inflammatory factors in patients of critical illness complicated with hyperglycemia, which brings beneficial effect to the patients.

Objective this research mainly analysis in the treatment of patients with ischemic cerebrovascular disease by comparison of clinical therapeutic effect of endovascular treatment and simple drug treatment. Methods 60 cases of patients with ischemic cerebrovascular disease admitted in our hospital from January 2016 to January 2017, and were randomly divided into control group and observation group, 30 cases in each group. The control group were treated by endovascular treatment, the observation group were treated with simple drug treatment, the two groups of patients treated for 6 months, 12 months to improve blood flow, the incidence of cerebrovascular events, mortality, prognosis Quality of life scores as a comparison basis.Results The patients in the observation group were treated for 6 months, 12 months after the blood flow improved superior to the patients in the control group (P<0.05); the patients in the observation group were treated for 6 months, 12 months of cerebrovascular disease incidence rate lower than that of the control group (P<0.05); the observation group after 6 months treatment and mortality of patients in the control group had no significant difference; the patients in the observation group after 12 months of treatment the mortality rate lower than that of the control group (P<0.05). The patients in the observation group survival quality scores were excellent in the control group (P<0.05). Conclusion The study proves that, in the treatment of patients with ischemic cerebrovascular disease in the treatment can effectively improve the treatment effect of endovascular intervention, improve the blood flow status of patients, reduce the events in patients with cerebrovascular disease incidence and mortality.

Objective To investigate and analyze the effect of pantoprazole and omeprazole in the treatment of gastric ulcer.Methods a total of 100 patients with gastric ulcer treated in Shizuishan First People's Hospital from January 2014 to June 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group.The control group was treated with omeprazole, and the experimental group was treated with pantoprazole.After taking one course of treatment, the clinical efficacy, treatment cost, eradication rate of Helicobacter pylori and recurrence rate of gastric ulcer were compared between the 2 groups.Results The total effective rate of the experimental group was 94%, which was significantly higher than that of the control group(72%), and the difference was statistically significant(P<0.05).After the corresponding treatment, the experimental group of 50 cases, Helicobacter pylori eradication rate was 72%, the recurrence rate of gastric ulcer was 12%.In the control group of 50 cases, the eradication rate of Helicobacter pylori was 52%, and the recurrence rate of gastric ulcer was 36%.As a result, the eradication rate of H.pylori in the experimental group was significantly higher than that in the control group.The cost of treatment in the control group was(499.78±74.81)yuan, and the treatment cost of the experimental group was(413.26±56.39)yuan.The treatment cost and gastric ulcer recurrence rate in the control group were significantly higher than those in the experimental group, with statistical difference(P<0.05).Conclusion Pantoprazole in the treatment of gastric ulcer is much better than omeprazole, high treatment efficiency, is the preferred drug for the treatment of gastric ulcer, after the treatment of gastric ulcer recurrence rate is low, the cost of treatment is low and high eradication rate, with the further promotion and application in clinic significance.

Objective To investigate the expression of COX-2 in multiple myeloma(MM)and the relationship between myeloma cells proliferation and apoptosis.To provide a new prognosis factor and therapeutic target.Methods COX-2 from the 22 newly diagnosed MM,14 relapsed MM and PCNA,HSP70 of the newly diagnosed patients were detected by immunohistochemistry method.Results All the newly diagnosed MM exhibited positive COX-2 immunoreactivity.50% had strong COX-2 and 50% showed weak COX-2.Relapsed MM exhibited strong COX-2.COX-2 was related with serum β2 microglobulin,marrow plasma cells,hemoglobin,PCNA,HSP70(P=0.019,0.003,0.048,0.006,0.034).Conclusion COX-2 was overexpressed in MM.Prognosis of patients with strong COX-2 is poorer than those with weak COX-2.COX-2 may promote the proliferation and inhibit the apoptosis of myeloma cells.

Objective To investigate the effects of Ruangan granule on transforming growth factor-β1(TGF-β1)/Smads signaling pathway in liver fibrosis in rats. Methods A total of 105 Wistar rats were randomly divided into normal control group, model group and colchicine, Dahuang-Zhechong pill group, high-, medium- and low-dose Ruangan granule groups (n=15 in each group). Liver fibrosis was induced by carbon tetrachloride and a high-cholesterol diet. After modeling, the low-, medium- and high-dose Ruangan granule groups were intragastric administrated Ruangan granule mixed suspension 3.6, 7.2, 14.4 g/(kg?d), respectively;Dahuang-Zhechong pill group was administrated with Dahuang-Zhechong pellets mixed suspension of 0.18 g/(kg?d);the colchicine group was intragastric administrated with colchicine mixed suspension of 0.108 mg/(kg?d);and the normal control group and the model group were intragastric administrated with the equal volume of distilled water. All rats were intragastric administrated for 8 weeks. The expressions of TGF-β1, Smad3 and Smad7 proteins in the liver tissue were detected with immunohistochemical staining method. The expressions of TGF-β1, Smad3, Smad7 mRNAs in the liver tussue were detected by RT-PCR. Results The expressions of TGF-β1 (2.59 ± 0.99 vs. 0.43 ± 0.21) and Smad3 (2.56 ± 0.67 vs. 0.41 ± 0.18) proteins and TGF-β1 mRNA (2.25 ± 0.21 vs. 0.71 ± 0.09) and Smad3 (2.34 ± 0.03 vs. 0.78 ± 0.12) mRNAs in the model group were significantly increased than those in the normal control group (all P<0.01). Compared with the model group, the expressions of TGF-β1 (1.12 ± 0.27 vs. 2.59 ± 0.99) and Smad3 (1.05 ± 0.34 vs. 2.56 ± 0.67) proteins in the high-dose Ruangan granule group decreased significantly, the expression of Smad7 increased significantly (2.33 ± 0.62 vs. 0.36 ± 0.18), and the expressions of TGF-β1 (1.09 ± 0.11 vs. 2.25 ± 0.21) and Smad3 (1.10 ± 0.02 vs. 2.34 ± 0.03) mRNAs decreased significantly, the expression of smad7 mRNA (1.18 ± 0.13 vs. 0.38 ± 0.11) increased significantly (P<0.05). Conclusions Ruangan granule can regulate the TGF-β1/Smads signaling pathway via down-regulation of TGF-β1, Smad3 and up-regulation of Smad7 in liver fibrosis in rats.

Objective To observe theRuangan granule on liver fibrosis in rats liver pathology change, the influence of hepatic function and hepatic fibrosis indexes, and to discusses the mechanism of its action to provide the basis for clinical prevention and treatment of liver fibrosis.Methods A total of 105 Wistar rats were randomly divided into a normal control group, a model group and a colchicines group, and Dahuang-Zhechong pill group, high-, medium- and low-doseRuangan granule groups (n=15 in each group). Liver fibrosis was induced by carbon tetrachloride and a high-cholesterol diet. After modeling, the low-, medium- and high-doseRuangan granule groups were intragastric administratedRuangan granule mixed suspension 3.6, 7.2, 14.4 g/(kg?d), respectively;Dahuang-Zhechong pill group was administrated with Dahuang-Zhechong pellets mixed suspension of 0.18 g/(kg?d); the colchicine group was intragastric administrated with colchicine mixed suspension of 0.108 mg/(kg?d); and the normal control group and the model group were intragastric administrated with the equal volume of distilled water. All rats were intragastric administrated for 8 weeks. HE staining and Masson trichromatic collagen staining were used to observe the pathological changes of liver While the change of AST, ALT, PH, TP and serum HA, LN, C-Ⅳ, PCⅢin blood serum were detected. Results Masson trichromatic collagen staining showed that, the percentage of liver collagen fiber area in rats of theRuangan granule high-dose group was significantly decreased (7.06 ± 1.18) % compared with model group (23.49 ± 1.34) %, colchicine group (11.35 ± 1.83) %, rhubarb worm pill group (15.27 ± 1.22) %,Ruangan granule medium-dose group (14.52 ± 1.75) %, and low dose group (16.08 ± 1.56) % (P<0.05 orP<0.01). Compared with model group,Ruangan granule high-dose group rats serum AST (75.86 ± 5.23 U/Lvs. 157.62 ± 24.04) U/L, the ALT (80.15 ± 5.94 U/Lvs. 160.58 ± 26.47) U/L, PH (52.58 ± 4.98μg/Lvs. 98.66 ± 6.75)μg/L significantly reduced, TP (74.19 ± 3.56 g/Lvs. 51.73 ± 5.92)g/L increased significantly (P<0.01).Ruangan granule high-dose group rats serum HA (277.22 ± 106.34 ng/mlvs. 553.19 ± 172.38 ng/ml), LN (89.82 ± 5.68 ng/mlvs. 134.25 ± 10.64 ng/ml), C-Ⅳ (47.94 ± 8.65 ng/mlvs. 84.18 ± 13.83 ng/ml), PCⅢ (16.53 ± 4.88 ng/mlvs.31.57 ± 5.35 ng/ml) decreased significantly in the model group (P<0.01).ConclusionRuangan granule has obvious effects for resisting liver fibrosis.

OBJECTIVE: To investigate the value of each single and combined applications of ultrasound thyroid imaging reporting and data system (TI-RADS), ultrasonic shear wave elastography in the diagnosis of thyroid microcarcinoma (TMC). METHOD: 323 patients with thyroid tiny nodules confirmed by surgery and pathology were analyzed prospectively. Then their TI-RADS and shear wave elastography features were summarized. SWE elasticity indices (mean, minimum and maximum value of interest) of nodules were measured. The surgical pathology results were regarded as the gold standard to calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS, shear wave elastography and their combination in the diagnosis of TMC. The receiver operating characteristic (ROC) curve of TI-RADS, shear wave elastography and combined application of both were drawn. The area under the ROC curve were calculated. Furthermore, the value of combined application of both examinations in the diagnosis of thyroid microcarcinoma (TMC) was investigated. RESULT: From 323 nodules,253 were thyroid carcinomas and 70 were benign. Areas under the ROC curves (AUC) of SWE parameters were 0. 648,0. 629 and 0. 605. For SWE, the optimal cut-off value according to ROC curve was SWE_max = 65.50 kPa and SWE_mean = 37.50 kPa. Generally, the sensitivity, specificity, accuracy, PPV and NPV were 88.14%, 82.86%, 87.00%, 94.89% and 65.91% for TI-RADS, and 49.01%, 74.29%, 54.49%, 87.32% and 28. 73% for SWE. There were statistically significant differences in the sensitivity, accuracy, PPV and no statistically significant differences in the specificity, and NPV. The sensitivity,specificity, accuracy, PPV and NPV were 95.26%, 67.14%, 89.16%, 91.29% and 79.66% for combined application of both. The area under the ROC curve of TI-RADS, shear wave elastography and their combination were 0.763, 0.616, 0.804. For nodules ≤ 5 mm, the sensitivity, specificity, accuracy, PPV and NPV were 91.67%, 66.67%, 87.07%, 92.44% and 64.29%. However, for nodules 5-10 mm,the sensitivity,specificity, accuracy, PPV and NPV were 98.50%, 67.44%, 90.91%, 90.34% and 93.55%. CONCLUSION The diagnose of TMC can be further improved by combined application of ultra-sonic TI-RADS and SWE.
Carcinoma ; complications ; Elasticity Imaging Techniques ; Humans ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis

Objective To explore the diagnosis,treatment and nursing of the patients complicated with pneumocystis carinii pneumonia (PCP) after renal transplantation,and to enhance the treatment effect of the disease.Methods The treatment and nursing processes of 37 patients complicated with PCP after renal transplantation in department of organ transplantation were retrospectively analyzed in the First Affiliated Hospital of China Medical University from May 1992 to July 2011.And the key points during nursing work were summarized.Results Of the total 37 patients,10 patients occurred respiratory failure,they were all treated by noninvasive ventilation,among which 6 patients were converted to tracheal intubation or tracheotomy mechanical ventilation.5 patients appeared rising serum creatinine(Scr) during treatment,but recovered to normal level after discontinuing SMZco for 1 week.4 patients died unfortunately,and the others were cured and discharged.Conclusions The occurrence of PCP after renal transplantation is closely related to the immune state of the patients,thus the priority of treatment for PCP should be prevention.Once happened,nursing care in aid is particularly important,then nurses should encourage patients to cooperate with treatment,relieve symptoms after infection,and promote recovery as well.

Purpose To explore the ultrasonic characteristics of idiopathic retroperitoneal fibrosis (IRPF) and assess the diagnostic value of ultrasound. Materials and Methods Ultrasonic images of 11 cases of IRPF were retrospectively analyzed.Results The hypoechogenic masses encasing the abdominal aorta were detected in all cases, among which the encasement of inferior vena cava was found in 4 cases, the involvement of iliac artery in 3 cases and hydronephrosis in 9 cases.Conclusion IRPF demonstrated ultrasonic characteristics that would facilitate its detection and diagnosis.