Objective To investigate the differential expression of monocyte ehemoattraetant protein-1 (MCP-1) in renal biopsy tissues of patients with IgA nephropathy, and to analyse the association between these 2 markers and their effect on various pathologic types of IgA nephropathy. Methods According to pathologic type, 88 renal biopsy tissues of patients with IgA nephropathy were divided into 4 groups: a minimal change group, a mesangial proliferative glomerulonephritis group, a focal sclerosing glomerulonephritis group, and a diffused sclerosing glomerulonephritis group. Immunohistochemical staining was used to detect the in situ expression of MCP-1 and CD68 on renal biopsy tissues. The expression levels were semi-quantified by image analysis and clinical data were collected from the patients. Results The differences in glomerular MCP-1 expressions were not statistically significant among all groups, while the tubulointerstitial MCP-1 expressions were statistically different among the 4 groups, with the average scores of 1.43 ± 0. 60, 5.98 ±0.92, 10. 60 ± 0.76 and 11.65 ±0.39 for minimal change group, mesangial proliferative glomerulonephritis group, focal sclerotic glomerulonephritis, and diffused sclerotic glomerulonephritis group, respectively. The tubular and interstitial CD68 scores were 0. 75 ± 0. 71, 5. 87 ± 0. 96, 10. 42 ± 0. 61, and 11.40 ±0.49 for the 4 groups, with significant differences in both MCP-1 and CD68 among the 4 groups. Correlation analysis indicated a positive correlation between tubulointerstitial MCP-1 and CD68 (r = 0. 688, P ＜ 0. 01) . MCP-1 in tubulointerstitial was significantly correlated with 24 h urinary protein excretion (r=0.531, P＜0.01). Conclusion MCP-1 plays a critical role in mac-rophage infiltration in the kidney. MCP-1 is associated with the severity of tubulointerstitial damage and clinical prognosis.

OBJECTIVE:To evaluate the efficacy and safety of Qianlie shutong capsule combined with Quinolone antibiotics in the treatment of chronic prostatitis, and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,VIP Database and Wanfang Database,randomized clinical trials(RCT)about the efficacy and safety of Qianlie shutong capsule combined with Quinolone antibiotics(test group)versus only Quinolone antibiot-ics(control group)in the treatment of chronic prostatitis were collected,Meta-analysis was performed by using Rev Man 5.3 soft-ware after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 16 RCTs were enrolled,involving 2 368 pa-tients. Results of Meta-analysis showed the total effective rate [RR=1.56,95% CI(1.29,1.88),P<0.001],US National Institutes of Health Chronic Prostatitis Symptom Index scores(NIH-CPSI scores)[MD=-6.97,95% CI(-8.67,-5.26),P<0.001],pain symptom scores[MD=-3.18,95%CI(-3.92,-2.44),P<0.001)],voiding dysfunction scores [MD=-1.62,95%CI(-1.85,-1.38), P<0.001],life quality scores[MD=-2.16,95% CI(-2.89,-1.43),P<0.001],EPS leukocyte count [MD=-8.90,95% CI (-11.79,-6.02),P<0.001] and recurrence rate[RR=0.22,95%CI(0.12,0.42),P<0.001] in test group were significantly better than control group,there were statistically significant differences between 2 groups;and there was no significant difference in the incidence of adverse reactions between 2 groups [RR=0.49,95%CI(0.11,2.13),P=0.34]. CONCLUSIONS:The efficacy of Qian-lie shutong capsule combined with Quinolone antibiotics is better than only Qianlie shutong capsule or Quinolone antibiotics in the treatment of chronic prostatitis,with similar safety.

Objective To assess the efficacy of early detection of breast cancer and the prognostic value of breast self-examination(BSE).Methods Randomized controlled trials(RCTs)involving BSE were included the present meta-analysis based on their qualities.The pooled analysis was performed with RevMany 4.2.8.Results Three RCTs were identified and then they were included the present metaanalysis.In women who conducted a BSE.the rate of biopsy fora lump in breast was 1.27%in the first 5 years,2.47%in more than 5 years but less than or equal to 10 years,and 2.50%in more than 10 years, respectively,all of which were significantly higher than in those who could not conduct a BSE(P<0.05) There was no significant difierence in the rate of final diagnosis and the mortality for breast cancer between the two populations in any follow-up time(P>0.05).Conclusion The rate of biopsy for a lump in breast in women could be increased by a BSE.which should not have been discarded from the early detection of breast cancer completely despite it is not helpful in increasing the rate of final diagnosis and decreasing the mortality for breast cancer.

Objective To report a new approach of splenic hilar lymph nodes dissection in radical gastrectomy for gastric cancer. Methods 193 cases of gastric cancer patient receiving radical resection of gastric cancer between May 2008 and October 2008 were studied. The tail and body of spleen and pancreas were thoroughly freed with retroperitoneal way retrogressively and extruded out of abdominal cavity in 80 cases. The other 113 cases received operation with routine way. Results In 80 cases who received operation with retroperitoneal approach retrogressively, the total splenic hilar lymph nodes were 519, the positive ones were 65, the positive rate was 12.5 %; In the other 113 cases the total splenic hilar lymph nodes were 565, the positive ones were 58, the positive rate was 10.3 %. The positive rate had statistic significance between these two groups. Conclusion Extruded splenic hilar lymph nodes dissection with retroperitoneal approach retrogressively is safe and has the same effect with splenectomy in gastric cancer operation.

Objective:To investigate the expression level and clinical value of serum miR-148a-3p and miR-551b-5p in patients with acute pancreatitis (AP).Methods:The clinical data of 152 patients with AP admitted to Danzhou people's Hospital from January 2017 to September 2020 were selected. According to the severity of their illness, they were divided into MAP group ( n=70), MSAP group ( n=40), and SAP group ( n=42). The SAP group was divided into survival group ( n=25) and death group ( n=17) according to the prognosis of the patients. Another 50 healthy people were selected as the control group. Fastening venous blood was collected on the day of onset, and the expression levels of serum miR-148a-3p and miR-551b-5p in each group were detected by real-time quantitative PCR. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated. The expression levels of serum miR-148a-3p and miR-551b-5p were analyzed to evaluate the prognosis of SAP. The correlation between serum miR-148a-3p and miR-551b-5p expression levels in SAP patients was analyzed by Pearson method. Results:The expression levels of serum miR-148a-3p (3.18±1.27 vs 0.96±0.28) and miR-551b-5p (1.94±0.85 vs 0.51±0.12) in AP group were significantly higher than those in control group ( P<0.001). The expression levels of serum miR-148a-3p (4.36±1.70 vs 2.84±1.10, 2.50±0.92) and miR-551b-5p (2.80±1.04 vs 1.68±0.53, 1.42±0.45) in SAP group were significantly higher than those in MSAP group and MAP group ( P<0.001). The expression levels of serum miR-148a-3p (5.30±1.95 vs 3.47±1.40) and miR-551b-5p (3.62±1.37 vs 2.08±0.91) in death group were significantly higher than those in survival group ( P<0.001). ROC curve analysis showed that the AUC of the combination of miR-148a-3p and miR-551b-5 in judging the prognosis of SAP was significantly higher than that of the single index of miR-148a-3p and miR-551b-5[0.943(95% CI0.886-0.997) vs 0.860(95% CI0.797-0.924), 0.822(95% CI0.795-0.880)], with a sensitivity of 98.3% and specificity of 84.6%. Correlation analysis showed that there were positive correlation between the expression level of serum miR-148a-3p and miR-551b-5p in SAP patients ( r=0.835, P<0.001). Conclusions:The expression levels of miR-148a-3p and miR-551b-5p in serum of AP patients were significantly increased, and the combined detection of miR-148a-3p and miR-551b-5p had a good value in judging the prognosis of SAP.

Objective: To study the effect of bifidobacterium-supplemented enteral nutrition in early postoperative patients with gastric cancer. Methods: 60 patients with gastric cancer were divided into two groups: bifidobacterium-supplemented enteral nutrition(BSEN-group, 30 cases), popular enteral nutrition group(EN-group,30 cases). The patients were infused with Nutrison Fibre or bifidobacterium-supplemented Nutrison Fibre for 7 postoperative days. Results: Bifidobacterium-supplemented enteral nutrient was well tolerated. The incidence of infections was significantly lower (P = 0.01) in BSEN-group than in EN-group. Conclusion: Early postoperative enteral nutrition plus bifidobacterium can reduce the rate of postoperative infections in comparison with popular enteral nutrition.

Objective To explore the diagnosis and treatment of altitude sickness combined with urinary retention. Methods 30 cases of altitude sickness combined with urinary retention were treated from April 16th to 26th,2010.They were all male,The average age of them was 24 years (range,19 -38).All were the first time entering the high altitude area (3600 -5000 m) from low altitude area (600 - 1800 m ).The urinary frequency of 25 patients reduced from 8 to 10 times/d to 2 to 4 times/d,the urine output reduced from the 1500- 2400 ml/d to 600- 800 ml/d; the other 5 patients had no urine in 12 -18 h,even had no sense to urinate.26 patients also combined with altitude pulmonary edema and 4 combined with altitude cerebral edema.30 patients had double renal columns enlarged,21 cases had urinary protein ( + ～ ++ ). Results 30 patients were exported urine 300 -600 ml within 10 min,leaded to urine 1800 -2300ml in 12 h,returned to normal voiding after catheter removal in 18 -24 h. After comprehensive treatment such as oxygen,dehydration,diuretic,sedative,antispasmodic and anti-infection,22 cases who with chest tightness,shortness of breath,dyspnea,hemoptysis foam sputum,headache,vomiting and other symptoms of jet-like improved apparently after hospital admission within 1 hour.Their heart rate downed from 90 - 145beats/min to 68 -92 beats/min,respiration from 28 -45 times/min to 18 - 28 times/min,oxygen saturation from 48％ - 84％ to 92％ - 100％ ; 8 cases who with shortness of breath,palpitation and headache improved not obviously.After the antihypertensive treatment,their blood pressure was still high (systolic blood pressure 150 - 180 mm Hg,diastolic blood pressure 90 -110 mm Hg),oxygen saturation between 78％ to 87％,so they were carried to rear area for further treatment.30 cases were all cured no death. Conclusions The high altitude urinary retention is reversible disease,which is often associated with high altitude pulmonary edema,altitude cerebral edema,acute subclinical renal dysfunction and gastrointestinal disorders.They are easily being induced by elements such as gastroenteritis,lung infection,tonsillitis,periodontitis,tiredness and so on; low atmospheric pressure,hypoxia and high altitude is the possible cause; the ratio of missed diagnosis is high; the treatment of oxygen and indwelling catheterization is better; The best method of prevention is to wear pressurized suits and adapt the environment in a ladder-step gradual way.

Objective To investigate application of modified abdominal closure technique by an all layer in ventro-pelvic part operation and evaluate its value and significance. Methods 3200 cases with ventre-pelvic part operation between May 2002 and Aug 2007, were subjected to single layer closure with non absorbable suture material. The clinic data and some results of follow-up were retrospectively analyzed. Results Operative incisions of 1780 (55.6%) cases were in epigastric zone and their rate of primary healing was 98.5%, others (44.3%) in hypogastric zone (including pelvic cavity) and rate of primary healing was 98.2% (P>0.05). Rate of primary healing in older age-group was 97.9% and control group 98.8%, and primary healing of group diabetes 97.4%, control group 98.2% (P > 0.05). Average time of abdmenal closure was only 11±4 min. Primary complications included dehiscence of wound (0.5%), infection (1.4%) and incisional hernia (0.2%). Follow-up (66%) was performed at 30 days, 3 and 6 months, and at 1, 2 and 3 years. Conclusion It is concluded that closure of an abdominal incision can be effected by a multifilament interrupted absorbable sutures without an increased risk of wound dehiscence or incisional hernia, meanwhile economic and fast. It is the optimal method of abdominal closure and can be generalized.

Objective:To determine children ’ s health status and influential factors in Nujiang prefecture , Yun-nan.Methods:Rickets morbidity rate , growth retardation rate , and low-weight rate were selected as the key indica-tors to calculate the sample size by using four-stage-sampling procedure .The data was collected through questionnaire survey, in-depth interviews, and focus-group discussions .χ2 test and qualitative analysis were used to analyze the quantitative and qualitative data .Results:The infant mortality rate was 13.14 %in 2011, which was 1.1 and 1.15 times more than the national and provincial average .The mortality rate of children under five was 16.35%in 2011, which was 1.05 and 1.13 times more than the national and provincial average .It was also 2.19 times more than the average in developed countries .The prevalence of medium and severe malnutrition in children under five was 2 .32%, which was 1 .54 times more than the national average .The incidence of low birth weight was 1 .41%.The research shows that the rates of rickets , growth retardation , and low-weight were 36.13%, 25.81%and 20.98%,and nutritional diseases are more serious .Conclusion:There are serious health problems for children in Nujiang pre-fecture, especially nutritional diseases .Influential factors include health policy and system , economic development, customs, geography, health service capacity , and parental health knowledge Suggestion:The government should im-prove top-level design , strengthen policy support , and develop the local economy in order to solve the social and poli-cy environment factors .Institutions and human capacity should be strengthened , access and quality of services should be improved , health education should be popularized , and health awareness and behaviors should be improved .

In this paper , we summarize the theoretical models and research progress about program evaluation and practical situation of children ’ s health in Nujiang prefecture .We then develop a framework for comprehensively evaluating the intervention for children ’ s health based on program theory .This framework comprises the outside pro-gram environment , intervention action modules and change modules , and assessment techniques environment .The e-valuation mainly includes leading agencies , implementing agencies , coordinating agencies , coordination/implementa-tion personnel , intervention and service standards , the environment and atmosphere , target populations , interven-tions, determinants, outcome and effect .