Objective To investigate efficacy in Alpmstadil and Shenkang on regulating renal function and lipids in patients with chronic renal failure (CRF).Methods Ninety-eight cases of CRF patients were collected for the study,and 1:1 randomized,double-blind experiment grouping principles were used in the current study.All cases were divided into study group and the control group (49 cases of each group).The two group were given the high quality low protein,low fat low salt diet,inftion control,diuretic swelling,correct acidosis,buck,correction of electrolyte imbalance and other conventional treatment.The patients in study group on the basis of conventional therapy were given 20 g Alprostadil injection + 100 ml saline,intravenous infusion of 1times/d,and 100 ml Shenkang injection +300 ml 5％ glucose the solution,intravenous infusion of 1 times/d.While patients of control grrup on the basis of conventional therapy plus 200 mg Ligustrazine + 250 ml 5％Glucose Injection,intravenous infusion of 1times/d.Two groups were treated for 14 d.Before and after treatment,renal function,lipid metabolism,adverse drug reactions were observed and determined.Results There was no significant difference in term of renal function between two groups before treatment(P ＞ 0.05).After treatment,the levels of serum creatinine,blood urea nitrogen,24 h-Urine protein and creatinine clearance(Ccr) in study group were (313.7 ±66.2) mmol/L,(15.3 ±2.9) mmol/L,(1.24 ±0.45) g/24 h and (35.7 ±5.4) mmol/L respectively,significant different from those in control group ((358.4 ± 53.9) mmol/L,(18.4 ± 3.0) mmol/L,(1.57 ±0.39) g/24 h and (28.4 ±4.3) mmol/L;t =3.754,7.864,5.873,4.312,P ＜0.05).There was no significant difference in term of blood fat between two groups before treatment (P ＞ 0.05).In study group,the levels of glycerin trilaurate,cholesterol total,high density hpoprotein cholesterol,low density lipoprotein cholesterol were significantly different than those in the control group ((2.12 ± 1.26) mmol/L vs.(2.32 ± 1.34) mmol/L,(4.91 ± 1.43) mmol/vs.(5.35 ± 1.31) mmol/L,(1.39 ± 0.43) mmol/L vs.(1.23±0.37) mmol/L,(2.39 ± 0.68) mmol/L vs.(2.73 ± 0.88) mmol/L; t =3.876,4.661,5.387,8.543 ; P ＜ 0.05) after treatment.There were no adverse drug reactions in both groups.Conclusion Combined usage of alprostadil and shenkang injection could significantly improve the patient's renal function,lipid metabolism disorders and shows no significant adverse reactions,suggesting that it is worthy of clinical application and promotion.

Objective To reduce the misdiagnosis of the inpatients admitted to digest department with abdominal pain through analyzing the consultation undertaken by surgeon.Method The causes and the constituent ratio according to the case records of those inpatients admitted to digest department because of abdominal pain were analyzed.Results The obstruction of hollow viscus was the first cauge(51.07%),and the tumor of digestive tract(17.78%)was the second cause for invitation for consultation to surgeon of the inpatients with abdominal pain in digest department wards.The ultrasound 32.78%,CT 26.67% and gastroenterological endoscope 13.89% were definite diagnosis,and should shorten the time of consultation.Conclusion Whether inpatient or outpatient with abdominal pain should be planned to be examined by ultrasound,CT or gastroenterological endoscope,obgerve the changes of the symptom and sign so that the misdiagnosis can be avoided.

Objective To understand the phenotype and enzyme genotype of pan‐drug resistant carbapenemase‐producing Acine‐tobacter baumannii to provide the evidence for clinical rational use of antibiotics and monitoring hospital infection .Methods A total of 117 clinically isolated strains of Acinetobacter baumannii were collected and performed the routine microbiological detection . Multi‐drug resistant Acinetobacter baumannii was screened by K‐B disk diffusion method .The phenotype of carbapenemase‐produ‐cing strains was detected by using the Carba NP colorimetry and modified Hodge test .The drug resistant genotype of multi‐drug re‐sistant Acinetobacter baumannii was verified by PCR .Results Among clinically isolated 117 strains of Acinetobacter baumannii ,64 strains were multi‐drug resistant Acinetobacter baumannii ,in which 33 strains were carbapenemase positive .OXA‐23 drug‐resistant genotype of carbapenemase was detected by PCR ,while IMP ,VIM and NDM‐1 drug resistant genes were not detected .Conclusion The CarbaNP method can rapidly detect carbapenemase‐producing strains with the advantages of strong sensitivity and simple oper‐ation ,which conduces to improve the detection rate of carbapenemase‐producing strains and monitor the nosocomial infection .

Objective:To investigate the feasibility of treating chronic HBV infection by inducing spe cific humoral immune response to HBV middle envelope protiens in normal and HBV transgenic mice with HBV DNA based immunization. Methods: The eukaryotic expression vector pCMV S2.S (PS) containing HBV S2.S gene and pc DNA3.0 were used respectively to immunize 5 C57BL/6 normal mice and HBV transgen ic mice. Each mouse was injected intramuscularly with one of those plasmids at t he same dose (100 ?g). Sera of mice were detected for anti HBs, anti preS2, HBsAg and HBeAg with ELISA. Pathological changes of transgenic mice liver were o bserved by microscopy. Results:PS can stimulate immune respons es of anti HBs and anti preS2 in normal and transgenic mice.The appearance of a nti preS2 was 1 2 weeks earlier than that of anti HBs. HBsAg and HBeAg in se ra turned negative 8 weeks after immunization. At the 8th week, hepatocytes show ed extensive granular degeneration and hydropic degeneration. There was no obvious difference in the amount of mononuclear lymphocytes between pre and post gen e immunization. Conclusion: It is showed that specific humoral immune response can be effectively induced by PS after DNA based immunization, and PS seems to be responsible for the disapearance of HBsAg and HBeAg in sera o f HBV transgenic mice. The results provide an evidence for furth er investigation of genetic vaccine in the treatment of chronic HBV infection.

Objective To evaluate the effect of Tandospirone citrate in the treatment of Alzheimer's disease with depression and anxiety disorder. Methods A total of 122 patients with Alzheimer's disease with depression and anxiety were enrolled at the Second Hospital of Jinhua City from January 2015 to December 2016.They were randomly divided into the Lorazepam group(n=61) and the Tandospirone citrate(ADHA)(n= 61).The behavioral pathology in Alzheimer's disease (BEHAVE-AD),self-care ability scale(ADL),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were evaluated in the two groups after three weeks of treatment.The BEHAVE-AD,ADL,HAMA,and HAMD scores and the incidence of adverse reactions were compared between the two groups before and after treatment. Results Baseline scores of BEHAVE-AD, ADL,HAMA and HAMD were not significantly different between the two groups(all P> 0.05). However,post-treatment scores of BEHAVE-AD,ADL,HAMA and HAMD were significantly lower than pre-treatment scores(all P< 0.05),and were more significantly decreased in the Tandospirone citrate group(all P<0.05).Furthermore,the incidence of adverse reactions was significantly lower in the Tandospirone citrate group than that in the Lorazepam group(6.5% vs.19.7%,P< 0.05). Conclusions Compared with Lorazepam,Tandospirone citrate is clinically more effective for Alzheimer's disease complicated with anxiety and depressive disorder.

Objective To investigate the mid-term efficacy and complications of bone cement or biotype hemiarthroplasty for the femoral neck fracture in the elderly patients.Methods From January 2011 to January 2014,sixty-seven elderly patients (67 hips) with femoral neck fracture were treated with hemiarthroplasty.All patients were treated with bipolar femoral head prosthesis,and the prosthesis included into bone cement and biologic type,according to the fixation of the femoral stem.The 3 year postoperative Harris score and surgeryrelated complications (joint dislocation,prosthesis loosening,acetabular subsidence,and mortality) were evaluated.Results All patients were followed up for 3 years.The excellent and good rate of Harris score was 87.1％ (27/31) in the bone cement group and 80.6％ (25/31) in the cementless group (X2 =0.47,P＞0.05).There was no significant difference in the complications between the two groups (P＞0.05).Conclusion The hemiarthroplasty is an effective and safe methodfor the treatment of femoral neck fracture in the elderly.The key to achieve excellent results is to choose the femoral prosthesis based on the preoperative planning and operation.

Objective: To observe the clinical effects and safety of orthokeratology(OK) lens in the treatment of mild and moderate myopia, and to evaluate the effects on the myopia control. Methods: The study included a total of 166 eyes in 83 myopia children who were treated in Jiaxing Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University from January 2014 to December 2014.They were randomly divided into two groups according to the digital table, 43 cases(86 eyes) in the observation group underwent standard OK lens, and the other 40 cases(80 eyes) in the control group were given common spectacles.The patients were followed up for two years.The uncorrected visual acuity, corneal curvature and ocular surface in the, observation group were examined, and diopter, axial length were examined in the two groups. Results: The visual acuity of the observation group improved significantly at 1 day, trended to be stable at 1 week, and then was basically stable within 1 year, but decreased at 2 years.After 3 months, the mean corneal curvature[(41.93±1.12)D]was significantly lower than before orthokeratology[(43.56±1.44)D], and the difference was statistically significant(t=11.539, P<0.05). However, the effect didn’t persist without continued OK lens wear 1 month later.Compared with the control group, the growth of the diopter and axial length in the observation group were significantly slower(t=16.784, P<0.05; t=5.623, P<0.05). At the initial wearing, 34% of the observation group occurred corneal epithelial injury, but they all recovered by stop wearing and appropriate medication.With the prolong of wear time, the proportion of injury reduced. Conclusion Uncorrected visual acuity of mild and moderate myopia children wearing OK lens can significantly improve at 1 day, then is basically stable after 1 year, but declines within 2 years, which indicates the need for timely replacement of the lens.Long-term wearing is effective and safe to control the development of myopia.

OBJECTIVETo investigate the effect of utilizing octreotide during perioperative period on pancreatic fistula after pancreaticoduodenectomy (PD).

METHODSThree hundreds and six patients admitted from January 2010 to October 2014, who prepared to undergo pancreaticoduodenectomy (PD) were randomly divided into octreotide group (147 cases) and control group (159 cases). In octreotide group, octreotide was used in subcutaneous injection instantly after PD, each 8 hours until postoperative 10(th) day, and patients in control group were injected with the same volume of saline. Differences of pancreatic fistula (Grade A, Grade B, Grade C), hospitalization days and treatment cost were compared. χ(2) test, t-test and Fisher exact test were used to analyzed to the data, respectively.

RESULTSNo statistical significance (P>0.05) between two groups in the incidence of pancreatic fistula after PD (Grade A: 8.8% vs. 10.2%, Grade B: 2.7% vs. 4.4%, Grade C: 0.7% vs. 1.3%; χ(2)=0.197, 0.700, 0.288; P=0.657, 0.403, 0.591), the length of hospitalization((12.1±1.2)days vs. (13.0±1.2)days)(t=1.711, P=0.104) and treatment cost (79 700±6 700 vs. 77 600±5 200)(t=1.378, P=0.185). When accompanied with high risk factors, such as soft texture of pancreas, pancreatic duct size less than 3 mm, BMI≥25 kg/m(2) and diabetes, compared with control group, octreotide group had the lower incidence rate of pancreatic fistula and clinical correlative pancreatic fistula(all P<0.05) after PD.

CONCLUSIONSGenerally, octreotide makes no contribution to reduce the incidence of pancreatic fistula after PD. However, for patients who is accompanied with high risk factors, such as soft texture of pancreas, pancreatic duct size less than 3 mm, BMI≥25 kg/m(2) and diabetes, octreotide can effectively prevent pancreatic fistula after PD.

Anastomosis, Surgical ; Humans ; Incidence ; Octreotide ; therapeutic use ; Pancreas ; pathology ; Pancreatectomy ; Pancreatic Ducts ; pathology ; Pancreatic Fistula ; drug therapy ; Pancreaticoduodenectomy ; adverse effects ; Perioperative Period ; Prospective Studies

Objectives: To evaluate the tumor-infiltrating PD-1 positive lymphocytes and regulatory T cells (Treg) as prognosis predic-tors of metastatic renal cell carcinoma (mRCC), and investigate the expression of PD-1 and Treg cells in mRCC and elucidate their corre-lation with clinicopathological parameters and prognosis. Methods: A total of 269 mRCC patients from June 2007 to June 2017 in Zhongshan Hospital, Fudan University, were included in the study. The expression of PD-1 and Tregs in mRCC samples were detected by immunohistochemistry. The relationship between the expression of PD-1 and Tregs was analyzed. Results: PD-1 positive expression in mRCC was 31.60% (85/269) and it was positively correlated with the tumor Fuhrman grade and negatively correlated with progno-sis. Tumor infiltration of Tregs in mRCC was 36.80% (99/269), and it was also positively correlated with the tumor Fuhrman grade and negatively correlated with prognosis. Univariate analysis showed that PD-1 positive lymphocytes and high Treg infiltration numbers were negatively correlated with overall survival (OS) and progression free survival (PFS) rates. Thus, PD-1 positive lymphocytes and high Treg infiltration numbers are independent prognostic indicators of OS and PFS and when combined, they can render a better pre-diction for prognosis. Conclusions: Intra-tumoral infiltration of PD-1 positive lymphocytes and Tregs can be used as significant prognos-tic indicators of mRCC, and the combined predictive effect is better than the individual predictive effect. Therefore, evaluating the number of PD-1 positive lymphocytes or infiltrating Tregs in mRCC is helpful in clinically estimating mRCC prognosis in patients.