110 g/m2 in females.④Logistic regression analysis was conducted taking sex, age, body mass index, body surface area, blood pressure, blood fat level, plasma aldosterone concentration and aldosterone synthase as independent variables while LVEDD, LVM or LVH as dependent variables respectively. RESULTS: All 68 patients were involved in the result analysis.①Among 68 cases of essential hypertension, there were 36 cases for TT genotype, 28 cases for CT genotype and 4 cases for CC genotype. And they were divided into TT genotype group and CT+CC genotypes group.②Compared with those subjects with TT genotypes, hypertensive subjects with CT+CC genotypes had a higher LVEDD, LVM and LVM index [(50.2?3.2) mm, (48.1?3.2) mm; (220.8?34.4) g, (197.4?35.5) g; (123.4?21.5) g/m2, (107.2?15.9) g/m2; t =2.73, 2.74, 3.54, P

OBJECTIVETo observe the clinical efficacy differences between regular acupuncture combined with acupuncture at trigone of urinary bladder and simple regular acupuncture for treatment of urination dysfunction induced by spinal cord injury.

METHODSSixty patients were randomized into an observation group and a control group, 30 cases in each one. The control group was treated with regular acupuncture at Sanyinjiao (SP 6), Zusanli (ST 36), Zhongwan (CV 12) and Tianshu (ST 25), etc. Based on the treatment of control group, the observation group was additionally treated with intensive needling at trigone of urinary bladder, once a day, 30 min per treatment. Ten treatments were considered as one course, and there was an interval of two days between courses, 4 courses of treatment were given in two groups. The improvement of urination function in two groups was evaluated, and the efficacy of urination function in two groups was compared.

RESULTSAfter treatment, the times of urine leakage, maximum urine output, bladder capacity and residual urine were all improved in two groups (all P<0.05). The improvement of times of urine leakage, bladder capacity and residual urine in the observation group was superior to that in the control group (all P<0.05). The total effective rate was 96.7% (29/30) in the observation group, which was superior to 83.3% (25/30) in the control group (P<0.05).

CONCLUSIONThe efficacy of regular acupuncture combined with intensive needling at trigone of urinary bladder on urination dysfunction induced by spinal cord injury is significantly superior to that of simple regular acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; Treatment Outcome ; Urination ; Urination Disorders ; etiology ; physiopathology ; therapy ; Young Adult

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for patient with multiple pulmonary in-fection after renal transplantation. METHODS:Clinical pharmacists participated in drug therapy for a patient with multiple pulmo-nary infection after renal transplantation,and assisted physicians to formulate primary therapy plan:ganciclovir 250 mg,ivgtt,q12 h+ Cefoperazone sodium and sulbactam sodium 3 g,ivgtt,bid+ methylprednisolone 80 mg,ivgtt,qd+ Compound sulfamethoxazole tablet,2 piece,po,qd+Ciclosporin soft capsule 75 mg,po,q12 h+Sodium bicarbonate tablet 1 g,po,qd+Nifedipine controlled release tablet 30 mg,po,qd+Famotidine tablet 20 mg,po,bid. The dose of ganciclovir was adjusted twice because of complica-tion cytomegaloviral pneumonia;the dose of ganciclovir was adjusted twice because of complication pneumocystis pneumonia. Pre-vention and disposal of ADR,patient education were also conducted. RESULTS:Physicians adopted the suggestion of clinical phar-macists;the pulmonary infection had been controlled,and the patient was discharged from hospital. CONCLUSIONS:Clinical pharmacists identify the breakthrough point to promote rational drug use,indicating the value of pharmaceutical care in the clinical treatment.

Objective To study the correlation between single nucleotide polymorphism (SNP) of downstream mononucleotide in signal transduction of Toll-like receptors and predisposing genes of rheumatoid arthritis (RA).Methods One hundred and sixty-two RA patients were selected from northern part of Han people in China,and 188 healthy subjects were enrolled as normal controls.Rs7744 of Myd88,rs5030445 of TRAF6,rs11265618 and rs4845626 of IL-6R were analyzed.The data of genotypic frequency and allele genotypic frequency were statistical analyzed by x2 test between the two groups.Results The difference of allele frequency of TRAF6 rs5030445 between the two groups were remarkable (x2=5.716,P＜0.05),and so did the IL-6R rs11265618 (x2=5.704,P＜0.05).But the difference of genotypic frequency was not statistically significant for locus of Myd88 rs7744,TRAF6 rs5030445 and IL-6R rs11265618 (P＞0.05).And the differenceof allele frequency and genotypic frequency between the two groups had no statistical significance in locus of Myd88 rs7744 and IL-6R rs4845626 (P＞0.05).Conclusion There is significant correlation between single nucleotide polymorphism and predisposing genes of RA.The G allele of TRAF6 rs5030445 gene locus is a possible predisposing gene for RA.The T allele of IL-6R rs11265618 is a possible predisposing gene of RA.

Objective To evaluate the effect of continuous blood purification (CBP) on cardiorenal syndrome (CRS) type Ⅰ.Methods Clinical data of 42 patients with CRS type [at our hospital were collected from January 2012 to June 2014.We observed and compared changes in mean arterial pressure (MAP),heart rate,respiration rate,acute physiology and chronic health evaluation (APACHE) Ⅱ score,and urinary volume before and 5 days after CBP.Meanwhile,levels of serum creatinine (Scr),cysteine proteinase inhibitor Cystatin C (CysC),serum creatinine (cTn) and B-type natriuretic peptid (BNP) were monitored.In addition,dynamic changes in cardiac index (CI),intrathoracic blood volume index (ITBI),global end-diastolic volume index (GEDI),central venous pressure (CVP),and extravascular lung water index (ELVWI) were monitored using the pulse induced contour cardic output plus monitoring system (PiCCO plus),and changes in left ventricular ejection fraction (LVEF) before and 5 days after CBP was measured by color Doppler ultrasound.Results There was no significant difference in MAP in patients with CRS type Ⅰ before and 5 days after CBP (P=0.08).Tacbycardia and tachypnea improved,while urine volume increased and the APACHE Ⅱ score decreased significantly,5 days after CBP(allP＜0.05).Plasma levels of Scr,CysC,cTn and BNP after treatment were lower than those before treatment [(126.8±68.3) μmol/L vs.(413.6±126.1) μmol/L,(1.1±0.8) g/L vs.(4.1±1.1) g/L,(2.6±0.4) μg/L vs.(3.5± 0.7) μg/L,(807.6±427.7) ng/L vs.(3300.3±567.6) ng/L,all P＜0.05)].Myocardial contractility,cardiac preload and lung related parameters also significantly improved after CBP (allP ＜0.05).Conclusions CBP can alleviate clinical symptoms of CRS type Ⅰ,improve cardiac and renal function,and is promising as an important auxiliary measure for the treatment of patients with cardiorenal syndrome type Ⅰ.

Objective To investigate whether there is any consistent evidence of linkage across multiple studies,and to identify novel AS susceptibility loci by using GSMA method.Methods Genome-search Meta-analysis(GSMA)method was applied to genome scans of AS and spondyloarthropathy(SpA)to assess evidence for linkage across studies.Results Four AS genome scans including 479 families with 1151 affected individuals were used.Suggesting these BINS most likely contain AS-linked loci;BINS 6p22.3-p21.1,6pter-p22.3,17pter-p12,2p12-q22.1 and 5q34-qter.Four AS genome scans and one SpA scan including 544 families with 1,331 affected individuals were used.The GSMA produced genome-wide evidence for linkage on bin 6p22.3-p21 and 16q23.1-qter.Conclusion This GSMA added the evidence of the HLA loci as the greatest susceptibility factor to AS and shows evidences of chromosome 6,17p,2,5q and 16q as non-HLA susceptibility loci.

Objective To systematically analyze and evaluate the association between the peptidylarginine deiminaseⅣ(PADI4) gene and rheumatoid arthritis (RA) based on the published data,and to provide evidence for the pathogenesis of RA.Methods By selecting five SNPs in PADI4 (rs11203366,rs11203367,rs874881,rs2240340,rs1748033) which had been extensively examined.Meta-analysis on each SNP was performed step by step according to Hugenet manual to investigate the association of the polymorphisms of the PADI4 gene with RA.Results This Meta-analysis enrolled 15 659 RA patients and 22 019 healthy controls from 21 studies worldwide.It demonstrated that rs11203366,rs11203367,rs2240340 and rs 1748033 confered susceptibility to RA in Asian ethnicity (P＜0.01,0.03,＜0.01,＜0.01),while rsl1203366,rsl1203367 and rs874881 confered susceptibility to RA in Caucasian of European ancestry (P=0.0002,0.004,0.03).It also shown that no significant association between rs874881 and RA in the Asian ethnicity populations (P=0.2),or rs2240340,rs1748033 and RA in Caucasian of European ancestry (P=0.18,0.1 ).A linkage disequilibrium study was also performed.The LD study showed that rs11203366,rs11203367,rs874881,rs2240340 and rs1748033 were in linkage disequilibrium both in the Asian ethnicity and Caucasian,which was basically inconsistent with the results of Meta-analysis.The conflicting results should be explained by many aspects such as bias in sample selection,genotyping,and the stratification.Conclusion The PADI4 genotype is partially associated with RA,and the underling mechanisms need further study.Haplotype based research and Metaanalysis would be valuable.

Objective: To evaluate the predictive value of plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) on short term prognosis in patients with acute coronary syndrome (ACS). Methods: Plasma NT-proBNP levels were measured in ACS patients within 24 h after admission with ELISA method. The 600 ACS patients were divided into two groups: event group （n=108）and no-event group （n=492）according to occurrence of cardiovascular events（including cardiac death, cardiac shock and heart failure）, The NT-proBNP levels were compared between two groups. Single factor and multiple factor Logistic regression analyses were used to evaluate if NT-proBNP was an independent predictor for short term prognosis. Results: The plasma NT-proBNP levels of event group were significantly higher than those of no-event group [1361.2 (965.3, 2088.6) pmol/L vs.605.7 (274.5, 1177.8) pmol/L, p<0.01]. Multiple factor Logistic regression analyses demonstrated that plasma NT-proBNP was an independent predictor for short term prognosis (OR=1.000, p<0.01) in ACS patients. Conclusion: Plasma NT-proBNP was an independent predictor for short term prognosis in ACS patients.

Objective To observe the clinical effect of tongluozhitong capsule combined with carbamazepine on the treatment of trigeminal neuralgia.Methods94 patients with trigeminal neuralgia from January 2012 to May 2014 in Dongyang people's hospital were randomized double-blindly divided into the control group and the observation group, 47 cases in each group.The control group received carbamazepine treatment, and the observation group received tongluozhitong capsule combined with carbamazepine.VAS score, the effect and adverse reaction were recorded and analyzed before treatment, atwo weeks and four weeks after.Recurrence was followed-up a half and one year after treatment.Results①VAS scores in the observation group 2 weeks and 4 weeks after treatment were (3.78±0.44), (2.01±0.23) points separately, which were lower than those in the control group (5.96±0.53), (4.02±0.38) points separately, and the differences were statistically significant (P<0.05).②The total effective rate in the observation group 4 weeks after treatment was 95.74%, which significantly higher than that in the control group 78.72%, and the difference was statistically significant (P<0.05).③ The adverse reactions in the observation group 4 weeks after treatment was 21.28%, 27.66% in the control group, the difference was not significant;④ The recurrence rate in the observation group six months and one year after treatment were 6.38% and 10.64%, which significantly lower than those in the control group 23.40% and 29.79%, and the differences were statistically significant (P<0.05).ConclusionIt can effectively relieve pain, reduce the recurrence rate, and will not increase the adverse reactions which tongluozhitong capsule combined with carbamazepine were used on the treatment of trigeminal neuralgia.It is a safe and effective treatment program.

OBJECTIVETo discuss the feasibility of terminal intestinal exteriorization (exteriorization without ileostomy) in laparoscopic anterior resection for rectal cancer.

METHODSClinicopathological data of 77 patients undergoing laparoscopic anterior resection for low rectal cancer in our department from January 2011 to December 2013 were retrospectively analyzed. After laparoscopic rectal resection, 32 patients received terminal intestinal exteriorization (exteriorization group) and 45 patients received preventive ileostomy (ileostomy group). Anastomosis-related, stoma-related and intestinal stoma closure-related morbidity was compared between the two groups.

RESULTSThere were no significant differences in operative time, blood loss and overall hospital stay between the two groups (all P>0.05). The total hospital cost was (5.39±1.74)×10(4) yuan in the exteriorization group, and (6.98±1.37)×10(4) yuan in the ileostomy group(P<0.01). The incidences of postoperative anastomotic fistula was not significantly different between the two groups(P>0.05). Three patients(9.4%) developed anastomotic leak in the exteriorization group and 2(4.4%) in the ileostomy group. The anastomotic leak was managed by opening the external intestinal wall and maturating an ileostomy under local anaesthesia. All these 5 patients were cured with nutritional support, antibiotics, continuous local drainage. In the exteriorization group, 5 patients had complications related to stoma and intestinal stoma closure operation(15.6%), which was lower than(42.2%) in the ileostomy group(P=0.013).

CONCLUSIONTerminal intestinal exteriorization in laparoscopic anterior resection is a safe and feasible surgical procedure with little trauma and less hospital cost, which can be an alternative as a prophylactic treatment for patients with high risk of anastomotic leak.

Anastomosis, Surgical ; Anastomotic Leak ; Drainage ; Humans ; Ileostomy ; Laparoscopy ; Length of Stay ; Postoperative Complications ; Rectal Neoplasms ; Retrospective Studies ; Surgical Stomas