Objective To study the influece of probucol on high-sensitivity C-reactive protein(hs-CRP) and bone morphogenetic protein-7 (BMP-7) in serum of patients with diabetic nephropathy.Methods 124 patients with diabetic nephropathy were randomly divided into two groups,the control group (n =62 cases) and the observation group(n =62 cases).The patients of the control group were treated through the conventional treatment.However,the patients of the observation group were treated by probucol on the basis of conventional treatment.They were treated for eight weeks.The 24-hour urinary protein,hs-CRP and BMP-7 were detected before and after treatment.Results The 24-hour urinary proteins were decreased in both two groups after treatment (t =6.161,5.23,P ＜ 0.01).There was significant difference between two groups(t =5.35,P ＜ 0.05).The hs-CRP and BMP-7 were improved after treatment (t =10.50,5.54,all P ＜ 0.05),while those of the observation group were more significantly improved than those of the control group(t =10.28,4.36,all P＜0.05).Conclusion Probucol could improve the conditions of diabetic nephropathy which was through improving hs-CRP and BMP-7.

According to laws and regulations , rules and relevant standards , combined with the actual condition of our hospital, to develop the hospital management policies of covering the whole process of medical care , and to update in time, which is the basis of ensuring the quality of medical care .Our hospital standardized the management of the policies , designed a unified process from the formulation , review, approval, issuance, revision, abolishment of the hospital management poli-cies, and supervised and implemented effectively , in order to achieve the sustainable development of hospital management policies standardly , integrally , dynamically .

Primary aldosteronism is a common cause of secondary hypertension.Laparoscopic surgery has become the golden standard for treatment of primary aldosteronism since the first laparoscopic adrenalectomy was performed in 1992.Adrenal-sparing surgery was recommended in surgical treatment for aldosterone-producing adenoma.This article reviews the factors influencing the improvement of postoperative blood pressure,and introduces the indications of the surgical treatment in patients with idiopathic hyperaldosteronism.

The three-level quality management organization system established in the hospital required both the hospital and department indicators to be submitted to quality management and patient safety committee and they will be approved after discussion .The quality manager of each department need to report the monitoring data monthly , and the leaders can directly consult the monitoring data in real time by logging in quality management system .When the abnormal data or adverse trend are found , the management and relevant departments will analyze the reasons , and the relevant departments will draw up and implement the plan to continuously improve the medical quality .

Objective To investigate the factors of postoperative complications of elderly patients with gastric cancer. Methods One hundred and fifth elderly patients with gastric cancer were selected as our subjects,who were underwent surgical treatments in general surgery department Jiangsu Shengze Hospital from Jan. 2009 to Dec. 2012. The general informations including age,staging of gastric cancer,radical operation performed or not,resection combined with other organs and operation periods were recorded. Results There were no significant differences between postoperative complications patients in terms of age,staging of gastric cancer,radical operation performed or not,resection combined with other organs( χ2 = 3. 113,P = 0. 078,χ2= 0. 465,P = 0. 495,χ2 = 0. 518,P = 0. 472,χ2 = 0. 303,P = 0. 582). The cases with operation periods < 3 h in complication group and no complication group were 30(57. 9% )and 51(81. 0% ),and the operation periods> 3 h were 22(42. 3% )and 12(19. 1% )respectively,and the difference was significant( χ2 = 6. 326,P= 0. 012). Conclusion Operation period is the main influencing factor of the elderly patients with gastric cancer. Therefore,reducing operation period under ensuring operation quality is more efficiency to decrease the complication.

Objective To observe the efficacy of drug treatment of coronary aneurysm complicated with embolism in Kawasaki disease (KD). Methods The clinical data of eight KD children with coronary aneurysm and embolism were retrospectively analyzed. Results Eight KD children (six males and two females) at age of 0.25-5.2 years (mean=2.89) ,were diagnosed with gigantic coronary artery aneurysms. The diameter of aneurysm was around 8.3-13.8mm. Thrombosis appeared from 19 days to five months after coronary aneurysms formation. The onset manifestations included sudden chest pain and myocardial infarction with symptoms of heart failure in one case, shock in one case and no symptom in six cases. The maximum diameter of the thrombus was 2.8 mm×15.4 mm in the shape of funicular. Four cases had thrombus in the right coronary artery, two cases in the left coronary artery, and two cases in both sides. The patients underwent anticoagulant therapy taking heparin, urokinase, warfarin, aspirin and dipyridamole. Anticoagulant therapy was successful in 7 cases and the thrombus was completely dissolved in 7 days to more than 4 months. One case had recurrent coronary thrombosis after 4 months. One case died in 12 hours after thrombolysis. Conclusions Coronary thrombosis usually appears in the half year after the onset of KD coronary aneurysm. Thrombolysis therapy takes long time in Kawasaki patients. Breaking off of thrombus are rarely seen.

Objective To investigate the causes and influencing factors of dead on arrival (DOA) in children.Methods The clinic data from 66 children with DOA admitted in the emergency department of Hunan Children's Hospital from Jan 2010 to Apr 2012 were analyzed retrospectively.Results All of the 66 cases had cardiac respiratory arrest when admission.Fourteen cases had arrest for 10 minutes,12 cases for 30 minutes to an hour,40 cases had no details.Forty-four (68.2％) cases were carried by parents,22(31.8％)cases were transferred by medical professionals.The main causes of DOA were severe pneumonia with respiratory failure and (or) heart failure,intracranial infection,neonatal diseases.All cases were taken to resuscitation room by triage immediately.Tracheal intubations were completed in 48 cases and intravenous access with injection of epinephrine and other resuscitative drugs were established in all cases,but all cases were dead due to breathing and heartbeat stopped for a long time.Conclusion DOA is one of the important reasons for pediatric high-risk.The key of reduction of DOA incidence and improvement of survival rate is to improve pediatric emergency medical service system,strengthen the health education for the parents,to carry out training and establish homogenization service in emergency ICU.

Objective To investigate the correlation between urinary calculi and upper urinary tract infections.Methods Twenty-six patients underwent lithiasis in upper urinary tract accompanied with infectious symptoms were enrolled in this study (test group).Blood culture was obtained in peak temperature before lithotrity,urine sample was obtained for bacterial culture.Thirty patients with calculi in upper urinary react accompanied no infectious symptoms in the same period were enrolled in control group.Calculi were pestled for bacterial culture and analyzed the components after the calculi were removed.Results In test group,the positive of blood,urine,calculi culture were 4,23,18 patients.The prominent component of calculi was hexahydrate magnesium ammonium phosphate.Bacteria in 13 positive urine sample had the same property with the calculi samples which came from the same cases.In control group,the positive of urine,calculi culture were 4,4 patients.The prominent component of calculi were calcium oxalate calculi and uricite calculi.The morbidity of upper urinary tract infections in test group was significantly higher than that in control group [69.2％(18/26) vs.13.3％(4/30)] (P ＜ 0.05).The coincidence of urine culture and calculi culture in test group was significantly higher than that in control group [72.2％(13/18) vs.25.0％(1/4)](P＜0.05).Conclusions Infectious calculi can easily result in upper urinary tract infections.Hexahydrate magnesium ammonium phosphate can make the prominent component in infectious calculi.

Apathy is a common neuropsychiatric complication after stroke,the identification of apathy after stroke and its related factors and providing an effective intervention on it may contribute to the rehabilitation in patients with stroke.This article reviews the incidence of apathy after stroke,pathophysiological mechanisms,diagnostic evaluation and treatment.

As a guanine nucleotide dissociation stimulator (GDS) of Rho-like GTPases, T lymphoma invasion and metastasis inducing factor 1(Tiam 1)possesses such biological functions as regulating reconstruction of cytoskeletal structure and migratory potential of cells. Studies had shown that over-expression of Tiam 1 was able to induce invasion and metastasis of tumor cells, the molecular biological basis of which includes the interactions between Tiam 1 and trans-membrane system of cytoskeleton, adhesion molecules and extra-cellular matrix, the effect on proliferation and apoptosis of tumor cells exposed by Tiam 1, as well as the activities of Tiam 1 regulated by other invasion and meatstasis associated factors. Simultaneously, these experimental results suggested that much more work would be needed in Tiam 1 on the diversity of its activity regulation ,the specificity of its biological effect, the realationship among Tiam 1 with other invasion and metastasis associated factors, as well as their mechanisms of signal transduction.