Objective To explore the efficacy and mechanism of combined hemodialysis-hemoperfusion in treating patients with end-stage renal failure associated cutaneous pruritus. Methods Eighty-one outpatients and inpatients with end-stage renal failure associated different degree of cutaneous pruritus were randomly divided into treatment group (combined hemoperfusion-hemodialysis, 50 cases) and control group (simple hemodialysis, 31 cases). At the pretreatment and 24 weeks posttreatment, all patients' serum creatinine, blood urea nitrogen, serum total calcium, serum phosphonium, serum intact parathyroid hormone and the intensity of cutaneous pruritus (visual analog scale,VAS) were determined detected. Results Compared with pretreatment, the intensity of cutaneous pruritus of patients in treatment group was obviously alleviated (P<0.01), but it was not alleviated in control group (P>0.05), there was significant difference between two groups (P<0.01). Compared with pretreatment, serum phosphonium and intact parathyroid hormone declined obviously in treatment group [(2.69±0.46) mmol/L vs (0.98±0.39) mmol/L and (632.78±76.89) ng/L vs(342.81±39.71) ng/L] ((P<0.01), but did not decline obviously in control group (P>0.05), there was significant difference between two groups (P<0.01). Conclusions Combined hemodialysis-hemoperfusion can obviously alleviate the intensity of cutaneous pruritus of patients with end-stage renal failure, but simple hemodialysis can not alleviate it,its mechanism may be that it can clean the internal irritant toxin which leads to cutaneous pruritus well.

Objective To understand the epidemiological characteristics of HIV infection in voluntary blood donors in Liuzhou city to provide the basis for the blood donation recruit launched by the blood collection and tranfusion service agencies and reduce the risk of transfusion transmitted HIV.Methods The epidemiological investigation on the voluntary unpaid blood donors infected with HIV during 2008-2012 was performed for analyzing the infection characteristics.Results HIV infection in blood donors in Liuzhou city had no statistical difference between different years (P >0.05);the differences in different sexes,age groups,married and unmarried persons had statistically significant differences (P <0.01 );the education background less than middle school ac-counted for 52.94%;56.21% of the infectors were the sexual transmission.Conclusion HIV infection in voluntary unpaid blood donors in Liuzhou city is dominated by young adult men and the persons with the education level less than junior high school,and the heterosexual transmission is predominant.The donor recruitment work should pertinently exclude the persons of high-risk be-havior and collect blood in low risk population as far as possible.

OBJECTIVE To study the antibacterial activity of pazufloxacin in vitro against bacteria isolated from(patients) with respiratory and urinary tract infection,compared with levofloxacin,ciprofloxacin,cefuroxime and(cefotaxime) to provide guideline for clinical application.METHODS The infected bacteria were identified by the(fully) automatic VITEK system.The susceptibility test was determined by MIC method and K-B disk diffusion method respectively.RESULTS The sensitivity of most Gram-negative bacteria to pazufloxacin was basically the same to levofloxacin,cefotaxime, etc.However,the sensitivity of Pseudomonas and Acinetobacter to(pazufloxacin) was higher than to other four antibiotics;the sensitivity of Gram-positive cocci,particularly(Streptococcus) to(pazufloxacin) was obviously lower than cephalosporins and no better than other quinolones.(CONCLUSIONS) The antibacterial activity of pazufloxacin in vitro against the bacteria isolated from patients with(respiratory) and urinary tract infection is comparatively strong,especially in the urinary system.Pazufloxacin has an excellent broad-(spectrum) and strong antibacterial activity.However,the antibacterial activity against Gram-positive cocci is(expected) to promote.

Objective To explore the correlation and significance between adult nut-cracker phenomenon (NCP) and varicocele. Methods The clinical characters of 226 adult patient (including inpatients and outpatients)with NCP diagnosed by color Doppler ultrasound examination were analyzed retrospectively, whose chief complaints were asymptomatic bematuria or/and orthostatic proteinuria (microalbuminuria). The ratio of left renal vein inner diameter before and after being compressed≥2 was regarded as the criteria of diagnosis of NCP. Among 226 cases, 184 male NCP patients were taken as study group, and the incidence of varicocele was tested. One hundred and fifty-six male adults who had physical examination in the same period and whose ages matched with study group were taken as control group, they were not NCP patients examined by color Doppler ultrasound. The incidence of varicocele was compared between two groups. The indexes associated NCP were examined in detail in study group. Logistic regression analysis was used to study the correlation between NCP and left varicocele. Results There were 184 male patients in study group, among which there were 22 patients with left sub-clinical varicocele (accounted for 11.96%), 47 patients with left varicocele (accounted for 25.54%).The total incidence of varicocole was 37.50%(69/184). There were 156 male adults in control group, among which there were 13 patients with sub-clinical varicocole(accounted for 8.33%), 8 patients with varicocele (accounted for 5.13%).The total incidence of varicocele was 13.46%(21/156). The total incidence of varicocele in study group was significantly higher than that in control group (P=0.000). In study group, there were 22 patients with left sub-clinical varicocele,with average age (24.73±1.03) years. The inner diameter of left renal vein(LRV) in front of spine was (3.65±0.11) mm(a),the inner diameter of LRV at left side of spine was (8.41±0.11)mm(b), and b/a ratio was 2.31± 0.06. The angle between superior mesenterie artery (SMA) and abdominal aorta(AA) was (15.95±0.59)°. There were 47 patients with left varicocele, with average age(26.62±1.74)years. The inner diameter of LRV in front of spine was (3.43±0.08)mm(a),the inner diameter of LRV at left side of spine was (8.72±0.14) mm (b), and b/a ratio was 2.54±0.08. The angle between SMA and AA was (14.54±0.53)°. In study group, Lagistic regression analysis proved that male patients with NCP were complicated with varicocele easier when the angle between SMA and AA became smaller, the inner diameter of LRV at the left side of spine (b)and age increased. Conclusions Male adult patients with NCP are complicated with left varicocele, which is significantly higher than that in non-NCP male adults at the same age. It shows that NCP is one important cause for varicocele and there is a close correlation between NCP and varicocele in male adults.

Objective To study the clinical significance of platelet, coagulation ,and fibrinolysis alteration in perioperative period in patients with different Child classifications of cirrhosis. Methods Alterations on the platelet count and the indices of coagulation and fibrinolysis in 17 cases of Child B class who underwent portal-systemic shunt, and 6 cases of Child C class who underwent portal-azygus vein disconnection were detected. Results Before operation,except the decrease in platelet count, there as no significant difference in the indices of other platelet function, coagulation and fibrinolysis in patients with Child B class compared with control group. While in patients with Child C class, the platelet count decreased, and GMP-140, FPA and D-dimer increased greatly. After operation, GMP-140 increased in patients with Child B class, while decreased in patients with child C class. The platelet count and factorⅧ:C in patients with Child C class decreased significantly compared with those with Child B class. Conclusions Operation may induce DIC in patients with Child C class, so it is necessary to determine the fibrinogen and factorⅧ:C during the operation.

Anti-neutrophil cytoplasm antibody-associated vasculitis (ANCA) is an autoimmune disease with multi organ involvement characterized by vascular wall inflammation and fibrinoid necrosis, including microscopic polyangitis (MPA), granuloma polyangitis (GPA), and eosinophilic granuloma polyangitis (EGPA). Because its clinical manifestations are complicated and non-speciifc, it is dififcult to make early diagnose. In recent years, some new progress has been made in diagnosis and treatment of this disease. The article will review the related information.

AIM　To study the structures of the epimerides of cycloclausenamide. METHODS　The structures of compound I, extracted from Clausena lansium (Lour.) Skeels, and synthesized compound III were determined by single crystal X-ray diffraction analysis. The stereo-structures of compound II and IV were also built up through Tripos force field based on crystal structures of compound I and III. RESULTS　The molecular formula and molecular weight were found to be C18H17O2N and 279.34 respectively. Compound I crystallized in monoclinic system, space group P21 with a=0.5928(1), b=1.5014(1), c=1.6190(1) nm, V=1.4410(3) nm3, Z=4, Dx=1.288 g*cm-3, Rf=0.075, Rw=0.073(w=1/σ2｜F｜), S=3.983; compound III crystallized in triclinic system, space group P1 with a=0.5667(1), b=1.2934(1), c=2.1119(1) nm, α=102.17(1), β=90.25(1), γ=102.65(2)°, V=1.4770(5) nm3, Z=4, Dx=1.224 g*cm-3, Rf=0.047, Rw=0.051(w=1/σ2｜F｜), S=0.467. CONCLUSION　These results showed that compound I and III both are cycloclausenamide except that the directions of the phenyl group on C6 are different. Cycloclausenamide can form 4 pairs of epimerides but the directions of the phenyl group does not affect their energy in free state.

Objective To analyze the therapeutic effect of percutaneous transhepatic cholangial drainage (PTCD) in the treatment of bile duct obstruction in patients with malignant hilar bile duct carcinoma,and to discuss the clinical application and practical value of PTCD.Methods A total of 55 patients with malignant biliary obstruction were divided into the PTCD group (30 cases who recieved percutaneous transhepatic cholangial drainage) and the control group (25 cases who recieved endoscopic stent implantation).Observed the preoperative and postoperative biochemical indexes of PTCD group,including serum total bilirubin (TB),serum direct bilirubin (DB),serum alanine aminotransferase (ALT) and serum glutamic acid amino turn shift of aspartate aminotransferase(AST) and serum alkaline phosphatase(AKP).Compared the effect rate and postoperative survival time of the two groups through postoperative follow-up.Results The TB,DB,ALT,AST and APK of PTCD group one week after operation changed obviously compared with the relative index before opreation with statistically significant differences (P<0.05), which indicated a significant improvement of biochemical indicators.The treatment efficiency of the PTCD group and the control group were 83.3% and 64.0% respectively, and survival time of the two groups were(7.5±2.6)months and(4.8±2.8)months respectively.Results of the PTCD group was significantly better than that of the control group,and the differences were statistically significant(P<0.05).Conclusion All the patients with PTCD get better biochemical indicators and longer postoperative survival time,and the interventional therapy PTCD can be used as an effective clinical treatment method for bile duct obstruction with malignant hilar bile duct carcinoma.

AIM:To study whether inhibition of forkhead box protein M1(FoxM1) sensitizes leukemia K562 cells to homoharringtonine ( HHT ) .METHODS: K562 cells were incubated with HHT at different concentrations ( 0μmol/L, 0.015 μmol/L, 0.030μmol/L and 0.045μmol/L) for different time (0 h, 24 h, 48 h and 72 h).The mRNA and protein levels of FoxM1 were detected by real-time PCR and Western blot.FoxM1 siRNA was transfected into K562 cells with 0.015μmol/L HHT after 6 h.After 72 h incubation, the cell proliferation was detected by cell counting and soft agar assay, and the proportion of apoptotic K562 cells was determined by flow cytometry.The expression of c-Myc and Sp1 were detected by real-time PCR and Western blot.RESULTS:FoxM1 expression was reduced time-dependently and dose-dependently, suggesting that HHT mediated the downregulation of FoxM1 in K562 cells.In K562 cells, treatment with FoxM1 siRNA and HHT inhibited the cell proliferation and promoted the apoptosis significantly.Therefore, inhibition of FoxM1 sensitized leukemia K562 cells to HHT.The expression of c-Myc and Sp1 was positively regulated by FoxM1. CONCLUSION:HHT inhibits Forkhead box protein M1 expression in K562 cells.Inhibition of FoxM1 sensitizes K562 cells to HHT.

Objective To observe the effect of ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with orthosis training for the treatment of lower limb spasticity for children with cerebral palsy.Methods Fifty-four patients with spastic cerebral palsy were randomly divided into an observation group and a control group using a random number table.Patients in the control group were given conventional rehabilitation training,while those in the observation group were additionally given ultrasound-guided BTX-A injection,followed by daily knee-ankle-foot orthosis rehabilitation training 24 h after the injection.Before and 6 weeks after treatment the lower limb function of the 2 groups was evaluated using the modified Ashworth scale (MAS) and the gross motor function measure (GMFM).Adductor angles,popliteal angles and motor ranges of the ankle joint were also measured and compared.Results After 6 weeks the average MAS scores were lower than before treatment in both observation[(1.26±0.63) vs (3.07±0.68)] and control group [(2.56±0.71) vs (2.89±0.64).And in both groups the average GMFM scores,adductor angles and popliteal angles,as well as range of motion of the ankle were all much better than before treatment.The observation group,however,improved significantly more than the control group(P ＜ 0.05).Conclusion Ultrasound-guided injection of BTX-A can effectively alleviate spasticity of lower extremity for children with cerebral palsy with accurate positioning,obvious curative effect and less adverse reactions.Knee-ankle-foot orthosis rehabilitation training after the injection can further alleviate spasticity and improve the motor function of the limbs.