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.

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.

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 .

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 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.

Objective To compare the efficacy of different doses of esomeprazole based quadruple therapy on Helicobacter pylori(H.pylori) eradication in Uygur population, and to study the relationship between H.pylori eradication and dyspepsia symptoms in H.pylori caused gastritis.Methods From August 2015 to May 2016, Uygur patients diagnosed with H.pylori positive superficial gastritis in Xinjiang Uygur Autonomous Region Kashgar Prefecture were recruited.According to random number table, patients were divided into single-dose group, standard-dose group and high-dose group.In single-dose group patients received esomeprazole 40 mg, once per day;in standard-dose group patients received esomeprazole 20 mg, twice per day;and in high-dose group patients received esomeprazole 40 mg, twice per day;besides esomeprazole the treatment of three groups were all combination of amoxicillin, clarithromycin and bismuth, magnesium compound granules.The treatment course of all three groups was 14 days.The H.pylori eradication rate, clinical efficacy, symptom score and adverse drug reaction were compared.The H.pylori eradication rate was evaluated with intention to treat analysis (ITT) and per-protocol sets (PP).Chi square test, t test and one-way analysis of vaiance were used for statistical comparison.Results A total of 248 patients were enrolled,82 cases in single-dose group, 83 cases in standard-dose group and 83 cases in high-dose group.There were five, five and six cases lose to follow-up or dropped out respectively in single-dose, standard-dose and high-dose group.The results of ITT analysis showed that the eradication rates of H.pylori in single-dose group, standard-dose group and high-dose group were 62.2%(51/82),77.1%(64/83) and 89.2%(74/83),respectively;the differences between each two groups were statistically significant (x2=4.34,16.33 and 4.30, all P<0.05).The results of PP analysis showed that H.pylori eradication rates of single-dose group, standard-dose group and high dose group were 66.2%(51/77),82.1%(64/78) and 96.1%(74/77),respectively;the differences between each two groups were statistically significant (x2=5.06, 22.47 and 7.84, all P<0.05).After four weeks of eradication therapy, the total dyspepsia symptom scores of single-dose group, standard-dose group and high dose group were all significantly lower than those before treatment (52.3±27.1 vs 99.4±44.1, 38.2±25.4 vs 101.0±48.9 and 28.8±16.1 vs 99.9±46.6), and the differences were statistically significant(t=5.88, 8.79 and 9.11, all P<0.01).After treatment, the total dyspepsia symptom scores of standard-dose group and high-dose group were both lower than that of single-dose group, and the differences were statistically significant (t=2.78 and 2.91, both P<0.01).The score of upper abdominal pain, epigastric burning, abdominal distention and symptom total score of high-dose group were all lower than those of standard dose group (4.8±3.9 vs 8.1±3.5, 3.1±2.5 vs 5.8±4.1, 7.9±6.8 vs 10.5±9.6 and 28.8±16.1 vs 38.2±25.4), and the differences were statistically significant (t=1.52,1.08,1.23 and 1.96, all P<0.01).After four weeks of treatment, the total efficacy rates of single-dose, standard-dose and high-dose group were 45.5%(35/77), 74.4%(58/78) and 87.0%(67/77),respectively.There were statistically significant differences between each two groups of three groups (x2=13.49, 29.73 and 3.98, all P<0.05).The incidences of adverse drug reaction of single-dose, standard-dose and high-dose group were 6.5%(5/77), 7.7%(6/78) and 7.8%(6/77),respectively;there was no statistically significant difference among the three groups (all P>0.05).Conclusions High dose of esomeprazole based quadruple therapy can increase the eradication rate of H.pylori in Uygur population, and H.pylori eradication therapy can significantly improve the dyspepsia symptoms of H.pylori caused gastritis in Uygur.High dose of esomeprazole may improve the clinical efficacy of H.pylori caused gastritis with dyspeptic symptoms in Uygur with safety.

AIM: To establish a RP-HPLC method for simultaneous determination of the dl-tetrahydropalmatine and imperatorin in Yuanhu Zhitong Prescription (Rhizoma Corydalis, Radix Angelicae Dahuricae). METHODS: dl- tetrahydropalmatine and imperatorin were extracted with ether and determined by HPLC using a BDS C 18 column(5?m,4.6?250mm),phosphate buffer(pH6.6)-methanol(39∶61) as a mobile phase. The mobile rate was at 1mL?min -1 and detection wavelength was at 280nm. RESULTS: The relationship between the concentration and the peak area of dl-tetrahydropamaltine and imperatorin were good linear relation, respectively. Either of correlation coefficient approached 0.999. CONCLUSION: This method can be used to determine the concentration of dl-tetrahydropalmatine and imperatorin in the preparation of Yuanhu Zhitong Prescription.

Chickenpox is an acute and highly infectious respiratory disease commonly seen in children.Varicela－zoster often results from the activation of latent virus in chickenpox called varicella－zoster virus（VZV）or called human herpesvirus type 3. Primary infection of VZV may induce typical disease of various severity and most healthy children infected with VZV have mild symptoms and good prognosis.But VZV infection，if occurs in special population such as persons of immune inhibition treatment will induce serious consequence or even death and it is as same serious as in adults.A detailed illustration of molecular biology，epidemiology，laboratory diagnosis，treatment and preventive strategy of the VZV were given.