Arteriovenous fistula stenosis developed in 32 patients who received hemodialysis from April 2014 to April 2016, including 24 cases of autologous arteriovenous fistula ( AVF) and 8 cases of artificial vessel arteriovenous fistula ( AVG).In AVF patients, there were 20 cases with blood flow decreasing and 4 cases of venous hypertension , while in AVG patients there were no cases with blood flow decreasing and 8 cases with venous pressure increasing (χ2 =17.77, P<0.001).All patients underwent percutaneous transluminal angioplasty ( PTA ) . In all patients the vascular diameter was increased significantly after PTA treatment [(3.6 ±0.2) vs.(1.2 ±0.1) mm, t=18.52, P<0.001].The blood flow during hemodialysis was increased significantly after PTA treatment in patients with anastomoti stenosis [(265.4 ±21.5) vs.( 150.5 ±23.1 ) ml/min, t =21.81, P <0.001 ]; however, there were no significant changes in venous pressure [(68.6 ±8.7) vs.(69.3 ±6.1) mmHg(1 mmHg=0.133 kPa), P>0.05].The blood pressure was decreased after PTA treatment [( 71.2 ±7.9 ) vs.( 170.4 ± 15.7) mmHg, t=34.62, P<0.001] in patients with venous outflowtract stenosis , however, there were no significant changes in the blood flow [(264.1 ±15.2) vs.(260.7 ±17.3) ml/min, t=1.04, P>0.05].

Tumor markers play an important role in tumor mass screening, diagnosis and differential diagnosis of tumor, tumor staging, therapeutic evaluation and prognosis assessment. According to the nature,tumor markers can be classified as follows: embryonic antigen, carbohydrate antigens, proteins, enzymes, hormones, and so on. And tumor markers have been used in clinical widely.

Objective To evaluate the diagnostic value of combined test of C-reactive protein,amylase and lipase for acute pan-creatitis patients in early stage,and its practicability in assessment of disease severity.Methods 71 cases of acute pancreatitis pa-tients in the hospital from March 2012 to March 2014 were enrolled in the study,including 60 cases of mild pancreatitis patients,11 cases of severe pancreatitis patients.Meanwhile,30 cases of non-acute pancreatitis patients were enrolled as Control Group A,and 50 cases of adults who underwent conventional examination and proved to be healthy were enrolled as Control Group B.Detection of C-reactive protein,amylase and lipase of these samples were performed and the results were recorded,compared and analyzed.Re-sults The serum amylase level of acute pancreatitis patients was (759.42±721.63)U/L,and serum lipase level were (1 624.34± 1 598.25)U/L,which were significantly higher than people in Control Group A and Control Group B,with statistical significance (P <0.05).However,C-reactive protein level of acute pancreatitis patients were (44.61±34.21)mg/L,which were not statistical-ly different compared with Control Group B.Combined test of the three indicators demonstrated that the sensitivity was 95.9%, specificity was 100% and accuracy was 96.9%,all of which were higher than other test combinations or singe test with statistical significance(P <0.05 ).Conclusion The combined test of C-reactive protein,amylase and lipase for acute pancreatitis patients doesn′t only improve early diagnostic efficiency,but also is helpful in disease severity judgment.

Objective To evaluate the effects of hypothermic cardiopulmouary bypass(CPB) on depth of anesthesia measured by BIS and auditory evoked potential index(AEPI) monitoring and cerebral O_2 and glucose metabolism. Methods Twenty-eight ASA Ⅱ-Ⅲ patients of both sexes(15 males, 13 females) aged 29-55 yrs undergoing elective cardiac valve replacement under hypothemic CPB were studied. Patients were excluded from the study if they had hearing disturbance, hepato-renal dysfunction, diabetes melhtus, hypertension, cerehro-vascular or mental diseases. The patients were premedicated with intramuscular morphine 0.15 mg?kg~(-1) and scopolamine 0.3mg. Anesthesia was induced with midazulam 0.05-0.1 mg?kg~(-1), fentanyl 10 ug?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with intermittent ⅰ.ⅴ. boluses of fentanyl, diazepam and pancuronium. Radial artery was cannulated for BP monitoring and blood sampling. A CVP catheter was inserted into right internal jugular vein and advanced in a cephalad direction until jugular bulb for blood sampling. BP, HR, T℃(naso-pharyngeal), BIS and AEPI were continuously monitored during operation. Arterial and jugular bulb blood samples were obtained before CPB(T_1), T℃ was lowered to 33℃(T_2)during stable hypothermia(T_3) during rewarming at 33℃(T_4) and 30 min after termination of CPB(T_5) for blood gas analysis and determination of glucose and lactate concentrations. Cerebral oxygen extraction rate(O_2 ER) cerebral glucose extraction rate(GER), arterial-jugular bulb venous lactate difference(DLa-jv) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) were calculated. Results Blood glucose and lactate concentrations were significantly increased, while arterial blood pH and DLa-jv did not change significantly during CPB. Cerebral oxygen extraction rate(O_2ER), cerebral glucose extraction rate(GER) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) decreased while jugular bulb venous oxygen saturation (SjvO_2) increased with decreasing body temperature. BIS and AEPI values decreased with decreasing T℃ and both were well correlated with T℃. AEPI was positively correlated with O_2 ER and negatively correlated with Ca-jvO_2 whereas BIS was positively correlated with PaO_2. Conclusion Cerebral metabolism is decreased during hypothermic CPB which also deepens anesthetic depth measured by BIS and AEPI monitoring.

A quantitative method using ultrahigh-performance liquid chromatography was established to simultaneously determine ten ginsenoside active ingredients including ginsenoside Rg6, F4, Rk3, Rh4, 20(S) -Rg3, 20(R) -Rg3, Rk1, Rg5, 20(S)-Rh2 and 20(R)-Rh2 in steamed notoginseng. The ten ginsenosides of steamed notoginseng with different head numbers, parts, and steaming time were determined by this method. An Acquity BEH C18 chromatographic column (2.1 mm x 100 mm, 1.7 microm) was used to perform the determination, which was maintained at 35 degrees C throughout the analysis. Mobile phase was composed of water and acetonitrile with flow rate at 0.3 mL x min(-1) under gradient elution, and detection wavelength was set to 203 nm for monitoring the separation. The results demonstrate ginsenoside Rg6, F4, Rk3, Rh4, 20 (S)-Rg3, 20 (R) -Rg3, Rk1, Rg5, 20 (S)-Rh2 and 20(R) -Rh2 have shown good linearity (R2 > or = 0.999 8) within 0.46-115, 2.06-515, 1.632408, 3.216-804, 1.392-348, 1.4-350, 0.496-248, 3.012-1 506, 0.82-205 and 0.832-208 mg x L(-1), and their average recoveries were 97.00%, 97.96%, 98.86%, 95.27%, 98.67%, 98.02%, 95.53%, 96.63%, 99.57% and 103.6%, respectively. The proposed approach was quick and accurate and portrayed excellent repeatability and determination efficiency. The quality of steamed notoginseng was effectively controlled, which served as a foundation for establishing a normalized processing technique and quality standard for ensuring the reliability and consistency of its clinical efficacy.
Chromatography, High Pressure Liquid ; methods ; Ginsenosides ; analysis ; Panax notoginseng ; chemistry ; Reproducibility of Results ; Steam

Objective To investigate the diagnostic value of Lugol solution staining combined with nar-row band imaging (NBI)for esophageal cancer and precancerous lesions.Methods From December 201 3 to December 2014,1 87 patients who were with suspicious esophageal lesions and stained with Lugol solution under endoscopy were selected as control group,while from January 2015 to June 2015,124 patients who were with sus-picious esophageal lesions and examined with Lugol solution staining and NBI under endoscopy were selected as observation group.The sensitivity,specificity and accuracy between the two groups were compared and analyzed. Results One hundred and four cases (75.0%)were found among observation group,which was higher than 93 cases (55.6%)among control group (χ2 =12.07,P <0.01 ).The total detection rates of esophageal cancer and high grade intraepithelial neoplasia (HGN)were 29.0% and 17.7% in observation group respectively,which were higher than 1 8.2% and 6.4% in control group (χ2 =4.15,P =0.04;χ2 =8.54,P <0.01 ).The Kappa value in observation group was 0.55,which was higher than 0.36 in control group.The sensitivity and accuracy in observation group were 89.9% and 82.3% respectively,which were significantly higher than 71 .8% and 68.4% in control group (χ2 =9.79,P <0.01 ;χ2 =7.38,P <0.01 ).Conclusion The sensitivity and accuracy of endoscopic Lugol solution staining combined with NBI for esophageal cancer and precancerous lesions are higher than Lugol solution staining,and it is worthy to popularize the application of Lugol solution staining com-bined with NBI in diagnosing esophageal cancer and precancerous lesions.

BACKGROUND:The chronic wounds, also cal ed non-heading wounds, can seriously affect the quality of life of patients and has brought heavy burden to patients, as wel as health care professionals. celltherapy is a new method for promoting wound healing and plays an important role in the repair of chronic wounds.
OBJECTIVE:To summarize the progress of researches on the chronic wound healing mechanism and celltherapy, and to provide evidences for the clinical management of chronic wounds and relative basic researches.
METHODS:A computer search of CNKI database from 2005 to 2012, PubMed database from 1995 to 2012 and Foreign Medical Journal Ful-Text Service database from 2000 to 2012 was performed using“non-healing wounds, diabetic foot ulcer, wound healing, celltherapy”in Chinese and English as the key words to retrieve articles about chronic wound healing mechanism and the application of celltherapy. Total y, 42 articles meeting the inclusive criteria were included in result analysis.
RESULTS AND CONCLUSION:The wound healing is a complex biological process, involving multiple celltypes, extracellular matrix and cytokine factors. The delayed healing of refractory wound seriously affects the quality of life of patients and has brought heavy economic burden to patients. At present, many methods have been employed to promote wound repair, such as local hyperbaric oxygen therapy, surgical treatment, herbal Chinese medicine, application of various growth factors, celltherapy and gene therapy. celltherapy is noninvasive and those delivered cells can adapt to their environment, are able to release growth factors and cytokines, and more importantly, are able to deliver the growth factors for the wound healing process due to cellsignaling capabilities. Currently, cells used for the treatment of chronic wound cells mainly include bone marrow stem cells, bone marrow-derived mesenchymal stem cells, cord blood stem cells, peripheral blood stem cells, epidermal stem cells, skin-derived progenitor cells, adipose stem cells, fibroblasts and platelets.

Objective:To investigate the clinical effects and safety of triple therapy based on ipratropium bromide inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary diseases ( AECOPD) . Methods:Totally 150 patients with acute exac-erbation of AECOPD were randomly divided into control group (75 patients) treated with budesonide combined with salbutamol by in-halation, and treatment group (75 patients) treated with ipratropium bromide inhalation additionally. The clinical effects, dyspnea score, pulmonary function index and blood gas analysis index before and after the treatment and the incidence of adverse reactions of the two groups were compared. Results:The clinical effects of the treatment group was significantly better than that of the control group (P<0. 05). The dyspnea score, pulmonary function index in and blood gas analysis index in the two groups after the treatment were significantly better than those before the treatment(P<0. 05), and the improvement of the treatment group was significantly better than that of control group (P<0. 05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0. 05). Conclusion:Triple therapy including ipratropium bromide inhalation in the treatment of acute exacerbation of AECOPD can ef-fectively alleviate clinical symptoms and signs and improve the lung ventilation function without increased risk of adverse reactions.

Objective]To introduce professor YU Jingmao’s experience in treament of children with adenoid vegetation. [Methods]To select 3 effective cases of adenoid vegetation diseases, clarify professor YU Jingmao’s features of treatment based on syndrome differentiation, stage therapy and drug characteristics, and then analyze and expound the clinical experiences of professor Yu Jingmao. [Result]Professor YU Jingmao in infantile adenoid vegetation body therapy, treats in three stages:the early cure dispelling wind pathogens to clear heat reducing swelling;medium-term plans to raise Yin and moisture lung, promoting blood circulation to remove blood stasis;late to invigorate qi for consolidating superficies, nourish yin to clear away heat,often obtains better effect. [Conclussion]Professor YU Jingmao’s dialectical claim of in treatment of adenoid vegetation,stage therapeutics,purgation-tonifying and cultivste vital qi are worth learning.