Natriuretic factors,include cardionatrin(CN)and digoxin-like immunoreac-tive substances(DLIS),were important humoral factors relating to ascites formation inliver cirrhosis.An observation was made on the levels of plasma CN,DLIS,angiotensinⅡ, aldosterone and serum and urine sodium contents berore and after ascites extinction in40 cirrhotic patients.The results showed that the plasma levels of CN and DLIS had dis-tinct changes before and after ascites extinction and their changes were parallel with theactivity of renin-angiotensin-aldosterone system.These facts suggested that CN and DLIShad certain relation with ascites formation in liver cirrhosis.

Objective To evaluate results of cancer early detection and early treated project screening and experience in Heilongjiang province from 2013 to 2014.Methods In Harbin and Daqing city resident popu-lation ,high-risk groups were screened through the risk factors questionnaire and screened corresponding clinical examine,respectively(lung cancer,liver cancer,breast cancer,upper gastrointestinal cancer and colorectal canc-er) .To explore cancer preventive effect of early detection and early treated in Heilongjiang province.Results We smoothly completed the cancer early detection and early treatment between 2013—2014 in Heilongjiang prov-ince,a total of 15628 people received a copy of risk factors questionnaire,10299 people in high-risk groups re-ceived clinical screening.A total of 66 cases of suspected cancer cases were screened.Conclusion completed Cancer early detection and early treatment are performed in Heilongjiang province between 2013—2014.Early de-tection can be treated early project for early discovery,early diagnosis and early treatment.It is important to im-prove the quality of screening survival time and survival of patients′.The project also promotes the early diagrosis and early treatment experience in Heilongjiang province.

Objective To analyze the clinical features of subacute thyroiditis (SAT ) manifested as fever of unknown origin (FUO) for early diagnosis .Methods The clinical and laboratory data were retrospectively reviewed for 20 SAT patients manifected as fever of unknown origin from October 2009 to February 2013 .Results A total of 20 patients were finally diagnosed as subacute thyroiditis ,about 3% of the 661 FUO patients .Only 5 SAT patients had complained of angina or pain in the anterior region of neck .Thyroid enlargement and tenderness were observed in 14 SAT cases .Elevated serum thyroid hormone and a very low serum level of thyroid stimulating hormone were seen in 17 patients with SAT .Ultrasound scan of thyroid showed inhomogenous hypoechongenic texture in 14 patients .99m Tc pertechnetate scan of thyroid showed extremely low radiopharmaceutical uptake in all the 20 cases .All patients had received antibiotic treatment prior to admission .Conclusions Subacute thyroiditis is an uncommon but important cause of FUO .Detailed history ,physical examination and laboratory evaluation can help minimize the chance of misdiagnosis and unnecessary antibiotic therapy .

OBJECTIVE:To establish a method for the identification and content determination of leguminosae in Qizhu bishi granules. METHODS:Thin layer chromatography (TLC) was used to identify the leguminosae. HPLC-ELSD was used to deter-mine the content of astragaloside A in leguminosae. The column was Diamonsil C18 with the mobile phase of acetonitrile-water(32∶68,V/V)at the flow rate of 1.0 ml/min,the column temperature was 40 ℃. The sample size was 20 μl. The drift tube temperature was 108 ℃ with the nitrogen gas flow rate of 2.8 ml/min. RESULTS:The TLC features of leguminosae were obvious with clear spots and good specificity. Astragaloside A had a good linear relationship in the range of 0.402 4-4.02 μg(r=0.997 0). RSDs of pre-cision,stability and reproducibility tests were≤0.8%. The average recovery was 99.00%(RSD=1.29%,n=9). CONCLUSIONS:The method is simple,accurate and reliable and can be used for the quality control of Qizhu bishi granules.

Blood stasis is the main pathological factor in the occurrence of cardiovascular diseases. Notoginseng Radix et Rhizoma is the representative medicine for activating blood and dissipating stasis. The effective components of panax notoginseng saponins, the active part of Notoginseng Radix et Rhizoma, are ginsenoside Rg1, ginsenoside Rb1, ginsenoside Rd, and notoginsennoside R1, having good intervention effects on cardiovascular diseases, which have become the research hotspots in recent years. This article reviewed the research progress in Notoginseng Radix et Rhizoma and its major saponins in the field of cardiovascular diseases, and provided ideas for clinical prevention and treatment and research and development of medicine.

Objectives: Use antisense VEGF to reduce the immunosuppression induced by tumor and enhance the antithumor effect of IL-2. Methods: After the MMT45.Li murine liver cancer cells were modified with antisense VEGF alone, or antisense VEGF combined with IL-2 gene, the tumorigenesis of modified MM45T.Li was studied. The apoptosis of cancer cell induced by antisense VEGF and IL-2 gene in vivo was also studied. The tumors were cryosmeared 3 weeks after the mice bearing tumor were treated correspondingly with Ad-antiVEGF or Ad-Il-2 or Ad-antiVEGF/IL-2 or Ad-lacZ, the immunohistochemical analysis of CD4 + , CD8 + was performed.Results: The tumorigenesis of MM45T. Li was reduced by antisense VEGF, and the number of CD4 + , CD8 + cell was increased in tumor tissue, and the immunosupression was also reduced; At the same time antisense VEGF also enhanced the antithumor effect of IL-2 gene.Conclusions: Antisense VEGF not only can inhibit the neovascularization, but also can reduce the immunosupression induced by tumor, and improve lymphocyte infiltration toward tumor site;when it was combined with Il-2,anti VEGF can enhance the antitumor effect greatly.

Objective To evaluate the efficacy of the first metatarsophalangeal joint arthrodesis versus resection arthroplasty for rheumatoid forefoot deformity.Methods Randomized controlled studies in the first metatarsophalangeal joint arthrodesis versus resection arthroplasty for rheumatoid forefoot deformity were collected in data bases like Cochrane library (Issue 3,2011),OVID (from January 1996 to June 2012),PubMed (from January 1990 to June 2012),CNKI (from January 1990 to June 2012),CBM,EMBASE (from January 1966 to June 2012) and Wanfang (from January 1990 to June 2012).Software RevMan 5.1 was used to analyze the trials included in terms of patient satisfaction,hallux area weight-bearing,AOFAS score,FFI score,HAV angle,IMA angle,operative time and complications.Results The totals of 5 RCTs were included in the study which involved 285 patients.The results of meta-analysis showed that the efficacy of the arthrodesis group was superior to that of the arthroplasty group in footwear (MD=-0.88,95％CI [-1.55,-0.22],P=0.010)and alignment (MD=-5.04,95％CI [-8.94,-1.14],P=0.01) significantly.The arthrodesis group also has an advantage of IMA and HAV angle correction (MD=1.43,95％CI [0.37,2.48],P=0.008; MD=13.27,95％CI [11.44,15.09],P＜ 0.00001).Significant difference was found between the two groups in the rate of complications.The rate of complication in the arthrodesis group was lower than that of the arthroplasty group (OR=2.32,95％CI [1.06,5.05],P=0.03).No significant difference was found between the two groups in patient satisfaction and FFI score.Conclusion Compared with resection arthroplasty,first metatarsophalangeal joint arthrodesis could be a better choice.It alleviates the pain effectively,improves the appearance and functions of the foot,and has a lower rate of postoperative complications.

Primary liver cancer (PLC) includes hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (CC).In recent years, the incidence of PLC has increased significantly in the world.At present, the therapy for liver cancer tends to diversify, but surgical resection is still the first choice and the most effective treatment for HCC in general.As the biomedical, evidence-based medicine, and medical humanities are proposed, to achieve the best therapeutic effect and minimize the trauma has become the goal of modem surgery.Moreover, this could promote the transformation of surgical model from traditional experiential surgery to precision surgery.Besides, as the critical techniques of treating HCC in preoperative evaluation,operative procedures, perioperative management and the innovation of surgical instruments develop fast, precise liver resection has come into being.And now this concept is getting more and more attention from hepatobiliary surgeons.In this paper, the progress on the application of precise liver resection in the treatment of PLC is reviewed based on the preoperative evaluation and intraoperative procedures.

Objective To investigate the causes of a suspected outbreak of lower respiratory tract infection (LR-TI)caused by carbapenem-resistant Acinetobacter baumannii (CRAB)in the general intensive care unit(ICU)of a hospital,and provide scientific evidence for effective control of healthcare-associated infection(HAI).Methods Epi-demiological investigation on patients infected with CRAB and on-site monitoring on ICU environmental hygiene from March 4 to 23,2014 were performed,active prevention and control measures were taken.Results A total of 7 patients developed CRAB infection,the total length of stay during epidemic period were 160 days,the infection density of LRTI was 43.75‰(7/160),4 of 5 patients at No.02 bed had CRAB LRTI.Univariate analysis revealed that adopting conventional sputum suction procedure was a risk factor;the qualified rate of bacterial count on the object surfaces was 31 .75% (20/63).CRAB was also isolated from outer frame of suction device of No.02 bed, which had the same antimicrobial pattern as CRAB from 7 patients’sputum.After taking a series of controlling measures,there was no CRAB infection case after March 24,2014,this outbreak was effectively controlled. Conclusion This suspected HAI outbreak may be caused by inadequate disinfection of outer frame of suction device contaminated by CRAB,and horizontally transmitted through manipulation of sputum suction by health care workers.Clean and disinfection of ICU environmental object surfaces is of great importance for preventing HAI.

Objective To investigate the changes of expression of peroxisome proliferator-activated receptor γ (PPARγ) and its coregulators and monocyte chemotactic factor (MCP-1) treated with intedeukin-1β (IL-1β), and to analyze the mechanism of interaction of these factors. Methods Renal tubular cells (HK-2 cells) were cultured in vitro. Total cellular RNA was isolated for real-lime quantitative polymerase chain reaction (real-time PCR), nuclear extracts were prepared for Western blot analysis and EMSA. The supernatant was collected for ELISA after the treatment of IL-1β at different concentrations and time points. Results Under stimulus of different concentrations of IL-1β (0～20 μg/L) for 24 hours, the mRNA expression of PPARγ, SRC-1, SRC-2 and PGC-1 decreased significantly (P<0.05), meanwhile NCoR increased obviously (P<0.05). In further time-dependent experiment, the mRNA levels of SRC-2 and PGC-1 decreased by 57% and 48%, respectively, at 1 hour after treatment with 10 μg/L IL-1β (P<0.05). The expression of SRC-1 decreased by 43%only after 2 hours (P<0.05). The expression of NCoR was not obviously changed until stimulated by IL-1β for 8 hours (2.17 folds, P<0.05), then it decreased slowly. In the same time-dependent experiment, Western blot analysis showed that IL-1β (10 μg/L) significantly decreased the protein level of PPARγ at 4 hours (P<0.05). ELISA analysis revealed that the secretion of MCP-1 kept on rising and reached the peak (160.56±2.80) ng/L at 8 hours (P<0.01), then decreased to (50.82±1.25) ng/L at 24 hours (P<0.01). IL-1β could down-regulate the DNA binding activity of PPARγ, and the activity of NF-κB was up-regulated. Conclusions PPARγ and its eoregulators are closely related to MCP-1 and NF-κB during inflammation response in kidney. The activation of NF-κB by IL-1β leads to the decrease of PPARγ, and its coactivators expression levels, however the expression of MCP-1 and NCoR in renal tubular epithelial cells is up-regulated. PPARγ together with its coregulators participate in the inflammation response in kidney.