Objective To explore the clinical effect of epalrestat combined with methylcobalamin in the treatment of diabetic peripheral neuropathy.Methods 88 patients with diabetic peripheral neuropathy were chosen from September 2014 to September 2016 in our hospital.The patients were randomly divided into two groups,The control group was treated with conventional treatment,the observation group was given epalrestat combined with methylcobalamin based on the conventional treatment.The effect of the two groups was compared.Results The total effective rate of the observation group was 95.5 ％ (42/44),which was significantly higher than 70.5 ％ (31/44) of the control group,the difference was statistically significant(x2 =9.029,P =0.007).Before treatment,the median nerve and common peroneal nerve sensory conduction velocity betweem two groups had no significant differences (t =0.293,0.920,P =0.704,0.096).After treatment,the median nerve conduction velocity and peroneal nerve total sensory conduction velocity in the observation group were (46.2 ± 4) m/s,(42.4 ± 6.3) m/s,which were significantly higher than those in the control group(t =9.038,7.039,P =0.001,0.004).Conclusion Epalrestat combined with methylcobalamin in the treatment of patients with diabetic peripheral neuropathy can effectively improve the nerve conduction velocity.

Objective:To study the content in the new version of EU-GMP ANNEX 15 (draft) to find the changes of the new and the old version and help the domestic pharmaceutical enterprises meet the requirements of the EU-GMP and complete verification and validation activities.Methods:The new version and the old version of EU-GMP ANNEX 15 were compared,and the changes in the new ANNEX 15 were analyzed in order to understand the changes deeply.Combined with the current implementation status of verification and validation activities in domestic pharmaceutical enterprises,some suggestions on qualification and validation work were provided for domestic pharmaceutical enterprises.Results and Conclusion:The new revision of EU-GMP ANNEX 15 (draft) emphasizes qualification and validation activities during the life cycle of products,and processes,and risk management methods should be used in qualification and validation activities.

OBJECTIVE:To observe clinical efficacy and safety of nitric oxide (NO) combined with sildenafil in the treatment of neonatal pulmonary hypertension. METHODS:66 cases of neonatal pulmonary hypertension were selected and randomly divided in-to observation group and control group,with 33 cases in each group. 2 groups of patients were given Dopamine injection 5 μg/(kg· min),ivgtt. Control group was given NO 5-20 ppm;observation group received oral or nasal feeding of Citric acid sildenafil tab-lets,0.5-1.0 mg/kg,96 h,on the basis of control group. Both group received 3 d of treatment. Clinical efficacy of 2 groups were observed as well as the level of PaO2,PaCO2,SaO2,PAP,NO,ET-1,HIF-1α,EPO and Ca2+before and after treatment. The inci-dence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 96.97%,which was sig-nificantly higher than that of control group(75.76%),with statistical significance(P<0.05). There was no statistical significance in the levels of PaO2,PaCO2,SaO2,PAP,NO,ET-1,HIF-1α,EPO and Ca2+between 2 groups before treatment(P>0.05);com-pared to before treatment,PaO2,SaO2,No and Ca2+ levels of 2 groups increased significantly after treatment,while PaCO2,PAP, EPO,HIF-1,ET-1 significantly lowered and the observation group was better than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Sildenafil combined with NO is effective in the treatment of neonatal pulmonary hypertension and can effectively improve pulmonary hypertension and blood gas indexes with good safety.

Objective To observe the short-term visual effects of cataract surgery patients with 1CU accommodating intraocular lens (IOL) compared with aspheric monofocal IOL. Design Non-randomed comparative trial. Participants Consecutively 118 senile cataract patients (118 eyes). Methods 59 cataract patients (59 eyes) were implanted 1CU accommodating IOL (1CU group), and 59 cataract patients (59 eyes) were implanted aspheric monofocal IOL (Tecnis ZA9003 group). All patients were assessed at 3 months post-operation in the aberrations of crystalline, the modulation transfer function contrast sensitivity of 10/100 percent in three sorts distance(40, 63, 100 cm), uncorrected distanced visual acuity(UCDVA), uncorrected near visual acuity(UCNVA), best-corrected distance visual acuity(BCDVA), best-corrected near visual acuity(BCNVA), distance corrected near visual acuity(DCNVA), pseudo-accommodation, and the rate of off-near glasses. Main Outcome Measures Visual acuity, aberrations, modulation transfer function, contrast sensitivity, pseudo-accommodation, the rate of off-near glasses. Results At 3 months postoperatively, both UCNVA and DCNVA were significantly better in 1CU group than in the aspheric monofocal IOL group (t=8.85, P=0.00; t=13.05, P=0.00). The accommodative range was (2.58?0.37) D in 1CU group and (1.46?0.25) D in monofocal IOL group (t=14.33, P=0.00). In 3 mm and 5 mm pupil diameter the difference of the total aberration and spherical aberration in Tecnis ZA9003 group or 1CU group was significant (3 mm pupil t=18.48, P=0.00; t=5.70, P=0.00. 5 mm pupil t=19.98, P=0.00; t=6.70, P=0.00). At 40 cm and 63 cm, VA scores were higher in 1CU group (85%)than in Tecnis ZA9003 group (25%) (t=3.64, P=0.00; t=2.74, P=0.00; t=2.65, P=0.00; t=2.44, P=0.01). The rate of off-near glasses in 1CU group was better than in the aspheric monofocal IOL group(?2=41.95, P=0.00). Conclusions The 1CU accommodating IOL can provide better useful near visual acuity than aspheric monofocal IOL, especially for the patients who want to get rid of spectacles.

Objective To study the early diagnostic value of CT for children with cerebral palsy.Methods CT manifestations of 124 cases with cerebral palsy were analysed retrospectively. Results 96 cases of the 124 cases showed a recognisable abnormality,the abnormal rate of CT was about 77.42％ ,and the most common abnormality was cerebral atrophy.Spastic type was the most common clinical type(71.77％ ).The less of the age,the higher of the abnormal rate of CT. Conclusion Although CT isn't the main basis of the diagnosis of cerebral palsy,it's helpful for us to find the pathological changes,and to find the eliology and location.It also provided basis for us to judge the prognosis of cerebral palsy.So CT has significant value in the early diagnosis of cerebral palsy.

Objective To investigate the clinical manifestations,pathological features,treatment and prognosis of nongesta-tional choriocarcinomas.Methods The clinicopathological data in 4 cases of nongestational choriocarcinoma were retrospectively analyzed and the relevant literatures were reviewed.Results All 4 patients had no confirmed diagnosis at first visit to hospital.All patients received the operative therapy and postoperative bleomycin,etoposide and cis-platinum (BEP)regimen chemotherapy.The followed up lasted for 3-32 months.One case died at postoperative 26 months due to pulmonary metastasis;one case was loss of follow up;two cases had relatively favorable condition.Conclusion Nongestational choriocarcinoma is a rare and highly invasive trophoblastic neoplasm,and is prone for early distant metastasis.The treatment is recommended to adopt operation combined with postoperative combined chemotherapy of multiple drugs.

We present a case of two-year old boy with solitary atypical adenomatous hyperplasia (AAH) in extralobar sequestration (ELS), which was misdiagnosed as diaphragmatic hernia before surgery. Review of AAH and pulmonary sequestration (PS) revealed that the present case is the youngest of solitary AAH and also the first report of solitary AAH arising in ELS without a primary lung cancer. In a sense, the present case firstly supports the hypothesis that ELS may be an underlying cancer predisposition syndrome, so aggressive surgical therapy should be recommended for ELS.

Objective To investigate the effect of uterine cavity injection of absolute ethanol on estrous cycle in mice.Methods Twenty mice with regular estrous cycle were selected by vaginal exfoliated cells staining, and then were injected absolute ethanol into their uterine cavity.The estrous cycle was observed and recorded every day.Ten mice were selected randomly to observe the changes of second estrous cycle every two hours.Results After the injection of absolute ethanol into the uterine cavity of the experimental mice, the estrous cycle was greatly prolonged, and the various degree of disorder was observed in estrus and pre-estrus.Conclusions The disorder was observed in estrous cycle of mice after the injection of absolute ethanol, which maybe provides some references for clinical use of absolute ethanol.

Objective To investigate the clinical significance of gastric cracks by investigating the relationship between stomach cracks under gastroscopy and H.pylori infection as well as its pathological manifestation,in order to improve the detection rate of H.pylori.Methods Gastroscopy patients were enrolled as our subjects excluding those with tumors,major diseases and under 18 years old.Mucosal biopsies were obtained from the lesser curvature of antrum and the greater curvature of body in each patient,then by HE staining,pathological and HP examination.The information including the pathological diagnosis,HP antibody,rapid urease test,endoscopic diagnosis and endoscopic gastric body cracking phenomenon were collected from all patient.H.pylori positivity was defined as a patient who showed two or more positive results in the Rapid Urea's Test,pathohistological examination and H.pylori antibody detection.Results (1) 437 patients with gastroscopy were included between December 2009 and December 2011,among whom 210 were male and 227 were female.There were 32 cases with gastric ulcer,59 cases with duodenal ulcer,51 cases with duodenitis,62 cases with reflux esophagitis,and 276 cases with chronic gastritis.(2) H.pylori distribution in stoma of all patients:160 of 437 patients(36.61％) are H.pylori positive,of which 68.75％ (110/160) was found H.pylori positive in both of gastric antrum and body,25.63％ (41/160) was H.pylori positive only in antrum,and 3.13％ (5/160) was H.pylori positive only in the body of stomach.(3)Relationship between the presence of cracks in gastric body and H.pylori infection:the H.pylori positivity was 62.58％ (97/155) and 22.34％ (63/282) respectively in the group with or without the presence of cracks in body.Cracks in gastric body examined by gastroscopy was related to H.pylori infection(x2 =69.788,P =0.000).(4) Relationship between the presence of cracks in gastric body and patho-histology:the presence of cracks in gastric body was related with severity of gastric inflammation by Wilcoxon rank sum test (P ＜ 0.0001),while there was no relationship between gastric body cracks and atrophy,intestinal metaplasia and atypical hyperplasia(P ＞ 0.05).(5) Relationship between the presence of cracks in gastric body and diseases:the presence of cracks in body was related with duodenitis,bile reflux under gastroscopy while there was no difference among in gastric body and gastric ulcer,esophagitis and chronic gastritis in terms of cracking appearance (P ＞ 0.05).Conclusion Our finding showed that cracking appearance in the gastric body is related with severity of inflammation in gastric mucosa bile reflux and duodenitis,suggesting that it can be one of the gastroscopic manifestations of more severe gastritis.