Objective To discuss the therapy for acute gastric mucosal lesion(AGML)after pericardial devascularization of advanced schistosomiasis. Methods Fifteen advanced schistosomiasis patients with AGML after pericardial devascularization re-ceived supporting therapy,reducing stomach acid and protecting gastric mucosa therapy,reducing gastric blood flow therapy,en-doscopic spraying topical hemostatic agents or electric coagulation therapy,etc. Results After pericardial devascularization of ad-vanced schistosomiasis,15 patients occurred AGML,and among which,10 cases occurred from 8 to 14 days,and the shortest pe-riod was 5 days and the longest was 23 days. Among the 15 patients,13 patients were cured(86.7%),and 2 died. Conclusion The comprehensive therapy including supporting therapy,reducing gastric acid and protecting gastric mucosa,and endoscopic he-mostasis is effective in the treatment of AGML.

OBJECTIVE:To put forward policy suggestions on the selection and revision of National Essential Drug List (NEDL) in China. METHODS: The selection principles, criteria and procedures of WHO Model List of Essential Medicines and Australia’s Pharmaceutical Benefits Scheme Directory which was commonly regarded as Essential Drug List of Australia were analyzed to provide reference for the selection and revision of NEDL in China. RESULTS & CONCLUSION: The selection and revision of NEDL which were strongly supported by related policies demand active participation of all social sectors, open and transparent working procedures, scientific and operational methods for selection and revision, authoritative monitoring and aftereffect evaluation system.

OBJECTIVE:To explore a new way for the investigating of processing impact on the property of the traditional Chinese medicine(TCM)so as to provide new ideas and methods for the scientific research on TCM.METHODS:Ideas of in?vestigating the impact of processing on the property of TCM by using the method of biothermodynamics and setting up a new method system of research and evaluation on TCM were put forward through reviewing and analyzing the status quo and problems of processing impact on property of TCM and the commonness and characteristics between TCM and biothermody?natics.RESULTS&CONCLUSIONS:Theoretically and practically,it is feasible to investigate processing impact on the property of TCM by using biothermodynamic ideas and methods,and it is expected that which can serve as a new visual angle and technical platform in the modernization study of TCM.

Objective To investigate the clinical significance of ultrasonography in the diagnosis of simple polyhydramnios . Methods 186 singleton pregnancies cases of inpatient and outpatient diagnosed with simple polyhydramnios were divided into three groups with a two-dimensional semi-quantitative method ,separate amniotic fluid index (AFI)> 20cm (A group) ,separate maxi-mum amnionic fluid volume(AFV)>8 cm(B group) ,AFI≥20 cm and AFV≥8 cm(C group) ,and the changes were dynamically monitored .Results Occurrence rates of persistent polyhydramnios and fetal malformations in C group was higher than in the other two groups ,and the difference showed no statistical significance(P<0 .05);No correlation was found between recurrent polyhydr-amnios and fetal malformation among these three groups(P>0 .05);Among the 84 .4% of simple polyhydramnios ,no fetal malfor-mation was found .Conclusion Ultrasound diagnosis of simple polyhydramnios shows clinical value in assessment of fetal malfor-mation ,fetal outcome ,perinatal morbidity and prognosis ,and is good for prenatal counseling and treatment .

Objective To analyze and compare the short-term efficacy and daverse reaction of postoperative adjuvant radio -chemotherapy versus simple chemotherapy in advanced gastric cancer .Methods A total of 64 patients with locally advanced gastric cancer were randomly but equally divided into 2 groups ,experimental group and control group .The experimental group patients ini-tially receive 4-cycles chemotherapy with Capecitabine Tablets 1 000 mg /m2 ,bid ,d1 - 14 plus Oxaliplatin 130 mg/m2 ,d1 ,and then receive Capecitabine Tablets 825 mg /m2 ,bid ,d1 - 35 plus 3DCRT 45 Gy/25 Fx /5 w concurrent radio-chemotherapy .Control group patients receive 6-cycles Capecitabine plus oxaliplatin combined chemotherapy .Then we observed the disease progression time ,toxic reaction ,1 year survival rate and 2 year survival rate simultaneously in two groups .Results The follow-up rate were 100% .The comparative results are listed as follows (experimental group and control group) :the rates of Ⅰ /Ⅱ grades of nausea and vomiting were 87 .50% and 62 .50% respectively (P< 0 .05) ,other adverse reactions were not statistically significant ;1-year overall survival rate and recurrence-free survival rate were 90 .63% ,87 .50% respectively (P > 0 .05) and 84 .38% ,62 .50% respectively (P <0 .05) ;2-year overall survival rate and recurrence-free survival rate were respectively 84 .38% ,59 .38% (P< 0 .05) and 75 .00% , 50 .00% respectively (P< 0 .05) .Conclusion The advantages of 3DCRT combined with Capecitabine Tablets chemoradiotherapy can raise the successful rate of local control in patients with advanced gastric cancer after operation and 4 cycles chemotherapy .The toxic reactions are tolerable for patients .

Objective To explore the clinical features of transbronchial tuberculous mediastinal lymph-adenitis and value of bronchoscopic interventional therapy. Methods The clinical data of 50 patients who had been diagnosed as tuberculous mediastinal lymphadenitis and had received bronchoscopic interventional therapy in our hospital during the period from January 2008 to January 2013 were retrospectively analyzed. The bronchoscopic change , improvement in symptoms , and time to sputum smear and culture conversion were used to assess the therapeutic effect. The patients were followed up for six months. Results The mean age of the patients was (35 ± 15) years and the male to female ratio was 1:1.2. The lesions occurred mostly at the right middle lobe in 24% (12/50) of the patients. The total effectiveness rate was up to 98% (49/50) after chemotherapy and bronchoscopic interventional therapy. The major complication associated with interventional therapy was hemoptysis (8%, 4/50). After follow-up of 6 months , 49 patients with active lesions were stable , with smooth bronchial mucosa and no obvious obstruction by granulation and caseous necrosis tissues. Conclusions The relavent clinical symptoms of transbronchial tuberculous mediastinal lymphadenitis is mainly caused by tuberculosis inflammation which destroys and blocks the airway. The fiber bronchoscopic therapy with forceps clip and drug infusion has a definite effect and fewer complications.

ObjectiveTo estimate the value of transthoracic coronary flow Doppler imaging to detect coronary flow reserve (CFR) changes in patient with obstructive sleep apnea syndrome (OSA). Methods Fifty patients with OSA who hospitalized or were outpatient in Aerospace 731 Hospital during the period of 2010 March to 2013 December were enrolled in this study and were divided into three groups according to apnea hypopnea index (AHI). Eighteen cases of patients which AHI was greater than 5 and less than 20 were defi ned as mild group, 16 cases of patients which AHI was more than 20 and less than 40 were defi ned as middle group, 16 cases of patients which AHI was greater than 40 were defi ned as severe group. The diastolic peak velocity (PDV) and meanfl ow velocity (MDV) of the distance segment of left anterior descending coronary (LAD) were measured by transthoracic echocardiography at rest and after intravenous infusion of adenosine triphosphate (ATP). Meanwhile, CFR was calculated. Forty healthy persons were chosen as control group. Thettest was used to compare the difference of PDV, MDV and CFR between OSA group and healthy controls. The single factor analysis of variance was used to compare the difference of PDV, MDV and CFR in patients with different AHI. SNK -q test was used to compare in different OSA groups. Thet test was used to compare the difference of PDV, MDV among OSA group, healthy control and OSA groups with different AHI at rest and after intravenous infusion of ATP.ResultsCoronaryfl ow velocity Doppler signals were successfully obtained in all the groups. PDV ([92.78±7.68] cm/s) and MDV ([85.93±6.98] cm/s) after intravenous infusion of ATP in control group were significant higher than those at rest ([28.09±4.55] cm/s and [21.76±5.09] cm/s) (t=49.687 and 58.259, bothP<0.001). PDV ([82.73±6.91] cm/s) and MDV ([77.39±6.73] cm/s) after intravenous infusion of ATP in OSA group were signifi cant higher than those at rest ([29.93±3.66] cm/s and [22.28±4.15] cm/s) (t=55.381 and 47.700, bothP<0.001). There was no statistically signifi cant difference between PDV and MDV at rest in OSA group and control group. The difference of PDV and MDV between OSA group and normal group was statistically signifi cant after intravenous infusion of ATP (t=6.524 and 5.884, bothP<0.01). There was no statistically signifi cant difference between OSA groups with different AHI at rest. There were statistically signifi cant difference between OSA groups with different AHI after intravenous infusion of ATP (5≤AHI<20:t=-32.903 and-32.771, both P=0.000; 20≤AHI<40:t=-37.122 and-32.623, bothP=0.000; AHI>40:t=-28.197 and-20.184, both P=0.000). PDV and MDV of patients with AHI>40 were less than those of patients with 5≤AHI <20 and 20≤AHI<40 and the differences were statistically signifi cant (PDV:q=21.048 and 15.667, bothP<0.05; MDV:q=12.958 and 18.182, bothP<0.05). However, the differences of PDV and MDV was not statistically signifi cant between patients with 5≤AHI<20 and patients with 20≤AHI<40.The CFRmax and CFRmean in OSA group were lower than those in control group (t=5.310 and 6.430, bothP=0.000). There were statistically signifi cant difference for CFRmax and CFRmean in patients with different AHI and the difference decreased with severity of OSA increased. The CFRmax and CFRmean in patients with 5≤AHI<20 were higher than those in patients with 20≤AHI<40 and AHI>40 (CFRmax:q=2.889 and 4.142, bothP<0.05; CFRmean:q=3.080 and 4.204, bothP<0.05). There was no statistical signifi cant difference for CFRmax and CFRmean between patients with 20≤AHI<40 and patients with AHI>40.ConclusionsIn patients with obstructive sleep apnea syndrome, transthoracic coronaryfl ow imaging combined with intravenous infusion of adenosine triphosphate shows impaired in CFR. It means the patients with OSA have a coronary artery microcirculation impairment in early stage. Assessing CFR in the patients with OSA is of important clinical value for the evaluation of treatment effective of medicine and surgery and follow-up.

Objeetive To explore the effects of renal artery calcification on the progression of diabetic nephropathy (DN),the activation and its role of bone morphogenetic protein 2(BMP2) signal pathway in renal artery of rats.Methods Sixty male SD rats were randomly divided into control group(CON group),DN group and DN with vascular calcification group (DN+VDN group).Rats of group DN and DN + VDN were fed with high sugar and fat diet and injected with streptozocin (STZ) into abdominal cavity to induce diabetes.After diabetic models were successfully made,rats of group DN+ VDN were treated by vitamin D3 plus nicotine.The rats were sacrificed at 8th,12th and 16th week respectively and the levels of renal function,blood glucose and 24 h urinary protein (24-h Upro) were measured.The pathologic changes to the renal artery were observed by yon-Kossa staining and the calcium content was detected by calcium assay kit.The pathologic changes to the kidney were observed by HE.Immunohistochemistry was applied to detect the protein expression of BMP2/Smad1/Runx2/ Osterix signal pathway in the renal artery and real-time PCR were applied to detect the mRNA expression levels of BMP2 and Runx2.Results The calcium content and the deposition of black granules in DN group were significantly higher than those in group CON and lower than DN + VDN group at each time point (P ＜ 0.05).The renal function indices in group DN and group DN+VDN were gradually increased in 8th,12th and 16th weeks,and were higher than those in group CON (P ＜ 0.05).Compared with that in DN group,although the level of BUN,Scr,Cys C and 24-h Upro in DN+VDN group rats were higher at different time point,the level of Cys C at each time point and the level of 24-h Upro in the 16th week showed significant differences (P ＜ 0.05).The pathological damages of the kidney in group DN and DN+VDN showed a continual worsening trend and the pathological changes of the kidney in group DN+VDN were more serious than those in group DN.Furthermore,the levels of BMP2/Smad1/Runx2/Osterix signal protein and BMP2,Runx2 mRNA in DN rats were higher than those in CON group,lower than DN+VDN group at each time point (P ＜ 0.05).Correlation analysis demonstrated that calcium content was positively correlated with serum BUN,Scr,Cys C,24-h Upro and the expression of BMP2,Runx2 mRNA (r=0.835,0.705,0.829,0.897,0.641,0.683,P ＜ 0.01,respectively).Conclusion Renal artery calcification may participate in and promote the progression of DN,and the BMP2 signal pathway may be an important regulating factor in DN with renal artery calcification.

Objective Acute kidney injury (AKI) frequently occurs after catheter-based interventional procedures and increases mortality. How-ever, the implications of AKI before thoracic endovascular aneurysm repair (TEVAR) of type B acute aortic dissection (AAD) remain un-clear. This study evaluated the incidence, predictors, and in-hospital outcomes of AKI before TEVAR in patients with type B AAD. Meth-ods Between 2009 and 2013, 76 patients were retrospectively evaluated who received TEVAR for type B AAD within 36 h from symptom onset. The patients were classified into no-AKI vs. AKI groups, and the severity of AKI was further staged according to kidney disease:im-proving global outcomes criteria before TEVAR. Results The incidence of preoperative AKI was 36.8%. In-hospital complications was significantly higher in patients with preoperative AKI compared with no-AKI (50.0%vs. 4.2%, respectively;P<0.001), including acute renal failure (21.4%vs. 0, respectively;P<0.001), and they increased with severity of AKI (P<0.001). The maximum levels of body tem-perature and white blood cell count were significantly related to maximum serum creatinine level before TEVAR. Multivariate analysis showed that systolic blood pressure on admission (OR:1.023;95%CI:1.003–1.044;P=0.0238) and bilateral renal artery involvement (OR:19.076;95%CI:1.914–190.164;P=0.0120) were strong predictors of preoperative AKI. Conclusions Preoperative AKI frequently oc-curred in patients with type B AAD, and correlated with higher in-hospital complications and enhanced inflammatory reaction. Systolic blood pressure on admission and bilateral renal artery involvement were major risk factors for AKI before TEVAR.

Objective To explore the effects of renal artery calcification on the renal function in type 2 diabetic ne-phropathy rats .Methods Rats were randomly divided into control group ( CON group ) , diabetic nephropathy group ( DN group) and DN with vascular calcification group ( DN+VC group) .Rats of group DN and DN +VC were fed with high sugar and fat diet and injected with streptozotocin (STZ)into abdominal cavity to induce type 2 diabetes. After diabetic models were made , rats of group DN+VC were treated by vitamin D 3 plus nicotine .The rats were sacrificed at 8 , 12 and16 week respectively and the pathologic change to the renal artery were microscoped by von Kossa staining .The calcium content were detected by calcium assay kit and double immunofluorescence staining and real-time polymerase chain reaction ( RT-qPCR) were applied to detect the protein and gene expression levels of BMP2 in the renal artery.Measure the levels of blood urea nitrogen (BUN),serum creatinine (Scr),cystatin C (Cys C) and 24 hour urinary protein (24-h UA)respectively at the 8th,12th and 16th weeks.Histopathology of kidney was assessed by hematoxylin/eosin staining .Results The deposition of black granules , the calcium content and the protein and gene expression levels of BMP 2 in DN group were significantly higher than those in group CON and lower than DN+VC group at each time points(P<0.05).The BUN, Scr, Cys C and 24-h UA in group DN and group DN+VC were gradually increased in 8th,12th and 16th weeks, and were higher than those in group CON( P<0.05 ) .Compared with the DN group , only the level of Cys C at each time point and the level of 24-h UA in 16th week in DN+VC group were significantly higher ( P<0.05 ) .The pathological damages of the kidney in group DN showed a continual worsening trend and the pathological changes of the kidney in group DN +VC were more serious than group DN .Calcium content was positively correlated with the increased serum BUN , Scr, Cys C, 24-h UA and BMP2 mRNA ( all P<0.01 ) .Conclusions The occurrence and severity of renal artery calcification may participate in and promote the progression of DN .