Objective To explore the therapeutic effects of carvedilol on renal and heart function,and on heart structure of patients with uremic cardiomyopathy.Methods One hundred and four patients with uremic cardiomyopathy were randomly divided into two groups(52 each).Patients in control group were treated with routine therapy,and in carvedilol group were treated with carvedilol 12.5-50mg/d in addition to routine therapy.The total course of treatment was 6 months.The related data of left ventricle were determined by echocardiography,and blood urea nitrogen(BUN),serum creatinine(Scr)and clearance rate of creatinine(Ccr)were measured before and after the treatments.Results After the treatment,the stroke volume(SV),cardiac output(CO)and ejection fraction(EF)were increased,and left ventricular end-diastolic diameter(LVEDD),left ventricular mass(LVM),left ventricular mass index(LVMI),end-diastole interventricular septum thickness(IVST)and end-diastolic left ventricular wall thickness(LVPWT)were decreased in both groups compared with those before the treatment(P0.05).Conclusion Carvedilol may effectually inhibit the ventricular remodeling of the patients with uremic cardiomyopathy,improve their left ventricular function and structure,but has no obvious effect on the renal function.

BACKGROUND:Recent studies have shown that platelet rich plasma has strong osteogenic ability and it has been widely used in the field of department of orthopedics and department of stomatology, but experimental study on avascular necrosis of the femoral head has been not reported.
OBJECTIVE:To observe the effect of platelet rich plasma gel combined with marrow core decompression in the repair of aseptic necrosis of rabbit femoral head.
METHODS:A total of 25 New Zealand white rabbits were obtained. Without dislocation of the hip joint, aseptic necrosis model was established by using liquid nitrogen cryotherapy on bilateral femoral head of rabbits. At 2 weeks after model establishment, rabbit models were randomly assigned. Model group with nine rabbits did not receive any treatment. Core decompression group with eight rabbits underwent core decompression treatment. Combination group with eight rabbits underwent core decompression combined with platelet rich plasma gel treatment. At 8 weeks after model induction, tissue sections of femoral head specimens were col ected and subjected to MRI and hematoxylin-eosin staining.
RESULTS AND CONCLUSION:(1) MRI examination:The model group showed low signal area of different forms in femoral head fat high signal, exhibited annular, ribbon and focal shapes. No evident changes in osteogenesis, no apparent minification of the defect cavity were detected at defect site in the core decompression group, showing long T1 and T2 signals. Defect cavity disappeared, and new bone of short T1 and T2 signals fil ed in the combination group. (2) Hematoxylin-eosin staining:Articular cartilage defect and repair existed in the model group, showing osteoarthritis-like changes. Empty bone lacuna of bone trabecula, hematopoietic celland adipocyte necrosis in bone marrow were detected in the core decompression group. Empty bone lacuna of bone trabecula, focal necrosis scattered in bone marrow were visible in the combination group. Results suggested that the outcomes of platelet rich plasma gel combined with core decompression were better than core decompression alone in treatment of rabbit models of femoral head necrosis.

Objective: To study the characteristics of peripheral nerve conduction (PNC) in advanced-stage amyotrophic lateral sclerosis (ALS) patients undergoing mechanical ventilation. Methods: The sensory conduction velocity(SCV), motor conduction velocity (MCV), distal motor latency (DML) and amplitude of compound muscle action potential (CMAP) were determined in three ALS patients undergoing mechanical ventilation. The clinical data and PNC characteristics of the patients were analyzed. Results: The 12 motor nerves were abnormal in all the three patients, including absence of responsive wave (66.7%, 8/12), decreased amplitude of CMAP(33.3%, 4/12), prolongation of DML(16.7%, 2/12) and reduction of MCV (16.7%, 2/12). The CMAP amplitude of patients gradually decreased with the progression of disease, and finally led to adverse reactions. The SCV and amplitude of sensory nerve action potential were normal in all the three patients. Conclusion: ALS patients undergoing mechanical ventilation may have severely damaged motor nerve conduction, and their sensory nerve is generally not affected, with the specific reason remains to be further studied.

Objective To explore the characteristics of hereditary spastic paraplegia with thin corpus callosum (HSP-TCC). Methods Clinical, electrophysiological, MRI features of 3 patients with HSP-TCC were reported. The genetic characteristics were reviewed. Results 3 patients revealed difficulty in walking, slowly progressive weakness, spasticity of the lower limbs and mental impairment. The electromyogram in 2 cases showed neurogenic damage in lower limbs muscle, and 1 case showed peripheral nerve damage. Cerebral MRI showed an extremely thin corpus callosum on sagittal image. The locus of 15q13-15 has been identified for HSP-TCC, but some HSP-TCC families have not been linked to this locus.Conclusion HSP-TCC is a common subtype of complicated HSP inherited by autosomal recessive mode. Brain MRI showed extremely thin corpus callosum. Electromyogram many reveal neurogenic damage.

Objective To investigate the concentration of monocyte chemoattractant protein-1 (MCP-1) and interleukin-18 (IL-18) in the urinary of children with primary nephrotic syndrome(PNS) at different time points,and to explore their correlation with occurrence,development,progression,and prognosis of PNS.Methods A total of 65 pediatric cases from our hospital was enrolled in this study,and was divided into three groups based on the retrospective the follow-up results including steroid-sensitive NS (SSNS) (n =35),steroid-resistant NS (SRNS) (n =15),and frequent-relapse NS (FRNS) (n =15) groups.Another 20 healthy children served as normal controls.Peripheral blood samples and urine specimen were collected at three time points (without glucocorticoids,treatment after 8 weeks,and treatment after 16 weeks or recurrence).The levels of MCP-1 and IL-18 in the urine were assayed by enzyme-linked immunosorbent assay (ELISA).The levels of blood urea nitrogen,creatinine,and 24-hour urinary protein excretion were assayed by full-automatic biochemical study appliance.Results (1)In SSNS group,the levels of urinary IL-18 before treatment and treated for 8 weeks were higher than the normal control group [before treatment:(160.30 ±27.29) pg/ml; treated for 8 weeks:(157.62 ±26.85) pg/ml; normal control group:(70.88 ± 14.43) pg/ul].However,after treated for 16 weeks,the levels of urinary MCP-1 and IL-18 were markedly decreased compared with that of control group and those before treatment and treated for 8 weeks [treated for 16 weeks:(20.98 ±4.53) pg/ml,and (79.09 ±7.23) pg/ml,P ＜0.05].(2)In SRNS group,the levels of urinary MCP-1 and IL-18 before treatment were remarkably higher than that of control group and that of SSNS group before treatment[SSNS group before treatment:(76.84 ± 5.58) pg/ml,and (252.37 ± 25.34)pg/ml,P ＜0.05],but no significant difference was found when it was compared with that treated for 8 weeks [treated for 8 weeks:(72.32 ±4.30) pg/ml,and (243.70 ±35.43) pg/ml,P ＞0.05] ; However,its level was markedly decreased after treated with immunosuppressants of CTX for 16 weeks when it was compared with those before treatment and treated for 8 weeks[treated for 16 weeks:(34.03 ± 2.56) pg/ ml,and (114.42 ± 21.33)pg/ml,P ＜ 0.05].(3)In FRNS group,the levels of urinary MCP-1 and IL-18 were no remarkable difference between control and SSNS groups [before treatment:(30.43 ± 4.61) pg/ml,and (156.65 ± 34.39)pg/ml; treated for 8 weeks:(29.41 ± 4.76) pg/ml,and (152.21 ± 34.73) pg/ml,P ＞ 0.05],but its level was markedly lower than SRNS group (P ＜ 0.05).When it was recurred,the levels of urinary MCP-1 and IL-18 were significantly increased compared with before treatment and treated for 8 weeks[recurred:(72.92 ±3.01)pg/ml,and (224.33 ±26.07)pg/ml,P ＜0.05].(4)No correlation was found between the levels of MCP-1 and IL-18 and the levels of blood urea nitrogen and creatinine (P ＞0.05).Positive correlation was found between the levels of MCP-1 and IL-18 and the 24-hour urinary protein excretion (r =0.706,0.556,P ＜0.01).There's a correlation between urinary MCP-1 and IL-18 (r =0.811,P ＜ 0.01).Conclusions For children with PNS,the detection of urinary MCP-1 and IL-1 8 contributed to the early prediction of children'sensitivity on glucocorticoid.The elevated levels of urinary MCP-1 and IL-18 in combination with clinical symptoms and proteinuria can be used as an important noninvasive marker to monitor PNS recurrence.

Bone Marrow Cells ; pathology ; Bone Marrow Neoplasms ; pathology ; physiopathology ; Humans ; Neoplasm Metastasis ; pathology ; physiopathology ; Tumor Cells, Cultured

OBJECTIVE:To evaluate the feasibility and effectiveness of Hazard analysis and critical control point (HACCP) system in the process of production of Loratadine tablets. METHODS:Taking wet granulation and tableting technology of Lorata-dine tablets as an example,and through the introduction of the concept of HACCP,the basic theory and method of HACCP were applied for hazard analysis on each production link to find critical control points and set critical limits for production quality man-agement. RESULTS:By HACCP analysis,three links namely drying,granules fitting and mixing,internal and external packaging were finally determined as the critical control points in the process of production of Loratadine tablets,thereby critical control lim-its were set for monitoring. After effective control over the risks in the process was ensured,HACCP work plan was made and veri-fied,and the results showed that HACCP system could effectively control and reduce the risks in the process of production and en-sure quality safety. CONCLUSIONS:Application of HACCP system to wet granulation and tableting technology of Loratadine tab-lets can fully embody its feasibility and effectiveness.

Objective To observe the therapeutic effects of rude rhubarb on intestinal barrier in septic patients. Methods A total of 40 septic patients were enrolled in this study and randomly divided into two groups:rude rhubarb treatment group(a=18)and control group(n=22).The ratio of laetulose to mannitol(L/M)and D-lactate were determined on the first day and the 6th day after patients were enrolled.Results No signifieant differences were found on L/M and D-lactate in plasma on the first day between the rude rhubarb treatment group and the control group(P＞0.05). The L/M on the 6th day in the eontrol group was(0.1674?0.0361),and that in the rude rhubarb treatment group was (0.0621?0.0128)(P＜0.05).D-laetate in plasma in the 6 th day in the the rude rhubarb treatment group was(0.09?0.03)mmol/L,and was obviously lower than that in the control group(0.24?0.06)mmol/L(P＜0.05). Conclusion Rude rhubarb can improve the intestinal barrier.

OBJECTIVE:To study the classification of deviation in drug production. METHODS:From the perspective of dom-inant and hidden deviation,combining with the theory of risk management,risk of deviation was evaluated with different risk man-agement tools to define the severity of the deviation,and it was handled by different methods. RESULTS & CONCLUSIONS:Ac-cording to the identifiability of deviation in actual management,the deviation was divided into dominance and hidden deviation. The dominant deviation can be divided into deep and shallow level. Whether the causes of deviation could be cleared and the conse-quences could be estimates were judged after the shallow level classification,and the deviation was further divided into simple and complex deviation. As for deviation complex,it could be evaluated with the tools of risk management to define the deviation severi-ty. As for hidden deviation,it needed beforehand preventing with the tools of risk management directly to define deviation levels and provide reference for preventive measures. In the process of deviation management,key point is to relay on the scientific meth-od to identify and classify deviation,and divide the influence levels. Combining the theory of risk management to select and use risk tools is the effective way to solve the problem.

Objective Investigate the effect of applying clinical pathway on the patients undergoing leiomyoma of uterus. Methods As an experimental group of patients, 50 cases of uterine leiomyoma are treated with clinical pathway. By contrast, another 100 cases are treated with the traditional medical care as control group. Results Waiting time for surgery and hospital stay of the experimental group are less than the control group; and the average hospitalization cost of experimental group is lower than the control group (P< 0.01). Conclusions Application of clinical pathway management will regulate the activities of medical treatment, ensure the quality of health care, improve the feeling of patients, increase efficiency of hospital services, reduce the financial burden of patients, increase the hospital social benefits.