Objective To observe the therapeutic efficacy of Ganshuang granules in the treatment of hepatic fibrosis.Methods Sixty-eight patients with cirrhosis due to chronic hepatitis B (CHB)were divided into experimental group (n=34)and control group (n=34).Both groups received adefovir dipivoxil for 6 months,and the experimental group received Ganshuang granules additionally for 24 weeks.After treat-ment,the changes in hepatic fibrosis indices including hyaluronic acid (HA),laminin (LN),collagenⅣ(CⅣ),and precollagenⅢ(PCⅢ),as well as liver stiffness value were evaluated by paired t test.Results In the experimental group,the serum levels of HA,LN,CⅣ, and PCⅢwere significantly decreased by 37.5%,34.2%,35.4%,and 39.9%,respectively (t=2.238,2.151,2.148,and 2.198,P<0.05 for all),and the liver stiffness value was significantly cut by 40.6%(t=2.189,P<0.05).However,the control group showed no sig-nificant changes in these indices.Conclusion For patients with cirrhosis due to CHB,Ganshuang granules can effectively reduce serum mark-ers of hepatic fibrosis and liver stiffness value and have a good therapeutic efficacy in the treatment of hepatic fibrosis.

Objective To explore the value of procalcitonin (PCT) in diagnosis and treatment of neonatal ventilator associated pneumonia(VAP).Methods Sixty neonates needed invasive mechanical ventilation admitted to our NICU from Jan 2012 to Dec 2013 were divided into VAP group (30 cases) and nonVAP group (30 cases),depending on whether the neonates developed to VAP or not in 7 days.The VAP group then was randomly divided into PCT group (15 cases) and control group(15 cases) according to random number table.The levels of serum PCT,C-reactive protein(CRP) and WBC count were detected when the neonates suspected VAP before and after mechanical ventilation.Besides,the sensitivity,specificity,positive and negative predictive values for PCT,CRP and WBC were calculated in the diagnosis of VAP.Results The serum levels of PCT in VAP group had significant difference before and after mechanical ventilation (t =1.58,P =0.000),the levels of PCT were (0.37 ± 0.25) μg/L and (2.17 ± 1.46) μg/L respectively.The levels of PCT in non-VAP group had no significant difference (t =3.67,P =0.055).The levels of CRP and WBC showed no significant differences between VAP and non-VAP group before mechanical ventilation (P ＞ 0.05).Taking PCT ≥0.40 μg/L,CRP≥ 28 mg/L and WBC ≥ 10 × 109/L as the cut off value,the sensitivity of the three indicators diagnosis of VAP were 93.3％,73.3％ and 66.7％ respectively.PCT had the highest sensitivity 93.3 ％,specificity 73.3％,positive predictive 77.8％ and negative predictive 91.7％.The antibiotic duration of PCT group was (12.6 ± 5.6) d compared with (15.1 ± 9.1) d in control group (P =0.018).Conclusion Serum PCT has high sensitivity and specificity in the diagnosis of VAP,PCT combined with clinical pulmonary infection score can improve the diagnostic accuracy of VAP,early diagnosis and timely monitoring of serum PCT is helpful in VAP.PCT guidance substantially reduces antibiotic use in VAP,so that timely surveillance of PCT is necessary for patients on ventilator.

Brain injury in preterm infants is an important reason for making the newborn disability.Neonatal cerebral injury of imaging examination method has a time lag.Looking for a simple,timely,accurate predictor of biological markers of brain injury in preterm infants is particularly important.In this paper,the role of S100B protein,glial fibrillary acidic protein and neuron-specific enolase of brain injury in preterm infants was reviewed,and the significance of early diagnosis of brain injury in preterm infants was discussed.

Objective To investigate the incidence of retinopathy of prematurity (ROP) in our hospital and to explore the risk factors of ROP.Methods Premature infants hospitalized in our hospital in January 2010 to December 2012 were chosen,and the gestational ages were less than 36 gestational weeks,birth weights were under 2 500 g.All the cases underwent ROP screening at two weeks after birth,and then they received regular follow-up.Children with systemic conditions and oxygen to the mother during pregnancy,oxygen,preeclampsia,placental abruption,and other factors were analyzed.Results Two hundred and fifty-five cases completed the retinal screening,terminated follow-up after the peripheral retinal neovascularization or disease degradation.We found ROP in 16 cases (26 eyes),ROP prevalence rate was 6.3％ (5.1％),including phase Ⅰ 12 cases,phase Ⅱ3 cases,phase Ⅲ 1 case.Gestational age,birth weight,inhale oxygen time,oxygen concentration,mechanical ventilation were associated with ROP (P ＜ 0.05).Mother oxygen during pregnancy,preeclampsia,placental abruption had nothing to do with the incidence of ROP.Conclusion Premature birth,high concentrations of oxygen,mechanical ventilation are major risk factors of ROP.Timely screening of ROP and found early to do the retinal laser photocoagulation in premature,can control the disease,reduce the blindness rate of premature infants.

OBJECTIVE:To observe the curative effects of compound glycyrrhizin injection in treatment of primary sjogren syndrome(PSS).METHODS:68 patients with PSS were randomized into the treatment group and control group,and treated for 4wk with hydroxypiperaquine,bromhexine and carmellose.The treatment group also received compound glycyrrhizin injection in addition to the three agents for the control group.RESULTS:After treatment for 4wk,both groups saw some declines in IgG,IgM,IgA,ESR and RF,and improvement in indicators such as schemer test and saliva flow rate,with the treatment group showing more significant improvement than the control group(P

OBJECTIVE: To study the curative effect of Sodium Ferulate( SF) on rheumatoid arthritis( RA) and its effects on the levels of serum vascular endothelial growth factor( VEGF) and tumor necrosis factor- ? ( TNF- ? ) . METHODS: A total of 43 patients with RA were randomly divided into trial group and the control group: conventional treatment was adopted in both groups, but the trial group was treated additionally with SF injection for 4 consecutive weeks. Serum levels of VEGF and TNF- ? before and after treatment were determined by the enzyme linked immunosorbent assay( ELISA) . RESULTS: The total effective rate in the trial group the control group were 91. 30% vs. 75. 00% ( P

Autoimmune Diseases ; drug therapy ; Hepacivirus ; Hepatitis C ; drug therapy ; Humans ; Interferons ; therapeutic use

Objective To investigate the pathogen and incidence of ventilator-associated pneumonia (VAP) under different pH value of gastric juice,and to explore the endogenous pathogenesis of VAP.Methods Ninety-eight cases were admitted in our neonatal intensive care unit from Dec 2008 to Dec 2010.According to whether VAP happened,they were divided into VAP group (52 cases) and non-VAP group (46 cases).The relation between pH value of gastric juice and the species of pathogenic bacteria in stomach was analyzed.Results The incidence of VAP was 53.1％ (52/98).The pH value of gastric juice affected the species of pathogenic bacteria in stomach.When pH ≤ 4,the major species of pathogenic bacteria were Candida and Gram-positive bacillus; and pH ＞ 4,the major species were Gram-negative bacillus.The incidence of VAP was 34.5％ (10/29) when pH≤4;on the contrary,the incidence was 60.9％ (42/69) when pH ＞ 4.The incidence of VAP at the time of pH ＞ 4 was significantly higher than that of pH ≤4 ( x2 =5.71,P =0.017).Conclusion The pH value of gastric juice is an important factor of the species of pathogenic bacteria in stomach,especially for Gram-negative bacillus,including multi-drug resistant extended-spectrum β-lactamase-producing bacteria.The higher of pH value,the incidence of VAP is higher.

Objective To explore the method that can block the infection route from stomach to lung so as to reduce the incidence of ventilator-associated pneumonia (VAP) in neonates.Methods Neonates with mechanical ventilation were randomly divided into two groups,the treatment group(40 cases) were given probiotics (Bifidobacteria) by nasogastric feeding,control group(40 cases) were given nothing.Prospective survey was performed on the incidence of VAP,gastric juice pH,gastric bacterial colonization,the homology between gastric bacterial colonization and VAP pathogen.Results The VAP incidence of treatment group and control group was 12.5％ (5/40) and 47.5％ (19/40) respectively,there was significant difference between the two groups ( x2 =10.21,P ＜ 0.01 ).The onset time of VAP in treatment group [ ( 5.4 ±2.1 ) d] was later than that of control group[ (4.3 ± 1.0) d] ( t =3.2,P ＜0.01 ).The ratio of treatment group that gastric juice dropped to pH≤3 (80.0％,32/40) was higher than that of control group(47.5％,19/40) ( x2 =11.5,P ＜ 0.01 ) ; and the ratio of gastric bacterial colonization in treatment group ( 30.0％,12/40) was lower than that in control group(80.0％,32/40) ( x2 =16.9,P ＜0.01 ).The homology ratio between VAP pathogen and colonization bacteria in treatment group (40.0％,2/5 ) was lower than that in control group (78.9 ％,15/19 ) ( x2 =8.7,P ＜ 0.01 ).Conclusion Probiotics can reduce gastric juice pH of neonates and inhibit gastric bacterial colonization.The onset time of VAP can be delayed,the incidence of VAP can be reduced effectively.

Objective To survey and analyze the factors that may affect the results of human-ities education about master degree postgraduates, and provide the basis and reference for traditional medical humanities education reform. Methods By using the self-made questionnalre, a survey was conducted among 100 medical postgraduates of a university. Questionnalre items included basic infor-mation of the postgraduates, humanities-related extracurricular experiences, whether there had been personal experiences corresponding to these options or these experiences affected the attitude of hu-manistic education options. The survey data were analyzed using SPSS 19.0 software and the results were expressed by the relative number. The differences between different gender, marriage and differ-ent specialty student satisfaction were analyzed by using chi-square test or Fisher's exact test, showing no statistical significance (P>0.05). Results Respondents believed that the highest rate of the top four which supported the experiences that promoted humanistic education were clinic volunteer activi-ties, interpersonal harmony, rescuing the patient experiences and illness experiences, accounting for 95.8%(91/95), 92.6%(88/95), 89.5%(85/95) and 88.4%(84/95), respectively. On the other hand, the highest rate of the top four that impeded humanities education-related experiences were academic stress, workload, limited communication and lack of humane care, accounting for 100.0% (95/95), 95.8%(91/95), 91.6% (87/95) and 84.2% (80/95) respectively. In addition, different types of students' attitude towards experiences that may have impact on the humanistic education were not statistically significant (P>0.05). Conclusion Humanities education in medical colleges should not be limited to classroom instruction form. We should broaden humanistic education approach, flexible assessment methods of humanities, to enhance the effect of humanities education.