Objective:To observe therapeutic effect of continuous renal replacement therapy (CRRT ) on different types of cardiorenal syndrome (CRS) .Methods :According to patient′s conclition ,a total of 247 CRS patients were divided into type 1 group (n=47) ,type 2 group (n=51) ,type 3 group (n=55) ,type 4 group (n=49) and type 5 group (n=45) .All patients received CRRT ,echocardiography and plasma level of N terminal pro B type natriuretic peptide (NT‐proBNP) detect to evaluate cardiac function status ;the 24h urine volume and endogenous creatinine clearance rate (Ccr) were measured to assess renal function status before and after treatment . Results:Compared with before treatment ,on one week after CRRT ,LVEF ,urine volume and Ccr level significantly rose ,NT‐proBNP level significantly reduced ( P<0.05 or <0.01) .Compared with type 4 and 5 group ,there were significant rise in LVEF [ (48.98 ± 1.55)% ,(44.67 ± 1.48)% vs .(55.13 ± 4.27)% ,(53.73 ± 3.52)% ,(57.95 ± 2.89)% ] ,urine volume [ (1118.83 ± 168.09 ) ml , (1125.47 ± 177.28 ) ml vs . (1655.67 ± 198.37 ) ml , (1697.47 ± 171.27 ) ml , (1702.72 ± 179.28) ml] and Ccr level [ (40.11 ± 1.79) ,(41.11 ± 1.39) vs .(52.33 ± 2.49) ,(50.97 ± 2.11) , (51.32 ± 2.01 )] , and significant reduction in NT‐proBNP level [ (3738.19 ± 118.77 ) , (3378.38 ± 121.82 ) vs . (2137.51 ± 123.59) ,(2421.12 ± 121.22) ,(2139.81 ± 147.28)] in type 1 ,2 and 3 group ,P<0.05 all .Conclusion:CRRT is effective on different types of CRS ,but it′s best on type 1~3 than those of type 4~5 , which may be re‐lated to different pathological mechanisms of CRS different types .

Objective:To investigate the anesthetic choice for patients undergoing cesarean section complicated with placenta implantation.Methods: A retrospective case review of the patients with placenta implantation between 2008 and 2013 at Peking University Third Hospital was conducted in the International Classification of Diseases (ICD)-9 codes,excluding natural birth and not first diagnosed in our hospital,a total of 96 cases were incorporated into this study.According to the degree of implantation,they were divided into three groups: accreta group,increta group and percreta group.We analyzed the time from the start of surgery to baby delivery and the anesthetic technique.Results: The accreta group included 49 cases,the increta group 33 cases,and the percreta group 14 cases.The average time from the start of surgery to fetus delivery in the three groups were (6.7±3.0) min,(7.2±4.6) min,and (11.9±4.9) min,and the percreta group was significantly different from the accreta group and the increta group (P<0.05).There were significant differences among the three groups in anesthetic choices (P<0.001): in the accreta group,45 cases (91.8％) underwent spinal anesthesia,2 cases (4.1％) underwent general anesthesia,and 2 cases (4.1％) were converted to general anesthesia after spinal anesthesia during the operation;in the increta group,22 cases (66.7％) underwent spinal anesthesia,4 cases (12.1％) underwent general anesthesia,and 7 cases(21.2％) were converted to general anesthesia after spinal anesthesia;in the percreta group,2 cases (14.3％) underwent spinal anesthesia,2 cases (14.3％) underwent general anesthesia,and 10 cases (71.4％) were converted to general anesthesia after spinal anesthesia.Conclusion: Spinal anesthesia can be used as the first choice of cesarean section complicated with placenta implantation and general anesthesia should be considered in placenta percreta.

Objective To evaluate the clinical and pathological features of eosinophilic cystitis (EC),and to discuss its diagnosis and treatment.Methods The clinical and pathological data of one case of eosinophilic cystitis were reported.An 86-year-old male with gross hematuria and urinary urgency for 15 days was admitted on 16 March 2015.A computed tomography scan showed uneven thickening of the bladder wall and a nodular soft tissue on the anterior wall protruding into the bladder cavity.Results Cystoscopic examination showed diffuse thickening of the bladder with polypoid red lesions on the anterior wall.Transurethral biopsies revealed infiltrating eosinophils,which was consistent with the diagnosis of EC.The patient was then treated with anti-inflammatory drugs,corticosteroids and anti-histamine drugs.At 6 months of follow-up,the patient was asymptomatic and had no evidence of local recurrence by ultrasonography.Conclusions Eosinophilic cystitis is a rare disease without specific clinical and imaging features,which can mimic bladder tumor.The final diagnosis of this disease depends on the pathology.Transurethral resection of the lesion along with postoperative hormone and antihistamines administration are the main choices of treatment.

The effect of reaction media cosolvent water activity, temperature and pH on Novozym 435-caulyzed enantioselective esterification of ketoprofen was systematically explored. Novozym 435 showed high catalytic activity and enantioselectivity in cyclohexane; E value increases markedly by addition of toluene to cyclohexane; the optimum temperature and the initial water activity were found to be 30℃ and 0.09 respectively; pH shows little effect on enzymatic reaction wilson the scope studied.

Objective: To explore the influence factors of the degenerate oligonucleotide primered PCR(DOP-PCR). Methods: Genome DNA template from the mouse single oocyte or liver tissue were used to perform DOP-PCR. DOP-PCR was carried out with templates of different origin, different gradient dilution, with or without low melting point gel purified to wipe off the small fragment that might interfere with the following analysis, and then PCR of gene FTCD and CBS were carried out to evaluate the influence of these factors on the amplification efficiency and specificity. Results: Compared with genome DNA template from mouse liver, the template from single oocyte had the same efficiency and specificity but a minor yield and different gradient dilution of DNA template had no effect on the efficiency and specificity. Furthermore, there was a higher specificity in the low melting point gel-purified DOP-PCR product than in untreated ones. Conclusion: We have got a satisfactory result and increased specificity from DOP-PCR product purified with the low melting point gel. Single oocyte of mice could be used for further investigation of special genes detection by DOP-PCR and of an optimization in the yield of the products.

Aim To investigate the method of culturing vascular smooth muscle cells (VSMC) of coronary arteries derived from experimental diabetic rats and to establish the model of VSMC for the study of chronic cardiovascular diseases of diabetes. Method After the establishment of the model of diabetic rats, the coronary arteries of rats were separated carefully to culture VSMC using the method of explanting culture. Results The primary culture of VSMC was performed successfully by the method mentioned above. The cells could be isolated by different kinds of digestive enzyme in three steps. 7 ~10 days afterward, the cells overlapped in layers and displayed the typical ‘hill and valley’ pattern and positive immunochemical staining for smooth muscle actin. Conclusion VSMC from experimental diabetes proliferates faster than normal VSMC and its cultivating condition is strictly limited. The morphology of diabetic VSMC is as same as that of normal rats.

Objective To study the effects of repetitive transcranial magnetic stimulation (rTMS) combined with hyperbaric oxygen (HBO) therapy on the recovery of neurological functional after cerebral infarction,and to discuss its possible mechanism.Methods Forty-five patients with cerebral infarction were randomly divided into a control group,an rTMS group and an rTMS plus HBO group,each group with 15 patients.The patients in the two treatment groups received 1 Hz rTMS to inhibit the unaffected hemisphere and 3 Hz rTMS to stimulate the affected hemisphere.One of the treatment groups also received HBO therapy,14 daily sessions.The National Institutes of Health stroke scale (NIHSS) and the Barthel index (BI) were evaluated on the 1st,14th and 30th day of treatment.Results The neurological function scores of those in the rTMS group and the rTMS & HBO group improved significantly.On the 1st and 14th day,no significant difference in NIHSS or BI scores was observed among the three groups,but by the 30th day the average neurological functional score in the rTMS & HBO group had improved significantly compared with the control group.The rTMS plus HBO group showed significantly better improvement than the rTMS group in terms of BI scores,but no significant difference in average NIHSS and BI scores was observed between the rTMS group and the control group.Fifteen days after the treatments had finished,the follow up results showed the improvements of the patients in the rTMS plus HBO group were significantly better than those in the other groups.Conclusion For patients with cerebral infarction,rTMS combined with HBO therapy can improve neurological function more significantly than rTMS therapy alone.

Objective To explore the experience of nursing patients with Crohn’s disease.Method The nursing histories of 80 patients with Crohn’s disease were retrospectively reviewed to analyze and summarize the measures for nursing them.Result After active treatment and effective nursing,all the patients were improved and discharged.Conclusion Effective nursing is of positive significance to improve the curative effect of Crohn's disease.

Objective To explore the significance of sample cultivation and drug resistance of the patients in PICU with severe lower respiratory tract specimens.Methods 1 107 pathogenic bacteria of lower respiratory tract samples collected were analyzed and the drug resistance was kept watch on.Results A total of 1107 samples were cultured into 948 strains of pathogens,with the positive rate of 85.64%,and 616 strains of Gram negative bacteria accounting for 64.98%,of which 145 strains of Pseudomonas aeruginosa(15.30%),Klebsiella pneumoniae 135(14.24%),Acinetobacter spp 131(13.82%),large intestine Egypt Greek bacteria 89(9.4%);Gram positive cocci 129(13.61%),the main pathogen was staphylococcus aureus and Fungi 203(21.41%),the main pathogen was candida albicans.Carbapenems was the most active antibiotics for gram negative bacill,and vancomycin for gram positive cocci.Conclusion Infectious bacteria have high selectivity to the sensitive antibiotics,and doctors should carefully use antibiotic according to the susceptibility test results in order to reduce hospital infection and the emergence and spread of resistant strains.

OBJECTIVE:To improve the information system of Out-patient pharmacy intravenous admixture center (OUIVA) to improve the pharmaceutical service rendered to the transfusion patient and ensure the safety of drug use. METHODS:The defi-ciency in OUIVA information system of our hospital were analyzed,in which improvement was made with respect to ungrouped doctor’s orders,inconsistency between the total doses charged and the prescribed doses and the error of transfusion days that occurred fre-quently. The conformity rate of out-patient fluid transfusion prescriptions and the time of patients’waiting for transfusion before and after the improvement were compared and evaluated. RESULTS:Improvement was made to OUIVA information system through the optimization of transfusion process,the application of condition limit,the adding of logical operation and verification and the other measures. After improvement,the unconformity rate of out-patient prescriptions in our hospital descended from 11.24% in 2013 to 3.69% in 2014,with an obvious increase in the accuracy rate of dispensing for fluid transfusion;and the time of patients’waiting for transfusion was shortened from 30-40 min to 15-20 min,with an increase in the degree of satisfaction of transfusion patients. CONCLUSIONS:The OUIVA information system can reduce the errors of drug dispensing for fluid transfusion and improve pharmaceutical services.