Objective To study the incidence and treatment measures of complications in esophageal stenting.Methods The processes of implantation of esophageal stents in 60 cases were done,of them,59 cases were malignant disease and 1 case was benign stricture.All cases were followed-up for 3~24 months.The types of stents to be used including domestic metal-coated stainless steel Z-stent in 12 cases,domestic gridding-shape nickel-titanium memory alloy coated stent in 47 cases and imports stent in one.Results The processes were successful in all cases,the complications such as arrhythmia in 2 cases,suffocation in one case during operation,and chest discomfort and feeling of foreign body in 49 cases,nausea and vomiting in 15 cases,chronic infection of esophageal stent upper port in 2 cases,stent displacement in 6 cases,stent obstruction in 16 cases,massive hemorrhage,dyspnea and esophago-thoracic fistula in 1 case respectively for 1~36 weeks after operation.After clinical treatment,except 1 patient died due to bleeding shock,all complications were controlled or improved.Conclusion The majority of complications during or after treatment of esophageal stricture with stent implantation are slight,but the indications of operation should be strictly controlled.

Objective:To investigate the expressions of CD4+ CD25+ T cells and IL-10 in the peripheral blood of patients with systemic lupus erythematosus(SLE) and their clinical significance.Methods:Thirty SLE patients(seventeen active and thirteen remissive) and twenty normal controls were enrolled in the study. Flow-cytometric assay was employed for detection of CD4+ CD25+ T cells,and double antibody sandwich ELISA was applied to detect IL-10 in sera from SLE patients and normal controls.Results:The levels of CD4+ T cells in active and remissive SLE were significant lower than normal controls; the positive rate of CD4+ CD25+ T cells in both active and remissive SLE was higher than that in normal controls; the levels of IL-10 in active stage of SLE were significant higher than in remissive stage of SLE or in normal controls. No correlation was found among the levels of CD4+ CD25+ T cells or IL-10 in SLE with SLEDAI scores, anti-DNA and C3 level.Conclusion:CD4+ CD25+ T cells in the peripheral blood of patients with SLE are the marker for activation of T-cells, and aberrant IL-10 production was related with onset of SLE.

[Objective]To explore new directions for traditional Chinese medicine(TCM) scientific research. [Method]Reviewing RWS overseas in recent years, with a randomized control ed trial(RCT) contrast, this study summarized the RWS features and discussed the limitations and advantages of RCT and RWS when carrying out the TCM scientific research.[Result] RWS is different from RCT in research purpose, brings into exclusion criteria, sample size, intervention and evaluation index, evaluation time, data col ection, management and statistical analysis method, etc. [Conclusion] Compared with RCT, RWS more fits the basic characteristics of TCM cal ed holistic concept and syndrome differentiation, is advantageous to the preservation of TCM, indicat-ing the new direction for TCM scientific research.

Objective To explore the change rule and clinical application value of hemorheologic indexes in patients with acute intracerebral hemorrhage ( ICH) . Methods The hemorheology indexes of 100 acute ICH patients ( ICH group) were detected within 24 h, and compared with 30 normal controls ( normal control group) . The effect of hemorheology index on history of hypertension, hemorrhage quantity and the hemorrhage location were analyzed. Results Compared with those in normal control group, the indexes of whole blood viscosity, plasma viscosity and erythrocyte sedimentation rate were significantly increased and erythrocyte aggregation index, erythrocyte deformability index and hematocrit were significantly decreased in acute stage ( all P< 0. 01 ) . Blood rheology indexes were changed significantly in hypertensive cerebral hemorrhage group (all P<0. 01), the whole blood viscosity (200 s-1 and 50 s-1 ) , erythrocyte aggregation index, hematocrit and erythrocyte sedimentation rate in non-hypertensive cerebral hemorrhage group were changed significantly ( P< 0. 05 - 0. 01 ). Compared with normal the non-hypertensive cerebral hemorrhage group, the whole blood rheology indexes except erythroate sedicmnt ation rate significantly erythrocyte sedimentation rate were significantly changed ( P< 0. 05 ) . As the hemorrhage quantity increased in each groups, the whole blood viscosity ( 200 s-1 and 50 s-1 ) and plasma viscosity of cerebral hemorrhage patients were significantly increased, otherwise the erythrocyte aggregation index was significantly decreased (P<0. 05-0. 01). There were statistical differences compared the indexes of whole blood viscosity (200 s-1 and 1 s-1 ) , plasma viscosity, erythrocyte aggregation index and erythrocyte sedimentation rate among each groups of different hemorrhage locations in acute ICH patients (all P<0. 05). Conclusions The blood of acute ICH patients shows a state of concentrated, sticky, aggregation and coagulation that severely affects the prognosis. The patients with hypertension and greater hematoma changed obviously, different hemorrhage location affected differently.

Patients with thyrotoxicosis had a normal circadian rhythm of ACTH and F,but the level of serum F was lower than controls due to excessive degradation.The responsiveness of ACTH to dexamet-hasone suppression or insulin hypoglycemic stimulation was normal.Whereas the circadian secretion of ACTH and F was also normal in patients with primary hypothyroidism,and the concentration of F was inreased with normal ACTH level.There were stunted responses of ACTH to suppressing and stimulating tests,which were thought to be due to the fact that the corticotropes were impaired by hypertrophy or hyperplasia of thyrotropes in primary hypothyroidism.

Objective To investigate the major risk factors of aseptic necrosis of bone in patients with systemic lupus erythemattrsus (SLE),and thus provide evidence for decision-making on prevention.Methods Meta-analysis Was used to systemically evaluate the 14 case-control studies about the risk factors of aseptic necrosis of bone in patients with SLE.Review Manager 4.2 Was utilized to carry out homogeneity checking and calculate the pooled odds ratio (OR) with 95% confidence interval.Results The OR values of risk factor of AVN in patients with SLE and 95% CI were as follows:Raynaud's phenomenon 2.43(1.12～5.29):dental ulcer 2.33(1.11～4.88);renal involvement 1.76(1.27～2.44);vasculitis 4.65(1.62～13.33):hyperlipidemia 3.28(1.76～6.12);anti-phospholipid antibody(APL)2.06(0.84～5.06):hypocomplementemia 0.63(0.35～1.14).Conclusion Glucocorticosteroid is an important risk factor in inducing aseptic necrosis of bone in patients with SLE,but it is not the only factor.Raynaud's phenomenon,dental ulcer,renal involve-ment,vasculitis and hyperlipidemia are major risk factors of aseptic necrosis of bone in patients with SLE.

ObjectiveTo evaluate the efficacy and safety of hydroxychloroquine(HCQ) in pregnant patients with systemic lupus erythematosus (SLE).Methods Twenty-four pregnant patients with SLE treated with HCQ during pregnancy from May,2006 to February,2011 were studied retrospectively.All babies were followed up during early infancy for growth development.ResultsOf them,22 patients were treated with HCQ throughout the whole pregnancy with no lupus flare occurred in 21 patients (95.4％),while temporary discontinuation of HCQ precipitated a flare of disease in two patients.Three patients ( 12.5％ ) had premature delivery,and pregnancy induced hypertension happened in 3 patients (12.5％ ).No congenital abnormalities occurred and mean follow-up of 26 months ( range 1 - 47 months) revealed no abnormalities in these children.Conclusion Our findings reinforce the safety of HCQ therapy during pregancy and HCQ should probably be maintained throughout the pregancy in patients with SLE.

Clinics are a main institutional form for doctors to open personal business in China .The develop-ment process of clinic reflects the situation of medical staff free practice .This study summarized the supervision poli-cies on clinic in China since the founding of China and got three conclusions .The first one was the attitude of the practice of the clinic has changed significantly .The change include four stages which were authorization ( 1949—1957 ) , limitations ( 1958—1977 ) , re-authorization ( 1978—1996 ) , promotion and encourage ( 1997—) along with macroeconomic system reform and the changes of government's governance ideas on health sector .The second conclu-sion was that the government gradually raised awareness of the status and role of the clinic institutions in the health system over the past several decades .The third conclusion was the supervision policies became more meticulous .In the future , clinical institutions can be a useful supplement to public medical institutions in China for its development process and characteristics .

The formation of tumor nodules is related to lymph node metastasis,neural invasion and vas-cular invasion.Tumor nodule is a negative prognostic factor in colorectal cancer patients,which increases the probability of recurrence and metastasis in patients with colorectal cancer.The prognostic value of tumor nodules in the lymph node metastasis is greater than the seventh edition of tumor nodules staging method,which provides a more accurate basis for the clinical treatment.

Objective To evaluate effects of glycemic control on refraction in diabetic patients.Methods Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose,glycosylated hemoglobin A1c( HbA1c) levels, fasting C-peptide and postprandial 2 h C-peptide levels were measured before treatment. The patients with random blood glucose ≥ 12. 0 mmol/L and HbA1c ≥ 10. 0%were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1,2, 3 and 4 during glycaemic control. Results A transient hyperopic change occurred in all the patients receiving glycemic control with a mean maximum hyperopic changes of 1.6 D ( 0. 50 D ～ 3.20 D). There was a positive correlation between the magnitude of the maximum hyperopic changes and the HbA1 c levels on admission ( r = 0.84, P ＜ 0.05 ). There was a positive correlation between the magnitude of the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment ( r = 0.53, P ＜ 0.05 ). There was no significant correlation between the magnitude of the maximum hyperopic changes and the levels of random blood glucose on admission. No significant correlation was observed between the maximum hyperopic changes and fasting C-peptide or postprandial 2 h C-peptide.There were no significant correlations between the magnitude of the maximum hyperopic changes and age,blood press, body mass index, triglyceride, total cholesterol, low-density lipoprotein or high-density lipoprotein. No significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length during glycemic control. Conclusions Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycaemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of glucose level over the first 7 days of treatment. This is probably due to the decrease of refractive power by lens hydration, not morphological change of lens.