Objective To investigate the relation between serum level of fibroblast growth factor (FGF)-23 and left ventricular hypertrophy in non dialysis patients with chronic kidney disease (CKD). Methods One hundred and twenty-four non dialysis patients with CKD were selected. Among them 34 cases were CKD 1-2 stage (CKD 1-2 stage group), 50 cases were CKD 3-4 stage (CKD 3-4 stage group), and 40 cases were CKD 5 stage (CKD 5 stage group). Thirty-two subjects of healthy people were selected as control group. The serum FGF-23, urea nitrogen, creatinine, calcium, phosphorus, intact parathyroid hormone (iPTH) and hemoglobulin levels were measured. The cardiac structural parameters were assessed by Doppler echocardiography, which included left ventricular end-diastolic diameter (LVDd), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular ejection fraction (LVEF). Left ventricular mass index (LVMI) was calculated by Devereux formula. The patients were diagnosed as left ventricular hypertrophy according to LVMI (male ≥ 125 g/m2, female ≥ 110 g/m2). The relation between FGF-23 and left ventricular hypertrophy was analyzed. Results Among the patients with CKD, left ventricular hypertrophy was in 46 cases (hypertrophy group), non left ventricular hypertrophy was in 78 cases (hypertrophy group), and the incidence of left ventricular hypertrophy in patients with CKD was 37.1% (46/124). The lgFGF- 23, lgiPTH and phosphorus levels in hypertrophy group were significantly higher than those in non hypertrophy group:1.69 ± 0.33 vs. 1.50 ± 0.27, 1.98 ± 0.45 vs. 1.74 ± 0.32 and (1.50 ± 0.59) mmol/L vs. (1.27 ± 0.39) mmol/L, the calcium, albumin, hemoglobulin and LVEF levels were significantly lower than those in non hypertrophy group:(2.06 ± 0.24) mmol/L vs. (2.17 ± 0.20) mmol/L, (35.76 ± 4.18) g/L vs. (39.74 ± 5.73) g/L, (96.65 ± 22.66) g/L vs. (117.15 ± 27.67) g/L and (59.62 ± 12.02)%vs. (67.76 ± 6.69)%, and there were statistical differences (P<0.01 or<0.05). There were no statistical differences in systolic blood pressure and diastolic blood pressure between hypertrophy group and non hypertrophy group (P>0.05). The incidences of left ventricular hypertrophy and LVMI in CKD 1-2 stage group, CKD 3-4 stage group and CKD 5 stage group were significantly higher than those in control group:11.8%(4/34), 36.0%(18/50) and 60.0% (24/40) vs. 3.1% (1/32), (91.18 ± 16.17), (111.25 ± 27.89) and (124.82 ± 24.80) g/m2 vs. (84.41 ± 13.77) g/m2, those indexes in CKD 3-4 stage group, CKD 5 stage group were significantly higher those in CKD 1-2 stage group, and those indexes in CKD 5 stage group were significantly higher than those in CKD 3-4 stage group, and there were statistical differences (P<0.01 or<0.05). The LVMI was positively correlated with lgFGF-23, lgiPTH and history of hypertension in CKD patients (r=0.297, 0.327 and 0.229; P = 0.019, 0.009 and 0.026). The LVMI had negative correlation with calcium, hemoglobulin and LVEF (r=-0.280,-0.432 and-0.432;P=0.028, 0.000 and 0.000). The LVMI had no correlation with phosphorus, systolic blood pressure, diastolic blood pressure, gender and age (P>0.05). Multiple linear regression analysis result showed that LVMI (Y) was negatively correlated with hemoglobulin (X1) and LVEF (X2), and the regression equation was Y = 255.201- 0.424 X1- 1.092 X2. Conclusions The incidence of left ventricular hypertrophy increases gradually with the decline of renal function in non dialysis patients with CKD. The serum level of FGF-23 is related to left ventricular hypertrophy and the degree of heart failure in non dialysis patients with CKD. Anemia and cardiac function state are closely related to left ventricular hypertrophy in non dialysis patients with CKD.

Objective To explore the reasons and clinical characteristics of gastrointestinal bleeding in maintenance hemodialysis patients.Methods Clinical data of 28 hemodialysis patients combined with gastrointestinal bleeding were retrospectively analyzed.The reasons and clinical characteristics of gastrointestinal bleeding were analyzed.Results The incidence rate of gastrointestinal bleeding in hemodialysis patients was 20.9%,hemorrhage of upper digestive tract in 23 cases (82.1%)and hemorrhage of lower digestive tract in 5 cases (17.9%).The reasons of hemorrhage of upper digestive tract were mucosal erosion bleeding of gastric esophagus duodenum in 15 cases (65.2%)and peptic ulcer in 8 cases (34.8%).The positive rate of helicobacter pylori infection was 66.7%(12 /18).In 10 cases (35.7%),gastrointestinal bleeding happened within three months after hemodialysis.Vascular access for hemodialysis were used by central venous catheterization in 13 cases (46.4%)and arteriovenous fistula in 15 cases (53.6%).The prognosis of gastrointestinal bleeding in hemodialysis patients were continuing hemodialysis in 23 cases (82.1%),turned to peritoneal dialysis in 2 cases (7.2%)and death in 3 cases (10.7%).Conclusion The major reason of gastrointestinal bleeding in hemodialysis patients is hemorrhage of upper digestive tract.Mucosal erosion bleeding of gastric esophagus duodenum is major in hemorrhage of upper digestive tract.The positive rate of helicobacter pylori infection is higher.More than 1 /3 gastrointestinal bleeding happens within three months after hemodialysis.The prognosis of the majority of patients is good by internal medicine combined therapies and no heparin hemodialysis.

ObjectiveTo explore the effect of the microsurgical treatment for intramedullary spinal cord tumors.Methods38 patients with intramedullary spinal cord tumors were retrospectively analyzed,and the removal of the tumor cases and functional changes in patients after surgery was summarized.Results38 cases of intramedullary spinal cord tumors,17 cases of ependymoma were all totally removed under the microscope;13 cases of astrocytoma resection achieved in 5 cases,near total resection in 4 cases,partial resection in 4 cases;5 patients most of the lipoma removed;3 cases of hemangioblastoma resection were done.32 patients before surgery in patients with different degrees of movement disorders at discharge in 29 patients with different degrees of improvement,no change in 1 case,2 cases decreased compared with preoperation ;29 patients with varying degrees of preoperative sensory disturbance,21patients at discharge with improvement,5 patients had no change,three cases aggravated; 14 patients had sphincter dysfunction,12 patients improveed than before surgery 2 patients had no change.ConclusionEarhy diagnosis and taking early microsurgical treatment was the preferred method in treatment of Intramedullary spinal cord tumors in clinical application.

OBJECTIVE To study the isolation rate of Acinetobacter baumannii, characteristics of infection distribution and antimicrobial resistance rates. METHODS Surveillance data of A. baumannii infection of wards, its distribution and resistance rates to 20 kinds of antibiotics in our hospital for 5 years were analyzed . RESULTS During the 5-year infection surveillance, 523 strains of A. baumannii were isolated in our hospital mostly from sputum. The commonest site was lower respiratory tract. The ward with the highest incidence of A. baumannii infection was ICU. The isolation rate was 11.1% in 2004, though 3.9% in 2000. A. baumannii was resistant to 20 kinds of antibiotics, especially to imipenem, cefoperazone /sulbactam and ampicillin/sulbactam. CONCLUSIONS The isolation rate of A. baumannii and antimicrobial resistance rate are increasing year by year. The increased rate of multidrug-resistance should be payed more attention .

A cold saponification method for determination of 5 lutein stereoisomers in dairy products by high performance liquid chromatography ( HPLC ) was developed. Samples were cold-saponified at room temperature and extracted by n-hexane/petroleum/dichloromethane ( 2: 2: 1 , V/V/V ) . Then 5 lutein stereoisomers were separated on a YMC C30 column with gradient elution using methanol/methyl tert-butyl ether as the mobile phase, and data were acquired by a photodiode array detector at wavelength of 445 nm. The calibration curve was linear in the range of 0 . 127-5 . 082 mg/L with correlation coefficient of 0 . 9999 , and the recoveries were from 96 . 7% to 102 . 2% with the RSDs in the range of 4 . 1%-5 . 4% ( n=6 ) . The limit of detection was 0 . 010 μg/g ( S/N=3 ) , and the limit of quantification was 0 . 030 μg/g ( S/N=10 ) . By presenting results of good accuracy, precision and sensitivity, this method validates its suitability for routine analysis of 5 lutein stereoisomers in dairy products.

Objective:To investigate the application value of auricular point pressing with beans combined with Chinese medicine for rehabilitation in older adults after total hip arthroplasty.Methods:This is a prospective case-control study. A total of 80 older adult patients with femoral neck fractures who underwent total hip arthroplasty at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from September 2020 to January 2022 were included in this study. These patients were randomly divided into a control group and an observation group, with 40 patients per group. The control group underwent conventional interventions, while the observation group underwent auricular point pressing with beans combined with Chinese medicine. Clinical efficacy was compared between the two groups.Results:The overall response rate in the observation group was 85.00% (34/40), which was significantly higher than 65.0% (26/40) in the control group ( χ2 = 4.27, P = 0.036). Before surgery, there were no significant differences in various indicators between the two groups (all P > 0.05). At 2 weeks after surgery, the hemoglobin level and Harris scores in the observation group were higher than those in the control group ( t = -7.11, -5.81, both P < 0.05). At 1 and 3 days and 2 weeks after surgery, the D-dimer level, prothrombin time, activated partial thrombin time, thrombin time, Visual Analogue Scale score, and Pittsburgh Sleep Quality Index (PSQI) in the observation group were significantly lower than those in the control group (all P < 0.05). At 3 days and 2 weeks after surgery, C-reactive protein, thigh and calf circumference of the affected limb in the observation group were significantly lower than those in the control group ( t = 2.34, 6.85, 4.47, 3.89, 6.63, 4.35, all P < 0.05). After surgery, the time to get off the bed and the length of hospital stay in the observation group were (3.58 ± 2.43) days and (7.14 ± 2.18) days, respectively, which were significantly shorter than (5.47 ± 2.35) days and (9.13 ± 2.14) days in the control group ( t = 3.54, 4.12, both P < 0.001). The incidence of postoperative deep vein thrombosis in the observation group was 5.00% (2/40), which was significantly lower than 10.00% (4/40) in the control group ( χ2 = 0.72, P = 0.396). Conclusion:Auricular point pressing with beans combined with Chinese medicine can promote rapid rehabilitation of older adult patients with femoral neck fractures after total hip arthroplasty.