Objective To explore the efficacy and mechanism of combined hemodialysis-hemoperfusion in treating patients with end-stage renal failure associated cutaneous pruritus. Methods Eighty-one outpatients and inpatients with end-stage renal failure associated different degree of cutaneous pruritus were randomly divided into treatment group (combined hemoperfusion-hemodialysis, 50 cases) and control group (simple hemodialysis, 31 cases). At the pretreatment and 24 weeks posttreatment, all patients' serum creatinine, blood urea nitrogen, serum total calcium, serum phosphonium, serum intact parathyroid hormone and the intensity of cutaneous pruritus (visual analog scale,VAS) were determined detected. Results Compared with pretreatment, the intensity of cutaneous pruritus of patients in treatment group was obviously alleviated (P<0.01), but it was not alleviated in control group (P>0.05), there was significant difference between two groups (P<0.01). Compared with pretreatment, serum phosphonium and intact parathyroid hormone declined obviously in treatment group [(2.69±0.46) mmol/L vs (0.98±0.39) mmol/L and (632.78±76.89) ng/L vs(342.81±39.71) ng/L] ((P<0.01), but did not decline obviously in control group (P>0.05), there was significant difference between two groups (P<0.01). Conclusions Combined hemodialysis-hemoperfusion can obviously alleviate the intensity of cutaneous pruritus of patients with end-stage renal failure, but simple hemodialysis can not alleviate it,its mechanism may be that it can clean the internal irritant toxin which leads to cutaneous pruritus well.

Objective To study changes of dielectric properties of gastrocnemius caused by simulated weightlessness.Methods Male Sprague-Dawley rats tail suspended for 10 wk were observed together with its normal control.AC impedance of isolated gastrocnemius was measured with an impedance analyzer(Agilent 4294A).Effects of simulated weightlessness on electric properties of cells in isolated rat sural muscle were also observed by analyzing the dielectric numerical characters of the dielectric spectra,the Cole-Cole plots,spectrum of loss factor and loss tangent,as well as spectrum of conductivity imaginary part.Results It was found that simulated weightlessness could induce certain changes:both relative permittivity at low frequency ?L and relative permittivity increment ??,as well as conductivity at high frequency ?h and conductivity increment ?? were all reduced.The first characteristic frequency fC1 decreased,while the second characteristic frequency fC2 increased.Peak of loss factor,peak of loss tangent and the maximum of conductivity imaginary part were also reduced.Conclusion Changes of dielectric property of gastrocnemius induced by simulated weightlessness can be observed effectively by frequency domain impedance technique.

AIM To investigate the protective effect of daidzeid (DZ) on cerebral ischemia and it mechanism in mice METHODS Cerebral ischemia was induced by cutting heads and bilateral carotid arteries were completely or incompletely ligated RESULTS The stroke index score in ischemic mice was reduced by DZ, an the persistent time of gasping of mice by decapitation and survival time of mice by bilateral carotid arteries ligation were prolonged by DZ DZ could reduce the content of brain lactic acid while improve the brain superoxide dismutase activity CONCLUSIONS The results indicate that DZ has the protectiveeffect on cerebral ischemia injury Its mechanism may be related with its effect of decreasing of lactic acid content and reducing of free radicals production

10mg/L(n=22) group,and CRP10mg/L group with CRP10mg/L group and the concentration of CRP inverse correlation with serum ALB,Fe,Hb levels.Conclusions The elevated concentration of CRP is considered to be the most common cause of decreased EPO or hyporesponsiveness to EPO in CRF anemia patients. CRP level can predict whether CRF anemia,dificult or easily degree of the anemia correction for CRF patients,all that provide evidence for improving CRF anemia.

Objective:To analyze the effects of SBAR(namely situation, background, assessment and recommendation) communication mode-guided scenario simulation exercise on the quality of shift change of practice nurses and the incidence of nursing risks.Methods:From May 2017 to December 2018, 46 nurses interning in the Department of Cardiovascular Medicine of Guangyuan Central Hospital were selected as the control group, and received practice guidance according to the conventional shift change mode; 46 nurses were selected as the research group having the SBAR communication mode-guided scenario simulation exercise from January 2019 to June 2020 in the same department. The evaluation results of the quality of nurses' shift change, the evaluation results of the quality of nurses' succession, and the satisfaction of nurses were compared between the two groups. SPSS 22.0 was used for t test and chi-square test. Results:The evaluation results of 7 items of nurses' handover quality in the research group were better than those in the control group ( P<0.001). The evaluation results of 6 items of nurses' succession quality in the research group were better than those in the control group ( P<0.001). The scores of 5 dimensions in the research group were higher than those in the control group ( P<0.001). Conclusion:The implementation of SBAR communication mode-guided scenario simulation exercise can improve the quality of nurses' shift change and the satisfaction of practice nurses.

AIM: To study the effects of Huoxue Huayu and Yiqi Wenyang compound prescription (composition; ginseng, radix astragali, plantaginis semen, lignum sappan, chuanxiong, salvia miltiorrhiza, radix aconiti lateralis preparata, bitter orange, cassia twig) of TCM on the congestive heart failure in rats. METHODS:The rats were given doxorubicin hydrochloride by intraperitoneal injection to establish the model of congestive heart failure and were randomly divided into control group, congestive heart failure model group, Xinbao treatment group ( XB treatment) and Huoxue Huayu and Yiqi Wenyang compound prescription treatment group (QXYTM treatment). Normal saline, liquid medicine Xinbao and liquid medicine Huoxue Huayu and Yiqi Wenyang compound prescription were administered respectively to four groups by gavage. Radioimmunoassay, semi - quantitative RT - PCR and flow cytometry methods were used to determine the expressions of plasma atrial natriuretic peptide ( ANP) , renal medulla aquaporin - 2 ( AQP2 ) and heat shock protein70 (HSP70) in congestive heart failure rats before and after treatment. RESULTS: In congestive heart failure rats treated with Huoxue Huayu and Yiqi Wenyang compound prescription, the cardiac output and left ventricle systolic pressure increased significantly, the left ventricular end diastolic pressure decreased, and the maximum ascending and declining rate of left ventricular pressure ameliorated, thus the hemodynamics was effectively improved. Meanwhile, the level of plasma cardionatrin decreased, the abnormal expression of renal medulla AQP2 was markedly restored, and the transcription and expression of HSP70 gene were also increased. CONCLUSION: Huoxue Huayu and Yiqi Wenyang compound prescription promotes the recovery of the pathogenetic conditions of congestive heart failure in rare. The mechanism may be in association with a decrease in plasma ANP level, correction of renal medulla AQP2 abnormal expression and enhancement of HSP70 expression.

Objective To study the CT and MRI characteristics of myxoid soft tissue tumours.Methods Fifty-three myxoid soft tissue tumours pathologically confirmed were retrospectively studied.MR and CT scan were performed before operation.Noncontrast T1 and T2 weighted images,fat-suppressed T2 weighted images were obtained before contrast-enhanced scan with fat-suppressed T1 weighted sequence was underwent.Plain and contrast-enhanced CT was performed with tube potential of 120 kV,matrix 512 × 512,and automatic tube current modulation technique.Results There were 18 myxoid liposarcoma,3 ganglioneuroma,8 myxofibrosarcoma,2 extraskeletal myxoid chondrosarcoma,10 intramuscular myxoma,and 2 juxta-articular myxoma.Microscopic examination showed myxoid soft tissue tumours which were consisted of abundant myxoid stroma with tumour cells and blood vessels associated with fibrous bands.Low density in CT images,hypointensity in T1 weighted images,significantly hyperintense in T2 weighted images were their common manifestations in the area of abundance of extracellular myxiod matrix.Plain CT images demonstrated equidensite,T1 weighted images isointensity,and fat-suppressed T1 weighted images significant enhancement relatively in the areas of increased number of tumor cells.Hemorrhage,necrosis and capsule of the lesion were revealed in high grade malignant tumors.The septa can be identified in most of myxoid tumours of soft tissue.Conclusion CT and MRI can definitely show the image characteristics of myxiod soft tissue tumours,which can help make a qualitative diagnosis before operation.

Objective To observe the clinical effect of Jiawei Zuojin Pills combined with western medicine on reflux esophagitis with liver-stomach disharmony syndrome. Methods Totally 90 cases were divided into observation group (45 cases) and control group (45 cases). The control group was given rabeprazole sodium enteric-coated capsule and domperidone tablets, and the observation group was given Jiawei Zuojin Pills additionally for four weeks. The clinical effect, TCM syndrome score and endoscopic improvement were observed. Results The total effective rate of observation group was 95.5%(43/45), control group was 93.3%(42/45), with no significant difference between the two groups (P>0.05). The excellent rate of observation group was 77.8% (35/45), control group was 57.8% (26/45), with significant difference (P<0.05). TCM syndrome score was improved in both groups (P<0.001), and the degree of improvement in the observation group was better than control group (P<0.05). The total effective rate rate under endoscopic of observation group and control group was 96.5% (43/45) and 77.8% (35/45) respectively, with significant difference (P<0.05). Conclusion Jiawei Zuojin Pills combined with western medicine has obvious efficacy in treating reflux esophagitis with liver-stomach disharmony syndrome.

County hospitals function as comerstones in China's health system,as their sustainable development plays a key role for the ongoing health reform.Disciplines are the most primary functional units of a hospital,and their disciplinary culture characteristic of the county hospital' s disciplines and fitting their current development status are definitely the most important and fundamental factor for sustainable development of the discipline.Based on extensive research,authors identified no less than eight cultural elements,namely values of life,self-confidence,a comprehensive model of talent development,safety first,teamwork,communication,scientific pursuit and health management.This study aimed at providing thoughts for the current county hospital development.

Objective To explore the correlation and significance between adult nut-cracker phenomenon (NCP) and varicocele. Methods The clinical characters of 226 adult patient (including inpatients and outpatients)with NCP diagnosed by color Doppler ultrasound examination were analyzed retrospectively, whose chief complaints were asymptomatic bematuria or/and orthostatic proteinuria (microalbuminuria). The ratio of left renal vein inner diameter before and after being compressed≥2 was regarded as the criteria of diagnosis of NCP. Among 226 cases, 184 male NCP patients were taken as study group, and the incidence of varicocele was tested. One hundred and fifty-six male adults who had physical examination in the same period and whose ages matched with study group were taken as control group, they were not NCP patients examined by color Doppler ultrasound. The incidence of varicocele was compared between two groups. The indexes associated NCP were examined in detail in study group. Logistic regression analysis was used to study the correlation between NCP and left varicocele. Results There were 184 male patients in study group, among which there were 22 patients with left sub-clinical varicocele (accounted for 11.96%), 47 patients with left varicocele (accounted for 25.54%).The total incidence of varicocole was 37.50%(69/184). There were 156 male adults in control group, among which there were 13 patients with sub-clinical varicocole(accounted for 8.33%), 8 patients with varicocele (accounted for 5.13%).The total incidence of varicocele was 13.46%(21/156). The total incidence of varicocele in study group was significantly higher than that in control group (P=0.000). In study group, there were 22 patients with left sub-clinical varicocele,with average age (24.73±1.03) years. The inner diameter of left renal vein(LRV) in front of spine was (3.65±0.11) mm(a),the inner diameter of LRV at left side of spine was (8.41±0.11)mm(b), and b/a ratio was 2.31± 0.06. The angle between superior mesenterie artery (SMA) and abdominal aorta(AA) was (15.95±0.59)°. There were 47 patients with left varicocele, with average age(26.62±1.74)years. The inner diameter of LRV in front of spine was (3.43±0.08)mm(a),the inner diameter of LRV at left side of spine was (8.72±0.14) mm (b), and b/a ratio was 2.54±0.08. The angle between SMA and AA was (14.54±0.53)°. In study group, Lagistic regression analysis proved that male patients with NCP were complicated with varicocele easier when the angle between SMA and AA became smaller, the inner diameter of LRV at the left side of spine (b)and age increased. Conclusions Male adult patients with NCP are complicated with left varicocele, which is significantly higher than that in non-NCP male adults at the same age. It shows that NCP is one important cause for varicocele and there is a close correlation between NCP and varicocele in male adults.