Objective To analyze the related factors of influencing deep vein indwelling catheter dysfunction in hemodialysis patients.Methods A total of 37 cases with deep vein indwelling catheter in hemodialysis patients were selected.They were divided into patent group and blocked group according to the appearance of catheter dysfunction (hemodialysis blood flow less than three times 180 ml/min,adjustment of body position,inversion of tube connection during hemodialysis,requirement of thrombolytic therapy and so on) in 5 months.The common data and biochemical indicator were compared between two groups.Results Patent group had 28 cases,and blocked group had 9 cases.There was no significant difference in age,diabetes mellitus ratio,platelet,low density lipoprotein cholesterol and albumin between two groups (P ＞0.05).Hemoglobin in patent group was lower than that in blocked group [(90.1 ± 13.8) g/L vs.(108.3 ± 11.6) g/L],and there was significant difference(P＜ 0.05).Conclusion Hemoglobin is the correlated factor that effects deep vein indwelling catheter dysfunction after hemodialysis.

Objective To observe the suppressing effect of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids on ultraviolet ray (UV)-induced erythema.Methods A solar simulator and an UV phototherapy device were used as light sources,respectively.Erythema reaction was induced on the back skin of 30 healthy volunteers by 1,2 and 3 minimal erythema doses (MED) of irradiation.Five preparations including butyl flufenamate 2.5％ ointment,butyl flufenamate 5％ ointment,the base of butyl flufenamate ointment,halometasone ointment,and diclofenac 1％ ointment,were applied to the irradiation sites respectively half an hour before or immediately after the irradiation.One irradiation site remained untreated and served as the control.The degree of erythema was evaluated by a chromameter at 4,24,and 48 hours after the irradiation.Intragroup and intergroup comparisons were done by t test and analysis of variance,respectively.Results When applied half an hour before solar-simulated irradiation,both 2.5％ and 5％ butyl flufenamate ointment totally suppressed the erythema reaction induced by 1-3 MED of UV irradiation,with no significant increase in erythema index at all the three time points after irradiation (all P ＞ 0.05); diclofenac 1％ only inhibited the erythema induced by 1 MED of UV irradiation at 4 and 48 hours,with no difference observed in erythema index between the baseline and these time points after irradiation; however,halometasone significantly aggravated the erythema reaction (P ＜ 0.05).Neither NSAIDs nor corticosteroids applied immediately after solar-simulated irradiation showed statistical effect on the degree of UV-induced erythema.When applied immediately after irradiation using the phototherapy device,butyl flufenamate 2.5％ ointment,butyl flufenamate 5％ ointment and halometasone ointment all induced a significant reduction in erythema reaction at 4 hours after 1 MED of irradiation (all P ＜ 0.05),and diclofenac caused a statistical decrease in erythema reaction at all the time points after 1-3 MED of irradiation (all P ＜0.05).Conclusions Topical use of butyl flufenamate before UV irradiation can effectively inhibit erythema reaction induced by 1-3 MED of irradiation.When applied immediately after irradiation,diclofenac shows the strongest erythema-suppressive effect,followed sequentially by butyl flufenamate and halometasone.

In order to promote the integration between disciplines, the convergence between basic course and clinical teaching, increasing students ability including the active learning and life-long learning ability, finding problem and solving problem ability, teamwork spirit and so on. After nearly 3 years preparation, Hebei Medical University successfully carried out the PBL teaching in Seven-year Clinical Medicine Science. Combining with the teaching activities, formative assessment was carried out, and PBL teaching website was established. The reform has already achieved initial results, got good responds from teachers and students. Through the study, it has been confirmed that the PBL teaching method in Hebei Medical University is effective and worthy to reference.

Objective To study the effects of preconditioning treadmill exercise on excitatory amino vacid changes in rats after the cerebral infarction and the protective effects against cerebral isehemia brain injury. Methods Thirty Sprague-Dawley rats were used in this study. Twenty-five rats were subject to an operation to establish the animal model of middle cerebral artery occlusion and divided into a isehemia group, an 1-week ex- ercise group (trained in the 4th week) , a 2-week exercise group (trained in the 3rd and 4th weeks) and a 4- week exercise group (trained for 4 weeks) , while the remaining 5 rats were subject to sham operation, and served as the controls. After 4 weeks of experiment, all the the rats were fixed on stereotactie apparatus for the brain microdialysis of the striatum. Then the focal middle cerebral artery ischemia and reperfusion were made with thread oeclussion in rats and microdialysis technique was used to collect extraeellular fluid in each period of pre-ischemia, ischemia (40, 80 and 120 min), and reperfusion (40, 80, 120, 160, 200 and 240 min) to detect the changes of the excitatory amino acid. At the same time the infarction volume was also measured at 24 hours after ischemia-reperfusion of the brain. Results The difference between any two groups was significant with regard to the volume of cerebral infarction (P < 0.05). Two weeks and four weeks of the preconditioning treadmill exercise couled significantly reduce concentration of Glu excessively released due to the ischemia (P < 0.01). Conclusion At least two weeks of preconditioning treadmill exercise can inhibit the excessive release of the important excitatory amino acid neurotransmitter glutamate, to some extent, in the process of the subse- quent ischemic brain injury and during reperfusion, which might be one of the protective mechanisms of move- ment against the early isehemie brain injury.

Objective To discuss effect of fasting and taking food on hemostasis effect of patients with gastric ulcer and bleeding. Methods 160 patients with gastric ulcer and bleeding were divided in-to the experimental group and the control group, the experimental group was allowed to take lower ho-moiothermy water gruel (liquid), the control group was required absolute fasting (not medication), until bleeding stop. The two groups adopted identical treatment and nursing. The lienable stomach tube was placed respectively, everyday pH value monitor and occult blood test were carried out by taking out gas-tric juice when fasting and 2 hours after meals. Continuous monitoring tests continued till occult blood test of gastric liquid became negative for 3 times. Stool was kept for occult blood test, at the same time the gastrointestinal tract symptom and bleeding condition were observed, routine blood test was carried out one every other day. The data underwent statistical analysis with SPSS13.0 statistics software package, compari-son between two groups used t test. Results The inner stomach pH value of the experimental group in-creased obviously, the average pH value and percentage of pH above 4 was evidently higher than those of the control group. The time of occult blood test of gastric liquid and stool turning to negative in the experi-mental group was shorter than those of the control group. Conclusions Taking food can elevate pH of gastric liquid, reduce damage caused by gastric acid to gastric mucosa, thus hasten hemostasis process and promote healing.

Objective To study the expression of plasma oxidized low-density lipoprotein (oxLDL) in children with acute phase Kawasaki disease (KD), and investigate its value for early prediction of coronary artery lesions in KD. Methods Totally 80 children with KD were collected. Children were divided into four groups by the results of echocardiogram of coronary artery in different periods: CAL1 group (children with coronary artery lesions (CAL+) both in acute and sub-acute phase, 8 cases), CAL2 group (children with CAL+in acute phase but recovery normal (CAL-) in sub-acute phase, 10 cases), NCAL1 group (children with CAL-in acute phase but occur CAL+ in sub-acute phase, 10 cases) and NCAL2 group (children with CAL- both in acute and sub-acute phase, 52 cases). The serum samples (before the use of intravenous immunoglobulin) were collected in acute phase. Twenty healthy controls and twenty fever controls were enrolled into the study, and their serum samples were collected. OxLDL was measured by enzyme linked immunosorbent assay (ELISA). They were compared using ANOVA, pairwise comparison LSD-t test. And ROC curve analysis was used to determine the threshold. Results Compared with the control groups,plasma oxLDL levels were higher in children with KD, both CA+and CAL-[(15.0±3.3) mU/L, (12.3±3.5) mU/L vs (9.2±2.2) mU/L, (8.0±2.3) mU/L, F=20.435, P<0.05]. Plasma oxLDL levels were increased more significantly in children with CAL+ than children with CAL- in KD [(15.0 ±3.3) mU/L vs (12.3 ±3.5) mU/L, t=2.28, P=0.002]. There was significant difference in the concentration of oxLDL between the groups of Kawasaki disease (F=5.068, P=0.003). Plasma oxLDL levels were significantly higher in the NCAL1 group than those in the NCAL2 group [(14.5 ±3.8) mU/L vs (11.9±3.3) mU/L, t=2.29, P=0.02], but there were no statistically significant difference between the NCAL1 group and CAL1 or CAL2 group [(14.5±3.8) mU/L vs (15.9±3.9) mU/L, (14.5±3.8) mU/L vs (14.2±2.7) mU/L, t=0.73, 0.20;P=0.41, 0.84]. ROCs analysis indicated that oxLDL≥13.83 mU/L, could be the threshold for the prediction of coronary artery lesions with the sensitivity of 0.607 and a specificity of 0.75. Conclusion OxLDL plays an important role in coronary artery lesions in KD. The coronary endothelial dysfunction is earlier than coronary dilatation, and oxLDL is expected to become a reliable early predictor of coronary artery lesions in KD.

Objective To study the level of clinical diagnosis of pulmonary tuberculosis and implementa-tion of tuberculosis prevention and control policy. Methods Frequencies and percentages of pulmonary tuberculosis, other lung diseases and health among 3315 cases with pulmonary tuberculosis suspicious symptoms ,transferred by non-tuberculosis control institutions during 2010-2015,were calculated and analyzed. Results Among the 3315 suspected cases of pulmonary tuberculosis ,cases of pulmonary tuberculosis ,tuberculosis ,other lung diseases and healthy group were 2068,598 and 649 based on final diagnosis and their percentages were 62.38%,18.04% and 19.58% respectively. As to groups of elder than fifteen years ,the proportion of patients with pulmonary tubercu-losis accounts for 72.62%,61.00%and 48.58% of the total of young group(15~44 years old ),middle age group (45 ~ 64 years old)and elderly group(≥ 65 years old )respectively. Conclusions Compared with pulmonary tuberculosis suspicious symptomscases from tuberculosis control institution during the same period ,the proportion of tuberculosis patients from transferred groups is roughly the same.It indicate high levels of tuberculosis diagnosis and implementation to tuberculosis control policy.

ObjectiveTo investigate the value of combined measurement of serum alpha-fetoprotein (AFP), Dickkopf-1 (DKK1), and cytoskeleton-associated protein 4 (CKAP4) in the diagnosis of hepatocellular carcinoma (HCC). MethodsA total of 122 patients with HCC (76 patients in the early stage), 152 patients with liver cirrhosis, and 105 patients with chronic hepatitis B, who were admitted to The First Affiliated Hospital of Soochow University from January 2013 to December 2017, were enrolled, and 101 individuals who underwent physical examination during the same period of time were enrolled as healthy control group. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between multiple groups. A binary logistic regression analysis was used to obtain the new variable of predicted probability, and the receiver operating characteristic (ROC) curve analysis was performed for each index and predicted probability to investigate the area under the ROC curve (AUC), sensitivity, and specificity of the three indices used alone or in combination. ResultsThe HCC group had significantly higher serum levels of AFP, DKK1, and CKAP4 than the liver cirrhosis group, the chronic hepatitis B group, and the healthy control groups (F=121.618, 84.559, and 91.769, P＜0.001). The combination of AFP, DKK1, and CKAP4 had an AUC of 0.967 (95% confidence interval ［CI］: 0.950-0.984), a sensitivity of 0.869, and a specificity of 0.980, which were significantly higher than the AUCs, sensitivities, and specificities of the three indices used alone (all P＜0.05). The combination of the three indices had an AUC of 0.965 (95%CI: 0.942-0.988), a sensitivity of 0.868, and a specificity of 0.980 in the diagnosis of early-stage HCC, which were significantly higher than the AUCs, sensitivities, and specificities of the three indices used alone (all P＜0.05). ConclusionCombined measurement of serum AFP, DKK1, and CKAP4 improves the accuracy, sensitivity, and specificity of HCC diagnosis and thus has an important clinical value in the screening for and early diagnosis of HCC.

Objective To investigate alterations of blood perfusion in subcortical regions in patients with Parkinson′s disease (PD) by three dimentional arterial spin labeling (ASL) magnetic resonance imaging (MRI). Methods Thirty patients with PD and 40 control subjects were recruited from the inpatient and outpatient of the Department of Neurology of Northern Jiangsu People′s Hospital during October 2014 to October 2016, and routine brain MRI and 3D pseudo?continuous pulse ASL were performed on all the subjects. The cerebral blood flow (CBF) maps derived from 3D ASL were coregistered to the Montreal Neurological Institute brain space. The stereo?templates of bilateral caudate nucleus, putamen nucleus, globus pallidum and thalamus from Anatomical Automatic Labeling were used as region of interest (ROI) to exstract absolute CBF values in these subcortical regions, respectively. The CBF ratio (rCBF) values represented by individual whole brain CBF divided by each of the regional CBF were also calculated in consideration of the difference between individual whole brain CBF. The CBF and rCBF values were compared respectively between groups by one?way analysis of variance. Results The subcortical CBF values (ml·100 g-1·min-1) for each ROI in PD (caudate nucleus (left: 35.32±6.47, right: 36.17±7.07), globus pallidum (left: 40.42 ± 5.83, right: 40.18 ± 5.70), putamen nucleus (left: 41.97 ± 6.12, right: 42.91 ± 6.43) and thalamus (left: 46.58 ± 7.71, right: 49.11 ± 7.10)) were significantly lower than that in the control group (caudate nucleus (left: 41.38±7.05,right: 41.63±6.85), globus pallidum (left: 45.65±8.35,right: 45.53±8.94), putamen nucleus (left: 48.49±8.78, right: 48.99±8.88) and thalamus (left: 54.32±11.94,right: 56.21±11.98), F=13.58, 10.56, 12.11, 10.06, 8.59, 8.23, 9.57, 8.30, P=0.000, 0.002, 0.005, 0.005, 0.001, 0.002, 0.003, 0.005, respectively ). The whole brain mean CBF values of each subject were also extracted and compared bewteen groups, and mean CBF values (ml·100 g-1·min-1) in PD patients (42.14±9.61) decreased significantly than those in the control group (51.59±9.67, F=16.42, P<0.01), and there was a 18.31% decrement in whole brain mean CBF in the patient group. However, rCBF values for almost all subcortical ROIs of the patients significantly increased when compared with the control group. Conclusions The decreased absolute cerebral blood perfusion involved not only subcortical regions, but also the whole brain level in the course of PD. The CBF metabolism in patients with PD may have been redistributed, with relative hyperperfusion in the subcortical brain regions contrast to the whole brain perfusion level of patients themselves.

Objective:To evaluate the efficacy of stem cell transplantation in treatment of ischemic stroke.Methods:Randomized controlled studies about stem cell transplantation in the treatment of ischemic stroke were searched from Pubmed, Cochrane Library, Embase, Ovid, China National Knowledge Infrastructure (CNKI), Wanfang and VIP database from database establishment to March 2021. The literature was screened according to the inclusion and exclusion criteria and the clinical data of the stem cell transplantation patients and conventional treatment patients were extracted. The differences of baseline value and final value of National Institutes of Health Stroke Scale (NIHSS) scores, Function Independent Measurement (FIM) scores, Fugl-Meyer Measurement (FMA) scores, Barthel index (BI), Activity of Daily Living (ADL) scale scores, modified Rankin scale (mRS) scores between the two groups were combined for Meta analysis.Results:Eighteen articles were included in the study, including 1334 patients; 668 patients were from the stem cell transplantation group and 666 patients were from the conventional treatment group. The results showed that NIHSS scores (difference in means [ MD]=3.510, 95%CI: 2.540-4.480, P=0.000], FIM scores ( MD=11.380, 95%CI: 5.470-17.280, P=0.000), FMA scores ( MD=13.830, 95%CI: 12.590-15.070, P=0.000), BI ( MD=22.100, 95%CI: 19.430-24.770, P=0.000), ADL scores ( MD=9.290, 95%CI: 3.530-15.050, P=0.002), and mRS scores ( P=0.004) in the stem cell transplantation group were significantly higher as compared with those in the conventional treatment group ( P<0.05). Conclusion:Stem cell transplantation on the basis of conventional treatment has good clinical efficacy in the recovery of neurological function, improvement of activity of daily living, and improvement of limb motor function in patients with ischemic stroke.