Objective To investigate the effect and safety of alprostadil in the treatment of diabetes complicating chronic kid‐ney disease to provide reference for clinical treatment .Methods 84 cases of diabetes complicating chronic kidney disease in this hospital from September 2013 to January 2015 were selected and divided into the observation group(44 cases) and the control group (40 cases) according to the voluntary principle .The control group used the epalrestat treatment ,while the observation group was combined with using alprostadil on the basis of control group .The effective rate ,serum creatinine ,blood urea nitrogen(BUN) ,uri‐nary albumin excretion rate ,C‐reactive protein(CRP) ,IL‐6 levels and adverse reactions were compared between the two groups .Re‐sults The effective rate of the observation group was 93 .18% ,which was significantly higher than 80 .00% in the control group , the difference was statistically significant (χ2 =4 .251 ,P=0 .005);the CRP and IL‐6 levels after treatment in the observation group were improved ,the difference was statistically significant (P<0 .05);the CRP and IL‐6 levels after treatment in the observation group[(0 .45 ± 0 .05)mg/L ,[(0 .72 ± 0 .11)μg/L] were significantly superior than[(1 .05 ± 0 .14)mg/L ,(1 .25 ± 0 .24)μg/L] in the control group ,the differences were statistically significant(P<0 .05);BUN ,urinary albumin excretion rate ,TNF‐αand endogenous creatinine clearance rate after treatment in the observation group were (6 .41 ± 1 .12)mmol/L ,(41 .12 ± 4 .46)μg/min ,(75 .54 ± 6 .64)ng/L and (92 .94 ± 8 .24)% ,which in the control group were (7 .39 ± 1 .05)mmol/L ,(91 .48 ± 7 .31)mmol/L ,(111 .42 ± 7 .69)ng/L and (81 .55 ± 9 .54)% respectively ,the improvement in the observation group was better than the control group ,the difference was statistically significant (P<0 .05);the occurrence rate of adverse reactions was 18 .18% in the observation group and 17 .50% in the control group ,showing the difference was not statistically significant (P>0 .05) .Conclusion Alprostadil in treating diabetes complicating chronic kidney disease has better effect ,conduces to improve the level of urinary albumin and inflammatory with high safety ,and is worthy of clinical promotion and application .

Objective To analyze the effect of clinical pathway management for capillary bronchitis in Department of Pediatrics.Methods 75 children with capillary bronchitis after the implementation of clinical pathway management were selected as the observation group,and 68 children with capillary bronchitis before the implementa-tion of clinical pathway management were selected as the control group.The hospitalization cost,average hospital stay, antibiotic use rate,cure rate,nonsocomial infection rate,rehospitalization rate within two weeks,service satisfaction and other comprehensive indices were compared.Result The total cost of drug of the observation group[(1 198.49 ± 397.48)yuan]was lower than (1 324.05 ±376.57)yuan of the control group(Z =2.00,P <0.05).The average hospital stay of the observation group[(6.99 ±2.39)d]was shorter than (8.01 ±2.22)d of the control group(Z =2.62,P <0.05).The service satisfaction rate of the observation group(95%)was higher than 82% of the control group(χ2 =5.44,P <0.05).The antimicrobial use rate of the observation group(49%)was apparently lower than 95% of the control group (χ2 =27.59,P <0.01).There were no statistically significant differences between the two groups in cure rate(hospital discharge rate),nosocomial infection rate and rehospitalization rate within two weeks(all P >0.05).Conclusion Clinical pathway management for capillary bronchitis in Department of Pediatrics of primary hospital can play a role in standardizing medical practice,reducing average hospitalization days,controlling medical cost,and improving service satisfaction under the precondition of ensuring medical quality.

Objective To estimate the test-retest reliability of limits of stability (LOS) measurement in healthy young adults. MethodsTwenty-five healthy young adults participated this study.Their center of pressure (COP) displacements were recorded while they stood on a force platform.The subjects performed maximal voluntary sway maneuvers in the anterior,posterior,left and right directions in turn.The LOS in each direction was calculated using balance clinic software.Each subject underwent 3 consecutive,identical tests at 7 day intervals with the same investigator.The test-retest reliability of LOS was analyzed using the intraclass correlation coefficient (ICC).ResultsFor the first test the ICC values ( ICC1 ) of the LOS ranged from 0.790 to 0.857.For the mean LOS of the first two tests the ICC2 ranged from 0.906 to 0.937,and for the mean LOS of three tests the ICC3 ranged from 0.910 to 0.948. ConclusionThe LOS test is a reliable measurement with healthy young adults.In clinical practice,averaging two LOS tests is suggested in assessing balance and postural control with young adults.

Objective To determine normal reference values for conduction in the posterior antebrachial cutaneous nerve.Methods Antidromic sensory conduction examinations of the bilateral posterior antebrachial cutaneous nerve were conducted with fifty-eight healthy subjects.The onset latency,peak latency,peak-to-peak amplitude and conduction velocity of the sensory nerve action potentials (SNAPs) were recorded and the inter-side ratios of the peak-to-peak amplitudes were calculated.Results The observed means (and standard deviations) of the onset time,the peak latency,the amplitude and the conduction velocity were 1.96 (0.12) ms,2.48 (0.14) ms,7.39 (2.36) μV and 61.39 (3.69) m/s,respectively.The side-to-side amplitude ratio (smaller/larger) was 0.88 ± 0.09,and no significant difference was observed between the left and right side.The average peak latency and amplitude were significantly different for different age groups.There was no statistically significant difference among the age groups with regard to onset latency or conduction velocity.Conclusion Conduction in the posterior antebrachial cutaneous nerve is easy to study.The peak latency is prolonged and the amplitude decreases with age,suggesting that different normal reference values should be established for different age groups.

Objective To observe effects of tetrandrine on β-glucan induced RAW 264 .7 cells proliferation .Methods RAW 264 .7 cells model was established .Four methyl thiazol tetrazolium(MTT) was used to detect the effects of different concentrations of tetrandrine on the proliferation of RAW264 .7 cells .The levels of interleukin(IL)-6 ,tumor necrosis factor-α(TNF-α) ,prostaglan-din E2 (PGE2 ) and IL-10 in the culture supernatant were measured by enzyme linked immunosorbent assay(ELISA) .Results MTT results showed that the growth curves of different concentrations of tetrandrine on RAW264 .7 cells had biphasic affections .ELISA results suggested that tetrandrine could inhibit the IL-6 ,TNF-α,PGE2 expressions and promote IL-10 expression .Conclusion Effects of tetrandrine onβ-glucan induced RAW264 .7 cells proliferation are relative to inhibition of IL-6 ,TNF-α,PGE2 expressions and promotion of IL-10 expression .

Objective:To investigate the comfort of postoperative rectal cancer patients with indwelling anal tube and analyze the influencing factors, so as to provide a basis for the formulation of prevention and improvement measures.Methods:The subjective comfort self-report method of digital score and visual analog score was used to investigate and analyze 64 patients with indwelling anal canal in anorectal surgery.Results:The main discomfort of patients with indwelling anal tube were difficulty in sitting and getting in and out of bed, of which 43 cases (61.9%) reported moderate and severe sitting difficulty, and 30 cases (46.88%) reported moderate and severe difficulty in getting up and down the bed. The exposed length of anal canal was the influencing factor of discomfort ( Fvalues were 22.018, 18.213, P<0.01). Conclusion:Rectal cancer patients with indwelling anal tube have serious difficulties in sitting position and getting in and out of bed. Corresponding measures should be taken according to the influencing factors and effective intervention methods should be used to improve the comfort of the patients.

Objective To investigate the roles of SENP1 in regulation of biological characteristics of NK cells.Methods Lentivirus-mediated-Senp1-small-hairpinRNA (shRNA) transduction was applied to NK92 cells.The expression of SENP1 in NK92 cells was determined by real-time PCR and Western blot.The proliferation of NK92 cells was detected by CCK-8 assay.The apoptosis of NK92 cells was determined by Annexin Ⅴ and PI labeling.The cytotoxicity of NK92 cells against K562 cells was evaluated by luciferase reporter assay.Results Treatment of NK92 cells with IL-21 resulted in SENP1 upregulation.Lentivirus mediated SENP1 knockdown reduced proliferation and increased apoptosis in NK-92 cells,but SENP1 inhibition had slight impact on the cytotoxic ability of NK92 cells to kill K562 cells.Conclusion SENP1 mediates the regulatory effect of IL-21 on the proliferation and survival of NK92 cells.

Objective The cytotoxic effect of bile acids on trophoblast and fetal development in intrahepatic cholestasis of pregnancy(ICP) were studied through the observation of ultrastructure changes and expression of epidermal growth factor receptor(EGFR) of placenta. Methods Twenty two ICP (7 with FGR and 15 without FGR) and 15 normal late pregnancies were selected. The placental ultrastructure was observed with transmission electron microscope. The expression of EGFR in placenta was determined by immunohistological method and the related quantity of EGFR mRNA was analysed by reverse transcription polymerase chain reaction (RT PCR). Results The morphological changes found in syncytiotrophoblast were the following: decrease in the number of superficial microvilli, dilatation of rough endoplasmic reticulum, tumefation or myelination of the mitochondria and abnormal distribution of chromatin. These changes of syncytiotrophoblast were more obvious in ICP with FGR. In addition, decrease in the number of capillaries and proliferation of degenerated collagenous fibrils in villi interstitium were also observed. Compared with the normal pregnancies, the expression of EGFR in placenta from ICP decreased significantly and there was no significant difference of EGFR expression in ICP with and without FGR. Conclusion Bile acids cause distinct injuries on trophoblast in a dose dependent manner and that maybe account for the decreased expression of placental EGFR in ICP.