OBJECTIVE:To observe the clinical efficacy and safety of Enalapril folic acid tablet combined with Shenkang injec-tion in the treatment of hypertensive nephropathy. METHODS:90 patients with hypertensive nephropathy were randomly divided in-to control group and observation group. All patients were given anti-infection,regulating electrolyte balance,supplying amino acids and other conventional treatment. Based on it,control group was orally given Maleic acid enalaprilat folic acid tablet 1 tablet in the morning,once a day;observation group was additionally given 100 ml Shenkang injection adding into 300 ml 10% Glucose injec-tion by intravenous infusion,20-30 drops/min,once a day. The treatment course for both groups was 4 weeks. The clinical effica-cy,and clearance rate of creatinine(Ccr),serum creatinine (Scr),morning urine test urine protein (Up)/urine creatinine (Ucr), serum malondialdehyde(MDA),superoxide dismutase(SOD),total antioxidant capacity(T-AOC)before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,the Ccr,SOD and T-AOC in 2 groups were significantly higher than before,and observation group was higher than control group,Scr and MDA were significant-ly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05). Morning urine test Up/Ucr,systolic blood pressure and diastolic blood pressure were significantly lower than before,and the differ-ences were statistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Based on the conventional treat-ment,Enalapril folic acid tablet combined with Shenkang injection has better efficacy than only Enalapril folic acid tablet in the treatment of hypertensive nephropathy,with similar safety.

Objective To research and make one kind of sealant gel to prevent glue from leaking effectively,and protect vascular anastomosis site,raise the vascular anastomosis patency.Methods The experiment was carried out based on theory and methods in chemistry;According to the membrane performance,the membrane water solubility,and other characters,the author took experiment on the alginic acid sodium,chitsan,the gelatin and other biological materials.Results Through the experiment by membrane performance,the alginic acid sodium met the requirement,which became the membrane with the CaCl2 reaction at once.Its membrane was not dissolved in the water.And the characters of its 1%-3% solution were good on fluidity and surface contact angle determines.The biological compatibility of the compound of it with 20% CaCl2 solution was good.Conclusion The characters of the composition,which is double component sealant made from 1-3% alginic acid sodium and 20%CaCl2 solution,is best in the biological experiment.Before new medical glue appeared in clinical,this gel is hopeful to be applied in clinic and provide theory basis for clinical anastomosis.

Objective To explore the clinical features of diabetic macular edema (DME) with optical coherence tomography (OCT) and correlation with visual function. Methods Forty-nine eyes from 40 patients with DME (DME group) and 31 eyes from 31 patients without DME (control group) were examined with OCT,pattern reversal visual evoked potentials (P-VEP),macular perimetry. According to proliferative diabetic retinopathy (PDR), 49 eyes with DME were divided into group A (without PDR, 30eyes) and group B (with PDR, 19 eyes). Results The retinal macular thickness of central fovea in DME group [(299.25±63.87)μm] was more than that in contol group [(204.35 ± 37.94)μm], visual acuity and macular visual field in DME group were significantly different than those in control group, respectively (P ＜ 0.05). The retinal macular thickness of central fovea,visual acuity and visual field were no significant differences between group A and group B (P＞0.05). OCT macular thickness and visual correlation coefficient was -0.437(P＜ 0.05 ); OCT macular thickness and mean defect correlation coefficient was 0.441(P ＜ 0.05). Conclusions OCT can provide a useful tool for monitoring the occurrence and development of DME, can assess the response to treatment. With increasing of the macular retinal thickness, the visual acuity and macular visual field of visual function are more damaged.

Objective To assess the influence of PBL formation study effectiveness of TCM students.Methods The controlled studies with the teaching format of both PBL and LBL were included to assess the effectiveness of learning,by searching CBM,CNKI and VIP database.All data was analyzed on Revman 5.1.Results 9 articles were included ; All were low in the quality of their methodology,and the theoretical scores of students in PBL or LBL format shows no statistical difference [SMD=3.76,95％ CI ( -0.62,8.15 ) ].PBL format was superior to LBL on students' practical scores [SMD=7.62,95％ CI ( 3.92,11.32 ) ]; Compared to LBL format,PBL proved to have a better influence on students' self-assessment for learning ability[OR=3.69,95％ CI( 1.88,7.21 )].Conclusion PBL helps to enhance the activeness of students,to improve their practical ability,which is valuable if applied in clinical concerned courses.But the included studies were low in quality; more rigorously randomized controlled teaching trials are expected to verify the conclusion.

Objective To determine the prevalence of female urinary incontinence among Chinese people in different areas. Methods A sampling survey of urinary incontinence was conducted on 668 female adults in a Beijing community,the Uygur region and a residential district inside the First Hospital of Peking University with questionnaire. Results The prevalence of female urinary incontinence was 46.5%(94/202) in the Beijing community,43.8%(134/306) in the Uygur Region and 40.6%(58/143) in the residential district inside the First Hospital of Peking University.The ratios of those who consulted with doctors to the separate surveyed population were 24.5%(23/94),29.1%(39/134),13.8%(8/58),respectively. Conclusions The prevalence of female urinary incontinence is similar in different population.Only a few of these women went to doctors,especially among the hospital staff and workers.

Objective To explore the application of the automatic bone age assessment of BoneXpert software in Children and adolescent of China (Shanghai).Methods Left hand and wrist radiographs of 434 cases of children from trauma (264 boys and 170 girls) were obtained from Jan.2010 to Dec.2013.Bone age was assessed by BoneXpert software and 40 radiographs were randomly chosen and re-evaluated after a week.Results Seven images were rejected by BoneXpert,so the efficiency of the software was 98.4％ and it takes only 14.5 s for every image.Sample assessments by two times are exactly the same.As to BoneXpert software,there were statistical differences between bone age and chronological age in 8 groups:7,8,9,11 years old boys and 2,3,9,11 years old girls(P ＜ 0.05) out of 26 groups,and the average difference was about 1 s.The following modifications suggested that 0.57,0.79,0.93,-0.38 and-0.22,0.30,0.37,0.59 years could be added respectively for the groups of boys aged 7,8,9,11 and girls aged 2,3,9,11 years old according to their average differences between the bone age and the chronological age.Conclusions The BoneXpert method for automated determination of skeletal maturity which evaluates bone age objectively and quickly can be applied clinically after slight adjustment in some age groups.BoneXpert software is 100 percent automatic and could eliminate the subjective evaluation inaccuracy.

Objective To analyze the results of surgical treatment on chronic pancreatitis(CP),and investigate how to choose the appropriate surgical procedure.Methods The clinical data of 54 patients with chronic pancreatitis who underwent surgery at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.Results All the 54 patients underwent surgery,including 8 decompression and drainage procedure (Partington procedure) ; 13 resections (7 cases of pancreaticoduodenectomy,1 case of distal pancreatectomy,4 cases of distal pancreatectomy combined with splenectomy and 1 case of pancreaticoduodenectomy combined with distal pancreatectomy,respectively); 12hybrids (7 cases of Beger procedure and 5 cases of Frey procedure,respectively) and 21 other procedures (15 cases of pancreatic pseudocyst jejunostomy,4 cases of exploratory laparotomy combined with pancreatic tissue biopsy,2 cases of gastrojejunostomy combined with choledochojejunostomy,respectively).There were 4 cases of post-operative pathologic evidence of cancer.Twelve patients had postoperative complications and were cured with non-operative management.Forty-four patients (81.5％) were followed for 2 to 67 months,36 out of 42(85.7％) patients who suffered from abdominal pain had a persistent remission,there were one case of new on-set diabetes and no steatorrhea was reported.Conclusions For CP patients with surgical indications,the choice of procedure should be individualized for the purpose of preserving the endocrine and exocrine functions of pancreas,and taking effectiveness as well as safety into consideration.

Objective To determine the relationship between cigarette smoking and the incidence of systemic lupus erythematosus.Methods Database including Cochrane Library,Pubmed,OVID and Elsevier were electronically searched to collect case-control and cohort studies on the relationship between cigarette smoking and incidence of systemic lupus erythematosus.The literatures were screened and the data were extracted independently according to the inclusion and exclusion criteria.The quantitative analysis were performed by using Stata 12.0 software.Results The pooled OR values (95％ confidence interval)of current smoking and ever smoking were 1.82 (95％CI 1.42～2.34) and 1.22 (95％CI 0.96～1.56) respectively.Conclusions Our Meta-analysis revealed a moderate but statistically significant association between current smoking and development of systemic lupus erythematosus.However,it is still not confirmed whether the past smoking is one of the risk factors of systemic lupus erythematosus.

Objective To find out a new treatment method for advanced pancreatic carcinoma. Methods Twenty-nine patients with advanced pancreatic carcinoma and liver metastases were randomly divided into 2 groups.Group A (n=11) underwent bilio-enterostomy and/or gastro-enterostomy combined with systemic chemotherapy after operation;Group B(n=18) underwent bilio-enterostomy and/or gastro-enterostomy combined with peripancreatic arterial ligation and arterial infusion regional chemotherapy.The alleviation of clinical symptom,the change of carcinoma volume by BUS and CT scan,survival period and serum CEA were observed in two groups. Results The symptoms were alleviated apparently in most cases in Group B;BUS and CT scan showed that the tumor volume decreased apparently in Group B;The response rate was 67.7% in Group B,and 18.2% in Group A,respectively(P＜0.01);the mean survival period was (4.8±0.6) months in Group A,and (12.5±1.2) months in Group B,respectively(P＜0.01),there was significant difference between the two groups.The decrease of serum CEA was 54% in Group A and 60% in Group B,but the difference was not significant(P＞0.05). Conclusion Peripancreatic arterial ligation combined with arterial infusion regional chmotherapy is believed to be effective against both pancreatic carcinoma and liver metastases,and it can alleviate the clinical symptoms,postpone the growth speed of tumor,and prolong the survival period.

Objective To study the anti-oxidative stress effects of benazepril and candesartan.Methods SHRs of 12 weeks old were given benazepril(10 mg/kg?d,n=9)or candesartan(4 mg/kg?d,n=9)or combina- tion(Ben:10 mg/kg?d+Can:4 mg/kg?d)for 12 weeks.The tail arterial pressure was measured every two weeks.At end of study,pathological changes in the thoracic aorta,activity of SOD,serum contents of NO and hydroxy radicals,plasma Ang Ⅱ and cGMP,eNOS and P22~(phox)protein expressions in aortic tunica intima were de- termined.Results The thoracic aorta wall was thickened markedly in SHRs,and blood pressure,hydroxy radi- cal,Ang Ⅱ and P22~(phox)protein expression were increased significantly,while the serum NO,level of cGMP and eNOS expression were decreased.Benazepril(Ben)or Candesartan(Can)inhibit the thickening of vessel wall, enhance the activity of SOD(Ben:68.7?2.1,Can:65.6?4.2 vs SHR:48.8?3.2 U/mL,P