OBJECTIVE:To observe the efficacy and safety of alprostadil combined with tanshinone ⅡA in the treatment of pa-tients with early chronic kidney disease(ECKD). METHODS:138 ECKD patients were randomly divided into group A,group B and group C,46 cases in each group. On the basis of conventional treatment,group A received 40 mg TanshinoneⅡA sodium sulfonate in-jection,adding into 250 ml 0.9% Sodium chloride solution,ivgtt,qd+10 μg Alprostadil injection,adding into 100 ml 0.9% Sodium chloride solution,ivgtt,qd;group B received the same dose with Alprostadil injection;group C received the same dose with Tanshi-noneⅡA sodium sulfonate injection. All patients were treated for 14 d. Clinical efficacy,laboratory indexes [24 h urine protein,serum creatinine(SCr),total cholesterol(TC),triglyceride(TG),blood urea nitrogen(BUN),uric acid(UA)] in 3 groups before and af-ter treatment were observed,and the incidence of adverse reactions was compared. RESULTS:The total effective rate in group A was 97.83%,which was significantly higher than group B(80.43%)and group C(76.09%),the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in 24 h urine protein,SCr,TC,TG,BUN and UA among 3 groups (P>0.05);after treatment,all above-mentioned indexes significantly reduced,and group A was lower than group B and group C,the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reac-tions among group A(10.87%),group B(6.52%)and group C(8.70%)(P>0.05). CONCLUSIONS:Alprostadil combined with tanshinoneⅡA shows good efficacy in the treatment of ECKD,it can improve renal function in patients with good safety.

With the improvement of China's population aging and health care consciousness, female pelvic floor dysfunction gets increasing attention in society. Modern TCM scholars conclude TCM doctors’ theories about etiology and pathogenesis of pelvic floor dysfunction, summarized as debility of Chong Ren meridians and inability to lift, and then they advocated invigorating qi and elevating yang, with a purpose to protect pelvic floor stability. This article conducted relevant discussion on the significance of rehabilitation of pelvic floor dysfunction based on TCM adjusting qi activity.

Asthma is a common disease in children. Adherence to inhaled glucocorticoid therapy directly affects the outcome of asthma. The article mainly reviews the adherence status, assessment method, patient barriers to non-adherence and intervention strategy,so as to provide references for clinical practices and scientific research of nursing staff.

Objective To Summary the first 40 cases underwent robotic atrial septal defect (ASD) closure or atrial septal defect closure combined bicuspid valve plasty (TVP) using da Vinci S surgical System on beating heart. Methods 40 cases of atrial septal defect or combined sever tricuspid valve regurgitation were repaired using da Vinic S surgical system on beating heart from March 2009 to December 2010 in cardiovascular department of PLA general hospital. The average age was (38 ± 13) yeas old. 23 cases were female and 17 cases were male. All patients were ostium atrial septal defect with or without pulmonary hypertension. The atrial defect diameter was 1.5 -3.5 cm, and the mean diameter was(2. 8 ±1.3)cm. 9 patients had sever tricuspid valve regurgitation. Without sternotomy, the extracorporeal circulation was established through groin artery,groin vein and internal jugular vein cannulation with the guidance of transeophageal echocardiography. 3 ports of 8 mm and 1 working port of 2 cm were made in the right chest wall. After da Vinci S syetem was set up, with the assistant of bed-side surgeon, the surgeon completed the atrial septal defect closure or combined tricuspid valve plasty in the surgeon console with three dimensions visualization. During the operation, without cardioplegia administrated and aortic occlusion, the procedure was completed through right atriotomy. The pleural space was insufflated with carbon dioxide to avoid the air embolism. The direct suturing was used in 22 cases and pericardial patch were used in 18 cases. 9 patients accepted concurrent De Vega tricuspid valve plasty. The transesophageal echocardiography were used to evaluate the result of atrial defect closure or tricuspid valve repair. The operation time, robotic using time and cardiopulmonary time were compared with totally robotic atrial defect repair in arrested heart. Results All cases were accomplished successfully without complication. There was no residual shunt and air embolism. The operation time, robotic using time and cardiopulmonary time were less than the arrested group. Conclusion Robotic atrial septal defect closure or combined tricuspid valve repair on beating heart can avoid aortic ocllusion and can be utilized effectively and safely.

BACKGROUND: It is difficult to in vitro isolate and culture the ovarian surface epithelium with high purity, strong vitality and stable biological characteristics. Tissue adherence and enzymatic digestion are commonly used for primary culture, but there are certain problems in cel col ection, cel viability and cel purity. OBJECTIVE: To establish a method for primary isolating, culturing and identifying human ovarian epithelium. METHODS: The ovarian surface epithelium was obtained with cel brush innovatively, and then the cells were isolated and purified with erythrocyte spal ation and differential adherence. The epidermal growth factor was added into the serum-free Dulbecco’s modified Eagle’s medium-F12 medium for cel culture. The cel morphology was observed under inverted microscope, and hematoxylin-eosin staining and immunocytochemical staining were used to identify the cells, then the growth curve was draw. RESULTS AND CONCLUSION: The ovarian surface epithelium became adherent after cultured for 24 hours, and reached fusion basical y after cultured for 6-12 days. The cells were polygonal or flat with strong transparency and refraction. The morphological characteristics of the cells were in line with those of the normal epithelial cells, and almost al the isolated cells could express the epithelial cells surface marker CK19. The cells could be passaged for 6-8 generations with wel growth and the cel growth curve was in “S” shape. The purity of the cells was more than 95%. The results suggest that cel brush method is simple to operate and can obtain a large amount of ovarian surface epithelium rapidly. The purity of the isolated cells can reach to 95% after treated with erythrocyte spal ation and differential adherence method and the cells are in stable growth.

Objective To observe levels of the serum albumin and their association with prognosis in children with hand-foot-and-mouth disease (HFMD) . Methods A total of 122 HFMD children admitted from 2011 to 2013 were selected and divided into three groups:common group (n=57), severe group (n=52) and critical group (n=13). Serum albumin levels, blood glucose levels, peripheral blood white cell counts of the children in the three groups were compared within 24 hours of admis-sion. Moreover, the incidence of hypoalbuminemia and mortality of the children were analyzed in each group. Results In critical group, serum albumin levels were signiifcantly decreased while blood glucose levels and peripheral blood white cell counts were signiifcantly increased than those in the severe group and common group, and the differences were all statistically signiifcant (all P<0.05). There were no signiifcant differences in serum albumin levels, blood glucose levels and peripheral blood white cell counts between severe group and common group (all P>0.05). There was no hypoalbuminemia and death in severe group and common group. The percentage of hypoalbuminemia and mortality of children in critical group were higher than those in the other two groups (all P<0.01). Conclusions The mortality was extremely high in children with critical HFMD. The decrease of serum albumin levels was a high risk factor for death in children with critical HFMD. Early and dynamic monitoring serum albu-min levels may be helpful in evaluation of disease condition and prognosis of HFMD.

Objective: To establish an HPLC-fluorescence detection method for the determination of thioguanosine-monophosphate (TGMP), thioguanosine-diphosphate (TGDP) and thioguanosine-triphosphate (TGTP) in red blood cells (RBC), as well as quantify the individual thioguanine nucleotides metabolites in kidney transplant recipients with azathioprine (AZA) therapy.Methods: The individual thioguanosine phosphates were extracted from RBC by dichloromethane and subsequently oxidized by potassium permanganate.The separation was achieved on a Nucleosil C18 column (150 mm×4.6 mm,5 μm) with an ion pairing reagent and detected by a fluorescence detector (excitation at 315 nm, emission at 390 nm).The mobile phase consisted of 20 mmol·L-1 potassium phosphate buffer (pH was adjusted to 6.8 by 5 mmol·L-1 tetrabutylammonium hydrogensulfate)-acetonitril (80:20) with the flow rate of 1.0 ml·min-1.Results: TGMP, TGDP and TGTP were quantified from RBC within the range of 50-500, 50-1000 and 100-5 000 pmol·ml-1, respectively.The limit of quantification (LOQ) was 50, 50 and 100 pmol·ml-1 RBC for TGMP, TGDP and TGTP, respectively.The intra-and inter-day RSDs were below 7.0% with the method recovery between 95.0% and 103.6%.The mean extraction recovery was above 90%.The assay was applied in the blood samples of 30 kidney transplant recipients with AZA therapy, and the results indicated that TGTP was the predominant phosphate metabolite in RBC.Conclusion: The method is simple, rapid, sensitive and specific, and it can quantitatively determine the individual thioguanosine phosphates in RBC of kidney transplant recipients with AZA therapy.

AIM:To treat the chemotherapy-induced premature ovarian failure ( POF) rats with the methods of tonifying kidney yin and yang by observing the indicator changes in apoptosis of ovarian granulosa cells and related cyto -kines before and after medication .METHODS:SD rats ( n=36) were chronically given intraperitoneal injection of cyclo-phosphamide ( CTX) for 15 d in order to establish the animal model of POF .The rats were randomly divided into control group, CTX group, CTX+kidney yin group and CTX +kidney yang group.The levels of tumor necrosis factor alpha (TNF-α) and interferon gamma ( IFN-γ) in the peripheral blood were detected by ELISA .The apoptosis of ovarian granulosa cells was observed by TUNEL method .The levels of apoptosis related proteins were determined by Western blot .RE-SULTS:After modeling , the levels of TNF-αand IFN-γin the peripheral blood were significantly increased .The protein expression of Bax was up-regulated and Bcl-2 was down-regulated .The apoptosis of ovarian granulosa cells was significantly induced with a deep staining .After treatment with tonifying kidney yin and yang , the levels of TNF-αand IFN-γin the pe-ripheral blood were decreased , the protein expression of Bax was down-regulated and Bcl-2 was up-regulated, and the apop-tosis of ovarian granulosa cells was reduced .CONCLUSION:The reserve function of the ovarian can be recovered by pre-scriptions of tonifying the kidney yin and yang via regulating the expression of TNF -α, IFN-γ, Bax and Bcl-2, and inhibi-ting the apoptosis of ovarian granulosa cells .

Objective To evaluate the advantages and disadvantages of various methods for the treatment of aortic dissection involving aortic arch. Methods The clinical data of 56 patients with aortic dissection involving aortic arch were analyzed retrospectively. All the patients were treated with throacic endovascular aortic repair (TEVAR) combined with chimney technique and hybrid operation to reconstruct partial vessels of the aortic arch according to the different morphology sites of aortic disease. Results Among 56 patients, 29 cases received TEVAR combined with chimney technique of left subclavian artery, and 27 cases received TEVAR combined with hybrid operation. Six cases had typeⅠendoleak. Among them, 2 cases improved by compliant balloon dilatation, and 4 cases were not treated. There was no death in perioperative period. The patients were followed up for 3-70 (22 ± 3) months, and all the branches of the artery were unobstructed during middle and long term follow-up. Conclusions Combined endovascular treatment is a safe and effective method for aortic dissection involving the aortic arch. In the meantime, strict preoperative evaluation and suitable operation method is also important.

Objective:To explore the role of T lymphocytes activation co-stimulation pathway in asthma pathogenesis and the ability of therapy asthma with Anti-CD86mAb.Methods:The blood samples were taken from 28 asthma children( including 18 male and 10 female, age 1 year-8.08 years) and 15 normal children( including 7 male and 8 female, age 3.25 years-10 years).ELISA was used to detect the levels of IL-4、IL-13、IFN-? in culture supernatants of PBMC stimulated with PHA and treated with mouse anti human CD86mAb. Results:①When treated control PBMC with anti-CD86mAb, the level of IL-4 in control group(13.30?4.66 pg/ml) was lower than that of mouse IgG control group (15.20?5.22 pg/ml,P