Objective To investigation effect of glucocorticoid combined with Qingkailing injection on lobar pneumonia IL-10 and serum TNF-levels.Methods 120 cases of lobar pneumonia in children were selected respiratory department fromasin our hospital in December 2012 to December 2014 as the object of study, were divided into control group and observation group, control group were treated with dexamethasone sodium phosphate injection,the observation group in the control group based on the combined with Qingkailing injection, serum IL-10, TNF-a level and curative effect were compared between the two groups pre-and post-treatment in patients.Results The total effective rate of the observation group was 86.67%, higher than that of the control group, the total effective rate was 70%(P <0.05).Before treatment, the two groups of patients with TNF-αand IL-10 were not statistically significant difference.After treatment, the two groups of patients with TNF-αand IL-10 were decreased, and lower than the control group (P<0.05) .Conclusion Glucocorticoid combined with Qingkailing injection can reduce serum IL-10, TNF-alpha level in lobar pneumonia,has a definite effect.

Objective To explore the complications of augmentation mammoplasty by polyacrylamide hydrogel (PAHG) injection and their management.Methods Preoperatively,174 patients underwent breast ultrasound image,and some patients received magnetic resonance imaging (MRI) to ascertain the distribution of injected PAHG.We used the periareolar incision and dissection extended to the subcutaneous tissue,mammary gland,and subgland space.We were able to suck most of the gel by the negative pressure machine and remove the abnormal breast tissue.The secondary breast deformity was repaired with subpectoral placement of silicone mammary implants (48 cases immediately,39 cases secondarily after 3-6 months) according to the individual situation.Results Following-up for 3 to 6 months,most of their symptoms were relieved after removal of the polyacrylamide hydrogel.In the patients who were performed with the implants augmentation mammoplasty,77 cases gained satisfactory results on the shape and texture of the breast (44.3％),and 10 cases were not satisfied with texture of the breast (5.7％).79 cases appeared breast atrophy or flat chest (45.4％).The severe breast deformities occurred in 8 cases (4.6％).Conclusions PAHG should be removed with surgical operation as soon as possible.The open operative technique via periareolar incisions may be a better method for the patients.The breast reconstruction is performed with implants prosthesis for those who are suitable and willing after removal of PAHG.

Objective To explore the methods and significance of section of multiple fibroadeno mas of breast with better incision.Methods From may 2005 to December 2014,21 cases were per formed by removing multiple fibroadenomas of breast with a new incision.Preoperatively,the diag nostic work-up included clinical examination,breast ultrasonography and/or mammography.A new approach,for removing of multiple fibroadenomas of the breast with the incision in periareolar site,was used in our hospital.All palpable breast lumps were excised with this approach through which the fibroadenomas were removed as a whole unit.Then,the breast cavity were irrigated with normal saline solution,and strict haemostasis of the bed was done by electrocautery.If the resulted cavity was larger,interrupted sutures should be performed with the absorbable stitches;otherwise,it was unnecessary.The skin wound was sutured to the deepithelialized area with Vicryl 5-0 (Ethicon).Results There were 21 cases,who underwent surgery using the described technique through which 95 lumps (0.5 cm× 0.5 cm-6.0 cm× 5.0 cm) were removed and included in the study.All patients' resected tumor specimens were pathologically confirmed as fibroadenoma.No major complications were encountered in any of the patients.The incision was well concealed by the dome of the nipple and the areolar pigmented and corrugated skin.Both doctors and patients were satisfied with postoperative aesthetic effect of the incision scar.Conclusions The incision in periareolar site for excision of multiple fibroadenomatas results in minimal scarring and a better appearance than that can be achieved with traditional methods.This technique,which can improve the aesthetic outcome of breast surgery,should be performed when feasible.

Objective To assess the relationship betw ee n the ultrasonographic manifestation and the pathological histology type in pros tatic cancer. Methods 50 cases of CaP and 50 cases of BP H were included in this study.All the patients were ultrasonographic,and the dat a were compared with its the pathological histology type postoperatively. Results The typical ultrasonographic manifestation is hypoecho ic nodules (62%) in CaP group and mixed echo nodules (54%) in BPH group.There is a significant differences between CaP group and BPH group( P

Objective To improve a HPLOUV method for the determination of Tramadol hydrochlo-ride in human plasma. Method Alkalinized samples of plasma were extracted with dichloromethane. Tramadol and internai standard were analyzed on Elite C18 column (200mm?5.0mm, 5?m) with a acetoni-trile-phsphate buffer (pH6.5) (74:26, v/v) mobile phase and detedted at 220nm. Results The Calibra-tion plots in human plasma were linear (r=0.9984, n =5) from 10 to 800 ng/ml. The limit of detection was 10 ng/ml. For 20, 100, 400 ng/ml check samples, intra-run precisions (RSD) were 3.81% -5.44% and inter-run preceisions (RSD) were 3.95% -4.41% , respectively. The average recoveries were 89% , 96% and 92% for the low, middle and high check samples, respectively. Conclusion The improved ana-lytical method for Tramadol hydrochloride was found to be sensitive, simple and rapid, suitable for applica-tion in forensic toxicological analysis and routine determination of numerous samples.

Objective To explore the current status of humanistic care among medical students in clinical practice in obstetrics and gynecology department and its related influencing factors and to propose the corresponding countermeasures.Methods Scale of humanistic care quality was used in the survey for clinical practice students in obstetrics and gynecology department.ResultsThe total score rate of human care quality of medical students before clinical teaching were (84.12 ± 9.24)with a scoring rate of 72％.Significant differences were observed in the medical students with different medical professional(P ＜0.05).The total score of humanistic care quality of medical students after clinical teaching were (96.41 ± 1 1.53 ),significant higher than that of before training ( P ＜ 0.05 ).ConclusionHumanistic care quality in medical students needs to be strengthen.Clinical training in obstetrics and gynecology department combined with humanities education has important practical significance to improve the quality of medical students.

Objective To investigate the effects of ghrelin on proliferation of vascular smooth muscle cells(VSMC)and the expression of mitochondrial fusion 2(Mfn-2)in cultured human aortic smooth muscle cells(HASMCs).Methods HASMCs were cultured in vitro,treated with different concentrations(10-9,10-8,10-7,10-6,10-5 mol/L)ghrelin or 10-6 mol/L ghrelin for different time(0,6,12,18,24 h).Subconfluent HASMCs at passage 4-6 were used in experiments.MTT essay was used to investigate the effect on proliferation of HASMCs.RT-PCR and Western blot were used to analyse the expression of Mfn-2.Results 10-7-10-5 mol/L ghrelin inhibited the proliferation of HASMCs,and the inhibitory effect of concentration of 10-6 mol/L was the most obvious(P<0.01).Ghrelin inhibited the proliferation of HASMCs in 6-24 h,and it reached the peak at 24 h(P<0.01).10-6 mol/L ghrelin significantly increased the expression of Mfn-2 mRNA and protein(P<0.01).The up-regulation of 10-6 mol/L ghrelin on Mfn-2 mRNA and protein expression reached the peak at 18 h(P<0.01).Conclusion Ghrelin might inhibit the proliferation of HASMC by up-regulating the expression of Mfn-2.

Objective To study the damage of liver function after transcatheter arterial chemoembolization (TACE) with low-dose versus conventional-dose anticancer drugs in patients with hepatocellular carcinoma (HCC). Methods One hundred and twelve patients with unresectable HCC were randomly divided into two groups (A and B) to receive superselective TACE. Low-dose anticancer drugs including mitomycin C (MMC) 2 ～ 8 mg, epirubicin (EPI) 5 ～ 10 mg and carboplatin (CBP) 100 mg were used in group A (n= 52), and conventional-dose of anticancer drugs (MMC 10 mg, EPI 40 mg and CBP 300 mg)for patients in group B(n= 60). Lipiodol-anticancer drugs emulsion was injected into the feeding arteries of tumor and then followed by embolization of gelatin sponge (GS) or polyvinyl alcohol (PVA) particles.Laboratory examination of the liver function including Child-Pugh scores, total bilirubin (TBIL), albumin (ALB) and alanine aminotransferase (ALT) were evaluated respectively before TACE and at third day, one week and four weeks after this procedure. Results In both groups, TBIL, ALT, and Child-Pugh scores increased (P ＜ 0.001 or P ＜ 0.05) and ALB decreased (P ＜ 0.001 or P ＜ 0.01) at three days and one week after TACE. Four weeks after-procedure, all the parameters described above showed no significant difference than those before the procedure in group A (P ＞ 0.05 ). On the contrary in group B, a significant difference (P ＜ 0.05) was found in the comparison of these parameters (except ALT). Conclusion Superselective TACE with low-dose anticancer drugs may induce transient impairment of liver function in the patients with HCC, but those patients used conventional-dose of anticancer drugs frequently cause lasting and more serious worsening of liver function.

Objective To study the relationship between X-linked inhibitor of apoptosis protein (XIAP) expression and transitional cell carcinoma(TCC) development. Methods Forty-three TCC tissues and 12 normal transitional epithelial tissues were applied to detect XIAP expression by semi-quantitative RT-PCR, immunohistochemistry and western blot. The data were statistically analyzed by using SPSS11.5 according to the 2 groups (TCC and normal transitional epithelial) as well as the dif-ferent subgroups (tumor stage, grade, single or multiple tumor, primary or recurrence tumor). Results XIAP expression in TCC tissues was higher than in normal transitional epithelial tissues(im-munohistochemistry: 22±5 and 16±2, Western blot:1.21±0. 15 and 0. 61±0.24, mRNA: 1.17± 0. 30 and 0. 75±0. 17, P<0. 05). In the bladder tumors group, XIAP expression in recurrence tumors was higher than in primary tumors(immunohistochemistry: 24±3 and 20±3, Western blot: 1.66±0.28 and 1.10±0. 23, mRNA: 1.44±0. 27 and 1.05±0. 23, P<0. 05). However, there were no significant differences according to the tumor stage and tumor grade as well as tumor multi-plicity or not. Conclusion XIAP expression might serve as a biomarker in TCC diagnosis and recur-rence prediction.

Objective To evaluate the efficacy of Fluency stent-graft (Bard Corp) in transjugular intrahcpatic portosystemic shunt (TIPS).Methods The clinical data of 21 consecutive patients treated by TIPS using Fluency stent-grafts were retrospectively reviewed.All of them were recurrent variceal bleeding secondary to portal vein hypertension,1 was bleeding secondary to primary hepatic carcinoma with port vein thrombns,and 1 was Budd-Chiari syndrome.They were followed-up after (10.1 ± 4.6) months (2.0 to 24.0 months).Stent-grafts patancy,portal vein pressure and liver function were recorded and compared.Results Twenty-five stent-grafts were successfully implanted in 21 patients,23 stent grafts were 8 mm 2 were 10 mm in diameter.The covered length of the stents varied from 6 to 8 cm.The bleeding was stopped and the portal vein pressure decreased significantly from (25.4 ± 3.5) mm Hg to (15.4 ± 2.8) mm Hg (t = 12.495,P < 0.01).During the follow-up period,The patient with primary HCC and portal vein thrombosis died 4 months after the procedure. One case had a new primary HCC during the follow-up and died 24 months after the procedure.One ease with variceal bleeding secondary to portal vein hypertension died of muhisystem organ failure.One case occluded in the hepatic vein and had another stcnt graft implanation.The other 17 cases had no stenosis after 7 to 17 months follow-up.Ultrasound showed that the stents were patent 1 week before the patients died.Three cases had transient symptoms of hepatic encephalopathy and recovered after treatment.The Child scores of the 19 patients survived more than 6 months were 6.3 ±1.4 before and 6.4 ± 1.9 after the procedure without significant difference (t = 0.645,P > 0.05).Conclusion The Fluency stent-grafts could increase the patency of the TIPS,but its efficacy on the long-term effect and hepatic encephalopathy need further investigation.