OBJECTIVE:To investigate the effects of erythropoietin (EPO) combined with hyperbaric oxygen on neurologic function recovery and cerebral tissue metabolism of hypoxic-ischemic encephalopathy (HIE). METHODS:A total of 47 HIE neo-nates in our hospital during Sept. 2012-Apr. 2015 were selected and divided into observation group (25 cases) and control group (22 cases)according to random number table. Both groups received routine symptomatic supportive treatment as reducing intracrani-al pressure,correcting acidosis,maintaining electrolyte balance and controlling seizures. Control group was given hyperbaric oxy-gen therapy,compressing 15 min,inhaling 30 min,decompressing 15 min,qd. Observation group was additionally given rhEPO injection(CHO cell)200 U/kg,subcutaneously at the first time,intravenous injection from the second time,qd. Both groups were treated for consecutive 10 d. NBNA score,neural reflex recovery time,consciousness recovery time,the serum levels of NSE, MBP and S100B protein were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in NBNA score,serum levels of NSE,MBP and S100B protein between 2 groups (P>0.05). Five and ten days after treatment,NBNA scores of 2 groups were increased significantly compared to before treatment,and the observation group was significantly higher than the control group at corresponding period,with statistical signifi-cance (P<0.05). The serum levels of NSE and S100B protein in 2 groups were decreased significantly compared to before treat-ment,and the observation group was significantly lower than control group at corresponding period,with statistical significance (P<0.05). After 5 days of treatment,serum levels of MBP in 2 groups were increased significantly compared to before treatment, with statistical significance(P<0.05),but there was no statistical significance between 2 groups(P>0.05). After 10 days of treat-ment,serum levels of MBP in 2 groups were decreased significantly,and the observation group was significantly lower than con-trol group,with statistical significance (P<0.05). After treat-ment,neural reflex recovery time and consciousness recovery time of observation group were significantly shorter than con-trol group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between observation group (8.00%) and control group (9.09%)(P>0.05). CONCLUSIONS:For HIE neonates,EPO combined with hyperbaric oxygen can effectively promote neurologic function recovery and cerebral tissue metabolism with good safety.

Accessory pathway-induced dilated cardiomyopathy is a new diagnosis proposed recently.Pre-excitation of part of the myocardium may mediate electrical and mechanical dyssynchrony,which will result in decreased left ventricular systolic function and increased diameter of left ventricle in patients with right-sided overt accessory pathways (type B ventricular preexcitation).Its features are listed as follows:(1) Incessant and prolonged tachyarrhythmia never happened.Tachycardiomyopathy and other causes of dilated cardiomyopathy are excluded.(2) Right-sided overt accessory pathways are shown by electrocardiogram.(3)Echocardiography indicates dyssynchronous left ventricle contraction,decreased left ventricular systolic function and increased diameter of left ventricle.Normal interventricular septal motion,recovered left ventricular and reversed left ventricular remodeling can be realized by radiofrequency ablation with a good prognosis.To infant patients,taking anti arrhythmia drugs to inhibit the conduction of the accessory pathway was recommended.

Objective To observe the effect of moxibustion on Sanyinjiao, Hegu acupoint first active phase of labor contractions pain.Methods One hundred and sixty cases of primipara were divided into test group by single blind, randomized methods (the Sanyinjiao acupoint group, Sanyinjiao acupoint and hegu point group) and control group(non-acupuncturev points group and the blank group).Each group with 40 cases.The patients were exerted mxibustion therapy 30 min in the Sanyinjiao acupoint group and Sanyinjiao acupoint and hegu point group, respectively in the maternal appear regularity uterine contraction pain, after ostium of uterus opened 3 cm.The women of the non-acupuncturev points group were exerted moxibustion therapy in the wrist horizontal stripes of radial side radial pulse place to elbow horizontal stripes biceps tendon of the midpoint of the radial side of attachment 30 min.The blank group women didn' t conduct notcarry moxibustion intervention.On the first active stage of labor time and uterine contraction pain were compared.Results The active labor time of Sanyinjiao group, Sanyinjiao and Hegu group,non acupoint group and blank control group patients were (116.11 ±65.89) min, (81.93 ± 53.45) min, (123.03 ± 7.67) min, (138.69 ± 104.01) min respectively, there was significant difference among Sanyinjiao and Hegu group, non acupoint group and blank group (P＜ 0.05), while the difference between the non acupoint group and blank group without statistical significance (P＞0.05).The first time of production process of 4 groups were (313.22± 141.15) min, (379.50± 182.82) min, (393.00 ±196.50) min, (488.08±236.61) min respectively, there was significant difference among Sanyinjiao group,Sanyinjiao and Hegu group and blank group differences (P ＜ 0.05).Moxibustion therapy after stopping, 2 h degree of cervical dilation of 4 groups were (8.37±2.19) cm, (8.14±2.74) cm, (7.64±2.91) cm, (6.29 ±3.05) cm respectively;contractions lasting time were (0.56±0.16) min, (0.52±0.13) min, (0.:48±0.17) min, (0.41± 0.09) min respectively;uterine contraction interval (2.98± 1.45) min, (2.56± 1.02) min, (3.89 ±1.54) min, (3.41 ± 1.32) min respectively;contraction strength enhaucement efficiency were 60.0％ (24/40) ,75.0％ (30/40), 17.5％ (7/40), 10.0％ (4/40) respectively, there were significant differences among Sanyinjiao group,Sanyinjiao and Hegu group,the non acupoint group and blank control group in terms of above indexes (P ＜ 0.05), while difference between the non acupoint group and blank group without statistical significance(P＞0.05).After the withdrawal of the moxibustion treatment 2 h, the pain reduction in childbirth of 4 groups were 52.5 ％ (21/40), 47.5％ (19/40), 22.5％ (9/40), 20％ (8/40) respectively, the pain reduction in childbirth of Sanyinjiao group, Sanyinjiao and Hegu Point Group were higher than that of non acupoint group and blank group, the differences were statistically significant (P＜0.05);while non acupoint group and blank group compared without statistically significant (P＞0.05).Conclusion The effect of Moxibustion at Sanyinjiao and Sanyinjiao compatibility Hegu Acupoint moxibustion on maternal production process and uterine contraction are significant, but combine with Acupoint Moxibustion can shorten the time of the active phase of labor, increase contraction of the uterus, promote the production process.

BACKGROUND: Present existed procedure protocol for urinary fistula has some limitations, which can not reflect diseased region, pathological change, or severe condition of patients, OBJECTIVE: To establish the procedure protocol for urinary fistula diagnosis and treatment following renal transplantation, in addition, to investigate its significance in clinical practice. METHODS: A total of 102 cases with urinary fistula, including 67 male and 35 female, range in age from 21 to 57 years. According to the business management mode, we have designed the "five-step procedure protocol" for the diagnosis and treatment of urinary fistula after renal transplantation. Four diagnosis steps consisting of qualitative, located, quantitative and classified, as well as one treatment step. Among 102 cases of urinary fistula, 34 were adopted conservative treatment, including 24 cases with drainage tube and retention type catheter, 10 cases with indwelling ureteric stents at tubal bladder. Other 68 cases received surgical treatment. In 47 cases with simple fistula, 36 cases received ureter/bladder replantation, 11 cases with ureteral anastomosis. Twenty-one cases with complex fistula were treated with surgical prosthesis using omentum majus after repairing. RESULTS AND CONCLUSION: Among the 34 cases receiving conservative treatment, 2 got urinary tract infection repeatedly, and 5 got the stenosis of ureterovesical anastomotic stoma. Among the 68 cases receiving surgical treatment, 2 had ureteral stoma stricture, 1 ureterovesical anastomotic stoma stricture, and 1 ureteral countercurrent. In the surgical treatment series, 3 cases died from severe pulmonary infection elicited by urinary fistula. 77 cases were available for long-term follow-up, 22 were dropped out. In the 57 cases with simple fistula were followed up for 1-10 years, the transplanted renal function was normal in 40 cases, and 17 cases suffered from chronic rejection. 20 cases with complex fistula treated with surgical prosthesis using omentum majus were followed up for 1-7 years, 19 cases were normal, 1 patient had increased creatinine, which was returned to normal after intravenous glucocorticoid therapy. The design of "qualitative, located, quantitative and classified" standard for urinary fistula diagnosis following renal transplantation, and the establishment of "five-step procedure protocol", make urinary fistula diagnosis and treatment more ordered and standard, which is more feasible for selecting optimal therapeutic scheme.

BACKGROUND: The urinary fistula rates following kidney transplantation are varying in each center, which lack of unified classification criteria and treatment standard. OBJECTIVE: To explore optimal treatments for urinary fistula following kidney transplantation by retrospective analyzing the characteristics, etiological factors and therapeutic efficacy of urinary fistula. METHODS: Totally 68 patients with urinary fistula were collected, including 42 males and 26 females, aged 21-57 years. The urinary fistula occurred at days 1-17 after operation. According to the location of urinary fistula, patients were divided into stomas fistula and ureter fistula groups. The location of fistula was determined by cystography, magnetic resonance hydrography (MRH) or operation research. In both groups, conservative treatment was first adopted, namely, placing a negative pressure drainage tube draining the wounds and placing a double-J catheter or a urinary canal in, however, if invalid, a surgical repair was performed. There were 45 patients underwent surgery. The location, onset period, therapeutic efficacies of urinary fistula was analyzed. RESULTS AND CONCLUSION: Among the 68 cases of fistula, 20(29.4%) were stomas fistula and 48 (70.6%) were ureter fistula. The onset period was (5.1±2.5) and (8.8±5.5) days after transplantation, respectively (P < 0.05). Fifteen of 20 stomas fistula (75.0%) were cured successfully by conservative treatment. Whereas, for the remaining 5 cases (25.0%), we attempted open surgery, among which 4 were cured, free of recurrence, and 1 case underwent nephrectomy because of acute rejection. For the 48 cases of ureter fisula, only 8 (16.7%) were cured by conservative treatment, but the other 40 (83.3%) must accept further open surgery, among which 35 were cured (including 6 cases of recurrent fistula). Three cases underwent nephrectomy failure of repair owing to acute rejection, besides 2 died of pulmonary infection. The achievement ratio of conservative treatment in lower fistulae was significantly higher than that of upper fistulae (P < 0.01). It is necessary to determine the location of urinary fistula following kidney transplantation. Compared to ureter fistula, stomas fistula occurred earlier with great leaked volume. Conservative treatment can first selected for stomas fistula, only if it is invalid can we resort to open surgery. However, for. ureter fistula, it is wise to adopt open surgery as soon as possible.

Objective To evaluate the efficacy and safety of Qianliejiedu capsule in the treatment of chronic prostatitis. Methods A multi-central,randomized,double-blind clinical trial was conducted.A total of 209 patients diagnosed as chronic prostatitis were randomly divided into two groups:the trial group were treated with Qianliejiedu Capsule,5 pills were taken orally for each time,twice a day;the control group were given Qianlietai Pill,5 pills were taken orally for each time and 3 times a day.All patients of the tWO groups were treated for 4 weeks,The efficacy was evaluated by urethra irritating,painful or discomfortable symptoms,and the WBC count in EPS after the treatment.Clinical criteria divided into 4 types,cure:symptom score compared with a decrease≥90%;markedly effective:symptom score compared with a decrease of 60%to 89%;effective:symptom score comparedwith a decrease of 30%to 59%;invalid:symptom score compared with a decrease of＜30%.Results There were 102 patients in the treatment group,11 got cured,49 cases were remarkably effectire,28 eases were effective,14 eases were ineffective and the total effective rate was 86.2%(88/102).There were 98 patients in the treatment group,4 got cured,38 cases were remarkably effective,35 cases were effective,21 cases were ineffective,and the total effective rate was 78.6%(77/98).The trial group and the control group could improve the symptoms such as frequent micturition,the remaining urine,the lower abdomen ache,the urethra stabbing pain,the unwell perineum,the waist and sacrum ache,the moist scrotum,and the testicle ache.The vanishing rate of the trial group was 87.6%,82.1%,74.5%,84.1%,93.7%,80.3%,82.5%,82.3%;and the control group was 74.7%,73.0%,71.0%,74.2%,71.4%,67.9%,72.3%,76.2%.The vanishing rates of frequent micturition symptom of the 2 groups were significantly different(P=0.032).The result of WBC of the trial group before treatment was as follows:WBC 10-19 28 cases,WBC 20-29 33 cases,WBC≥30 41 cases.The result of WBC of the trial group after treatment was as follows:WBC＜10 45cases,WBC 10-19 34 cases,WBC 20-29 20 cases,WBC≥30 3 cases.The result of WBC of the control group before treatment was as follows:WBC 10-19 26 cases,WBC 20-29 35 cases,WBC:≥30 37 cases.The result of WBC of the control group after treatment was as follows:WBC＜10 42 caaes,WBC 10-19 33 cases,WBC 20-29 15 cases,WBC≥30 8 cases.There were significant differences between the before and after treatment results(P＜0.05).Two cases in the trial group and 3 cases in the control group had mild adverse reactions such as nausea,epigastric discomfort,and watery stool. Conclusion Qianliejiedu capsule is effective and safe for the treatment of chronic prostatitis.

Objective Thymic epithelial tumors(TET) consist of thymoma and thymic carcinoma. The purpose of this study was to investigate the diagnostic value of 18 F-fluorodeoxyglucose (FDG) coinci-dence SPECT imaging in TET. Methods 18 F-FDG coincidence SPECT images of 37 TET patients ( male 16, female 21, age range 24-82 years; mean age 55 years) were retrospectively analyzed according to the simplified WHO histological classification: high survival thymoma (types A, AB and B1 ), median survival thymoma (types B2 and B3 ), and low survival thymoma (thymic carcinoma). Qualitative visual interpreta-tion was based on foci of18F-FDG uptake'higher than that of normal mediastinum. Turnour/lung radioactivity ratio (TLR) was calculated from the counts of region of interest (ROI) drawn around the mass and over a comparable area of normal lung tissue in TET patients. The distribution of18F-FDG uptake was compared with the enhanced CT findings. TLR was also correlated with the Ki67-1abeling index. Statistical comparison for TLR in different groups were performed with variance analysis. Results Thirty-four TET were positive and 3 negative ( A, A, AB) by 18 F-FDG coincidence SPECT images. The differences among the 3 sub-groups were statistically significant (F=9.99,P<0.05). The TLR of these 3 subgroups was variable: 1.42±0.27, 2.13±0.74, 3.00±1.19, respectively. A close correlation (r=0.613, P=0.002) of the TLR with the Ki67 labeling index (n= 22) was found. In addition, 18 F-FDG coincidence SPECT detected two metastases ( anterior chest wall and right supraclavicular fossa lymph node) that were not identified on enhanced CT. Conclusions 18 F-FDG coincidence SPECT is useful in differentiating subgroups of thymic epithelial tumors and in identifying more invasive thymic lesions.18 F-FDG may be a novel tracer that ena-bles in vivo evaluation of cellular proliferation in human TET.

Objective To investigate the prevalence of thyroid disease in early pregnancy women of Hangzhou,and further to discuss the necessity of screening thyroid function in early pregnant women.Methods From March to October 2013,1 165 cases of women in the center of community health service (or health) for routine prenatal care during early pregnancy were used as research subjects.Household salt,fasting morning urine and serum samples were collected.The salt iodine level was measured by direct titration of sodium thiosulfate.The urinary iodine level was measured by arsenic-cerium contact process method.The levels of serum TSH,FT4,and thyroid peroxidase antibody (TPOAb) were measured by chemiluminescence method.Results The median of urinary iodine of the early pregnancy women was 135.2 μg/L,and only 26.7％ of early pregnancy women' s iodine-nutrition status were optimal.These were no significant difference in median urinary iodine as well as the frequency distribution between urban and suburban(P＞0.05).The abnormal rates of TSH and FT4 in early pregnancy women with negative TPOAb were 6.8％ (71/1 039) and 8.9％ (92/1 039),and the abnormal rates of TSH and FT4 in suburban areas were higher than those in urban areas(P=0.035,P =0.001).The prevalences of hypothyroidism,subclinical hypothyroidism,and hypothyroxinemia in early pregnant women of Hangzhou were 0.3％ (3/1 165),2.0％ (23/1 165),and 4.8％ (56/1 165) respectively,and the prevalence of hypothyroxinemia in suburban areas was significantly higher than that in urban areas (6.1％ vs 3.5％,P =0.040).The positive rate of TPOAb was 9.9％ (114/1 153).The early pregnant women with positive TPOAb have an increased risk of thyroid dysfunction,the ratio of TSH over the reference values was significantly higher than that in the negative group and more prone to subclinical hypothyroidism (OR =3.34,95％ CI 1.29-8.65).Conclusion The early pregnant women in rural areas or with positive TPOAb have an increased risk of abnormal thyroid function,thyroid function and iodine nutrition screening or monitoring should be highlighted.

Objective To explore the impact of iodine nutrition on pregnant women after adjusting the iodine content in iodized salt in Hangzhou and provide a scientific basis for supplementation of iodine to pregnant women.Methods After adjusting the iodine content of salt from 2012 to 2014,proportional probability sampling method was used to select 300 families and 100 pregnant women from every county (area,city) of Hangzhou City,and the household salt and urine samples were collected to detect iodine.Results Totally 3 904,3 900 and 3 900 samples of household salts were collected with the medians of salt iodine concentration of 23.77,22.75 and 23.30 mg/kg of each year from 2012 to 2014,respectively.The qualified rate of iodized-salt was 95.87％ (3 550/3 703),97.04％ (3 510/3 617) and 96.53％ (3 564/3 692) and the consuming rate of qualified iodized salt was 90.92％ (3 550/3 904),90.01％ (3 510/3 900) and 91.38％ (3 564/3 900),respectively,from the year 2012 to 2014.Totally 1 300,1 217 and 1 315 urine samples of pregnant women were collected and the median of urinary iodine (MUI) of each year from 2012 to 2014 was 119.90,136.40 and 124.00 μg/L,respectively.Conclusion After adjusting the iodine content of salt in Hangzhou,the salt iodine consumption levels of pregnant women's family are stable,but the level of urinary iodine is low,which should be pay attention to.

Objective To explore the impact of iodine nutrition on 8-10 years old children after adjusting the iodine content in iodized salt in Hangzhou.Methods Twelve counties (areas,cities) were divided into urban,suburban and rural areas in Hangzhou.By population proportion survey (PPS),every county(area,city) was divided into east,west,south,north and middle districts; one school was selected in each district; forty children (half male and half female) aged 8-10 years old in each school were selected; family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Results Two thousand seven hundred and twenty-five household salt samples were collected.The median of salt iodine,the iodized salt coverage rate,the qualification rate of iodized salt and the consumption rate of qualified iodized salt were 24.00 mg/kg,4.35％(2 571/2 725),91.02％(2 340/2 571) and 85.87％(2 340/2 725),respectively.The medians of salt iodine in urban,suburb and rural areas were 24.10,22.12,24.30 mg/kg,respectively.A total of 2 664 children urine samples were collected.The median of urinary iodine (MUI) of the children was 177.24 μg/L.The MUIs in urban,suburb and rural areas were 175.00,178.55,178.00 μg/L,respectively; in male was 183.00 μg/L and female was 170.50 μg/L.When non-iodized and unqualified iodized salt were taken,the differences of urinary iodine within groups were statistically significant in urban,suburb and rural areas(x2 =18.652,14.686,all P ＜ 0.05).In rural area,the difference of urinary iodine of 8-10 years old children who ingested different types of iodized salt was statistically significant(x2 =39.07,P ＜ 0.05).Conclusion After adjusting the iodine content of salt in Hangzhou,the iodine-nutritional status of 8-10 years old students is at a appropriatelevel.