Objective To study the effect of integrated tradition and western medicine on unstable angina.Methods Sixty-six patients with unstable angina were randomized into two groups:control group treated only with routine therapy(n=33) and experiment group treated with routine and jia jian luang gan jian therapy(n=33).The difference of EKG,symptoms and clinic comprehensive evaluation between before treatment and after-3-week-treatment were compared.Results The rate of symptoms and ECG improvement was higher in experiment group than control group(94% vs 73%;73% vs 45%).The difference of clinic comprehensive score between before treatment and after 3 weeks treatment was significantly higher in experiment group.Conclusion The treatment of integrated tradition and western medicine on patients with unstable angina is more effective.

Objective To explore the effect of swimming training on the microcirculations of cochlea in guinea pigs with tertram ethylpyrazine(TMP) treatment after chronic hypoxia.Methods 28 guinea pigs were divided into normal control group outside of cabin (A) and chronic hypoxia model group (B). After four weeks the model group were divided into the model control group (B 1),TMP treatment group (B 2),swimming training group(B 3) and swimming training with TMP treatment group (B 4).Until the given time,LDF was used to investigate the blood flow of every guinea pig's cochlea.The spiral ligament spreaded-slice optical lens was used to observe guinea pig's vascular veins, capillary appearance and RBC counts.Results There was significant difference in cochlear blood flow(CBF) and RBC counts between B 2,B 4 groups and B 1 group.CBF and RBC counts of B 3 group was improved comparing with B 1 gorup,so did that of B 4 group comparing with B 2.But no significant difference was found.Conclusion Swimming training can relieve the swelling on the thin blood vessel and improve the effect of TMP on the microcirculation in cochlea of guinea pigs under chronic hypoxia environment.

Objective To investigate the features of female sexual dysfunction (FSD) in type 2 diabetic patients (T2DM)and to analyze its risk factors. Methods According to FSFI indexes in the sexual function questionnaire,227 female T2DM patients were divided into DM group without FSD [n=144,FSFI≥25] and DM+FSD group[n=83,FSFI<25]. 80 healthy women served as normal controls. The risk factors for FSD were analyzed using logistic regression analysis. Results The occurrence of FSD was 36.6%(83/227) in female T2DM patients. The levels of FSH,TSTO and LH were higher,and E2 was lower in DM+FSD group and DM group than those in NC group(P<0.01),but there was no statistical significance between DM+FSD group and DM group(P>0.05). The score of sexual desire[(2.54±0.58) vs (3.76±0.90) vs (4.59±1.22) score],sexual arousal[(2.30±0.42) vs (3.57±0.85) vs (4.81±1.00) score],vaginal lubricate[(3.35±0.29) vs (4.46±1.32) vs (5.14±0.83) score],orgasm[(2.75±0.68) vs (3.40±1.86) vs (4.02±1.25)score] and total score [(17.94±4.15) vs (24.71±6.33) vs (28.13±5.78) score] were lower in DM+FSD group and DM group than those in NC group. The score of sexual satisfaction[(3.45±1.68) vs (4.94±0.93),(4.99±0.86)score] and pain[(3.55±0.50) vs (4.58±0.47),(4.58±0.62)score] were lower in DM+FSD group than those in DM group and NC group(P<0.05),but there was no statistical significance between DM group and NC group(P>0.05). Logistic regression analysis showed that age,BMI and HbA1c were risk factors for FSD in T2DM patients (P=0.029,0.001,0.022,respectively). Conclusion The occurrence of FSD is common in female type 2 diabetic patients. BMI and HbA1c are the main risk factors for FSD.

AIM:To approach the therapeutic effects of mycophenolate mofetil(MMF)in hormonal resistance nephrotic syndromes.METHODS:Patients were diagnosed as nephrotic syndrome and treated with prednisone at the dose of 1 mg?kg-1?d-1 for over 8 weeks,and 24 patients with unsatisfactory results or were palindromic were selected,and several patients in the 24 patients had been treated with cyclophosphamide or cyclosporine A.All patients were treated with MMF combined with low dose hormone.The initial dose of MMF was 1.0-1.5 g/d for 3 months,later the dose were reduced,and the maintenance dose of MMF was 0.5-1.0 g/d,the dose of prednisone was 5-20 mg/d,the follow-up visit period more than six months.The changes on urine protein,serum albumin,liver function,renal function were compared before and after treatment.RESULTS:Before and after treatment,urine protein decreased from(3.4?1.7)g/d to(0.9?0.2)g/d,serum albumin increased from(19.6?5.4)g/L to(36.1?7.7)g/L.serum creatinine level decreased from(105.7?6.4)?mol/L to(90.1?5.8)g/L.20 patients(83.3%)pathogenetic condition were relieved,15 patients(65.2%)were with complete remission.5 patients(20.8%)were partially recovered,and 4 patients(16.6%)had no response.The adverse effects were observed,including gastrointestinal events(n=8,33.3%),bacterial pneumonia(n=4,16.6%),herpes zoster(n=1,4.1%),hepatic function mild damage(n=3,12.5%).CONCLUSION:It is safe and effective to combine MMF with low dose hormone in treatment of hormonal resistance nephrotic syndrome,which could become a therapeutic option for refractory nephrotic syndrome(RNS).

Objective To report the clinical experience of extracorporeal membrane oxygenation (ECMO)in the emergency management of fulminant myocarditis.Methods The patient,an 11 year-old boy,had fever for 4 day and abdominal pain,vomiting for 1 day and anuria for 12 hours.Electrocardiogram showed Ⅲ atrial-ventricular block,multifocal ventricular rhythm,bundle branch block,convulsivum multifocal ventricular tachycardia,extensive low voltage,ST-T elevation at lead Ⅰ,AVR,V1,V2,V3;and there were ST-T intrusion,T wave inversion at lead Ⅱ,Ⅲ,AVR,AVF,V4～5.Blood creatine kinase was 2 161 U/L,reatine kinase isoenzyme 109 U/L,α-hydroxybutyrate dehydrogenase 612 U/L,lactate dehydrogenase 696 U/L,troponin Ⅰ 22.1 U/L.Echocardiogram showed right atrium 4.4 mm,right ventricular 2.3 mm,severe tricuspid valve regurgitation,left ejection fraction 33％,left ventricular fractional shortening 15％,ventricular wall motion dyssynchrony.Blood lactate was 4.0 mmol/L.The patient's condition was still unstable after using dobutamin,dopamine,milrinone,furosemide,large dose methylprednisolone,intravenous human immunoglobin,phosphocreatine and so on.ECMO was used for cardio-pulmonary support.It is necessary to monitoring the consciousness,temperature,heart rate,respiration,blood pression,SaO2,urinary volume,ariterial blood gas,blood electrolytes,blood lactate,blood glucose,liver function,renal function,blood routine,activated clotting time(ACT),lower extremity blood supply and so on.ACT was maintained at 160～200 s.Heparin was used persistently[5～10 U/(kg·min)].Results ECMO system had been successfully used for 7 days.The cardiac function of the patient was improved significantly.There was no complication,such as hemorrhage,infection,and embolism.Heart arrest in the patient occurred three times,ventricular fibrillation and ventricular flutter occurred one time respectively during ECMO.The rhythm was recovered by electric defibrillation and antiarrhythmic drugs.On day 20,the patient was discharged.At the time of hospital discharge,the patient demonstrated good activity,with normal myocardial enzymes.The echocardiogram showed the size of the cardiac chambers and the contractile function of the myocardia were normal.Electrocardiogram showed Ⅰ degree atrial-ventricular block,complete right bundle branch block.Two weeks later,the electrocardiogram demonstrated complete right bundle branch block.Echocardiogram showed septal thickening(0.9 cm).Two months later,the electrocardiogram was just as that of two weeks before.Echocardiogram showed septal thickening(0.7 cm).The children had no symptom after he was discharged and acted without limitation.Conclusion ECMO is a kind of effective treatment for fulminant myocarditis.The key to desirable therapeutic effect is the timing of its application.

Objective: Little has been reported on the utilization of the preoperative preparing room before anesthesia.This article aimed to investigate how to improve work efficiency in the operation theatre by utilizing the preoperative preparing room.Methods: Two hundred patients undergoing elective surgery were equally randomized into an operation room group and a preoperative preparing room group,for which the preoperative preparations were made in the operation room and the preoperative preparing room,respectively.Records were made of such parameters as the anxiety score,mean arterial pressure(MAP) and heart rate(HR) of the patients,as well as the surgery rotation time.Results: The anxiety score,MAP and HR were significantly lower(P

Objective To discuss the effects of repairing nasal ala defects by free transplantation of autogenous auricle composite tissue flap. Methods 50 cases with nasal ala defects were repaired by free auricular composite tissue flap transplantation from Janu 2003 to May 2013. The defects size was 0.5cm x 0.7cm~1.3cm x 1.5cm. According to the size of the defects, full thick wedge-shaped auricle composite tissue flap were cut off, then inserted into the nasal ala defects area and fixed stablely, the donor sites were sutured directly avoiding ear cartilage. Salvianolate and hyperbaric oxygen were used in postoperative treatment for 5-7 days. Results 48 cases achieved good results, 2 cases had partial necrosis of composite tissue flap after operation, also achieved good results after reoperation. Over 3 months~5 years follow-up, all cases had satisfactory results. The volume of auricle composite tissue flap reduced less than 10%. Surgical incisions had a linear scar, good color matching, nostril symmetry. All patients were satisfied with the overall appearance. Conclusions Autogenous auricle composite tissue flap free transplantation for repairing middle and small size of nasal ala defects can recover ala formation and structure very well, nasal appearance can be improved greatly with nostril symmetry. There is no hypertrophic scar in donor sites. This method is simple and easy,and is also a good method for repairing nasal ala defects.

Objective To investigate the increased expression of microRNA-146a(miR-146a) in peripheral blood mononuclear cells (PBMC) of patients with chronic immune thrombocytopenic purpura (ITP) and its clinical significance. Methods Twenty-eight patients with chronic ITP and 28 healthy controls matched with age and gender were enrolled in this study. Fluorescent quantitative PCR reaction was used to detect the relative expression of miR-146a in their PBMC. The serum concentration of TNF-α, IL-2,IL-1 β and IFN-γ were measured by ELISA. CCK-8 method was used to detect the proliferation ability of PBMC , which transfected with miR-146a mimics or inhibitor and then stimulated with platelet . Results The relative expression of miR-146a in ITP patients was higher than that of healthy controls. The increased expression of miR-146a was negatively correlated with the serum TNF-α, IL-2 and IFN-γ. The PBMC transfected with miR-146a mimics had reduced expression of IL-2 and proliferation when stimulated with platelet.In contrast, the opposite effect was observed with the miR-146a inhibitors transfection. Conclusion MiR146a was involved in the pathogenesis of chronic ITP by controlling IL-2 production and PBMC proliferation.Thus, it may be a potential therapy target for chronic ITP.

Objective To determine the characteristics of retinal vascularization in premature infants. Methods A prospective study was carried out which included all premature infants with birth weight<2 000 g, who were hospitalized in Guangdong Women and Children's Hospital from September 1, 2009 to August 31, 2010. Close retinal screening and follow-up were carried out in order to record retinal vascularization at different post-conceptional ages. Spearman correlation analysis was performed for statistical analysis. Results A total of 231 infants were enrolled, and follow-up was completed in 212 infants giving a follow-up rate of 91.8%. Twenty-eight infants developed retinopathy of prematurity (ROP) resulting in a ROP morbidity of 13.2%, and 184 cases had full retinal vascularization. The median birth weight was 1 600 g (1 000-1 900 g) and the median gestational age was 32.4 weeks (27.0-35.5 weeks). In the 32-week post-conceptional age group, the proportion with full vascularization in ZoneⅠ,ⅡandⅢwas 87.1%(81/93), 7.5%(7/93) and 0.0%(0/93), respectively. In the 36-week post-conceptional age group, full vascularization was observed in ZoneⅠ, and the proportion with full vascularization in ZoneⅡandⅢrose sharply at 38-week and 40-week post-conceptional age, respectively. The proportion with full vascularization in ZoneⅢwas 100.0%(24/24) at 43-week post-conceptional age. According to Spearman correlation analysis, there was a positive correlation between ZoneⅡand Zone Ⅲ retinal vascularization progression and post-conceptional age (r=0.690 and 0.720;P=0.000). In premature infants, full retinal vascularization in ZoneⅠoccurred at 36-week post-conceptional age. The median gestational age for ZoneⅡand ZoneⅢretinal vascularization was 38 weeks (32.2-40.4 weeks) and 41 weeks (36.0-42.6 weeks), respectively. Therefore, a further 2-3 weeks were required for full retinal vascularization in ZoneⅡand ZoneⅢ. The time differences for under-vascularization in ZoneⅡandⅢwere 8 to 10 weeks, and the time differences for full vascularization in ZoneⅡandⅢwere 8 weeks and 6 weeks, respectively. Conclusion Retinal vascularization varies in premature infants. Almost all premature infants complete vascularization by term gestational age and the majority of infants need to be followed up to 41 weeks. It is essential to focus on the different retinal regions during maturation.

Objective To observe and analyze clinical characteristics of diabetes patients suffering from pancreatic cancer . Methods We recruited 107 cases of pancreatic cancer(66 without diabetes and 41 with diabetes) and 100 diabetes patients without pancreatic pancreas as control .Patients′ demographic information ,degree of tumor differentiation ,serum markers etc .were com‐pared in order to find out the relevant clinical features of diabetes patients suffering from pancreatic cancer .Results (1)Patients with pancreatic cancer mostly were middle‐aged males .55 .1% of them suffering from dysglycemia ,18(16 .8% ) and 41(38 .3% ) of whom had impaired fasting glucose and diabetes ,respectively .(2)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes were more prone to be asymptomatic and weight loss(P< 0 .05) .(3)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes had significantly higher levels of fasting blood glucose(FBG) andγ‐glutamyltranspep‐tidase(γ‐GT)(P<0 .05) .(4)When compared with diabetes control ,pancreatic cancer with diabetes were older and shorter duration and lower body mass index(BMI)(P<0 .05) .They were more prone to weight loss(P<0 .05) .Moreover ,serum CA19‐9 and CEA levels in them were significantly higher than those in the diabetes control(P<0 .05) .Conclusion Older age ,shorter duration ,low BMI are all risk factors for diabetes patients to develop pancreatic cancer .Being asymptomatic and weight loss are their clinical characteristics .CA19‐9 and CEA are both sensitive serum markers to detect pancreatic cancer patients with diabetes .