Objective:To observe the efficacy of Ionic silver dressing + gel in treating diabetic foot ulcer. Methods:43 cases of this disease were divided into two groups randomly. In treating group(A),the wounds were treated with Ionic silver dressing + gel and the wounds were treated with basic method in controlling group(B). Results:Ionic silver dressing + gel could control wound infection,promote wound granulation and epithelium regeneration and lessen inflammatory reaction. In treating group,the average wound healing time decreased to (53.18?9.49)days from (66.86?7.90)days in control group(P

10 days) an gel in the treatment group, while the wounds in the control group were treated with normal saline gauze. Wound healing was observ dynamically. MAIN OUTCOME MEASURES: Wound healing was recorded at day 3, 10 and 17 after treatment. RESULTS: The average wound healing period in the treatment group was significantly shorter than that in the control group (P

Objective To analyze the causes of rhabdomylysis (RM), pathogenetic mechanisms and possible effective interventions for secondary multiple organ dysfunction syndrome (MODS) caused by RM. Methods causes of RM, clinical manifestations, severity of disease evaluated by APACHE Ⅱ and Marshall MODS Score, results of laboratory, clinical interventions and outcome were analyzed in all three MODS cases secondary to RM. Results The specific causes of RM were not clear. However, persistent acute twitch and hyperthermia occurred very early in all three cases. Plasma CK was increased 50 fold over the normal level. Number of injured organs was 7, 4 and 6, respectively. Marshall MODS score ranged from 15 to 21. APACHE Ⅱ scores were greater than 20 in all cases. One patients survived, the other two died. CRRT started early had been shown to be beneficial to decrease the markedly elevated plasma CK, CK-Mb, ALT, ALT and LDH. Conclusion Although the mechanism of RM with secondary MODS has not been elucidated yet, deep sedation as well as effective hypothermia to control acute twitch and hyperthermia should be the essential interventions to attenuate further organ injury. Additionally, based on effective advanced life support, CRRT started early could be an important therapy for MODS secondary to RM.

Objective:To approach the effect of Naotangfang extracts on expression of vascular endothelial growth factor(VEGF) after focal cerebral infarct in rats. Methods:30 Sprague-Dawley(SD) rats were randomly divided into 6 groups:sham operation group,model group,Naotaifang extract groups(low,middle,and high dosage) ,and Naofukang group. Some indexes were detected such as neurological scores,VEGF mRNA expression by RT-PCR,and the number of VEGF positive cells by immunohistochemical methods. Results:The symptoms in nervous function were improved in the Admin. groups,especially in the Naotaifang middle dosage group. The number of VEGF positive cells and VEGF PCR production in Naotaifng middle dosage group was higher than that in the model group. Conclusion:Naotaifang has neuroprotective effect against focal cerebral ischemic injury by improving the expression of VEGF.

Objective To evaluate the effect of early clinical interference strategies on preventing the conversion of acute pancreatitis to the severe form and aggravation of severe acute pancreatitis(SAP).Methods The patients with acute pancreatitis admitted to this hospital were divided into two therapeutic phases by different therapeutic methods from January 2001 to December 2008.Patients in the first phase(from January 2001 to December 2004) were treated by the routine management,and the second phase(from January 2005 to December 2008) by the routine management combined with early clinical interference strategies.Then,the ratio of conversion from acute pancreatitis to SAP and prognosis of SAP between two phases were compared.Results Compared with the first phase,the rate of aggravation of acute pancreatitis was significantly decreased in the second phase(4.48% vs.21.18%),the average healing time of SAP,the incidences of systemic and local complications and the mortality of pancreatitis were reduced(P

termined by serum cotinine determination.Effects of tobacco exposure on arterial elasticity in residents of poor areas in north China were more than those in urban residents.

AIM: To investigate the effect of caveolin - 1 and phosphorylation of ERK1/2 on 17β - estradiol ( E_2 ) induced inhibition of vascular smooth muscle cells ( VSMCs ). METHODS: The proliferation in cultured VSMCs was determined by using [~3H ] - thymidine incorporation. The expressions of caveolin - 1, MKP -1 and ERK1/2 phosphorylation were measured by Western blotting. The expression of caveolin - 1 mRNA was measured by RT - PCR. RESULTS: Exposed to fetal calf serum ( FCS) for 24 h, the increase in proliferation of VSMCs was detected by [~3H] -thymidine incorporation. Pretreatment with various concentrations of E_2 for 24 h inhibited VSMC proliferation induced by FCS. The results of Western blotting and RT - PCR showed that pretreated with 17β - estradiol for 24 h reserved the decrease in caveolin - 1 induced by FCS. Western blotting results further proved that the expression of MKP - 1 was significantly increased and the expression of ERK1/2 phosphorylation was decreased after incubated with 17β - estradiol. CONCLUSION: 17β -estradiol increases caveolin - 1 and MKP - 1 expressions, and decreases ERK1/2 phosphorylation, leading to the inhibition of VSMC proliferation.

Objective To investigate the clinical effects and significance of different-dose atorvastatin on soluble CD105(sCD105),high sensitive-C reactive protein(hs-CRP)and the parameters of heart rate turbulence in patients with acute coronary syndrome(ACS). Methods One hundred and six ACS patients were divided into three groups by random digits table: control group(30 patients, routine treatment),treatment group Ⅰ(38 patients, routine treatment + atorvastatin 20 mg), and treatment group Ⅱ(38patients, routine treatment + atorvastatin 40 mg). All patients were treated for 4 weeks. The levels of serum sCD105,hs-CRP,and the parameters of heart rate turbulence before and after treatment. Results Before treatment, the levels of turbulence onset(TO), turbulence slope(TS),sCD105 and hs-CRP in three groups had no significant difference(P ＞ 0.05). After treatment, TO,sCD105 and hs-CRP decreased significantly,and TS increased significantly(P＜ 0.05 or ＜ 0.01). The change amplitude of treatment group Ⅱ was the most obvious, and the levels of above mentioned index showed significantly difference compared with that of treatment group Ⅰ[TO:(0.22 ±0.18)% vs.(0.66 ± 0.23)%;TS:(6.22 ±0.83)ms/RR interval(RRI)vs.(3.90 ±0.73)ms/RRI;sCD105:(1.65 ±0.43)mg/L vs.(2.92 ±0.50)mg/L;hs-CRP:(1.68 ±0.55)mg/L vs.(2.08±0.61)mg/L](P ＜0.01). Correlation analysis showed the levels of sCD105 and hs-CRP had significantly positive correlation with TO(P ＜ 0.01)and had negative correlation with TS(P ＜ 0.01).Conclusions The atorvastatin treatment in patients with ACS may stabilize coronary vascular endothelial cells and atherosclerotic plaque, and improve autonomic nerve function. Larger doses of atorvastatin may get more benefit.

Objective To improve the diagnostic accuracy of silicosis by investigating its CT appearances.Methods CT appearances in 45 patients with silicosis were analyzed retrospectively.All these patients were male,aged from 42~71 years(mean age,56 years old),including stageⅠin 5,stageⅡin 18 and stage Ⅲ in 22 cases.All patients underwent plain CT scan,CT findings of lung parenchyma,hilus, mediastinum,and pleura were analysed.Results CT appearances of silicosis included:(1)Lung parenchyma:①All cases showed diffuse small nodules;②Progressive massive fibrosis were found in 16 in stageⅡ(16/18) and in 22 in stageⅢ(22/22);③All cases showed fibrous strips and reticular opacities.Central fibers and vascular bundles thickening were found in 2 in stageⅡ(2/18) and in 5 in stageⅢ(5/22);8 in stageⅢ(8/22) cases showed obvious interlobular septal thickening and subpleural lines;④ 3 in stageⅡ(3/18) and 8 in stageⅢ(8/22)patients showed emphysema.(2)All cases except 4 in stageⅠshowed enlarged hilar and mediastinal lymph nodes,which contained silicon powder;2 in stageⅡ(2/18)and 9 in stageⅢ(9/22) patients showed fleck,mulberry,eggshell calcifications in the hilar lymph nodes.(3)Pleural thickening was showed in 6 in stageⅡ(6/18) and 13 in stageⅢ(13/22)cases,some of which showed typical bandlike pleural thickening.Conclusion CT features of silicosis in combination with clinical history will lead to accurate diagnosis.

Objective To discuss the surgical effect of adult lipomatous tethered cord syndrome (TCS). Methods The clinical data of 29 patients with adult lipomatous TCS were systematically analyzed. Eleven of male and 18 of female,who ranged from 20 to 59 years. All patients were performed filum terminale release and lipoma excision, the clinical outcome after operation was analyzed according to Hoffman grading criteria and visual analog scale (VAS). Results According to Hoffman grading criteria, 9 cases were obviously improved in leg muscle weakness, including 1 case with urination disturbance improved significantly. Also the lower back pain of patients were improved obviously: (2.63 ± 1.30) scores vs. (8.67±0.30) scores, there was significant difference (P<0.05). Conclusions Filum terminale release and lipoma excision can effectively improve the symptom of lower back pain of adult lipomatous TCS patients, meanwhile the symptom of paraparesis can improve appropriate postoperatively. But urinary deficits do not show a significant change.