Objective To study the short-term curative effect of total parathyroidectomy (t-PTX) and cinacalcet therapy for treating refractory secondary hyperparathyroidism (SHPT).Methods The clinical data of 118 patients with refractory SHPT admitted in our hospital from January 2012 to September 2015 wereretrospectively analyzed,and according to different therapeutic methods the patients were divided into the group A (receiving the conventional medical treatment after poor effect by the impact therapy,n=62),B(performing t-PTX,n=26) and C (oral cinacalcet,n=30).All patients were given the conventional medical treatment.The calcium,phosphorus and calcium-phosphorus product,and parathyroid hormone (iPTH) follow-up on 0,1 d,and at 1,3,6 months was finished in 3 groups.Results The gender,age,dialysis time,calcium,phosphorus,calcium-phosphorus product and iPTH level on 1 d had no statistically significant difference among 3 groups(P＞0.05).the pain relief rates of the group A,B and C were 0,92.31 ％ and 60.00 ％ respectively;compared with the group A,phosphorus,calcium-phosphorus product and iPTH at various time points after processing in the group B and C were significantly decreased(P＜0.01);compared with the group C,calcium,phosphorus,calcium-phosphorus product and iPTH at various time points after processing in the group B were significantly reduced(P＜0.05).Conclusion If the patients with refractory SHPT are tolerable for surgery,t-PTX therapy should be taken as the first choice;oral cinacalcet treatment provides the possibility of non-operative therapy for the patients with refractory SHPT.

Objective To observe the effects of aerobic exercise on the plasma content of homocysteine (Hcy),total nitric oxide synthase(T-NOS) and nitric oxide (NO) in rats fed a high methionine diet. Methods A total of 24 male Wistar rats were randomly divided into a normal diet(CR)group,a high methionine diet(MR) group and a high methionine diet plus swimming group(T+MR),and treated accordingly for 8 weeks.At the end of the treatment,all the animals were tested for plasma T-NOS,NO and homocysteine levels.Results Plasma homo-cysteine doubled,whereas T-NOS and NO levels in the MR group decreased significantly as compared with the CR group,suggesting that hyperhomocysteinemia was induced by the high methionine diet.Plasma homocysteine content decreased significantly in the T+CR group,but plasma T-NOS and NO increased significantly compared with the MR group.These indicators were not significantly different for the T+MR group from those of the CR group. Conclu-sion Adequate aerobic exercise can decrease the plasma level of homocysteine in rats fed a high methionine diet,and increase the plasma level of T-NOS and NO,helping prevent the development of hyperhomocysteinemia.

Composite tissue allotransplantation is a new option in reconstruction surgery,but the immunological rejection is accepted as an public medical problem after surgery.As the number of composite tissue allotransplantation increases,postoperative immunosuppression becomes the new hot.This article will illustrate and summarize the progess of postoperative immunesuppression.

BACKGROUND:Conservative treatment is mostly invalid in treatment of severe degenerative lumbar scoliosis-induced low back pain, so surgical intervention is general y required. Repair methods are decompression, rigid fixation, and selective interbody fusion for the“responsible vertebra”to re-establish normal lumbar curvature, spinal balance and good stability. OBJECTIVE:To investigate clinical curative effect of local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. METHODS:Data of 57 cases of degenerative lumbar scoliosis from Armed Police Corps Hospital of Hunan Province from January 2011 to January 2014 were retrospectively analyzed. According to clinical characteristics of the patients, selective fusion, local decompression and pedicle screw fixation were used for repair. The imaging analysis and Suk criteria were used to evaluate fixation, decompression and bone fusion. Japanese Orthopaedic Association scores were utilized to assess therapeutic effect. RESULTS AND CONCLUSION:(1) Operation time was 157-255 minutes, averagely 176 minutes. Amount of bleeding was 480-1 700 mL, averagely 835 mL. Postoperative drainage volume was 140-210 mL, averagely 155 mL. (2) 57 patients were fol owed up for 12-38 months. Postoperative X-ray revealed that Cobb’s angle was (3.8±2.1)° on the coronal plane after treatment, and the correction rate of lordosis was 54%. The sagittal Cobb’s angle was (6.3±10.5)°, and the correction rate of lordosis was 35%. According to Suk standard, the fusion rate of vertebra was 95%. According to low back pain score system recommended by Japanese Orthopaedic Association scores, the effective rate was 91%at the end of fol ow-up. (3) There were 2 cases of cerebrospinal fluid leakage, 1 case of nerve injury, and 1 case of pedicle screw failure, no infection, no blood vessel injury. (4) These findings suggest that according to imaging data and self clinical features, local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis can rebuild and stabilize degenerative lumbar scoliosis in the coronal and sagittal planes to different degrees, with satisfactory clinical curative effect.

Objective To explore the variation of the main chemical constituents of Herb Epimedii in decocting Herb Epimedii and Radix Astragali separately and compatibly. Methods Herb Epimedii combined with Radix Astragali were decocted with water in which the proportion of them were 1∶0, 2∶1, 1∶1, 1∶2 and 0∶1, respectively. RP-HPLC was used to compare the content of icariin and the fingerprints in separate and compatible decoction. Results Afeter combination, the number of chromatographic peaks were added and no new peaks were detected. The contents of some chemical constituents such as icariin in Herb Epimedii were increased, especially in the compatible decoction at the proportion was 1∶1. Some constituents were not changed obviously. Conclusion Herb Epimedii decocted together with Radix Astragali especially at a ratio of 1∶1 can increase the solubility of the chemical constituents in Herb Epimedii. This provides a scientific basis for more effective use of the compatible decoction of the two herbs.

Objective To investigate the influence of smoking,drinking cognition and behavior among the officers and soldiers in South China War Zone after health management,and to explore the establishrent of appropriate health management model for the army.Methods Harmfulness cognition,rate,quantity,types of drinking and smoking were investigated and analyzed before and after health management among 1 102 officers and soldiers in South China War Zone by providing a set of health education,psychological counseling service,disease and lifestyle intervention of health management as a whole.Results The harmfulness cognition rate of smoking and drinking raised from 95.6％ and 94.1％ to 98.7％ and 97.8％,the smoking and drinking rate dropped from 64.7％ and 72.6％ to 37.2％ and 61.4％ after health management.The x2 values were 18,18.9,153,20.8,and had significant difference (P＜0.001).The rate of occasional smoking,a small amount of smoking,often smoking dropped from 28.3％,25.8％,45.9％ to 18.5％,12.2％,31.5％ as well as the rate of occasional drinking,a small amount of drinking,often drinking has dropped from 56.6％,32.3％,11.1％ to 49.8％,23.4％,4.1％.The x2 values were 26.8,62.1,31,9.61,8.06,19.4,and had significant difference (all P＜0.01).Conclusion The health management improves the harmfulness cognition of smoking and drinking,and decreases the rate and quantity of smoking and driking.It has a positive effect on improving the heahh literacy and developing health way of life in officers and soldiers.

BACKGROUND:Currently, there is a lack of efficient, non-invasive way to transplant stem cels to the target organ or tissue. Exploring a way to guide targeting transplantation of stem cels and to improve the efficiency of stem cel homing is now one of focuses in the field of stem cels research.
OBJECTIVE: To establish a simple and feasible method to chemicaly modify the cel surface using biotin-streptavidin reaction system, and to evaluate the efficiency of this method to label bone marrow mesenchymal stem cels (BMSCs) and its effects on cel biological functions.
METHODS: Passage 3 BMSCs were obtained by whole bone marrow culture method and verified by flow cytometry. Biotin, streptavidin, sulfonated biotin-N-hydroxy-succinimide were used to equip the adhesion molecule ligand, sialyated LewisX (SLeX), to the BMSCs surface. The labeling rate of BMSCs was assessed using fluorescence microscope, the vitality of BMSCs was evaluated by trypan blue staining, and the proliferation of BMSCs was evaluated by cel counting kit-8 assay. Adipogenic and osteogenic inductions were used to evaluate the effect of the method on the multi-differentiation function of BMSCs.
RESULTS AND CONCLUSION: After culture for 2 weeks, passage 3 BMSCs were obtained and confirmed by expressing CD90, CD29 and lack of CD34, CD45. Biotin, streptavidin, sulfonated biotin-N-hydroxy-succinimide were successfuly used to equip sialyated LewisX (SLeX) to the BMSCs surface and had minor effects on the vitality, proliferation, and differentiation of BMSCs. This method was simple for surface modification and had a high modification rate of 88%. The homing of BMSCs modified by this method to the target organ or tissue could be greatly enhanced. Therefore, this method potentialy could have extensive and important applications.

Objective:To study the diagnostic value of MR diffusion weighted imaging (DWI) and CT and MR perfusion imaging in patients with different degrees of liver cirrhosis.Methods:A total of 60 patients with liver cirrhosis,who were treated in Ziyang Hospital of West China Hospital of Sichuan University from August 2015 to February 2017 were selected.According to the Child-Pugh classification,32 cases of grade A were mild cirrhosis (denoted as group A),16 cases of grade B and 12 cases of grade C were moderate to severe cirrhosis (denoted as group B),30 healthy volunteers were selected as group C in the same period.All the subjects in the three groups were examined by DWI,CT and MR perfusion imaging.The ADC value,hepatic portal perfusion ratio [SSr (CT) and SSr (MR)] were compared among the three groups,and Spearman correlation analysis was used to analyze the correlation between the indexes.Results:There was no significant difference in ADC values among the three groups (P＞0.05),and the ADC values of group A and B were lower than those of group C,but the difference was not statistically significant (P＞0.05).There was no significant difference in ADC values between group A and B (P＞0.05).The levels of SSr (CT) and SSr (MR) in the three groups were compared,the difference was statistically significant (P＜0.05);the levels of SSr (CT) and SSr (MR) in group B were significantly higher than those in group A and C,the difference was statistically significant (P＜0.05).There was no significant difference in the levels of SSr (CT) and SSr (MR) in group A and C (P＞0.05).Spearman correlation analysis showed that SSr (CT) was positively correlated with SSr (MR) in the patients with liver cirrhosis (r=0.687,P=0.000).Conclusion:CT and MR perfusion imaging can reflect the lesion degree of liver cirrhosis,and diagnostic effects of the two are better than DWI imaging,which is worthy of clinical promotion.

Objective: To observe therapeutic effects of ticagrelor combined tirofiban on patients with ST elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and their short-term prognosis.Methods: A total of 280 STEMI patients undergoing emergency PCI were selected.According to random number table, patients were randomly divided into clopidogrel group (received clopidogrel combined tirofiban therapy) and ticagrelor group (received ticagrelor combined tirofiban therapy).TIMI blood flow grade of infarct related arteries, platelet aggregation rate and P2Y12 reaction unit (PRU) before and after PCI, and incidence of major adverse cardiovascular events (MACE) within 30d follow-up, hemorrhage event and cardiac function were measured and compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of TIMI blood flow grade 3 (81.4% vs.91.4%), and significant reductions in platelet aggregation rate [(55.2±4.1)% vs.(50.8±4.4)%] and PRU [(196.2±15.1)U vs.(180.8±12.0)U] in ticagrelor group, P<0.05 all.Compared with clopidogrel group after 30d follow-up, there were significant reductions in incidence rates of re-myocardial infarction (5.0% vs.2.9%) and cardiogenic death (2.9% vs.0.7%), left ventricular end-diastolic dimension [(53.1±2.8)mm vs.(49.0±2.0)mm] and left ventricular end-systolic dimension [(40.2±2.1)mm vs.(37.4±1.8)mm], and significant rise in left ventricular ejection fraction [(51.8±2.7)% vs.(55.4±2.5)%] in ticagrelor group, P<0.05 all.There were no severe hemorrhage events in both groups, and no significant difference in incidence rate of mild hemorrhage (5.0% vs.6.4%) between clopidogrel group and ticagrelor group, P=0.591.Conclusion: For STEMI patients undergoing emergency PCI, ticagrelor combined tirofiban can effectively reduce platelet aggregation rate, improve TIMI blood flow of infarct related arteries, therapeutic effects and their short-term prognosis without increasing hemorrhage risk, which is worth extending.

Objective To study the safety and clinical efficacy of transurethral 120 W 2 μm laser prostate vaporesection in the treatment of benign prostatic hyperplasia (BPH).Methods Forty-one BPH cases were treated with 2 μm continuous wave laser prostate vaporesection.Laser output power was 120 w.International prostate symptom scores (IPSS) were collected on all patients before and after surgery at one,six and 12 months for maximum urinary flow rate (Qmax) and post-voiding residual urine volume (PVR).Operative time,estimated bleeding loss,electrolyte changes,and the time of catheter removal were recorded and analyzed respectively.Results All procedures were successfully completed.The obstructive symptoms of lower urinary tract symptoms were relieved in varying degrees post-operatively.Preoperative and postoperative one,six and 12 months IPSS,Qmax and PVR showed statistical difference ( P ＜0.01 ).Operative time was 32.9 ± 10.7 min,decreased hemoglobin levels was 5.36 ± 2.78 g/L,no cases needed blood transfusion,and all patients were without electrolyte disturbance resulted in the safe perioperative period.The time of removal of the catheter was 2.5 ± 0.7 d.There was no secondary surgery,urinary incontinence,and complication such as bladder neck contracture at 12 months post-operative follow-up.Conclusions RevoLix 2 μm continuous wave laser prostate vaporesection as a treatment option for BPH is safe and effective over a short and long period of time.RevoLix 2 μm wave laser prostate vaporesection can significantly improve BPH patient symptoms of lower urinary tract obstruction.