Objective To investigate the cause of refractory hiccups. Method 34 patients with refractory hiccups admitted to our hospital from January 1996 to December 2003 were examined with gastroscopy. The correlation of hiccups with reflux esophagitis and the efficacy of omeprazole treatment were studied. Results 10 patients were proven endoscopically to have esophagitis and duodenal ulcer, and the other 24 were suffering from esophagitis. According to Tokyo classification, 14 cases were having grade III esophagitis, and 20 were grade IV. All patients received omeprazole 20mg twice daily and cisapride 10mg thrice daily, and hiccups disappeared after 3 days. Conclusion Refractory hiccups may be the initial or primary symptom in moderate-severe esophagitis in aged people. Proton pump inhibitor therapy is effective in stopping refractory hiccup.

Objective To explore an effective therapy for post-operative urine retention. Methods A total of 264cases were randomly recruited into a intervention group (135 cases) and a control group (129 cases). The intervention group was treated with acupuncture and acupoints massage, and the control group was treated with conventional therapy. Results The total effective rate of was 97.04% and 77.52% in the intervention group and the control group respectively, showing significant difference (χ2=28.657, P＜0.01); The average time for the first time urination of two groups was 24.38min and 35.41 min respectively, also showing significant difference (t= -14.552, P＜0.01). Conclusion Acupuncture and acupoints massage was an effective way for the treatment of post-operative urinary retention.

Objective:To understand the pain experience of discharged patients after thoracoscopic lobectomy, identify the out-of-hospital pain management needs of patients, and help patients improve the level of out-of-hospital pain management.Methods:The phenomenological method in qualitative research was used in the study, and the Colaizzi 7-step data analysis method was used to analyze the interview data.Results:Six topics were summarized: pain cognition, different pain coping styles, misunderstanding of painkillers, negative emotions, postoperative paresthesia, and lack of professional guidance.Conclusion:Medical staff should strengthen the publicity and education of discharge, pay attention to the follow-up, provide professional guidance for patients outside the hospital, relieve pain and improve the quality of life of patients.

Objective To explore the correlation between thyroid peroxidase antibody (TPOAb) and outcomes during pregnancy and the effects of treatment on outcomes. Methods PubMed, Cochrane Library, Science Direct, Embase, Chinese Biomedicine, and Wanfangdata had been searched. Case-control and cohort studies about TPOAb and pregnancy outcomes were searched according to the inclusion and exclusion criteria. Fifty studies were finally recruited (all of cohort-studies, 10 for English and 5 for Chinese). Review Manager 5.3 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models. Results Meta-analysis showed TPOAb (+)with normal thyroid function increase the risks of miscarriage,and premature delivery, OR calculated were 2.02(95%CI:1.13-3.62, P=0.001)and 1.39(95%CI:1.11-1.76, P=0.005), while showed no relative risk to hypertensive disease,placental abruption in pregnancy and fetal growth restriction, OR calculated were 1.29(95%CI:1.00-1.67, P=0.080),0.42(95%CI:0.12-1.43, P=0.210)and 1.61(95%CI:0.23-11.12, P=0.100). TPOAb(+)with normal thyroid function increase miscarriage in in vitro fertilization and embryo transfer (IVF-ET), OR calculated were 2.14(95%CI:1.43-3.21, P=0.000). Levothyroxine (LT4) for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes, OR calculated were 0.43(95%CI:0.22-0.85, P=0.020). Conclusions TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery. TPOAb(+) with normal thyroid function increase miscarriage in IVF-ET. LT4 for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes.

Studies show that metformin inhibits the proliferation of several types of cancer cells.All evidences,therefore propose the anti-tumor effect of metformin.Metformin can repress the oxygen consumption of tumor cells,and suppress hypoxia-inducible factor-1α (HIF-1ct) accumulation through the translational and posttranslational mechanisms,and suppress the expression of HIF-1α by activating AMP-activated protein kinase (AMPK).

Objective To investigate treatment of caesarean scar pregnancy (CSP) and associated problem.Methods From January 2011 to January 2013,57 cases with CSP undergoing treatment in Affiliated Hospital of Hebei University were studied retrospectively.Among 57 patients,it was divided into 12 cases treated by curettage (curettage group) ;22 cases treated by uterine artery embolization(embolization group) ;8 cases treated by laparotomy(laparotomy group) and 15 cases treated by transvaginal debridement (transvaginal group).Results (1) Successful rate of curettage group,embolization group,laparotomy group and transvaginal group were 12/12,86％ (19/22),7/8,13/15.(2) The intraoperative blood loss and the hospital stay were 20 (17-28) ml,(5.1 ± 1.9) days in curettage group,10 (5-15) ml,(10.2 ± 3.2) days in embolization group,200 (80-300) ml,(11.3 ± 3.3) days in laparotomy group,50 (45-100) ml,(6.8 ± 1.2) days in transvaginal group.There was statistically different between curettage group and embolization group (P ＜ 0.05).There was statistically different between laparotomy group and transvaginal group (P ＜ 0.05).Conclusions Curettage,uterine artery embolization,abdominal and transvaginal scar debridement surgery can be used in treatment of the CSP.It should be carefully chosen with surgical intervention,if myometrium was implanted greater than 1/2,or near to serosa.It should be carefully chosen with vaginal surgery,if the blood flow signals was rich around the lesion.

Objective To investigate the effect and safety of a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone on treatment of moderate and severe IgA nephropathy (IgAN).Methods Fifty-seven patients with IgAN confirmed by biopsy combining with clinical presentations were enrolled,with their ages ranged from 15 to 55,proteinuria excretion ≥ 1.0 g/24 h,serum creatinine (SCr) ≤ 265.20 μmol/L,grade Ⅲ or above in Hass histologic grading systems for renal biopsy.The patients were randomly divided into trial group( n =28 ) and control group( n =29 ) and received treatment for six months.The patients in trial group were treated with a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone,while those in control group were treated with prednisone and fosinopril.Results ( 1 ) After 6 months of treatment,the rates of complete remission (CR) and partial remission (PR) were 52.0％ and 40.0％ respectively in trial group,and 20.8％ and 54.2％ respectively in control group.The total remission rate(TR)and CR in trial group were significantly higher than those in control group ( TR x2 =0.47,P ＜ 0.05 ; CR x2 =5.11,P ＜ 0.05 ).( 2 ) The SCr level was decreased in trial group ( [ 115.83 ± 16.78 ] μmol/L v.s.(93.29 ±12.41 ) μmol/L,P ＜ 0.05 ),while increased in control group ( [ 112.79 ± 12.79 ] μmol/L v.s.( 136.99 ±25.97 )μmol/L,P ＜ 0.05 ).The two groups had significant difference on SCr clearance rate after treatment( P ＜0.05).There was no significant difference between the two groups on the endogenous creatinine clearance rate (Ccr) ( P =0.52 ),and no significant difference within trial group ( [ 79.34 ± 6.09 ] ml/min v.s.[ 85.12 ±12.26] ml/min,P =0.05)and within control group( [80.18 ±6.51 ] mi/min v.s.[84.22 ±8.39] ml/min,P =0.67 ).The levels of 24-hour proteinuria excretion after 6 months were decreased in both groups ( trial group:[1.93 ±0.55]g/24 hv.s.[0.78 ±0.42]g/24 h,P＜0.05;control group:[1.85 ±0.51]g/24 h v.s.[1.30±0.35 ] g/24 h,P ＜ 0.05 ),and the treatment effect was better in trial group ( P =0.04 ).Conclusion Treatment of moderate and severe IgA nephropathy with low-dosed urokinase combined with fosinopri plus leflunomide and prednisone is effective and safe by improving renal function and decreasing proteinuria.

Objective To study the effect of the serum testosterone/estradiol ratio (T/E2) alteration on sperm defect and fertility. Methods The testosterone, estradiol, FSH, LH, PRL,sperm parameters and sperm morphology of 90 men were analyzed and the T/E2 and multiple anomalies index (MAI) were calculated. The patients were divided into 3 groups; T/E2≤10 (Ⅰ), T/E2＞10 (Ⅱ), and T/E2＞20 (Ⅲ). Results The sperm concentration and motility among the 3 groups were not significantly different (P＞0. 05). The percentages of the sperm whose head, neck and tail were abnormal declined gradually with the increase of the T/E2 in serum. The percentage of sperm head defeet of group Ⅰ was significantly higher than that of group Ⅲ (t=2. 482, P=0. 016) and that of sperm neck defect of groups Ⅰ and Ⅱ were significantly higher than that of group Ⅲ (t=4.113, 2. 050, P=0.000, 0. 046, respectively). The percentage of sperm tail defect among 3 groups was significantly different (t=2. 722, 3. 996, 3. 110, P=0. 008, 0. 000, 0. 003, respectively). The SDI of group Ⅱ was significantly higher than that of group Ⅰ (t= -2. 293, P= 0. 025). But the TZI increased gradually with the increase of the serum T/E2 and the TZI of groups Ⅱ and Ⅲ were significantly higher than that of group Ⅰ (t=2. 285, 2. 727, P=0. 025, 0. 009, respectively). The percentage of the men in group Ⅰ whose partners became pregnant was 29. 5% and those of groups Ⅱ and Ⅲ were 50% and 42.9%, respectively. Although the percentage among three groups was not different statistically (x2 = 3. 285, 0. 854, 0. 199, P= 0. 070, 0. 355, 0. 655, respectively), the relative risks of groups Ⅱ and Ⅲ were 2.4 and 1.8 times of that of group Ⅰ. There were 25, 15, 7 cases of idiopathic infertility among the 3 groups, respectively. The relative risk of I group was 1.5 and 1.3 times of that of Ⅱ and Ⅲ groups. The correlation analysis showed that the T/E2 in serum had significantly negative correlation with the percent of the sperm head or neck or tail defects (r= -0. 209, -0. 316 and -0. 335,respectively and P= 0. 048, 0. 002 and 0. 001, respectively). Conclusions The decrease of T/E2 in serum was correlative with the decrease of fertility probability, but it did not alter the sperm density and the sperm motility. It showed that the level of the T/E2 in serum was important for spermatogenesis and sperm fertilizing capability.

Objecfive To observe the effects of combined acupuncture and point injection in the treatment of diabetic ophthalmoplegia patients.Methods 40 patients with diabetic ophthalmoplegia were randomly recruited into a control group and a treatment group,with 20 patients in each group.The control group was treated with acupuncture,and the treatment group was additionally treated with point injection.Therapeutic effects were observed after the treatment.Results Effective rate was 85% and 55%in the treatment group and the control group respectively,showing significant difference(P=0.0384<0.05).Conclusion Acupuncture combined with point injection is effective in treating patients with diabetic ophthalmoplegia.