Objeetive To investigate the effects of timisartan on microinflammation state in maintenance bemodialysis patients.Methods In 40 maintenance hemodialysis patients and 20 healthy control subjects, the levels of C-reactive protein(CRP),interlukin-6(IL-6),tumor necroais factor alpha(TNF-α)were measured,the 40 maintenance bemodialysis patients were randomly divided into 2 groups to receive timisartan 80 mg daily or non-timisartan theraphy.All above parametes were assayed again after 24 weeks.Results Compared with healthy people,the serum CRP,IL-6,TNF-α were elevated significantly in patients with maintenance hemodialysis.After 24 weeks treatment,the levels of CRP,IL-6,TNF-α in Timisartan group was lower than before,and the levels of CRP, IL-6, TNF-α were much lower in timisartan group than non-timisartan group(P<0.01).Conclusions Timisartan can relieve the microinflammation state in maintenance hemodialysis patients.

Objective To study the clinical effect of minimally invasive treatment of 24 patients with hemor-rhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,ther-apeutic results of minimally invasive treatment were studied retrospectively.Results 24 patients with hemorrhagic moyamoya disease spontaneous intracerebral hematoma who need to acutely remove the hematoma were examined by CT angiography ( CTA) .Emergency minimal invasive puncture was performed according to the result of CTA,and the role of CTA in operation was analyzed.In all 24 patients,most of them were cerebral hemorrhage breaking into ventri-cles,5 cases with intracranial aneurysm.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AchA and P-CoM were observed in 9 patients,superficial temporal artery.Conclusion Minimally invasive treat-ment of hemorrhagic moyamoya disease scheme is simple,practical and effective,the maneuverability is strong.

Laparoscopic cholecystectomy(LC),as a new minimal invasive technical method,is now the golden standard treatment for symptomatic gallbladder stone.The article is to discuss the principle during course of deveiopping LC should be followed on the view of medical ethics. The doctors' high sense of responsibility,the strict laparroscopic surgical training,the cooperation between doctors and the right attitute to converting to an open cholecystectomy must be the importat factors to develop LC smoothly.

Female ; Humans ; Maternal Health Services ; Maternal Mortality ; Pregnancy

Objective Ryanodine receptor (RyR) is one of the Ca2+ release channels on the intracellular Ca2+ stores. RyR induced-Ca2+ release is activated by the voltage-dependent Ca2+ entry, that is, calcium-induced calcium release (CICR). Intracellular free Ca2+ concentration (ECa2+]i) plays a key role on cochlear function. Our study is to investigate the differential expression of RyR in the developing rat cochlea, and to analyze the relationship between the expression of RyR and auditory functional development. Methods Immature SD rats, which were 1 day (P1), 5 days (P5), 10 days (P10), 14 days (P14), 28 days (P28) after parturition, and adutl rats(5 rats for each age) were included in the study. Frozen cochlea sectioning and immunofluorescence were applied to observe the differential expression of RyR. Results The RyR expression in the Corti's organ increased during the cochlear development. It's not significant that the stain was observed on the hair cells and supporting cells in the Corti's organ of P1 and P5 rats. The appearance of the Corti's organ of P10 rats trended to maturity. In P14 rats the RyR expression on hair cells located in the synaptic area against the afferent or efferent nerve, and the strain on supporting cells was extensive. There was little different between the strain on cochlea of P14 and P28 rats. In postmature rat spiral ganglion neurons (SGN), the RyR expression verged gradually from extensive whole cell soma to the synaptic area near to the plasma membrane. Conclusion The RyR expression peaked the 14th day after parturition, which was close to that in the mature cochlea. The time course of the RyR expression during the cochlear development was coincident with that of the auditory functional development. The RyR expression on both hair cells and SGNs located in the synaptic area near to the plasmolemma, implying that RyR induced-CICR was related to the auditory functions such as neurotransmission. Extensive RyR expression in the soma of SGNs at the early stage possibly involved in apoptosis of SGNs during neuron development.

Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) was a common complica-tion of small cell lung cancer (SCLC). Recent studies have suggested that the origin of this disease is related to seceration of tumor cells and application of medecine. The inappropriate antidiuretic hormone secretion can lead to disturbance of metabolism of water and sodium, resulting in hyponatremia. Because the symp-toms are atypical, the diagnosis is difficult. Many cases are misdiagnosed or misseddiagnosed. The primary tumor must be treated and the restriction of water intake is the main and effective method to deal with SIADH. Prognosis of SCLC patients with SIADH is poor in most reports.

Objective To study the anticoagulation effect of low molecular weight heparin ( LMWH) on hemodiafiltration by different forms of administration. Methods Twenty-four uremic patients undertook hemodiafiltration were divided into ia and iv group randomly, acecepted single injection of LMWH. LMWH was administered to 12 patients by arterial injection ( predialyzer), while in the other 12 patients by venous injection (postdialyser). The APTT were measured before treatment and at 1 h,2 h,3 h time points after treatment in all patients. The dialysis fluid and blood levels of LMWH were measured at 2 minutes,5 minutes,1 h,2 h,3 h time points after the treatment started. Results The LMWH levels during hemodiafiltration were significantly higher in iv group than ia group (0.457 ± 0.073 ) U/ml vs. (0. 217 ± 0. 053 ) U/ml, t = 9. 702, P = 0. 001 ). However there were no significant APTT, dialyzer residual substance differences between two groups (P ＞ 0. 05 respectively )Conclusions Different ways of drug administration resulted in significantly different blood levels of LMWH, but did not affect the anticoagulant effect during hemodiafiltration, which would be related to LMWH absorption on dialysis membrant.

Objective To investigate an effective method of autologous arteriovenous fistula formation for the elderly uremic patients with diabetic nephropathy.Methods The nest in the elbow above the median cubital vein at the curved incision 1-2 cm,inline high Fistula,namely arm cephalic vein and brachial artery bifurcation of the upper portion of the distal radioulnar side anastomosis in 20 cases over 75 years elderly uremic patients with diabetic nephropathy.And compared the effect of 16 cases of patients with similar conventional fistula.Results Twenty cases over 75 years elderly uremic patients with diabetic nephropathy were successful in all high dynamic fistula intravenous,blood flow was (1 007±131) ml/m,the immediate opening rate of 16 patients similar to conventional instant fistula was 12.5％,and a year after the opening rate was 6.25％ Conclusion High fistula are more easy to shape conventional,easy mature,full blood flow characteristics comparing with commom fistula,so elderly uremic patients with diabetic nephropathy fistula making difficult situation has been effectively improved.

China has a large number of hepatocellular carcinoma patients, and more than half of the new cases and deaths of hepatocellular carcinoma in the world occur in China every year. The chemosensitivity of hepatocellular carcinoma is relatively low. Targeted therapy with antiangio-genic drugs are main treatment options for advanced hepatocellular carcinoma, but the effective rate and survival prolonging effect are very limited. Recently immune checkpoint inhibitors have exhibited promising efficacy in hepatocellular carcinoma, which is changing the pattern of hepatocellular carcinoma treatment. However, challenges still exit. Biomarkers commonly used in clinical practice including programmed death ligand-1, tumor mutational burden and mismatch repair proteins have limited clinical value in hepatocellular carcinoma. Compared with other etiology related liver cancer, hepatitis B related hepatocellular carcinoma in China harbors unique gene mutation map, but the individualized treatment strategy based on molecular typing has not yet been established. More effective and diversified systematic treatment methods can promote the comprehensive treatment of hepatocellular carcinoma into a new era, and the relevant diagnosis and treatments need to be further explored and established. Based on relevant literatures and combined with clinical practices, the authors investigate the progress and consideration of immunotherapy strategy for hepatocellular carcinoma.

Objective::To preliminarily investigate the values of failure mode and postoperative radiotherapy in non-small cell lung cancer (NSCLC) patients with chest wall invasion.Methods:A total of 69 T 3 stage NSCLC patients who underwent thoracic surgery in our hospital from 2010 to 2018 and presented with postoperative pathological findings of chest wall invasion were recruited. The outcomes between the post-operative radiotherapy and non-radiotherapy groups were assessed by propsensity matching analysis. Kaplan- Meier survival analysis and Cox’s model prognostic factors analysis were performed. Results:The median survival time of 69 patients was 25 months and the median progression-free survival was 8 months. Thirty-six cases were diagnosed with primary stage M 0 including 28 cases (78%) of R 0 resection and 33 cases (48%) were diagnosed with stage M 1a and received non-R 0 resection because of pleural metastases. In total, 53 cases (77%) suffered from disease progression, and 26 cases (38%) experienced local recurrence including 58% of mediastinal lymph node recurrence and 36% of chest wall tumor bed recurrence. Distant metastases were observed in 50 cases (73%) including 43% of pleural metastases. Univariate analysis showed that age, pathological staging, range of primary lesion invasion, postoperative radiotherapy and postoperative targeted therapy were significantly associated with overall survival (all P<0.05). The overall survival in the postoperative radiotherapy group was better than that in the non-radiotherapy group. No statistical difference was observed in the progression-free survival, local recurrence-free survival and distant metastasis-free survival between two groups (all P>0.05). Conclusions:For NSCLC patients with chest wall invasion, distal metastasis failure is the main cause, while local failure mainly consists of mediastinal lymph node and chest wall recurrence. Postoperative radiotherapy may improve survival. Nevertheless, the combination and benefit degree of postoperative comprehensive treatment need to be further confirmed by prospective studies.