Objective: To investigate the efficacy of oral, external and oral plus external application of recipes for promoting granulation on chronic skin ulcers in rats. Methods: Sixty SD male rats were randomly divided into normal group, untreated group, oral group, external group and combined group (n=12). Chronic skin ulcer was induced by hydrocortisone injection and back skin incision. After oral administration of Fuzheng Huyu Recipe or (and) external application of Baiyu ointment, the compound traditional Chinese medicines for wound healing, healing time and healing rate of the ulcers were observed. Results: The healing rate was lower and the healing time was longer in the untreated group than in the normal group (P<0.01). The healing rates of the oral group and the combined group were higher than those of the untreated group at all observation points (P<0.05), and the healing rate of the external group was higher on the 3rd and 14th day after model establishment (P<0.05). On the 7th and 10th day after model establishment, the healing rates of the oral group and the combined group were higher than those of the external group (P<0.05), and the healing time of the combined group was shorter than that of the oral group and external group (P<0.05). Conclusion: Both orally and externally administered wound healing recipes can promote the restoration of chronic refractory ulcers; the effect of combined administration is superior to single administration. Oral, external and combined application can all improve the wound healing in inflammatory phase. Oral and combined application can obviously improve the wound healing in granulation phase and epithelial phase.

BACKGROUND:Internal fixation has been shown to decrease intertrochanteric fracture complications in the clinic and to improve quality of life of patients. The major method widely used in the clinic is the fixation of proximal femoral nail and dynamic hip screw. ＜br> OBJECTIVE:To observe the clinical effects of proximal femoral nail and dynamic hip screw in treatment of intertrochanteric fracture in the elderly. ＜br> METHODS:A total of 60 patients with intertrochanteric fracture were randomly divided into proximal femoral nail and dynamic hip screw groups (n=30), and they respectively received proximal femoral nail and dynamic hip screw fixation. ＜br> RESULTS AND CONCLUSION:Compared with the dynamic hip screw group, operative time, blood loss, the incidence of complications one year after repair, fracture healing time and complications were lower in the proximal femoral nail group (P＜0.05). After repair, the excellent and good rate of Harris hip scores was higher (P＜0.05). No significant difference was detected in healing time of wound between the two groups (P>0.05). Results verified that compared with the dynamic hip screw fixation, the clinical effects of proximal femoral nail fixation were better, more safe and reliable in the treatment of intertrochanteric fracture in the elderly.

OBJECTIVE:To observe the clinical efficacy and safety of recombinant human interferon α2b (rhIFN α2b) combined with bozhi glycopeptides or thymopentin in the treatment of chronic hepatitis B (CHB).METHODS:Ninety HBeAg-positive CHB patients were selected from our hospital during Jan.2014-Jan.2015 and then randomly divided into group A,B,C,with 30 cases in each group.Group A was given rhINF α2b for injection (Pseudomonas) 5 million IU subcutaneously,qod;group B was additionally given Bozhi glycopeptides injection 4 mL added into 5％ Glucose injection 250 mL,ivgtt,qd,on the basis of group A;group C was additionally given Thymopentin for injection 2 mg added into 5％ Glucose injection 250 mL,ivgtt,qd,on the basis of group A.Three groups were treated for 24 weeks.The rate of ALT recovering to normal,negative rate of HBeAg,transformation rate of HBeAg/anti-HBeAg serum,negative rate of HBV-DNA and the decrease of HBsAg and HBV-DNA were compared among 2 groups after 4,8,12,24 weeks of treatment.The occurrence of ADR was recorded.RESULTS:After 4,8,12 weeks of treatment,there was no statistical significance in the rate of ALT recovering to normal,negative rate of HBeAg,transformation rate of HBeAg and the decrease of HBsAg among 3 groups (P＞0.05).After 4 weeks,negative rate of HBV-DNA in group B,C were significantly higher than group A;the decrease of HBV-DNA in group C were more significant than group A and B,with statistical significance (P＜0.05).After 8,12 weeks of treatment,the negative rate of HBV-DNA and the decrease of HBV-DNA in group B,C were significantly higher than group A,with statistical significance (P＜0.05);but there was no statistical signifi cance between group B and C (P＞0.05).After 24 weeks of treatment,there was no statistical significance in the rate of ALT recovering to normal,transformation rate of HBeAg,the decrease of HBsAg and negative rate of HBsAg among 3 groups (P＞0.05).The negative rate of HBsAg,negative rate of HBV-DNA and the decrease of HBV-DNA in group B,C were significantly higher than group A,with statistical significance (P＜0.05);there was no statistical significance between group B and C (P＞0.05).There was no statistical significance in the incidence of ADR among 3 groups(P＞0.05).CONCLUSIONS:rhIFN α2bcombined with bozhi glycopeptides or thymopentin shows good inhibitory effect on CHB,therapeutic efficacies of them are similar in the rate of ALT recovering to normal,but transformation rate of HBeAg,the decrease of HBsAg and negative rate of HBeAg.

Objective To investigate rare etiological causes of giant gastric ulcers. Methods A retrospective investigation was made on 4986 endoscopically proved giant gastric ulcer in our hospital, from January 1976 to December 2000. The morphological features under endoscopy, pathology, diagnosis, treatment and prognosis were analyzed in 59 giant gastric ulcers with special causes. Results Thirty two cases of gastric eosinophilic granuloma,8 gastric carcinoid tumor,8 gastric schistosomiasis, 5 gastric Crohn's disease,4 gastric lymphoma and 2 gastric Behcet's disease were identified. Ten gastric eosinophilic granuloma,3 gastric carcinoid tumor,3 gastric schistosomiasis, 5 gastric Crohn's disease,3 gastric lymphoma , 1 gastric Behcet's disease were misdiagnosed at initial endoscopy.Conclusions Rare etiological causes of giant gastric ulcers could be divided into 3 categories: non-epithelium gastric tumor, gastric granulomatous disease and gastric vascular disease. Careful observation ulcer endoscopy, history inquiry, physical examination, comprehensive analysis and laboratory examination may provide useful information for the diagnosis. Biopsy may be falsely negative in some cases.

Objective To summarize the experience for diagnosis and treatment of parathyroid carcinoma(PTC).Methods The clinical data of 6 patients with PTC were retrospectively analyzed.Results Five patients complained of primary hyperparathyroidism,3 patients had manifestations of palpable neck mass,4 patients were admitted for hypercalcemia with calcium level of(3.62?0.56)mmol/L,and in 4 patients the parathyroid hormone(PTH) level was higher than two fold of the normal upper limit.Frozen section histopathology established diagnosis in 3 patients,routine histopathology combined with immunohistochemistry established the diagnosis in 2 patients,and routine histopathology combined with immunohistochemistry and clinical data established the diagnosis in 1 patient.Parathyroidectomy and ipsilateral subtotal thyroidectomy was performed in 5 patients,who were followed up for 1-5 years,recurrence in 1 patient 3 years after operation;tumor resection alone was performed in 1 patient with parathyroid cancer complicated with multiple bone metastasis,and the patient died of MOF 16 days postoperation.Conclusions The diagnosis of PTC is difficult before operation.Routine blood examinations,blood PTH,99mTc-MIBI scintigraphy,ultrasonography,CT,observation of specimen,and frozen section histopathology during operation are helpful to diagnosis.The surgical procedure of choice is parathyroidectomy and ipsilateral subtotal thyroidectomy.

Objective To study the effect of concentration of TCR-specific antigen peptides on priming naive CD4~+ T cells to develop into Th1/Th2 cells or naive CD8~+ T cells to develop into Tc1/Tc2 cells. Methods TCR-specific peptides with series of concentration were co-cultured with routine spleen DCs to activate murine naive CD4~+/CD8~+ T cells. The production of intracellular cytokines IFN-γand IL-4 were measured by flow cytometry. The dividing profile of activated T cells was analyzed by CFSE staining. Results Lower concentration of specific peptides favored Th2/Tc2 polarization while higher concentration benefited Th1/Tc1 polarization. The influence of peptides concentration on Th cells differentiation is higher than that on Tc cells. Conclusion Antigen peptides can stimulate activation of naive T cells in a wide range of concentration. However, with the increase of peptides concentration, activated T cells differentiated grad-ually from Th2/Tc2 to Th1/Tc1, which will provide significant value to control immunized dose of vaccine candidates in animal experiments.

This article makes a summary on the vascular access issues related to pediatric blood purification and progress,especially in view of the characteristics,principles of selection,maintenance and development direction of various vascular access in application of children patients.

Objective To establish a quality standard for Biqing Suppository. Methods Rhizoma Dioscoreae Septemlobae, Rhizoma Acori Tatarinowii, Radix Et Rhizoma Salviae Miltiorrhizae and Cortex Phellodendri Chinensis were qualitatively identified by TLC method. The content of berberine hydrochloride in Biqing Suppository was determined by HPLC method. The chromatographic column was Waters C18 (250 mm×4.6 mm, 5 μm);the mobile phase was acetonitrile∶water (0.2%phosphoric acid-0.02%three triethylamine)=25∶75;the flow rate was 1 mL/min;the detection wavelength was 265 nm. Results The spots of qualitative identification method were clear without interference. Berberine hydrochloride had good linear relationship in the range of 0.235-9.40 μg;the regression equation was Y=40 033 998.176 3X-85 021.2, r=0.999 7;the average recovery rate was 99.16%, RSD=3.45%. Conclusion The method is simple, flexible and reproducible, which can be used as the quality control standard for Biqing Suppository.

Objective To investigate the efficacy and toxicity of bortezomib in combination with dexamethasone for the treatment of patients with multiple myeloma(MM).Methods Fourteen patients(11 males,3 females,mean age 65.1 yrs)with MM,who were hospitalized in the First Affiliated Hospital of Wenzhou Medical College from June 2005 to July 2007,were treated with bortezomib(1.3 mg/m2)by intravenous bolus twice a week for 2 weeks in a 21-day cycle,followed by an intravenous injection of dexamethasone 20～40 mg.The patients received one to eight courses.Response to bortezomib was evaluated according to the criteria of the European Group for Blood and Marrow Transplantation(EBMT)before initiation of each bortezomib chemotherapy course.Adverse effects were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0.Results The median follow-up duration from the begining of bortezomib treatment was 3.5 months.Clinical reponse was observed in 12 patients(86%),including complete response in 2,nearly complete response in 6,partial response in 3,minimal response in 1 and progressive disease in 2.The most common adverse effects were fatigue(10 patients),peripheral neuropathy(7 patients),gastrocnemius myalgia(2 patients),gastrointestinal symptoms(4 patients),thrombocytopenia(5 patients),disseminated herpes zoster(1 patient)and refractory hyponatremia(1 patient).The adverse effects were subsided on routine supportive care.Conclusion Bortezomib in combination with dexamethasone is an effective therapy with a high response rate for MM patients.All the adverse effects are more than common but are manageable with symptomatic therapy and(or)dose modification.

Objective To investigate the effect of community nursing intervention on hypertension combined with diabetes in elderly patients.Methods Five hundred and twenty elderly hypertensive patients with diabetes aged over 60 years in 10 communities of Shenzhen were randomly divided into a control group and a study group,260 cases in each group.All the patients in the two groups were given regular follow-ups in community clinics after discharge.Then the control group received instructions on relevant knowledge by the nurses in the community clinics,while the study group received nursing intervention by phone calls or visits by professional nurses once a month.The two groups were compared in terms of blood pressure,blood sugar and blood lipids 12 months after intervention.Results There were no significant differences in blood pressure,blood sugar and blood lipids between the two groups before the intervention(all P>0.05).After intervention,however,the differences were significant(all P<0.05).Conclusion Community nursing intervention may effectively improve hypertension and diabetes in the elderly patients by improving the levels of blood pressure,blood glucose and blood lipid,thereby reducing the incidence of cardiovascular and cerebrovascular events.