Objective To investigate the operative technique and efficacy of PPH for severe hemorrhoids. Methods The clinical data of 153 cases of severe hemorrhoids treated by PPH, individualized according to size and nature of the piles, concomitant morbidities and conditions at the dentate line, and analysis of the relevance between operative technique and clinical efficacy as well as postoperative complications, were revieuled retropectively. Results All of the prolapsed tissue retracted immediately. Bleeding at the anastomotic site occurred in 49 cases, pulsatile bleeding in 12 cases, all of which were sutured under direct vision with cessation of bleeding. The width of excised-tissue was 2.1~4.6cm(average 3.5cm). The main symptoms of patients on the 1st post-operation day were abdominal distention caused by dysuria, pain, and tenesmus and burning sensation. At followup of 1-40 months, there was no stenosis of stoma, anal incontinence or recurrence of prolapse. After operation, a very satistactory result was achieved in 87 cases, satisfactory in 63 cases and mostly satisfactory in 3 cases. Conclusions In order to achieve ideal results with good retraction of tissues, avoidance of complications and improve patient satisfactory rate, the use of PPH for severe hemorrhords must be individualized and technical skill during operation are important.

Adult ; Cardiomyopathy, Hypertrophic ; complications ; pathology ; Humans ; Male ; Myocardium ; pathology

Objective To study the comprehensive hospital patients with psychological health department liaison consultation characteristics of the factors to cause delirium.Methods General hospital in 102 patients of psychological health department liaison consultation,this paper analyzed the factors which cause delirium.Results 102 cases(63 males and 39 females),the sex ratio was 1 :0.62;Men's and women's average age had no statistical difference(t =1.866,P =0.087 ).Age or age:70 ~ 79years,80 ~ 89 years of age to delirium patients were 39.26%,30.39% respectively.Delirium distribution respectively the main cause of the central nervous system disease,acute vascular disease,infection,disorder of digestion and absorption,anemia,endocrine metabolic disorders, acute metabolic disorders,trauma,surgery,spirit of active substances and non addictive drugs,etc.;Cause delirium in first place of the central nervous system disease,the etiology of acute vascular disease and infection of 29 cases respec-tively(28.43%),11 cases(10.78%),16 cases(15.69%).Additional surgery,spirit of active substances and non addictive drugs were 11 cases(10.78%),13 cases(12.75%),2 cases(1.96%).Many kinds of disease:102 patients with each with 1 ~7 kinds of diseases,the average (4.09 ±1.56)kinds.Share of drug species:102 patients in each oral 0 ~8 kinds of drugs,to average (5.86 ±1.52)kinds.Conclusion Comprehensive hospital patients with age or age group,the main factors to cause delirium etiology,patients with various diseases and share related species of drugs,disease complex,such as strengthening contact consultation for clinical sense.

ObjectiveTo evaluate the safety and efficacy of tirofiba in the treatment of patients with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). MethodsA total of 158 patients with acute STEMI were randomly divided into tirofiban group 1 (59 cases, received tirofiban before PCI), tirofiban group 2 (56 cases, received tirofiban when PCI) and control group(43 cases, only received PCI). The coronary reperfusion flow(TIMI grade) of infarct related artery (IRA) after PCI, the resolution of the sum of ST segment elevation(sum STR) at 90 min after the procedure, the changes of myocardial enzyme at 6 h and 12 h afterwards, the left ventricular ejection fraction (LVEF) 1 week later, the major adverse cardiac events(MACE) within 30 d, bleeding and thrombocytopenia complications were analyzed and compared among the three groups. ResultsTIMI reperfusion grades in tirofiban group 1[98.3％(58/59 )]and tirofiban group 2[92.9％(52/56)]were higher than those in control group[60.5％(26/43)](P ＜0.05). The resolution of sum STR at 90 min after PCI in tirofiban group 1 [(89.3 ± 6.9)％]and tirofiban group 2[(82.4 + 7.3)％]was higher than that in control group[(65.6 +8.1 )％](P＜ 0.01 ),and there was significant difference between tirofiban group I and tirofiban group 2 (P＜0.05 ). The occurrence of MACE within 30 d was lower in tirofiban group 1 and tirofiban group 2 than that in control group (P＜ 0.05). The level of CK-MB at 6 h and 12 h afterwards was lower in tirofiban group 1 than that in tirofiban group 2,and tirofiban group 2 was lower than control group (P＜ 0.05). LVEF 1 week later in tirofiban group 1[(56.2 + 6.4)％]was higher than that in tirofiban group 2[(51.1 + 4.9)％]and control group[(49.8 + 5.7)％](P ＜ 0.05),but there was no significant difference between tirofiban group 2 and control group (P ＞ 0.05). Although bleeding incidence in tirofiban group 1 and tirofiban group 2 was higher than that in control group, no severe bleeding and thrombocytopenia was observed. Conclusion Tirofiban can safely and effectively reduce the incidence of the ischemic events in the patients with acute STEM1 during preoperative of emergency PCI.

Over-expression of P-glycoprotein (Pgp) is associated with the development of multi-drug resistance ( MDR). Pgp has been focused on as the main target in designing chemotherapy strategy. In this article we review some of the latest advancement in designing and evaluation methods of P- glycoprotein inhibitors.

Objective:To evaluate the clinical effects of Pumpkin Polysaccharide Granules for diabetes Ⅱ.Methods:The clinical effects were evaluated on the governing principle of clinical investigation of diabetes treatment with new Chinese medicinal. In experiment the clinical effects of Pumpkin Polysaccharide Granules (as a treatment group) were compared with that of Xiaoke pill (as a control group).Results:The total effective rate of treatment group was 87.13%, 10 cases of then marked effect, 16 cases effect, 4 cases no improvement. The total effective rate of control group was 70.00%. The treatment group was superior to the control group ( P

Objective: To study the best condition of extracting effective component in Daphne odora Thurrb fresh flower by CO 2 supercritical fluid extraction(SFE). Methods: Uniform design was taken in these 4 factors: extracting pressure, extracting temperature, releasing pressure and releasing temperature, together with the experiments of 7 levels in each factor. Results: The best conditon in SFE: extracting pressure 35MPa, extracting temperature 40 ?C , releasing pressure over 8MPa and releasing temperature 36 ?C . Conclusion: This method is simple, highly selective and efficient in extracting effective component of Daphne odora thurrb fresh flowers.

Objective To semi-quantitatively assess the MRI manifestations of knee in patients with juvenile idiopathic arthritis (JIA) and to explore the relationship between the semi-quantitative scores with clinical inflammatory biomarkers. Methods Fifty children diagnosed as JIA and presented with knee pain, swelling or limitation were enrolled and their clinical and imaging findings were retrospectively analyzed. Contrast-enhanced MRI scan of the knee were performed in all cases (a total of 50 knees). MRI abnormalities, including synovial hypertrophy, joint effusion, bone marrow edema, joint cartilage injury and bone erosion, were assessed with a semi-quantitative score system. The erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) at the same period with MRI were collected. The relationships between the MRI scores and laboratory biomarkers (CRP and ESR) were analyzed with Spearman correlation analysis. Results In MR images of all the 50 knees with JIA, synovial hypertrophy(43, 86%)and joint effusion(40, 80%)were major abnormalities, bone marrow edema was seen in 6 knees, joint cartilage injury in 12 knees and no bone erosion was seen. The scores of synovial hypertrophy, joint effusion, marrow edema, joint cartilage injury and bone erosion were 7(0-12), 3(0-7), 0(0-6), 0(0-10), 0, respectively. There was significant correlation between synovial hypertrophy and joint effusion(r=0.719, P=0.001). There were positive relationship between synovial hypertrophy and ESR and CRP(r=0.306 and 0.285; P=0.031 and 0.043, respectively).Other indexes had no significant relationship with ESR or CRP. Conclusions MRI could comprehensively evaluate knee involvement in patients with JIA. Joint effusion could be a useful reference to evaluate the condition of synovitis for pediatric patients with non-enhanced MR images.

To explore the effect of Kudiezi injection on renal function in the real world, in order to provide the basis for the clinical medication safety. Patient aged between 18-80 were selected from 18 large hospitals information system (HIS) databases established by clinical research institute for basic traditional Chinese medicine of China academy of Chinese medical sciences. The patients who were treated with Kudiezi injection (24 225 cases) were defined as the exposed group, whereas those who were not treated with Kudiezi injection (14,191 cases) were defined as the non-exposed group. The propensity score method was used to balance the confounding factors. Classic logistic regression, GBM weighted propensity score logistic regression, GBM propensity score weighted logistic regression with covariate and sensitivity analysis were adopted to study the effect of Kudiezi injection on renal function. The results showed no significant difference in the possibility in abnormality in serum creatinine (Scr) (P = 0.940, 0.679, 0.834) and urea nitrogen (BUN) (P = 0, 0.045, 0.164) between both groups. Therefore, the existing data indicated no damage of Kudiezi injection on renal function. Because this study is a retrospective study based on the real world, there may be unknown confounding factors and potential bias. Therefore, further studies shall be conducted to monitor whether Kudiezi injection causes damage on renal function, in order to ensure the clinical medication safety.
Blood Urea Nitrogen ; Drugs, Chinese Herbal ; adverse effects ; Hospital Information Systems ; Humans ; Injections ; Kidney ; drug effects ; physiology ; Kidney Function Tests ; Logistic Models ; Propensity Score ; Retrospective Studies

Objective To study the effective composition of Aster ageratoides Turcz for relieving asthma and its toxicity . Methods Seventy‐two qualified male guinea pigs ,body mass(300 ± 20)g ,were randomly divided into the control group ,aminophyl‐line group(0 .047 g/kg) and different ratio group of total saponins and total flavonoids (8∶1 ,4∶1 ,2∶1 ,1∶1 ,1∶2 ,1∶4 ,1∶8) . Every group received at dose of 0 .38 g/kg once a day for 3 days by intragastric administration .The effect of relieving asthma was taken as the indicators for the optimization of compositions ,which was detected by observing the latent period of asthma induced by acetylcholine‐histamine in guinea rats .The relaxation percentage of smooth muscle retracted by acetylcholine was detected by Pow‐erlab biological signal collecting system when aminophylline(1 .25 mg/mL) and different matching drugs(0 .02 g/mL) were added in Krebs′solution .The acute toxicities of total saponins ,total flavonoids and mixture of total saponins with total flavonoids (ratio of 1∶2) were detected by classical acute toxicity test of mice .Results Compared with the control group ,aminophylline group ,each group latent period of inducing asthma significantly or very significantly prolonged (P<0 .05) ,among them ,1∶1 ,1∶2 ,1∶4 group and other matching group were significantly different(P<0 .05) ,but 1∶2 group cited the longest incubation period .Aminophylline group and the ratio could significantly relaxe guinea pig tracheal smooth muscle retracted by acetylcholine .Aminophylline group di‐astolic percentage was the largest(24 .12 ± 1 .20)% ,all the groups were less than the percentage of diastolic aminophylline group (P<0 .05) ,but in 1∶2 group with the closest .Aster ageratoides Turcz ,tatarian aster total saponins ,total flavonoids and the ratio of 1∶2 to mice maximum tolerance was respectively 300 ,345 ,325 g/kg .Conclusion For the same total dosage ,the relieving asth‐ma effects of proportions of 1∶2 Aster ageratoides Turcz were obvious .There are no abnormal changes in the acute toxicity trila with total flavonoids ,total saponins ,as well as the ratio of 1∶2 ,safety is relatively good .