ObjectiveTo observe the clinical efficacy of warming-unblocking Yin Heel Vessel plus rehabilitation training in treating post-stroke strephenopodia, for seeking the optimal treatment protocol.MethodNinety eligible subjects withpost-stroke strephenopodia were randomized into an acupuncture group, a rehabilitation group, and a united group, to respectively receive warming-unblocking Yin Heel Vessel, rehabilitation treatment, and warming-unblocking Yin Heel Vessel plus rehabilitation training. ResultTwo treatment courses later, there was no significant difference in comparing the strephenopodia score between the acupuncture group and rehabilitation group (P>0.05); the strephenopodia score in the united group was significantly different from that in the acupuncture group and rehabilitation group (P<0.05), and the improvement in strephenopodia in the united group was superior to that in both acupuncture group and rehabilitation group.ConclusionWarming-unblocking Yin Heel Vessel plus rehabilitation can produce a content efficacy in treating post-stroke strephenopodia.

OBJECTIVE:To optimize the extraction technology of Compound epimedium chewable tablets. METHODS:Using the extraction rate of icariin,the content of crude polysaccharide and yield of extractum as index,the effects of water amount,ex-traction time and extraction times on extraction effect were investigated by orthogonal test. The extraction technology was optimized and validation test was conducted. RESULTS:The optimized extraction technology was as follows as 6-fold water,extracting 3 times,2 h each time. The validation test showed that the average extraction rate of icariin was(83.80±0.02)%,the average con-tent of crude polysaccharide was (29.28 ± 0.55) mg/g,and the average yield of extractum was (28.47 ± 0.29)%(RSD≤0.55%, n=3). CONCLUSIONS:The optimized extraction technology is stable,and can be used for the extraction of Compound epimedi-um chewable tablets.

Objective:To discuss relativity of different TCM syndrome with sex,age and laboratory indices in 265 cases of diabetic nephropathy renal failure,and this work is meaningful to open out the naure of TCM syndrome.Methods:The research proceeded the questionary of diabetic nephropathy established according to task group.Including commonly instances,four diagnostic methods information of TCM and correlative laboratory indices.Canonical correlative analysis was adopted to research the relativity of laboratory indices with different TCM syndrome.Results:The results of canonical correlative analysis displayed that phlegm-dampness and BMI,dampness-turbid and creatinine clearance rate,deficiency of yin and glycosylated hemoglobin had pertinence(P

?AIM: To compare the clinical effect of 23G and 25G+vitrectomy for retinal detachment.?METHODS:Forty seven patients with retinal detachment were treated with 23G vitrectomy (27 eyes in 27 cases as group A) and 25G+ vitrectomy (20 eyes in 20 cases as group B ) . The operation time and the incidence of intraoperative complications were recorded. The occurrence of retinal reposition, visual acuity, intraocular pressure ( IOP ) and complications were observed. Postoperative follow-up time of the two groups were 3d, 1wk, 3mo. The relevant records were statistically analyzed and compared.?RESULTS: The operation time of 23G group and 25G+group were 50. 21+4. 52min, 49. 15+5. 14min,respectively and there was no significant difference between the two groups (P>0. 05). The main complications were retinal hemorrhage and iatrogenic retinal hole. There were 3 eyes with retinal hemorrhage, 2 eyes with iatrogenic retinal hole in 23G group, and 1 eye with retinal hemorrhage, 1 eye with iatrogenic retinal hole in the 25G+group, and the difference was statistically significant ( P<0. 05). The postoperative visual acuity of 23G group and 25G + group were significantly improved, and the differences between the two groups were not statistically significant at different time points after operation ( P>0. 05). The number of eyes with hypotonia in 23G and 25G+group were 3 and 1 eyes respectively, the difference was statistically significant ( P < 0. 05 ). But there were no significant differences between the two groups on IOP at 1wk and 3mo after surgery (P>0. 05). At the last follow-up, the results showed that 26 eyes ( 96%) with retinal reposition in 23G group, 19 eyes (95%) in 25G+ group, the difference was not statistically significant (P>0. 05).?CONCLUSION: The clinical effect of 23G and 25G+vitrectomy for retinal detachment is similar, but 25G+vitrectomy can reduce incidence of complications and early postoperative low IOP.

Objective To investigate the effects of prostaglandin E1 (PGE1) on renal cell apoptosis in rats with diabetic nephropathy(DN). Methods Totally 55 male Wistar rats were intraperitoneally injected with streptozotocin (STZ) to develop DN model.46 successfully established DN rat models were randomly divided into 4 groups:PGE1 group received PGE1 intravenously at dose of 10 μg · kg-1 · d-1 for 10 d (n=12),angiotensin converting enzyme inhibitors(ACEI) group given ACEI orally at dose of 10 mg kg-1·d-1 for 8 W(n=12),PGE1+ACEI group given both PGE1 and ACEI (n=11),DN control group(n=11) and normal control group(n=10) given saline only.All rats were killed after 8 weeks and blood samples or kidney tissue were collected.Blood urea nitrogen (BUN),serum creatine(Scr),albuminuria of 24 h were detected.Renal pathological morphology and apoptosis of renal cells were observed by HE staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL) test. Results At 8 week after treatment,the 24-hour urinary albumin levels were decreased significantly in the following order:DN control group＞ PGE1 group ＞ ACEI group ＞PGE1+ ACEI group＞ control group[(374.6±54.1)μg,(570.0±72.5)μg,(253.1±28.9)μg vs.(1123.4±106.2)μg,P＜0.01 or P＜0.05].BUN[(9.3±2.6)mmol/L,(11.0±3.5)mmol/L,(8.4±2.2)mmol/Lvs.(15.1±4.0)mmol/L]and Scr [(74.5±19.2) umol/L,(83.5± 15.8)μmol/L,(64.6±17.3) μmol/L vs.(117.7±33.0)μmol/L]levels after treatment were also reduced in PGE1,ACEI and PGE1 + ACEI groups as compared with DN control group (P＜0.01or P＜ 0.05). Pathological manifestations of all treatment groups showed better results than DN group,and PGE1 + ACEI group was the best.There was no obvious apoptosis in glomerular area with on significant differences between groups.While apoptosis of renal tubules was observed in DN rats. Conclusions Renal tubule but not glomerular cell apoptosis may play some role in Prostaglandin E1 reduciug albuminuria.

Objective To explore the clinical efficacies of open and laparoscopic surgery in the treatment of adult patients with congenital choledochal cyst.Methods The clinical data of 36 adult patients with congenital choledochal cysts who were admitted to the Sir Run Run Shaw Hospital from February 2008 to February 2015 were retrospectively analyzed.Twenty-four patients underwent common bile duct cyst resection + cholecystectomy +biliojejunal Roux-en-Y anastomosis (open surgery group),12 patients underwent laparoscopic common bile duct cyst resection + cholecystectomy + biliojejunal Roux-en-Y anastomosis (laparoscopy group).The intraoperative conditions,detection indexes and postoperative recovery indexes in the 2 groups were analyzed.The follow-up by regular outpatient examination and telephone interview were done up to March 2015.Non-normal distribution data were described as M(P25,P75).Comparison between groups was analyzed using the Mann-Whitney U test and Fisher exact probability.Measurement data with normal distribution were presented as (x) ± s and analyzed using t test.Count data were evaluated by the ratio and proportion.Results The operation time of the open surgery group and laparoscopy group were 238 minutes (191 minutes,283 minutes) and 270 minutes (225 minutes,326 minutes),with a significant difference between the 2 groups (Z =-1.360,P ＞ 0.05).The volume of intraoperative blood loss in the open surgery group and laparoscopy group were 200 mL (113 mL,363 mL) and 75 mL(50 mL,138 mL),with a significant difference between the 2 groups (Z =-3.377,P ＜0.05).The level of C-reactive protein in the open surgery group and laparoscopy group were 94 mg/L (81 mg/L,104 mg/L) and 29 mg/L (21 mg/L,61 mg/L),with a significant difference between the 2 groups (Z =-4.296,P ＜0.05).The pain scores at postoperative day 3,time to anal exsufflation,time for fluid diet intake and duration of hospital stay of the open surgery group and laparoscopy group were 2.5 ± 0.9,(3.7 ± 1.0) days,(5.0 ± 1.6) days,(10.0 ± 2.7) days and 1.9 ±0.3,(2.6 ± 1.0) days,(3.6 ± 1.6) days,(7.8 ± 2.2) days,respectively,showing significant differences between the 2 groups (t =3.146,3.286,2.450,2.523,P ＜ 0.05).Nine patients in the open surgery group and 3 patients in the laparoscopy group had the complications,with improvement of conditions after symptomatic treatment,showing no significant difference between the 2 groups (P ＞ 0.05).All the 36 patients were followed up for a median time of 36 months (range,1-72 months) with good recovery,without long-term postoperative complications and re-operation.Conclusion Laparoscopic surgery in the treatment of adult patients with congenital choledochal cyst is safe and feasible,with the advantages of less intraoperative bleeding,less surgical trauma,fast recovery compared with open surgery.

Objective To evaluate the diagnostic value of serum (1-3)-β-D-glucan detection for invasive fungal infection (IFI) in neonates. Methods Eighty-seven neonates who were suspected to be IFI cases in neonatal intensive care unit from May 2008 to January 2010 were enrolled into this study. All subjects had infection symptoms, while did no react to the antibiotics treatment. The diagnosis of IFI was made according to Invasive pulmonary fungal infection diagnostic criteria of children set by Subspecialty Group of Respiratory Diseases, the Society of Pediatrics, Chinese Medical Association and Invasive fungal infection diagnostic criteria for critical patients set by the Society of Critical Care Medicine, Chinese Medical Association. Circulating (1-3)-β-D-glucan levels were determined with GKT-5M set kinetic fungus detection kit. Levels of (1-3)-Β-D-glucan in IFI group and that in the control group were compared; optimal cut-off value was established with receiver operating characteristic (ROC) curve; and the sensitivity and specificity at the cut-off value of 20.0 pg/ml and optimal cut-off value were calculated and compared. Results Among the 87 suspected cases, 59 cases were not diagnosed as IFI and 28 cases were diagnosed as IFI finally. Five patients were confirmed to be IFI; seven cases were clinically diagnosed and 16 cases were still suspected IFI. Among the five confirmed cases, four cases were blood culture positive for Candida parapsilosis, one case Candida albicans positive and two cases both cerebrospinal fluid culture and blood culture positive for Candida albicans. The median levels of (1-3)-β-D-glucan of patients diagnosed as IFI (n=28) was 131.6 pg/ml(18.6-9999.0 pg/ml), which was higher than that of the patients without IFI (8.5 pg/ml, 5.0-34.6 pg/ml)(Z=-5.064, P<0.05). Area under ROC curve was 0.806 (95% CI: 0.725-0.886, P<0.05). The sensitivity (96.43% vs 69.49%) and specificity (72.22% vs 84.21%) for (1-3)-β-D-glucan were different as 20.0 pg/ml and 53.7 pg/ml were used as the cut-off values for diagnosing IFI. Conclusions (1-3)-β-D-glucan level could be used to diagnose IFI of neonates, but further studies are needed to evaluate false-positive rates and its cut-off value in IFI diagnosis.

Objective To explore the diagnosis and treatment of liver trauma.Methods A retrospectively analysis of clinical data of 160 cases of liver trauma, including 96 cases of blunt trauma and 64 cases of open trauma, was made.Results Among the 160 cases, one case with stage IV trauma and severe thoracic injury died 30min after admission. Among the other 159 cases, 45cases (9 cases of stage Ⅰ, 31 cases of stage Ⅱ and 5cases of cases Ⅲ) received nonoperative treatment, and 114cases (7 cases of stage Ⅱ, 67 cases of stage Ⅲ and 50 cases of stage Ⅳ) received operative therapy. In non-operative treatment group, the cure rate was 100 %(45/45). In operation treatment group the cure rate was 98.2 %(112/114), the mortality rate was 1.8 %(2/114), 1 case died of hemorrhage after operation and 1 case died of ARDS. Five patients with postoperative complications were cured, including hepatic abscess in 2 cases, biliary fistula in 2 cases, and hemorrhage after operation in 1 case. Conclusions B-ultrasound is the method of choice for diagnosis of liver trauma, and CT can be used if conditions permit. Cases of lives truma of stages Ⅰ and Ⅱ and some cases of stage Ⅲ that have stable hemodynamics, can receive nonoperative treatment under close observation. Some cases of stage Ⅱ, most cases of stage Ⅲ and all cases of stages Ⅳ to Ⅵ injury should preferably undergo surgical treatment.

Objective To study the disease trend of Keshan in Hubei Province and provide a basis for scientifically making control and prevention strategy.Methods According to Chinese Surveillance Plan of Keshan Disease,physical examination and electrocardiogram were done for surveillance subjects and suspected patients were filmed chest X-ray in Keshan disease areas.Results Totally 4 822 people were monitored from 2007-2014.The numbers of females (2 589,53.69％) were more than those of the males (2 233,46.31％).The group of people under the age of 15 accounted for 52.47％ (2 530/4 822) which was higher than that of the group over the age of 55 (19.14％,923/4 822).The rate of electrocardiographic abnormality was the highest in 2011 (61.33％,268/ 437) and the lowest in 2014 (5.61％,23/410).In the eight years,only potential type of Keshan disease patients were detected,and the incidences from 2007 to 2014 were all lower than 3％ and had a decreasing trend yearly.No Keshan patient was detected in 2012-2014.Ninety-one suspected cases were taken chest X-ray.Most of the suspected cases (63.74％,58/91) had normal cardiothoracic ratio.The cardiothoracic ratio increased,excepting one,other 32 were all potential type Keshan disease patients.Conclusions The disease trend of Keshan disease in Hubei Province is weak.Nevertheless,surveillance and health education are indispensable,in case the disease relapses.

Objective To study the relationship between serum uric acid and insulin resistance in type 2 diabetic patients Methods A total of 728 middle-aged and elderly type 2 diabetic patients were recruited and the anthropometric,clinical and biochemical parameters and fasting serum C-peptide were measured and retrospectively studied.All patients were divided into groups based on the levels of uric acid and on metabolic syndrome diagnosis or not.Results Among a total of 728 patients,the proportion of hyperuricemia was 26.9％(196/728),and metabolic syndrome(MS)was 64.6％.The levels of body mass index(BMI),waist circumference(WC),systolic pressure (SBP),diastolic pressure (DBP),triglyceride (TG),fasting C-peptide,HOMA(C-Peptide) were significantly higher in hyperuricemia group than in normal uric acid group,while the level of HDL was lower in hyperuricemia group than in normal uric acid group.The proportion of MS was statistically higher in hyperuricemia group (81.6％)than in normal uric acid group (58.3％,P ＜ 0.05).Groups Ⅰ,Ⅱ,Ⅲ,Ⅳ-the four quartiles of serum uric acid from low-to high-level were correlated with MS component number of 2.1±1.0,3.1±1.1,3.3±1.2,3.7±0.8,separately,and with HOMA(CP)of 3.7± 0.8,3.7 ± 0.8,4.0 ± 0.6,4.1 ± 0.9,separately (all P ＜ 0.05).When all patients were divided into groups based on with or without MS,the level of uric acid in MS group was (377.3 ± 43.5)μumol/L,and the proportion of hyperuricemia was 34.0％ (160/470),and HOMA(CP)was 3.90±0.72,all were significantly higher than those of non-MS group[(318.2±47.9)μmol/L,14.0％ (36/258),3.64±0.67].The levels of serum uric acid in groups with 1-5 components of MS were(285.0±62.8)μmol/L,(335.7±62.7)μmol/L,(367.1±45.0) μmol/L,(377.9±40.2) μmol/L,(389.8±46.6)μmol/L,and HOMA(CP) was 3.6±0.6,3.7±0.7,3.9±0.8,3.9±0.7,4.3±0.7 separately(P＜0.05).Serum uric acid was positively correlated with age,WC,BMI,TG,SBP,fasting C-peptide,and HOMA (CP),while negatively correlated with glycosylated hemoglobin(HbA1C),high density lipoprotein cholesterol (HDL-C).Binary logistic regression showed that the OR value of MS was 1.033 with the increase of serum uric acid,and 95％CI:1.026-1.041,P＜0.05.Conclusions Serum uric acid is correlated with insulin resistance in middle-aged and elderly hospitalized patients with type 2 diabetes.Hyperuricemia might be a new risk factor for MS.