Objective To study the effect of cyclophosphamide pulse therapy combined with leflunomide (LEF) on refractory lupus nephropathy (RLN).Methods Thirty-six patients diagnosed as RLN were selected.Several observation parameters were compared before and after cyclophosphamide pulse therapy combined with LEF.The observation parameters included serum albumin,serum complement C3 and C4,systemic lupus erythematosus (SLE) activity index and urinary protein change.The side effects of cyclophosphamide pulse therapy combined with LEF were observed.Results The serum albumin was (20.17 ± 4.09) g/L,complement C3 was (0.40 ± 0.19) g/L,complement C4 was (0.08 ± 0.03) g/L,SLE activity index was 16.06 ± 4.17,and urinary protein was ( 9.79 ± 3.42 ) g/24 h before treatment and (38.10 ± 5.16) g/L,(0.78 ± 0.11 ) g/L,(0.16 ± 0.13)g/L,4.01 ± 1.24,( 1.14 ± 0.59) g/24 h after treatment,and there were significant differences between before treatment and after treatment (P ＜ 0.01 ).During the therapy,side effects were reported in 22 patients.However,these side effects had no impact on the therapy.After further treatment,these side effects gradually decreased and eventually disappeared.Conclusions Cyclophosphamide pulse therapy combined with LEF is effective in treating RLN.Patients' tolerance to the therapy is generally very good.

The multifunctional infusion kit for wartime and peacetime use contains conventional drugs for first-aid and infusion. With this kit, such performances can be fulfilled as infusion, anti-shock, hemospasia, emergency sputum aspiration and early administration for CPR.

ObjectiveTo explore the species distribution and constituent ratio of diatoms in main sections of urban district rivers where drowning occurs frequently in Chengdu.MethodsTotal 39 water samples from the sampling points of 5 rivers(Jinjiang, Jinniu, Qingyang, Wuhou and Chenghua districts)in Octo-ber 2014 were collected. The diatoms smear were made and the species distribution and constituent ratio of diatoms from the water samples were analyzed using biological microscope and acquisition system of digital microscope.ResultsTotal 21 species of diatoms were detected in main sections of urban district rivers in Chengdu. Significant differences in the dominant diatom species and proportions of the different rivers were observed, and there were different species existed in all sampling points of the upstream, midstream and downstream of the rivers.ConclusionThe database of species map, species distribution and constituent ratio of diatoms in main sections of urban district rivers in Chengdu are preliminarily es-tablished, which has special meaning for the analysis and evaluation of falling location inference using diatoms test in case investigation.

Objective To explore the experience of diagnosis and treatment of laparoscopic abdominal inci-sion hernia repair.Methods The clinical data of 15 patients treated with laparoscopic incision hernia repair were ret-rospectively analyzed.Results All 15 cases were successful in operation by laparoscopy.The operation time was 60~180 mins,and the mean operation time was (117 ±30.46) mins,the post-operation aerofluxus time was 1~2 days and the mean time of post-operation hospital stay was (16.53 ±3.46) days.During the operation no association with serosal layer damage or massive hemorrhage occurred;no postoperative seroma infection,intestinal fistula,infec-tion of incision,patches or deaths occurred.Ten patients(66.67%) had abdominal wall nail regional pain to different degree.2~11 months′postoperative follow-up indicated no recurrent cases.Conclusion Laparoscopic adoption of stapler or stapler with sutures through abdominal wall to repair incisional hernia is safe and effective.Compared with the open surgery,laparoscopic incisional hernia repair has the advantage of minor injury,quicker recovery,and lower recurrence rate.

Objective To study the effect of of human cytomegalovirus (HCMV) infection on the expressions of Hox genes.Methods Forty eight kunming mice were randomly divided into infection group (n=32) injected with HCMVAD169 and control group (n=16) injected with saline into their brain.After 7,15,30,and 60 days,the cerebral lesions were observed by pathological method.HCMV antigen was detected by immunohistochemical method and HCMV DNA was detected by polymerase chain reaction (PCR). On the basis of developing HCMV mouse model. reverse trancriptase-polymerase chain reaction (RT-PCR) was applied to determine the expressions of Hox gene in the brains of infected mice.The expression of Hox genes were also analysed with Northern-blot by isotope labelled Hox genes oligonucleotide probes. Results A HCMV infection model was developed and extensive pathological damages in brain tissue of infected mice were observed.Meanwhile.the HCMV-LA and HCMV-DNA were also found in brain tissues of HCMV infected mice.The expression level of Hox genes in control and infected mouse brain were determined by RT-PCR and Northern-blot.RT-PCR and Northern-blot showed that mouse brain expressed Hox-A9,Hox-A10,Hox-A11,Hox-A12,and Hox-A13,but they did not express Hox-B13.After HCMV infection,murine brain was induced to express Hox-B13 gene(P＜0.01),and reached the peak at 30 d after infection.Comparing with the control group,the expression of Hox-A9 and Hox-A11 were down-regulated in infected group (P＜0.05);the expression of Hox-A10 and Hox-A13 were significantly higher in infected groups (P＜0.05).Conclusion The results suggest that HCMVAD169 is able to cause mouse CNS infection and induced the abnormal expressions of Hox genes. which provides more information for understanding the mechanism of congenital abnormal due to HCMV infection and a valuable method of clinical prevention and treatment of HCMV infection.

Objective To compare the efficacy and toxicity of late-course concurrent radiochemotherapy and sequential chemoradiotherapy for advanced esophageal carcinoma. Methods Eighty-two patients with advanced esophageal carcinoma were randomized into two groups: 41 cases in late-course concurrent radiochemotherapy (LCRC) group were received two cycles chemotherapy and then underwent concurrent radiochemotherapy;41 cases in sequential chemoradiotherapy (SCR) group were received four cycles chemotherapy and then underwent radiotherapy. The regimen of chemotherapy in all cases:cisplatin 25mg/m2, 1-3 d;calcium folinate (CF) 150 mg/m2, 1-5 d;fluorouracil 375 mg/m2, 1-5 d, 21 d was one cycle. All patients were received the three-dimensional conformal radiation therapy, the total dose of radiation was same as 64 Gy. Results The short-term response rate was 85.4%(35/41) in LCRC group and 65.9%(27/41) in SCR group, they had significant difference ( P<0.05). The rates of acute radiation esophagitis that need treatment was 90.2%(37/41) in LCRC group and 87.8%(36/41) in SCR group, there had no significant difference (P>0.05). The l year, 2 years, 3 years survival rate were 68.3%(28/41) and 65.9%(27/41), 56.1%(23/41) and 51.2%(21/41), 46.3%(19/41) and 36.6%(15/41) respectively,the median survival time were 30.0 months and 26.0 months, there had no significant difference ( P>0.05). Conclusion The short-term efficacy of advanced esophageal carcinoma could be improved by the late-course concurrent radiochemotherapy.

Objective: To analyze the correlated risk factors of endodontic interappointment emergencies(EIAE) and the intervention effect of microwave endodontic sterilization. Methods: 163 patients with chronic periodontitis, pulpitis or dental pulp necrosis (without acute inflammation) were involved in the study. All the patients were distributed into microwave group (n=80) and control group (n=83) randomly. Unitarily finished endodontic therapy was conduced in microwave group after the microwave endodontic sterilization. Same endodontic therapy was applied in control group but without microwave endodontic sterilization. Risk factors of EIAE were investigated by releasing questionnaire. Logistic regression analysis was used to analyze the data. Results: Incidences of EIAE were related to age, gender, the position of the tooth, with or without fistula, filling condition and with or without microwave endodontic sterilization. The risk factors of EIAE of ultra-filling, posterior inferior tooth,the age older than 45 years and the female was 3.32,3.49, 5.87 and 3.71 respectively (P

Objective To explore the value of the diagnosis and differential diagnosis of the sacral tumors with MRI. Methods Twenty nine patients with histologically proven sacral tumors were viewed, including sacral chordoma( n =5), giant cell tumor( n =1), neurilemmona( n =3), ganglioneuroma( n =2), malignant lymphoma( n =4), osteosarcoma( n =1), malignant neurilemmoma ( n =1), and secondary tumors ( n =12).All patients were examined with MR,CT and plain radiograph. MR findings were analyzed. Results (1) sacral tumors involved sacral bone with a regularity. Four patients with sacral chordoma involved usually above S3 level, not including S1 bone. One patient with giant cell tumor involved S2 S3. Six patients with neuromas involved S1 S3, including S1 bone. (2) signal intensity: moderate and/or low signal on T 1 weighted images, mottled signal on T 2WI. (3) sacral pores were destructed, disappeared, or enlarged. Sacral pores enlarged in six patients with neuromas, destructed in others. (4) sacral canal were destructed, disappeared, or enlarged. (5) tumors were classified into central ( n =16), centrifugal ( n =9), and mixed ( n =4) types. (6) sacral tumors were segmental on sagittal MR images. Conclusion MRI is superior to CT and plain X ray in assessing classification, segment and sacral pores and the like, so MRI is very important to the diagnosis and the differential diagnosis of the sacral tumors.

OBJECTIVE:To explore the ward round model of clinical pharmacists.METHODS:The ward round model of clinical pharmacists was designed and explored based on clinical practice.RESULTS & CONCLUSION:Clinical pharmacists can engage in ward rounds either in cooperation with physicians or alone in special department,or by targeting at those patients using certain drugs.Each model has its distinctive characteristics and clinical pharmacists can choose suitable model based on their own level as well as the conditions in software,hardware and environment so as to facilitate rational administration.

Objective To investigate the effect of acute exposure to cadmium combined with bacitracin on the endoplasmic reticulum stress (ERS) in testes and ovaries of rats and its regulation by nuclear factor erythroid-2-related factor 2 (Nrf2). Methods According to the 4×2 factorial design model, 48 specific pathogen free adult SD rats were divided into four groups: the control group and the low-, medium- and high- dose cadmium chloride exposure groups. Each group was further divided into with- or without bacitracin combined subgroup. There were six rats in each subgroup with 3 males and 3 females. The low-, medium- and high- dose groups were intraperitoneally injected with 5, 10, 20 mg/kg body weight of cadmium chloride solution, respectively. The control group was intraperitoneally injected with the same amount of 0.9% sodium chloride solution. Among them, rats in the bacitracin combined subgroup were given a one-time intraperitoneal injection of bacitracin at a dose of 20 mg/kg body weight two hours before cadmium chloride exposure. After 48 hours, the rats were sacrificed. The mRNA expression of glucose regulated protein78 kD (Grp78), protein kinase R-like endoplasmic reticulum kinase (Perk), Nrf2 in testes and ovaries of rats was determined using quantitative real-time polymerase chain reaction. The protein expression of GRP78, PERK, NRF2 was determined using Western blotting. Results The mRNA expression of Grp78, Perk, Nrf2 and the protein expression of GRP78, PERK, NRF2 in testes and ovaries of rats in the no bacitracin combined subgroups of the three dose groups showed different degrees of up-regulated changes compared with the no bacitracin combined subgroup of the control group (all P<0.05). Among them, the expression of the three kinds of mRNAs and proteins in the testes and ovaries of rats in the no bacitracin combined subgroups of the high-dose group was up-regulated (all P<0.05), and most of them were higher than those in the no bacitracin combined subgroups of the low- and medium-dose groups (all P<0.05). The expression of most of the three kinds of mRNAs and proteins in testes of rats showed different degrees of down-regulated changes (all P<0.05), but the expression of the three kinds of mRNAs and proteins showed different degrees of up-regulated changes in ovaries (all P<0.05) in the bacitracin combined subgroups of the three doses groups than that in the bacitracin combined subgroups of the control group, and especially in the bacitracin combined subgroups of the high-dose subgroup. The expression of the three kinds of mRNAs and proteins in testes and ovaries of rats in the bacitracin combined subgroups of the three doses groups showed different degrees of changes (all P<0.05) compared with the no bacitracin combined subgroup in the same group, and the expression in the bacitracin combined subgroups of the medium- and high-dose groups showed mainly down-regulated changes (all P<0.05). Conclusion Acute exposure to cadmium can induce different degrees of ERS, activate PERK/NRF2 signaling pathway, and improve the toxicity to testis and ovary. Bacitracin can inhibit cadmium-induced ERS, thereby inhibiting the activation of PERK/NRF2 signaling pathway, and enhancing the synergistic effect of cadmium on testis and ovary toxicity. The higher the exposure dose of cadmium, the more obvious the inhibitory effect.