With the development of the dialysis technology,the survival time of patients with chronic renal failure is prolonged,while more complications which affect the quality of life or even threat the life of patients are followed.Secondary hyperparathyroidism(SHPT)with a certain incidence and mortality is one of the common complications,and its main characteristic performances ale hyperphosphatemia,hypocalcemia and high level of parathyroid hormone.Most patients Can be cured by the treatment of medicine while surgical treatment is still required by some cases in which the disorder of the parathyroid function can not be well regulated through medicine treatment.The purpose of this paper is to make a review of the recent studies of surgical treatment in patients with SHPT.

BACKGROUND: Some researches report that diffusion-weighted imaging (DWI) can appear abnormal signal in minutes after cerebral ischemia.OBJECTIVE: To investigate the manifestation and regularity of diffusion coefficient in middle cerebral artery occlusion (MCAO) of rats after cerebral ischemia.DESIGN: Randomized controlled study.SETTING: Neurological Department of Clinical College of ChongqingMedical University.MATERIALS: The experiment was conducted at the Radiological Department of the First Affiliated Hospital of Chongqing Medical University from April to July 2004. Totally 18 adult Wistar rats with clean grade were randomly divided into three groups: control group, sham operation group and cerebral ischemia group with 6 rats in each group.METHODS: The origin of right middle cerebral artery was blocked with filament into right internal carotid. In the sham-operated group, the filament was just inserted into the common carotid artery not into the origin of middle cerebral artery, rats in normal control group were not treated with anything after anesthesia. MRI experiments were performed on a 1.5 T GE signa Highspeed NMR spectrometer to obtain DWI and ADC values at the time-point of 7, 15, 30, 60 minutes, 3,6, 12, 24 hours, 3, 7, 15 days, 1 and 2 months after operation.MAIN OUTCOME MEASURES: Changes of ADCs in infarct hemisphere and contralateral hemisphere.RESULTS: There was no significant change in MRI T1-and T2-weighted imaging in rats at 7 minutes post-infarction, but abnormal high intensity was emerged during the period of 1 hour to 3 hours, and enlarged over time. Finally, the infarction area located the right basal ganglia and the frontal-parietal lobes at 12 hours and increased less significantly later.Focal abnormal high signal was noted in DWI 7 minutes after cerebral ischemic insult, and the ADC values was decreased at the same time,reduced gradually after significant recover at 30 minutes, dropped to the lowest level at 12 hours and again increased at 24 hours, since then all the ADC values were remained high throughout follow-up, which increased by 5 times at 2 months than that at 12 hours. Correspondingly,rADC values showed the contrary pattern of evolution.CONCLUSION: It is reflected that ADC is highly sensitive not only to onset of cerebral ischemia but also to chronic cerebral ischemia.

To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods　Textual researches of materia medica were carried out and their history in clinical application were traced. Results　T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion　We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

Objective To develop an assay of HPLC for the content determination of dryocrassine in Guanye Jinsitao drop pills. Methods The column was Kromasil-C18 (150 mm×4.6 mm, 5μm);mobile phase was acetonitrile-chloroform-isopropanol-0.1% phosphoric acid (52∶8∶30∶10);flow rate was 1.0 mL/min;UV detection was performed at 285 nm;detected drift tube temperature was set at 25 ℃. Results The calibration curves were linear in the range of 0.236-2.124 μg for dryocrassine (r=0.999 9). The average recovery rate of dryocrassine was 99.64% (RSD=1.90%). Conclusion The method is simple and accurate. It is suitable for the determination of dryocrassine in Guanye Jinsitao drop pills.

Objective:To investigate the dynamic changes of coagulation system following radiofrequency catheter ablation(RFCA) and effect of molecular weight heparin. Methods:Blood samples were collected at 6 different times to measure the thrombin-antithrombinⅢcomplex (TAT) and hepatocyte growth factor (HGF) in 60 RFCA candidates and 22 controls undergoing electrophysiological study (EPS).Patients were randomly divided into 2 groups.Low molecular weight heparin was given to 31 pationts (subgroup B) after RFCA,but not to the others (subgroup A). Results:①Plasma TAT exhibited a double peaked pattern in the subgroup A.The first peak occurred instantly after RFCA (42.8?15.7 ng/ml),and the second 3 days later (20.1?19.4 ng/ml).The second peak was significantly higher than that of the control group (2.7?1.5 ng/ml) and the subgroup B(4.3?5.2 ng/ml)(P

Object To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods Textual researches of materia medica were carried out and their history in clinical application were traced. Results T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

OBJECTIVE:To systematically review the procalcitonin(PCT)-guided therapy in patients with sepsis. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CJFD,Wanfang Datebase,related trails about PCT-guided therapy(test group)versus conventional treatment group(control group)in the treatment of sepsis were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 5 studies were enrolled,involving 826 patients. Results of Meta-analysis showed,use time of antibiotics in test group was significantly shorter than control group, with statistical significance [MD=-2.52,95%CI(-3.07,-1.98,P<0.001];there were no significant differences in the mortality rate [OR=1.14,95%CI(0.83,1.56),P=0.42],ICU treatment days [MD=-0.22,95%CI(-1.40,0.96),P=0.72] and total hospi-talization [MD=-1.81,95%CI(-4.37,0.76),P=0.17]. CONCLUSIONS:PCT-guided therapy can effectively reduce the use of antibiotics and shorten treatment time in the treatment of patients with sepsis.It can be considered as inflammatory markers for guid-ing rational use of antibiotics in clinic.

Punicalin is an important ellagic tannin in Pericarpium Granati with the pharmacological effects such as antioxidation,anti-bacteria,antivirus and anti-inflammation.The studies on Pericarpium Granati at home and abroad were reviewed in the paper,and the extraction,separation,content determination,pharmacological activities and metabolism of punicalin were also summarized to provide theoretical basis for the development and application of punicalin.

Objective To provide data support for safe and accurate lower cervical pedicle screw implantation by observing the lower cervical pedicle and its relationship between the adjacent spinal cord, endorhachis, nerve root and vertebral artery, particularly its relation-ship between the endorhachis and epidural sinus. Methods Measured the C3 ~ C7 cervical sample of 32 adult with vernier caliper and pro-tractor, including the distance between cervical pedicle and its upper and lower nerve root, the distance between cervical pedicle and en-dorhachis, the distance between cervical pedicle and vertebral artery, and the distance between cervical pedicle and epidural sinus. Results The distance betweencervical pedicle and its upper nerve root was 1. 18~1. 40 mm, the distance between cervical pedicle and its lower nerve root was 2. 33~3. 11 mm;the distance between cervical pedicle and endorhachis was 2. 75~3. 33 mm;and there was nearly no distance be-tween cervical pedicle and vertebral artery and epidural sinus. Conclusion Cervical pedicle has a very close relationship with spinal cord, endorhachis, vertebral artery and nerve root, and the cervical pedicle is narrow and small. Therefore, it requires fully assess accroding to in-dividualization so as to prevent injury of important anatomical structures.

Objective To analyse the effect of hedyotisdiffusa on expressions of apoptosis related protein Fas , caspase3 and caspase7 in Renca renal cell carcinoma of model mice.Methods One hundred and twenty BALB/C male mice were randomly divided into normal control group, model control group, interleukin group, hedyotisdiffusa group, 30 mice in each group, half male and female.Excepted for normal control group , renal cell carcinoma models were established in the other groups , and were given corresponding drug treatment.The tumor size and weight , and the tumor inhibition rate of all mice were observed, and the expression levels of Fas,FasL,caspase3 and caspase7 were detected.Results Compared with model control group, the tumor size and weight were lower , the tumor inhibition rate were higher , the positive expression rates and protein levels of Fas were higher , the positive expression rates and protein levels of FasL were lower, the positive expression rates and expression levels of Caspase3,Caspase7 protein were higher in the mice of interleukin group and hedyotisdiffusa group, all with significant differences ( P<0.05 ).The above indicators in hedyotisdiffusa group were significant improved compared with interleukin group (P<0.05).Conclusion The hedyotisdiffusa can effectively promote the expressions of apoptosis related protein Fas,caspase3 and caspase7 in renal cell carcinoma of model mice, inhibit the expression of FasL protein, improve the tumor suppression rate.