Objective To investigate the clinical efficacy of hemodialysis (HD) combined with hemoperfusion (HP) versus HD combined with hemodiafiltration(HDF) in treating uremic pruritus .Methods The randomized controlled trials(RCTs) on HD combined HP versus HDF in treating uremic pruritus were retrieved from the electronic databases of Cochrane library ,PubMed , Science ,CNKI ,Chinese Biological Medicine ,Wanfang and CNKI by computer .The domestic medical journals ,monographs ,meeting documents and academic dissertations were manually retrieved .The retrieval time limit was from their establishment to October 2015 .Meanwhile the obtained reference literature indexes were consulted .The two researchers independently screened the collected literatures according to the formulated inclusion and exclusion standards .The visual analogue scale (VAS) ,skin itchy effect judg‐ment criteria ,Dirk R Kuypers score ,PTH ,Ca2+ and P3 - were adopted as the evaluation standards .The Review Manager 5 .3 soft‐ware was used to conduct the meta‐analysis .Results Nine RCTs were finally included ,involving 405 patients .The meta analysis showed that HD+ HP had better effect than HD+ HDF in treating uremic pruritus and clearing blood BUN ,HD+ HDF had better effect than HD+ HP for maintaining Scr and P3 - clearing effect ,while no statistically significant difference was found in terms of PTH decrease and Ca2+ influence (P>0 .05) .Conclusion The dialysis mode of HD+ HP is more effective in treating uremic pruri‐tus .

OBJECTIVE:To observe the short-term efficacy and ADR of tenofovir disoproxil fumarate(TDF)in the treatment of multi-drug resistant chronic hepatitis B(CHB). METHODS:32 patients with multi-drug resistant CHB were analyzed retrospec-tively,and HBV drug-resistant genes were detected before treatment;there were a number of points to resistance;they were gave TDF orally. The recovery rate of serum alanine aminotransferase(ALT),HBV-DNA conversion rate,lactic acid and renal function were observed before and after treatment. RESULTS:The recovery rate of ALT reached 100% at 3 months,and the conversion rate of HBV-DNA reached 96.88%. The lactic acid levels and renal dysfunction was not found during treatment. CONCLUSIONS:TDF take effect quickly on multi-drug resistant CHB,and no obvious ADR is found.

Objective To study the effects of allogeneic blood transfusion on expression of CD40L on peripheral blood monocytes (PBMCs) in patients undergoing radical gastrectomy for gastric carcinoma. Methods Thirty patients classified as ASA physical status Ⅰ- Ⅱ undergoing radical gastrectomy for gastric carcinoma were randomly divided into three groups with 10 patients in each group : group A received no allogeneic blood; group B received leukodepleted blood; group C received allogeneic whole blood during operation or within 12 h after operation. The patients were premedicated with intramuscular phenobarbital sodium 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.06 mg ? kg-1 , fentanyl 2 ?g ?kg-1 , propofol 1.5 mg ?kg-1 and vecuronium 8mg and maintained with continuous infusion of propofol (100?g?kg-1?min-1) and vecuronium (5?g ?kg-1?min-1) and intermittent inhalation of 1l%-2% isoflurane. The patients were mechanically ventilated after tracheal intubation. Blood samples were taken before operation and 2, 5 and 10 days after operation. The PBMCs and plasma were separated from peripheral blood by Ficoll-Hypaque centrifugation. The PBMCs were washed and incubated with the patients own plasma (final-concentration 10% ) and PHA (final concentration 20 ?g?ml-1 ) at 37℃ in a 5% CO2 atmosphere for 48h. CD40Lexpression on PBMCs was quantified by flow-cytometry.Results The demographic data including sex, age, bodyweight and duration of operation and intraoperative blood loss were comparable among the three groups. There was no significant difference in the CD40L expression before operation among the 3 groups. In group A there was no change in CD40L expression after operation. In group B CD40L expression on PBMCs increased significantly on the 2nd postoperative day, but returned to preoperative level on the 5th postoperative day. In group C the CD40L expression on PBMCs kept increasing on the 2nd and 5th postoperative day and did not return to preoperative level on the 10th day. The increase in CD40L expression was significantly larger in group C than that in group B ( P

Objectives To study the impact of initial age of treatment on testicular morphology and function in male pa-tients with multiple pituitary hormone deficiency using human chorionic gonadotropin (hCG) and human menopausal gonadotro-pin (hMG). Methods Patients with multiple pituitary hormone deficiency were treated with hCG and hMG while keeping other hormone levels normal. Correlations among their testicular volume, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and height, bone age were analyzed. Results After 6-month hCG and hMG treatment, the penis length of 54 male patients was significantly increased from (2.58 ± 0.69) cm to (4.19 ± 0.77) cm , and penis circumference was also increased from (3.71 ± 1.36) cm to (5.95 ± 1.26) cm;the testicular volume was increased from (1.76 ± 1.49) ml to (5.20±2.30) ml;height was increased from (147.01 ± 12.29) cm to (151.98 ± 11.52) cm and bone age was increased from (11.22 ± 2.71) years to (11.64 ± 2.72) years;the differences before and after treatment were statistically significant (all P<0.01). As the patients' age increased, their testicular volume and testosterone level increased slowly, and significant differences amongst each age group were found (P<0.05). The in-creased value of testicular volume, serum FSH and LH levels, and height growth tended to be negatively correlated to the initial age of therapy (r=-0.517~-0.334, P<0.05). Conclusions Early and proper treatment in male patients with multiple pituitary hormone deficiency using hCG and hMG improves testicular function and secondary sex characteristics.

BACKGROUND:Titanium ions have been proved to stimulate the secretion of bone remodeling-related factors from T lymphocytes;however, the effects of titanium ions on the early activation, intermediate activation, and cel cycle of T lymphocytes remain unclear. OBJECTIVE:To investigate the effects of titanium ions on the proliferation and activation of T lymphocytes in vitro. METHODS:Cel proliferation and cycle test:Jurkat E6-1 T lymphocytes in logarithmic phase were col ected and cultured in the medium containing 0 (control), 25 (low concentration), 50 (middle concentration), and 100μmol/L (high concentration) titanium ions for 24 hours to detect the cel relative proliferation rate and cel cycle. Cel activation trial:Jurkat E6-1 T lymphocytes were divided into two groups that were subdivided into four groups containing 0, 25, 50, and 100μmol/L titanium ions, respectively with or without phytohemagglutinin (PHA) pre-stimulation. The expressions of CD69 and CD25 were measured after cultured for 24 hours. RESULTS AND CONCLUSION:Titanium ions enhanced T lymphocytes proliferation in a concentration-dependent manner (P<0.05). Compared with the control group, the percentages of G0/G1 phase decreased and the proportions of cel s in S and G2/M phase increased significantly in the low, middle and high concentration groups (P<0.05). The proportion of G0/G1-phase cel s in the high concentration group was less and the proportion of G2/M phase cel s was higher than those in the middle and low concentration groups (P<0.05). With PHA pre-stimulation, the expression of CD69 in the high concentration group was higher than that in the middle and low concentration groups (P<0.05);whereas the difference of CD25 expression was not significant among four subgroups. Titanium ions promoted the expression of CD69 in a concentration-dependent manner (P<0.05), but there was no CD25 expression in each subgroup without PHA pre-stimulation. To conclude, titanium ions can significantly promote T lymphocyte proliferation and early activation in vitro, and moreover, induce S and G2/M phase arrest in T lymphocytes.

Objective:To investigate the influencing factors and to build a model for predicting successful labor induction with cervical ripening balloon (CRB) in primipara.Methods:312 cases of primipara in late trimester of pregnancy induced by CRB between January 2018 and April 2019 in the First Affiliated Hospital of Shenzhen University were reviewed retrospectively. Factors including gravidity, age, body height, body weight, body mass index (BMI), the cervical Bishop score, neonatal birth weight, pregnant complication and other factors were collected to analyze the effect on successful labor induction.Results:Pregnancy times, cervical Bishop score and height in primipara were positively correlated with the success rate of induced labor, while BMI and neonatal weight were negatively correlated with the success rate of induced labor. The area under receiver operating characteristic (ROC) curve was 0.849 and diagnostic threshold was 0.725, with a sensitivity of 80.7% and a specificity of 75.7%.Conclusions:Among the primipara, the gravidity and cervical Bishop score are the most significant factors influencing the successful labor induction. These factors can be used as the predictive indexes for the outcome of labor induction along with pregnancy times, height, BMI and neonatal birth weight, which is beneficial to reduce the artificial interventions and improve the success rate of labor induction.

Objective: To investigate the trends in incidence of stroke in Jindong District, Jinhua City, Zhejiang Province from 2016 to 2022, so as to provide to the evidence for improving the stroke control strategy. Methods: The incidence of stroke in Jindong District from 2016 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The gender-, age- and subtype-specific incidence of stroke was calculated, and the trends in stroke incidence were investigated with average annual percent change (AAPC). Results: A total of 9 159 stroke cases were reported in Jindong District from 2016 to 2022, with crude incidence of 386.52/105 and standardized incidence of 276.75/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=3.704%, 95%CI: 0.792%-6.700%, P<0.05), while the standardized incidence showed no significant changing patterns (P>0.05). The crude incidence of stroke was significantly higher among men than among women (438.69/105 vs. 334.66/105; χ2=14.028, P<0.05), and the standardized incidence of stroke was significantly higher among men than among women (316.58/105 vs. 237.31/105; χ2=6.985, P<0.05). The crude incidence of stroke appeared a tendency towards a rise with age（χ2=5 290.180, P<0.05), and the crude incidence of stroke appeared a tendency towards a decline with age among residents at ages of 45 to 64 years (AAPC=-9.135%, 95%CI: -15.003% to -2.861%, P<0.05), while no significant changing patterns were found in the crude incidence of stroke among residents at other age groups (P>0.05). The crude incidence of ischemic stroke was significantly higher than that of hemorrhagic stroke (306.08/105 vs. 76.89/105; χ2=137.184, P<0.05). Conclusions The incidence of stroke appeared a tendency towards a rise in Jindong District from 2016 to 2022, with ischemic stroke as the predominant subtype. Male and middle-aged and elderly populations should be given a high priority for stroke control.

Objective To investigate the cognition of basic doctors on essential drugs in Luo County. Methods The random sampling was used to investigate the basic doctors in Luoping County, and 200 copies questionnaire were distributed. Results The questionnaire response rate was 98%. The survey results indicated that the cognition on essential drugs among basic doctors was poor, but most basic doctors have positive attitudes and behaviors in essential drugs. Conclusion It is necessary to improve the awareness of essential drugs among basic doctors in Luo County.

Objective To analyze the MRI manifestations of meningeal carcinomatosis, and to investigate the value of MRI in diagnosis of meningeal carcinomatosis.Methods The MRI data of 28 cases with proven meningeal carcinomatosis were reviewed retrospectively.Results 11, 8 and 25 cases were detected respectively on pre-contrast T 2WI and T 1WI of SE sequence , and post-contrast T 1WI.According to the manifestations of post-contrast MRI, meningeal carcinomatosis were divided into two types: dura-arachnoid enhancement(7 cases) and pia-subarachnoid space enhancement(18 cases) in accordance with the standard of Meltzer.Conclusion MRI, especially the post-contrast MRI is a reliable modality in diagnosis of meningeal carcinomatosis. Double dosage of contrast medium and thin slice thickness can provide more informations.

As a widely accepted and convenient method,the Apgar score has been applied to assess the status of the newborn infants and the response to resuscitation since 1952.But the Apgar score has also been used inappropriately in infants to predict specific neurologic outcomes in many cases.The Apgar Score produced by American Academy of Pediatrics(AAP) in collaboration with American College of Obstetricians and Gynecologists(ACOG),updated policy statements of the Apgar score in October 2015.The Apgar score has limitations,and it is not appropriate to use it alone to establish the diagnosis of asphyxia;the method does not predict individual neonatal mortality or neurologic outcome.AAP/ACOG encourages the use of an expanded Apgar score reporting form that accounts for concurrent resuscitation interventions.