Objective To observe the clinical effects of treating acute upper gastrointestinal bleeding(AUGIB) with freezing Zidi mixture lavage. Method 183 UGIB patients from the First Affiliated Hospital to Guanzhou University of TCM in August 2013 were randomly recruited into a control group with 91cases and a treatment group with 92 cases. The treatment group was treated with intragastric administration of freezing Zidi mixture, while the control group was treated with intragastric administration of cryohydrate and norepinephrine. The changes of clinical effects, blood pressure, hemoglobin, blood urea nitrogen, pulse and dark stool were observed and the bad emotions as anxiety, depression and fear were evaluated. Results ① On therapeutic effect, the total effective rate was 96.7% and 85.7% in the treatment group and the control group respectively, with statistical difference(χ2=2.943,P<0.05). ② On the time of symptom disappearance:the disappearing time of vomiting, dark stools and occult blood test in the treatment group was obviously shorter than the control group after the treatment(t=6.628、14.052、21.706,P<0.05 or 0.01). ③ On body symptom changes: after the treatment, the systolic pressure, heart rate, hemoglobin, and blood urea nitrogen [(114.3±12.1)mmHg,(78.6±11.4)/min,(98.1±10.5)g/L,(5.9±1.1)mmol/L] in the treatment group were all obviously improved than those [(106.3±11.2)mmHg, (88.7±12.1)/min,(88.2±11.7)g/L,(6.9±1.4)mmol/L] in the control group;body temperature returned to normal in both groups, and there was no statistical difference score was either in or between groups(P>0.05). ④ On changes of anxiety, depression and fear:the treatment group [the(42.5±9.4), (41.6±9.7), (26.3±5.4)for each]was obviously improved after the treatment than the control group[the score was(51.2±10.1),(50.4±11.5),(30.4±6.9)for each],P<0.05. Conclusion Freezing Zidi mixture lavage can obviously elevate systolic pressure, decrease heart rate, enhance hemoglobin, decrease blood urea nitrogen, relieve body stress reaction and other clinical symptoms. Its effects were better than intragastric administration of cryohydrate and norepinephrine in treating AUGIB.

Objective To explore the effects of early intervention on brain injury in premature infants with neonate respiratory failure (NRF). Methods 151 premature infants in neonatal intensive care unit (NICU) who were diagnosed as NRF within 24 hours after birth in our hospital were studied. All of them accepted endotracheal intubation and mechanical ventilation, and were complicated with brain injury. According to their admission date and their parents' desire, these premature infants were divided into routine group (n=71) and intervention group (n=80). Both 2 groups received similar routine care, and the intervention group accepted touching, passive exercise and stimulation of hearing, vision and touch in addition. Active motor training and family intervention were also given to the intervention group after dis-charge. They were assessed with Neonatal Behavioral Neurological Assessment (NBNA) at the corrected age of 40 weeks, Infant Neurologi-cal International Battery (Infanib) at the corrected age of 3 and 6 months, mental development index (MDI) and psychomotor development index (PDI) at the corrected age of 6, 12 and 18 months, Gesell Development Schedules at the corrected age of 18 months. Results There was no significant difference in NBNA score between 2 groups at 40 weeks of gestational age (P>0.05). The percentage of normal ones with Infanib was higher in the intervention group than in the routine group at the age of 3 and 6 months (P<0.05). The MDI and PDI were signifi-cantly higher in the intervention group than in the routine group at the age of 6, 12 and 18 months (P<0.001). The scores of gross motor, fine motor, adaptation, language and social skills were significantly higher in the intervention group than in the routine group at the age of 18 months (P<0.001). The incidence of sequelae was lower in the intervention group (12.5%) than in the routine group (25.4%) (P<0.05). Con-clusion Early intervention can promote the intelligence and motor development, and improve the outcome of brain injury in the premature infants with NRF.

Objective To assess the efficacy and safety of topiramate monotherapy in the treatment of alcohol de?pendence. Methods The Cochrane library, PunMed, EMBase, CNKI, VIP and CBM database were searched to collect the randomized contolled trials (RCTs) of topiramate monotherapy to compare with placebo or positive control drug in al?cohol dependence. Data were extracted from the included literatures after the literatures’qualities were assessed. The meta-analyses were conducted with RevMan 5.2 software. Results Thirteen trials were included. Compared with place?bo, topiramate reduced score of obsessive compulsive drinking scale(MD=-5.90,95%CI:-10.99~-0.82,P=0.02), de?creased drinks per drinking day(MD=-6.94,95%CI:-12.20~-1.68,P=0.01), and increased percentage of days absti?nent(MD=15.36,95%CI:4.15~6.56,P<0.01). The incidence of paraesthesia, taste perversion, weight loss, memory or concentration impairment, dizziness, psychomotor retardation in topiramate group was higher. But the incidence of other adverse events was similar between groups. Compared with naltrexone, topiramate significantly postponed the days to first relapse(MD=2.10,95%CI:0.23~3.97,P=0.03). The adverse events were similar between groups. Conclusions Topira?mate in treatment of alcohol dependence is effective and safety.

Objective To develop a knowledge-attitude-practice scale of elder abuse for caregiver.Methods The elder abuse related knowledge-attitude-practice scale was established by literature review,in-depth interview,expert consultation and discussion among focus group.200 caregivers were selected conveniently for investigation.T-test,correlation analysis,factor analysis,etc.were used to select items.Results Three sub-scales were built which were knowledge,attitude and practice respectively.The number of items of each sub-scales were 22,14 and 15 respectively through item selection.Conclusions The scale,which has good representativeness,applicability and operability,can be used for measuring the caregiver elder abuse knowledge-attitude-practice and providing an objective evidence for the health education to the caregiver.

Objective To explore the protective roles of Emodin in the intestinal mucosal lay of rats with severe acute pancreatitis (SAP) and its mechanism. Methods SD rats (n=30) were divided into 3 groups: sham operation group, SAP group and Emodin group (SAP rats treated with Emodin). The SAP rat models were established via retrograde injection of 3%sodium taurocholate to pancreatic duct. Rats in Emodin group were peritoneally injected with Emodin (2.5 mg/100 g) at both 1 hour and 3 hour after sodium taurocholate injection. Apoptosis of intestinal epithelial cell was detected by TUNEL analy?sis. The expression of glucose-regulated protein78 (GRP78) protein was assessed by immunohistochemistry. Results Com?pared with sham operation group, apoptosis in intestinal epithelial cells and the expression of GRP78 protein were increased significantly in SAP group(P<0.05). Emodin treatment reduced AP-induced mucosal intestinal epithelial cell apoptosis (P<0.05). But there is no significant difference of GRP78 expression between SAP group and Emodin group(P>0.05). Conclusion Emodin has a protective effect on intestinal layer in rats with SAP through inhibiting intestinal epithelial cell apoptosis. However, ER stress is not likely to be involved in this protective effect.

Objective To explore the value of SpyGlass (direct visualization system) guided laser lithotripsy for large bile duct stones in ERCP.Methods Thirty-three patients with large bile duct stones were randomly assigned to two groups: SpyGlass guided laser lithotripsy group (n =16) and mechanical lithotripsy group (n =17).All patients underwent ERCP procedures for stones extraction.The success rate of complete stone removal, the early complication rate related to the procedure and procedure time were compared between the two groups.Results The success rate of complete stone removal in SpyGlass guided laser lithotripsy group was higher than that of the mechanical lithotripsy group [75.0％ (12/16) VS 41.2％ (7/17) ,P ＜ 0.05].There were no significant differences between two groups in either procedure time [(51.6 ± 18.6) min VS (60.4 ± 12.3) min, P ＞ 0.05] or the early complication rate related to the procedure (18.8％ VS 5.9％ ,P ＞ 0.05).Conclusion SpyGlass guided laser lithotripsy is safe and effective for large bile duct stones.

Objective To investigate the correlations between the clinical manifestations based on pathologic grades and renal pathological features of Henoch - Schonlein purpura nephritis(HSPN)in children. Methods The clinical data of 77 patients with HSPN in the Department of Nephrology,Anhui Provincial Children's Hospital from Ja-nuary 2004 to March 2014 were retrospectively analyzed. The relationship between clinical manifestation and pathologi-cal features was analyzed. Results Among the 77 patients,21 cases(27. 3% )had both abdominal symptoms,and ar-thritis was reported in 15 cases(19. 5% ),28 cases(36. 4% )had abdominal symptoms and arthritis,and 13 cases (16. 9% )had no such symptoms. Hematuria and proteinuria were the most common clinical types[48. 1%(37 / 77 ca-ses)],followed by simple hematuria or proteinuria[27. 3%(21 / 77 cases)],nephrotic syndrome[23. 4%(18 / 77 ca-ses)],and chronic nephritis[1. 3%(1 / 77 cases)]. The major of pathological changes in HSPN were grade Ⅱ[46. 8%(36 / 77 cases)]and grade Ⅲ[45. 5%(35 / 77 cases)],the minority of them were grade Ⅰ[6. 5%(5 / 77 cases)]and grade Ⅳ[1. 3%(1 / 77 cases)]. The severity of urine protein was positively associated with pathologic classification (r s = 0. 472,P = 0. 000). According to the glomerular deposition of immune complex,there were 6 types. The percen-tage of deposition of IgA + IgM was 62. 3%(48 / 77 cases),IgA + IgG + IgM was 19. 5%(15 / 77 cases),IgA 14. 3%(11 / 77 cases),that of IgA + IgG 1. 3%(1 / 77 cases),and the IgM 1. 3%(1 / 77 cases),no Ig 1. 3%(1 / 77 cases). In these cases,76. 6%(59 / 77 cases)had complements C3 deposition;pathologic stage characterized by Ⅲ level and a-bove were common[54. 2%(32 / 59 cases)],Ⅱ level 42. 2%(25 / 29 cases),Ⅰ level 3. 4%(2 / 59 cases). Among the different types of immune complex depositions,there was no statistically significant difference in pathological types of distribution,while the clinical type and complements C3 deposition were significantly associated with pathologic classifi-cation(rs = 0. 361,P = 0. 001). Sixty - two cases were rated as level 1(80. 5% ),and 15 cases was level 2(19. 5% );in different clinical group,rating in glomeruli was statistically different(χ2 = 17. 2,P = 0. 004). Renal tubular interstitial rating of all the patients were level 1(100% ). Conclusions The severity of urine protein,complements C3 deposition is associated with pathologic classification. Pathologic classification can basically reflect the renal damage in HSPN.

Objective To evaluate a method named “one-step procedure”,i.e.,combined duode-noscopy,laparoscopy and choledochoscopy for choledocholithiasis accompanied with cholecystolithiasis.Meth-ods Fifty-three cases with gallbladder stones combined with common bile duct stones diagnosed from February 2012 to February 2014 were assigned to two groups,29 cases in “one-step procedure”group,who underwent duodenoscopy,laparoscopy and choledochoscopy in one operation,and 24 cases in the control group,who first-ly underwent endoscopic sphincterotomy to remove common bile duct stones,and then LC was performed after several days.The rate of complications related to the procedure,success rate of complete stone removal,length of hospital stay and hospitalization expenses were compared between the two groups.Results All 53 patients underwent the surgery and ERCP procedure successfully.There were no significant differences between the“one-step procedure”group and the control group in complication rates[3.4%(1 /29)VS 12.5%(3 /24),P =0.21],complete stone removal rates[96.6%(28 /29)VS 100.0%(24/24),P =0.37].Differences were sig-nificant in length of hospital stay (6.7 ±1.3d VS 10.9 ±1.6d,P <0.01 )and hospitalization expenses (15 724 ±1 613 yuan VS 19 829 ±2 433 yuan,P <0.05)between the “one-step procedure”group and the control group.Conclusion The “one-step procedure”,the combined duodenoscopy,laparoscopy and chole-dochoscopy,is safe,effective,and has smaller length of hospital stay and lower hospitalization expenses.

AIM:To investigate the expression characteristics of TRIM 27 in human nasopharyngeal carcinoma tissues, nasopharyngeal carcinoma 5-8F cells and NP69 cells, and to observe the effect of TRIM27 on the proliferation, in-vasion and migration of 5-8F cells.METHODS:The levels of TRIM27 in the nasopharyngeal carcinoma tissues and normal nasopharyngeal epithelial tissues were observed by the method of immunohistochemistry .The mRNA and protein levels of TRIM27 in the 5-8F cells and NP69 cells were determined by real-time PCR and Western blot .TRIM27 siRNA was trans-fected into the 5-8F cells with Lipofectamine 2000.The relative mRNA expression of TRIM27 was detected by real-time PCR.The relative protein expression of TRIM 27 was detected by Western blot .The cell proliferation was analyzed by CCK-8 assay and cell colony formation assay .The change of cell invasion was examined by Matrigel invasion assay .The change of cell migration were examined by wound healing assay .RESULTS:The results of immunohistochemistry showed that the protein expression of TRIM27 in the nasopharyngeal carcinoma tissues was obviously higher than that in the normal nasopha -ryngeal epithelial tissues .The results of real-time PCR and Western blot showed that the mRNA and protein levels of TRIM27 in the 5-8F cells were obviously higher than those in the NP69 cells.The abilities of proliferation, invasion and migration in the 5-8F cells were significantly suppressed after TRIM27 gene silencing ( P <0.05).CONCLUSION:TRIM27 acts as a oncogene in the 5-8F nasopharygeal carcinoma cells .The abilities of proliferation , invasion and migration are significantly suppressed after TRIM27 gene silencing in the 5-8F cells.

Objective To investigate the hygienic status of large bottles of medical ultrasonic coupling gel in medical institution.Methods From February 2012 to April 2016, microbial contamination of large bottles of medical ultrasonic coupling gel in a women and children''s hospital was investigated and analyzed through on-the-spot random sampling and detection method.Results A total of 170 large bottles of medical ultrasonic coupling gel specimens were collected, 25 specimens were qualified, the qualified rate was 14.71％.Specimens were mainly from inpatient wards(58.24％) and operating departments(21.76％);there was no statistical difference in the qualified rate of specimens in each department(P>0.05).Contamination rates of coupling gel before and after the opening were both>80％, difference was not significant(P>0.05).A total of 145 strains of pathogenic bacteria were isolated, 18 of which were from unopened bottles, and 127 from opened bottles.Burkholderia cepacia was the main strain in both unopened and opened bottles, which accounting for 83.33％ and 54.33％ respectively,in addition, Pseudomonas aeruginosa and Serratia marcescens were also isolated from opened bottles, both were 15.75％, mixed contamination bacteria all included Serratia marcescens Conclusion The total bacteria counts in medical ultrasonic coupling gel in large bottles exceed the standard seriously, the manufacturer should strictly observe the quality control standards, medical institutions should adopt effective cleaning and disinfection measures.