Objective To study the therapeutic effect of diltiazem and felodipine in treatment of hypertension after renal transplantation.Methods Sixty patients with hypertension after renal transplantation who were treated with tacrolimus as basic immunosuppressive therapy were divided into two groups by random digits table method with 30 cases each.The diltiazem group took diltiazem 90 mg orally once a day.The felodipine group received felodipine 2.5 mg orally twice a day.The drug dosages were adjusted according to the level of blood pressure.The patients were followed up for 1 year.The artery pressure,concentration-to-dose ratio of tacrolimus and renal function was detected and compared.Results Blood pressure was significantly decreased in both groups after 1 year treatment.Blood pressure was found to be significantly lowered from (153.6± 7.5)/ (97.7 ±6.7) mm Hg (1 mm Hg=0.133 kPa) to (119.1 ± 26.4)/ (72.6± 19.3) mm Hgin felodipine group; and from (152.0 ± 7.6)/(95.4 ± 6.9) mm Hg to (120.3 ± 25.5)/(73.2 ± 22.5) mm Hg in diltiazem group.There was no significant difference in blood pressure before and after treatment between two groups (P ＞ 0.05).The concentration-to-dose ratio of tacrolimus was increased after treatment in diltiazem group[(173.2 ± 59.3) g/L vs.(119.3 ± 78.3) g/L] (P ＜ 0.05),but there was no significant difference before and after treatment in felodipine group (P ＞ 0.05).The serum creatinine had no significant difference in two groups (P ＞ 0.05).Conclusion Diltiazem and felodipine can be used safely and effectively in the treatment of hypertension after renal transplantation,and diltiazem can lower the dose of tacrolimus.

Objective To explore the function of high-intensity focused ultrasound in the treatment of allergic rhinitis.Methods To treat 46 patients who have allergic rhinitis for a long time with the instrument of CZB high-intensity focused ultrasound. Results We made a follow-up visit for 3 momths after the surgery,the symptom of stuffy nose van- ished from the 46 patients who were treated with the high-intensity focused ultrasound,and they haven't appeared sneezes again. Only 6 patieats have a little dear nasal mucus in the early morning. They don't have any complication and the se- quda. Conclusion The trearment with high-intensity focused ultrasound has the actual effect. Under reasonable therapeutic dose,the patients does not have the complication,and it is easy to do,it is really a kind of physical therapy method that can be promoted.

Objective To investigate the necessity to test the hearing of patients whose initial symptom is tinnitus with pure tone audiometer. Methods To analyze the results of pure tone audiometer of 218 tinnitus patients.Results Among 218 cases of tinnitus patients,a total of 123 patients with abnormal hearing,among 95 cases of patients with normal hearing, except for 50 cases of tinnitus, no other cause of disease. Conclusion Among the normal hearing tinnitus patients, we should do further hearing test for them if they are not identified a clear cause of disease,such as auditory brainstem response,otoacoustic emission and other necessary checks to clear the reasons for tinnitus or the position of the unusual auditory system. It is important for early diagnosis and treatment of tinnitus. But the pure-tone audiometer should be a routine examination when tinnitus patients come for the first visit.

ObjectiveTo identify the risk factors related to the mortality of severe acute pancreatitis.Methods Clinical data of 57 cases of severe acute pancreatitis in our hospital from August 1997 to February 2004 were collected and analyzed retrospectively. There were 32 males and 25 females. The median age was 51 years. Cases were divided into death group and survival group according to their outcome. The characteristics, severity and surgical therapy were analyzed. ResultsEleven patients died, the mortality was 19.3%。 Thirty cases underwent surgery, 8 died, the mortality was 26.3%.Factors which were of significant differences between the two groups by univariate analysis were age, Ranson score, APACHEⅡscore, ascites, MODS, ARDS, heart failure and renal failure. Multivariate logistic regression showed that independent risk factors included age, ascites, MODS. ConclusionsIn case of severe acute pancreatitis,the independent risk factors related to mortality were age, ascites and MODS.

Objective A new type adsorbent for removal of bacterial ET was prepared by immobilizing L-serine covalently onto polyvinylidene difluoride membrane (PVDF-Ser) to study the effect of hemoperfusion on sepsis induced lung injuries in a pig model. Method Endotoxemia were induced in thirteen pigs by injecting endotoxin (1 μg/(kg·h) ) intravenously for 2 h. One hour later, the pigs were treated with absorber of PVDF-Ser volumn (group hemoperfusion) or empty adsorber (group control) for 2 h. Extravascular lung water indexed to body weight and alveolar capillary permeability, levels of serum endotoxin, tumor necrosis factor-α, interleukin-6, malondialdehyde, glutathione, myeloperoxidase activity, and lung histological changes and myeloperoxidase immunohistochemical analysis were measured. Results Hemoperfusion treatment with PVDF-Ser volumn significantly improved extravascular lung water, pulmonary alveolar capillary permeability and lung injuries ( P ＜ 0. 05). In addition, hemoperfusion attenuated both serum and pulmonary cytokines, and decreased lung malondialdehyde and myeloperoxidase levels ( P ＜ 0. 05). Conclusions Hemoperfusion with the adsorber of PVDF-Ser volumn effectively reduced inflammatory responses and improved lung injuries and oxidative stress in endotoxemia. It has a high potential of clinical application for treatment of patients with severe sepsis.

Objective To evaluate the role of ERK1/2 signal transduction pathway in sevoflurane postconditioning-induced reduction of oxygen-glucose deprivation(OGD)injury in rat hippocampal slices.Methods Male adult SD rats weighing 80-100 g were anesthetized with ether and decapitated.The hippocampi were removed and sagittally sliced(400μm thick)and placed in artificial cerebrospinal fluid(aCSF)aerated with 95％ O2-5％CO2.Fifty hippoeampal slices were randomly divided into 5 groups(t =10 each):OGD group; 4％ sevoflurane postconditioning group(group Sevo); PD98059(specific inhibitor of ERK)group(group PD); dimethyl sulfoxide (DMSO)group; 4％ sevoflurane postconditioning + PD98059 group(group SPD).OGD was induced by incubating the slices in glucose-free aCSF aerated with 95％ N2-5％ CO2 for 15 min in group OGD.The hippocampal slices were perfused with aCSF saturated with 4％ sevoflurane for 30 min after OGD was induced in group Sevo.The hippocampal slices were perfused with aCSF containing PD98059 50 μmol/L for 10 min after OGD was induced in group PD.The hippocampal slices were perfused with aCSF containing DMSO 1 mol/L for 10 min after OGD was induced in group DMSO.The hippocampal slices were perfused with aCSF containing PD98059 50 μmol/L and aerated with 4％ sevoflurane for 30 min after OGD was induced in group SPD.The hippocampal slices were then perfused with plain aCSF for 1 h again in all the groups.The electrophysiological technique was used 1o record the amplitude of orthodromic population spike(OPS)in the stralum pyramidale of the CAI region.TTC staining was used to determine the degree of tissue injury.Results Compared with group OGD,the recovery amplitude and rate of OPS were significantly increased,and the degree of tissue injury was significantly decreased in group Sevo(P ＜0.01),while no significant change was found in each parameter in the other three groups(P ＞ 0.05).Compared with group Sevo,the recovery amplitude and tale of OPS were significandy decreased,and the degree of tissue injury was significantly increased in groups PD,DMSO and SPD(P ＜ 0.01).Conclusion ERK1/2 signal transduction pathway is involved in sevoflurane postcondilioning-induced reduction of OGD injury in tat hippocampal slices.

Objective To analyze the clinical characteristics of Klebsiella pneumoniae infection in preterm infants. Methods Clinical data of 75 preterm infants infected with Klebsiella pneumoniae treated in BaYi Children's Hospital from February 6,2008 to February 10,2010 were retrospectively analyzed.The difference of auxiliary examination between early-onset and late-onset infection group were compared by two independent samples t test.Spearman correlation analysis and non-conditional Logistic regression analysis were used to analyze the high risk factors and the prognostic factors of Klebsiella pneumoniae infection in preterm infants. Results The incidence of Klebsiella pneumoniae infection was 2.8％ (75/2721) in preterm infants,and the mortality rate was 9.3％ (7/75). There were 71 cases of Klebsiella pneumoniae sepsis and 4 cases of Klebsiella pneumoniae pneumonia.Among 75 cases,63 cases were early-onset infection (onset age≤72 h) and 12 were late-onset infection (onset age＞72 h).All patients presented with poor response,heart rate during quiet sleep ＞ 160/min and low oxygen saturation.The mean corpuscular volume and mean corpuscular hemoglobin concentration in early-onset Klebsiella pneunoniae infection cases were higher than those in late-onset neonates [(128.87±24.60) fl vs (113.72±13.54) fl,t=-2.07,P＜0.05and (38.11±2.15) pg vs (36.98±1.05) pg,t=-2.76,P＜0.05].Low birth weight and caesarean section were associated with early-onset Klebsiella pneumoniae sepsis (r=0.250 and -0.240,P＜0.05). The prognosis of Klebsiella pneumoniae infection was associated with hospital stay and duration of premature rupture of membranes (r=0.368 and 0.318,P＜0.05). Conclusions There were no specific clinical manifestations for Klebsiella pneumoniae infection in preterm infants.Preterm infants with low birth weight,long duration of premature rupture of membranes,delivered by caesarean section and received invasive operation are likely to develop Klebsiella pneumoniae infection.

Objective To investigate the effects of ginkgolide B on neuronal cell apoptosis,superoxide dismutase activity,malondialdehyde,interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum of rats with intracerebral hemorrhage in order to explore the role of ginkgolide B in suppressing the neuronal cell apoptosis.Methods A total of 175 male Wistar rats were randomly (random number)divided into sham operation group,intracerebral hemorrhage group,as well as low,medium and high dose treatment groups.The rat model of intracerebral hemorrhage was made with infusion of autologous whole blood to caudate nucleus in the right basal ganglia region.Ginkgolide B in dose of 5 mg/kg,10 mg/kg and 20 mg/kg was given to rats in the low,middle and high dose treatment groups by intraperitoneal injection once a day for 5 days after intracerebral hemorrhage.The rats with intracerebral hemorrhage in the sham operation groups received intraperitoneal administration of 1 mL saline.Animals were sacrificed by decapitation 2,6,12,24,48,72 h and 5 days after intracerebral hemorrhage.Brains were taken and blood samples were collected.Neuronal cell apoptosis was measured by using terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling(TUNEL),and superoxide dismutase activity in serum was determined by using xanthine oxidase method,and serum malondialdehyde level was detected by using thiobarbituric acid reactive substance assay,and interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum were assayed with enzyme linked immunosorbent assay(ELISA).Statistical analysis was carried out by using one-way analysis of variance and least-significant difference test.Results As 2 h,6 h,12 h,24 h,48 h,72 h,and 5 days after intracerebral hemorrhage,the differences in the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels between the low dose treatment group and intracerebral hemorrhage group were not significant statistically(P ＞0.05).As 12 h,24 h,72 h,and 5 days after intracerebral hemorrhage,the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels in the medium dose and high dose treatment groups were significantly statistically lower than those in the intracerebral hemorrhage group(P ＜ 0.05),but these differences in above biomarkers were not significant statistically among these three groups 2 and 6 hours after intracerebral hemorrhage(P ＞ 0.05).Conclusions Ginkgolide B may lessen neuronal cell apoptosis by means of inhibition of free radical production and inflammatory reactions after intracerebral hemorrhage.

Objective To investigate the effects of continuous hemofihration on gastrointestinal dysfunction for treating patients with intra-abdominal hypertension.Methods A total of 37 patients were divided into two groups randomly (random number),namely control group (n =17) and continuous blood filtration (CBF) group (n =20).The patients of control group were treated with routine treatment,and the patients of CBF group were given CBF for 72 hours in addition to the routine treatment.The intra-abdominal pressure (IAP),gastrointestinal (GI) symptoms,and SOFA score were documented at 0 hour,24 hours,72 hours and 7 days after treatment.Results The MAP of patients in the CBF group was not significantly changed (P =0.218),while the IAP was decreased significantly (P =0.001) and the abdominal perfusion pressure (APP) increased significantly after CBF (P =0.036).Compared with the control group,there were more than 2 GI symptoms markedly relieved after CBF for 24 hours (P =0.049).The SOFA score of CBF group decreased significantly (P =0.037).There were no differences in 28-day and 60-day mortality between two groups.Conclusions The CBF can decrease IAP,increase APP,improve splanchnic blood circulation,and ameliorate gastrointestinal dysfunction.But CBF does not reduce the mortality in comparison with routine treatment.

Objective To investigate the influencing factors and preventive measures of postoperative wound infection in patients who undergo the aseptic surgery of urinary system.Methods Clinical data of 302 cases of patients underwent the aseptic surgery of the urinary system between January 2011 to May 2013 were reviewed and studied by Logistic regression analysis.Results Wound infection occurred in 17 cases,the incidence of wound infection was 5.6％ among 302 patients in this study.Postoperative wound infection risk factors were open surgery,operative time ≥ 2 h,to replace the drainage bag every one or two days once,and with some other underlying diseases.Conclusions To strengthen the basic disease treatment,select endoscopic operation if the surgery and treatment of disease allowed,shorten the operation time,reduce the number of drainage tube and reduce the frequency of replacement of drainage bag may effectively prevent postoperative wound infection in patients who undergo the aseptic surgery of the urinary system.