Objective To investigate the methods of diagnosis and treatment of acute lower gastrointestinal massive bleeding. Methods Retrospective analysis was made on diagnozing and treating of 21 patients with acute lower gastrointestinal massive bleeding Results Within a total of 21 cases,bleeding was controlled by conservative treatment in 6 cases(28.6%),supermesenteric angiography showe positive findings in 92.8% and the interventional therapy was applied successfully in 84.6%. no recurrence was observed after Ⅰ month to 4 year follow up. Conclusions Patients with acute lower gastrointestinal massive bleeding should be treated firstly by conservatie method,uncontrollable bleeding should be evaluated by selective supermesenteric angiography;after the bleeding artery was recongnized by angiography,the intervention embolotherapy should be taken;the patients whose angiography are negative and bleeding cannot be controlled should be operatded

Objective The aim of this phase Ⅱ study was to determine the efficacy and safety of combined bortezomib and thalidomide (VT) regime as initial treatment for newly diagnosed multiple myeloma (MM) in China. Methods Thirty-four patients were enrolled in this study and received VT regime up to 21-day cycles. Bortezomib (1.3 mg/m2) was administered intravenously on days 1, 4, 8, and 11, while oral thalidomide ( 100 mg/day) was given from days 1 to 21. The primary end point was clinical response.The secondary end point was safety. Results Among the 34 patients, 20 were male, 14 were female, with a median age of 59 years, and 15 in international stage system (ISS) Ⅲ ,18 in ISS Ⅱ , 1 in ISS Ⅰ . Among them, 28 completed 2 cycles' treatment and achieved an overall response rate (ORR) of 92.9%; 26 were able to complete the planned 8 cycles of therapy. After 8 cycles, the ORR was 100% ( complete response 30. 8%, near-complete response 23.1%, partial response 42. 3%, minimal response 3.8% ). After followed up with a median time of 12 months, the estimated rate without progress of disease was 62%, and the estimated continous remission rate of 12 months was 62%. The median survival time was not achieved. The most common adverse events were mild to moderate ( grades 1, 2). The main toxicities were hematologic (53. 3% ), gastrointestinal ( 40. 0% ), peripheral neuropathy ( 38.0% ), fatigue ( 36. 6% ) and fever (32. 0% ). Conclusions VT regime provides a very high ORR and complete response rate in the treatment of newly diagnosed MM patients. No patients experienced deep venous thrombosis. In conclusion,bortezomib in combination with thalidomide is a very effective regimen for newly diagnosed MM patients and the toxicities are manageable.

Objective To evaluate salmeterol/fluficasone combined with N-acetylcysteine in treatment of stable chronic obstructive pulmonary disease (COPD). Methods Sixty patients with stable COPD were randomized into treatment group(n = 30) and control group(n = 30). Patients in control group were given salmeterol/fluticasone twice per day ; while patients in treatment group in addition to salmeterol/ fluticasone, also took N-acetylcysteine 0.6 g three times per day. The course of treatment lasted for four weeks. Pulmonary function was measured in all patients; interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), superoxide dismntase (SOD) and malondialdehyde (MDA) in blood serum and induced sputum were determined. The white cell count and classification in sputum smear was examined and the quality of life (QOL) of patients was evaluated. Results FEV1, FEV1 %, QOL evaluation, IL-8, TNF-α, white cell count and the percentage of neutrophil granulocytes in induced sputum after treatment were significantly improved compared with those before treatment in control group (P <0.05 or P <0.01). FEV1, FEV1%, QOL evaluation, SOD and MDA in blood serum, IL-8, TNF-α, SOD and MDA, total white cell count, the percentage of neutrophil granulocytes and macrophage in induced sputum after treatment were significantly improved in treatment group (P <0. 05 or P <0.01). The differences in SOD and MDA in blood serum and the percentage of neutrophil granulocytes in induced sputum smear between treatment group and control group were staffsticaUy significant (93 ± 8) × 10-6 U/L, (4. 0 ± 1.0) × 10-3 mmol/L and 0. 5 ± 0. 3 vs (85 ± 10) ×10-6U/L,(4.2±1.1) ×10-3mmol/Land0.6±0.2; allP<0.05. Conclusion Combination of salmeterol/fluticasone and N-acetylcysteine has better therapeutic results in treatment of airway inflammation of stable COPD.

Objective To explore protective effects of curcumin on lung injury in the early hepatic ischemia/reperfsion (reperfusion for 1 and 3 hour) inrats. Methods Wistarratswererandom]y divided into the fo]]owinggroups: GroupA (shamoperation), group B (control group) and group C (cureumin applied). Contents of superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), myeloperoxidase (MPO) in lung tissues were determined to evaluate the protective effect of eurcumin on lung injury in the injury of isehemia/ reperfusion. Results Curcumin relieved edema of diaphragmatic wall and exudation of blood cell and white cell in pulmonary alveoli. Curcumin increased the contents of SOD, CAT and decreased contents of MDA, MPO in lung tissue. Conclusion By repressing the generation of oxygen free radical and infiltration of polymorphonuclear leukocyte in lung tissue, curcumin can relieve lung injury in the early hepatic ischemia/repeffusion.

Objective To investigate the relationship between interventricular septum thickness(IVS) and renal function in patients with diabetes mellitus.Methods Two hundred and sixty-five patients of type 2 diabetes without dialysis were enrolled in a cross-sectional study.According to their IVS,the patients were divided into normal group (IVS≤ 11 mm) and higher IVS group (IVS ＞ 11 mm).All patients according to evaluated glomerular filtration rate (eGFR) level were divided into eGFR≥60 ml· min-1 · (1.73 m2) 1 group and eGFR ＜ 60 ml· min-1 · (1.73 m2)-1 group.The demographic characteristic,biochemical examination,eGFR,and proteinuria of different groups were compared.Pearson or spearman correlation was used to analyze the relationship between eGFR,IVS and other parameters.eGFR ＜ 60 ml · min-1 · (1.73 m2)-1 and IVS thickening were analyzed by binary logistic regression.Risk factors affect the prognosis of renal function in patients with diabetes mellitus were analyzed by Cox regression analysis.Results Compared with normal group,patients in the higher IVS group had higher systolic pressure (P=0.002),their level of Scr,BUN,24 h urinary protein were increased (all P ＜ 0.05),while the level of eGFR,albumin (ALB),hemoglobin (Hb) and fasting blood glucose were decreased (all P ＜ 0.05).The prevalence of hypertension was increased (81.16％ vs 58.67％,x2=11.273,P=0.001),and there was also a difference in the proportion of patients in each stage of CKD (x2=34.593,P ＜ 0.001).Correlation analysis showed that IVS was positively correlated with BMI,systolic BP,Scr,BUN,24 h urinary albumin,24 h urinary protein (all P ＜ 0.05),while negative correlation was observed between the thickened degree of IVS and Hb,albumin,eGFR and total calcium (all P ＜ 0.05).It's worth noting that IVS also correlated with history of hypertension and degree of renal injury (all P ＜ 0.01).Logistic regression analysis showed that longer duration of diabetes,higher systolic pressure and BUN were independent risk factors for eGFR ＜ 60 ml·min-1·(1.73 m2)-1 (all P ＜ 0.05),while higher Hb and Alb were independent protective factors for eGFR ＜ 60 ml· min-1· (1.73 m2)-1 (all P ＜ 0.05).Logistic regression analysis also showed that the baseline increased Scr was independent risk factor for interventricular thickening (P ＜ 0.05),while the increase of fasting blood-glucose was independent protective factor for interventricular thickening (P ＜ 0.05).Cox regression analysis showed that interventricular thickening was an independent risk factor in predicting the progression of type 2 diabetes (HR=1.396,95％ CI=1.098-1.774,P=0.006).Conclusion Interventricular septum thickness is closely related to the state of renal function,as well as is an independent risk factor to predict kidney function decline in patients with type 2 diabetes.

Objective To compare the effects of cleaning oral among different nursing methods for patients with dysphagia after brain injury who take food by gastric tube as well as by mouth. Methods A total of 59 patients with dysphagia after brain injury were divided into research group ( 29 cases, mouth nursing by modified method of brushing their teeth and irrigation ) and control group ( 30 cases, mouth nursing by traditional oral care routine) according to the random number table method from October 2012 to May 2014. Results were observed by comparing oral condition, indexes of pharyngeal swab culture and water-swallowing test. Results Incidence rates of halitosis and unclean mouth were all 13. 8% in the research group which were lower than those (73. 3%, 63. 3%) in the control group with statistically significant differences (χ2 =21. 208, 15. 214;P<0. 01). The effective rate of water-swallowing test was 79. 3% in the research group which was higher than that (56. 7%) in the control group (χ2 =12. 202,P<0. 01). There was no statistically significant difference in abnormity rates between two groups before intervention (P >0. 05). The abnormity rate in the research group was lower than that in the control group at 4th week (χ2 =8. 958,P <0. 01). There was statistically significant difference in abnormity rate before interventions and at 4th week in the research group (P<0.01), with no statistically significant difference in the control group (P>0.05). The rate of oral mucosa bleeding was 3. 4% in the research group and 6. 7% in the control with no statistically significant difference (χ2 =0. 316,P >0. 05), but there was no mechanical injury of oral mucosa in two groups. There was no statistically significant difference in index of water-swallowing test between two groups before interventions ( P>0. 05), with significant difference at 4th week (P<0. 01). Conclusions The implementation of mouth nursing by modified method of brushing their teeth and irrigation not only can achieve the purpose to clean oral effectively, but also can reduce oral bacteria and promote the recovery of swallowing function.