Objective To discuss the clinical feature of cholestasis preterm infants who have used parenteral nutrition early after birth,and analyze the relative factors and preventive meatures of parenteral nutrition associated cholestasis (PNAC).Methods We retrospectively analyzed the preterm infants who were born and hospitalized at Shengjing Hospital of China Medical University from January,2011 to April,2016.There were 89 cases in total that used at least 2 weeks of parenteral nutrition in the early stage after birth and were developed to cholestasis afterwards.We divided 89 cases into PNAC group and multifactor group:the former was corresponded to PNAC diagnosis standards,accounting for41 cases (46.07％);the latter with other etiology in addition to parenteral nutrition accounts for 48 cases.The clinical characteristics were studied and analyzed using case-control method.Results The sex ratio of premature cholestasis was 2.18:1,the mean gestational age was (31.05 ±2.15) weeks,the mean birth weight was (1360.55 ±421.14) g,and the mean using-time of parenteral nutrition was (26.22 ± 9.78) d.Futhermore,PNAC group was divided into hepatitis group and non-hepatitis group according to the alanine aminotransferase level,and they both had statistical significance in gestational age,starting time of parenteral nutrition,appearance time of jaundice,enteral feeding time,starting dose of amino acid,maximum dose of fat emulsion (P ＜ 0.05).We divided them into long-term group (≥20 d) and short-term group (＜ 20 d) according to the using time of parenteral nutrition.The level of alanine aminotransferase,glutamic oxalacetic transaminase,total bilirubin,direct bilirubin and bile acid of longterm group was higher than those of short-term group,but with P≥0.05.The multifactor group was mostly accompanied with multiple infections in the order of bacterial infection (75.0％),fungal infection (20.83％),cytomegalovirus infection (8.33％) and syphilis infection (2.08％),etc.The other complication's incidence rate of PNAC group and multifactor group had no statistical significance.In terms of prognosis,the liver function of two group improved remarkably than before,with PNAC group having more significance (P ＜0.05).Conclusion PNAC is the major factor of preterm cholestasis,and the degree of liver damage of PNAC preterm was related to starting time of parenteral nutrition,using time of parenteral nutrition,enteral feeding time,starting dose of amino acid and maximum dose of fat emulsion.The liver function of PNAC group is recovered obviously through regulatory treatment,and it possesses a better prognosis than multifactorgroup.

Objective To explore predictive factors of early-onset complications in children with acute bacterial meningitis.Method Retrospective study was made on clinical data and predictive factors of early-onset complications of 75 children with acute bacterial meningitis who were treated in our hospital during 2000-2005.Results The incidence of early-onset complications in children with acute bacterial meningitis was 50.7%,subdural effusions and hydrocephalus occured freqiently.The incidence of early-onset complications were closely correlated with onset age,coma,seizure,cerebrospinal fluid(CSF) protein concentration and CSF glucose concentration.Onset age younger than 12 months(OR=11.876,95% CI:2.592-54.33 P

OBJECTIVETo investigate the influence of three primers on the shear bond strength between cast titanium (Ti) and composite resin.

METHODSThe disks (n = 40) were cast by commercially pure (CP) Ti, which diameter were 8 mm and thick were 3 mm. The titanium surfaces were polished with silicon carbide sand papers under running water and then treated by sandblasting and acid (4%HF) etching. They were divided into four groups: control group (group A), treated with KH-570 (group B), treated with Alloy Primer (group C), treated with Metal photo primer (group D). After treatment, the specimens were evaluated for their shear bond strengths by universal testing machine. The values were statistically analyzed. The fractured surfaces were observed by scanning electron microscope (SEM).

RESULTSThe shear bond strengths of group A, B, C, D were (9.773 +/- 0.67), (11.463 +/- 0.82), (14.224 +/- 0.75), (13.157 +/- 0.73) MPa. There were significant differences in bond strength between A and B, C, D (P < 0.01). B and C, D had significant differences (P < 0.01). C and D had no significant differences (P>0.05).

CONCLUSIONKH-570, Alloy Primer, Metal photo primer significantly improve the bond strength of ceramage composite resin to cast titanium. KH-570 group bonding strength is lower than the the Alloy Primer group and Metal photo primer group.

Objective To investigate the clinical effects of Shugan Jieyu Capsule combined with sertraline in the treatment of postpartum depression (PPD), to improve the postpartum depression and quality of life.Methods 72 cases of postpartum depression treated in our hospital were retrospectively chosen.They were randomly divided into two groups, each group was of 36 patients, and they were taken with different drug regimen.The control group was treated with conventional treatment drug sertraline, and the study group was taken with Shugan Jieyu capsule on the basis of the control group.six weeks of treatment were as the observation period, and the differences of scores of HAMD, TESS and Quality of Life Index for the two groups on admission, four and six weeks after treatment were compared.Results After treatment, the scores of HAMD, TESS and QL-Index of the study group were (0.92 ±0.58), (1.36 ±0.46), (7.83 ±1.68), significantly better than the control group of (1.67 ±0.43), (2.48 ±0.72), (6.79 ±1.24), ( P <0.05 ) .Conclusion The combination of Shugan Jieyu Capsule and sertraline can improve the patients'quality of life after the treatment of postpartum depression, the depression is improved, and with few adverse reactions.It has a positive effect in improving the quality of life of patients.

Objective:To determine the residual formaldehyde fumigation on the surface of pharmaceutical equipments by AHMT method. Methods:The reaction time of AHMT was controlled in 20 min, the solution with sodium periodate was then shaken for 30 seconds and stood for 30 seconds, and then the absorbance at 550 nm was measured. Results: The linear range of formaldehyde was 0. 250~2. 495 μg·ml-1. The recovery of formaldehyde on glass plate, color steel plate and stainless steel plate was (83. 42 ± 1. 48)%(n=3), (83. 63 ± 1. 94)%(n=3)and (83. 94 ± 2. 28)%(n=3), respectively. Conclusion:The method is proved to be convenient and accurate, and is suitable for the determination of formaldehyde on the surface of pharmaceutical equipments.

Objective To study the efficacy of CPT-11 TACE in the treatment of unresectable HCC.Methods A retrospective review was undertaken on unresectable HCC patients receiving doxorubicin transarterial chemoembolization (59 cases) and irinotecan(CPT-11) in 24 cases from May 2003 to November 2011.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the two groups were assessed for statistical significance with the log-rank test.Results Overall survival time was significantly longer in patients treated with CPT-11 compared with doxorubicin treated group (21.7 vs 14.5 months,P =0.042).There was no significant difference in time to progression between the two groups,but time to progression was longer in CPT-11 group than doxorubicin treated group (11.42 vs 9.46 months,P =0.091).Subgroup analysis showed that for intermediate-stage HCC,CPT-11 resulted in a significantly longer time to progression and overall survival compared with doxorubicin treated group (P =0.029 and P =0.014,respectively).There were no significant differences in adverse events among the two groups (P ＞ 0.05).Conclusions Chemotherapeutic agent CPT-11 in the form of TACE significantly improved overall survival when compared with doxorubicin for the treatment of unresectable HCC.

Objective To evaluate the efficacy of chemoradiotherapy in patients with unresectable pancreatic cancer who were previously treated with PTCD.Methods From September 2005 to December 2012,47 unresectable pancreatic cancer patients with obstructive jaundice were enrolled in this study.They were divided into two groups.21 patients received after PTCD chemotherapy or radiation,or chemoradiotherapy.26 patients in support care group received only nutrition,analgesia and other related support treatment.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the groups were assessed for statistical significance with the log-rank test.Results The median overall survival time of patients after PTCD was 7.19 months.The median overall survival time of chemoradiation group was 9.07 months,which was higher than that of support care group (5.52 months),P=0.017.12 patients received single therapy (either chemo or radiation),and 9 patients received chemoradiotherapy.The median overall survival times were 8.31 months and 11.15 months,respectively (P =0.325).Conclusions Post PTCD chemoradiotherapy helps prolong the survival time in unresectable pancreatic cancer patients.

Objective To evaluate the clinical efficacy of local intra-arterial thrombolysis (LIT) with urokinase in patients with acute ischemic stroke.Methods One hundred and sixty two patients with acute ischemic stroke were treated with LIT by using urokinase and relationship of reconalization for different occluded arteries with the Glasgow outcome scale (GOS) scores three months later was analyzed. Results Angiography showed occlusion of the cerebral artery in 162 patients, among which 119(73.5%) patients showed the sites in the internal carotid artery system, with 27 occlusions in the internal carotid artery (ICA)trunk, 63(38.89%) in the middle cerebral artery (MCA)and 29(17.9%) in the anterior cerebral artery (ACA), and the remaining 43(26.5%)patients of vertebrobasilar artery (VBA); successful recanalization was achieved in 103 (63.58%)patients, including 11 (40.7%), 49(77.8%), 20(69.0%) and 23(53.3%), respectively, after intraarterial infusion of urokinase. Unsuccessful recanalization occurred in 59patients (36.42%). Followed up for 90 days, 90 (55.6%) patients obtained a good outcome; 72(44.44%) had poor prognosis including 20(12.35%) deaths. 8 patients associated with hemorrhage (4.9%) 73 with reperfusion injury (45.1%) and 5 arterial re-occlusion (3.1%). Based on statistic analysis, ICA trunk and VBA had low ratio of successful recanalization with poor clinic prognosis MCA and ACA possessed high ratio of successful recanalization and good clinic outcomes. There was a significant relationship between arterial recanalization rate and clinic prognosis (r=0.86).Conclusions Successful recanalization of cerebral occlusive artery by using intra-arterial thrombolysis could improve clinic prognosis in patients with acute ischemic stroke. Clinical prognosis has a significant relationship with both initial treatment time and arterial recanalization rate.

Objective To explore the causes and preventive measures of symptomatic intracranial hemorrhage in 217 patients with acute cerebral ischemic stroke treated with local intra-arterial urokinase. Methods From February1999 to June 2004, 217 patients were treated for acute ischemic stroke with local intra-arterial urokinase in our hospital. Factors associated with symptomatic intracranial hemorrhage of intra-arterial thrombolysis were analyzed by Stepwise logistic regression to identify some factors relating the prediction symptomatic intracranial hemorrhage. Results Symptomatic intracranial hemorrhage occurred in 8 cases (3.7%). Predictors of the symptomatic intracranial hemorrhage were the elevated systolic blood pressure before therapy (odds ratio, 1.096; 95% CI, 1.006 to 1.194) and urokinase (UK) treatment (odds ratio , 1.068; 95% CL, 1.053 to 1.247). Risk of secondary symptomatic intracranial hemorrhage was increased with elevated systolic blood pressure. Other factors like age, initial treating time, NIHSS, diabetes and collateral circulation did not predict the symptomatic intracranial hemorrhage respectively. Conclusions Predictors of symptomatic intracranial hemorrhage after local intra-arterial infusion of urokinase for acute ischemic stroke were the elevated systolic blood pressure before therapy and urokinase (UK) treatment.