Objective to observe the effects of ulinastatin(UtI)and xuebijing on treatment of burns sepsis after coagulation and systemic inflam-mation. Methods A total of 103 patients diagnosed of sepsis in burn department of our hospital during 2009-01 - 2014-01 were recruited for the study and randomly divided into 2 groups. the control group(51 cases)received conventional fluid resuscitation,mechanical ventilation,renal re-placement,wound dressing or operation,metabolic nutrition support;the treatment group(52 cases)received vein infusion of xuebijing 100 mL, bid on the basis of conventional therapy,ulinastatin 400 000 U intravenous drip,bid,for 10 d. the blood routine,blood coagulation function and in-flammatory reaction index and plasma lipopolysaccharide(LPS),tumor necrosis factor-alpha(tNF-alpha),interleukin-6(IL-6),interleukin-10 (IL-10),C- reactive protein(CRP)and procalcitonin(PCt)of the patients in each group were respectively detected before treatment and after treatment in the 1,3,7,10 days. Results After treatment of coagulation,indexes of blood fibrinogen degradation product(FDP),plasma fibrino-gen(FIB),blood concentration of two D- dimer(D-Dt),platelet and inflammatory reaction index compared were significantly improved compare with those before treatment in both two groups(P < 0.01). In addition,the treatment group showed significantly better effects than the control group, and the difference was statistically significant(P < 0.05). 7 d after treatment inflammation index levels in treatment group decreased more significant-ly compared with the control group,and the difference was significant(P < 0.05). Conclusion Combined application of xuebijing,ulinastatin with auxiliary treatment of post-burn sepsis can reduce the systemic inflammatory response,improve blood hypercoagulable state.

Objective To evaluate left ventricular torsion and untwisting in patients with coronary artery disease by speckle tracking imaging. Methods Study population consisted of 48 patients, who were diagnosed coronary artery disease initially and received one of coronary arteriography, coronary artery spiral computerized tomography, radionuclide imaging, interventional therapy and bypass surgery. High frame rate (≥60 frame/s) two-dimensional dynamic images of the left ventricular apical long-axis views and parasternal short-axis views at basal and apical levels were recorded. Rotation was measured in the left ventricular short-axis views using 2D strain software. Left ventricular torsion was defined as relative rotation degree between the apical level and basal level. Patients were divided into three groups according to clinic final diagnosis [myocardial infarction ( MIN) group, n = 19; myocardial ischemia ( MIS) group, n =19; normal coronary artery (Contrast) group, n - 10]. Results In MIS group,peak rotation value and rotation value at aortic valve closure in basal level were smaller than those in apical level. Untwisting rate reduced in MIN group. There was linear correlation between left ventricular peak torsion and end-diastolic diameter. There was aslo linear correlation between left ventricular peak torsion and eject fraction. Left ventricular peak rotation at basal level was correlative to eject fraction. Left ventricular untwisting rate had linear correlation to eject fraction, and also had correlation to peak torsion. Conclusions In patients with myocardial ischemia, left ventricular rotation value at apical level is larger than that at basal level. Left ventricular diastolic function is injured severely in patients with myocardial infarction. Untwisting rate is a quantitative index to evaluate myocardial diastolic function.

Objective To assess global systolic function of left ventricle (LV) using speckle tracking echocardiography in patients who are left volumetric overload and to establish the correlativity between strain and left ventricle end-diastolic volume index (LVEDVI). Methods Seventy-seven patients who were left volumetric overload and 30 normal volunteers were enrolled in this study. Respective 3 high frame rate (＞ 100 frames/s) 2D images were recorded from the left ventricular short axis views: the levels of mitral valve annulus, papillary muscle and apex. Three global peak systolic radical strain and strain rate were measured using 2D strain imagirg. LVEDV was obtained by two-plane Simpson method and LVEDVI was obtained by normalized LVEDV with surface body area. Patients were divided into 6 groups: transitionalgroup,group A (LVEDVI:90- 120 ml/m2),group B (LVEDVI: 121 - 150 ml/m2 ),group C (LVEDVI:151 -180 ml/m2),group D (LVEDVI: 181 - 210 ml/m2),and group E (LVEDVI＞210 ml/m2). Patients were divided into two groups by left ventricular ejection fraction (LVEF): group Ⅰ (LVEF≥ 50 % ), group Ⅱ (LVEF＜50％). Results①Compared with normal control group,GRS,GRSr in transitional group showed no change at three short axis levels (P ＞0.05). The above parameters in group A, B and C were significantly higher than those in normal control group( P ＜0. 01 ). In transitional group,group A,B and C,GRS, GRSr of three short axis gradually increased with LVEDVI augmentation. Compared with group A, B,C,D and normal control group,the above parameters of 3 short aixs in group E were decreased( P ＜0. 01 ),which gradually decreased in group C, D, E with LVEDVI augmentation. ②GRS,GRSr of 3 short axis views in group Ⅰ were more significantly high than those in group Ⅱ and normal control group. The parameters above were significantly low in group Ⅱ ( P ＜0.01). ③In group A,B,C,GRS of papillary muscle and apex levels were correlated positively to LVEDVI ( rpapillary muscle = 0.55,0.64,0.76 and rspex = 0. 74, 0. 79,0.71,P ＜0.05) ; In group D, there was no correlativity between GRS of papillary muscle and LVEDVI( r =- 0.35, P ＞ 0.05) while negative correlativity was established in apex level( r = - 0.73, P ＜ 0. 05). In group E,the negative correlativity was found between GRS of papillary muscle and LVEDVI( r = -0. 70,P ＜0.05) while no correlativity was established in apex level( r = - 0.39, P ＞0. 05). GRS of mitral valve annulus was correlated positively to LVEDVI in group A, B( r = 0.79, 0.77, P ＜ 0.05) and had no correlativity in group C,D. The negative correlativity between them was found in group E( r = - 0. 54, P ＜0.05). At LVEDVI: 180- 190 ml/m2 ,GRS of papillary muscle and apex level reach the peak point about 93% and 62% ;GRS of mitral valve annulus level reach the peak about 63% at LVEDVI 150 - 160 ml/m2.Conclusions Radial strain,strain rate change periodically with LV volume overload. Wall motion of left ventricle can be evaluated accurately by speckle tracking echocardiography, which provide useful modality for evaluation cardiac systolic function.

Objective To evaluate left atrial function by velocity vector imaging (VVI) in patients with rheumatic mitral stenosis(RMS). Methods Thirty eight patients with RMS and 42 normal controls were studied with VVI analysis software. Peak systolic strain (S), systolic strain rate(SRs), early diastolic strain rate(SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured,and also the SRa peak time delay(Td-SRa). Results Comparing to the controls group, the S, SRs and SRe of all segments were significantly lower(P<0.05). Except the base latero-aorta's SRa, the other segments' SRa were lower (P<0.05). In patients with atrial fibrillation(AF),56% segments had no SRa,and 18.6% had irregular low amplitude movement at late diastole, while 25.4% had discernible positive peak. The base and middle inferior SRa of patients with AF were lower (P<0.05 ) than those of the patients with sinus rhythm. While the Td-SRa of patients was longer than that of control group,especially what of the patients with AF. Conclusions The segmental and globe left atrial function of patients with RMS can be evaluated with VVI.

Pregnant women drug research is quite necessary and urgent,of which human trail is an important link.Pregnant women are vulnerable subjects,but they should not be excluded from drug clinical trials because of possible special risks.The governments should refine the relevant laws and regulations to standardize the clinical trials of pregnant women and safeguard their rights and interests.In order to prevent and control the risks of human trail in pregnant women drug research,it is suggested that the subjects should be limited to the pregnant women who are ill and carry out the 0 phase clinical trial of pregnant women drug research.The ethical review of pregnant women drug research should adhere to the principle of risk minimization,informed consent and reasonable compensation.Meanwhile,the ethical review should emphasize the tracing review.Risk prevention and control of pregnant women in clinical trials should form a joint force.

OBJECTIVE: To explore the therapeutic effect of prostaglandin E1 lipid drug-loaded microcapsules(Lipo PGE1) on the earlier diabetic nephropathy (DN). METHODS: 72 cases with early DN were randomly divided into treatment group and control group. The control group were assigned to receive routine hypoglycemic agent,blood pressure controlling, and symptomatic treatment, while the treatment group were given another drip infusion of Lipo PGE1 20ug plus NS100ml q.d besides the routine therapy as in the control group. Both groups received 3 weeks’ course of treatment. The changes of urinary albumin excretion rate(UAER), urinary transferrin(TRF), urinary microglobulin(?1MG)and so on in the 24h urine of the 2 groups before and after treatment were observed.RESULTS: There was great decrease in UAER, TRF and ?1MG in the 24h urine in the treatment group after treatment(P

Objective To discuss the application valueof the multi-slice spiral CT indiagnosing breast cancer. Methods The images of scanning, enhancing and reconstruction were analyzed in 71 cases of breast cancer proved by clinical pathology. Results All the 71cases were the type of mass. The shapes of the tumor in 57 cases were irregular, burrs can be seen in 48 cases , the skin in 8 cases changed, the nipples in 4 cases sunk, the tissue around the tumor was invaded in 12 cases; The CT value of the tumor rised greatly after enhancement, theranges of value was form 18 to 83 HU. Axilla lumph nodes were detected in 32 cases, Wecan find the lumph node in mediastinum and lung metasis; The tumor and tissue around it can be shown well in multi-orientations through images reconstruction. Conclusions The multi-slice spiral CT has the evident application value in pualitative diagnosing breast cancer.

Objective To study the therapeutic effects of mycophenolate mofetil(MMF) in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods 16 refractory ITP patients were treated with MMF (1.0～1.5g/d),which were given in divided doses for three months as one course;the patients with significant therapeutic effect were given the dose for another three months and reduced by degree.Results Very effective results were obtained in 4 cases,striking improvement in 7,partial response in 1 and no response in 4.The total efficacy was 68.75%.The main side effect was observed as light digestive malaise.Conclusion MMF has striking therapeutic effect in treating refractory ITP with little side effect and can be used as an effective way of treatment.

Objective:To understand the attitudes of medical students to public elective courses of humanistic quality and the existing problems. Method:Questionnaires were used in 1 ~5 grade students in randomly selected five medical colleges in Guizhou. Results:Total 1000 questionnaires were sent out, 957 were received, the recovery rate was 95. 7%;817 valid questionnaires, the effective rate was 81. 7%. 75. 56% of the students supported for medical colleges and uni-versities setting up humanistic quality public elective courses, but 24. 44% had negative attitude. Conclusions:It's nec-essary to make efforts to improve the mind medical student's humanistic quality. From the perspective of serving students, school should improve medical college students' humanistic quality from various aspects.

Early diagnosis and timely treatment of hepatic steatosis is very important for controlling the development and improving the prog-nosis of disease.This paper introduces the controlled attenuation parameter (CAP),a novel non -invasive method to quantitatively assess hepatic steatosis.This paper briefly describes the advantages of CAP compared with other methods for detecting hepatic steatosis:CAP is simple,fast,repeatable,and generally accepted by patients.CAP is of great value for early detection of fatty liver.Moreover,this paper re-views the optimal cut -off values of CAP for detection of fatty liver in different studies.CAP can be used to dynamically monitor the progres-sion and regression of fatty liver as a guide to clinical treatment.