Objective To investigate the efficacy of Ginkgo‐Leaf Capsule combined with tripterygium glycoside in the treat‐ment of diabetic nephropathy(DN) and its influence on CysC ,Hcy and VEGF .Methods Eighty patients with DN treated in our hospital from January 2013 to April 2015 were selected as research subjects and equally divided into the control group and the ob‐servation group according to the random number table ,40 cases in each group .Besides the conventional Western medicine treat‐ment ,the control group was given tripterygium glycoside ,while the observation group was given Kinkgo‐Leaf Capsule combined with tripterygium glycoside .The treatment course was 3 months .Then ,the curative efficacy ,indices of renal function ,levels of Cy‐sC ,Hcy and vascular endothelial growth factor(VEGF) ,and occurrence situation of adverse reactions were compared between the two groups .Results The total therapeutic efficacy rate in the observation group and the control group was 92 .50% and 80 .00%respectively without statistically significant difference (P>0 .05) .In the comparison with the control group after treatment ,the re‐nal function indices of serum creatinine ,urea nitrogen ,24 h urinary protein ,level of serum CysC ,Hcy and VEGF in the observation group were statistically decreased (P< 0 .05) .During the treatment process ,no severe adverse reactions occurred in the two groups .The incidence rate of adverse reactions in the observation group and the control group was 17 .5% and 12 .5% respectively without statistical difference (P>0 .05) .Conclusion Ginkgo‐Leaf Capsule combined with tripterygium glycoside is effective and reliable for treating DN ,which can significantly improve the renal function ,reduces the level of serum CysC ,Hcy and VEGF .

[Objective] To investigate the causes of failures of long bone fractures with internal fixations and to study the treatments and effects of reoperations of long bone fractures with inter-locking intramedullary nail and limited open reduction.[Method]Twenty-four patients of failures of long bone fractures with internal fixations were retreated with inter-locking intramedullary nail and limited open reduction.There were 15 cases of femoral fracture,7 cases of tibial fracture and 2 cases of humerus shaft fracture.Of the femoral fracture,there were 14 cases of fractures of shafts of femurs and 1 case of supracondylar fracture of femur;11 male,4 female;7 left cases,8 right cases;1 case complicated with bending of bone plate and screw,6 cases with breakages of plate;1 case with bending of common intramedullary nail,2 cases with breakages of common intramedullary nails,1 case of screw and wire lock fixation complicated with pseudoarticulation formation,4 cases with nonunion of fracture.Of the cases of tibial shaft fracture,there were 6 male,l female;3 left cases,4 righe cases;3 cases complicated with breakages of bone plate and screw,1 case with failure of external fixator,3 cases with nonunion of fracture.Of the cases of humerus shaft fracture,there were 2 cases of male and left ones;1 case complicated with breakage of bone plate and screw,1 case with breakage of common intramedullary nail.The ages of patients ranged from 18 to 68 years old with mean ages 43.7 years old.All fixation failure cases were retreated with inter-locking intramedullary nails and limited open reductions with autogenous iliac bone grafts or bone allografts.[Result]The average follow-up time was 25 months(12～35 months).All cases were cured with bone unions.Complications with submerge,breakages and bending of intramedullary nails did not occur.In the reoperating cases of femoral and filial fractures,the knee function were excellent in 18 cases,good 2 cases,fair 1 case and poor 1 case according to Karlstrom scale.Among the reoperating cases of humeral fractures,there were 1 case excellent and 1 good of shoulder function according to HAN score.[Conclusion]Reoperations with inter-locking intramedullary nail and limited open reduction are effective methods for treatment of internal fixation failure of long bone fracture.

Objective To study the changes of the four active substances endothelin(ET),calcitonin gene related peptide (CGRP), thromboxane B2 (TXB2) and 6-Keto-prostaglandin F1? (6-Keto-PGF1?) in plasma when they acted on . each other in the formation and development of diabetic retinopathy. Methods Using the method of radio-immunity,the levels of ET,CGRP,TXB2, 6-Keto-PGF,. in plasma were measured in four groups of patients with type 2 diabetes (group 1: 40 cases without retinopathy; group 2: 40 cases with primary retinopathylgroup 3. 40 cases with hyperplasia type of retinopath; group 4: 40 cases normal controls). Results The results showed that ET increased progressively (P

Objective To develop a kind of multi-functional cleaning-out device for medical apparatus.Methods Drawing on experience of traditional medical apparatus cleaning techniques by human or machine,a new cleaning-out device was designed.The prototype was made and proofed by series of tests.Results This device has outstanding advantages in producing cost,cleaning quality and cleaning cost.Conclusion This device worth popularizing for its easy-operation and low cost.

Objective　To study the changes of the four active substances endothelin(ET),calcitonin gene related peptide (CGRP),thromboxane B2(TXB2) and 6-Keto-prostaglandin F1α(6-Keto-PGF1α) in plasma when they acted on each other in the formation and development of diabetic retinopathy.Methods　Using the method of radio-immunity,the levels of ET,CGRP,TXB2,6-Keto-PGF1α in plasma were measured in four groups of patients with type 2 diabetes (group 1∶40 cases without retinopathy;group 2∶40 cases with primary retinopathy;group 3.40 cases with hyperplasia type of retinopath;group 4∶40 cases normal controls).Results　The results showed that ET increased progressively (P＜0.01) with the prolonging of the duration of DM and the worsening of retina damage、CGRP showed a decreasing tendency (P＜0.05,P＜0.01) in the advanced stage of DM retinopathy.Rectilinear regression analysis showed that the association of ET/CGRP with TXB2/6-Keto-PGF1α became closer with the worsening of deabetic retinopathy (r=0.44,P＜0.05;r=0.596,P＜0.01).Conclusion　The four active substances acted on each other in the formation and development of diabetic retinopathy.It had a significent meaning in the initial mechanism of DM,in the development of disease and in the direction of medication usage to understand their relationship.

Objective To evaluate the tumor dose distribution of routine radiotherapy plan in esophageal cancer with 3D treatment planning system. Methods For the 19 esophageal cancer patients who were diagnosed, the thoracic CT were done and GTV, CTV and PTV were delineated on the image of CT. Then a routine 3 field radiotherapy planning was produced using the Cad Plan 6.4.7 treatment planning system. The dosimetric results of GTV, CTV and PTV, target conformity and the dosimetric uniformity of variant target volume gained from DVH were compared. Results The maximal dose of GTV, CTV and PTV was 51.64Gy, 51.94Gy, 51.48Gy, respectively; the minimal dose was 41.17 Gy, 25.31 Gy, 18.94 Gy, respectively; the mean dose was 49.5 Gy, 47.34 Gy, 42.92 Gy, respectively; the conformity index was 0.94, 0.69, 0.38, respectively; and the dose variability was 2.2 Gy, 7.57 Gy, 14.56 Gy. Conclusions The routine radiotherapy plan in esophageal cancer could not offer satisfactory dose distribution. The method of CT simulation and 3D treatment planning systems should be applied to decide treatment planning.

Objective To understand pathogen spectrum of bacterial and fungal infection of central nervous system (CNS),and evaluate the etiological diagnostic value of universal primer polymerase chain reaction (PCR).Methods Data about patients with suspected or confirmed bacterial and fungal infection of CNS from January 2009 to March 2015 were collected,species of pathogens from cerebrospinal fluid (CSF)were analyzed,DNA from patients’CSF were performed PCR amplification and sequencing with universal primers of bacterial 16S rRNA and fungal 28S rRNA, PCR detection results were compared with CSF culture during the same period.Results A total of 400 patients were with confirmed or suspected bacterial or fungal infection of CNS,132 of whom were with positive CSF culture.150 pathogenic isolates were detected,including 48 isolates of gram-positive bacteria,90 gram-negative bacteria,and 12 fungi;the top three isolated bacteria were Acinetobacter baumannii (n =32 ),coagulase negative staphylococcus (n=16)and Klebsiella pneumoniae (n=13);the most common fungus was Cryptococcus neoformans (n=8).CSF from 88 infected patients and 20 non-infected patients were selected for PCR amplification,the sensitive of PCR am-plification assay was higher than the culture method (35.23% [31/88]vs 28.41 %[25/88],χ2 =4.17,P <0.05).

Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from surgi-cal patients with infection.Methods Distribution and antimicrobial resistance of 1 208 pathogens isolated from sur-gical patients with infection from January 2013 to January 2014 were analyzed retrospectively.Results Of 1 208 pathogenic isolates,gram-negative bacteria,gram-positive bacteria and fungi accounted for 64.57% (n = 780 ), 24.92%(n = 301 )and 10.51 % (n = 127 )respectively.The main specimens were sputum (44.78%),urine (21 .11 %),blood(11 .51 %),and pus(10.26%).Antimicrobial susceptibility testing results showed that the produ-cing rate of extended-spectrumβ-lactamases (ESBLs)of Escherichia coli and Klebsiella pneumoniae was 62.60%and 33.61 % respectively,resistant rate to imipenem was 0.76% and 15.57%,respectively.The resistant rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem was 38.93% and 75.80% respectively.Methi-cillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus was 71 .68% and 87.93% respectively.Conclusion The major pathogens isolated from surgical patients with infection are gram-neg-ative bacteria,the main infection sites are respiratory tract and urinary tract in this hospital;multidrug resistance is serious,especially carbapenem resistance,which should be paid attention.

Objective: To investigate the relationship between heart rate variability (HRV), blood pressure variability (BPV) and autonomic nerve function, blood vessel damage in patients with essential hypertension (EH) via synchronous monitoring. Methods: A total of 275 EH patients admitted to our hospital from 2011-04 to 2014-01 were enrolled. The vascular function was assessed by carotid-femoral pulse wave velocity (PWV). Based on PWV, the patients were divided into 2 groups: Normal PWV group (PWV<9m/s),n=185 and High PWV group (PWV≥9m/s),n=90. Synchronic 24h dynamic electrocardiogram (Holter) and 24h ambulatory blood pressure monitoring (ABPM) were performed in all patients. t-test, chi-square test, person liner correlation study and multi stepwise regression analysis were conducted to explore the relationship between HRV, PBV and PWV. Results: HRV and BPV in High PWV group had been changed unusually. Compared with Normal PWV group, High PWV group showed decreased standard deviation of the average of all normal-to-normal intervals in all 5-minute intervals (SDANN) (159.66±66.50) ms vs (194.36±119.29) ms and increased 24 h systolic blood pressure standard deviation (24h SSD) (14.40±3.65) mmHg vs (12.98±3.46) mmHg, all P<0.01; increased new index of night/day HR ratio (0.90±0.08) vs (0.87±0.06), P<0.01 and it had liner correlation to PWV (r=0.169, P=0.005). Multi stepwise liner regression analysis indicated that 24hSSD and HRV at low frequency (LF) portion had obvious and independent correlation to PWV (standard β value=0.352 and 0.212 respectively). Conclusion: ① EP patients were with decreased HRV (SDANN), increased BPV (24h SSD) and the higher incidence of arteriosclerosis; 24h SSD and HRV at LF portion were the most 2 important risk factors affecting PWV. ②Autonomic nerve dysfunction, vagus nerve over-excitatory were the independent risk factors for promoting the occurrence and development of arteriosclerosis in EH patients. ③Night/day HR ratio as a sensitive index for examining autonomic nerve function was independently related to hypertensive vessel damage. Synchronic monitoring of HRV and BPV is helpful to identify blood vessel damage in EH patients.

Objective To create a new drying surgical instruments drying cabinet for the drying equipment with some technical short-comings and without widely used. Methods The air cleanliness,temperature and speed of special properties in the process of drying surgical instruments were study to create a new technology of drying cabinet for surgical instruments with a low cost,advanced features and the maneu-verability. Results A new type of dry prototype for surgical instruments was successfully developed and tested with heating and drying,the average heating time and the shortest processing time under 70 ℃ were 5. 1 min and 15. 6 min,respectively,the average heating time and the shortest processing time under 90℃ were 7. 8 min and 14. 2 min,respectively,which has more advantages than traditional drying equipment. Conclusion The new surgical instruments drying cabinet has a high application value and good prospect of industrialization,which can be the basic equipment for CSSD and operating departments of hospital.