Objective To evaluate the therapeutic effect of Danhong injection combined with calcium dobesilate for diabetic retinopathy (DR). Methods A total of 81 DR patients were recruited and randomly divided into a calcium dobesilate group (41 patients) and a combined treatment group (40 patients). Blood glucose was controlled (fasting blood sugar 4.5-6.5 mmol/L, postprandial 2 h blood glucose ≤10.0 mmol/L) in all patients. The calcium dobesilate group received oral calcium dobesilate tablets (0.5 g, 3/day), and the combined treatment group received intravenous Danhong Injection and oral calcium dobesilate tablets (0.5 g, 3/day) for 3 months. The changes of the gray scale of the visual field, microaneurysm volume, ecchymosis area, the thickness of the macula lutea, and the therapeutic effect were evaluated. Results After the treatment, the gray scale of the visual field (1.53%± 0.22%vs. 2.13%± 0.16%;t=17.315, P<0.01), microaneurysm volume (11.33 ± 3.21 cm3 vs. 13.44 ± 4.01 cm3; t=3.259, P<0.01), ecchymosis area (1.11 ± 0.24 mm2 vs. 2.01 ± 0.53 mm2; t=9.885, P<0.01), the thickness of the macula lutea (308.12 ± 13.29?m vs. 369.31 ± 14.57?m;t=24.556, P<0.01). The percentage of eyes with visual acuity improvement was in the combined treatment group was significantly higher than that in the calcium dobesilate group (63.1%vs. 35.0%;χ2=8.748, P=0.003). The total effective rates in the combined treatment group were significantly higher than those in the calcium dobesilate group for patients (95.1%vs. 67.5%;χ2=8.489, P=0.004) and for eyes (93.8%vs. 61.7%;χ2=17.226, P=0.001). Conclusions Danhong injection combined with calcium dobesilate can improve visual acuity and visual field loss in patients with DR.

Objective To evaluate the efficacy and safety of gabapentin in preemptive analgesia for hysterectomy after general anesthesia.Methods PubMed, Cochrane, Embase, Ovid, Springer Link, Web of Science, CNKI, Wanfang and Weipu databases were searched for randomized placebo-controlled trials involving the efficacy of gabapentin for preemptive analgesia published from 2000 to 2016.The methodological quality of the included randomized controlled trial (RCT) was assessed and the data were extracted according to the Cochrane Handbook.The meta-analysis was performed using the RevMan 5.3 software.Results A total of 10 RCTs involving 609 patients were included.Compared with the control group, there was a significant decrease in 24-hour cumulative narcotic consumption at 24 hours when gabapentin was administered before surgery (WMD=-8.83 mg, 95%CI-12.70——4.97, P<0.001), there was no significant decrease in VAS score in preemptive analgesia group (WMD=-7.70 mm, 95%CI-18.22-2.82, P=0.15).Compared with the control group, the rate of vomiting was less in the gabapentin group (RR=0.49, 95%CI 0.35-0.69, P<0.001).Compared with the placebo group, there was no significant decrease in nausea (RR=0.73, 95%CI 0.45-1.17, P=0.19) and somnolence (RR=2.08, 95%CI 0.62-6.92, P=0.23).Conclusion Preemptive administration of gabapentin is effective in decreasing accumulation of opium and vomiting.

Objective To analyze the effect of modified Yulin Decoction on hormones and ovarian function in patients with premature ovarian failure (POF).Methods 142 cases of patients with POF and kidney-yang deficiency syndrome were selected and randomLy divided into the control group (n=64) and the observation group (n=78).Levels of serum hormones and ovarian function,the traditional Chinese medicine (TCM) symptom score in the two groups were observed before and after treatment.Results Before treatment, there were no significant differences between the two groups in the scores and levels of hormones.After treatment, levels of serum FSH, LH and E2 were significantly decreased in the two groups, and the changes were more obvious in the observation group than the control group (P<0.05).After treatment, TCM symptom scores of two groups were significantly decreased, and the observation group were significantly lower than those in the control group (P<0.05).Conclusion Modified Yulin Decoction is significantly effective in the treatment of POF of spleen and kidney-yang deficiency syndrome.It can significantly improve the level of estrogen, adjust endocrine and relieve clinical symptoms.

Objective To investigate the effect of creatine phosphate on perioperative myocardial injury caused by living donor liver transplantation(LDLT)in adult patients.Methods Forty ASA Ⅱ -Ⅳ patients(liver function Child-Pugh grade B or C)aged 45-62 yr weighing 47-91 kg undergoing LDLT were randomly divided into 2 groups(n = 20 each): control group(group C)and creatine phosphate group(group CP).In group CP,creatine phosphate 30 mg/kg was injected intravenously at skin incision followed by creatine phosphate infusion at 4 mg· kg- 1 · h- 1 until the end of surgery.In group C,equal volume of normal saline was infused instead of creatine phosphate.HR,MAP,CVP,PCWP,CO and SvO2 were recorded immediately before skin incision,at 5 and 30 min of anhepatic phase,at 5 and 30 min of neohepatic phase and at the end of operation.Blood samples were taken from central vein immediately before skin incision(baseline,T0),at 30 min of anhepatic phase(T1),at 30min of neohepatic phase(T2),at the end of operation(T3)and at 4 and 24 h after operation(T4,5)for determination of serum cardiac troponin I(cTnI)and creatine kinase MB(CK-MB)concentrations and lactate dehydrogenase(LDH)activity.Postoperative adverse events were recorded.Results The serum cTnI and CK-MB concentrations and LDH activity were significantly increased at T2-5 as compared with the baseline value at T0 in both groups(P ＜0.05 or 0.01).MAP and CO were significantly higher from 5 min of neohepatic phase to the end of operation,the serum cTnI and CK-MB concentrations and LDH activity were significantly lower at T2-5,and the incidence of ventricular arrhythmia was significantly lower in group CP than in group C(P ＜ 0.05 or 0.01).Conclusion Creatine phosphate can attenuate perioperative myocardial injury caused by LDLT in adult patients.

Objective To investigate the expression of H19 imprinted genes in the villus tissues of women with spontaneous abortion.Methods Reverse transcription-polymerse chain reaction method(RT-PCR) was employed to detect H19 imprinted genes allele-specific expression levels of the villus tissues extracted from 45 cases of spontaneous abortion and 30 cases of normal pregnancy.Results Nineteen cases of 21 heterozygous cases in spontaneous abortion samples showed billelic expression of H19(19/21),whereas no billelic expression was found in the normal pregnancy samples(0/13)(P

Objective To investigate clinical effects of neoadjuvant chemotherapy of TAC scheme in breast cancer.Methods 82 patients with locally advanced breast cancer receiving neoadjuvant TAC chemotherapy program were retrospectively analyzed.The total efficiency,toxicity,and recent surgical cases were evaluated.Results There were 21 cases of CR in 82 cases with breast cancer,accounting for 25.6％,47 PR(57.3 ％),14 SD(17.1％),so the clinical total effective rate was 82.9％.The major toxic reactions was bone marrow suppression and neutropenia occurrence rate was 81.7％.Other adverse effects include gastrointestinal symptoms and liver dysfunction,and alopecia.All patients after symptomatic treatment can be tolerated.Conclusion TAC program neoadjuvant chemotherapy for locally advanced breast cancer patients can improve the cure rate,increase breast-conserving opportunities.

Objective To compare the severity of kidney injury following liver transplantation performed under sevoflurane versus propofol combined anesthesia in patients.Methods Fifty ASA Ⅱ or Ⅲ patients of both sexes,aged 40-64 yr,weighing 47-85 kg,scheduled for elective orthotopic liver transplantation,were randomly divided into 2 groups (n =25 each) ∶ propofol combined anesthesia group (group P) and sevoflurane combined anesthesia group (group Se).During maintenance of anesthesia,propofol was given by target-controlled infusion and the target plasma concentration was 2-4 μg/ml in group P,and sevoflurane was continuously inhaled and the endtidal concentration was maintained at 1.0％-3.0％ in group Se.Venous blood samples and urine specimens were taken immediately before skin incision (T0),at 30 min after occlusion of the inferior vena cava (T1),at 30 min of neohepatic phase (T2),at the end of surgery (T3),and at 1,3 and 5 days after operation (T4-6) for determination of serum concentrations of creatinine (Cr),blood urea nitrogen (BUN),β2-microglobulin (β2-MG) and urinary β2-MG concentrations.Results Compared with group P,the serum concentrations of Cr,BUN and β2-MG and urinary β2-MG concentrations were significantly lower at T3,4 in group Se (P ＜ 0.05 or 0.01).Conclusion The severity of kidney injury is reduced in patients undergoing liver transplantation performed under sevoflurane combined anesthesia compared with that under propofol combined anesthesia.

Objective:To explore the changes of neuron-specific enolase (NSE) and S-100β protein (S-100β) during perioperative period in infants undergoing living liver transplantation and examine the effect of brain injury.Methods:From January 2015 to January 2016 in Department of Anesthesiology First Central Clinical College Tianjin Medical University, study group was composed of forty infants of congenital biliary atresia with an age range of (4-12) months, a body weight of (4-10) kg and American Society of Anesthesiologists (ASA) class Ⅲ/Ⅳ. Another 40 infants undergoing general surgery were selected as control group. In study group, blood samples were harvested from central vein pre-operation (T0), before skin incision (T1), 30 min after anhepatic phase (T2), 1 h of neohepatic phase (T3) and 24h after hepato-reperfusion (T4). In control group, blood samples were collected at pre-operation (T0) and 24 h post-operation (T4). Serum levels of S-100β, NSE, heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and bispectral index (BIS) were monitored at T1-4 and end of surgery. All children were assessed by Bayley Scale of Infant Development (BSID) at Day 1 pre-operation and 2/4 weeks post-operation for observing mental and motor development status. The results were described with mental development index (MDI) and psychomotor development index (PDI). Pediatric anesthesia emergence delirium (PAED) was employed for evaluating the severity of delirium during the recovery stage at 30 min and 2/4h post-extubation.Results:In study group, serum levels of S-100β and NSE changed significantly during non-hepatic and neohepatic reperfusion phases. After inferior vena cava occlusion, serum concentrations of S-100β and NSE spiked ( P<0.05) and gradually recovered during neohepatic reperfusion period ( P<0.05). No significant inter-group difference existed in serum S-100β or NSE at T4 ( P>0.05). In study group, as compared with Day 1 pre-operation, MDI/PDI decreased at Week 2 post-operation ( P<0.05) and increased from Month 1 post-operation ( P<0.05). Both MDI and PDI were lower than control group before and at Week 2 post-operation ( P<0.05). MDI/PDI of study group basically reached the preoperative level at Month 1 post-operation ( P<0.05). In control group, no significant difference existed in MDI/PDI at Day 1 pre-operation and Week 2/4 post-operation ( P>0.05). In study group, the delirium rate was up to 30% post-extubation and decreased at 2/4h post-extubation. In control group, the incidence of delirium was low at 30 min and 2/4h post-extubation ( P<0.05). Conclusions:Perioperative evaluations of serum levels of NSE and S-100β are significant for predicting the postoperative onsets of delirium and cognitive impairment in children with living donor liver transplantation.

Kidney plays an important role in maintaining the homeostasis as an important excretory and endocrine organ.The occurrence and development of kidney disease is closely associated with glomerular filtration barrier dysfunction and renal interstitial remodeling.Matrix metalloproteinase-9 (MMP-9),a major enzyme in the extracellular matrix (ECM),plays an important role in the process of kidney disease by regulating the ECM components and its interaction with cytokines.The paper reviews the pathophysiology of MMP-9 in glomerular filtration barrier dysfunction and renal fibrosis to provide a theoretical basis for clinical treatment of kidney disease.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.