Objective To analyze the early renal function of donors after nephrectomy.Methods Clinical data of 467 cases of living kidney donors during the period from April,2010 and November,2014 in our center were retrospectively analyzed.Data on serum creatinine (Scr),glomerular filtration rate (GFR),serum uric acid (UA),and urine microproteins before operation and three days,seven days,one month and three months after operation were collected to evaluate the impact of nephrectomy on early renal function after operation for donators.Results Before operation and three days,seven days,one month,three months after operation,the average serum creatinine (Scr) level was (59.9±12.8),(85.8±21.0),(91.2±21.3),(92.8±21.6),(91.0±21.3) μmol/L,respectively; The GFR were (113.5±25.3),(75.1± 17.9),(70.3± 15.2),(68.5± 16.0),(69.5± 15.1) ml/min,respectively; The levels of uric acid were (292.60±79.58),(142.18±55.28),(228.41±66.39),(321.31± 83.72),(346.61±87.21) μmol/L,respectively; All these data above-mentioned after operation reached statistical significance compared with that before operation (P ＜ 0.05).Parameters including urine IgG,urine albumin,urine retinol-binding protein and urine β2-microglobulin post-operation time point were significantly different when compared with relative parameters pre-operation (P ＜ 0.05).Conclusions Nephrectomy has significant influence on GFR,uric acid,and urine microprotein for donors in the early stage after operation.It's worth to evaluate nephrectomy's long-term effect on the renal function of donors in clinical practice.

Objective To compare the dissolution curves of metronidazole tablets from 38 national manufactures and original drugs of Britain in four dissolution mediums,and provide the reference for the quality and clinical effect consistency evaluation of metronidazole tablets.Methods Paddle method was adopted at 50 r · min-1 in four dissolution mediums with the volume of 900 mL.The dissolution profiles were determined by ultraviolet spectrophotometry.The cumulative dissolution percentages were calculated and the dissolution curves were drawn.Similarity factor (f2)was used for comparing of the differences between dissolution curves.Results The dissolution profiles of 4 manufactures in pH 1.2 and 9 manufactures in pH 4.5 were similar (f2 ≥ 50)to that of original drugs,only 1 and 3 were similar to original drugs in water and pH 6.8,respectively.There are no companies whose dissolution curve were similar to that of original drugs in 4 dissolution mediums.Conclusion Great difference exists between domestic manufactures and pharmaceutical enterprises of origin in dissolution behaviors of metronidazole tablets.In order to ensure the consistency between the metronidazole tablets generics and original drugs of Britain in quality and clinical effect.It is advisable for the relevant companies to improve their product quality by improving the formulation and preparation.

Objective To construct a nomogram prognostic model for predicting the survival of patients with lung adenocarcinoma based on the large sample data from the SEER database. Methods We retrospectively analyzed the clinical data of patients who were diagnosed with lung adenocarcinoma from 2010 to 2015 in the SEER database. A nomogram model was created based on independent parameters influencing the prognosis of patients with lung adenocarcinoma using Lasso Cox regression analysis. The C-index and calibration curve were utilized to assess the ability to distinguish and calibrate the nomogram. NRI and DCA curves were used to evaluate the prediction ability and net benefit of the nomogram. Results A total of 15 independent risk factors affecting the prognosis of lung adenocarcinoma were identified and integrated into the nomogram model. The C-index of the prediction model was 0.819 in the training cohort and 0.810 in the validation cohort. The predicted specific survival rate of the 1-, 3- and 5-year calibration curves of the training cohort and the validation cohort were consistent with the actual specific survival rate. In comparison to the 7th edition of the AJCC TNM staging system, the NRI and DCA curves demonstrated a considerable boost to the predictive capacity and net benefits achieved by the nomogram model. The risk stratification model constructed with this nomogram model was able to distinguish the patients with different risks well (P < 0.0001). Conclusion A nomogram prognostic model is successfully developed and validated, which provides a simple and reliable tool for the survival prediction of the patients with lung adenocarcinoma. Meanwhile, the risk stratification model constructed by the prediction model can conveniently screen patients with different risks, which is important for the individualized treatment of lung adenocarcinoma patients.

OBJECTIVETo investigate the proliferation effects and apoptosis induction of cryptotanshinone on Hela cell line of cervical cancer.

METHODThe MTT assay was used to detect the growth inhibition rates of Hela cells at 24, 48, 72 h which cultured with cryptotanshinone in different concentrations. The cell cycle distribution and apoptosis were measured by flow cytometry. The protein expressions of E6, p53 and p21 were studied by Western blot.

RESULTThe different concentrations (0.5-16 mg x L(-1)) of cryptotanshinone had cytotoxicity on Hela cells, which were clearly dose and time-dependent. The IC50 of 24, 48, 72 h were 17.8, 8.17, 6.55 mg x L(-1), respectively. Cells were treated with cryptotanshinone which had significant effects on cell cycle of Hela cell, and induced apoptosis. Western blot showed cryptotanshinone decreased expressions of HPV E6 and increased expressions of p53 and p21 proteins.

CONCLUSIONCryptotanshinone had significant cytotoic and radiosensitization effects on cervical cancer Hela cells. One of the mechanism may be that it might make significant G0/G1 phase arrest and induced apoptosis, a decrease in S phase, and restore the function of p53 to induce apoptosis in Hela cells to kill the tumor cell.

Apoptosis ; drug effects ; Blotting, Western ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Flow Cytometry ; HeLa Cells ; Humans ; Oncogene Proteins, Viral ; metabolism ; Phenanthrenes ; therapeutic use ; Repressor Proteins ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; Uterine Cervical Neoplasms ; drug therapy

Objective To analyze the efficacy and safety of hypofractionated stereotactic radiotherapy ( FSRT ) combined with temozolomide ( TMZ ) for large brain metastases ( BMs ) in a prospective phaseⅡclinical trial.Methods From 2010 to 2015, a total of 33 patients were enrolled as subjects.The median Karnofsky Performance Status scores before and after treatment were 70 and 80, respectively.The major primary tumor was non-small cell lung cancer (57.6%).The brain metastasis had a diameter of≥3 cm or a volume of ≥6 cm3 .The radiation dose was 52 Gy in 13 fractions or 52.2 Gy in 15 fractions.Patients received TMZ at a dose of 75 mg/m2 per day concurrently.The radiotherapy was followed by 6 cycles of adjuvant treatment with TMZ (150 mg/m2, days 1-5, 28 days per cycle).Patients were reexamined by magnetic resonance imaging ( MRI) during the treatment.The radiation field would be shrunk if the gross target volume ( GTV) was reduced by≥20%.The treatment outcomes were evaluated by MRI at 2-3 months after treatment.Results The total numbers of tumors and GTVs were 95 and 38, respectively. Twenty-four (63%) out of the 38 GTVs had a volume larger than 10 cm3 and the median GTV was 15.3 cm3 (5.7-142.8 cm3).Twenty-two (67%) out of the 33 patients achieved field shrinking during the treatment, and the median reduction rate of GTV was 44%( 21%-88%) .The median total dose was 59.5 Gy, and 100%and 21.2%of patients completed the concurrent and adjuvant treatment with TMZ, respectively.In all patients, the overall response rate was 97.0%;the 1-year local control, intracranial progression-free
survival, and overall survival rates were 97%, 70%, and 62%, respectively;the median survival time was 15.3 months.The main adverse reactions were grade 1-2 nausea and vomiting.One patient got grade 3 liver function impairment.Conclusions FSRT combined with TMZ is a safe and effective approach for treating large BMs.More than 50%of patients can achieve field shrinking to shorten treatment duration and reduce toxicity.Clinical Trial Registry ClinicalTrials.gov,registration number:NCT02654106.

Objective To evaluate the prevalence of metabolic syndrome (MS) in Chinese children and adolescents to provide scientific basis for early prevention of MS in the related populations.Methods Studies on CNKI,Wanfangdata,VIP and PubMed databases on related prevalence of metabolic syndrome in Chinese children and adolescents between 2004-2014 were searched.Quality of literatures was evaluated according to the cross-sectional study standard in Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.Stata 12.0 software was used to estimate the prevalence of MS,as well as on gender,weight and other factors to make subgroup analysis.According to funnel plot and Egger assess publication bias,sensitivity analysis performed by excluding the impact of any article was generated by the combined effect of the value of literature.Results This study included 19 papers from the literature (5 in English,14 in Chinese).According to International Diabetes Federation (IDF),National Cholesterol Education Program Ⅲ (NCEP Ⅲ) and The definition and prevention recommends of metabolic syndrome in Chinese children and adolescents (CHN2012),the prevalence rates of MS in Chinese children were seen as 1.8％,2.6％ and 2.0％.According to IDF,the prevalence rates of MS appeared 2.9％ in boys and 1.8％ in girls,0.2％ in children with normal weight,4.7％ in overweight and 17.3％ in obesity.Both the results from NCEP Ⅲ and CHN2012 showed that the prevalence rates of MS as boys＞girls,obesity＞overweight＞normal weight.Conclusion Prevalence of MS in Chinese children and adolescents showed a general trend.Data under different standards showed different prevalence rates.Obesity appeared an important risk factor of MS,suggesting that in order to control obesity in children,attention should be paid to identifying and carrying out effective interventions on children under overweight or obesity.

Objective To observe the effect of early enteral nutrition (EEN) on nutritional indicators and clinical outcomes in patients with severe heart failure undergoing mechanical ventilation. Methods Thirty-four patients with severe heart failure (grade Ⅲ-Ⅳ of cardiac function) and pulmonary infections undergoing mechanical ventilation admitted to intensive care unit (ICU) of Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from May 2017 to April 2018 were enrolled. They were randomly divided into EEN group and delayed enteral nutrition (DEN) group. Both groups were given routine treatment, including mechanical ventilation, improvement of cardiac function, anti-infection, protection of vital organ function, regulation of blood sugar and adjustment of electrolyte and acid-base balance. The patients in EEN group received enteral nutrition (EN) within 48 hours after ICU admission, and in DEN group, EN was started after the patients had spent the early stage of stress and had stable vital signs (48 hours after ICU admission). The changes in serum B-type natriuretic peptide (BNP), C-reactive protein (CRP), nutritional indicators and liver function indicators at ICU admission and 7 days after treatment were compared between the two groups. The time needed for patients to reach EN target, duration of mechanical ventilation, length of ICU stay, and the 28-day mortality were recorded, and complications were observed. Results There was no significant difference in serum BNP, CRP, nutritional indicators or liver function indicators at ICU admission between the two groups. After treatment for 7 days, BNP and CRP in both groups were decreased significantly as compared with those at ICU admission [BNP (ng/L): 592.1±370.9 vs. 2 517.7±1 163.4 in EEN group, 621.9±418.8 vs. 2 251.5±1 006.8 in DEN group; CRP (mg/L): 46.0±19.6 vs. 59.8±22.5 in EEN group, 40.5±18.8 vs. 61.2±24.6 in DEN group, all P < 0.05], pre-albumin (PA) and transferrin (TF) were significantly increased [PA (g/L): 0.18±0.05 vs. 0.15±0.06 in EEN group, 0.17±0.04 vs. 0.12±0.06 in DEN group; TF (g/L): 1.6±0.4 vs. 1.5±0.4 in EEN group, 1.7±0.5 vs. 1.4±0.5 in DEN group, all P < 0.05]. However, there was no significant difference in the above indicators after treatment between the two groups (all P > 0.05). There was no significant change in liver function after treatment in both groups. The EN treatment was successfully completed in both groups. Some patients developed abdominal distension and diarrhea in varying degrees, which were alleviated by slowing down the infusion rate, supplemented by gastrointestinal motility drugs and intestinal flora adjustment drugs. The time needed to reach EN target in EEN group was significantly earlier than that in DEN group (hours: 42.4±10.2 vs. 53.8±17.1, P < 0.05), the duration of mechanical ventilation (days: 14.2±8.7 vs. 13.4±7.9), the length of ICU stay (days: 17.8±6.7 vs. 18.3±5.6) and 28-day mortality [5.9% (1/17) vs. 11.8% (2/17)] showed no significant difference as compared with those in DEN group (all P > 0.05), and it did not increase the incidence of aspiration pneumonia [23.5% (4/17) vs. 17.7% (3/17), P > 0.05]. Conclusion EEN could help to achieve nutritional goals as soon as possible, improve the nutritional status of the body, and provide conditions and basis for further treatment of severe heart failure patients.

Objective To study the effects of mirabilite stuck on umbilical region combined with early enteral nutrition (EEN) on gastrointestinal function and serum inflammatory mediators in patients with mechanical ventilation. Methods Sixty-four patients with mechanical ventilation admitted to the Department of Intensive Care Unit of the Second Affiliated Hospital of Zhejiang Traditional Chinese Medical University from January to December 2016 were enrolled, and they were divided into an observation group and a control group by random number table, 32 cases in each group. The control group was treated with routine western medicine+ EEN, and the observation group was treated additionally with mirabilite stuck onto umbilical region on the basis of the treatment of the control group. The clinical effect was observed after 7 days of treatment. The differences in gastrointestinal function scores and the levels of serum inflammatory mediators were compared between the two groups before and after treatment.Results After treatment, gastrointestinal function scores of the diarrhea, bowel sound, abdominal distension and the levels of white blood cell count (WBC), serum procalcitonin (PCT), serum C-reactive protein (CRP) were decreased significantly in both groups compared with those before treatment, and the degrees of decreasing in above index levels after treatment in the observation group were more obvious than those in the control group [diarrhea: 0.72±0.03 vs. 1.59±0.21, bowel sounds: 0.87±0.05 vs. 1.54±0.18, abdominal distension: 0.77±0.04 vs. 1.63±0.09, WBC (×109/L): 9.87±1.25 vs. 12.46±2.04, PCT (μg/L): 5.43±1.02 vs. 9.65±1.63, CRP (mg/L): 56.87±4.52 vs. 89.43±8.24, allP < 0.05].Conclusion Applying mirabilite stuck on umbilical region combined with EEN can effectively promote the recovery of gastrointestinal function and significantly decrease the levels of serum inflammatory mediators in patients with mechanical ventilation.

Objective To evaluate the clinical efficacy and safety of 577 nm subthreshold micropulse laser on diabetic macular edema (DME).Methods Retrospective case series study.A total of 30 patients (35 eyes) with center-involving DME were enrolled in this study.All the patients received the examinations of best corrected visual acuity (BCVA),fundus colorized photography,fluorescein fundus angiography (FFA) and optical coherence tomography (OCT).BCVA was measured by Early Treatment Diabetic Retinopathy Study charts.The average retinal thickness (ART),total macular volume (TMV) and the retinal thickness (RT) and macular volume (MV) of 9 ETDRS domains were measured by the Japanese Topcon 3D-OCT 2000 instrument.The mean BCVA was 62.4± 10.5 letters.The mean ART was 327.3± 41.2 μm.The mean TMV was 9.24 ± 1.17 mm3.All patients were treated with 577 nm subthreshold micropulse laser treatment.Subthreshold micropulse laser were performed in the micropulse mode,using a 200 μm spot diameter,a 0.2 s duration with 5％ duty cycle and its treatment energy was 6-7 times of threshold energy.Three months after treatment,re-treatment was performed on patients with incomplete absorption of macular edema.The treatment was the same as before.The BCVA,ART,TMV and the RT and MV of each ETDRS domain were compared and analyzed before and after treatment.The possible complications of micropulse laser treatment were also observed and the safety was evaluated.Results The difference of BCVA were statistically significant in month 3 and month 6 (t=-5.58,-7.24;P＜0.05),but not in month 1 (t=-1.82,P＞0.05).The average CRT (t=4.11,4.17,5.96),CMV (t=3.92,4.05,5.80) significantly decreased in 1,3 and 6 months after treatment,the difference was statistically significant (P＜0.05).At sixth months,the average retinal thickness (t=3.53,5.07,5.02,4.87,4.94,3.48,4.03,3.17,3.73) and retinal volume (t=3.54,5.16,4.99,4.91,5.05,3.47,4.08,3.10,3.70) of the 9 ETDRS subdomains significantly decreased,and the difference was statistically significant (P＜0.05).There was no visible laser spots,changes in the outer retina and complications of neovascularization and subretinal fibrosis in the fundus of all patients.Conclusion 577 nm subthreshold micropulse laser can reduce the CMT,CMV and improve the BCVA of DME patients with high security.

Objective:To systematically sort out and cluster the existing indicators of key issues in the quality of postgraduate clinical degree education based on the bibliometric study, so as to build a multidimensional quality assessment index system that integrates scientificity, rationality and representativeness, and to provide a scientific measurement tool for assessing clinical professional postgraduate education in China.Methods:By mining the related functions of UCINET6 network analysis integration software and its one-dimensional and two-dimensional data analysis NetDraw program, the social network analysis (SNA) method was used to extract and cluster the education quality problem set of clinical professional degree postgraduates.Results:A three-dimensional evaluation index system was constructed. The first dimension concluded such 8 key issues in the quality of postgraduate education in clinical medicine as ability assessment, teaching system, teaching quality assurance system, professional cognition and career prospects, assessment and evaluation system and organization, and the pulse taking and diagnosis.Conclusion:The clinical graduate education quality evaluation index system is an effective measurement tool for education quality improvement, based on a multidimensional perspective, with key issues as priority areas for intervention, providing an effective evidence-based basis for ensuring the development of professional graduate education efforts from 2020-2025.