Objective To explore the curative effect of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy (ICP) and the effect on total bile acid (TBA) in post partum fetal umbilical venous blood .Methods 30 patients with intrahepatic cholestasis of pregnancy who were admitted into the Hospital Affiliated to Sichuan Medical University during January 2014 to December 2014 were selected as the research objects and randomly divided into observation group and control group ,15 cases in each group.The observation group were given ursodeoxycholic acid tablets while control group were injected with ademetionine butanedisulfonate .The curative effect of two kinds of drugs in treatment of intrahepatic cholestasis of pregnancy was observed and the effect on total bile acid in post partum fetal umbilical venous blood was analyzed .ResuIts After treatment , the TBA and ALT of observation group were significantly lower than those pre-treatment and those of control group (P<0.05).There were no significant differences of TBIL and ALP between two groups and within groups.TBA and TBIL in post partum fetal umbilical venous blood of observation group were significantly lower than those of control group (P<0.05).There was no significant difference of ALT level between two groups .There were two cases of abnormal perinatal outcomes in observation group while seven cases in control group (χ2 =3.97, P<0.05).ConcIusion Ursodeoxycholic acid could effectively reduce the total bile acid levels in maternal and fetal umbilical vein blood, reduce the mortality rate of the fetal and improve the perinatal outcomes , with high security.

Objective To explore the clinical practice and patient experience of perioperative therapeutic communication in rectal cancer patients, in order to provide theoretical basis for the further clinical application of therapeutic communication. Methods To adopt phenomenology method of qualitative research, collecting data by the direct participation, observation, half structural formula thorough interview and other methods. To establish coding and refine theme. Results Four themes of the rectal cancer patients experience of perioperative therapeutic communication were generalized: emotional adaptation, actively coping with surgery, intraoperative cooperation, postoperative rehabilitation and self-care. Conclusions Application of therapeutic communication system can effectively interfere with patients cognitive behavior, improve communication ability of nurses and extended the nursing service connotation.

Forty cases of bronchial asthma were treated by comprehensive methods of acupuncture, ear-embedding and acupoint-injecting. Thirty-six cases were treated by single body acupuncture and 38 cases were treated by herbal medicine for comparison. The therapeutic effects were analyzed among the three groups. The total effective rate was 95.0% in the comprehensive group, 80.6% in the single acupuncture group and 73.7% in the herbal medicine group, with a significant difference (P＜0.05) among the three groups. The combined use of acupuncture, ear-embedding method and acupoint-injecting method were better than single acupuncture and herbal medicine in the treatment of asthma.

Objective To investigate operative methods and indications for the surgical repair of hypospadias. Methods Clinical data of 91 cases of hypospadias repaired in this hospital between 1997 and 2003 were retrospectively analyzed. Results Postoperative urethral fistula took place in 15 cases, with an overall incidence of 16 5% (15/91), including 6 cases treated by Duckett procedure, 4 cases treated by Duckett combined with Duplay procedure, 1 case treated by Mathieu procedure, 2 cases treated by scrotal island flap procedure (Onlay procedure), 1 case treated by Denis-Browne procedure, and 1 case treated by Snod-grass procedure. Conclusions For patients with hypospadias associated with serious chordee, because the urethral plate can not be preserved, adaptable methods should include scrotal island flap procedure, Duckett procedure, or Duckett procedure combined with Duplay procedure. Urethral plate conserving operations are suitable for hypospadias without chordee or with mild chordee, involving the Mathieu procedure, Onlay procedure, Snod-grass procedure and Denis-Browne procedure.

Objective To investigate haemodynamic change during hemodialysis and analyze effects of cardiac index (CI) on hemodynamic parameters and associated influencing factors in maintenance hemodialysis (MHD) patients.Methods Seventy-five patients bearing an arteriovenous fistula (AVF) entered the study.Cardiac output (CO),cardiac index (CI),central blood volume (CBV) and peripheral vascular resistance (PR) were determined by ultrasound dilution technique at the end of 1 hour,2 hours and 3 hours of dialysis.AVF blood flow (Qa) was also measured with the same device before haemodynamic parameters investigation.Results Mean age of patients was (55.84 ±12.39) years old (range 21-81 years) and 43 patients (57.3％) were female.Systolic arterial pressure,SV,CO,CI and CBV were significantly declined and no significant change for diastolic arterial pressure and heart rates at the end of 2 hour and 3 hour hemodialysis,whereas PR was increased gradually during hemodialysis.Patients were divided into there groups with CI less than 2.5 L·min 1·(m2)-1,2.5-4.2 L·min-1·(m2)-1 and more than 4.2 L·min-1 ·(m2)-1 at the end of 1 hour dialysis.Statistically significant decreasing SV,CO and increasing PR were detected in patients with CI＜2.5 L·min-1· (m2)-1 and 2.5-4.2 L· min-1· (m2)-1,compared with CI＞4.2 L·min-1· (m2)-1 group (P＜0.01).The hemodynamic change was the most obvious in the group of CI less than 2.5 L· min-1· (m2) 1,and no significant changes happened in CI＞4.2 L·min-1 ·(m2)-1 group.Some factors were found to be associated to CI values.Qa and systolic arterial pressure had positive relationship with CI,while age and diabetes had negative relationship with CI.Conclusions Systolic arterial pressure,CO,CI and CBV decrease and PR increases during hemodialysis.Obvious change occurs when CI is less than 2.5 L·min-1· (m2)-1.CI is associated with Qa,systolic arterial pressure,age and diabetes.

Objective To explore the expression and clinical significance of constitutive androstane receptor(CAR)in placenta syntrophoblast from patients with intrahepatic cholestasis of pregnancy(ICP).Methods Placenta were collected from women with ICP who delivered from April 2009 to March 2010 in First Affiliated Hospital of Chongqing Medical University.According to the severity of ICP,patients were classified into mild ICP group(n=10)and severe ICP group(n=10).Ten healthy pregnant women who delivered in the same period were chosen as control group.The location of CAR protein in placenta was studied by immunohistochemical streptavidin-biotin complex(SABC)method.CAR mRNA level was determined by reverse transcription(RT)-PCR technique and CAR protein expression level was determined by western blot.Results(1)CAR was located in the placenta syncytiotrophoblastic cells in control group and mild ICP group,showed light tan when stained,and was mainly in the cytoplasm.In severe ICP group,CAR was also located in placenta syncytiotrophoblastic cells but mainly in the nucleolus,showed dark tan when stained.(2)The mRNA expressions of CAR in control group,mild ICP group,severe ICP group were 0.06 ±0.03,0.07 ±0.03 and 0.56±0.03.respectively.CAR in severe ICP group was significantly higher than those in control group and mild ICP group(P＜0.05).The difference of mRNA between control group and mild ICP group wag not statistically significant(P＞0.05).(3)The CAR protein levels in control group,mild ICP group,severe ICP group were 0.74±0.03,0.79±01 03 and 1.02±0.04,respectively.CAR protein expression in the severe ICP group was significantly higher than the other two groups(P＜0.05).And there was no statistical significance between mild group and control group(P＞0.05).Conclusion In ICP women.especially severe ICP patients,the CAR expression in placenta syncytiotrophoblastic cells increased appreciably,which may be involved in the maintenance of placenta barrier function and protection in ICP pathogenesis.

Objective To analysis the clinical and pathological features, results of laboratory tests and prognosis of nephrotic syndrome (NS) in patients with non-heamatological maligancy. Methods The data were collected from 25 patients who presented with NS around the diagnosis of non-heamatological malignancy. Results Twenty-five cases were investigated (age: (56.6±17.7) years; male/female ratio: 20/5). Malignancy and NS occurred within one year in 92% patients. There was a wide distribution of malignancy with involvement of 36% in digestive system and 20% in respiratory system. Ten patients (40%) presented with NS as their initial manifestation. Heamaturia appeared in 67% patients and acute renal insufficiency was complicated in 12% cases before treatments. Some other non-specific laboratory tests were found including elevated serum gamma-globulin in 50% and anemia not related with renal failure in 28% cases. Membranous nephropathy was the most common pathological changes in 67% cases. Although NS still continued for several weeks in 8 of 9 cases after surgery and/or chemical therapy, glucocorticoids was helpful to achieve the remission in these patients. However, no remission was achieved in patients without the treatment for malignancy. Conclusion Malignancy may present with NS as its initial manifestation. It should be inspected routinely and regularly in elder patients with NS, especially in those with membranous nephropathy, as well as gamma-globulinemia and anemia.

Hepatic nodules in patients with Budd-Chiari syndrome (B-CS) are identified in clinical work and the differentiating diagnosis is very important for making the treatment strategy.Most B-CS patients with hepatic nodules have nonspecific clinical manifestations.Ultrasonography,computed tomography and magnetic resonance imaging are often used for differentiating diagnosis.According to the results of retrospective study on clinical and imaging data of 51 B-CS patients with hepatic nodules,we draw a conclusion that the differentiating diagnosis of hepatic nodules in patients with B-CS depends on imaging characteristics.Different treatment strategies are adopted according to the comprehensive analysis of these imaging data and satisfactory results can be achieved.

Purpose To investigate the correlation of Dock180 and miR-31 expression in breast cancer cells,and to observe the effect of miR-31 on the invasion of breast cancer cells by Dock180.Methods MiR-31 was transfected into breast cancer cells by liposome transfection technique.The actual binding site of miR-31 to the 3'-untranslated region of Dock180 was confirmed through luciferase assay.Western blot was performed to detect the expression of Dockl80 and other related proteins.Real-time PCR was used to measure the expression of Dock180.Matrigel invasion were performed to detect the invasion of breast cancer cell lines with miR-31 increased.Resuits The protein levels of Dock180 in breast cancer cell lines negatively correlated with miR-31 expression,and Dock180 was directly targeted by miR-31.Dock180 downregulation and miR-31 overexpression reduced breast cancer cells invasion.Conclusion Dock180 modulated by miR-31 plays an important function in breast cancer cell lines invasion.