Objective To observe the effect and safety of low dose milrinone used in patients suffering from refractory heart failure and renal dysfunction. Methods Forty-two patients with refractory heart failure and renal dysfunction were divided into treatment group(21 cases ) and control group(21 cases )by random digits table. All the patients accepted a therapy of cardiac booster, diuretics and vasodilators, and treatment group also accepted the therapy of milrinone [0.375 μ g/( kg· min), 10 mg/d, for 7 days]. And then the symptom, signs, blood pressure, heart rate, heart function and renal function before and after the treatment were observed. Results The total effective rate in treatment group was 85.7%( 18/21 ) ,significantly higher than that in control group [57.1% (12/21)] (P ＜0.05＝. After treatment,the heart rate,systolic blood pressure,diastolic blood pressure,stroke volume,cardiac output and left ventricular ejection fraction in treatment group and control group improved significantly than those before treatment, and these index improved better in treatment group [(79.3 ± 12.4) beats/min vs. (85.4 ± 10.2) beats/min, ( 107.6 ± 15.4)mm Hg ( 1 mm Hg = 0.133 kPa) vs.( 119.1 ± 13.5 ) mm Hg, (60.8 ± 9.4) mm Hg vs. (65.8 ± 8.5 ) mm Hg,(66.3 ± 10.2 ) ml vs. (61.2 ± 9.3 ) ml, (5.3 ± 0.6 ) L/min vs. (4.8 ± 0.9) L/min, (56.6 ± 8.4 )% vs. (48.9 ±7.3)% ,P ＜ 0.05＝. In two groups,there were no statistical difference in renal function. Conclusions Low dose of milrinone can improve the heart function of the patients with refractory heart failure and renal dysfunction and has good renal safety.

Objective:To observe the efficacy of calcitriol combined with calcium receptor agonist therapy in patients with chronic renal failure-secondary hyperparathyroidism (CRF-SHPT) and its serum β2-Effects of β2-microglobulin ( β2-MG) and fibroblast growth factor-23 (FGF-23) levels. Methods:A total of 86 patients with CRF-SHPT who were admitted to the Department of Nephrology, Huzhou Hospital of Traditional Chinese Medicine, Zhejiang University of Traditional Chinese Medicine from Mar. 2020 to Mar. 2022 were included. Triol treatment) , combined treatment group (43 cases, calcitriol + calcium receptor agonist treatment) , the treatment effect was evaluated, and the serum phosphorus (P 3-) , serum calcium (Ca 2+) , ,and serum levels were measured before and after treatment intact parathyroid hormone (iPTH) , β2-MG, FGF-23 and renal function, blood lipid index levels, the occurrence of adverse reactions during the administration period, the measurement data were compared between groups using independent samples t test, count Comparison of data between groups was performed using the χ2 test. Results:The total effective rate (90.70%) in the combined treatment group was significantly higher than that in the control group (72.09%) ( χ2=4.91, P=0.027) ; the levels of P 3- and iPTH in the combined treatment group after treatment [ (220.16±23.76) ng/L, (1.22±0.14) mmol/L] were significantly lower than the control group [ (301.25±31.71) ng/L, (1.64±0.18) mmol/L], and the Ca 2+ level in the combined treatment group was significantly higher (2.59±0.41) mmol/L. Compared with the control group (2.26±0.34) mmol/L ( t=13.42, 12.08, 4.06, P=0.000, 0.000, 0.0000) , the serum levels of β2-MG and FGF-23 in the combined treatment group after treatment [ (34.67±4.12) mg/L, (71.36±8.05) ng/L] were significantly lower than the control group [ (40.36±4.87) mg/L, (78.97±8.73) ng/L] ( t=5.85, 4.20, P=0.000, 0.000) ; After treatment, the levels of triglyceride (TG) and total cholesterol (TC) in the combined treatment group [ (1.51±0.19) mmol/L, (4.11±0.51) mmol/L] were significantly lower than those in the control group[ (1.74±0.24) mmol/L, (4.75±0.59) mmol/L] ( t=4.93, 5.38, P=0.000, 0.000) ; Serum creatinine (Scr) , blood urea nitrogen (blood urea) in the two groups after treatment. There was no significant change in nitrogen) levels ( P>0.05) ; there was no significant difference in the incidence of adverse reactions between the combined treatment group and the control group during the treatment period ( P>0.05) . Conclusion:The treatment of CRF-SHPT patients with calcitriol combined with calcium receptor agonists can effectively reduce the iPTH level, improve the calcium-phosphorus imbalance and lipid metabolism disorder, and down-regulate the serum FGF-23 and β2-MG levels without damaging renal function of the residual of the patients.

Objective:To evaluate the efficacy and prognostic factors of 125I seeds implantation for primary hepatocellular carcinoma. Methods:From December 2011 to January 2021, 102 primary hepatocellular carcinoma patients (86 males, 16 females; median age 61 years) who underwent 125I seeds implantation from 5 hospitals in China were enrolled in this retrospective study. Local progression-free survival (LPFS), overall survival (OS) and the prognostic factors were analyzed. Kaplan-Meier method was used to draw the distribution curve of survival time, and LPFS rate and OS rate were calculated. Log-rank test and Cox regression were used to analyze the influencing factors of survival. Results:The median follow-up time was 38 months until April 2021. The local control rate was 96.1%(98/102). The 1-, 3- and 5-year LPFS rate were 61.3%, 25.5% and 12.7%, and the 1-, 3- and 5-year OS rate were 73.9%, 39.1% and 22.6%, respectively. There were 75 patients with progressive disease, including 42 patients with intrahepatic recurrence and metastasis after seed implantation, and 55 patients died. Multivariate analyses showed that short-term efficacy complete response (CR) (hazard ratio ( HR)=0.34, 95% CI: 0.20-0.58) was protective factor related to LPFS; short-term efficacy CR ( HR=0.25, 95% CI: 0.13-0.47) was the protective factors related to OS; Barcelona clinic liver cancer (BCLC) C stage ( HR=2.33, 95% CI: 1.27-4.27), intrahepatic progression and extrahepatic metastasis ( HR=3.18, 95% CI: 1.28-7.86; HR=3.23, 95% CI: 1.27-8.21) were independent risk factors related to OS. No sever adverse effects were observed. Conclusions:125I seeds implantation is safe and effective for the treatment of primary hepatocellular carcinoma. BCLC stage, short-term efficacy and post-implantation progression are independent factors related to survival time.

To summarize professor 's own experience on the acupuncture sensation. Professor puts forward his opinion through the sensation of acupuncture on himself, from the aspects of the expression, the material basis, the distinction and the clinical significance of acupuncture sensation, etc. Professor thinks that the production and conduction direction of acupuncture sensation have their material basis and objectively exist, based on which, professor puts forward the amount of acupuncture stimulation and the total amount of acupuncture stimulation. Professor believes that the amount of acupuncture stimulation is the main basis for the individual reinforcing and reducing of acupuncture. The amount of acupuncture stimulation is related to the depth and intensity of acupuncture, the time of the needle retention, the number of needles, etc. The reinforcing and reducing of acupuncture are relative to the deficiency and excess of the disease, and they are the reaction of acupuncture for body. The tolerance degree of the individual to the stimulation of acupuncture is also the main factor affecting the reinforcing and reducing.