Objective To investigate the risk factors of worsening renal function (WRF) in patients with chronic heart failure ( CHF) and WRF influence on prognosis. Methods A case-control study were undertaken to analyze independent risk factor statistically related to incidence of WRF, and to assess the influence of WRF on prognosis. Results The independent predictors of WRF were creatinine level at admission (OR 2.248,95% CI 1.088-4.647, P = 0.029) and NYHA class on admission ( OR 2.485, 95% CI 1.3854. 459, P = 0.002). The mortality of patient with WRF was obviously higher than that of control group during hospitalization( OR 3. 824,95% CI 2. 452-5. 637 ,P ＜0.015). Conclusions WRF is a common complication among patients hospitalized for CHF, and is obviously associated with mortality during hospitalization. Higher creatinine level and weak heart function are independent risk factors for incidence of WRF of patients with CHF.

Objective:To explore the causes and preventive measures of early complications after free gracilis muscle transfer in reconstruction of brachial plexus injury, and to improve the postoperative function of the transferred gracilis muscle.Methods:Patients were recruited from August, 2005 to December, 2016. All 111 patients of brachial plexus injury underwent reconstructive surgery using 122 free gracilis flaps. Early postoperative complications, including recipient site, donor site and systemic complications, were closely observed and recorded. Outcome measurements included incidence and timing of flap compromise, type of flap compromise, causes of vascular occlusion and salvage rate. The postoperative strength of gracilis was evaluated according to the BMRC score. The data were statistically analyzed. The difference was statistically significant if P<0.05. Results:The survival rate of 122 free gracilis transfers was 98.4% (120/122). Early complications occurred in 32 cases (including 2 complications in 6 patients) : 27 cases with recipient site complications (84.4%), 4 with donor site complications and 7 with systemic complications. Among the 32 cases of complications, 17 flap compromises caused by vascular obstruction and 15 of them were salvaged completely after exploration. Flap crisis was the main issue that affected the postoperative function of gracilis muscle, and 58.8% (10/17) of patients with vascular crisis showed muscle strength above M 3 after surgery. The main causes of vascular crisis were venous tortuosity and venous thrombosis, which had nothing to do with operation time and intraoperative blood loss. Conclusion:Flap crisis is the main factor affecting the postoperative function of gracilis. The rate of flap salvage can be tremendously increased by early detection, re-exploration and effective management of the flap crisis.

Objective: To study the expression of CD138 in normal cervical mucosal tissue,cervical intraepithelial neoplasia ( CINⅠ/Ⅱ and CINⅢ) and cervical squamous cell carcinoma.And to investigate the clinical pathologic significance of CD 138 expression with lymph node metastasis , microvascular density ( MVD ) , CD68 expression and clinical stage in cervical squamous cell carcinoma.Methods:To detected the expression of CD 138 in 120 cases of cervical squamous cell carcinoma ,106 cases of CINⅢ,14 cases of CINⅠ/Ⅱand 54 cases of normal cervical mucosa tissues.Results: The expression of CD138 was lowest in cervical cancer tissue,followed by normal cervical mucosal tissue ,CIN I/II and CINIII,that there had significant difference (P<0.001).The expression level of CD138 was higher in without lymph node metastasis group than in lymph node metastasis group ( P<0.05 ).In cervical cancer , the expression level of CD 138 was higher in early stage ( stage 0 andⅠ) than in advanced stage (Ⅱ) ( P<0.001 );and higher in CD68 expression negative group than in positive group (P<0.05).Furthermore,MVD was higher in CD138 expression negative group than in positive group ( P<0.05 ).Conclusion: CD138 play an important role in the process of development of cervical squamous cell carcinoma,especially for the role of lymph node metastasis is more obvious.CD138 could be used as a indicators for determinate the process of progress in cervical squamous cell carcinoma.

Early exercise training after stroke is a therapeutic strategy that has been paid w idespread attention. A series of studies found that early exercise training after stroke can increase expression of neurotrophic factors and maintain the integrity of the blood-brain barrier by inhibiting acute neuroinflammation and apoptosis, and reduce brain damage. This artice reviews the neuroprotective roles of early exercise training after stroke and their possible molecular mechanisms.

Objective To synthesize 4 kinds of 111 In?TPP cations and evaluate their properties as tumor cationic radiotracers in vivo and in vitro. Methods DO3A?xy?TPP, DO3A?xy?mTPP, DO3A?xy?dmTPP and DO3A?xy?tmTPP were radiolabeled with 111 In;their lipid?water partition coefficients and in vivo and in vitro stability were evaluated. The binding affinities of 4 kinds of 111 In?radiotracers were determined in cell uptake and cell efflux assay using U87MG tumor cells. Biodistribution studies and γ imaging studies were performed using the athymic nude mice bearing U87MG human glioma xenografts to explore the biologi?cal properties of 4 kinds of 111 In?radiotracers. One?way analysis of variance was used. Results The labeling yields of 4 kinds of 111 In?radiotracers were all above 85%, and the radiochemical purity were all greater than 99% after purification. Binding assay in U87MG cells showed that 4 kinds of radiotracers had great binding affinity and cell retention ability, and 111In?DO3A?xy?mTPP had the best binding ratio (1?49%;F=177.8, P<0.05) . Gamma imaging and biodistribution results showed that the U87MG tumors could be clearly visualized by 111In?DO3A?xy?mTPP, 111In?DO3A?xy?dmTPP and 111In?DO3A?xy?tmTPP, and the liver uptake of the 3 tracers was lower than that of 111In?DO3A?xy?TPP. In particular, 111In?DO3A?xy?mTPP had the best tumor/liver ratio (0.13±0.05, 2 h postinjection;F=9.4, P<0?05). Conclusions The tumor?targeted ability of 111In?DO3A?xy?mTPP is better than those of 111In?DO3A?xy?dmTPP, 111In?DO3A?xy?tmTPP and 111In?DO3A?xy?TPP, suggesting that it has the potential to be a promising tumor cationic radiotracer.

Objective To observe the curative effect of cervicogenic headache(CEH)treatment through the combination of pulse radio frequency(PRF)on the C2 dorsal rootganglion and continuous epidural space block.Methods Sixty patients with CEH in our hospital were randomly divided into groups A and B,30 cases in each group.The group A was treated with combination of PRF on cervical dorsal root ganglion and continuous epidural space block.The group B was treated with PRF on cervical dorsal root ganglion method.The pain VAS scores before treatment and at 1 week,3,6 months after treatment were compared between the two groups.Results Compared with pretreatment,the VSA scores at 1 week,3,6 wonths after treatment in the two groups had statistical difference(P＜0.05),moreover,the VAS score decrease in the group A was better than the group B.All the patients had no nerve and artery injury or infection complications.Conclusion It is safe and effective to treat cervical CEH through the combination of ganglion PRF on the cervical 2 dorsal root and continuous epidural space block.

Objective To study clinical features, treatment and prognosis of nasal NK/T cell lymphoma associated Hemophagocytic Syndrome (HPS).Methods Retrospectively analysis method was used to analyze the clinical data of 3 patients with nasal NK/T cell lymphoma associated HPS. Results 3 patients with nasal NK/T cell lymphoma fulfilled the criteria of HPS. All patients had adverse prognostic factors of lymphoma.1 patient developed HPS as the main primary manifestations of underlying lymphoma,the other 2 patients developed HPS during lymphoma progression. In three cases, bone marrow was infiltrated with lymphoma cells.When HPS occurred,the disease progressed rapidly.The most obvious clinical features were fever,pancytopenia,hypofibrinogenemia,hyperferritinemia,and hemophagocytosis in bone marrow. After being treated according to the HLH-2004 combined with chemotherapy, all patients showed a clinical response,but with the progression of lymphoma,HPS quickly relapsed,and all patients died of severe hepatic dysfunction,coagulopathy,or DIC.Conclusion Nasal NK/T lymphoma associated HPS is an invariably fatal disease with poor prognosis,typically occurring at advanced stage or the terminal phase of the disease.HLH-2004 based protocol in combination with chemotherapy is helpful for nasal NK/T cell lymphoma associated HPS,which may delay disease progression and provid opportunities for the treatment of primary disease.

Objective To explore the initial effects of the treatment of proximal femoral nail-helical blade (PFNA) in elderly patients with intertrochanteric fracture of the incomplete lateral wall type. Methods A total of 25 patients were enrolled in this study including 8 cases of type A2, 17 cases of type A3 according to AO classification. All patients under-went three-dimensional CT scan. In all patients with type A2 fracture, there were 6 cases with coronal plane fracture on the greater trochanter, and PFNA was used instead of DHS when an iatrogenic fracture occurred in 2 patients. All other patients were treated with closed reduction and fixed with PFNA. Results All patients healed and the average healing time was 11 weeks, one patient fell down once again and the fracture occurred on the shaft, when a long PFNA was used, both of the frac-tures healed 14 weeks after surgery. In all of the 25 patients,1 patient died due to cerebral hemorrhage 13 months after sur-gery;2 patients needed walking aids due to the presence of osteoarthritis of the knee and calf muscular venous thrombosis was diagnosed in 3 cases. No complications were found in the other patients, such as infection, nonunion and fixation failure. According to the Harris hip score system, there were 14 cases of“excellent”,8 cases of“good”,2 cases of“fair”and1 pa-tient of“poor”.Conclusion The PFNA treatment can provide a good fixation for intertrochanteric fractures of incomplete lateral wall type, which allow patients to do exercise early and achieve an excellent initial outcome.