Background The clinical efficacy and safety of mouse nerve growth factor(NGF) for injection have been evaluated by Ⅰ,Ⅱ,Ⅲ stage of clinical trials.But as a clinical drug,its adverse effects for special population should been further studied.Objective This clinical trial was to observe and assess the safety and tolerability of mouse NGF for injection during the application in juvenile and elder patients with optic nerve damage.Methods A multicenter non-randomized controlled trial for the safety evaluation of mouse NGF injection solution was performed in 100 eye centers in China.This study protocol was approved by the Ethic Committee of each drug research center,and written informed consent was obtained from the subject,legal mandatary and guardian prior to this study.Total 2046 patients who met the included criteria of optical nerve damage were enrolled.The patients were divided into the juvenile group(90 cases,＜ 18 years),youth-middle-age group (1868 cases,1 8-75 years) and older group(88 cases,＞75 years).Mouse NGF(30 μg)was intranuscularly injected once per day for 21 days in all the patients.Systolic and diastolic blood pressure,heart rate,intraocular pressure (lOP),laboratory examinations of blood and urine,blood biochemical indexes were recorded before and after injection.All adverse events were evaluated after administration of drug.Results There were 189 (189/2046,9.23％)dropped out cases,including 184 lost cases after 3 weeks of treatment and 5 withdrew cases from adverse responses of drug,with a shedding rate ＜10％ in each group.Total 1857 individuals finished this trial.No significant differences were found in the IOP,heart rate and blood pressure between before and after admninistration of grug in the juvenile group,youth-middle-age group and older group (P＞0.05).The incidence rate of the adverse response in the juvenile group,youth-middle-age group and older group was 57.78％,68.18％,60.01％ respectively,and the primary local adverse events were pain(48.89％),redness and swelling(59.09％),duration(54.49％),without significant difference in the rate of local adverse events among the three groups(X2 =2.302,P =0.324).The abnormal rates of laboratory results of blood and urine were not significantly different among the three groups(all at P＞0.05).The percentage of impaired fasting glucose was 7.46％,23.73％and 7.79％ in the juvenile group,youth-middle-age group and older group,respectively,and the percentage in the older group was higher than that in the juvenile group and the youth-middle-age group (x2 =8.685,P =0.005 ;x2 =27.720,P =0.000).Conclusions Injection of mouse NGF is well tolerated in juvenile and elder patients over the age of 75 years.

Objective To study the characteristics and diagnosis of renal sinus lipomatosis (RSL) complicated with renal staghorn calculi, and report our preliminary experience on percutaneous nephrolithotripsy for the disease. Methods A total of 547 patients with complex renal calculi were admitted to our hospital from January 2005 to June 2007. In 2 of them, RSL complicated with renal staghorn calculi was diagnosed by B-ultrasonography, CT, and MRI. Both the patients were female, aged 42 and 82 years respectively. B-ultrasonography-guided percutaneous nephrolithotripsy was performed on the two patients without removing the kidneys.Results Totally, 7 ml and 5 ml of stones were removed respectively from the two patients by percutaneous nephrolithotripsy. No retained calculi were found by KUB performed one week postoperation. Biopsy of the submucosal fat obtained from the renal pelvis during the operation showed hyperplasia and fibrosis of fatty tissues and inflammatory effusion. The patients were followed up for half a year, during which no recurrence of renal calculi occurred, and no abnormal fatty tissues were found at the renal sinus or surrounding the kidney. Conclusions Imaging examination is valuable for the diagnosis of RSL. B-ultrasonography-guided percutaneous nephrolithotripsy is safe and effective for RSL complicated with renal calculi.

Objective To evaluate efficacy and therapeutic satisfaction of novel analogue glargine combined with repaglinide in type 2 diabetic patients(T2DM) after switching from the most frequently used twice daily injection of premixed insulin(Humulin 70/30 30% rapid acting and 70% NPH before meals).Methods 18 patients with T2DM whose blood glucose control was poor receiving twice daily premixed insulin had been switched to receive a once daily injection of glargine together with repaglinide and biguanides(metfomin) or TZDS(reglitazone) was continued if it was taken to relieve insulin resistance.After 16 weeks the blood glucose concentrations and HbA1c levels were detected and hypoglycemia was reported.Results At the time of post-16week after the switch,fasting blood glucose access to normal;blood glucose fluctuation relieved and HbA1c levels decreased(from 7.84?0.21 to 6.52?0.13).Symptomatic hypoglycemia decreased.Conclusion These results indicate that insulin glargine combined with repaglinide can be replaced from the twice daily premixed insulin injection regiment for the T2DM even with poor glucose control.

[Objective]To investigate the indications,complications and mid-term results of total knee arthroplasties using rotating hinge knee prosthesis. [Methods]Thirty total knee arthroplasties using rotating hinge prosthesis were performed in twenty-eight patients from July 1998 to July 2008.Seven patients were male and twenty-one patients were female.The average age was 62 years(42-75 years).The diagnosis included osteoarthritis in 8 patients,rheumatoid arthritis in 2 patients,traumatic arthritis in 3 patients,Paget's disease patient,serious genu valgum in 7 patients and 10 failure TKAs.All patients were followed up for 12 to 120 months.The patients were evaluated according to knee score system and the complications were observed.[Results]The pain was relieved and function was improved in all knees.The average knee pain score increased from 19.5 to 77.9,and knee function score from 22.5 to 50.5.Range of motion of knees increased from 58.4?to 72.8?.No revision was needed in all patients,The complications included anterior knee pain(8 cases),extension lag(5 cases),prosthesis broken(1 case) and patella tendon rupture(1 case).[Conclusion]The mid-term results of total knee arthroplasty using rotating hinge knee for severe knee deformity are satisfactory.Complications should be prevented carefully.

Objective To analyzed distribution characteristics of gene mutation and gene carrying rate of thalassaemia in Shenzhen.Methods 2 500 cases with adult,neonatal umbilical cord blood of 2 500 cases for alpha thalassaemia,beta thalas-saemia,gene types and carry frequency were analyzed.Results 8 types of alpha thalassemia gene 128 cases,rate of detection was 5.12% (128/2 500),and the main genetic types were-SEA/αα(54 cases,42.19%),-SEA/-α3.7 (32 cases,25%)respec-tively.2 500 cases of adult samples were checked out 7 types of gene mutation 101 cases,and detection rate was 4.04%(101/2 500).Main gene mutation type were CD41-42 (39 cases,38.61%),IVS-2-654 (20,21 cases,79%),CD17 (18 cases, 17.82%)and-28 (13 cases,12.87%)respectively.Conclusion Shenzhen thalassaemia mutation type and frequency had ob-vious regional characteristics and times characteristics,health authorities should strengthen epidemiology study,formulate corresponding prevention and intervention measures.

Objective To evaluate the value of enhanced CT scan in differential diagnosis of thyroid neoplasm.Methods 27 cases of thyroid neoplasm including 18 cases of thyroid adenoma and 9 cases of thyroid papillary carcinoma proved by operation and pathology were retrospectively analyzed.Results In 18 cases of thyroid adenoma,there were 12 cases with well defined enhanced ring and 6 cases with enhanced nodule in adenoma.In 9 cases of thyroid papillary carcinoma,there were no complete enhanced ring on the wall,and 4 cases with enhanced nodule on the wall,there were 7 cases with fine granular or plague like calcifications and 4 cases with sign of surrounding structures involved.Conclusion In CT diagnosis of thyroid neoplasm,enhanced scan is necessary for characterization of the tumors.Invasion of surrounding structures is a characteristic sign of malignancy.Nodules enhancement of the tumor wall accompanied with granular calcification is the signs of thyroid papillary carcinoma,tumor sharp wall is the sign of adenoma.

Objective:To evaluate the correlation between the polysomnographic findings and the degree of obstruction caused by adenoid and tonsillar hypertrophy in children with clinical history of apnea. Method: Retrospectively studied the children who were diagnozed clinically of, obstructive sleep apnea hypopnea syndrome(OSAHS) and underwented polysomnograph and endoscopy. Patients were divided nto OSAHS and non-OSAHS group according to polysomnographic findings. Result: Ninty-four children were involved in the study population, and 63 children of them were male. The mean age of the children at the time of inclusion in the study was 6.7 years. 36 children(38.3%) diagnosed OSAHS clinically had normal polysomnographic findings. No differences were found between children with PSG-documented OSAHS and others. Tonsillar and/or adenoid hypertrophy were not correlated to more severe apnea among enrolled children. Conclusion-There was no significant correlation between polysomnographic and clinical findings in children with OSAHS.

Objective To investigate the effect of minimally invasive surgery in patients with midge-upper advanced gastric cancer (AGC). Methods 167 patients with middle-upper AGC underwent total gastrectomy+D2 lymph node dissection from January 2009 to December 2013 were enrolled in the study and divided into laparoscopic assisted total gastrectomy (LATG) group (n = 57) and open total gastrectomy (OTG) group (n = 110). Baseline data, operative, postoperative data and follow-up result were compared between the two groups. Results There were no significant differences in baseline data between the two groups (P > 0.05); The intraoperative blood loss and incision length in LATG group were significantly lower than that in OTG group (P < 0.05). There were no significant differences in operation time, ratio of intraoperative blood transfusion, distance between the upper margin and the tumor, the number of lymph node dissection between two groups (P > 0.05); Postoperative first aerofluxus time, ecovery liquid diet time, postoperative hospitalization days and VAS score of pain in 3 d after operation in LATG group were significantly lower than that in OTG group (P < 0.05). There was no significant differences in incidences of postoperative complication between two groups (P > 0.05); There was no patient dying within 30 d after surgery.The median follow-up time was 38.2 months (1~58 months). Postoperative 1, 3 year overall survival rates in LATG group and OTG group were 87.7% and 83.6%, 71.9% and 64.5%, and there were no significant differences between the two groups (P > 0.05). Conclusion For patients with middle-upper AGC, LATG+D2 lymph node dissection has lots of advantages including less intraoperative blood loss, shorter incision, faster postoperative recovery, shorter hospital stay and so on, which is safe and effective, and their short-and long-term results are satisfactory.

Objective To compare different blood purification techniques on serum fibroblast growth factor 23(FGF -23)scavenging effect in patients undergoing maintenance hemodialysis (MHD),in order to choose the best blood purification method for clinical maintenance hemodialysis patients.Methods 60 MHD patients were randomly divided into hemodialysis group (HD),hemodiafiltration group (HDF)and HD +HP group,20 cases in each group. Three groups of patients in the observation 1st start of treatment and observation at the end of the last treatment were detected cacium,phosphorus,FGF -23,intact parathyroid hormone(iPTH).Results After treatment,HD group and HDF group,Ca:t =0.29,P =0.77;P:t =1.65,P =0.11;iPTH:t =16.85,P =0.00;HD group and HD +HP group:Ca:t =0.20,P =0.84;P:t =2.62,P =0.01;iPTH:t =42.64,P =0.00;HDF group and HD +HP group:Ca:t =0.09,P =0.92;P:t =2.18,P =0.04;iPTH:t =31.41,P =0.00.After treatment,FGF -23 in the three groups were decreased significantly than before treatment,and the HD +HP group decreased most significantly(HD group and HDF group,t =4.47,P =0.00;HD group and HD +HP group:t =8.06,P =0.00;HDF group and HD +HP group:t =3.20,P =0.00).Conclusion HD +HP treatment can effectively remove phosphorus maintenance dialysis patients and FGF -23.

Objective　To evaluate the effect of palliative resection of advanced primary hepatocellular carcinoma (PHCC). Methods　98 patients with advanced PHCC were divided randomly into two groups in our hospital from March 1996 to Jan. 2000:(1) Therapy group (49 cases), dealt with palliative resection of liver cancer and implanted with a drug delivery system (DDS). (2) Control group (49 cases), only implanted with DDS. Results　In therapy group and control group, The decline rate of AFP was 60.0% and 31.7% respectively (P<0.05); and the survival rates of 0.5, 1, 3 　years after operation were 85.7% 　(42/49), 60.5%(23/38), 45.4%(10/22) and 　67.3%(33/49), 32.5%(13/40), 　10%(2/20) (P<0.05). Conclusions　Palliative resection of liver cancer can improve survival duration and life quality of patients with advanced HCC.