0.05).Conclusion The local relapse rate and the survival rate within 3 years has no significant difference between patients with lower rectal cancer of Duck stage A after sphincter-preserving surgery and Miles surgery.

Objective:To explore the effect of red blood cell distribution width (RDW) on long-term follow-up study in patients with acute pulmonary thromboembolism (APE).
Methods:A total of 214 consecutive patients with the first episode of APE admitted in our hospital from 2009-01 to 2012-12 were enrolled. The patients were divided into 2 groups:RDW≤15%group, n=202 and RDW>15%group, n=12. Baseline RDW was measured at admission, the follow-up study was conducted at 3, 6, 12 months thereafter, and then at once per year. The major primary end point was chronic thromboembolic pulmonary hypertension (CTEPH). The independent predictor for CTEPH occurrence was studied by uni-and multivariate logistic regression analysis and the predictive capability of RDWwas evaluated by ROC curve.
Results: All patients ifnished the follow-up study at the mean of (31±17) months. The overall occurrence rate of CTEPH was 7.5% (16/214), which was higher in RDW>15% group than that in RDW≤15% group (33.3% vs 5.9%, P=0.002). Multivariate logistic regression analysis indicated that with adjusted clinical data and other predictors, RDW>15%was still the strong predictor for CTEPH occurrence (OR=7.916, 95%CI 1.474-42.500, P=0.016). Adding RDW to the evaluating model, the predictive capability could be signiifcantly improved by ROC curve (AUC increased from 0.856 to 0.901, P<0.01).
Conclusion: Elevated RDW is the independent predictor for CTEPH occurrence in APE patients, which is helpful to estimate the prognosis and treatment strategy in APE patients.

Objective To study the prevention and cure effect of immunoregulation therapy on postoperative infectious complications of calculous obstructive jaundice.Methods Prospective,randomized,blind and controlled clinical analysis of 40 patients conforming to the standard of calculous obstructive jaundice was carried out.The patients were divided into two groups at random.One was control group (n=20) with regular therapy,and the treatment group (n=20) with ulinastatin plus thymosin-α1 on the base of regular therapy for 1 week.The immunological indexes were determined before and after therapy on the 1st,3rd,5th、7th and 14th day,including the changes in lymphocyte count,CD14+ monocytes human leukocyte antigen (locus) DR (HLA-DR),and the incidence of postoperative infection were observed.Results The incidence of postoperative infectious complications in treatment group (10％) was remarkable lower than that in control group (30％,P＜0.01).There was significant difference between two groups (P＜0.05).After the 3rd,up to 14th day of therapy,the counts of lymphocyte and CD14+ monocytes HLA-DR were significantly higher than those in control group (all P＜0.05).Conclusions Immunoregulation therapy can improve the prognosis of obstructive jaundice patients in a period of 14 days of observation,and lymphocyte counts and CD14+monocytes HLA-DR were increased significantly,showing that immuno suppression can be ameliorated.Immunoregulation therapy could effectively prevent infectious complications of calculous obstructive jaundice.

Objective To investigate the effect of herpes simplex virus thymidine kinase/ganciclovir (HSV-TK/GGV)system driven by human alpha fetoprotein(AFP)enhancer on hepatocellular carcinoma(HCC)cells in vitro and in vivo.Methods HCC-specific eukarotypic expression vector carrying suicide gene driven by AFP enhancer(pAFP-cDNA3.1-TK)was constructed.The plasmid was trasfected to AFP-positive HepG2 cells and AFP-negative SMMC7721 cells by liposomes.Protein and mRNA expressions of TK were detected by RT-PCR or Western blot.The survival rates of HCC cells were detected by methyl thiazolyl tetrazolium assay.The effects of GGV on the in vitro proliferation,survival and apoptosis of HCC cells were observed,and the inhibitive effect of GGV on the survival of HCC cells in vivo was also detected.All data were analyzed by using the t test.Results The pAFP-cDNA3.1-TK was successfully constructed and transfected to the HCC cells.The protein and mRNA expressions of TK were detected in AFP-positive HepG2 cells.GGV dose-and time-dependently inhibited the growth and induced the apoptosis of HepG2 cells in vitro,but it had no effect on SMMC7721 cells.No protein or mRNA expression of TK was detected in the SMMC7721 cells.There was a significant difference on the inhibitory effects of GGV on HepG2 cells and SMMC7721 cells(t =2.58,2.73,3.12,P ＜0.05).GGV specifically inhibited the growth of AFP-positive HepG2 cells,and the inhibition rate was 46%;the growth of AFP-negative SMMC7721 cells was not influenced by GGV.There was a significant difference in the inhibitive effect of GGV on the growth of HepG2 cells and SMMC7721 cells(t = 3.36,P ＜ 0.05).Conclusion HSV-TK/GGV systemdriven by human APF enhancer kills APF-positive HCC cells and inhibits the growth of HCC cells.

OBJECTIVETo study the change of schisandrin in Shengmaisan (SMS) and decomposed group.

METHODThe HPLC-UV was used to determine schisandrin in SMS and decomposed group.

RESULTTo extract Schisandra chinensis with ginseng, ophiopogon, general ginsenoside or ginsenoside Rg1 could promote the content of schisandrin.

CONCLUSIONSaponin is propitious to extracting the schisandrin.

Cyclooctanes ; analysis ; chemistry ; Drug Combinations ; Drug Interactions ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ginsenosides ; chemistry ; Lignans ; analysis ; chemistry ; Ophiopogon ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Polycyclic Compounds ; analysis ; chemistry ; Schisandra ; chemistry

Objective To evaluate the efficacy and safety of infliximab plus methotrexate combination therpy in Chinese with rheumatoid arthritis patients.Methods This was a double-blind placebo-controlled phaseⅢclinical trial,173 patients who had active rheumatoid arthritis were randomised to placebo(n=86)or infliximab(n=87)group on a background of a stable dosage of methotrexate.Patients were assessed at weeks 0,2,6,14 and 18.Results At week 2,the American College of Rheumatology(20)response criteria,which represent a 20% improvement from baseline,the same results with swollen joint count,tender joint count,du- ration of morning stiffness,VAS score,CRP,ESR were achieved in 52.9% of patients,compared with 14.0% of patients receiving placebo plus methotrexate.A 20% improvement was achieved in 75.9% of infliximab plus methotrexate at week 18,compared with 48.8% of patients on placebo plus methotrexate(P=0.0003).A 50% improvement was achieved in 43.7% of infliximab plus methotrexate at week 18,compared with 25.6% of pa- tients on placebo plus methotrexate(P=0.011).Infliximab was well-tolerated;withdrawals for adverse events as well as the occurrence of serious adverse events or serious infections were similar to those in the placebo group.There was only one case of tuberculosis in the treatment group.Conclusion Treatment with infliximab plus methotrexate is more effective than methotrexate alone in patients with active rheumatoid arthritis.It has rapid onset of effect and the efficacy is persistent.

0.05) and the two methods had good correlation(r=0.822).CONCLUSIONS The method of FCST established by as in this study is simple,repeatable,with high accuracy and easy to determine MIC and has good application prospects in clinical antifungal susceptibility testing.

Objective: To evaluate cardiopulmonary exercise testing (CPET) on sildenaifl effect for treating the patients with pulmonary arterial hypertension (PAH). Methods: A total of 25 PAH patients received sildenaifl treatment in our hospital from 2012-01 to 2014-01 were enrolled as PAH group, in addition, there were a Control group including 24 healthy subjects. The CPET, echocardiography, NYHA function class, 6-mimute walking distance (6MWD) and plasma levels of NT-proBNP at the baseline, (6-12) months and (13-18) months after sildenaifl treatment were assessed and compared between 2 groups. Results: Compared with Control group, PAH group showed decreased aerobic capacity (peakVO?2, Peak O2pulse) and ventilation efifciency (PETCO2@AT, VE?/VC?O2@AT), allP<0.05. At (8±2) months after sildenaifl treatment, aerobic capacity and ventilation efifciency was improved, meanwhile, NYHA function class, 6MWD and plasma levels of NT-proBNP were improved, allP<0.05. At (16±2) months after sildenaifl treatment, 6MWD was similar,P=0.26, while peak VO?2 and peak O2 pulse were decreased than they were at (8±2) months after sildenaifl treatment,P=0.04 and 0.06; the ventilation efifciency was elevated (as presented by increased VE?/VC?O2@AT and decreased PETCO2@AT,P=0.04 and P=0.04); plasma level of NT-proBNP was increased,P=0.05. Conclusion: CPET can effectively evaluate sildenaifl effect for treating PAH patients and therefore and guide the drugs therapy.

Objective The use of tourniquets in total knee arthroplasty has been controversial. Many studies have focused only on the different time courses and neglected the effects of pressures. Currently,there is no study explaining the mechanism of tourniquet-induced injury. The aim of this study was to explore the effects of different tourniquet pressures on pain and swelling after total knee arthroplasty and to explore the mechanism of injury. Methods Ninety-six patients who underwent total knee arthroplasty at Nanjing General Hospital from June 2017 to December 2017 were randomly as-signed to 240 mmHg group (low pressure),270 mmHg group (medi- um pressure),and 300 mmHg group (high pressure). The patient's pain and thigh circumference were measured before and 1-2 days after surgery. Blood samples were taken before and 3,8,and 24 hours after surgery. Superoxide dismutase 1 (SOD1),prostaglandin E2 (PGE2) and myoglobin were detected,analysed and compared. Results In the perspective of the pain and swelling of affected limb after surgery,the 300 mmHg group (73.24±10.51) was significantly different from the 240 mmHg group (58.18±9.66) and the 270mmHg group (63.06±10.06). In the perspective of the SOD1 level in serum,the 300mmHg group (97.77±13.82) was significant-ly different from the 240mmHg group (63.72±15.02) and the 270 mmHg group (70.58±5.85) at 3h after surgery,and then the diver-gence was gradually decreased. In the perspective of the PGE2 level in serum,the 300 mmHg group (478.05±35.80) was significantly different from the 240mmHg group (334.42±33.12) and the 270mmHg group (391.85±19.41) at 3h after surgery,and the divergence was started to decrease after 8 h. In the perspective of the myoglobin level in serum,the 300 mmHg group (30.43±9.79) was also sig-nificantly different from the 240 mmHg group (17.58±1.93) and the 270 mmHg group (22.28±4.21) at 8 h after operation,the diver-gence was started to decrease after 24 h. which began to decrease after 24 h. Correlation analysis showed that there was a significant cor-relation between pain (correlation coefficient 0.518,P<0.001),swelling (correlation coefficient 0.345,P<0.05) and stress after sur-gery. Conclusion The pain and swelling of the affected limb is positively correlated with the pressure of the tourniquet during the operation. Muscle necrosis is the main mechanism of the injury. Oxidative stress occurs in the ischemic phase and inflammation occurs in the reperfusion phase.

OBJECTIVETo investigate the risk of Alzheimer's disease (AD) associated with life style, early exposure to magnetic fields, family history of dementia and other risk factors.

METHODSWe conducted a case-control study among the inpatients of Chinese PLA General Hospital in 2000 - 2003. Sixty-two AD cases and 124 controls were selected and matched for age. Univariate and multivariate analyses were conducted using logistic regression model.

RESULTSAll subjects were males aged 66 to 102. In univariate analysis, lack of social activities, more physical exercises, early exposure to magnetic fields, suffering from negative life events and family history of dementia were statistically different between two groups (P < 0.05). Multivariate analysis showed that after adjusting for potential confounders, suffering from negative life events, family histories of dementia increased the risk of AD with odds ratio (OR) and 95% confidence interval (CI) 3.27 (1.53 - 6.97) and 5.78 (1.39 - 24.10). Early exposure to magnetic fields seemed a possible risk factor for AD, with OR (95% CI) 2.49 (0.96 - 6.45). The amount of social activities, cigarette smoking and history of cancers were negatively correlated with AD and their ORs (95% CI) were 0.81 (0.72 - 0.92), 0.46 (0.21 - 1.00) and 0.31 (0.12 - 0.82) respectively.

CONCLUSIONThe study demonstrated that suffering from negative life events and family history of dementia were risk factors for AD, and the early exposure to magnetic fields might also play a role.

Aged ; Aged, 80 and over ; Alzheimer Disease ; epidemiology ; etiology ; Case-Control Studies ; China ; epidemiology ; Electromagnetic Fields ; adverse effects ; Humans ; Logistic Models ; Male ; Middle Aged ; Military Personnel ; Occupational Exposure ; Risk Factors ; Smoking ; adverse effects