Objective To explore the effect of acupuncture on ankle varus after stroke. Methods 61 stroke patients with ankle varus were randomly divided into two groups. The control group (n=30) was treated with exercise and function electrical stimulation (FES), while the observation group (n=31) was treated with acupuncture in addition. Clinical Spasticity Index (CSI), Simplified Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI), Berg Balance Scale (BBS), and Holden Functional Ambulation Category (FAC) were applied to assess ankle spasticity, lower limb motor function, the activities of daily living (ADL), balance function and walking ability respectively before and 8 weeks after treatment. Results Compared with pre-treatment, two groups improved in the ankle spasticity, lower limb motor function,ADL, balance function and walking ability 8 weeks after treatment (P<0.05), and the observation group was better than the control group (P<0.05). Conclusion Acupuncture can facilitate to improve the ankle spasticity, lower limb motor function, ADL, balance function and walking ability for stroke patients ankle varus.

Objective To observe the effect of recombinant human tumor necrosis factor receptor Fc fusion Protein (rhTNFR:Fc) treatment on IgM-RF,IgG-RF,IgA-RF of patients with rheumatoid arthritis.Methods A randomized,active-comparator controlled,parallel group study were conducted.110 patients were enrolled and were randomly divided to the treatment group,in which patients were treated with twice weekly subcutaneous injection of rhTNFR:Fc (25 mg) (rhTNFR:Fc treatment group,n=55),and the MTX froup,in which MTX (the mean dosage was 15 mg/week) (MTX group,n=55) for 24 weeks.Blood routine,IgM-RF,IgG-RF,IgA-RF,and disease activity score 28 (DAS28) were monitored.Student's t-test was used for statistical analysis.Results The level of IgM-RF decreased significantly in the rhTNFR:Fc treatment group 24 week(29±16) U/ml later.However,the level of IgG-RF(145±20) U/ml,IgA-RF(153±34) U/ml increased significantly in the rhTNFR:Fc group,and the level of IgG-RF (62±14) U/ml,IgA-RF (66-±19) U/ml decreased significantly in the MTX group.Conclusion Although rhTNFR:Fc,is effective in treating the clinical symptoms of RA,it seems to affect RF producing-B cells either directly or indirectly.

Objective To summarise the methods for a long segmental avulsed inj ury of ureter.Methods Ureteroscopies were performed on three male patients with upper ureteral calculi and one female patient with haematuria from upper urinary tract.Ureteral calculi caused small and middle hy-dronephrosis,obstruction wasn't seen on the upper urinary tract with haematuria.The kidney on the affected side showed normal founction on IVP.Four patients were suffered from a long segmental avulsed inj uries of full-thickness of ureter from ureteroscopy in a continuous epidural anesthesia.The injuries took place in UPJ and upper ureter.The length of avutsed ureters is 20-25 cm,mean length is 24 cm. Results The ureteroscopies were altered to open operations which were ileal ureteral substi-tutions on two patients,being anastomosed the avulsed ureter wrapped by caul on one patient and nc-phrectomy on one patient under general anesthesia in an emergercy.Two ileal ureteral substitutions had reached satisfied results that were no damaged renal functions,no metabolic acidosis,no repeatly U-rinary tract infections and no complains about micturition.One patient has maintained normal renal morphology and function after thirteen years followup,the other formed stricture in the anastomosis of the proximal piece of-ileum to the renal pelvis tWO years after operation,and then improved after ante-grade dilation.The patient with being replaced back and anastomosed the avulsed ureter had compli-cated with a renal atrophy on the affected side three months after the double-J was extracted.The kid-ney showed no function on isotop nephrogram and then was ablated.The last one with nephrectomy and the one before were followed up regularly,the renal functions and blood pressures remain normal.Conclusion Ileal ureteral substitution would be a good choice and has a stable curative effect and provide a good prognosis for treating long segmental avulsed injury of ureter suffered from ureterosco PY when no available urinary tract was utilized for reconstruction.

Objective To investigate clinical characteristics and emergency managements of postrenal acute renal failure(ARV)induced by melamine in infant.Method Fluid therapy for urine alkalization and hydration,cistoscope drainage and peritoneal dialysis step by step were exerted in those who had both a history of certain milk intake and ARF according to the definition of pediatric ARF which developed by Pediatric Nephrology Assembly of Chinese Pediatric Association in 1994.Results Thirty-four postrenal ARF cases with anuria due to melamine in Nanjing Children's Hospital of Nanjing Medical University were involved in the study.Seventy cases(50%)re-ceived fluid therapy only.Nine cases(26.5%)received fluid thempy and eistoscope drainagemand 4 cases (11.8%)received fluid therapy and cistoscope drainage and peritoneal dialysis.Four cases(11.8%)received ur-gent peritoneal dialysis due to severe hyperkalemia.All cases(100%)survived.The urine pH at the first day.the second day,and after the second day in those who just pass away urine were 6.1±1.0、6.5±0.7.5.3±0.4,respectively(F=4.563,P=0.026).Conclusions Fluid therapy for urine alkalization and hydration and stop sequential thempy are effective in infant with postrenal ARF induced by melamine.

Abstract: A high-performance liquid chromatographic (HPLC) method for the assay of pregabalin gastric retention sustained-release tablets was established, successfully solving the problem of low recovery of pregabalin through a special sample pretreatment method. By comparing salting-out and excipient dispersion, the pretreatment methods to overcome the viscosity of the test solution were established. Both methods can be used for the determination of the product content, but the salting-out method is easier to operate. The HPLC conditions were Inertsil ODS-3 (4.6 mm×0.25 m, 5 µm) column with mobile phase of 3.4 g/L potassium dihydrogen phosphate (pH adjusted to 6.3 by ammonia) and methanol (85︰15);the column temperature was 30 ℃;the flow rate was 1.0 mL/min;the sample size was 50 µL;and the detection wavelength was 210 nm. Through the validation of the salting-out method, the average recovery of the drug was 99.74% and the RSD was 0.43%; the precision test RSD was 0.77%;the test solution was stable within 12 h;the chromatographic system had good durability;and the excipient did not interfere with the content detection.The method is stable, reliable and suitable for the assay of pregabalin gastric retention sustained release tablets.

Objective To study the relationship between the abnormal blood fat components and the serum hypersensitivity C reaction protein concentration and the progression of diabetic retinopathy.Methods Fundus examination was carried out to inpatients in the Department of Endocrinology in the hospital from From July 2015to July 2017.These patients were divided into three groups according to results of fluorescein sodium contrast:The non retinopathy group (group A) , the non proliferative retinopathy group (group B) , the retinopathy proliferative phase group (group C) .The content of blood fat component and serum hypersensitivity C reaction protein in the experimental cases were measured, and the ratio of TC/HDL-C was calculated.The statistic software of SAS9.4was used for statistical processing.Results The concentration of the serum hypersensitive C reaction protein in patients with diabetic retinopathy was significantly increased and the ratio of TC/HDL-C increased significantly (P<0.05) .The hs-CRP concentration and TC/HDL-C ratio of the three study groups were compared with those of the healthy control group:the difference was statistically significant (P<0.05) .Among them, the hs-CRP concentration and TC/HDL-C ratio of group A were compared with group B and group C respectively and the difference were statistically significant (P<0.05) .There was no significant difference in hs-CRP concentration and TC/HDL-C ratio between group B and group C (P>0.05) .Linear correlation analysis was used to analyze the concentration of serum hypersensitive C reaction protein and the ratio of TC/HDL-C.It was found that there was a positive correlation between them, and there was a positive synergistic effect.Conclusion The measurement of serum hypersensitive C reactive protein has important clinical value for the discovery, evaluation and prognosis of diabetic retinopathy.The abnormalities of the blood fat component reflected by the TC/HDL ratio are also an important factor in assessing the progression of diabetic retinopathy.

Objective Based on gender differences,this paper discusses the characteristics of facial color diagnosis in male and female patients with metaplastic chronic atrophic gastritis(CAG),and explores the pathological mechanism of different gender patients from the perspective of TCM pathogenesis,so as to provide personalized reference for TCM prevention and treatment of metaplastic CAG.Methods In this study,the complexion information of patients with chronic non atrophic gastritis(CNG)and CAG was collected by MT-BX-01 four-diagnostic instrument.The color colorimetric characteristics of male and female metaplastic CAG patients and CNG patients were analyzed by case-control study.Results In female patients,the L value and a value of liver region in CAG with mild intestinal metaplasia(IM)group,moderate and severe IM were significantly lower than those in CNG group(P<0.05).In male patients,the L value of spleen region in CAG with moderate and severe IM group was significantly higher than that in CNG group(P<0.05).Conclusion There is a certain gender difference in the facial color characteristics of patients with metaplastic CAG.The facial chromaticity value of female patients with metaplastic CAG changes most significantly in the liver area,while that of male patients mainly in the spleen area.It is suggested that the incidence of female metaplastic CAG is mostly related to liver,while that of male is mostly related to spleen,which provides a personalized method for clinical diagnosis and treatment of metaplastic CAG based on gender differences.

Objective: To summarize the diagnosis and prognosis of adrenocortical carcinoma in children. Methods: Medical records of 10 pediatric patients with adrenocortical cancer treated in Children's Hospital of Nanjing Medical University from September 2010 to March 2018 were retrospectively reviewed, and their clinical manifestation, laboratory, auxiliary, and pathological examination results, and prognosis were analyzed. Results: The average age of all patients (5 male and 5 female pediatric patients) was (53.3+48.4) months. Clinical mani-festations included abdominal mass, hypertension, cortisol level, and peripheral precocious puberty. Laboratory tests showed that lactate dehydrogenase, neuroenolase, and cortisol levels were high in some patients, and sex hormones were abnormal. Auxiliary examination using the abdominal computed tomography enhancement showed irregular an adrenal gland, uneven density, necrosis, mass calcification, and some infiltration into the surrounding tissue. Pathological examination suggests tumor cell pleomorphism, more frequent pathological division, high mitotic index, abundant interstitial sinusoid, necrosis, tumor infiltration, vascular invasion, and Weiss score of≥3 points. Lactate acid dehydrogenase and cortisol levels; Weiss score; and tumor size, staging, and resection rate were not statistically different among prognostic factors. Conclusions: For pediatric patients with adrenal masses, the survival rate should be improved by combining the clinical manifestation, laboratory examination, and auxiliary examination for the early diagnosis of adrenocortical carcinoma and to select the appropriate treatment. Combined with pathological results, adrenocortical carcinoma can be well differentiated from other adrenal masses.

Objective To analyze and estimate, the treatment of patients with histologically confirmed subependymal giant-cell astroeytoma (SEGCA). Methods The data from 23 patients with SEG-CA who were diagnosed between February 1995 and February 2008 were retrospectively evaluated. Various combinations of surgery and radiotherapy had been used for treatment. Results Total resection was 16 cases, subtotal resection was 7 cases, radiotherapy was 17 cases. The average follow-up time was 53 months.One postoperative SEGCA recurrence. Epilepsy was totally disappeared in 17.6% (3/17), partly disappeared in 47.1%(8/17). All cases survived. Conclusions The key of treatment is total resection. The significance of radiotherapy is not sure. The overall prognosis of SEGCA is favorable.

Objective To examine the diagnosis and outcomes in the treatment of the patients with histologically confirmed central neurocytoma (CNC). Methods The data from 71 patients with CNC who were diagnosed between March 2003 and December 2007 were retrospectively evaluated. Various combinations of surgery, and radiotherapy had been used for treatment. Results The average bulk of tumors was 40 cm3. The median follow-up was 22 months. The 22 months overall survival and local control rate was 95.8%(68/71) and 95.6%(65/68), respectively. Conclusions The overall prognosis is favorable although the follow-up is not very long. Surgery and postoperative radiotherapy can significantly improve local control.