Objective To explore the effect of Shenmai injection on profile and function of CD4+CD2+5 Treg cells in ITP patients.Methods 78 ITP patients were selected and divided into the two groups, each group in 39 cases.The control group were given prednisone,while the observation group were given Shenmai injection additionally. CD4+CD2+5 FoxP3 +Treg cell counts were detected before and after treatment with flow cytometry,and the serum IL-2, IL-4 and IFN-γcontents were detected with ELISA kit.Results The effective rate of 56.41%and total effective rate of 92.31% in the observation group were higher than those of 30.77% and 71.79% in the control group (χ2 =4.222,3.933,all P<0.05).Furthermore,after the treatment,the CD2+5 FoxP3+Treg cell counts of 30.66%vs 24.10%and 7.49%vs 5.15%and serum IL-2,IL-4 and IFN-γcontents of (15.6 ±4.3)ng/mL vs (10.3 ±3.1)ng/mL, (9.5 ±2.7)ng/mL vs (13.9 ±3.4)ng/mL,(37.1 ±4.3)ng/mL vs (31.2 ±4.9)ng/mL in both the two groups increased(P<0.05);while all indexes′levels of the observation group were higher than those of the control group after treatment(χ2 =4.329,4.012,4.568,4.105,all P<0.05).Conclusion The defeat of CD4+CD2+5 Treg cells may be involved in the process of ITP,and Shenmai injection may be able to play a role in treatment through this link.

Objective To analyze serum calcium and phosphorus levels and its related factors of clinical type 2 diabetes mellitus (T2DM) with overt diabetic kidney disease (T2-dDKD).Methods Ninety cases of T2DM patients according to K/DOQI Recommendations in 2007 were selected as the study subjects.Based on the patients' 2 times mean urinary albumin/creatinine ratio (ACR),these people were divided into three groups,namely Normal albuminuria group (30 patients,ACR＜30 mg/gCr),Microalbuminuria group (30 patients,ACr =30-300 mg/gCr),Macroalbuminuria group (30 patients,ACR＞300 mg/gCr).Thirty cases of healthy at the same period were selected as the Control group.Serum calcium,phosphorus,hs-CRP,IL-6,HbA1c were detected.And glomerular filtration rate (eGFR) was calculated.Results The eGFR in Normal albuminuria group was more higher than other groups (P＜0.05),the eGFR of Microalbuminuria group was significantly lower than other groups (P＜0.05).Subgroups of T2DM with different albuminuria presence and severity,duration was also different between the groups,the more albumin in urine,the longer its duration.The contents of HbA1c in the groups of varying degrees of albuminuria increased as urinary albumin aggravation (HbA1c was (8.87±2.44) ％,(9.27±2.74)％,(11.04±2.86)％ respectively,P＜0.05),but there was not statistically significant between Microalbuminuria group ((9.27±2.74)％) and Normal albuminuria group ((8.87±2.44) ％).Compared with Control group,in subgroups of T2DM,serum calcium was decreased((2.22±0.19) mmol/L,(2.16±0.14) mmol/L,(2.13±0.18) mmol/L,and the Contorl group was (2.32±0.11)mmol/L,P＜0.05),and serum phosphorus ((1.16±0.31) mmol/L,(1.42±0.52) mmol/L,(1.98±0.58)mmol/L,and the Control group was (1.08±0.28) mmol/L),hs-CRP ((4.82±0.89) mmol/L,(8.46± 2.85)mmol/L,(13.09±3.49) mmol/L,and the Control group was (2.46±0.48) mmol/L),IL-6((10.32±4.19)pg/L,(14.78±4.34) pg/L,(16.67±6.62) pg/L,and the Control group was (7.03±2.15) pg/L) were increased(P＜0.05).In subgroups of T2DM,hs-CRP was significantly increased with the increase of the serum albumin((4.82±0.89) mmol/L,(8.46±2.85) mmol/L,(13.09±3.49) mmol/L,P＜0.05),there were no statistical significance about blood phosphorus among Macroalbuminuria group (1.98±0.58) mmol/L),control group((1.08±0.28) mmol/L),normal albuminuria group((1.16±0.31) mmol/L) and albumin urinary group (1.42±0.52) mmol/L).Serum phosphorus in Microalbuminuria group were positively correlated with hs-CRP,IL-6,HbA1c (r =0.431,0.384,0.517 respectively,P＜0.05).Serum phosphorus in Macroalbuminuria group were positively correlated with hs-CRP,IL-6,HbA1c (r=0.825,0.622,0.683 respectively,P＜0.01),but negatively with eGFR(r=0.600,P＜0.01).Conclusion Serum phosphorus metabolism is abnormal in patients with diabetic nephropathy,hs-CRP,IL-6,and HbA1c are the related factors influencing the progression of serum phosphorus in patients with diabetic nephropathy.

Objective To study the changes and clinical significance of P selectin (CD 62P), lysosome protein (CD 63) expression in patients with ischemic stroke.Methods 168 cases of acute ischemic stroke (both acute and convalescence) and 40 normal controls were tested for CD 62P and CD 63 expression using flow cytometry. The correlation between the expression and neurological functional deficit scale was analyzed.Results (1) The expression of CD 62p and CD 63 in acute phase (9.48%, 8.36%) of ischemic stroke was markedly higher than that in convalescence phase (5.73%, 4.21%)( P0.05). (3) CD 62P and CD 63 expressions were positively related with the scores of neurological functional deficit scale( r=0.84 and r=0.817, P

OBJECTIVE To analyze the risk factors of the Catheter-Related Blood Stream Infection(CRBSI) in the intensive care unit(ICU),and to approach effective methods for preventing the CRBSI in ICU.METHODS With the method of objective investigation,all patients in ICU from Jan,2008 to Dec,2008 were studied.The risk factors of CRBSI were investigated.RESULTS 257 patients entered the study.A total of 147 cases suffered from the nosocomial infection(NI).The incidence rate of the NI was 57.2%.Among these,36 cases were dignosised of the CRBSI,and the case-infection rate was 14.07%.The number of CRBSI account for 24.49% of the patients who suffered from the NI.The nosocomial infection rate perday the CRBSI was 16.57‰.It was significantly higher than that of the general wards′.The pathogen detection showed the main pathogen was the G+ bacteria,accounting for 54.04%.Then was the G-bacteria,accounting for 37.84%.The fungus accounted for 8.11%.11 unusual drug resistance bacteria were found(6 ESBLs positive bacteria and 5 MRS bacteria).CONCLUSIONS The incidence of the CRBSI is related to the following reasons: days and the sites of the catheter being placed,the procedure the medical personnel done,the immune function of the patients,and the utilization or unutilization of the high-nutrition drugs through the vein.According to these reasons,strict aseptic technique,reasonable choice of the catheter site,shortening the duration the catheter insertion,and maintaining catheter unobstructed are the keys to prevent the incidence of the CRBSI.

0.05).(4) There was significant correlation between CD62p and CD63 ( P 0.05). Conclusions Patients with cerebral infarction show evidence of enhanced platelet activation and increasment of MPV and MAR,which may relate to the pathological process of cerebral infarction. Moreover MPV and MAR can reflect the clinical severity of cerebral infarction better than PLT. Anti-platelet aggregation treatment should be further taken in patients with cerebral infarction.

Objective To investigate the effect of α-keto acid combined with low protein diet on kidney function, calcium-phosphorus metabolism and adenosine deaminase activity in malnourished patients with long term peritoneal dialysis.Methods Forty-six cases malnourished patients with long term peritoneal dialysis were selected from May 2013 to August 2014 in the hospital and divided into two groups.The control group (n=23) were treated by conventional therapy, acceptable daily intake of protein 1.2 g/(kg? d).The experiment group (n=23) were treated by α-keto acid combined with low protein diet, acceptable daily intake of protein 0.8 g/(kg? d).Two groups were treated for three months.Serum calcium, phosphorus, nutritional status assessment, adenosine deaminase activity and renal function were observed and compared after treatment.ResuIts After twelve months ’ treatment, compared with control group, serum creatinine, blood urea nitrogen, serum uric acid of experiment group were lower ( P<0.05); serum calcium level was higher (P<0.05), serum phosphorus level was lower (P<0.05);ADA activity and white blood cell count were lower (P<0.05). The incidence of malnutrition rate had no significant difference between two groups(χ2 =3.136,P>0.05).ConcIusion α-keto acid combined with low protein diet could effectively increase serum calcium level, reduce serum phosphorus level, ADA activity and WBC count, and improve nutritional status in long-term peritoneal dialysis patients, which has important significance.

Objective To investigate the agitation effect of dexmedetomidine in the operation of radical hysterectomy by general anesthesia in patients.Methods 68 cases in this study who were under the operation of radical hysterectomy by general anesthesia in our hospital were selected, and randomly divided into the group A and the group B, 34 cases in each group.Group A received dexmedetomidine after tracheal intubation, and group B received physiological saline as the measurement of group A, hemodynamic and inflammatory factors were measured at different time points in anesthesia, the corresponding indexes and the degree of emergence delirium were compared.Results Compared with T1 , levels of HR and MAP increased, levels of SpO2 decreased at T3 and T4 in group B, levels of CRP, TNF-αincreased at T2 , T3 , T4 , T5 in group B, levels of CRP, TNF-αincreased at T3 , T4 , T5 in group A(P<0.05), and compared with the group A, levels of HR and MAP were higher at T3 and T4, levels of SpO2 were lower,levels of CRP, TNF-αwere higher at T2, T3, T4, T5in group B(P<0.05).The cough response score and agitation score in group B were higher than group A, and sedation score was lower than group A ( P <0.05 ) , the grade of emergence delirium in group A was better than group B ( P <0.05 ) . Conclusion Dexmedetomidine in the operation of radical hysterectomy by general anesthesia could reduce the emergence of agitation occurred, inhibit extubation reaction, but would not extend the anesthesia recovery time.

Objective To investigate the effect of different methods of intestinal preparation on intestinal cleaning for elderly gynecological patients undergoing surgery. Methods Sixty-four elderly patients undergoing gynecological surgery were divided into two groups according to admission seguence. The control group was treated with enema using 800~1000 mL 0.2%soapy water, while the experiment group was treated with enema using sodium phosphate salt oral solution mixed with 800 ~ 1000 mL 0.9% sodium chloride solution. The intestinal cleanness and enema times of the two groups were observed. Results The effect of intestinal cleanliness in the experiment group was better than that in the control group. There was significant differences between the two groups. (P<0.01). Conclusions For the elderly patients undergoing gynecological surgery, sodium phosphate salt oral solution can not only reduce the frequency of enema but also achieve the purpose of cleaning intestinal tract, to ensure the operation effect. It is the ideal method for cleaning bowels of the elderly patients in preoperative prepartion of the surgery.

Shanyao (Dioscorea opposita Thunb.) is the one of the conventional herbs in the clinical practice, which is good at nourishing yin, and entering the lung, spleen and kidney meridian. Through analysis on all formulae contain-ing Shanyao in past dynasties, we found out the top 30 kinds of traditional Chinese medicine (TCM) herbs for the highest frequency in combination with Shanyao, among which there were 28 herbs recorded in the Shen Nong Ben Cao Jing (Shen Nong's Classic of the Materia Medica) and 23 herbs were considered as the top grade medicinals. This article was focused on the analysis of the compatibility meaning and rules of Shanyao and supplementing medic-inals in order to provide scientific basis for clinical formulae and daily health cultivation so as to make good use of Shanyao.