Objective To explore the clinical effect of chlorpromazine(TMZ)in treatment of chronic heart failure(CHF).Methods 70 patients with CHF were randomly divided into control group and treatment group 35 cases in each gronp,control group was given conventional treatment,treatment group on the basis of additional application TMZ,20mg/times,3 times/d.8 weeks after the observation and comparison of two groups of cardiac function in improving the situation.Results Treatment group before the treatment of LVEF(38.0 ± 2.4)％ After treatment,LVEF(48.0 ±2.3)％ ;control group before treatment LVEF(38.2 ±2.2)％ after treatment,LVEF(42.0 t2.5)％ ;Twosets of treatment LVEFdifference statistically significant(t =6.9419,2.8482,allP ＜ 0.05); Treatment group compared with control groups after treatment improve even more obvious(t =4.3147,P ＜0.05)o Control groups and then hospitalized 10 cases(28.5％),the treatment group hospitalization 3 cases(8.5％),both groups rate difference statistically significant(x2 =4.629,P ＜0.05).Both groups were no deaths,no serious adverse effects.Conclusion General against heart failure therapy on the basis of the combined with TMZ could significantly improve the cardiac function of patients with chronic heart failure,reducing hospitalization rates.

Cell Transformation, Neoplastic ; metabolism ; Humans ; Liver Neoplasms ; metabolism ; Non-alcoholic Fatty Liver Disease ; metabolism ; PPAR alpha ; metabolism

Animals ; Fructose ; Humans ; Non-alcoholic Fatty Liver Disease ; Risk Factors

Objective To investigate the clinical efficacy and safety of tolterodine combined with flupentixol melitracen in the treatment of women with overactive bladder (OAB).Methods 84 female patients with OAB were chosen and randomly divided into the observation group and the control group.42 cases in observation group were treated with tolterodine combined with flupentixol melitracen.42 cases in control group were only treated with tolterodine.The clinical efficacy was recorded and compared after treatment for 4 weeks.Results The total effective rate of the observation group was higher than the control group (95.24％ vs 76.19％,x2 =6.291,P ＜ 0.05).The 24h frequency of urination,the average 24h number of incontinence episodes,initial urinate capacity and maximum bladder pressure capacity had statistically significant differences between the two groups (all P ＜ 0.05).Conclusion Tolterodine combined with flupentixol melitracen in the treatment of women with OAB has advantages of short course of treatment,excellent efficacy,and few side effects.

Objective To investigate the protective effect of rosiglitazone on acute necrotizing pancreatitis (ANP) associated lung injury in rats.Methods Seventy-five male Wistar rats were randomly divided into sham operation group (SO group),acute necrotizing pancreatitis group (ANP group) and rosiglitazone pretreatment group (ROSI group).ANP model was induced by retrograde infusion of 5％ sodium taurocholate into the biliopancreatic duct.Thirty minutes after ANP induction,ANP groups were injected with 10％ DMSO (0.2 ml/100 g) through femoral vein,and ROSI group were injected with ROSI dissolved with 10％ DMSO (6 mg/kg) through femoral vein,while SO group was injected with normal saline,and 30 minutes later was injected with same amount of 10％ DMSO.Rats were sacrificed at 3 h,6 h and 12 h after the operation.Serum amylase and lung wet/dry weight ratio (W/D) were measured,lung tissues were harvested for pathologic examinations.STAT1 protein and phosphorylation-STAT1 protein (p-STAT1) expression were detected by Western blot.Results The serum levels of amylase,lung W/D,pathologic score of lung tissues in ANP group were increased with time,and reached the peak at 12 h,which were (5017 ± 203)U/L,3.12 ±1.30,(3.33 ±0.18) score,and these were significantly higher than those in SO group (P ＜ 0.05 or 0.01),the expression of STAT1 protein was not statistically significant,but the expression of p-STAT1 reached the peak at 3 h (5.23 ± 0.03),then it gradually decreased,but it was still significantly higher than that in SO group (0.16 ± 0.04,p ＜ 0.01).The serum levels of amylase,lung W/D,pathologic score of lung tissues in ROSI group at 12 h were (1912 ± 164) U/L,1.83 ± 1.26,(2.78 ± 0.16),which were significantly lower than those in ANP group (P ＜ 0.05).The expression of STAT1 protein was not statistically significant,and the expressions of p-STAT1 at 3 h,6 h,12 h was 0.41 ±0.04,0.22±0.05,0.15 ±0.03,which were significantly lower than those in ANP group (P ＜ 0.05).Conclusions Rosiglitazone has the protective effect on ANP associated lung injury by inhibition of phosphorylation-STAT1 protein expression in the early phase.

Objective To explore the clinical characteristics and diagnosis of autoimmune pancreatitis(AIP) with the aim to raise awareness of AIP.Methods Clinical data of 32 patients with AIP were retrospectively analyzed,including clinical manifestations,imaging features,laboratory examination,histopathology and treatment from November 2009 to April 2013 in the First Affiliated Hospital of Medical School,Zhejiang University.Results All 32 AIP patients including 25 males and 7 females had a median age of (62.5 ± 12.6) years (27-84 years).The initial symptoms included obstructive jaundice in 50.0％patients (16/32),abdominal pain in 43.8％ (14/32),fatigue and weight loss in 12.5％ (4/32),and bloody stool in 6.3％ (2/32).Laboratory findings revealed abnormal liver function in 6.3％ (2/32)patients,increased immunoglobulins in 71.9％ (23/32)patients and elevated IgG4 in 8/10 patients.Computerized tomography(CT) scan and ultrasonography were performed in all patients.Diffusely enlarged pancreas were found in 62.5％ (20/32) patients and focally enlarged in 37.5％ (12/32),additionally main pancreatic duct stenosis in 62.5％ (20/32) patients.Nineteen patients obtained histopathological examination,indicating pancreatic interstitial fibrosis,and infiltration of lymphocytes and plasma cells.Conclusions Autoimmune pancreatitis is an autoimmune disease which may be misdiagnosed as pancreatic cancer.The clinical features,laboratory findings,imaging characteristics,and typical histopathologic presentation,as well as good response to glucocorticoids provide supportive evidence for the diagnosis of AIP.

Objective To analyze the clinical features of hepatic veno-occlusive disease (HVOD) and to explore the diagnosis criteria and treatment.Methods A total of 50 cases of HVOD administrated at The First Affiliated Hospital of College of Medicine,Zhejiang University from August 2008 to August 2011 were analyzed for etiology,clinical manifestation,laboratory examination,image,pathological features and treatment.Results Among the 50 HVOD cases,38 cases (76％)had a history of taking Gynura segetum.The main clinical manifestations were ascites,hepatomegaly,right upper quadrant pain,jaundice,and weight gain.Laboratory examinations indicated liver function injury and increased serum CA125 level.Color Doppler ultrasound showed hepatomegaly,decrease in diameter of hepatic vein and slow blood flow.The computed tomography scan suggested hepatomegaly,enhanced scan showed liver inhomogeneous enhancement at portal and delayed phase,map-like changes and markedly decrease in diameter of hepatic vein.Pathological examination suggested hepatic sinusoid congestion,central vein stenosis and vessel wall thickening.The main therapy was anticoagulant treatment.One case cured,33 cases improved,13 cases uncured and three cases died.Conclusions HVOD because of taking Gynura segetum is common in Zhejiang Province,which can be diagnosed according to medical history,clinical manifestations, and typical image characteristic.However,diagnosis of the atypical cases still needs liver biopsy.Anticoagulation therapy can achieve better efficacy.

Objective To compare and analyze gene expression patterns in rat model of nonalcoholic fatty liver disease (NAFLD).Methods Twelve male Sprague-Dawley rats were randomly given either general diet (control group) or a high-fat diet (model group) for 4 weeks.The histopathologic changes of the liver were observed and gene expression patterns were analyzed and compared by cDNA mieroarray.Results Hepatocellular steatosis and inflammatory infiltration were observed in model group after high-fat diet for 4 weeks.Fifty-one differential genes were found in model group,20 of which were up-regulated (sterol regulatory element binding factor 1,stearoyl-coenzyme A desaturase 1 and Bcl 2 modifying factor)and 31 were down-regulated (peroxisomal enoyl coenzyme A hydratase 1,heat shock 70 protein 1A and ATPase inhibitory factor 1). The up-regulating genes were involved in lipogenesis and cell apoptosis,while down-regulated genes were involved in fatty acid oxidation, protein modification and energy metabolism.Conclusions The differential expression of genes may involve in the pathogenesis of NAFLD.

Objective To investigate whether the spleen diameter,serum albumin and periphefial blood cells might be as non-invasive predictive indicators for the presence of esophageal varices(EV)in patients with liver cirrhosis.The predictive values of these parameters to the large esophageal varices were evaluated.Methods OBe hundred and sixty-seven patients with liver cirrhosis underwent endoscopic examination.Among them,127 patients(mild in 41,medium in 38,severe in 48)were found with EV and 40 patients without(NEV).The diameters of portal vein and spleen vein,the sizes of spleen and the ratio of platelet count/spleen size were examined by Doppler ultrasound.The platelet count and the level of albumin were calculated.Results The average of age,diameter of portal vein and spleen vein,and sizes of spleen were higher in EV group than those in NEV group,while the platelet count,the level of albumin and the ratio of platelet count/spleen size in EV groups were lower than those in NEV group.Multifactor analysis revealed that the index related to serious EV were the blood platelet count(＜70×109/L),the ratio of platelet count/spleen size(＜1.0)and albumin level (＜35 g/L).Conclusions The degree of EV in patients with liver cirrhosis were paralleled with the degree of portal hypertension.The patients who present with platelet count＜70×109/L,or platelet count/spleen size＜1.0 or albumin＜35 g/L should be considered as EV,and endoscopic examination is needed.

ObjectiveTo evaluate the efficacy of biapenem in percutaneous nephrolithotripsy for the prevention and control infections.MethodsA retrospective study was accomplished.The clinical data of 68 patients with PCNL which used biapenem for prevention and control infection from Aug 2009 to Feb 2011 in the hospital of Hubei Provincial Corps of CAPF were collected,the treatment effect of biapenem in percutaneous nephrolithotripsy was evaluated.Results57 cases use the injection biapenem each 0.3g,2 times a day intravenously 7 to 14 days could effectively prevent postoperative infections in perioperative period;11 cases of urinary infection and systemic inflammatory response syndrome after pereutaneous nephrolithotripsy use injection biapenem each 0.3g,every 8-hour intravenously 7 to 14 days,were effective treatment of postoperative infections.ConclusionBiapenem was effective in the prevention of infection in percutaneous nephrolithotripsy.