Objective To observe and discusses the application of larger-bore autologous arteriovenous fistula as dialysis pathways in diabetes patients with chronic renal failure. Methods 86 cases of diabetic patients with chronic renal failure were divided into elderly group and non-elderly group. The patients within each group were assigned randomly into Experimental subgroup and control subgroup. Patients underwent wrist autogenous arteriovenous fistula angioplasty.The surgical method was end to side anastomosis between cephalic vein and radial artery. Vertical incision on the radial artery is about 0.7 cm-0.8 cm in the control subgroup and vertical incision on the radial artery is about 1.0 cm-1.1cm in the experimental subgroup. Results The success rate of the operation in experimental subgroup(90.9%, 95.2%) was significantly higher than that of control group(77.3%, 85.7%). The differences were significant (P<0.05). There was no heart failure in the patients underwent surgery. Conclusions In diabetes patients with chronic renal failure need autogenous arteriovenous fistula angioplasty. Properly increasing the diameter of anastomosis can meet the demand on blood flow of hemodialysis without increase complication of heart failure.

Vascular surgery is a new and course crossing medical science and has developed rapidly in recent years.The patients of vascular surgery have become more and more and are usually diagnosed incorrectly,so we should put emphasis on vascular surgery teaching and take advantage of multimedia,real demonstration and so on.

The quality management of drug research,development,registration,production and marketing strengthened by good practice for pharmaceuticals ensure the drag safety,effectiveness and quality control.Teaching of new drug research and evaluation in compliance with good practice for pharmaceuticals will be of value in making teaching content close to actual work,extending the students'knowledge and training student's good habits in scientific study.

To provide theoretical and practical basis for the successful formulation design of physically-mixed inhalation dry powder of proteins and peptides, related references were collected, analyzed and summarized. In this review drug micronization technology and commonly used carriers for inhalation dry powder preparation were introduced. For proteins and peptides, supercritical fluid technology and spray-drying are more suitable because of their capabilities of keeping drug activity. Being approved by U. S. Food and Drug Administration, lactose has been extensively used as carriers in many inhalation products. Formulation and process factors influencing drug deposition in the lung, including carrier properties, drug-carrier ratio, blending order, mixing methods, mixing time and the interaction between drug and carrier, were elucidated. The size, shape and surface properties of carries all influence the interaction between drug and carrier. Besides, influence of micromeritic properties of the dry powder, such as particle size, shape, density, flowability, charge, dispersibility and hygroscopicity, on drug deposition in the lung was elaborated. Among these particle size plays the most crucial role in particle deposition in the lung. Moreover, based on the mechanisms of powder dispersity, some strategies to improve drug lung deposition were put forward, such as adding carrier fines, adding adhesive-controlling materials and reprocessing micronized drug. In order to design physically-mixed inhalation dry powder for proteins and peptides with high lung deposition, it is essential to study drug-carriers interactions systematically and illustrate the potential influence of formulation, process parameters and micromeritic properties of the powder.
Administration, Inhalation ; Drug Carriers ; chemistry ; Dry Powder Inhalers ; Lactose ; chemistry ; Particle Size ; Peptides ; administration & dosage ; Powders ; administration & dosage ; Surface Properties ; Technology, Pharmaceutical

Objective To compare the curative effect of laparoscopic and laparotomic operation for elderly Chinese women with cervical cancer. Methods The randomized controlled trials (RCT) and case controlled trials (CCT) were collected by searches of WanFang database, CNKI, VIP, China Biology Medicine (CBM) , PubMed. Data were extracted from these trials and data analysis was performed by RevMan 5.2.9. Results There were no RCTs, however, a total of 10 CCTs met the inclusion criteria and had data extracted for this review. The baseline characteristics of the laparoscopic group were similar to those of the laparotomic group. Comparing to laparotomic group, the laparoscopic group have longer operation time (MD =32.60, 95%CI: 5.65~59.55, P = 0.020), less amount of bleeding (MD = -94.01, 95%CI: -130.65 ~ -57.37, P = 0.000), smaller number of lymph node dissection(MD = 1.69, 95%CI: 0.67 ~ 2.72, P = 0.001), earlier anus exhaustion (MD=-17.09, 95%CI: -21.19 ~ -12.98, P = 0.000) and shorter hospital stays (MD = -4.30, 95%CI: -5.57 ~ -3.02, P = 0.000). There was significant difference between the two groups. But there was no statistical significance in postoperative indwelling catheter time (MD = -0.67, 95%CI: -1.92 ~ 0.58, P = 0.290) and surgical complications incidence (OR=0.62, 95%CI: 0.27 ~ 1.42, P = 0.260) between the two groups. Conclusion Laparoscopic management has the advantages of less traumatic and recovered quickly, and did not increase the incidence of complications. Laparoscopic operation is an ideal procedure for elderly Chinese women with cervical carcinoma.

Objective To investigate the effects and mechanism of zinc on airway inflammation in asthmatic rats.Methods Animal model of asthma was established by OVA challenging,zinc-deficient and zinc-supplementary diet were given accordingly.Thirty-two SD rats were divided into four groups according to weight: zinc-deficient diet with OVA challenge group(group A),zinc-supplementary diet with OVA challenge group(group B),zinc-normal diet with OVA challenge group(group C) and zinc-normal diet with saline challenge group(group D).Twenty-four hours later asthma was induced,right side lungs were harvested for HE staining to observe histomorphological changes and the respective numbers of eosinophirs,neutrophils and macrophage in the bronchial mucus were counted.The contents of interferon-?(IFN-?),interleukin-4(IL-4),superoxide dismutase(SOD),malondialdehyde(MDA) and glutathione peroxidase(GPX) in lung homogenate were detected.Results Compared with group C,the number of eosinophils,neutrophils and macrophage,and the contents of SOD increased in group A,but significantly decreased in group B(P

Objective To investigate the factors that related to acute biliary pancreatitis including size and the location of the common bile duct stone. Methods Clinical data from 3497 patients with common bile duct stone admitted to the hospital between Jan. 2002 and Dec. 2008 were retrospective analyzed. All patients were grouped according to the size and the location of the bile duct stones. The incidence of acute pancreatitis was compared among groups. Results In patients with common bile duct stone accompanying the acute pancreatitis,common symptoms were fever, bellyache and jaundice, as well as elevated serum amylase. There was a negative correlation between size of the common bile duct stone and the severity of acute hiliary pancreatitis, which was easily induced by the stone in the Vater's ampullar or distal common bile duct. Conclusion Early endoscopic treatment should be carried out in patients with microlith located in the Vater's ampullar or distal common bile duct in order to prevent the acute biliary pancreatitis.

Objective To explore the long-term efficacy of endoscopic sphincterotomy (EST) for choledocholithiasis and to evaluate the necessity of cholecystectomy after EST. Methods Two hundred and fifty seven patients who underwent EST for choledocholithiasis in 2006 were followed up for an average period of 34. 8 months (26-48 months). According to the existence of cholecystolithiasis, the patients were divided into group A (combined with cholecystolithiasis, n = 151) and group B (without cholecystolithiasis, n = 106) , and group A was further divided into group A1 as undergoing cholecystectomy after EST (n =56) and group A2 as not having cholecystectomy after EST ( n = 95). Results Of the 257 patients, late complications occurred in 31 patients (12. 1% ) , including recurrent choledocholithiasis in 25 (9.7% ), cholangitis in 27 (10. 1% ) , acute pancreatitis in 2 (0. 8% ) and cholangiocarcinoma in 1 (0.4% ). The rates of late complications and recurrent choledocholithiasis were significantly higher in group A2 than those in group A1 (P<0.05). Conclusion EST is safe and effective for choledocholithiasis. Cholecystectomy after EST is necessary in patients with cholecystolithiasis.

Objective To estimate the long-term efficacy of endoscopic sphincterotomy (EST)in treatment of choledocholithiasis and to analyze the potential risk factors for disease recurrence.Methods A total of 154 patients with choledocholithiasis,who underwent EST between January 2006and December 2006, were enrolled. Multivariate analysis was used to evaluate the association of clinical features and experimental parameters with recurrence of choledocholithiasis. Results Longterm complications developed in 22 patients (14.29%) including recurrent choledocholithiasis (18/154,11.69 % ) and combined cholangitis (16/154). Cholangitis without calculi was found in 1 case (0.65%), acute pancreatitis in 2 cases (1.30%) and cholangiocarcinoma in 1 case (0.65%). High body mass index and serum cholesterol were proved to be risk factors for recurrence of choledocholithiasis. Whereas the incision size (0.5 cm-1.5 cm) of vater's papilla was the protective factor for recurrence of choledocholithiasis. Conclusions Body mass index, serum cholesterol and the incision size of vater's papilla are related to recurrence of choledocholithiasis.

Objective To compare the effects of ticagrelor and clopidogrel on patients undergoing percutane-ous coronary intervention(PCI)with acute ST elevated myocardial infarction (STEMI).Methods 120 patients with STEMI received PCI within 12h of symptom onset in our hospital were randomly divided into clopidogrel treated group (n=60)and ticagrelor treated group (n=60).Serum was collected before surgery and 36 hours after PCI for ALT, Cr,CK-MB,and MA.Cardiac ultrasound was examined,too.All patients were followed 6 months post-PCI for main adverse cardiovascular and cerebrovascular events (MACCE)and medicine side effect.Results No significantly difference was noted in baseline between the two groups.The level of CK-MB and MA in the ticagrelor treated group [CK-MB(56.5 ±8.3)U/L,MA (45.9 ±6.4)mm[and clopidogrel treated group[CK-MB(74.3 ±9.6)U/L,MA (35.6 ±7.3)mm]were significant difference (CK-MB,P=0.043;MA,P=0.038).The MACCE of patients in ticagrelor treated group were significantly lower than patients in clopidogrel treated group during post-PCI 6 months follow-up(The ratio of angina in ticagrelor group was 1.7%,while in clopidogrel group was 6.7%,P=0.042). Conclusion Ticagrelor is more effective in suppress the function of platelet,decrease MACCE in patients with STE-MI undergoing PCI.