With the population ageing, the number of elderly patients with end-stage renal disease(ESRD)is increasing, and the proportion of elderly patients undergoing hemodialysis is also increasing year by year.The elderly patients undergoing hemodialysis are susceptible to frailty due to the comorbidities, polypharmacy, chronic inflammation, malnutrition and other factors.In addition, frailty can lead to a variety of adverse prognosis such as falls, fractures, cognitive decline, all-cause hospital readmissions and all-cause death in elderly patients undergoing hemodialysis.

Mammal multidrug and toxin extrusion proteins (MATEs) play an important role in the transport of organic cations in the body. MATEs mediate the final excretion step for multiple organic cation drug used clinically and important endogenous substances. This article reviews the discovery, type, gene coding and polymorphism, body distribution, classification of substrates and inhibitors and their research method of MATEs. The article also discusses the major research significance of MATEs with examples.

ObjectiveTo evaluate the clinical effect of ultra pulse CO2 laser in treatment of 32 patients with primary amyloidosis of the skin. Methods64 patients with primary amyloidosis of the skin were selected and randomly divided into two groups,the observation group(32 cases)and the control group(32 cases).The observation group were treated with ultra pulse CO2 laser,and the control group were treated by routine medicine method.Clinical effect were compared between the two groups after twelve weeks therapy. ResultsThe total effective rates of the observation group and the control group were 90.6%,53.2% respectively.There were a significant difference between the two groups(x2 = 11.13,P＜0.01).There were some different irritations in two groups after therapy,to give symptomatic treatment could help relieve.The relapse rate in the observation group was significant lower than that in control group after treatment of 3 ～ 6 months(x2 = 9.471,P＜0.01). ConclusionUltra pulse CO2 laser therapy of primary amyloidosis of the skin was safe and effective.

Objective:To investigate the clinical effectiveness analysis on biliary stent combined with 125I seed implantation in the treatment of malignant obstructive jaundice.Methods:98malignant obstructive jaundice patients undergoing percutaneous transhepatic biliary drainage requirement of biliary stent were divided into combined group(n=53) and simple group(n=45).Patients in combined group were taken biliary stent combined with 125I seed implantation,while in simple group were only taken biliary stent.All patients were followed up for 4 to 28 months.The changes of total bilirubin were recorded before percutaneous bile duct drainage,7 d,30 d and 90 d after biliary stent implantation.The recurrences of biliary obstruction of the two groups were recorded.The changes of T lymphocyte subsets in peripheral blood were detected before percutaneous bile duct drainage and after biliary stent implantation 7 d.The survival times of the two groups were compared.Results:All patients were successfully completed biliary stent implantation,surgical success rate was 100％.The total bilirubin levels of patients in combined group 30 d and 90 d after stent implantation were significantly lower than the simple group,the differences were statistically significant (P＜0.05).After surgery 7 d,the CD4 level and CD4/CD8 ratio in combined group were increased compared with before surgery,while in the simple group were declined,the differences were statistically significant (P＜0.05).Compared with the simple group,the CD4 level and CD4/CD8 ratio in combined group after surgery 7d were significantly increased (P＜0.05).2 cases (3.8％) of patients were recurrence of biliary obstruction,which were lower than 17 cases (37.8％) in the simple group,the difference was statistically significant (P＜0.001).The median survival time in combined group was 10.6 months,which was significantly longer than 7.5 months in the simple group,the difference was statistically significant (P＜0.05).Conclusion:Biliary stent combined with 125I seed implantation in the treatment of malignant obstructive jaundice might relieve the symptom of biliary obstruction,and helped to improve cellular immune function of patients and reduce the recurrence of biliary obstruction.It had great significance to improve the quality of life of patients and prolong the survival time.

Objective To study the toxic effect of acrylamide (AA) to sperm quality of mice in order to provide scientific data to elucidate the reproductive toxicity of AA. Methods 25 male KM mice aged 7-8 weeks,25-30 g,were randomly divided into negative control group (H2O),AA groups (20,40 and 60 mg/kg) and positive control group (cyclophosphamide). The mice were treated with AA by gavage,once a day,for 5 consecutive days. The mice were sacrificed on the 14th day after the first administration,the quantity,motility,morphology of sperms were examined. Results The sperm quantity in each AA group reduced significantly (P

Objective:To evaluate the implementation effects of critical illness insurance of New Cooperative Medical System(NCMS) on the occurrence rate and economic burden of major disease expenditure.Methods:Based on the peasant household data of China Family Panel Studies(CFPS) in 2014.the two-part model was applied to analyze the changes in major disease occurrence and burden after the implement of insurance.Results:NCMS critical illness insurance did not reduce the occurrence of critical disease expenditure,but signally cut down the economic burden of serious illness peasants in central and eastern China.Conclusion:The implementation effect of NCMS critical illness insurance was well in central and eastern China,but was poor in western China;the prevention and health care system of NCMS should be built,while the implementation plans and compensation level of critical illness insurance should be improved in western region.

Preoperative minimally invasive biopsy has been widely used in the diagnosis of breast lesions, along with the development of radiologic technology, cosmetic appearance requirements for breast cancer patients after surgery, and the diversity of the therapeutic regimens for breast lesions. Preoperotive minimally invasive biopsy is characterized as simple operating, safe and fast, and avilable for the pathological diagnosis before surgery, which make it possible for the benign ones being saved from surgery and the maglinant ones receiving further individual regimens based on molecular biological markers. This paper reviews the advances in preoperative minimally invasive biopsy in diagnosis of breast lesions.

Disease Management ; Humans ; Tinnitus ; therapy

ObjectiveTo compare the therapeutic efficacy of acupuncture at Diji (SP8) versus acupuncture at Dijiand Guanyuan (CV4) in treating primary dysmenorrhea, for exploring the combination relation of the commonly-used acupoints in acupuncture treatment for primary dysmenorrhea.MethodForty patients with primary dysmenorrhea were randomized into a single acupoint group and a double acupoint group, 20 in each group. The single acupoint group was intervened by acupuncture at Diji, while the double acupoint group was by acupuncture at Diji and Guanyuan. The change of Visual Analogue Scale (VAS) score was observed and compared between the two groups.ResultThe changes of VAS score in the double acupoint group were more significant than that in the single acupoint group at each different time point.ConclusionAcupuncture at Diji alone and acupuncture at Diji and Guanyuan both can effectively treat primary dysmenorrhea; however, acupuncture at Diji and Guanyuan tends to produce a more significant effect than acupuncture at Diji alone; Diji and Guanyuan may work synergistically in acupuncture treatment for primary dysmenorrhea.

Objective To explore the risk factors for acute kidney injury (AKI)in patients with acute myocardial infarction (AMI).Method The medical data of hospitalized patients with AMI admitted from October 2013 to May 2014 were reviewed.All patients were divided into AKI group and non-AKI group.The univariate comparison analysis were performed to obtain the AKI risk factors.Results A total of 565 patients were enrolled.The incidence of AKI (n =91 )was 16.1% and there were 474 non-AKI patients.The mortality of AKI group was 19.8% and mortality of non-AKI group was 0.4% (P <0.01). Univariate analysis demonstrated that the risk factors of AKI were age,hypertension,previous myocardial infarction,heart failure history,chronic kidney disease,cerebral infarction history,peripheral vascular disease;ventricular fibrillation,heart rate,Killip grade ≥3 stage,left ventricular ejection fraction,serum creatinine,eGFR,hemoglobin,blood urea nitrogen,troponin I,B-type natriuretic peptide and C-reactive protein,fasting glucose,albumin,maximum daily dose of furosemide,non-use of ACEI /ARB and statins, the use of intra-aortic balloon pump, temporary pacemaker and pulmonary mechanical ventilation, implementation of PCI and coronary artery bypass graft surgery.Conclusions These risk factors for AKI after AMI were found to identify high-risk patients,helping the clinicians to make decision for preventive intervention.