Objective To observe the effect of valsartan combined with salvia miltiorrhiza ligustrazine in treating early diabetic nephropathy(DN),looking for an effective method for the treatment of early DN.Methods 51 DN patients were divided into two groups,28 cases in the treatment group were treated with valsartan and salvia miltiorrhiza ligustrazine therapy,23 cases in the control group only received valsartan treatment.Fasting blood glucose before and after treatment (FPG),2h postprandial blood glucose (2hPG),glycosylated hemoglobin (HbA1 c),BUN,Scr,urine albumin excretion rate(UAER) index were detected.Results Before and after treatment,FPG,2hPG,HbA1c,UAER in the two groups had statistically significant differences (t =5.361,6.458,3.026,7.894,5.648,7.604,6.590,8.652,all P ＜ 0.05).After treatment,2hPG,HbA1c,UAER between the two groups had statistically significant differences (t =3.125,3.520,3.881,all P ＜ 0.05).No statistical difference was observed before and after treatment in two groups of BUN,Scr (P ＞ 0.05).Conclusion Valsartan combined with salvia tetramethylpyrazine in treatment of early DN was more effective than single valsartan treatment,and no significant adverse reactions was found in combined treatment.Therefore,the combined treatment can be used as a new method for clinical treatment of early DN.

Nurse workstation, a typical client program of "No.1 Military" project, is trailed and speculated with Oracle tools such as TOAD, and then the general startup flow mode for "No.1 Military" project can be determined, which is instructive for its maintenance and programming.

ObjectiveTo evaluate the application value of the emergency laparoscopic surgery in incarcerated inguinal hernia of children. MethodsManual reduction of incarcerated hernia was laparoscopic- assisted after anesthesia, high-ligation of hernia sac was done by one hole method of laparoscopic treatment.ResultsAll of 22 cases of pediatric incarcerated hernia were done, no complications occurred. Eighteen patients were followed up for 3 - 15 months, 9.3 months on average, without serious complications. ConclusionsThe emergency laparoscopic surgery in children of incarcerated inguinal hernia is safe and feasible,with smaller trauma, quicker recovery and smaller health risk.

Objective To evaluate the effects of hypogastric artery ligation to treat massive hemorrhage in pelvic fractures with abdominal organ injuries. Methods The pelvic fractures of 16 patients were classified as Tile B type in 10 cases and C type in 6. Among them there were 6 open fractures and 20 sites of abdominal visceral injuries. The capacity of retroperitoneal hematoma, which was ruptured in 6 cases, ranged from 800 ～2 500ml with 1 400ml on average. The bleeding volume in the survivals was 1 500～5 800ml with 2 600ml on average. Ligation of bilateral hypogastric artery was carried out in all patients with intra abdominal injuries within 6h. Of them, skeletal traction was used in 7 cases while pelvic external fixation in 5 cases. Results One death occured dut to consumptive coagulopathy with hematorrhea. Of the 15 survivals, bleeding was controlled in 8 cases, decreased in 5 and uncontrolled in 2. The effective rate was 81.3%(13/16) and the survival rate 93.8%(15/16). Conclusion When emergency celiotomy is performed for abdominal injuries, a rational application of hypogastric artery ligation can play a positive role in control of pelvic hematorrhea.

Objective To investigate the different effects of different resection position of fibula on shape of tibiofibular syndesmosis,and explore the best position of cut fibula,providing reference for clinical surgeon to use fibula reasonably.Methods Ten adult male cadaverie specimens 172-176 cm long were used for 20 shank-ankle specimens.10 cm long fibula was cut proximally at the lower point 1/6,lower point 1/4,lower point 1/3,middle point 1/2 respectively,which was compared with the nornlal one to analyze the changes of shape of tibiofibular syndesmosis.Results Normally,the distance oftibiofibular syndesmosiswas(0.30±0.10)mm.Underthe condition of cut at the lower point 1/6,the distance of tibiofibular syndesmosis was enlarged[(0.54±0.20)mm](P＜0.05).In contrast,under the condition of cut 10 cm long fibula proximally at the middle point 1/2.the distance of tibioffbu1ar syndesmosis hadlittle effect[(0.31±0.20)mm](P＞0.05).Conclusion The best resection position of fibula is in the proximity of the fibula at the point 1/2.

Objective To retrospectively review the clinical characteristics and antimicrobial resistance profile of nosocomial bloodstream infections caused by Klebsiella pneumoniae in surgical patients for better use of antimicrobial agents.Methods The clinical data of the surgical patients who were diagnosed with K.pneumoniae-associated bloodstream infections in Tung Wah Hospital from January 2013 to June 2015 were reviewed and analyzed retrospectively.The diagnosis of bloodstream infections was based on national diagnostic criteria.The pathogens were routinely isolated and identified.Antimicrobial susceptibility testing was carried out by using Kirby-Bauer method.The data were analyzed by WHONET 5.6 software.Results A total of 78 surgical patients were identified with nosocomial bloodstream infections due to K.pneumoniae during this period,including primary bloodstream infections (12.8％,10/78) and secondary bloodstream infections (87.2％,68/78).These infections were mainly associated with surgical and invasive procedures.Nearly 40％ of the K.pneumoniae isolates were resistant to ceftriaxone,cefuroxime and piperacillin.ESBLs were produced in 43.6％ (34/78) of the K.pneumoniae isolates.The ESBLs-producing strains showed significantly higher resistance rates to various antibiotics than non-ESBLs-producing strains.Piperacillin-tazobactam,amikacin,imipenem,and meropenem still have good antibacterial activity against these K.pneumoniae isolates.However,imipenem-resistant strains are emerging.Conclusions Most of the bloodstream infections caused by K.pneumoniae were secondary to infections in other body sites in surgical patients.Hospital infection control measures should be strengthened.Meanwhile,the clinicians should take full advantages of microbiological laboratory to profile the pathogens and their susceptibility patterns,which is crucial for rational use of antibiotics.

Objective To introduce our experience in embolizing cerebral ruptured-aneurysms of elderly patients in our hospital. Methods Totally 76 elderly patients were referred to our hospital due to ruptured-aneurysms.81 aneurysms were confirmed by DSA,all of them were sac aneurysms,among which 75 cases (body/neck≥ 1) were treated with balloon-assisted coiling,29 narrow-necked (body/neck≥2) aneurysms and 30 wide-necked (1 ≤ body/neck＜ 2) aneurysms were treated with balloon-assisted coiling successfully,but 6 narrow-necked (body/neck≥2) were treated with balloonassisted coiling in emergency,followed by a stent-assisted coiling in secondary embolization,4 cases with body/neck＜1 were treated with stent-assisted coiling technique in emergency,2 non ruptured aneurysms could not be treated.The times of balloon dilation were (2.1 ± 1.3),single expansion of filling was (33.4±14.1)s. Results The arterial thrombosis happened in two patients (2.7 ％),two aneurysms ruptured (5.3％) during the procedure. No stent-related thrombosis happened. 86were elevated as good,8 as serious according to the Glasgow outcome scale,neither died after operation or delayed thrombosis or infarction lesion during following up. Conclusions Balloonassisted coiling is a safe and effective method in elderly patients during acute stage of rupturedaneurysms.

Objective:To investigate the effects of Zhitaiqing Granule on aortic endothelial cells in rabbit with experimental atherosclerosis. Methods:10 New Zealand rabbits were selected as blank control randomly and fed with normal forage,while the rest rabbits were fed with high-fat forage in formula A. After six weeks,hyperlipidemia models were formed and they were randomly divided into model group,Zhitaiqing treatment group,simvastatin control group and hawthorn tablet control group. From the 7th week,rabbits in treatment and control groups were fed with corresponding drugs while the blank and model groups with the same quantity of normal saline by lavage. After 11 weeks lavage,total cholesterol (CHO),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),apolipoprotein AI (apo AI),apolipoprotein B (apo B).were detected. With the help of optical microscope,the pathological changes of the aortic arch,thoracic aorta and abdominal aortic intima were observed. Results:In Zhitaiqing group,CHO,LDL-C,and ApoB reduced dramatically (P

Object To observe the improving effects of BUSHEN YIZHI DECOCTION (BSYZD) on interspace explore learning and memory in rat model with Alzheimer's disease. Methods Eighty 15-month Wistar rats were induced by ip D -galactose for four weeks and injection of basal nucleus of Meynert with ibotenic acid (IBO) to make AD model, then randomly divided into AD model group, Hup-A treated group, BSYZD (high dose, 12 g/kg?d) treated group and BSYZD (low dose, 6 g/kg?d) treated group, and also normal aged and young groups. After treating for four weeks, Morris water maze was used to assess the improvement of rat interspace explore learning and memory. Results In the interspace explore experiment, the significant differences were observed between the model, Hup-A treated groups and normal aged, young groups (P0.05). Conclusion BSYZD possesses a certain preventive effects on interspace explore learning and memory in AD rat model.

Objective To observe the therapeutic effects of exercise combined with tiotropium bromide and salmeterol/fluticasone inhaling on stable chronic obstructive pulmonary diseases (COPD).Methods Sixty COPD patients with pulmonary function Ⅲ-Ⅳ grade were randomly allocated into experiment group and control group (30 cases in each group).The patients in experiment group were treated with inhaled tiotropium bromide and salmeterol/fluticasone combined with excise,while the patients in control group were treated only with inhaled tiotropium bromide and salmeterol/ fluticasone.Respiratory training with shrinkage lip respiration and steps training was given to the patients in experiment group for 8 weeks.Main outcome measures included forced expiratory volume in one second (FEV1),FEV1,in the anticipation value (FEV1%),FEV1/forced vital capacity (FVC),Medical Research Council (MRC) score,activities of daily living (ADL) score and 6-minute walking distance (6MWD).Results MRC score in control group and experiment group was both lower than that of pre-treatment (P < 0.01).ADL score,6MWD and pulmonary functional parameters in both groups were improved than those of pre-treatment (P< 0.01).FEV1,FEV1%,FEV1/FVC,MRC score,ADL score and 6MWD were (1.41 ±0.25) L,(53.76 ±11.17)%,(62.12 ±10.78)%,(1.56 ± 1.16) scores,(5.51 ±0.18) scores and (342.7 ± 19.7) m after treatment in experimentgroup,and (1.28 ± 0.23) L,(46.27 ±8.85)%,(55.76 ±8.57)%,(2.29 ±1.13)scores,(4.47 ±0.13)scores and (280.6 ± 17.8)m after treatment in control group.There were significant differences between two groups (P<0.05).Conclusion Tiotropium bromide,salmeterol/ fluticasone inhaling can improve life quality and pulmonary functional parameters in patients with stable COPD,while exercise combined with that can significantly enhance the therapeutic effects.