Ascites is an important indicator of poor prognosis of liver cirrhosis.Although several guidelines and consensus statements on the management of ascites have been published in the past years,there are still a lot of controversial problems in this regard.The current contro-versial problems and difficulties in the management of ascites,such as the timing of sodium supplementation or sodium restriction,the selec-tion of diuretics,the application value of aquaretics,the strategy of albumin administration after large-volume paracentesis,and the indica-tions and efficacy of transjugular intrahepatic portosystemic shunt,are reviewed.It is pointed out that further studies on these problems with evidence-based medicine means will enhance the diagnosis and treatment of cirrhotic ascites and improve patients'prognosis.

There is evidence to show that the treatment in a stroke unit reduces mortality in patients with stroke and improves neurological functional recoxery.Early mobilization is benefit to improve the prognosis in patients stroke,however,there is a lack of high-quality evidence.The term of"early mobilization"after stroke is not well defined now.A number of medical workers lack enough understanding of the early mobilization.How to perform the early mobilization to get the best benefit is unclear.This article reviews the related studies about the early mobilization after stroke.

OBJECTIVE:To discuss the characteristics and regularities of adverse drug reactions (ADR) in our hospital. METHODS:ADR reports of 618 cases collected via ADR network system and submitted to state ADR database from 2005 to 2006 were analyzed statistically in respect of patients' age and sex,rating of correlated factors and outcome,clinical manifestations,routes of administration,and the involved drugs etc. RESULTS:Anti-infective drugs dominated the first place on the list of ADR incidence rate,followed by antineoplastic agent and Chinese patent medicines. The main symptoms of ADR were drug eruption,allergic,athma,followed by gastrointestinal reaction. There were fewer incidences of serious ADR such as bone marrow depression,hypoleukemia and shock. CONCLUSION:The ADR monitoring in Fuzhou General Hospital is lack and should be strengthened,and knowledge of ADR must be publicized for guiding the rational,safe and effective drug use in clinic.

Objective To investigate the causes of intra-abdominal hernia and improve the level of early (diagnosis) and therapy of intra-abdominal hernia. Methods A retrospective analysis of the clinical data of 68 cases of intra-abdominal hernia was made. Results The postoperative confirmed diagnosis was para-occal hernia in 1 patient;herniation of efferent jejunal loop through the space between the afferent jejunal loop and the mesocolon after Billroth II gastrectomy in 6 patients,one of which had bowel necrosis,all of the 6 patients were cured after reduction of the hernia or enterectomy after and enteroanastomsis;internal henia though (ruptured) pelvic (peritoneum) after Miles operation in 4 patients;internal hernia though the space between the (descending) colon and the lateral abdominal wall after colostomy of descending colon in 6 patients;internal (hernia) caused by (adhesion) of omentum to the intestinal wall of sigmoidostomy in 1 patient;internal hernia through hiatuses caused by postoperative or post-peritonitis adhesions to the peritoneum,ovaries,urinary (bladder),uterus,(intestinal) wall or between loops of intestine in 50 patients(73.5%),including 3 cases of bowel (necrosis).All of those patients were cured after reduction of the hernias,repair of the hiatuses,release of (adhesions) or enterectomy and enteroanastomosis. Conclusions Preoperative diagnosis of internal abdominal hernia is difficult.The possibility of internal abdominal hernia should be cansidered in patients with a history of operation,and who complain of frequent abdominal pain or bowel obstruction.Early diagnosis and prompt (operation) is necessary to prevent the occurrence of bowel strangulation and bowel necrosis.

Objective Through the application of recombinant human Ⅱ tumor necrosis factor-Fc function protein (rhTNFR:Fc) in the treatment of juvenile idiopathic arthritis (JIA) with randomized control study,clinical characteristic and clinical effect were summarized.Methods According to the randomized controlled principle,124 patients with JIA were divided into control group and treatment group.The basic treatment in two groups were one antirheumatic slow-acting drug,nonsteroidal drug,adrenal cortical hormone.There were no significant differences between clinical type and basic treatment in two groups (P ＞ 0.05).Sixty-two patients of JIA treated with rhTNFR:Fc by subcutaneous injection.The doses was 0.8mg /kg per week.There were 17 cases of oligoarthritis,15 cases of polyarthritis,30 cases of systemic arthritis in the treatment group and control group respectively.The basic antirheumatic drugs,nonsteroidal anti-inflamatory drugs ( NSAIDs),adrenal cortex hormone were allowed to continued.Clinical evaluation index included ACR Pedi 30,ACR Pedi 50 and ACR Pedi 70.The adverse drug reactions were recorded.Results The remission rate of ACR Pedi 30,50,70 in 2 weeks,one month,three monthes and six monthes were different in types of JIA patients in the treatment group ( P ＜ 0.05 ).The remission rate of systemic arthritis was lower than the other two groups of arthritis ( P ＜ 0.05 ).Only 44％ ACR Pedi 50 remission was achieved after three monthes medication in systemic arthritis and 41.7％ ACR Pedi 50,29.2％ ACR Pedi 70 were achieved after six monthes.The remission rate in the types of oligoarthritis and polyarthritis at different time points (2 weeks,one month,three monthes,six monthes) of ACR Pedi 30,50,70 were similar.After six monthes,more than 80％ reached ACR Pedi 50 remission,more than half of patients reached ACR Pedi 70 remission.Three cases of macrophage activation syndrome in systemic arthritis group was effective treated with rhTNFR:Fc.In the treatment group,2 cases of systemic arthritis appeared ache and discomfort after one week treatment,3 cases appeared repeated mild upper respiratory tract infection and diarrhea during treatment,including one varicella infection.The incidence of adverse reactions in the treatment group of systemic arthritis were 16.7％,Other 2 types of patients did not show adverse reaction during rhTNFR:Fc treatment.Conclusion rhTNFR:Fc has good effect on oligoarthritis and polyarthritis of JIA.The adverse reactions of six monthes were rare.The cases of systemic arthritis could reach some clinical remission,but need to guard against infection and the occurrence of adverse reactions.To whom did not respond to conventional therapy in systemic arthritis or systemic arthritis combined with macrophage activation syndrome,it could be considered with rhTNFR:Fc.

Objective To constitute a database of chronic wounds for characterizing the patients with chronic wounds.Methods Based on the guideline of chronic wounds defined by international wound healing society,86 outpatients with chronic wounds were selected between January and October in 2013 to set up a wound database using the wound information management system.The parameters including etiology,age distribution,mean time of fracture healing and wound healing time posterior to different treatments were analyzed.Results (1) Statistical difference existed for cause distribution (P ＜0.05).Top three causes were trauma (29％),varicosity (26％) and pressure sore (19％).(2) Age distribution varied significantly among the patients with various causes of chronic wounds (P ＜ 0.05).(3) Statistical difference was observed in healing time of various types of chronic wounds (P ＜ 0.05).Diabetic wound and varicose ulcer took the longest healing time,with average 116.36 days and 88.48 days respectively.(4) Patients treated with novel dressings had shorter healing time than those managed with traditional dressings (P ＜ 0.05).Conclusions Trauma,varicosity and pressure ulcer are relatively common among the outpatients.Etiology of chronic wounds is strongly related to age and novel dressings contributed to a shortened cause of the disorder.

AIM　To investigate the inhibitory effects on the growth of SMMC-7721 human hepatocellular carcinoma cell line and its mechanism by theasinesin. METHODS　MTT assay,colony formation test, 3H-TdR, 3H-Leu incorporation test, determination of the intracellular cAMP and cGMP level, in situ hybridization were used. RESULTS　Theasinesin at 50 mg*L-1 could significantly inhibit the growth and colony formation of SMMC-7721 cells. Theasinesin could strongly inhibit DNA and protein synthesis and increase intracellular cAMP levels. C-myc gene expression was significantly decreased and p53 gene increased strongly in a dose-dependent manner.CONCLUSION　Theasinesin demonstrates significant inhibitory effects on the growth of SMMC-7721 cells. Its mechanisms may involve the inhibition of DNA and protein synthesis ,the elevation of intracellular cAMP levels, inhibition of c-myc gene expression and enhancement of p53 gene expression.

Objective To compare the effectiveness of nose jejunal tube (NJT) and nasogastric tube (NGT) in providing early enteral nutrition for patients with severe craniocerebral injury. Methods Forty patients with severe craniocerebral injury and required early enteral nutrition were equally and randomly divided into NJT group and NGT group based on the tube type. The biochemical indicators, gastrointestinal tract tolerance, and complications were compared between these two groups. Results Serum albumin, blood glucose, and lymphocyte count were not significantly different between these two groups before and immediately after nutritional support (all P ＞0. 05). However, 14 days after nutritional support, the blood sugar level significantly decreased compared with the baseline levels in the NJT group (P =0. 0001). The incidences of reflux (P = 0. 001) and abdominal distension (P =0.011) were significantly lower in NJT group than in NGT group. Conclusion NJT is superior to NGT in providing early enteral nutrition for patients with severe craniocerebral injury.

Objective To observe the effect of sublingual Nifedipine on brain function in emergency cases with hypertension.Methods The changes of blood pressure, electroencephalogram (EEG) and brain electrical activity mapping (BEAM) in 56 patients with emergency hypertension before and after sublingual Nifedipine were analyzed.Results Within 2 hours after sublingual medicine, EEG results improved in 3 cases and did not change in 27. More severe abnormal EEG changes were seen in 26 cases, ? and ? band power rose evidently in these patients (all P

Src is a non-receptor protein tyrosine kinase activated by a number of extracellular signal moleculars. It is recruited to peripheral sites through myristoylation and the SH3 domain. Src initiates intracellular signal trandsduction pathways that influence cell adhesion, migration, growth, differentiation and survival though catalytic domain. Src is normally maintained in an inactive conformation because of carboxy terminal Src kinase, but can be activated transiently during cellular events such as mitosis or constitutively by abnormal events such as mutation and some cancers. In additions, c-Src protein is found to be highly activated and the Src gene is frequently over-expressed in many cancers. These findings suggest that the relationship between c-Src activation/over-expression and cancer progression appears to be significant.