Objective To observe the clinical effect of medicated diet of primary hyperuricemia .Methods 80 cases of primary hyperuricemia patients were randomly divided into experimental group and control group , 40 casesin each group.The experimental group used traditional Chinese medicine medicated diet on the basis of conventionaltherapy, and the control group was given conventional treatment .The change of indicators including main, secondaryclinical symptoms, signs and laboratory were observed before and after treatment in the two group patients .Results In the experimental group, the total effective rate was 92.5%; The control group the total effective rate was 82.5%.The experimental group was more efficient than the control group .Two groups of curative effect in the treatment ofsymptom improvement, there was significant difference (p <0.05).Blood uric acid before and after treatment wasimproved in the two groups (p <0.05).Blood uric acid level of experimental group decreased significantly comparedwith the control group (p <0.05).Conclusion The physique of Chinese Medicined Diet as dialectical auxiliary pri -mary hyperuricemia in clinical treatment of the exact effect , has not found adverse reactions.It is worth popularizationand application, and the formula need to be further enriched and perfected .

Objective:To investigate the protective effect of dimethylsulfoxide(DMSO) on axon degeneration.(Methods: Cultured) rat superior cervical ganglia were treated with DMSO(100%,10 ?l) per well to disconnect axons from the cell bodies.SCGs in DMSO control group were treated with a mixture of DMSO(10 ?l) and medium (2 ml) per well;in positive control group were transfected with herpes simplex virus over-expressing Wld~S protein and the cell body was eliminated;and in blank control group were treated with 10 ?l PBS.The separated axons were fixed with 4% poly formaldehyde at 0,4,8,12 and 24 h after treatment with DMSO for immunostaining with specific antibody to microtubulin.Thus,the changes of axonal structure were investigated.The axonal protein was collected and the degeneration of neurofilament was detected by Western Blotting.Results: In DMSO disconnected group,the axonal morphology and structure showed no obvious change at 12 h post disconnection,but slight degeneration was observed at 24 h post disconnection.The degradation of microtubulin was obviously slowed down and their axonal structures maintained intact 12 h later.The neurofilament could be detected 12 h after disconnection.The above changes in disconnected group were similar to those in positive control group.No obvious protective effects on axonal degeneration were observed in blank and DMSO control groups.Conclusion: Local high concentration of DMSO can delay axonal degeneration,which indicates that DMSO can be used for adjuvant treatment of neurodegenerative diseases.

?Acute retinal necrosis syndrome ( ARN) is a serious eye disease, which caused by Herpes virus mostly, with unknown pathogenesis. Because of the aggressive progression, treatment of ARN is difficult, and the blindness rate is extremely high. Current treatment strategies are the combination of the drug therapy and the operative treatment. Drugs commonly used are antiviral drugs, glucocorticoids, and antiplatelet drugs, and the operative treatment includes laser photocoagulation and vitrectomy.

Objective:To evaluate the analgesic effect of low dose ropivacaine combined with fentanyl in patient controlled epidural analgesia (PCEA) and its influence on labor and safety of mothers and their newborns. Methods:One hundred and forty healthy nullipara at term were randomly assigned to epidural analgesia or control group. The analgesia group received PCEA when their labor stage reached active period in the first stage of labor.The PCEA mode was background infusion 6 ml/h, bonus 2 ml,lockout time 10 min/each infusion. The VAS, modified Bromage scale(MBS),duration and mode of labor, postpartum hemorrhage,Apgar scores of newborns were recorded. Results:Fifteen minutes after application of PCEA,98.58% of patients felt no pains(VAS 0.057?0.48),only 4.8% showed a mild motor block(MAS 0.07?0.31).By the 60 min,all patients could move the lower limbs freely (MAS 0). The analgesia group had a significantly shorter duration of active period in the first stage of labor than that of the control group, but a significant longer duration of the second stage. In addition, the oxytocin usage was significantly more frequently in analgesia group than those in placebo group.There was no difference between the two groups in the duration of third stage, postpartum hemorrhage, Apgar scores of newborns in 1 min and 5 min, rate of cesarean section and instrumental delivery.Conclusion:Epidural analgesia with low dose ropvicaine combined with fentanyl is safe and effective, which has no influence on mothers and their infants. It could shorten the active period of labor, but may increase oxytocin usage. The ratio of cesarean section and instrumental delivery was similar between the two groups. This kind of labor analgesia is beneficial and do no harm to mothers as well as newborns.

Clinical teaching plays an important role in the education of medical graduate students.In the clinical teaching of the graduate students of burn and plastic surgery,we based it on clinical practice and guided the students in changing their modes of learning and thinking from examination-orientedness to problem solving,from simple vertical to clinical lateral thinking.We made sure that they all acquired innovative ideas and correct methods of clinical research by various academic activities,and cultivated their practical abilities and medical virtues by strict training and moral education.

Objective To study the effects of total saponins of Chaenomeles speciosa on release of β-hexosaminidase from rat basophilic leukemia-2H3 ( RBL-2H3 ) mast cells. Methods After rat RBL-2H3 mast cells were prepared, total saponins of Chaenomeles speciosa and the RBL-2H3 mast cells were co-cultured.The toxic effects of total saponins of Chaenomeles speciosa on mast cells were detected by MTT method, β-hexosaminidase release rate was measured by fluorescence quantitative spectrophotometric method, and cell supernatants of tumor necrosis factor-α( TNF-α) release were detected by ELISA. Results After total saponins of Chaenomeles speciosa were co-cultured with RBL-2H3 mast cells with different antigen stimulation, β-hexosaminidase release rates and the levels of TNF-α of mast cells significantly decreased compared with the control group. Conclusion Total saponins of Chaenomeles speciosa inhibit the degranulation of RBL-2H3 mast cells in a dose dependent manner, which provids basis for studying mechanism of inhibiting allergic reactions.

Objective To analyze the epidemiologic characteristics and risk factors for mortality in non-(human immunodeficiency virus,HIV) infected children with pneumocystis carinii pneumonia(PCP). Methods The data of non-HIV infected children with PCP diagnosed in Beijing Children′s Hospital from January 1,2006 to December 31,2012 were collected. They were divided into survival and non-survival group according to the prognosis. The epidemiologic characteristics and risk factors for mortality were analyzed. Results Sixteen patients were enrolled in this study. Ten of them survived and 6 of them were non-survived. The basic diseases included malignant tumor in 5 patients and non-malignancy diseases in 11 of them. Com-pared with the survival group,the non-survival group had a higher average age [(12. 00 ± 2. 00) years vs. (6. 65 ± 4. 32)years,P=0. 01],higher ratio to need mechanical ventilation (6/6 vs. 4/10,P=0. 04),lower PaO2/FiO2[(73. 88 ±26. 95) mmHg vs. (167. 50 ± 97. 17) mmHg,1 mmHg=0. 133 kPa,P=0. 01] and lower pediatric critical illness score(75. 67 ± 5. 72 vs. 86. 40 ± 8. 88,P=0. 02). There were no differences on sex ratio,kinds of basic diseases,whether with co-infections,the time of immunosuppressant administration, the time from onset to diagnosis,the time from onset to beginning trimethoprim-sulfamethoxazole therapy, PaCO2 ,white blood cell counts,lymphocyte counts,CD4+ cell counts,C-reactive protein,and hemoglobin con-centrations between the survival and non-survival group. Conclusion A higher age, need for mechanical ventilation,lower PaO2/FiO2 and lower pediatric critical illness score were risk factors for mortality in non-HIV infected children with PCP.

OBJECTIVETo investigate the feasibility of immediate breast and nipple-areola reconstruction after skin-sparing mastectomy.

METHODS24 patients who received skin-sparing mastectomy underwent immediate breast reconstruction with or without breast implants. The nipple-areola complex is also reconstructed with the skin paddle of the latissimus dorsi flap in one stage.

RESULTSAll the latissimus dorsi myocutaneous flaps survived completely. Partial necrosis happened in two reconstructed nipples which healed after dress changing. The follow-up period ranged from 6 to 12 months. 3 patients presented with capsular contracture (Baker I), with no necessary of surgical revision. The retraction rate of reconstructed nipples projection is 35.4% at 6 months postoperatively and 38.6% at 12 months postoperatively. 91.7% of patients were satisfied or very satisfied with the breast shape, while 83.3% were satisfied or very satisfied with the breast volume. All the patients considered the reconstructed nipple very good, while 91.6% were satisfied with the nipple projection. 91.7% considered immediate nipple reconstruction to be very important, and 8.3% considered it to be important. 66.7% considered the new breast could replace the breast they had lost, and 8.3% considered that it could not.

CONCLUSIONFor skin-sparing mastectomy, immediate breast and nipple reconstruction can achieve good aesthetic results.

Breast Neoplasms ; surgery ; Esthetics ; Female ; Humans ; Mammaplasty ; methods ; psychology ; Myocutaneous Flap ; transplantation ; Nipples ; surgery ; Superficial Back Muscles ; transplantation

Objective To investigate the feature of diabetic foot ulcer and the relative mechanism, and to analyze its predilection site. Methods The precipitating factors and the areas of ulcer were analyzed in 121 diabetic patients with foot ulcer. The peripheral neuropathy was diagnosed by measuring the skin sensation, tendon reflex, electromyogram or vibration perception threshold (VPT). The diabetic peripheral neuropathy (DPN) was evaluated by positive symptoms, ultrasound or magnetic resonance angiography. According to morbid changes, the patients were divided into neuropathic ulcer group (n = 33), ischemic ulcer group (n = 27), and mixed type ulcer group (n = 61). Results The ulcers of 97 cases (80. 2%) were distributed in digital pedis and plantar pedis. In neurogenic ulcer group, there were 48.5% lesion at planta pedis, 30.3% at dorsum pedis, and 21.2% at digiti pedi. In ischemie ulcer group, there were 59.3% at digiti pedis, 29.6% at dorsum pedis, and 11.1% at planta pedis. In mixed type ulcer group, there were 49. 2% at digiti pedis, 41% at planta pedis, and 9.8% at dorsum pedis. The difference of ulcer distribution was apparent in these groups. Among these three groups, patients in mixed type ulcer group was the oldest, and had the longest duration of diabetes (P<0.05) and the largest area of ulcer at diagnosis. However, the BMI and blood pressure in isehemic ulcer group were higher than those of the other groups (P>0.05). Conclusions The difference of lesion basis affects the position of diabetic foot ulcer, and the thumbs and plantar pedis are the predilection area of diabetic foot.

Objective In order to investigate the relationship between hearing loss and diabetic peripheral neuropathy( DPN ) via comparing the pure tone thresholds and vibration perception threshold(VPT) in type 2 diabetic patients and control person without diabetes. Methods 173 subjects including 138 type 2 diabetic patients(DM)and 35 non-diabetes controls were examined for VPT and hearing threshold. Nerve conducting velocity ( NCV )including sensory nerve conducting velocity( SCV )and motorial nerve conducting velocity( MCV )of diabetic patients were determined. The participants were divided into three groups: control group (n = 35 ), DM group without peripheral neuropathy( non-PN group, n = 74 ), and DM group complicated with peripheral neuropathy (PN group,n = 64 ). The clinical characteristics, biochemical parameters , the incidence of sensorineural hearing loss ( SNHL),pure tone threshold, and VPT were compared among three groups. At last, the relationship between hearing thresholds and NCV were analyzed. Results The incidence of hearing impairment of sensorineural type was 29.69% in PN group, which was significantly higher than that of non-PN group( 17.57% )and control group( 17. 14% ). There was significant differences in age, duration of diabetes, glycolated hemoglobin (HbA1c), glycolated serum albumin ( GA), Fasting blood glucose( FPG), 2h postprandial blood glucose( PPG), VPT, and hearing threshold among the three groups( all P＜0. 05 ). The value of hearing threshold increased significantly( all P＜0. 05 ) in 3 VPT subgroups with VPT≤ 15 V, VPT 16-25 V, and VPT ＞25 V. The Spearman correlation analysis showed median NCV was negatively correlated with hearing threshold on 1.00, 2.00, 4. 00, and 8. 00 kHz ( All P ＜ 0. 05 ). The logistic regression analysis indicated that the age( regression coefficient =0. 088, P＜0. 01 ) was the independent risk factor of SNHL, median nerve MCV ( regression coefficient = -0. 135, P = 0. 046 ) was the important influencing factor of SNHL. Conclusion Diabetic patients are more likely to suffer from impaired middle-frequency and high-frequency hearing, DPN in patients is often complicated with hearing impairment. Age and median nerve MCV were major risk factors of SNHL in diabetic patients.