Objective To analysis the relationship between blood homocysteine concentration in diabetic retinopathy patients with vascular endothelial cell damage and platelet activation.Methods 80 type 2 diabetes mellitus(T2DM)patients,including 50 no diabetic retinopathy(NDR group)and 30 diabetic retinopathy(DR group)and 30 normal controls were selected to measure the concentration of Hcy as well as circulating endothelial cells(CEC),Endothelin(ET),Yon Willebrand(vWF)and platelet activation markers CD62p and CD63.Results The level of CEC,ET,vWF,CD62p,CD63 and Hcy in T2DM group were,distinctly higher than those of control(P＜0.01),furthermore,the level of these markers in DR group were also higher than that in NDR group(P＜0.01).Blood CEC level Was positively related with ET(r=0.839,P＜0.05),and the same relationship was found in Hcy and CEC(r=0.615,P＜0.05),ET(r=0.642,P＜0.05),CD62p(r=0.623,P＜0.05)and CD63(r=0.542,P＜0.05).Conclusions High blood Hcy,CEC,ET,vWF,CD62p and CD63 level were tighdy related with DR.High level of Hcy,vascular endMermis cell damage and platelet activation maybe play an important role in the pathogenesis of DR.

Objective Research of chromosome’s influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional genetic analysis to 80 Ph+ CML patients,and contrast CML patients’chromosome changing situation with first and second generation tyrosine kinase inhibitor therapy.Results There were 1 1 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases were resistant or intolerant to imatinib.35 patients (87.5%)achieve sustained complete cytogenetic remission (CCyR)who treated with imatinib (TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases (17.5%)got CCyR in 3 months;10 cases (25%)got CCyR in 6 months,13 cases (32.5%)got CCyR in 12 months,and 5 cases (12.5%)got CCyR in 18 months.33 patients (82.5%)achieve sustained completecytogenetic remission (CCyR)who treated with dasatinib/nilotinib (TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases (40%)got CCyR in 3 months;9 cases (22.5%)got CCyR in 6 months,5 cases (1 2.5%)got CCyR in 1 2 months,and 3 cases (7.5%)got CCyR in 1 8 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,espe-cially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time effica-cy.

Primary biliary cirrhosis (PBC) is considered to be an autoimmune liver disease. Its etiology is unknown. Pathogenesis of PBC is associated with many aspects such as genetic factors, environmental factors, independent activity of target antigen, T-cell autoreactive immune responses and so on. Recently, new materials that involved in the morbidity of PBC have been identified constantly. Antimitochondrial antibodies (AMA) are characteristic of PBC. In particular, AMA-M2 is highly positive for the serological diagnosis mark of PBC. At present, treatment still cannot be for the etiology of PBC. Symptomatic treatment and support treatment are main measures. Ursodeoxycholic acid (UDCA)is the only one recognized medication with specific effect on the PBC. At present, the liver transplant can increase the survival rate and extend their survival time for end-stage of patients with PBC. This article emphasis on the progress of pathogenesis and treatment of the PBC are reviewed to explore research.

Objective To investigate the molecular mechanism of Klebsiella pneumoniae resistant to imipenem.Methods Anti-microbial susceptibility was evaluated by disk diffusion test,Seven imipenem-resistant strains of Klebsiella pneumoniae were select-ed.And PCR was used to amplify so as to detect eighteen resistant genes.Results Seven imipenem-resistant strains of Klebsiella pneumoniae were more sensitive to aminoglycosides and sulfamethoxazole/trimethoprim.The positive rates of KPC,ant(3′′)-Ⅰ, SHV,CTX-Mand ant(2′′)-Ⅰin these imipenem-resistant strains were high.Conclusion Carbapenem-resistant Klebsiella pneumon-iae isolated from our hospital carries several kinds of resistant genes.Carrying KPC may be the main resistant mechanism of Kleb-siella pneumoniae resistant to carbapenem,but other mechanisms also exist at the same time.

Objective: To observe the effect of electroacupuncture (EA) combined with Stretta radiofrequency treatment on contents of motilin (MTL) and gastrin (GAS) in gastroesophageal reflux disease (GERD) patients.
Methods: A total of 90 eligible GERD cases were randomly allocated into three groups, 30 in each group. Patients in the EA group were treated with EA, patients in the radiofrequency group were treated with Stretta radiofrequency, and patients in the observation group were treated with EA combined with Stretta radiofrequency. Assessment was made after a course of treatment.
Results: The recovery, improvement and failure cases and total effective rate in the EAgroup were 2, 18, 10 and 67.7% respectively, versus 13, 13, 4 and 86.7% in the radiofrequency group and 20, 9, 1 and 96.7% in the observation group. The therapeutic efficacy in the observation group was significantly better than that in the other two groups (P<0.01). After treatment, symptom scores of regurgitation, heartburn and substernal burning pain in all three groups were significantly reduced (P<0.05); the reduction in the observation group was more significant than that inthe other two groups (P<0.05),and the reduction in the radiofrequency group was more significant than that in the EA group (P<0.05). After treatment, the contents of MTL and GAS in all three groups were increased; and the increase in the observation group was more significant than that in the other two groups (P<0.05).
Conclusion: EA combined with Stretta radiofrequency treatment can significantly improve the clinical effect of GERD patients, improve regurgitation, heartburn and substernal burning pain and increase the contents of MTL and GAS.

Objective To evaluate the effect of dexamethasone on lumbar plexus combined sciatic nerve block (CLPSNB). Methods Sixty patients were randomly allocated into three groups with 20 cases each. Guided by a nerve stimulator,CLPSNB was performed with 0. 5% ropivacaine 45 ml plus dexametbasone 10 mg in group A,0. 5% ropivacaine 45 ml plus normal saline(NS) 2 ml and dexametbasone 10 rng Ⅳ. in group B,or 0. 5% ropivacaine 45 ml plus NS 2 ml in group C. ResultsThe durations of sensory and motor blockade in group A were [(15. 2 ± 3. 3)h and (12. 6 ± 2. 8)h], respectively, which were significantly longer than [(10. 1 ± 2. 1)h and (7. 9 ± 1.6)h]in group B and [(10. 4±2. 5)h and (7. 6±2. 3)hi in group C(P<0. 05). Conclusion Dexarnetbasone added to 0. 5% ropivacaine significantly prolonges CLPSNB.

Anti-Inflammatory Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Ear Cartilage ; Female ; Humans ; Integrative Medicine ; methods ; Middle Aged ; Panniculitis ; complications ; drug therapy ; Phytotherapy ; Polychondritis, Relapsing ; complications ; drug therapy ; Prednisone ; therapeutic use ; Treatment Outcome

Objective To investigate the efficacy of patient-controlled epidural analgesia(PCEA)with ropivacaine plus fentanyl for postoperative analgesia after suprapubic prostatectomy(SPP).Methods Thirty-six ASAⅡorⅢpatients aged 62-78 yrs weighing 52-84 kg undergoing SPP were randomly divided into 3 groups with 12 patients in each group:groupⅠreceived PCEA with 0.12% ropivacaine and fentanyl 1?g?ml~(-1);groupⅡreceived PCEA with 2% ropivacaine and fentanyl 1?g?ml~(-1) and groupⅢreceived patient-controlled intravenous analgesia(PCIA)with morphine 0.2 mg?ml~(-1).Postoperative pain was assessed using VAS(0=no pain,10= worst pain).The degree of motor blockade(modified Bromage scale)was evaluated at 6,24,48 and 72 h after operation(T_(1-4)).Bladder spasm episodes were recorded.Side effects including nausea,vomiting and pruritus and the total number of RBC in rinse solution were also recorded.Results(1)Bromage score(0=no motor block,3 =inability to flex ankle joint)was significantly higher in groupⅠandⅡthan in groupⅢat T1(6 h after op.), but significantly lower in groupⅠandⅢthan in groupⅡat T_(2-4)(24-72 h after operation).(2)VAS score(0= no pain,10=worst pain)was not significantly different among the 3 groups without bladder spasm but significantly higher in groupⅢthan in other 2 groups during episodes of bladder spasm.(3)The number of bladder spasm episodes was not significantly different among the 3 groups within 6h after operation,but was significant larger in groupⅢthan in the other two groups during 6-72 h after operation.During 6-24 h after operation more bladder spasm attacks occurred in groupⅠthan in groupⅡ.(4)The incidence of side effects was significantly lower and the total number of RBC in rinse solution was significantly smaller in groupⅠandⅡthan in groupⅢConclusion PCEA with 0.12% or 2% ropivacaine plus fentanyl can effectively reduce the number of bladder spasm attack and postoperative bladder bleeding.Different concentrations of ropivacaine should be used for PCEA during different postoperative periods.

Objective To determine if propofol-remifentanil and isoflurane have any different effects on intrapulmonary shunt during one-lung ventilation (OLV). Methods Twenty-four ASA Ⅰ or Ⅱ patients (18 male, 6 female) aged 42-69 yr undergoing radical esophagus cancer resection via left thoracotomy were randomly divided into 2 equal groups ( n = 8 each) : propofol group (Pro) and isoflurane group (Iso) . The preoperative lung function was normal in both groups. The patients were premedicated with intramuscular diazepam 10 mg and atropine 0.5 mg. Radial artery was cannulated and S-G catheter was placed via right internal jugular vein in pulmonary artery. Anesthesia was induced with propofol 1.5-2.0 mg?kg-1, fentanyl 4 ?g?kg-1 and succinylcholine 1.5 mg?kg-1 and maintained with TCI of propofol and remifentanil (target plasma concentration was set at 3.2 ?g?ml-1 and 4.5 ng?ml-1 ) or isoflurane inhalation ( end- tidal isoflurane concentration = 1.5% -2.5 % ) and intermittent i. v. boluses of fentanyl. The patients were mechanically ventilated after endobronchial intubation with double-lumen tube (VT = 8-10 ml, RR= 10-12 bpm, I:E = 1:2) . During OLV VT was reduced to 6-8 ml and RR increased to 14-16 bpm.PaCO2 was maintained at 35-45 mm Hg. ECG, HR, MAP, SpO2, auditory-evoked potential index (AAI), cardiac index (CI), airway pressure and end-tidal isoflurane concentration were continuously monitored during operation. Blood samples were taken from radial artery and pulmonary artery at 10 min after S-G catheter placement (T0, baseline) at 10 min bilateral ventilation (in right lateral position) (T1) at 15, 30, 60, 90 min of OLV (T2-5) for measurement of blood gases and calculation of Qs/Qt.Results The two groups were comparable with respect to age, M/F ratio, body weight and preoperative lung function. AAI was below 30 during operation and PaCO2 and pH were within normal range in both groups. Qs/Qt was significantly increased while PaO2 was significantly decreased during operation (from T1 to T5 ) as compared to baseline values (T0) but Qs/Qt was gradually decreasing while PaO2 was gradually increasing from T2-5 in both groups. Qs/Qt was significantly lower in Pro group than in Iso group at each interval (T2-5) but there was no significant difference in PaO2 at T2-5 between the two groups. Conclusion There is less intrapulmonary shunt during OLV under general anesthesia with propofol-remifentanil than with isoflurane but the difference is not significant enough to affect PaO2.

OBJECTIVE To explore the scientific and standardized experience of blood purification center of infectious diseases hospital in the hospital infection management.METHODS The development of its experience was summed up.RESULTS Sound system,wide range of focused training,as well as hospital infection in day-to-day management basis,and establishment and improvement of the incident management were carried out to control the nosocomial infection.CONCLUSIONS Correct system and norms,stringent measures and continuously updating the concept of nosocomial infection can effectively improve the management of hospital infection.