Objective To evaluate the efficacy of Mahuang-Fuzi-Xixin decoction and Wuling powder combined with routine western medicine therapy for chronic kidney disease (CKD) stage 3.Methods A total of 65 patients with CKD stage 3 were recruited and randomized into a treatment group (32 cases) and a control group (33 cases).On the basis of the same routine western medicine therapy,the patients in the treatment group was treated with Mahuang-Fuzi-Xixin decoction and Wuling powder,while those in the control group was treated with ketosteril.All patients were treated for one month.Renal function was evaluated by serum creatinine,urea nitrogen and uric acid before and after treatment.The therapeutic effect was compared between the two group.Results The serum ereatinine after treatment in the treatment group was significantly decreased than that in the control group (387.52 ± 92.13 mol/L vs.502.78 ± 117.35 mol/L;t=4.395,P＜0.01).The total effective rate in the treatment group was significantly higher than that in the control group (87.5％ vs.42.4％;X2=12.533,P＜0.01).In respects of syndrome improvements,tiredness/weakness (90.6％ vs.48.5％,x2=11.637),waist soreness/leg weakness (90.0％ vs.35.5％;x2=17.040,P＜0.01),anorexia and tympanites (93.3％ vs.37.9％;x2=17.802,P＜0.01),loose stool (93.1％ vs.25.8％;x2=25.219,P＜0.01),anasarca (84.6％ vs.41.7％;x2=8.214,P＜0.01),pale and teeth-printed tongue (76.7％ vs.26.7％;x2=13.081,P＜0.01) in the treatment group were significantly better than those in the control group.Conclusions Mahuang-Fuzi-Xixin decoction and Wuling powder combined with routine western medicine therapy can improve the renal function and syndromes in patients with CKD stage 3.

Objective To establish a new effective method by using real-time polymerase chain reaction (PCR) to detect single nucleotide polymorphism (SNP) typing for rapid identifying apolipoprotein E alleles.Methods To determine alleles of human apolipoprotein E genetic polymorphism at Cys112Arg locus was detected by PCR melting curve analysis with fluorophore SYBR Green I. In order to increase the speciality of SNP assays, high fidelity Taq polymerase was used. The reliability of SNP typing was validated by comparison with the results of direct DNA sequencing.Results Each sample was determined by double tubes, and two melting curves were analysis. As compared the Tm value of samples with the Tm of standard substance, the apoE genotype of samples was determined. The apoE genotype of 30 samples were E3/3 (27/30) and E3/4 (3/30) respectively, which was accordant with the results of PCR-RFLP and DNA sequencing.Conclusion The presented allelic assay was specific, easy to operate and applicable for discrimination of apolipoprotein E genotyping of human blood.

Objective To explore the morphological characteristics of Barrett's esophagus under confocal laser endomicroscopy (CLE).Methods A total of 112 patients with suspected Barrett's esophagus (BE) under endoscopy were enrolled in this study.The lower esophageal columnar mucosa was examined with CLE to real-time forecast the histological type and extent of intestinal metaplasia of BE,followed by mucosal biopsies and histopathological examination in inspected area.The relationship between the features under common endoscopy or CLE and histopathological diagnosis was analyzed.Results A total of 94 patients were diagnosed as BE.Island type is the most common type under common endoscopy (54.3％),and the incidence of short-segment BE was higher than that of longsegment BE (86.2 ％ vs 13.8 ％).Specialized intestinal metaplasia,cardiac and fundic epithelium can be distinguished under CLE,and the accuracy was 94.7％,89.4％ and 91.5％ respectively.The histopathological examination in targeted biopsy specimens indicated that the proportion of intestinal metaplasia was higher in long-segment BE (9/13) than that of short-segment BE (33.3 ％,x2 =4.684,P=0.039),and the proportion of intestinal metaplasia was higher in circumferential(11/17) and tongue-like BE (65.4％) than that of island type (15.7％,x2 =15.217 and 19.399 respectively,P＜0.01).There were no significant difference in the extent of intestinal metaplasia among island type,circumferential type and tongue-like type in short-segment and long-segment BE.Conclusions The histological type of BE can be accurately distinguished with CLE.The most common type of BE is island type.The incidence of intestinal metaplasia is higher in circumferential and tongue-like type.The incidence of intestinal metaplasia is higher in long-segment BE than that of short-segment BE.

Objective To discuss the surgical method of resection of petroclival tumors used temporal base transtentorial approach.Methods Analyzed 26 cases of petroclival tumors.All of them were surgically treated under intraoperative neurophysiological monitoring by temporal base transtentorial approach.Firstly the supratentorial part of tumors were resected by pieces,and then the tentorium was cut open,in order to resect residue of the subtentorial part of tumors.This surgical maneuver was applied to reduce the retraction to surrounding vessels,nerves and brain stem,as well to protect important structures and to finally achieve radical removal of the tumors.The efficacy and complications were observed.Results Among 26 cases,19 cases (73.1％,19/26) achieved total removal,5 cases (19.2 ％,5/26) achieved subtotal removal and 2 cases (7.7％,2/26) achieved great partial removal.There was no surgery-related death.Eleven cases suffered from partial neurological deficit.All cases were followed up for 3 months to 4 years,3 cases underwent complete recovery,4 cases underwent partial recovery,and 4 cases underwent permanent deficit.Conclusions Using temporal base transtentorial approach to resect petroclival tumors is convenient,applicable,safe and with minimal injury and with high proportionality of total resection.Under intraoperative neurophysiological monitoring,this approach may be an ideal choice for surgical treatment of these tumors.

A new, convenient, and rapid method for kinetic measurement of human fibrinolysis was established. The alteration of absorbance (A) in the process of blood coagulation and lyses was automatically scanned and recorded using a UV2000 spectrophotometer connected to a computer. The parameters of human fibrinolysis kinetics were established. Urokinase at 20 U/mL was the optimal concentration used. There was significant difference in fibrinolysis kinetics and plasma plasminogen concentration between 22 normal subjects and 27 patients with acute myeloblastic leukemia (P<0.05 and <0.01 respectively). The coefficience of variation was (5.24+/-1.51)%. This method could also be used to measure the plasma fibrinogen concentration at the same time. It was concluded that this method was stable and was capable of providing dynamic, direct experimental data and multiparemeters for clinicians. It was also valuable in evaluating the anti-and pro-fibrinolytic capcity of patients' plasmas, allowing for monitoring of therapy, choice of drugs and adjustment of drug concentrations.

Background Clinical researches showed that antimicrobial-resistance of bacterium is gradually serious.It is very important to master pathogen distribution and antimicrobial susceptibility after eye surgery.Objective This study was to investigate the distribution and drug sensitivity of pathogenic bacteria from ocular operative infection in 3-year duration to provide a reference for reasonable selection of antibiotics.Methods Sixtyfive positive specimens were obtained from 65 patients due to postoperative infection in Department of Ophthalmology of Shenzhou Hospital and Shengjing Hospital from 2009 January through 2011 December.The pathogenic bacteria were isolated and then the drug sensitivity test of conventional antibiotics was performed.Results Among the 65 ophthalmic specimens,35 strains of Gram-positive bacteria were isolated with the constituent ratio 53.8％,and 15 strains of Gram-negative bacteria accounted for 23.1％.Fungus was found in 15 cases with the constituent ratio 23.1％.Staphylococcus epidermidis accounted for 42.9％ in Gram-positive bacteria,and Pseudomonas aeruginosa accounted for 33.3％ in Gram-negative bacteria.Aspergillus was the main component of fungus,which accounted for 60.0％ of the proportion 3 strains of methicillin-resistant Staphylococcus aureus (MRSA) in 8 strains of Staphylococcus aureus,but no vancomycin-resistant Enterococcus (VRE) and vancomycin-resistant Staphylococcus (VRS) were seen.The in vitro drug sensitivity test showed that the main Gram-positive bacteria,Staphylococcus epidermidis and Staphylococcus aureus,were sensitive to linezolid,vancomycin,levofloxacin and ciprofloxacin with the sensitive rates ＞50.0％,and these bacteria were lowly sensitive to penicillin and erythromycin with the sensitive rates ≤30.0％.Pseudomonas aeruginosa appeared to be the main Gram-negative bacteria,showing a sensitive rate ≥ 80.0％ to tobramycin,amikacin,ceftazidime,cefepime,cefoperazone/sulbactam,piperacillin/tazobactam,imipenem and meropenem.Conclusions Staphylococcus epidermidis,Staphylococcus aureus,Pseudomonas aeruginosa and Aspergillus are primary pathogens in ocular infection after operation.Antibiotics such as penicillin,erythromycin,levofloxacin,cefotaxime seem to be relatively high resistant to eye infection.To choose sensitive antibiotics timely and reasonably is a key to the prevention and control of ocular infection after operation.

A commonly used Chinese crude drug Allii Macrostemonis Bulbus has been shown to possess good anticancer activities and related properties such as antioxidation, nitrite scavenging, nitrosamine synthesis blocking and immune enhancement, and has been widely used as an effective auxiliary drug in the treatment of some malignant tumors. This paper systematically reviews the advances in the study of anticancer-related activities of Allii Macrostemonis Bulbus's various components such as raw juice, extracts, saponins, volatile oil, polysaccharides, nitrogen compounds, etc.
Allium ; chemistry ; Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Antioxidants ; pharmacology ; Humans ; Oils, Volatile ; pharmacology ; Plant Extracts ; pharmacology

Objective To establish diagnostic standards of confocal laser endomiroscopy (CLE) in pathological classifications of gastric cancer and evaluate the diagnostic value of CLE in vivo. Methods The confocal images of 36 patients, who were diagnosed as gastric cancer with confirmation of pathology, were collected and analyzed to establish diagnostic standards of CLE for pathological classifications of gastric cancer. The sensitivity, specificity and accuracy of CLE were determined with reference to histopathologic findiugs retrospectively. Results According to changes of glandular architecture and microvessels under CLE, gastric cancers were divided into differentiated and undifferentiated type. The sensitivity, specificity and accuracy of CLE in diagnosing differentiated carcinoma were 85.7%, 92. 3% and 90. 5%, respectively, which were 85.7%, 92. 3% and 90. 5%, respectively, in undifferentiated carcinoma. Conclusion CLE is a new tool to make pathological classifications of gastric cancer during routine endoscopic examination procedure, which correlates well with histopathologic fingdings.

Objective To estimate the value of confocal laser endomicroscopy (CLE)for differential diagnosis of gastric ulcer. Methods Patients diagnosed as gastric ulcer by conventional endoscopic mode of CLE were enrolled. The eonfocal endoscopic mode of CLE was used to observe the borderline and/or the surface of the ulcers. Biopsy specimen was taken for histopathological examination and the result of CLE was compared with histopathological finding. Results A total of 12 769 CLE images were obtained from 150 sites of 43 patients. The sensitivity and specificity of CLE for phlegmonosis process were 83.54% and 85.92%, respectively, with positive predictive value of 86.84% and negative predictive value of 82.43%. Whereas the sensitivity and specificity of CLE for intraepithelial neoplasia were 53.57% and 88.52%, respectively, with positive predictive value of 51.72% and negative predictive value of 89.26%. As for diagnosis of gastric cancer, the sensitivity and specificity of CLE were 88.37% and 93.46%, respectively, with positive predictive value of 84.44 % and negative predictive value of 95.24%. The kappa values for agreement of histopathological findings and CLE for diagnosis of phlegmonosis process, intraepithelial neoplasia and gastric cancer were 0.69,0.42 and 0.81, respectively. Conclusions CLE can provide a real-time histopathological diagnosis of the gastrointestinal tract with high sensitivity, specificity, positive and negative predictive values. Targeted biopsy can be done under CLE and the detective rates of precancerous lesions and tumors will be increased.

Heuristic teaching is propitious to cultivating students' ideation. We have used different heuristic modes for example problems, stories, contrast, associationin and so on to cultivate medical students' ideation in pathobiology and immunology teaching and acquired good effect.