Objective To observe the clinical efficacy of Tong Du Wen Yang (unblocking the Governor Vessel and warming yang) in treating amyotrophic lateral sclerosis (ALS).Method Twenty-eight eligible ALS patients were randomized into two groups by following the visiting sequence. Thirteen patients in the control group were intervened by orally taking Riluzole tablets; 15 cases in the treatment group were by Tong Du Wen Yang needling in addition to oral administration of Riluzole tablets. Before treatment and after 6-month treatment, the therapeutic efficacies were evaluated by using the Chinese medicine syndrome and sign scoring for Wei-flaccidity diseases and Appel function scale.Result After the treatment, the Chinese syndrome and sign scoring scores for Wei-flaccidity dropped in both groups, and the decrease in the treatment group was more significant than that in the control group (P<0.05). The Appel scores dropped in both groups after the treatment, while the decrease in the treatment group was less significant than that in the control group (P<0.05).Conclusion Tong Du Wen Yang needling plus orally taking Riluzole tablets can produce a more significant efficacy than using Western medication alone in treating ALS.

Objective To study the distribution and homology of foodborne-associated extended-spectrumβ-lacta-mases (ESBLs)-producing Escherichiacoli (E. coli).Methods ESBLs-producing E. coli were isolated from differ-ent food specimens in Shaoguan from 2014 to 2015,strains were typed with pulsed-field gel electrophoresis (PFGE) and BioNumerics software.Results 1 1 strains of diarrhea-causing E. coli and 29 strains of ESBLs-producing E. co-li were isolated from 347 different sources of food specimens. PFGE analysis showed that 29 strains could be divided into 21 cluster groups,group A was predominant pattern,which included 7 strains(J2,J3,J4,J7,J9,B4,S3), group B included 2 strains (J6,J8),the other strains were sporadic clones. Similarity coefficient (SC)of 3 strains (J2,J7,J9)from health practitioners was 100% ,SC of strains from drinking water and patients with diarrhea (B4) was 97. 1% ,SC of S3 strain and 4 strains (J2,J3,J7,J9 )from health practitioners were all>90. 0% . Conclusion Foodborne-associated ESBLs-producing E. coli are widely distributed in food,water,animal,and pop-ulations,and can be transmitted through food chain,surveillance should enhanced to avoid further spread.

The 2008 World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (4th edition) has greatly advanced the diagnosis, treatment, academic exchange, and research of lymphoma worldwide. A new revised edition will be published soon, in which the diagnosis and management of lesions at the very early stages of lymphomagenesis, the diagnostic criteria for several entities, and the genetic/molecular landscape of numerous lymphoid neoplasms and their clinical correlates have been clarified, refined, detailed, and expanded. Furthermore, several new concepts have been suggested in the upcoming revised edition, although the framework of classification remains the same. These updates will lead to development of more targeted therapeutic strategies and increase our confidence in the era of precision medicine. This manuscript will review the major advances and updates that are helpful for our un-derstanding and improvement in tumor diagnosis.

Prostate cancer is one of the most common malignant tumors among males, and nearly all patients will inevitably de-velop castration-resistant prostate cancer (CRPC). The prognosis of CRPC patients is very poor. How to implement the individualized treatment plan with minimal side effects and optimum benefit as well as how to prolong the patients' lives have recently become impor-tant issues. Current staging and grading systems fail to provide accurate prognoses of most CRPC, which have complicated biological behaviors. Over the past few years, a host of tumor molecular markers have been discovered and can provide prognostic information for CRPC. This review summarizes the molecular prognostic biomarkers that affect the prognosis of CRPC.

Arterial stenosis-induced hemodynamic changes and their evaluation have long been studied by lots of scholars by in vivo and in vitro experiments,clinical observation and improved experimental devices and methods,which has contributed a lot to the diagnosis and treatment of arterial stenosis.This review describes the current research results.

Objective:To study percutaneous transhepatic gallbladder drainage(PTGD) under color Doppler ultrasound in critically ill patients with acute calculus cholecystitis.Methods:A paracentetic needl was stuck into the cholecyst after going straight through 1.5-2.5 cm hepar under color Doppler ultrasound.The operator took out the bullet core,put in a guide wire,extracted the needl,inserted a central venous catheter along the guide wire,and then drew out the bile and clusised the cholecyst with metronidazole until the extracted fluid was clear and bright.Results:PTGD immediately relieved the pain in the of upper right quadrant in all the patients.Body temperature and WBC descended obviously 24 hours and returned to normal 5 days after the operation. Conclusion:Color Doppler ultrasound guided PTGD,easy to perform and with few complications and high suness rate,is an returned effective and reliable procedure for critically ill patients who are intolerant of cholecystectomy or for whom the operation is difficult to perform.

Objective To explore the role of clinical pharmacists in nutrition support therapy in the patients with hyperemesis gravidarum. Methods The clinical pharmacist played a positive role in nutrition support care of a patient with hyperemesis gravidarum by analysising disease characteristics and adverse drug reactions, providing suggestion on the selection of fat emulsion and offering an individualized pharmaceutical care. Results The clinical pharmacist recognized the potential risk in nutrition support plan, took modifications timely, and prevented the occurrence of unfavorable clinical outcomes. Conclusion The participation of clinical pharmacists in nutrition support therapy of the patients with hyperemesis gravidarum is beneficial to improve the efficacy and safety of nutrition support and promote the rational use of drugs.

Objective To investigate the risk factors of peripartum hysterectomy in placenta previa through retrospective study of 3 840 placenta previa cases. Methods The clinical data of 3 840 patients with placenta previa who delivered in West China Second University Hospital between Jan 2005 and June 2014 were analyzed retrospectively. The relationship of certain factors and peripartum hysterectomy was analyzed, including maternal age, residence place, parity, prior curettage, prior cesarean section, twin or multiple pregnancy, antenatal vaginal bleeding, type of placenta previa, suspected placenta accreta, antenatal level of hemoglobin and gestational age at delivery. Results The prevalence of placenta previa was 4.84% (3 840/79 304) in West China Second University Hospital during the study period, and the incidence of preipartum hysterectomy in patients with placenta previa was 2.76% (106/3 840). One-factor analysis demonstrated that residence place, parity, times of prior curettage, prior cesarean section, prenatal vaginal bleeding, anterior placenta, type of placenta previa, placenta accreta, antenatal anemia and gestational age at delivery were potential risk factors for peripartum hysterectomy (P<0.01). Variables with P<0.1 in one-factor analysis were introduced to multi-factor logistic regression analysis, which suggested that one prior cesarean section (OR=12.9,95%CI:6.3-26.3), two or more prior cesarean sections (OR=14.4, 95%CI:3.9-53.2), anterior placenta (OR=4.8, 95%CI:2.1-10.7), complete placenta previa (OR=5.9, 95%CI:1.8-42.5), placenta accreta (OR=11.2, 95%CI:6.8-18.6), antenatal hemoglobin<100 g/L (OR=1.7, 95%CI:1.0-2.8) and delivery before 34 gestational weeks (OR=3.2, 95%CI:1.6-6.3) were independent risk factors of peripartum hysterectomy in patients with placenta previa (P<0.05). Conclusions Prior cesarean section, anterior placenta, complete placenta previa, placenta accreta, antenatal anemia and delivery before 34 gestational weeks are high risk factors of peripartum hysterectomy in placenta previa patients. Perinatal care and risk evaluation before cesarean section are important to improve perinatal outcomes and reduce peripartum hysterectomy.

Objective To compare the effectiveness and safety of radiofrenquency ablation(RFA) with other therapeutic methods for patients with early hepatocelluar carcinoma(HCC). Methods Randomized clinical trials(RCTs)which compared the efficacy or safety of RFA with other therapeutic methods for primary hepatocellular carcinoma in Cochrane library,EMBASE,PubMed,OVID and CBM were searched.Trials were considered of high quality if methodological quality score was 3 or more according to Jadad standard.Statistical heterogeneity between trials was evaluated bv STATA 9.0 and considered to exist when P＜0.1.Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Sensitivity analysis was performed and publication bias was investigated through visual inspection of funnel plots and Egger regression model.Results Six RCTs including 862 cases were analyzed.As compared with other therapeutic approaches,RFA significandy increased 3-year overall survival rate and reduced local recurrence rate of early hepatocelluar carcinoma:the total OR were 2.06(95%CI being 1.54-2.77,P=0.000)and 0.40(95%CI being 0.28-0.57,P=0.000)respectively.As compared with other therapeutic approaches,the total OR of new HCC recurrence rates,extrahepatic metastasis rate and major complications in patients with HCC treated with RFA were 0.92 (95%CI being 0.68-1.24),0.98(95%CI being 0.30-3.22),1.35(95%CI being 0.49-3.77)respectively,showing no significant differences(P＞0.05).Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias(P=0.670,0.160,0.884,0.087,0.317,respectively,by Egger regression model).Conclusions RFA is superior to other treatment methods with respect to local recurrence and 3 year overall survival in early HCC and is the preferred tberapeutic method for small HCC because it is minimally invasive,simple and convenient.

Objective To discuss the relevance between vitreopapillary traction (VPT) and anterior ischemic optic neu?ropathy (AION). Methods Two patients suffering from AION were underwent routine ophthalmic examination, and visual field (VF), fundus fluorescence angiography (FFA) and optical coherence tomography (OCT) examination. The images were analyzed. Results VPT syndrome was observed by OCT in both cases. In addition, the affected parts of VPT were consis?tent to that of AION. Conclusion Vitreopapillary traction is a possible reason of anterior ischemic optic neuropathy.