Objective To explore the effect of Buyanghuanwu decoction on blood glucose control and renal function protection in patients with early diabetic nephropathy.Methods 170 cases of patients with early diabetic nephropathy from May 2012 to June 2013 in wenzhou hospital of integrated traditional chinese and western medicine were selected,all patients were divided into observation group and control group,the control group was given routine treatment,the observation group treatment with Buyanghuanwu decoction based on control group .The clinical effective rate was compared between the two groups after treatment,the levels of blood lipids, 24 h urine microalbumin and hemorheology were compared between the two groups before and after treatment.Results After treatment, the total effective rate of the observation group was 90.59%,which was significantly higher than the control group 76.47% (P<0.05).Compared with before treatment,the levels of triglycerides and cholesterol decreased in two groups,high-density lipoprotein levels increased,24 h urine microalbumin decreased,whole blood viscosity,whole blood viscosity trimming and fibrinogen decreased,the difference was statistically significant(P<0.05).Compared with the control group,the levels of triglycerides and cholesterol in observation group was lower,high-density lipoprotein was higher,24 h urine microalbumin was lower,whole blood viscosity,whole blood viscosity trimming and fibrinogen were lower,the difference was statistically significant(P<0.05).Conclusion Buyanghuanwu decoction in the treatment of diabetic nephropathy is effective in treating diabetic nephropathy,it can effectively reduce blood lipids and blood viscosity,significantly reduce urinary protein excretion and protect the kidneys.

Objective To study curative efficacy of euthyrox in treatment of hypothyroidism during pregnancy and its effect on levels of TSH , FT3 and FT4.Methods 100 patients of hypothyroidism during pregnancy who received therapy from June 2014 to June 2015 in our hospital were selected as research objects, and divited into control group and observation group,50 cases in each group.The control group was treated with Fugui Dihuang wan, while the observation group was treated with euthyrox on the basis of control group.Then the levels of TSH,FT3 and FT4, pregnancy outcome, neonatal adverse outcome, treatment outcome of two groups after treatment were compared.Results After treatment, the level of TSH in observation group was lower than the control group, the levels of FT3 and FT4 was higher than the control group ( P<0.05 ); Incidence of pregnancy complications in observation group was less than the control group [12.00%(6/50)vs 40.00%(20/40)](P<0.05);Total neonatal adverse outcomes [8.00%(4/50) vs 26.00%(13/50)](P<0.05); The total effective rate of observation group was statistically higher than that in the control group [96.00%(48/50) vs 80.00%(40/50)](P<0.05).Conclusion Euthyrox is well for hypothyroidism during pregnancy, which can improve TSH, FT3 and FT4 levels, relieve clinical symptoms.

Objective To investigate the relationship between serum nesfatin-1 and gestational diabetes mellitus (GDM). Methods The serum nesfatin-1 concentrations were measured in 45 GDM patients and 44 NGT pregnant women , as well as 47 non-pregnant healthy women served as control. Serum nesfatin-1 were measured by sandwich enzyme linked immunosorbent assay (ELISA). Meanwhile FPG、 lipoid、 FFA、 FINS、 C-tide were also measured. Result Serum nesfatin-1 level in GDM were significantly higher in GDM patients than in NGT and control (P < 0.01), while serum nesfatin-1 in NGT was significantly lower than in control (P < 0.01). Correlation analysis showed that serum nesfatin-1 was positively correlated with FINS , C-tide , HOMA-IR , triglycerides FBG and OGTT 1 hour glucose, HbA1c (P < 0.05). Conclusion Serum nesfatin-1 level in pregnant women significantly decreas, while in GDM patients significantly increase. Serum nesfatin-1 level in pregnant women is positively correlated with Insulin resistance (IR) and triglycerides level.

Objective:To analyze the invasion characteristics and prognostic factors of patients with Masaoka-Koga stage Ⅲ thymoma.Methods:The tumor invasion characteristics of 179 patients who were diagnosed with Masaoka-Koga stage Ⅲ thymoma and treated in Affiliated Cancer Hospital of Zhengzhou University from January 2000 to June 2018 were analyzed retrospectively. According to the treatment methods, all patients were divided into the radical operation group ( n=94), palliative operation group ( n=39) and simple biopsy group ( n=46). The χ2 test was used to compare the classified variables, Kaplan- Meier method was utilized to calculate the cumulative survival rate, log-rank method was used for group comparison and univariate analysis, and Cox’s regression model was used for multivariate analysis. Results:Mediastinal pleural invasion (86.0%) was the most common site, followed by pericardium (50.8%), great vessel (40.8%) and lung (36.3%). The proportion of macrovascular invasion in the radical operation group was 14.9%, significantly lower than 79.5% and 60.9% in the palliative surgery group and biopsy group (both P<0.001). Multivariate analysis showed that the nature of operation ( P<0.001), age ( P=0.011), radiotherapy ( P=0.020) were the independent factors affecting overall survival (OS), while nature of operation ( P<0.001), age ( P=0.004), radiotherapy ( P=0.020), number of invasive organs ( P=0.023) and pathological type ( P=0.016) were the independent factors affecting progress-free survival (PFS). Conclusions:For patients with Masaoka-Koga stage Ⅲ thymoma, mediastinal pleura is the most common site of invasion, pericardium, lung and great vessels are also commonly invaded. The invasion of mediastinal pleura, pericardium and lung exerts slight effect on surgical resectability, whereas great vessel involvement can significantly affect surgical resectability. OS and PFS in patients undergoing radical resection are significantly better than those in patients treated with palliative resection and biopsy. Radical resection is the most important factor affecting prognosis.

Objective:To observe the clinical efficacy of Yin-Yang balancing acupuncture plus Tuina(Chinese therapeutic massage)for post-stroke depression(PSD). Methods:A total of 72 PSD patients were randomized into an acupuncture-Tuina group and a Western medicine group using the random number table method,with 36 cases in each group.The Western medicine group was treated with fluoxetine hydrochloride capsules.The acupuncture-Tuina group was treated with Yin-Yang balancing acupuncture plus Tuina therapy.Both groups were treated for 4 weeks.After treatment,the clinical efficacy was compared,and the changes in Hamilton depression scale(HAMD)score,National Institute of Health stroke scale(NIHSS)score,serum neurotransmitter levels,and electroencephalogram(EEG)were observed. Results:The total effective rate of the Western medicine group and the acupuncture-Tuina group was 83.3%and 94.4%,respectively.There was a significant difference in the total effective rate between the two groups(P<0.05).After treatment,the serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)were higher than those in the same group before treatment,and the intra-group differences were all statistically significant(P<0.05).The serum levels of 5-HT,NE,and DA in the acupuncture-Tuina group were higher than those in the Western medicine group,and the differences between the groups were statistically significant(P<0.05).After treatment,the scores of HAMD and NIHSS in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The scores in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were all statistically significant(P<0.05).After treatment,the EEG diffuse wave[(delta+theta)/(alpha+beta)]ratio(DTABR)and delta/beta ratio(DBR)in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The ratios in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were statistically significant(P<0.05). Conclusion:Yin-Yang balancing acupuncture plus Tuina therapy has a better efficacy than oral fluoxetine hydrochloride capsules in the treatment of PSD,which can increase the levels of serum 5-HT,DA,and NE,and regulate brain waves.

Objective:To evaluate the efficacy and safety of stereotactic ablative radiotherapy (SABR) in patients with pulmonary oligometastases.Methods:Clinical data of patients with pulmonary metastases treated with SABR from 2011 to 2018 were retrospectively analyzed. The local control rate (LCR) and overall survival (OS) were calculated by Kaplan- Meier method. log-rank test was used for univariate analysis and Cox’s regression model for multivariate analysis. Results:A total of 214 lung metastases were detected in 159 patients, and the median follow-up time was 43 months. The 1-, 3-and 5-year LCR were 90.1%, 73.9% and 65.8%, respectively. The 1-, 3-and 5-year OS were 73.8%, 43.6% and 11.9%, respectively. Univariate analysis showed that biological effective dose (BED)≥100 Gy was significantly correlated with LCR ( P=0.033). Cox’s multivariate analysis showed that BED and primary tumor source were the independent prognostic factors of LCR ( P=0.023, P=0.043). No>grade 3 adverse events were observed in all patients during treatment. Conclusions:SABR is a safe and effective treatment of lung oligometastases. SABR should be actively aD ministered for pulmonary oligometastases, especially for those with lesions from lung cancer and the radiation dose should be selected as BED ≥100 Gy.

Objective:To explore the influence of social support on cognitive function in patients with mild vascular cognitive dysfunction, as well as the chain mediating effect of quality of sleep and life.Methods:From September 2020 to March 2021, convenience sampling was used to select 201 patients with mild vascular cognitive impairment in the Department of Neurology of the Fifth Hospital of Harbin Medical University as the research object. The General Information Questionnaire, Beijing version of the Montreal Cognitive Assessment (MOCA-B) , Social Support Rate Scale (SSRS) , Pittsburgh Sleep Quality Index (PSQI) and the Mos 12-item Short-form Health Survey (SF-12) were used to investigate the patients.Results:The mediating effect test showed that the direct effect of social support on cognitive function was significant ( P<0.05) , and the mediating effect of sleep quality and health-related quality of life between social support and cognitive function were significant ( P<0.01) . The chain mediating effect of sleep quality and health-related quality of life between social support and cognitive function were significant ( P<0.01) . Conclusions:Social support can directly predict cognitive function, or indirectly predict cognitive function through the mediating effects of sleep quality and health-related quality of life, as well as the chain mediating effects of sleep quality and quality of life.

Objective To compare the clinical efficacy and safety between stereotactic ablative radiotherapy (SABR) and surgery in the treatment of early-stage non-small cell lung cancer (NSCLC).Methods A total of 227 patients who were initially diagnosed with early-stage NSCLC and with complete clinical data admitted to Henan Cancer Hospital between June 2012 and December 2016 were recruited and assigned into the SABR (n=73) and surgery groups (n=154).Kaplan-Meier method was used to calculate survival rate and survival comparison was performed using the log-rank test.Chi-square test was adopted to compare the baseline data between two groups.Results All patients completed corresponding treatment.The samples of SABR group and operation group were 74 and 155 cases respectively.The 1-year and 3-year overall survival (OS) rates in the SABR and surgery groups were 97.2％,81.9％ and 96.5％,78.2％ (P=0.603),respectively.The 1-year and 3-year progression-free survival (PFS) rates in the SABR and surgery groups were 90.1％,66.9％ and 89.2％,66.9％ (P=0.565),respectively.The 1-year and 3-year locoregional recurrence free survival rates in the SABR and surgery groups were 92.8％,84.0％ and 96.5％,90.8％ (P=0.133),respectively.The 1-year and 3-year distant metastasis-free survival rates in the SABR and surgery groups were 97.2％,75.4％ and 89.2％,69.8％ (P=0.095),respectively.Conclusions SABR and surgery yield similar OS,PFS,locoregional recurrence-free and distant metastasis-free survival rates in the treatment of early-stage NSCLC.Therefore,SABR is an alternative treatment for patients with early-stage NSCLC.

Objective: To compare the effect of neoadjuvant chemoradiotherapy (NCRT) and neoadjuvant chemotherapy (NCT) on the survival of patients with esophageal cancer. Methods: Clinical data of 275 cases of thoracic esophageal squamous cell carcinoma treated with neoadjuvant therapy combined with surgery from December 2011 to December 2015 were analyzed retrospectively. The data of treatment and follow-up were complete and analyzable. There were 70 cases in the NCRT group and 205 cases in the NCT group. The survival rate was calculated by Kaplan-Meier method and statistically compared by log-rank test, and multivariate analysis was performed by Cox regression model. Results: The median follow-up time was 32(3-84) months. The median survival time and recurrence-free survival time was 42(3-84) months and 30(3-84) months, respectively. The overall 3-and 5-year survival rates were 56.8% and 45.9%, respectively, and the 3-and 5-year recurrence-free survival rates were 45.1% and 38.9%, respectively. The median survival time in the NCRT and NCT groups was 46(7-84) and 40(4-74) months, and the median recurrence-free survival time was 31(3-84) and 28(3-69) months, respectively. The 3-and 5-year overall survival of the two groups were 59.1%, 47.1% and 56.3%, 47.5%(P=0.515), and the 3-and 5-year recurrence-free survival were 44.5%, 40.1% and 47%, 39%, respectively. There was no significant difference in the survival between two neoadjuvant therapy modes (P=0.554). Multivariate analysis showed that postoperative pathological TNM staging was an independent factor affecting the prognosis of patients with esophageal cancer (P=0.001). Conclusions The survival results of NCRT are similar to those of NCT. Postoperative pathological staging is an independent survival factor.

Objective To evaluate the prognostic value of a novel prediction model based on fibrinogen concentration in combination with neutrophil-to-lymphocyte ratio (F-NLR score) in patients with esophageal squamous cell carcinoma (ESCC) receiving neoadjuvant therapy and investigate their relationship with pathologic complete response (pCR).Methods Clinical data of 218 eligible ESCC patients treated with neoadjuvant therapy in the Affiliated Cancer Hospital of Zhengzhou University between 2012 and 2015 were retrospectively analyzed.The cut-off values for fibrinogen and neutrophil-to-lymphocyte ratio (NLR)were defined by the receiver operating characteristic (ROC) curve.The effects of different F-NLR scores on survival and pCR were evaluated.The survival rate was analyzed using the Kaplan-Meier method.The relationship among fibrinogen,NLR and pCR was analyzed by using Wilcoxon rank sum test.Results The 3-year overall survival (OS) rates with F-NLR scores of 0,1 and 2 were 72.1％,66.5％ and 50.2％(P=0.010),respectively.The corresponding 3-year disease-free survival (DFS) rates were 64.1％,60.2％ and 45.4％ (P=0.012),respectively.The clinical prognosis of patients with an F-NLR score of 2 was significantly worse compared with those of their counterparts with an F-NLR score of 0-1 (P=0.003).Multivariate analysis demonstrated that the F-NLR score (P=0.004) and TNM stage (P=0.000) were the independent prognostic factors.Conclusions The F-NLR score can be used as an independent prognostic factor for ESCC patients treated with neoadjuvant therapy,which is promising supplement to current TNM staging system,thereby facilitating more accurate risk stratification analysis and achieving individualized multidisciplinary treatment for ESCC patients.