Objective To observe the clinical efficacy and adverse reactions of docetaxel and carboplatin 21 day regimen (TC)as second -or third -line in treatment of patients with advanced triple -negative breast cancer (ATNBC).Methods 37 ATNBC patients with anthracyclines resistance were given docetaxel 70mg/m2 ,the first day of intravenous drip,carboplatin AUC =5,through intravenous drip on the first day,21 days for a course of treatment, until disease progression or not tolerated or most received six cycles of chemotherapy.Results 147 cycles of chemo-therapy were completed in 37 patients,and the median chemotherapy cycle was 4 cycles.The efficacy and adverse reactions could be evaluated in all patients.Among them,complete remission (CR)in 0 patient,partial remission (PR)in 12 patients (32.43%),stable (SD)in 11 patients (29.73%),and progression (PD)in 14 patients (41.18%).The effective rate(CR +PR)was 32.43%.The disease control rate (CR +PR +SD)was 62.15%,median TTP was 3.9 months (95%CI:4 -8months),and median OS was 10 months.Until the end of follow -up,there were 3 patients with no progress.The main adverse reactions were hematological toxicity (51.53%)and gastrointestinal reaction (56.76%).Conclusion TC regimen is effective and safe in the treatment of patients with ATNBC.

Objective To investigate the actual cost and benefit of stoma nursing at present as a reference for the improvement of stoma care cost management program. Methods A cross sectional study was carried out in gastrointestinal surgery of a tertiary- level hospital in southwestern China from April 2014 to December 2014. The consumption of intestinal stoma care work, the average monthly income/average monthly working hours ratio and other indicators of stoma care nurse specialist were measured by the step cost allocation method, to investigate the actually cost of a single stoma care service which colostomy patients had received and analyze the gap between actually costs and charge standard of Sichuan Province. Results The directly human cost of stoma care expenses were (22.33 ± 3.66) yuan; working fee expenses were (4.18 ± 0.68) yuan;administrative expenses were (1.87 ± 1.32 ) yuan; research and education expenses were (1.87 ± 1.32 ) yuan; the total cost of investment was (29.14 ± 4.76) yuan, which was much higher than the current charge standard of Chengdu Bureau of Commodity Prices (t=119.50, P <0.05). Conclusions There is a difference between the actual cost and charge standard of stoma care. The situation of low pay to labor is not in line with economic laws, and not conducive to the future development of stoma care speciality.

Objective To study the interactive debridement methods in treatment and nursing of the wound in patients with abdominal surgical incision infection.Methods In May 2010 to December 2013 in West China hospital of Sichuan University,54 patients with postoperative incision infection accompanied with tissue necrosis after gastrointestinal surgery were divided into two groups,23 cases who accepted interactive debridement treatment were set as the observation group,31 cases with traditional dressing hypertonic saline gauze debridement were named as the control group.The wound debridement completion time,wound healing velocity,wound healing time,dressing change frequency and cost were compared between two groups of patients.Results Compared with those of the control group,in the observation group,the wound debridement completion time was shorter,wound healing velocity was faster,dressing change frequency was longer.Although single dressing change cost was higher in the observation group,but the total dressing change cost was lower compared with the control group.Conclusions The interactive debridement methods used in treatment and nursing of patients with abdominal surgical incision infection showed good effect and safety,which is worthy of wide clinical application.

Objective To investigate the risk factors and clinical characteristics,auxiliary examination char-acteristics,treatment and prognosis for acute stroke patients with deep vein thrombosis (DVT),in the hope of provi-ding the detailed clinical data for hospitalized patients with stroke in early prevention,early diagnosis and early treat-ment of DVT.Methods 160 cases of stroke patients were reviewed including 66 cases of patients with hemiplegia after stroke and ultrasound confirmed DVT data analysis,And compared with the same period of 94 cases of DVT in patients with stroke.The purpose of this study was to evaluate the incidence of DVT,possible risk factors,and clinical characteristics.Results Stroke in patients with DVT spent an average of 16d.DVT occurred in elderly patients (65 years or higher) with 44 cases,accounting for 66.67%;Serious paralytic 42 cases (72.72%),long-term bed 52 cases (78.78%);The most commonly comorbid disease was diabetes mellitus,hypertension and hyperlipidemia;The plasma fibrinogen concentration was (5.02 ±1.38) g/L,which was significantly higher than (2.74 ±1.65) g/L of the control group.Compared with control group,the difference was statistically significant (t=4.78,P<0.01). Conclusion Limb paralysis,long-term lie in bed,older age and high condensation state are DVT risk factors,which should be paid to prevent in advance clinically.

Objective:To observe the clinical effect of acupuncture on chronic obstructive pulmonary disease (COPD), and the improvements of patients’ pulmonary ventilation function and 6-minute walk test (6-MWT) distance. Methods:A total of 80 COPD patients [grade 3-4 in Global Initiative for Chronic Obstructive Lung Disease (GOLD), qi deficiency of the lung and kidney in traditional Chinese medicine (TCM) pattern] were randomly allocated into a treatment group (n=40) and a control group (n=40). Salmeterol Xinafoate and Fluticasone Propionate powder (Seretide,50μg/250μg) for inhalation was used for basic treatment in both groups (once in the morning and once in the evening). Patients in the treatment group received acupuncture at Feishu (BL 13), Shenshu (BL 23), Qihai (CV 6), Guanyuan (CV 4), Dingchuan (EX-B 1), Danzhong (CV 17) and Zusanli (ST 36) twice a week for 3 months. After 3 months of treatment, clinical effects, lung ventilation functions and 6-MWT distance were observed and compared in the two groups. Results:After 3 months of treatment, the total effective rate was 95.0% in the treatment group, versus 80.0% in the control group, showing a statistical difference (P<0.05); the phlegm expectoration, dyspnea and shortness of breath were more significantly improved in the treatment group than those in the control group (P<0.01,P<0.05); and the 6-MWT distance and forced expiratory volume in 1 second percentage of predicted value (FEV1%) were more significantly improved in the treatment group than those in the control group (P<0.05,P<0.01). Conclusion:Seretide inhaler combined with acupuncture can improve signs and symptoms in COPD patients, increase the 6-MWT distance, improve FEV1% and obtain better results than Seretide alone.

AIM: To study the optimum technological parameters for extraction of Astragalus polysaccharides by ultra-high pressure extraction. METHODS: Measured concentration of total astragalus polysacharides served as the marker,the design of uniform distribution was applied to evaluating the ultra-high pressure extration efficiency in comparison with reflux and ultrasonic extraction efficiency. RESULTS: The optimal parameters of ultra-high pressure extraction was as follows: 350 MPa pressure,60 mL/g ratio of solvent to solid material,5 h soaking time,2 min extraction time.Under the conditions,the high yield was up to 24.2 %. CONCLUSION: Ultra-high pressure extraction has a series of advantages,such as higher yield,less impurity,easier separation-purification,shorter extraction time and lower energy input.

Objective To investigate the associated factors of complete virological response (CVR) in Entecavir treatment among chronic hepatitis B (CHB) patients with positive HBeAg.Methods Data of 166 CHB patients with positive HBeAg receiving Entecavir treatment in Yantai Infectious Diseases Hospital during December 2009 and May 2014 were collected.Clinical data including age,gender,genotype,baseline alanine aminotransferase (ALT),HBV DNA load,HBsAg and HBeAg levels as well as CVR cumulative rates at different time points during Entecavir treatment were retrospectively analyzed.The cumulative rate of CVR was estimated using Kaplan-Meier method,and the difference in cumulative CVR rates was studied with Log-rank test.Cox's proportional hazards regression model was used to analyze the factors associated with CVR during Entecavir treatment.Results The cumulative rates of CVR during Entecavir treatment in HBeAg positive CHB patients were 54.5％ (87/157),74.3％ (106/129),80.2％ (109/119) and 86.8％ (110/112) at 48,96,144 and 192 weeks,respectively.Log-rank test showed that female patients and patients with genotype B,high baseline ALT level or low baseline HBV DNA load had higher CVR rates (x2 =15.601,11.542,17.021 and 10.094,all P ＜ 0.01).Cox's proportional hazards regression model showed that female was the only associated factor for CVR in Entecavir treatment among HBeAg positive CHB patients [hazard ratio (HR) =3.015,95％ confidence interval (CI):1.875-4.968,P ＜ 0.01].Conclusion CVR rate is increasing with the course of Entecavir treatment in HBeAg positive CHB patients,and CVR is more likely to occur in female patients.

OBJECTIVE:To study the improvement effect of geniposide on cognitive dysfunction in model rats with diabetes. METHODS:50 rats were randomly divided into blank control group(distilled water),model group(distilled water)and genipo-side low-dose,medium-dose,high-dose groups(5,10,20 g/kg),10 in each group. Except for blank control group,rats in other 4 groups were fed with high-sugar and high-fat diet and injected streptozotocin to induce diabetes model. After modeling,rats in each group intragastrically administrated relevant medicines,once a day,for 8 weeks. After last administration,fasting blood glu-cose(FPG),glycosylated hemoglobin(HbA1c)levels,escape latency period in Morris water maze test,and correct rate of behav-iors in Y maze test of rats in each group were detected. RESULTS:Compared with blank control group,FPG,HbA1c levels of rats in model group were obviously increased,escape latency period was obviously prolonged,correct rate of behaviors in Y maze test was obviously decreased,with statistical significances(P<0.05). Compared with model group,above-mentioned indexes in genipo-side groups were obviously improved(P<0.05),which were positively correlated with dose(P<0.05). CONCLUSIONS:Genipo-side can effectively reduce blood glucose level of model rats with diabetes and improve their cognitive dysfunction.

Objective To investigate the diagnostic value of CTP-SI in acute stroke less than 9 hours.Methods In present study."one-stop shop"CT examination were performed in 34 patients with symptoms of acute stroke in le88 than 9 hours.We divided patients into two groups according to with and without delayed perfusion on CTP-SI.and compared ASPECTS (Alberta Stroke Program Early CT Score Study)scores on non-contrast CT(NCCT),arterial phase CTP-SI,venous phase CTP-SI with follow-up imaging.The ASPECTS were analyzed on arterial phase CTP-SI and veIlous phase CTP-SI using Wilcoxon rank-sum test.then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median(min-max)scores of ASPECTS on NCCT,arterial phase CTP-SI,venous phase CTP-SI and follow-up imaging were 9.0(6.0-10.0),6.5(1.0-8.0),8.0(3.0-10.0)and 7.0(0-10.0)in group with delayed perfusion,respectively,and 9.0(1.0-10.0),8.5(1.0-10.0),8.5(1.0-10.0)and 8.0 (0～10.0)in group without delayed perfusion respectively.ASPECTs scores measured on arterial phase CTP-SI did not differ from venous phase CTP-SI in group without delayed perfusion ( Z = - 1.00, P =0.317), while there was significant difference in group with delayed perfusion (Z = -3.08, P = 0.002 ).There were significant correlation with ASPECTS scores measured on NCCT, arterial phase CTP-SI and venous phase CTP-SI to follow-up imaging ASPECTS (r =0.899,0.926,0.928,P ＜0.01 ) in group without delayed perfusion; ASPECTS measured in venous phase CTP-SI showed the best correlation to follow-up imaging ASPECTS (r = 0.762, P = 0.004) in group with delayed perfusion.Multiple linear regression showed that the correlation in only venous phase CTP-SI with foUow-up imaging ASPECTS was statistically significant:in group without delayed perfusion, Beta = 0.966, P ＜ 0.001 ; in group with delayed perfusion,Beta = 0.765, P = 0.004. Conclusion Presence of delayed porfusion in CTP-SI is quite important in identifying ischemic penumbra, which plays a critical role in imaging-guided thrombolytie therapy.

Objective: To investigate the clinical application of repairing the large-area skin defect of legs with medial-lower-leg-flap with a healthy limb cross-leg bridging thoracic umbilical flap. Methods: 16 cases with a large area of soft tissue defects caused by severe trauma were included in this study. The vascular pedicles of free thoracic umbilical flap were anastomosed with the opposite posterior tibial artery and vein, and the pedicle skin tubes were made and amputated 4 weeks after surgery.Observation of postoperative flap include survival situation, shape, color, elastic, scar contracture, and dysfunction. Results: 16 cases of postoperative all flaps survived.In 1 case pain occurred 10 hours after the operation and led to arterial crisis, which was relieved with analgesia.There were no vascular crisis in other 15 eases. Followed up for 2-24 months, all the flaps survived with good color, elasticity and sensory recovery. There was no apparent stiffness in double knee and ankle joint. Conclusions For the injured limbs impossible to be repaired with local vascular pedicle, routine local transfer of skin flap or cross leg skin flap, the bridge cross anastomosis of free flap graft may be an ideal surgical treatment.