Objective To analysis the effect of paclitaxel on CEA, CA19-9 and CA72-4 levels in patients with advanced gastric cancer.Methods46 patients who were diagnosed with advanced gastric cancer in Pinghu hospital of traditional Chinese medicine were collected.All patients were randomly divided into experimental group and control group,23 cases in each group.The control group was treated with cis-platinum complexes and capecitabine, and the experimental group was treated with paclitaxel and capecitabine, after the treatment, the serum levels of CEA, CA19-9, CA72-4, vascular endothelial growth factor, endostatin and clinical curative effect were detected in all patients.ResultsAfter treatment, compared with control group,①the serum level of CEA was lower in the experimental group (P<0.05);②the serum level of CA19-9 and CA72-4 were lower in the experimental group (P<0.05);③the serum level of VEGF was lower in the experimental group (P<0.05);④the serum level of Endostatin was higher in the experimental group (P<0.05);⑤The clinical efficiency of the experimental group was higher(P<0.05).ConclusionsThe paclitaxel can significantly reduce the serumCEA, CA19-9, CA72-4 and VEGF levels, elevated serum Endostatin level in patients with advanced gastric cancer, improve the treatment effect, and have a guiding significance for clinica.

Objective To investigate the influence of warfarin anticoagulation intensity on curative effect and prognosis in patients with non valvular atrial fibrillation in elderly patients with stable coronary heart disease .Methods From February 2012 to March 2014,96 elderly patients with stable coronary heart disease and non valvular atrial fibrillation in the Second People's Hospital of Yuyao were randomly divided into study group ( low intensity warfarin therapy) and control group(warfarin therapy) according to the digital table,with 48 cases in each group.The patients were followed up for average 2 years after treatment ,the condition of taking drugs ,major secondary end point ,end point and safety were compared between the two groups .Results The INR and warfarin dosage of the study group were lower than those of the control group [(1.71 ±0.38) vs.(2.37 ±0.36),(2.72 ±0.28) mg/d vs.(3.54 ± 0.34)mg/d],the differences were statistically significant (t＝8.736,12.898,all P＜0.05),there were no statistically significant differences in other drugs use between the two groups (χ2＝0.178,0.066,0.344,0.071,0.545,0.042, 0.066,all P＞0.05).There were no statistically significant differences in ischemic stroke and body circulation embolism rate between the two groups (χ2＝0.000,0.211,0.211,0.000,0.000,0.000,0.000,1.011,0.000,all P＞0.05). There were no statistically significant differences in end point of all －cause death or nonfatal myocardial infarction incidence between the two groups (χ2＝1.011,0.000,0.000,0.211,0.000,0.000,0.000,0.211,all P＞0.05). The mild bleeding and total bleeding rate of the study group were lower than those of the control group (2.08% vs. 12.50%,4.16%vs.18.75%),the differences were statistically significant (χ2＝3.852,5.031,all P＜0.05).There was no statistically significant difference in the rate of major bleeding events between the two groups (2.08% vs. 6.25%,χ2＝1.043,P ＞0.05).Conclusion The low intensity and moderate intensity warfarin anticoagulation therapy has similar efficacy for elderly patients with stable coronary heart disease and non valvular atrial fibrillation, but low intensity warfarin anticoagulation therapy is safer .

Objective To explore the value of 18F-fluorodeoxyglucose (FDG) PET/CT for therapeutic assessment in patients with bone metastases from differentiated thyroid carcinoma (DTC) after 131I treatment.Methods Between January 2006 and August 2017,35 DTC patients (11 males,24 females,median age 60 years) with bone metastases who were treated with 131I and underwent 18F-FDG PET/CT scan were retrospectively analyzed.Therapeutic response assessment was based on morphological changes or the maximum standardized uptake value (SUVmax) changes of bone metastases,and the agreement (Cohen's Kappa coefficient) between two methods was analyzed.The progression-free survival (PFS) was estimated by Kaplan-Meier survival analysis and compared among patients with different treatment response (log-rank test).Results Morphological changes were consistent with SUVmax changes in 82.1％(23/28) of patients with positive 18F-FDG uptake (Kappa=0.731,95％ CI:0.628-0.834,P＜0.01).Five patients had stable disease according to morphological assessment,while 18F-FDG PET indicated they had metabolic response or disease progression.The serum thyroglobulin (Tg) levels confirmed the accuracy of 18F-FDG PET in 3 of those 5 patients.Compared with the patients with metabolically or morphologically progressive disease,patients who showed metabolically or morphologically stable disease or complete/partial response had significantly favorable prognosis (x2 values:4.132-6.543,all P＜0.05).Conclusions The therapeutic response based on metabolic criteria is in agree with that based on morphological criteria in most of the DTC patients with bone metastases.The SUV may act as a sensitive and efficient indicator of early therapeutic response or disease progression of bone metastases in DTC patients with positive 18F-FDG uptake.

Palliative care not only embodies modern life perspectives, but also encompasses significant traditional Chinese cultural elements.The primary objective of palliative care is to alleviate patient suffering, preserve their dignity, and facilitate a peaceful passing.Traditional Chinese medicine, known for its simplicity, accessibility, affordability, and efficacy in disease prevention and treatment, adopts a holistic approach to address systemic pain through personalized treatment based on symptom differentiation.This approach aims to enhance the quality of life for terminally ill patients.To equip palliative care providers with essential clinical skills in traditional Chinese medicine, the National Center of Gerontology and Beijing Palliative Care Guidance Center collaborated with experts and scholars to develop guidelines focusing on common end-of-life symptoms.Through extensive deliberation, expert evaluation, and revisions, this guidance document was crafted as a valuable resource for palliative care practitioners, traditional Chinese medicine clinicians, and researchers in the field.

OBJECTIVE： To study the effects of ADRB2 （rs1042713） gene polymorphism on therapeutic efficacy of anticholinergic drug in the treatment for refractory asthma pediatric patients. METHODS： 171 children with refractory asthma were selected from outpatient department of Kunming Children’s Hospital during Nov. 2016 to Jul. 2019. The distribution of ADRB2 （rs1042713） genotype， the clinical efficacy [asthma control test （C-ACT） score， FEV1， FVC， PEF， maximal mid-expiratory flow （MMEF）] of anticholinergic drug were analyzed statistically； the response of different genotypes to the use of anticholinergic drug were also analyzed statistically. RESULTS： 148 of 171 refractory asthmatics pediatric patients were administered anticholinergic drug， among them 50 of the 71 AA genotype and 36 of the 77 GA genotype responded to anticholinergic drug treatment. Statistical analysis showed that 71 children with AA refractory asthma had improved C-ACT score， FEV1， FVC， PEF and MMEF， there was statistical significance， compared with GA genotype （P＜0.05）； the response rate of the AA genotype to anticholinergic drugs was 2.71 times that of the GA genotype [OR＝2.71， 95％CI （1.38， 5.34）， P＝0.005]. CONCLUSIONS： The detection of ADRB2 （rs1042713） gene polymorphism has some guiding significance in the treatment of refractory asthma with anticholinergic drugs， and the response of AA genotype is better.