Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus umbilical therapy for senile functional constipation due to Qi deficiency of lung and spleen.Methods: A total of 60 patients who met the inclusion criteria were randomly divided into a control group and an observation group by the random number table method, with 30 cases in each group. The patients in the control group were given lactulose oral solution, while the patients in the observation group were treated with Tuina and umbilical therapy. After two weeks of treatment, the scores of the Wexner continence grading scale (WCGS) and patient assessment of constipation-quality of life questionnaire (PAC-QOL) were observed. The effective rates in the two groups were compared. Results: After two weeks of treatment, the total effective rate in the observation group was 90.0％, while that in the control group was 76.7％, presenting a significant difference between the two groups (P<0.05). There were no significant differences in the WCGS and PAC-QOL scores between the two groups before treatment (P>0.05). After two weeks of treatment, the WCGS and PAC-QOL scores of both groups decreased significantly compared with those before treatment (P<0.05), and the two scores in the observation group were lower than those in the control group (P<0.05). Conclusion: The efficacy of Tuina plus umbilical therapy for senile functional constipation is confirmed. This method can improve patients' quality of life. Its efficacy is better than that of taking lactulose oral solution.

Objective To explore the distribution characteristics of intra/extracranial large-artery disturbance in patients with ischemic stroke (IS)/transient ischemic attack (TIA).Methods The medical history information of 169 IS/TIA patients was recorded.The results of laboratory examination,electrocardiogram,echocardiography,abdominal ultrasound and chest radiography were analyzed.At the same time,the intra/extra-cranial large arteries were examined to analyze the degree,distribution and pattern of their disturbance.Results Among them,there were intra/extra-cranial large-arterial stenosis (n =112,66.3％) and small-arterial disturbance (n =57,33.7％).Multiple vascular disturbance pattern was more common in patients with intra/extra-cranial large-arterial stenosis (n =71,63.4％).The incidence of intracranial large-arterial stenosis was significantly higher than that of extracranial large-arterial stenosis (53.8％ vs.35.5％,P ＜ 0.05).And middle cerebral artery was the most commonly affected artery,36 of those were culprit vessels accounting for 73.5％ (36/49).Conclusions The IS/TIA patients have a high incidence of intra/extra-cranial large-arterial stenosis.Multiple vascular disturbance is a more common pattern.The incidence of intracranial large-arterial stenosis is greater than that of extracranial and middle cerebral artery is the most common affected artery.

Objective To study the expression of proliferating cell nuclear antigen (PCNA) in the occurrence and development of hepatocellular carcinoma. Methods Sixty SD rats were randomly divided into control group and experimental group. 3′-Me-DAB was administrated into rats to establish the experimental model of hepatocarcinoma. The expressions of PCNA of different phases were detected by immunohistochemistry and the liver pathologic changes were observed by optical microscope. Results The process of canceration was divided into three stages: inflammation, proliferative fibrosis and hepatic carcinoma. The expression of PCNA firstly presented in the oval cells that located in the portal area at the stage of inflammation, and a part of PCNA were hyper-expressed in the portal area. The expression rate of PCNA in the middle phase of inflammatory stage was higher than that of any other phases but declined later. Yet, when it came to the stage of hepatic carcinoma, the rate increased again. Conclusion Under the experimental circumstance when liver cancer is caused by the carcinogenic agent, PCNA may be firstly expressed in the oval cells, and the dynamic expression of PCNA may be an indicator for the early diagnosis of hepatocarcinogenesis.

Objective:To explore the application effect of optimizing the anti-epileptic drug (AED) administration nursing procedure for patients with severe epilepsy at the first time after ICU admission.Methods:A quasi-experiment study was conducted by convenience sampling. The 44 patients with severe status epilepticus admitted in our department from January 2016 to December 2017 were selected as the control group .The 44 patients with status epilepticus admitted in our department from January 2018 to December 2019 were selected as the experimental group .The experimental group was implemented the optimized administration procedure after ICU admission. The control group was implemented the routine administration procedure after ICU admission. Some data of the two groups were compared, including baseline data, first administration time after admission, administration step time, AED dose reserve, and seizures at different time periods and so on.Results:Comparative analysis of the time of the first drug administration after admission into the two groups .The administration time of the control group was 31.0 (10.0-69.0) min, which was significantly longer than that of the experimental group, 25.0 (16.0-31.8) min ( χ2 value was -2.760, P<0.05). Comparison and analysis of the time taken for each step of drug administration: The time taken for step 1(Patient admission—medical order confirmation) in the control group was significantly greater than that in the experimental group ( χ2 value was -2.811, P<0.05); step 2 (medical order confirmation—Prepare medicines)in the control group was significantly greater than that in the experimental group ( χ2 value was -4.327, P<0.05).There was no significant difference in the time taken for step 3(Prepare medicines—Drug delivery to complete)between the two groups ( χ2 value was -1.137, P>0.05). Control group AED reserve ratio 63.6% (28/44), experimental group AED reserve was 100.0% (44/44), and the difference was statistically significant ( χ2 value was 19.556, P<0.05). Epilepsy control in two groups of patients: the total control rate after the first administration of the experimental group was 93.2% (41/44), which was significantly higher than 61.4% (27/44) of the control group ( Z value was -3.445, P<0.001). Conclusion:It can shorten the time to first give AED and improve the patient's clinical symptoms that optimizing the first drug administration procedure for patients with status epilepticus after admission.

Based on the minimum basic requirements of global medical education (GMER), and taking example of training experience of domestic and foreign medical students' learning clinical skills , we have made a detailed analysis of the backgrounds , necessity and feasibility of opening course clinical basic skills to the order-oriented medical students in Chongqing. We have also put for-ward some countermeasures and suggestions to ensure the quality of teaching , so as to promote the course smoothly.

Objective To explore the distribution and migration of oval cells in progressive hepatic injury.Methods Sixty SD rats were divided into the control group ( n =20) and experimental group ( n =40). After the establishment of hepatic carcinoma models, C kit was continuously detected by immunohistochemistry and the liver pathologic changes were regularly observed by optical microscopy. Results The hepatic surface was smooth with eumorphism in histology in the control group. The C kit positive cells were occasionally found. In the experimental group, the oval cells with C kit positive were initially discovered in the portal regions in the second week, and these cells proliferated along the bile duct epithelia. With the hepatic injury becoming more serious, the oval cells extended into the hepatic lobular regions from the portal regions. When hepatocellular carcinoma occurred,the majority were mixed carcinomas, and the oval cells were found inside and outside the carcinoma nodes. In this period, the most of C kit positive cells still located in the portal regions. Conclusion ①The oval cells are the most sensitive cells for the hepatic injury. ②The oval cells which migrate unruly participate in the formation of hepatic pseudolobules. ③The oval cells play an important role in hepatocarcinogenesis.

Objective To determine the relationship between blood biochemical metabolites and benign prostatic hyperplasia (BPH).Methods From Jan.2008 to Oct.2010,the medical records of 73 BPH patients diagnosed by postoperative histopathology were retrospectively studied.The age of patients ranged from 55 to 86 years.The average patient age was 70 years.Of the 73 cases,65 cases were not taking medications which could have an impact on metabolic levels of serum glucose and lipoprotein.Three months prior to operation,the patients were placed in a group to analyze the correlation between the total volume of the prostate (TP),prostate average annual growth rate and biochemical metabolites including serum glucose,high-density lipoprotein cholesterol (HDL-c) and prostate specific antigen (PSA).To compare the changes of prostate volume,prostate annual growth rate and PSA,the 73 cases were divided into two groups; patients with metabolic syndrome (MS) and those without MS.Results Of the 65 BPH patients,the mean of TP and prostate annual growth rate were (58.76 ± 25.96) ml and (1.32 ± 0.89) ml,serum glucose was (4.99 ± 0.73) mmol/L,HDL-c was (1.36 ± 0.39) mmol/L,and PSA was (5.99 ±8.30) μg/L.Stratified with prostate volume,patient's serum glucose,prostate annual growth rate and PSA levels increased with the increased TP (F =4.63,P =0.0060; F =62.98,P =0.0001 ; F =4.83,P =0.0044).On the other hand.HDL-c decreased with the increased TP (F =5.32,P =0.0025).There was a positive relationship between TP and serum glucose (r =0.48,P =0.0005).There was a negative correlation between TP and HDL-c (r =-0.26,P =0.0353).Of the 73 patients,20 cases had MS.The MS group had PSA levels (6.52 ± 5.28) μg/L,TP (79.41 ± 38.24) ml and prostate annual growth rate (1.86 ± 1.14) ml.These levels were higher than the 53 cases without MS.The group without MS had PSA levels (3.95 ± 3.77) μg/L,TP (54.98 ± 20.94) ml and prostate annual growth rate (1.23 ± 0.80) ml (t=2.29,P=0.0253; t=2.65,P=0.0147; t=2.22,P=0.0360).Conclusions PSAlevels,TP and prostate annual growth rate in BPH patients are related with blood biochemical metabolites.Both serum glucose and HDL-c affect prostate volume.BPH patients with MS have a remarkable clinical progression.

Objective To investigate characteristics of TCM syndromes of pulmonary tuberculosis,and to explore new methods for its treatment. Methods TCM syndrome scale was designed to investigate and summarize the characteristic of the syndrome, the syndrome of the general information, and the main clinical symptoms of 516 pulmonary tuberculosis patients. Results The between-group comparison of distribution of TCM syndromes in patients with pulmonary tuberculosis showed statistical difference (P＜0.05) . The occurrence rate of TCM syndromes in the 516 pulmonary tuberculosis patients were listed in descending order as follows:syndrome of both Qi and yin deficiency complicated with stasis ＞ syndrome of lung yin deficiency complicated with stasis＞syndrome of both Qi and yin deficiency＞syndrome of yin deficiency with various with age (P＜0.05) . Patients with blood stasis syndrome occupied 66.15% of the total number in the youth group; Patients with blood stasis syndrome occupied 78.03% of the total number in the middle-aged group;distribution of TCM syndromes was statistically different with the initial treatment and re-treatment (P＜0.05) .Patients with the blood stasis syndrome occupied 72.73% of the total number in the initial group, patients with effulgent fire ＞ lung yin deficiency syndrome.① The distribution of TCM syndromes was statistically various with age (P＜0.05) . Patients with blood stasis syndrome occupied 66.15％ of the total number in the youth group; Patients with blood stasis syndrome occupied 78.03％ of the total number in the middle-aged group; Patients with blood stasis syndrome occupied 78.22％ of the total number in the old-aged group. ② The distribution of TCM syndromes was statistically different with the initial treatment and re-treatment (P＜0.05) . Patients with the blood stasis syndrome occupied 72.73％ of the total number in the initial group, patients with the blood stasis syndrome occupied 75.61％ of the total number in the re-treatment group.③ The distribution of TCM syndromes was statistically different with the main symptoms (P＜ 0.05 ) . Conclusion All 516 cases of pulmonary tuberculosis had Yin deficiency. There were 380 patients had the stasis, occupying 73.64%.Therefore, the methods of nourishing yin and removing blood stasis should be used to treat patients with pulmonary tuberculosis.

With the development of radiotherapy techniques,the efficacy of radiotherapy for liver tumors has been improved,and radiothera-py can be considered as an alternative treatment for patients who are not suitable for surgery.The progress in liver tumor radiotherapy repor-ted in the 55th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO)in 2013,particularly the efficacy and safety of stereotactic body radiation therapy for liver tumors,is reviewed.In the future,radiotherapy may be increasingly used as an ef-fective method in the treatment of liver tumors.The main studies reported at the meeting are sorted as follows in this article.

Objective To determine the cleaning and the shortest disinfectant time for gastroscope Methods 1? g/ml HBsAg and 3? 108/ml bacteria of Aureus Staphylococci(ATCC 6538),Escherichia coli(ATTC 8099),Bacterium earuginosum(ATCC 27853)were artificially spreaded on the body of gastroscope ,biopsy hole and biopsy clamp.The gastroscope was routinely cleaned and disinfected.HBsAg and pathogens in the samples,which collected before and after cleaning the gastroscope and 3min,5min,10min after disinfection,were tested by using ELISA and bacteria culture,respectively.Results Pathogen and HBsAg can be detected before cleaning the gastroscope.Pathogen can also be detected,but HBsAg disappears after cleaning.Both HBsAg and pathogen was negative 3 min after gastroscope was immersed in glutaraldehyde.Conclusion The tests for pathogens and HBsAg can be negative after gastroscope was cleaned and immersed in 2％ glutaraldehyde for 3 min.