Purpose:To evaluate the protection of astragalus injection for Doxorubicin (adriamycin)-associated cardiotoxicity. Methods:58 patients were randomized into two groups for this clinical trial. 30 patients were in the test group ,and 28 in control group. Patients in the test group received astragalus injection in 5% glucose solution once every day for two weeks starting three days before adriamycin-based chemotherapy. 28 patients in the control group began to receive oral vitamin E 100 mg twice a day and coenzyme Q10 20 mg three times a day for two weeks. Chemotherapy is the same as that in the test group. Electrocardiogram (ECG) and echocardiogram were employed to evaluate the cardiac function. Results:There was a substantial difference in ejection fracton between the two groups,but the difference was not statistically significant. Statistically significant differences were observed in the two groups with regard to all other parameters,including abnormal changes in ECG and LVIDD、LVISD、A/E、FS. Conclusions:Astragalus injection is a good drug which can prevent the occurrence of acute cardiotoxicity associated with adriamycin. It can also reduce the occurrence of chronic cardiotoxicity.

Purpose:To investigate the prognostic factors for breast cancer patients with liver involvement.Methods:114 breast cancer patients with liver metastases,who were hospitalized in Fudan University Cancer Hospital between January,1996 and December,2003,were included in this study.Their survival data were analyzed.Results:The response rates with first-,second-,third-,fourth-line chemotherapy were 31.9%,27.8%,16.7% and 0%,respectively.Univariate analyses indicated that patients with impaired liver function and patients with a short interval between surgery and the first recurrence or metastasis had a poor prognosis.Multivariate analyses suggested that the presence of liver function impairment was an independent prognostic factor for overall survival.Conclusions:The response rates of chemotherapy drop with number of lines of chemotherapy.Breast cancer patients with liver involvement and impaired liver function have a poor prognosis.

Objective: To study the effect of hyperplasia suppressor gene (HSG) in inducing vascular smooth muscle cell apoptosis and the underlying mechanisms. Methods: The cultured VSMCs were transfected with an adenoviral vector containing rat HSG gene. Effects of HSG on VSMC apoptosis were investigated by fluorescent dye staining to detect the tact of nuclei, and by flow cytometry to define the content of DNA and to detect the levels of caspase-3. The expressions of Bcl-2 and Bax were also performed by Western blot analysis. Results: The increased expression of HSG in VSMCs infected with AdHSG induced apoptotic cell death detected by flow cytometry assay and nucleic staining. Compared with control groups, HSG induced vascular smooth muscle cell apoptosis 72 h after infected with adenoviral vector (39.6%?3.2% vs. 2.6%?0.9%,P

Objective To comprehensively evaluate prevention and health care services of community health centers in Shandong province since the ongoing health reform and provide policy basis for development of community health services.Methods To study with rank sum ratio method and important quadrant models.Results Seventy-eight percent of community health centers were appraised as“average”.Overall satisfaction of residents for preventive and health services was 2.66 points.Preventive and health services of community health centers are expected to improve.Conclusion Overall prevention and health services of CHS centers were found less than satisfactory.Prevention and health services of CHS centers in regions a and B were poor,which deserves attention of the government health authorities.The government is expected to take actions to promote development of CHS centers for prevention and health care service.

Grounded theory was used to summarize and analyze influencing factors and their mechanism on availability of essential medicine.Four factors which influenced the availability of essential medicine were singled out:defective top design in the essential medicine system,interactions among its policies,deviations in the policy implementation by government agencies,and deficiency of supporting policies for the system.The availability of essential medicine in rural areas was influenced by a variety of factors.The ideas and methods of the grounded theory prove helpful for this study.In the future studies,both qualitative and quantitative study should be made to perfect this model formed by the grounded theory,to identify roadblocks and underlying causes in order to provide evidence for improving availability of essential medicine in rural areas.

Objective Explore the spine fractures treated by percutaneous one-way pedicle screws surgery compared with curative effect of traditional open surgery.Methods From October 2012 to October 2015,to collect 61 patients with single segmental thoracolumbar fractures were retrospectively analyzed,respectively for percutaneous minimally invasive one-way long tail pedicle screw(Observation group,n =32) of internal fixation were compared with traditional open surgery (control group,n =29).Compare two groups of paticnts in the differences of operation time,amount of operative bleeding,operative wound,postoperative VAS scores,the ratio of postoperative injured vertebral front height,and hospitalization expenses.Results All patients were followed up for an average of 9.6 months (from 7 to 14months),neither of the groups showed internal fixation of related complications.Time of operation(min):observation group(87.4 ± 13.6) min,control group (92.3 ± 10.3) min,(t =-1.648,P ＞ 0.05);Mount of operative bleeding:observation group (73 ± 8.8) mL,control group (352 ± 63.7) mL,(t =-23,385,P ＜ 0.05);Wound of operative (cm2):observation group (12.3 ± 2.30) cm2,control group (81.5 ± 14.2) cm2,(t =-25.937,P ＜ 0.05);Expenses of hospitalization (RMB ten thousand):observation group (3.5 ± 0.3),control group(2.3± 0.5),(t =-11.223,P ＜ 0.05);VAS score 2 days and 6 months after surgery:observation group (3.0±0.4) and (1.3±0.6),controlgroup(4.2±0.5) and (2.7±0.7),(t=-10.396 and-8.409,P＜ 0.05),and comparcd with the preoperative also statistically significant (P ＜ 0.05);2 days and 6 months after surgery in the ratio of injured vertebral front height:observation group(89.6 ±7.2)％ and (84.2 ±5.7)％,control group (91.3 ± 5.8) ％ and (86.3 ± 4.6) ％,(t =-1.009 and-1.573,P ＞ 0.05),but in the same group recovery of injured vertebral leading edge height ratio compared with preoperative postoperative were significantly (P ＜ 0.05).Conclusion For a single section of thoracolumbar spine fracture,Compared with the control group,Percutaneous one-way long tail pedicle screw internal fixation technology have the advantage of little trauma,less sequel,rapid postoperative recovery,also in the recovery of vertebral body height and loss of late has achieved the same cur-ative effect,but patients with costly.

Objective To assess the differences in carotid artery stiffness properties and endothelium-independent dilation (EID)between elderly and young patients,and evaluate the echotracking (ET)system for vascular stiffness at different ages.Methods A total of 79 outpatients with multiple cardiovascular risks were recruited.Clinical data including medical history,height,weight,blood pressure,fasting blood glucose and blood lipid were collected.We evaluated the arterial stiffness parameters of carotid artery and EID using an ultrasonic ET system in 46 elderly subjects,compared with 33 sex-matched non-elderly subjects.The impaired EID function was defined as brachial artery nitroglycerin mediated dilation (NMD)below 4％.Results All stiffness parameters including pressure-strain elasticity modulus stiffness index β (Ep),pulse wave velocity β (PWVβ)and augmentation index (AI)were significantly increased in elderly group compared with the non-elderly group [(138.9±64.7)kPa vs.(100.6±30.8)kPa,(10.9±4.7)vs.(8.2±2.3),and (6.9±1.4)m/s vs.(6.1±0.9)m/s,P＜0.05 respectively],while the exception of arterial compliance (AC)was reduced (0.9±0.3)mm2/kPa vs.(1.0±0.5)mm2/kPa(P＜0.05).The incidence of impaired EID in elderly group was higher than in non-elderly group [56.5％ (26 cases) vs.33.3％ (11 cases),P＜0.05].ET parameters including Ep,stiffness index β,PWVβ,AC and AI were related to age (r=-0.44,-0.45,-0.40,-0.40,0.34,all P＜0.01)； Ep,stiffness index β,PWVβ and AC were also related to impaired EDI (r=-0.38,-0.40,-0.34,-0.29,all P＜0.01).Conclusions Arterial stiffness properties and EID measured by ET system was more serious in elderly with multiple cardiovascular risks than in non-elderly subjects.As a convenient and accurate assessment of stiffness parameters,ET system is optimal option for measuring arterial stiffness and EID in elderly people.

Objective: To study the different clinicopathological characteristics between classic and epithelioid renal angiomyolipoma, and the relationships between clinicopathological characteristics and biological behaviors as basis for clinical treatment. Methods: The clinicopathological and follow-up data for the patients diagnosed with renal angiomyolipoma between 2004 and 2011 were retrospectively reviewed and analyzed. Results: There were 414 cases of renal angiomyolipoma diagnosed over 8 years ago, accounting for 8.1% (414/5 287) of all renal parenchymal tumors. The patients included 122 male and 292 female (male-to-female ratio of 1.0∶2.4), mean age 44.0 years (range 15-74 years). Of these, 195(47.1%) tumors occurred in the left kidney, 212(51.2%) in the right kidney and seven (1.7%) were bilateral. Clinically, some cases presented with hypochondrial pain, hematuria or palpable masses. Histologically, 394(95.2%) were classic angiomyolipoma, 20(4.8%) were epithelioid angiomyolipoma; 54, 23 and 7 cases had hemorrhage, necrosis and cystic degeneration, respectively; and 5, 30 and 14 cases had perirenal fat invasion, atypical cells and polymorphic/giant tumor cell. There was a positive correlation between atypical cells and epithelioid tumor type, respectively. The other clinicopathological parameters did not correlate with histological type. Follow-up data was available in 360 patients, with follow-up period of 3 to 99 months. One case died from other causes. The remaining patients were free of disease. Conclusions Angiomyolipoma is a common renal parenchyma tumor. Clinically, it is usually biologically benign. Histologically, it can be either classic or epithelioid types. The epithelioid type should be differentiated from the classic renal cell carcinoma, Mit family translocation renal tumor and renal hemangioblastoma. Atypical cells, more commonly found in the epithelioid angiomyolipoma, do not affect the clinical prognosis of patients.

With the advancement of surgical techniques, the 5-year survival rate of colorectal cancer has significantly improved. However, incomplete lymph node dissection during operation leads to local recurrence and distant metastasis of the tumor, which has seriously affected the prognosis of patients. In the era of laparoscopy, surgeons' sense of touch is limited, making it difficult to feel and distinguish lymph node metastasis and the location of early colorectal cancer with their hands. The emergence of carbon nanoparticle suspension can help surgeons accurately locate tumors and clean lymph nodes under laparoscopy. This article reviews the clinical application of carbon nanoparticles in lymph node tracing and tumor location in colorectal cancer.

Objective:To investigate the value of MR subtraction images in improving the interobserver agreement for Bosniak Ⅱ, ⅡF, and Ⅲ cystic renal masses (CRMs) with Bosniak classification version 2019.Methods:From January 2009 to August 2020, 323 patients (335 CRMs) with surgical pathology results and complete preoperative MRI examination (T 2WI, T 1WI precontrast images and enhanced MRI in corticomedullary, nephrographic, and excretory phases) were retrospectively collected in the First Medical Center of PLA General Hospital. The CRMs of Bosniak Ⅱ, ⅡF, and Ⅲ were selected and classified by 2 experienced genitourinary radiologists according to the Bosniak classification version 2019. The "Subtraction" function in the American GE ADW 4.4 workstation was used to perform subtraction images reconstruction on the enhanced images in the corticomedullary, nephrographic, and excretory phases. Blinded to pathologic information, the other 2 radiologists independently classified the enrolled CRM cases with and without subtraction MR images, respectively, with an interval of 1 month. Ultimately, by using weighted Kappa value, interobserver agreement was evaluated, and the differences in weighted Kappa value were compared using the Gwet coefficient. Results:A total of 187 patients with 187 CRMs were enrolled in the study. The results of the classification of Bosniak Ⅱ, ⅡF, and Ⅲ CRMs categorized by 2 radiologists without and with subtraction images showed that 119 and 141 cases were consistent, and 68 and 46 were inconsistent, respectively. The weighted Kappa value for interobserver agreement among two radiologists without and with subtraction MR images was 0.60 (95%CI 0.53-0.68) and 0.73 (95%CI 0.66-0.80), respectively. The interobserver agreement was higher with subtraction images than that without subtraction images ( t=-2.56, P=0.011). Conclusion:According to the MRI criteria of Bosniak classification version 2019, the interobserver agreement for Bosniak Ⅱ, ⅡF, and Ⅲ CRMs could be improved using subtraction MR images, which may facilitate the popularization and application of Bosniak classification version 2019.