Objective To observe the therapeutic efficacy of electroacupuncture at the acupoints on extremities or abdominal acupoints and orally taking Mosapride in treating functional dyspepsia (FD) and the different effects on life style, for guiding the points selection in acupuncture-moxibustion treatment for FD.Method Sixty FD patients were randomized into an extremity-electroacupuncture group, an abdomen-electroacupuncture group, and a Western medication group by their visiting sequence, 20 cases in each group. In theextremity-electroacupuncture group, Zusanli (ST36), Sanyinjiao (SP6), Neiguan (PC6) and Gongsun (SP4) were selected. Bilateral Zusanli and Sanyinjiao were respectively connected to G6805-2 electroacupuncture apparatus, 30 min for each session, once everyother day, 10 sessions in total. In the abdomen-electroacpuncture group, Zhongwan (CV12), Tianshu (ST25), and Qihai (CV6) were selected. Bilateral Tianshu were connected to electroacupuncture apparatus, with same treatment time, frequency and sessions. The Western medication group was intervened by oral administration of Mosapride, 1 tablet each time, 3 times a day, for 20 d in total. The three groups were evaluated by using Nepean Dyspepsia Index (NDI) prior to the treatment, after the treatment and 1 month after the treatment (follow-up study), and the therapeutic efficacies were estimated after the treatment.Result The effective rate of the extremity-electroacupuncture group was higher than that of the abdomen-electroacupuncture group and Western medication group, while there was no significant difference between the abdomen-electroacupuncture group and Western medication group in comparing the effective rate. After the treatment, the improvement of Nepean Dyspepsia Symptom Index (NDSI) in the extremity-electroacupuncture group was more significant than that in the abdomen-electroacupuncture group and Western medication group (P<0.05), while there was no significant difference between the abdomen-electroacupuncture group and Western medication group (P>0.05). The 1-month follow-up showed that the improvement of symptoms in the extremity-electroacupuncture group was more significant than that in the abdomen-electroacupuncture group (P<0.05), and the improvement in the abdomen-electroacupuncture group wasmore significant than that in the Western medication group (P<0.05). After the treatment, the improvements of Nepean Dyspepsia Life Quality Index (NDLQI) in the extremity-electroacupuncture group and abdomen-electroacupuncture group were superior to the improvement in the Western medication group (P<0.05), while there was no significant difference between the two electroacupuncture groups (P>0.05). The 1-month follow-up study showed that the quality of life in the extremity-electroacupuncture group was still significantly improved compared to that before the treatment, while the improvement in the Western medication group was insignificant.Conclusion Electroacupuncture at the acupoints on extremities and abdominal acupoints both can more effectively and consistently improve the symptoms and quality of life of FD patients compared to orally taking Mosapride. Compared to electroacupuncture at the abdominal acupoints, electroacupuncture at the extremity points works better in improving the symptoms of FD butdoesn't show advantage in improving the quality of life.

Malnutrition is a common problem in cancer and cancer cachexia is always present in advanced stage,which is responsible for poor prognosis.The mechanism of malnutrition and cancer cachexia has not been well understood.The major metabolism is change of glucose composing rate,glocongenesis and glycolysis to lactate increased,fat mobilization and oxidation accelerated and protein synthesis decreased.

Objective To investigate the influence factor of the recovery time of oculomotor nerve palsy (ONP) after traumatic carotid-cavernous sinus fistula (TCCF) treated by balloon embolization.Methods The clinical data of 76 patients with ONP after TCCF were retrospectively analyzed.All patients accepted intravascular balloon embolization treatment.Nonparametric test was applied to make single factor analysis of the influence factor of ONP recovery time,and linear regression analysis was applied to make multiple factor analysis.Results Seventy-six patients (100.0％) had a perfect occlusion for orificium fistulae after operation immediately,and 73 patients (96.1％) retained the internal carotid artery.Patients were followed up for 6-70 months,with an average of 34.2 months and no death cases.Seventy patients (92.1％) succeeded for embolization at the first time,and 6 patients (7.9％) relapsed after embolization for 6 weeks.The reasons of relapse was balloon leak,and no patients recurred after twice embolization.Seventy-six patients (100.0％) had recovery from ONP,and recovery time was (42.17 ± 32.39) d.The single factor analysis showed that the courses of diseases,fistula location,eye-tubercle location,degree of ONP,balloon quantity,state of internal carotid artery were the factor affecting the ONP recovery time (P ＜ 0.01 or ＜ 0.05).The linear regression analysis showed that the courses of the disease,fistula location,degree of ONP,balloon quantity were independent factor affecting the ONP recovery time (P ＜ 0.01).Conclusions Intravascular balloon embolization in the treatment of ONP after TCCF is safe and reliable.The courses of diseases,fistula location,degree of ONP and balloon quantity are the influencing factor of the oculomotor nerve functional recovery time,and should be given enough attention.

Objective Pulmonary benign metastasizing leiomyoma (PBML) is a rare entity that leiomyoma of uterus metastasized to the lung.The clinical characteristics of this rare disease were analyzed in this article.Methods The detailed clinical records of 7 patients diagnosed as PBML at Peking Union Medical College Hospital between January 2001 and June 2015 were reviewed.Results All patients were women with median age of 44 years (range 28-62).Symptoms included dyspnea (2/7),chest pain (1/7),cyanosis (1/7),cough (1/7) and bloody sputum (1/7),while 4/7 cases were asymptomatic.Six patients had the past-history of leiomyoma of uterus 20 months to 14 years ago among whom 5 patients received hysterectomy.Chest CT showed bilateral,random-distributed multiple round solid nodules,or diffuse-distributed miliary nodules,or single solid nodule,even some small cavities.Extra-pulmonary metastasis was found in left superclavicular lymph node (1 case) and right heart (1 case).Histological tissues were obtained by video-assisted thoracic surgery lung biopsy (4/7),mass resection on tricuspid valve (1/7),transbronchil lung biopsy (1/7),and CT-guided percutaneous lung biopsy (1/7).Pathology showed an interlacing pattern by spindle cells having elongated nuclei without cellular atypia.Ki-67 index was less than 1％.Molecules such as smooth muscle antibody,estrogen receptor (ER) and progestrone receptor (PR) were positive in immunohistochemistry staining.Neither letrozole nor zoladex was effective.Two patients responded to bilateral adnexectomy,presenting as shrunk nodules.No relapsed disease was seen in one patient with single nodule after resection.There was only one patient with disease-related mortality,whose chest CT showed milliary nodules.Conclusion Although CT findings of PBML are similar to malignancies,the clinical outcome is good.Despite the positive expression of ER and PR,the effectiveness of hormone related treatment is limited.And periodical follow up is suggested even to those uneventful patients.

In the development of primary care system,Shenzhen has called into play the model of hospital-centering,and made it a link to build a new urban medical service system of clear-cut levels,rational division of responsibilities and mutual benefit.This design provides the primary care with a good credit,a reasonable medical insurance system,and appropriate technical support.Furthermore,it improved the efficiency of unban health resource allocation and utilization and alleviated residents' burden of medical costs.This study aims to introduce the measures and advantages in the implementation of the primary care system in Shenzhen,analyze the problems found in Shenzhen' s community health service system and make recommendations for the improvement.

BACKGROUND: There are various reports on studies of tear secretion and tear film function in patients with diabetes mellitus over the past. In recent years, tear proteins have drawn more and more attentions on evaluation of tear film function.OBJECTIVE: To observe the contents of main tear proteins and basal tear secretion of patients with type 2 diabetes mellitus and normal persons so as to probe into tear secretion and tear film function of patients with diabetes mellitus.DESIGN: Case-control observation was designed.SETTING: Department of Ophthalmology, Southwest Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 50 cases (100 eyes) of type 2 diabetes mellitus were employed, which were diagnosed in Department of Ophthalmology and Department of Endocrinology, Southwest Hospital of Third Military Medical University of Chinese PLA from December 2001 to December 2002. They were free from ocular surgical and laser treatment, local medication in recent period and contact lens. Of those, there were 25 cases (50 eyes) in proliferating diabetic retinopathy group and 25 cases (50 eyes) in nonproliferating diabetic retinopathy group. In addition, 25 cases (50 eyes) of normal persons with matched age and sex were taken as the control group.There was no significant difference in age and sex among 3 groups (x2=0.024,0.321 ;P ＞ 0.05). All of the participants were in the know before the experiment.METHODS: [1] Tear collection: 10 cases (20 eyes) were randomized from two diabetic groups and the control successively. Capillary pipette method was used to collect non-irritative tear 10 μL from lower lacrimal punctum that was preserved in refrigerator at -20 ℃ (＜ 1 month). [2] Determination of total tear protein amount: Lorry method was used to determine the concentration of total tear protein, in which, calf serum albumin was taken as the criteria. [3] Determination of contents of main tear proteins: SDS-PAGE (sod.dodecyl sulfate-polyacrylamide gel electrophoresis) was used and Coomassie brilliant blue staining and Bio-Rad imaging analyzing system were applied for the analysis of isolated protein strips in quality and quantity. [4] Determination of rupture time of tear film: glass rod was used to get 20 g/L fluorescein sodium and drop in conjunctival sac. The examined person was required to blink gently for several times and open the eyes naturally and stare forward. That the first ruptured "black hole" was discovered on the complete tear film was taken as the rupture time of tear film. [5] Experiment of basal tear secretion: No.41 Whatmann filtering paper was used, folded in 5 mm, and placed at 1/3 of conjunctiva in the lower eyelid. Five minutes later, the paper was removed and length of it after wetting was measured. [6]Experiment with rose Bengal staining: glass rod was used to get 10 g/L rose Bengal and drop in conjunctival sac. After eyes blinking for several minutes, the observation was performed with green light filter under slit lamp (evaluation criteria: corneal conjunctiva of palpebral fissure stained+, stained to the inferior bulbar conjunctiva++,stained to the superior bulbar conjunctiva). Dry eye disease was diagnosed indirectly with red-stained epithelial cells and mucin.MAIN OUTCOME MEASURES: [1] Concentration of total tear protein. [2]Concentrations of various main tear proteins. [3] Rupture time of tear film. [4]Value of basal tear secretion. [5] Positive rate of rose Bengal staining.RESULTS: Totally 50 cases (100 eyes) in diabetes groups and 25 cases(50 eyes) in the control group all entered result analysis. [1] Concentration of total tear protein: there was no significant difference among 3 groups (P＞ 0.05). [2] Concentrations of various main tear proteins: the results of lysozyme, lactoferritin and tear specific prealbumin in proliferating diabetic retinopathy group were lower remarkably compared with the control[ (0.94±0.21)vs ( 1.33±0.31 )g/L , ( 1.10±0.24)vs ( 1.67±0.43 )g/L, (0.98±0.22) vs (1.49±0.32)g/L, P ＜ 0.01]. Compared with non-proliferating diabetic retinopathy group, the results of lactoferritin and tear specific prealbumin were lower (P ＜ 0.05). There was no significant difference in human serum albumin among 3 groups (P ＞ 0.05). [3] Rupture time of tear film:compared with non-proliferating diabetic retinopathy group and the control, the rupture time of tear film in proliferating diabetic retinopathy group was reduced significantly [(7.68±2.21)s vs (9.92±2.37)s and(10.80±2.23)s,(P ＜ 0.01 )]. [4] Value of basal tear secretion: the value in proliferating diabetic retinopathy group was less significantly than that in non-proliferating diabetic retinopathy group and the control [ (8.00±2.10)vs( 11.02± 1.97 )mm and ( 12.17±2.08 )mm, P ＜ 0.05]. [5] Positive rate of rose Bengal staining: the positive rate in proliferating.diabetic retinopathy group was higher significantly than non-proliferating diabetic retinopathy group and the control (48% vs 24% and 14%, P ＜ 0.05, P ＜ 0.01).CONCLUSION: It is suggested in the results of this paper that abnormal tear secretion and tear film function are apt to present in patients with type 2 diabetes mellitus and the declined tear film function is more remarkably in the patients with proliferating diabetic retinopathy specially. SDS-PAGE benefits the discovery of changes in tear proteins in diabetic patients.

Objective To evaluate the safety and efficacy of icotinib as first-line therapy in Chinese non-small cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) sensitive mutations.Methods Patients with stage ⅢB/Ⅳ NSCLC who had EGFR sensitive mutation and had no previous treatment were enrolled into this study.The response rates , progress free survival ( PFS) , overall survival ( OS ) , and the safety were analyzed.Results Ninety advanced adenocarcinoma patients were enrolled in this study , 44 patients had partial response ( PR ) , 42 patients had stable disease ( SD ) , 4 patients had progressive disease (PD), with an overall response rate (ORR) of 48.9%, and a disease control rate (DCR) of 95.6%.The median PFS was 14.9 months (95%CI 13.5-16.3) and the OS was 37.0 weeks ( 95%CI 27.9 -46.1 ).Patients with brain metastases showed higher ORR ( P =0.049 ).Patients with stage ⅢB had longer PFS than those with stage Ⅳ( P=0.007 ).The most common adverse events were grade 1 -2 skin rash (38 patients, 40.9%).Other adverse events included dry skin , oral mucositis, diarrhea and liver function injury.Three patients withdrew because of severe liver injury or skin rash.No treatment related mortality occurred .Conclusions Icotinib is effective and safe as first-line treatment for Chinese advanced NSCLC patients with EGFR sensitive mutation.

This study aimed to assess the specificity of auricular acupoints in responding to changes of qi and blood which, in traditional Chinese medicine, are considered as the fundamental substances in the human body for sustaining normal vital activity.

OBJECTIVE To type the genes of plasmid DNA in 54 clinical Klebsiella pneumoniae isolates producing extended -spectrum beta-lactamases (SHV) by denaturing high-performance liquid chromatography (DHPLc) and evaluate their sensitivity and specificity, and explore a rapid and convenient method for detecting the antibiotic resistance of K. pneumoniae. METHODS Plasmid DNA from each extended-spectrum beta-lactamase (SHV) producing strain was subjected to PCR amplification. After we performed DNA sequencing of these amplicons and identification of mutation and their genotype, DHPLc was undertaken to investigate whether its results correlate the distinctive chromatogram with each genotype. RESULTS All the strains were found abnormal elution peaks (two or three peaks) which were different from each other. The result of DNA sequencing demonstrated that all the strains had DNA mutation in comparison with SHV-1. Moreover, DHPLc could produce specific peak patterns that correlate with genotype. CONCLUSIONS The sensitivity of DHPLc is 100% in this study. And each genotype is corresponded to specific peak pattern. So we can use DHPLc technique to type the genes of plasmid DNA in K. pneumoniae and detect mutations rapidly. DHPLc not only has high accuracy , but also is a convenient and rapid technique for the detection of mutation in the bacterial genome. It has a great potential clinical value.

Objective: To study whether the bond strength between enamel and composite resin could be enhanced by intraoral sand abrasive. Methods: Ten human maxillary first incisior teeth were divided into 2 groups The experimental group was sandblasted with 30 ?m Al 2O 3 (CoJet Sand, pressure 300 kPa) from a distance of 5 mm for 5 seconds, and the control group were not sandblasted. The Herculite composite resin composite cylinders were bonded with Coltene system. Bonded specimens were stored in 37 ℃ distilled water for 24 h, then were subjected to shear force in a testing machine Stress at failure was calculated in Mpa, and mode of failure was recorded. The Student t test was applied to the data. Results: The shear bond strength of experimental groups was (33.0?1.8) MPa , and that of control groups was (26.7?5.2) MPa ,there was significant difference between these two groups. All the adhesive failures happened at the enamel composite resin interface , except that cohesive failure happened in one sandblasted specimen. Conclusion: Intraoral sandblasting could significantly enhance the shear bond strength between enamel and composite resin.