Objective To observe the clinical efficacy of acupuncture-moxibustion plus tuina in treating neurosensory tinnitus and hearing loss.Method Eighty-six patients with neurosensory tinnitus and hearing loss were randomized into a treatment group of 56 cases and a control group of 30 cases. The treatment group was intervened by warm needling plus tuina, while the control group was treated with conventional medications. The clinical efficacies were compared between the two groups.Result The total effective rate was 87.5% in the treatment group versus 63.3% in the control group, and the between-group difference was statistically significant (P<0.01). In the treatment group, the total effective rates of those with a disease duration<1 year, ≥1 year and<2 years, and<5 years were significantly different from the rate of those with a disease duration>5 years (P<0.01). In the treatment group, the total effective rate was 93.8% in those due to liver fire, 94.1% in those due to phlegm heat stagnation, 83.3% in those due to spleen-stomach deficiency, and 72.7% in those due to kidney essence insufficiency. The total effective rates of the liver fire and phlegm heat stagnation types were significantly different from the rate of the kidney essence insufficiency type (P<0.05).Conclusion Acupuncture-moxibustion plus tuina is an effective approach in treating tinnitus and hearing loss.

Objective To identify the main clinical characteristics helpful for diagnosis and differential diagnosis of Crohn s disease (CD) from primary intestinal lymphoma (PIL). Methods Ninety cases of CD and 46 cases of PIL during 1983-2004 in Peking Union Medical College Hospital were investigated retrospectively. Results The average age of PIL was nearly 10 years elder than that of CD (45. 0?16. 2 vs. 36. 7?15. 7, P

Objective To probe the differences and similarities of clinical feature between alcoholic and biliary chronic pancreatitis (CP) and their therapy. Methods Retrospective analysis of the clinical features was made in 110 cases of CP in Peking Union Medical College Hospital from 1991 to 2000. Results ① In 110 cases of CP, the clinical manifestations were abdominal pain (85.4%), diarrhea (22.7%), calcification of pancreas (13.6%), and pseudocyst of pancreas (28.2%); 3 cases (2.7%) complicated with pancreatic carcinoma. ② The frequency of the different kind of clinical manifestations in alcoholic CP was higher than in biliary CP.③The frequency of diarrhea (29.1%),diabetes mellitus (41.9%) and calcification of pancreas (22.6%) in alcoholic CP was also higher than in those caused by bile duct system diseases (16.7%, 19.1% and 9.5%).④The response rate of medical treatment was 81.2%. Conclusions The clinical features and complications are more typical and occur earlier in alcoholic CP than those in biliary CP. With regard to management, medical treatment is less used than surgical therapy.

Objective To comprehend the clinical characteristics and treatment of primary hepatic amyloidosis.Methods A total of 10 cases of primary hepatic amyloidosis included. 4 cases from Peking Union Medical College Hospital and 6 cases from other hospitals.reported in the literature in recent 20 years were reviewed,Results (1)The frequent clinical symptoms related to primary hepatic amyloidosis presented as hepatomegaly(90%),abdominal distension(80%),shifting dullness(60%),anorexia(50%),fatigue(40%),edema(40%),weight loss(40%) and abdominal pain(30%).(2)Laboratory tests revealed elevated serum alkaline phosphatase which was (558.3?517.2)U/L,and other liver function involvement were rare:six patients(85.7%)had either a serum or urine monoclonal protein.(3)Liver biopsy is golden standard.The amyloid deposition was mainly located at sinusoida(4 casese,57.1%),and only 2 cases was at vascular(28.6%).Complication of bleeding after liver biopsy was reported(1 case).(4)The classical therapy scheme was melphalan and prednisone,four cases died from liver function failure and infection.Conclusion The clues to the diagnosis of primary hepatic amyloidosis include elevated monoclonal protein,hepatomegaly and an unexplained elevated serum alkaline phosphatase level which is not parallel with other liver functions.Live biopsy is golden standard.The treatment scheme include melphalan and prednisone,but its prognosis is poor.

Objective Objective To evaluate the response,survival and toxicity of concurrent chemoradiotherapy for patients with inoperable esophageal cancer. Methods Eighty-eight patients with inoperable esophageal cancer were divided randomly into two groups, 43 patients in group R+C received chemoradiotherapy, while 45 patients in group R received radiotherapy only. For both groups, the same radiation technic was carried out by conventional fractionation, to a total dose of 60-65Gy/30-33Fr/6.0-6.5W. For group R+C patients, concurrent chemotherapy(5-Fu 500mg/d1-4,DDP 20mg/d1-4) was given. Results Complete response rate in group R+C was 33%,while in group R, it was 13% (P

Objective Through death analysis of critically ill children with interhospital transportation,to explore the cause of death and its influencing factors.Methods We collected the data of death cases within 24 hours who were one-way transported from primary hospital to the emergency department of Guangzhou Women and Children's Medical Center between July 2012 and May 2014.We analyzed the diseases type,physiopathologic status,and the treating measures in the process of transportation.Results There were total 1 122 cases,34 children died,the mortality was 3.0％,7 cases died before admission,27 cases died within 24 hours after admission.The first three types of diseases were respiratory system diseases(8/34,23.5％),nervous system diseases (7/34,20.6％) and accidental injury (6/34,17.6％).The physiopathologic status were analyzed according to physiological status and laboratory data at admission.Most of the children had a variety of physiopathologic status.Electrolyte disturbances were found in 22 cases(81.5 ％),metabolic acidosis and respiratory failure in 19 cases (70.4％).Most cases had intravenous channel (33/34,97 ％),intravenous infusion (32/34,94.1％)and electrocardiogram monitoring (30/34,88.2％),none of the cases received vasoactive agents in transportation.Conclusion Insufficient disease evaluation before the transportation of critically ill children,inadequate monitoring and treating measures on the way are important factors causing the death of children.

Objective To determine the diagnostic accuracy of alarm features in predicting upper gastro intestinal malignancy in patients who received gastroscopy examination.Methods A retrospective analysis of patients who underwent gastroscopy from Oct 2014 to Oct 2015 was conducted.Biopsy or surgical pathological findings served as the golden standard.The main outcome measure was the diagnostic accuracy of alarm features.Results Among 921 gastrointestinal outpatients,39 patients (4.2％) with malignancy were detected,including 13 (33.3％) with esophageal cancer,24 (61.5％) with gastric cancer and 2(5.1％) with duodenal ampulla cancer.36 patients (92.3％) were found with advanced cancer.In 137patients who had alarm features,21 (15.3％) were found to have malignancy and all were advanced.The sensitivity,specificity,positive predictive value and negative predictive value of alarm features were 53.8％(21/39),86.8％ (766/882),15.3％ (21/137) and 97.7％ (766/784),respectively.Conclusions Alarm features have a definite but limited value in predicting upper gastrointestinal malignancy.Noninvasive screening methods for Chinese patients are still needed to reduce unnecessary endoscopy workload.

Background and Purpose:In recent years,along with marked rise in the incidence of lung cancer,the incidence of brain metastasis from lung cancer has increased year by year.The main treatment strategy of lung cancer with brain metastasis is irradiation,while so far there are only few researches concerning chemotherapy combined with radiotherapy for these patients.The aim of this study is to evaluate the therapeutic effect,survival rate and toxicity of chemotherapy with VM_(26)+DDP regimen given concurrently with whole-brain radiotherapy in lung cancer with brain metastasis.Methods:From Sep.2000 to Oct.2001,forty-one patients with lung cancer with brain metastasis were divided randomly into two groups: 20 patients(14 male,6 female) received concurrent chemoradiotherapy(chemoradiotherapy group),the other 21 patients(14 male,7 female) received only radiotherapy(radiotherapy group).In the chemoradiotherapy group,the average age was 50 years with range 40 to 70 years,16 patients were non-small-cell lung cancer,4 patients were small-cell lung cancer.In the radiotherapy group,the average age was 52 years with range 40 to 73 years and 19 patients were non-small-cell lung cancer,2 patients were small-cell lung cancer.For both groups,the same radiation technique was given with conventional fraction.Radiotherapy was delivered by 6MV.Fractionations of 3Gy/fraction/day was delivered 10Gy/5 factions/week.The total dose was 30Gy/10Fr/2W.For chemoradiotherapy group,the patients were also given concurrent chemotherapy(VM_(26) 60mg/m~(2)/ day iv on days 1-3,cisplatin 60 mg/m~(2) iv on the 1~(st)day).Results:The response rate and complete response in the chemoradiotherapy group was significantly higher than that in the radiotherapy group(75% ?? 38.10%,P

0.05).Conclusions:Concurrent chemoradiotherapy can be well tolerated even though the acute side-effects less than grade 2 were higher in concurrent chemoradiotherapy than other group.Immediate response was very encouraging in the concurrent group.There was no advantage in terms of survival rate in the concurrent group compared to the sequential group.

Objective To evaluate the value of clinical data and various methods of diagnostic imaging in the patients with pancreatic cancer. Methods Two hundreds and fifty-six patients with pancreatic cancer admitted into Peking Union Medical College Hospital between 1996 and 2004 were included. The clinical symptom and the accuracy of various imaging methods (B-US, CT, ERCP, EUS, DSA and MRI) in assessing pancreatic carcinoma were analyzed. Results Weight lost was the most common symptom in 79% of patients with pancreatic carcinoma. Jaundice was mostly seen in patients with pancreatic head carcinoma. Upper abdominal pain was in 86% of patients with carcinoma in pancreatic body and tail. The diagnostic accuracies of B-US, CT, ERCP, EUS, DSA and MRI were 83% , 89% , 90% , 91% , 82% and 79% respectively. Conclusion B-US and CT scanning should be undergone in patients with abdominal pain, jaundice and weight lost who were suspected to have pancreatic carcinoma. Further imaging techniques such as EUS, ERCP and MRI should be advised in patients highly suspected to have pancreatic carcinoma, in spite of the results of B-US and CT were negative.