Objective To investigate the correlation of serum alpha-fetoprotein (AFP) with clinical pathological factors and prognosis of hepatocellular carcinoma ( HCC ).Methods Two hundred and twenty patients with HCC who hospitalized in our hospital from January 2007 to June 2009 were enrolled in this study.The relationship of AFP levels before operation to clinical pathological factors such as pathological grade,tumor size,tumor encapsulation,tumor numbers,portal vein tumor thrombus,TNM stage and postoperative recurrence were analyzed.Results Serum AFP concentration before operation were related with tumor size ( x2 =11.76,P ＜ 0.05 ),tumor encapsulation ( x2 =17.07,P ＜ 0.05 ),portal vein tumor thrombus ( x2 =8.944,P ＜ 0.05 ),higher TNM stage ( x2 =4.929,P ＜ 0.05 ) and early postoperative recurrence rate ( x2 =5.569,P ＜ 0.05 ).However,it had no correlation with pathological edmondson grade tumor numbers.Conclusion HCC patients with high serum AFP concentration often has greater tumor without encapsulation,high occurrence rate of portal vein tumor thrombus and higher TNM stage,they are more likely to early postoperative recurrence.Serum AFP before operation is useful not only for diagnosis,but also as a prognostic biomarker to predict prognosis and recurrence.

Objectives:In situ coronary calcium is a specific anatomic marker of coronary atheroma. Electron beam CT is the first noninvasive method to determine coronary artery calcium. The aim of this study was to investigate the coronary artery calcium(CAC) in Chinese. Methods:Nine hundred and fifty-nine Chinese cases undergoing electron beam screening were divided into six age groups: ①younger than 29,②30～39,③40～49,④50～59,⑤60～69,⑥older than 70 years old, and were divided into another three groups according to coronary artery disease(CAD) symptoms.①symptomatic group: symptomatic patients with CAD;②doubtful symptom group: patients had atypical chest pain, but without sufficient information of angina,③asymptomatic group: patients without CAD symptoms. Results:① Prevalence of CAC and the total scores of CAC in asymptomatic men and women increased significantly with increased ages. ② There was a large increase in the prevalence of CAC in asymptomatic women between the age of 40～49 and 50～59. Conclusions: ①Coronary artery calcium prevalence increases with age in both men and women.②There is a marked difference in the prevalence of calcium between men and women.③The noninvasive detection of CAC by EBCT has certain prognostic and predictive value for coronary artery disease.

Background and purpose:Gastric cancer is one of the common malignancies seen in our country, most patients were diagnosed at a late stage. Surgery remains as one of the main treatments for the patients but the local local and regional failures were still high. The importance of the role of chemotherapy and radiotherapy has been investigated in the treatment of gastric cancer.We evaluated the efficacy and side-effects of CPT-11 combined with capecitabine for the treatment of advanced gastric cancer. Methods:Since May 2004 to May 2006, twenty patients with pathologically proved gastric cancer have been treated by CPT-11 plus capecitabine in our hospital. The regimen consisted of CPT-11 120 mg/m2 infusion at 1st day and 8th day, capecitabine 1000 mg/(m2?d) twice a day from 1st-14th day . The cycles were repeated every three weeks. All the patients were planned to receive at least 2 cycles of chemotherapy.Results:In 20 evaluable patients, 1 case had complete response; 8 case had partial response; 6 case had stable disease and 5 case with progressive disease. The response rate of the whole group was 45.0%(9/20); Clinical tumor control rate was 75.0%(15/20). The major toxicities were bone marrow suppression (52.1%) and reactions relative to digestive system (35.2%). All of complications were RTOGⅠ/Ⅱ degree.Conclusions:Combination of CPT-11 and capecitabine is effective for advanced gastric cancer and well tolerated by the patients. For the patients with either old age, poor general status or relapse after other chemotherapeutic regimen, the regimen could be the one of choice.

Epidemiological and animal studies have demonstrated that dietary lower intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) and(or) higher intake of n-6 polyunsaturated fatty acids(n-6 PUFAs) leading to imbalance of their ratios are closely related to obesity.The mechanisms underlied are involved in PUFA′s effects on fatty acid synthesis and oxidation,adipocyte proliferation and differentiation and leptin expression.At transcription level,PUFAs can regulate the activities of peroxisome proliferator-activated receptors and CCAAT enhancer bin-ding proteins.

Objective:To investigate the expression of pre-B-cell leukemia homeobox 3 (PBX3) and the phosphatase and tensin homology deleted on chromosome 10 (PTEN) in cervical cancer and its relationship with the clinicopathologic characteristics and prognosis.Methods:Cervical cancer tissues and adjacent tissues of 85 patients with cervical cancer admitted to Xianlin Gulou Hospital from June 2014 to December 2018 were collected and the expression levels of PBX3 and PTEN were detected by immunohistochemistry. The univariate analysis and Logistic regression model were used to analyze the relationship between the expression levels of PBX3, PTEN and clinicopathologic features. Kaplan-Meier survival curve was used to analyze the relationship between the expression levels of PBX3, PTEN and prognosis.Results:The positive expression rate of PBX3 protein in cervical cancer tissues was higher than that in adjacent tissues: 38.82%(33/85) vs. 25.53%(20/85); the positive expression rate of PTEN protein was lower than that in adjacent tissues: 36.47%(31/85) vs. 98.82%(84/85), and there were significant differences ( P<0.05). The univariate analysis showed that the expression levels of PBX3 and PTEN were associated with clinical stages, degree of tumor differentiation, lymph node metastasis, vascular invasion, and degree of tumor invasion ( P<0.05). The multiple Logistic regression model showed that the clinical stages, tumor differentiation and lymph node metastasis were independent influencing factors for the positive expression of PBX3 or PTEN in cervical cancer tissues ( P<0.05). While 45.45%(15/33) of patients with positive PBX3 expression died, with a median survival of 31 months, and 25.00% (13/52)of patients with negative expression died, with a median survival of 38 months. Kaplan-rank test showed that the survival time in the patients with positive PBX3 expression and in the patients with negative expression had significant difference ( P=0.025). While 22.58%(7/31) of patients with positive PTEN expression died, with a median survival of 39 months, and 38.89%(21/54) of the patients with negative expression died, with a median survival time of 33 months. Kaplan-rank test showed that the survival time in the patients with positive PTEN expression and in the patients with negative expression had significant difference ( P=0.035). Conclusions:The expression of PBX3 is up-regulated and PTEN is down-regulated in cervical cancer. The expression levels of PBX3 and PTEN are related to clinical stage, tumor differentiation and lymph node metastasis. The prognosis of the patients with positive PBX3 expression is worse than that of the patients with negative expression, and the prognosis of the patients with positive PTEN expression is better than that of the patients with negative expression.

Objective To investigate the effects of Buyang-Huanwu decoction combined with western medicine on early diabetic renal injury.Methods 200 cases of early diabetic renal injury were randomly recruited into study group and control group,with 100 cases in each group.The control group was treated with insulin injection and oral benazepril hydrochloride,and the blood pressure,blood lipid changes were closely monitored; while the study group was additionally treated with Buyang-Huanwu decoction on the basis of the control group.Results The total therapeutic effects in the study group was significantly higher than the control group (x2=15.62,P＜0.01).The values of FBG,2 h PG,DBP,SBP,HbAlc in both groups were significantly reduced after the treatment (P＜0.05,t=4.23,4.47,3.59,3.87,3.99 in the study group,t=4.34,4.76,4.05,3.78,3.69 in the control group) ; but the difference between the two groups had no significance (P＞0.05).Before treatment rnALB,Urea,Cr,TG and TC were not significantly different (P＞0.05) ; the values of mALB,Ureaand Cr were significantly reduced in the study group after the treatment (P＜0.05,t=4.56,3.73,3.28);especially mALB in the study group was obviously lower than the control group (P＜0.05,t=5.01).Conclusion Buyang-Huanwu decoction combined with western medicine was effective to treat early renal damage of type 2 diabetes,with the functions of reducing urinary protein,improving microcirculation and protecting renal function.

AlM:To provide a proper assessment of the clinical use of orthokeratology by observing and analyzing the ocular biometric changes of the eyes and the stereopsis of the myopia.
METHODS:Sixty eyes from 30 myopia ( from 8 to 17 years old) were fitted with orthokeratology. Stereopsis, visual acuity, near visual acuity, central corneal thickness, anterior chamber depth, average anterior corneal refractive power ( K value ) , and intraocular pressure were measured before the orthokeratology treatment and 3mo after it. Refraction was expressed as spherical equivalent ( SE) , and the subjects were divided into 3 groups according to refraction: low myopia group (SE<-3.00D), moderate myopia group (-3. 00D≤SE<-6. 00D), and high myopia group (SE≥-6. 00D).
RESULTS:All subjects had significant improvements in visual acuity and near visual acuity 3mo after the orthokeratology treatment (P<0. 01). ln the comparisons of any pair of the groups, there was no significant difference in the near visual acuity ( P>0. 05 ). Three months after the orthokeratology treatment, Naked eye near stereoacuity values of all subjects were decreased (P<0. 01). There was no significant difference in the comparisons of the differences of stereopsis between any pair of the groups ( P> 0. 05 ). There was significant correlation in stereopsis and anisometropia ( Pearson coefficient r = 0. 778, P < 0. 01 ). And with greater anisometropia, the stereopsis was higher. All subjects had significantly lower K values than before 3mo after the orthokeratology treatment ( P< 0. 01 ). There was no significant difference in central corneal thickness, anterior chamber depth, and intraocular pressure (P>0. 05).
CONCLUSlON:Orthokeratology could lower K value in a short time and change the corneal curvature to correct myopia, to improve visual acuity and near visual acuity. lt also has an influence on improving stereopsis. There are no obviously changes in patients' central corneal thickness, anterior chamber depth or intraocular pressure after the orthokeratology treatment, making it a safe and effective treatment for adolescent.

Objective To investigate the effect of antihypertensive therapy on brachial-ankle pulse wave velocity (baPWV) in patients with essential hypertension (EH). Methods The 150 EH patients (EH group)receiving antihypertensive therapy with valsartan 80 mg/d, and 135 healthy controls (control group) were enrolled in this study. Automatic pulse wave velocity (PWV)measurement system was employed to examine baPWV, and the investigation about cardiac risk factors, physical and laboratory examination was performed. The baPWV was used as an index to show artery stiffness.Results The baPWV was significantly higher in EH group than in control group [(2105.8±378.4) cm/svs. (1371.5±176.5) cm/s, t=4.05, P＜0.001]. The detection rate of atherosclerosis was 82.0% and 21.8% in EH and control group respectively. In EH group, there were positive relationships between age and baPWV (r= 0.51, P＜0. 001), SBP and baPWV (r=0.53, P＜0.001), pulse pressure (PP) and baPWV (r=0.43, P＜0. 05), PP index (PPI) and baPWV (r=0.51, P＜0.05), blood glucose and baPWV (r=0.39, P＜0.01). The baPWV decreased significantly from (2105.8±378.4) cm/s to (1704.2±332.0) cm/s (t=3.85, P＜0. 05) in EH group. The baPWV was significantly lower in the subgroup with a target BP than without a target BP in EH patients [(1588.8±278.7) vs. (1857.7±324.9) cm/s, t=3.67, P＜0.001].Conclusions The age and SBP are primary risk factors for baPWV in EH patients. The antihypertensive therapy can relieve baPWV with a target blood pressure.

Cardiac Catheterization ; standards ; Heart Defects, Congenital ; therapy ; Humans

More attentions have been paid to the development of evidence-based clinical practice guidelines (ECPGs) of Chinese medicine (CM). International guideline evaluation instruments such as Appraisal of Guidelines for Research and Evaluation (AGREE I) has been gradually applied in ECPGs quality evaluation of CM. Nowadays, there are some certain methodological defects in partial ECPGs of Chinese medicine, with relatively low applicability and slowly update. It is suggested to establish technical specifications of CM-ECPGs in accordance with the characteristics of CM and international general specification, strengthen the quality evaluation of CM-ECPGs, attach great importance to the regularly update as well as popularization and application of CM-ECPGs.
Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Practice Guidelines as Topic