The management of patients with cancer of unknown primary site (CUP) is a notoriously medical problem. The outcome is bad in most patients. The clinical general characteristics, histopathology, im-aging features and endoscopies can provide some useful information, and the primary site can be detected in part of these patients, but most are not. With the application of molecular biology and positron emission tomography-computed tomography(PET-CT) technology, the detection rate of CUP has increased significantly.

Objective To explore clinical curative effect of lamivudine in treatment of HBV reactivation.Methods The clinical data of HBV reactivation patients in immunosuppressive therapy were retrospectively analyzed. Results The clinical symptom and liver function recovery rate, HBV-DNA darkening rate, HBeAg darkening rate and HBe-Ag/anti HBe frequence of seroconversion of detection group were higher than that of control group,the difference was statistically significant( all P ＜ 0. 05 ). Conclusion The clinical curative effect of HBV reactivation in immunosuppressive therapy by Lamivudine was good.

BACKGROUND: Numerous studies have shown that Danshen Root can suppress adhesion and aggregation of neutrophils as well as production of oxygen free radical, can activate blood circulation to dissipate blood stasis. However, there are few studies about precise mechanisms underlying protection of vascular endothelium and anti-thrombosis, especially concerning the mechanism of action following coronary artery stent implantation.OBJECTIVE: To investigate the influence of Danhong injection on vascular endothelial function before and after coronary artery stent implantation in patients with acute coronary syndrome (ACS). METHODS: A total of 60 ACS patients were randomly assigned to two groups. The patients in the conventional treatment group were subjected to conventional drug treatment following coronary artery stent implantation. The patients in the Danhong injection group received conventional drug treatment and Danhong injection (20 mL/d) following coronary artery stent implantation. The treatment course was 10 days. Before and after implantation as well as before and after Danhong injection treatment, endothelium-derived blood flow-mediated vasodilation, plasma endothelin, thromboxane B2, 6-keto-prostaglandin levels were determined, and the vascular endothelial function were evaluated. Simultaneously, short-term prognosis was observed in patients of both groups.RESULTS AND CONCLUSION: Plasma endothelin and thromboxane B2 levels were significantly increased, but 6-keto-prostaglandin levels were significantly decreased following stent implantation in patients of both groups compared with that before implantation (P < 0.05). Plasma endothelin and thromboxane B2 levels were significantly reduced, but endothelium-derived blood flow-mediated vasodilation and 6-keto-prostaglandin levels were significantly increased in both groups following treatment compared with that following implantation (P < 0.05, P < 0.01), especially in the Danhong injection group (P < 0.05). During hospitalization, the incidences of cardiovascular events were diminished in the Danhong injection group compared with conventional drug treatment group (P > 0.05). Results suggested that Danhong injection significantly improves vascular endothelial function, induces vasodilatation, improves blood supply, inhibits platelet aggragation, and shows the tendency of ameliorating short-term prognosis.

DBJECTIVE: To evaluate the efficacy of traditional Chinese medicine in the treatment of complications following cerebrovascular stent placement.METHODS: A computer screen was performed for Science Direct database and Ei database between January 1960 and October2009,using key words of"traditional Chinese medicine,stent placement,complication",and the language was limited to English.At the same time,Chinese Journal Full-text database and Chinese Biomedical Literature database between January 1994 and October 2009 were searched for related articles,using key words of"traditional Chinese medicine,cerebral blood vessels,stent placement,complications",and the language was limited to Chinese.In addition,several monographs were manually consulted.The basic and clinical trials addressing the prevention and treatment of traditional Chinese medicine on the complications following cerebrovascular stenting were included.RESULTS: Subsequent to the cerebrovascular stent placement,the traditional Chinese medicine interventions include benefiting Qi,invigorating blood circulation,and eliminating phlegm,which all serve as the basic approach,in addition these interventions are accompanied by relieving Qi and stagnancy in liver,soothing the nerves and benefiting water,cooling blood and stopping bleeding.The commonly used traditional Chinese medicine compound is consisted of Shengmai San,Buyang Huanwu decoction,Xuefu Zhuyu decoction,sini decoction and resist decoction.Modern pharmacological studies have shown that a large number of traditional Chinese medicine and compound which are always used to benefit Qi,invigorate blood circulation,dissipate blood stasis and eliminate phlegm,can effectively prevent the complications following cerebrovascular stent placement through a multi-component,multi-target,multi-channel integration regulatory role.CONCLUSION: The traditional Chinese medicine interventions during the peri-operative period of cerebral vascular stent placement exhibit a feature of Chinese medicine and play an important role for improving the success rate of surgery,preventing and reducting peri-operative period and long-term complications.

Child ; Diagnostic Errors ; Epilepsy ; diagnosis ; Female ; Humans ; Pseudohypoparathyroidism ; diagnosis

Humans ; Voice ; Voice Quality

Objective To study the current status of morning blood pressure peak in elderly masked hypertension patients and study the correlation between morning blood pressure peak and cognitive function.Methods A total of 72 elderly masked hypertension patients were selected in this study,.Morning blood pressure peak was measured by ABPM examination.The patients were divided into three groups according to the morning blood pressure peak.Morning blood pressure peak ≤ 30 mmHg were divided into non-Morning blood pressure surge group ( NMS group),morning blood pressure peak ＞30 mmHg were divided into Morning blood pressure surge group ( MS group).The cognitive function scale was determined (MMSE and MoCA).T-test and linear regression analysis were performed.Results MMSE score(27.69±2.04) and MoCA scores(24.85 ± 1.52) in MS group were lower than NMS group (28.87 ± 1.34,26.54± 1.53) ( P ＜0.01 ).MMSE and MoCA scores were negatively correlated with the morning blood pressure peak ( r =- 0.308,- 0.447,P ＜ 0.01 ).Conclusions Elderly masked hypertension patients remained the phenomenon of the morning blood pressure peak,the morning blood pressure peak could lead to cognitive impairment.

Objective To examine and assess the clinical effect of Er ∶ YAG 2940 nm fractional laser resurfacing for skin wrinkles.Methods A total of 16 patients with Fitzpatrick skin type Ⅳ and facial wrinkles,were treated with Er ∶ YAG 2940 nm fractional laser resurfacing and follow-up were given every week after treatment,four weeks in all.Response to treatment was evaluated by observers and patients themselves.Photos were analyzed by the photoshop 12.0 software.Results During the four-week follow-up,the skin of patients was more and more better than pretreatment,and a large part of wrinkles was disappeared.The assessment of observers for wrinkle amelioration rose from (6.50--2.33) ％ to (34.80±5.24) ％ and the scores of content of patients was up to 4.00±0.27(generally satisfied),whereas no one satisfied at beginning.Analyzed by photoshop 12.0 software,the data of average and middle values were on the trend of increasing in all these four weeks while SD was basically on the trend of decreasing.Conclusions Fractional ablative photothemolysis using Er ∶ YAG 2940 nm laser is a promising option for skin wrinkles.

[Summary] The incidences of obesity and its associated diseases are increasing worldwide.Bariatric surgery leads to more sustainable weight loss and better glycemic control compared with conservative medical treatment. Potential mechanisms mediating the improvement in glycemic control after bariatric surgery include changes in the levels of food intake, gastrointestinal hormones, bile acids as well as intestinal bacterial flora.

Objective To explore the efficacy and side effect of CAG (G-CSF, aclarubicin and cytarabine) priming chemotherapy for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Methods 54 patients with AML at diagnosis and relapse or MDS were'enrolled for the initial treatment with CAG regimen. Patients who have achieved complete remission (CR) were treated with various regimens. Results The total effective rate was 72.2 %, complete remission rate was 48.1% and partial remission rate was 24.1%. The incidence of granulocyte deficiency was 40.7 %(22/54). The severe infection rate was 24.1%(13/54). One case died of function damage in liver. The study includes 36 patients below 60 years, 18 patients above 60 years, and overall effective cases are 28 (77.8 %), 11 (61.1%),respectively. There was significant difference (P ＜0.05). Conclusion CAG regimen is effective and well tolerated in remission for AML and MDS-RAEB.