Objective To evaluate the clinical efficacy of integration of traditional Chinese and western medicine (ITWM) or pure western medicine on the patients with immune thrombocytopenia (ITP). Methods Randomized controlled trials (RCTs) on ITWM treatment of ITP were searched in PubMed, EMBASE, Wanfang database, CBMDisc, CNKI and VIP. Quality of the RCTs was evaluated strictly, and statistical analysis was performed with Cochrane Collaboration’s RevMan5.1.7 software. Results Twenty-two trials involving 1527 patients were included. The results of Meta-analysis showed that the ITWM treatment of ITP significantly improved the total effective rate [RR=1.23, 95%CI (1.17, 1.29), P<0.000 01] compared with that of pure western medicine treatment. Funnel plot showed that publication bias was small. Meanwhile, peripheral platelet count and the number of megakaryocyte which can generate platelet in bone marrow increased, obvious advantage was showed in long-term effect, and adverse reactions were reduced with ITWM treatment in ITP patients. Conclusion The existed limited evidences suggest that ITWM treatment of ITP can significantly improve clinical efficacy. The quantity and quality of research literature were limited, and well-designed randomized double-blind controlled trials with large sample and multi-centers are required for a more reliable conclusion.

ObjectiveTo evaluate the feasibility of using dexmedetomidine (Dex) as supplement to stellate ganglion block (SGB) in the treatment of trigcminal post-herpetic neuralgia in elderly patients.MethodsForty-five ASA Ⅱ patients with trigeminal post-herpetic neuralgia aged 65-85 yr weighing 45-85 kg undergoing stellate ganglion block were randomly divided into 3 groups ( n =15 each): group SGB; group Dex 0.4 and 0.6 μg/kg +SGB (groups DS1 and DS2).SGB was performed on the affected side with 0.5％ ropivacaine 8-10 ml.Dex 0.4 and 0.6 μg/kg in normal saline were infused iv over 15 min before SGB in groups DS1 and DS2 respectively.The onset time and duration of block were recorded.Bradycardia,hypotension and respiratory depression were also recorded.The intensity of pain was assessed with VAS scores (0=no pain,10 =worst pain) before and at 1,2,4,8 weeks after SGB.VAS score ≤3 was defined as satisfactory analgesia.The rate of satisfactory analgesia was calculated.ResultsThere was no significant difference in the incidence of bradycardia,hypotension and respiratory depression among the 3 groups.The duration of block was significantly longer and the rate of satisfactory analgesia at 2,4,8 weeks after SGB was significantly higher in groups DS1 and DS2 than in group SGB.There was no significant difference in the onset time,duration of block and the rate of satisfactory analgesia between groups DS1 and DS2.ConclusionSGB with Dex has better therapeutic effect than SGB in elderly patients with trigeminal post-herpetic neuralgia.

Objective The paper focused on teaching status of evening college among different ma-jors, and tried to provide data support and suggestion for teaching reform of evening college in medical university. Method Using methods of questionnaires and interviews, the investigators analyzed five aspects of students in Peking University Health Science Center, which were the influences on study from family and work, and the evaluation on teaching, etc. The investigators entered data with Epidata 3.1 software and de-scribed it with SPSS 20.0 statistical software, with which they also did chi-square and nonparametric rank sum test. Results 38.2% (63/165) of clinical medicine students, 45.8% (27/59) of laboratory medical sci-ence students and 43.0%(71/165) of nursing students regarded hard work and limited energy as their major difficulty from jobs. Limited time for study was treated as the biggest problem for students of clinical medicine (58.2%, 96/165), laboratory medical science (46.5%, 27/58) and nursing (66.5%, 105/158). 41.9%(70/167) of clinical medicine students tended to receive traditional face-to-face teaching; 39.0%(23/59) of laboratory medical science students preferred partial face-to-face teaching with partial network teaching; while 37.2% (68/183) of nursing students tended to partial face-to-face teaching with partial self-study. 58.4%(97/166) of clinical medicine students, 55.9%(33/59) of laboratory medical science students and 64 . 8% ( 118/182 ) of nursing students preferred examination of both memorization and application . Conclusion Results showed that students in different majors presented similar opinions on teaching status, but also with a few dif-ferences. There were the same characteristics between students of clinical medicine and nursing, both with high satisfaction. While students in the laboratory medical science showed the special characteristics, with low satisfaction.

Objective To investigate the vessel structure changes of carotid artery with age in normal adults with a newly-developed 3-dimensional ultrasound imaging modality.Methods One hundred and twenty-five normal adult volunteers were divided into five groups:group A,20-29 years old,25 cases;group B,30-39 years old,27 cases;group C,40-49 years old,28 cases;group D,50-59 years old,23 cases;group E,older than 60 years old,22 cases.The straight sections of common carotid arteries were scanned by full-volume three-dimensional ultrasound probe.With a vessel plaque quantification software (VPQ),the following parameters were obtained:intima-media thickness (IMT),vessel total area (VTA),vessel lumen area (VLA),vessel wall area (VWA),and normalized wall index (NWI).Results IMT,VTA,VWA,VLA and NWI were all positively correlated with age (r =0.79,0.48,0.77,0.27 and 0.67 respectively,P =0.00),and there was significant difference among age groups (P ＜0.01).IMT,VTA,VWA increased with age gradually whereas VLA increased only in group E and NWI showed no significant difference between group E and D.VWA and VTA of males were significantly greater than those of females in group A,B and C,and VLA of males was significantly greater than females in group A and B.There was no significant difference in IMT and NWI between gender groups.Conclusions Age is an important factor to carotid remodeling,and IMT,VTA and VWA increase with age,but VLA keeps constant in people under 60-year-old while NWI becomes stable in people over 50-year-old.It is essential to consider the physiological changes of carotid with age when pathophysiological process of atherosclerosis is involved.

Objective To explore the value of three-dimensional ultrasound (3D-US) gray scale median (GSM) in quantitative evaluation of the drug treatment of carotid plaques.Methods Eighty-one patients with 93 carotid plaques were enrolled from May 2015 to October 2015.Patients were received 3D-US,3.0T MRI and blood lipid examination including total cholesterol(TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),and high-density lipoprotein cholesterol(HDL-C) before drug treatment.After atorvastatin therapy with a daily dose of 20mg for 6-12 months,3D-US and blood lipid examination were repeated,and 55 patients were followed successfully with a total of 62 plaques obtained.According to data acquired by MRI and 3D-US before treatment,the patients were divided into low-risk group,medium risk group,and high-risk group.The differences of GSM value and blood lipid levels were compared among groups and the changes of these parameters before and after the treatment in each group were compared.Results There was no significantly difference in serum TC,TG,LDL-C and HDL-C levels among the groups before treatment.After treatment,the serum TC and LDL-C levels were significantly lower than those before(P ＜0.05),the differences of TG and HDL-C levels were not significant,and the LDL-C level in high-risk group was significantly lower than those in other groups(P ＜0.05).The GSM values in of high-risk and medium-risk group were significantly increased after drug treatment than those of before (33.87 ± 6.53 vs 27.50 ± 7.82,47.35 ± 5.42 vs 44.56 ± 4.36,P ＜0.05),and had no significantly change in low risk group(62.01 ± 10.68 vs 63.13 ± 10.41,P ＞0.05).The difference of GSM between before and after treatment in each group was negatively correlated with the difference of LDL-C (r =-0.28,P =0.03).Conclusions Three-Dimensional ultrasound (3D-US) gray scale median (GSM) can be a reliable parameter in clinic quantitative evaluation drug treatment of carotid plaques,and has a better value especially for high-risk and medium-risk plaques.

Objective To compare the efficacy and prognosis of epirubicin combined with paclitaxel and epirubicin combined with docetaxel in the treatment of breast cancer.Methods Patients in the study group were treated with epirubicin and paclitaxel, while the control group was treated with epirubicin plus docetaxel.Results The two groups of breast cancer patients by the end of the treatment were valid for 5 years of follow-up, five year survival rate(86.67%)than the control group(68.89%), the study group the recurrence rate(4.44%)than in the control group(15.56%), the data had significant differences(P<0.05).Conclusion The epirubicin is conducive to breast cancer patients for better disease control effect and prognosis than star, paclitaxel combined with chemotherapy.

Objective To evaluate the effects of gender on the pharmacokinetics of propofol in patients.Methods Twenty ASA physical status Ⅰ or Ⅱ patients of both sexes (10 male,10 female),aged 42-59 yr,weighing 46-76 kg,scheduled for elective surgery for gastrointestinal cancer,were randomly divided into 2 gender groups (n =10 each):male group and female group.Combined intravenous-inhalational anesthesia was performed during surgery.Anesthesia was induced with iv injection of 2％ propofol 2 mg/kg,remifentanil 1.5 μg/kg,and suxamethonium chloride 1.5 mg/kg.The patients were tracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of the mixture of 1％-2 ％ isoflurane and nitrous oxide (N2 O ∶ O2 =1 ∶ 1.),iv infusion of remifentanil 0.2-0.3 μg/kg and intermittent iv boluses of atracurium.Blood samples were taken from the central vein before propofol administration,and at 1,2,3,4,6,10,15,30,45,60,90,120,180,240,360 and 720 min after propofol administration for determination of the plasma concentration of propofol by high-performance liquid chromatography.The blood concentration-time curve of propofol was drawn and the pharmacokinetic parameters were calculated.Results The blood concentrations of propofol were significantly lower at each time points within 10 rmin after administration of the single bolus of propofol in female group than in male group (P ＜0.05).The blood concentration-time curves of propofol were fitted to a three-compartment open model in the 2 groups.The central volume of distribution and clearance rate were significantly larger in female patients than in male patients (P ＜ 0.05).Conclusion After iv injection of propofol,the blood concentration of propofol is lower,and the central volume of distribution and clearance rate are larger in female than in male,suggesting that gender has significant effect on pharmacokinetics of propofol.

Objective To investigate the clinical and cytogenetic features of myelodysplastic syndrome (MDS) ,and to investigate the application of the International Prognostic Scoring System Revised (IPSS-R) in myelodysplastic syndrome .Methods A retro-spective analysis was conducted on 112 patients diagnosed with MDS on basis of French-American-British(FAB) and World Health Organization(WHO) criterion .Conventional cytogenetics are performed to investigated the cytogenetics changes .Results Karyo-type abnormalities are found in 46(41 .1% ) patients .Cytogenetics subgroups are devided into 5 groups according to IPSS-R criteri-on :very good ,good ,intermediate ,poor ,very poor ,which account for 2 cases(1 .8% ) ,48 cases (42 .9% ) ,41 cases (36 .6% ) ,10 ca-ses (8 .9% ) ,11 cases (9 .8% ) ,with a median survival time(MS) 59 ,36 ,15 ,10 month respectively ,except for very good .Conclusion It is of great guiding significance of IPSS-R criteria for prognostic stratification .

Objective To evaluate the agreement of bispectral index values recorded from tumor side and the contralateral areas during supratentorial craniotomy.Methods Thirty-five patients (16 males, 19 females, aged 18-65 years, ASA physical status Ⅱ or Ⅲ) scheduled for supratentorial tumor resection were enrolled in this study.Bispectral index (BIS) sensors were placed at bilateral frontal areas.The patients were anesthetized with propofol.From each BIS monitor, we collected data at each of four time stages: before the induction of anesthesia, before dura opening, removal of tumor and recovery of conscious.These data were compared using Bland-Altman analysis.Results Bland and Altman analysis revealed a BIS negative-bias (limits of agreement) of before induction-0.8(-7.2-5.7), before dura opening 0.6 (-8.3-9.5), and removal of tumor 1.5(-6.9-9.9), recovery of conscious 0.2 (-9.3-9.8).Conclusion There are significant agreement for BIS values between the frontal area of tumor side and the contralateral areas.BIS values can be used interchangeably between bilateral frontal.

Objective To evaluate the effect of resolvin D1 on focal cerebral ischemia?reperfusion ( I∕R) injury in rats. Methods One hundred and twenty adult male Sprague?Dawley rats, aged 7 weeks, weighing 260-280 g, were randomly divided into 5 groups ( n=24 each) using a random number table:sham operation group (group S), group I∕R, low?dose resolvin D1 group (group LRD), medium?dose resolvin D1 group ( group MRD) , and high?dose resolvin D1 group ( group HRD) . Focal cerebral I∕R was induced by right middle cerebral artery occlusion using a nylon thread inserted into internal carotid artery and advanced cranially until resistance was met. The occlusion was maintained for 2 h followed by 24 h reperfusion. In LRD, MRD and HRD groups, 0.03, 0.10, 0.30 nmol resolvin D1 5 μl was injected into the lateral cerebral ventricle at the beginning of reperfusion, respectively. Neurological deficits were evaluated at 24 h of reperfusion and scored. The rats were then sacrificed, and their brains were removed for determination of infarct volume (by TTC staining), cerebral water content, Evans blue content and expression of matrix metalloproteinase?9 ( MMP?9) in the ischemic cortex. Results Compared with group S, the neurological deficit scores, cerebral infarct volume, and cerebral water and Evans blue content were significantly increased, and the expression of MMP?9 was up?regulated in the other 4 groups. Compared with group I∕R, the neurological deficit scores, cerebral infarct volume, and cerebral water and Evans blue content were significantly decreased, and the expression of MMP?9 was down?regulated in group MRD and group HRD, and no significant change was found in the parameters mentioned above in group LRD. Conclusion Resolvin D1 can attenuate focal cerebral I∕R injury in rats, and down?regulation of MMP?9 expression and decrease in permeability of blood?brain barrier may be involved in the mechanism.