The‘prevention and early treatment of diseases’conception as‘Huangdi Neijing’suggested,is the highest academic realm among the Chinese medical theory,it flows through the entire process of Chinese medical theory and diseases prevention.Four aspects of the prevention conception manifested in the process of Chinese medical prevention of diseases are: Taking preventive measures before confirmed diagnosis(health cultivation),impeding diffusion after confirmed diagnosis, deterring diffusion from deterioration,and restraining deterioration from being malignant.The malignant causal chain conversion of the coexistence of asthenia and sthenia is considered as the inducing links of critical illness’occurrence,evolution and transformation.Therefore,to intercept the malignant causal chain conversion comes to the key technique of Chinese medical remedy for critical illness.The‘prevention and early treatment of diseases’conception must impenetrate the versal process of treating critical illness.The overall clue and method of Chinese medical remedy for critical illness is to identify and grasp the vital contradiction and each respect of the malignant causal chain conversion which concurs with the evolution of the critical illness,simultaneously utilize the method which combined the prevention in etiology and pathogenesis with the remedy in etiology and pathogenesis,then actuate the pathologically changed organism to extricate from critical conditions at the first opportunity, finalizing with convalescence and recuperation thereafter.

Objective To compare the efficacy in radical cure of H.Pylori (Hp) by different proton pump inhibitor (PPI)-based treatment regimens.Methods One thousand two hundred and three H.Pyloriinfected patients diagnosed by both endoscopic pathology and a rapid urease test were enrolled in this study.Reviewed 13 C-urea breath test at the end of Hp eradication treatment for more than 4 weeks,and retrospective analyzed the different effect of Hp eradication regimens.All patients were given treatment regimens,which including PPI (esomeprazole azole,bella,esomeprazole,pantoprazole omeprazole,2 times/d) plus antimicrobial for 7,10,14 d.According to antimicrobial,patients were divided into A,B,C,D,E group.Patientss in group A(421 cases) were given amoxicillin 1.0 g,2 times/d,clarithromycin 0.5 g,2 times/d;In group B (49cases) were given amoxicillin 1.0 g,2 times/d,levofloxacin 0.2 g,2 times/d;In group C(69 cases) were given amoxicillin 1.0 g,2 times/d,metronidazole 0.4 g,2 times/d;In group D(559 cases) were given clarithromycin 0.5 g/d,2 times/d,levofloxacin 0.2 g,2 times/d and in group E(105 cases) were clarithromycin 0.5 g,2times/d,metronidazole 0.4 g,2 times/d.Bismuth were colloidal bismuth pectin 200 mg,2 times/d.Results The radical cure rate of Hp was 84.04％ (453/539) in the group treated by regimens with Amoxicillin,and significant higher than that of without Amoxicillin (69.12％ (459/664),x2 =36.104,P =0.000),and the radical cure rate of Hp was 14.92％.The Hp radical cure rate of quadruple therapy was 76.85％ (767/998),while triple therapy was 70.73％ (145/205).However,no significant difference between these two regimens was found(x2 =3.476,P =0.062).The Hp radical cure rates of 14-,10-and 7-day course therapies were 84.28％ (134/159),75.79％ (579/764),71.07％ (199/280) respectively,and there was significant different among the three groups (x2 =9.644,P =0.008).There was significant increases trend in the 14-day therapy group comparing to 10-and 7-day regimen groups (x2 =5.399,11.719,P =0.020,0.001 respectively),while no significant difference was shown between the 10-and 7-day therapy groups(x2 =2.398,P =0.121).The radical cure rates were 84.80％ (357/421),81.63％ (40/49),81.16％ (56/69),69.95％ (391/559),64.76％(68/105) respectively in A,B,C,D and E groups,and there was significant difference among the groups (x2 =37.999,P =0.000).Conclusion Radical cure therapy of Hp should be PPI-based.A 14-day triple or quadruple treatment regimen with combination of Amoxicillin and clarithromycin is suggested as a first-line therapy.It is worth to clinically popularize such regimens in the light of the superior efficacy.

Objective To investigate neurological recovery effect and mechanisms of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemorrhage.Methods 68 patients with hypertensive cerebral hemorrhage in our hospital were divided into two groups.34 patients of the control group were given conventional western medicine,and 34 patients of the observation group were taken conventional western medicine combined with blood activating and phlegm removing decoction.The clinical outcomes, hematoma volume change and neurological recovery were compared,and analyzed its mechanism of action.Results The effective rate of the observation group(94.12%) was significantly higher than 73.53%of the control group (χ2 =5.31,P<0.05). After 7d,14d,21d treatment,NIHSS scores of the observation group [(12.87 ±1.43) points,(8.55 ±1.11) points and (5.67 ±0.76) points] were significantly lower than those of the control group [(20.43 ±2.57) points, (17.66 ±2.08)points,(14.54 ±1.44)points],and the differences were statistically significant (t=14.99,22.53, 31.76,all P<0.05).After treatment,hematoma volume of the observation group[(6.44 ±0.54)mL]was significant-ly lower than before treatment[(16.30 ±1.90)mL]and after treatment in the control group [(12.11 ±1.44)mL] (t=29.11,21.50,all P<0.05).After treatment,ALD score of the observation group [(66.34 ±5.22)points] was significantly lower than before treatment[(27.53 ±2.20)points]and after treatment in the control group[(47.55 ± 3.33)points],and the differences were statistically significant(t=39.95,17.70,all P<0.05).Conclusion The effect of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemor-rhage is significant,can significantly improve neurologic impairment and daily living skills,has no obvious conflict of interest and high application value,worthy of promotion and application.

With the concepts of minimal invasive surgery and precision medicine embedding deeply in modern medicine, traditional clinical treatment strategies are constantly updated due to the rapid progression of medical research. Systematic dissection of the regional lymph nodes is a key component in the surgical therapy of gynecologic malignancies, however it may result in a series of complications, such as lower extremity lymphedema, deep venous thrombosis, immune disorders and so on, which seriously impact the patients' quality of life. The necessity of systematic lymphadenectomy and the extent of lymph nodes resection have always been one of the most controversial issues in gynecologic oncology. In recent years, the extensive application of sentinel lymph node (SLN) technology has been increasingly used in the treatment of gynecologic malignancies, which may provide important guidance on this issue. This article reviews the clinical application status, detection methods, detection efficiency, and current controversies regarding SLN mapping and biopsy in cervical cancer, endometrial cancer, ovarian cancer and vulvar cancer, discussing the application value of SLN technology in gynecologic oncology.

Objective:To summarize the preliminary experience of percutaneous radiofrequency ablation(RFA) in the treatment of early breast cancer(the length of the lesion<15 mm) with negative sentinel lymph node(SLN), and to evaluate its feasibility and efficacy.Methods:From October 2016 to November 2019, 18 patients with early breast cancer(the length of the lesion<15 mm) treated in the First Affiliated Hospital of Zhengzhou University underwent FNAC of axillary SLN under the guidance of CEUS were enrolled. Patients with pathologically negative axillary SLN were treated with percutaneous RFA of breast cancer. The complete ablation rate and the relapse rate were evaluated. Intraoperative pain, postoperative complications and postoperative patient satisfaction were analyzed.Results:Eighteen patients underwent CEUS-guided FNAC of SLN, of which 1 case was positive and 17 cases were negative. Seventeen breast cancer lesions of the 17 negative patients underwent percutaneous RFA. The length of the lesions was 3.3-14.0 (8.2±3.9)mm, the complete ablation rate was 100%, the ablation time was 9-18 (12.8±2.7)min. During the follow-up of 9-46 months, no patient developed tumor progression. There were no serious complications related to RFA after operation. The patients′ satisfactory rate for postoperative appearance was 100%.Conclusions:RFA of early breast cancer(the length of the lesion<15 mm) with negative SLN is feasible and has the advantages of safety, minimal invasion and beauty.

ObjectiveTo investigate influence on adults'visual function and fluid intelligence with N-back working memory training based on Gabor signal.MethodsControlling group including 13 adults had no training,training group including 14 adults received an eight-days training,half an hour a day.The stimulus was N-back training which has on improved Gabor signal with adjustable spatial frequency and contrast sensitivity.The contrast sensitivity and fluid intelligence were record using OPTEC 6500 and Raven's Standard Progressive Matrices before and after training,then the data was analyzed and processed by SPSS.ResultsContrast sensitivity:there was a siguificant different of the contrast sensitivity between pretest and posttest ( ( 1.93 ± 0.17 ) log,( 1.76 ±0.20 ) log) in training group ( t =-4.579,P =0.001 ).Fluid intelligence:there was a significant different of fluid intelligence between pretest and posttest( ( 129.9 ± 9.0 ) scores,( 113.7 4-16.0 ) scores ) in training group ( t =-4.373,P =0.001 ),and superior to controlling group,which also had a statistical significance (F =1.353,P =0.004).ConclusionThe method of N-back working memory training based on Gabor signal not only enhances working memory and fluid intelligence,but also improves the visual function effectively,and more various effect is acquired comparing to traditional training method.

Objective To investigate clinical value of three-dimensional transvaginal sonography (3D-TVS) in the diagnosis of septate uterus and the relationship between its parameters and adverse pregnancy.Methods From Mar.2010 to Sept.2011,73 patients (aged 23-35 years) with septate uterus who were diagnosed by 3D-TVS in Fujian Province Maternal and Child Health Hospital were enrolled in this retrospective study.The septum width,septum angle,septum length and the length of remaining uterine cavity were measured among the patients with subseptate uterus,and then,the distortion rate was calculated.The hysteroscopic surgery was used as the gold standard,and the diagnostic titer of 3D-TVS in the diagnosis of septate uterus was determined.Receiver operating characteristic curve (ROC) were plotted to evaluate the diagnostic titer of uterine parameters measured by 3D-TVS in predicting the adverse pregnancy outcome among patients with subseptate uterus.Univariate logistic regression was used to analyze the effectiveness of uterine parameters on adverse pregnancy outcome.Results Using hysteroscopic surgery as the gold standard,the coincidence rate of diagnosis of septate uterus by 3D-TVS was 94％ (69/73).Among the patients with septate uterus,25％ (17/69)were complete septate uterus,75％ (52/69) were subseptate uterus.Among patients with subseptate uterus,the septum length [(2.2 ± 0.6) cm] and distortion rate in patients with adverse pregnancy(0.60 ± 0.10)were significantly higher than those without adverse pregnancy [(1.5 ±0.6) cm,0.43 ±0.13,both P ＜0.05].However,no significant difference in the width,angle and length of septum were observed between the two groups (P ＞ 0.05).The area under ROC curve (AUC) of septum length and distortion rate in determining adverse pregnancy were 0.833 (95％ CI:0.721-0.944) and 0.800 (95％ CI:0.671-0.929),respectively.The optimal cutoff point of septum length was 1.94 cm,with the sensitivity was 74.3％ and the specificity was 76.5％ ; the optimal cutoff point of distortion rate was 0.48,with the sensitivity was 77.1％ and the specificity was 76.5％.The expectation morbidity ratio of adverse pregnancy was 2.717,3.067 and 0.514 by every adding level of septum length,distortion rate,and length of remaining uterine cavity,respectively.Conclusions 3D-TVS showed high accuracy in diagnosis of septate uterus.The septum length and distortion rate may predict the risk of adverse pregnancy,and the value of them can be used for screening adverse pregnancy in clinical practice.

Objective:To explore the immune response in mice fed orally with the conjugated antigen of HpaA-CtxB(HCTB).Methods:A recombinant strain which could express bivalent antigen of HpaA and CtxB subunit was constructed. HpaA and CtxB gene was amplified by PCR. The DNA products of HpaA and CtxB were inserted into a prokaryotic expression vector pQE-30 respectively, and then translated into E.coli strain DH5? to express HCTB fusion protein. Its immunogenicity was analyzed by Western blot. After purification, to fed mice by oral immunization. The change of antigen-specific ASC antibody(IgG and IgA) in the mucosa of the animals were detected by ELISPOT and ELISA assay. Results:HCTB fusion gene was sequenced as 1 161 bp, the fusion protein encoded polypeptides of 387 amino acid residues.The molecular weight was 40 kD analysed by SDS-PAGE. The level of soluble expression product was about 41.67% of total cell protein. After affinity chromatography, the purity of fusion protein was above 92%.Western blot analysis confirmed that fusion protein could be specifically recognized by the serum of anti-HpaA and anti-CT. Antigen-specific ASC and antibody response in animals immunized with HCTB or HpaA was determined by ELISPOT and ELISA. The results showed that the number of sIgA and IgG-ASC increased significantly in PP and gastric mucosa, especially those of the sIgA-ASC by orally immunization with HCTB. The levels of specific antibody were also higher than those of controls. Conclusion:The results indicated that the oral immunization with HCTB induces effective mucosal immune respones and produced higher levels sIgA. The recombinant fusion protein HCTB can be used as an effective oral vaccine for prevention and treatment of infection of Hp.

OBJECTIVE:To prepare nanostructured lipid carrier of adefovir dipivoxil(ADV-NLC),and optimize the formula-tion. METHODS:Using stearic acid and glycerin monostearate as solid lipid,oleic acid as liquid lipid,Gemini surfactant and poly-sorbate 80 as emulsifier,sodium dodecyl sulfate (SDS) as stabilizer,solvent dispersion ultrasonic method was used to prepare ADV-NLC. And using particle size,polydispersity index,Zeta potential,encapsulation efficiency as indexes,single factor test was conducted to screen Gemini surfactant-polysorbate 80 ratio,emulsifier dosage(ratio of emulsifier to water phase),drug-lipid ratio, solid-liquid lipid ratio. RESULTS:The formula was as follow as 3% emulsifier (Gemini surfactant-polysorbate 80 ratio of 1:2), 4.5% drug-lipid ratio,solid-liquid lipid ratio of 6:5. The average particle size of the prepared ADV-NLC was(48.83±2.65)nm, polydispersity index<0.3,Zeta potential was(-28.7±1.8)mV,encapsulation efficiency was(77.65±0.03)%(n=3). CONCLU-SIONS:ADV-NLC is successfully prepared,and the formulation is reasonable and feasible.