Objective To evaluate the therapeutic effect ofGuizhi-Fuling Pill combined with conventional western medicine therapy for diabetic peripheral neuropathy (DPN).Methods A total of 78 patients with DNP were randomly divided into treatment group (40 patients) and control group (38 patients).The patients in the control group were administrated with mecobalamin on the basis of conventional treatment. In addition to the therapy of control group,patients in treatment group were givenGuizhi-Fuling Pill. The patients in both groups were treated for 2 weeks.The level of homocysteine (Hcy) and sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) in both groups were measured. Toronto clinical scoring system (TCSS) was used to evaluate the curative effect.Results The total effect rate in the treatment group was significantly higher than that in the control group (95.0%vs. 76.3%;χ2=5.616,P=0.018). After treatment, the MNCV of common peroneal nerve (46.1 ± 6.3 m/svs.42.5 ± 5.5 m/s;t=2.734,P<0.01 ), MNCV of median nerve (49.8 ± 5.2 m/svs.46.3 ± 5.9 m/s;t=2.607,P<0.05 ), SNCV of common peroneal nerve (38.5 ± 4.6 m/s vs. 35.4 ± 4.3 m/s;t=3.105,P<0.05 ), SNCV of median nerve (45.3 ± 5.2 m/svs. 42.3 ± 4.8 m/s;t=2.627, P<0.05 ) in the treatment group were significantly increased than those in the control group. The integral of TCSS (5.3 ± 3.1vs. 7.2 ± 2.9;t=2.823,P<0.01) and the level of Hcy (13.3 ± 3.2 μmol/Lvs. 17.1 ± 3.4 μmol/L;t=5.178, P<0.05) were significantly lower in treatment group than those in control group (P<0.05).Conclusions The Guizhi-Fuling Pill combined with conventional western medicine therapy could improve MNCV and SNCV and reduce the level of Hcy and improve the clinical effect.

0.05)。The median time to progression (mTTP)was 5.8 months in XELOX group and 5.7 months in FOLFOX4 group. The median survival time (MST) was 10.0 months in XELOX group and 9.8 months in FOLFOX4 group, The toxicities were well tolerated,The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in XELOX group than in FOLFOX4 group (P0.05).Conclusions:Both of the two regimens were feasible, well tolerated and effective in treatment of advanced gastric cancer。XELOX regimen may be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.

Background and purpose:It has been shown that chemotherapy could improve the quality of life and prolongation of survival time of the patients with advanced gastric cancer. There is still no standard chemotherapy regimen for advanced and metastatic gastric cancer, and regimens with high efficacy and safety are scare. Toxicities are considered to be limiting factors and in? uence the quality of life in the patients with advanced gastric cancer. The purpose of this study was to investigate the effi cacy and toxicity of docetaxel(DOC) in combination with oxaliplatin(OXA) as fi rst-line treatment in advanced gastric cancer and try to fi nd a regimen that would be more tolerable without deterioration of treatment response. Methods:48 patients with advanced gastric cancer were treated with docetaxel 35 mg/m2, ivgtt, d1,d8 combined with oxaliplatin 130 mg/ m2,ivgtt,d1 ;repeated every 3 weeks (one cycle) ,The effect was evaluated after two cycles. The effi cacy and toxicity were evaluated according to WHO standard. Results:48 patients could be evaluated for clinical response. Complete response in 3 pts and partial response in 24 pts were observed with an overall response rate of 56.25%, median time to progression (MTTP) was 5.6 months and median overall survival (MST) was 11.8 months. The most common toxicities were bone marrow suppression, peripheral neuritis, nausea and vomiting. All of them are reversible. Conclusion:Combining weekly docetaxel and oxaliplatin is an effective and well tolerated alternative treatment in advanced gastric cancer and has yielded promising results.

Objective To investigate the entry points for clinical work of intensive care unit (ICU) pharmacists.Methods Through combination with daily work and referring the domestic and foreign literature,the characteristics of ICU medications were discussed to find out the entry point for clinical work of ICU pharmacists.Results ICU patients particularly need individualized pharmaceutical care because of the special pathophysiological characteristics and medicine use.Conclusion ICU pharmacists should provide pharmaceutical care based on Pharmacokinetics/pharmacodynamics knowledge and focus on the drug dosage adjustment,drug interactions and adverse event prevention.

Objective To analyze the effect of different methods of anesthesia maintenance on clinical efficacy and postoperative recovery in elderly patients with gynecological diseases undergoing laparoscopic surgery.Methods A total of 80 elderly patients with gynecological diseases scheduled for laparoscopic surgery were enrolled in this study in our hospital from January 2015 to December 2016.All the patients were randomly divided into two groups of anesthesia maintenance:an intravenous anesthesia alone (n=40) and a combined intravenous and inhaled anesthesia (n =40).The pre-and post-anesthesia changes in arterial blood gas,blood pressure,heart rate and cognitive function,and postoperative complications were analyzed and compared between the two groups.Results There were no significant differences between the two groups in the times of palinesthesia,extubation and talking (all P＞ 0.05).After anesthesia,the levels of arterial blood gas,the blood pressure and the heart rate were relatively stable in both groups,and their differences between the two groups were without statistically significant (all P ＞ 0.05).While,the postoperative cognitive function recovered more rapidly in patients receiving intravenous anesthesia alone for anesthesia maintenance than in those receiving a combined intravenous and inhaled anesthesia,especially at 6 h after extubation.The Mini-mental State Examination (MMSE) score was significantly higher in patients receiving intravenous anesthesia alone (28.8 ± 0.5) than in patients receiving a combined intravenous and inhaled anesthesia (25.1 ±0.6),with statistically significant difference (P＜ 0.05).In addition,there was no statistical difference between the two groups in the incidence of complications.Conclusions As anesthesia maintenance,both an intravenous anesthesia alone and a combined intravenous and inhaled anesthesia can ensure a successfully laparoscopic surgery for gynecological diseases in elderly patients.However,the impact on cognitive function after laparoscopic surgery is smaller in the maintenance of intravenous anesthesia alone than in a combined intravenous and inhaled anesthesia in elderly patients.Intravenous anesthesia alone can be used in elderly patients to receive laparoscopic surgery as routine anesthesia maintenance.

Intensity-modulated radiation therapy (IMRT)is a more advanced radiotherapy technique than routine radiotherapy,and has been effectively utilized in the treatment of nasopharyngeal carcinoma (NPC).Rradiotherapy alone has disappointing effect to local advanced cases.Nevertheless,chemoradiotherapy provides long term survival.Chemoradiotherapy is becoming the standard therapeutic regimen for local advanced NPC.But different ways of chemomdiotherapy such as induction,concurrent,adjuvant chemotherapy still need to be defined.

0.05).The median time to progression (mTTP) was 7.8 months in HCPTOX group and 7.9 months in FOLFOX4 group, respectively. The median survival time (MST) was 13.1 months in HCPTOX group and 13.3 months in FOLFOX4 group, respectively. The toxicities were well tolerated.The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in HCPTOX group than in FOLFOX4 group (?2=4.538,P0.05). Conclusion:Both of the two regimens were feasible, well tolerated and effective in treatment of metastatic colorectal cancer.HCPTOX regimen might be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.

Objective To study the method of preparation of donor liver in liver transplantation. Methods The methods and skills of donor liver preparation and the anomaly artery reconstruction of graft in 64 cases of orthotopic liver transplantation (OLT) were retrospectively analyzed. Results All allografts had preparation and were suitable for clinical transplantation. Thirteen cases with hepatic artery anatomy variation were found. Among the 13 cases, 5 cases were reconstructed. Splenic artery (3/5) and gastro-duodenal artery (2/5) were typically used for anastomosis of the variant hepatic arteries. No complications resulted from donor liver preparation. Conclusions Correct preparation of the donor hepatic artery and biliary tracts, can decrease the incidence of hepatic artery and biliary tract complications after liver transplantation, and is the key to ensure successful donor liver preparation.

Objective To review the HPV infection status of the females in Shantou in the past years.Methods 3 664 speci-mens of cervical exfoliated cells of the female patients with gynecological disease from 2013 to 2014 were selected to ampli-fied HPV gene and conducted genetypes detection.The infection rate and various subtypes of HPV were analyzed.All these patients were divided into 5 groups according to their ages and the infection status of each group were also discussed.Results 805 patients were infected with HPV (22%,805/3 664).The single infection type and the mixed infection type were both visible,HPV-16 was the most common single infection type,followed by subtypes HPV-52,43,58 and 56.HPV16+52 was the most common mixed infection type,followed by HPV16+33 and HPV43+52.The infection rates of the each group were differences (χ2 =27.08,P < 0.01),No.1 (> 25),No.2 (25 ~ 34)and No.5 group (< 55)were the high-risk groups of HPV infection.Conclusion The main genotypes of these women whose infection with HPV were HPV-16,52,43,58 and 56 in Shantou region,respectively.The females aged less than 35 years old and more than 55 years old both had high-risk for HPV infection.It has important significance to developed the vaccines which can efficiently prevent HPV-16,52,43,58,56 and reduce the cervical cancer incidence.

Objective To investigate the correlations of expression of interferon inducible protein 10 ( IP-10) mRNA in peripheral blood mononuclear cells ( PBMCs) with serum levels of HBsAg and HBV DNA in patients with HBV-related acute on chronic liver failure ( HBV-ACLF ) , and to assess its value in predicting disease prognosis .Methods Eighty patients with HBV-ACLF, 60 patients with chronic hepatitis B (CHB), and 25 healthy subjects were enrolled during October 2013 and February 2015.IP-10 mRNA in PBMCs was measured by real time quantitative polymerase chain reaction ( RT-qPCR) , and the difference in IP-10 mRNA expression among three groups was compared by ANOVA .Serum levels of HBsAg and HBV DNA were also measured in patients with HBV-ACLF, and Pearson correlation test was performed to analyze the correlations of IP-10 mRNA with HBsAg and HBV DNA levels .t test was used to analyze the differences in IP-10 mRNA, HBsAg and HBV DNA levels between fatal and surviving cases after 3-month entecavir therapy in HBV-ACLF group.Receiver operating characteristic curves ( ROC) was used to evaluate the prognostic value of IP-10 mRNA, HBsAg and HBV DNA in HBV-ACLF patients .Results IP-10 mRNA level in HBV-ACLF group was 0.998 ±0.186, which was higher than those in CHB patients and healthy controls (0.641 ±0.083 and 0.412 ±0.062, t=3.841 and 16.661, P<0.01).Pearson correlation analysis showed that IP-10 mRNA level was negatively correlated with HBsAg level in HBV-ACLF patients (r=-0.576, P<0.01), but positively correlated with HBV DNA level (r=0.547, P<0.01).After 3-month entecavir therapy , IP-10 mRNA level in surviving cases of HBV-ACLF group was 0.894 ±0.164, which was lower than that in fatal cases ( 1.103 ±0.177, t =-4.328, P <0.01 ); HBsAg level in surviving cases was higher than that in fatal cases (3.303 ±0.565 vs.2.605 ±0.844, t =3.251, P<0.01).The area under ROC of IP-10 mRNA in evaluating prognosis of HBV-ACLF was 0.820, which was higher than those of HBsAg (0.663) and HBV DNA (0.570).Conclusions IP-10 mRNA in patients with HBV-ACLF is over-expressed and is correlated with HBsAg and HBV DNA levels .It may be used for predicting the prognosis of patients with HBV-ACLF.