Evidence-based medicine,personalization,standardization are the three common sense of cancer care in the 21st century.The model of cancer treatment has changed from experience-guided treatment into gene guided personalized treatment.Recently,personalized treatment of cancer develops fast,particularly in molecular profile for prognosis,molecular marker for efficiency of target drug and so on.

The origin and development of "five elements motion and six kinds of qi" acupuncture technique are reviewed, and acupuncture for treatment and prevention of disorders of "five elements motion and six kinds of qi" is summarized. Also its principle is analyzed. Problems such as the inconformity of acupoint selection, lack of systematic theory are discussed. It is pointed out that, instead of indiscriminate copy, treatment should be based on the observation of the transportation and transformation of qi; it is suggested that the classics should be inherited and innovated, combining the tradition with contemporary, and according to a sixty-year cycle, the acupuncture technique of "five elements motion and six kinds of qi" can be improved systematically for promotion and application.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians ; Qi ; history

ObjectiveTo explore clinical manifestations and CT performance characteristics of amalgamative AIDS tuberculosis. MethodsThe clinical data and CT manifestations of 28 patients who were already diagnosed with AIDS amalgamative tuberculosis were analyzed. ResultsThe common clinical manifestations of AIDS amalgamative tuberculosis: were cough, sputum, fever, night sweats, angular, difficult breathing, diarrhea, superficial lymph node enlargement,etc. The CT manifestations:were diffuse com grain of venereal change, the spot piece infiltrating kitchen,lung door ormediastinumlymphnodeenlargement, pleuraleffusion. Emptyandcalciticationwererare.ConclusionThe clinical manifestations and CT performance characteristics of amalgamative AIDS tuberculosis were not typical,whose performance was related with the body's immune state. When AIDS patients appoare diffuse lung in corn grain, spot piece infiltration sex pathological change focal, lung door or mediastinum lymph node enlargement, the possibility of amalgamative tuberculosis pleural effusion should first be diagnosed.

Problem-based learning ( PBL ) has become the major teaching method to cultivate medical student's autonomous learning and their ability to solve problems.It's basic elements are the scene authenticity and problem construction.Thoratic surgery clinical probation is the most important part of clinical teaching.The author summerized and analysized the PBL teaching experience in thoratic surgery and had some new understanding and experience on the problem construction,and therefore made some exploration and improvement to it and got some good teaching effect.

With the continuous improvement of drag for stroke prevention, ipsilateral stroke risk in patients with asymptomatic carotid stenosis has been equal to or lower than that in the revascularization group in randomized controlled trials. Under this condition, is the asymptomatic severe carotid stenosis an indication for revascularization? This article introduces the views of different researchers.

0.05) respectively in groupC1-C4,while in groups T1-T5,the rates were 21%,28%,36%,40%,37.5% ( P 0.05).However,the differentiation rate of MSCs increased probably with the incubation time prolonged.During the procedure of MSCs differentiation,the expression pattern of some genes such as GATA4 and cTNT may make some difference.

Objective:To investigate the prevalence,antibiotic resistance and risk factors of Acinetobacter Baumannii hospital-acquired pneumonia(ABHAP)in Respiratory Intensive Care Unit(RICU)of our hospital for guidance of clinical prevention and treatment of ABHAP.Methods:Clinical information and results of Antibiotic susceptibility test for all of the patients with hospital-acquired pneumonia(HAP)in RICU of our hospital from May 2007 to October 2008 were collected.Antibiotic resistance and risk factors of ABHAP were analyzed retrospectively.Results:159 patients suffered from HAP.Of which,49 patients had ABHAP and accounted for 30.8% of all cases.Acinetobacter Baumannii was the second commonest pathogen of HAP.The resistance rate of Acinetobacter Baumannii strains to the third generation of Cephalosporin and Fluoroquinolone were over 90%.And the resistance rate to Imipenen was 42.7%.Pan-resistant rate was 23.5%.Univariate analysis showed that APACHEII score ≥20,hospita1ization in RICU ≥2 weeks,invasive mechanical ventilation,invasive mechanical ventilation ≥7 days,trachea intubation or tracheotomy,trachea intubation or tracheotomy≥7 days and broad-spectrum antibiotic therapy≥7 days were associated with BAHAP.Multivariate logistic analysis showed that hospita1ization in RICU≥2 weeks,invasive mechanical ventilation≥7 days,APACHEII score≥20 and broad-spectrum antibiotic therapy ≥7 days were independent risk factors of ABHAP.Conclusions:The present study found high incidence rate,severe drug-resistance and therapeutic difficulties of ABHAP in RICU.Shortening duration of hospitalization and invasive mechanical ventilation,rational use of antibiotics are helpful to prevent and treat ABHAP.

The Systemic Theory of Shaoyang, Sanjiao and Moyuan aimed to apply systemic complex research method to expose the same half superficial and half inside syndrome, the same harmony method. On the systemic level for the same type of evidence, to explore different space disease spot of half superficial and half inside syndrome of Shaoyang, Sanjiao and Moyuan; the treatment principle, different harmonizing Shaoyang and gallbladder, cut away in purgation Sanjiao, dredge for penetration-pleurodiaphragmatie interspace. On the systemic level of differentiating signs for difference of the formulae of Xiaochaihu Decoction, Haoqin Qingdan Decoction, Xianbuling Wendan Decoction, Dayuanyin, inherit classics, develop the half superficial and half inside syndrome study of exogenous febrile disease, opening up thoughts of treatment based on differentiation of present globalization intensive epidemic diseases, as well as of TCM active and initiative in tervention.

Objective To compare the effects of three kinds digestive tract reconstruction after radical gas-trectomy for gastric cardia carcinoma.Methods The data of 150 patients underwent radical gastrectomy for gastric cardia cancer patients were analyzed.According to the reconstruction of digestive tract,they were divided into group A (55 cases),group B (46 cases),group C(49 cases).Patients in group A underwent jejunal anastomosis.Patients in group B underwent esophageal empty intestine Roux-en-Y anastomosis.Patients in group C underwent esophageal gas-tric wall anastomosis.All were follow-up for 12 months.Results During the follow-up period,the rate of reflux esoph-agitis in group A were significantly lower than that in B group (1.82%vs 19.57%,χ2 =6.966,P=0.008),the rate of reflux esophagitis in B group were significantly lower than that in C group (19.57%vs 38.78%,χ2 =4.212,P=0.042) .12 months after operation,overall health,constipation,diarrhea,nausea and vomiting index score of group A was significantly lower than those of group B and group C (all P<0.05).Conclusion The esophagus jejunum Roux-en-Y anastomosis is suitable for radical total gastrectomy in the treatment of gastric cardia carcinoma.The jeju-nal interposition anastomosis after proximal radical gastrectomy in the treatment of gastric cardia carcinoma shows low incidence of reflux esophagitis and high quality of life.

Objective To investigate the exfoliative toxin serotype genes and antibiotic resistance of Staphylococcus aureus (SA) isolated from children with staphylococcal scalded skin syndrome (SSSS). Methods In total, 108 strains of SA were isolated from 36 patients with SSSS, 36 patients with impetigo and 36 patients with abscess. Multiplex PCR was used to detect the staphylococcal exfoliative toxin A, B and D genes, Kirby-Baner method to test the susceptibilities of SA strains to 20 antibiotics. Results All the 36 SA isolates from SSSS patients were ET-positive, and 2 (6%) produced ETA, 7 (19%) ETB, 27 (75%) both ETA and ETB; of the 36 isolates from patients with impetigo, 78% produced ET, and 14% produced ETA, 64% produced both ETA and ETB, while no single ETB-producing strain was found; ET was detected in only one (2.8%) SA isolate from abscess patients, which produced both ETA and ETB. ETD was detected in none of the SA isolates. There was a statistical difference in the distribution of ET serotype among the three diseases (χ2=89.4, P < 0.01) and the proportion of ET-producing strains in SSSS group was signifi-cantly higher than that in impetigo group (χ2=9.0, P < 0.01) and abscess group (χ2= 68.1, P < 0.01). All the SA isolates were highly resistant to penicilin, ampicillin, macrolides and clindamycin, but sensitive to other 15 common antibiotics such as cephalosporin. Two strains of MRSA were found in patients with abscess. Conclusion In Chongqing, ET-producing SA is the common pathogenic bacteria of SSSS and impetigo, and most of SA strains produce both ETA and ETB.