Baihui (GV 20), Neiguan (PC 6), Zusanli (ST 36), Taichong (LR 3), Fuliu (KI 7),Guanyuan (CV 4), Tianshu (ST 25) and Zhongwan (CV 12) were treated with cap-shaped warm acupuncture to treat obesity with hyperlipidemia in 48 cases. After 4 courses of treatment, 15 cases got marked effectiveness, 23 cases got effectiveness and 10 cases failed,with the total effective rate of 79.2%.

Objective]To study the discipline of Guizhi Tang in clinical application, understand further indication of Guizhi Tang to improve clinical efficacy. [Method]After consulting medical cases about Guizhi Tang that are from different medical practitioners, analysis on the discipline of Guizhi Tang in clinical application with the help of six meridian syndrome differentiation, zang-fu differentiation and drug efficacy of Guizhi Tang. [Result]Guizhi Tang can be used to cure urticaria, coronary heart disease, nape carbuncle, high fever, half sweating and diarrhea. The cases of urticaria, diarrhea and nape carbuncle all contain symptoms of tai yang disease.The case of high fever is due to discord of ying-wei. The case of half sweating is due to discord of yin-yang. The case of coronary heart disease reflects Guizhi Tang can regulate spleen-stomach. [Conclusion] The medical cases about Guizhi Tang involve the departments of internal medicine, surgery, gynaecology and pediatrics,such as urticaria, coronary heart disease and so on. Using Guizhi Tang should get help from six meridian syndrome differentiation or zang-fu differentiation. When using six meridian syndrome differentiation, doctors should pay attention to difference of tai yang disease and other five meridian diseases. When using zang-fu differentiation, doctors should attach importance to the feature of Guizhi Tang that involves regulating yin-yang, spleen-stomach and ying-wei.

Objective To probe into the status quo of maltreatment tendency among family caregivers of elderly patients with chronic diseases and its influence factors.Methods Totally 402 family caregivers of the elderly patients with chronic diseases were selected and surveyed by using the Chinese version of caregiver elder abuse assessment scale and the results underwent statistical analysis.Results 63.70％ of family caregivers in elderly patients with chronic diseases had the elder abuse risk tendency and its influence factors were involved with both aspects of family caregivers and the care recipients,including the gender,cultural level and self-care ability of daily living in the elderly patients with chronic diseases and the age,cultural level,care period and living together with elderly in caregivers.Conclusion The elder abuse problem in the patients with chronic diseases should be paid more attention to,which needs the collaboration of multidisciplinary team,various effective ways should be adopted to relieve the family caregivers' pressure for reducing the occurrenc of elder abuse risk.

Objective To probe into the status and correlation between elder abuse tendency and psychological resilience of family caregivers of the elderly with chronic diseases. Methods Totally 402 family caregivers of the elderly with chronic diseases were investigated by the Chinese version of Caregiver Abuse Screening and Conner-Davidson Resilience Scale. Then the results underwent statistical analysis. Results Nearly 63.68%(256/402) family caregivers had the risk of elder abuse tendency. The median of family caregivers′resilience score was 53, lower than normal population(Z=-10.106, P=0.000), and was significantly negatively correlated with elder abuse tendency(r=-0.480, P=0.000).And caregivers′ high level of resilience was a protective factors for elder abuse tendency. Conclusions Nurses should motivate the family caregivers of the elderly with chronic diseases to adapt successfully when faced stress which could be associated with resilience. Thus the psychological resilience would play a role of protective effect against elder abuse tendency, with the purpose of reducing the risk for abusing the elderly who suffered from chronic diseases.

During the resistance to SARS, medical staff's medical ethics accumulation reflects generously. The test of SARS has promoted the medical staff's social responsibility consciousness, strengthened the coordination between each other and sublimed the morals in the whole society. Therefore, the sufficient realization of the accumulation of medical ethics depends on the enhancement of hygiene industry input;the display of the accumulation of medical ethics depends on the positive propaganda and encouragement to medical staff; the expansion of the medical ethics epitaxy depends on the fully excavation and utilization of the accumulation of medical ethics.

Upper limb lymphedema usually complicate breast cancer, which significantly impact the patients' quality of life. The management includes physical therapy, medicine, surgery, Chinese Medicine decoction, Chinese patent medicine injection, and acupuncture and massage. Combined strategy is needed for none of a single therapy is effective enough.

Objective: To establish a quality control protocol based on microscopic, TLC, and HPLC methods, and to verify the optimal harvesting time for the leaves of Malus hupehensis (LMH). Methods: The LMH were pulverized into powder for microscopic identification or TLC and HPLC analysis after ultrasonic extraction with methanol. Seasonal variations of the phlorizin content and average leaf weight were determined by HPLC analysis and weighing up the leaves collected from May to October. Results: Microscopic and macromorphologic characteristics have been described for the leaf identification. A qualitative TLC assay and a quantitative HPLC method have been established for the quality control of LMH. Phlorizin was selected as a reference marker, which resolved at Rf 0.53 in TLC assay and at 14.0 min in HPLC assay. The content of phlorizin decreased gradually from 17.0% in leaves collected in May to 7.5% in October. The average leaf weight reached the level of 0.6 g in August and maintained until its falling. Conclusion: These methods are simple, selective, accurate, and reliable for the quality control of LMH. The period from late August to early September is suggested as the optimal harvesting time of the LMH. © 2013 Tianjin Press of Chinese Herbal Medicines.

Objective To compare the clinical and histological features and prognosis of patients with ovarian cancer from different genetic background, and to make further understanding of the genetic model of BRCA genes used pedigree analysis. Methods There were 71 patients from 67 independent families enrolled in our study from Apr. 2000 to Jun. 2009 in Peking Union Medical College Hospital. All exons of BRCA1/2 genes were analyzed using denaturing high-performance liquid chromatography(DHPLC) followed by direct sequencing, and clinical features of patients were compared by statistical analysis. Pedigree analysis of two families with BRCA genes mutation were performed. Results The mutation rate of BRCA genes was 28%(20/71). The frequency of BRCA1 and BRCA2 gene mutation was 23%(16/71) and 6%(4/71), respectively (P=0.004). Histology types of patients with and without BRCA genes mutation were different. The onset age between patients with and without BRCA genes mutation was similar (52.6 versus 54.6 years old, P=0.393), and tend to be early-onset breast or ovarian cancer in high-risk group. There was no significant difference of platinum-resistant rate, disease free survival and overall survival rate between patients with and without BRCA genes mutation (all P>0.05). According to the pedigree analysis, up to 100% of female offspring inherited pathogenic mutations, and male offspring could be a mutation carrier. Conclusions The genetic screening and clinical intervention should be performed as early as possible for the members from families at risk of hereditary ovarian cancer. Genetic consulting is important for patients with high-grade papillary serous adenocarcinoma of ovary. It is still unknown that whether the patients with BRCA gene mutations have better prognosis than sporadic ones, and further perspective, randomized controlled trial is still needed.

Objective: To study the diagnosis and treatment of primary hyperparathyroidism.Methods: The clinical data of 8 primary hyperparathyroidism patients(1992 2002) in our hospital were summarized and the references were reviewed.Results: It was found that primary hyperparathyroidism was liable to be misdiagnosed.Information on blood calcium,parathyroid hormone(PTH) and imaging may be helpful for diagnosis. Surgical resection(4 cases), anhydrous alcohol injection (2 cases), electron radiation (1 case) and internal medicine (1 case) were applied. Conclusion:Information on blood calcium,PTH and early imaging is helpful for diagnosis.Operation is the first choice of treatment, and for patients who can not tolerate surgery, anhydrous alcohol injection is an effective and safe treatment.

Objective To evaluate the effect of continuous renal replacement therapy (CRRT) on extracorporeal membrane oxygenation (ECMO)-induced expression of inflammatory factors in pig kidney.Methods Twenty-four adult pigs of either sex,weighing 25-32 kg,were randomly divided into 4 groups (n =6 each) using a? random number table:control group (group C),sham operation group (group S),ECMO group and CRRT group.Anesthesia was induced with ketamine,diazepam and atropine and maintained with ketamine and diazepam.The pigs were tracheotomized,intubated and mechanically ventilated.The left femoral arteries were cannulated for MAP monitoring.Heparin 150 U/kg was injected intravenously.Right femoral artery and left internal jugular vein were cannulated for blood-letting and fluid infusion.In ECMO and CRRT groups,ECMO was performed for 24 h starting from 1 h after cannulation,in addition CRRT was performed for 24 h simultaneously in ECMO group.The pigs were then sacrificed and kidney specimens were obtained for determination of the content of interleukin-1β (IL-1 β),IL-6 and tumor necrosis factor-α (TNF-α) by ELISA.Results There was no significant differ-ence in the content of IL-1β,IL-6 and TNF-α between C and S groups (P ＞ 0.05).Compared with C and S groups,the content of IL-1β,IL-6 and TNF-α was significantly increased in E and CRRT groups (P ＜ 0.01).Compared with group E,the content of IL-1β,IL-6 and TNF-α was significantly decreased in group CRRT (P ＜0.01).Conclusion CRRT can decrease ECMO-induced expression of inflammatory factors in pig kidney to some extent,indicating that it can alleviate the inflammatory responses in kidney.