Objective To investigate the efficacy of integrated traditional Chinese medicine (TCM) with Western medicine in treatment of diarrhea type irritable bowel syndrome (IBS-D) and its effect on serum inflammatory cytokine levels.Methods One hundred and sixty four IBS-D patients treated in Guangfu Hospital from July 2013 to August 2015 were randomly divided into study group and control group with 82 cases in each group.All patients received oral Saccharomyces boulardii 1.0 b.i.d, while patients in study group received additional Shuganjianpi decoction b.i.d for 4 weeks.The clinical efficacy was observed, serum IL-10, IFN-γ and TNF-α levels were measured in 2 groups.Results After treatment, the total score of clinical symptoms in study group was lower than that of control group [(5.71±1.41) vs.(11.70±2.88) points,t=16.707, P<0.01].Serum levels of IFN-γ, TNF-α in study group decreased significantly after treatment [IFN-γ (2.88±1.38) ng/L vs.(1.00±0.44) ng/L, t=11.609, P<0.01;TNF-α (41.26±5.29) ng/L vs.(24.13±3.27) ng/L,t=24.636, P<0.01], IL-10 significantly increased [(142.23±21.58) ng/L vs.(170.23±33.45) ng/L,t=6.291,P<0.01].The overall effective rate of study group was higher than that of control group, [87.50% (70/80) vs.68.75% (55/80), x2=8.228, P<0.01].After treatment, the quality of life scores in both groups were improved;but the improvement of diet, spirit, mood and sleep scores in study group were better than those in control group [(240±69) vs.(193±60), t=4.579, (316±74) vs.(230 ± 69), t=7.603, (297±62) vs.(228±59), t=7.211;(284±62) vs.(230±54), t=5.874, all P<0.01].Conclusion The efficacy of integrated traditional Chinese medicine with Western medicine in treatment of IBS-D is significantly better than that of Western medicine alone, which may be associated with its regulatory effect on the serum inflammatory cytokine levels.

Background: Percutaneous radiofrequency ablation (RFA) is a first-line treatment for very-early-stage hepatocellular carcinoma (HCC), whereas the efficacy of percutaneous microwave ablation (MWA) for very-early-stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very-early-stage HCC. Methods: Clinical data of 460 patients who were diagnosed with very-early-stage HCC and treated with percutane-ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili-tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed. Results: No significant differences were observed between the two groups in terms of the 1-, 3-, or 5-year OS rates (99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively;P= 0.331). Furthermore, no signif-icant differences were observed between the two groups in terms of the corresponding RFS rates (94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively;P= 0.309), the LTP rates (9.6% vs. 10.1%,P= 0.883), the complete ablation rates (98.3% vs. 98.1%,P= 0.860), or the occurrence rates of major complications (0.7% vs. 0.6%,P= 0.691). By multivariate analysis, LTP, antiviral therapy, and treatment of recurrence were independent risk fac-tors for OS (P < 0.001), and the alpha-fetoprotein level was an independent prognostic factor for RFS (P= 0.002). Conclusions: MWA is as safe and effective as RFA in treating very-early-stage HCC, supporting MWA as a first-line treatment option for this disease.

This research is to establish an HPLC method for the simultaneous determination of ophiopogonin D, ophiopogonin D', ophiopogonin C, deacetylophiopojaponin A and ophiogenin-3-O-α-L-rhamnosyl-(1-->2)-β-D-glucoside in Ophiopogonis Radix. HPLC-ELSD analysis was performed on a Kromasil 100-5 C₁₈ column (4.6 mm x 250 mm, 5 µm), with the mobile phase of acetonitrile (A) -water (B) in gradient elution mode (0-45 min, 35%-55% A), at a flow rate of 1 mL · min⁻¹. The column temperature was 35 °C and the drift tube temperature was 100 °C in a gas flow rate of 3.0 L · min⁻¹. The result showed that baseline of all the 5 constituents was well separated, and every constituent had wide linearity range and good linear relation (r > 0.999). The recovery rate was between 95.75% and 103.1%. The new established method for simultaneous determination of saponin constituents in Ophiopogonis Radix was sensitive and has good, repeatability. It could be applied to quality evaluation of Ophiopogonis Radix.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ophiopogon ; chemistry ; Plant Roots ; chemistry ; Saponins ; chemistry ; isolation & purification

Objective To characterize hypersensitivity reactions to chemotherapy with carboplatin in patients with gynecologic malignancies and serve use of carboplatin.Methods We retrospectively analyzed the clinical features,management,or outcome of carboplatin-related hypersensitivity reactions in 13 patients with gynecologic malignancies from 1983 to 2008.Results Twenty times hypersensitivity reactions happened in thirteen women with carboplatin hypersensitivity reactions.The earliest one was at the 5th cycle,the last one was at the 28th cycle;the average cycle was 11.6.The accumulative dosage of carboplatin was 1 900-11 400 mg.The average dose was 4840 mg,2500-7200 mg were the main dose range.More than 5 cycles and (or) more than 2500-7200 mg of carboplatin administration significantly increased the incidence of hypersensitivity reactions in the twelve patients.Beactions were generally occurred at the first 5-10 minutes during intravenous infusion.The average time was 7.6 minutes.Symptoms included mild-to-moderate reactions and severe reactions.Thirteen patients experienced earboplatin hypersensitivity.Two out of 13 cases exhibited severe hypersensitivity reaction at the first time.The first hypersensitivity reactions was mild-to-moderate in 11 cases.When retreated with carboplatin,4 exhibited no more reactions,5 exhibited mild-to-moderate hypersensitiviry reactions,2 exhibited severe reactions.Mildto-moderate reactions were resolved by temporary interruption of carboplatin infusion,and (or) using steroid,while severe hypersensitivity reactions were resolved by more medicines.Conclusions The hypersensitivity reactions in the patients receiving carboplatin are increased after multiple doses of the agent.The possible of retreat with the carboplatin for the mild-to-moderate reactions may be considered.Hypersensitivity reactions should be treated actively.The following chemotherapy should be planed individually.The primary chemotherapy protocol for the patients with severe hypersensitivity reactions should not be reconsidered.

Objective To study the clinical characteristic, the optimal treatments and the prognosis for the recurrence and failure of primary treatment in malignant ovarian germ cell tumors (MOGCT).Methods The clinical data of 17 recurrent and failure of primary treatment in MOGCT cases treated in Pecking Union Medical College Hospital from January 1983 to May 2008 were analyzed retrospectively to evaluate failure of primary treatment and second treatment. Results Only the 4 eases of recurrent and failure of primary treatment of MOGCT were underwent comprehensive surgical staging. After primary surgery in 1 -8 months, 16 cases received the non-standard chemotherapy were found the lesion again. The secondary debulking surgery was done for the 15 cases and also received the standard chemotherapy. Among of them, 8 cases were survival during follow up, 5 cases gave up the treatment and 4 patients were lost following up during the treatment. Conclusions The standard primary treatment is the most important for the MOGCT. Even for the recurrence and failure of primary treatment of MOGCT, the satisfied cytoreduetive surgery plus the standard chemotherapy also show the significant impact on the prognosis.

Objective To observe the outcomes of fast track surgery program applied in thoracoscopic/laparoscopic esophagectomy.Methods From March 2010 to December 2012,99 esophagus cancer patients were randomly allocated to receive thoracoscopic/laparoscopic esophagectomy[minimally invasive esophagectomy (MIE) group,50 cases] and open esophagectomy [open esophagectomy (OE) group,49 cases].Same fast track surgery program was applied in both groups.Perioperative data of all patients were collected and analysized.Results The baseline of both groups was similar.Compared with OE group,MIE group got more abdominal lymph nodes resection,13(6-40) vs.4(0-20),P ＜0.05.In both groups,the level of the total albumin,hemoglobin and total cholesterol in the 8th postoperative day was higher than that of the 1 st postoperative day,P ＜0.05.Statistical difference was observed in the 48 h patient controlled analgesia usage,24 h and 48h visual analogue scales score of motion and less motion,postoperative creatine kinase level,the white cell count and C-reaction protein level in the 8th postoperative day,of which the MIE group got better results,P ＜ 0.05.Patients in MIE group took less time to begin oral nutrition (6 days vs.9 days P ＜ 0.05),besides,the parenteral nutrition duration [(7.9 ± 2.4) days vs.(8.6 ± 2.9)days,P ＜ 0.05] and postoperative hospital stay [(12.5 ± 3.1) days vs.(17.1 ± 6.3) days,P ＜ 0.05] were also shorter,P ＜0.05.Conclusion Fast track surgery program is safe and feasible for patients receiving esophagectomy.MIE combined with fast track surgery program can promote early rehabilitation by easing pain,reducing inflammatory response,improving nutrition state,lowering postoperative morbidity,shortening hospital stays,and as a result,have more obviously advantages.

AlM:To study the refractive status characteristics aftser cataract surgery and the correlation between preoperative anterior chamber depth ( ACD) and refractive status.METHODS: Ninety-six cases of patients with cataract were randomly divided into two groups. The patients in phacoemulsification group were treated with phacoemulsification combined intraocular lens ( lOL ) implantation while the patients in small incision group were treated by small incision extracapsular cataract extraction combined with lOL implantation. Changes in ACD and postoperative refractive status and refractive fully corrected value were counted and the correlation of them were analyzed .RESULTS: ACD of the phacoemulsification group s deepened 0. 74mm while that of the small incision group deepened 0. 78mm after treatment and there was no significant difference (P>0. 05). After operation, the ACD of two groups significantly deepened ( P<0. 05 ). The postoperative visual acuity of two groups were significantly better than the uncorrected visual acuity of two groups (P<0. 05). The postoperative refraction of two groups patients were mainly 0 ~ +1. 0D ( 41. 67% and 54. 16%) and+1. 25~+2. 0D (43. 75% and 33. 33%) (P>0. 05). CONCLUSlON: ACD is significant deepened after operation. Surgeon needs full consideration of changes to improve the refractive lOL calculation accuracy.

A total of 9 806 type 2 diabetics managed by the communities were selected by the stratified cluster random sampling.The characteristics, behavior and life style, history of diseases and treatments, and familial history were collected by a standard questionnaire.Their heights and weights were measured.Furthermore, their HbA1C was tested.Logistic regression was used to analyze the association between familial history of diabetes and glycemic control.The results showed that among the diabetics, patients with familial history accounted for 18.99%, and glycemic control rate was 42.72%.Compared with the diabetics without familial history, glycemic control rate in patients with parental history of diabetes and with many relatives decreased by 0.27 fold (OR=1.27, 95%CI 1.01-1.59) and 1.01 fold (OR=2.01, 95%CI 1.25-3.23), suggesting that family history of diabetes could reduce the glycemic control rate.

Objective To understand the status of renal function abnormalities and explore its influencing factors in a community-based population with type 2 diabetes mellitus (T2DM).Methods Totally 9 413 patients with T2DM who have registered and received management of community public health service in 2014 were recruited in our study.All participants undertook questionnaire survey,physical examination and laboratory test.A simplified MDRD formula was used for estimating Glomerular Filtration Rate (eGFR),and Logistic Regression method was used to analyze the risk factors.Results The average eGFR was 91 ml/min · 1.73 m2 and the attack rate of people with eGFR ＜60 ml/min 1.73 m2 was 10.56％.The difference of renal function in participants with different age and gender was significant(x2 =6.306,P =0.012;x2 =269.293,P ＜ 0.001).Renal function in male patients and older patients was more worse.Multivariate analysis showed that long duration of diabetes,high levels of low density lipoprotein (LDL),total cholesterol (TC) and triglycerides (TG),uncontrolled blood glucose were independent risk factors for renal dysfunction.Conclusions Patients with T2DM are susceptible to renal function abnormalities.Comprehensively control of blood glucose,blood lipid and blood pressure should be performed to decrease the risk of the disease.

ObjectiveTo retrospectively analyze the clinical characteristics and outcomes of endometrial carcinoma patients aged 45 years and younger MethodsFifty-two cases of endometrial carcinoma aged 45 years and younger were treated in Peking Union Medical College Hospital They were further divided into group A (35 years of age and younger) and group B (older than 35 years) Clinical data of these patients were reviewed and the two groups were compared ResultsPatients aged 45 years and younger accounted for 12 7% of all the endometrial carcinoma cases About 50% of the patients were nulliparous, infertile or had irregular menstruation and endometrial hyperplasia, 29% were obese, 23% had polycystic ovaries Eighty-three percent of the patients were stage [ Int ernational Federation of Gynecology and Obstetris (FIGO),1988] Group A had mo re polysystic ovaries and atypical endometrial hyperplasia than group B (53% v s 9%, 59% vs 26% respectively, P