With the aging of the population,management of cancer in the elderly aged people represents a priority for health care.However,fewer evidence-based data are available to promote the treatment of these patients.Comprehensive geriatric assessment (CGA) is developed recently as a multi-disciplinary in-depth evaluation to assess life expectancy and risk of morbidity from cancer in elderly patients,which is helpful for physicians to develop a coordinated plan for cancer treatment and to provide appropriate interventions to decrease the risk of morbidity and mortality.

AIM: To investigate the antagonistic action of Captopril (Cap) on the activation and injury of human umbilical vascular endothelial cells (HUVECs) induced by lipopolysaccharide(LPS) and the possible mechanisms. METHODS: After 18 h exposure of the cultured HUVECs to LPS (1 mg/L), or LPS (1 mg/L) plus Cap at the concentration of 10~(-7)mol/L, 10~(-5)mol/L and 10~(-3)mol/L, the expression of vWF protein in the conditioned media was tested by enzyme-linked immunosorbent assay (ELISA), the expression of ICAM-1 protein in HUVECs was determined by indirect immunofluorescence technique with flow cytometry as well. In addition, the expression of TNF? mRNA was determined by in situ hybridization. RESULTS: The results of ELISA and indirect immunofluorescence technique showed that exposure to LPS at a concentration of 1 mg/L led to a significant increase in the vWF and ICAM-1 expression in HUVECs as compared to the control (P

OBJECTIVETo compare the differences of clinical effects on primary hypertension between acupuncture combined with auricular point sticking and western medicine.

METHODSNinety patients with primary hypertension were randomly divided into a medication group and a combination group, 45 cases in each group. In the medication group, captopril tablets were treated with oral administration, 12.5 mg each time, twice a day; in the combination group, acupuncture and auricular point sticking were used, and acupuncture was applied at Renying (ST 9), Fengchi (GB 20) and Baihui (GV 20), while auricular point sticking was adopted at Shenmen (TF4), Xin (CO15), Jiangyagou and Jiaogan (AH6a), once a day for continuous 4 weeks. After treatment, the changes of 24 h ambulatory blood pressure, angiotensin II (Ang II) level, creatinine level and syndrome scores were observed and the clinical efficacy was assessed in the two groups.

RESULTSAfter 4 weeks' treatment, the 24 h ambulatory blood pressure was both improved compared with that before treatment in the two groups (P<0.01, P<0.05). The reducing of 24 h ambulatory blood pressure in the combination group was superior to that in the medication group (P<0.05). There were reducing tendencies about coefficients of variation (CVs) of the two groups, and in the combination group, the CVs of 24 h ambulatory blood pressure and systolic pressure acquired more obvious reducing range compared with the medication group (both P<0.05). Serum Ang II level and plasma creatinine level of the patients in the two groups after treatment were both decreased (both P<0.05) and the reducing of Ang II level and creatinine level of the combination group was more obvious than that of the medication group (both P<0.05). The syndrome scores of the two groups after treatment were both remarkably decreased (both P<0.05), and the reducing of the syndrome scores of the combination group was more marked than that of the medication group (P<0.05). The total effective rate of the combination group was 95.6% (43/45), which was superior to 71.1% (32/45) of the medication group (P<0.05).

CONCLUSIONAcupuncture combined with auricular point sticking for primary hypertension has reliable effect. It is better than captopril for the improvement of 24 h ambulatory blood pressure, AngII level and creatinine level, and can improve dizzy, palpitation and other clinical symptoms.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adult ; Aged ; Blood Pressure ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Male ; Middle Aged ; Treatment Outcome

Many studies show that excision repair cross-complementing gene 1 (ERCC1),ribonucleotide reductase subunit M1 (RRM1),p53,epidermal growth factor receptor (EGFR),and vascular endothelial growth factor (VEGF) are closely related to the curative effect and prognosis of non-small cell lung cancer (NSCLC).In recent years,many studies have investigated the association between polymorphisms of these factors and the curative effect and prognosis in patients with NSCLC.The polymorphisms of these factors may be potential biomarkers to predict the clinical outcome in patients with NSCLC.

Objective To observe the clinical effect of Wangbi tablet oral therapy combined with joint mobilization in the treatment of periarthritis of shoulder, to provide reference for the treatment of periarthritis of shoulder.Methods A total of 136 patients with scapulohumeral periarthritis in our hospital from January 2015 to June 2016 were selected as the research object, according to the order of hospitalized patients were randomly divided into observation group and control group,with 68 cases in each group, the observation group was treated with Wangbi tablet combined with joint mobilization,the control group was treated with single joint mobilization.After treatment, the clinical curative effect,complications or adverse reactions were comparedbetween the two groups, visual analogue scale(VAS)was used to compare the degree of pain of shoulder joint of patients before and after treatment, the shoulder joint function score were compared by the Japanese Orthopedic Association(JOA)'s shoulder disease score, the patients were followed up for a half a year and the Barthel index score was used to compare the daily life ability score of dynamic contrast.Results (1)The total effective rate of the observation group was(64/68), the control group was 82.35%(56/68), the observation group was significantly better than the control group(P<0.05).(2)The incidence of adverse reactions in the observation group was(8/68), the control group was 7.35%(5/68), and the safety of the two groups was good.(3)the VAS score of the observation group was(3.09±0.98), the control group was(4.53±1.02), and the pain of the observation group was significantly lower than that of the control group(P<0.05).(4)After treatment, the JOA score of the observation group was(16.54±2.36), and the control group was(12.97±2.71).The observation group was significantly higher than the control group(P<0.05).(5)The observation group treatment and follow-up of the Barthel index score was(73.11±6.21),(83.89±7.95)points, the control group was(68.41±5.65),(73.88±6.80), the activities of daily living of the observation group were higher than that of the control group(P<0.05).Conclusion There is a significant effect of Wangbi tablet therapy combined with joint mobilization for the treatment of patients with periarthritis of shoulder, the safety of the treatment is high, can reduce the pain of patients, improve the activity of shoulder joint function and activity of daily living, the comprehensive curative effect, with a high clinical value to promote.

ObjectiveThe study was designed to understand the education training situation and demand of rural doctors,identify problems in training and provide theoretical basis for the relevant government departments to further the development of rural doctors education,explore the pattem of ru ral health education and improve the effectiveness of training.MethodsThe participants were a sample of rural doctors among the east and center-west region in China (Beijing Municipality,Jiangsu,Zhejiang,Hainan,Shanxi,Guangxi Zhuang Autonomous Region,Guizhou,Yunan and Gansu).20 288questionnaires were issued,18 259 of them were taken back,which occupied 90.1％ recovery rate.Group interview method and stratification-cluster sample method were conducted in the Cross-sectional study.Results70.2％ were male doctors,with an average age of 44.3 ±10.9 years,63.0％ of whom received technical school education and technical secondary school Training time was mainly less than 12 days per year (48.8％),training content was mainly about clinical skills(80.6％),and traning mode was mainly conference traning (56.6％).There was a certain gap between training status and demand.ConclusionThe on-site clinically guide-based,comprehensive and short-term non-job training should be demand-orientedly carried out aiming at young doctors in rural areas.

ObjectiveTo explore the clinical features,etiological factors,diagnosis and treatments in children with hemophagocytic syndromes (HPS).MethodsA retrospective study was carried out to analyze etiological factors,clinical symptoms and sighs,laboratory findings and outcomes of 32 children with HPS in our hospital.Results( 1 ) Etiological factors:virus infection cases accounted for 75.0％ (24/32),in which Epstein-Barr virus infection cases were predominant,making up to 68.8％ (22/32) ; (2) Main clinical features:included persistent fever,hepatosplenomegaly,lymphadenopathy; ( 3 ) Characteristic laboratory findings:included decrease of three lines or two lines of peripheral blood cells,hyperferrttinemia,abnormal liver function and coagulation function,hypertriglycerdema and decreased fibrinogen,hemophagocytosis in bone marrow,high soluble interleukin-2 receptor level,decreased natural killer cell activity.(4) Treatments and outcomes:twenty-four(24/32) virus infection cases received antivirus and high dose of immunoglobulin treatment.Twenty-two cases were treated with glucocorticoid and cyclophosphamide,resulting in 11 cases improvement,5 cases with complete remission,2 cases giving up and 4 death.The other 10 cases were treated under the guide of HLH-2004 protocol treatmemt with 4 cases improved and 6 cases with complete remission.Conclusion HPS is mainly triggered by infections,especially Epstein-Barr virus infection.Serum ferrifin,interleukin-2 receptor level and natural killer cell activity are biomarkers of the disease,so that they should be monitored during the progress of chemotherapy.HLH-2004 protocol is a good guide for the treatment of this disease.

Soft aid for health has become an important component of China's foreign aid. Soft aid for health with a focus on human resources development reflects the core spirit and the innovative mechanism of China's foreign aid. This paper examines three different types of aid for health human resources: medical assistance teams, govern-ment scholarships for students from developing countries, and health training courses for officials from developing countries. It also argues that China's foreign aid exposes problems, including insufficient strategic planning, non-in-volvement of civil society and NGOs, and lack of research on China's soft aid practices. In this paper, we suggests that to improve the effectiveness of foreign aid, the government should improve its strategic planning for aid, ensure the full public participation, strengthen the academic research, and improve knowledge sharing.

Objective To assess the effect of intraarterial washout with UW solution and tanshinone Ⅱ A for skeletal muscle preservation during ischemia and reperfusion.Methods Ischemic rat limbs were perfused with UW solution or UW solution plus tanshinone Ⅱ A (0.05,0.1 and 0.2 mg/ml) for 0.5 h before reperfusion; controls received no perfusion.Serum CPK,LDH,and AST were measured pre-ischemia and after reperfusion (2 h,4 h,and 6 h).Muscle water content,MDA,SOD,ATPase were assessed pre-reperfusion and after 6 h reperfusion.ICAM-1 was detected after 6 h reperfusion.Results Intraarterial washout with UW and UW + T could inhibit the express of ICAM-1 in skeletal muscle.The serum levels of CPK,AST,and LDH in UW group were significant lower than those in control group after 2 h of reperfusion,but no difference was observed between UW group and control group after 4 h and 6 h of reperfusion.After 4 h of ischemia,there were significant differences in water content,MDA,SOD,and ATPase in skeletal muscle between UW group and control group,but no difference was found after 6 h of reperfusion.In contrast,all parameters of laboratory test and biochemical analyzing in UW + T(0.05,0.10,and 0.20 mg/ml) groups were significantly different from those in control group at corresponding reperfusion period.Conclusion Intraarterial washout with UW solution is effective in preserving skeletal muscle integrity against I/R insult.Tanshinone Ⅱ A as a beneficial adjunct to UW solution improves the protective effect of UW solution for ischemic skeletal muscle.To better preserve ischemic skeletal muscle,an appropriate dose of tanshinone Ⅱ A (0.1 or 0.2 mg/ml)added to UW solution is required.

Objective To explore the aursing points for patients with acute pancreatitia.Methods Retrospectively summarized the nursing courses among 65 patients with acute pancreatitis.Results Among the 65 patients with acute pancreatitis,there were 10 patients receiving operation,there were 55 patients receiving conservative treatment.5 cases died,and the others rccoverd.Conclusion The key nursing points for patients with acute pancreatitis are careful observation,systematic nursing intervention according to the conditions of patients and preventing complications.