Objective To investigate the clinical efficacy of Chinese herbal medicine and liquid wax in treating oral apatinib-induced hand-foot syndrome. Method Thirty patients with gastric or gastroesophageal junction adenocarcinoma, who had developed hand-foot syndrome after oral administration of apatinib for four weeks, with grade 0 in 3 cases, grade Ⅰ in 16 cases, grade Ⅱ in 9 cases and grade Ⅲ in 2 cases, were enrolled and treated by external application of Chinese herbal medicine and liquid wax on both hands and feet for three weeks. Result The 30 patients with hand-foot syndrome had grade 0 in 14 cases, grade Ⅰ in 14 cases, grade Ⅱ in 2 cases and grade Ⅲ in 0 case after treatment with Chinese herbal medicine and liquid wax. There was a definite therapeutic effect and a statistically significant difference (P<0.05). Conclusion External application of Chinese herbal medicine and liquid wax on both hands and feet for hand-foot syndrome not only has a definite therapeutic effect but is also an ideal means of prevention and treatment because of its noninvasive procedure and the high compliance of the patients.

Objective To examine the pathological changes in the liver of an AIDS patient with complicated infection of Pneumocystis carinii(PC). \ Methods\ A liver biopsy was made. The tissue was stained with HE, PAS, Giemsa, GMS, and acid\|fast staining, and examined under light microscope and transmission electron microscope. \ Results\ Granulomas (acid\|fast negative) in the tissue and numerous pathogens (PAS positive) in hepatic sinusoids were detected. Giemsa and GMS staining and electron microscopy all confirmed that the pathogen was Pneumocystis carinii. \ Conclusion\ The pathological findings revealed a diffuse extrapulmonary infection of Pneumocystis carinii in the patient of AIDS.

Objective To study the value of common X-ray and CT scanning in the spinal bursting fracture (abridged English:BF).Methods By the frontal,lateral X-ray film and CT scanning,the imaging manifestations of BF in 43 cases were analysed,contrasted,summarised and classified .Results Among the BF 43 cases,the classifications were type A(10 cases),type B(15 cases),type C(2 cases),type D(9 cases) and type E(7 cases).The three-post injure had 34 cases,the two-post injure had 9 cases,the spinal canal narrowing:0?was 8 cases,1?was 12 cases,2? was 23 cases;the rear spinal edges discontinuation was 35 cases.Conclusion The diagnostic value of X-ray film to BF is reflecting the bones injured change of spinal fracture type,flexion and damaged rear edge.The CT scanning advantage is showing the fracture lines trend,relative scope,degree of spinal canal deformation and narrow,infering the pressed situation and injured spinal cord.The two methods combine and confirm each other in order to help clinical diagnosis the right treating.

0.05).Every one of the patients completed hemodialysis except one needing to rebuild blood circulation by changing another dialyzer, whose vein pressure became higher and the dislyzer was of cruor as it was difficult to build blood circulation. The rate of success has reached 99 percent. Conclusion There is no influence upon the general cruor mechanism when using hemophan dialyzers to heparin-free hemodialysis treat the acute or chronic renal failure. This simple method is not only effective but also safe, which can provide a reliable measure to rescue patients suffering from acute or chronic renal failure with serious tendency of hemorrhage.

Objective To assess the efficacy and safety of multimodal analgesia with different doses of nalbuphine combined with flurbiprofen on patients who received intravenous patient -controlled analgesia(PCIA) after thoracotomy.Methods Sixty patients underwent thoracotomy,ASA Ⅰ -Ⅱ,18 -65 years old,who underwent postoperative PCIA,were randomly divideded into three groups according to the digital table,nalbuphine 60 mg group (N60 group),nalbuphine 80 mg group(N80 group)and nalbuphine 100 mg group (N100 group),20 cases in each group.All patients were given 150mg flurbiprofen,a total of 100mL.PCIA solution:the background dose was 2mL/h, PCIA dose of 0.5mL,locking time of 15min.10min before surgery,each patient was intravenously given flurbiprofen 50mg,given a loading dose of 0.1mL/kg when closed chest.All patients were followed up for 48h.The incidence of adverse reactions such as vital signs,number of times,visual analog scale(VAS)score,sedation score,nausea and vomiting were recorded.Results There were no significant differences in the age,gender,body mass index and surgery duration among the three groups(all P >0.05).The vital signs were stable within 48h after operation.The VAS scores of N60 group were higher than the other two groups(N80 group:t =7.94,6.35,6.49,5.21,5.63,all P =0.00;N100 group:t =8.41,9.10,5.80,8.07,8.18,all P =0.00)at 4,6,8,24 and 48h after operation(all P <0.05).The VAS score of N80 group 48 h after operation was lower than that of N100 group(t =2.30,P =0.03),and the difference was not statistically significant in remaining(all P >0.05).The effective /actual compression ratio of PCIA of N80 group and N100 group were significantly higher than that of N60 group (t =7.30,8.35,all P <0.05). There were no differences in the incidence of adverse reaction among the three groups(group N80:χ2 =0.17,0.23, 1.03,all P >0.05;group N100:χ2 =3.14,0.23,1.03,all P >0.05).Conclusion Postoperative PCIA with nalbu-phine (80 mg)combined with flurbiprofen(150 mg)has significant analgesic effect and lower costs.

Objective To assess the efficacy and safety of ACD-A solution as anticoagulant during continuous renal replacement therapy (CRRT) in high risk of bleeding patients.Methods Forty high risk bleeding patients on continuous veno-venous hemofiltration (CVVH) were randomly divided into two groups:ACD-A group (22 patients,61 cases) and heparin-free group (18 patients,47 cases).Serum creatinine,function of the coagulation system,electrolyte and acid-base were monitored pre-and post-CVVH.The vital signs of the patients during treatment,dialyser clotting and the incidence of bleeding episodes were recorded.Results (1) The serum level of creatinine decreased significantly after treatment in both groups,but the rate of decrease was obviously higher in ACD-A group than that in heparin-free group[(55.4± 10.2)％ vs (42.0±5.2)％,P=0.031].(2) The average duration of CVVH treatment was (17.3±3.8) h in ACD-A group and (9.7±4.5) h in heparin-free group.There was significant difference between them (P =0.019).The frequency of dialyzer clotting was much higher in heparin-free group than that in ACD-A group (88％ vs 4.9％,P ＜ 0.001).(3) There was no significant difference in the function of the coagulation system between pre-and post-CVVH in either group (P ＞ 0.05).(4) Electrolyte,acid-base and glucose tended to be stable during the treatment in ACD -A group.(5) The vital signs were kept stable and no bleeding episodes were found in all patients of two groups.Conclusions Anticoagulation with ACD-A is safe,effective and convenient for CRRT in critically ill patients at high risk of bleeding.The occurrence of complications can be reduced by configurating appropriate replacement fluid and close laboratory monitoring.

Objective To study the limitation analysis of Staphylococcus spp Susceptibility Test Kit ATB STAPH 5 from Bi-oMerieux in clinical application and to propose remedy.Methods The coverage area and break point of antibiotics ATB STAPH 5 from BioMerieux were analysed by using CLSI M100-S23 as standard.Results The kit ATB STAPH 5 did not include chloromycetin,oxazolidinones and lipopeptide three antibiotics that were recommend by CLSI.The 16 kinds of antibi-otics break point in the kit ATB STAPH 5 were all not inconsistent or did not contain with the standard of CLSI M100-S23. It may lead to error drug sensitivity tests,false sensitive or false drug resistance.Conclusion Only using this kit ATB STAPH 5 for Staphylococcus spp ,it may occurre errors or mistakes.Other experiments must be corrected before the re-port.

Objective To investigate the changes of silver-stainng protein of nuclear organizer regions(AgNORs)expression of T lymphocytes and helper T (Th) cell subsets in peripheral mononuclear cells (PBMC) from cancer patients and to analyze the relationship between them.Methods AgNORs expression in T cells activated by a multiple clonal activator was examined using a special image system. After activation of PBMC with ionomycin plus PMA for 5 h, both interferon-? (IFN ?) and interleukin-4 (IL-4)producing cell frequencies were detected by enzyme-linked immunospot assay (ELISPOT). The stimulated with ionomycin plus PMA for 24 h, the IFN ?-and IL-4-production were assayed by ELISA.Resuts AgNORs expression of activated T cells in PBMC from cancer patients (n=86) and healthy persons (n=44) was (4.90?1.20) I.S% and (7.82?1.28) I.S% respectively. Th2 frequency was significantly higher and the ratio of Th1 to Th2 frequency was more lower in cancer patient group. Moreover, the IFN ? and IL-4 production in cancer patient group were changed in the way similar to Th subset frequencies. In lung cancer patients the AgNORs expression, Th1 frequency, Th1/Th2 ratio and IFN ? production were significantly decreased in metastasis or in recurrence status,AgNORs expression in cancer patients correlated with their Th1 frequencies, Th1/Th2 ratio, IFN ? production levels and Karnofsky′s estimators.Conclusions In analyzed cancer patient cases, the expression of AgNORs and the function of Th1 cell were significantly decreased and correlated.

Pathology is the bridge of medicine between basic and clinic.It is needed for the graduate students of pathology to supplement the study of surgical pathology that is lacked now for adaptation to the employment situation as the qualified personnel in the field.

Objective To explore the effect of comprehensive intervention on anxiety in patients of acute myocardial infarction (AMI) undergoing intra-aortic balloon pump (IABP). Methods 50 patients with AMI undergoing IABP with the score of Hamilton Anxiety Rating Scale (HAMA) more than 14 points, were divided into conventional intervention group (n=25) and comprehensive intervention group (n=25). The conventional intervention group received all the conventional nursing measures including cognitive behavioral intervention, and the comprehensive intervention group received propofol intravenous pumping in addition with Ramsay sedation at II-III level. The vital signs, HAMA scores, major cardiovascular events, and vascular complications were recorded before and the 1st-5th days after intervention. Results The HAMA scores, systolic blood pressure, diastolic blood pressure and mean pressure decreased in most of the time points after intervention in the comprehensive intervention group (P<0.05). And there was no complication such as low blood pressure, respiratory depression. The incidence rates of cardiac arrhythmias, puncture hematoma/bleeding and catheter displacement were lower in the comprehensive intervention group than in the conventional intervention group (P<0.05). Conclusion Comprehensive intervention can improve the symptoms of anxiety in the patients with AMI undergoing IABP, and reduce the incidence of arrhythmia, vascular complications and catheter displacement.