Integrative Medicine

Objective To compare and evaluate the oncological and functional outcomes between reserving thyroid partial laryngectomy and traditional partial laryngectomy for the treatment of stage T2-3glottic laryngeal carcinoma.Methods One hundred and twenty-eight patients treated from January 1999 to January 2009 were selected from all glottic laryngeal carcinoma patients with stage T2-3,who underwent surgery combined with radiation therapy.A retrospective review was randomized and matched by tumour subsite,TNM stage and age,which were confirmed by pathology and observation without thyroid perichondrium invaded or only local invasion of thyroid cartilage,there was no need to extensively resect laryngeal cartilages.Patients were divided into reserving thyroid partial laryngectomy group(study group) and traditional partial laryngectomy group (control group).Each group included 64 cases,which included T2N0 38 cases,T2N1 6 cases,T2N2 1 case,T3N0 17 cases,T3N1 2 cases.Local control rate,decannulation rate,the 3-year and 5-year accumulative survival rate were compared between two groups.Results The 3-year and 5-year accumulative survival rate were 89.8％ and 84.3％ in study group,91.5％ and 85.4％ in control group,there was no sognificant difference (x2 =1.687,P ＞ 0.05).The local control rate was 91.7 ％ (55/60) in study group and 93.2 ％(55/59) in control group,there was no significant difference (x2 =0.103,P ＞0.05).The decannulation rate was 98.3％ (59/60) in study group and 89.8％(53/59) in control group,there was significant difference (x2 =4.933,P ＜0.05).Conclusions Comparing with traditional partial laryngectomy,reserving thyroid partial laryngectomy is successful for treating properly selected stage T2-3 glottic laryngeal carcinoma.This operation has higher decannulation rate and lower complication,which is effective for reducing surgical invasion and facilitated the resumption of respiratory.

Essential hypertension is one of the most prevalent and important public health concerns in both westernized and developing countries. Recent studies have demonstrated that successful long-term treatment of hypertension has a significant impact on morbidity and mortality from cardiovascular diseases (CVDs) and stroke. Chinese classical formulas, which are important components of traditional Chinese medicine (TCM), have been increasingly accepted by patients with CVDs worldwide. According to TCM theory and syndrome differentiation, hypertension could be categorized into 3 patterns including fire syndrome, fluid retention syndrome, and deficiency syndrome. Chinese classical formulas, including Chaihu Jia Longgu Muli tang, Tianma Gouteng yin, Zhen Gan Xifeng tang, Banxia Baizhu Tianma tang, Liu Wei Dihuang wan, etc, play an important role in the treatment of essential hypertension, which could be further research priorities.
Aged ; China ; Drug Prescriptions ; history ; Drugs, Chinese Herbal ; history ; therapeutic use ; Essential Hypertension ; Female ; History, Ancient ; Humans ; Hypertension ; drug therapy ; history ; Male ; Medicine in Literature ; Middle Aged

Hypertension is a significant medical and public health issue which puts an enormous burden on health care resources and the community. It is a chronic medical condition in which the systemic arterial blood pressure (BP) is elevated. Serious complications including cardiovascular and cerebrovascular diseases would be preventable if the rise in BP with age could be prevented or diminished. The majority of hypertensive patients require long-term treatment. Oral antihypertensive drugs, lifestyle modification including exercise and dietary modification are milestones for hypertension therapy. However, the control rate of hypertension hasn't reached the expected requirements currently. "Three lows" status quo, just low awareness, low treatment, and low control, are still the major problems confronting modern medicine. Recently, uncontrolled factors of blood pressure are widely concerned, which include insomnia, constipation, mood disorders, exogenous, etc. What's more, the control strategies of hypertension should not only pay close attention to "patient's high blood pressure", but also to "hypertensive patient". Therefore, the treatment of uncontrolled factors of blood pressure plays an important role in hypertensive therapy, which could be further research priorities.
Aged ; Antihypertensive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Diagnosis, Differential ; Essential Hypertension ; Female ; Humans ; Hypertension ; diagnosis ; drug therapy ; physiopathology ; Male ; Middle Aged

After decades of development, thymus minimally invasive surgery has derived a variety of surgical methods. In selected cases, it can achieve equivalent therapeutic effect as open surgery. Because mediastinal disease is rare compared with other chest diseases, there is a lack of large-scale comparative study among different surgical methods, and the choice of surgical approaches is mostly based on the experience and habit of the operator. The purpose of this review is to discuss the evolution of minimally invasive thymus surgery, summarize several kinds of minimally invasive thymus surgery approaches that are widely used in and abroad, and analyze the integration and improvement strategies of minimally invasive thymus surgery in China.

Objective: To propose an effective algorithm for solving the shortest circuit problem of military health support. Methods: Partheno-genetic algorithm (PGA), which only used mutation operation and selection operation, was adopted in the present study. The algorithm was based on K-random-nearer-neighbor algorithm combined with two-random-point exchange, two-neighbor-point exchange, circular-based part inversion and random insertion mutation operations. Furthermore, greedy strategy was applied in selection to improve the hill-climbing capability of PGA. Results The simulation results of CTSP31 and standard dataset from TSP library indicated that the PGA was more effective than existing algorithms from the literature. Conclusion: PGA can serve as a basis for further development of a computer-assisted program, and it provides optimized decision-making scheme for improving the quality and speed of military medical service disposition.

Objective:To compare the efficacy of anhydrous ethanol and lauromacrogol in the treatment of ovarian endometriosis cyst (OEC), and to provide evidence for more effective use of these two sclerotic drugs.Methods:Thirty-three cysts in 30 patients with OEC, who were admitted to Taizhou Hospital of Zhejiang Province from February 2017 to June 2018, were treated by ultrasound interventional therapy, followed by catheter aspiration, saline cavity cleaning, anhydrous ethanol rinsing and sclerotherapy, and lauromacrogol alcohol 1∶1 mixed solution retained in the capsule (mixed group). The therapeutic effects were observed 6 and 12 months after operation. A total of 30 OEC in 28 cases admitted to the same hospital from 2013 to 2015 were retrospectively analyzed after similar treatment steps, but the intracapsular retention fluid was anhydrous ethanol (ethanol group). A total of 28 OEC in 26 patients admitted to the same hospital from 2015 to 2017 were washed with normal saline, then washed with lauromacrogol and retained in the capsule with lauromacrogol (lauromacrogol group). The therapeutic effects of 6 and 12 months after treatment between the three groups were compared.Results:According to the classification of cure, marked effect and inefficacy, there was a weak correlation among the three groups. The mixed group did not tend to be ineffective, while the lauromacrogol group tended to be ineffective 6 and 12 months after treatmen.the difference was statistically significant (adjusted standardized residual >2). According to the total effective (cure+ markedly effective) and ineffective classification, the effective rate of the mixed group was significantly higher than that of the lauromacrogol group ( P<0.016 7). There was no significant difference for the effective rate between the mixed group and the ethanol group, and between the ethanol group and the lauromacrogol group ( P>0.0167). Conclusions:The retention of ethanol-lauromacrogol mixture in the capsule of sclerotic OEC, after pre-rinsing with anhydrous ethanol is helpful to improve the curative effect of OEC and give full play to the therapeutic effect of common sclerosing agents used in ultrasound intervention.

Objective To investigate the extubated timing in acute severe organophosphorus pesticide poisoning patients.Methods Seventy-five patients with mechanical ventilation for acute severe organophosphorus pesticide poisoning were divided into early group (34 cases) and late group (41 cases) by extubation time.Mechanical ventilation time,ICU retention time,tracheal intubation time,ventilator-associated pneumonia (VAP) incidence and extubation success rate of both groups were observed.Results The mechanical ventilation time,ICU retention time between two groups showed no significant difference [(110.66±28.59)h vs.(114.47±34.21)h,(140.63±28.52)h vs.(138.44±34.74) h,P＞0.05].The tracheal intubation time in late group was significantly longer than that in early group [(135.27 ± 28.84) h vs.(119.03 ± 35.05) h,P ＜ 0.05],but the VAP incidence was nostatistically significant difference between two groups [29.27％ (12/41) vs.20.59％ (7/34),P ＞ 0.05].The success rate of extubation in late group was significantly higher than that in early group [97.56％ (40/41) vs.79.41％ (27/34),P ＜ 0.05].Conclusion Delayed extubation can significantly improve the chances of successful extubation,and no increase in VAP risk and more secure in acute severe organophosphorus pesticide poisoning patients.

Objective To study the estimated value on normal reference ranges of inferior vena cava (IVC) Doppler indices from gestation 16 to 40 weeks of fetus with color ultrasound.Methods Seven hundred and forty-four single birth gravida with gestation 16 to 40 weeks were grouped according to the gestational weeks with 27-35 cases each.The IVC Doppler indices were measured by color ultrasound,including preload index,peak velocity index and pulsatile index.Results All IVC Doppler indices rapidly declined from gestation 16 to 24 weeks,and they were relatively constant or slightly decreased throughout the end of pregnancy.Conclusions To set up the normal reference ranges of IVC Doppler indices for gestation from 16 to 40 weeks means a lot for every pregnant.This normative data may be a useful noninvasive tool for evaluation of fetal cardiac function.

Background and purpose:Resistance to antitumor agents is a major cause of treatment failure in patients with breast cancer. Research has shown that, tumor stem cell marker aldehyde dehydrogenase 1 (ALDH1) is related with some anticancer drugs (such as cyclophosphamide, cisplatin) resistance, and the content of ALDH1 in tumor cells after treatment is higher than that before treatment. Breast cancer resistance protein (BCRP) is not expressed in normal tissues, but high expressed in breast cancer of after treatment, it may be associated with the mechanism of tumor drug resistance. This study was to investigate the correlation between expression and the relationship between these two kinds of protein ALDH1, BCRP and clinical pathological characteristics. Methods:Immunohistochemistry was performed to detect the expression of ALDH1 and BCRP in breast inifltrating ductal carcinoma tissues, and whether there is a correlation between and explore their relationship with clinical pathological features and their expression. Results:The expression of ALDH1 protein and BCRP protein in breast cancer and paracarcinoma breast tissues has signiifcant difference(χ2=14.685, P=0.000;χ2=12.243, P=0.000).The expression of ALDH1 with patients age, pathologic stage, axillary lymph node metastasis, histological grading, ER, PR, and HER-2 state were not relevant(P>0.05). HER-2, BCRP protein, expression was higher in cancer tissue (χ2=5.289, P=0.021). There were no relevant with the expression of BCRP with patients age, pathologic stage, axillary lymph node metastasis and histological grading, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER-2) (P>0.05). Conclusion:ALDH1 proteins may be an independent factor compared with occur drug resistant protein, and participate breast cancer drug resistance in the chemotherapy and tumor invasion and metastasis of malignant biological behavior.