Objective To support a reasonable and standard TCM treatment principle for advanced non-small-cell lung cancer (NSCLC) by exploring TCM syndrome features in NSCLC patients with factor analysis. Methods 105 cases of advanced NSCLC patients,who were admitted to the hospital after 1st January,1998 from 18 to 75 years old,were studied retrospectively with factor analysis of the data. Results According to analysis and synthesis of tongue,pulse and symptoms,the deficiency of qi and yin (37.14%) and the stagnation of phlegm and blood stasis (39.05%) were the major syndromes when advanced NSCLC was diagnosed. Conclusion One of TCM intervention treatment principles for NSCLC,which includes invigorating qi and yin,promoting blood circulation and removing blood stasis,regulating the flow of qi and resolving phlegm,is proposed to instruct the application of herbs,Chinese traditional patent medicines or injections in integration treatment and stage treatment for improving quality of life and elongating survival period.

Objective To investigate the effects of Compound Zhe Bei granule (CZBG) combined with doxorubicin on the expression of GST and Topo - Ⅱ in K562/A02 cell line multidrug resistance tumor xenografts in mice. Methods Tumor xenografts model was established by injecting the multidrug resistance cell line K562/A02 in the axillary flank of BALB/c - nu - nu mice. Drug - comgbination of CZBG intragastric administration and doxorubicin intraperitoneal injection ( i. p. ) was given to the BALB/c - nu nude mice. The tumor xenografts were made into slice after the dissection, and the expression of GST and Topo - Ⅱ in K562/A02 tumor xenografts in mice was investigated by immunohistochemical technique. The integral optical density (IOD) of GST and Topo- lⅡ in K562/A02 tumor xenografts was measured by Image ProPlus 6.0. Results Compared with the single treatment of doxorubicin i. p group,the combination of the doxorubicin and CZBG with dosage classified by three types( high, middle, low) can decrease IOD of GSH and Topo - Ⅱ in K562/A02 tumor xenografts with statistical significance( P

Objective To investigate the change of Th22 cells in the peripheral blood of the patients with primary biliary cirrhosis (PBC) and evaluate its clinical significance. Methods The proportion of Th22 cells in the peripheral blood of PBC patients and healthy controls were evaluated by flow cytometry. The cytokine IL-22 of each group was measured by ELISA and ALT, AST, GGT, TBIL and CRP were measured by Automatic biochemical analyzer. The proportion of Th22 cells correlation with IL-22 , ALT, AST, GGT, TBIL and CRP were analyzed. Results The proportion of Th22 cells was higher in PBC patients than healthy controls (P < 0.05), Moreover the frequency of Th22 was increased in PBC patients with liver cirrhosis than in PBC patients with liver non-cirrhosis (P < 0.05). The level of IL-22, ALT, AST, GGT, TBIL and CRP were increased in PBC patients (P < 0.05). Moreover Th22 frequency of peripheral blood was positively associated with IL-22, ALT, AST, GGT and CRP (P < 0.05). Conclusion Th22 may be involved in the pathogenesis of and it is a potential therapy target for PBC.

English training is important for young doctors＇ career development in general hospital.The stagewise English training mode of Beijing Tiantan Hospital of Capital Medical University was introduced.By summarizing the experience of five years trial,viewpoints were brought forward that hospital English training in radiological department of general hospital should adopt a stagewise mode,create an English communication atmosphere,show the special feature of department and combine with clinical daily work.

Objective To explore the new operation method and clinical effect of treating degloving injuries of the whole thumb.Methods Nine cases of the whole thumb degloving injury caused by machine were treated with free wrap-around flap from the big toe and the flap from the opposite foot.The phalanges,joints and tendons of all injured thumbs were integral relatively,except that the interphalangeal joints in 3 cases were destroyed and the flexor and extensor pollicis longus were ruptured.The size of the dorsal tissue defects varied from 4.8 cm × 2.9 cm to 6.2 cm × 3.4 cm,and the volar tissue defects ranged from 4.7 cm × 3.2 cm to 6.1 cm × 4.0 cm.The area of the wraparound flap from the big toe harvested was from 5.0 cm × 3.2 cm to 6.7 cm × 3.9 cm.The flap from the opposite foot was tibial flap with dorsalis pedis flap from the opposite second toe,and the area of the flap was from 5.0 cm × 3.5 cm to 6.6 cm × 4.5 cm.Results All 9 combined flaps survived.The wound healed primarily.Skin grafts in the donor sites of the foot also survived.Postoperative follow-up ranged from 6 to 20 months,with an everage of 9 months.The pulp of the thumb was well-stacked.Sensory recovery ranged from S3 to S3 +.Thumb nail grew well.Thumbs performed good functions as grabbing,grasping and nipping.The range of motion of the MP joints of the reconstructed thumb was normal.The motion of interphalangeal joints were acceptable in 6 cases,but worse than the normal thumb.The interphalangeal joint in 3 cases destroyed was fused.There was no obvious influence on the function of the foot.Conclusion Applying combined wrap-around flap from the big toe with the tibial flap and dorsalis pedis flap from the opposite foot in treating degloving injuries of the whole thumb is a new operation method,which could achieve good appearance and function,but have a small influence on the donor site.It is worthy being used widely in clinical.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism ( PHPT) initially with urinary calculus .Methods The clinical data of 26 patients who diagnosed as PHPT ini-tially with urinary calculus were retrospectively reviewed .Results There were 22 cases with bilateral urinary calculus and 4 cases with unilateral relapsed urinary calculus .Ultrasonography , CT and radionuclide were helpful to determine the location of the neoplasia .24 cases underwent percutaneous nephroscope or ureteroscopy pneu-matic ballistic lithotripsy , 2 cases discharged ureteral calculi by themselves .All patients were performed surgical treatment of PHPT , which was confirmed by intraoperative frozen pathology and postoperative pathological exami -nation.There was great improvement of clinical symptoms after surgical procedures .The preoperative serum calci-um, urine calcium and parathyroid hormone elevated , while serum phosphate decreased .The postoperative indi-cators were just the opposite .The difference had statistical significance ( P<0.05 ) .Conclusions Laboratory investigations and imaging studies are very important to diagnose PHPT initially with urinary calculus .The para-thyroid surgery can remarkably reduce the calculus recurrence and improve renal function .

Objective:To understand the effect of a new tracheal tube fixation device in the "double fixation" of oral tracheal intubation for critically ill patients in adult emergency department.Methods:A retrospective analysis of patients with oral tracheal intubation admitted to our EICU from January 2016 to June 2017 was performed using traditional tape and inch band fixation as a control group; the experience of treatment from July 2017 to December 2018 for patients with oral tracheal intubation, the new double-fixation method of tracheal tube fixation device was used as the observation group. The degree of displacement, oral cleanliness, facial skin allergies and injuries, and comfort of the two groups of patients was compared.Results:The rate of tracheal displacement in the experimental group was mildly 11.2% (11/98), moderately 5.1% (5/98), and the control group was mildly 24.2% (15/62), moderately 14.5% (9/62) and severe 6.5% (4/62). The incidence of facial skin allergy and skin damage was 6.1% (6/98), 0, and the control group was 24.2% (15/62), 11.3% (7/62), the difference was statistically significant ( Z value was -4.021, χ2 value was 24.48, P<0.05). The comfort score of the test group was (1.05±1.01) points, which was significantly higher than (2.10±1.71) points of the control group ( t value was 4.920, P<0.01). Conclusions:The new type of tracheal tube fixation device "dual fixation" for critically ill patients with mechanical ventilation through oral endotracheal intubation is visually beautiful, and has good firmness and comfort. It can effectively reduce the occurrence of adverse events and has good application value.

Objective To evaluate the repair of perforated fingers using complex tissue transplantation of articulated second toe.Methods From July 2001 to January 2008, complex tissue grafts of articulated second-toe with blood supply were used to repair 14 cases of perforated finger defects, 11 males and 3 females.Their average age wag 25.4 years old.Using the proximal interphalangeal joint of the second toe, total joint transplantation was conducted in 5 cases and half joint transplantation in 3 cases.Using the metatarsophalangeal joint of the second toe, total joint transplantation was performed in 2 cases and half joint transplantation in 4 cases.Results Primary healing of the grafted complex tissues was achieved in 13 cases, though partial necrosis of skin flap was observed in 1 patient with a defect at the metacarpophalangeal joint of the little finger, whose wound healed after change of dressings.In the other cases, followed up for 6 to 15(average, 11)months, the grafts had satisfying appearance and fine healing of joints.No nonunion, bone deformity or degeneration of joints was present.Finger functions were favorably recovered, and finger to finger activity was achieved.According to the criteria for hand functions by Chinese Medical Association, 4 cases were excellent, 6 fine, and 4 fair.Conclusion Repair of perforated fingers using composite tissue grafts of the second toe is a one-off repair of defects of bone, joint, tendon, skin and other tissues, providing fine rehabilitation for each subtle defect and maximizing functional recovery of injured fingers.

Objective To report a familial dentinogenesis imperfecta type Ⅱ (DGI type Ⅱ) with a novel splicing mutation in DSPP (dentin sialophosphoprotein) gene.Methods Based on the result of linkage analysis performed previously to map the candidate gene DSPP in the family, the promoter,the first four exons and exon-intron boundaries of DSPP were directly sequenced for the members of the DGI type Ⅱ family. Denaturing high performance liquid chromatography (DHPLC) analysis was performed to confirm the results of sequencing.Results A novel splicing mutation of 23 bp deletion in intron 2 of DSPP gene was identified by DNA sequence analysis. The mutation changed acceptor site sequence from CAG to AAG, and might result in functional abolition of possible branch point site in intron 2. DHPLC result was consistent with that of sequencing. The mutation may be identified in all affected individuals, but not found in normal members of the family and 50 controls.Conclusion These results suggest the deleted mutation of DSPP gene causes DGI type Ⅱ in the family. The mutation has not been reported before.

Objective To evaluate the clinical effects of free dorsalis pedis flap on the repair of two skin and soft tissue defects in hand. Methods From February 2003 to February 2009, free dorsalis pedis flap was used to repair two skin and soft tissue defects in 11 patients. Six cases were males and 5 females.Two was used the hand skin and soft tissue defects in 4 cases; back of the hand skin and soft tissue defect with the middle finger proximal palmar skin and soft tissue defect in 1 case, the hand ripped through injury to the back of the hand of the hand ripped through skin and soft tissue defects in 3 cases, were cut flap:proximal flap 3 cm× 3 cm-8 cm × 7 cm, distal flap 4 cm × 2 cm-6 cm × 5 cm. Foot for the area will adopt the lower abdominal full-thickness skin grafting. Results Uniform flap survival period of the wound healing class, foot skin graft donor sites were successfully survived. Ten patients were followed up from 6 to 19 months, with an average follow-up of 9 months. Follow-up flap fine texture, appearance of natural, nonbloated, feeling to restore S2-S3, hand function recovered satisfactorily, for the district of foot healed well without ulceration and ulcer formation,had no effect on walking function. Conclusion The dorsalis pedis flap for hand two series of skin and soft tissue defects, with design flexibility, excellent texture flaps, etc., is to repair the hand skin and soft tissue defects of the two better way.