Objective To study the effect of bacillus licheniformis and live combined bifidobacterium and lactobacillus on chemotherapy-induced diarrhea (CID). Methods Seventy-two gastric cancer patients with CID were collected and the clinical data were analyzed retrospectively. The patients were divided into 4 groups according to different treatment methods with 18 cases each. The patients in group A were treated with montmorillonite powder, the patients in group B were treated with montmorillonite powder and bacillus licheniformis, the patients in group C were treated with montmorillonite powder and live combined bifidobacterium and lactobacillus, and the patients in group D were treated with montmorillonite powder, bacillus licheniformis capsule and live combined bifidobacterium and lactobacillus. The patients with severe diarrhea in 4 groups were treated with rehydration, maintaining water and electrolyte balance and nutritional support. The Karnofsky performance scale score (KPS score), diarrhea grading before and after treatment and treatment effect were recorded. Results The KPS score after treatment in group A, group B, group C and group D were significantly higher than that before treatment: (70.6 ± 10.6) scores vs. (62.2 ± 12.2) scores, (76.1 ± 7.8) scores vs. (61.7 ± 9.9) scores, (77.2 ± 7.5) scores vs. (61.1 ± 10.8) scores, (83.9 ± 5.0) scores vs. (63.9 ± 10.9) scores. Moreover, The KPS score in group B, group C and group D were significantly higher than that in group A, the KPS score in group D was significantly higher than that in group B and group C, and there were statistical differences (P<0.05). The diarrhea grading after treatment in 4 groups were improved compared with that before treatment. Furthermore, the diarrhea grading in group B, group C and group D were significantly better than that in group B and group C, and there were statistical differences (P<0.05). In group A, there were 2 cases with excellent effect, 10 cases with effect and 6 cases with no effect;in group B, there were 8 cases with excellent effect, 8 cases with effect and 2 cases with no effect;in group C, there were 7 cases with excellent effect, 9 cases with effect and 2 cases with no effect; in group D, there were 9 cases with excellent effect, 9 cases with effect and 0 case with no effect. The treatment effect in group D was significantly better than that in the other 3 groups, and there were statistical differences (Hc = 10.81, P<0.05). Conclusions Bacillus licheniformis and live combined bifidobacterium and lactobacillus is more effective in the treatment of gastric cancer patients with CID.

BACKGROUND: Mesenchymal stem cells (MSCs) have the abilities of self-renewal, multidirectional differentiation and immunomodulation, and have become the focus of current research. OBJECTIVE: To summarize the immunomodulation of MSCs to different immune cells and the clinical applications of MSCs in the treatment of immune-related diseases. METHODS: The first author searched the PubMed and the CKNI databases for relative articles from January 1974 to December 2016. The key words were mesenchymal stem cells, immunomodulation, MSC1 and MSC2, autoimmune diseases in English and Chinese, respectively. Finally, 52 representative articles were included. RESULTS AND CONCLUSION: MSCs can inhibit the function of T lymphocytes, reduce the activation, proliferation and antibody secretion of B lymphocytes, affect the polarization of macrophages, inhibit the maturation of dendritic cells, inhibit the proliferation and toxicity of NK cells, so MSCs have the great potential in the treatment of immune-related diseases. However, MSCs exhibit the opposite immunomodulatory abilities under different inflammatory microenvironments, and moreover the definite and controllable mechanism of this phenomenon is still unclear, Therefore, future investigations may focus on the specific mechanism of MSCs in the clinical treatment of immune-related diseases.

OBJECTIVE:To investigate the current situation of unreasonable prescriptions in outpatient and emergency depart-ments of our hospital,and to provide reference for rational drug use in the clinic. METHODS:The evaluation of outpatient and emergency prescriptions in our hospital during 2013-2015 were summarized and analyzed. Irrational prescriptions were divided into 3 categories,involving 19 items. The main,secondary and general factors of irrational prescriptions were analyzed by Pareto chart. RESULTS:Among 19 types of irrational prescriptions,main factors included unsuitable drug selection,inappropriate usage and dosage,inappropriate drug combination,prescribing not in accordance with the antibiotics management regulations,incomplete di-agnosis. No indications of medication,drug dosage beyond the regulations ofthree urgent seven slowwere treated as the second-ary factors. Other 12 items were general factors. CONCLUSIONS:According to the main and secondary irrational drug use types, clinical pharmacists should carry out effective intervention and pharmaceutical care to improve the level of rational drug use and en-sure the safety of clinical drug use.

Objective To observe the effect of acupuncture plus acupoint injection on the hyperhomocystinemia in the convalescent stage of cerebral infarction patients.Method A total of 120 patients in the convalescent stage of cerebral infarction with hyperhomocystinemia were randomized into group A, group B, and group C, 40 cases in each group. The three groups were intervened by conventional western medicine treatment and rehabilitation therapy, the group A was byXing Nao Kai Qiao acupuncture treatment in addition, the group B was by acupoint injection with cobamamide for injection and the group C was byXing Nao Kai Qiao acupuncture plus acupoint injection treatment. The change of the plasma homocysteine (HCY) level, the Barthel Index (BI) score and National Institutes of Health Stroke Scale (NIHSS) score were observed before and after treatment.ResultEach index(the HCY level, BI score and NIHSS score) in the three groups was significantly changed after treatment(P<0.01). Each index in the group C was significantly different from that in the group A and group B after treatment(P<0.05,P<0.01). The HCY level of the group B after the treatment was significantly different from that of the group A.Conclusion Acupuncture plus acupoint injection can significantly change the HCY level of the convalescent stage of cerebral infarction patients with hyperhomocystinemia, improve the activity of daily living and nerve function.

Objective To evaluate the predictive value of Wells score combined with D-dimer in the diagnosis of acute pulmonary embolism.Methods A total of 540 patients with suspected pulmonary embolism admitted from 2008 to 2011 were enrolled for study.The diagnosis of pulmonary embolism (PE) was confirmed by using computed tomography pulmonary angiography (CTPA).These patients were divided into two groups:PE group and non-PE group.Comparative analysis was carried out in demographics,underlying diseases,chief complaints,physical signs,venous thrombosis risk factors,laboratory findings and Wells scores between the two groups.Results Of 502 patients selected into this study,there were 246 in PE group and 256 in Non-PE group.The incidence rates of history of recent surgery or bed-ridden,recent fracture of pelvis or lower limb,symptoms of hemoptysis,transient disturbance of consciousness,signs of unilateral lower limb swelling,hypoxia and hypocapnia of arterial blood gas analysis,elevated levels of D dimer,high Wells score in PE group were significantly higher than those in non-PE group (P ＜ 0.05).And there were no statistical difference in other variables found between the two groups.The areas under the ROC curve of Wells score,D-dimer and the combination of the two were 0.775 (95％ CI:0.719-0.831),0.802 (95 ％ CI:0.751-0.853) and 0.899 (95 ％ CI:0.834-0.964),respectively.And the area under the ROC curve of the combination of the two was greater than that of separated application (P ＜ 0.05).When the cut-off value of Wells score was 5 and D-dimer was 1 724 μg/L,the weighted maximum sensitivity and specificity were reached,and these cut-off values were higher than above determined values,the reliability of the diagnosis of PE was obviously increased,and those were lower than these cut-off values,the reliability of excluding PE was also increased.Conclusions Wells score combined with D-dimer showed a higher value in predicting acute pulmonary embolismthan than their separated application.

Objective To analyze the epidemic situation of human brucellosis in Qinghai Province,in order to provide a theoretical basis for prevention and treatment of the disease.Methods Xining city,Ping'an,Haiyan,Tianjun,Jiuzhi,Henan and Dari Counties were selected as monitoring counties(city) in Qinghai Province,and three or four townships(towns) were selected as monitoring points in each county.People aged from 6 to 60 closely contacted with livestock were monitored.The methods of rose bengal plate agglutination test(RBPT) and standard tube agglutination test(SAT) were used for serological testing.Results A total of 4 331 people from 6 counties and 1 city were examined for brucellosis,and 225 people (by RBPT) of them were serologically confirmed with a positive rate of 5.19％.SAT positive 63 people,the average positive rate was 1.45％.Two hundred and twenty-five people were infected and the average infection rate was 5.19％.Fifty-six new cases were discovered.Conclusion Human brucellosis has increased in Qinghai Province,effective prevention and cure should be adopted to prevent its outbreak.

Objective To evaluate the status of self-efficacy and its influencing factors in adult patients with low vision,then explore an effective approach to improve their self-efficacy levels.Methods Seventy adult patients with low vision were sampled by random number table method.General social-demographic questionnaire and self-efficacy questionnaire were used to investigate these patients' general information and self-efficacy.Seventy pieces of questionnaires were issued and returned with the valid rate of 100％.Results The total score of self-efficacy in seventy adult patients with low vision was(16.25:±:1.93) points,92％ of patients had a low level of self-efficacy.The influencing factors of self-efficacy in adult patients with low vision were the attitude toward disease,mental status and gender.Conclusions The selfefficacy in patients with low vision was affected by many factors at different levels,so we should focus on main influencing factors to adopt corresponding nursing measures in order to improve self-efficacy of adult patients with low vision.

Objective To track superparamagnetic iron oxide (SPIO)-labeled pancreatic islet cells in rats using 3.0T magnetic resonance imaging (MRI), and to detect the survival and rejection of grafts after transplantation. Methods Twenty male Wistar rats and 5 male Lewis rats were included in the study. SPIO-labeled pancreatic islet cells were tracked using a GE 3.0T Signa Excite MRI scanner with an animal coil. The images of SPIO-labeled islet cells in rats after transplantation were compared with those of the unlabeled ones. FSE T2WI sequence and GRE T2*WI sequence were used for the detection. The sensitivity of images for detection of grafts was also compared. SPIO-labeled pancreatic islet cells isolated from Wistar and Lewis rats were transplanted into the liver of Wistar rats. Afterwards, the survival and rejection of islet cells were observed sequentially in these two growps. The rats in the syngeneic group were sacrificed 3 months post-transplantation, while the rats in the allogeneic group were sacrificed 3 weeks post-transplantation. MRI of the grafts were correlated with the pathological results. Results SPIO-labeled pancreatic islet cells were seen on MRI as distinct homogenous, hypointense spots in the liver. GRE T2*WI were more sensitive to the detection of SPIO-labeled islet cells than FSE T2WI. The relative count of hypointense spots in the syngeneic group were (90.03±9.52)%, (92.87±18.21)% and (86.25±24.81)%, respectively at 1 week, 2 weeks and 3 weeks after transplantation, while the relative count in the allogeneic group were (41.40±15.41)%, (33.41±14.01)% and (23.58±16.78)%, respectively. The difference between these counts was statistically significant (P<0.01). Iron particles were detected only in the SPIO-labeled cells. Three months post-transplantation, the grafts were found well-preserved in the liver of the rats of the syngeneic group, while only a few grafts were found in that of the allogeneic group. Conclusions MRI can be used to track SPIO-labeled islet cells in vivo, and has significant value in detecting the survival and rejection of grafts after transplantation in rats.

Objective To evaluate the sensitivity and specificity of prenatal ultrasound for detecting fetal cleft lip and palate,and the diagnosis rate of associated congenital structural and chromosomal abnormalities.Methods Thirty one thousand two hundred and forty five singleton pregnant women accepted prenatal examination and delivered in Guangzhou Women & Children' s Medical Center from Jan.2006 to Dec.2010 were recruited in this study.All pregnant women underwent prenatal ultrasound screening during second trimester,and whose fetuses were suspected to be cleft lip and palate were suggested to accept karyotype analysis.All babies delivered received oral examination to diagnose cleft lip and palate.Results Cleft lip and palate was diagnosed in 48 cases (1.5‰,48/31 245).Among which,there were 16 cases (33.3％,16/48) of cleft lip,21 cases (43.8％,21/48) of cleft lip with cleft palate and 11 cases (22.9％,11/48) of cleft palate.Prenatal ultrasound screening suggested 18 cases of cleft lip and 14 cases were comfirmed after birth with the accuracy rate of 77.8％,3 cases were diagnosed to be cleft lip with cleft palate and one cases was misdiagnosed.Prenatal ultrasound screening suggested 18 cases of cleft lip with cleft palate in accordance with the diagnosis after birth.Thirteen cases were normal in prenatal ultrasound screening,but two were diagnosed as cleft lip and 11 were diagnosed as cleft palate after birth.The sensitivity of prenatal ultrasound screening for cleft lip and cleft lip with cleft palate was 86.5％(32/37),and the sensitivity for cleft lip and palate was 66.7％ (32/48),the false positive rate was 2.1％ (1/48).Ten cases (27.8％,10/36) of cleft lip with cleft palate were found to be complicated with other abnormalities.Nine of the 18 cases prenatally diagnosed cleft lip with cleft palate accepted karyotype analysis and 7 were abnormal.Twenty-three of 36 cases with fetal cleft lip and palate in prenatal ultrasound screening were induced.Conclusions Ultrasound screening has a high sensitivity for detection of cleft lip with or without cleft palate,but difficult to detect cleft palate.The risk of combining with chromosomal defects in cleft lip fetus is very low,but might increase once associated with cleft palate.

Sudden sensorineural hearing loss (SSHL),which is a common and frequently encountered disease,is considered to be a medical emergency in otolaryngology.The prevalence of SSHL is increasing in China.The pathogenesis of SSHL is not clear yet.Microcirculatory disorder of inner ear is considered as one of the most important causes of SSHL.In recent years,several reports have found the levels of serum lipids were changed in patients affected by SSHL.The relationship between SSHL and serum lipids was reviewed to provide new ideas for the diagnosis and treatment of SSHL.