Objective To evaluate the impact of sub-stage on the clinical prognosis of T 1 G3 and evaluate the feasibility of the T1me system in pT1G3 sub-staging.Methods The clinical data,pathological specimen and follow-up data were collected from 56 patients out of 87 patients diagnosed with initial high-grade T1 bladder urothelial carcinoma .The patients were divided into Group A [ T1-microinvasive (T1m),17 cases] and group B [T1-extensive-invasive (T1e),39 cases] according to pathological evaluation after transurethral resection.Clinical parameters were analyzed with Chi-square test,and recurrence-free and progression free survival were obtained by Kaplan-Meier analysis and Log-rank test.Results Age,tumor size,number and intravesical instilled medication showed no significant differences between the 2 groups ( P>0.05 ) .There were significant differences of 5-year recurrence-free rate ( P =0.037 ) and progression-free survival rate ( P =0.045 ) between the 2 groups, and the prognosis of group A was significantly better than that of group B .Conclusion The pathological sub-stage is an important predictor in initial high-grade T1 bladder urothelial carcinoma patients , and the T1me system is objective and feasible.

Objective To elucidate significance of hyperintense vessel signs(HVS)on FLAIR MRI in patients with cerebral infarction. Methods Two hundred and sixty-two patients with cerebral infarction admitted in our hospital were included in this study. We retrospectively defined HVS on FLAIR MRI in these patients in comparison with time of flight(TOF)on MR angiograms(MRA), hyperintense lesions on diffusion-weighted images(DWI). Results HVS on FLAIR MR[were identified in 117 patients with cerebral infarction(45.4%), of which 47 patients(83.9%)were obtained within 24 hours of symptom onset. HVS on FLAIR MRI were detected in 74 patients at sylvian fissure(62.2%), 11 at cortical sulci (9.2% ,11/119),34 at the posterior circulation regions(28.6% ,34/119). HVS on FLAIR MRI coincided well with ischemia of TOF on MRA and lesion patterns on DWI (χ2 test,P<0.01, respectively). Conclusion HVS on FLAIR MRI is helpful to evaluate abnormal major cerebral arteries of patients with cerebral infarction.

To study the effects of puerarin on the aromatase P450 (P450(arom)) mRNA expression and the effects of low-dose puerarin on transcription factors of the P450(arom) gene (P II) 5'-flanking region.

Objective·To investigate correlation of serum acute amyloid A (A-SAA) level and activity of Behcet's disease (BD).Methods·Blood samples from patients with active BD (n=40),remission BD (n=15),Takayasu disease (TA,n=12),rheumatoid arthritis (RA,n=25),systemic lupus erythematosus (SLE,n=25) and healthy donor (HD,n=25) were collected.Serum A-SAA,ESR,and CRP levels were detected and compared among groups.The correlation between A-SAA and its downstream IL-8 or International Society for Behcet's disease (ISBD) disease activity scores was analyzed as well.Results·Serum A-SAA level was significantly increased in the patients with active BD [(115.70±87.78) mg/L],as well as patients with RA and TA,which levels were (68.72±61.50) mg/L and (96.25±87.41) mg/L respectively,but remained unchanged in SLE patients.Moreover,serum A-SAA level was found correlated with ISBD score as well as IL-8 level.Conclusion·A-SAA can work as a detection index for evaluating BD activity.

Objective To observe the clinical effect of acupuncture combined with vibroacoustic therapy on upper limb spasticity post stroke. Methods From November, 2014 to November, 2015, 90 patients with upper limb spasticity post stroke were randomized into treat-ment group (acupuncture combined with vibroacoustic therapy), control 1 group (simple vibroacoustic therapy) and control 2 group (simple acupuncture) with 30 cases in each group. All the patients accepted routine fundamental treatment and rehabilitation training. The modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were used to assess the upper limb muscle ten-sion, motor function and activities of daily living before and four weeks after treatment. Results After treatment, MAS score decreased in all groups (Z>3.067, P<0.001), and FMA score and MBI score increased (t>3.326, P<0.01). MAS score decreased more (Z>2.919, P<0.01), and FMA score and MBI score increased more (P<0.05) in the treatment group than in the control groups after treatment. However, there was no significant difference between the control groups (P>0.05). The total effective rate was 80%in the treatment group, 50%in the control group 1 and 53%in the control group 2 (χ2=8.573, P=0.014), respectively. Conclusion Acupuncture combined with vibroacoustic therapy can alleviate the upper limb spasticity, and promote the recovery of motor function and activities of daily living.

Objective To explore the effects of proton pump inhibitors (PPIs) therapy on esophageal acid exposure of patients with gastroesophageal reflux disease(GERD),and the correlation of anxiety and depression with recurrence of acid-related symptoms after discontinuation of PPIs.Methods From February 2010 to June 2011,28 patients with GERD diagnosed by ambulatory 24 h esophageal pH monitoring admitted to Beijing Jishuitan Hospital were treated with esomeprazole 20 mg 2 times/d for 8 weeks (male 16,female 12).Symptoms after drug discontinuation were monitored.Ambulatory 24 h esophageal pH monitoring was performed on patients,whose symptom recurred within 8 weeks after treatment.BMI,Self-rating Anxiety Scale(SAS),and Self-rating Depression Scale (SDS) were detected.Results Among the 28 patients with GERD,15 (53.6％) recurred symptoms after withdraw of PPIs.Compared with the asymptomatic group after withdraw of PPIs,the pretreatment duration of pH 4 (supine),24 h total acid reflux time,number of time periods with acid reflux ＞5 minutes,the maximal acid reflux time and 24 h total number of acid reflux in the symptomatic recurrence group were statistically significantly increased ( 11.7％vs 4.5％,138.8 minutes vs 62.1 minutes,6.0 vs 2.0,27.0 minutes vs 12.4 minutes,74.0 times vs43.0times,respectively,all P values ＜ 0.05 ).There were no significant differences in BMI,SAS and SDS between the two groups.Conclusions The basic level of esophageal acid exposure of patients with GERD before PPIs therapy may influence the esophageal acid exposure after PPIs therapy and then may affect the recurrence of symptoms.Although anxiety and depression is common in patients with GERD,it is not found that the recurrence of acid-related symptoms after the discontinuation of PPIs therapy is related to the anxiety and depression.

Objective To analysis the result of tumor screening for health examination participants.Methods Tumor screening was applied for 15 863 health examination participants without malignant tumor disease history.Clinical examination,laboratory tests and imaging studies were comprehensively analysed combining the results of other medical items.The cancer detection rate and asymptomatic rate were compared among groups of different age,gender and existence of relevant clinical symptoms,respectively.χ2 test and Fisher exact test were adopted for statistical analysis.Results Among 475 tumor patients with a definite diagnosis,116 were malignant tumor;The total detection rate of the group who were younger than 35 year-old(0.617%)was higher than other groups,the detection rate of intracranial neoplasms of the two groups who were younger than 45 year-old (0.206% and 0.132%,respectively)was higher than other groups,the total detection rate of 75-85 group (0.248%)was lower than other groups; The detection rate of lung cancer,liver cancer of the male(0.228% and 0.080%,respectively)was higher than the female,The detection rate of breast cancer and intracranial neoplasms of the female(0.366% and 0.100%,respectively)was higher than the male; There are 67 patients without correlated clinical symptoms,the asymptomatic rate was 57.8%.Conclusions Tumor screening was of importance in health management,which should be carried out actively in health examination.

Objective To explore the efficacy and safety of dyclonine hydrochloride mucilage applied as a lubricant for orotracheal intubation. Methods A prospective study was conducted,144 patients with respiratory failure(RF)and clear consciousness admitted into Emergency Department of Xingtai People's Hospital in December 2010 to June 2013 for orotracheal intubation were randomly divided into experimental and control groups(each, 72 cases). Topical spray anesthesia onto the throat wall was applied for all the patients before orotracheal intubation. In the experimental group,the patients received 1%hydrochloric acid dyclonine mucilage as a lubricant,while in the control group,they received paraffin oil as a lubricant before the insertion of tracheal tube. The operating procedure of the insertion was in accord to the rules of orotracheal intubation in both groups. The changes of heart rate,systolic blood pressure,diastolic blood pressure,pulse oxygen saturation(SpO2),success rate of once tracheal intubation,incidence of choking cough,the time of tracheal intubation and dyclonine adverse reactions were observed. Results The heart rate,systolic and diastolic blood pressures were significantly higher and SpO2 was obviously lower after the intubation in both groups than those before the procedure,and the changes were more significant in the control group〔heart rate(bpm):135.2±9.9 vs. 98.1±8.1,systolic blood pressure(mmHg,1 mmHg=0.133 kPa):145.6±20.8 vs. 138.8±22.1,diastolic blood pressure(mmHg):96.1±17.6 vs. 82.9±22.8,SpO2:0.643±0.128 vs. 0.749±0.102, all P<0.05〕;the success rate of once tracheal intubation in experimental group was significantly higher than that in the control group〔98.6%(71 cases)vs. 84.7%(61 cases),P<0.01〕,the incidence of choking cough was obviously lower than that in the control group〔36.1%(26 cases)vs. 52.8%(38 cases),P<0.05〕,the time for insertion of tracheal tube in experimental group was also significantly shorter than that of control group(minutes:1.9±0.9 vs. 2.3±1.1,P<0.05). No drug adverse reactions occurred. Conclusion Compared with paraffin oil,dyclonine hydrochloride mucilage as a lubricant for tracheal intubation is a simpler and easier operation which has the advantages of having better anesthesia,effectively reducing the irritation of the throat wall,improving the success rate of intubation,being more tolerable by the patients,reducing the adverse reaction rate during insertion of tube and having no occurrence of drug adverse reactions,therefore dyclonine can be applied in tracheal intubation.

Objective To evaluate the efficacy and safety of ureteroscopic endo-incision and drainage in the treatment of renal cysts.Methods Thirty cases(19 females and 11 males)of renal cysts(1 1 parapelvie cysts,15 simple cysts.and 4 multiple cysts)were treated with ureteroscopic endo-incision and drainage.The renal cysts were located in renal pelvis,and opened and decompressed by electrotme with ureteroscope.Double J stent was placed afterwards.Urinary and blood biochemistry were tested post-operatively.Results All the operations were successfully completed with no severe complication.The cyst managing time ranged from 15 tO 45 min.Urinary biochemistry(urinary protein and glucose)turned normal 1 2 days after the surgery.Patients were followed up for 3 to 9 months.Renal cysts disappeared in 24 cases,diminished in 4 cases,and recurred in 2 cases.Conclusion Application of ureteroscopic technique in the treatment of renal cyst is safe,effective and minimally invasive.

Background and purpose:For patients with advanced lung adenocarcinoma harboring an activating EGFR gene mutation, the current standard of care is EGFR-TKI alone. This study aimed to compare efficacy and safety of gefitinib plus chemotherapy with gefitinib or chemotherapy alone for treating advanced lung adenocarcinoma with an activatingEGFR gene mutation.Methods:This study included 61 patients with lung adenocarcinoma harboring an acti-vatingEGFR gene mutation (19 exons deletion and exon 21 L858R mutations) whose ECOG performance status was 0 or 1. Patients were randomly divided into 3 groups. Group A (n=20) were given carboplatin/pemetrexed of a 4-week cycle, six cycles at most, plus gefitinib (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1; gefitinib 250 mg/d, d 5-21), and then re-ceived pemetrexed of a 4-week cycle plus gefitinib as maintenance therapy; Group B (n=20) were given carboplatin/peme-trexed of a 4-week cycle, six cycles at most (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1), then received pemetrexed as maintenance therapy; Group C (n=21) were given gefitinib (gefitinib 250 mg/d). Patients continued to receive therapy until disease progression or unacceptable toxicity or death. The primary end point was middle PFS and 12 months PFS rate. The secondary end points included objective response rate and adverse events.Results:Groups A and C both lost 1 case during follow-up. Median PFS for patients was 20.1 months (95%CI:18.0-22.2) in group A, 5.5 months (95%CI:3.9-7.2) in group B, and 9.8 months (95%CI:6.8-12.8) in group C. PFS rates of 12 months for groups A, B and C were 78.9%, 15.0% and 40.0%, respectively. The overall objective response rates for groups A, B and C were 84.2%, 35.0% and 65.0%, respectively. Serious adverse events were reported by 36.8% for group A, 30.0% for group B, and 5.0% for group C. The most common grade 3/4 adverse events were neutropenia (3 cases in group A, 4 cases in group B), fatigue (2 cases in group A, 2 cases in group B) and liver function impairment (2 cases in group A, 1 case in group C).Conclusion:Among patients withEGFR mutant lung adenocarcinoma, combination of chemotherapy with gefitinib as first-line treatment demonstrates an improvement in PFS. Long-term survival results will be further followed up.