OBJECTIVE: Ventricular reconstruction after myocardial infarction is one of the important dangerous factors to the remote occurrence of cardiac functional disturbance. Chinese medicine is of unique advantages in the main therapeutic principles and methods for the post-infarct ventricular reconstruction.DATA SOURCES: To search for and proofread the relevant literatures on the researches on post-infarct ventricular reconstruction in Nuclear Journals of Chinese Medicine from January 1987 to December 2003 by www. google. com,Medline. Referring word: ventricular reconstruction,myocardial infarction,removing blood stasis and resolving phlegm,clearing heat and nourishing yin.STUDY SELECTION: Fifty-six papers on post-infarct ventricular reconstruction were selected, excluded the original literatures on non-random researches and included the original literatures on non-blind researches.DATA EXTRACTION: Of 56 papers,14 papers were deleted for they were repeated in the contents in different degrees. The rest 42 papers were classified and 12 papers of which were selected as the references.DATA SYNTHESIS: Myocardial infarction is the syndrome in which the root cause is deficiency and the symptoms are excess. The main therapeutic principles are to benefit qi,eliminate stasis,resolve phlegm,activate blood circulation,regulate qi,strengthen spleen,clear away heat and nourish yin. Of which, benefiting qi is the primary of the treatment for the root cause and nourishing yin is the secondary of the treatment for the root cause. Eliminating stasis and resolving phlegm is the primary of the treatment for symptoms,regulating qi and clearing away heat is the secondary of the treatment for symptoms. To benefit qi and activate blood circulation can improve blood dynamics to probably benefit the protection of ventricular reconstruction by reducing ventricular pressure and vascular resistauce of systematic circulation.CONCLUSION: After myocardial infarction, it happens inadaptable myocardial hypertrophy and external stromal accumulation and fibrosis of cardiac muscles. Long-term application of the principles for eliminating stasis,resolving phlegm,clearing away heat and nourishing yin can resist ventricular reconstruction and improve post-infarct cardiac function.

Objective To explore the application effect of PDCA cycles on the normal limb position of stroke patients with hemiplegia. Methods The stroke patients with hemiplegia (128 cases) were selected as study subjects. Patients(62 cases)during January to September 2014 were set as the control group,and received routine nursing care. Patients(66 cases)during October 2014 to July 2015 were set as the experimental group,and used PDCA cycles management on the normal limb position additionally. The application effect of PDCA cycles on the normal limb position was evaluated through comparing two groups with qualification rates of normal limb position and incidence of complications. Results The qualification rates of normal limb position in the control group was 38.71%(24/62), which was higher than that of the control group, which was 75.76% (50/66) (χ2=16.504, P<0.01). The complications occurred in the control group were strephenopodia (11 cases), foot drop (16 cases), dislocation of shoulder (9 cases), omodynia (27 cases) and myospasm (34 cases), and they were 3 cases, 7 cases, 2 cases, 15 cases and 18 cases in the experimental group respectively. The incidence of complications was lower than those of the control group (χ2=4.001-8.961, P < 0.05), and the difference was statistically significant between two groups. Conclusions PDCA cycles management could improve the qualification rates of normal limb position and reduce the incidence of complications, which was beneficial to the recovery of limb function.

Purpose　To inquire into the clinical and pathological features of subcutaneous panniculitis-like T-cell lymphoma. Methods　The histopathology and immunophenotypes of subcutaneous panniculitis-like T-cell lymphoma in 8 cases were observed. Results　Clinically one or more subcutaneous nodules were first found, then the lesion infiltrated up to the epiderm or down to the fascia. Half of the cases were stable for long time without systematic symptoms. The others got high fever with bone marrow, lymphonode involvement, had tumescent liver, and spleen, and decreasing of the counts of thrombocytes or whole blood cells. A few were accompanied with lethal hematophage syndrome. Some rapidly advanced and died less than 3 years. Pathologically, atypical large, midium-size and small lymphocytes with variable ratio rounded the lipocytes like rosettes and were confluent to small patchs or foci or formed a reticular pattern. There were many karyokineses and karyorrhexis made of distinct karyorrhexis bodies. The histocytes reactively proliferated accompanied with phagoerythrocytic phenomena, and polynuclear giant cells and granulomatoid reaction were found. The tumor cells infiltrated in the lipolubules. They expressed T-cell immunophenotype. Conclusions　This tumor is a special type of skin lymphoma involving subcutaneous fat tissue and special clinicophathological features.

Objective To investigate the impact of enhanced recovery after surgery (ERAS) program on postoperative recovery in patients undergoing laparoscopic colorectal resection. Methods Eighty-four patients undergoing laparoscopic colorectal resection from March 201 5 to June 201 6 (55 males,29 females,aged 36-78 years,ASA physical status Ⅰ or Ⅱ),were randomly divid-ed into two groups (n = 38 each).Patients in group E were received epidural block combined with general anesthesia,and a series of perfect ERAS strategies,such as strengthen preoperative educa-tion, maintaining perioperative normothermia, perioperative goal-directed fluid therapy, intraoperative and postoperative analgesia.While the patients in group C received routine anesthetic management.The volume of fluid,the nasopharyngeal temperature,the time of recovery of bouel sound,first anal exhaust,eating fluid food,ambulation and remove of the catheter were recorded in two groups.Furthermore,time of PACU after surgery,the total days of hospitalization and total hos-pital costs were recorded.Results The volume of fluid [(1 328 ± 64)ml vs.(2 463 ± 135 )ml]in group E were significantly lower than group C (P <0.05),the nasopharyngeal temperature [(36.2± 0.2)℃ vs.(35.1±0.5)℃]was significantly higher in group E (P <0.05).Compared with group C,the time of recovery of bowel sound [(33.4 ± 12.5 )h vs.(42.8 ± 14.3 )h],first anal exhaust [(43.6±13.9)h vs.(60.7±1 5.4)h],eating fluid food [(26.8±4.1)h vs.(67.4±13.5)h],first ambulation [(7.4±1.6)h vs.(26.5±3.8)h]and remove of the catheter [(29.2±6.1)h vs.(5 1.8 ±7.6) h ], time of PACU [(26.4 ± 8.5 ) min vs.(37.2 ± 1 1.6 ) min ], the total days of hospitalization [(7.5±0.9)d vs.(9.7±1.2)d]were significantly shorter (P <0.05),and hospital costs [(2.1±0.6)ten thousand yuan vs.(2.6±0.8)ten thousand yuan]were significantly decreased (P <0.05).The incidence of adverse reactions such as nausea and vomiting (2.4% vs.21.4%),pru-ritus (7.1% vs.23.8%),agitation (4.8% vs.26.2%)and chills (0% vs.1 9.0%)were significantly lower in group E (P <0.05).Conclusion ERAS program applied to patients undergoing laparoscopic colorectal resection can reduce the intraoperative sufentanil consumption,avoid the occurrence of postoperative hypothermia, accelerate recovery of gastrointestinal function, which can obviously reduce the hospitalization costs and shorten the hospitalization time.

Objective To evaluate the expression of molecular markers in prostate cancer and to clarify the significance of these markers as prognostic indicators for androgen deprivation therapy. Methods A series of 116 prostate cancer patients under androgen deprivation therapy as a single treatment was reviewed. Expression levels of 7 proteins, including androgen receptor(AR),E-cadherin, Chromogranin A(CgA) , Ki-67, Survivin, EZH2 and hepsin, were measured by immunohistochemical staining. Results Of the 7 molecules. Ki67,EZH2 and Survivin expression were significantly associated with several conventional prognostic factors. Univariate analysis identified clinical stage, Glea-son scores,pretreatment serum PSA level, Ki-67 and Survivin expression as significant predictors for prostate-specific antigen (PSA) progression after endocrine therapy. Of these significant factors, Survivin expression, clinical stage and Gleason scores appeared to be independently related to PSA progression after endocrine therapy by multivariate analysis. Furthermore, there were significant differences in PSA progression-free survival according to positive numbers of these three independent risk factors. Conclusion Survivin could be a useful independent prognostic factor in prostate cancer with endocrine therapy, besides clinical stage and Gleason score.

Objective To investigate the interaction between rifampin(RFP)and levofloxacin(LVFX)in retreatment of smear positive pulmonary tuberculosis(TB). Methods One hundred retreated smear positive TB patients admitted to our hospital between January 2013 and December 2015 were randomly divided into two groups:the control group in 50 patients with only RFP treatment,and the treatment group in 50 patients with both RFP and LVFX treatments. The RFP plasma concentration was tested 0.5 h,1 h,and 2 h after intake of medicine. Sputum smear test was performed at the end of February,May,August and September to investigate the interaction between RFP and LVFX in retreatment of smear positive TB. Results The plasma concentration of RFP did not show significant difference(P > 0.05)between the control group and the treatment group at 0.5 h,1 h,and 2 h after intake of medicine. As the treatment time went on,the level of smear positive gradually decreased. The sputum smear positive rate after 2,5,8,and 9 months of treatment showed significant difference between the control group and the treatment group. After 8 months of treatment,the ratio of stabilized patients and patients under treatment also showed significant difference(P<0.05). Conclusion Rifampicin and levofloxacin have no antagonism effect in retreatment of smear positive TB,and RFP and LVFX can be used together to treat the repeated smear positive TB.

Objective To observe the expression of Her-2/neu protein and androgen receptor (AR) in human prostate cancer and to evaluate their significances in the progression of prostate cancer. Methods The Her-2/neu protein and AR immunohistochemical stain were carried out in human prostate tissue microarray that consisted of prostate cancer (107 cases) and benign prostate tissue (42 cases). The prostate cancer cases were divided into 4 groups: group one (Gleason score 6),group two (Gleasonscore 7), group three (Gleasonscore 8) and group four (Gleasonscore 9) according to the Gleason score. The immunostains immunohistochemical stain were interpreted in two aspects of the staining intensity and the percentage of positive cells. The significance and relationships between the expression of Her-2/neu protein and AR in prostate cancer and benign prostate tissue (BPT) and the grouping of different Gleason scores of prostate cancer were then evaluated. Results The positive expression rate of Her-2/neu protein was significantly higher in prostate cancer tissue than in BPT [43.9%(47/107) vs. 14.3%(6/42), x2=11.562, P=0.009], and the positive expression intensity of Her-2/neu immunoreactivity was also higher (x2= 11.764, P=0.008). There were significant differences in positive expression intensity of Her-2/neu immunoreactivity among the different Gleason scores groups (x2 = 20. 512, P = 0. 015), and the expression intensity was significantly positively correlated with Gleason scores ( r= 0. 269, P = 0. 005). There was significant difference in AR immunoreactivity between in prostate cancer (67 %, 72/107) and in BPT (50 %, 21/42, x2 =3. 843, P=0. 050). Among prostate cancer cases, the positive expression intensity of AR was not significantly different among groups 1 through 4 (x2 = 4. 318, P = 0. 229), and was not significantly correlated with Gleason scores ( r = - 0. 065, P = 0. 505 ). Moreover, the positive expression intensity of Her-2/neu protein was not significantly correlated with that of AR (r = -0. 115, P=0. 237). Conclusions Overexpression of Her-2/neu protein in human prostate cancer tissue suggests that Her-2/neu may have some role in prostate tumorigenesis. Her-2/neu protein expression is positively correlated with Gleason score in prostate cancer, which suggests that Her-2/neu may be a potential prognostic predictor of prostate cancer.

OBJECTIVE To find out about the transverse section use rate of antimicrobials in our hospital. METHODS A transverse section survey was made from midnight on June 24,2004 to midnight on June 25,2004 within all the inpatients. RESULTS Among 1132 inpatients,the transverse section use rate of antimicrobials was 58.83%,the combined medication ratio being 34.08%.Of all antimicrobial takers 65.92% were given single drug,31.68% double,and 2.40% were given triple.Among all departments of the hospital,the universal ICU had the highest use rate which was 100.00%,next to which were those in the departments of nephrology and gynecology,being respectively 90.00% and 87.23%.The antimicrobial use rate in surgical department(69.68%) was remarkably higher than that in medical department(43.08%).The departments of ophthalmology and otorhinolaryngology had the highest prophylactic use rate which was 83.64%.Rate of etiological examination for therapeutic medication in the whole hospital was 35.97%. CONCLUSIONS The transverse section use rate of antimicrobial in our hospital is slightly higher than the national average use rate.The constituent ratio of prophylactic medication is on the high side and the rate of etiological examination for therapeutic medication is on the low side.Management should be further strengthened for rational use of antimicrobials.

Objective To evaluate the value of transperineal targeted biopsy with real-time fusion images of transrectal ultrasound (TRUS)and multiparametric magnetic resonance imaging (mpMRI)for the diagnosis of prostate cancer (PCa).Methods Clinical and imaging data of 62 consecutive patients suspected of PCa at the mpMRI scan and PSA>4.0 μg/L were retrospectively analyzed.Targeted biopsies (TB)were carried out for each cancer-suspicious lesion,and followed a systematic 12-core biopsy (SB) protocol.Pathological findings of TB and SB were analyzed.Results The age of the patients was (68.38± 6.57)years (range 5 1 -79 years).The preoperative PSA value was (10.21 ±5.57)μg/L (range 4.5 -30.1μg/L).Preoperative prostate volume was (34.05±9.86)ml (range 19-64 ml).The PCa patients detected by SB and/or TB were 34 (54.8%).Cancer-detected rates of SB and TB cores were 7.53% and 26.2%, respectively (P <0.001).The positive core length of SB and TB cores were (3.71 ±2.77)mm (range 1 -14 mm)and (5.00±3.04)mm (range 2-1 7 mm),respectively (P =0.016).The positive core percent of SB and TB cores were (28.77 ± 20.13 )% (range 7 - 100%)and (35.76 ± 1 8.73 )% (range 1 1 % - 100%), respectively (P =0.048).Moreover,clinically cores detected by the SB and TB for final diagnosis of PCa were 19 cores (2.6%)and 48 cores (1 8.5%),respectively (P < 0.001 ).Conclusions Transperineal TB using real-time TRUS and mpMRI fusion imaging can improve sampling quality and elevate clinically detection rate of PCa when application combined with SB.

Seventy patients with advanced non-small-cell lung cancer (NSCLC) aged 65 or above were treated with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) erlotinib or gefitinib from February 2006 to September 2010. The efficacy and toxicities of treatment were retrospectively analyzed.The overall response rate and disease control rate were 31.4％ and 84.3％,respectively. Themedian progression-free survival time and median survival time were 8.0 months and 13.5 months,respectively(P ＜ 0.05 ). One-year survival rate was 54.3％. Response rate ( CR + PR) ( 42.9％ ) anddisease control rate (94.3％ )in female patients were superior to males (20.0％ and 74.3％ ) (P ＜ 0.05 ).Non-smoking and PS score ＜ 2 were good predictors for survival.The side effects were generally mild and mainly were skin rash and diarrhea.