Objective To identify the common clinical symptoms and signs of pectoral qi insufficiency syndrome;To provide evidence for its clinical treatment.Methods By retrieving 129 medical cases related to pectoral qi insufficiency syndrome in CNKI from January 1954 to October 2013 and Wanfang Database from January 1985 to October 2013, the authors made a statistical analysis of the symptoms and signs in medical cases related to pectoral qi insufficiency syndrome and elementarily generalized the common clinical characterization on pectoral qi insufficiency syndrome under the guidance of the TCM specialists.Results The cardinal syndromes of common clinical manifestation on pectoral qi insufficiency syndrome were shortness of breath and panting on exertion. The concomitant syndromes were pale or dim complexion, lassitude of spirit, lack of strength, shortage of qi and disinclination to talk, inability to sleep, dizziness, dizzy vision, etc. And it commonly superimposed failing to circulation qi-blood of cardiopulmonary as oppression in the chest, chest pain, palpitations, cyanosis, cough, etc, dysfunction of the spleen in transportation and transformation as torpid intake, sloppy stool, abdominal distension, and impairment of qi transformation due to Yang deficiency as cold limbs, fear of cold, edema, inhibited urination, and dry mouth.Conclusion The authors summarized cardinal syndrome, concomitant syndromes and superimposed symptoms on pectoral qi insufficiency syndrome from reported medical cases, which can provide scientific basis for normalizing the clinical diagnosis and treatment and interpreting the scientific connotation of pectoral qi insufficiency syndrome.

In this paper, through a systematic review of literatures on pectoral qi theory, we summarized the defini-tion of pectoral qi, physiological function, deficiency-excess changes, clinical manifestations of pectoral qi deficiency and modern research progress of pectoral qi theory, in order to deepen the understanding of pectoral qi connotation. The connotations of pectoral qi have four major kinds of views. The pectoral qi is a combination of the natural fresh air inhaled by the lungs and the foodstuff essence-qi transformed by the spleen-stomach accumulated in the thorax. The substance of pectoral qi is heart-lung yang qi. Pectoral qi is the special title of acquired essences in the thorax. Pectoral qi accumulated in the thorax is the beating-qi beneath the left breast. Its physiological function includes flowing through the respiratory tract to promote the respiration movement of the lungs, permeating the heart and ves-sels to promote circulation of qi and blood, comprehensively regulating of the heart and lungs, controlling all qi and zang-fu, accumulating body fluids, resisting external evils, controlling mental activities, maintaining mental state healthy and vigorousness, controlling vision, hearing, sound, color, smell and movement, converging primordial qi to maintain the vigor and vitality. Disorders of pectoral qi are mainly manifested as deficiency or excess. Deficiency is mainly manifested in pectoral qi insufficiency, or pectoral qi sinking. Excess is mainly manifested in pectoral qi ob-struction, or pectoral qi counterflow. The common clinical manifestations of pectoral qi insufficiency include short-ness of breath and panting on exertion. The concomitant symptoms are pale or dim complexion, lassitude, lack of strength, shortage of breath and disinclination to talk, insomnia, dizziness, spontaneous sweating, emaciation, darkish tongue with thin and white fur, sunken thin or weak pulse. And it commonly superimposed with failing to circulation qi-blood of heart and lungs as chest distress, chest pain, palpitations, cyanosis, cough, expectoration, and hard stool. Spleen transportation and transformation dysfunction were manifested as poor appetite, loose stool, and abdominal dis-tension. Impairment of qi transformation due to yang deficiency is manifested as cold limbs, aversion to cold, edema, urination difficulty, and dry mouth. In addition, diseases which are treated with pectoral qi are give priority to the heart-lung diseases, and then gradually extend to diseases of other systems. At the same time, there are many reports on using pectoral qi theory in disease treatment. The essence of pectoral qi is also discussed from the perspective of modern medicine. Generally speaking, pectoral qi theory has been put forward early; however, the systematic study is difficult to meet the needs of clinical diagnosis and treatment. There are many problems which remain to be further studied and solved.

Objective The study of loss of heterozygosity (LOH) on chromosome 1p36 was performed to locate the deletion areas probably harboring tumor suppressor genes in invasive ductal breast carcinoma not otherwise specified (IDC NOS).Methods Eighty paired breast cancer/normal tissue DNA samples were examined for LOH on chromosome lp36 using eight polymorphic microsatellite (MS) loci.The PCR products were electrophoresed on 8％ denatured polyacrylamide gel and stained using silver staining.Finally,the data were analysed and compared with the clinicopathological parameters using statistical analysis.Results In 80 IDC NOS,LOH was identified in 45 cases (56.3 ％) at least in one MS locus.MS locus D1S1310 showed the highest rate of LOH [35.7％ (25/70)].Conclusion Chromosome 1p36 might be the highly deleted region.The results of this study indicate that the chromosomal regions 1p36.23-33 might contain tumor suppressor genes associated with human breast carcinomas.

Objective To research the expression of the estrogen receptor alpha ( Erα) and estrogen receptor beta ( Erβ) in uvea tissues of the female rats, and to provide molecular biology data for further studies of the relation estrogen to uvea diseases. Methods Twenty-two adolescent SD female rats were selected. All rats were killed by dislocation of cervical vertebra, the eyeballs were in paraffin imbedding and made to a series of sections, using immunohistochemical method;Erα and Erβ distribution were investigated in uvea tissue of rats;and quantitied by Tanaka scores analytical method. The uteri of rats was used as positive control and PBS as negative control. The level of estradiol in serum of the rats were examined by radioimmunoassay. Results The expression level of Erβ was moderate or highter in stroma cell, anterior pigment epithelium as well as pasterior pigment epithelium of the iris, unpigmented epithelium, pigmented ciliary epithelium and vascular endocemet of the choroid layers. But Erα was not obviously expressed in uvea tissues. The expression rate of Erβ was higher than Erα in these tissues(P＜0.05). Immnoreactivity positive substance was granule, which was distributed in the cytoplasm or in the nucleus. The level of estradiol in serum of the rats was (22.13±3.54)ng/L.Conclusion The expression of either Erα or Erβ in uvea tissues of rats is mainly in Erβ. The results indicate that uvea tissue is regulated directly by estrogen throught Erβ.

Objective To evaluate the therapeutic effects of recombinant expression plasmid containing hepatocyte growth factor (HGF) and augmenter of liver regeneration (ALR) on rats with hepatic fibrosis. Methods Ninety Sprague-Dawley rats, which had been established into hepatic fibrosis models, were equally divided into 6 groups: blank group, pcDNA3.1 therapy group,pcDNA3.1-HGF therapy group, pcDNA3. 1-ALR therapy group, pcDNA3.1-HGF and pcDNA3. 1-ALR combined therapy group, and pcDNA3. 1-HGF-ALR therapy group. Zero point one μmol of blank or plasmid was injected into model rats in each group by tail vein once a day for 3 days. Model rats in blank group didn't receive any treatment. Additional 10 rats were chosen as control group, which were not given any interference during the experiment. All rats were sacrificed 4 days after end of treatment. Liver tissues were reserved for observing pathologic changes after HE staining and detecting proliferating cell nuclear antigen (PCNA) and c-jun by immunohistochemistry. Measurement data were compared by single-factor analysis of variance. Comparison between groups was done by SNK test. Enumeration data were analyzed by Fisher's exact test. Results In blank group and pcDNA3.1 therapy group, hyperplasia of fibrous connective tissue was very obvious, false lobules were formed. There was no significant difference between these two groups (x2 =0. 317,P= 1. 000).In the 4 remaining groups, hepatic fibrosis all achieved different degree of amelioration, and the therapeutic effect of pcDNA3.1-HGF-ALR was optimal. In control group, the expressions of PCNA and c-jun in liver tissues were low, with absorbance value of 8.6±1.9 and 3.2 ± 1.2, respectively. In blank group and pcDNA3. 1 therapy group, the expressions of PCNA and c-jun were obviously increased, with absorbance value of 24. 1±3.0, 24.5±4.3 and 23.8±3.1, 24.9±4.2, respectively,which were significant different from control group (all P＜0.01). In the 4 remaining groups, the expressions of PCNA were all obviously increased, and expressions of c-jun were all obviously decreased. The maximum change scope was observed in pcDNA3. 1-HGF-ALR therapy group.Conclusions The recombinant expression plasmid pcDNA3. 1-HGF-ALR can effectively ameliorate experimental hepatic fibrosis of rats. The anti-fibrosis effects are achieved probably by up-regulating PCNA expression and down-regulating c-jun expression.

[ABSTRACT]OBJECTIVETo investigate the morbidity rate and the epidemiological characteristics of snoring among the elderly in Yangpu District of Shanghai City.METHODSOne thousand six hundred and thirty persons(≥60 years) were investigated through questionnaires in Yangpu District of Shanghai City by a method of cluster sampling.The prevalence and risk factors of snoring were estimated. The relationship between snoring and the common clinical complications was observed by correlation factor analysis.RESULTS1630 questionnaires were provided, among which 1489 questionnaires(91.35%) were effective for evaluation.Of 1489 subjects, 213(14.3%) subjects had habitual snoring. Multivariate analysis revealed that obesity as a significant risk factor of snoring. The prevalence rate of snoring in the elderly with hypertension and poor quality of sleep was higher than that in the normal elderly.CONCLUSIONThe prevalence of snoring in the elder persons (≥60 years) in Yangpu District of Shanghai City is high. Obesity is a significant risk factor of snoring. The main clinical presentations of snoring in the elderly are atypical by the performance of poor sleep quality and the complication of hypertension.

Objective To demonstrate the effect of comprehensive treatment under nasal endoscopy for epistaxis. Methods The bleeding sites of 92 patients were defined by nasal endoscopic examination. Epistaxis was cured by single pole or bipolar coagulation, combined with micro packing and systemic treatment. The bleeding sites and effect were studied retrospectively. Results The hemorrhagic foci were found in the following sites: 60.87%(56/92) in Little area, 13.04%(12/92) in the middle and back of nasal septum, 10.87% (10/92) in olfactory sulcus, 8.70% (8/92) in middle turbinate , 3.26% (3/92) at the top of inferior meatus, 2.17% (2/92) at the top of nasal cavity, 1.09% (1/92) at unknown part at the back of nasal cavity. Epistaxis was successfully controlled by once nasal endoscopic examation and hemostasis in 86 of 92 patients. While in 5 of 92 patients, epistaxis was cured by twice nasal endoscopic examation and hemostasis. Endoscopicligation of the sphenopalatineartery was performed in 1 patient with unknown posteriorepistaxis. In 92 patients,15 cases were given micro packing combined with systemic treatment. All the patients were cured and were followed up for 3 months without recurrence and the cure rate was 100.00%. Conclusions The major bleeding site is Little area. Single pole or bipolar coagulation, combined with micro packing and systemic treatment under nasal endoscope is effective for epistaxis and worth of clinic application extensively.

Objective To investigate the effect of neoadjuvant chemotherapy on the proportion of G0-G1 phase cells and the expressions of ATP-binding cassette sub-family G member 2 (ABCG2)and CD44 +CD24 -/low in breast cancer patients.Methods Sixty untreated cases with breast invasive ductal carcinoma from May 201 3 to March 201 4 were chosen.All patients were tested by core needle biopsy and pathological diagno-sis,then treated by neoadjuvant chemotherapy.The proportion of G0-G1 phase cells and the contents of ABCG2 and CD44 +CD24 -/low before and after therapy were compared.Results After chemotherapy,the contents of ABCG2 and CD44 +CD24 -/low were (25.1 0 ±1 .50)% and (36.40 ±3.80)/1 05 ,and the proportion of G0-G1 phase cells was (70.50 ±1 .50)%,which were higher than those before treatment [(1 5.88 ±1 .22)%, (25.00 ±3.40)/1 05 ,(60.65 ±1 .30)%](t =8.685,P <0.05;t =9.226,P <0.05;t =8.898,P <0.05).All patients completed four courses of chemotherapy,and the cCR rate,cPR rate,SD rate were respec-tively 1 8.3% (1 1 /60),73.3% (44 /60),8.3%(5 /60).Conclusion Cell cycle can be arrested and the proportion of stem cells can be raised after neoadjuvant chemotherapy which has exact curative effect and clini-cal popularization value.

Objective:To establish a simple and efficient clinical prediction model of moderate and severe obstructive sleep apnea hypopnea (OSAHS) in snoring patients based on the clinical data and morphological measurement data in order to increase the early diagnosis and then early intervention of OSAHS. The prediction model is evaluated by external validation.Methods:A total of 299 subjects from January 2015 to December 2018 were selected to perform polysomngraphy (PSG) in Yangpu Hospital, Tongji University School of Medicine. According to the PSG results, they were divided into moderate and severe OSAHS groups (143 cases) and control groups (156 cases). Clinical complications data and morphological measurement data were collected. The regression equation and ROC curve were established according to the Logistic regression method. Then, another 110 subjects from January 2019 to October 2019 were chosen as verified data group, and used to verify the accuracy of the prediction model. The data of 110 subjects were put into the equation according to risk factors and assignment. The ROC curve was drawn and the area under the curve was calculated. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.Results:The predicted equation was: y = -10.707 86+0.589 60 × sex+ 0.141 61 × BMI+ 1.281 62 × tonsil size degree+ 1.807 43 × modified Mallampati degree′tongue position. The AUC of the ROC curve of prediction model in training set was 0.851(95% CI 0.807-0.895), the sensitivity was 83.9%, the specificity was 79.5%, and the cut-off value was 0.634.The AUC of the ROC curve in validation set was 0.827(95% CI 0.751-0.904) with a sensitivity of 73.3% and a specificity of 86.0%, and an accuracy of 79.1%. Its positive predictive value was 5.238, and negative predictive value was 0.310. Conclusions:The predictive model constructed by the combination of clinically accessible data (sex) and morphological measurement (BMI, tonsil size degree, modifiedMallampatidegree) has a relatively high predictive efficiency for screening snoring patients with moderate and severe OSAHS. The predictive model is proved with good forecast accuracy by the external verification method.

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of gastrointestinal glomus tumors (GIGT). Methods: Totally 15 cases of GIGT were collected at the First Affiliated Hospital, Zhengzhou University, from January 2011 to June 2018. The clinicopathological features, immunophenotype, BRAF V600E mutation and prognosis were retrospectively analyzed. Results: The 15 patients′ age ranged from 37 to 59 years(median 49 years, mean 50 years). Eleven patients presented with intermittent abdominal pain and distention, three showed antral space-occupying lesions at physical examination, and one had abdominal pain accompanied by fecal blood. Fourteen tumors were located in the stomach, and one was in the ileum. Imaging showed the gastric glomus tumors were located in the submucosal layer with obvious enhancement in the arterial phase, and the ileum glomus tumor involved the whole layer of intestinal wall causing luminal obstruction. The maximum diameters of the tumors ranged from 1.5 to 3.0 cm (mean 2.3 cm). Grossly, the gastric glomus tumors were solid. Microscopically, the gastric glomus tumors were mostly located in the muscularispropria layer and were vascular. The tumor boundary was distinct but without capsule formation. The tumor cells were round or oval, and showed perivascular hemangiopericytoma-like or solid nest-like structures. The tumor cells were mildly pleomorphic, with rare mitosis and no necrosis. Two tumors had focal calcification, two showed mucosal invasion, two showed vascular invasion and five showed perineural invasion. The ileum glomus tumor was cellular, with prominent cellular atypia, and the mitotic count in hot spots was about 5-6/HPF. Immunohistochemistry showed that SMA and collage Ⅳ were strongly expressed in all the tumor cells; caldesmon and calponin were moderately expressed in some regions, and syn was weakly expressed in 12 cases. The Ki-67 proliferation index in the gastric glomus tumors ranged from 1% to 30% (mean 6%); and that in the ileum glomus tumor was about 70%. BRAF V600E mutations were not detected in any of 15 GIGTs. All patients did not receive radiotherapy or chemotherapy post operatively. Thirteen patients were followed up by telephone for 18-90 months (mean 42 months). Twelve patients with gastric glomus tumors survived without recurrence and metastasis, and the patient with ileum glomus tumor had liver metastasis 15 months after operation. Conclusions Glomus tumors is a rare mesenchymal tumor of the gastrointestinal tract. It should be differentiated from gastrointestinal stromal tumors, neuroendocrine tumor, leiomyoma, solitary fibrous tumor and paraganglioma. Most GIGTs are benign and have good prognosis. More experience is needed to understand the biologic behavior and prognostication of GIGTs.