Objective To observe the clinical efficacy of acupuncture in treating cancer-related fatigue (CRF) due to spleen-kidney deficiency.Method Sixty eligible subjects with CRF due to spleen-kidney deficiency were randomized into a treatment group and a control group, 30 cases in each group. The control group was intervened by nutritional support and symptomatic management, while the treatment group was treated with acupuncture in addition to the intervention given to the control group. The Karnofsky Performance Status (KPS), Piper Fatigue Scale (PFS), and peripheral blood test were observed before and after treatment.Result The KPS scores were significantly changed after treatment in both groups (P<0.05). The PFS item scores (behavior, affect, sensory, and cognition) were significantly changed after intervention in the treatment group (P<0.05). The behavior score in the control group was significantly changed after treatment (P<0.05). After treatment, there were significant differences in comparing the PFS item scores between the two groups (P<0.05). There were significant differences in comparing the lymphocyte levels between the two groups after treatment (P<0.05).Conclusion Acupuncture is an effective method in treating CRF due to spleen-kidney deficiency, and it can up-regulate the peripheral blood cells and strengthen the immunity.

80 extracted human mandible premolars were divided into 10 groups(n =8)based on the post with different tilted angles(0°, buccal 15°and 30°,ligual 15°and 30°).The samples in experiment group were restored with fiber post while in the control group with cast post.Then all the teeth were restored with cast crown and bonded by glass ionomer.Compressive load with the speed of 1.0 mm/min was ap-plied to the restored teeth with a universal material testing machine until failure and the fracture modes were observed.The fracture load of fi-ber post and cast post restoration with the same tilted angles was similar(P >0.05).The main fracture mode of the teeth in all groups was unfavorable tooth fracture.No significant interaction was observed(P =0.217)between the 2 kinds of post and angulation of tilted teeth.

Objective To investigate the expression of human leukocyte antigen F (HLA-F) in hepatocellular carcinoma (HCC) tissues and to evaluate its relation to clinicopathological features and prognosis of HCC.Methods HLA-F expression of tumor lesions and their adjacent normal liver tissues from 115 HCC patients were analyzed by immunohistochemistry,and its relationship between HLA-F expression and the clinicopathological features and prognosis of HCC patients was also analyzed.Results HLA-F expression was positive in 47.0％ (54/115) of the HCC lesions and in 10.6％ (7/66) of the normal liver tissues (x2 =24.799,P ＜ 0.05).HLA-F expression in HCC lesions was significantly correlated with portal vein invasions (x2 =7.644,P =0.006),tumor number (x2 =4.210,P =0.040) and patient sex (x2 =6.759,P =0.009).The mean survival time of the HLA-F positive HCC patients was 34.0 months(95％ CI:27.5-40.5 months),which was significantly shorter than that of HLA-F negative HCC patients(44.6 months,95％ CI:38.3-50.9months) (x2 =5.148,P =0.023).HLA-F expression was an independent predictor of overall survival of HCC patients.Conclusions Positive HLA-F expression is negatively correlated with the prognosis of HCC patients.

Objective To observe the effectiveness of early enteral nutrition (EEN) in managing ICU mechanically ventilated patients.Methods Totally 47 patients who had been ventilated for more than one week were randomly divided into EEN group and control group.The EEN group was supplied with enteral nutrition (EN) 12-24 hours after ICU admission,whereas the control group received EN 72 hours-5 days later.The function of intestinal mucosal barrier was evaluated by the reabsorb concentration of disaccharides lactulose/mannitol (L/M).In addition,the body mass index (BMI),body temperature,urine L/M ratio,serum albumin,pre-albumin,and ventilation days were recorded or calculated.Results On the seventh day,the L/M ratio was (0.036 ±0.004) in the EEN group,which was significantly lower than that (0.108 ±0.020) in the control group (t =2.746,P ＜0.01) ; the average body temperature was significantly lower in the EEN group than in the control group [(38.25 ± 1.20) ℃ vs (38.92 ± 1.40) ℃ ; t =2.683,P ＜ 0.05)] ; the incidences of adverse reactions such as constipation and diarrhea were significantly lower in the EEN group [16.7％ (4/23) vs 27.3％ (6/22),P＜0.05].The weaning rate within 2 weeks also favoured the EEN group [90％ (18/20) vs 80％ (16/20),P ＜ 0.05].Compared with the control group,the nutritional status of serum albumin and pre-albumin also showed a favourbale trends in the EEN group.Conclusions EEN can improve intestinal mucosal barrier and increase the weaning possibility in patients with mechanical ventilation.

Objective To investigate the expression characteristics of PAK5,CyclinD1 in HCC and its relationship with clinicopathological factors and prognosis.Methods The immunohistochemical method was used to detect the expression of PAK5 and CyclinDl in 76 cases of HCC tissue and 31 cases of adjacent liver tissue.The correlation between the abnormal expression of PAK5 and CyclinD1 and clinicopathological factors and prognosis was also analyzed.Results The PAK5 expression in tumor lesions and adjacent tissue was 86.8％ (66/76) and 54.8％ (17/31) (x2 =12.962,P ＜ 0.05).Meanwhile,the CyclinD1 was positive in 73.7％ (56/76) of the HCC tissue and in 41.9％ (13/31) of the adjacent tissue (x2 =9.691,P ＜0.05).The expression of PAK5 was significantly correlated with sex (x2 =5.063,P =0.024),tumor diameter(x2 =9.159,P =0.002) and portal vein-emboli (x2 =4.469,P =0.035).CyclinD1 expression was correlated with portal vein-emboli (x2 =4.842,P =0.028),TNM (x2 =7.930,P =0.005).PAK5 expression was positively correlated with CylinD1 (γ =0.284,P =0.033).The mean survival time of PAK5positive patients after operation was shorter than the PAK5 negative patients(x2 =7.104,P =0.008).By Cox multiple factors analysis,the PAK5 expression was independent impact factors affecting the prognosis of HCC patients (RR =0.186,P =0.012).Conclusion In HCC patients positive PAK5 expression predicts poor postoperative survival.

Objective To influence the success rate of CPR factors for in-depth and meticulous research,in order to improve the province of pre-hospital sudden death in patients with a success rate of recovery. Methods A retrospective analysis from June 2008 to March 2009,after 266 I treatment center for diagnosis and treatment of patients and intermediate links through. Results in 266 cases of sudden death cases,13 cases of successful recovery (or 4.88%),7 cases recovered and were discharged. Conclusion 8 percent in China and developed countries the success rate of recovery compared to the larger gap between the need to be improved in the following sudden death in patients with a flew to improving the success rate of recovery:(1)Full attention to "life chain" issues.(2)Scientific configured site first aid and shorten the first radius and reaction time,the basis of a timely manner to support life; 3,weighing the pros and cons as soon as possible,the application of epinephrine and naloxone consumption; 4,one of the most substantial is the "life chain" in the second part of the fracture should be universal universal lust-aid knowledge

Objective To report a simple formula to estimate phosphate removal by standard four-hour hemodialysis in Chinese patients.Methods A total of 165 MHD patients in Huashan Hospital were enrolled.Effluent dialysate samples were collected during treatment to estimate the total amount of phosphate removal.Pre-dialysis levels of serum phosphate,potassium (K+),hematocrit(Hct),parathyroid hormone(iPTH),carbon dioxide combining power(CO2CP),alkaline phosphatase (AKP),Kt/V,and ultrafiltration volume,age,gender,dry body weight,blood flow,phosphate clearance of dialyser,phosphate concentration of dialysate at 60 min after the start of HD were obtained.80％ observations were randomly selected for formula building by backward stepwise and the remaining 20％ observations were used to validate the formula.Results The formula was described as Tpo4 =88.6 ×C60-0.03 ×Age + 1.07 ×Gender +0.06 ×Clearance-4.59,where C60 was phosphate concentration in dialysate measured 60 min into HD and Clearance was the phosphate clearance of dialyser.Formula validation further suggested good predictive ability.Conclusion This study derives an approach to quantify phosphate removal by a simple formula,which will be helpful for clinicians to treat patient individually.

Objective To evaluate the impact of cardiopulmonary resuscitation (CPR) training on the willingness to perform on-site rescue for patients with apnea and cardiac arrest. Methods Through questionnaire survey, the analyses on the differences in the results of evaluating various indicators in CPR Willingness Questionnaire in 364 willingness (including 14 recurrent training personnel) of Yunnan Emergency Center from January 2017 to June 2018 before and after CPR training were carried out in order to observe the impact of training on willingness CPR willingness. Results A total of 364 questionnaires were distributed and 364 valid questionnaires were recovered, with a recovery rate of 100%. Compared with those before the CPR training, the analyses of the contents of the questionnaire showed that the proportions of following 6 types of volunteer who were reluctant to implement CPR on site begore training were significantly lower after CPR training [no confidence in their own operational skills: 20.3% (74/364) vs. 83.2% (303/364), being impossible to identify the patients requiring CPR: 25.5% (93/364) vs. 87.1% (317/364), fear of mouth-to-mouth artificial respiration to contract infectious diseases: 30.2% (110/364) vs. 82.4% (300/364), worried about chest compressions leading to bone fractures: 23.3% (85/364) vs. 86.8% (316/364), worried about the inaccurate positioning of chest compressions: 12.4% (45/364) vs. 82.4% (300/364) and fear of taking legal responsibility: 14.3% (52/364) vs. 89.8% (327/364)], and the differences were statistically significant (all P < 0.05); after training, the following 3 kinds of proportions of carrying out CPR were much higher than those before training [volunteers were willing to implement CPR on site for strangers: 83.2% (303/364) vs. 54.9% (200/364), volunteers were willing to implement CPR on site for friends, colleagues, classmates and other acquaintances: 83.5% (304/364) vs. 58.2% (212/364), volunteers were willing to implement CPR on site for family members: 84.6% (308/364) vs. 61.8% (225/364)], the differences being statistically significant (all P < 0.05). Conclusion CPR training for volunteers can improve their willingness to perform on-site rescue for patients with apnea and cardiac arrest, but there are still partial barriers of CPR willingness for strangers.

Adult ; Endoscopy ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Nasal Septum ; injuries ; surgery ; Periosteum ; transplantation

Objective:To explore the difficulties and surgical decision of laparoscopic technique in patients with complicated hepatolithiasis.Methods:The clinical data of 13 patients with complicated hepatolithiasis who underwent laparoscopic hepatectomy at Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College from December 2019 to December 2020 were collected. There were 3 males and 10 females with average age of 50.8 years (range: 14 to 67 years). All patients had upper abdominal pain and a history of cholecystectomy, 4 of them had fever.Seven cases underwent laparoscopic left hemihepatectomy+bile duct exploration, 2 cases underwent laparoscopic right hemihepatectomy+bile duct exploration, 2 cases underwent laparoscopic quadrate hepatectomy (liver 4B+Part 5)+hilar cholangioplasty+bile duct exploration, 2 cases underwent laparoscopic quadrate lobe resection (liver 4B+Part 5)+cholangioplasty+cholangiojejunostomy. All patients were re-examined with abdominal ultrasound and choledochoscope 3 months after operation.Results:The median operation time was 5.2 hours (range: 3.6-6.5 hours), blood loss was 278 ml (range: 120-580 ml). During the operation, 1 case had duodenal bulb injury, and the defect area was about 1.0 cm × 1.2 cm. After timely detection, the defect area was carefully evaluated and trimmed. Absorbable suture was used to suture duodenal bulb, and gastrojejunostomy was performed after repair. One case had small intestinal serosa injury, which was intermittently sutured and embedded with absorbable suture. All the patients recovered smoothly without death. Three months after the operation, 12 patients completed abdominal ultrasound and T-tube sinus choledochoscopy. Residual stones were found in 3 patients, stones were removed in 2 patients by T-tube sinus choledochoscopy 3 months after the operation, 1 patient was still in the recovery period (within 3 months after surgery). No residual stones were found in the remaining 10 patients.Conclusion:The three key laparoscopic techniques in operation of complex hepatolithiasis: adhesiolysis and porta hepatis exposure, laparoscopic hepatectomy, and laparoscopic choledochojejunostomy are very important.