Objective To evaluate the short-term efficacy and adverse effects of capecitabine as adjuvant chemotherapy of gastric cancer after resection in aged patients. Methods Sixty aged patients with gastric cancer (Ⅱ-Ⅲstage) after resection were randomized to two groups: the high dose group,in which 30 patients were treated least 6 therapeutic cycles (3 weeks for 1 cycle). Efficacy and adverse effects were assessed after 2 cycles. Results Two years' survival was 80% (24/30) in the high dose group and 77% (23/30) in the low dose group (χ2=0.54,P=0.45). The recurrence-free survival time was 19.2 months and 19.0 months respectively (χ2=0.82,P=0.36). Patients in the high dose group experienced more significant nausea/vomiting (Ⅰ-Ⅱ grade) than patients in the low dose group (χ2 = 9.82,P=0.02). However,there was no significant difference on grade Ⅲ-Ⅳ nausea/vomi-ting between the 2 groups(χ2=0.34,P=0.71). The incidence of grade Ⅰ-Ⅳ mucositis,hyperbilirubinemia and hand-foot syndrome (HFS) in the high dose group were higher than in the low dose group( P=0. 04,0. 02 and 0.04,respectively). There was no difference on weakness,lack of appetite and neutropenia between the two groups. in aged patients with similar efficacy and better tolerance of adverse effects compared to capeeitabine [2500 mg/

Objective: To evaluate the curative effect of auricular point sticking therapy on vertebral artery type of cervical spondylosis. Methods: With the single-blind randomized controlled trial design, the treatment group of 42 cases was treated by auricular point sticking therapy and the control group of 38 cases was treated with herbal medication. Fifteen days made up a treatment course, and the total treatment period should be no more than 2 course of treatment. Results and Conclusion: The total effective rate was 97.6% in treatment group and 73.7% in control group; there was a statistically significant difference between two groups, and the treatment group is marked superior to control group.

Keratoconus is a relatively common, bilateral, non-inflammatory corneal ectasia characterized by thinning and scarring of the central portion of the cornea,seriously destroyed the vision. The aetiology of this condition is probably multiple factors,such as collagen themry,genetic themry,epithelia themry,etc.Now,recent investigations devote to gene,and think it one of the major aetiological factors. Laboratory studies suggest a role for degradative enzymes and proteinase inhibitors and a possible role for the interleukin-1 system in its pathogenesis, but these roles need to be more clearly defined. It has well-described clinical signs, but early forms of the disease may go undetected unless the anterior corneal topography is studied. Contact lenses are the most common treatment modality. When contact lenses fail, corneal transplant is the best and most successful surgical option.

Objective To observe and analyze the four changes of plasma D- dimer and coagulation in pregnant women at different stages of pregnancy, and to explore the value of the test. Methods The subjects of this study were 120 pregnant women who underwent routine physical examination in our hospital, according to different stages of pregnancy (early pregnancy, middle pregnancy, late pregnancy, and before delivery) Four D- dimer and four blood coagulation tests were performed in pregnant women, and the results were observed and compared. Results During the pregnancy, D- dimer has increase trend (P<0.05); early in pregnancy, pregnancy and late pregnancy, PT has shortened(P<0.05); pregnancy, APTT has shortened (P<0.05), at the end of pregnancy and parturient period, showing a significant shortening (P<0.05); phenomenon in early pregnancy to mid pregnancy stage, FIB increased significantly (P<0.05), and at the end of pregnancy to perinatal period, with a sharp increase (P<0.05). Conclusion It is of great significance to perform dynamic monitoring of of plasma D- dimer and coagulation four indices in pregnant women during pregnancy.

Through all times and around the world,those who discipline themselves with high ethical standards can be regarded as truly noble men successfully taking advantage of moral authority of the people.Books on the art of war in ancient China raised a couple of ethical requirements for those superior military officers and governors.If officers want to affect his men′s mental state and generate the army′s spirit of combat effectiveness,they must assume a certain degree of ethical responsibility.Also,active share of ethical responsibility calls to take the initiative to develop a sense of ethical responsibility.Furthermore,to develop a sense of ethical responsibility calls for the building of ethical self-consciousness to participate in the training of ethical responsibility.However,the participation of ethical building consciousness can not be separated from the ethical sense of responsibility.In conclusion,each part of the three links,complementing each other,can not be biased and separated.

Animals ; Breast Neoplasms ; metabolism ; pathology ; therapy ; Cell Proliferation ; Female ; Hedgehog Proteins ; metabolism ; Humans ; Neoplastic Stem Cells ; metabolism ; pathology ; Phosphatidylinositol 3-Kinases ; metabolism ; Receptors, CXCR4 ; metabolism ; Receptors, Notch ; metabolism ; STAT Transcription Factors ; metabolism ; Signal Transduction ; Wnt Proteins ; metabolism

Objective To investigate the effect of early medical intervention in neuropsychological development of premature infant.Methods 94 premature infants were divided into experimental group and control group.The experimental group were treated with drug, cerebral circulation and early intervention rehabilitation training.The control group were treated with drug and cerebral circulation.Developmental evaluation were performed in 1 old.Results The developmental quotient (DQ) of experimental group was much higher than that of control group ( ( 101.80 ± 9.60 ) vs ( 86.10 ± 10.55 ), P ＜ 0.05 ).The cerebral palsy incidence of experimental group was much lower than that of control group, also lesser than control group( ( 3.07% vs 27.59%, P＜ 0.05 ).In the evaluation of neuropsychological development, much improved in experimental group (P＜ 0.05 ).Conclusion Early medical intervention could promote neuropsychological development of premature infant and reduce the sequelae.

Objective:To investigate the differences between patients with small cell carcinoma of the cervix and other type of cervical cancer on clinicopathological characteristics,treatment,prognosis through the retrospective analysis,also study the prognostic factors in patients with SCCC.Methods:The patients with SCCC(63 cases,research group) and patients with Non-SCCC(60 cases,control group) such as squamous cell carcinoma and adenocarcinoma of cervix were chosen during May 2003 and June 2015 in department of obstetrics and gynecology,west China second university hospital.The clinical pathological and survival data were collected,sort out,checked and analyzed.Chi-square test or Fisher's exact probability method was used to compare the differences of clinical features between the two groups.The 5-year disease-free survival(DFS) rate and 5-year overall survival(OS) rate were generated using the Kaplan-Meier method.Univariate and multivariate analysis were applied to research the prognostic factors.Results:①The median age of the patients in research group was 40 years old,younger than control group whose median age was 44 years old (P =0.001).The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in research group were significantly higher than those of control group (P ＜ 0.05).There were no significantly differences between two groups in clinical symptoms,FIGO stage,therapeutic schedule.②In the survival analysis,the research group estimated 5-year overall survival (OS) rate (29.2％) and estimated 5-year disease-free survival rate (DFS)(26.6％) was significantly lower than those of the control group(82.6％,and 76.7％,respectively) P ＜ 0.05.③In the COX multivariate regression analysis,the results showed that the lymph node metastasis was the independent factor influencing overall survival rate and disease-free survival rate(HR =4.784、3.067,P ＜ 0.05).In addition,the tumor size was the independent factor influencing overall survival rate (HR =3.610,P ＜ 0.05),and advanced FIGO staging was the independent factor influencing disease-free survival rate (HR =2.793,P ＜ 0.05).Conclusions:The patients with SCCC were younger than other cervical cancer,and the clinical symptoms,cervical appearance,treatment between the two types are almost the same.However,The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in patients with SCCC were significantly higher than other cervical cancer,and the prognosis of the patients with SCCC was very poor.The main prognostic factors were lymph node metastasis,advanced FIGO stage and tumor size.

Objective:To observe the effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy.Methods:A total of 92 patients undergoing elective laparoscopic cholecystectomy in Wuhan Third Hospital between January 2017 and August 2019 wereselected. They were divided into the control group (63 cases) and the observation group (29 cases) by voluntary. The control group were given simple general intravenous anesthesia, and the observation group were given ultrasound-guided paravertebral nerve block combined with general intravenous anesthesia. Changes in hemodynamic parameters and concentrations of blood angiotensin-Ⅱ (AT-Ⅱ) and cortisol (Cor) in the two groups were observed. The cerebral state indexes (CSI) of both groups were recorded, and pain degree of patients was evaluated with the visual analogue scale (VAS).Results:The mean arterial pressure (MAP) and heart rate (HR) of the observation group were higher than those of the control group at 30 min after anesthesia, 30 min after operation, 3 hours after operation ( P<0.05), the stroke volume variation (SVV) was lower than that of the control group ( P<0.05); the AT-Ⅱ, Cor and CSI in the observation group were lower than those in the control group at each time point ( P<0.05); The dosage of narcotic drugs in the observation group was significantly lower than that in the control group ( P<0.05); The recovery time of spontaneous breathing, recovery time, extubation time and respiratory satisfaction time in the observation group were less than those in the control group ( P<0.05), and the VAS scores at 3 h, 6 h and 12 h after operation in the observation group were lower than those in the control group ( P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block combined with general anesthesia can effectively reduce the patient's stress response during laparoscopic cholecystectomy, with good analgesic effect, which is helpful to maintain the hemodynamic stability of patients.

Objective To study the imaging of central pentine myelinolysis (CPM) and extrapontine myelinolysis(EPM) after liver transplantation and value of DWI. Methods Eight patients after liver transplantation with CPM and EPM were included in our study, 4 cases of female and 4 cases of male.MR examinations were performed on Philips 1.5 T MRI system. The sequences included SE T1 WI, FSE T2Wl,axial SE-EPI DWI,TR/TE 6225/118.7 ms, ETL 128, FLIP 90°, thickness 5 nun, matrix 128 ×128,b=1000 mm2/s. Results Four of B type hepatitis and cirrhosis and 1 case combined with hepatic carcinoma, 1 of C type hepatitis with cirrhosis from schistosome,2 of C type hepatitis and cirrhosis, 1 of cholangiogenic cirrhosis. MR demonstrated prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem sparing of the corticospinal tract and peripontine tissue. The lesion manifested high signal intensity both on DWI and ADC map indicating T2 effect and vasogenic edema. Follow up MR in 2 cases 2 months later showed more prolongation of T1 and T2 than the first time and the lesion manifested iso-intensity signal on DWI and high signal intensity on ADC map suggesting increased diffusivity. Abnormal signal intensities were detected on the bilateral caudate head, globus pallidus, putamen and cerebral cortex in 3 cases. Conclusion CPM should be considered when prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem, sparing of the corticospinal tract and peripontine tissue was detected for patients of pest-transplantation. When combined with other area abnormality, EPM and CPM should be considered. DWI can early and sensitively show the lesion.