OBJECTIVETo observe the efficacy of acupuncture on pain after replantation of severed finger.

METHODSA total of 80 patients who underwent replantation of severed finger were randomly divided into an observation group and a control group, 40 cases in each one. The patients in the control group were treated with postoperative routine care of hand surgery, while patients in the observation group, based on the regular treatment, were treated with acupuncture within first 72 h of surgery. The health side of Yanglingquan (GB 34), Xuehai (SP 10), Hegu (LI 4), Houxi (SI 3) were selected and the needles were retained for 30 min. The acupuncture was given for 6 times. The evaluation was performed by using visual analogue scale (VAS) 2 h, 4 h, 6 h, 12 h, 24 h, 48 h and 72 h after surgery. The use of analgesics after surgery was recorded in the two groups, and the blood supply and survival rate of severed finger were evaluated.

RESULTSCompared between the two groups, the VAS 4 h, 6 h, 12 h, 24 h and 48 h after surgery in the observation group was lower than that in the control group (all P<0. 05); the use frequency of analgesics in the observation group was lower than that in the control group (P<0. 05); the abnormality rate of blood supply in the observation group was lower than that in the control group (P<0. 05).

CONCLUSIONAcupuncture can significantly relieve postoperative pain of replantation of severed finger, and reduce the occurrence rate of abnormal blood supply, which is worthy of clinical promotion.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Finger Injuries ; complications ; surgery ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; therapy ; Replantation

Objective To investigate the effect of blocking VEGF expression on the radiation sensitivity of esophageal cancer cell line TE-1 in vivo. Methods 32 male Balb/c/nu nude mice were randomly divided into four groups, including control group, radiation group, anti-VEGF group, and anti-VEGF + radiation group. The anti-VEGFcDNA cells were subcutaneously injected into the paw pats of mice (2 × 106/100 μl). The subcutaneous tumors were irradiated with 18 Gy of 60Co y-rays when the diameter of tumors varied from 0. 8 to 1.0 cm. The volume of the tumors was measured before and after irradiation, respectively. The expression level of VEGF mRNA and protein were examined by RT-PCR and Western blotting, respectively. Apoptotic cells were detected by electron micrographs. Results Latent period of the tumor formation of anti-VEGF group was lengthened compared with other groups(t = 13. 898,P ＜0.01 ). The volumes of tumor in anti-VEGF group [ ( 1207. 50 ± 97.07 ) mm3 ] and anti-VEGF +radiation group [ ( 1057. 5 ± 91.50 ) mm3 ] were not statistically different post-irradiation ( t = 1. 124, P ＞0.05 ) , but smaller than those in control group [ ( 5442. 50 ± 185.08 ) mm3 ] and radiation group [ (2922. 50 ± 152. 773)mm3 ] with statistical differences( t = 9. 475-21. 238, P ＜ 0. 01 ). The expression level of endogenous VEGFmRNA and protein in anti-VEGF group and anti-VEGF + radiation group were statistically different from control group and radiation group (F = 387.394, 13.519, P ＜ 0.01 ).Conclusions Antisense VEGF could inhibit the proliferation of esophageal cancer cell in the nude mice.Effect of blocking VEGF expression before irradiation on esophageal cancer xenografts might be limited.

Objective To observe the prevention effect of Hubai powder applied on navel for nausea and vomiting induced by chemotherapy with cisplatin.Methods 97 patients who received chemotherapy with cisplatin (75mg/m2 )were randomly divided into observation group(n =49)and control group(n =48).In the control group, 30min before chemotherapy,the patients were treated with intravenous granisetron 3mg as antiemetic;Based on the control group,the observation group were treated with Hubai powder 10g applied on Shenque point in the night before the chemotherapy until the end of the next morning after chemotherapy.The curative effect of the two groups were observed.Results The acute vomiting rate of the observation group was 83.7%,which was significantly higher than that of the control group(60.4%)(χ2 =5.423,P =0.019);The delayed vomiting rate of the observation group was 85.7%,which was significantly higher than that of the control group(56.3%)(χ2 =8.867,P =0.003);The patient appetite of the observation group was obviously better than that of the control group,0 -Ⅰ degree occurrence rate of the two groups had statistical significance(χ2 =6.469,4.552,P =0.011,0.033);Ⅱ -Ⅲ degree occurrence rate of the two groups did't have statistical significance.Conclusion Hu Bai powder umbilicus can effectively prevent nausea and vomiting induced by chemotherapy with cisplatin.

Objective To observe the preventive and therapeutic effect of Yangyin Shengxue Mixture (Herbal decoction for nourishing yin and blood) on radiation-induced oral mucosal injury.Methods Sixty nasopharyngeal carcinoma patients were randomized into two groups: treatment group (30 cases) receiving Yangyin Shengxue Mixture three days before till one week after radiotherapy, and control group (30 patients) using conventional Tinidazole Gargle for prevention of oral-mucositis. Before and after treatment, the body weight, hemoglobin and state of infection of patients were examined. The time of occurrence of symptoms, degree of acute radiation mucositis and degree of pain were observed to evaluate the damage of oral mucosa according to RTOG standard for radiation injury of oral mucosa and Numeric Rating Scales (NRS). Results There were different degrees of radiation mucositis in both groups during radiotherapy, but the time of occurrence in the treatment group was significantly later than that of the control group (P

BACKGROUND: Speech audiometry is decisive in selecting hearing aid,but it is seldom used in clinic in China.OBJECTIVE: To understand the differences in the speech resolution with speech audiometry between in-the-ear (ITE) and behind-the-ear (BTE)hearing aids.DESIGN: Paired controlled study.SETTING: Auditory Center of the 414 Hospital of Chinese PLA, Auditory Rehabilitation Center of Jiangsu Province.PARTICIPANTS: A total of 62 patients with auditory disability were selected from the Auditory Center of the 414 Hospital of Chinese PLA and Auditory Rehabilitation Center of Jiangsu Province. Among 32 ITE hearing aid users, average hearing loss at 500, 1 000, 2 000 and 4 000 Hz, was less than 85 dB, and the patients were aged from 16 to 60 years. Among 30 BTE hearing aid users, average hearing loss at 500, 1 000, 2 000 and 4 000 Hz, was also less than 85 dB, and the patients were aged from 16 to 60 years. All patients were consent.METHODS: Open and close methods were adopted for speech audiometry among ITE and BTE hearing aids users. Monosyllabic and disyllabic words were chosen as the type of speech and 20 words were given to one ear, respectively.MAIN OUTCOME MEASURES: Comparison of speech resolution with monosyllabic and disyllabic words test between ITE and BTE hearing aid.RESULTS: In aspect of the effect of ITE and BTE hearing aids, there were no significant differences of both monosyllabic and disyllabic words no matter through open or close method (P ＞ 0.05). At the opening state, there were significant differences in resolution of monosyllabic and disyllabic words (P ＜ 0.05); while, there were no significant differences (P ＞ 0.05) at the closing state.CONCLUSION: Carrying out speech audiometry in the selection hearing aid is influenced by many factors.

Objective:To summarize the clinical experience of treating patients with severe acute organic fluorine poisoning using extracorporeal membrane oxygenation (ECMO).Methods:In January 2021, an acute mass organic fluorine gas poisoning incident occurred in Quzhou, Zhejiang Province. The clinical data of 4 severe patients with acute poisoning of organic fluorine treated by ECMO in our hospital were retrospectively analyzed, and the epidemiological characteristics, clinical symptoms, signs, the abnormal laboratory studies/examinations, and treatments of this kind poisoning patients, especially, the treatment pattern, support time, complications, and outcomes of ECMO were collected and analyzed.Results:All the 4 patients were male, with an average age of (52±9) years, and all of them came to the emergency department complaining chest tightness, cough and pharyngeal discomfort 6 h after exposure by inhalation. The patient’s condition progressed rapidly with severe acute respiratory failure and circulatory failure as the prominent manifestations. The mechanical ventilations were performed (13.0±4.8) h after poisoning, and ECMO treatment was performed (15.5±5.3) h after poisoning. Among them, 2 patients were treated using venoarterial (VA) ECMO, and 2 patients using venovenous (VV) ECMO, but 1 patient was converted to VA-ECMO 8 h later. The duration of ECMO support for the patients was (8.8±3.6) d. The duration of mechanical ventilation was (23.0±28.7) d and stay in intensive care unit was (42.0±55.4) d. Among them, one patient was transferred to a specialized rehabilitation hospital after the amputation surgery due to lower limb necrosis after VA-ECMO support, and the remaining 3 patients were discharged after recovery.Conclusions:ECMO support might have the irreplaceable value in the treatment of patients with severe acute organic fluorine poisoning, and should be considered as one of the reserves of regional health care system in dealing with public health emergencies.

Malnutrition is a common complication of cancer patients, and solving nutrition problems is still one of the challenging tasks in clinical practice. The incidence of malnutrition in head and neck cancer patients during the peri-radiotherapeutic period is high, which is not only related to disease-mediated metabolic disorders, complications and psychological factors, but also associated with the toxic and side effects induced by radiotherapy. Malnutrition will reduce the tolerance, accuracy, and therapeutic effects of radiotherapy, which in turn lowers the quality of life and even adversely affects the prognosis of disease. Medical nutrition therapy can improve the nutritional status of the body, ensure smooth progress of radiotherapy, and improve the efficacy of comprehensive cancer treatment. It is necessary and urgent to deliver standardized nutrition therapy and management of head and neck cancer patients during the peri-radiotherapeutic period. Nutritional risk screening, nutritional assessment, and acute radiation injury assessment are required to develop an individualized nutrition treatment plan and make dynamic adjustment. In this article, relevant literature of nutrition therapy for head and neck radiotherapy at home and abroad was summarized, and the standardized nutrition therapy for head and neck cancer patients during the peri-radiotherapeutic period was reviewed.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.