Acupuncture Points ; Child, Preschool ; Dyspepsia ; therapy ; Female ; Fever ; therapy ; Humans ; Male ; Massage

Objective:To observe the clinical efficacy of Xueshuantong combined with the conventional treatment and the impact on fibrinogen (FIB) and D-dimer in the patients at acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Meth-ods:Totally 218 cases of AECOPD inpatients were divided into the observation group and the control group randomly .The control group received the conventional therapy , while the observation group was intravenously treated with 250 mg Xueshuantong lyophilized powder dissolved in 250 ml 10%glucose injection additionally .The treatment course was 14 days.The changes of FEV 1 , FEV1/FVC, FIB and D-dimer in the two groups after the treatment were compared , and then the clinical efficacy of the two groups was evaluated . Results:After the treatment, the levels of FEV1 , FEV1/FVC, FIB and D-dimer in the two groups were significantly improved when compared with those before the treatment , and the changes in the observation group were more significant than those in the control group (P<0.05).The total effective rate of the control group was 80.73%, and that of the observation group was 89.91% (P<0.05). Conclusion:Anticoagulant therapy using Xueshuantong on the basis of the conventional therapy can significantly reduce the amount of fibrinogen and D-dimer serum fiber in AECOPD patients , which is helpful to improving the hypercoagulable and fibrinolysis state and the lung function of AECOPD patients .

The use of laparoscopic liver resections for benign and malignant diseases has spread worldwide.As in open liver surgery,anatomical orientation and the ability to control intraoperative challenges as bleeding have to be combined with expertise in advanced laparoscopic techniques.We provide an overview regarding the literature on laparoscopic liver resection for benign and malignant liver tumors with the aim to discuss the current standards and define remaining challenges.Laparoscopic liver resection is feasible and safe in selected patients and experienced hands.The minimal invasive approach offers benefits in perioperative shortterm outcome without compromising oncological outcomes compared to open liver resections.Further randomized trials are needed to formally prove these statements and to define the optimal indication and techniques for the individual patient.

Objective To explore the effect of water analgesia on the pain relief for primiparas in labor, especially on the point of the acutest pain and total time of severe pains by tracking and comparing with remifentanil patient- controlled intravenous analgesia and the conventional vaginal delivery. Methods A total of 139 singleton and full-term primiparas who chosed analgesia labor were selected. There were 3 groups:56 cases in water analgesia group (hereinafter referred to shortly as water group), 37 cases in remifentanil patient-controlled intravenous analgesia group (hereinafter referred to shortly as vein group ) and 46 cases in traditional vaginal delivery group (hereinafter referred to shortly as traditional group). In addition, labor pain intensity was assessed with numerical rating scale (NRS). All groups were evaluated by NRS score in five different time points during the delivery:cervical dilation to 2-3 cm or 1 minute before labor analgesia; labor analgesia after 10 minutes; labor analgesia after 30 minutes; labor analgesia after 60 minutes;point of acutest pain. Meanwhile, total time of acutest pain, progress of labor, use of oxytocin, mode of delivery, postpartum hemorrhage and neonatal asphyxia were all observed. Results Comparison of labor progress and postpartum bleeding, mode of delivery and neonatal Apgar score in three groups of primipara showed no significant difference (P>0.05). Compared with the traditional group, the NRS score and point of acutest pain in water group obviously declined, the total time of severe pain shortened 36.58 min on average, which showed significant difference (t=-4.400, P<0.05). Compared with the vein group, the NRS score of water group at 10 minutes after labor analgesia was below the vein group (t=-2.358, P<0.05), so was point of acutest pain (t=-2.703, P<0.05). But the score of water group was higher than intravenous analgesia after 60 minutes, which showed significant difference (t=2.833, P<0.01). The rate of oxytocin application in water group was only 12.5%(7/56), significantly less than the rate in vein group, which was 37.84%(14/37), there were significant differences (χ2=8.182, P<0.05). Conclusions Water analgesia can effectively alleviate maternal pain and reduce intrapartum intervention, and more, less influence on maternal and newborn, and is a safe and effective analgesia method.

Objective To explore the efficacy and safety of large and conventional fractionated three dimensional conformal radiation therapy for non small cell lung cancer with superior vena cava compression syndrome, and to provide clinical reference for improving the prognosis of patients with non small cell lung cancer. Methods The general data of 63 patients with non small cell lung cancer complicated with superior vena cava syndrome treated in Lu'an Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were analyzed retrospectively. According to the different treatment methods, the patients were divided into observation group ( n =28) and control group ( n =35) .The control group was given conventional fractionated three-dimensional conformal radiation therapy, three dimensional conformal radiation therapy was given to the observation group. The clinical efficacy, toxicity, and 1, 2 years survival rate of the two groups were compared. Results The complete remission rate of observation group was 96.43%, which was significantly higher than 74.29%in the control group (P<0.05) . The complete remission in the observation group was 89.29%in two weeks, which was significantly higher than 62.86%in the control group (P<0.05) . The total effective rate of observation group was 85.71%, which was significantly higher than that 62.86%in the control group (P<0.05) . The clinical benefit rate of observation group was 96.43%, and there was no significant difference between the two groups (P>0.05) . There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05) . There was no significant difference in 1, 2 year survival rate between the two groups (P>0.05) . Conclusion Three dimensional conformal radiation therapy for non small cell lung cancer patients with superior vena cava syndrome is superior to conventional treatment, and does not increase the toxic side effects, which is worthy of clinical attention.

Early prognostication of neurological outcome in comatose survives after cardiopulmonary resuscitation,an essential component of post-cardiac arrest care is significantly meaningful in both clinical and economic fields.From the perspectives of predictors based on neurological examination,electroencephalogram,evoked potentials,neuroimaging and blood biomarkers and taking advantage of therapeutic hypothermia into consideration,this article reviews the development in evaluation of neurological outcome in comatose survives after cardiac arrest.

Since the early symptoms are very hidden,most of patients with colorectal cancer (CRC)have occurred metastasis when diagnosed.Recently,chemotherapy combined with targeted therapy is the major therapeutic strategy for metastatic CRC and the high frequency activation of phosphatidylinositol 3-kinase (PI3K) signaling pathway has been validated sharing a close relationship with the development of CRC,contributing important values for the diagnosis and therapy of CRC.

Objective To evaluate the value of gelsolin for the prognosis of patients with severe sepsis.Methods 50 patients in the emergency intensive care unit of Beijing hospital from January 2015 to July 2015,were determined white blood cell count (WBC),C-reactive protein (CRP),procalcitonin (PCT),gelsolin at admission,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were estimated within 24 hours.According to the 28 days of survival outcome,50 patients were divided into two groups:survival group and death group.The significant difference of these factors was compared.Binary logistic regression analysis was applied for screening independent risk factors for the prediction of death.The receiver operating characteristic (ROC) curve was applied for the evaluation and comparison about prognosis ability.Results 31 patients were in the survival group,19 patients in the death group.The gelsolin [(21.43±10.54) vs.(13.31±8.54),P=0.007] andAPACHE Ⅱ score [(19.2±6.86) vs.(24.6 ± 8.9),P =0.021] in two groups had significance difference.Binary logistic regression analysis indicated that the gelsolin and APACHE Ⅱ score were independent risk factors of predicting death.The area under of ROC curve (AUC) of the gelsolin was 0.745 (95％ CI:0.599-0.851,P =0.004) and the APACHE Ⅱ score was 0.699 (95％ CI:0.537-0.862,P =0.019).Both prognosis ability were equivalent.To combine the tow factors,the accuracy of predition was 90％ and has better complementarity.Conclusions the gelsolin could assess the severity of patients with severe sepsis and predict the prognosis more accurately.

The high mutation rate during hepatitis B virus (HBV)replication leads to HBV quasispecies.The study of HBV quasispecies has an important significance for the hepatitis B pathogenesis,prognosis,and outcome prediction.Recently,the next-generation sequen-cing (NGS)is extensively used in many biological and medical fields due to its high throughput,ultra-deep coverage,and high sensitivity, which also brings new strategies to HBV quasispecies studies.This article describes the working principles and features of several commonly used NGS technologies,reviews the application of NGS technologies in HBV quasispecies detection in recent years,and particularly discus-ses the variations in different regions of HBV genome and the population characteristics of HBV quasispecies.For now,NGS technologies used in HBV variation detection mainly presents the advantages of high sensitivity and high throughput.However,how to lower the cost,in-crease the accuracy of sequencing,and standardize the procedure of massive sequencing data management and personalized analysis are still challenging problems.The issue about NGS that matters at present and urgently needs to be solved is how to overcome its limitations,and then put it into HBV-related studies and ultimately clinical application.

Chemotherapy is one of the three most common treatment modalities for cancer .However , chemotherapy as current firstline therapy induces significant side effects and limited efficacy ,leading to multidrug resistance and fast recurrence challenging the patient survival rate .Drug metabolizing enzymes ( DMEs) and efflux transporters promote the metabolism,clearance,and detoxification of chemotherapeutic agents .Nuclear receptors, especially pregnane X receptor (PXR,NR112)and constitutive androstane activated receptor (CAR,NR113),reg-ulate the expressions of target genes that could encode phase I DMEs ,phase II DMEs,and efflux transporters in the development of multidrug resistance ( MDR) during chemotherapy .Recent studies have revealed that PXR and CAR play pivotal roles in MDR of various human carcinomas .And their expressve levels or activation statuses could predict the risk of drug resistance in the patients subjected to chemotherapy .Accordingly ,PXR/CAR antag-onists,combining with existing chemotherapeutics that activate PXR /CAR,are promising options that could over-come MDR in cancer.