Objective To study the effect of Shugan Tongluo Recipe on the patients with upper limb swelling after breast cancer surgery, and to explore the efficiency of treatment.Methods84 patients with breast cancer were selected from June to December 2015 in the traditional Chinese medicine clinic of Ge zhen,, were randomly divided into control group and observation group, control group using beta seven yezao sodium and conventional rehabilitation therapy, observation group based on the combined application of Shugan Tongluo Decoction, and compared the effectiveness of treatment.ResultsThe effective rate of the observation group was 92.8%, significantly better than the control group 78.6%, the difference between the two groups significantly, with statistical significance (P<0.05).At the same time, the observation group VAS score, IL-6 score and CCL-18 score were lower than the control group, EORTC QLQ score is higher than that of the control group, the treatment of feedback better(P<0.05).In addition, the incidence of adverse reactions was 4.7%, 9.5% in the control group, the observation group treatment.ConclusionThe prescription of Shugan Tongluo decoction has a good effect on the treatment of upper limb swelling after breast cancer surgery, and it has high safety and good patient satisfaction.

Red cell immunologic adherent function and Se quantity were measured in 48 normal children of Keshan disease area and the reaction of red cell C3bR to these children. The results showed that the Se quantity and the rosette formation rate of red cell C3bR of normal children in Keshan disease area were significantly lower than that in the control(P0.05).

Objective To probe the repair effect of bone defect after getting rid of free bone in chronic osteomyelitis patients. Method Eighteen chronic osteomyelitis patients were reconstructed with vascularized fibula graft at one stage after getting rid of free bone and 2 cases were reconstructed with regional transplantation of pedic fibula after inflammable bone segment were exsected. Result Twenty chronic osteomyelitis patients who were treated with vascularized fibula graft or regional transplantation of pedic fibula after getting rid of free bone were followed up 3 - 6 months (mean 3. 5 months). The reconstructed bone unioned well,the inflammation of all bones near to joints were controlled; the repaired limbs achieved satisfactory function and outline. Conclusion The operation to reconstruct bone defect after getting rid of free bone in chronic osteomyelitis patients with vascularized fibula graft or regional transplantation of pedic fibula primerally is a good method' The advantage lies in avoiding the long alteration period of free bone, bettering the blood circulation of receipt region, controlling inflammation, shortening the resident period,times and operation times,and so. The method is a good attempt to repair inflammatory bone defect using vascularized bone graft.

The separation of teaching and test is not only important in improving teaching quality but also effective to the prevention of cheating in the exams,the improvement of the quality of exams and the correct checkout of the teaching effect.

Angina Pectoris, Variant ; physiopathology ; Arrhythmias, Cardiac ; Electrocardiography ; Humans ; Male ; Middle Aged

Objective To study the role of inositol requiring enzyme 1 (IRE1)-mediated endoplasmic reticulum stress on hepatocyte apoptosis of experimental fulminant hepatic failure (FHF).Methods Thirty male depuratory Wistar rats were manufactured to be FHF model by peritoneal injection of D-galactosamine (D-GalN) and lipopolysaccharide (LPS),and 30 rats were injected peritoneally with 0.9％ sodium chloride solution as controls.The apoptosis of liver cells was detected by flow cytometry.The protein and mRNA expressions of Caspase-12 and IRE1 in liver tissues were detected by immunohistochemistry and reverse transcriptation-polymerase chain reaction (RT-PCR).The independent samples were compared by Kruskal-Wallis H test.The comparison between two groups at the same time point was done by Mann-Whitney U test.The correlation analysis was done by rank correlation.Results The apoptotic rates of liver cells at 2,4,8 and 12 hours were increased over time in model group (x2 =25.475,P=0.01),which were higher than control group (U=0,P＜0.01).The expressions of Caspase-12 and IRE1 proteins in liver tissues were upregulated in model group,while the expressions were not detected in control group.The expressions of Caspase-12 and IRE1 mRNA in model group were also increased over time and peaked at 8 h,then gradually decreased; the differences among different time points were statistically significant (x2 =23.983,x2 =24.820; both P＜0.01),and all higher than control group (U=0,P＜0.01).IRE1 was positively correlated with both Caspase-12 and hepatocellular apoptotic rate (r=0.733 and 0.715,respectively;both P＜0.01).Caspase-12 was positively correlated with hepatocellular apoptotic rate (r=0.586,P＜0.01).Conclusions IRE1 mediated endoplasmic reticulum stress on hepatocyte apoptosis is closely related to the development of FHF.The earlier intervention on endoplasmic reticulum stress pathway,the more protective effect in liver failure.

BACKGROUND: Umbilical cord blood (UCB) with limited karyocytes is mainly used in child patients. Recently, physicians have tried to mix two units of cord blood in the treatment of adults with hematological system diseases.OBJECTIVE: To monitor quantitatively the dynamic changes and the development rules of engraftment, chimera types and relative amount after allogeneic transplantation of mixed UCB from two units in adults with leukemia.DESIGN: Donors and the recipient were regarded as observational subjects in umbilical cord blood transplantation (UCBT). DNA extracted from blood samples of donors and the recipient before and after transplantation was considered as detecting samples. Short tandem repeat (STR) loci were as observational measures.SETTING: Key Laboratory of Immunology and Genetics of Institute of Transfusion Medicine of Shenzhen Blood Center.PARTICIPANT: A 43-year male patient with acute myeloid leukemia (AML), 75 kg, who was hospitalized at Shenzhen Hospital of Peking University, was enrolled in June 2005. The patient received two units of human leucocyte antigen (HLA), one locus mismatched unrelated UCBT (2.5×107 kg-1 karyocytes in UCB 1, and 1.53×107 kg-1 karyocytes in UCB 2) at month 6 after complete remission from first chemotherapy. UCB was collected from Guangzhou umbilical cord blood bank. The patient signed the informed consent.METHODS: The adult with AML received two units of HLA, one locus mismatched unrelated UCBT (2.5×107 kg-1 karyocytes in UCB 1, and 1.53×107 kg-1 karyocytes in UCB 2). Nine STR loci of the blood sample were determined before and after transplantation by quantitative technique of fluorescence labeling with multiplex polymerase chain reaction (MPCR), while the engraftment and chimera types were qualitatively evaluated by comparing differential loci between the recipient and the donors. The relative amount of two units of UCB was calculated in the patient after transplantation according to the differential gene peak areas of two donors with 377XL DNA sequencer after fluorescence scanning. The engraftment level and the development rules of donors' cells were analyzed quantitatively. In addition, the results were also compared with that of HLA loci distinct analysis for engraftment.MAIN OUTCOME MEASURES: After UCBT, transition process of nine STR loci of the recipient and two donors was observed, and engraftment was quantitatively and qualitatively described.RESULTS: Two units of UCB at day 15 after transplantation were engrafted simultaneously and revealed a complete chimera of the two. The relative amounts of UCB 1 and UCB 2 were 51.3% and 48.7%, respectively. Subsequently, UCB 1 went up to 70.0% and UCB 2 declined to 30.0% at day 30. However, only the genotype of UCB 1 was detected at day 52, and engraftment turned to a complete chimera of a single donor. The one with fewer karyocytes was rejected and the one with more karyocytes was engrafted for a long term.CONCLUSION: To detect quantitatively STR chimera with fluorescence labeling and MPCR can show precisely the engraftment level and the change of two units of UCB. It provides an accurate and reliable experimental basis for clinical UCB application and donor selection. It is proved that adult transplantation at the same time with mixed UCB from two units HLA one locus mismatched unrelated donors is feasible.

Objective To analyze the cost-effectiveness of integrated pharmaceutical care (IPC) in community-based patients with chronic obstructive pulmonary disease (COPD).Methods The COPD patients were divided randomly into intervention group (group A,n =79) and control group (group B,n =71).Group A received the IPC intervention measures,including serial lectures of pharmaceutical knowledge,home supervision and web-based communications for while group B group had none.Results As compared with group B,group A obviously improved on the knowledge of pharmaceutical treatment effect and side effect (95.1％,67.4％ vs.63.1％,21.9％,x2 =12.445,P=0.000 vs.x2 =55.557,P=0.000).There were notable differences between two groups [ ( 1.77 ± 1.23 ) vs.( 2.42 ± 1.66 ) s,t =2.583,P=0.011],pulmonary rales [ (0.01 vs.0.01)s,Z =2.370,P=0.018],6-min walk distance (6 MWD) [ (457 ± 67 ) vs.(425 ± 72) m,t =2.760,P =0.007 ],vital capacity ( VC ) [ ( 1.60 ± 0.25 ) vs.( 1.49 ± 0.23 ) L,t =2.718,P =0.007 ) ] andquality-of-life items ( 48 ± 10 vs.52 ± 11,t =2.624,P =0.010) after intervention.Analyze of cost-effectiveness show that groupA was superior to group B [ total effect total cost(TE/TC =764.6/4936,15.49％ )vs.(TE/TC =1509.4/4708),32.06％,x2 =6.183,P ＜ 0.01 ].Conclusion IPC can improve the disease condition and achieve excellent cost-effectiveness for community-based COPD patients.

To establish a sensitive and specific method for simultaneous determination of gestodene, etonogestrel and ethinylestradiol in plasma by LC-MS/MS, plasma samples were extracted and derivatized before injection. An ESI ion source was used and operated in the positive ion mode with multiple reaction monitoring (MRM). Norgestrel was chosen as internal standard and performed on a C18 (100 mm x 2.1 mm, 5 microm) column. The concentrations of gestodene, etonogestrel and ethinylestradiol were measured, using step-gradient mobile phase and step-gradient flow rate. The method was validated over the concentration range of 0.1-20 ng x mL(-1) for gestodene and etonogestrel and 0.01-2 ng x mL(-1) for ethinylestradiol, and showed excellent linearity. The intra- and inter-assay accuracy and precision were below 10.0% and recovery was 93.6%-110.9% over the three concentration levels evaluated. The method was applied in pharmacokinetic study of the compound gestodene patch and the compound etonogestrel patch in rabbits. The LC-MS/MS method was selective, accurate and sensitive, especially the LOQ were 100 pg x mL(-1) for gestodene and etonogestrel and 10 pg x mL(-1) for ethinylestradiol. The method was successfully applied in pharmacokinetic study for contraceptives.

OBJECTIVE To demonstrate the bleeding sites and the major blood supply in patients with hidden epistaxis. METHODS The clinical data of 106 patients with hidden epistaxis were studied retrospectively. The bleeding sites and hemorrhagic focus was not found by routine anterior nasoscope examination was defined as hidden epistaxis. The bleeding sites were located and the bleeding was stopped under nasal endoscope. RESULTS The hemorrhagic foci were found in the following sites: 55.7%(59/106)at the top of inferior meatus, 33.0% (35/106)middle turbinate and the top of middle meatus, 9.4%(10/106)olfactory cleft and the nasal septum, and 1.9%(2/106)unknown. The bleeding sites were found and the bleeding was stopped with radiofrequency under nasal endoscope in 104 cases. Bleeding was stopped by treatment once in 102 cases(96.2%)and treatment twice in 2 cases(1.9%). All the patients were followed up for over one month without recurrence and the cure rate was 98.1%. Bleeding sites were not found in 2 cases because of heavy damage of the nasal mucosa. CONCLUSION ①The majority of hidden epistaxis is supplied by the sphenopalatine artery. ②To find the bleeding sites and stop the bleeding in hidden epistaxis patients under nasal endoscope using radiofrequency is effective, minimally invasive and worth of clinic application extensively.