OBJECTIVETo observe the life quality improvement of spastic hemiplegia of stroke treated with fire-needle.

METHODSSixty patients were randomly divided into a fire-needle group and a rehabilitation group, 30 cases in each one. In the two groups, the conventional treatment of neurology and rehabilitation strengthening limbs function were applied. In the fire-needle group, fire-needle was used at Jianyu (LI 15), Binao (LI 14), Quchi (LI 11), Yanglingquan (GB 34), Xuehai (SP 10) and Sanyinjiao (SP 6), etc. , once two days and continuously for 30 days (15 times). In the rehabilitation group, conventional rehabilitation exercises were given five times a week for 4 weeks (20 times). Before treatment, at the end of treating program and one month later after treatment, spasticity of upper and lower limbs was assessed by Ashworth scale and clinic spasticity index (CSI); limbs function was evaluated by Fugl-Meyer (FM) scale; life quality was estimated by patient-reported outcome (PRO). Clinical effects were compared between the two groups.

RESULTS(1) At the end of treating and one month later after treatment, the Ashworth scales were better than those before treatment in the two groups (P < 0.05, P < 0.01), and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group (both P < 0.05). (2) At the end of treating and one month later after treatment, the CSIs were better than those be fore treatment in the fire-needle group (both P < 0.01), but not changed apparently in the rehabilitation group (both P > 0.05). And the indices of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01). (3) The FM scales of upper and lower limbs at the end of treating and one month later after treatment were better than those before treatment in the two groups (all P 0.01), except the lower limbs at the end of treating in the rehabilitation group (P > 0.05). The FM scales of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01). (4) At the end of treating and one month later after treatment, the PRO scales were better than those before treatment in the two groups (all P < 0.01), and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01).

CONCLUSIONFire-needle can effectively relieve spastic hemiplegia of stroke, and improve limbs motor function and life quality. It is better than rehabilitation.

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Hemiplegia ; Humans ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; physiopathology ; therapy ; Needles ; Quality of Life ; Stroke ; complications ; therapy ; Treatment Outcome ; Upper Extremity ; physiopathology

Objective:To investigate the efficacy of Zhongjiefeng dispersible tablets combined with ranitidine in the treatment of recurrent oral ulcer and its effec on inflammatory factors. Methods:Eighty-six patients who received recurrent oral ulcer in Yiwu Hospital of Traditional Chinese Medicine from January 2019 to January 2020 were included in this study. They were randomly assigned to receive treatment with either ranitidine (control group, n = 43) or Zhongjiefeng dispersible tablets combined with ranitidine (observation group, n = 43) for 4 weeks. Before and after treatment, visual analogue scale score and inflammatory factor were compared between the control and observation groups. Change in main symptom score after treatment relative to before treatment and the curative effect were also compared between the two groups. Results:After treatment, the visual analogue scale score in the observation group was significantly lower than that in the control group [(1.32 ± 0.37) vs. (3.06 ± 0.54), t = 17.430, P < 0.05]. After treatment, serum interleukin-2 [(16.42 ± 3.18) μg/L], interleukin-6 [(6.56 ± 1.28) ng/L], tumor necrosis factor-α [(7.69 ± 1.34) μg/L] levels in the observation group were significantly lower than those in the control group [(25.97 ± 5.24) μg/L, (9.84 ± 1.62) ng/L and (11.86 ± 1.83) μg/L, t = 10.217, 10.4617 and 12.056, all P < 0.05]. After treatment, ulcer area score [(0.76 ± 0.14) points] and ulcer number score [(0.68 ± 0.19) points] in the observation group were significantly lower than those in the control group [(1.21 ± 0.20) points and (1.24 ± 0.30) points, t = 12.087, 10.341, both P < 0.05]. Total effective rate in the observation group was significantly higher than that in the control group [93.02% (40/43) vs. 72.09% (31/43), χ 2 = 6.541, P < 0.05]. Conclusion:Zhongjiefeng dispersible tablets combined with ranitidine exhibits obvious curative effect on recurrent oral ulcer in patients through reducing pain and inflammatory reaction.

Objective To evaluate the clinical value of endoscopy for the treatment of acute obstructive suppurative cholangitis. Methods Data of 182 patients suffering from acute obstructive suppurative cholangitis, in whom endoscopic treatment was undertaken, were retrospectively analysed. Results All patients received endoscopic sphincterotomy (EST). Among them, 25 patients underwent endoscopic retractor-biliary drainage (ERBD), 140 patients received endoscopic naso-biliary drainage (ENBD), and in 17 cases endoscopic metal retractor-biliary drainage (EMBD) was done. The treatment was successfully in all patients. The clinical findings were markedly improved after treatment in all of them. Conclusion Endoscopic treatment was a fast, safe, effective and economic method for the treatment of acute obstructive suppurative cholangitis.

Objective To evaluate the clinical curative effects of pancreatic stents on chronic pancreatitis.Methods 18 cases of chronic pancreatitis were diagnosed by clinical symptoms,by lab tests and by relative examinations.All cases had received pancreatic stents endoscopic treatment,and were followed up postoperatively about the change of the clinical symptoms and the lab tests.Results All cases were placed successfully pancreatic stents.Abdominal pain relieved completely within one month.The remissive rate of abdominal pain was a hundred percent.The clinical symptoms such as marasmus and fatty diarrhea were markedly improved.The serum amylase level recovered to the normal range within 1 to 14 days,except one case in which the serum amylase level recovered slowly for the dysfunction of pancreatic external secretion.The stent was replaced in 1 case after 10 days because of obstruction.Conclusion Pancreatic stents endoscopic treatment of chronic pancreatitis is a preferred method which is secure,low-traumatic,low-expenditure,convenient and effectual,and it is of prominent clinical application value.

Objective To evaluate the effects of endoscopic treatment on chronic pancreatitis. Methods 33 cases with chronic pancreatitis having received endoscopic treatment in a 2 years' period were retrospectively analyzed. The diagnosis was confirmed in all the patients by clinical examination, lab tests, CT, ultrasonography and endoscopic retrograde cholangiopancreatography (ERCP). According to the patients' condition, various treatment measures including endoscopic pancreatic sphincterotomy (EPS), endoscopic papillo-sphincterotomy (EST), pancreatic stenting (PS), pancreatic stone extraction, naso-pancreatic drainage (ENPD), pancreatic duct stricture dilation, etc, were used individually or jointly. Results 18 cases received EPS and 27 underwent EST. Pancreatic duct stone extraction by basket or balloon was performed in 6 cases, PS in 13, ENPD in 5, and pancreatic duct dilatation in 9 cases. The endoscopic drainage by transgastric placement of a stent was done in a patient with a huge pseudocyst. Abdominal pain disappeared or markedly relieved in 29 cases after treatment. Marked improvement after treatment was shown by lab examination and imaging. Conclusion The combined application of various treatment measures for chronic pancreatitis through endoscopic approach is a safe, minimal-invasive and effective procedure.

Development of small molecule drugs is important for targeted and personalized therapy for cancers.However,it is staggering to take new compounds from the research bench to clinical trial pipelines and eventually to the clinical practice,due to the time,effort and costs.Most drugs need five years of development after discovery in the laboratory before they are ready to be tested for efficacy and safety.Compared to development of new drugs from scratch, increasing research efforts have been made to turn existing drugs to new uses to treat cancers, which may bypass years of costly work.Metformin used in cancer care is a good example of giving old drugs a new life.The activity of metformin on anti-cancer has recently drawn significant attention.Epidemiological and experimental studies have shown that metformin can cut down the incidence of cancer in diabetic patients and reduce metabolism-related cancers.Meanwhile, recent study has found metformin can induce autophagy of esophageal cancer cells by inhibiting inflammatory signaling pathway.In recent years, increasing studies have shown that metformin plays a major role in suppressing cancers via multiple mechanisms.In this mini-review,we summarize the updates of the research on metformin in cancer prevention and treatment.

Objective To evaluate the clinical results from different endoscopic treatments of patients with chronic pancreatitis. Methods Thirty-seven cases of chronic pancreatitis had accepted endoscop-ie treatments were analvzed retrospectively. Results All cases were diagnosed clearly by ERCP showing different degree of pancreatic duct dilatation. Among them 21 cases had pancreatic duct stricture, 9 cases pancreatie duet ealeification. EPS in 18 cases and EST in 37 cases, basket extraction pancreatic duct stones in 6 eases, PDSD in 17 cases, NPD in 5 cases were conducted. The abdominal pain in 34 cases disappeared or markedly relieved alter treatment. Conclusion Endoseopie treatments have the advantages of safe, less-trauma and effectiveness. The combination of different endoscopic treatments improved evidently the current state of chronic pancreatitis treatment, thereby the therapeutic results.

Objective To investigate the short-term acute rejection incidence of the recipients under the steroid-free immunosuppressive therapy after liver transplantation. Methods This retrospective study included 186 patients who were divided into two groups by random number table.The patients in no steroid group (the study group, n =94) received tacrolimus (Tac) with mycophemolate mofetil (MMF) or cyclosporine with MMF,and those in the steroid group (the control group,n =92) received the aforementioned immunosuppressive therapy combined with steroids.The acute rejection incidence was analyzed during six months post-transplantation.Results There was no significant difference in the gender,age,indication for transplantation,Child-Pugh score,MELD score,operating time,bleeding and transfusion volume during the operation,warm ischemia time and cold ischemia time between the two groups (P＞0.05).Liver biopsy was done on 9 cases of each group.The acute rejection incidence had no significant difference between the study group and the control group (5/94 vs 4/92,5.3％ vs 4.4％,P＞0.05).Conclusion The steroid-free immunosuppressive therapy after liver transplantation did not increase the short term acute rejection incidence.

Objective To evaluate the clinical value of endoscopic palliative stents drainage in patients with unresectable carcinoma at pancreas head.Methods Endoscopic stents placement was Derformed in 197 patients with unresectable pancreas head carcinoma,from August 2003 to August 2007,and the clinieal data was studied retrospectively.Results Bile duct obstruction was present in all patients.in which 126 were accompanied with dilation of distal pancreatic duct,91 with atrophy of pancrea body and tail. Stent placement in pancreatic duct Was performed in 108 patients with a Success rate of 96.4%,and placement in bile duct was performed in all patients with a success rate of 99.0%.In 195 patients with successful stent placement,jaundice dissolved after the procedure.Of 101 patients who had abdominal pain,complete pain alleviation Was achieved in 98,partially alleviation achieved in 3. Serum amylase level increased after the operation in 24 cases,which resumed tO normal value after corresponding managements.All Datients received a lifelong follow-up at mean duration of 373.57±157.35 days,with a longest survival time of 842 days.Conclusion Endoscopic palliative stents drainage is safe and effective in patients with unresectable Dancre.atie carcer,which miight increase survival rate and improve life quality.

Aimed at the current plight of medical students' professionalism education,such as ignoring the top -level design and the overall plan but emphasizing practice,ignoring the permeability of professional spirit but emphasizing the impartation of professional knowledge,ignoring humanities but emphasizing professional issues in curriculum setting,Capital Medical University advocated the all-dimensional education philosophy implenented by all staff through the whole process,made top-level design scientifically for medical students' professionalism education.The university strengthened professionalism through teaching,permeated professionalism through a series of educational activities,consolidated professionalism through clinical practice,and thus to strengthen the cultivation of medical students' professionalism and realize scientific education by all staff and throughout the whole process.