Objective To observe the efficacy of palace production technique of Puerpera with gestational hypertension by ropivacaine combined with sufentanil and epidural anesthesia.Methods77 cases with hypertensive disorders in pregnancy from January 2014 to January 2015 hypertensive, 39 cases were randomly divided into observation group and the control group of 38 patients, the control group received ropivacaine anesthesia, the observation group received ropivacaine combined with sufentanil and epidural anesthesia, observed two groups of mothers onset time of anesthesia, operative time, pain duration, neonatal apgar score, postoperative pain scores and adverse reactions.ResultsThe onset time of anesthesia, analgesia duration, and postoperative pain scores were significantly better than the control group, the difference was significant (P<0.05);two groups of mothers in the operation time, score and adverse neonatal apgar, the total incidence the difference was not statistically significant.ConclusionRopivacaine combined with sufentanil CSEA anesthesia for hypertensive disorders in pregnancy cesarean exact effect is better than alone ropivacaine spinal anesthesia program, and no obvious side effects and is worthy of further promotion and application.

A new HPLC-UV technique for the separation and analysis of 10 monosaccharides achieved within 13.5 min using 1-phenyl-3-methyl-5-pyrazolone (PMP) as the labelling molecule of the reductive monosaccharides has been established by combining common high performance liquid chromatography-UV and C18 column. The established technique was applied to the quantification of the monosaccharide components in extract of Silybum marianum. The results showed that the tested 10 monosaccharides as PMP derivatives were baseline separated under the HPLC conditions proposed. It was confirmed that Silybum marianum extract was composed of mannose, rhamnose, glucuronic acid, galacturonic acid, glucose, xylose, galactose and arabinose with the molar ratio of 0.66:0.84:0.58:1.0:1.6:0.69:2.7:4.8. Quantitative recoveries of the compositional monosaccharides separated from the extract were in the range of 92.4%-104.0%, and the RSD values fell within 0.68%-3.81%. The results demonstrated that the proposed HPLC method was simple, rapid, convenient, and precise, and it was applicable to the analysis of the compositional monosaccharides of Silybum marianum extract.

Objective:To evaluate the efficacy and safety of Tuina(Chinese therapeutic massage)in the treatment of functional dyspepsia(FD)in children and adults. Methods:Related articles in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China Biology Medicine Disc(CBM),Wanfang Academic Journal Full-text Database(Wanfang),China National Knowledge Infrastructure(CNKI),and Chongqing VIP Database(CQVIP)were collected.The retrieval time was from each database's start to March 2022.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.A meta-analysis was then performed using the RevMan 5.4 software. Results:A total of 19 clinical trials were included,9 of which encompassed studies on adults while 10 were on children with FD,comprising a total of 1961 patients.The findings of the meta-analysis showed that the effective rate of FD in children and adults treated with Tuina was significantly higher than that in the control group[risk ratio(RR)=1.15,95%confidence interval(CI)(1.09,1.21),P<0.001],[RR=1.13,95%CI(1.06,1.21),P<0.001].In addition,the effective rate of FD in children and adults treated with Tuina combined with other treatments was significantly higher than that in the control group[RR=1.14,95%CI(1.07,1.21),P<0.001],[RR=1.12,95%CI(1.02,1.24),P=0.02].In terms of single symptoms,Tuina improved epigastric burning sensation score in adults[standardized mean difference(SMD)=-0.41;95%CI(-0.79,-0.02);Z=2.08;P=0.04]compared with that of the Western medicine group.Compared with children treated with oral Chinese medications(CM)or Chinese patent medicine(CPM),children with FD demonstrated lower scores of epigastric pain[SMD=-0.38,95%CI(-0.56,-0.19);Z=3.96;P<0.001],postprandial fullness[SMD=-0.30,95%CI(-0.50,-0.10);Z=2.88;P=0.004],and early satiety[SMD=-0.26,95%CI(-0.47,-0.06);Z=2.54;P=0.01]after receiving Tuina combined with CM or CPM treatment.No adverse events were reported in the Tuina treatment group,and the follow-up indicated that the symptom scores in the Tuina group improved. Conclusion:Compared with the control group,both Tuina and Tuina combined with other treatments are shown to have better effective rates,lower incidence of adverse events,and better follow-up outcomes.The study results suggest that Tuina may be a clinically viable complementary therapy.However,due to limitations in the number and quality of the included studies,the above conclusions should be verified by further high-quality studies.

BACKGROUND:Nickel-titanium memory-shape compression anastomosis clip (Ni-Ti CAC) has been used in gastrointestinal anastomosis, but its efficacy and safety still remain controversial.OBJECTIVE:To evaluate the efficacy and safety of Ni-Ti CAC in gastrointestinal anastomosis.METHODS:A computer-based online research of PubMed, EMbase, Cochrane Library, CBM, CNKI, and VIP databases was performed for articles published before January 15th, 2017 using the keywords of nickel-titanium, compression anastomosis clip, anastomosis, gastric, jejunum, ileum, small intestine, colon, rectum, and large intestine in English and Chinese, respectively. The randomized controled trials about Ni-Ti CACversus conventional methods for gastrointestinal anastomosis were included. Meta-analysis of the anastomosis time, time of exsufflation, and hospitalization time was performed, and sequential analysis was conducted on TSA v0.9 software.RESULTS AND CONCLUSION:A total of 18 eligible randomized controlled trials were enroled, involving 1860 patients. Ni-Ti CAC could reduce the anastomosis time [MD=-3.83, 95%CI(-6.48,-1.19),P=0.004] and time of exsufflation [MD=-0.14, 95%CI(-0.22,-0.05),P=0.002], but there was no significant difference in the hospitalization time [MD=-0.83, 95%CI(-1.82, 0.16), P=0.10]. The quality was ranked as low level based on GRADE system. The time of exsufflation of Ni-Ti CAC was superior to that of conventional method, which was confirmed by sequential analysis. One case of death was reported and incision infection was the most common adverse effects; additionaly, pulmonary embolism and abdominal pain occurred. To conclude, Ni-Ti CAC can facilitate gastrointestinal anastomosis, accelerate the time of exsufflation, and holds a good safety. However, more multicenter and high-quality randomized controlled trials are needed.

The advance care planning is conducive to reducing the over treatment of terminally ill patients and improving the quality of life of patients. Video decision aid can effectively transmit terminal decision-making information, which has become an important means to implement advance care planning in countries and regions with better palliative care development. This paper summarizes the application types and effects and puts forward suggestions for constructing and using relevant tools in China, so as to provide references for research and practice of video decision aids in advance care planning in China.

OBJECTIVE:To evaluate the clinical efficacy and safety of Shenqi fuzheng injection combined with chemotherapy in the treatment of colorectal cancer.METHODS:Retrieved from PubMed,EMBase,Clinical Trials,Cochrane Library,CJFD,CBM,Wanfang database and VIP,RCTs about Shenqi fuzheng injection combined with chemotherapy (trial group) vs.chemotherapy alone (control group) in the treatment of colorectal cancer were included.Meta-analysis was performed by Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual.RESULTS:A total of 25 RCTs were included,involving 1 987 patients.Results of Meta-analysis showed that objective remission rate of trial group was significantly higher than control group [RR=1.19,95％ CI (1.02,1.39),P=0.02];the improvement of survival quality was significantly better than control group [RR=1.72,95％CI(1.49,1.99),P＜0.001];CD4VCD8+ was significantly higher than control group [MD=0.40,95％ CI (0.29,0.50),P＜0.001];the incidence of gastrointestinal reaction was significantly higher than control group [RR=0.59,95％CI(0.52,0.68),P＜0.001];the incidence of liver and renal injury was significantly lower than control group [RR=0.52,95％CI(0.41,0.67),P＜0.001],with statistical significance.CONCLUSIONS:Shenqi fuzheng injection combined with chemotherapy can improve objective remission rate of colorectal cancer patients,survival quality and immune function,and reduce the occurrence of toxic reation.

In recent decades,non-invasive techniques have markedly developed.Non-invasive body contouring represents the fastest growing area of modem aesthetic medicine.Patients' fear of surgery has made micro-invasive and non-invasive lipolysis technology a hot topic in recent years.There are currently five leading non-invasive or micro-invasive techniques for reducing localized subcutaneous adipose tissue,including deoxycholic acid injection,cryolipolysis,ultrasonic lipolysis,radiofrequency lipolysis and laser lipolysis.This review mainly summarizes the recent findings regarding the action mechanisms,clinical efficacy of and adverse reactions to non-invasive lipolysis techniques.

Objective:To observe the short-term efficacy and safety of apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple-negative breast cancer (TNBC) patients.Methods:From September 2018 to September 2019, 17 stage Ⅱ/Ⅲ TNBC patients were enrolled in this single arm, single center prospective phase Ⅱ study. They received neoadjuvant treatment of apatinib 250 mg per day, paclitaxel 175 mg/m 2 on 1 st day and a dose of carboplatin according to the area under curve (AUC)=4 on 2 nd day, every 14 days as a cycle. Results:By January 2020, 16 cases completed 4-7 cycles of apatinib treatment and 4-8 cycles of chemotherapy. The median cycles of apatinib treatment and chemotherapy were 5 cycles and 6 cycles, respectively. Two cases achieved complete responses (CR), 12 achieved partial responses (PR), 2 achieved stable diseases (SD) and no progressive disease was observed. The objective response rate (ORR) was 87.5%, disease control rate (DCR) was 100%. By January 2020, among 12 patients who received surgery, 8 achieved pathologic complete response (pCR, 66.7%). The grade Ⅲ/Ⅳ adverse events included: neutropenia, thrombocytopenia in 3 cases (18.8%) each, anemia, fatigue, arrhythmia and alanine aminotransferase (ALT) elevation in 1 case each. Apatinib was interrupted in 5 cases, and was discontinued in 3 cases; chemotherapy dosage was reduced in 1 case.Conclusion:Apatinib in combination with dose-dense paclitaxel and carboplatin neoadjuvant therapy are effective and well tolerated in locally advanced TNBC patients.

OBJECTIVE To compare the efficacy of Eustachian tube pressure nebulization and insuffiation system and conventional drugs on acute otitis media of effusion in adults. METHODS Sixty ears of acute otitis media of effusion in our hospital were selected as the research objects. All patients were divided into two groups according to the treatment,which received drug therapy alone and received drug therapy and nebulizer therapy. The course lasted for 7 days. ETS,ETDQ-7,related hearing tests(acoustic immitance and pure tone threshold),and the therapeutic effect were compared among the three groups. RESULTS In drug therapy alone group,6 ears were cured,10 ears were improved,and the total effective rate was 53.3％. In drug therapy and nebulizer therapy group,17 ears were cured,9 ears were improved,and the total effective rate was 86.7％. There were no complications or adverse reactions in all patients. CONCLUSION The effective rate of the patients treated with Eustachian tube pressure nebulization and insuffiation system combined drug therapy was significantly higher than that of drug therapy alone. On the basis of conventional drug therapy combined with eustachian tube pressure nebulization and insuffiation system might can be a new effective choice for acute otitis media of effusion in adults.

Objective:To observe the short-term efficacy and safety of apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple-negative breast cancer (TNBC) patients.Methods:From September 2018 to September 2019, 17 stage Ⅱ/Ⅲ TNBC patients were enrolled in this single arm, single center prospective phase Ⅱ study. They received neoadjuvant treatment of apatinib 250 mg per day, paclitaxel 175 mg/m 2 on 1 st day and a dose of carboplatin according to the area under curve (AUC)=4 on 2 nd day, every 14 days as a cycle. Results:By January 2020, 16 cases completed 4-7 cycles of apatinib treatment and 4-8 cycles of chemotherapy. The median cycles of apatinib treatment and chemotherapy were 5 cycles and 6 cycles, respectively. Two cases achieved complete responses (CR), 12 achieved partial responses (PR), 2 achieved stable diseases (SD) and no progressive disease was observed. The objective response rate (ORR) was 87.5%, disease control rate (DCR) was 100%. By January 2020, among 12 patients who received surgery, 8 achieved pathologic complete response (pCR, 66.7%). The grade Ⅲ/Ⅳ adverse events included: neutropenia, thrombocytopenia in 3 cases (18.8%) each, anemia, fatigue, arrhythmia and alanine aminotransferase (ALT) elevation in 1 case each. Apatinib was interrupted in 5 cases, and was discontinued in 3 cases; chemotherapy dosage was reduced in 1 case.Conclusion:Apatinib in combination with dose-dense paclitaxel and carboplatin neoadjuvant therapy are effective and well tolerated in locally advanced TNBC patients.