Objective] The article explores and analyses the clinical dialectical experience of my postgraduate tutor in the treatment on chronic abdominal pain of children. [Methods]From following professor Sang Gao clinical studies,summarize the experience and thoughts of treating chronic abdominal pain of children,and with a case. [Results]My tutor believes that the pathogenesis of chronic abdominal pain of children caused by weakness of middle energizer, disorder of Qi, which lead to the spleen deficiency and qi stagnation, to cure the disease must treat with liver and spleen together, with activating the spleen and regulating the liver, harmonizing stomach and relieving pain as a rule which can achieve good effect. [Conclusion] Activating the spleen and regulating the liver is an effective treatment, it is worthy of in-depth study and promotion.

This study was aimed to analyze the medication rules of AIDS fever by Professor Li Fazhi, in order to pro-vide the corresponding medication reference basis for Chinese medicine treatment of AIDS fever. The complex net-work analysis method was used. This study was conducted among AIDS fever patients treated by Professor Li Fazhi from September 2007 to June 2012 in Weishi County, Henan Province. The analysis was made on the etiology and pathogenesis of AIDS fever, syndrome differentiation and treatment as well as medication of senior famous Chinese medicine doctors. The results showed that through a multidimensional query analysis, the core medication in the treatment of AIDS fever included harmonization and heat-clearing herbs such as Bupleurum, Licorice, Scutellaria, as well as qi-supplementing and healthy qi reinforcing herbs such as Codonopsis and Astragalus. The core prescriptions were modified Xiaochaihu Decoction and Buzhong Y iqi Decoction. It was concluded that the treatment rules of AIDS fever by Professor Li Fazhi was to clear heat in combination with supplementing the center and boost qi.

Objective　To investigate the changes and their significance of bcl-2 and c-myc in nordihydroguaiaretic acid (NDGA)-induced apoptosis of human malignant glioma cell line SHG-44. Methods　The apoptosis of SHG-44 cells was observed with light and electron microscopy and TUNEL method. The expression of bcl-2 and c-myc gene was measured with immunohistochemistry, in situ hybridization and image analysis. Results ① The SHG-44 cell apoptosis was induced by NDGA at a concentration lower than 200 μmol/L in a time-dependent manner. ② The expressions of bcl-2 and c-myc gene in SHG-44 cells were decreased after the treatment of 100 μmol/L NDGA with the elapse of time, indicating a close association with cell apoptosis. ③ The expressions of bcl-2 and c-myc mRNA in SHG-44 cells were decreased after the treatment with 100μmol/L NDGA, which was apparently consistent with the immunohistochemical results. Conclusion　The NDGA-induced apoptosis in human malignant glioma cells might be related with the down-regulated expressions of bcl-2 and c-myc gene. The exact mechanism needs further research.

Objective　To investigate roles of cyclin-dependent kinase 4 (CDK4) in nordihydroguaiaretic acid (NDGA)-induced inhibitory effect on proliferation of human malignant glioma cells. Methods　The techniques of cell culture, cell counts, flow cytometry, immunoprecipitation, immunohistochemistry and image analysis were employed in this study. Results　①A concentration-dependent inhibition of proliferation was demonstrated in the SHG-44 cells incubated for 24 hours in the presence of NDGA, and cell proliferation was blocked in the G1→S phase. ②The activity of CDK4 was decreased apparently in the SHG-44 cells treated for 24 hours with 10 to 200 μmol/L NDGA in a concentration-dependent way. ③The expression of CDK4 gene was downregulated in the cells after NDGA treatment. Conclusion　CDK4 plays an important role in NDGA-induced inhibition of glioma cell proliferation.

Objective To investigate the efficacy of hepatitis B vaccination in preventing hepatitis B (HBV) recurrence after liver transplantation for hepatitis B virus-related (HBV-related) recipients.Methods 30 healthy recipients who survived for more than 2 years after liver transplantation received vaccination using hepatitis B surface antigen (HBsAg)-containing vaccine.There were a total of 5 injections at 0 month, 1 month, 2 months, 3 months and 6 months respectively, and each dose was 40 μg.Thirty healthy adults who received hepatitis B vaccination during the same period were selected into the control group.The antibody of hepatitis B surface (Anti-HBs) titer was tested at 1 month, 2 months, 3 months, 6 months, 9 months and 12 months after the first vaccination.Results 6.7％ (2/30) of the liver transplantation recipients had good response (defined as a rise of Anti-HBs titer of more than 100 IU/L at 12 months after the primary vaccination), and 16.7％ of recipients (5/30) had partial response (Anti-HBs titer in 3 patients at less than 100 IU/L, Anti-HBs titer in 2 patients at more than 100 IU/L at first, then less than 100 IU/L after 12 months).For the 9 patients who received liver transplantation for acute liver failure, 2 had good response (22.2％) and another 2 patients (22.2％) had partial response.For the liver transplant recipients who survived for more than 5 years, 2 had good response (22.2％) and another patient (11.1％) had partial response.In the healthy control group, the good response rate was 73.3％ (22/30), and the partial response rate was 10％ (3/30).Conclusions Some HBV-related liver transplant recipients could acquire Anti-HBs by vaccination.Good response rate was lower in the HBV-related group of liver transplant recipients than in the healthy control group of people.Recipients for liver transplantation carried out for acute liver failure and recipients who survived for more than 5 years had higher response rates to HBV vaccination.HBV vaccination can be a way to prevent HBV recurrence in some liver transplant recipients.

Objective To compare the efficacy after conventional radiotherapy and late course accelerated fractionation radiotherapy for nasopharyngeal carcinoma (NPC).Methods A total of 200 NPC patients were enrolled and randomly assigned to conventional radiotherapy (CF) group with 99 cases or late course accelerated fractionation radiotherapy (LCAF) group with 101 cases,who received irradiation to 60Co γ or 6 MV X-rays.In the CF group,the total dose of nasopharynx was 70 Gy/35 fractions at 2 Gy daily.In the LCAF group,for the first two-thirds of the treatment,two daily fractions of 1.2 Gy were given to the primary lesion and the total dose was 48 Gy/40 fractions.For the last one third of the treatment,the dose per fraction was increased to 1.5 Gy and the total dose was 30 Gy/20 fractions.Results There were 25,16,25 in CF group and 16,13,18 patients in LCAF group who had recurrence of nasophaynx,cervical lymph nodes,and distant metastasis,respectively.The 5-year nasopharyngeal control and overall survival rates was 75.9％ and 87.6％ in CFgroup (x2 =4.066,P＜0.05),58.0％ and 74.1％(x2 =5.076,P ＜ 0.05) in LCAF group,respectively.Cervical lymph nodes local rates and distant metastasesfree rates at 5 years were 8 1.5％ and 90.0％ in CF group (P ＞ 0.05),74.1％ and 83.3％ (P ＞ 0.05) in LCAF group,respectively.Conclusions Compared with CF,LCAF can improve nasopharyngeal control and overall survival rates,but there are no significant difference in the recurrence rates of cervical lymph nodes and distant metastasis.

Objective To determine the change of tumor bed volume during whole breast irradiation by repeated computed tomography scanning and to analyze the dosimetric impact of boost-planning on different CT images. Methods From July 2008 to Jan 2009, sixteen patients with early-stage breast cancer underwent breast conservative surgery (BCS) were enrolled in the study. All patients received whole breast irradiation and tumor bed boost, no adjuvant chemotherapy was given. Two additional CT scans were acquired in addition to the planning CT ( CT1 ), one in the course of radiotherapy ( CT2 ) and the other before the boost (CT3). Tumor beds were contoured in all CT images. Three-dimensional conformal radiotherapy planning for tumor bed boost was done on CT1 and CT3 respectively. Results The mean tumor bed volume on CT1, CT2 and CT3 were 49.5 cm3, 25.6 cm3 and 22. 2 cm3 ( F = 5. 63, P = 0. 007 ),respectively. Further analysis found statistically significant difference between CT1 and CT2 ( q = 0. 03, P =0. 010), CT1 and CT3 ( q = 0. 01, P = 0. 004), but not between CT2 and CT3 ( q = 1.00, P = 0. 333 ). The average reduction of tumor bed volume from CT1 to CT3 was 43.4%. A reduction of 20% or above was found in 88% of the patients ( n = 14), 50% or above in 38% of the patients (n = 6). In the boost-planning, the volume of the ipsilateral breast receiving 100% prescribed dose (V100%) on CT1 and CT3 was 183.5 cm3 and 144. 5 cm3, respectively ( t = 3.06, P = 0. 008 ). Conclusions Volume of tumor bed is dynamically reduced in the course of whole breast irradiation after BCS, with more important reduction in the early weeks after the beginning of irradiation. A second CT scan before tumor bed boost is warranted.

Objective To evaluate the volume of left ventricle (LV) based on PET-CT in left-sided breast cancer patients treated with adjuvant radiotherapy. To assess the impact of dose and volume in interrelations for heart and cardiac sub-structures using dose-volume histograms. Methods From October 2008 to February 2009, 14 patients with post-operatively confirmed left-sided breast cancer were enrolled in this study. Patients were scanned using contrast enhanced CT for simulation and FDG PET-CT have been applied to display the structure of left ventricle in each patient before radiotherapy (RT). The LV has been delineated based on PET-CT. Other critical sub-structures, such as left anterior descending coronary artery (LAD) have been contoured in each patient. The six-field simple intensity modulated radiotherapy (slMRT)technique has been created in all patients. Results The mean volumes of left ventricle based on PET-CT (LV-PET) were 112. 931 cm3. The volume of LV receiving ≥50% prescription dose highly correlated with the volume of heart receiving ≥50% prescription dose (R = 0. 869, P = 0. 000). There was less correlation between the volume of LAD and the volume of heart receiving ≥ 50% prescription dose ( R = 0. 220, P =0. 440). Conclusions The left ventricle could be delineated efficiently based on imaging of PET-CT. The volume of LV receiving higher dose in RT has high correlation with the volume of heart using sIMRT technique. It may pave the way for further exploring radiation induced cardiac injury in patients with breast cancer.

This article reviews that Guangzhou Medical University has explored the selection mechanism of "3+3 Successive Master-Doctor Program" for academic postgraduates of medical doctor and improved the quality of doctoral student selection by the following ways: stimulating the enthusiasm of the supervisor team through "competition", improving the quality of doctoral students through "selection", and optimizing the allocation of graduate education resources through "management mechanism reform". Our selection mechanism focuses on improving the quality of graduate education, fully listens to teachers and students, gives full play to the role of scholarships and financial aids, and pays equal attentions to the selection of outstanding applicants and the management of the training process of successive Master-Doctor program, which provides the beneficial reference for medical schools to explore the innovation of talent training models.

Objective To analysis the short-term quality of life and clinical outcome of early enteral immunonutrition(EIN)used after operation in patients with totally endoscopic esophagectomy.Methods This randomized controlled trial enrolled 110 patients receiving totally endoscopic esophagectomy in department of thoracic surgery of the fourth hospital of Hebei medical university between May 2015 and November 2016.The patients were randomly divided into enteral immunonutrition group (EIN group,n =56) and parenteral nutrition group (PN group,n=54).The scale scores of quality of life,the time of first postoperative anal exhaust,the time of removal of drainage tube,the number of postoperative infections and the length of hospitalization were compared between the two groups before operation and after operation.Results (1) There were no significant differences in age,gender,education,marital status,tumor location,clinical stage,intraoperative bleeding between the two groups (P＞0.05).(2) There were no significant differences in the quality of life before operation (P＞0.05);All functional scale scores of EIN group were significantly higher than PN group (P＜0.05),while the symptom scale score were significantly lower than PN group(P＜0.05).(3) There were significant differences in the time of first postoperative anal exhaust,the time of removal of drainage tube,the number of postoperative pneumonia compliCations and the length ofhospitalization in the two groups (P＜ 0.05).There was no significant difference in the incidence of anastomotic fistula between the two groups(x2=0.621,P=0.431 4) The scale scores of quality of life (the overall health status as the representative) had a negatively linear relationship with the clinical outcome(P =0.000),the absolute value of correlation coefficient in EIN group was higher than that in PN group.The higher score of the quality of life,the shorter time of the postoperative anal exhaust,removal of drainage tube and the length of hospitalization.Conclusion Enteral immunonutrition can improve the quality of life,improve the prognosis and promote the rapid recovery of patients with totally endoscopic esophagectomy.