Major points: Zhongwan (CV 12), bilateral Zusanli (ST 36) and Neiguan (PC 6); for excessive cold-dampness, plus Pishu (BL 20) and Sanyinjiao (SP 6); for Liver-qi affecting stomach, plus Yinlingquan (SP 9) and Taichong (LR 3); for deficiency of both spleen and sto mach, plus Pishu (BL 20) and Weishu (BL 21). Forty-six cases of diabetic gastric disorder were treated with acupuncture and 30 cases got marked effect, 16 cases got effect and the total effective rate reached 100%.

Objective To study the level of serum vascular endothelial growth factor(sVEGF)in advanced non-small cell lung cancer(NSCLC) and its clinical significance.Methods Serum level of VEGF was detected by ELISA method in 96 patients with advanced NSCLC.sVEGF level was analyzed after giving 2-4 cycles of cisplatin-based chemotherapy.At the same time,serum level of VEGF in 50 healthy controls was detected.Results The level of sVEGF was significantly higher in patient with lung cancer than in control group (P＜0.01).No statistical significant defference was observed between sVEGF level of stage Ⅲ and Ⅳ NSCLC patients,the patients with squamocellular lung cancer and adenocarcinoma(P＞0.05);Descended sVEGF level was found in the patients with response to chemotherapy(P＜0.05).Conclusion sVEGF can be used to evaluate chemotherapy response and diagnoses in the patients with advanced NSCLC.

Objective To investigate the effects of parecoxib pretreatment on the intrapulmonary shunt during one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients of both sexes,aged 25-64 yr,weighing 45-70 kg,with body height 156-178 cm,undergoing elective esophageal surgery,were randomly divided into 2 groups (n =20 each):normal saline group (group NS) and parecoxib group (group P).Parecoxib 40 mg (in normal saline 10 ml) was injected intravenously 30 min before anesthesia in group P,while the equal volume of normal saline was given instead of parecoxib in group NS.Anesthesia was induced with iv injection of propofol,fentanyl and rocuronium.Bronchial blocker was inserted after tracheal intubation and the correct position was confirmed by bronchoscopy.Anesthesia was maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of atracurium.HR,MAP,SpO2 and mean airway pressure (Pmean)were determined at 5 min of two-lung ventilation,at 40 min of one-lung ventilation,and at 30 min after re-expansion of the collapsed lung (T0-2).Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis.Intrapulmonary shunt (Qs/Qt) was calculated.Results There were no significant differences in hemodynamic parameters and Pmean between the two groups (P ＞ 0.05).PaO2 was significantly lower,while Qs/Qt was significantly higher at T1,2 than at T0 in groups NS and P (P ＜ 0.05).PaO2 was significantly higher,while Qs/Qt was significantly lower at T2 than at T1 in groups NS and P (P ＜ 0.05).Qs/Qt was significantly lower at T1,2 and PaO2 was significantly higher at T2 in group P than in group NS (P ＜ 0.05).Conclusion Parecoxib 40 mg injected intravenously at 30 min before anesthesia can reduce the intrapulmonary shunt during one lung ventilation in patients undergoing esophageal cancer resection.

Endophytic fungi which reside in the tissue of mangrove plants seem to play an important role in the discovery of new biologically active substances. During the course of screening for the antimicrobial metabolites from the endophytic fugus Penicillium sp. FJ-1 of mangrove plant Avicennia marina, a new aurone glycoside (1) was isolated by repeated column chromatography on silica gel and recrystallization methods. The structure of 1 was elucidated as (Z)-7,4'-dimethoxy-6-hydroxy-aurone-4-O-β-glucopyranoside, on the basis of spectroscopic analysis. Compound 1 exhibited antifungal activity against Candida sp., with the potency comparable to amphotericin B and much better than fluconazole. Compound 1 can also inhibit extracellular phospholipase secretion in a concentration-dependent manner.
Antifungal Agents ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Benzofurans ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Candida ; drug effects ; Glycosides ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Molecular Structure ; Penicillium ; chemistry ; genetics ; isolation & purification ; metabolism ; Seawater ; microbiology

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs)and anti-angio-genic drugs have individually demonstrated clinical benefit in the treatment of patients with advanced non-small cell lung cancer (NSCLC).Recent studies demonstrate that the combination of anti-EGFR and anti-angiogene-sis can more significantly enhance clinical benefit,and even can remit EGFR-TKIs resistance in the treatment of advanced NSCLC.According to the different kinds of anti-angiogenesis drugs,recent clinical studies mainly include the combination of anti-vascular endothelial growth factor monoclonal antibody bevacizumab plus EGFR-TKIs and multi-targeted receptor anti-angiogenic tyrosine kinase inhibitor plus EGFR-TKIs,and the for-mer results show a more significant improvement in terms of safety and efficacy in the treatment of advanced NSCLC.Therefore,the combination of bevacizumab plus EGFR-TKIs can be used as a new treatment standard in the treatment of some patients with NSCLC.

Objective To observe the clinical characteristics and surgical methods of strabismus following external approach for retinal detachment,and explore the common factors related to deviation angles of strabismus.Methods Twenty-five cases of secondary strabismus following external approach for retinal detachment underwent strabismus surgery were recruited,and the follow-up time was from 5 months to 41 months.Ophthalmic examinations were performed before operation.Clinical characteristics of these cases were observed by intraoperative exploration,including preoperative and postoperative eye position and ocular movement (at 1 week and further followup).The preoperative and postoperative deviation angles of strabismus were evaluated according to the times of retinal detachment operation,postoperative BCVA and the surgery procedure of hang-back recession.Results Before strabismus operation,all cases underwent abnormal eye-movements,8 cases suffered from diplopia,and scar adhesions were observed in all involved ocular muscles during operation.Seven cases underwent weakening procedure of extraocular muscle,18 cases underwent weakening procedure plus strengthening procedure.Ten cases underwent hang-back recession among them.At 1 week and the final follow-up,the eyeball in21 cases and 15 cases were in position,4 cases and 9 cases were in undercorrection,5 cases and 7 cases were in limitation,and 2 cases and 1 case were in diplopia.The more operations were performed in retinal detachment,the more scar adhesions were presented,and statistical significance existed with the mean deviation angles before and after operation(in a week) between cases that had one-time and over-one-time of retinal detachment surgery (P =0.01,0.00).No difference of mean deviation angles was found at one week after operation and at follow-ups between the cases with and without hang-back recession (P =0.26,0.63).Conclusion Abnormal eyemovements,diplopia and scar adhesion are the most common clinical characteristics of strabismus following retinal detachment surgery.Times of retinal detachment operation and postoperative BCVA can influence the deviation angles of strabismus,and hang-back recession seems the safe and effective method of strabismus surgery.

Objective To investigate the value of magnetic resonance (MR) imaging for diagnosing typeⅠ congenital choledochocele and its complications. Methods The MR imaging data of 13 cases with proved typeⅠ congenital choledochocele associated with complications were retrospectively reviewed and compared with operative findings. MR imaging sequences included axial T2W and T1W plain scan, true-FISP coronal images, 2D-MRCP, and Gd-enhanced T1W images. Results All patients had cystic dilatation of the common bile ducts to various degrees. In 6 patients complicated with stone and infection, the bile duct showed uniform wall thickening with marked enhancement, and calculus were depicted within the duct lumen with dilatation of the proximal biliary duct. In 7 cases complicated with carcinoma of biliary duct, a polypoid soft tissue mass or nodule was seen inside the ductal lumen in 3 cases, or the duct wall was irregularly thickened in 4 patients. Six cases received curative operation, but one patient with extensive local infiltration, vascular encasement and lymphadenopathy had only palliative treatment. MR imaging observations were verified by surgery findings in all 13 patients. Conclusion MR imaging is very valuable not only in diagnosing typeⅠ congenital choledochocele, but also in revealing its complications.

Objective To discuss diagnosis ant treatment of post traumatic fat embolism syndrome.Methods Since 1997,9 patients with FES have been treated in our hospital.These cases were analyzed on clinic features and results of treatment.Results According to Sevitt classification,there were 2 in fulminant,2 in typical,and 5 in subclinical.2 patients in fulminant died,7 patients were cured because of early diagnose and correct treatment.Conclusion Identify this disease,early and correct treatment help to improve the result.Post traumatic resuscitation is effecrive in decreasing the incidence of FES.

Objective To observe MSCT and clinical features in patients of laryngocarcinoma combined with other primary carcinomas. Methods Five patients of laryngeal cancer combined with multiple primary cancer were enrolled in the study. Three paitents had long-term smoking history more than 20 years. Three paitents had various degree of radiotherapy, chemotherapy and immunotherapy. The second primary cancer located in right upper lung lobe in 2 patients of synchronous cancer and 1 patient of metachronous cancer. The others located in soft palate, uvula and the left side of zone Ⅱ and zone Ⅳ in the neck, respectively. MSCT and clinical characteristics were analyzed. Results Five patients of multiple primary cancers included 2 patients of synchronous cancer and three patients of metachronous cancer. MSCT found the appearances of malignant tumors in various parts in all 5 patients and cervical lymph nodes metastasis in 2 patients. Conclusion The possibility of prime laryngocarcinoma combined with other primary cancers should be considered when other organ malignant tumor was detected in patients with laryngeal carcinoma, especially in patients with history of long-term smoking, radiotherapy and chemotherapy and immunotherapy. Long-term following-up of cervix and other organs should be taken for the postoperative patients of laryngocarcinoma.

Programmed death-ligand 1 (PD-L1 ),which is highly expressed in NSCLC,can be divided into two categories:membrane PD-L1 and soluble PD-L1 .PD-L1 participates in tumor immune escape through combining with its receptor.PD-L1 immune checkpoint inhibitors have entered the phase Ⅰ studies and showed a good application prospect.It is also found that the sensitivity of PD-L1 immune checkpoint inhibitors is strongly associated with the expression of PD-L1 in tumor.Therefore,PD-L1 can be used as a biomarker to pre-dict its curative effect.