Three-dimensional syndrome differentiation is a new mode of syndrome differentiation of exopathic febrile diseases, which is based upon the six meridian syndrome differentiation initiated in Treatise on Cold Attack and defence-qi-nutrient-blood and triple-Jiao syndrome differentiation in the art of warm disease of traditional Chinese medicine. Syndromes appeared in the course of cold pathogenic diseases and warm diseases were differentiated through the survey of clinical cases and observation on syndrome features of exopathic febrile diseases, by applying means of analyzing, reasoning, concluding and deducting, from the stadium, location and nature of the disease. Three-dimensional syndrome differentiation theory explains and generalizes pathological mechanism and types of syndrome on acute exopathic febrile diseases roundly, has constructed theoretical frame and synthetical model of syndrome differentiation of exopathic febrile diseases. However, any new method of syndrome differentiation can not be leave nothing to be desired in the beginning, so it is proposed that we must develop epidemiologic investigation on syndromes of exopathic febrile diseases sequentially, make models of clinical commonly seen syndromes of exopathic febrile diseases and dispose fuzzy phenomenon of syndrome by applying mathematical method. By above measures, three-dimensional syndrome differentiation will be perfected gradually, therefore, it can provide scientific theoretical basis for the treatment of exopathic febrile diseases.

Objective:To investigate the relationship between Creactive protein(CRP)/albumin ratio (CAR) and lymph node metastasis of gastric cancer. Methods:A total of 96 cases of gastric cancer were included in the study. The clinical pathological stage and lymph node detection in patients with gastric cancer were analyzed, with the preoperative CAR as the dependent variable. Results:1) The pa-tients with preoperative CAR>0.04 has higher transfer rate and metastasis than the patients with preoperative CAR≤0.04, and the dif-ference was significant (P<0.05). The lymph node stage of patients with preoperative CAR>0.04 was significantly higher than that of the patients with preoperative CAR≤0.04, and the difference was significant (P<0.05). 2) The mean CAR of patients with Borrmann typesⅠ,Ⅱ,Ⅲ, andⅣgradually increased;with the progression of the pathological stage of gastric cancer, the mean value of CAR in-creased. 3) During the operation, the total number of lymph node dissections was high and the mean value of CAR before the opera-tion was high. Conclusion:The correlation between preoperative CAR and lymph node metastasis in patients with gastric cancer may reflect the degree of lymph node metastasis to a certain extent.

OBJECTIVETo investigate the better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction adenocarcinoma.

METHODSA total of 153 cases of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from January 2003 to December 2011 were prospectively enrolled and randomly divided into two groups by table of random number according to methods of digestive tract reconstruction, including 3S anastomosis group (80 cases, 3S jejunal interposition) and traditional anastomosis group (73 cases, esophageal remnant gastric posterior wall anastomosis). Postoperative complications, operative time, mortality, nutritional parameters and postoperative quality of life were compared between these two groups.

RESULTSThere were no significant differences between two groups in postoperative complications, operative time and mortality (all P>0.05). 3S anastomosis group was better in nutritional parameters than traditional group six months after operation (P<0.05). As compared to traditional group, incidence of reflux esophagitis decreased [20.0%(16/80) vs. 46.6%(34/73), P<0.01] and gastric emptying time prolonged obviously [(160.8±8.1) min vs. (61.1±10.8) min, P<0.01] in 3S anastomosis group 18 months after operation. Postoperative QLQ-C30 rating scale revealed quality of life was significantly higher in 3S anastomosis group as compared to traditional group.

CONCLUSIONJejunal interposition is a better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction carcinoma.

Adenocarcinoma ; surgery ; Anastomosis, Surgical ; methods ; Digestive System Surgical Procedures ; Esophageal Neoplasms ; surgery ; Esophagogastric Junction ; pathology ; Gastrectomy ; methods ; Humans ; Jejunum ; pathology ; Operative Time ; Postoperative Complications ; Postoperative Period ; Quality of Life ; Reconstructive Surgical Procedures ; methods ; Stomach Neoplasms ; pathology

OBJECTIVETo study the safety and feasibility of fast track surgery (FTS) in the promotion of postoperative recovery for gastric cancer patients undergoing gastrectomy.

METHODSFrom January to December in 2013, 71 gastric cancer patients were prospectively enrolled and randomized into the FTS group and the control group. Patient in the FTS group received FTS management and those in the control group received routine management. The postoperative recovery and stress were compared between the two groups.

RESULTSFTS was associated with shorter time to bowel function return [(67.8±19.7) h vs. (90.0±20.6) h, P<0.01], shorter hospital stay [(13.5±3.0) d vs. (17.8±7.3) d, P=0.01], lower hospital cost [(23.8±3.7) thousand Yuan vs. (27.8±6.1) thousand Yuan, P<0.05], and less stress response (lower pain score, WBC count, C-reactive protein, all P<0.01). The postoperative complications including ileus, infection, anastomotic leakage were similar (all P>0.05).

CONCLUSIONFast track surgery decreases postoperative stress response and promotes recovery.

Aged ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Perioperative Care ; Postoperative Complications ; prevention & control ; Prospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

We think that all the methods of puncturing into the skin to prevent and treat diseases are belong to acupuncture science. In spite of its basic theory of meridian and acupoint, anatomy and physiology have been important parts of modern acupuncture science. "Dry needling", however, is limited to trigger point theory. As for the positions, acupuncture is applied mainly at acupoints, involving in skin, muscles, tendons, vessels and nerves; while "dry needling" is used mostly at muscles. The needles of acupuncture are in various lengths and diameters and its manipulations are abundant, including the traditional skills and the achievements of modern science and technology research, such as electroacupuncture. It is different from the "dry needling" with the single tool and manipulation. Thus, acupuncture is suitable for a large range of syndromes, but "dry needling" is mainly for fascia muscularis pain and other related disorders. The acupuncturists need to embrace Chinese and western medicine, which is more rigorous than the training for "dry needling" practitioners. Based on the above reasons, we consider "dry needling" as part of acupuncture science, and it is a method during the modern development of traditional acupuncture.