Child ; Child, Preschool ; Epilepsy, Generalized ; complications ; epidemiology ; genetics ; Female ; Humans ; Infant ; Male ; Pedigree ; Phenotype ; Seizures, Febrile ; complications ; epidemiology ; genetics

Acupuncture Therapy ; Eczema ; psychology ; therapy ; Humans ; Male ; Middle Aged ; Sleep ; Treatment Outcome

Objective To assess the influence of PBL formation study effectiveness of TCM students.Methods The controlled studies with the teaching format of both PBL and LBL were included to assess the effectiveness of learning,by searching CBM,CNKI and VIP database.All data was analyzed on Revman 5.1.Results 9 articles were included ; All were low in the quality of their methodology,and the theoretical scores of students in PBL or LBL format shows no statistical difference [SMD=3.76,95％ CI ( -0.62,8.15 ) ].PBL format was superior to LBL on students' practical scores [SMD=7.62,95％ CI ( 3.92,11.32 ) ]; Compared to LBL format,PBL proved to have a better influence on students' self-assessment for learning ability[OR=3.69,95％ CI( 1.88,7.21 )].Conclusion PBL helps to enhance the activeness of students,to improve their practical ability,which is valuable if applied in clinical concerned courses.But the included studies were low in quality; more rigorously randomized controlled teaching trials are expected to verify the conclusion.

Breast cancer is one of the most common malignancies happened in female patients.The incidence of breast cancer in Chinese females has increased in recently years.Human epidermal growth factor receptor-2 (HER-2) exhibits gene amplification or high expression of receptor protein in about one third of breast cancer patients.HER-2 positive breast cancer patients has poor prognosis,high risk of recurrence and short survival.Trastuzumab is a specific inhibitor of human epidermal growth factor receptor-2 [1],which has been widely used in the treatment of HER-2-positive breast cancer patients,and trastuzumab molecular targeting therapy compared with the traditional chemotherapy,with the advantages of high specificity and low toxicity.It changes the natural disease progression of patients with HER-2-positive breast cancer and prolongs the patient's survival time.This article will review the researches on the four aspects,which including the development and the application of trastuzumab in the treatment of HER-2 positive breast cancer.

Objective To find out a new treatment method for advanced pancreatic carcinoma. Methods Twenty-nine patients with advanced pancreatic carcinoma and liver metastases were randomly divided into 2 groups.Group A (n=11) underwent bilio-enterostomy and/or gastro-enterostomy combined with systemic chemotherapy after operation;Group B(n=18) underwent bilio-enterostomy and/or gastro-enterostomy combined with peripancreatic arterial ligation and arterial infusion regional chemotherapy.The alleviation of clinical symptom,the change of carcinoma volume by BUS and CT scan,survival period and serum CEA were observed in two groups. Results The symptoms were alleviated apparently in most cases in Group B;BUS and CT scan showed that the tumor volume decreased apparently in Group B;The response rate was 67.7% in Group B,and 18.2% in Group A,respectively(P＜0.01);the mean survival period was (4.8±0.6) months in Group A,and (12.5±1.2) months in Group B,respectively(P＜0.01),there was significant difference between the two groups.The decrease of serum CEA was 54% in Group A and 60% in Group B,but the difference was not significant(P＞0.05). Conclusion Peripancreatic arterial ligation combined with arterial infusion regional chmotherapy is believed to be effective against both pancreatic carcinoma and liver metastases,and it can alleviate the clinical symptoms,postpone the growth speed of tumor,and prolong the survival period.

Adult ; Female ; Humans ; Middle Aged ; Thyroid Diseases ; microbiology ; Tuberculosis, Endocrine

Objective:To observe the effect of electroacupuncture (EA) for Alzheimer’s disease (AD). Methods:A total of 30 eligible cases were treated by needling Shenting (GV 24), Baihui (GV 20), Dazhui (GV 14), Fengfu (GV 16), Mingmen (GV 1) and Yongquan (KI 1). Upon arrival of qi, the G6805-II electric stimulator was connected to Shenting (GV 24) and Baihui (GV 20) (one pair), to Dazhui (GV 14) and Fengfu (GV 16) (one pair) and to bilateral Yongquan (KI 1) (one pair) for 25 min, using continuous wave at the frequency of 2-100 Hz and voltage of 2-4 V. With a tolerable intensity, the EA was conducted once a day for 10 d (one treatment course). There was a 3-day interval between two courses. After three courses, the therapeutic efficacies were evaluated using the mini-mental state examination (MMSE), revised Hasegawa dementia scale (HDS-R), activities of daily living (ADL) and neurological function defect scale (NFDS). Results:After EA treatment, the MMSE and HDS-R scores were significantly increased (P<0.01) and the ADL and NFDS scores were significantly decreased (P<0.01). Conclusion:EA is effective for AD and can improve the overall intelligence and repair neurologic deficits in AD patients.

Objective To compare the quadriceps strength and short-term outcome in patients who had undergone primary total knee arthroplasty (TKA) with minimally invasive (MIS) or conventional surgical technique.Methods Sixty-eight knees undergoing TKA were evaluated and they were randomly divided into two groups.One group included 34 knees which were undergone conventional approach,and the other group included 34 knees undergone MIS approach.The age,BMI,quadriceps strength,extension lag,American Knee Society Score (KSS),Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) of pain of all patients were evaluated at the day before surgery and the 1st,2nd,3rd,6th,and 12th months after surgery.Results At the 1st,2nd,3rd,6th,and 12th months after surgery,the quadriceps strength in MIS group was 0.59±0.12,0.74±0.18,0.86±0.16,1.02±0.17,1.05±0.04 N·m/kg respectively,while in conventional group was 0.46± 0.56,0.56±0.12,0.70±0.16,0.94±0.19,1.04±0.03 N· m/kg respectively.The extension lag in MIS group was 13.11°±6.56°,8.53°± 5.12°,4.79°±3.62°,1.53°±2.64°,1.62°±1.76° respectively,while in conventional group was 22.47°±8.41°,16.23°±6.26°,10.58°± 4.4°,2.58°±2.85°,1.62°±1.76° respectively.There were significantly differences in the two groups.Meanwhile,compared with conventional patients,MIS patients demonstrated significantly higher KSS scores at the 1st and 2nd months postoperatively.WOMAC scores were significantly lower in MIS group than in conventional group at the 1st month after surgery.During the first postoperative week,MIS technique significantly decreased VAS scores,showing significance.On the other hand,no significant difference was observed with respect to deep infection incidence and radiological outcome between two groups.Conclusion MIS TKA offers a significant improvement in extensor muscle strength over conventional surgery.These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

Objective: To observe the clinical efficacy of acupuncture plus subtle adjustment manipulation of the cervical spine for peripheral facial paralysis.Methods: A total of 60 patients with peripheral facial paralysis who met the screening criteria were selected and divided into two groups according to the method of random number table, with 30 cases in each group. The patients in the acupuncture plus tuina group received routine treatment of acupuncture and subtle adjustment manipulation of the cervical spine, while the patients in the acupuncture group only received the same acupuncture treatment. Assessment of peripheral facial paralysis with integrated traditional Chinese and Western medicine was adopted for rehabilitation assessment. Results: The total effective rate of the acupuncture plus tuina group was 93.3％, while that of the acupuncture group was 70.0％, and there was a significant between-group difference (P<0.05). After treatment, the total scores of rehabilitation assessment in both groups were significantly higher than those before treatment (both P<0.05), and the score of the acupuncture plus tuina group was significantly higher than that of the acupuncture group (P<0.05). Conclusion: The treatment of acupuncture plus subtle adjustment manipulation of the cervical spine can improve the function of facial muscles in patients with peripheral facial paralysis, and its clinical efficacy is better than that of the acupuncture treatment alone.

Objective To evaluate the changes in sagittal profiles and complications during treatment with growing rods (GRs) in hyperkyphotic early-onset scoliosis (EOS).Methods From December 2009 to December 2016,a total of 32 EOS patients who received growing rods treatment in our center,including 8 males and 24 females,were reviewed retrospectively.All the patients had minimum 2-year follow-up and over 2 lengthenings.Based on the reference value of thoracic kyphosis (TK) in T2-12 of normal children,the patients were categorized into an N group (20°≤TK≤50°,15 cases,4 males and 11 females) or K group (TK≥50°,17 cases,4 males and 13 females).The distribution of etiology was similar between the two groups.The average age was (6.2±2.0) years and (6.3±2.3) years respectively,curve flexibility was 34.6％± 10.4％ and 35.8％± 11.2％ before surgery.The precontoured rods were tunneled submuscularly,connecting proximal and distal anchors,and tandem or domino connectors.The rods were then locked after applying direct distraction that allowed appropriate elongation.The connectors were all placed under the deep fascia.Results The mean follow-up in the N and K groups was (5.5±1.9) years and (5.5±2.1) years,respectively.The distribution of proximal and distal anchors was similar between the two groups.The N and K groups,respectively,had an average number of lengthenings of 5.1±2.0 and 5.3±2.3,with mean lengthening intervals of (11.3±2.3) months and (10.9±1.9) months,respectively.In the N group,TK was decreased from 36.0°±9.4° to 30.6°±.8.3° after surgery,and to 32.2°±7.8° at the last follow-up,demonstrating it was maintained within the normal range.In the K group,TK was markedly reduced from 67.6°±11.6° to 41.7°±8.7° after the index surgery,with a correction rate of 38.3％± 14.6％,and the difference was statistically significant.And then it slightly increased to 46.5°±8.4° at the last follow-up,with correction loss of 7.1％±4.2％,and the difference was not statistically significant compared with the postoperatiom.The complication rate in the K group was significantly higher than in the N group (76.5％ vs.33.3％,P=0.031).The most common implant-and alignment-related complication in both groups was rod fracture (15.6％) and proximal junctional kyphosis (21.9％),respectively.The incidence of rod fracture in the N group and K group was 6.7％ and 23.5％,respectively.And the incidence of proximal junctional kyphosis was noted as 13.3％ and 29.4％ in the N group and K group,respectively.Proximal junctional angle (PJA) in the K group was greater than that in the N group preoperatively,postoperatively and at the last follow-up.Moreover,the increasing amount of PJA was significantly greater in the K group compared to the N group (1.6°± 1.0° vs.0.7°±0.8°).Four and seven complication events in the N and K groups,respectively,were evaluated with Grade Ⅰ.Four and seven complication events in the N and K groups,respectively,were classified as Grade Ⅱ A.Conclusion GRs can effectively restore the sagittal profile in hyperkyphotie EOS patients,but with a higher complication rate compared to the patients with normal kyphosis.