In recent years, w ith the w idespread use of advanced neuroimaging techniques and the aging of the population, more and more asymptomatic smal unruptured intracranial aneurysms (sUIAs) are incidentaly detected in clinical practice. Studies have show n that the prevalence of unruptured intracranial aneurysm (UIA) is 2%-3% in adults, and more than 2/3 of them are smal aneurysms of < 7 mm in diameter. Usualy these sUIAs do not have any symptoms and the risk of rupture is low er. They are also know n as incidental or asymptomatic aneurysms, but they are not w ithout the risk of rupture. At present, there is no unified opinion about w hether to conduct conservative treatment or surgical clipping or endovascular interventional therapy. This article review s the latest research progress of sUIAs ( < 7 mm in diameter), hoping to provide more evidence for clinical assessment, decision -making, and individual treatment of this kind of aneurysms.

OBJECTIVETo evaluate the efficacy and the relevant effect factors of acupuncture for type 2 diabetes mellitus (T2DM) in females.

METHODSOf 83 female patients of T2DM, 49 cases were deficiency of kidney yin syndrome and 34 cases were yin and yang deficiency syndrome. Acupuncture was adopted and the acupoints were selected according to the syndrome differentiation. In kidney yin deficiency syndrome, Taixi (KI 3), Shenmen (HT 7), Taichong (LR 3) and Sanyinjiao (SP 6), etc. were selected. In yin and yang deficiency syndrome, Shenshu (BL 23), Pishu (BL 20), Yishu (Extra) and Jingmen (GB 25), etc. were selected. In 3 courses of treatment, the changes in fasting plasma glucose (FPG), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistace index (Homa-IR), index of islet beta-cell function (Homa-beta), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared before and after treatment between the two groups. The relationship of the efficacy was analyzed in terms of the syndrome differentiation, age, duration of sickness, obesity and hereditary factors.

RESULTSAfter the treatment, the levels of FPG, FINS, Homa-IR, TC, TG and LDL-C were reduced obviously (all P < 0.01) and the levels of ISI, Homa-beta and HDL-C were increased apparently (all P < 0.01). The total clinical effective rate was 80.7% (67/83), in which, that of kidney yin deficiency syndrome was 83.7% (41/49) and that of yin and yang deficiency syndrome was 76.5% (26/34). The efficacy was not different significantly between the two syndromes. But, the younger the age was, the better the efficacy was.

CONCLUSIONAcupuncture positively regulates the glucose and lipid metabolism in the patients of T2DM. This therapy improves insulin resistance, enhances the body sensitivity to insulin and improves insulin beta-cell function. The efficacy is related to the patient's age.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; therapy ; Female ; Humans ; Middle Aged ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

OBJECTIVE:To observe the stabilities of zedoary turmeric oil and glucose injection mixing with 5 kinds of antibiotics METHODS:The contents of curcamol in mixed fluid were detected with UV spectrophotometry,and the external appearance and value of pH were observed RESULTS:After mixing zedoare turmeric oil and glucose injection with 5 kinds of antibiotics,no gas and sediment were found Values of pH were different in the 5 simples,and did not change markedly over 3 hours The concentration of curcumol was markedly reduced and the sample turned to brown in mixing with cefoperazone sodium;the concentration was declined in mixing with ceftriaxone sodium and decreased 6% with cefradine and was not markedly reduced in mixing with clindamycin and netilmicin CONCLUSION:This preparation is compatible with netilmicin and clindamycin,however,it is incompatible with cefoperazone and ceftriaxone

Objective To investigate the clinical outcomes of the medial displacement calcaneal osteotomy with reconstruction of posterior tibial tendon insertion on navicular for the flatfoot related with accessory navicular.Methods From March 2009 to October 2011,13 patients (16 feet) with flatfoot related with accessory navicular received treatment by the medial displacement calcaneal osteotomy with reconstruction of posterior tibial tendon insertion on navicular.There were 4 males and 9 females,with an average age of 41.3 years (range,18-64 years).All patients had obvious valgus calcaneus,the angle of which was 11.3°± 1.4°.According to AOFAS ankle-hindfoot scores,the arch height,calcaneus inclination angle (CI),talocalcaneal angle (TC),talar first metatarsal angle (TMT) on the lateral weight-bearing radiograph of foot,and the talocalcaneal angle (TC),talar first metatarsal angle (TMT) on the AP view of the weight-bearing radiograph of foot,and the heel valgus alignment on axial radiographs of the hindfoot were measured on the X-ray film.Results All patients were followed up for 12 to 31 months,with the average of 16.8 months.Eleven patients (13 feet) felt no pain 6 months after operation,while 2(3 feet) felt pain after long walking.There was no complication,including infection,nerve injury,un-union,and so on.The average AOFAS ankle-hindfoot score improved from 56.4-±6.4 preoperatively to 88.1±2.8 at the last follow-up.Radio graphically,all parameters were statistically significant between pre-operation and the last follow-up,including the arch height,CI,TC,TMT modifying from 3.8±0.3 mm,9.5°±1.1°,47.3°±2.5°,17.6°±1.6° to 12.0±1.1 mm,20.1°±1.5°,32.3°±2.5°,6.8°±1.0° respectively on the lateral weight-bearing view; TC improving from 39.5°±2.3° to 26.2°±2.0°and TMT improving from 15.2°±1.7° to 6.3°±1.0° on the AP weight-bearing view.Conclusion The medial displacement calcaneal osteotomy with reconstruction of posterior tibial tendon insertion on navicular is a good choice for the treatment of flatfoot related with accessory navicular with excellent clinical outcomes.

Pressure ulcer is a kind of cutaneous and subcutaneous exelcosis and necrosis as suffered long-term pressure. Pressure ulcer mainly related with age, long-term in bed, chronic diseases, lower resistibility, vasculitis and less activities, as well as long-term pressing, poor blood circulation and untidy body environment. Pressure ulcer can be classified into 4 stages with severity. The risk to pressure ulcer should be evaluated, mainly with Braden score. Prevention of pressure ulcer included keeping clean, avoiding long-term pressure and find-ing potential pressure ulcer as soon as possible, based on improving the system situation and dealing with original diseases. For the patients suffered from pressure ulcer, it was important to decompress, debride the wound, keep humidity, and apply some new dressing with external drugs and vacuum sealing draining (VSD) and good psychological nurse and communication.

Lung cancer is the leading cause of cancer-related deaths, with high morbidity and mortality, as well as poor prognosis in China and worldwide. Despite the recent advances in surgery, irradiation, chemotherapy, and targeted therapy, the curative effect of non-small cell lung cancer (NSCLC) in advanced cancer patients is unsatisfactory, and the five-year survival rate of patients remains low. Immunotherapeutic approaches, such as checkpoint inhibitors, active vaccination, and adoptive vaccination, have been given in-creasing attention for the treatment of patients with NSCLC. Results of phase I clinical trials show a higher remission rate, and the out-comes of phases II and III clinical trials are under exploration. This review provides an overview of the latest advances and challenges in immunotherapy for NSCLC.

Objective To study the protective effect of redix astragail on intestinal mucosa barrier in infant rabbits with intestinal ischemiareperfusion.Methods Twenty male infant rabbits were divided into 4 groups randomly:sham control group,intestinal ischemia reperfusion(IIR) group(model group),redix astragail group,control group.Redix astragail group and control group intraperitonerlly injected redix astragail 6 mg/(kg?d)or sodium chloride preoperative.Intestinal mucosa and blood plasma superoxide dismutase(SOD) activity,intestinal mucosa tissue degree of injury were observed in infant rabbits with IIR.Meanwhile,the effect of redix astragail on them was studied.Results After IIR,SOD activity in intestinal mucosa and blood plasma obviously decreased,and intestinal mucosa tissue morphous and intestinal mucosa barrier lesion were progressively aggravated.Redix astragail might increase blood plasma and intestinal tissue SDD activity significantly.Conclusion Redix astragail plays an important role in protecting intestinal mucosa barrier in infant rabbits with IIR.

Objective To explore the pathological basis and clinical characteristics of children with congenital choledochal cyst(CCC) combined with liver damage.Methods According to the age,38 patients with CCC were divided into 2 groups:group A had 24 cases(ranged 6 months to 3 years old);group B had 14 cases(ranged 4 to 14 years old).A comparative analysis of them was conducted retrospectively in the clinical characteristics,hepatic pathological changes,perioperatively liver function and operation.Results Group A was obvious higher than group B in jaundice,white bole stool and abdominal mass,but group B was more in stomachache.Group A was obvious higher than group B in liver function lesion,alkaline phosphatase,bilirubin increase and blood coagulation disfunction(Pa

OBJECTIVE:To improve the information system of Out-patient pharmacy intravenous admixture center (OUIVA) to improve the pharmaceutical service rendered to the transfusion patient and ensure the safety of drug use. METHODS:The defi-ciency in OUIVA information system of our hospital were analyzed,in which improvement was made with respect to ungrouped doctor’s orders,inconsistency between the total doses charged and the prescribed doses and the error of transfusion days that occurred fre-quently. The conformity rate of out-patient fluid transfusion prescriptions and the time of patients’waiting for transfusion before and after the improvement were compared and evaluated. RESULTS:Improvement was made to OUIVA information system through the optimization of transfusion process,the application of condition limit,the adding of logical operation and verification and the other measures. After improvement,the unconformity rate of out-patient prescriptions in our hospital descended from 11.24% in 2013 to 3.69% in 2014,with an obvious increase in the accuracy rate of dispensing for fluid transfusion;and the time of patients’waiting for transfusion was shortened from 30-40 min to 15-20 min,with an increase in the degree of satisfaction of transfusion patients. CONCLUSIONS:The OUIVA information system can reduce the errors of drug dispensing for fluid transfusion and improve pharmaceutical services.

Objective To study the chemical constituents from the exocarp of Juglans mandshurica.Methods The compounds were isolated by Diaion HP-20,Sephadex LH-20,MCI CHP-20,and silica gel column chromatography.Their structures were identified by physicochemical properties and spectroscopic analysis.Results Twelve compounds were elucidated as pinostrobin (Ⅰ),quercetin (Ⅱ),quercetin-3-O-?-D-glucoside (Ⅲ),chrysophanol (Ⅳ),gallic acid (Ⅴ),4-hydroxyl-cinnamic acid methyl ester (Ⅵ),vanillin (Ⅶ),caffeic acid (Ⅷ),4-hydroxylcinnamic acid (Ⅸ),?-sitosterol (Ⅹ),daucosterol (Ⅺ),and 5-hydroxyl-1,4-naphthoquinone (ⅩⅡ).Conclusion The compounds Ⅰ,Ⅳ,and Ⅵ—Ⅸ are isolated from J.mandshurica for the first time.