Objective To approach the effects of decoction changed from Didangtang and Xiaoxianxiongtang Modified Formula on mucoprotein in stratum medium and the III-type collagen level of serum in experimental rats with fibrosis disease in lung interstitial tissue. Methods 40 male Wistar rats were randomly divided into 4 groups, that is pseudo-operation group, model control group, traditional Chinese drug group (TCD) and western medicine group (WM). Every group has 10 rats. Acid hydroc bleocin was dripped disposably into trachea of every group rats except pseudo-operation group, and Sodium Chloride with same volume as Acid hydroc bleocin was dripped disposably into trachea of pseudo-operation group. 24 hours after operation, the rats of TCD was lavaged with Decoction changed from Didangtang and Xiaoxianxiongtang Modified Formula, and the rats of WM was lavaged with Prednisone physiological saline solution. The rats of pseudo-operation group and model control group was lavaged with Sodium Chloride of same volume as TCD and WM. 28 days after operation, the rats was executed. And contents of mucoprotein in stratum medium of and the III-type collagen serum was detected. Results Didangtang and Xiaoxianxiongtang Modified Formula could decrease contents of mucoprotein in stratum medium of and the III-type collagen in serum of experimental rats, and extenuate fibro-accrementition in lung interstitial tissue. Conclusion Didangtang and Xiaoxianxiongtang Modified Formula has the function of treating fibrosis disease in lung interstitial tissue probably by decreasing contents of extracellular matrix in experimental rats with fibrosis disease in lung interstitial tissue.

Abdominal fullness in Taiyin disease,marked by being aggravated after vomiting,is mainly caused by internal exuberance of cold dampness,which indicates that the pathogenic cold dampness is accumulated in not only the interior of intestines,but also the exterior of intestine in the abdominal cavity.According to the description about hardness beneath chest in outline syndrome of Taiyin disease,Taiyin disease may be considered as such diseases as cirrhosis,congestive splenomegaly due to portal hypertension.Sini decoction should be used to treat abdominal fullness in taiyin disease with the function of warming and eliminating cold dampness,which shows the decoction has the function of recovery of cirrhosis of the liver decompensation.

Previous teaching of"Four Classic Subject" of TCM was a passive process for students to learn. Problem based learning (PBL), being an original teaching mode, could provoke activeness and conduce to group spirit of students.However, at present, there were problems such as inadequate teaching ability of teachers, not enough supply of teachers, short of corresponding teaching materials, and lack of independence and group spirit of students, which needed to be solved badly.

Objective To study the effect of psychological counseling for patients with thoracic surgery recovery period.Methods Ono hundred patients with lobectomy were selected,they were divided into experimental group and control group with 50 cases each according to the treatment method.Two groups of patients were in the ward completed indwelling catheter,inserted into the right double lumen endotracheal tube by high seniority anesthesiologists,postoperative given perfect analgesia.Two group patients were treated with routine operation before the visit,assess the condition and signed the anesthesia informed consent,the test group were given psychological support therapy,explain in detail postoperative recovery period may be uncomfortable,eliminate the anxiety of patients,establish the confidence to overcome the disease,Two groups of patients after surgery by the recovery room nurse to give psychological counseling,complete extubation and record the restlessness,24 h after the patient satisfaction questionnaire.Results In test group patients were able to follow instructions and coordinate nurse smooth tube removal,15 cases of patients need to brake,additional sedatives and dehyed extubation,the difference between the two groups has statistical significance (P ＜ 0.05).The satisfaction questionnaire in test group was significantly higher than that in control group:100％ (50/50) vs.82％ (41/50),there was statistical difference (P ＜ 0.05).Conclusion Psychological counseling can effectively avoid agitation in recovery period of patients with postoperative chest tube removal,smooth.

Objective Evaluate the diagnostic value of PET/CT in the preoperative advanced gastric carcinoma comparing with mult;-slice spiral computed tomography. Methods Thirty-nine advanced gastric carcinoma patients taking PET/CT and abstract 40 advanced gastric carcinoma patients performing MSCT before operation,were done the TNM staging, and the Results were compared with the operation histopathology. Results For diagnosing primary lesions, regional lymph nodes, N3 lymph nodes ,PET/CT was accurate in 92.3% , 66.7% and 100.0%.Instead, MSCT was accurate in 82.0% , 50.0% and 62.5%. Conclusions (1) PET/CT and MSCT have high accuracy in diagnosing primary lesions and regional lymph nodes. But for detecting the N3 lymph nodes and distant metastasis, PET/CT has higher accuracy than MSCT. PET/CT combining abdominoscopy may decrease or avoid exploratory laparotomy.

Objective To analyse the factors that have effects on patients' procalcitonin (PCT)level after gastic surgery and to evaluate PCT as a parameter for detection of infectious complications.Methods A total of 153 patients undergoing gastric surgery were included in the study between Jul 2011 and Jan 2013.Temperature and routine blood samples for determining PCT level,neutrophil ratio,white blood cell count were obtained on postoperative days (POD) 1,3,7.Predictive values for each of the markers were examined.Results Postoperative complication,preoperative infection and surgery type affected the PCT level of patients on POD 1.Meanwhile,the independent factor that had influence on PCT level on POD 3 and 7 was postoperative complication.After excluding those patients with preoperative infection,patients with infectious complication exhibited significantly higher PCT levels (t =2.92,P ＜0.01,t =5.34,P ＜0.01,t =4.03,P ＜0.05) on POD 1,3,7 respectively),neutrophil ratio (on POD 3 and 7) and WBC count (on POD 3) than did those without complication.According to receiver operating characteristic analysis,PCT showed the highest AUC on POD 1,7 (AUC =0.89 and 0.87 respectively).In the patients without complication,the mean PCT value was (0.47 ± 0.97),(0.36 ± 0.50),(0.23 ± 0.24) ng/ml on POD 1,3,7 respectively.The PCT level declined 55％ from POD 1 to POD 3 and from POD 3 to POD 7.Conclusions The serum PCT level of patients without any complication showed a decreasing trend while PCT level of those with infectious complications increased significantly.Continuous monitoring PCT level could serve as a diagnostic tool for the early identification of infectious complication after gastric surgery.

Objective To analyze the clinical characteristics of adult patients with hemophagocytic lymphohistiocytosis (HLH) receiving haploidentical donor hematopoietic stem cell transplantation (HID HSCT).Method We retrospectively reviewed 20 adult patients with HLH from August 2009 to August 2014.The clinical features and outcome were analyzed.Results Conditioning regimens consisted of total body irradiation/etoposide/cyclophosphamide (TBI/VP-16/CTX) and busulfan (Bu)/VP-16/CTX in HLH with anti-thymocyte globulin (ATG) 8 mg/kg.The stem cells were mobilized from donors' peripheral blood.Median time to white blood cell engraftment was 13 (9-27) days.Median time to platelet engraftment was 14 (10-28) days.Mixed chimerism after transplantation developed in 4 patients and no patient presented graft failure.Eight patients developed grade Ⅱ to Ⅲ acute graft-versus-host disease (GVHD),while as chronic GVHD occurred in 9 patients.Among 12 patients with EB virus (EBV) reactivation,2 patients developed post-transplant lymphoproliferative disorder (PTLD),7 were suspected as PTLD and 3 were considered as relapse of primary disease.With a median follow-up of 20 months (range:0.5-108 months) after transplantation,the estimated 2-year overall survival (OS) rate was (60.0 ± 11.0) ％ in all patients.During the follow-up,12 patients survived,8 died including 5 within 100 days after HSCT.Among 5 non-remission patients before HSCT,4 patients died within 100 days after HCT.Conclusions HID HSCT is an effective treatment for adult patients with HLH to achieve remission and long-term survival.High proportion of mixed chimerism has been seen at early stage after transplantation.EBV reactivation and early transplant-related mortality are common.

Incidence of acute closed Achilles tendon rupture is high in clinic. Accurate diagnosis of this injury depends on a combination of physical signs and imaging examinations. Although conservative and surgical interventions are common for acute closed Achilles tendon rupture, its optimal treatment remains controversial. This literature review focuses on the research progress concerning this injury so as to analyze its risk factors, diagnostic methods, treatments, early functional rehabilitation, postoperative complications and prognosis evaluation.

Objective To analyze the change of chromosome test level after participating in the inter‐laboratory proficiency test(PT) program of the College of American Pathologists (CAP) .Methods The results for participating in CAP PT during 2011-2014 were analyzed ,the accuracy of the cytogenetic chromosome quality control test in this laboratory was obtained accord‐ing to the CAP evaluation results ,and the effect of CAP external quality assessment item on increasing the chromosome detection level in this laboratory was evaluated by analyzing the chromosome band levels before and after participating in CAP .Results This laboratory participated in CAP PT test for 10 times during 2011-2014 ,a total of 59 cases were analyzed ,the accuracy rate for jud‐ging chromosome karyotype was 100% ,the karyotype description accuracy rate was 95 .1% .The chromosome test results of clinical cases in this laboratory displayed that peripheral blood chromosome abnormal detection rate was 18 .9% and bone marrow chromo‐some abnormal detection rate was 25 .9% ,the abnormal rate of newly diagnosed leukemia was 66 .8% ;the detection failure rates of peripheral blood chromosome and bone marrow chromosome were 0 .5% and 5 .0% respectively ;the detection failure rates of pe‐ripheral blood chromosome and bone marrow chromosome after participating in CAP were decreased ,the chromosome band average level was improved ,showing statistical difference compared with those before participating in CAP (P<0 .01) .Conclusion Partici‐pating in high quality external laboratory assessment item can increase the clinical analytic level of cytogenetic chromosome test .

Objective To investigate the efficacy of rituximab-containing regimen in Epstein-Barr virus associated hemophagocytic lymphohistiocytosis (EBV-HLH). Methods A retrospective analysis involving 6 EBV-HLH patients who had received treatment with rituximab-containing regimen was performed. The patients who were diagnosed with lymphoma or primary HLH subsequently were not included in the analysis. Results All patients were males. The median age was 27.5 years (range 20-61 years). Two patients received rituximab-containing regimen as primary therapy, and got partial remission (PR) within 2 weeks after the first course of rituximab, but relapsed within 4 weeks. Four patients received rituximab-containing regimen as salvage therapy, but none achieved remission. The 6 patients died due to HLH and complications, such as infection and hemorrhage. Laboratory data including white blood cell count, haemoglobin concentration, platelet count ferritin, alanine transaminase, aspartate transaminase,total bilirubin, fibrinogen and EBV-DNA did not show statistical significance (all P>0.05). Conclusion The efficacy of rituximab as a treatment for EBV-HLH is not as good as that in the previous study, and a prospective clinical trial of rituximab-based monotherapy is needed to answer the question.