Objective To study therapeutic efficacy of Aredia in treating malignant metastatic bone tumors. Method 60～ 90 mg Aredia was administrated iv in 31 cases with malignant metastatic tumors,once each week. Results Pain in 12 cases was significantly relieved.14 cases acquired relif.Total effective rate was 83.9% .Activity ability was improved by 80.6% .No apparent toxicological and adverse effects as well as fever and cold symptoms were observed.Conclusion Aredia is a kind of ideal drugs for treatment of pain caused by malignant metastatic bone tumors.It is convenient in use and could be endured by patients.

Objective To study and evaluate the MRI findings and their diagnostic value for breast carcinoma.Methods Preoperative contrast-enhanced MR imaging and mammography were performed in 12 patients who underwent surgery and were histopathologically proved with breast carcinoma.MR imaging findings were compared with clearly mammography.Results Twenty-one breast lesions in 12 cases were detected with MR imaging.Seventeen of the twenty-one lesions were detected with mammography.Contrast-enhanced MR imaging was superior to mammography to demonstrate lesions in these dense breasts.It could clearly indicate the extension of posterior breast carcinoma into the pectoralis major muscle and the metastases of parasternal lymphatic node,while it was difficult to evaluate with mammography.The "rim enhancement sign" might be valuable to diagnose breast carcinoma.Conclusion The sensitivity and accuracy of MR imaging is superior to that of mammography.Contrast-enhanced imaging of the breast is helpful not only in early diagnosis of breast carcinoma but also in staging breast carcinoma and planning therapy.

Objective To assess the value of magnetic resonance imaging for acute pancreatitis.Methods 77 patients of acute pancreatitis were examined with holding breath MRI sequence.Transverse scan:2D Flash T 1WI/T 1W+FS,TSE T 2WI+FS or HASTE+FS,Trufisp.Coronals scan:2D Flash T 1W+FS.MRCP was used in 34 patients.2D Flash dynamic contrast enhanced were used in 77 patients.Results 59 cases of acute edematous pancreatitis showed swelling and low signal intensity on T 1WI and higher signal intensity on T 2WI.Excepted the above findings,18 cases of hemorrhagic necrosis pancreatitis alos showed the higher signal intensity on T 1WI and peripancreatic exudative hydrops.Conclusion MRI is a reliable method for demonstrating acute pancreatitis.

BACKGROUNDTo investigate the efficacy of combined hyperfractionated radiation therapy (HFX RT) plus accelerated HFX RT and concomitant chemotherapy (CHT) in stage IIIA or IIIB non-small-cell lung cancer (NSCLC) compared with HFX RT alone.

METHODSFrom August 1998 to December 2001, 56 patients with NSCLC were randomized into the following groups: HFX RT alone group (group I, n=28), HFX RT with 1.2 Gy twice daily to a total dose of 45.6 Gy, followed by accelerated HFX RT with 1.6 Gy twice daily, the total planned radiation dose was 68.0 Gy in tumour; HFX RT/CHT concomitant group (group II, n=28), same RT with CHT consisting of 20 mg/m² of cisplatin (DDP) on days 1 to 3 and 50 mg/m² of etoposide (VP 16) on days 1 to 3, repeated every two weeks during the RT course.

RESULTSThe overall response rate was 78.6% in group II, including 10 patients with complete response and 12 with partial response; 39.3% in group I, including 11 patients with partial response. Group II had a higher overall response rate compared to Group I (P=0.003). The median survival time was 16 months for group II, 13 months for group I. There was a significant difference in the median survival time between two groups (P= 0.000 3 ). Group II (57.1%) had a lower distant metastasis rate compared with group I (85.7%) (P= 0.018 ). Patients in group II showed a higher incidence of acute and/or late high-grade toxicity (hematologic toxicity, esophagitis, late lung toxicity) compared with group I patients, but no significant difference was observed between the two groups.

CONCLUSIONSThe HFX RT plus accelerated HFX RT and concomitant PDD/VP-16 CHT is tolerable and substantially increases the response rate and prolongs survival in IIIA/IIIB NSCLC patients.

With the rapid development of the interdisciplinary area of artificial intelligence and medicine, large language model (LLM) has been widely used in the fields such as diagnosis and treatment, medicine, and healthcare. LLM has unique advantages in the field of traditional Chinese medicine (TCM), such as high consistency with the "Four Diagnostic Methods", perfect combination of natural language and self-supervised learning in TCM, the ability to adapt to the characteristics TCM formulas, and the assistance in TCM diagnosis and treatment. At present, various LLM models have been developed, including the "Qihuang Ask Big Model" and the Digital Traditional Chinese Medicine Big Model "GLM-130B", but they still face challenges such as value mismatch and medical abuse, increased demand for interpretability, lack of advanced technology, and domestic policy access. This article reviews the evolution of LLM, its unique advantages and applications in the field of TCM, the problems and challenges, and the future development trends, in order to providereference for the further promotion of LLM in traditional medicine.

OBJECTIVES: Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment. METHODS: Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline. RESULTS: A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41). CONCLUSIONS Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans ; Citric Acid/adverse effects* ; Prospective Studies ; Sodium Citrate ; Hemorrhage/chemically induced* ; Citrates/adverse effects* ; Anticoagulants/adverse effects* ; Renal Dialysis/adverse effects*