Objective To investigate the relationship between the changes of blood coagulation index before and after neoadjuvant chemotherapy and the chemotherapeutic efficacy in patients with breast cancer.Methods Ninety patients with breast cancer were selected,and detected the changes of blood coagulation index before and after neoadjuvant chemotherapy (TAC regimen),and the relationship between blood coagulation index and the chemotherapeutic efficacy were analyzed.Results The levels of fibrinogen (Fib),platelet count (PLT) after chemotherapy were significantly higher than those before chemotherapy [(3.42 ±0.50) g/L vs.(2.44 ±0.46) g/L,(267.83 ±61.34) × 109/L vs.(174.18 ±48.65) × 109/L] (P ＜ 0.01),D-dimer (D-D) was significantly lower than that before chemotherapy [(176.32 ± 101.41) mg/L vs.(214.55 ± 106.34) mg/L] (P ＜ 0.01).The remaining indicators before and after chemotherapy had no significant differences (P ＞ 0.05).The level of D-D in 68 cases was reduced after chemotherapy,the effective chemotherapy in 53 cases (77.9％,53/68),ineffective in 15 cases (22.1％,15/68);the level of D-D in 22 cases was increased after chemotherapy,the effective chemotherapy in 9 cases (40.9％,9/22),ineffective in 13 cases (59.1％,13/22),the difference was statistically significant (P=0.000).The level of PLT in 10 cases was reduced after chemotherapy,the effective chemotherapy in 3 cases(3/10),ineffective in 7 cases (7/10);the level of PLT in 80 cases was increased after chemotherapy,the effective chemotherapy in 59 cases (73.8％,59/80),ineffective in 21 cases (26.3％,21/80),the difference was statistically significant (P=0.044).Conclusions The Fib and PLT increase while the D-D decreases after chemotherapy,so it is necessary to monitor Fib,PLT,D-D level during chemotherapy.The D-D and PLT are effective indexes in evaluating curative effect of neoadjuvant chemotherapy in patients with breast cancer.

The academic origin and characteristics of medical families of acupuncture-moxibustion in northern Zhejiang Province were explored in this paper. With acupuncture-moxibustion characteristic of medical families in northern Zhejiang Province such as the LING (see text), the YAN (see text), the SHI (see text) and the SHENG (see text) analyzed and arranged, it was found out that taking the Internal Canon of Medicine as theory basis, their academic thoughts comprehensively absorbed acupuncture-moxibustion theories in all ages, and they continuously made innovations through constant practices, resulting in academic thoughts that focusing on application of acupuncture-moxibustion in clinic, using moxibustion for deficient illness and adopting acupuncture-moxibustion and Chinese herbs for severe and acute patients. The academic thoughts of medical families of acupuncture and moxibustion in northern Zhejiang Province are featured by unique acupoint selection and ma nipulation, thorough moxibustion methods and combined application of Chinese herbs and acupuncture-moxibustion, which is a clinical system of diagnosis and treatment with typical Jiangnan features.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Moxibustion ; history

Objective To optimize the technology of extracting Paeoniflorin and Puerarin from Tongqing Granules. Methods The experiment used the orthogonal experimental design (4 factors and 3 levels) with the shift-rate of Paeoniflorin and Puerarin as experimental criterion in screening the factors affecting the technology of extracting Tongqing Granules. Results All the 3 factors designed in the orthogonal experiment non-signifantly affected the extracting technology. In consideration of the industrial practice, the best condition of extracting the constituents from Tongqing Granules was decided:water extraction for 3 times, extracting with 12 fold water for 1 hours for the first time, with 5 fold water for 0.5 hours for the second time, and with 5 fold water for 0.5 hour for the third time. Conclusion The condition is the optimized technology of extracting Paeoniflorin and Puerarin from Tongqing Granules.

In China, cooking oil fume is a kind of indoor air pollutant that is ubiquitous. With the development of catering trade, the pollution of cooking oil fume is becoming more and more severe. The results of animal experiments showed that cooking oil fume could damage the genetic substance and cause cancer. The results from the epidemiological studies indicated that cooking oil fume could induce lipid peroxidation and change the pulmonary and immunologic functions, cause chromosome damage and increase the risk of lung cancer.

Objective To evaluated the effect of Total Glucosides of Paeony (TGP)combined with urokinase for the patients with acute cerebral ischemic stroke.MethodsA total of 152 patients with ACIS were divided into the control group (77 patients) and the observation group (75 patients) by completely randomized grouping method. Patients in the control group were treated with Urokinase by intravenous, and the observation group were treated with TGP combined with Urokinase. All patients were treated with thrombolysis treatment with in the 24 h after the exclusion of cerebral hemorrhage by brain CT and coagulation mechanism disorder. In the following 14 days, they were given the treatment of anti platelet aggregation, lowering blood lipid, trophic nerve and improving circulation. The National Institutes of Health Stroke Scale(NIHSS), the modified Rankin scale(mRS) and the daily life ability index(Barthel) were measured.ResultsThere were 28 (37.3%) patients with the NIHSS scores decreasing 4 points in observation group and 12 (15.6%) in control group after treatment of 7 days,and there was significant difference between two groups (χ2=8.181,P=0.004). There were 68 (90.7%) patients with mRS score less than 4 points in observation group and 51 (15.6%) in control group after treatment of 14 days,and there was significant difference between two groups (χ2=11.945,P=0.001). The NIHSS scores in the observation group was lower than control group (8.3 ± 2.2vs. 9.9 ± 2.5;t=4.192,P<0.05). The mRS score in the observation group was lower than control group (2.3 ± 0.9vs. 2.9 ± 1.1;t=3.684,P<0.01), and the Barthel index in the observation group was higher than the control group (88.7 ± 16.2vs. 77.5 ± 15.2;t=4.401,P<0.01). ConclusionsThe TGP capsules combined with Urokinase intravenous thrombolysis could improve the neurological deficit, and the ability of daily life of ACIS patients.

Objective To study the effect of homecare on the health of diabetic patients in China. Methods A retrieval was done all on CNKI, Wanfang database, VIP database, China Biological Medicine. After excluding the literature out of the criteria, the meta-analysis was performed to compare the intervention group and control one in terms of the fasting plasma glucose , 2-hour postprandial blood glucose , quality of life , treatment compliance , standardized mean difference ( SMD ) and risk ratio ( RR ) . Results 12 RCTs, which involved 1,193 participants including 596 patients in the intervention group and 597 patients in the control group, were included in the final analysis. The fasting plasma glucose, 2-hour postprandial blood glucose, the quality of life, treatment compliance of the intervention group were significantly better than those of the control group , with effect size and 95% CI: SMD =-1.77, 95%CI (-2.28,-1.26);SMD=-1.62, 95%CI (-2.28,-0.95);SMD=1.31, 95%CI (0.50, 2.13);RR=1.27, 95%CI (1.13, 1.43) (P<0.01). Conclusion Homecare can improve the plasma glucose and quality of life of patients with diabetes and can help them to develop a healthy lifestyle.

Objective To explore the lesion distribution pattern of poststroke pathological laughing or crying (PSPLC) by using MRI,and to discuss its pathogenesis. Methods All 24 cases selected from stroke patients who were treated in the department of neurology from May 2012 to December 2015 and had complete follow?up information after their discharge through 6 months were screened for pathological laughing and crying( PLC) . MRI characteristics of cases were analyzed retrospectively to identify lesion distribution. 28 cases with acute isolated pontine infarction who did not demonstrate PLC were enrolled as a comparison group. Lesion pattern difference between 14 cases of the pontine infarction with PLC and 28 cases of acute i?solated pontine infarction without PLC was compared. Results In these 24 cases,the highest occurrence rate of PLC was 41.67% in the second month. 15 cases had forced crying (62.5%),3 cases had forced laughing (12.5%),6 cases had pathological laughing or crying (25%). MRI studies showed lesion location in the left side were 3 cases,in the right side were 1 case,in the bilateral brain were 20 cases,in the basal ganglia were 9 cases,in the thalamus were 8 cases,in the corona radiata were 6 cases,in the semioval center were 5 cases, in the cerebral cortex were 4 cases,in the cerebellum were 4 cases and in the brain stem were 14 cases. In the cases of PLC with brain stem lesion,only 1 case was isolated pontine infarction,the other patients all combined with lesions of other parts. Compared with the pontine infarction with PLC,the isolated pontine in?farction without PLC was more likely to suffer with unilateral brain lesions(71%vs 50%),but there was no significant difference (χ2=0.844, P=0.358) . Conclusion PSFLC is not a rare complication after stroke, which is associated with multiple site of brain involvement especially pontine infarction.

The developed countries have increasingly used private sector involvement in the practices of developing, financing and providing public health infrastructure and services through public-private partnerships (PPPs) in recent years.The main reasons for this uptake in these countries are manifold ranging from the rising expenditures for refurbishing, maintaining and operating public assets, and the increasing constraints on the governmental budgets stifle because of the economic downturn.As a result, the government needs funds to cover inadequate inputs and seeks innovation through private sector experts and management expertise aiming for better operational risks mitigation.In this paper, 18 risk factors in health sector of China were tracked through the literature research, and the research aims to identify the risk allocation by issuing the questionnaires and conducting interviews with experts from the academia, and public and private sectors.This paper finally provides the scheme about the appropriate risk allocation to focus on improving the mitigation of the existing risks in order to achieve successful PPP projects.

Recently, Public-private Partnerships (PPPs) are being increasingly used in the public facilities and services provision in China.The procurement system ranges from simple contracting of services to the involvement of the private sector in the infrastructure financing, design, construction, operation and maintenance.However, organizing a PPP is not an easy task due to its complexity and long term contractual obligations and this some projects to fail to attract the private sector in the partnership and in the services provision.18 critical success factors of PPP project in the Chinese health sector were undermined by the investigation of this research.The mostly identified CSFs are thorough and realistic benefit assessment, sound policies, appropriate risk allocation and risk mitigation, and the public/private sector responsibilities.This paper finally puts forward the recommendations based on the statistics that are published from the Integrated Information Platform of CPPPC in order to focus on validating them for successful PPP projects achievement.

Objective To summarize the experience of diagnosis and treatment of lower gastrointestinal bleeding caused by small intestinal vascular malformation .Methods 12 patients with lower gastrointetinal bleeding caused by small intestinal vascular malformation were retrospectively reviewed.Results ⑴Repeated intermittent hematochezia were the most common cases in our date of lower gastrointestinal bleeding caused by small intestinal vascular malformation.⑵The most common course of disease was 2～3 years.⑶Bleeding was halted after operation in 100% cases and no one relapse.Conclusions ⑴Active bleeding period should be evaluated firstly by angiography and prepare to emergency operation.⑵By treatment combined with enteroscopy during operation could help to diagnose.⑶Surgical operation is the most effective treatment for bleeding of small intestinal vascular malformation.