Objective To summarize the clinical experience of nasal endoscopic treatment for refractory epistaxis. Methods .A retrospective analysis was made on 258 patients with refractory epistaxis treated with intranasal endoscopic exploration and hemostatic treatment from January 1998 to December 2004 in this hospital. Results .Hemorrhage was found on the nasal septum and the lateral nasal wall in 118 and 47 patients, respectively. Nose bleeding resulted from intranasal tumor in 8 patients. The site of bleeding was not clearly identified in 85 patients. Of the 258 patients, 257 responded to the treatment (99.6%) and 1 died ( 0.4%).Recurrent bleeding occurred in 43 patients. The incidence of recurrent bleeding was significantly higher in patients with unknown bleeding sites than in clearly diagnosed patients (?2=17.689,P=0.000). Conclusions .The emphasis of nasal endoscopic treatment for refractory epistaxis should be laid on the initial management, during which the bleeding site should be carefully identified. For patients with repeated nose bleeding, a combination treatment, including endoscopic filling-up of the anterior nasal cavity, endoscopic embolization of anterior and posterior nose, or embolization of the internal maxillary artery, is necessary.

Objective To observe the clinical efficacy of Wendan decoction in the treatment of phlegm-heat accumulation type acie vulgaris.Methods 62 patients with phlegm-heat accumulation type ache vulgaris were randomly divided into a treatment group and a control group randomly,with 31 patients in each group.The control group was given dietary advice and skin cleansing techniques,while the treatment group was given oral administration of Wendan decoction on the basis of the control group.Results ①skin damage comparison:after the treatment,skin damage symptoms such as tenderness (0.71 ±0.32),redness (0.47±0.63),cyst(0.59±0.53),and tubercle (0.63±0.54) in the treatment group were significantly improved than the control group [the values were (1.12±0.32),(1.44±0.21),(1.40±0.36),(1.18±0.43),respectively] (P＜0.05).②symptoms score comparison:The symptoms score in the treatment group after the treatment (42.95±1.53) was significantly improved than that before the treatment (52.89± 1.98),(P＜0.05),and also obviously better than the control group after the treatment.③clinical efficacy comparison:Total efficacy was 96.77％ in the treatment group and 54.83％ in the control group,showing marked difference(P＜0.05).Conclusion Wendan decoction is effective in treating phlegm-heat accumulation type acne vulgaris.

Objective To investigate the feasibility and clinical value of medical history and clinical manifestation-based protocol(MHCMP) for the diagnosis of spontaneous coronary artery dissection(SCAD)using intravascular ultrasound (IVUS).Methods Based on the MHCMP designed in our centre,intraoperative sequential analysis was performed in patients with acute coronary syndrom and clinical tip of SCAD,SCAD and its classification were defined according to the result of IVUS.Results Of the 37 patients admitted with ACS at the Cardiology Service,29 patients had SCAD as the cause(78.4 ％).All the patients underwent coronary angiography and IVUS,of which 9 patiens were type I (24.3 ％),15 patients were type Ⅱ (40.5％) and 5 patients were type Ⅲ (13.5％).The left anterior descending artery was the most frequently affected (16 patients),followed by the the right coronary artery (7 patients),while 5 patients had dissection of the circumflex artery and 1 patient had dissection of the left main coronary artery.Type I (evident arterial wall stain):this was the pathognomonic angiographic appearance of SCAD with contrast dye staining of the arterial wall with multiple radiolucent lumens.Type Ⅱ (diffuse stenosis of varying severity):this angiographic appearance was not well appreciated and was often missed or misdiagnosed.SCAD commonly involved the mid to distal segments of coronary arteries,and could be so extensive that it reached the distal tip.There was an appreciable (often subtle) abrupt change in arterial caliber,with demarcation from normal diameter to diffuse narrowing.This diffuse and usually smooth narrowing could vary in severity from inconspicuous mild stenosis to complete occlusion.Type Ⅲ (mimic atherosclerosis):this appearance was the most challenging to differentiate from atherosclerosis and most likely to be misdiagnosed,while IVUS was helpful for the differential diagnosis.Conclusions MHCMP is able to screen out all kinds of SCAD and guide the treatment decisions making.

The STandards for Reporting Interventions in Clinical Trials Of Moxibustion (STRICTOM), in the form of a checklist and descriptions of checklist items, were designed to improve reporting of moxibustion trials, and thereby facilitating their interpretation and replication. The STRICTOM checklist included 7 items and 16 sub-items. These set out reporting guidelines for the moxibustion rationale, details of moxibustion, treatment regimen, other components of treatment, treatment provider background, control and comparator interventions, and precaution measures. In addition, there were descriptions of each item and examples of good reporting. It is intended that the STRICTOM can be used in conjunction with the main CONSORT Statement, extensions for nonpharmacologic treatment and pragmatic trials, and thereby raise the quality of reporting of clinical trials of moxibustion. Further comments will be solicited from the experts of the CONSORT Group, the STRICTA Group, acupuncture and moxibustion societies, and clinical trial authors for optimizing the STRICTOM.

In recent years， NOD-like receptor protein 3 （NLRP3） inflammasome in tumors has become a research hotspot， especially in melanoma， colorectal cancer， lung cancer， and breast cancer， and more and more evidence has shown that inflammation plays a role in the development， progression， angiogenesis， and invasion of cancer. Hepatocellular carcinoma （HCC） is the most common type of primary liver cancer， and there are still controversies over the role of NLRP3 inflammasome in the development and progression of HCC. Therefore， this article reviews the potential impact of NLRP3 inflammasome in the progression of HCC and its mechanism of action in anticancer therapy， and it is believed that NLRP3 inflammasome can be used as an effective therapeutic target for HCC patients.