Objective To observe the clinical efficacy of acupuncture-moxibustion plus tuina in treating neurosensory tinnitus and hearing loss.Method Eighty-six patients with neurosensory tinnitus and hearing loss were randomized into a treatment group of 56 cases and a control group of 30 cases. The treatment group was intervened by warm needling plus tuina, while the control group was treated with conventional medications. The clinical efficacies were compared between the two groups.Result The total effective rate was 87.5% in the treatment group versus 63.3% in the control group, and the between-group difference was statistically significant (P<0.01). In the treatment group, the total effective rates of those with a disease duration<1 year, ≥1 year and<2 years, and<5 years were significantly different from the rate of those with a disease duration>5 years (P<0.01). In the treatment group, the total effective rate was 93.8% in those due to liver fire, 94.1% in those due to phlegm heat stagnation, 83.3% in those due to spleen-stomach deficiency, and 72.7% in those due to kidney essence insufficiency. The total effective rates of the liver fire and phlegm heat stagnation types were significantly different from the rate of the kidney essence insufficiency type (P<0.05).Conclusion Acupuncture-moxibustion plus tuina is an effective approach in treating tinnitus and hearing loss.

Objective To probe the differences and similarities of clinical feature between alcoholic and biliary chronic pancreatitis (CP) and their therapy. Methods Retrospective analysis of the clinical features was made in 110 cases of CP in Peking Union Medical College Hospital from 1991 to 2000. Results ① In 110 cases of CP, the clinical manifestations were abdominal pain (85.4%), diarrhea (22.7%), calcification of pancreas (13.6%), and pseudocyst of pancreas (28.2%); 3 cases (2.7%) complicated with pancreatic carcinoma. ② The frequency of the different kind of clinical manifestations in alcoholic CP was higher than in biliary CP.③The frequency of diarrhea (29.1%),diabetes mellitus (41.9%) and calcification of pancreas (22.6%) in alcoholic CP was also higher than in those caused by bile duct system diseases (16.7%, 19.1% and 9.5%).④The response rate of medical treatment was 81.2%. Conclusions The clinical features and complications are more typical and occur earlier in alcoholic CP than those in biliary CP. With regard to management, medical treatment is less used than surgical therapy.

Objective To identify the main clinical characteristics helpful for diagnosis and differential diagnosis of Crohn s disease (CD) from primary intestinal lymphoma (PIL). Methods Ninety cases of CD and 46 cases of PIL during 1983-2004 in Peking Union Medical College Hospital were investigated retrospectively. Results The average age of PIL was nearly 10 years elder than that of CD (45. 0?16. 2 vs. 36. 7?15. 7, P

Objective To comprehend the clinical characteristics and treatment of primary hepatic amyloidosis.Methods A total of 10 cases of primary hepatic amyloidosis included. 4 cases from Peking Union Medical College Hospital and 6 cases from other hospitals.reported in the literature in recent 20 years were reviewed,Results (1)The frequent clinical symptoms related to primary hepatic amyloidosis presented as hepatomegaly(90%),abdominal distension(80%),shifting dullness(60%),anorexia(50%),fatigue(40%),edema(40%),weight loss(40%) and abdominal pain(30%).(2)Laboratory tests revealed elevated serum alkaline phosphatase which was (558.3?517.2)U/L,and other liver function involvement were rare:six patients(85.7%)had either a serum or urine monoclonal protein.(3)Liver biopsy is golden standard.The amyloid deposition was mainly located at sinusoida(4 casese,57.1%),and only 2 cases was at vascular(28.6%).Complication of bleeding after liver biopsy was reported(1 case).(4)The classical therapy scheme was melphalan and prednisone,four cases died from liver function failure and infection.Conclusion The clues to the diagnosis of primary hepatic amyloidosis include elevated monoclonal protein,hepatomegaly and an unexplained elevated serum alkaline phosphatase level which is not parallel with other liver functions.Live biopsy is golden standard.The treatment scheme include melphalan and prednisone,but its prognosis is poor.

Objective Objective To evaluate the response,survival and toxicity of concurrent chemoradiotherapy for patients with inoperable esophageal cancer. Methods Eighty-eight patients with inoperable esophageal cancer were divided randomly into two groups, 43 patients in group R+C received chemoradiotherapy, while 45 patients in group R received radiotherapy only. For both groups, the same radiation technic was carried out by conventional fractionation, to a total dose of 60-65Gy/30-33Fr/6.0-6.5W. For group R+C patients, concurrent chemotherapy(5-Fu 500mg/d1-4,DDP 20mg/d1-4) was given. Results Complete response rate in group R+C was 33%,while in group R, it was 13% (P

Objective Through death analysis of critically ill children with interhospital transportation,to explore the cause of death and its influencing factors.Methods We collected the data of death cases within 24 hours who were one-way transported from primary hospital to the emergency department of Guangzhou Women and Children's Medical Center between July 2012 and May 2014.We analyzed the diseases type,physiopathologic status,and the treating measures in the process of transportation.Results There were total 1 122 cases,34 children died,the mortality was 3.0％,7 cases died before admission,27 cases died within 24 hours after admission.The first three types of diseases were respiratory system diseases(8/34,23.5％),nervous system diseases (7/34,20.6％) and accidental injury (6/34,17.6％).The physiopathologic status were analyzed according to physiological status and laboratory data at admission.Most of the children had a variety of physiopathologic status.Electrolyte disturbances were found in 22 cases(81.5 ％),metabolic acidosis and respiratory failure in 19 cases (70.4％).Most cases had intravenous channel (33/34,97 ％),intravenous infusion (32/34,94.1％)and electrocardiogram monitoring (30/34,88.2％),none of the cases received vasoactive agents in transportation.Conclusion Insufficient disease evaluation before the transportation of critically ill children,inadequate monitoring and treating measures on the way are important factors causing the death of children.

Objective To improve the understanding of autoimmune disease related panereatitis by analyzing their clinical features.Methods The clinical features were analyzed retrospectively in 28 autoimmune disease related pancreatitis cases from Peking Union Medical College Hospital(PUMCH),according to the associated autoimmune diseases.Results (1)The average age was(40.0±16.1)years,and the ratio of male to female patients Was 1:6.There were 24 acute and 4 chronic pancreatitis in the 28 cases.(2)The common related autoimmune diseases were systemic lupus erythematosus(20/28)and Sjogren's syndrome(6/28).(3)The characteristics of the autoimmune diseases was multi-system involvement,such as hematologic system,kidney,liver,etc.(4)Clinical features of those acute pancreatitis shown that no distinct trigger exist for acute pancreatitis.and the radiological changing Was not prominent.(5)In laboratory examination,an obvious increase of CA199 coaid be seen,paralleling the severity of pancreatitis.(6)Glucocorticoids or immunosuppressors was effective,and the mortality rate of acute pancreatitis cases was 33.3%.ConclusionsAutoimmune disease related pancreatitis is dominant with acute pancreatitis and females is common,which may reflect the activity of autoimmune diseases.Autoimmune disease related acute pancreatitis has a high mortality rate.Glucocorticoids and/or immunosuppressors may be useful to relieve the pancreatitis.

Objective To explore the clinical features and possible carcinogenesis mechanism of the ulcerative colitis (UC)-associated colorectal cancer. Methods From 1984 to 2008, 6 clinical cases of UC-associated colorectal cancer were collected at Peking Union Medical College Hospital. The characters of morbidity, clinical features, pathology type, treatment and prognosis were analyzed.Immunohistochemistry(IHC) was performed to study the protein expression of adenomatous polyposis coli protein(APC), β-catenin, P53 and Wnt-1 in the specimens. Results The canceration of UC was 1.1 %, higher in female cases (5/6), the average duration was 14.3 years. All cases presented typical UC manifestation, most involved total colon (5/6) and none of them complicated with primary sclerosing cholangitis (PSC). There were 4 rectal cancers and 2 descending colon caners the UC cases collected. The major pathology type was adenocarcinoma with poor prognosis. The positive protein expression ratio of APC, β-catenin, P53 and Wnt-1 were 6/6, 6/6, 5/6 and 6/6 respectively.Conclusion The rectal cancer should be monitored and prevented in UC patients with total colon involved and long disease duration. Multi-pathway may possibly be involved in the carcinogenesis.

Objective To determine the diagnostic accuracy of alarm features in predicting upper gastro intestinal malignancy in patients who received gastroscopy examination.Methods A retrospective analysis of patients who underwent gastroscopy from Oct 2014 to Oct 2015 was conducted.Biopsy or surgical pathological findings served as the golden standard.The main outcome measure was the diagnostic accuracy of alarm features.Results Among 921 gastrointestinal outpatients,39 patients (4.2％) with malignancy were detected,including 13 (33.3％) with esophageal cancer,24 (61.5％) with gastric cancer and 2(5.1％) with duodenal ampulla cancer.36 patients (92.3％) were found with advanced cancer.In 137patients who had alarm features,21 (15.3％) were found to have malignancy and all were advanced.The sensitivity,specificity,positive predictive value and negative predictive value of alarm features were 53.8％(21/39),86.8％ (766/882),15.3％ (21/137) and 97.7％ (766/784),respectively.Conclusions Alarm features have a definite but limited value in predicting upper gastrointestinal malignancy.Noninvasive screening methods for Chinese patients are still needed to reduce unnecessary endoscopy workload.

Objective To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).Methods Clinical data of 337 traditional SAP patients,who were admitted to Peking Union Medical College Hospital (PUMCH)from January 2001 to December 2012,were retrospectively studied.These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP.Disease severity,therapy and prognosis among three groups were compared.Results Among the total 337 traditional SAP patients,253 were classified as MSAP and 84 as SAP.In the group of SAP,40 patients were categorized as CAP and 44 as non-CAP.Compared with non-CAP patients,CAP patients had significantly higher mortality rate which was 70％ (28/40).Other results were all significantly higher in CAP group rather than non-CAP group,including ICU admission rate 77.5％(31/40),length of ICU stay (15.5 ± 20.6) days,Ranson,APACHE Ⅱ,BISAP,MCTSI,modified Marshall scores 4.6 ± 1.4,16.8 ± 5.8,3.0 ± 1.0,8.6 ± 1.7,and 7.4 ± 2.9,respectively (P ＜ 0.01 in each endpoint).These parameters of SAP group were also significantly higher than those of MSAP group (P ＜0.01).Conclusions Using the new three-category classification to distinguish traditional severe acute pancreatitis,namely MSAP,SAP,and CAP,can better reflect the severity of disease,predict outcome and guide clinical management.