OBJECTIVETo systematically evaluate the effectiveness of integrative medicine (IM) for preventing postoperative recurrence of primary hepatic carcinomas (PHC).

METHODSSuch databases as The Cochrane Library, PubMed, EMbase, China National Knowledge Infrastructure (CNKI), VIP Database, Wan-fang Database were retrieved to collect randomized controlled trials (RCTs) on preventing postoperative recurrence of PHC by IM. The retrieval period started from database establishment to June 2013. Literature screening, data extraction, and quality evaluation were performed by two reviewers strictly according to inclusion criteria. Meta-analysis was conducted using RevMan 5.2 Software.

RESULTSA total of 5 RCTs involving 367 patient cases were included. Results of Meta-analysis showed that the IM group was superior to the Western medicine (WM) group in the 1-, 2-, and 3-year recurrence rates (P < 0.05).

CONCLUSIONIn the prevention of postoperative recurrence of PHC, the effectiveness of IM was more significant, when compared with treatment of Western medicine.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Integrative Medicine ; Liver Neoplasms ; prevention & control ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To analyze the clinical features and its influencing factors of depression pa?tients with and without psychotic symptoms. Methods According to the presence of psychotic symptoms, 374 patients with major depression were divided into psychotic major depression ( PMD group,79 case) and nonpsychotic major depression ( NMD group,268 case) . All patients completed social demographic question?naire ( including gender,age,marital status,educational level,family history,positive family history of psychi?atric disorder,disease onset age,frequency of attack,times of hospitalization,etc.) and Hamilton's depression scale (HAMD?24). Results Positive family history(PMD group 47/79,NMD group 104/268, P<0.01), psychiatric disorder positive family history(PMD group 19/79,NMD group 26/268, P<0.01) and times of hospitalization(PMD group(2.52±1.29),NMD group(1.39±1.31), P<0.01) in the PMD group were signifi?cantly higher than the NMD group.HAMD total scores(PMD total score(47.85±8.69),NMD total score (43.44±8.51), P<0.01),the factor score of anxiety/somatization(PMD group(11.40±3.28),NMD group (9.19±3.54), P<0.01) and cognitive impairment(PMD group(12.24±3.77),NMD group(9.45±3.68), P<0.01) in the PMD group were significantly higher than the NMD group.Disease onset age(PMD group(30.09 ±5.17),NMD group(35.95±9.06), P<0.01),the course of the disease(PMD group(1.58±0.76),NMD group(3.02±2.87), P<0.01),the factor score of day and night change(PMD group(0.76±0.46),NMD group(1.01±0.51), P<0.01) in PMD group were significantly lower than the NMD. Logistic regression anal?ysis showed the major depression with positive family history of mental disorders( β=3.278) ,attack in early age( β=-2.524),seriously cognitive dysfunction in patients( β=3.836) may indicate the psychotic symp? toms( P<0.05).Conclusion PMD patients more positive family history,psychiatric disorder positive family history,likely to be hospitalization,severe symptoms and attack in early age compared with NMD. With posi?tive family history of mental disorders,attack in early age,seriously cognitive dysfunction in patients with ma?jor depression may indicate the psychotic symptoms.

Objective To evaluate the status of abnormal glucose metabolism in patients being alive over 3years after liver transplantation and discuss the possible mechanism of post-transplant diabetes mellitus ( PTDM ).Methods In this study, the clinical data of patients with liver transplantation were collected from April 2001 to December 2008. Patients with diabetes mellitus before operation and those who had died and failed to appear during follow-up were exluded. 199 patients living over 3 years after liver transplantation were follow-up. The prevalence of PTDM was evaluated according to fasting plasma glucose(FPG). Among those without diabetes according to FPG,32patients underwent 75 g oral glucose tolerance test (OGTT) , and fasting and 2 h plasma glucose and insulin were determined. 32 patients were divided into three groups [normal, impaired glucose regulation ( IGR ) , and PTDM groups], proportion of PTDM and homeostasis model assessment ( HOMA ) index were calculated. Results In patients alive over 3 years after liver transplantation, the prevalence of PTDM was 34.67% according to FPG. The OGTT result showed that the proportion of PTDM was 9.38%, IGR, including impaired fasting glucose(IFG) and impaired glucose tolerance ( IGT ) , was 56. 25% , while 34. 37% remained normal. The homeostasis model assessment β cell function index( HOMA-β ) decreased progressively from normal group, IGR group to PTDM group,and that in PTDM group was significantly lower than those in normal and IGR group( P＜0.01 ). IGR group had the highest homeostasis model assessment for insulin resistance (HOMA-IR) and PTDM group the next, and HOMA-IR in IGR group was significantly higher than normal group. Conclusion In patients alive over 3 years after liver transplantation, the prevalence of PTDM reached 44.05%. Insulin resistance existed during early period of impaired glucose regulation, while the degeneration of β cell progressed with the worsening of impaired glucose regulation.

Objective To investigate the changes and clinical significances of the chemokines of interferon-?-inducible protein-10(IP-10),monocyte chemoattractant protein-1(MCP-1) and growth-related oncogene-?(Gro-?) involved in pathagenesis of Kawasaki disease(KD) and HenochSchonlein purpura(HSP).Methods The chemokines production of IP-10,MCP-1 and Gro-? were assayed by ELISA in 15 patients with KD,12 patients with HSP and 10 healthy children.Results The plasma levels of IP-10 and MCP-1 were markedly elevated in KD group [(394.2?176.4)and(420.5?163.4)ng?L-1]compared with HSP group[(94.8?66.4)and(109.2?76.6)ng?L-1] and the control group [(76.4?46.5)and(87.7?47.8)ng?L-1](all P0.05),as well as Gro-? between the three groups.Conclusion Monocyte may enhance the immune damage in KD pathogenesis,and the levels of IP-10,MCP-1 may be important indexes for KD.Neutrophil may be not involved in pathogenesis of HSP and KD.

Atrioventricular Node ; physiopathology ; Cardiac Complexes, Premature ; diagnosis ; physiopathology ; surgery ; Catheter Ablation ; Humans ; Male ; Middle Aged

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Objective To investigate the effect of total glucosides of paeony ( TGP ) on the expression of Toll-like receptor 9 (TLR9) in peripheral blood B lymphocytes of the patients with systemic lupus erythematosus (SLE). Methods Sixty SLE patients and thirty healthy volunteers were enrolled, peripheral blood mononuclear cells ( PBMC) were isolated from blood samples and divided into 4 groups, which were incubated with CpG-ODN(final concentration was 1 μmol·L-1), CpG-ODN+TGP ( TPG final concentration was 1í10-4 mol·L-1 ) ,TGP and RPMI medium ( as the blank control group) for 48 hours, respectively. FLA ( Flow cytometry analysis) was used to detect the expression of TLR9 on peripheral blood B lymphocytes after incubated. Results ①In the health people, TLR9 expression in the group of CpG-ODN was(9. 10±2. 12) %, which was higher than the blank control group(4. 96±2. 11) % (P<0. 01).②In the SLE patients, the TLR9 expression in the group of CpG-ODN was(14. 86±3. 42)% , which was significantly higher than the blank control group(9. 20±3. 43) %(P<0. 01). The TLR9 expression in the group of CpG-ODN+TGP was (11. 95±3. 63)%, which was lower than that in the group of CpG-ODN (P<0. 05). The TLR9 expression in the group of CpG-ODN with lightly active degree SLE patients was (10. 74±3. 17)%, which was higher than the blank control group(5. 19±2. 05) % (P<0. 01). For SLE from the moderately to vigorously active degree, the expression of TLR9 in the group of CpG-ODN(16. 51±1. 72) % was higher than the blank control group(10. 80±2. 37) %(P<0. 01), but that in the group of CpG-ODN+TGP (13. 59±2. 58) % was lower than the group of CpG-ODN (P<0. 01). Conclusion Our data indicate that TGP antagonize upregulation effect of CpG-ODN on the expression of TLR9 in peripheral blood B lymphocytes.

Objective In this study,we aim to investigate and evaluate the application of peer education on the teaching of medical graduate students and to evaluate the teaching effect,in order to provide the basis for subsequent practice reform.Methods 49 graduate students majoring Internal Medicine-Pulmonology were randomly divided into traditional teaching(24) and peer education groups (25).We chose the primary culture technology of rat distal pulmonary arterial smooth muscle cells to be the teaching contents.For the traditional teaching group,we used the mode of class lecture giving and experimental skills learning under the assistance of the teachers; while in the peer education group,students benefited from the combination of class lecture given by the teacher and the seniors fixed teaching in which seniors help younger students.We selected the experimental operating time,cell purity and the practicing time to reach a standard culture as the evaluation indexes by filling a follow up questionnaire.The SPSS 13.0 was applied to the related data forx2 or t test.Results In the traditional teaching group,the average time to reach three times of standard culture was(3.2 ± 0.5) hour,which was(2.3 ± 0.4) hour in the peer education group.The cell purity was 80.1 ± 3.6％ in the traditional teaching group,while(85.4 ± 5.9)％ in the peer education group.The average practicing time was(6.3 ± 1.0) in the traditional teaching group,while(4.9 ± 0.6) in the peer education group.The peer education group master the teaching content better than the traditional teaching group (P=0.00).95.8％(23/24)of the students in the peer-education group considered the teaching contents simple,which was statistically higher(P=0.00) than traditional group (62.5％,15/24).Meanwhile,95.8％ (23/24)of the students in the peer-education group considered the teaching methods easy to accept,which was also statistically higher(P=0.02) than traditional group(70.8％,17/24).The difference was statistically significant (P=0.02).Conclusion The application effect of peer education is good and there is high degree of acceptance among the students.Besides,peer education accords with the medical postgraduate experiment teaching rules,and can cultivate medical graduate students' spirit of cooperation and communication ability in the process of implementation.

Objective:To investigate the effects of Nano-chitosan rhBMP-2 Gel(NCS/BMP-2 Gel)on the repair of mandibular de-fect.Methods:NCS/BMP-2 Gel and NCS Gel were prepared and respectively injected into the subcutaneous space on both sides of dorsum of 9 rats.3 rats were respectively sacrificed 10,20 and 30 d after injection.The subcutaneous nodules were histologicaly ex-amined.Mandibular defect was made in 54 SD rats and the rats were divided randomly and into 3 groups(n=18):NCS/BMP-2 Gel was implanted into the defects in group 1,NCS Gel in group 2,no injection in group 3.Animals were sacrificed 3,6 and 9 weeks after transplantation.X-ray examination,pathologic observation were conducted.Results:Subcutaneous nodules were found in both sides of the rat dorsum.The residual mandibular defect area in study group 1 was apparently smaller than that in group 2 and 3(P<0.05). More new bone formation was observed in the gel injected area in group 1 than in group 2 and 3.Conclusion:Nano-CS/BMP-2 Gel is biocompatible and can accelerate the healing of mandibular defect.