Objective In recent years,as people have attached importance to the application of regional chemotherapy in the surgery of advanced gastric cancer,the research of fluorouracil sustained release implant,a regional chemotherapeutic drug,is on the increase.Fluorouracil sustained release implant is a new anti-carcinogen combined with fluorouracil,a conventional chemotherapeutic drug,through polymeric scaffolds and rete technology.It can be implanted into cancerous lesion area,as its slow-releasing potential and targeting property will give full play to the antitumor effect of fluorouracil,which can decrease the rate of local recurrence and metastasis of gastric cancer and prolong the life span of the patients.Based on the study of the researches on fluorouracil sustained release implant,a summary was made from different perspectives: basic medicine,pharmacy and clinical medicine.It may have reference value for clinical application and further study.

Objective To investigate the effectiveness of panoramic mandibular index (PMI) in detecting the bone mineral density (BMD) of mandibular bone and whole-body bone in patients with chronic end-stage renal failure. Methods A total of thirty patients with peritoneal dialysis treatment were used as experimental group and 31 healthy adults were used as control group. The panoramic jaw tomography was taken for the measurement of superior PMI (sPMI) and inferior PMI (iPMI) in two groups. The dual-energy X-ray absorptiometry (DXA) was used to detect BMD of lumbar spine bone. Data were compared between two groups. The correlation of sPMI, iPMI and BMD of lumbar spine bone was analyzed. Results All indicators including sPMI(0.262 2 ± 0.026 7 vs 0.284 2 ± 0.025 4, t=3.301) , iPMI (0.314 1 ± 0.028 3 vs 0.334 1 ± 0.027 5, t=2.808) and BMD of lumbar spine bone (0.832 3 ± 0.101 0 vs 0.906 9 ± 0.113 6,t=2.709) were significantly lower in experimental group than those in control group (P＜0.01). There was a positive correlation between sPMI and iPMI with BMD of lumbar spine bone (r=0.439 and 0.389, P＜0.05). The BMD of lumbar spine bone was significantly lower in female patients than that of male patients in control group (0.849 7±0.114 7 vs 0.968 0±0.076 3,t=3.357). The BMD of lumbar spine bone was also significantly lower in female patients than that of male patients in experimental group (0.775 4±0.068 4 vs 0.882 1±0.099 9,t=3.365). There were no significant differences in values of sPMI and iPMI between male and female patients of two groups. Conclusion The BMD of mandibular bone is lower in patients with chronic end-stage renal failure than that of the normal people. PMI index is a simple and effective method to detect the BMD of mandibular bone, which can reflect the BMD of whole body bone in patients with chronic end-stage renal disease.

Objective To investigate the local or systemic effects of initial periodontal therapy on peritoneal dialysis in patients with chronic kidney disease and periodontitis. Methods Sixty-one patients with both periodontitis and regular peritoneal dialysis were selected in this study and were randomly divided into observation group (n=31) and control group (n=30). Patients in observation group were given periodontal initial therapy (ultrasonic supragingival scaling and ultrasonic subgingival irrigation, drug, root planing, oral health education) and peritoneal dialysis treatment. Patients in control group were given only peritoneal dialysis treatment. Clinical parameters including plaque index (PLI), gingival index (GI) and probing depth (PD) were detected before and one month after treatment in two groups. The concentrations of high-sensitivity C-reactive protein (hs-CRP) in gingival sulcus fluid and serum samples were measured by immune transmission turbidity method in two groups. Results There were no significant differences in PLI, GI, PD, hs-CRP of gingival sulcus fluid, and serum hs-CRP before treatment between the two groups. After one-month initial therapy, all the indexes were decreased in observation group, which were significantly different compared with those before treatment (P<0.05). And all the indexes were significantly lower in observation group than those of control group. There were no significant differences in PLI, PD, GI, hs-CRP of gingival sulcus fluid, and serum hs-CRP between control group and observation group before treatment. Conclusion Periodontal initial treatment can improve the periodontal inflammation in patients with chronic kidney disease, and reduce the concentration of systemic inflammatory factor hs-CRP, decreasing the risk of infection.

OBJECTIVE:To observe the clinical efficacy and safety of Feijin zhitong capsule combined with methotrexate and tripterygium glycosides in the treatment of rheumatoid arthritis. METHODS:70 patients with rheumatoid arthritis were randomly di-vided into control group(34 cases)and observation group(36 cases). Control group received Methotrexate for injection by intrave-nous infusion,10 mg every times,once a week;and also Tripterygium glycosides tablet,10 mg every times,bid,po. Observa-tion group additionally received Feijin zhitong capsule,3 capsules every times,bid,po. The treatment course for both groups was 6 months. The clinical efficacy,symptoms and signs,erythrocyte sedimentation rate (ESR),rheumatoid factor (RF),C-reactive protein(CRP),interleukin(IL)-1,IL-6,IL-8 and TNF-α levels before and after treatment in 2 groups were observed,and the in-cidence of adverse reactions was recorded. RESULTS:The effective rate in observation group was 85.71%,which was significant-ly higher than control group(70.59%),the difference was statistically significant(P<0.05). After treatment,duration of morning stiffness,joint pain index,joint swelling index,joint tenderness index,ESR,RF,CRP,IL-1,IL-6,IL-8 and TNF-α in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically signifi-cant (P<0.05 or P<0.01). And there was no significant difference in the adverse reactions in 2 groups (P>0.05). CONCLU-SIONS:Feijin zhitong capsule combined with methotrexate and tripterygium glycosides has good efficacy and safety in the treat-ment of rheumatoid arthritis,it can reduce the inflammatory index level,improve symptom and sign.

Objective To explore the effect of breast-conserving therapy for breast cancer(BCT) and its prognosis. Methods The clinical data of 69 cases of BCT admitted from January 1992 to December 2003 were analyzed retrospectively. The cases included those who had BCT without radiotherapy and those who had BCT with adjuvant radiotherapy, chemotherapy and hormonal therapy. The patients were followed up for 12 to 140 months. Results The 3-year recurrence rate for patients without radiotherapy (11.54%) was higher than that for those with radiotherapy (3.03%) (P

Objective To investigate the morphological changes of whole brain gray matter in patients with postherpetic neuralgia(PHN),and evaluate the correlation between morphological changes of whole brain gray matter,visual analogue scale (VAS) and duration of PHN.Methods By using VBM-DARTEL method,firstly the 3D T1WI structure images of 17 patients with PHN and 17 normal control were preprocessed,then the segmented gray matter volume was compared between the two groups, and the correlation between difference of cerebral gray matter volume,VAS and duration of PHN were analyzed.Results Compared with the normal control, gray matter decrease in PHN group was found in bilateral orbital frontal regions(orbital gyrus,rectus gyri),left inferior frontal gyrus,left insular lobe, left caudate, right cingulate gyrus,left superior temporal gyrus, left cuneus, bilateral cerebellum posterior lobe and bilateral cerebellum anterior lobe.And gray matter increase in PHN group was found in bilateral superior frontal gyri, left middle frontal gyrus, vermis, pons.The gyrus volume change for two hemispheres was asymmetric (the left side greater than the right side).These different brain region changes in gray matter volume for patients with PHN were not correlated with VAS and duration of PHN.

The accuracy of preoperative staging diagnosis of colorectal cancer directly determines the accuracy of treatment and prognosis.Endoscopic ultrasonography,CT,MRI and positron emission tomography/computed tomography (PET/CT) imaging have their own advantages and disadvantages in preoperative staging of colorectal cancer.According to the actual situation of patients,choosing the best method of examination,when necessary,several effective methods combined,can improve the accuracy of preoperative staging diagnosis of colorectal cancer.

Objective:To search, evaluate, and summarize the best evidence for difficult peripheral intravenous catheterization in children.Methods:Following the "6S" evidence pyramid model, literature related to the management of difficult peripheral veins in children was searched in both English and Chinese databases including UpToDate, BMJ Best Practice, National Guidelines Clearinghouse, the Joanna Briggs Institute Evidence-Based Health Care Database, PubMed, Medlive, SinoMed, CNKI, and Wanfang Database. The search period was from the establishment of the database to January 2023. Two researchers trained in systematic evidence-based nursing, independently evaluated the quality of included literature and extracted relevant evidence.Results:Five articles were included: two guidelines, two expert consensuses, and one systematic review. 19 best evidence were summarized, covering five aspects: difficult vein quality management, difficult vein assessment, difficult intravenous catheterization site and needle type selection, difficult intravenous catheterization auxiliary methods, and handling of failed difficult intravenous catheterization.Conclusions:This study summarizes the best evidence for difficult peripheral intravenous catheterization in children, demonstrating clinical nursing practicality. It provides evidence-based guidance for pediatric nursing staff performing difficult intravenous catheterization.

The integrated curriculums of basic medicine in Shanxi Medical University are as follows: nine basic medical courses were integrated into 10 medical modules, with additional training including PBL and TBL case discussion, clinical clerkship, flipped classroom and other non-integrated subjects etc. In order to assess the interest of students for integrated curriculum, their intrinsic motivation, as well as their comprehension and application of medical knowledge, we gave anonymous questionnaire to 149 students, 16 teachers in basic medicine, and 10 teachers in clinical medicine. Results showed that more than 90% students were willing to take the integrated curriculum and participate in PBL and TBL case discussion, and students who were unwilling to take the curriculum were less than 10%, they thought that the knowledge of new curriculum system was incoherent. The proportion of students from higher grade who were unwilling to participate in the flipped classroom was increased from 6.7% to 95.0%. Most of the teachers both in basic and clinic medicine believed that new curriculum system was helpful for students to comprehend basic medical knowledge and strengthen their discriminating ability, but did not function in improving students' practical ability. In the further reform on teaching, details like the coherence of knowledge and the content selected when self-studying should be improved.