OBJECTIVETo observe the efficacy difference in the treatment of breast hyperplasia between the combined therapy of auricular point sticking and Xiaopijian and the simple application of Xiaopijian.

METHODSNinety-one patients were randomized into an observation group (46 cases) and a control group (45 cases). In the observation group, the sticking therapy on the auricular points was applied in combination with the oral medication of Chinese herbal medicine, Xiaopijian. Auricular points included Ruxian, Neifenmi (CO18), Luanchan, Shenmen (TF4), Gan (CO2), Pi (CO13). The auricular point sticking therapy was applied once a week on the auricular points of one side alternatively. Xiaopijian was the self-prepared decoction. The main ingredients are radix bupleuri Bupleurum chinense, spica prunellae prunella vulgaris and radix peoniae alba Paeonia lactiflora, 30 mL each time, three times a day. In the control group, Xiaopijian was simply prescribed for oral administration, 30 mL each time, 3 times a day. The treatment was discontinued during menstruation in the two groups. The menstrual cycle of one month made one session of treatment. The treatments for 3 sessions were observed. The scores of symptoms and physical signs, including the degree of breast pain, hardness and size of breast masses as well as the scores of general and supplementary symptoms were compared before and after treatment in the patients of the two groups. The clinical efficacy was compared between the two groups.

RESULTSAfter treatment, the scores of symptoms and physical signs were reduced apparently as compared with those before treatment in the patients of the two groups (both P<0. 05). The score reduction in the observation group was much more than that in the control group (11.02±1. 78 vs 9.82±1. 53, P<0. 05). The total effective rate was 95.7% (44/46) in the observation group, higher apparently than 80. 0% (36/45, P<0. 05).

CONCLUSIONThe combined therapy of auricular point sticking and Xiaopijian achieves the superior efficacy on breast hyperplasia as compared with the simple application of Xiaopijian.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Breast ; pathology ; Breast Diseases ; drug therapy ; pathology ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hyperplasia ; drug therapy ; pathology ; therapy ; Middle Aged ; Young Adult

Objective To understand the incidence trend of ventilator -associated pneumonia(VAP)in ICU and to evaluate the effects of the interventions on the incidence of VAP,so as to provide scientific evidences for the prevention of VAP.Methods A study of 149 patients with VAP occurred in the 3 710 patients of ICU before and after intervention during 7 /2010 -12 /2014 in Wujin People's Hospital,Changzhou city was conducted.It was divided into two stages:baseline survey and stem expectations,VAP interventions included:training and education,chlorhexidine oral care and maintain appropriate endotracheal tube cuff pressure,elevated head of bed to up to 30°and improved hand hygiene.Hospital infection control professionals collected the number of patients,basic information,length of hospital stay,days of receiving mechanical ventilation and the VAP incidence data in ICU.And then change of the VAP incidence of the intervention before and after the intervention was compared and evaluation of the effect of combined intervention measures.Results Prospective data from 3 710 patients hospitalized in ICU were collected for an aggregate of 14 831 days,the utilization rate of ventilator was 55.2%.The occurrence of VAP was 149 cases.The average rate of VAP was 18.2 cases per 1 000 ventilator -day.VAP was associated with a crude mortality of 7.56%and with increased ICU LOS of 13.2d.As the results of the interventions,the rate of VAP was decreased from 52.38 /1 000 during 7 /2010 -6 /2011 to 5.71 /1 000 during 1 /2014 -12 /2014.Conclusion The rate of VAP in the inves-tigated ICU has led to a decreased incidence of VAP under the comprehensive interventions.

ObjectiveTo observe the clinical efficacy of acupoint application plusXiao Pi Jianin treating hyperplasia of mammary glands.MethodTotally 103 patients with hyperplasia of mammary glands were randomized into a treatment group of 52 cases and a control group of 51 cases. The treatment group was intervened by acupoint application plus oral administration ofXiao Pi Jian, while the control group was by oral administrationofXiao Pi Jianalone. The criteria for diagnosis and therapeutic evaluation of hyperplasia of mammary glands were adopted in the study.ResultThe total effective rate was 94.2% in the treatment group, significantly higher than 82.4% in the control group(P<0.05).ConclusionAcupoint application plusXiao Pi Jiancan produce a significant efficacy in treating hyperplasia of mammary glands.

Objective To evaluate the related risk factors in preterm infants with cerebral injury. Methods A total of 268 cases whose gestational age less than 36 weeks had cranial ultrasound scans between 0 to 7 days after birth from January 1, 2006 to October 31,2007, and their clinical data were reviewed. Results One hundred and thirty patients (48.5 %) were diagnosed cerebral injury, total incidence of intraventricular haemorrhge and periventricular leukomalacia were 43.3% (116/268) and 14.3% (38/268) respectively. The incidence of cerebral injury was correlated with low birth weight, prematurity, asphyxia, respiratory distress syndrome, apnea, respiratory failure, pulmonary haemorrhge, anemia, hypotension, hypoglycemia, infection, premature rupture of membrane, low gestaional age at birth and ventilation. Conclusion The incidence of preterm brain injury are related to many factors. Risk factors of cerebral injury should be prevented in clinical practice and cranial ultrasound scans are required for early diagnosis of preterm cerebral injury.

Objective To investigate the clinical value of PET-CT scans in lymphomatous patients in post-therapy evaluation. Methods 18F-FDG PET-CT imaging were performed in 40 lymphomatous patients whom had been received therapy. Successive PET-CT imaging were performed in 5 cases, and the treatment was evaluated with clinical evaluation. Results Successive PET-CT imaging were performed in 5 cases, in which the tumor was eradicated in 2 cases, improved in 2 cases, and relapsed in 1 case. In 35 patients PET-CT imaging was repeated after treatment, among them 30 cases with complete or partial remission, and PET-CT imaging was positive in 25 cases. PET-CT imaging was still positive in 8 cases with recurrent or remnant tumor. PET-CT imaging changed the therapeutic regime. Conclusion PET-CT imaging can detect the recurrent or remnant tumor sensitively and accurately. There is a significant value for the guidance of clinical therapeutic.

Objective To study the methods and therapeutic effect of coverage the soft tissue defect in the foot and ankle with neurocutaneous sural artery island flap.Methods 30 patients had been reconstructed foot and ankle soft-tissue defects with neurocutaneous sural artery island flap,the area of soft tissue defect from 2.0 cm × 3.5 cm～ 8.0 cm× 16.5 cm,the flaps were designed with the size measuring 2.5 cm × 4.0 cm to 8.5 cm × 18cm.Results 26 flaps survived completely and 4 with partial or margin necrosis,the wound infection occurred in 6 patients and were treated with dressing,shin graft and antibiotic drug.Conclusions Sural neurocutaneous island flaps are easy to separate.Major arteries are not injured.It is the ideal flap to repair the soft tissue defect around ankle and foot,the texture,color and contour of the flap is similar to recipient area.

OBJECTIVE:To analyze fatty oil and volatile oil in seed of Metaplexis japonica. METHODS:Fatty oil and vola-tile oil in seed of M. japonica were analyzed by GC-MS:HP-5MS quartz capillary column,high purity nitrogen as carrier gas, flow rate of 1 mL/min,injector temperature of 220 ℃,primary column temperature of 120 ℃(temperature programmed),column pressure of 80 kPa,split sampling,split ratio of 20:1,sample size of 1 μL. Mass condition:electron bombardment ion source, electron energy of 70 eV,interface temperature of 250 ℃,mass scanning range of m/z 50-550,scanning interval of 1.0 s. The dif-ference of volatile components in seed of M. japonica before and after processing was analyzed by HSGC-MS:HP-5MS quartz cap-illary column,high purity nitrogen as carrier gas,flow rate of 1 mL/min,headspace heating temperature of 90 ℃,heating time of 30 min,primary column temperature of 80 ℃(temperature programmed),column pressure of 80 kPa,split sampling,split ratio of 20:1,sample size of 1 μL. Mass condition:electron bombardment ion source,electron energy of 70 eV,interface temperature of 210 ℃,mass scanning range of m/z 50-550,scanning interval of 1.0 s. RESULTS:A totall of 30 components were identified in fatty oil,among which relative contents of linoleic acid,oleic acid,palmitic acid were in high level;54 components were identi-fied in volatile oil,main components were terpenes,among which relative contents of cananga oil diene,thujopsene,dehydro aro-madendrene were in high level. Terpinen-4-ol was found and dihydrocarveol increased 100% after frying,compared with before fry-ing. CONCLUSIONS:The study basically confirm main component of fatty oil and volatile oil in seed of M. japonica;there is dif-ference of volatile components in seed of M. japonica before and after frying.

Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.

Objective To observe any effects of using isokinetic strengthening exercises combined with intra-articular injection of sodium hyaluronate and joint mobilization in treating patients with knee osteoarthritis (KOA).Methods Eighty-one KOA patients were divided into a combined treatment group,a conventional treatment group and a control group.The combined treatment group received isokinetic strengthening training,intra-articular injections of sodium hyaluronate and joint mobilization therapy; the conventional treatment group received the injections and mobilization only; the control group was instructed to do ankle pumps at home on their own.Before the start of treatment and after 4 weeks,knee pain was self-assessed [using a visual analogue scale (VAS) for pain] along with knee range of motion (ROM),quality of life (using the WOMAC condensed health survey rating scale) and indexes of isokinetic strength [including the knee flexors,extensor peak torque (PT),and the flexion and extension angles corresponding peak torque (AOPT)] in both groups.Results After 4 weeks of treatment,statistically significant improvements compared to the baseline values were observed in both groups.The combined treatment group,however,improved to a significantly greater extent than the conventional treatment group in terms of all of the measures.Conclusion Isokinetic strength training combined with intra-articular injections of sodium hyaluronate and joint mobilization has a synergistic effect in enhancing knee stability and improving the performance in activities of daily life of KOA patients.

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a breakthrough in the field of hepatobiliary surgery.The remnant liver regeneration was stimulated during the first stage of the operation,and the radical resection of the tumor could be successfully carried out during the second stage of the operation.ALPPS is a new approach for patients with tumor which is previously considered unresectable during one hospital stay.In April 2014,a patient with hepatocellular carcinoma (HCC) in the right liver and liver cirrhosis was admitted to the Southwest Hospital.Preoperative examination confirmed that the ratio of the remnant liver volume to the standard liver volume was 26.9％,which indicated that the patient was inappropriate to receive radical resection of HCC.Therefore,totally laparoscopic ALPPS was applied.In the first stage of the operation,the portal vein ligation associated with liver hanging tape placement and in situ splitting of liver were carried out after hanging the Glisson's pedicle under the laparoscope.Thirteen days after the first stage of the operation,the ratio of the remnant liver volume to the standard liver volume was 40.6％.The second stage of the operation was carried out 14 days after the first stage of the operation.The right hepatic pedicle and right hepatic vein were transected with a stapler.The tumor was removed after full mobilization of the right liver.The distance between the resection margin to the tumor was 1.5 cm.No complications were detected after the first stage of the operation,while the patient was complicated with pleural effusion after the second stage of the operation and was cured by pleural puncture and drainage.The patient was discharged at postoperative day 9 and followed up at postoperative month 1.The results of follow-up confirmed that the hepatic function was normal,and no mass occupying lesions and pleural effusion were detected.Totally laparoscopic ALPPS is safe and feasible with satisfactory short-term efficacy.