This paper analyzes the explore the factors influencing the TCM clinical pathway using the fishbone dragram. We found that the main impacting factors of TCM clinical pathway were government policy factors, hospital management factors and personal factors. It was suggested to promote Chinese medicine clinical pathway pilot job, not only need to cooperate with the administrative departments of health and medical institutions, also need to strengthen the change of the idea of both doctors and patients.

The curative effects of multi-disciplinary and comprehensive treatments for colorectsl cancer have been widely recognized in recent years.Because of the diversification of colorectal cancer treatment and the relatively mature technology,the current treatment of colorectal cancer could embody the multi-disciplinary and comprehensive treatment.The curative effect of neo-adjuvant chemoradiotherapy has been validated by several recent clinical trials.Other treatment methods such as Chinese medicine,radiofrequency ablation and hepatic artery infusion therapy are also involved in the comprehensive treatment,which provide considerable curative effects.

Bacteremia ; microbiology ; Female ; Humans ; Infant ; Pseudomonas Infections ; pathology ; Pseudomonas aeruginosa

Therapeutic hypothermia (TH), also known as targeted temperature management (TTM), is the intentional reduction of core body temperature to 32-35℃. Mild-to-moderate hypothermia and advanced cooling technology can be used as an effective component of multimodal therapy for ischemic encephalopathy, brain trauma, haemorrhagic stroke, or other forms of severe brain injury and acute neurological injuries to achieve neuroprotection. The events occured after an episode of acute neurological injuries and cerebral ischemia are multiple. And the possible explanation for the neuroprotective benefits of hypothermia therapy is inhibiting metabolic disruption, excitotoxicity, oxidative stress, cell apoptosis signals, inflammatory responses, and promoting neuronal integrity and blood-brain barrier integrity. To know the molecular mechanisms of action of TH, which exerts neuroprotective function, will provide clinicians a better understanding the indications and contraindications of this therapy, and provide a possible theoretical reserves and clinical practice for other therapies when used in conjunction with hypothermia.

To explore some variation about normal electrocardiograph (ECG). Methods 6800 people aged 17～40 who hadhealth physical examination in our hospital from 1993～2011 were reviewed. Results The ECG of 4640 (68.24%) people are normal, 136(2%) were abnormal. The rest 2024 (29.76%) people probably had some ECG variation as follows: shorter PR interval (PR<0.12 s); PⅡ upsidedown; heart rate (HR): 40～60 beats/min, HR: 100～110 beats/min; incomplete right bundle branch block (ICRBBB); left ventricular hypertrophy(LVH); abnormal Q; RV1～RV5 amplitude were not increasing; SⅠSⅡSⅢ; STV3～V6 elevation>0.3～0.5 mV; Heart electrical axis is somewhatdeviation and heart position is somewhat shift; occasional superventricular premature beats or ventricular premature beats, etc. Theywere finally diagnosed as normal healthy people after 3～6 months follow-up with ultrasonic cardiogram (UCG), Holter and chest X rays,etc. Conclusion These abnormal ECG beyond normal ECG diagnosis standards are variation of normal ECG in health people.

Adult ; Cervical Vertebrae ; pathology ; surgery ; Humans ; Male ; Spinal Neoplasms ; pathology ; surgery ; Teratoma ; pathology ; surgery

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; administration & dosage ; Cyclophosphamide ; administration & dosage ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; Humans ; Injections, Intra-Arterial ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Phytotherapy

Objective To observe the changes of choroidal thickness after ranibizumab treatment for non-proliferative diabetic retinopathy (NPDR) with macular edema,and determine the association between choroidal thickness and visual acuity.Methods Twenty-three eyes from 23 patients diagnosed with NPDR and diabetic macuiar edema were treated with 3 monthly intravitreal injections of ranibizumab.The subfoveal choroidal thickness and central macular thickness were measured,and the best corrected visual acuity was recorded.Changes of subfoveal choroidal thickness,correlation between subfoveal choroidal thickness and best corrected visual acuity were assessed at 3 months follow-up.Results After 3 monthly anti-VEGF treatments,subfoveal choroidal thickness and central macular thickness decreased significantly,there was no statistical difference at 1 month and 2 months compared with pre-treatment (all P ＞ 0.05),but there was statistical differences at 3 months compared with pre-treatment (P =0.04,0.01).In the treatment,the best corrected visual acuity increased gradually,there was no statistical difference at 1 month and 2 months compared with pre-treatment (all P ＞ 0.05),but there was statistical differences at 3 months compared with pre-treatment (P =0.04).Before the treatment,the subfoveal choroidal thickness was positive correlated with macuiar retinal thickness (R2 =0.94,P =0.00);And the best corrected visual acuity before treatment and 3 months after treatment had a positive correlation (R2 =0.93,P =0.00;R2 =0.82,P =0.00).There was a positive correlation between central macular thickness and best corrected visual acuity at 3 months after treatment (R2 =0.83,P =0.00).There was a positive correlation in the best corrected visual acuity between before treatment and 3 months after treatment (R2 =0.84,P =0.00).Conclusion The subfoveal choroidal thickness is a clinical index to evaluate the efficacy of anti-VEGF in the treatment of diabetic macuiar edema.Baseline subfoveal choroidal thickness can be considered as one of the indicators of clinical efficacy in the short term.

Anti-Bacterial Agents ; therapeutic use ; Bartonella henselae ; Cat-Scratch Disease ; drug therapy ; microbiology ; physiopathology ; Child ; Female ; Humans

Intrauterine growth retardation (IUGR) is one of the most commonly encountered developmental toxicity, which could lead to perinatal morbidity and mortality, be also extended from the fetus to adulthood, and seriously affect the quality of the population. Caffeine widely exists in a variety of daily beverages and some drugs. Its consumption is increasing year by year. Caffeine intake during pregnancy is one of the risk factors for IUGR. However, its mechanism of adverse outcome based on embryonic research is still unclear. In this paper, the possible mechanisms of caffeine-induced IUGR focusing on 3 important factors-the mother, placenta and fetus were explored. Caffeine's impact on the mother is the chronic activation of renin-angiotensin system; on the placenta, caffeine induces cell damage or the failure of the cell proliferation/apoptosis balance, leading to blockage of blood supply to the placenta; caffeine is also capable of directly affecting fetal development through interfering its neuroendocrine.