Lung adenocarcinoma accounted for about 70％ of non-small cell lung cancer,and now a higher risk of detected.Early diagnosis and early treatment can significantly improve lung adenocarcinoma patients after operation and improve the survival rate of patients.Bronchoscope clinical diagnosis of lung cancer and chest wall puncture in pathology has problem in that it is an operation and specimen is not easy to get,compared to tumor markers that are easy to obtain.A series of studies in recent years have shown that the joint detection of tumor markers has important value in early detection and diagnosis,prognosis assessment,and tumor recurrence of lung adenocarcinoma.

OBJECTIVETo observe the curative effect of Qianjin Kouchuang Jiawei Granule (QKJG) on recurrent oral ulceration [yin deficiency fire excess type (YDFET)].

METHODSTotally 120 patients who suffered from recurrent oral ulceration (YDFET) were randomly assigned to two groups, the experiment group and the control group, 60 in each group. Patients in the experiment group took QKJG, 20 g each time, twice per day, while those in the control group took Kouyanqing Granule (KG) , 20 g each time, twice per day. Fourteen days consisted of one therapeutic course, two for all. Scores for patients' symptoms and signs (ulcer area, exudation, hyperaemia, edema, the number of ulceration, burning sensation, and pain degrees) were assessed before treatment, at day 3 and 7 after treatment. Short-term efficacy was assessed by visual analogue scale (VAS). The total paralysis time and the total number of ulceration at month 12 after treatment were taken as judgment for long-term efficacy. Results Compared with before treatment in the same group, symptoms and signs were obviously improved at day 3 and 7 after treatment in the two groups (P < 0.05). Compared with the control group at day 3 after treatment, the improvement of edema, exudation, pain degree, and burning sensation was more obvious in the experiment group (P < 0.05, P < 0.01). The improvement of edema, pain degree, and burning sensation at day 7 after treatment was more obvious in the experiment group than in the control group (P < 0.05). As for short-term efficacy, the total effective rate was 86.67% (52/60 cases) in the experiment group and 83.33% (50/60 cases) in the control group, with no statistical difference between the two groups (P > 0.05). As for long-term efficacy, the total effective rate was 90.00% (54/60 cases) in the experiment group, significantly higher than that of the control group with statistical difference [81.67% (49/60 cases), P < 0.05]. At month 12 after treatment, the total number of ulceration was reduced and the paralysis time of ulcer attack prolonged in the experiment group, with statistical difference when compared with the control group (P < 0.05).

CONCLUSIONQKJG showed better long-term efficacy than that of KG in treating recurrent oral ulceration (YDFET).

Chronic Disease ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Pain Measurement ; Phytotherapy ; Treatment Outcome ; Yin Deficiency ; drug therapy

Objective To evaluate contrast-enhanced MRI sequence for diagnosing cholangiocarcinoma.Methods Cholangiocarcinoma was confirmed by surgery and pathology in 17 cases,all underwent preoperative CT and MRI T1-VIBE scan with contrast-enhancement sequence.We retrospectively analyzed imaging signs in two scan methods,including lesion position,number,size,enhancement degree,expansion degree of bile duct,invasion of adjacent artery and portal vein,and portal vein tumor thrombosis.The differences on detecting lesions between two methods were compared.Results The contrast to noise ratio (CNR) between tumor and liver tissue in MRI T1-VIBE images was obviously superior to that in CT images.Peripheral lesion boundary in T1-VIBE enhanced images was clearer than CT.One hemorrhage lesion was shown in T1-VIBE images,and tumor thrombosis was visible in the left branch of portal vein in 1 case.Bile duct wall lesions in T1-VIBE enhanced images was more evident than CT in hilar cholangiocarcinoma and extrahepatic cholangiocarcinoma.The VIBE enhanced images find more lesions in 9 out of 11 multiple focus cases,compared with CT images.Conclusions Contrast-enhanced MRI T1-VIBE sequence can give more comprehensive and clear evaluation on cholangiocarcinoma,and has important clinical diagnostic values.

Objective To summarize the experiences in clinical diagnosis and surgical treatment of chest cancers invading the superior vena cava (SVC). Method Retrospective study of 12 cases with chest cancers invading the SVC, SVC and innominate vein were reconstructed with prosthesis in 3 cases, the side wall of the SVC was excised and repaired in 9 cases. Results Complete resection was performed in 10cases,2 cases had incomplete resection. There was no death associated with operation in these patients. All patients were followed up for 1 - 7 years after operation,and 3 cases were lost to follow up,5 of remaining 9cases were dead because of relapse and metastasis, their median survival time was 8 months,other 4 cases lived, their median survival time was 42 months. Conclusions Patients with chest cancers invading the SVC should have surgical treatment of not only tumor resection but also the vessel reconstruction,the prognosis would be better than without surgical treatment. These patients have a high quality of life and live with long-term survival.

PEI Xue-yi has 60 years,experience in treating pediatric diseases with traditional Chinese medicine,especially obtains good effect in children's nephrapiathy.Based on the regulation and characteristics of children's zang-fu,yin-yang,blood-qi and children's nephrapiathy,he makes different therapeutic plans in different phases.In clinical treatment,he emphasizes the lung,the spleen and the kidney and combines syndrome differentiation with disease diagnosis.Eliminaing pathogens,excessive damp-heat is used in acute phase and strengthening healthy qi,securing the spleen and kidney is used in recovery phase.Children's nephrapiathy is treated by three phases as the edema,protein urine and rescovery stage.He adopts the methods of dispersing lung qi and invigorating spleen for diuresis,clearing heat-damp,nourishing spleen and kidney,nourishing yin for protecting lower jiao.

Nursing work environment impacts patient outcomes. This article summarized the concept and connotation of nursing work environment, related theories of how nursing work environment impacts patient safety outcomes and related researches conducted by foreign scholars. The effort of this review article aims to put forward new research direction.

High-fat diet-induced insulin resistance rat model was assessed by euglycemic-hyperinsulinemic clamp technique.Compared with the control group,the vaspin mRNA expression in adipose tissue was significantly decreased in insulin resistant rats induced by high-fat diet( P＜0.05 ),which was increased by metformin( P＜0.05 ).These data indicate that metformin may ameliorate insulin resistance in rats via upregulating vaspin mRNA expression.

AIM To establish the quality standard for Tibeten medicine Ershiwuwei Feibing Pills [Inula racemosa Hook.f.,Swertia bimaculata (Sieb.et Zucc.) Hook.Thors.ex Clarke,Phyllanthus emblica Linn.,Terminalia billerica (Gaertn.) Roxb.,etc.].METHODS TLC was applied to the qualitative identification of L racemosa,S.bimaculata,P.emblica and T.billerica,and HPLC was adopted in the quantitative determination of alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A.RESULTS The TLC spots were clear without negative interference.Alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A showed good linear relationships within the ranges of 4.324-216.2 μg/mL (r =0.999 9),32.222-1 611.1 μg/mL (r =0.999 9),4.072-203.6 μg/mL (r =0.999 9) and 4.266-213.3 μg/mL (r =0.999 9),whose average recoveries (RSDs) were 100.6％ (0.93％),100.3％ (2.1％),101.5％ (3.0％) and 100.1％ (1.8％),respectively.CONCLUSION This simple method can be used for the rapid quality control of Ershiwuwei Feibing Pills.

Objective To describe the prevalence and change of rationing of nursing care (RNC) in medical and surgical units of level 2 and level 3 general hospitals across Guangdong province. Methods RNC were measured by asking nurses about the completion status of 12 necessary nursing care activities, and the prevalence of RNC in 2014 was compared with the study results from the China Hospital Nursing Workforce Research(CNWR) in 2009 (exclusively using the data of Guangdong province) to describe the change of RNC. Results Six activities were rationed averagely in 2014, and the most frequent activities rationed wereComfort/talk with patients accounted for 69.8% (975/1 396) andEducating patients and familiesaccounted for 67.3%(940/1 396). According to the CNWR in 2009, the average number of nursing care activities rationed was 3 which was statistically lower than the number in 2014 (P < 0.01). Conclusions RNC is prevalent in level 2 and level 3 general hospitals across Guangdong province, especially psychosocial care to the patients; the prevalence of RNC has not decreased since 2009.

ObjectiveContrast research the operative effect of the pulmonary artery banding (PAB) in the congenital heart disease with pulmonary artery hypertension,underwent the single ventricle repair procedure in different age.Methods 49 cases,male 31 and female 18.Age (7.8 ± 3.8 ) years old,weight ( 8.82 ± 4.24) kg,percutaneous blood oxygen saturation ( SPO2 ) 0.90 ± 0.04,preoperative mean pulmonary artery pressure (mPAP) ( 54.6 ± 16.8 ) mm Hg.single ventricle 13cases,tricuspid atresia 12 cases,double outlet of right ventricle with left ventricular dysplasia 11 cases,tricuspid stenosis 5 cases,ventricular imbalance type complete atrioventricular canal defect 5 cases and cross heart cases 3 cases.divided into three groups:≤0.5 years old of 17 cases,0.5 to 2.0 years old of 17 cases,≥2.0 years old 15 cases.All cases taken PAB under anesthesia and cpb,inhaled oxygen concentration 40％,SPO2 0.85,MPAP 20 mmHg.comparatively analysis postoperative SPO2,MPAP,Ventilator using time,ICU stay time and operation mortality of the three groups.ResultsThe postoperative PAP obviously decreased.Three groups of postoperative SPO2,mPAP,ventilator using time,ICU stay time were not significantly different.More than were followed up 6-72 months,1 cases ( 1-2 months) dead in aspiration two months postoperation.the other three cases had been completed Glenn and/or Fontan.ConclusionPAB can effectively reduce the pulmonary artery pressure in the different age children with congenital heart disease and pulmonary artery hypertension,the effect is good.more than 2 years old children still PAB feasible operation,and likely to complete the Glenn and/or Fontan procedure.