Objective To investigate the effect of intraperitoneal injection of compound sophora injection in the treatment of advanced gastric cancer patients with malignant peritoneal effusion.Methods 60 advanced gastric cancer patients with peritoneal fluid were randomly divided into two groups according to the different treatment meth-ods.A group of compound sophora injection with intraperitoneal therapy(group A),treatment 2 times per week for four weeks,Another group of compound sophora injection with vein therapy (group B),for 4 consecutive weeks.The efficacy of the two groups was compared.Results The effective rate of group A was 58.1%,which was higher than 27.6% of group B,the difference was statistically significant(χ2 =5.69,P <0.05).Conclusion Intraperitoneal perfusion with compound sophora injection can improve the effect in the treatment of peritoneal effusion in patients with advanced gastric cancer,and the adverse reaction is mild,it is worthy of clinical application.

ObjectiveTo probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations.MethodsOne of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object.Within this district,the data of their revenue,expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis.ResultsThe percentage of service revenue among the total revenue has dropped from 68.34％ before the system was in place to 65.44％ after,reducing 4.24％.The percentage of drug revenue has dropped from 71.68％ before to 63.57％ after,reducing 11.31％.The percentage of service surplus has dropped from 15.81％ before to - 23.07％ after,reducing 245.94％.The total standard workload has increased 61.77％.Average medical expense per outpatient and per inpatient has reduced 32.85％ and 57.18％,from 71.44yuan and 2642.08 yuan before to 48.33 yuan and 1131.28 yuan after respectively.ConclusionThe deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism,further adjust the revenue-expenditure structure,set up the system of rational drug use,and effectively reduce the medical expense of patients.

Objective To reconstruct on the basis of histological study the computerized 3D ima ges of the fascicular groups of ulnar nerve,which can be used to guide the microsurg ical repair of injuries of brachial plexus and ulnar nerve and to provide morpholog ical evidence for the functional rec overy of intrinsic muscles of hand after root avulsion of brachial plexus.Methods The successive AchE-staining histo logical cross-sections were made.T he photos of the sections were transformed into digital information and sto red in the computer.Different functional fas-cicular groups were distinguished a nd marked on each section.The topographic database was analyzed by image pro-cessing software,with the support o f OpenGL three dimensional graphic l ibrary.3D images of the fascicular g roups of ulnar nerve were reconstructed usin g the contour-based surface constru ction method in the program written w ith VC language.Results The 3D images of the individual external surface of the reconstructive fa scicular groups were displayed and the human-computer in teraction was realized by performin g the arbitrary rotation and the rand om cross-section.By selecting the int erested object,the spatial structu re of any fascicular group could be di splayed in the same space simultaneously.Compare d with the result of microanatomy,th e 3D shape could truly reflect the str ucture,adjacent relationship and arrangem ent of fascicular groups in the ulnar nerve trunk.Conclusions Since the re-constructive 3D images can truly reflect the arrangement and distribution of the functional fascicular grou ps,they will have positive effects on understanding the internal structure of ulnar nerve,designing operative procedur e and adjusting operative method for surgeons.[

Objective To investigete the viral and atypical pathogens in children with acute respiratory infection (ARI) .Methods A total of 17 048 serum samples were collected from children ,who were intended to diagnose as ARI .Indirect immunofluores-cence assays were performed to detect IgM antibodies against 9 common pathogens ,including mycoplasma pneumonia(MP) ,influen-za virus B(FluB) ,respiratory syncytial virus(RSV) ,parainfluenza virus(PIV) ,adenovirus(ADV) ,influenza A virus(FluA) ,legio-nella pneumophila(LPN) ,coxiella burnetii(COX) ,chamydophila pneumonia(CPn) .Results The total detection rate of the 9 patho-gens was 60 .24% (10 269/17 048) .The detection rate of MP was 47 .78% (8 146/17 048) which was the highest ,followed by FluB which was 30 .87% (5 262/17 048) .The detection rate of MP kept at a high level through the whole year ;FluB appeared a little popular in the summer ,winter and spring ;RSV had higher detection rate in winter and spring ;ADV had higher detection rate in spring ;FluA appeared a little popular in spring and summer ;PIV and LPN didn′t show any seasonal change .There were significant differences in the detection rates of ADV ,CPn ,FluA ,FluB ,LPN ,MP ,PIV and RSV among different age groups (P< 0 .05) .In mixed infection with 2 kinds of pathogens ,MP+FluB was the most common pattern which accounted for 39 .58% of mixed infec-tion .In mixed infection with 3 kinds of pathogens ,MP+FluB+RSV was the most common pattern which accounted for 13 .68% .In mixed infection with 4 kinds of pathogens ,MP+ FluB+ RSV+ PIV was the most common pattern which accounted for 3 .84% . Other mixed infection pattern was rare .Conclusion The most common pathogens causing ARI in children of Wuhan were MP ,FluB and RSV .The detection rate of each pathogen displayed specific seasonal variations and variations among different age groups . Mixed infections were more common than single infections ,and the most common pattern was MP+ FluB .

Objective To analyze dialectical thinking and medication laws of TCM master LI Ji-ren in treating rheumatoid arthritis (RA); To provide references for clinical medication. Methods Medical cases of RA in outpatient department of the First Affiliated Hospital of Wannan Medical College during January 2014 to June 2015 treated by Professor LI Ji-ren. SPSS18.0 statistical software was used to carry out frequency analysis, correlation analysis, and cluster analysis. Results The included medical cases covered 123 cases, 199 prescriptions and 211 kinds of medicine. The total medication frequency was 3503, with 52 kinds of high frequency medicine (>10%), including Astragali Radix, Angelicae Sinensis Radix, Scorpio, Spatholobi Caulix, and Sargentodoxae Caulix. 36 kinds of medicine belonged to Liver Meridian of Foot-Jueyin (69.2%); 21 kinds of medicine belonged to Kidney Meridian of Foot-Shaoyin (40.4%); 20 kinds of medicine belonged to Spleen Meridian of Foot-Taiyin (38.5%); 16 kinds of medicine belonged to Heart Meridian of Hand-Shaoyin (30.8%). High frequency medicine was mainly to be sweet, spicy and bitter. High frequency medicine was mainly to be medicine with the functions of clearing heat, tonifying (tinifying qi, blood, yang and yin), activating blood and expelling stasis, and expelling rheumatism. 127 pairs of high frequency medicine was in positive correlation, among which 36 pairs showed the correlation coefficient >0.9. High frequency cluster analysis could be mainly divided into 6 categories. Conclusion The medication laws in this study and Professor LI Ji-ren's treatment for RA emphasize consolidating basis, and are in accordance with the ideas of expelling wind and humidity, activating blood and expelling stasis and stopping pain, which can provide references for clinic.

Objective To observe the arrangement and distribution of the fascicular groups in the ulnar nerve trunk to the intrinsic muscles so as to provide anatomical evidence for selective repair in the clinic.Methods 12 cadaveric upper extremities recently embalmed with formalin were obtained. The ulnar nerve and its branches were exposed. Microanatomy and longitudinal contradissection of each functional fascicular group were performed by tracing their terminal branches, and the arrangement and distribution were observed and recorded. The fascicular groups to the intrinsic muscles of hand in the nerve trunk were observed to see how they crossed and mixed with other fascicular groups. The diameter of the nerve trunk and the fascicles to the intrinsic muscles were measured, and the area and the distribution range of the fascicles calculated. Results The shape and the diameter of the ulnar nerve trunk varied at different positions. The fibers of functional fascicular groups had the definite differentiation at distal while interfused and diffused at proximal. The fascicular groups to the intrinsic muscles of hand were the largest and their fibers relatively concentrated (the distribution range occupied 40% ～ 80% of the ulnar nerve), and had the definite localization at the forearm and distal to the 3/8 segment of upper arm. Conclusion Since the fascicles to the intrinsic muscles of the hand are the most important in the ulnar nerve, selective repair by using epineural and perineural techniques at the forearm and upper arm will reduce the loss of nerve fibers and will contribute to the functional recovery.

Objective To investigate the role of p38MAPK in the differentiation of murine osteoblasts, and to observe the expressions of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). Methods The calvarial osteoblasts of newborn BALB/c mice were cultured in MEM medium containing 10% NCS. Raloxifene (10~(-7) mol/L) and 17β-estradiol (10~(-8) mol/L) were added respectively when cells reached 70%-80% confluence combined with or without 5 μmol/L SB202190, an inhibitor of p38MAPK. The osteoblasts alkaline phosphatase activity assays were performed 72 hours later using PNPP method, and mRNA levels of alkaliphosphatase (ALP), OPG and RANKL were determined by RT-PCR. Results 17β-estradiol and raloxifene increased ALP activity and ALP mRNA level in osteoblasts in vitro which were blocked by p38MAPK inhibitor.The mRNA levels of RANKL and OPG were up-regulated by 17β-estradiol and raloxifene while the ratio of OPG/RANKL kept constant. SB202190 (5 μmol/L) inhibited the highly expressed RANKL and OPG in osteoblasts, and obviously decreased the ratio of OPG/RANKL. Conclusions p38MAPK inhibition blocked the differentiation of osteoblasts and decreased the up-regulated OPG and RANKL expressions in osteoblasts significantly (P<0.05).

Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy(HCT)compared with chemotherapy (CT)for ovarian cancer. Methods Related literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,CNKI and CBM.Then the meta?analysis was performed by using RevMan 5.3 software. Results A total of 10 RCTs involving 546 patients were included. The results of Meta?analysis showed that the HCT group was superior to the CT group in the effective rate,tumor control rate,effective rate of CA125,ascites control rate and PD,with significant differences(P<0.05). There was no significant difference in the improvement rate of life quality and the incidences of myelosuppression,severe myelosuppression,severe nausea and vomiting,severe constipation and diarrhea,liver and renal damage(P>0.05). Conclusion Compared with CT,HCT can significantly increase short?term curative effect,ameliorate the quality of life,and it does not increase the incidence of adverse reactions. HCT is worthy of clinical applica?tion.

Objective To investigate the role of prokinetic agent itopride in colonic preparation before colonoscopy examination in patients with constipation.Methods A total of 115 outpatients with history of chronic constipation who requested colonoscopy were collected.According to colonic preparation proposal,patients were divided into three groups.Group A (39 cases) took standard dosage of PEG-E solution six hours before colonoscopy examination.Group B (38 cases) took 150 mg itopride 30 minutes before administration of lavage solution.Group C (38 cases) took itopride 150 mg at 7 am,12 am and 8 pm the day before the examination and on the examination day took the same medicine as that of group B.The blood pressure,heart rate and blood electrolytes were monitored before and after taking medicine in the patients of three groups.Quality of colon cleansing of each group was observed and side effects were also observed.One-way analysis of variance (least significant difference,LSD) test was performed for pairwise comparisons among the three groups.Chi-square test was applied for count data.Results Both group A and group B excluded one patient because of malignant carcinoma with colon stricture under colonoscopy,and 113 patients completed the whole colon examination.There was no significant difference in the baseline patients' data of three groups.The colon cleaning score of group C (7.28±1.11) was higher than those of group A and B (6.55±1.18 and 6.51±1.16,LSD test,both P＜0.05).The frequency of bowel movements defecation of group C (8.31± 1.32) was more than those of group A and group B (7.11± 1.41 and 6.94± 1.51,LSD,test,both P＜0.05).There was no significant difference in terms of intestinal bubble scores,blood pressure,heart rate,blood electrolytes the uncomfortable degree of colonic preparation and rate of side effects of the three groups.Conclusion The colonic preparation can be safely and effectively improved by taking high dose of itopride one day before and on the day of colonoscopy examination.

Objective To study whether bortezomib combined with dexamethasone can relieve bone pain of patients with multiple myeloma and to see whether bortezomib have effect on bone metabolism through determining the concentration of bone turnover marks.Methods 59 cases of patients with multiple myeloma treated with BD and 38 cases of patients treated with VADM were observed before and after chemotherapy to compare the alleviation of bone pain,the improvement of the ability to move and the occurrence of skeletal related events between the two groups.The plasma from 25 patients were collected before and after chemotherapy when they were in hospital each time and the concentrations of TRACP-5b,BALP and DKK1 in plasma were determined by ELISA.Results BD group was better than VADM group in the rate of alleviation of bone pain,the improvement of the ability to move and the incidence of skeletal related events(75.7% vs 50%,64.9% vs 20.8% and 13.8% vs 57.8%,all P