OBJECTIVE:To observe the efficacy of capecitabine combined with cisplatin in the treatment of advanced gastric cancer and its effect on invasion and metastasis of gastric cancer. METHODS:94 patients with advanced gastric cancer were ran-domly divided into control group(47 cases)and observation group(47 cases). Control group received 65-75 mg/m2 Docetaxel injec-tion,d1,continuous intravenous infusion of 2 h+15-20 mg/m2 Cisplatin for injection,d1-5,continuous intravenous infusion of 2 h in the dark. Observation group received 1 000 mg/m2 Capecitabine tablet,orally,twice a day+Cisplatin for injection(the same us-age and dosage with control group). 3-week was regarded as a treatment course,and it lasted 3 courses. Clinical efficacy,matrix metalloproteinase-2(MMP-2)and MMP-9 levels were observed,6 and 12 months survival rate and incidence of adverse reactions were followed-up. RESULTS:There was no significant difference in the total effective rate in 2 groups(P>0.05). Grade 1-2 liver dysfunction,thrombocytopenia,and the incidence of nausea and vomiting in observation group were significantly lower than con-trol group,6 and 12 months survival rates were significantly higher than control group,the differences were statistically significant (P<0.05). Before treatment,There was no significant difference in MMP-2 and MMP-9 levels in 2 groups(P>0.05). After treat-ment,MMP-2 and MMP-9 levels in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy of capecitabine combined with cispla-tin is similar to docetaxel combined with cisplatin in the treatment of advanced gastric cancer,but docetaxel combined with cisplat-in is superior in terms of reducing MMP-2 and MMP-9 and safety.

Drug-resistant bacteria pulmonary infection in the elderly is increasing, which brings difficulties to the selection of antibiotics. Based on the integrated traditional Chinese and Western medicine, targeting the key to the pathogenesis of the drug-resistant bacteria pulmonary infection deficiency of vital energy, phlegm and dampness, the author adopted Fuzheng Qinghua therapy to obtain satisfactory efficacy.

Severe traumatic brain injury is a common clinical emergency, which is often combined with pulmonary contusion syndrome, and the treatment will be more difficult. This article started from the integration of traditional Chinese and Western medicine, and adoptedHuoxue Tongfu therapy by targeting the key pathogenesis qi stagnation and blood stasis of the disease, which achieved satisfactory efficay.

Objective To summarize and excavate technical points of acupoint application to intervene infantile recurrent respiratory tract infection based on literature; To provide basis for formulation the standard of the TCM featured therapy. Methods Articles about acupoint application to intervene infantile recurrent respiratory tract infection from CNKI platform (CNKI), Chinese science and technology journals database (VIP), Chinese biomedical literature database (CBM), and Wanfang database were retrived by computers. The medicine, acupoints, the amount of stimulation and the timing for the treatment were analyzed. Results After systematic search, a total of 62 articles were included in the quantitative study, including 6547 patients. The main sticking medicine of 10 highest used rate were:Asari Radix et Rhizoma, Sinapis Semen, Kansui Radix, Corydalis Rhizoma, Cinnamomi Cortex, Astragali Radix, Atractylodix Macrocephalae Rhizoma, Anhelicae Dahuricae Radix, Caryophylli Flos, and Saposhnikoviae Radix, and most of them used ginger juice as anclliary medicine. The acupointwith the highest frequency was Feishu (99.03%), followed by Danzhong, Gaohang, Tiantu, Dingchuan, and Dazhui (28.59%–62.66%). The acupoint application was on the first days of the first, second and third of the three ten-day periods of the hot season, or the first days of the first ninth, the second ninth and the thrid ninth days during the winter time, one dosage for each day. The single sticking time was suggested as 2–4 hours each time (23.44%). Conclusion This study summarizes and evaluates the articles of acupoint application to intervene infantile recurrent respiratory tract standard formulation. infectionin recent years and summarizes the key technical points, which can provide references for clinical and standard formulation.

Purpose To investigate clinicopathological features, immunohistochemical findings and differential diagnosis of papillary glioneuronal tumor ( PGNT) . Methods The clinical features, imaging, histological and immunohistochemical findings were analyzed in three cases of PGNT, along with review of the related literatures. Results Two patients were female adults, and the other was male adults. One presented with dizziness, and the other exhibited intractable seizures. Magnetic resonance imaging ( MRI) revealed a cyst-ic space-occupying mass in brain parenchyma of left temporal lobe or right parietal lobe. Microscopically, it was characterized by pseu-dopapillary structures composed of hyalinized vessels rimmed by cuboidal glial cells, oligodendrocyte-like cells and the proliferation of neuronal cells. On immunohistochemical staining, the perivascular cuboidal cells were GFAP-positive, the oligodendrocyte-like cells were Olig-2-positive, and the neuronal cells were synaptophysin-and nuclear protein-positive. Conclusion PGNT is a rare and new variant of mixed neuronal-glial neoplasm, the natural evolution of this tumor is one of low malignant potential and it has a good progno-sis. The distinctive pathologic features help to differentiate this entity from other neoplasm of the central nervous system which has pa-pillary structures.

Objective To analyze the training and evaluation standards on urine analyzers in the grass-roots medical unit.Methods The applicability,requirements,subject setup and items of the standards as well as the requirements of evaluation scoring chart were expounded in detail,and the related elementary knowledge was analyzed including the structure,working principle,installation and adjustment,operation,application,maintenance and etc of the analyzer.Combined personnel with the equipment was suggested to ensure the accuracy and high efficiency of the test result.Results The interpretation of the standards contributed to enhancing the quality of medical equipment training and the ability of practical support,and facilitated the examiner to perform annual evaluation with the scoring chart.Conclusion It is necessary to grasp accurately the connotation of the standards,to improve the quality of medical equipment training and to enhance combat support capability for the grass-roots medical unit and examiner.

Objective To evaluate the clinical diagnostic value of pelvic floor sEMG in pelvic floor dyssynergia (PFD) by using receiver operating characteristic curve (ROC curve). Methods The pelvic floor sEMG of 90 patients with PFD and 101normal controls were determined by the Glazer protocol.Parameters including amplitude (AVG),coefficient of variance (CV),onset time and median frequency (MF),and the ROC curve werealso investigated. Results Compared to the control group,the PFD group had a higher AVG of pre-baseline (P < 0.05), a lower AVG during Flick and Tonic steps(P < 0.05), and ahigher CV duringTonic and Endurance steps(P < 0.05).The area under curve(AUC) of CV duringthe tonic step was 0.883 withthe best cut-off of 0.355, and with sensitivity of 88.4%and the specificity of 71.1%, respectively; The AUC of CV duringEndurance step was 0.825 withthe best cut-off of 0.305, and with the sensitivity of 84.9%and the specificity of 67.8% , respectively. Conclusion The CVs of the tonic and the endrnace phases can be used as valuable clinical values in diagnosis of PFD.

0.05) . Time consumed for registration and waiting for consultation, average medical care cost, time consumed for dispensing prescription and average total patients' visit time except for diagnosis and treatment were significantly less in primary-care hospitals than those in secondary-care ones( P 0.05) . Conclusions Quality of medical care service process in primary and secondary-care hospitals was perceived good by the outpatients. In general, phenomena of long queues for registration, waiting for consultation, payment, getting drugs and short time for diagnosis and treatment in outpatient departments have been improved a little bit. Medical doctors in primary-care hospitals could provide medical care service as nearly the same as that in secondary-care ones, while time consumed for registration, waiting for consultation, payment and getting drugs, as well as for a total visit was much less in primary-care hospitals.

Objective To explore the effect of the unilateral lumbar anesthesia by hypobaric bupivacaine and general anesthe‐sia in elderly hip replacement and their influence on the stress response .Methods Forty elderly patients undergoing hip replace‐ment in our hospital from December 2013 to November 2014 were selected and randomly divided into the unilateral lumbar anesthe‐sia group and general anesthesia group according to the random number table ,20 cases in each group .Venous blood was collected to determine the levels of blood sugar ,serum catecholamine(CA) and cortisol(CORT ) at 10 min before anesthesia(T0 ) ,end of surgery (T1 ) and at postoperative 24 h(T2 ) .MAP ,HR ,SpO2 ,intraoperative adverse reactions and postoperative related complications were recorded at each time point ,and the comparative analysis was performed .Results All patients successfully completed surgery and the anesthetic effect was satisfied .The occurrence rates of intraoperative hypotension ,hypertension and bradycardia in the unilateral lumbar anesthesia group were lower than those in the general anesthesia group ,the differences had statistical significances (P>0 .05) .HR and MAP at T1 in the two groups were reduced ,but the differences between the two groups were no statistical signifi‐cance(P>0 .05);the levels of GLU ,CORT and CA were increased ,moreover the differences between the two groups were statisti‐cally significant(P<0 .05) .SpO2 at T2 in the general anesthesia group was obviously lower than that in the unilateral lumbar anes‐thesia group ,while CORT was higher than that in the unilateral lumbar anesthesia group ,the differences were statistically signifi‐cant(P<0 .05) .The occurrence rates of postoperative nausea and vomiting ,sore throat ,dizziness ,drowsiness and pulmonary infec‐tion in the unilateral lumbar anesthesia group were lower than those in the general anesthesia group ,the differences were statistical‐ly significant(P<0 .05) .Conclusion The unilateral lumbar anesthesia by using hypobaric bupivacaine and general anesthesia all could offer better anesthetic effect .The unilateral lumbar anesthesia by using hypobaric bupivacaine can effectively regulate the stress response in elderly patients with hip replacement .

Objective To investigate the mechanism of a dipeptidyl-peptidase-4 (DPP-4) inhibitor, saxagliptin, pro?moting the regeneration of islet beta cells in diabetic rats. Methods The male SD rats were randomly divided into three groups including control group (NC, n=10), diabetes group (DM, n=10) and diabetes treated with saxagliptin group (DM-S, n=10). DM-S group was treated with saxagliptin 1 mg/(kg·d) for twelve weeks. The pancreaticβcell function was analysed by hyperglycemic clamps. Immunohistochemistry with anti-PCNA was performed to observe the proliferation rate of pancreaticβcells. Immunofluorescence double staining with anti-insulin, anti-glucagon, anti-DPP-4 and anti-SDF-1 were performed to observe the expression of insulin, glucagon, DPP-4 and SDF-1 in pancreatic tissue. Western blot assay was performed to test the expression of Akt, p-Akt,β-catenin and free-β-catenin protein, and RT-PCR was performed to test the expressionlevels of c-myc and cyclinD1 mRNA in pancreatic tissue. Results Compared with NC group, there were significantly in?creased blood glucose, decreased islet function andβcell mass in DM group. Compared with DM rats, saxagliptin treatment significantly inhibited the expression of DPP-4, decreased the degradation of SDF-1, stimulated the proliferation ofβcells, and ultimately improved the islet function and histopathological changes of pancreas. Conclusion DPP-4 inhibitor saxa?gliptin can significantly improve islet function, which involved in the inhibition of the expression of DPP-4, the decreased degradation of SDF-1 and the stimulation of the proliferation ofβcells.