Objective To evaluate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with three-dimension conformal radiotherapy (3DCRT) in treating unresectable primary Hepatic carcinoma(PHCC).Methods 64 cases of PHCC were randomly divided into 2 groups,TACE combined with 3DCRT group (Treatment group) and TACE alone group (control group).34 cases in treatment group were treated with TACE 2 ～3 times at first,after resting for 2-4 weeks,3DCRT treatment was used.30 cases in control group were treated with TACE 2 ～ 3 times only.Results The percentage of tumor regression rate (CR + PR) was 73.5% in treatment group and 36.6% in control group.The difference was significant (P ＜0.01).The percentage of AFP declined was 100% in treatment group and 92.9% in control group,which difference was not significant (P ＞0.05).The cumulative survival rate of 1-,2-and 3-years were 76.5%,58.8% and 41.2% in treatment group,and 56.7%,26.7%,13.3% in control group respectively.There was significant difference between the two groups (P ＜ 0.05).Conclusion The treatment of TACE combined with 3DCRT is an effective and security treatment method for primary Hepatic carcinoma.

Objective To explore the therapeutic effect of endoscopic treatment for common bile duct stricture secondary to chronic pancreatitis.Methods The clinical data of 58 patients with common bile duct stricture secondary to chronic pancreatitis diagnosed between January 2007 and January 2014 were retrospectively analysed.Results A total of 58 patients with common bile duct stricture secondary to chronic pancreatitis underwent 157 endoscopic procedures with placement of 204 polyethylene stents.The mean time of stenting was 12.2 months(3-33 months).After treatment,stricture disappeared in 20 patients(34.5％),with a mean stenting period of 7.8 months(3-22 months).Treatment was successful in 37 patients(63.8％),with a mean stenting period of 9.5 months (3-22 months),and was incompletely successful in 12 patients (20.7％) with a mean stenting period of 19.8 months(12-33 months).Nine patients(15.5％) referred to surgery were considered a failure of endoscopic therapy.Conclusion The endoscopic treatment of common bile duct stricture due to pancreatic edema or pancreatic cyst is effective.Endoscopic treatment is a safe,effective and minimally invasive method for common bile duct stricture secondary to chronic pancreatitis,which can be the first option.

Objective This research approaches the methods of intensifying the medical clinical skills training to develop students’medical abilities in clinical practice.Methods We chose 129 seven-year medical students.They were devided into two groups in random.The con-trol group entered the clinical practice directly,while the experimental group accepted the clini-cal skill training before they entered the clinical practice.Results The examination record and qualification number of experimental group were higher than the control group obviously.After the clinical skill training,the examination record became higher than before.Conclusion The experiment shows that receiving clinical skill training before entering clinical practice is the ef-fective method of elevating medical students’clinical abilities and practical skill level.

Aged ; Chordoma ; pathology ; Humans ; Male ; Nasal Cavity ; pathology ; Nose Neoplasms ; pathology

This study was aimed to observe the protective effect of astragalus on bones of vitamin D deficiency rat model. A total of 30 male SD rats were randomly divided into 3 groups, which were the control group, model group, and the astragalus group. The experimental period was 8 weeks. After the experiment, enzyme immunoassay was used for the detection of serum 25 hydroxy vitamin D3 [25 (OH)VD3], fibroblast growth factor-23 [FGF-23], Klotho, and HE staining of femur. The results showed that compared with the normal control group, the vitamin D deficiency rat model group had a decrease in both serum 25 (OH)VD3 and Klotho, and a increase in FGF-23, which meant the ex-istence of osteoporosis. Compared with the model group, the astragalus group had a decrease in both the serum 25 (OH)VD3 and FGF-23, and a increase in Klotho, which meant the osteoporosis of the astragalus group had been im-proved significantly. It was concluded that astragalus can regulate FGF-23 and Klotho in vitamin D deficiency rats in order to have a protective effect for bones.

Objective To review the epidemiologic features of norovirus infection outbreaks in Zhejiang province during 2004-2014.Methods Epidemiological data of norovirus infection outbreaks in Zhejiang province from January 2004 to February 2014 were collected from the Emergency Public Reporting System in Zhejiang Provincial CDC.The distribution of time,area,population,route of transmission and genotype of norovirus were analyzed.Results There were 16 outbreaks of norovirus infections with 2 037 cases during 2004-2014 in Zhejiang province.Eleven outbreaks occurred during February and April,and 13 outbreaks occurred in schools.The outbreaks in schools mainly involved students aged 15-20 years,while other outbreaks took place mainly in the young and middle-aged population.The sex ratio of male to female was 1.05 ∶ 1.Among 16 outbreaks,10 were induced by norovirus G Ⅱ infections,3 were induced by norovirus G Ⅰ infections and 3 were induced by norovirus G Ⅰ and G Ⅱ infections.Fourteen outbreaks were caused by water pollution.Conclusion Outbreak of norovirus infection usually occurs in schools during winter and spring in Zhejiang province,and the epidemic of disease is mainly associated with polluted water.

Objective To quantify the expression levels of calpain 1 and caspase-3 in lichen planus (LP) lesions and their relationship with the apoptosis in keratinocytes.Methods Biopsy samples were obtained from the lesions of 20 patients with LP and normal skin of 10 healthy controls,and embedded in paraffin.Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) was used to evaluate the apoptosis in keratinocytes,and immunohistochemical staining to detect the expressions of calpain 1 and caspase-3,in these tissue specimens.Data were processed by SPSS 13.0 software.Comparison analysis was carried out by t test for apoptosis index,and by rank sum test for the expressions of calpain 1 and caspase-3.Spearman correlation analysis was conducted to evaluate the relationship between these parameters.Results The apoptosis index of keratinocytes was higher in LP lesions than in the normal skin (67.59 ± 13.50 vs.28.26 ± 7.56,t =8.52,P ＜ 0.01).Significantly increased expressions of calpain 1 and caspase-3 were observed in the epidermis of LP lesions compared with the normal skin (T =78.00 and 77.00,respectively,both P ＜ 0.01).The expressions of both calpain 1 and caspase-3 were positively correlated with apoptosis index of keratinocytes (r =0.71 and 0.74,respectively,both P ＜ 0.01).Conclusions The expressions of calpain 1 and caspase-3 are upregulated in LP lesions,which may be closely associated with the accelerated apoptosis in keratinocytes.

Objective To study the feasibility of high performance liquid chromatography-evaporative light scattering detector ( HPLC-ELSD) in quantitative analysis of multi-components ( QAMS) by single marker. Methods Four saponins in Astragali Radix were simultaneously determined by HPLC-ELSD using external standard method, and malonylastragaloside I served as internal standard. The relative correction factors between internal standard and astragaloside Ⅰ, astragaloside Ⅱ and astragaloside Ⅳ were calculated, and the stability was investigated. Results Astragaloside Ⅳ in Astragali Radix was little, while malonylastragalosideⅠand AstragalosideⅠwere abundant.The relative correction factors lacked stability, so ELSD could not be used in QAMS. Conclusion HPLC-ELSD can precisely determine contents of four saponins in Astragali Radix. The detector needs to be further studied when the components have poor ultraviolet absorption such as saponins by QAMS.

OBJECTIVE:To study protective effects of glutamine (Gln) on cardiac muscle cell in septic model rats. METH-ODS:Rats were randomly divided into sham operation group (normal saline),model group (normal saline) and Gln low-dose, medium-dose and high-dose groups(0.5,0.75,1.0 g/kg)with 10 rats in each group. In these groups,septic rat model was induced by cecal ligation and puncture except sham operation group received sham operation. They were given relevant medicine intrave-nously 10 min after operation,and the characteristics and apoptosis of cardiac muscle cell were observed 12 h after operation. The serum contents of CK,LDH and TnⅠ,and the expression of Bcl-2 and p53 mRNA were all detected. RESULTS:Compared with sham operation group,myocardial necrosis of model group was found,and the serum content of CK,LDH and TnⅠ and apoptotic index increased,and mRNA expression of Bcl-2 in cardiac muscle cell decreased while that of p53 increased,with statistical signifi-cance(P<0.05). Compared with model group,myocardial injury relieved significantly in Gln high-dose and medium-dose groups, and serum contents of CK,LDH and TnⅠ and apoptotic index decreased;mRNA expression of Bcl-2 increased in cardiac muscle cell while that of p53 decreased,with statistical significance (P<0.05). CONCLUSIONS:Gln can improve myocardial injury of septic model rats significantly,by a possible mechanism of down-regulating the expression of p53 gene and up-regulating the ex-pression of Bcl-2 gene.

OBJECTIVETo observe the impacts on the muscle strength in the patients of stroke-induced acroparalysis treated with Xunjingcuiqi needling technique.

METHODSOne hundred patients were randomized into a Xunjingcuiqi group and a routine acupuncture group, 50 cases in each group. In the routine acupuncture group, the routine acupuncture technique was adopted at the main acupoints, such as Shangxing (GV 23), Baihui (GV 20), Dicang (ST 4), Quchi (LI 11), Huantiao (GB 30) and Zusanli (ST 36), etc. In Xunjingcuiqi group, on the basis of the routine acupuncture technique, Xunjingcuiqi needling technique (pricking technique was quickly applied with the filiform needle along the running course of meridian to promote the conduction of meridian qi) was added. For the patients being hard to feel the needling sensation and with the muscle strength of 0 to 1 degree, Dongzhencuiqi technique was supplemented at shu-stream points of yang meridians (after qi arrival, the needling manipulation with limb movement was given to promote the conduction of meridian qi). The treatment was given once every day in the two groups. Ten treatments made one session. Three sessions of treatment were required. At the end of each session treatment, the muscle strength and clinical efficacy were assessed.

RESULTSIn the 1st, 2nd and 3rd sessions of treatment, 20, 24 and 36 cases achieved the 3 to 5 degrees muscle strength in Xunjingcuiqi group, respectively; and 6, 10 and 15 cases achieved the 3 to 5 degrees muscle strength in the routine acupuncture group. The differences were significant statistically in comparison of the two groups (P < 0.01, P < 0.05). The markably effective rates were 60.0% (30/50), 64.0% (32/50) and 70.0% (35/50) after the 1st, 2nd and 3rd sessions of treatment in Xunjingcuiqi group, respectively; and those were 38.0% (19/50), 44.0% (22/50) and 46.0% (23/50) in the routine acupuncture group, respectively. The differences were significant in the 1st and 3rd sessions of treatment between the two groups (both P < 0.05).

CONCLUSIONXunjingcuiqi needling technique combined with routine acupuncture achieves the apparent superior efficacy on acroparalysis induced by ischemic stroke as compared with the simple routine acupuncture. Xunjingcuiqi needling technique obviously improves muscle strength and shortens the duration of sickness.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Aged ; Female ; Humans ; Male ; Middle Aged ; Paralysis ; etiology ; therapy ; Qi ; Stroke ; complications ; Treatment Outcome