Objective:This study aimed to compare the efficacy and adverse reactions of two different chemotherapeutic regi-mens. In particular, chemotherapy with paclitaxel liposome was administered in combination with either S-1 or oxaliplatin as the first-line therapy of advanced gastric cancer. Methods:A total of 118 patients with advanced gastric cancer were randomly divided into groups A (61 cases) and B (57 cases). In group A, paclitaxel liposome combined with S-1 was administered;in group B, paclitaxel lipo-some combined with oxaliplatin was applied. The short-term efficacy, adverse reactions, Karnofsky performance status score, median time to progression (mTTP), and median overall survival (mOS) of the two groups were observed and compared. Results:No signifi-cant differences were observed in the objective response rate, disease control rate, and mTTP between groups A and B (31.1% vs. 29.8%, 75.4%vs. 71.9%, 4.2 months vs. 3.8 months;P>0.05). The mOS rates were 10.5 and 8.9 months in groups A and B, respectively, with statistically significant differences (P=0.006). The incidence of degreesⅢtoⅣdiarrhea and peripheral nerve toxicity was signifi-cantly higher in group B than in group A (P<0.05). No statistical differences were found between the two groups in terms of other side effects. Conclusion:The two paclitaxel liposome-based regimens showed similar therapeutic effect in patients with advanced gastric cancer. S-1/paclitaxel liposome treatment could be more effective in terms of mOS and had a tendency of lower toxicity.

Hegu needling is mainly used for the treatment of orthopedic and neurologic diseases, such as cervical spondylosis, third lumbar transverse process syndrome, myofasciitis, periarthritis of shoulder, and stroke sequela, which has a rapid and benefial effect in relieving pain and improving symptoms and signs. It is often combined with other treatment methods, such as point-point needling, electric needling, QI needling, SHU needling, bloodletting, stagnant needling, warm needling, ginger partitioned moxibustion, Qistimulated massage, Tuina, bonesetting and xercise therapy. Filiform needle or round sharp needle are mostly used in Hegu needling. At present, the acupoints of Hegu needling are mostly Ashi points or stimulation points, but the acupoints of the fourteen meridians are rarely selected. Hegu needling is rarely used in the treatment of gynecological and pediatric diseases. Hegu needling has certain effect on dementia, vertigo, panic attack, trigeminal neuralgia, facial paralysis, and cancer pain, but few clinical studies confirmedit.

Objective To investigate the placenta perfusion in pre-eclampsia by three-dimensional power Doppler ultrasound and analysing the clinical outcome. Method 80 cases of normal and pre-eclampsia pregnant women from July 2007 to May 2008 in Beijing Obstetrics and Gynecology Hospital were studied. The control group of 36 cases, pre-eclampsia were divided into three groups: a total of 44 cases, mild pre-eclampsia group (9 cases), severe pre-eclampsia group (26 cases) and chronic hypertension with pre-eclampsia group (9 cases). The placental vascular index (VI), flow index (FI), blood vessels and blood flow index (VFI) by three-dimensional Doppler histogram and the umbilical blood flow systolic to diastolic (S/D) by color Doppler flow imaging were calculated and the gestational age after delivery, birth weight, placental weight after birth were recorded respectively. Results (1)VI、 FI、 VFI and umbilical blood flow S/D value :6.3±2.9, 38.6±4.4, 2.7±1.3, 2.5±0.6 in normal group ;5.7±3.8, 36.3±7.2, 2.4±2.0, 2.4±0.3 in mild pre-eclampsia group;3.0±2.4, 31.7±5.0, 1.1±1.0, 2.9±1.3 in severe pre-eclampsia group ;2.2±1.6, 26.1±4.4, 0.8±0.6, 3.1±1.6 in chronic hypertension with pre-eclampsia group. Placenta of normal group and mild preeclampsia group VI, FI, VFI were no significant difference (P>0.05), placental VI, FI, VFI of severe preeclampsia group and chronic hypertension with severe pre-eclampsia group were significantly lower than the normal group (P<0.01) and than mild pre-eclampsia group (P<0.05). The umbilical blood flows were not obvious difference among four groups (P>0.05) ; (2) Gestationul age after birth, birth weight, low newborn weight rate and placental weight:(38.7±1.5 ) weeks, (3280±520) g, 3%, (568±141) g in normal group; (37.9±1.0) weeks, (2971±265) g, 0,(576±98) g in mild pre-eclampsia group; (33.2±2.6) weeks, (1820±737) g,58%, (458±154) g in severe pre-eclampsia group; (32.6±2.6) weeks, (1497±533) g, 7/9, (396±141) g in chronic hypertension with pre-eclampsia group. The normal group and mild pre-eclampsia group in gestationul age after birth, birth weight, low newborn weight rate and placental weight were not significant difference (P>0.05); severe pre-eelampsia and chronic hypertension with severe pre-eclampsia group in them were significantly lower than the normal group (P<0.01) and than mild pre-eclampsia group (P<0.05).Conclusions (1) Placental blood flow perfusion of the severe pre-eclampsia and pre-eclampsia with chronic hypertension of pregnancy decreased resulting in clinically lower placental weight, birth weight and gestational age at delivery, but there were no obvious differences in umbilical blood flow S/D values. (2) The investigation was helpful to clinical diagnosis in the placenta perfusion of pre-eclampsia by three-dimensional power Doppler ultrasound.

Objective The clinical value of ifrst-trimester standard ultrasound views in screening for fetal structural abnormalities. Methods From September 2008 to March 2011, transabdominal sonographic screening by standard ultrasound views was performed in 3 134 viable singleton pregnancies during the ifrst trimester at Beijing Obstetrics and Gynecology Hospital. Used the following views:(1) Fetal proifle;(2) Neck sagittal;(3) Skull and brain;(4) Thorax;(5) Abdomen;(6) Bladder;(7) Upper limbs, and (8) Lower limbs. The women underwent 20-to 24-week and 28-to 32-week ultrasound examination if the anatomical survey was normal during the ifrst trimester. Follow-up was obtained by reviewing of the birth records from hospital charts. Results Sixteen prenatal abnormalities were detected at 11-to 13-week scan (including one case of encephalocele and meningoceles, one case of endothelial cushion defect and single umbilical artery, one case of ectopia cordis, gastroschisis, and spinal abnormalities, two cases of exencephaly, one case of anencephaly, one case of gastroschisis and lower limb malformation, two cases of omphalocele, one case of encephalocele, ectopia cordis, and gastroschisis, one case of single ventricle, one case of endothelial cushion defect, four cases of hyhrop). All of the 13 women decided on termination of pregnancy. Three suspected structural abnormalities (hydrops) detected at the ifrst-trimester scan were found as normal after birth. Seven cases were diagnosed at 20-to 24-week scan (including one case of dextrocardiac and double outlet right ventricle;two cases of endothelial cushion defects;one case of trisomy 21 with VSD;one case of omphalocele, one case of short ulna and radial with wrist distortion, and one case of club foot). One case of diaphragmatic hernia was detected at 32-week scan. Two cases (one case of cardiac defects and one case of ear deformity) were identified after birth. Of all the 3 134 fetuses, follow-up was obtained in 2 822 cases, 312 cases were excluded from the analysis because the outcome of their pregnancy could not be traced. Twenty-three fetuses with at least one major structural defect detected by prenatal ultrasonography were confirmed by follow-up. The sensitivity of the standard first-trimester ultrasound views was 56.5%(13/23), speciifcity was 99.9%(2 796/2 799), CR was 99.6%(2 812/2 822), and the false negative rate was 43.5%(10/23). Conclusions The standard views of the ifrst trimester are feasible and effective in screening the major fetal abnormalities including exencephaly, anencephaly, gastroschisis, omphalocele, ectopia cordis and single ventricle. However, ultrasound screening in early pregnancy still has some limitations, continuous scanning in different stages of pregnancy is necessary.

Reference materials are one of the major approaches to achieve measurement accuracy and metrological comparability. Different functions of reference materials should also be distinguished when applied to mass spectrometry as an emerging technology in clinical laboratory. Proper reference materials for validation, calibration and quality control of measurement method can ensure the accuracy and comparability of test results. Based on the problems of reference materials in clinical mass spectrometry, the precautions for the use of reference materials are summarized in the aspects of measurement method validation, calibrator usage and quality control.

Objective To observe the effect of electroacupuncture(EA) on the learning-memory ability in Alzheimer's disease(AD) rats.Methods Thirty SD rats were equally randomized into control,model and EA groups.AD model was established by injecting ?-amyloid(A?25-35,10?g) into the bilateral dentate gyri of the hippocampal CA 1 area(AP-3.5mm,ML?2.0mm,DV 2.7mm).EA(4Hz,1-2mA) was applied to "Baihui"(GV 20),"Dazhui"(GV 14),bilateral "Shenshu"(BL 23) and bilateral "Yongquan"(KI 1) for 30min,once daily for 7 days.The learning-memory ability was detected by using step-down test.Long term potentiation(LTP) of hippocampal CA 1 area was recorded by using tungsten microelectrodes after high frequency stimulation(HFS) conditioning of the cortical anterior perforated substance.Results In AD rats,the error number and total error time of step-down test were increased significantly(P

Objective To investigate the relationship between peripheral blood circulating follicular helper T cells and antibody-secreting B cells in patients with ankylosing spondylitis (AS). The role of circulating follicular helper T cells and antibody-secreting B cells in the pathogenesis of AS were explored. Methods Flow cytometry was used to detect the levels of peripheral blood CD4 +CXCR5+ T (cTfh), CD4+CXCR5+PD-1+ T, CD4+CXCR5+ICOS+ T, CD19+ B, CD19+CD38+ B cells in 59 patients with AS (including 36 cases of active AS patients and 23 cases of inactive AS patients). In addition, twenty healthy persons were selected as the controls. Data analysis were performed by independent-sample t test, One way ANOVA analysis, Pearson's and Spearman's correlation test. Results The percentages of cTfh [(26.8 ±10.4)%], CD4+CXCR5+PD-1+T [(12.1±14.0)%], CD4+CXCR5+ICOS+T [(13.6±9.5)%], CD19+CD38+B [(80.7±13.0)%] in the peripheral blood of AS group were significantly higher than healthy controls [(15.6 ±4.5)%, (6.4 ±2.4)%, (9.4 ± 4.5)%, (68.2±13.0)%] (t=6.663, P<0.01; t=2.999, P<0.01; t=2.573, P<0.05; t=2.712, P<0.01). The percentages of cTfh in the active AS group [(30.2 ±11.0)%] were significantly higher than those in the inactive AS group [(21.4±6.5)%] and HC (t=3.444, P<0.01;t=7.004, P<0.01). The percentage of CD19+CD38+B[(85.1±10.0)%] in the peripheral blood of active AS group was significantly higher than that of the inactive AS group [(73.8 ±14.2)%] and HC (t=3.561, P<0.01;t=5.410, P<0.01). The relationship between Bath AS disease activity index (BASDAI) and the percentage of cTfh, CD19+CD38+B was a positive correlation (r=0.442, P<0.01; r=0.405, P=0.001), and significant positive correlation was observed between the percentages of cTfh and CD19+CD38+B cells (r=0.420, P=0.001). Conclusion CD4+CXCR5+cTfh cells are significantly increased in peripheral blood in AS patients with aberrant CD19+CD38+ antibody-secreting B cells, suggesting that cTfh and CD19+CD38+antibody-secreting B cells may play an important role in the pathogenesis of AS .

Objective To compare the skills level before and after pediatric advanced life support course and analyze the effect of the training. Methods The pediatric advanced life support was used as the textbook. The skills were got through attending theory classes, watching demonstrations and taking part in the simulator training. The questionnaires were filled strictly and the data was analysed. Results The test scores were increased after the training (P＜0. 01). There were only 8.7% of the trainees had used the rescue equipments and 61.3% had never seen the rescue equipments before training. More than 80% of the trainees were satisfied with the training about the utility and novelty. Conclusion pediatric advanced life support course can successfully deliver a large number of healthcare providers with international unique pediatric emergency treatment skills ,and raise the participants abilities of rescuing critical children.

Objective To investigate the risk factors for postoperative delirium in patients undergoing noncardiac surgery. Methods From September-December 2009, 480 patients undergoing elective noncardiac surgery were included in this study. The criteria for enrolment of the patients in this study were (1) age ≥ 65 yr,(2) age ＜ 65 yr if associated with coronary artery disease, hypertension, diabetes mellitus, brain injury, cerebral hemorrhage, cerebral infarct, emphysema, chronic bronchitis; duration of operation ≥ 3 h and intraoperative blood loss was expected to exceed 20% of blood volume. The diagnosis of delirium was based on Confusion Assessment Method (CAM). Multivariate logistic regression was used to analyze the risk factors for postoperative delirium.Results Postoperative delirium developed in 79 patients during the first three postoperative days. The incidence of postoperative delirium was 16.5%. The logistic stepwise regression analysis indicated that the risk factors for delirium included advanced age, method of anesthesia, long operation, postoperative pain, emphysema and alcholic. Conclusion Age, method of anesthesia, long operation, postoperative pain, emphysema and alcholic are risk factors for postoperative delirium in patients undergoing noncardiac surgery.

OBJECTIVETo observe the effects of "menstrual cycle-based acupuncture therapy" on ovarian function and pregnancy results of in vitro fertilization-embryo transfer (IVF-ET) in patients with decline in ovarian reserve (DOR).

METHODSA total of 63 patients of DOR who received treatment of IVF/intracytoplasmic sperm injection (ICSI) were randomly divided into an observation group (30 cases) and a control group (33 cases). The patients in the observation group were treated with "menstrual cycle-based acupuncture therapy". The syndrome differentiation and treatment were given based on different phases of menstruation. Shiqizhui (EX-B 8) and Mingmen (GV 4) were selected during menstrual phase, Shenshu (BL 23), Geshu (BL 17), Sanyinjiao (SP 6) and Taixi (KI 3) were selected after menstruation, Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36) were selected during ovulatory period, Qihai (CV 6), Guanyuan (CV 4), Yanglingquan (GB 34), Taichong (LR 3) were selected before menstruation. The acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The total times of acupuncture was (15 ± 2). After acupuncture, patients were treated with IVF-ET. The patients in the control group were treated with IVF-ET but no acupuncture. The indices of ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the observation group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups.

RESULTSCompared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in the observation group (all P< 0. 05). Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in the observation group (all P < 0.05). Also, the implantation rate, the clinical pregnancy rate were improved (both P < 0.01) and cycle cancellation rate was reduced (P< 0.01).

CONCLUSIONThe "menstrual cycle-based acupuncture therapy" can effectively improve the ovarian reserve function in DOR patients, leading to an improved clinical pregnancy rate of IVF-ET.

Acupuncture Therapy ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Menstrual Cycle ; Middle Aged ; Ovarian Reserve ; Ovary ; physiopathology ; Pregnancy ; Young Adult