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 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 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 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.

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.

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 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 surgical effect and complications of arytenoid resection in bilateral vocal cord fold paralysis(BVFP) patients via endoscopic laser approach and external cervical approach. METHOD: A total seventy-eight BVFP patients who underwent arytenoid resection surgery via endoscopic laser approach (laser group, n=30) or external cervical approach (external cervical group, n=48) were enrolled in this study. Videostroboscopy, vocal perception evaluation, maximum phonation time (MPT) text were preformed in all patients both preoperatively and postoperatively. The decannulation rate was also calculated. RESULT: Videostroboscopy showed that vocal fold on the operated side in both groups could abduct to various extent postoperatively, which showed significant difference when compared with preoperative abductive movements (P<0. 05). Postoperative glottal closure showed various increment in both groups. However, when with preoperative glottal closure, external cervical group showed significant difference (P < 0. 05), while laser group showed no significant difference (P> 0. 05). Postoperative videostroboscopy showed no significant difference in vocal fold position and glottal closure between these two groups(P>0. 05). Vocal perceptual evaluation(RBH score) showed a significant deterioration in voice quality postoperatively in both groups respectively (P<. 05). Postoperative MPT values showed no significant difference between the two groups (P>. 05). However, they were significantly shorten/shorter than preoperative ones in these two groups respectively (P<0. 05). The overall decannulation rate were 90. 0% and 95. 8% for laser group and external cervical group respectively. In Both groups, patients presented aspiration symptoms postoperatively, except one patient of external cervical group who developed pneumonia due to recurrent aspiration. CONCLUSION Arytenoid resection surgery via both endoscopic laser approach and external cervical approach can both enlarge glottic area so as to solve respiration problems, in BVFP patients. Two kinds of surgery have obvious voice damage.
Arytenoid Cartilage ; surgery ; Endoscopy ; methods ; Humans ; Lasers ; Neck ; surgery ; Postoperative Complications ; Postoperative Period ; Vocal Cord Paralysis ; surgery ; Vocal Cords ; physiopathology ; Voice Quality

PurposeTo explore the significance of dual energy CT in differential diagnosis of squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis in the neck.Material and Methods Twenty-five patients with a total of 62 cervical enlarged lymph nodes confirmed with squamous cell carcinoma metastasis or lymph node tuberculosis by pathology underwent dual energy enhanced CT scan. Iodine coverage value of two different kinds of pathological properties of lymph nodes was measured. The trend of the spectrum curve was observed and the energy spectrum curve slope of two kinds of lymph nodes were compared. The sensitivity, specificity and accuracy of energy spectrum curve slope in differential diagnosis were analyzed. Results Of all 62 lymph nodes, there were 32 squamous cell carcinoma metastatic lymph nodes and 30 lymph node tuberculosis. There were statistic significance in the iodine coverage between the squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis (t=3.806 and 3.698,P<0.05). In the range from 60 keV to 180 keV, CT value of the two kinds of lymph nodes decreased with increase of keV value. It showed the higher the keV value the less CT value decreased, with the energy spectrum curve of drop type. The area of the iodine coverage was 0.756 with the differential diagnostic sensitivity of 56% and the specificity of 80%. The area of energy spectrum curve slope was 0.898 with the differential diagnostic sensitivity of 76% and the specificity of 85%.Conclusion The iodine coverage value and the energy spectrum curve slope have significance in differential diagnosis of the cervical squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis. The energy spectrum curve slope is superior to the iodine coverage value in differential diagnosis.