By employing the mother-child and meridian relations between the spleen and the lung, this paper expanded on the therapeutic method of“banking up earth to generate metal” and its clinical practice in terms of excess and deficiency. After that, a modern research on the theory was made from the following 6 perspectives:refractory angina, asthma, bronchitis and reflux gastritis, pulmonary and digestive lymphatic system, pulmonary and digestive immune system, pulmonary and digestive endocrine system, pulmonary inflammatory disease and gastrointestinal flora system, and the influence of them on spleen-deficiency asthma rats airway inflammation, which fully demonstrated the importance of the classic traditional Chinese medicine (TCM) treatment principle of“banking up earth to generate metal” on the treatment of lung and digestive diseases.

Objective To establish the quality standard for Guishao Zhenxian Tablets. Methods Radix Glycyrrhizae,Radix Codonopsis,Radix Bupleuri were identified by TLC. The content of paeoniflorin in the preparation was determined by HPLC. Results The spots of TLC color spectrum were distinct and there was nointerference from the negative control. The calibration curve was linear over the concentration range of 0.245 2～0.735 6 ?g for paeoniflorin (r=0.999 7) and the average recovery was 98.3%,RSD=1.52% (n=5). Conclusion The established quality standard is convenient and reliable,and can be used to control the quality of Guishao Zhenxian Tablets more effectively.

Objective To study the relationship between resting heart rate(RHR)and essential hypertension(EH).Methods 215 patients with EH and 82 healthy subjects underwent RHR detection.The relationship between RHR and the state of EH was analyzed.Results RHR in EH group was significantly higher than that in normal group[(78.9±9.1)bpm vs(69.5±10.9)bpm,P＜0.01)],RHR in different stages of EH was significantly different(F=21.280,P＜0.01,respectively),and increased with grades(P＜0.05 orP＜0.01).RHR in EH patients complicated with left ventricle hypertrophy(LVH)was higher than those with no LVH[(83.9±9.1)bpm vs (75.9±8.9)bpm,P＜0.01].There was positive correlation between RHR and LVH(r=0.8097,P＜0.01).Conclusion RHR is related to the development and progress of EH,and it may be one of the index for estimating the state of EH.

Objective To observe the effect of combined continuous femoral nerve blockade (CFNB)with epidural morphine postoperative analgesia on total knee arthroplasty (TKA)in elderly patients.Methods Eighty elderly patients scheduled to undergo TKA were randomly divided into two groups:groups FN and FNM.Groups FNM and FN were received 0.1% morphine 2 ml and normal saline 2 ml through epidural space respectively at the end of surgery.After surgery,all patients were implanted catheter around femoral nerve guided by ultrasound,and were infused 0.2% ropivacaine 25 ml.Continuous infusion of 0.2% ropivacaine for femoral never block was administrated at a rate of 5 ml/h for 48 hours to all patients.VAS scores and bending degree during rest,active and passive exer-cise were recorded at time point of postoperative 24,48,72,96 h.Ambulation status on the fifth day after operation were observed.Satisfaction of hospitalization were graded before hospital discharge. Results Compared with group FN,VAS scores during rest,active and passive excercise were signifi-cantly decrease at 24 h in group FNM (P <0.05 or P <0.01).The bending degree of knee joints in group FNM were significantly greater compared with group FN at 24 h after surgery (P <0.01).Am-bulation status on the fifth day after surgery were significantly better in group FNM compared with group FN (P <0.05).The level of patient satisfaction was much higher in group FNM (P <0.05). Conclusion After TKA,CFNB combined with single epidural morphine injection can provide better analgesia and bending degree with a high level of satisfaction.

Objective To investigate the efficacy of imatinib combining with allogeneic hematopioetic stem cell transplantation or chemotherapy for bcr-abl positive acute lymphoblastic leukemia (ALL). Methods 12 cases were diagnosed on morphology, cytochemistry, immunophenotype and bcr-abl fusion gene. The induction is imatinib (400 mg/d) combining chemotherapy. 8 cases accepted allogeneic hematopoietic stem cell transplantation after complete remission (CR). If bcr-abl became positive, the patient was treated with imatinib (400～600 mg/d). 3 cases were tested with imatinib alternating chemotherapy after cr. Results 11 patients gained CR, CR rate 91.7 %; 5 patients (41.7 %) became bcr-abl negative through 2 courses induction. 3 cases relapsed after transplantation. 2 cases relapsed in imatinib combining chemotherapy group. The median remission interval is 16 months (imatinib combining transplantation group) and 10 months (imatinib combining chemotherapy group) (P <0.01) respectively. The median survival time is 18 months (imatinib combining transplantation group), and the other group (imatinib combining chemotherapy) is 12 months (P <0.01). Conclusion Imatinib combining chemotherapy achieved high CR rate for the bcr-abl positive ALL. Imatinib combining allogeneic hematopoietic stem cell transplantation is superior to imatinib combining chemotherapy for CR patients.

OBJECTIVE: To investigate the possibility of thyroidectomy/lobectomy without drainage after surgery. METHOD: Eighty-eight consecutive cases with thyroid mass have been underwent operations including: lobectomy group(42 cases), thyroid lobectomy with contralateral partial thyroidectomy group (17 cases) and total thyroidectomy group (29 cases) from 2013. 06 to 2014. 06 in Nanjing Tongren Hospital. FIfteen patients with thyroid operation in other hospital were collected from 2014. 01 to 2014. 06, the recovery of postoperative incision were compared. RESULTS: Eighty-four cases were smoothly discharged from hospital except 4 thyroidectomy cases suffered from a small amount of effusion in surgical cavity. Our postoperative wound recovery were more in line with the principle of cosmetology compared with other hospital operation group. CONCLUSION Drainage following thyroidectomy is not essential, if the thyroid surgery is meticulous in each step of the surgery, and can increase the effect of beauty.
Drainage ; methods ; Humans ; Postoperative Period ; Thyroid Diseases ; Thyroidectomy

Objective To compare the efficiency and safety of regimens of empiric antibiotic therapy in neutropenic hematological maligence patients.Methods The clinical data of empiric antibiotic therapy for 260 febrile episodes in 125 neutropenic hematological maligence patients were analyzed retrospectively.Results A total of 45 febrile episodes were treated with tazocin plus amikacin(regimen TA).80 episodes were treated with ceftazidime plus amikacin(regimen CA),75 episodes with imipenem plus amikacin(regimen IA) and 60 episodes with maxipime plus amikacin(regimen MA).The medians of initial therapy in each regimen were 7～8 days.Percentage of satisfactory response had no significant difference in episodes treated with regimens TA,IA and MA(65%,70% and 79% respectively),and it was better than regimen CA(P

Objective To investigate the cytogenetic and immunological phenotypes of acute myeloid leukemia (AML) with t(8;21),and explore the risk stratification and risk-adapted treatments.Methods The chromosomal karyotype of bone marrow was detected and analyzed in 22 newly diagnosed patients with t(8;21) AML by direct culture and G banding technique.Patients were divided into two groups according to the chromosomal karyotypes.Clinical characteristics and immunological phenotypes were compared between patients with isolated t(8;21) and those with additional aberrations.A follow-up study with median time 30 months (4-68 months) was conducted to analyze prognostic factors.Results 13 cases (59.1％) were isolated t(8;21) AML,while 9 (40.9 ％) had additional aberrations.Loss of sex chromosome was found in 3 cases and complex variant translocation in 2.The 10q-,9q-,-18 and +10 were found in single cases.Overall survival of patients with additional aberrations was significantly poorer than those with isolated t (8;21) (P =0.0176).Analysis of prognostic factors showed that t(8;21) chromosomal karyotype,initial white blood cells at diagnosis,and treatment regimen (chemotherapy alone or plus hematopoietic stem cell transplantation) had effects on overall survival.Conclusion Patients with t (8;21) AML are frequently associated with additional chromosomal aberrations.The latter indicates a poorer outcome and can be one of the bases of risk stratification.Hematopoietic stem cell transplantation might help to improve the overall survival.

Objective To investigate the setup errors of super chest segment of esophageal cancer patients before radiotherapy delivery by KV cone beam CT,and evaluate the margin from CTV to PTV.Methods From 2010 to 2012,13 patients with super chest segment of esophageal cancer whose IMRT planning CT images were included in this study.Delineate target on the CT images of treatment planning and enlarge the margin of CTV to form ITV,then enlarge the margin of ITV gradually 10 times by 1 mm each time to form varied PTV,and create the plan according to the size of the PTV,simulate setup errors in the new plan to obtain the simulation of the actual exposure curve and find a suitable PTV to assure 95％ ITV volume as ever to approach the prescription dose,obtained the outside enlarge distance of CTV → PTV.Results The maximum setup errors in the direction of the anterior and posterior positioning was (3.42 ±2.19) mm.The margin of ITV→PTV is 5 mm which was figured out by PTN enlarging method.Compared to the original plan that under the condition of draw up the radiotherapy plan that based on the method of PTV enlarging obtained the CTV→PTV and simulate the actual dose distribution according to the setup errors:total lung V5,spinal cord D1cm3,increased by about 0.87％,4.95 Gy,heart V40,PTV D95,PTV V100,ITV D95,ITV V100 were reduced about 0.62％,4.95 Gy,8.38％,1.84 Gy,1.87％,all of them have statistically difference.Conclusions Range of external expansion of the left to right,superior to inferior and anterior to posterior is 7 mm,8 mm and 7 mm respectively,according to the method of PTV enlarging obtained the margin of CTV→PTV of super chest segment of esophageal cancer patients.

OBJECTIVE To study the clinical features of acute leukemia(AL) patients with complication of infection. METHODS A retrospective analysis of prevalence of infection occurring in 123 AL patients,their bacterial spectrum,and the effect of G-CSF on the infection were done. RESULTS The prevalence of infection in AL patients was 94.3%,among which 49.2% were infected with Gram-positive organisms,42.4% with Gram-negative bacilli and 8.4% with fungi.Blood culture occurred mostly with Escherichia coli and Pseudomonas infection.Patient′s neutropenia was significantly related to the infection.The patients with neutrophil count less than 0.2?10~9/L had more frequently suffered severe infection with long-lasting time,and had more than two sites of infection.Age,hemoglobin level,prophylactic intestinal usage of antibiotics could not reduce patient′s infection.The total mortality of AL patients with infection was 6%.Pulmonary infection and septicemia increased mortality,but G-CSF therapy reduced it. CONCLUSIONS AL patients are at high risk of infection which is significantly associated with severe neutropenia.G-CSF therapy exerts an assistant role to antibiotics in controlling the infection.