Objective To evaluate the therapeutic effect ofGuizhi-Fuling Pill combined with conventional western medicine therapy for diabetic peripheral neuropathy (DPN).Methods A total of 78 patients with DNP were randomly divided into treatment group (40 patients) and control group (38 patients).The patients in the control group were administrated with mecobalamin on the basis of conventional treatment. In addition to the therapy of control group,patients in treatment group were givenGuizhi-Fuling Pill. The patients in both groups were treated for 2 weeks.The level of homocysteine (Hcy) and sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) in both groups were measured. Toronto clinical scoring system (TCSS) was used to evaluate the curative effect.Results The total effect rate in the treatment group was significantly higher than that in the control group (95.0%vs. 76.3%;χ2=5.616,P=0.018). After treatment, the MNCV of common peroneal nerve (46.1 ± 6.3 m/svs.42.5 ± 5.5 m/s;t=2.734,P<0.01 ), MNCV of median nerve (49.8 ± 5.2 m/svs.46.3 ± 5.9 m/s;t=2.607,P<0.05 ), SNCV of common peroneal nerve (38.5 ± 4.6 m/s vs. 35.4 ± 4.3 m/s;t=3.105,P<0.05 ), SNCV of median nerve (45.3 ± 5.2 m/svs. 42.3 ± 4.8 m/s;t=2.627, P<0.05 ) in the treatment group were significantly increased than those in the control group. The integral of TCSS (5.3 ± 3.1vs. 7.2 ± 2.9;t=2.823,P<0.01) and the level of Hcy (13.3 ± 3.2 μmol/Lvs. 17.1 ± 3.4 μmol/L;t=5.178, P<0.05) were significantly lower in treatment group than those in control group (P<0.05).Conclusions The Guizhi-Fuling Pill combined with conventional western medicine therapy could improve MNCV and SNCV and reduce the level of Hcy and improve the clinical effect.

Objective To analyze the effect of different methods of anesthesia maintenance on clinical efficacy and postoperative recovery in elderly patients with gynecological diseases undergoing laparoscopic surgery.Methods A total of 80 elderly patients with gynecological diseases scheduled for laparoscopic surgery were enrolled in this study in our hospital from January 2015 to December 2016.All the patients were randomly divided into two groups of anesthesia maintenance:an intravenous anesthesia alone (n=40) and a combined intravenous and inhaled anesthesia (n =40).The pre-and post-anesthesia changes in arterial blood gas,blood pressure,heart rate and cognitive function,and postoperative complications were analyzed and compared between the two groups.Results There were no significant differences between the two groups in the times of palinesthesia,extubation and talking (all P＞ 0.05).After anesthesia,the levels of arterial blood gas,the blood pressure and the heart rate were relatively stable in both groups,and their differences between the two groups were without statistically significant (all P ＞ 0.05).While,the postoperative cognitive function recovered more rapidly in patients receiving intravenous anesthesia alone for anesthesia maintenance than in those receiving a combined intravenous and inhaled anesthesia,especially at 6 h after extubation.The Mini-mental State Examination (MMSE) score was significantly higher in patients receiving intravenous anesthesia alone (28.8 ± 0.5) than in patients receiving a combined intravenous and inhaled anesthesia (25.1 ±0.6),with statistically significant difference (P＜ 0.05).In addition,there was no statistical difference between the two groups in the incidence of complications.Conclusions As anesthesia maintenance,both an intravenous anesthesia alone and a combined intravenous and inhaled anesthesia can ensure a successfully laparoscopic surgery for gynecological diseases in elderly patients.However,the impact on cognitive function after laparoscopic surgery is smaller in the maintenance of intravenous anesthesia alone than in a combined intravenous and inhaled anesthesia in elderly patients.Intravenous anesthesia alone can be used in elderly patients to receive laparoscopic surgery as routine anesthesia maintenance.

0.05)。The median time to progression (mTTP)was 5.8 months in XELOX group and 5.7 months in FOLFOX4 group. The median survival time (MST) was 10.0 months in XELOX group and 9.8 months in FOLFOX4 group, The toxicities were well tolerated,The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in XELOX group than in FOLFOX4 group (P0.05).Conclusions:Both of the two regimens were feasible, well tolerated and effective in treatment of advanced gastric cancer。XELOX regimen may be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.

Background and purpose:It has been shown that chemotherapy could improve the quality of life and prolongation of survival time of the patients with advanced gastric cancer. There is still no standard chemotherapy regimen for advanced and metastatic gastric cancer, and regimens with high efficacy and safety are scare. Toxicities are considered to be limiting factors and in? uence the quality of life in the patients with advanced gastric cancer. The purpose of this study was to investigate the effi cacy and toxicity of docetaxel(DOC) in combination with oxaliplatin(OXA) as fi rst-line treatment in advanced gastric cancer and try to fi nd a regimen that would be more tolerable without deterioration of treatment response. Methods:48 patients with advanced gastric cancer were treated with docetaxel 35 mg/m2, ivgtt, d1,d8 combined with oxaliplatin 130 mg/ m2,ivgtt,d1 ;repeated every 3 weeks (one cycle) ,The effect was evaluated after two cycles. The effi cacy and toxicity were evaluated according to WHO standard. Results:48 patients could be evaluated for clinical response. Complete response in 3 pts and partial response in 24 pts were observed with an overall response rate of 56.25%, median time to progression (MTTP) was 5.6 months and median overall survival (MST) was 11.8 months. The most common toxicities were bone marrow suppression, peripheral neuritis, nausea and vomiting. All of them are reversible. Conclusion:Combining weekly docetaxel and oxaliplatin is an effective and well tolerated alternative treatment in advanced gastric cancer and has yielded promising results.

Intensity-modulated radiation therapy (IMRT)is a more advanced radiotherapy technique than routine radiotherapy,and has been effectively utilized in the treatment of nasopharyngeal carcinoma (NPC).Rradiotherapy alone has disappointing effect to local advanced cases.Nevertheless,chemoradiotherapy provides long term survival.Chemoradiotherapy is becoming the standard therapeutic regimen for local advanced NPC.But different ways of chemomdiotherapy such as induction,concurrent,adjuvant chemotherapy still need to be defined.

Objective To investigate the entry points for clinical work of intensive care unit (ICU) pharmacists.Methods Through combination with daily work and referring the domestic and foreign literature,the characteristics of ICU medications were discussed to find out the entry point for clinical work of ICU pharmacists.Results ICU patients particularly need individualized pharmaceutical care because of the special pathophysiological characteristics and medicine use.Conclusion ICU pharmacists should provide pharmaceutical care based on Pharmacokinetics/pharmacodynamics knowledge and focus on the drug dosage adjustment,drug interactions and adverse event prevention.

【Objective】To optimize the process conditions for active compounds of Flos Datura by microwave-assisted extraction.【Methods】Uniform design was used to observe the effects of microwave power,microwave radiation time,solvent volume,soaking time and extracting time on the extraction of dry extract,total alkaloids,scopolamine of Flos Datura.The contents of total alkaloids and scopolamine of Flos Datura were determined by acid stain colorimetry and HPLC,and the obtaining rate of dry extract was measured by weight method.【Results】 The optimal process conditions for Flos Datura were as follows: soaking the medicinal material for 2 hours with 10 times of 75% alcohol,with continuous radiation for 25 min at the power of 730 W,at 65℃.【Conclusion】Microwave-assisted extraction is superior to soaking extraction method in increasing productivity and economizing the solvent.

0.05).The median time to progression (mTTP) was 7.8 months in HCPTOX group and 7.9 months in FOLFOX4 group, respectively. The median survival time (MST) was 13.1 months in HCPTOX group and 13.3 months in FOLFOX4 group, respectively. The toxicities were well tolerated.The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in HCPTOX group than in FOLFOX4 group (?2=4.538,P0.05). Conclusion:Both of the two regimens were feasible, well tolerated and effective in treatment of metastatic colorectal cancer.HCPTOX regimen might be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.

Objective To study the method of preparation of donor liver in liver transplantation. Methods The methods and skills of donor liver preparation and the anomaly artery reconstruction of graft in 64 cases of orthotopic liver transplantation (OLT) were retrospectively analyzed. Results All allografts had preparation and were suitable for clinical transplantation. Thirteen cases with hepatic artery anatomy variation were found. Among the 13 cases, 5 cases were reconstructed. Splenic artery (3/5) and gastro-duodenal artery (2/5) were typically used for anastomosis of the variant hepatic arteries. No complications resulted from donor liver preparation. Conclusions Correct preparation of the donor hepatic artery and biliary tracts, can decrease the incidence of hepatic artery and biliary tract complications after liver transplantation, and is the key to ensure successful donor liver preparation.

Objective To explore the association between the level of lactate dehydrogenase (LDH)in gastric cancer patients’ serum or the relative expression of LDH in their tissues and the patients’prognosis.Methods 60 specimens of gastric canc-er patients who confirmed by pathological diagnosis were collected from 2012 to 2013,include the serum specimens and tis-sue specimens.Their serum level of LDH were detected,and the relative expressions level of LDH in the sample of normal tissues,gastric cancer tissues and metastatic lymph nodes were quantify by real-time fluorescence quantitative reverse tran-scription-PCR (Realtime-PCR).Finally,the relationship between the expression of LDH and clinical pathologic features were analyzed by independent t-test or anova statistics.Results The serum level of LDH was highly increased than control group (340.89±10.67 IU/ml,t=24.7,P<0.01);the relative gene expression of LDH in normal tissue,human gastric cancer and metastatic lymph node were 1.0,3.39 and 2.35.The result suggests the serum level of LDH were associated with pTNM stage and lymph node metastases (t=5.2,4.8,P<0.01).The relative gene expression of LDH in gastric canc-er tissues were associated with tumor sizes,pTNM stage and lymph node metastases (t=18.2,15.3,P<0.01 and F=7.2, P<0.01).Conclusion The serum LDH level and the expression of LDH in cancer tissue were significantly increased,and their expression were correlated with the patient’s prognosis.The serum level of LDH and the expression of LDH in gastric cancer tissue may be potential indicator to evaluated the prognosis of the patient with gastric cancer.