Objective To compare the efficacy and side effects of S-1 combined with oxaliplatin and capecitabine combined with oxaliplatin in treatment of advanced gastric cancer. Methods From Mar 2011 to Dec 2014, the data of 93 cases with gastric cancer in Zhengzhou Peopleˊs Hospital were studied retrospectively. 48 cases treated by S-1 combined with oxaliplatin (SL group) and 45 cases treated by capecitabine combined with oxaliplatin (XL group). The patients of SL group received S-1 80 mg·m-2·d-1, bid, po, d1-14, L-OHP 130 mg/m2, ivgtt, 2 hours, d1. The patients of XL group received capecitabine 2 000 mg·m-2·d-1, bid, po, d1-14, L-OHP 130 mg/m2, ivgtt, 2 hours, d1. The course was 21 days in two groups. The efficacy and side effects were evaluated after two courses. Results The efficacy rates of SL and XL group were 52.08 % (25/48) and 53.33 % (24/45), respectively there was no significant difference (P > 0.05). The incidence rate of gastrointestinal reaction in SL group was obviously higher than that in XL group [52.08%(25/48) vs 24.44%(11/45), P<0.05]. The incidence rate of oral mucositis in SL group was significantly lower than that in XL group [25.00 % (12/48) vs 51.11 % (23/45), P< 0.05]. Conclusion Both S-1 combined with L-OHP and capecitabine combined with L-OHP for gastric cancer treatment are safe and effective.

LU’s acupuncture therapy is one of the representatives of Shanghai schools of traditional Chinese medicine, and has been indexed by Shanghai Intangible Cultural Heritage List and National Intangible Cultural Heritage List, making a profound influence. From the perspectives of its origin, main academic theories, and inheriting study basements of LU’s acupuncture school, this article elucidated and studied LU’s acupuncture therapy, for further promoting LU’s acupuncture school and reviving acupuncture schools of Shanghai region.

Cardiac toxicity is found in frequently used chemotherapeutic agents.There are many factors related to the cardiac toxicity caused by chemotherapeutic agents.The common cardiovascular complications include heart failure,ischemia,hypertension,hypotension,edema,QT prolongation,pleural effusion,pericardial effusion,bradyarrhythmia and thromboembolism.It is necessary to monitor the left ventricular function before and after chemotherapy and take effective measures to protect myocardium.

Objective:To explore the predictive value of a scoring model based on MRI images for diagnosing invasive placenta accreta and associated adverse clinical outcomes.Methods:This retrospective cohort study involved 260 patients delivered at Peking University Third Hospital from January 2015 to December 2018, who were suspected to be placenta accreta with two or more ultrasound image findings and underwent MRI examination. Placenta accreta was finally diagnosed and classified based on the intraoperative clinical findings or pathological examination. Adverse clinical outcomes were defined as intraoperative bleeding ≥1 500 ml and/or having hysterectomy. Quantitative and qualitative interpretation of five MRI signs were performed, including intraplacental low-intensity band on T2 weighted imaging, abnormal intraplacental vascularization, vascularization of uterovesical interface, uterine bulging and cervical involvement. Chi-square and t test were used for univariate analysis of the five MRI signs and the receiver operating characteristics (ROC) curve of each MRI sign for predicting invasive placenta accreta and adverse clinical outcomes were drawn. The predictive value was assigned as 1 when ≥ the cutoffs that matched to the maximum Yoden index values, and was assigned as 0 when below the cutoffs. A scoring model based on the five MRI signs was established, ROC curves of the model for predicting invasive placenta accreta and adverse clinical outcomes were drawn and the area under the curve (AUC), sensitivity, specificity and Youden index were calculated. Results:(1) Univariate analysis showed that all five MRI signs were significantly associated with invasive placenta accreta and adverse clinical outcomes. Except for cervical involvement, the other four signs had an AUC value of greater than 0.5 in predicting invasive placenta accreta and adverse clinical outcomes. (2) The predictive cut-off values of abnormal intraplacental vascularization image and intraplacental dark band area on T2 weighted imaging were 2.0 cm 2 and 0.6 cm 2, respectively, and were all 1.0 for the other three signs. The AUC value of MRI signs-based scoring model for predicting invasive placenta accreta was 0.863. When the score was ≥ 2 points, the diagnostic sensitivity was 0.836 and the specificity was 0.726. The scoring model predicted adverse clinical outcomes with an AUC of 0.841. When the score was ≥3 points, the predictive sensitivity was 0.707 and the specificity was 0.818. Conclusions:The scoring model based on MRI signs is of good value for the diagnosis of invasive placenta accreta and the prediction of adverse clinical outcomes.

OBJECTIVETo identify the Cynomorii Herba and its analogues species using DNA barcoding technique.

METHODTotal genomic DNA extracted from all materials using the DNA extraction kit. The internal transcribed spacer 2 (ITS2) regions were amplified using polymerase chain reaction (PCR), and purified PCR products were sequenced bi-directionally. Sequence assembly and consensus sequence generation were performed using the CodonCode Aligner 3.7.1. The Kimura 2-Parameter (K2P) distances and GC content were computed using MEGA 5. 0. Species identification analyses were conducted through the species identification system for traditional Chinese medicine and neighbor-joining (NJ) trees.

RESULTThe ITS2 sequence lengths of Cynomorii Herba were 229 bp. The average intra-specific genetic distances of Cynomorii Herba were 0.003. The average inter-specific genetic distances between Cynomorii Herba and its adulterants species were 0.760. The results showed that the minimum inter-specific divergence is larger than the maximum intra-specific divergence. The species identification system for traditional Chinese medicine and NJ trees results indicated that Cynomorii Herba and its adulterants species can be easily identification.

CONCLUSIONThe ITS2 region is an efficient barcode for identification of Cynomorii Herba, which provide a new technique to ensure clinical safety in utilization of traditional Chinese medicine.

ObjectiveTo analysis the clinical characteristics and the high risk factors of children with cerebral palsy.MethodsClinical data of 100 children with cerebral palsy were retrospectively analyzed.Results51% of children were born with asphyxia, 42% were born prematurely, 39% were low birth body weight. 85.7% of children involved had mental retardation, 12% had hearing loss and 7% had visual impairment. 88% of children involved had abnormal cranial CT results and 46.1% had abnormal EEG. 50.0% of the children had abnormal brain stem auditory evoked potentials.ConclusionAsphyxia, prematurely birth and low birth body weight are high risk factors of cerebral palsy. Most of the children with cerebral palsy in this group are mental retarded.

Background Studieshowed thaDelta-like ligand 4 (Dll4) participatein the deveopmenof retinal celland angiogenesis.The Dll4-Notch pathway and vasculaendothelial growth facto(VEGF) are thoughto be critical mediatorof neovascularization undehypoxiconditions.The relationship between Dll4 and VEGF inovery cleaand furtheresearch ineeded.Objective Thistudy wato observe the inhibition of Dll4 on experimental retinal neovascularization and VEGF expression.MethodThe retinal neovascularization animal model wainduced by oxygen-induced retinopathy (OIR) in 5-day-old SPF SD ratby rearing the new postnatal ratwith the motherattogethein closed box with oxygen level a(80±2) ％ till 12-day-old.The ratwere then raised in normal aifo5 days.Aftethat,2.5μl (0.5 μg) of Dll4 monoclonal antibody wainjected into the mid-vitreoucavity in the righeye(Dll4 injected group) and PBwaused in the same way in the fellow eye(PBcontrol group) in the 12-day-old rats.Retinawere isolated in the 17-day-old rats,and retinal vasculamorphology waexamined by adenosine diphosphatease (ADPase) staining of retinal flatmounts,and the endotheliocyte nuclei above the internal limiting membrane were counted in the retinal tissue-slices.Reverse transcription PC(RT-PCR) waused to detecthe mRNexpression level of Dll4,VEGF,VEGF receptor-1 (VEGFR-1),VEGFR-2 and neuropilin-1 mRNin the retinas.Statistical analysiwaperformed by the paired t-test.The care and use of the animalcomplied with the Guidance Suggestion issued by the Ministry of Science and Technology of Chinin 2006.ResultThe Dll4 mRNexpression in the retin(Dll4 mRNA/β-actin mRNA) wa0.22± 0.06 and 0.98 ± 0.13 in the Dll4 injected group and the PBcontrol group,respectively,with statistically significandifference (=21.839,P =0.000).No significandifferencewere found in the expression of the VEGF mRNA,VEGFR-1 mRNand VEGFR-2 mRNin the retinabetween the two group(t=0.463,P=0.649;=1.687,P=0.109;=-1.674,P=0.111).Compared with the PBcontrol group,the expression of neuropilin-1 mRNwasignificantly elevated in the Dll4-injected group (0.73±0.08 vs.0.64±0.07) (t=-2.677,P=0.015).ADPase staining showed thathere were much more new blood vesselin the Dll4 injected group than those of the PBcontrol group.The numbeof nuclei structurally adjacento the vitreal side of the internal limiting membrane wa(63.6± 11.6)/slide in the Dll4 injected group,which wamore than thaof the PBcontrol group a(35.1±5.2)/slide (=-7.879,P =0.000).ConclusionDll4 playan essential role in the procesof pathological angiogenesiin the retina.Dll4 ithoughto be feedback regulatoof VEGFR,which participatein the procesof restraining pathological vasculogenesis.

Objective To study the impact of the off-pump coronary artery bypass compared to the on-pump coronary artery bypass technique on the rate of acute kidney injury.Methods A retrospective analysis of 824 patients accepted coronary artery bypass surgery in FuWai Hospital Surgical ICU from March 2011 to January 2013.Patients were divided into two groups according to the surgical approach,597 patients in on-pump group and 227 patients in off-pump group.Then compared the difference of acute kidney injury incidence in the two groups.Results 92 patients in the on-pump group occurred AKI,the incidence of AKI was 15.4％.32 patients in the off-pump group occurred AKI,the incidence of AKI was 14.1％.Two groups of patients had no statistical difference in the incidence of AKI,x2 =0.222,P =0.638.Based on the preoperative baseline creatinine clearance levels.We defined normal creatinine clearance (SCR ≥ 60 ml/min),mild renal insufficiency (45 ml/min ＜ SCR ＜60 ml/min),moderate renal dysfunction group(31 ml/min ＜ SCR ＜45 ml/min).Decline with the preoperative creatinine clearance rate,the AKI incidence was elevated significantly,P ＜0.05.Patients with moderate renal insufficiency,offpump patients had lower incidence of AKI than those in on-pump group,P ＜ 0.05.The incidence of renal replacement in the two group patients had no statistical differences.Conclusion The incidence of AKI after coronary artery bypass surgery had no statistical differences with or without pump.In the patients with preoperative moderate renal insufficiency,off-pump can reduce the incidence of AKI,but could not change the kidney the incidence of renal replacement treatment.

Objective To explore clinical effect of the stellate ganglion block combined buflomedil in the treatment of vertebral artery type of cervical syndrome (CSA).Methods One hundred and twenty cases of CSA were included in the study,and randomly divided into two groups.Study group (60 cases)patients were treated by stellate ganglion block therapy combined with buflomedil intravenous;the controlled group (60 cases)was treated with buflomedil intravenous therapy only.In the treatment,vertebral-basi-lar artery mean flow velocity (Vm)was measured before and after treatment and comparison of Vm difference was the clinical ba-sis.According to the CSA standard of clinical cure,the clinical curative effect was observed.Results After treatment,the total ef-fective rate of study group was 95.00%,total effective rate of control group was 71.67%,the difference statistically significant (χ2 =24.474,P <0.05).vertebral artery blood flow velocity of the two groups after treatment increased more obvious than that of before treatment,the difference was statistically significant (P <0.05),vertebral artery blood flow velocity after treatment of study group (38.44±2.20)cm/s was significantly higher than that of the control group (34.36±3.50)cm/s,the difference was statisti-cally significant (t=7.645,P <0.05).basilar artery blood flow velocity of the two groups after treatment increased more obvious than that of before treatment,the difference was statistically significant (P <0.05),basilar artery blood flow velocity after treat-ment of study group(56.34±4.10)cm/s was significantly higher than that of the control group (47.69±3.90)cm/s,the differ-ence was statistically significant (t= 11.841,P <0.05).Conclusion The clinical efficacy of stellate ganglion block combined bu-flomedil in treatment of vertebral artery type of cervical syndrome is obvious.The cure rate with respect to the drug treatment has significant advantages and the therapy is worthy of further promotion.

ObjectiveTo verify the reliability of the mouse model of cerebral cortical microinfarct induced by two-photon microscopy and to explore its pathological changes.MethodsSeventeen male C57BL/6J mice were randomly divided into a microinfarct group (n=11) or a sham operation group (n=6).A thinned cranial window of 3 mm diameter was performed over the cerebral cortex with a high-speed micro-drill until the small blood vessels were clearly observed under a dissecting microscope.Then, a permanent single cortical penetrating arteriole occlusion was induced with a gradually enhanced ultrashort laser irradiation through the thinned cranial window with two-photon microscopy.At 7 days after modeling, the cerebral microinfarct volume was measured with HE staining, and the neuron loss, activation of glial cells and deposition of 3-nitrotyrosine were assessed using immunohistochemistry.ResultsThe target vessels of cerebral cortex in 8 (72.7%) mice were occluded and the microinfarcts formed in the microinfarct group, and the average microinfarct volume was 317.23±20.29 μm3.There were remarkable neuron loss and microglia infiltration in the infarcted core, a large number of reactive astrocytes surrounding the infarcted lesion, and massive deposition of 3-nitrotyrosine in the peri-infarct area.No infarcts were observed in the sham operation group.The deposition of 3-nitrotyrosine in the sham operation group was significantly less than that in the microinfarct group (8.00±1.48 vs.98.38±9.10;t=23.962, P<0.001).Conclusions The mouse model of cerebral cortical microinfarct induced by two-photon microscopy is reliable, and its histopathologic changes are consistent with the pathologic features of cerebral microinfarct.