Objective To investigate the prognostic value of preoperative neutrophil lymphocyte ratio (NLR) in patients with gastrointestinal stromal tumors (GIST).Methods The clinical-pathological data from 85 GIST cases were collected from the Second Affiliated Hospital of Wenzhou Medical University and retrospectively analyzed from June 2009 to December 2013.According to the exclusion criteria,79 cases were enrolled.Preoperative neutrophil and lymphocyte count was collected and NLR was calculated.According to the receiver operating characteristic (ROC) curve of NLR,GIST patients were divided into low NLR group (NLR ＜ 2.30) and high NLR group (NLR ≥ 2.30).Clinic-pathological features and five year disease free survival (DFS) were compared between the two groups.Results There was a statistical significant difference in tumor size and tumor risk between high NLR group and low NLR group (respectively,x2 =9.517,12.411,all P ＜ 0.05).Univariate analysis showed that the five year disease free survival rate of low NLR and high NLR group were 78％ and 32％ (x2 =18.749,P =0.000).By multivariate analysis a high NLR was identified as an independent risk factor of poorer prognosis for patients with GISTs (RR:3.516,95％CI:1.453-8.506,P=0.005).Conclusion A high preoperative NLR is an independent risk factor for the prognosis of GISTs.

Objective To evaluate the clinical efficacy of dragon-tiger contending needling at Xi-cleft points plus electroacupuncture in treating postherpetic neuralgia (PHN).Method Seventy PHN patients were randomized into a treatment group of 36 cases and a control group of 34 cases. The treatment group was intervened by dragon-tiger contending needling at Xi-cleft points plus electroacupuncture, while the control group was treated with electroacupuncture alone. In the 4-week treatment, the Visual Analogue Scale (VAS) scores right before and after the 1st, 2nd, 6th, 9th and 12th treatment sessions were recorded, “the maximum pain intensity since the last treatment session” and “real-time analgesic effect” were observed, and the total therapeutic efficacy was also evaluated.Result The real-time analgesic effects right after the 1st, 2nd and 6th treatments in the treatment group were significantly better than those in the control group (P<0.05). The “maximum pain intensities since the last treatment session” prior to the 2nd, 6th, 9th, and 12th treatment sessions were significantly different from the pain intensity before the intervention in the two groups (P<0.05). The “maximum pain intensities since the last treatment session” prior to the 6th, 9th, and 12th treatment sessions were significantly different from those in the control group (P<0.05). The total effective rate and recovery plus markedly-effective rate were respectively 97.2% and 77.8% in the treatment group, versus 91.2% and 59.2% in the control group. There was a statistically significant difference in the recovery plus markedly-effective rate between the two groups (P<0.05).Conclusion Dragon-tiger contending needling at Xi-cleft points plus electro- acupuncture is an effective approach in treating PHN; it acts efficiently and can produce a satisfactory real-time analgesic effect.

Shanghai began to strengthen the community health service system in 1997 , and had officially en-tered the period of “connotation construction” with the core policy of family doctor system in 2011 after the period of“service framework and network establishment” and“operational mechanism reform”. Through summarizing the poli-cy files related the family doctor system and based on 2013 report on monitoring and evaluation of family doctor system in Shanghai, the paper presented the progress of the system from aspects of system coverage, signature relationship, service mode and operational mechanism, and analyzed the development bottlenecks of the system from aspects of the policy itself, service principal, service supervision and service objects. Finally, the paper proposed some suggestions in order to give some references for further development of national general practitioner system.

The study introduced the general evaluation indicator system for community health services in Shanghai and its characteristics,analyzing the results of the comprehensive evaluation from the aspects of regions and institutions.From six aspects of financial input,human resource construction, operation mechanism,family doctor system,information system construction and the application of the comprehensive evaluation results,the paper recommended on deepening the reform of community health services.

OBJECTIVE: To analyze the indications and dominant diseases of the spreading moxibustion therapy. METHODS: By retrieving 7 databases of both Chinese and English version, such as CNKI, WANFANG, VIP and PubMed, the eligible articles of randomized controlled trials (RCTs) treated with spreading moxibustion therapy were collected. The number of annual publications, the number of each disease system, the indications and dominant diseases involved in the related articles were analyzed statistically, as well as the number of cases and the corresponding clinical effective rates. RESULTS: A total of 182 articles were included, including 40 indications for the spreading moxibustion and covering 9 major disease systems. Specially, the indications in the motor system were maximal in number, accounting for 17.50% (7/40) of the total number of indications. The number of indications in the digestive system was on the second top, accounting for 15.00% (6/40). The dominant diseases were mainly distributed in motor system, respiratory system, nervous system and gynecological system. There were 3 dominant diseases in motor system, i.e. ankylosing spondylitis, back pain and rheumatoid arthritis; 1 dominant disease, i.e. chronic obstructive pulmonary disease in the respiratory system, 1 dominant disease, i.e. primary dysmenorrheal in the gynecological system and 1 dominant disease, i.e. post-stroke paralysis in the nervous system. CONCLUSION At present, the indications of the spreading moxibustion therapy are widely distributed and the dominant diseases are concentrated, representatively by ankylosing spondylitis. But, the indications and the dominant diseases of spreading moxibustion are changeable dynamically and the disease spectrum of spreading moxibustion needs to be further explored.
Acupuncture Therapy ; Dysmenorrhea ; Female ; Humans ; Moxibustion ; Randomized Controlled Trials as Topic ; Spondylitis, Ankylosing ; therapy