Objective:To explore the relationship between Jiegu pastes and blood biochemical indices and the expression of cal-catonin gene related peptide( CGRP) in the process of fracture healing. Methods: The tibial fracture model of rats was established, and the rats were randomly divided into five groups:the blank control group, model control group, positive control group, Jiegu paste at low dose group ( L, 1 g·ml-1 , calculated by raw materials) and at high dose group ( H, 2 g·ml-1 , calculated by raw materials) with 60 ones in each. The blank control group and the model control group were given 2 ml saline, the positive control group was given 2 ml concentrated dipsacus bone mixture, and Jiegu paste L group and H group was given 2 ml concentrated solution at low concentra-tion and high concentration, respectively, and all the groups were with the following regimen: ig,qd, for 28 days. The blood samples and callus specimens were obtained on the 7th, 14th, 21st and 28th day after fracture. Blood biochemical indices were detected, and HE staining and immunohistochemical staining were performed. Results: Compared with those in the model control group, the serum calcium and phosphorus ion concentration in Jiegu paste H group significantly increased on the 14th and 21st day, and the serum AKP significantly increased on the 14th and 28th day (P<0. 05). The expression of CGRP in Jiegu paste H group was significantly higher than that in the control group (P<0. 05). There were no significant differences between H group and the positive control group (P>0. 05). Conclusion:Jiegu paste can achieve the purpose of promoting fracture healing by improving the activity of serum AKP, in-creasing the concentration of calcium and phosphorus and regulating the activity of neuropeptide CGRP.

Objective To evaluate the effect of different education models on the self care ability of peripherally inserted central catheters (PICC) placement patients.Methods The randomized controlled trial (RCT),controlled clinical trail (CCT),self-controlled trial and cohort study on self care ability of patients with PICC placement were collected using databases by manual and Internet searching.Data were analyzed with Revman5.0 software,data which could not be gathered were expressed by descriptive analysis.Results Eight articles were included in the study.The results of Meta-analysis revealed that different education models could significantly improve the self care ability of PICC patients in the intervention (experimental) group.Conclusions Different education models had significant meaning on the self care ability of PICC placement patients.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma with highly heterogeneous both clinically and biologically. So the prediction for prognosis of DLBCL and identifying patients with high risk are coming into the focus of the 58th American Society of Hematology (ASH) Annual Meeting. International prognostic index (IPI) risk model is widely known as the powerful prognostic indicator for DLBCL but in rituximab-era is challenged by a variety of new prognosis systems. Biological markers and mutation and expression of genes play an important role in the pathogenesis and progression of lymphoma, and its prognostic value draw much more attention. The prognostic factors of DLBCL, specific types, such as primary breast DLBCL, intravascular large B-cell lymphoma, the presence of a DLBCL component in a follicular lymphoma and relapsed/refractory DLBCL have been paid more attention in this meeting.

Objective To observe the effect of EGFR‐TKI combined with chemotherapy on the changes of serum insulin‐like growth factor1(IGF‐1)and anterior gradient‐2(AGR2)levels in the patients with advanced non‐small cell lung cancer(NSCLC) ,and to investigate whether IGF‐1 and AGR2 can serve as a potential indicator of the prognosis and efficacy of chemotherapy in NSCLC . Methods Sixty‐eight patients with advanced NSCLC were selected as the experimental group treated by EGFR‐TKI combined chemotherapy and 30 healthy people served as the healthy control group .(treatment group) .The levels of serum IGF‐1 and AGR2 before chemotherapy and at 3 weeks after chemotherapy were detected by ELISA .The influence of serum IGF‐1 and AGR2 levels on the prognosis was analyzed by using Kanplan‐Meier method .Results (1)The disease control rate(DCR)in the EGFR‐TKI com‐bined chemotherapy was 52 .9% ;(2)the level of serum IGF‐1 before treatment in the experimental group was (329 .35 ± 88 .13)μg/L ,which was significantly higher than (146 .36 ± 41 .27)μg/L in the healthy control group(P<0 .01);the level of serum AGR2 in experimental group was(16 .72 ± 6 .23)ng/mL ,which was significantly higher than (4 .38 ± 2 .17)ng/mL in the healthy control group(P<0 .01);serum levels of IGF‐1 and AGR2 after treatment were(211 .53 ± 52 .31)μg/L and (9 .72 ± 3 .56)ng/mL respec‐tively ,which were significantly lower than those before treatment (P<0 .01);serum IGF‐1 and AGR2 in NSCLC patients were pos‐itively correlated(r=0 .489 ,P<0 .01);(3)serum levels of IGF‐1 and AGR2 after chemotherapy were(128 .62 ± 48 .24)μg/L and (7 .22 ± 4 .27)ng/mL respectively ,which were obviously lower than(334 .23 ± 82 .11)μg/L and(18 .43 ± 6 .17)ng/mL before chem‐otherapy(all P<0 .01) .The Kanplan‐Meier analysis revealed that serum IGF‐1 and AGR2 levels in advanced NSCLC had an obvi‐ous influence on the prognosis .Conclusion Serum IGF‐l and AGR2 levels may have a potential clinical value to assess the therapeu‐tic efficacy of EGFR‐TKI combined chemotherapy and prognosis in advanced NSCLC .

Modern medical staff are facing the challenge to survive in competitions and develop through cooperation.Thus it is of great importance for the future medical staff,that is,medical students to cultivate and enhance their teamwork for future demand.Cultivating approaches mainly include creating a collaborative environment,carrying out cooperative scientific research,creating teamwork in the curriculum,and launching community service activities.

Coronary Disease ; complications ; Erdheim-Chester Disease ; complications ; Humans ; Male ; Middle Aged

Objective To study the clinical efficacy of recombinant human epidermal growth factor (rhEGF) in the treatment of sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after appling rhEGF to reinforce wound bed preparation (WBP). Methods From January 2007 to October 2009, 60 patients with sacrococcygeal decubitus ulcers Grade Ⅲ, were divided into control group and treatment group. The ulcer size was 3 cm × 4 cm to 10 cm × 12 cm and all ulcers were infected for 15-70 d. Treatment group received traditional dressing change and appling rhEGF to reinforce wound bed preparation. Control group received traditional dressing change only. The operative technique that we used in two groups was direct polymerizing suture. Cure rate of stage Ⅰ and complication morbidities were analyzed. Results Cure rate of stage Ⅰ was 87% in treatment group and 70% in control group. Complication morbidities were 13% in treatment group and 30% in control group. The difference between these two groups was statistically significant (P ＜ 0.05). Conclusion Appling rhEGF to reinforce wound bed preparation before operation could make subsequent treatment more effective and improve the cure ratio of operation with decreasing complications and morbidities. And more, dissecting under fascia possesses the advantages of easiness to perform and rich blood supply.The method of appling rhEGF with direct polymerizing suture is a simple, high efficient approach for the first repairment of sacrococcygeal decubitus ulcers grade Ⅲ, especially desirable for the elderly.

Objective To observe the clinical effect of abdominal Tuina and acupuncture in treating Swiss generalized anxiety disorder (GAD). Methods 80 patients of GAD caused by liver depression-qi stagnation were randomly recruited into a treatment group and a control group, 40 patients in each. The treatment group was treated with abdominal tuina & acupuncture; while the control group was treated with acupuncture exclusively. Clinical effects and hamilton anxiety scale (HAMA) score were observed in both groups before and after the treatment. Results ①There was significant difference in total efficacy between the two groups CP<0.05), and the treatment group was better than the control group. ②The HAMA score of the two groups after the treatment was lower than that before the treatment, and the difference was significant (P< 0.05). There was also significant difference of HAMA score between the two groups after the treatment (/><0.05), with the treatment group showing better results than the control group. Conclusion Abdominal tuina combined with acupuncture has sound effects in treating Swiss GAD due to liver depression-qi stagnation.

Adrenal Gland Neoplasms ; Adult ; Humans ; Male ; Pheochromocytoma ; Rupture, Spontaneous

BACKGROUND:Nowadays,the internal fixation materials for the clinical treatment of femoral intertrochanteric fractures are broadly divided into two categories: intramedulary fixation system and extramedulary fixation system.Artificial femoral head replacement can be selected for unstable intertrochanteric fractures.However,the effects of diverse treatments usualy lack of macroscopical evaluation.OBJECTIVE:To investigate and compare the clinical effects of different surgical treatments for femoral intertrochanteric fractures in the elderly.METHODS:168 elderly patients with intertrochanteric fractures,who were treated in the Department of Orthopedics,Beijing Municipal Corps Hospital of Chinese People's Armed Police Forces from June 2005 to June 2010,were enroled in this study.They were treated by screw plate fixation system (dynamic hip screw,dynamic condylar screw),intramedulary fixation system (Gamma 3 nail,expandable intramedulary nail) and artificial femoral head replacement,including 69 males and 99 females,at the age of 75-94 years,averagely 81.4 years.According to Evans type,there were 20 cases of type Ⅰ,43 cases of type Ⅱ,57 cases of type Ⅲ,33 cases of typeⅣ and 15 cases of type Ⅴ.Operative time,blood loss,weight-bearing ambulation time,and hip function were compared and evaluated in patients of each group.RESULTS AND CONCLUSION:After treatment,patients were folowed up for 14-39 months.At 12 months after treatment,Harris score was used to assess hip function in the affected side.Fracture was healed within 12 months.There was no significant difference in excelent and good rate among four groups (P＞0.05).Operative time and blood loss were significantly better in the expandable intramedulary nail group than in the other groups (P＜ 0.05).Weight-bearing ambulation time was significantly better in the artificial femoral head group than in the other groups (P＜ 0.01).Results suggest that according to fracture typing,in combination with osteoporosis in elderly patients,suitable repair method could improve therapeutic effects for femoral intertrochanteric fractures,and reduce postoperative complications.Dynamic hip screw is firstly selected for Evens types Ⅰ and Ⅱ stable intertrochanteric fractures.The intramedulary fixation system can be selected for unstable intertrochanteric fractures as Evans types Ⅲ-Ⅴ.Artificial hip arthroplasty is good for elderly patients with unstable intertrochanteric fractures as wel as severe osteoporosis.