Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for bone meta-static cancer. Methods 71 cases with bone metastatic cancer were randomly divided into observation group (40 ca-ses) and control group (31 cases). The observation group was treated with zoledronic acid, 4 mg intravenously and local radiotherapy. The control group was treatd by radiotherapy alone. Results Pain relief was noted in 90% pa-tients in the observation group and 83.9% in the control group, respectively. The statistical difference was not signif-icant(P > 0.05). After the treatment had finished 3 months pain alleviation situation:Pain relief was noted in 87.5% patients in the observation group and 67.7% in the control group, respectively. The difference between the two groups was significant(χ2 =4.09, P =0.043). No serious radiotherapy and serious adverse drug reactions was found. Conclusion Zoledronic acid combined with radiotherapy was superior to radiotherapy alone for metastatic cancer bone pain relief, analgesic effect maintain a longer time.

OBJECTIVE:To develop a detection LC-MS/MS method for global DNA methylation in medicinal plants. METH-ODS:Genomic DNA was isolated using plant DNA extraction kit,and then hydrolyzed by 88% formic acid at 140 ℃. After dried with nitrogen,extracted DNA was dissolved again with mobile phase. LC separation was performed on HILIC column with mobile phase consisted of 7 mmol/L ammonium formate-acetonitrile (gradient elution) at flow rate of 0.3 ml/min. The analysis was con-ducted by tandem MS with positive ion electrospray ionization in multiple reaction monitoring(MRM)mode. The ratio of genomic DNA methylation in 10 commonly used medicinal plants was calculated. RESULTS:The linear ranges of Cyt and 5mC were 1-500 ng/ml(r=0.999 5)and 0.2-100 ng/ml(r=0.999 6). The relative standard deviations(RSDs)of accuracy were 1.12% and 3.68%(n=6). The RSDs of intra-day precision were 2.36% and 4.02% for Cyt and 5mC,respectively (n=5). The RSDs of inter-day precision were 1.04% and 3.54% for Cyt and 5mC,respectively (n=3). The RSDs of repeatability test were 1.53% and 3.27%for Cyt and 5mC,respectively(n=6). The recoveries of Cyt and 5mC were 98.7%-102.1% and 91.2%-103.5%. The percentages of global DNA methylation in 10 medicinal plants were ranged from 17.63% to 25.18%. CONCLUSIONS:LC-MS/MS method is simple,rapid,sensitive and precise,and can be used for the detection of global DNA methylation in medicinal plants.

Objective To observe the BMD threshold of hip fracture in the elderly, analyze the pre-imposing factors leading to femoral neck fracture or intertrochanteric fracture, and provide some evidences for fracture prevention. Methods The BMD examination were performed on 496 fractured patients over 60 years old which were grouped after admission according to their age, gender and fracture types, and then the results were statistically analyzed. Results The BMD of fracture cases in the elderly over 60 years old was 2.5 s less than peak bone volume. There is no obvious difference in BMD between femoral neck fracture and intertrochanteric fracture among various age groups. According to our study, most hip fractures happened at the age of 60-79 years, accounting for 73%of all hip fractures. Conclusions Decreased bone mass or osteoporosis is an important factor leading to hip fracture in the elderly. The fracture types (femoral neck fracture or intertrochanteric fracture) depend mainly on the impaction force to the hip, not only on the BMD change.

? AIM: To explore the curative effect of dacryocystorhinostomy under endoscopy with mitomycin for the treatment of chronic dacryocystitis.?METHODS: Totally 73 cases ( 78 eyes ) with chronic dacryocystitis were treated with dacryocystorhinostomy under endoscopy with mitomycin and followed up for 6-12mo.?RESULTS: In the 73 patients, 66 cases with 70 eyes (90%) were cured, 2 cases with 3 eyes (4%) improved, 5 cases with 5 eyes ( 6%) not changed. In the recurrent 5 eyes, 2 eyes were treated under endoscopy to remove granulation, enlarge the opening, then anesthetic tube was placed after cotton sheet with 0. 4g/L mitomycin was put on the incision for 5min. The rest 3 eyes were treated in superior hospital with laser, and all were successful. There was no severe complication observed.?CONCLUSION:Dacryocystorhinostomy under endoscopy with mitomycin for chronic dacryocystitis is effective.

Background: Hypoalbuminemia adversely affects the clinical outcomes of various cancers. The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3–5 weeks after treatment in patients with metastatic renal cell carcinoma (mRCC) who received sorafenib or sunitinib as first-line treatment. Methods: In this single-center, retrospective study, we assessed the progression-free survival (PFS) and overall sur-vival (OS) of 184 mRCC patients who received first-line sorafenib or sunitinib treatment. PFS and OS were compared between patients with post-treatment hypoalbuminemia (post-treatment albumin level <36.4 g/L) and those with normal post-treatment albumin level (albumin level ≥36.4 g/L). The Memorial Sloan Kettering Cancer Center (MSKCC)risk model stratified mRCC patients into three risk categories. Prognostic values of all patient characteristics including MSKCC risk category were determined by using univariate and multivariate Cox regression models. Prognostic value was further determined using the Harrell concordance index and receiver operating characteristic curve analysis. Results: The median PFS and OS of the 184 patients were 11 months (95% confidence interval [CI] 9–12 months) and 23 months (95% CI 19–33 months), respectively. Patients with post-treatment hypoalbuminemia had significantly shorter median PFS (6 months [95% CI 5–7 months]) and OS (11 months [95% CI 9–15 months]) than patients who had normal post-treatment albumin levels (PFS: 12 months [95% CI 11–16 months], P < 0.001; OS: 31 months [95% CI 24–42 months], P < 0.001), respectively. Multivariate analysis showed that post-treatment hypoalbuminemia was an independent predictor of PFS (hazard ratio [HR], 2.113; 95% CI 1.390–3.212; P < 0.001) and OS (HR, 2.388; 95% CI 1.591–3.585; P < 0.001). Post-treatment hypoalbuminemia could also be combined with the MSKCC risk category for better prediction about OS. The model that included post-treatment hypoalbuminemia and MSKCC risk category improved the predictive accuracy for PFS and OS (c-index: 0.68 and 0.73, respectively) compared with the basic MSKCC risk model (c-index: 0.67 and 0.70, respectively). The prognostic values for PFS and OS of the integrated MSKCC risk model involving post-treatment hypoalbuminemia were significantly more accurate than the basic MSKCC risk model using likelihood ratio analysis (both P < 0.001). Conclusions: Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors. Additionally, integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.

Objective To investigate the impact of chronic disease self-management on motor function, activities of daily living, quality of life, and depression of patients in poststroke rehabilitation in community. Methods 120 stroke patients living in Gangdu community, Wuhan city were selected and randomly divided into self-management group (n=60) and control group (n=60). The control group experienced home rehabilitation and functional training by themselves, meanwhile they were asked to have regular outpatient referral and do the followup clinic when feeling indisposed. Self-management mode was used in the self-management group instructed by the professor and under the rehabilitation assessment by community doctors, therapist and family members. Also group separated instruction, individualized rehabilitation plan, home visit processes and patients' group activity had been organized. They were evaluated with Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI), Hamilton Depression Rating Scale (HAMD) and the World Health Organization Quality of Life (WHOQOL-100) before and 6 months after intervention. Results There were no difference in FMA upper and lower limbs scores as well as the MBI score, HAMD score and WHOQOL-100 score before intervention (P>0.05). The FMA upper and lower limbs score, MBI score and WHOQOL- 100 score significantly improved in the self-management group and were better than in the control group 6 months after intervention (P<0.05). The control group also improved in the above items, however, the differences were not statistically significant (P>0.05). HAMD score significantly reduced in the self-management group and less than in the control group 6 months after intervention (P<0.05). The control group also reduced in the above scores, however, the differences were not statistically significant (P>0.05). Conclusion Chronic disease self-management for stroke patients in community can significantly improve their motor function, activities of daily living and quality of life, and reduce depression caused by stroke.

Background: Sorafenib and sunitinib are widely used as first-line targeted therapy for metastatic renal cell carcinoma (mRCC) in China. This study aimed to compare the efficacy, safety, and quality of life (QoL) in Chinese mRCC patients treated with sorafenib and sunitinib as first-line therapy. Methods: Clinical data of patients with mRCC who received sorafenib (400 mg twice daily; 4 weeks) or sunitinib (50 mg twice daily; on a schedule of 4 weeks on treatment followed by 2 weeks off) were retrieved. Primary outcomes were overall survival (OS), progression-free survival (PFS), adverse events (AEs), and QoL (SF-36 scores), and secondary outcomes were associations of clinical characteristics with QoL. Results: Medical records of 184 patients (110 in the sorafenib group and 74 in the sunitinib group) were reviewed. PFS and OS were comparable between the sorafenib and sunitinib groups (bothP > 0.05). The occurrence rates of leukocytopenia, thrombocytopenia, and hypothyroidism were higher in the sunitinib group (36.5％ vs. 10.9％, P < 0.001; 40.5％ vs. 10.9％,P < 0.001; 17.6％ vs. 3.6％,P= 0.001), and that of diarrhea was higher in the sorafenib group (62.7％ vs. 35.2％,P < 0.001). There was no significant difference in SF-36 scores between the two groups. Multivariate analysis indicated that role-physical and bodily pain scores were associated with the occurrence rate of grade 3 or 4 AEs (P= 0.017 and 0.005). Conclusions: Sorafenib has comparable efficacy and lower toxicity profile than sunitinib as first-line therapy for mRCC. Both agents showed no significant impact on QoL of patients.

Objective To explore the effectiveness and safety of limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD)for patients with large common duct stones and periampul-lary diverticula (PAD).Methods Data of 40 patients with large common duct stones (diameter ≥10 mm) and PAD who underwent ESBD were retrospectively reviewed.The clinical feature,operation method,suc-cess rates of stone removal and early complications rates during hospitalization were evaluated according to PAD subtypes.Results The stone removal rate in first session was 90.0%(36 /40,with a median time of 29 minutes per procedure.Three patients underwent a second procedure to remove residual stones.The over-all stone removal rate was 97.5% (39 /40).The early complications rate was 15%(6 /40),including mild pancreatitis in two cases(5%),hyperamylasemia in two (5%),postoperative late bleeding in two (5%), which were cured with conservative treatment.No perforation,massive hemorrhage or death occurred.No significant differences in success stone removal rate and early complication rate were found between PAD sub-types.Conclusion ESBD is an effective and safe procedure for removing choledocholithiasis in patients with PAD,regardless of PAD subtypes.

Anxiety disorder is one of the most common mental disorders and seriously impairs the physical and mental health of patients. Due to the efficacy of acupuncture for tranquilization, acupuncture displays its unique advantage on the treatment of anxiety disorder, but the relevant biological mechanism has not been elaborated. The modern medicine study has proved that the heart and brain have their own independent natriuretic peptide (NP) system. The dysfunction of ANP and its receptor are closely related to the occurrence of anxiety disorder. The ANP acts on anti-anxiety. Hence, focusing on the three aspects, named the anti-anxiety effect of acupuncture based on its tranquilizing effect, the anti-anxiety effect of ANP and the positive regulation of acupuncture on NP, the mechanism on ANP and its receptor was explored in anti-anxiety with acupuncture based on tranquilizing effect, and the idea was put forward on that the anti-anxiety effect of acupuncture was possibly based on its action of tranquilization through regulating the ANP and its receptor. As a result, it is expected to provide the theoretic support for the mechanism study on anti-anxiety with acupuncture based on its tranquilizing effect.
Acupuncture Therapy ; Animals ; Anti-Anxiety Agents ; metabolism ; Anxiety ; metabolism ; therapy ; Atrial Natriuretic Factor ; metabolism ; Humans ; Receptors, Atrial Natriuretic Factor ; metabolism

Objective To investigate the approach and safety of minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi. Methods Clinical data of 21 cases with symptomatic caliceal diverticular calculi were retrospectively reviewed. Twelve females and 9 males aged 22 to 57 years old. The average diameter of caliceal diverticulum was 3.7 cm (2.5-7.0 cm) and average diameter of calculi was 2.3 cm (0.8-3.5 cm). The patients underwent flexible ureteroscopic lithotripsy, PCNL or mPCNL, laparoscopic techniques and laparoscopy-assisted transperitoneal PCNL, respectively. Four cases underwent flexible ureteroscopic lithotripsy. PCNL (2 cases) or mPCNL(5 cases)were performed in 7 cases. Nine cases underwent laparoscopic techniques. Laparoscopyassisted transperitoneal PCNL was performed in 1 case. Results The operations were performed successfully in 21 cases. No case need to transfer to open surgery during the operation and no major complications like perforation or organic injury were noted. One case with iatrogenic arteriovenous fistula of the kidney after 1 week postoperative was cured by delayed hemorrhage 2 days later, while clinical symptoms of 2 cases with residue calculi relieved. 19 cases without residue calculi were followed up for 6 to 12 month without recurrence. Conclusions After handling indication of treatment efficiently and creating advisable therapeutic decision-making, minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi appears to be effective and safe.