Child ; Female ; Humans ; Sarcoma, Myeloid ; Spine ; pathology

Objective This study is aimed to assess the accuracy of clinical measurement of remission and investigate the association between clinical remission and the ultrasound imaging assessment of synovitis and infla'mation and to explore the value of ultrasound imaging in the evaluation of disease activity in the tight control of rheumatoid arthritis (RA).Methods RA patients with a disease activity score in 28 joints (DAS28-ESR) ≤2.6 for at least 3 months were stratified-using a standard and more stringent DAS28 and simplified disease activity index (SDAI) remission thresholds and the corresponding clinical and ultrasound imaging measures of synovitis were recorded.In addition,a retrospective analysis of disease activity in patients was carried out.Mann-Whitney U test,x2 test and multi-factor analysis of variance of repeated measurements were used for statistical analysis.Results A total of 48 cases were recruited.Thirty-seven cases (77％) met the ACR remission criteria,29 cases (60％) fulfilled the SDAI remission criteria,and 32 (67％) cases reached 2010 ACR/EULAR Boolean-based definition of remission criteria.There was no significant differences on imaging disease activity between SDAI remission patients and those who were not in remission (GS score,P=0.38; PD score,P=0.32).Seventy-nine percent patients in SDAI remission had GS and/or PD activity,but the difference was not statistically different when compared with patients who did not reach SDAI remission (P=0.29).Sustainable remission obtained in patients who also had achieved image remission could have longer remission time (P＜0.01) Conclusion Using more stringent clinical remission criteria could help in reducing residual inflammatory activity of,but ultrasound PD activities may not be significantly reduced.Integrated clinical indicators such as physical examination and imaging tools such as ultrasound can provide more accurate assessment of disease activity and could be used to guide treatment to achieve trueremission.

The visual acuity testa were performed in 8219 children(16 438 eyes)under 5 years of age with sound and light toys,electric torch and a retinoscope.The general ocular examination and mydriatic optometry were also performed for the ametropia.In 8219 children 61 were found to have dominant strabismus,including 59 cases of concomitant strabismus and 2 paralytic strabismus.AbnormaJ refraction was detected in 404 children(739 eye)accounting for 4.92%,including 68 cases of anisometropia (0.83%).In 16 438 eyes 621(3.78%)were moderate or hyper-presbyopia;53(0.32%)were myopia;65 (0.40%)were mixed astigmatism.The vision acuity test described above is a simple and convenient method suitable for children under 5 who are not able to read the conventional test chart.

OBJECTIVETo investigate the correlation between the pathogeneses of diarrhea-pre- dominant irritable bowel syndrome (D-IBS) complicated functional dyspepsia (FD) patients of Gan-stagnation Pi-deficiency Syndrome (GSPDS) and symptoms, psychological states, and gastrointestinal hormones.

METHODSA total of 111 patients with confirmed D-IBS complicated FD of GSPDS were recruited as the treated group by using Rome III standard and Chinese medical syndrome standard. And 30 healthy volunteers were recruited as the control group. The general condition, scoring for digestive symptoms, and the distribution of GSPDS subtype of all subjects were recorded by a questionnaire, and assessed by Symptom Checklist (SCL-90; a software for psychological test developed by Beijing Huicheng Adult Cor- poration). Meanwhile, plasma levels of 5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), endothelin (ET), interleukin 10 (IL-10), and interleukin 12 (IL-12) were measured in all subjects.

RESULTS(1) The subtype of D-IBS complicated FD of GSPDS was dominant in Pi-qi deficiency type (51/111,45.9%),Pi yang deficiency type (34/111,30.6%), and GSPDS. There was no statistical difference in the scoring of digestive symptoms among the 3 subtypes (P >0.05). (2) Compared with the control group, the anxiety factor score and the total score significantly increased in all three subtypes of D-IBS complicated FD of GSPDS, and the depression score of Pi yang deficiency type and Gan-depression type also significantly increased (P <0.05, P <0.01); the depression score of Gan-depression type was significantly higher than that of the Pi-qi deficiency type (P <0.01). Plasma 5-HT levels were obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities, and VIP and IL-10 levels were significantly lower than those in the control group (P <0.05). Plasma VIP levels were also obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities (P <0.01), and SS levels were significantly lower than those in the control group (P <0.05). There was no statistical difference in plasma ET or IL-12 levels in each patient group, when compared with the control group (P >0.05). (3) Compared with the.control group, plasma 5-HT levels significantly increased, plasma VIP and IL-10 levels significantly decreased in ach subtype of D-IBS complicated FD patients of GSPDS (P <0.05, P <0.01), and no significant change of SS, ET, or IL-12 occurred (P >0.05). Besides, plasma 5-HT levels were significantly higher in Gan-depression type than in Pi yang deficiency type, VIP levels were lower in Gan-depression type than in Pi-qi deficiency type (all P <0.05).

CONCLUSIONSGan stagnation and Pi deficiency were dominant in D-IBS complicated FD patients of GSPDS. Psychological abnormalities, increased plasma 5-HT levels, and decreased plasma VIP levels were closely correlated with Gan stagnation subtype, which provided some reference for looking for objective indicators of Chinese medical syndromes in treating D-IBS complicated FD patients of GSPDS.

Adult ; Case-Control Studies ; Diarrhea ; etiology ; Dyspepsia ; blood ; complications ; psychology ; Gastrointestinal Hormones ; blood ; Humans ; Irritable Bowel Syndrome ; blood ; complications ; psychology ; Psychological Tests ; Qi ; Serotonin ; Surveys and Questionnaires ; Yang Deficiency

Objective To investigate the clinical efficacy of the laparoscopic Roux-en-Y gastric bypass (LRYGB) and metformin in the treatment of obese patients with type 2 diabetes mellitus,and influencing factors of remission rate of diabetes.Methods The case-control study was conducted.The clinical data of 172 obese patients with type 2 diabetes mellitus who were admitted to the First People's Hospital of Shangqiu (43 patients) and the First Affiliated Hospital of Sun Yat-sen University (129 patients) from June 2010 to June 2015 were collected.Of 172 patients,82 undergoing LRYGB were allocated into the group A and 90 taking oral metformin were allocated into the group B.Observation indicators:(1) follow-up situations;(2) comparison of metabolic indices after treatment between the 2 groups;(3) influencing factors analysis of remission rate of diabetes in patients undergoing LRYGB;(4) influencing factors analysis of remission rate of diabetes in patients taking oral metformin.Follow-up using outpatient examination and telephone interview was performed to detect occurrence of treatment-related complications up to January 2017,and metabolic indices were measured regularly.Measurement data with normal distribution were represented as ±s and comparison between groups was analyzed using the independent-sample t test.Repeated measurement data were analyzed by the repeated measures ANOVA.Comparisons of count data were evaluated by the chi-square test.The univariate analysis and multivariate analysis were respectively done using the chi-square test and Logistic regression model.Results (1) Follow-up situations:172 patients were followed up after treatment for 19-43 months,with a median time of 28 months.During the follow-up,5 patients complicated with mild diarrhea and 1 complicated with iron deficiency anemia at 1 year postoperatively were improved by symptomatic treatment in the group A,and there was no treatment-related complications in the group B.(2) Comparison of metabolic indices after treatment between 2 groups:body mass,BMI,2-hour postprandial blood glucose (2HPBG),2-hour postprandial serum C-peptide,glycosylated hemoglobin (GHb),fasting insulin,2-hour postprandial insulin (2HPI),low-density lipoprotein (LDL) and cases with hypertension in the group A were (89±6) kg,(31.5±2.0) kg/m2,(19.4±3.9) mmol/L,(3.52± 0.32) μg/L,15.7％ ±5.3％,(8.0± 1.4) uIU/L,(20.6± 2.5) uIU/L,(3.7 ± 1.3) mmol/L,24 before LRYGB and(77±16)kg,(24.2±2.9)kg/m2,(10.6±2.6) mmol/L,(7.19± 2.23) μg/L,5.3％±4.5％,(9.2± 4.3)uIU/L,(28.3±2.9)uIU/L,(2.2±2.1)mmol/L,9 after LRYGB,respectively,with statistically significant differences between preoperative and postoperative indicators (F=2.112,3.026,1.253,2.107,1.257,3.473,1.223,2.584,x2 =8.540,P ＜ 0.05).Fasting blood glucose,2HPBG,fasting serum C-peptide,2-hour postprandial serum C-peptide,GHb,fasting insulin and 2HPI in the group B were (11.3±2.5)mmol/L,(18.5± 4.4) mmol/L,(1.54±0.33) μg/L,(3.57±0.91) μg/L,17.5％ ±8.0％,(8.2± 1.3) uIU/L,(21.2±2.6) uIU/L before taking oral metformin and (6.6 ± 1.1) mmol/L,(10.2 ± 2.8) mmol/L,(3.52 ± 1.34) μg/L,(7.68 ± 1.94) μg/L,5.4％ ±2.1％,(9.6± 3.9) uIU/L,(30.3± 3.1) uIU/L after taking oral metformin,respectively,with statistically significant differences between before and after taking oral metformin (F=1.245,3.224,3.127,2.064,3.672,2.074,1.137,P＜0.05).Remission rate of diabetes and excess weight loss (EWL) in patients after treatment were 14.6％,80％ ± 15％ in the group A and 11.1％,60％ ± 10％ in the group B,respectively.There were statistically significant differences in body mass,BMI and EWL after treatment between the 2 groups (t=1.973,2.326,2.347,P＜0.05),and no statistically significant difference in remission rate of diabetes between the 2 groups (x2 =0.477,P＞0.05).(3) Influencing factors analysis of remission rate of diabetes in patients undergoing LRYGB:the results of univariate analysis showed that BMI,diabetes duration and LDL were factors affecting remission rate of diabetes in patients undergoing LRYGB,with statistically significant differences (x2=11.267,9.519,5.567,P＜0.05).The results of multivariate analysis showed that diabetes duration ＜ 10 years was an independent factor affecting good remission rate of diabetes in patients undergoing LRYGB,with statistically significant differences [OR=2.202,95％ confidence interval (CI):1.418-3.420,P＜0.05].(4) Influencing factors analysis of remission rate of diabetes in patients taking oral metformin:the results of univariate analysis showed that diabetes duration,GHb and LDL were factors affecting remission rate of diabetes in patients taking oral metformin,with statistically significant differences (x2 =6.306,7.758,4.652,P＜0.05).The results of multivariate analysis showed that GHb ＜ 15.0％ was an independent factor affecting good remission rate of diabetes in patients taking oral metformin,with statistically significant differences (OR=3.167,95％CI:1.586-6.325,P＜0.05).Conclusions LRYGB and oral metformin in the treatment of obese patients with type 2 diabetes mellitus are safe and effective,showing an equivalent remission rate of diabetes,and LRYGB had an advantage of weight loss.Diabetes duration ＜ 10 years and GHb ＜ 15.0％ are respectively independent factors affecting good remission rate of diabetes in patients undergoing LRYGB and taking oral metformin.

Background and purpose:Advanced and metastatic colorectal cancer is the second leading cause of cancer death. In the past ,the standard treatment for patients with advanced CRC was fluorouracil(5-FU) biochemically modulated by leucovorin(LV), which demonstrated a response rate of about 23% .In 1990s, a number of new treatment options have been available. In particular, one new cytotoxic agent ,irinotecan (CPT-11), which is a specific inhibitor of topoisomerase I, have been proven to have efficacy in the tretment of CRC .Furthermore, several first-line phase Ⅲ trials show a significant improvement in result with the addition of CPT-11 to FU-LV combination therapy (FOLFIRI).We observed the survival situation, efficacy and safety of irinotecan plus 5-FU/LV after first-line chemotherapy failure for Chinese patients with advanced or/and metastatic colorectal cancer. Methods:Twenty-four patients with metastatic colorectal cancer whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics were included to receive biweekly FOLFIRI regimen (irinotecan 180mg/m~ 2 on day 1,with LV 200mg/m~ 2 adiministrated as a 2-hour infusion before 5-FU 400mg/m~ 2 administrated as an intravenous bolus injection and FU⒉4g/m~ 2 as 46-hour infusion immediately after 5-FU bolus ).All the patients were planned to receive at least 6 cycles of chemotherapy .They were assessed on the basis of WHO evaluation standard of objective therapeutic effect for solid tumor.Results:24 patients were assessable to observe the efficacy and safety. No case was CR.5 case were PR, response rate was 20% (5/24). 17 case were SD , rate was 70% (17/24). 2 case were PD, rate was 8%(2/24). Median time to progression (TTP) were 6.6 months (6 to 24 months ),median overall survival was 10.7 months. The majority of adverse reaction were nausea, vomiting, anorexia, diarrhea, leucopenia, alopecie. Most of them were Ⅰ/Ⅱ degree, only 6 cases reached III/IV degree. 3 cases had diarrhea with leucopenia and fever.Conclusions:The biweekly regimen of irinotcan in combination with 5-FU/LV results in significant and clinically meaningful improvement in survival and quality of life among patients with metastatic colorectal cancer. Toxicity is manageable.

Objective: To observe the clinical efficacy of combining two needling manipulations, Er Long Xi Zhu (two dragons playing with a pearl) and Guo Yan Re (heat produced to reach the eyes), in treating dry eye syndrome (DES) of lung-yin deficiency pattern. Methods: Fifty-six eligible DES patients of lung-yin deficiency were randomized into an observation group and a control group, with 28 cases in each group. Same acupoints were selected in the two groups: Cuanzhu (BL 2), Sizhukong (TE 23), Taiyang (EX-HN 5) and Fengchi (GB 20) were chosen as the major points and Feishu (BL 13) and Chize (LU 5) as the adjuvant. Er Long Xi Zhu and Guo Yan Re needling manipulations were applied in the observation group while twirling reinforcing manipulation was used in the control group. Treatment was conducted once per day in both groups, for two sets of 15 consecutive days at a 2-day interval. Changes in the symptom score, tear break-up time (BUT) and tear production were observed afterwards, and the clinical efficacy was also compared between the two groups. Results: The total effective rate was 92.8％ in the observation group, higher than 71.4％ in the control group, and the between-group difference was statistically significant (P<0.05). After treatment, the symptom score, tear BUT and tear production showed significant improvements in both groups (all P<0.05); the symptom score, BUT and tear production in the observation group were significantly different from those in the control group (all P<0.05). Conclusion: Given the same acupoint selection, combining Er Long Xi Zhu and Guo Yan Re needling manipulations can produce more significant clinical efficacy than twirling reinforcing manipulation in treating DES of lung-yin deficiency pattern.

Objective To optimize the particle size of Huoxue powder by contents comparison of emodin,phellodendrine,berberine and jatrorrhizine before and after permeabilized skin absorption of Huoxue powder in different particle size of 0.150,0.075,0.048,0.038 mm.Methods The contents of emodin,phellodendrine,berberine and jatrorrhizine in transparent absorbent fluid of Huoxue power in different particle size within 24 hours were measured by ultra performance liquid chromatography tandem mass spectrometry,and optimize its particle size by contents comparison of the effective components.Results The contents of the active components in Huoxue power with the particle size of 0.075 mm were high before and after percutaneous absorption.Conclusion Particle size of 0.075 mm is best for Huoxue powder.

The teaching methods were explored to improve the quality of medical genetic teaching for foreign students according to the common problems during the teaching process. The negative effects of communication barriers in medical genetic teaching could be reduced by interactive teaching or problem-based learning in groups,in which the ability to resolve problems by themselves could be improved. In order to improve the teaching systematicness and teaching quality,the teaching contents in class should be from simple to deep,covering genetic laws,pathogenesis,diagnosis and control measure of genetic diseases. From the perspective of practical application and combining with the construction of self-de-signed teaching textbook and cases, the quality of medical genetic teaching ultimately could be further improved.

Objective To investigate the effect of early warning face pattern of weight combined with health education in weight management of maintenance hemodialysis patients.Methods Toally 223 maintenance hemodialysis patients hospitalized in the hospital from July to December 2014 (17,617 cases of hemodialysis) were set as the control group and 223 maintenance hemodialysis patients from January to June 2015 (17,281 cases of hemodialysis) were set as the experiment group.The control group was given routine health education and the experiment group was given health education and early warning face pattern of weight.The two groups were compared in terms of the ratio between interdialytic weight gain (IDWG) and interdialytic dry weight ratio (IWGR) as well as the hemodialysis-related complications.Results The IDWG/IWGR ratio in the experiment group was significantly better than that of the control group (P＜0.05).The incidence of hemodialysis-related complications were significantly lower than that of control group.Conclusion Early warning face pattern of weight used in health education can effectively control the patient's interdialytic weight gain (IDWG) and reduce the hemodialysis-related complications.