Objective To study the treatment effects of capecitabine and docetaxel on anthracyclines resistant breast cancer,so as to provide the evidence for the effective treatment of the disease.Methods 1 00 patients with anthracyclines resistant breast cancer were treated in our hospital from January 201 3 to January 201 5,and they were considered as research subjects in this study.The clinical data were analyzed retrospectively.Capecitabine and docetaxel were used for treatment in the treatment group (n =51 ),and there were 49 cases treated with docetaxel in the control group.The indexes were observed including KPS score,the rate of survive to 1 year,TTP and MST.The treatment effects and safety were also compared in these two groups.Results (1 )Before treatment,KPS scores in the treatment group and the control group were (83.6 ±1 .6)points and (83.4 ±1 .7)points respectively,and the difference was not statistically significant (t =0.606,P >0.05).After treatment,the KPS scores were (89.5 ±1 .2)points and (86.4 ±1 .6)points,which of the treatment group was significantly higher than the control group (t =1 0.989,P <0.05).(2)After treatment,1 year survival rate,TTP and MST in the treatment group were significantly higher than those in the control group[1 years survival rate:62.74% vs.40.82%,χ2 =4.815,P <0.05;TTP:(8.5 ±1 .1 )months vs.(6.3 ±1 .2)months,t =9.563,P <0.05;MST:(1 5.6 ±1 .2)months vs.(1 5.6 ±1 .2)months,t =1 0.871 ,P <0.05].(3)The treatment efficiency and the clinical benefit rate in the treatment group were significantly higher than those in the control group (the treatment efficiency:90.1 9% vs.63.27%,χ2 =1 0.234,P <0.05;clinical benefit rate:94.1 2% vs.73.47%,χ2 =6.466,P <0.05).(4)However,there was no difference about the ratio of adverse reaction between the two groups (bone marrow suppression:1 3.73% vs.1 2.24%,χ2 =0.048,P >0.05;nausea and vomiting:1 1 .76% vs.1 4.29%,χ2 =0.1 04,P >0.05;constipation:1 9.61 % vs.1 8.37%,χ2 =0.025,P >0.05;alopecia:21 .57% vs.20.41 %,χ2 =0.020,P >0.05;indigestion:25.49% vs.22.45%,χ2 =0.1 27,P >0.05;joint pain:1 5.67% vs.20.41 %,χ2 =0.378,P >0.05 ).Conclusion Capecitabine and docetaxel are used in the treatment of anthracyclines resistant breast cancer,and it can delay the patients'condition and improve the survival time.Besides,it is also safe and effective.Therefore,this method is worth to promote and use in clinic.

Some traditional Chinese medicine technologies,with strong safety, quick and significant effect, standerdized manipulation, simple operation and good prospect for promotion and application are selected in the research project for application and demonstration of rural health appropriate technology. Through the application of the project, we have new experience in medical teaching.

Objective To explore the effect of atorvastatin on postoperative complications after the burr hole drainage of chronic subdural hematoma (CSDH). Methods The clinical data of 172 CSDH patients who had underwent the burr hole drainage were retrospectively analyzed. Among them 82 patients were given atorvastatin (atorvastatin group), and 90 patients were not given atorvastatin (control group). The postoperative complications were compared between 2 groups. Results All patients were followed up for 6 months. The total incidence of postoperative complications in control group was significantly higher than that in atorvastatin group:47.78%(43/90) vs. 31.71%(26/82), and the recurrent rate of subdural hematoma and incidence of subdural effusion in control group were significantly higher than those in atorvastatin group: 22.22% (20/90) vs. 8.54% (7/82) and 28.89% (26/90) vs. 12.20%(10/82). There were statistical differences (P<0.05). There were no statistical difference in the incidences of pneumocephalus, acute epidural/subdural hematoma and brain damage induced by drainage tube (P>0.05). Conclusions Atorvastatin can improve the prognosis of CSDH patients, especially in reducing the incidence of recurrent subdural hematoms and subdural effusion.

There is a fact that there is TCM education in some western medical universities.Starting from the problems existing in medical universities,the author in this article thinks TCM education should bring into full play its superiority and put emphasis on training talented persons with knowledge of TCM and western medicine and talented persons with ability to communicate with foreigners in TCM,and so on.It's the developing trend for TCM education development in some western medical universities and it's also the problem needing to be highly thought of in the reform of TCM education in western medical universities.

OBJECTIVE: To investigate the diagnosis applying effects of ocular vestibular evoked myogenic potentials(oVEMP) in peripheral BPPV disease. METHOD: During September 2012 to January 2015, we selected 80 healthy people in our hospital medical center as the control group, choose the same period of primary benign paroxysmal positional vertigo as the observation group of 80 patients. Two groups were carried out fully functional auditory evoked potential analysis, determination of oVEMP and cervical vestibular evoked myogenic potentials (cVEMP) anomaly amplitude threshold, P1 latencies, N1 incubation period. RESULT: The cVEMP abnormal rate in the observation group was 28.8%, the oVEMP abnormal rate was 38.8%, while cVEMP and oVEMP abnormal rates in the control group was 1.3% and 2.5% respectively that compared to significant differences between the two groups (P < 0.05). The oVEMP test amplitude in the observation group was (5.98 ± 2.15) µv, the N1 incubation period was (10.03 ± 0.76)ms, while the control group were (4.09 ± 2.11)µv and (11.67 ± 0.78) ms that compared difference were statistically significant (P < 0.05). The cVEMP test amplitude in the observation group was (154.8 ± 43.9)2 µv, while the control group was (180.49 ± 45.34)µv, compared the difference was statistically significant (P < 0.05). CONCLUSION Paroxysmal positional vertigo patients ocular vestibular evoked myogenic potentials abnormal rate is relatively high, the utricle dysfunction for more severe than the balloon can be the subject of an objective function of the ear stone judgment, judgment in favor of the disease.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Case-Control Studies ; Humans ; Saccule and Utricle ; physiopathology ; Vestibular Evoked Myogenic Potentials

Objective To study the expression and clinical significance of autoantibodies in serum and cer-vical mucus in female patients with infertility .Methods 100 cases of infertility patients (study group) ,100 ca-ses of patients (cases control group) with cervical inflammation and 100 (healthy control group) cases women without spontaneous abortion were recruited as subjects from February 2014 to February 2017 .Serum and cer-vical mucus autoantibodies and peripheral regulatory T cells (Treg) levels were detected in all subjects ,then analyzed the correlation between them .Results The study group patients′ serum and cervical mucus an-tisperm antibody ,ovarian antibody resistance ,resistance to human chorionic gonadotropin ,endometrial anti-body and thyroid autoantibodies and anti-β-2 glycoprotein 1 antibody levels were significantly higher than that of case control group and healthy control group ,the difference was statistically significant (P＜0 .05) .Treg in patients with peripheral blood levels of study group was (3 .28 ± 0 .39)%,which were significantly lower than the case control group(8 .92 ± 1 .20)% and healthy control group(9 .10 ± 1 .32)%,the difference was statisti-cally significant (P＜0 .05) .The Pearson correlation analysis available :infertility patients′serum and cervical mucus antisperm antibody ,ovarian antibody resistance ,resistance to human chorionic gonadotropin ,endome-trial antibody and thyroid autoantibodies and anti-β-2 glycoprotein 1 antibody levels were in negative correla-tion with the level of peripheral blood Treg (P＜0 .05) .Conclusion The serum of sterility patients and cervi-cal mucus of the autoantibody levels are closely related to T reg level ,and can be used as an index of clinical di-agnosis and treatment of infertility .

Objective: The purpose of this study is to investigate the safety, tolerability and efficacy of titrating dose of rivastigmine oral solution in patients with mild to moderate Alzheimer’s disease (AD) in Taiwan. Methods: We recruited 108 mild to moderate AD patients with RivastⓇ (rivastigmine oral solution 2 mg/ml) treatment for 52 weeks. We recorded the demographic characteristics, initial cognition by mini-mental state examination (MMSE), initial global status by clinical dementia rating (CDR) with CDR-Sum of Boxes (CDR-SB), initial dose, and titrating dose at each visit. We investigated the adherence, proportion of possible side effects, optimal dose, and time to optimal dose. We demonstrated the proportion of cognitive decline and its possible risk factors. Results: During the course, 9 patients discontinued the rivastigmine oral solution due to poor compliance or preference. Twelve out of 99 patients (12.1%) reported possible side effects. Among 87 patients, the mean age was 77.2 ± 9.0 years ago with female predominant (65.2%). The optimal dose was 3.6 ± 1.4 ml in average and 4 ml (n = 31, 35.6%) in mode. The duration to optimal dose was 12.5 ± 10.2 weeks and 24 weeks (n = 35, 40.2%) in mode. It presented 25% with cognitive decline in MMSE, 27% with global function decline in CDR and 63% with global function decline in CDR-SB. Conclusion We demonstrated the clinical experience of rivastigmine oral solution in mild to moderate AD patients. It suggested rivastigmine oral solution 4ml is the optimal dose with 24 weeks to the optimal dose for at least one third of patients.

Objective: The purpose of this study is to investigate the safety, tolerability and efficacy of titrating dose of rivastigmine oral solution in patients with mild to moderate Alzheimer’s disease (AD) in Taiwan. Methods: We recruited 108 mild to moderate AD patients with RivastⓇ (rivastigmine oral solution 2 mg/ml) treatment for 52 weeks. We recorded the demographic characteristics, initial cognition by mini-mental state examination (MMSE), initial global status by clinical dementia rating (CDR) with CDR-Sum of Boxes (CDR-SB), initial dose, and titrating dose at each visit. We investigated the adherence, proportion of possible side effects, optimal dose, and time to optimal dose. We demonstrated the proportion of cognitive decline and its possible risk factors. Results: During the course, 9 patients discontinued the rivastigmine oral solution due to poor compliance or preference. Twelve out of 99 patients (12.1%) reported possible side effects. Among 87 patients, the mean age was 77.2 ± 9.0 years ago with female predominant (65.2%). The optimal dose was 3.6 ± 1.4 ml in average and 4 ml (n = 31, 35.6%) in mode. The duration to optimal dose was 12.5 ± 10.2 weeks and 24 weeks (n = 35, 40.2%) in mode. It presented 25% with cognitive decline in MMSE, 27% with global function decline in CDR and 63% with global function decline in CDR-SB. Conclusion We demonstrated the clinical experience of rivastigmine oral solution in mild to moderate AD patients. It suggested rivastigmine oral solution 4ml is the optimal dose with 24 weeks to the optimal dose for at least one third of patients.

Objective:To evaluate the efficacy of oral pyrotinib in treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer in the real world, and to explore its influencing factors.Methods:The clinical data of 148 patients with HER2-positive metastatic breast cancer treated with oral pyrrolitinib in Shanxi Cancer Hospital from September 2018 to December 2020 were retrospectively analyzed. The efficacy was evaluated according to the efficacy evaluation criteria for solid tumors, version 1.1, and the adverse effects were graded according to the National Cancer Institute common terminology criteria of adverse effects, version 4.0. The Kaplan-Meier method was used to draw progression-free survival (PFS) curves, the patients were stratified by different clinical characteristics, and log-rank test was used for univariate analysis of PFS; the multivariate analysis of PFS was performed using Cox proportional hazards model.Results:The objective response rate (ORR) of 148 patients was 71.6% (106/148), and the disease control rate (DCR) was 89.2% (132/148). The overall median PFS time was 11.0 months (95% CI 10.1-11.9 months), and the median PFS of 19 patients with brain metastases was 10.0 months (95% CI 7.4-12.6 months). The differences in PFS between patients stratified by disease-free interval (DFI), the number of metastatic site and Eastern Cooperative Oncology Group (ECOG) score were statistically significant (all P < 0.05), but the difference in PFS between patients with negative and positive hormone receptor was not statistically significant ( P > 0.05). Multivariate Cox regression analysis showed that DFI (>1 year vs. ≤1 year: HR = 5.254, 95% CI 0.728-37.933, P = 0.046) and ECOG score (≥2 points vs. 0-1 point: HR = 2.454, 95% CI 1.261-4.788, P = 0.008) were independent influencing factors of PFS. The most common ≥grade 3 adverse effects were diarrhea (31 cases, 20.9%) and hand-foot syndrome (38 cases, 25.8%). Conclusions:The pyrotinib has definite efficacy and good safety in the treatment of HER2-positive metastatic breast cancer in the real world, especially for patients with DFI > 1 year and ECOG score 0-1 point, the efficacy and safety are particularly good.

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.