Objective: To investigate the clinical value and significance of B ultrasonography guiding percutaneous gallbladder catheterized drainage (PGCD)in elder patients with acute chole-cystitis. Methods: The clinical data of 34 elder patients with acute cholecystitis in our hospital who were treated with PGCD were analysed retrospectively, and comparing with those clinical data of 22 elder patients with acute cholecystitis in our hospital during the same period who were treated with traditional gallbladder removal operation, and these data were evaluated with statistical analysis. Results: The incidence rate of postoperative complications and death rate in the group of elder patients with acute cholecystitis who were treated with PGCD were 0, the average stay was 18.2 days. The incidence rate of postoperative complications in the group of elder patients with acute cholecystitis who were treated with traditional gallbladder removal operation was 40.9% , the death rate of this group was 13.6% , and the average stay was 23.7 days. Statistical analysis confirmed that the difference of incidence rate of postoperative complications, death rate and average stay between these two treatments have statistical significance. Conclusion: Ultrasonography guiding PGCD is a safe, effective and easily operating method for the first treatment plan treatment of elder patients with acute cholecystitis.

Objective:To explore the correlation between lymph node metastasis rate and prognosis in non-small cell lung cancer (NSCLC) patients with stage Ⅲ A/N 2. Methods:The clinical data of 350 NSCLC patients with stage Ⅲ A/N 2 receiving surgical treatment from January 2012 to June 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. The patients were divided into the high lymph node metastasis rate group and the low lymph node metastasis rate group according to the optimal cutoff value of lymph node metastasis rate determined by Cox hazard regression model. The relationship between clinicopathological features and lymph node metastasis rate was analyzed. Prognostic risk factors were analyzed by using Cox regression model, and overall survival (OS) and disease-free survival (DFS) of both groups were analyzed by using Kaplan-Meier method. Results:The optimal cutoff value of lymph node metastasis rate was 0.2. There were 180 cases with high lymph node metastasis rate (>0.2) and 170 cases with low lymph node metastasis rate (≤0.2). The proportion of the patients with adenocarcinoma and the highest lymph node metastasis in the high lymph node metastasis rate group was higher than that in the low lymph node metastasis rate group [72.2% (130/180) vs. 52.9% (90/170), 52.8% (95/180) vs. 29.4% (50/170), all P<0.05]. The proportion of patients with jumping N 2 lymph node metastasis, single station N 2 lymph node metastasis and single station N 2 lymph node metastasis in the highest group was lower than that in the low lymph node metastasis rate group [51.1% (92/180) vs. 71.8% (122/170), 25.0% (45/180) vs. 44.1% (75/170), 38.9% (70/180) vs. 75.3% (128/175), all P<0.05]. Cox multi-factor regression model analysis showed that adenocarcinoma, multiple stations N 2 lymph node metastasis, lymph node metastasis rate were independent risk factors of DFS for NSCLC patients with stage Ⅲ A/N 2 ( HR = 2.201, 95% CI 1.444-3.355; HR=2.971,95% CI 1.950-4.529; HR=3.543, 95% CI 1.874-6.699; all P<0.05). Lymph node metastasis rate was an independent risk factor of OS for NSCLC patients with stage Ⅲ A/N 2 ( HR = 3.669, 95% CI 1.941-6.938, P<0.05). The 5-year OS rate of the low lymph node metastasis rate group was higher than that of the high lymph node metastasis rate group (64.00% vs. 36.58%, χ2 = 11.422, P = 0.001). The 5-year DFS rate in the low lymph node metastasis rate group was higher than that in the high lymph node metastasis rate group (45.00% vs.18.32%, χ2 = 13.624, P<0.01). Conclusion:Lymph node metastasis rate is an independent influencing factor for the prognosis of NSCLC patients with Ⅲ A/N 2 stage, and it can effectively evaluate the prognosis.

Objective To investigate the frequencies of variant of lipoprotein lipase(LPL)gene,HindIII site at intron 8 and PvuII site at intron 6,and its relation with type 2 diabetes mellitus and insulin resistance(IR).Methods PCR-RFLP method was used to determine the DNA polymorphism of 8 th intron and 6 th intron of LPL gene in 78 T2DM patients and 49 controls.Results(1)Compared with control group,the frequencies of H+H+ genotypes and alleles ″H+″ was significantly higher in type 2 diabetes patients(P

Objective]Help students to construct the system of TCM clinical thinking and to cultivate the ability of differential diagnosis and prescription. [Methods]In the late clinical teaching, make junior doctor with a high grade of students, graduate students, or some clinical experience as a research object, designing as a medical record has gradually evolved into a number of different medical records dynamic group, let students practice the tentacles medical records. [Results]Gradually,students learned to distinguish the different parties in the different clinical symptoms, and enhance the understanding of drugs and prescriptions. [Conclusion] The tentacles medical records practicing can cultivate the students' ability of dialectical thinking integration.

OBJECTIVE:To observe the efficacy and safety of Shexiang zhenggu tincture combined with Huoxue zhitong pow-der in the treatment of acute traumatic swelling and pain. METHODS:Totally 160 patients with acute traumatic swelling and pain were randomly divided into group A and group B. Patients in group A were given Shexiangzhenggu tincture for external use,3 times a day;patients in group B were orally added one bag of Huoxue zhitong powder,3 times a day,based on the treatment of control group. 7 d was course and it lasted 2 courses. The clinical efficacy,the scores of visual analogue pain score (VAS) and swelling remission before and after 7 and 14 d treatment and the incidence of ADR were observed. RESULTS:After 7 d treatment, the total effective rate in group A was significantly higher than group B,with significant difference(P<0.05);after 14 d treat-ment,there was no significant difference in the total effective rate between 2 groups (P>0.05). After 7 and 14 d,the scores of VAS and swelling remission were significantly lower than before;14 d treatment was lower than 7 d treatment,and group B was significantly lower than group A after 7 d treatment,with significant differences (P<0.05);there were no significant differences among the scores of VAS and swelling remission in 2 groups after 14 d treatment (P>0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Shexiang zhenggu tincture combined with Huoxue zhitong powder has better efficacy, can relieve the pain and swelling faster,with similar safety.

OBJECTIVE:To observe the efficacy and safety of amlodipine besylate combined with Xinkeshu in the treatment of hypertension. METHODS:100 patients with hypertension were randomly divided into control group (50 cases) and observation group(50 cases). Control group was orally given one Amlodipine besylate tablet,once a day;observation group was additionally given 4 Xinkeshu tablets,3 times a day. The treatment course was 8 weeks. Clinical efficacy,systolic blood pressure(SBP)and di-astolic blood pressure(DBP)before and after treatment in 2 groups were observed,the incidence of adverse reactions was record-ed. RESULTS:The total effective rate in observation group was significantly higher than control group,the incidence of adverse re-actions was significantly lower than control group,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in the SBP and DBP between 2 groups (P>0.05). After treatment,the SBP and DBP in 2 groups were significantly lower than before,the differences were statistically significant(P<0.05);but there was no significant difference between 2 groups (P>0.05). CONCLUSIONS:The efficacy of amlodipine besylate combined with Xinkeshu is superior to amlo-dipine besylate alone in the treatment of hypertension,with better safety.

Objective To improve the diagnosis of metastatic adrenal carcinomas. Methods 123 cases of primary canc-er which had been proved by autopsy in recent 10 years were reviewed. 23 cases of metastatic adrenal carcinomas werefound in all cases,the metastatic being unilateral in 20 and bilateral in 3. Results All the 23 cases of metastatic adrenal-carcinomas had been found missed diagnosis. Conclusion 16 cases are from lung cancer,among which 8 cases are smallcell lung cancer. It is important to prevent metastatic adrenal carcinomas from small cell lung cancer.

To probe course and mechanism of cellular immune respone in early syphilitic lesion, the expression levels of CD3, CD20, CD68 were determined by immunohistochemistry and a computer image analysis system. The results showed that the expressions of CD3, CD20, and CD 68 were positive in 43 cases of primary and secondary syphilis. The expression level of CD68 was higher thanthat of CD3, CD20, especially around blood vessels. The expression level of CD 20 was very low. This study indicates that T cells, B cells, and in particular macrophages play an important cellular immunologic regulating role in clearance of Treponema pallidum from the infected tissue, but the efficacy is not high enough.

Objective To study the drug retention of HPC MMC in bladder after intravesical instillation. Methods The pharmacokinetics of the intravesical mucous adhesive anticancer agent HPC MMC in urine and in tissue were comparatively studied with conventional mitomycin C aqueous solution(S MMC) by means of animal experiment. Results After instillation, the half life of MMC in urine in the 2 groups was 2.61 h and 0.56 h and in tissue 2.33h and 0.46 h respectively. Conclusions Suggesting that HPC MMC remained longer within the urinary bladder. It may be therapeutically more efficient.

Objective:To investigate the clinical efficacy and economic effect of Alprostadil in the pharmacotherapeutic scheme for cerebral infarction.Methods:A total of 156 successfully treated cases of cerebral infarction were selected from those admitted from March 2003 to March 2004 and divided into two pharmacotherapeutic groups,with Alprostadil given to Group Ⅰ.The data were evaluated and compared by pharmacoeconomic cost-effect analysis.Results:The costs were $11 271.47 and $8 147.06,and the effectiveness rates were 84.21% and 70.00% respectively in the two groups,with the cost-effect ratios of 133.86 and $114.34 / unit effectiveness.It cost $219.87 for Group Ⅰ to increase a unit of effectiveness over Group Ⅱ.Conclusion:Group Ⅰ had a higher effectiveness rate,while Group Ⅱ a lower cost-effect ratio.