Objective To observe the clinical effect of alprostadil combined with Yiqi Huoxue Huatan Tongluo Decoction in treating arteriosclerosis obliterans.Methods 60 cases of lower extremity arteriosclerosis occlusion disease outpatient and hospitalized patients were randomly divided into treatment group and control group according to the random number table method, each group were 30, the oral administration of enteric coated aspirin experimental group is set to control group intravenous injection of alprostadil treatment for 4 weeks, the treatment group was treated with Huatan Tongluo Decoction on the basis of the control group.The clinical symptoms, blood vessel function (ABI),low density lipoprotein-cholesterol (LDL-C), total cholesterol( TC) were observed in the two groups of patients, and blood rheology indexes included whole blood viscosity, fibrinogen, liver and kidney function and adverse reactions.ResuIts Total effective rate of the treatment group was 93.33% than control group 73.33% (P<0.05), the treatment group of ankle brachial index ( ABI) was better than the control group, the treatment group TC, LDL-C, high shear whole blood viscosity, low shear whole blood viscosity, fibrinogen protein improve were better than those of the control group (P<0.05).ConcIusion Disease curative effect is better than pure alprostadil in the treatment of occlusion Huoxue Huatan Tongluo Decoction combined with alprostadil in the treatment of lower limb arteriosclerosis.

OBJECTIVE:To investigate clinical significance of programmed cell death 5 (PDCD5) protein in serum of pa-tients with lung cancer. METHODS:80 lung cancer inpatients were selected from the First Affiliated Hospital of Shihezi University School of Medicine(hereinafter referred to asour hospital)as lung cancer group;60 healthy volunteers were selected from our hospital at the same period as normal group. ELISA was used to test the expression of PDCD5 protein,and the relationship of PDCD5 protein with clinical pathological features of lung cancer patients were analyzed. RESULTS:The expression of PDCD5 pro-tein in normal group was significantly higher than lung cancer group,with statistical significance (P<0.05). The expression of PDCD5 protein in lung caner patients was not associated with gender,smoking history and pathological type(P>0.05);it was de-creased as the decrease of tumor differentiation degree,with statistical significance(P<0.05). The expression of PDCD5 protein in patients with carcinoembryonic antigen(CEA)<5.6μmol/L was significantly higher than those with CEA≥5.6μmol/L;the expres-sion of PDCD5 protein in patients with cytokeratin 19 soluble fragment (CYFRA21-1)<5.6 μmol/L was significantly higher than those with CYFRA21-1≥5.6 μmol/L,with statistical significance(P<0.05). The expression of PDCD5 protein in patients with Ⅰ-Ⅱ stage lung cancer was significantly higher than Ⅲ-Ⅳ stage lung cancer patients;the expression of PDCD5 protein in patients without distant metastasis was significantly higher than those with distant metastasis. The expression of PDCD5 protein was in de-creasing as the increase of the number of metastasis site,with statistical significance(P<0.05). CONCLUSIONS:PDCD5 protein in serum of patients with lung cancer shows low expression level,which is related to tumor differentiation degree,tumor marker level as CEA and CYFRA21-1,tumor stage and distant metastasis,etc. The detection of PDCD5 protein may contribute to clinical diagnosis of lung cancer.

Objective To observe the effects of early exercise on the expression of synaptophysin pro-tein and Nissl bodies in the hippocampus after hypoxic-ischemic brain damage( HIBD) , and to investigate possi-ble mechanisms. Methods A total of 35 neonatal Wistar rats aged 7 days were randomly divided into a train-ing group of 13, a control group of 11 and a sham-operation group of 11. HIBD was induced in the rats of the training and control groups, while those in the sham-operation group had the left common carotid artery separa-ted, but without ligation. Seven days after successful modeling, the training group began swimming training for 10 min every day lasting for 14 days, while the other groups were not trained. Western blotting was used to detect the expression of synaptophysin in the affected hippocampus of the brain based on the ratio of the gray band val-ues for synaptophysin and beta. Nissl staining was applied to observe the number of Nissl bodies and the morphol-ogy of the neurons in the hippocampus. Results The average expression of synaptophysin in the sinistrocere-bral hippocampus of the rats in the control group was significantly lower than that in the sham-operation group, but significantly higher than that of the training group. The control group had significantly fewer Nissl bodies than the sham-operation group, but significantly more than the training group. Conclusion Early training can in-crease the expression of synaptophysin and the number of Nissl body in the hippocampus after hypoxic-ischemic brain damage.

Objective To discuss the feasibility of constructing the system of traditional Chinese medicine nursing diagnosis.Methods Based on the theoretical analysis and status quo analysis,the feasibility of constructing the system of TCM nursing diagnosis was discussed,and the achievements and problems waiting for settlement were also narrated.Resuts It has the foundation of constructing the system of TCM nursing diagnosis,but some problems still need to be solved.Conclusions It is feasible for building TCM nursing diagnosis system,and the TCM nursing diagnosis system does not conflict with NANDA-I.

Objective To assess the value of the myocardial segment number of color change in the bull's eyes of three-dimensional speckle tracking echocardiography (3D-STE)in the detection of multi-vessel coronary stenosis at the resting state.Methods A total of 125 consecutive patients were enrolled and divided into the following three groups according to the coronary angiography(CAG):multi-vessel coronary stenosis group (n=48),single-vessel stenosis group(n =34)and control group (n =43).All patients underwent two-dimensional (2D)and three-dimensional echocardiography (3D)and three-dimensional speckle tracking echocardiography (STE).The bull's eyes of left ventricular 17 myocardial segments including longitudinal strain(LS),circumferential strain (CS),area strain(AS)and radial strain(RS)were acquired by 3D-STE.The homogeneous colors were regarded as normal wall motion myocardial segment (LS,CS,AS is a uniform red,RS for uniform blue ),the colors were uneven or shallower,or changes were regarded as abnormal wall motion myocardial segment.The myocardial segment number of color change in the bull's eyes can be calculated.Receiver operating characteristic (ROC ) curves were computed to determine optimal strain cutoff values to predict multi-vessel coronary stenosis.Results The myocardial segments of abnormal wall motion in the bull's eyes (LS,CS,AS,and RS)were significantly increased compared with the control group(P <0.001).In particular,the multi-vessel coronary stenosis group were dramatically increased than the single-vessel coronary stenosis group.Meanwhile,these parameters were higher in patients with multi-vessel coronary stenosis than in those with single-vessel coronary stenosis (P <0.05).ROC analysis demonstrated areas under the curve of 0.84 for 3D GLS,0.89 for 3D GCS,0.95 for 3D GAS,and 0.89 for 3D GRS.An optimal cutoff value of magnitude,sensitivity and specificity were LS,12,89.6%,76.7%;CS,11,89.6%,74.4%;AS,12,91.7%,88.4%;RS,13,81.2%,86.0%,respectively. Conclusions The myocardial segment number of color change in the bull's eyes by 3D-STE is useful to detect multi-vessel coronary stenosis,where in GAS are more valuable indicators with higher sensitivity and specificity.

Objective To investigate the relationship of epidermal growth factor receptor (EGFR) mutation with clinical features of baselines as well as serum CEA level in patients with recurrent non-small cell lung cancer (NSCLC). Methods A total of 54 patients with first recurrence of advanced lung cancer who had received chemotherapy were included in this study. ADx-ARMS was performed to detect EGFR gene mutations in surgical specimens taken from the primary tumor. Serum CEA level was measured by the electrochemical luminescence method. Results The mutation rate of EGFR was significantly higher in females than in males (χ2= 11.868, P =0.006), with a total mutation rate of 60.8%in 106 patients. The rate was higher in adenocarcinoma than in other histological types(χ2=6.002,P=0.014), and significantly higher in non-smokers than in smokers (χ2= 8.502,P=0.004) and in the patients with serum CEA level over or equal to 5.0 ng/mL than those with CEA level less than 5.0 ng/mL (χ2=22.543,P=0.000). A multivariate analysis revealed that a higher serum CEA level at the time of disease recurrence was associated with EGFR gene mutations (P = 0.002). Conculsions Serum CEA level is closely associated with the presence of EGFR gene mutations in patients with first recurrence of advanced NSCLC. A higher serum CEA level at the time of disease recurrence is independently associated with EGFR gene mutations. CEA level can be used as a potential indicator to determine EGFR mutation.

Objective:To investigate the clinical characteristics and pathogen spectrum of acquired immunodeficiency syndrome (AIDS) patients complicated with pulmonary filamentous fungal infection in Guangdong Province, so as to provide evidences for improving the diagnosis and treatment.Methods:A total of 143 AIDS patients with pulmonary filamentous fungal infection hospitalized in Guangzhou Eighth People′s Hospital, Guangzhou Medical University from January 2016 to December 2018 were included. The filamentous fungi cultured in bronchoalveolar lavage fluid of these patients were identified with morphological and molecular biological methods. And their clinical characteristics were analyzed. Nonparametric Kruskal-Wallis H test and chi-square test were used for statistical analysis. Results:Among the 143 patients, 116(81.1%) had fever, 104(72.7%) had cough, 83(58.0%) had expectoration, and 59(41.3%) had anhelation. The CD4 + T lymphocyte count was 22.0(9.3, 60.8) cells/μL and 118(82.5%) cases were below 100.0 cells/μL. The white blood cell counts decreased in 52(36.4%) cases and increased in 18(12.6%) cases, anemia was found in 109(76.2%) cases, platelet count decreased in 29(20.3%) cases. Sixty-four (44.8%) cases were positive for galactomannan test. Chest computed tomography showed diffuse infection of both lungs in 114(79.7%) cases, miliary changes in 12(8.4%) cases, pleural effusion in 44(30.8%) cases, and enlargement of pleural and (or) mediastinal lymph nodes in 45(31.5%) cases. After receiving antifungal therapy, 124 (86.7%) cases were cured or improved, and 19 (13.3%) cases were discharged automatically or died of disease deterioration. Among the 143 strains of filamentous fungi, there were 56 strains of Aspergillus species pluralis (39.2%, including 24 strains of Aspergillus fumigatus), 37 strains of Talaromyces marneffei ( T. marneffei) (25.9%), 22 strains of Penicilium species pluralis (15.4%), and 28 strains of other genera of filamentous fungi (19.6%). The median CD4 + T lymphocyte counts in patients infected with Aspergillus species pluralis, T. marneffei, Penicilium species pluralis and other genera were 24.5, 15.0, 53.5 and 22.0 cells/μL, respectively, and the difference was statistically significant ( H=11.282, P=0.010). The proportions of AIDS patients with different pulmonary filamentous fungal infection of CD4 + T lymphocyte count ≤50.0 cells/μL in descending order were T. marneffei group (89.2%(33/37)), Aspergillus species pluralis group and other genera group (67.9%(38/56), 67.9%(19/28)), and Penicillium species pluralis group (54.5%(12/22)), and the difference was statistically significant ( χ2=9.296, P=0.026). Conclusions:The clinical manifestations of pulmonary filamentous fungal infection in AIDS patients in Guangdong Province are not specific. The pathogenic spectrum contains various genera, and T. marneffei and Aspergillus fumigatus are dominant, which could be correlated with CD4 + T lymphocyte count.

Objective:To evaluate the effect of different reconstruction images on cardiac dose evaluation by comparing the differences between 4D-CT series and special reconstruction images in evaluating the dose-volume index of cardiac structures.Methods:ECG 4D-CT series were scanned in 15 female patients with left breast cancer. The images of 0-95% 20 phases were reconstructed at an interval of 5% cardiac cycle. The maximum intensity projection (MIP), minimum intensity projection (MinIP), average intensity projection (AIP) and sum intensity projection (SIP) images were obtained by special reconstruction of 4D-CT series. Left ventricle (LV) and left anterior descending coronary artery (LADCA) were delineated on 4D-CT and special reconstruction series, respectively. The intensity-modulated radiation therapy plan of the left breast cancer was designed on the basis of 0% phase, and the cumulative dose (Dose-cumulate) of 20 phases was obtained by deformation registration. The doses of 0% phase were deformed and registered to MIP, MinIP, AIP and SIP images to obtain the corresponding dose distribution. The dose-volume indexes of LV and LADCA based on different CT images were compared.Results:In the evaluation of dose-volume index of LV, compared with 4D-CT series, the change rates of V 5Gy, V 30Gy, V 40Gy, D max and D mean on MIP images were 3.8%, 2.0%, 0.9%, 3.8% and 1.7%, respectively. There was significant difference in V 5 and D max between MIP and 4D-CT (both P<0.05). Compared with 4D-CT, the change rates of D max on MinIP, SIP and AIP images were 2.5%, 3.1% and 1.5%, respectively (all P<0.05). In the evaluation of dose-volume index of LADCA, only the change rate of D max on four special reconstructed images was<5%( P<0.05). Conclusions:In the dose-volume evaluation of LV, the V 30Gy, V 40Gy and D mean obtained by MIP are basically equivalent to those obtained by 4D-CT series, which can be used to substitute 4D-CT series to evaluate the dose-volume. The special reconstruction image of LADCA can not replace 4D-CT series.

ObjectiveTo analyzing the psychological status of hospitalized patients of internal medicine and its impact factors.Methods Hospitalized patients of internal medicine underwent a survey by using Chinese Health Questionnaire (CHQ-12),Social Support Scale and Disease-Cognition Scale.Those with a score of ＞4 received further investigation of Symptom Check-List 90 (SCL-90).Correlation analysis was performed between all factors of SCL-90 and social support or disease-cognition scale score.Results There was no significant difference of psychological status between males and females ( P ＞0.05 ).All SCL90 factors were negatively correlated with social support,of which obsessive,paranoid,and phobic presented stronger negative correlations with social support and objective support (P ＜ 0.05 ).Furthermore,all factors were negatively correlated with disease-cognition scale score.A significantly negative correlation between phobic factor and disease-cognition scale score was identified ( P ＜ 0.05 ).Improvement was found in 26.2％ patients after intervention.Conclusion Patients tend to show unhealthy emotion when they are under the stress of hospitalization.Hospitalization support system may need to be improved and patients' cognition of disease should be increased.

Objective To determine the long-term results after combined pancreas-kidney transplantation at a single-center institution.Methods Fifty-three consecutive patients with insulin-dependent diabetes mellitus and end-stage nephropathy were followed up for more than three years after combined pancreas-kidney transplantation. Immunosuppressive protocol consisted of tacrolimus ( TAC ),mycophenolate mofetil (MMF),and steroids,and antithymocyte globulin or anti-CD25 receptor mAb.The impact of different risk factors was analyzed on long term patient and graft survival.Results The 3-,5- and 8-year survival rate in recipients was 90.1％,89.1 ％ and 80.0％,respectively.The 3-,5- and 8-year survival rate of pancreas grafts was 84.9％,84.8％ and 60.0％,and that of kidney grafts was 83.0％,82.6％ and 53.3％,respectively.Principal causes of death were Infection (n =4),renal failure (n =2),cardiovascular events (n =1 ),and cerebrovascular accident (n =1 ).Graft failure for the pancreas was caused by death with a functioning graft (n =6),rejection (n =2),thrombosis (n =1 ) and pancreatitis (n =1 ).Graft failure for the kidney was due to rejection (n =9),and death with a functioning graft (n =9).Conclusion This series representing the largest experience with long-term follow up in China confirms an excellent long-term survival.Infection,rejection and surgical complication were the major risk factors leading to deaths and graft loss.