Objective To compare postoperative adjuvant chemoradiotherapy with adjuvant chemotherapy in patients with gastric cancer by a meta-analysis.Methods PubMed,EMbase,Cochrane Library,Wanfang,CNKI,VIP,and CBM databases were searched to identify the controlled clinical trials of postoperative adjuvant chemoradiotherapy versus adjuvant chemotherapy for gastric cancer.The obtained data were analyzed using RevMan 5.2.5 and Stata 12.0.The difference between two groups was estimated by calculating the odds ratio (OR) with 95％ confidence interval (CI).Results A total of 12 controlled clinical trials involving 1674 gastric cancer patients,which were selected according to inclusion and exclusion criteria,were included in this meta-analysis.The meta-analysis showed that the 3-and 5-year survival rates were significantly higher in the adjuvant chemoradiotherapy group than in the adjuvant chemotherapy group (OR=2.96,95％ CI=1.75-5.03,P=0.000; OR=1.45,95％ CI=1.06-1.99,P =0.020);the local recurrence rate was significantly lower in the adjuvant chemoradiotherapy group than in the adjuvant chemotherapy group (OR =0.50,95％ CI =0.34-0.72,P =0.000) ; there was no significant difference in distant metastasis rate between the two groups (OR =0.79,95％ CI =0.58 -1.07,P =0.130).Conclusions The meta-analysis of existing study results shows that compared with adjuvant chemotherapy alone,adjuvant chemoradiotherapy is a relatively safe and effective postoperative treatment for gastric cancer.

Objective To investigate the change of CNP (C-natriuretic peptides) in patients with PCOS (polycystic ovary syndrome) undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH-α longprotocol for controll ovarian hyper-stimulation(COH).Methods From March 2012 to September 2014,22cases patients with PCOS undergoing IVF-ET in the Reproductive Medical Center of the Center Hospital of JiangMen were selected as study group(Group 1),and 32 cases patients with normal ovarian reserve,the age younger than 35,and the number of oocytes retrieved more than 6 at the same period were selected as control group(Group 2).The level of serum CNP and estradiol(E2) on the day of human chorionic gonadotropin (HCG) and retrieving oocytes,the level of CNP and E2 in follicular fluid were analyzed.In additional,the levels of CNP and E2 in follicular fluid of different fertility and embryo quality were compared.Results (1) CNP and E2 on the day of HCG were significantly higher than that on the day of retrieving oocytes (CNPof Group 1:(107.21±78.55) μg/L vs.(73.01±55.99) μg/L,CNP of Group 2:(69.16±32.39) μg/L vs.(44.11±27.23) μg/L;E2 of group 1:(5231.38±1489.00) ng/L vs.(1985.52±662.54) ng/L,E2 of Group 2:(3678.45±969.57) ng/L vs.(1567.71±493.93) ng/L;t =2.968,2.752,8.147,14.567;P＜0.05).CNP and E2 on the day of retrieving oocytes and E2 on the day of HCG of Group 1 were higher than that of Group 2(t=2.866,2.227,2.173;P＜0.05).CNP in follicular fluid in Group 1 was higher than that in Group 2,but E2 of in follicular fluid in Group 1 was lower than that in Group 2 (t =2.244,-2.650;P＜0.05).(2) In Group 1,CNP and E2 in follicular fluid of normal fertility were lower than that of unnormal fertility,and E2 in follicular fluid of unnormal fertility were higher than that of no-fertility,and there were significant differences(t =-6.117,-2.374,2.760;P＜0.05).(3) In Group 2,only E2 in follicular fluid of unnormal fertility were higher than that of no-fertility,and there was significant difference(t=2.658,P＜0.05).(4) In 2 groups,CNP in follicular fluid of high-quality embryo were lower than that of non-high-quality embryo,and there was significant difference (t =-2.910,-2.029;P＜0.05).CNP in follicular fluid of non-high-quality embryo in Group 1 were higher than that in Group 2,but E2 in follicular fluid of non-high-quality embryo in Group 2 were higher than that in Group 1,and there were significant differences (t =2.141,-2.009;P ＜ 0.05).Conclusion There are differences in the change of CNP in the patients with PCOS and non-PCOS,and there are some deficiencies of the first meiosis in the patients with PCOS.

OBJECTIVEThe aim of this study was to compare the mandibular position when speaking with the intercuspal position and to check the stability of phonetics when determining the horizontal jaw relation in healthy adults.

METHODSA total of 19 healthy volunteers were recruited. Seven Chinese letters, namely, /xi/, /er/, /yi/, /ci/, /mi/, /ni/, and /ri/, were chosen in the test. O-bite was used to record the mandibular position when speaking these letters. A full-adjusted articulator was used to find the mandibular position during speech, and the mandibular position was measured using a vernier caliper. The mandibular position during speech with intercuspal position was compared in both anterior-posterior and left-right directions of the horizontal plane. Multi-factor analysis of variance was conducted for the statistical analysis of the effect of objects and letters on the mandibular position.

RESULTS1) The mandibular position was in front of the intercuspal occlusion position when speaking all seven letters, and almost no deviation was observed in the left and right directions (the mandibular position value of 82% was in the range of 0.5 mm). 2) Different objects had different mandibular positions during speech, whereas different letters did not. The distance between the centric relation position and the intercuspal position had a positive correlation with the range of the mandibular position during speech.

CONCLUSIONThe mandibular position was in front of the intercuspal position when speaking all seven words in the test. In the same object, the mandibular position was stable during speech.

Adult ; Centric Relation ; Dental Articulators ; Dental Occlusion ; Humans ; Jaw Relation Record ; Mandible ; Phonetics ; Speech

The traditional Chinese medicine (TCM) constitution theory is an important means to reveal the host′s genetic characteristics from the perspective of TCM. The types of constitution can influence liver pathological changes and the prognosis of disease in patients with chronic hepatitis B virus infection, and to a certain degree, they are associated with the polymorphisms of genes involved in immunoregulation, for example, human leukocyte antigen(HLA) class Ⅱ gene. Yin-deficiency constitution is associated with various adverse clinical outcomes, as well as the genotypes of genes including HLA-DQA1*0501. Preliminary data also show that the chronic hepatitis B (CHB) patients with yin-deficiency constitution have a poor response to interferon therapy. This article reviews the current application of TCM constitution theory in the diagnosis and treatment of CHB, its potential value, and existing problems.

OBJECTIVETo study the clinical characteristics of pediatric Kawasaki disease complicating mycoplasma pneumoniae pneumonia.

METHODSRetrospective analysis was conducted on 11 children who had been diagnosed with Kawasaki disease with Mycoplasma pneumoniae pneumonia.

RESULTSThe 11 cases presented with varying degrees of fever, conjunctival congestion, skin rashes, lymphadenectasis, distal extremities lesions, heart and lung lesions. 8 of them were standartly treated with azithromycin, while 3 of them were treatad with azithromycin and erythromycin. 2 patients with pleural effusion complicated by lobar pneumonia consolidation were treated with gamma globulin combined aspirin. All of the 11 patients were healed.

CONCLUSIONInfections are common at the diagonosis of KD. Reasonable examination and antibiotics is useful to cure KD with MPP.

Child ; Child, Preschool ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; Pneumonia, Mycoplasma ; diagnosis ; drug therapy ; etiology ; Retrospective Studies

OBJECTIVETo investigate the drug-resistant genes at hepatitis B virus (HBV) polymerase region during entecavir (ETV) treatment.

METHODSSerum samples from chronic hepatitis B patients with virologic breakthrough during enticavir therapy were studied. The resistant mutation patterns in the polymerase gene of hepatitis B virus were analyzed using the polymerase chain reaction (PCR)-sequencing method.

RESULTSETV resistance was detected from 19 out of 29 ETV-refractory patients, among whom 16 (84.2%) had a history of lamivudine-refractory. The mutation patterns were diverse, while rtL180 + rtM204 + rtT184 (58.6%, 17/29) was most common in patients with ETV genotype resistance. Four of 7 patients (7/29, 24.1%) with genotype B were detected to have ETV genotype resistance, while 15 of 22 patients (22/29, 75.9%) with genotype C were detected to have ETV genotype resistance. The rate of ETV genotype resistance was 57.1% (4/7) and 68.2% (15/22) in patients with genotype B and genotype C,while no statistical difference was found(P = 0.665).

CONCLUSIONSETV genotype resistance is more common in patients who have been refractory to ETV and lamivudine sequential treatment. rtM204+rtL180+rtT184 mutation is common in genotype B and C ETV resistance patients.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; genetics ; DNA-Directed DNA Polymerase ; genetics ; Drug Resistance, Viral ; genetics ; Female ; Guanine ; analogs & derivatives ; therapeutic use ; Hepatitis B virus ; enzymology ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Mutation ; Viral Proteins ; genetics ; Young Adult

Objective To understand caregivers concerning on the nutritional status of patients with esophageal cancer after operation and to provide reference for esophageal cancer patients with postoperative rehabilitation guidance, to help nurses providing targeted health education for esophageal cancer patients. Methods A phenomenological approach was used to conduct unstructured interviews with 8 caregivers of patients with esophageal cancer in the cancer hospital.Data Data were analyzed by Colaizzi's phenomenological procedure. Results Through reading, analysis, reflection, classification and extraction,there were 3 themes: lacking of esophageal cancer related nutrition knowledge, but the belief of active acquisition is strong and behavior compliance is poor. Caregivers are positive about dietary nutrition;Caregivers have poor compliance and professionalism on behavior of dietetic care. Conclusions Doctors and nurses need to carry out elaborate diet instruction for caregivers of patients with esophageal cancer, to meet their nutritional knowledge needs, to provide a variety of effective and authoritative counseling channels, and to supervise their care behavior and promote patients rehabilitation as soon as possible.

Objective To investigate the status quo of health literacy,motivation and self-management behaviours of patients with knee osteoarthritis(KOA),to explore the influence of health literacy and motivation on self-management behaviours to the patients with KOA,and to clarify the relationships among the three factors.Methods Convenience sampling method was used to select 169 KOA patients who were treated in 3 tertiary hospitals in Xianyang between September and December 2021.General status table,chronic disease health literacy scale,patient motivation scale and chronic disease self-management behaviour scale were employed in the on-the-spot survey.Pearson correlation was used to analyze the correlation of health literacy,motivation and self-management behaviour of patients with KOA.Results Total scores of health literacy,motivation and self-management behaviour of the patients with KOA were 79.66±11.91,54.97±9.95 and 23.75±8.89,respectively.It was found that health literacy and motivation of the patients were positively correlated with their self-management behaviour(r=0.872,r=0.822,both P<0.01).Health literacy of the patients was positively correlated with motivation of patients(r=0.877,P<0.01).Health literacy of the patients could be used to directly predict self-management behaviour of patients(β=0.708,95%CI:0.539-0.876),as well as to predict self-management behaviour of the patients through the mediating effect of patient motivation(β=0.228,95%CI:0.676-0.787).The mediating effect accounted for 24.36%of the total effect.Conclusions The health literacy,motivation and self-management behaviours of patients with KOA are all poor and they should be further improved.Patient motivation is the mediating variable in health literacy and self-management behaviour of the patients.It is suggested that nursing staff could encourage the motivation of patients hence to improve the self-management behaviour in the patients with KOA based on an improvement of health literacy.

Diabetic retinopathy is one of the serious microvascular diseases caused by diabetes. It is the leading cause of visual impairment among workers over 40 years old in developed countries. At present, western medicine methods for treating diabetic retinopathy include pan-retinal photocoagulation, vitrectomy, and intravitreal injection of anti-vascular endothelial growth factor and other methods. Traditional Chinese medicine treatment of diabetic retinopathy is mainly to treat patients using oral Chinese herb preparation based on syndrome differentiation and using certain external traditional Chinese medicine methods, such as auricular point therapy. This paper investigates the research progress of diabetic retinopathy treatment with traditional Chinese and western medicine and provides novel ideas for treating diabetic retinopathy with traditional Chinese combined with western medicine.

Objective: To analyze the correlation of growth differentiation factor-15(GDF-15)level with the severity of coronary artery disease and prognosis and in elderly patients with acute coronary syndrome. Methods: A total of 168 elderly patients with acute coronary syndrome admitted into Hangzhou Xixi Hospital and Shaoyifu Hospital Affiliated to Medical College of Zhejiang University from March 2017 to April 2018 were enrolled in the study.Patients were divided into three groups: GDF-15>1 800 μmol/L(n=28), GDF-15 between 1 200-1 800 μmol/L(n=45), and GDF-15<1 200 μmol/L(n=95). Plasma levels of high-sensitivity C-reactive protein(hs-CRP)and GDF-15, and SYNTAX score, single-vessel-, double-vessel, multi-vessel coronary disease and major adverse cardiovascular events(MACE)were analyzed and compared between groups. Results: Plasma levels of hs-CRP and GDF-15 had significant differences among the three groups(P<0.05). There were significant statistically differences in SYNTAX score, single-vessel, double-vessel and multi-vessel coronary disease and MACE among the three groups(P<0.05). Logistic regression analysis showed that the levels of GDF-15(OR=2.092, 95%CI: 1.585~2.687), SYNTAX score(OR=1.948, 95%CI: 1.097~2.098), double-vessel lesions(OR=1.124, 95%CI: 1.006~1.251)and multi-vessel lesions(OR=1.744, 95%CI: 1.149~2.642)(all P<0.05)were statistically significant influencing factors for the prognosis. Conclusions GDF-15 level is correlated with SYNTAX score, double-vessel lesions and multi-vessel lesions, and could predict the severity of coronary artery lesions and prognosis in patients with acute coronary syndrome.