ObjectiveTo observe the clinical efficacy of warming-unblocking Yin Heel Vessel plus rehabilitation training in treating post-stroke strephenopodia, for seeking the optimal treatment protocol.MethodNinety eligible subjects withpost-stroke strephenopodia were randomized into an acupuncture group, a rehabilitation group, and a united group, to respectively receive warming-unblocking Yin Heel Vessel, rehabilitation treatment, and warming-unblocking Yin Heel Vessel plus rehabilitation training. ResultTwo treatment courses later, there was no significant difference in comparing the strephenopodia score between the acupuncture group and rehabilitation group (P>0.05); the strephenopodia score in the united group was significantly different from that in the acupuncture group and rehabilitation group (P<0.05), and the improvement in strephenopodia in the united group was superior to that in both acupuncture group and rehabilitation group.ConclusionWarming-unblocking Yin Heel Vessel plus rehabilitation can produce a content efficacy in treating post-stroke strephenopodia.

Based on link control concepts, the life cycle of science and technology projects was divided into five stages,, such as project application, selection, implementation, output and assessment.All the science misconducts that might occur among these five stages were listed.Finally, different precautions were made to prevent different misconducts during different stage..

0.05),but the MLD values at the tumor margin were significantly higher than that of normal mucosa(P

Objective To explore the diagnostic value of color Doppler ultrasonography and ultrasonography in the differential diagnosis of ectopic pregnancy.Methods 142 patients with ectopic pregnancy were given ultrasonic examination,to observe whether intrauterine gestational sac,carefully looking for recognition of ovarian masses and distinguish the relationship and structure,and were compared with pathologic diagnosis.Results Ultrasound could clearly display the uterus,ovary,failed to break the gestational sac and blood(block) mass image structure,with pathological diagnosis coincidence rate was 95.1％ (135/142),the misdiagnosis rate was 1.4％ (2/142),the missed diagnosis rate of 3.5％ (5/142).Conclusion Ultrasound was rapid,simple,noninvasive,high-accuracy,it was the preferred method for early diagnosis of the ectopic pregnancy.

Objective To study the relationship between serum uric acid and insulin resistance in type 2 diabetic patients Methods A total of 728 middle-aged and elderly type 2 diabetic patients were recruited and the anthropometric,clinical and biochemical parameters and fasting serum C-peptide were measured and retrospectively studied.All patients were divided into groups based on the levels of uric acid and on metabolic syndrome diagnosis or not.Results Among a total of 728 patients,the proportion of hyperuricemia was 26.9％(196/728),and metabolic syndrome(MS)was 64.6％.The levels of body mass index(BMI),waist circumference(WC),systolic pressure (SBP),diastolic pressure (DBP),triglyceride (TG),fasting C-peptide,HOMA(C-Peptide) were significantly higher in hyperuricemia group than in normal uric acid group,while the level of HDL was lower in hyperuricemia group than in normal uric acid group.The proportion of MS was statistically higher in hyperuricemia group (81.6％)than in normal uric acid group (58.3％,P ＜ 0.05).Groups Ⅰ,Ⅱ,Ⅲ,Ⅳ-the four quartiles of serum uric acid from low-to high-level were correlated with MS component number of 2.1±1.0,3.1±1.1,3.3±1.2,3.7±0.8,separately,and with HOMA(CP)of 3.7± 0.8,3.7 ± 0.8,4.0 ± 0.6,4.1 ± 0.9,separately (all P ＜ 0.05).When all patients were divided into groups based on with or without MS,the level of uric acid in MS group was (377.3 ± 43.5)μumol/L,and the proportion of hyperuricemia was 34.0％ (160/470),and HOMA(CP)was 3.90±0.72,all were significantly higher than those of non-MS group[(318.2±47.9)μmol/L,14.0％ (36/258),3.64±0.67].The levels of serum uric acid in groups with 1-5 components of MS were(285.0±62.8)μmol/L,(335.7±62.7)μmol/L,(367.1±45.0) μmol/L,(377.9±40.2) μmol/L,(389.8±46.6)μmol/L,and HOMA(CP) was 3.6±0.6,3.7±0.7,3.9±0.8,3.9±0.7,4.3±0.7 separately(P＜0.05).Serum uric acid was positively correlated with age,WC,BMI,TG,SBP,fasting C-peptide,and HOMA (CP),while negatively correlated with glycosylated hemoglobin(HbA1C),high density lipoprotein cholesterol (HDL-C).Binary logistic regression showed that the OR value of MS was 1.033 with the increase of serum uric acid,and 95％CI:1.026-1.041,P＜0.05.Conclusions Serum uric acid is correlated with insulin resistance in middle-aged and elderly hospitalized patients with type 2 diabetes.Hyperuricemia might be a new risk factor for MS.

Objective To explore the interaction of calcitonin receptor (CTR) gene polymorphisms and environmental factors in the population lived in coal-burning-borne endemic fluorosis areas in Chongqing.Methods A 1 ∶ 1 case-control study was carried out and Duping Township of Wushan County and Xinglong Township of Fengjie County of Chongqing were chosen as the endemic fluorosis areas.The observation subjects were divided into case group 121 cases and internal control group 130 cases.The Alu I polymorphism in the CTR gene was genotyped using the PCR-RFLP procedure.Logistic regression model was used to analyze the environment and genetic factors,and the interaction between genes and environment was determined according to interaction indicators.Results The rate of CC genotype in case group was lower than that of the control group [60.33％ (73/121) vs.74.62％ (97/130)],while the TT genotype was higher than that of the control group[9.09％ (11/21) vs.3.85％(5/130)].Significant differences in Alu I genotypes were observed between groups(x2 =6.57,P =0.037 ＜ 0.05; 95％CI:0.029-0.036).Allele frequencies of CTR genotypes differed significantly between groups(x2 =7.67,P =0.006 ＜ 0.01 ; OR =0.53,95 ％ CI:0.338-0.834).Urinary fluoride level (≥ 1 mg/L) was demonstrated to be a risk factor of fluorosis(OR =1.814,P =0.041 ＜ 0.05).There was a positive interaction(OR =5.530,γ =2.457) between CT + TT genotypes in CTR and the fluorosis environment of the people (urinary fluoride level ≥ 1 mg/L).Conclusions There is a certain type of interaction between CTR gene C/T polymorphism and environmental fluorine content (urinary fluoride ≥ 1 mg/L) in Chongqing population lived in coal-burning-borne fluorosis areas,and the onset of fluorosis is the result of interaction between heredity and environment.

Objective:To explore the way and feasibility of carrying out developmental-behavioral pediatrics(DBP) teaching for medical students on probation.Method :To divide 230 medical students on probation into experimental group(120 students) and control group(110 students).The former group spent four class hours in child developmental-behavioral outpatient department and another four hours in sensory integrative therapy room to assist doctors in their training work as volunteers,and their rest probation contents were the same as those of the latter group which had classes according to teaching outline of pediatrics.Test scores of pediatrics of the two groups were compared.Questionnaires filled in by students of experimental group were analyzed.Results of the two groups,scores of pediatrics were not different,which showed that scores weren't influenced by extra teaching contents.Results of questionnaires showed that teaching of DBP was welcome to students,and they had made advances in relative knowledge and their overall quality.Conclusion: It is necessary to carry out DBP teaching.The teaching way of this study has got good effect and is feasible.

Objective:To establish and validate a method for the determination of particle size and size distribution of gefitinib. Methods:A Malvern Mastersizer 3000 laser size analyzer and a Hydro LV wet autosampler were used,a light scattering method for the determination of particle size and size distribution was adopted to analyze the particle size of gefitinib,and then the methodological study was carried out. The pump speed was 2 000 r·min -1 ,the obscuration was 8% -20% ,the measurement time of background and sample was 10 s,the sample RI was 1. 500,and the sample absorbance was 0. 00. Results:The D10 of 3 batches of gefitinib was less than 7 μm,the D50 was less than 15 μm and the D90 was less than 25 μm,which all met the preparation requirements of final products. Conclusion:The method is accurate,simple and repeatable,and suitable for the particle size analysis of gefitinib.

Objective To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy (LATG) for gastric cancer by systematic review and meta-analysis.Methods The literature database before February,2012 was extensively searched to retrieve the comparative studies of LATG and open total gastrectomy(OTG) with a relevance of study goal.The inclusion and exclusion criteria were formulated.Aftera quality evaluation,the data was extracted.The Cochrane collaboration RevMan 5.1 version software was used for meta-analysis.Results There are ten studies meeting the inclusion criteria for meta-analysis.The total sample size of these studies was 942 cases.Compared to OTG,LATG experienced longer operation time [weighted mean difference(WMD) =41.12 min,95％ confidence interval(CI):20.62-61.63,P ＜0.01)],less blood loss(WMD =-198.36 ml,95％ CI:-300.94--95.78,P ＜ 0.01),earlier time to flatus(WMD =-0.80 days,95％ CI:-1.17--0.42,P＜0.01),shorter hospital stay(WMD =-4.02days,95％ CI:-6.03--2.01,P ＜ 0.01) and decrease in overall complications [relative risk (RR) =0.55,95％ CI:0.40-0.76,P ＜ 0.01)].The number of dissected lymph nodes,proximal or distal resection margin and mortality were similar between the two groups.Conclusions Laparoscopy-assisted total gastrectomy is a safe and feasible procedure with less blood loss,less overall complications and quick recovery.

Objective To investigate clinical efficacy of Easy First strategy in laparoscopic pancreaticoduodenectomy (PD) for borderline resectable pancreatic cancer.Methods The clinical data of 9 patients with borderline resectable pancreatic cancer who were admitted to the Sir Run Run Shaw Hospital of Zhejiang University (8 patients) and Zhejiang Provincial People's Hospital (1 patient) from June 2013 to March 2015 were retrospectively analyzed.Nine patients underwent laparoscopic pancreaticoduodenectomy based on the Easy First strategy (to sequentially dissect and amputate jejunum,stomach,hepatoduodenal ligament,common bile duct,main portal vein,head of pancreas,second segment and third segment of the duodenum,uncinate process and neck of pancreas).The operation time,volume of intraoperative blood loss,postoperative pathological examination,complications and duration of hospital stay were recorded.Patients were followed up once every 3 months by outpatient examination and telephone interview up to June 2015.Results Of 9 patients,4 received totally laparoscopic PD (2 received partial resection and repair of portal venous wall),1 received laparoscopic assisted resection and digestive tract reconstruction,and 4 received laparoscopic transection of jejunum,bile tract and stomach and conversion to open surgery for resection and digestive tract reconstruction (1 with severe adhesion between tumor and portal vein,3 with bleeding due to dissection of neck and unciform process of pancreas).The operation time and volume of intraoperative blood loss in all patients and in 4 patients with totally laparoscopic PD were (404 ± 49) minutes and (456 ± 348) mL,(395 ± 61) minutes and (188 ± 25) mL,respectively.Of 9 patients,5 with postoperative complications were cured without perioperative death,including 2 with Grade B pancreatic fistula,1 with biliary leakage,1 receiving reoperation due to gastric stump bleeding at postoperative day 7 and 1 with abdominal infection.The extubation time of right drainage tube and left drainage tube was (9 ± 5) days and (11 ± 4) days,respectively.The duration of hospital stay was (24 ± 10)days.All patients were diagnosed as with pancreatic cancer by pathological examinations with the tumor diameter of (3.2 ± 0.8) cm.The number of harvested lymph nodes in all patients and in 4 patients with totally laparoscopic PD were 16.8 (range,6.0-25.0) and 19.8 (range,15.0-25.0).All the patients were followed up for mean time of 12 months (range,4-24 months),including 1 death at postoperative month 3,1 with tumor survival of 20 months and others with tumor-free survival.The postoperative survival time of 4 patients was more than 18 months at the end of follow-up.Conclusion Easy First strategy in laparoscopic PD is safe,feasible and practical for borderline resectable pancreatic cancer.