OBJECTIVE:To evaluate therapeutic efficacy and safety of chemotherapy combined with Xiaoaiping injection in the treatment of elderly patients with advanced gastric cancer. METHODS:60 elderly patients with advanced gastric cancer were collected from our department during 2012-2014,and then divided into union group and single group with 30 cases in each group. Single group was given irinotecan(CPT-11)150 mg/m2 added into 0.9%Sodium Chloride injection,and union group was addition-ally given Xiaoaiping injection 80 ml,qd,on the basis of single group. A treatment course lasted for 14 days,and both groups re-ceived 4 courses of treatment. The tumor markers,disease single rate,progression-free survival (PFS) and the incidence of ADR were compared between 2 groups. RESULTS:After treatment,the levels of CEA,CA199 and CA242 in 2 groups were significant-ly lower than before;the union group was significantly lower than the single group,with statistical significance(P<0.05). The dis-ease single rate of union group was 70.00%,which was significantly higher than that of single group (33.33%). PFS of union group was(11.23±2.17)months,which was significantly longer that of single group [(9.36±0.84)months],with statistical signif-icance(P<0.05). The incidence of leucopenia,alanine aminotransferase elevation,diarrhea,stomatitis and hand-foot syndrome in union group was significantly lower than in single group,with statistical significance(P<0.05). CONCLUSIONS:Xiaoaiping in-jection combined with irinotecan chemotherapy for advanced gastric cancer has obvious effect with a low incidence of ADR.

Objective To discuss the application value of the Nickel-Titanium patella concentrator(NT-PC) in surgical treatment of patellar fracture.Methods A retrospective analysis was made on clinical data of 32 cases of patellar fracture treated with the NT-PC in this hospital from January 2001 to December 2003.Results Re-examination of radiography at 12 weeks after surgery showed bone union was achieved in all the cases,with a smooth patellofemoral articular surface.The patella was preserved completely in all the comminuted fracture cases.According to the Lu's criteria,excellent and good outcomes were achieved in 26 and 6 cases,respectively,the rate of excellent or good results being 100%.The NT-PC was removed at 4 months ~ 2 years(mean,14 months) postoperatively without complications.Conclusions Application of NT-PC in the treatment of patellar fracture can preserve the comminuted patella completely,facilitate the reduction and fixation of the patellofemoral articular surface,and make early postoperative motions available.It is worthy of being recommended.

Objective To investigate the pharmacokinetics of intravenously infused domestic alfentanil in the patients undergoing general anesthesia.Methods Twelve American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-47 yr,weighing 49-86 kg,scheduled for elective subtotal thyroidectomy under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.02 mg/kg,alfentanil 25 μg/kg,propofol 1.5 mg/kg and rocuronium 0.8 mg/kg.The patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of 0.8％-2.0％ sevoflurane,iv infusion of alfentanil 1 μg · kg-1 · min-1,and intermittent iv boluses of rocuronium 10-20 mg,bispectral index value was maintained at 40-60,and infusion was stopped at 10 min before the end of surgery.Before induction of anesthesia,at 1,3,5,8,10,14,20,35,65,95 and 125 min ofalfentanil infusion,and at 5,15,30,60,120,180,240,300 and 360 min after termination of alfentanil infusion,venous blood samples were collected for determination of the plasma concentration of alfentanil (by high performance liquid chromatography-mass spectrometry/mass spectrometry).DAS 3.0 software was used to analyze the pharmacokinetic parameters of alfentanil.Results The pharmacokinetics of domestic alfentanil was best described by a two-compartment pharmacokinetic model.The distribution half-life was (1.8 ± 0.8) min,and the elimination half-life was (91±22) min.The volume of distribution at steady state was (0.38±0.12) L/kg,and the clearance was (4.3± 1.6) ml · kg-1 · min-1.The elimination of domestic alfentanil followed the first-order kinetics.Conclusion The distribution of intravenously infused domestic alfentanil is fitted to a two-compartment pharmacokinetic model with elimination following the first-order kinetics in the patients undergoing general anesthesia.

Objective To analyse the clinical effect and mechanism of hirudin in the treatment of patients with lower limb venous thrombosis after fracture.Methods 56 patients who were diagnosed with lower limb venous thrombosis after fracture in our hospital were collected.All patients were randomly divided into experimental group (n:28) and control group (n:28).12h after fracture operation, patients in control group were treated with subcutaneous injection of low molecular weight heparin calcium, patients in experimental group were treated with Maixuekang capsule ( hirudin) orally on the basis of control group.Before and after the treatment, the plasma levels of thrombin antithrombin complex ( TAT) , thrombin activated fiber soluble inhibitor (TAFI), D-Dimer (D-D), fibrinogen (FIB), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and clinical effect were detected in all patients.Results After treatment, the total effective rate of experimental group ( 92.86%) was significantly higher than that of the control group ( 71.43%) ( P<0.05 );compared with control group, the plasma levels of TAT, TAFI were lower in the experimental group (P<0.05); the plasma levels of D-D, FIB were lower in the experimental group (P<0.05); the plasma levels of TT,PT,APTT were higher in the experimental group ( P<0.05 ) .Conclusion The hirudin could inhibit thrombin activation and coagulation function in fracture patients with lower limb venous thrombosis, decrease the plasma D-D and FIB levels for improving blood hypercoagulable state and preventing thrombosis,thus improve the clinical efficacy.

Inflammatory bowel disease( IBD),comprising Crohn’s disease( CD)and ulcerative colitis( UC),is a chronic intestinal inflammatory disease and its etiology has not yet been clarified. Studies showed that intestinal microbiota disorder is closely associated with the development and progression of IBD. Currently,fecal microbiota transplantation (FMT)is considered as a special organ transplantation and used in treatment of IBD,Clostridium difficile infection, irritable bowel syndrome,metabolic syndrome,etc. This article reviewed the relationship between FMT and IBD.

Objective To investigate the effect of pegylated interferon combined thymopeptideenteric-coated tablets on CXCR3, CCR6 and serum IL-2 and soluble ligand in patients with chronic hepatitis.Methods 125 patients with chronic hepatitis B patients from June 2015 to June 2016 in our hospital were selected and divided into observation group 62 cases and control group 63 cases.The observation group was treated with pegylated interferon combined thymopeptideenteric-coated tablets, and the control group was treated with thymopeptideenteric-coated tablets, the expression of T cells in patients with CXCR3 and CCR6 was detected by flow cytometry, the serum levels of interleukin-2 and soluble interleukin-2 receptorwere measured by enzyme-linked immunosorbent assay, and compared the treatment of two groups of patients.Results After treatment, the levels of IL-2 and sIL-2R in the observation groupwere (16.4 ±5.6), (9.4 ±2.1), significantly lower than that in the control group, while CXCR3 and CCR6 were (5.8 ±0.9), (5.54 ±1.2), significantly higher than the control group, the difference was statistically significant (P<0.05), the levels of HBsAg, HBeAg and HBV-DNA in the observation group were (1.5 ±0.4), (1.6 ±0.9), (1.6 ±0.3), significantly lower than those in the control group, the difference was statistically significant (P<0.05), the levels of ALT, AST, TBIL, IBIL in the observation groupwere (34.5 ±8.7), (31.4 ±6.9), (14.6 ± 6.9), (9.4 ±2.9), significantly lower than those in the control group, the difference was statistically significant (P<0.05).Conclusion Interferon combined thymopeptideenteric-coated tablets therapy for chronic hepatitis B is helpful to improve the level of chemokine receptor and inhibit the degree of inflammatory reaction.It can help to improve liver function and inhibit viral replication in patients with hepatitis B.It is better than the treatment of chronic hepatitis with thymosin alone.

Dens invaganatus is a type of abnormal morphological differentiation because of the involution in crown surface before tooth calci-fication,it is mostly found in maxillary lateral incisor teeth and rare in incisor.A case of a malformed lingual groove of left maxillary central incisor with 2 root canals is reported in the paper.

Objective To provide evidences which are for clinicians to formulate effective prevention and treatment measures by analyzing the perinatal pregnant women vaginal group B streptococcus (GBS)infection and adverse pregnancy outcomes. Methods From January 2013 to February 2015,the vaginal secretions were sampled from 795 cases of perinatal pregnant women for culture identification of GBS,the final results were statistical analyzed.Results In the 795 pregnant women ca-ses,there were 256 GBS carriers cases,the carrier rate was 32.2%.There was statistically significance (χ2 = 19.095,P <0.01)between less than 30 years old group (28.9%)and greater than or equal to 30 years old group (42.3%).The differ-ent incidence rate of clinical symptoms between GBS negative cases and GBS positive cases (18.8% vs 8.0%)was also had statistically significance (χ2 =39.514,P <0.01).The antimicrobial resistant rates of ten kinds of antibacterial drugs (vanco-mycin,linezolid,penicillin,ampicillin,ceftriaxone,nitrofurantoin,levofloxacin,clindamycin,erythromycin and tetracycline) was 0,0,0.6%,3.1%,6.6%,9.6%,21.9%,23.8%,29.9% and 58.1% respectively.The positive rate of D-bacteriostatic ring experiment was 23.9%.Conclusion The carrier rate of perinatal pregnant women GBS was higher in this region,and the elderly were easier to be infected.Perinatal pregnant women infected with GBS to vancomycin and rina thiazole amine and penicillin and ampicillin and ceftriaxone and with nitrofurantoin because of the sensitive rate is high.

Objective To establish the quality standards for Shufeng Zhike Extract;To improve the controll ability of the extract and ensure medicine efficacy. Methods To establish a HPLC method for simultaneous differentiation of Paeoniae Radix Alba, Saposhnikoviae Radix, Polygoni Cuspidati Rhizomaet Radix, Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Bupleurum in Shufeng Zhike Extract. Phenomenex Kintex C18 column (4.6 mm×100 mm, 2.6 μm) was used. Acetonitrile-0.05%phosphoric acid was as the mobile phase in gradient elution (0–25 min, 10%acetonitrile; 25–26 min, 10%→14% acetonitrile; 26–35 min, 14% acetonitrile; 35–36 min, 14%→34% acetonitrile;36–55 min, 34%acetonitrile) at flow rate of 0.8 mL/min, and column temperature was 40 ℃. The detection wavelength was 250 nm. To establish a HPLC method for simultaneous determination of Paeoniflorin and Prim-O-glucosylcimifugin in Shufeng Zhike Extract, Phenomenex Luna C18 column (4.6 mm×150 mm, 5 μm) was used; acetonitrile-0.05%phosphoric acid (12:88) was as the mobile phase at flow rate of 1 mL/min; column temperature was 40 ℃; the detection wavelength was 250 nm. Results The chromatographic peak separation with HPLC method for simultaneous differentiate of Paeoniae Radix Alba, Saposhnikoviae Radix, Polygoni Cuspidati Rhizoma et Radix, Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Bupleurumin in Shufeng Zhike Extract was clear and negative control had no interference. The linear range of Paeoniflorin was 0.035 93–2.514 8 μg (r=0.999 5), and the average recovery was 100.54%(n=6). The linear range of Prim-O-glucosylcimifugin was 0.006 7–0.67 μg (r=0.999 5), and the average recovery was 100.39%(n=6). Conclusion The established quality standards are simple, reliable, and accurate. It can rapidly identificate Paeoniae Radix Alba, Saposhnikoviae Radix, Polygoni Cuspidati Rhizomaet Radix, Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Bupleurum, and suitable for rapid determination of Paeoniflorin and Prim-O-glucosylcimifugin, which can provide the basis for the quality inspection of Shufeng Zhike Extract.

Objective To study the application of open reduction and plasticity titanium plate in the treatment of calcaneal fracture.Methods 29 patients with sanders Ⅱ、Ⅲ、V calcaneal fracture were treated by surgery with open reduction and titanium plate fixation.The clinical effects were observed.Results All patients were followed by Maryland Foot score postoperative functional evaluation system,the group of 29 cases of fracture,excellent 21 cases,good 9 cases,acceptable 2 cases,excellent rate was 93.7％.Condtusion The open reduction and internat fixation with plastic titanic plate was reliable to treat displaced intra-articular fracture of calcaneus.