Objective To investigate the effect of perineural invasion (PNI) on evaluating the prognosis of patients with gastric cancer.Methods The clinical data of 116 patients who underwent gastric resection were analyzed retrospectively,all of the paraffin sections were stained with S-100 albumen,the association between PNI with clinicopathological features and prognosis were analyzed.Results PNI was positive in 41 of all the 116 patients (35.3％,41/116).The occurrence of PNI related with depth of invasion,histological type,lymph node metastasis (P ＜0.05),unrelated with gender,tumor size,Borrmann classification,TNM stage (P ＞0.05).One hundred and five patients completed follow-up,the median follow-up time was 49 months,the median life span and 5-year survival of the PNI-positive patients were significantly worse than that of PNI-negative patients [23.6 months vs.43.8 months,30.6％(ll/36) vs.53.6％ (37/69),P ＜ 0.05].Univariate and multivariate analysis were prompted PNI with perineural invasion (P ＜ 0.05).Conclusions The PNI-positive tumor cell may have more power in invasiveness,and it could serve as an independent predictor of prognosis of gastric cancer.

Objective To investigate the clinical efficacy of acupoint catgut embedding in treating patients with early-stage type 2 diabetes.Methods Two hundred and forty patients with early-stage type 2 diabetes were randomly allocated to treatment and control groups, 120 cases each. The control group received diet control and kinesitherapy and the treatment group, acupoint catgut embedding in addition. Fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin (GHB) and body mass index (BMI) were measured in the two groups before and after treatment and the clinical therapeutic effects were compared between the two groups.Results There were statistically significant post-treatment differences in FPG, 2hPG and GHB between the two groups (P<0.05). There was a significant difference in comparing FPG and GHB between the two groups after intervention (P<0.05).The total efficacy rate was 98.3% in the treatment group and 85.0% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusions Acupoint catgut embedding can improve glucose tolerance and reduce the incidence of diabetes in patients with early-stage type 2 diabetes.

Objective To investigate the effect of the early occupational therapy (OT) on depressive mood and activities of daily life in patients with stroke.Methods Retrospectively 80 cases of acute stroke patients in our hospital were randomly divided into the early occupational therapy group (40 patients) and control group (40 cases), and two groups of patients were given conventional medical and rehabilitation treatments.Early functional occupational therapy also included occupational therapy group, the personal activities of daily life, the secondary and vocational rehabilitation activities such as job.Hamilton depression scale (HAMD) and activities of daily living scale(ADL) were used to assess the incidence of depression and activities of daily life before and after treatment.Results Compared with the control group(17 cases/40 cases) ,the incidence of post-stroke depression of early occupational therapy group (5 cases/40 cases) was lower, and the difference was statistically significant (x2=5.2012, P＜0.05).The HAMD score of occupational therapy group(10.98±3.66) was lower than the control group(17.70±3.83), and the difference was statistically significant (t=8.0230, P＜0.05).The ability to daily life of occupational therapy group was higher than that in control group,and significantly difference was showed (58.17 ± ±25.82 vs 45.33±25.15, t=2.2530, P＜0.05).Conclusion Early occupational therapy can improve the activities of daily life and have a certain preventive effect on depressive mood in patients with stroke.

Objective To investigate the efficacy of Ginkgo‐Leaf Capsule combined with tripterygium glycoside in the treat‐ment of diabetic nephropathy(DN) and its influence on CysC ,Hcy and VEGF .Methods Eighty patients with DN treated in our hospital from January 2013 to April 2015 were selected as research subjects and equally divided into the control group and the ob‐servation group according to the random number table ,40 cases in each group .Besides the conventional Western medicine treat‐ment ,the control group was given tripterygium glycoside ,while the observation group was given Kinkgo‐Leaf Capsule combined with tripterygium glycoside .The treatment course was 3 months .Then ,the curative efficacy ,indices of renal function ,levels of Cy‐sC ,Hcy and vascular endothelial growth factor(VEGF) ,and occurrence situation of adverse reactions were compared between the two groups .Results The total therapeutic efficacy rate in the observation group and the control group was 92 .50% and 80 .00%respectively without statistically significant difference (P>0 .05) .In the comparison with the control group after treatment ,the re‐nal function indices of serum creatinine ,urea nitrogen ,24 h urinary protein ,level of serum CysC ,Hcy and VEGF in the observation group were statistically decreased (P< 0 .05) .During the treatment process ,no severe adverse reactions occurred in the two groups .The incidence rate of adverse reactions in the observation group and the control group was 17 .5% and 12 .5% respectively without statistical difference (P>0 .05) .Conclusion Ginkgo‐Leaf Capsule combined with tripterygium glycoside is effective and reliable for treating DN ,which can significantly improve the renal function ,reduces the level of serum CysC ,Hcy and VEGF .

Objective To investigate the expression and clinical significance of bcl-2 and NF-κB/ p65 in different subgroups of diffuse large B-cell lymphoma (DLBCL). Methods Immunohistochemical staining was used to detect the expressions of CD10, bcl-6, and MUM-1 in the DLBCL patients. According to immunohistochemical algorithm of Hans et al. DLBCL were subdivided into GCB and non-GCB/ABC subgroups and the expressions of bcl-2 and NF-κB/p65 were detected. The expressions of bcl-2 and NF-κB/ p65 in GCB DLBCL were compared with that in ABC DLBCL,and the correlation of bcl-2 and NF-κB/p65 expressions with survival in the two major subgroups of DLBCL were analyzed. Results The expression rates of bcl-2 and NF-κB/p65 proteins in DLBCL were 67.1% and 77.1%, and there was significant correlation between them. The expression rates of bcl-2 and NF-κB/p65 were 52.0 % and 56.0 % in GCB DLBCL, but were 75.6 % and 88.9 % in ABC DLBCL. The expression rates of two proteins were higher in ABC DLBCL than in GCB DLBCL. There was no significant correlation between bcl-2 and NF-κB/p65 protein expressions and overall survival within the GCB DLBCL subgroup, but bcl-2 and NF-κB/p65 expressions had a significant effect on overall survival within the ABC subgroup. Conclusion bcl-2 and NF-κB/p65 expressions are associated with poor survival in the ABC subgroup only. Hence, the significance of bcl-2 and NF-κB/p65 protein expressions should be assessed in the context of DLBCL subgroups in the future.

Objective To explore the effect of scalp acupuncture combined with rehabilitation on acute cerebral infarction patient's movement disturbance synchronously.Methods Fugl-Meyer Assessment was used to assess the motor function of scalp acupuncture combined with rehabilitation synchronously and non synchronously.Results The motor function of the group for scalp acupuncture combined with rehabilitation synchronously was improved prominently and was superior to control group on the 20th day and 30 day of the period of treatment.Conclusion The therapy of scalp acupuncture combined with rehabilitation synchronously and non synchronously can all improve the patient's motor function obviously,and the effect can increase with prolong of the period of treatment in a certain period. The advantage of the two Methods being used synchronously was appread and increased gradurally with prolong of the period of treatment and the therapy is worthy of being generalized.

OBJECTIVE: To analyze clinical features with benign paroxysmal positional vertigo (BPPV) and discuss the attentions in the canalith repositioning procedures. METHOD: A total of 76 male and female patients aged 80 and over with BPPV (elderly group) and 76 patients aged 60-65 years old with BPPV (older group) was retrospectively analyzed. RESULT: (1)Semicircular canal condition: in elderly group, posterior semicircular canal was involved in 72 cases, whereas the horizontal semicircular 4 cases. In older group, posterior semicircular canal was involved in 70 cases, whereas the horizontal semicircular and multiple canals in 5 cases and 1 case respectively. (2) Precipitating factors: precipitating factors of elderly were variety. Its closely related with emotion, infection, seasonal alternation surgery, and trauma. There were significant differences between the two groups (P<0. 05). (3) The symptoms of undergoing treatment and post-treatment: the duration of dizziness and carebaria were significant difference after canalith repositioning procedure treatment between two groups (P<0. 05), the duration of balance disturbance and symptoms of vegetative nerve functional disturbance like nausea and sweating were significant difference (P<0. 05). (4) Treatment and outcomes: the remission, partial remission rate were 34. 2 %, 81. 6% re- spectively, after the first or second time of repositioning treatment. The efficacy of repositioning treating at the first time was significantly different between two groups (P<0. 05). It was poor efficacy in elderly group. There is no difference in efficacy for repositioning treatment at the second or third time (P>0. 05). (5) The elderly always accompanied with other medical condition and had risk factors of cerebrovascular disease. The efficacy was not associated with the complication(P>0.05). However, it was most likely to overtreatment caused by emphasizing other medical conditions treatment. BPPV was easy to ignore and misdiagnose, meanwhile, delayed the diagnosis and increased the medical costs. (6) Many elderly were accompanied cervical spondylosis, lumbar spondylosis body stiffness and fear of vertigo which increased the difficulty of repositioning treatment. (7) Recurrence: we followed up 2 years after treatment. In older group, 11 patients (14. 5%)were relapsed. In elderly group, 29 patients (38. 2%) relapsed. There were significant differences between the two groups (P<0. 05). CONCLUSION There are various precipitating factors in elderly patients with BPPV, the most frequent precipitating factors were related to psychological factor and overfatigue. The symptoms of the patients attack BPPV was always mask with other diseases, but do not impact on the efficacy of Canalith repositioning at the first time; Even the efficacy of repositioning is poor at the first time, it's effective and safety after multiple treatments of repositioning; It prolonged the symptoms including carenaria, dizziness and nausea after treatment.
Aged ; Benign Paroxysmal Positional Vertigo ; complications ; diagnosis ; psychology ; therapy ; Dizziness ; Emotions ; Female ; Humans ; Male ; Masks ; Patient Positioning ; adverse effects ; methods ; Recurrence ; Retrospective Studies ; Semicircular Canals ; Spondylosis ; Vertigo

The incidence of adenocarcinoma of the esophagogastric junction ( AEG) is rising rapidly in recent years. AEG as an independent disease different from squamous cell carcinoma of the esophagus and gastric adenocarcinoma is getting acknowledged for most of scholars, with the distinctive anatomy location and involute recurrence and metastasis style. A higher rate of relapse and poor prognosis after resection become conscious since most of patients have been diagnosed with advanced disease, and adjuvant chemoradiotherapy needs to be valued further. But so far, there is no clinical data and subgroup analysis aimed at the value of postoperative treatment for AEG specially, leading to controversy is remaining in patients could get benefit from postoperative treatment, and delineation of the radiation target, etc. The design of the irradiation target should in terms of the clinical?pathological characteristics of the AEG, Siewert'''' s subtypes, the lymph node metastasis mapping and recurrence characteristics after surgery.

Objective To research the function of the vagus nerve center nucleus of solitary tract(NTS)in the influence of gastric pressure by acupuncture at "Zusanli" in rats with motility disturbances of the stomach.Methods Adopting electrophysiological methods,the extracellular discharge signals of neuronic action in NTS were recorded with glass microelectrode.The influence of the discharges of NTS neurons and gastric pressure responding to the acupuncture at "Zusanli" point were observed in normal status and the condition of Atropine or Metoclopramide intravenous injection.Results In the normal status,acupuncture at "Zusanli" activated the discharges of NTS neurons and promote the gastric pressure remarkably.After Atropine intravenous injection,the background discharges of NTS neurons decreased.There was no statistical difference in the discharges responding to the effect of acupuncture before and after Atropine administration.And the gastric motion reinforced obviously by acupuncture at "Zusanli" after Atropine administration.But after intravenous injection of Metoclopramide,the background discharges of NTS neurons increased.There was also no statistical difference in the discharges responding to the effect of acupuncture before and after Metoclopramide administration.Moreover,the function of promoting gastric motion by acupuncture at "Zusanli" got more obviously after Metoclopramide administration.Conclusion The function of adjusting gastric motion by acupuncture at "Zusanli" point has close relation to the activation of NTS neurons,and the increasing amplitude of the discharges of NTS neurons wasn't influenced by cholinergic receptor blocker Atropine and dopamine-receptor antagonist Metoclopramide.