Objective To Observe the effects of treating primary trigeminal neuralgia with modified Shaoyao-Gancao decoction and carbamazepine. Methods 76 patients with primary trigeminal neuralgia were randomly divided into a treatment group and a control group, 38 patients in each. The treatment group was treated with modified Shaoyao-Gancao decoction and carbamazepine; and the control group was treated with carbamazepine only. Clinical curative effect, pain improvements and adverse reactions were observed after the treatment and 6 week follow-up. Results The total effective rate was 89.3%and 75.5%in the treatment group and the control group respectively, the difference was statistically significant(P=0.043). The onset frequency, duration, degree of pain were all improved in both groups after the treatment and 6 week follow-up[treatment group after the treatment is (0.54±0.78), (2.15±1.73), (1.58±1.26), 6 week follow-up is (0.24±0.63), (1.36±1.03),0.86±1.95);control group after the treatment is (1.98±1.68), (3.96±1.49), (3.02±1.45), 6 week follow-up is (1.06±1.78), (1.97±1.69), (2.13±1.54), P<0.05],and the treatment group was better than the control group(P=0.040 and 0.039 respectively). Conclusion Modified Shaoyao-Gancao decoction combined carbamazepine has good clinical curative effect in treating primary trigeminal neuralgia.

Objective:To investigate the relationship among happiness, resilience, optimistic intelligence quotient and perceived social support in patients with advanced gynecological cancer.Methods:A total of 269 patients with advanced gynecological cancer from January 2018 to January 2019 in three top three hospitals in Shanghai were selected as subjects by convenient sampling.The basic information questionnaire, Memorial University of New-foundland scale of happiness, Connor-Davidson Resilience Scale simplified Chinese version, Optimistic Intelligence Quotient Questionnaire and Perceived Social Support Scale were used to investigate.Results:The score of happiness was (32.45±6.37), the score of resilience was (30.64±8.78),the score of optimistic intelligence quotient was (62.74±12.49) and the score of perceived social support was (68.14±4.25) in patients with advanced gynecological cancer. Linear regression equation analysis showed that happiness and optimistic intelligence quotient × happiness had significant predictive effect on resilience ( β values were 0.547, 0.016, P < 0.05), optimistic intelligence quotient had no significant predictive effect on resilience ( P>0.05), and optimistic intelligence quotient, happiness, resilience, optimistic intelligence quotient×happiness had significant predictive effect on perceived social support ( β values were 0.015-0.251, P<0.01). Happiness could regulate the direct path and the first half of the mediating effect of resilience between perceived social support and optimistic intelligence quotient. According to Johnson-Neyman's analysis, the boundary value of the moderating effect of happiness between optimistic intelligence quotient and resilience was 26.19, and the boundary value of the moderating effect of happiness between optimistic intelligence quotient and perceived social support was 22.08. Conclusions:There is a positive correlation between optimistic intelligence quotient and perceived social support in patients with advanced gynecological cancer. Resilience can play a significant mediating role between optimistic intelligence quotient and perceived social support under the regulation of happiness, which can provide corresponding psychological intervention for patients with advanced gynecological cancer.

Objective To compare and analyze the changes of CEA,CA19-9,CA72-4 in different pathologictypes of gastric cancer.Methods 93 patients with gastric cancer were divided into different groups according to the histological types,pathologic types and TNM staging.The levels of CEA,CA19-9,CA72-4 of the patients were measured,then the results were compared and analyzed.Results The level of serum tumor marker of the moderately differentiated group was obviously higher than that of well-differentiated group(P ＜ 0.05),while the level of serum tumor marker of the poorly differentiated group was obviously higher than that of moderately differentiated group (P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between the well-differentiated group,moderately differentiatedgroup and poorly differentiated group were statistically significant(F =61.433,57.882,125.547,all P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between patients of TMN Ⅰ stage,TMN Ⅱ stage,TMN Ⅲ stage,TMN Ⅳstage were statistically significant(F =189.624,95.236,80.342,all P ＜ 0.05).The difference of serum tumor marker between different histological groups was not statistically significant (all P ＞ 0.05).Conclusion The concentration of serum CEA,CA19-9,CA72-4 will be higher if the gastric tumor is poorly differentiated or invades deeply,but the concentration of serum tumor has nothing to do with the histological types of the tumor.

At present,reports at home and abroad suggest a low probability of successful preservation of ovarian endocrine function after ovarian shift radiotherapy.After radiotherapy for cervical carcinoma,the ovarian function is associated with various factors,such as radiotherapy dose and method,patient's age,shift position,and concurrent chemotherapy drugs.Therefore,as for each patient,the dose to the ovarian tissue should be controlled within the individual dose limit to effectively preserve the ovarian function.

OBJECTIVE:To study the effects of indometacin on apootosis and proliferation of cervical cancer Hela cell. METH-ODS:Hela cell was cultured in vitro as study object,and cultured with 0(blank control),200,400,600,800 and 1 000 μmol/L indometacin for 24,48 and 72 h. The inhibitory rate of indometacin to the proliferation of Hela cells was detected by MTT assay. After treated with 0(blank control),400,600 and 800 μmol/L indometacin for 24 h,the change of cellular morphology was ob-served by invert microscope;cell cycle phase and apoptosis were analyzed by flow cytometry. RESUITS:Indometacin of 600, 800,1 000μmol/L could inhibit the proliferation of Hela cell,which was positively correlated to drug concentration and time. Com-pared with blank control,indometacin could induce that Hela cell transformed from polygonous to round in appearance,and result-ed in cell apoptosis and necrosis;the proportion of cells at G0/G1 phase increased,while the proportion of cells at S phase reduced;the apoptotic rate of cells raised. CONCLUSIONS:Indometacin could inhibit the proliferation of Hela cell,block cell cycle at G0/G1 phase and induce apoptosis.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) or high glucose on the toll-like receptor 4 (TLR4) expression,inflammatory cytokines and fibrotic factors in human tubular epithelial cells (HK-2),revealing the innate immune-related pathogenesis of diabetic nephropathy (DN) which may have clinical implications.Methods Three TLR4 siRNA sequences were designed and synthetized.After transfection,the most effective siRNA was selected to use for further expriments.The experiment consisted of 2 parts.Part 1:Cells were divided into three groups:normal-glucose group (NG,5.5mmol/L glucose),mannose group (M,5.5 mmol/L glucose + 19.5 mmol/L mannose),High-glucose group (HG,25 mmol/L glucose),preliminary validated the effects of high glucose and high osmotic pressure.Part 2:Cells were divided into seven groups:NG group,HG group,Ang Ⅱ group,Ang Ⅱ + negative group,HG+ negative group,Ang Ⅱ + siRNA group and HG+ siRNA group.Real time PCR was used to analyze the mRNA expression of TLR4,myeloid differentiation factor 88 (MyD88),heat shock protein 47 (HSP47).Western blotting was used to observe the protein expression of TLR4,MyD88,HSP47,NF-κB,type Ⅳ collagen (ColⅣ).ELISA was used to detect the expression of monocyte chemotactic protein-1 (MCP-1) and interleukin-6 (IL-6).Results Compared with NG group,TLR4,MyD88,HSP47 mRNA and TLR4,MyD88,NF-κB,ColⅣ,HSP47 protein were highly expressed under high glucose or Ang Ⅱconditions (P ＜ 0.01),and the expression levels of MCP-1 and IL-6 also increased significantly (P ＜ 0.01).Compared with HG or Ang Ⅱ group,the above indicators were obviously inhibited in the TLR4 siRNA groups (P＜0.01).Comparison between blank vector transfected groups and HG group as well as Ang Ⅱ group indicated no statistic significance (P ＞ 0.05).Conclusions Both Ang Ⅱ and high glucose stimulate TLR4 expression,which result in the up-regulation of inflammatory and fibrotic factors in HK-2.Specific target of TLR4 gene silencing can block the TLR4 pathway that is activated by high glucose and Ang Ⅱ,and thus reduce the inflammatory and fibtogenic factors' release.TLR4 signal is the common innate immune response pathway which induces the release of inflammatory and fibrotic factors in HK-2 under high glucose or high angiotension conditions.

Professional postgraduates in geriatric medicine are one of the most important re-courses of geriatric specialists. However, training model for geriatric postgraduates is still unclear in China. In general, geriatric medicine has no independent training plan, and is included in internal medicine training. Such model cannot represent the feature of geriatric medicine. The present paper aimed to discuss the ability construction for geriatric postgraduates based on the geriatric medicine specialist training experience both at home and abroad, including diagnosis and treatment of multi-system diseases, ability of geriatric assessment, management of geriatric syndromes, consultation for geriatric rehabilitation and ability for continuity health service in order to cultivate the compound tal-ents suitable for the aging society requirement for geriatric medicine in China.

Objective To investigate the long-term safety and efficacy of the domestic biodegradable drug-eluting cor?onary stents (BuMA) in treating coronary heart disease (CHD). Methods Patients (n=440) who received BUMA stents were designated as observation group while patients (n=460) received Resolutestents were designated as control group. The base?line clinical characteristics, extend of pathological change shown by Coronary Arteriography (CAG),the procedure of percu?taneous coronary intervention were similar between these two groups. The patients were followed up for a mean of 24 ± 4 months;the primary endpoint was the occurrence of definite or probable stent thrombosis;secondary endpoint was major ad?verse cardiac events (MACEs) including complex end such as recurrent angina, acute non-fatal myocardial infarction, death, target vessel revascularization (TVR); other endpoints include all- cause mortality, cardiac death, myocardial infarc?tion (MI), target lesion revascularization (TLR), non-target vessel revascularization and stroke. Some patients were lost dur?ing follow up, which include 5 in observation group and 26 in control group. Results Patients in observation groups were in?serted with 615 stents while patients in control group were implanted with 614 stents, both groups with average of implanting 1.41 stent/case. There are no statistical significance differences in the primary endpoint [1.4%(6/435) vs 1.8%(8/434), χ2=0.087], secondary endpoint [12.3%(54/435) vs 10.8%(47/434),χ2=0.524] and other endpoints between the two groups. Con?clusion These data suggest that domestic biodegradable drug-eluting coronary stents (BuMA) are with good long-term safe?ty and efficacy.

Objective To investigate the characteristics of intestinal flora in infants with different feeding patterns.Methods Sixty-two cases of health infants(30-120 d)were divided into 4 groups according to their feeding patterns:breast feeding,imported powder milk feeding,domestic powder milk feeding and mixed feeding.Samples of their fresh feces in each group were collected and divided into sections equally:the bifidobacteria were isolated in anaerobic box and the number was counted for one section;for the other section,total DNA of intestinal flora was extracted and enterobacterial repetitive intergenic consensus (ERIC) fingerprints were amplified with the method of ERIC-PCR.After that,the specific bands observed in different groups were cloned and sequenced and alignmented.Results The colonies of bifidobacteria were more in breast feeding and mixed feeding groups[(9.10 ± 1.33) cfu/g;(8.62 ± 1.35) cfu/g]than those in domestic powder milk feeding and imported powder milk feeding groups[(7.62 ± 1.22) cfu/g;(7.32 ± 0.80) cfu/g,t =3.23,P ＜ 0.05];while there was no significant difference between breast feeding and mixed feeding groups,and between 2 powder milk feeding groups.Two specific bands were found from the ERIC fingerprints (A:1 100 bp mainly in breast feeding,domestic powder milk feeding and mixed feeding groups;B:1 000 bp mainly in imported powder milk feeding group).Sequencing and analysis of Basic Local Alignment Search Tool showed that homologous bacteria of A and B fragments were bifidobacterium longum.The encoding protein of A fragments might be related to the enzymes of carbohydrate metabolism,and B fragments were related to the enzymes of protein metabolism.Conclusions The colonies of bifidobacteria in intestinal tract are more in breast feeding and mixed feeding infants than those in formula feeding groups.The distribution of intestinal flora in domestic powder milk feeding infants is more similar to that of the breast feeding infants.

Objective To discuss the effectiveness between arthroscope cleaning combined with exercise therapy and exercise therapy in senile osteoarthritis patients.Methods Two hundred and ten senile osteoarthritis patients were divided into operation group and non-operation group by random digits table method with 105 cases each.Patients in operation group received the arthroscope cleaning and exercise therapy,and patients in non-operation group received the exercise therapy alone.The visual analogue score (VAS) and international knee documentation committee knee evaluation form (IKDC) score before treatment and 1,6 and 12 months after treatment were compared.Results A total of 210 patients received the analysis of result without drop-out.There were no statistical differences in VAS and IKDC scores before treatment and 6 and 12 months after treatment between operation group and non-operation group (P ＞ 0.05).The VAS and IKDC scores 1,6,12 months after treatment were significantly improved compared with those before treatment in operation group,and there were statistical differences (P ＜ 0.05).The VAS and IKDC scores 6,12 months after treatment were significantly improved compared with those before treatment in non-operation group,and there were statistical differences (P ＜ 0.05).According to the IKDC score,in operation group 15 patients were excellent,61 patients were fine,19 patients were general and 10 patients were bad after treatment,and good effectiveness rate was 72.38％ (76/105).In non-operation group,14 patients were excellent,59 patients were fine,20 patients were general and 12 patients were bad after treatment,and good effectiveness rate was 69.52％ (73/105).There was no statistical difference in the good effectiveness rate between 2 groups (P ＞ 0.05).Conclusions Exercise therapy with guidance can significantly improve the function of senile knee joint osteoarthritis,and ease joint pain symptoms.Arthroscope cleaning combined with exercise therapy can relieve the joint acute inflammatory symptoms,but it has no significant clinical effectiveness in long-term treatment of osteoarthritis.