OBJECTIVE: To study the inhibitory effect of Danggui Buxue Tang (DBT), a compound traditional Chinese herbal medicine for supplementing blood, on tumor growth in tumor-bearing mice after inoculation of EL-4 cells, and its immune mechanism as well as its synergic effect in reducing toxicity of cytoxan (CTX). METHODS: Experiment was carried out in tumor-bearing mice after inoculation of EL-4 cells. The mice were randomly divided into four groups after 7 days of the inoculation: untreated group, DBT-treated group [24 g/(kg x d)], CTX-treated group [7.5 mg/(kg x d)] and DBT plus CTX-treated group, with another ten normal mice as control. Inhibitory rate of tumor growth, survival time, immune function and variability of blood cells were measured in the mice during the experiment. RESULTS: After treatment of relevant interventions for 15 days, the tumor in the DBT-treated group, CTX-treated group and DBT plus CTX-treated group grew slower than the untreated group (P<0.05). Murine survival time in the DBT-treated group, CTX-treated group and DBT plus CTX-treated group was lengthened as compared with that in the untreated group (P<0.05). Compared with the untreated group, all kinds of immune indexes in the DBT-treated group and DBT plus CTX-treated group were significantly improved (P<0.05), while the immune indexes in the CTX-treated group were decreased (P<0.05). Compared with the CTX-treated group, all kinds of immune indexes in the DBT plus CTX-treated group were significantly improved (P<0.05). CONCLUSIONS: DBT can enhance the immune function in tumor-bearing mice and the inhibitory effect of DBT on tumor growth is related to the enhanced immune response. DBT can also increase the therapeutic effects and reduce the side effects of CTX.

Objective To investigate the diagnosis of Crohn's disease(CD)in Ruijin hospital of School of Medicine of Shanghai Jiaotong University according to the criteria made by World Health Organization(WHO)and Chinese Medical Association.Methods The consecutive patients with CD diagnosed in Ruijin hospital between 1998 and 2007 were retrospectively analyzed.The clinical manifestation.endoscopic,radiologic and pathologic findings of all patients were re-evaluated accordingto the diagnostic criteria of CD proposed by WHO and Chinese Medical Association in 2007.The diagnostic level of CD was assessed.Results Only 5 and 10 patients were confirmed to be well consistent with the criteria of WHO and Chinese Medical Association,respectively.Two hundred and thirty-six patients were confirmed as suspected diagnosis to the criteria of Chinese Medical Association and 20 patients to WHO.The level of endoscopic diagnosis was raised,wherease the level ofpathologic diagnosis was decreased in recent years compared with that before 2004.Conclusion The pathologic diagnosis rate of CD is still at a low level.The current diagnostic level of CD is lagging behind the demand of the guidelines.

Objective To investigate the method and effect of monosegment pedicle instrumentafinn on thoraeolumbar vertebral fracture.Methods Sixteen patients with thoracolumbar vertebral fractures treated by open reduction and monosegment pedicle instrumentation through posterior approach.Posterolateral bone grafting was done in all cases,9 cases were quite decompressed using laminectomy.The follow-up time Was 8-24 months.The spine radiographs and CT scan were taken pre-and post-operation.The parameters used for clinical evaluation were the Denis pain scale,neurological evaluation by the Frankel scale and bone graft healing evaluation by the Suk scale.Results All of the fractures were reduced satisfactorily during the follow-up.The height of the injured vertebral improved rate was 30.8%,kyphosis of the injured vertebral segment rectified obviously.There was no implant break,and no signs of losing were observed in any patient.Nine patients which had neurological deficiency had average improvement more than one degree by the Frankel scale.After operation the pain score was P1 in 14 patients and P2 in 2 patients.Condnsion For the appropriate patients with thoracolumbar vertebral fractures,open reduction and internal fixation of monosegment pedicle instrumentation through posterior approach is a safe and effective method.

Objective To investigate the CT and MRI features of Langerhans cell histiocytosis (LCH) with multiple spinal involvement.Methods The CT and MRI data of 13 patients with multiple LCH lesions in spine confirmed by pathology were retrospectively analyzed.All of 13 cases underwent CT examination (1 case underwent enhanced scanning) and 12 cases underwent MR examination (6 cases underwent enhanced scanning).Results In 13 cases,there were 8 cases of single central lesions invading the adjacent vertebrae and 5 cases of multiple central lesions.There were 19 core spinal lesions and 15 adjacent invading lesions in a total of 34 vertebrae lesions.Eighteen core lesions (18/19,94.74 ％) had different degrees and shape of vertebral compression.A total of 34 abnormal vertebrae were found in 13 cases by CT,which were manifested as osteolytic bone destruction.Eighteen cortical bones of 19 core vertebrae were incomplete,and a paravertebral soft-tissue masses were observed.There were 33 vertebrae lesions in 12 patients who underwent MR examination,including 18 core spinal lesions and 15 adjacent invading lesions.The lesions displayed equal,slightly lower or low signal on T1WI,slightly higher or high signal on T2WI and high signals on fat suppression sequences.A paravertebral soft-tissue masses were observed in 17 core spinal lesions (17/18,94.44％).Conclusion CT and MRI manifestations of spinal multiple LCH have certain characteristics.The level of diagnosis and differential diagnosis should be improved by deepen understanding of the disease image performance,but the diagnosis still depends on the pathology.

ObjectiveTo evaluate the sufficiency of dialysis and nutri ti onal status of 44 end-stage renal disease (ESRD) with urea metabolic parameters such as TACurea,KT/V and PCR.MethodClinical data were collecte d and analyzed with statistic methods.ResultsTACurea and PCR w ere significantly lower in patients in insufficient dialysis group than those in sufficient dialysis group.There was no statistical difference between the two g roups in terms of KT/V.PCR was not influenced by KT/V in sufficient dialysis gro up,while it was significantly influenced by KT/V in insufficient dialysis group. ConclusionTACurea and PCR are significant indicators to assess whether the blood dialysis is sufficient or not in the long run.KT/V can direct ly indicate the effectiveness of single dialysis.Therefore,it is the best indica tor for adjusting the dialytic strategy.However,it is not important if the dialy sis is not sufficient.

Objective To study the CT and MRI features of the chordoma in the mobile spine.Methods The CT and MRI fea-tures were retrospectively analyzed in twenty-four cases of chordoma in the mobile spine.Results In all the twenty-four cases,bone lesions were solitary in eight cases and multiple in sixteen cases,mostly occurred in cervical,occasionally occurred in thoracic or lum-bar vertebra.Both vertebral body and part appendix were involved in all cases.CT imaging showed that all the lesions mainly mani-fested as osteolytic bone destruction,peripheral osteosclerosis and the cortical bone were incomplete.Soft-tissue mass involved para-vertebral and intraspinal.Five lesions appeared vertebrae compression.Eight lesions appeared intervertebral foramen expansion.Le-sions appeared honeycomb or annular enhancement after contrast media injection.Lesions were presented as heterogeneous slightly hypo-isointensity on T1 WI,hyperintensity on T2 WI.Low signal fibrous septa within the tumors were seen.Lesions appeared hon-eycomb enhancement after Gd-DTPA injection.Conclusion CT and MRI findings of chordoma in the mobile spine can be regarded as characteristic,which are helpful for clinical diagnosis.

Objective To explore the efficacy and safety of transcatheter intra-arterial hyperthermo-chemotherapy for advanced ovarian carcinoma. Methods 36 patients with unresectable or recurred ovarian carcinoma were divided into two groups randomly: treatment group(n=20) and control group(n=16). Transcatheter intra-arterial infusion warmed to 62 degree chemo-agents via the ovarian tumor supplied artery was performed in the treatment group while routine intraarterial chemotherapy was done in the control group. The CA125 level dynamic change, short-term efficacy and side effect after the interventional procedure were compared between two groups.Results The CA125 level decreased significantly in the treatment group more than that in the control group(?

Objective To investigate the effects of intra-articular injection of ropivacaine plus compound betamethasone after arthroscopic debridement for knee osteoarthritis.Methods A total of 164 patients with knee osteoarthritis after arthroscopic debridement were randomly divided into three groups:combination group (n=62) treated by 2 ml sodium hyaluronate and 0.75％ ropivacaine of 5 ml plus 1 ml compound betamethasone,compound betamethasone group (n=54) by 2 ml sodium hyaluronate and 1 ml compound betamethasone,control group (n=48) by simply sodium hyaluronate.The Lequesne Index was used to evaluate the clinical effects before and 1 week,6 weeks and 12 weeks after operation.All patients received at least 12 weeks follow-up Results According to Lequesne Index score criteria,a significant decrease was found in all groups before versus after operation(P＜0.05).The clinical effects in combination group and compound betamethasone group were more improved as compared with control group at 1,6 and 12 weeks after operation (P＜0.05).The effect in combination group was better than compound betamethasone group at 1 and 6 weeks after operation,but not at 12 weeks (P＞0.05).Conclusions The intra-articular injection of ropivacaine plus compound betamethasone after arthroscopic debridement is a good method for relieving pain and improving the knee function.

Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.

Objective:To understand the coronavirus disease 2019(COVID-19)prevention and control work and the problems and difficulties faced by non-government primary medical institutions in China during the epidemic period.Methods:A survey on the coronavirus disease 2019(COVID-19)prevention and control work of non-government primary medical institutions was conducted on April 14 to 21, 2020 with the self-designed questionnaire. The questionnaire contained three parts: the first part was basic information of medical staff in non-government primary medical institutions, including position and institutional information; the second part was the status quo of non-government primary medical institutions participating in the prevention and control of COVID-19, including the specific work and difficulties faced by the responders during the epidemic period; and the third part was the prevention and control effect of COVID-19 in the responders′ institutions, including whether there were confirmed cases and infected medical staff. An online invitation was issued among the members of General Practice Branch of Chinese Non-government Medical Institution Association. The invited participants included the heads, general practitioners and other medical personnel of the non-government primary medical institutions the invited participants voluntarily scanned the online two-dimensional code to fill in.Results:A total of 761 individuals in primary health institutions from 20 provinces, municipalities and autonomous regions in China participated in the survey. There were 290 (38.1%) men and 471 (61.9%) women with age of 40(32, 48) years; 83.0% (632/761) had worked for more than 5 years; 33.8% (257/761) owned primary professional titles and 33.0% (251/761) owned intermediate titles. Among all participants 28.5% (217/761) were general practitioners, 26.9% (205/761) were institutions/department managers, 14.6% (111/761) were specialists and 40.3% (307/761) were other related personnel. A total of 549 institutions continued to operate during the epidemic period and 96.5% (530/549) participated in the work related to the prevention and control of the epidemic, including prescreening and triage, health consultation, follow-up of suspected patients, donation, quarantine of suspected cases, follow-up of close contacts/discharged patients, diagnosis and treatment of patients with new coronavirus pneumonia. 44.7% (340/761) of respondents participated in the epidemic prevention as front-line staff and directly contacted patients/suspected patients, and 63.1% (480/761) participated in the epidemic prevention work of primary medical institutions, including clinical outpatient service, prescreening triage and screening. The working sites were not limited to the institutions, but also other sites including high-speed railway station. The 97.8% (744/761) responders expressed their willingness to participate in epidemic prevention work under the unified leadership and command of the state. The 63.9% (486/761) of the responders were worried about the lack of protective equipments and measures, and 90.4% (688/761) respondents showed that they needed medical supplies (protective equipment: masks, goggles, protective gowns, etc.).Conclusion:The participation of non-government primary medical institutions and their staff in COVID-19 infection prevention and control is a key component of the epidemic prevention process.