Objective To explore the clinical efficacy and adverse reactions of transarterial chemoembolization(TACE)combined with sorafenib for the treatment of liver carcinoma.Methods Forty-eight cases of intermediate-advanced liver carcinoma patients were divided into TACE combined with sorafenib group(test group)and TACE only group(control group)according to the wishes of the patient,with 24 patients in each group.The median Survival Time(mOS),clinical efficacy,quality of life,liver function indexes and adverse reactions were compared in two groups.Results Until the deadline of follow-up time,the mOS in test group(15.9 months)was significantly higher than that in control group(9.3 months).The difference was statistically significant(P<0.05).The ORR,CBR in test group(58.3%,87.5%)were significantly higher than those in control group(33.3%, 54.2%).The difference was statistically significant(P<0.05).The quality of life improvement rate in test group(79.2%)was significantly higher than that in control group(37.5%).The differences were statistically significant (P<0.05 ).The ALB,TBIL increased significantly after treatment than before treatment in both groups.The differences were statistically significant(P<0.05 ).Conclusion TACE combined with sorafenib is more efficiency than TACE only treatment,and it could effectively extend the period of life to guarantee the quality of life.What's more,it has well tolerated adverse reactions,which is worthy of promoting.

Objective To evaluate the semen quality of potential semen donors of college students and investigate their reproductive health status. Methods According to the screening procedure in the Basic Standard and the Technical Norms of Human Sperm Bank revised by Chinese Ministry of Health in 2003,all sperm samples of 355 potential donors were examined. Results 37 of 355 donors sperm(10.4%) were qualified to the normal standard revised by Chinese Ministry of Health;and the rest(89.6%) were abandoned,because the sperm numbers of 267 donors were not reached the identified semen standard of the human sperm bank in the first screen,26 donors(7.4%)were with abnormal health status,4 donors did not ejaculate and got samples,9 donors with normal semen quality did not take physical health examination,the normal shape percentage of 6 donors sperm was lower than 30% and the thawed revival percentage with(a+b) grade of 6 donors was lower than 60%.135 of 355 donors(38.0%) sperm quality were qualified to the male productive standard of WHO. Conclusion The results indicated that the sperm quality of undergraduate declines and the society should pay more attention to the reproductive health of college students.

Objective To identify antimicrobial susceptibilities of community-acquired Staphylococcus aureus infections and the risk factors of severe infections.Methods Clinical data of 184 cases of community-acquired Staphylococcus aureus infections collected from 4 hospitals in Ningbo during May 2008 and May 2013 were reviewed.Microbial sensitivity test and virulence genes ( pvl and tst) detection were performed in clinical isolates, and SCCmec genotyping was performed in methicillin-resistant Staphylococcus aureus ( MRSA) strains.Binary logistic regression analysis was used to identify the risk factors for severe infections.Results Among 184 cases of community-acquired Staphylococcus aureus infections, 39 ( 21.20%) were severe cases. Staphylococcus aureus strains were highly resistant to penicillin, erythromycin and clindamycin, but more than 75% strains were sensitive to oxacillin, aminoglycosides, quinolones, rifampicin and vancomycin.Logistic regression analysis showed that advanced age (OR=1.024, 95%CI:1.005-1.043, P<0.05), malignant tumor (OR=15.288, 95%CI:1.609-145.229, P<0.05) , autoimmune diseases or long-term hormone therapy ( OR=12.102, 95%CI:2.082-70.338, P <0.01 ) were risk factors for severe community-acquired Staphylococcus aureus infections. Conclusions Strains isolated from the patients with community-acquired Staphylococcus aureus infections in Ningbo are usually sensitive to oxacillin, aminoglycosides, quinolones, rifampicin and vancomycin, which may be recommended for clinical use.Elder patients and those with malignant tumor, autoimmune diseases or long-term hormone therapy are more likely to develop severe Staphylococcus aureus infections.

Objective To explore one mechanism of therapeutic action of electroacupuncture on Alzheimer’s disease (AD), that is, improving the way to eliminate cerebral microvascular Ab by investigating the effect of electroacupuncture on hippocampal microvascular Ab deposition and learning and memory abilities in APP/PSI double transgenic mice. Method Twenty-four 7-month-old male APP/PSI double transgenic mice were randomized into model and electroacupuncture groups, 12 mice each. Same sex transgene-negative littermate mice (12 mice) constituted a blank control group. The electroacupuncture group received electric acupuncture at points Baihui (GV20) and Yongquan (KI1), 15 min once every other day, for a total of six weeks. After treatment, mouse learning and memory abilities were tested using the Morris water maze. The expressions of Ab 1-40 and Ab 1-42 in the hippocampal microvascular wall and senile plaque were determined by immunohistochemical method. Hippocampal microvascular Ab-positive expression was semi-quantitatively analyzed using the Imagine Pro Plus software. Result The Morris water maze test showed that escape latency lengthened (P<0.05), and the number of crossing platform and swimming time in the platform quadrant decreased (P<0.05) in the model group compared with the blank control group. Escape latency shortened (P<0.05), and the number of crossing platform and swimming time in the platform quadrant increased (P<0.05) in the electroacupuncture group compared with the model group. The immunohistochemical results showed that hippocampal microvascular Ab 1-42 and Ab 1-40 integral optical densities were higher in the model group than in the blank control group (P<0.05) and senile plaques appeared in the hippocampus. Hippocampal microvascular Ab 1-42 and Ab 1-40 integral optical densities were lower in the in the electroacupuncture group than in the model group (P<0.05). Conclusion Electroacupuncture reduces mouse learning and memory impairments and hippocampal microvascular Ab deposition. Its mechanism may be that electroacupuncture improves the way of eliminating cerebral microvascular Ab to decrease cerebral Ab deposition.

Objective To observe the effect of the optimized formulas of extracts of Radix Astragali and Radix Angelicae Sinensis on the survival status of the idiopathic pulmonary fibrosis (IPF) mice,and on the expression levels of transforming growth factor-β (TGF-β) and vascular endothelial growth factor(VEGF),so as to optimize the therapeutic regimen and to explore the therapeutic mechanism.Methods One hundred and five SPF ICR male mice were randomly divided into normal group,model group and 5 Chinese medicine treatment groups (group 1,2,3,4,5 of the optimized formula of Radix Astragali and Radix Angelicae Sinensis extracts).The mice in the model group and the 5 treatment groups were intratracheally injected with bleomycin (5 mg/kg) to induce the pulmonary fibrosis model.On day 21,the lung tissues were taken out for the test.Hydroxyproline content was detected by alkaline hydrolysis method,and morphological changes of lung tissues were observed by hematoxylineosin (HE) staining and Mallory's staining methods.The expression levels of TGF-β and VEGF were detected by polymerase chain reaction (PCR).Results The HE staining and Mallory's staining results showed that the pulmonary fibrosis in the 5 treatment groups was relieved as compared with that in the model group,especially in the group 1,and the alveolar structure recovered better.The 21-day overall death rate in the treatment groups were lower than those in the model group,and group 1 and group 5 had the lowest rates,the difference being statistically significant (P＜ 0.05).Compared with the model group,the content of hydroxyproline in the lung tissues of the treatment groups were decreased to some degrees,and there was significant difference (P ＜ 0.05 or P ＜ 0.01).The expression levels of TGF-β and VEGF in model group were higher than those in normal group,but were deceased in the treatment groups to some degrees,except TGF-β expression in group 5,and the difference was significant(P ＜ 0.05 or P ＜ 0.01).Conclusion When the contents of Radix Astragali water-extract and Radix Angelicae Sinensis alcohol-extract were predominated,the extract formula exerts certain effects on decreasing hydroxyproline content in the lung tissues,inhibiting the expression levels of TGF-β and VEGF,and relieving the degree of pulmonary fibrosis in IPF mice.

Cultivating Clinical thinking ability is an important tache of clinical medical education. Teachers'guidance, the charateristics that suit teaching, the organic combination of the active methods which can mobilize clinical medical interns' learning enthusiasm, such as problem-based learning, and humanity education are effective approaches to enhancing interns' clinical thinking ability.

Background and purpose: Primary signet ring cell carcinoma(SRCC) of the bladder is rarely diagnosed in the clinic. Few cases have been reported in the literature, so there was lack of understanding of the primary bladder SRCC in terms of diagnosis and treatment. Our study was to investigate the clinical features and treatment strategy for primary SRCC of the bladder and review the status of the disease along with the literature. Methods: 3 cases of primary bladder SRCC were studied, including clinical features, treatment, follow-up and their prognosis.The literature was reviewed. Results: All cases received ultrasound, computerized tomography, cystoscopy, biopsy and other related lab tests for diagnosis and differential diagnosis. Laparoscopic radical cystectomy and orthotopic ileal neobladders were performed in 2 cases, while the other case received laparoscopic radical cystectomy and ileal conduit diversion, Chemotherapy (cisplatin and 5-fluorouracil) was delivered in one case after surgery. One patient died at 6 months postoperatively because of multiple metastasis. The other 2 cases have been followed-up only for 8 and 12 months postoperatively, and no recurrence or metastasis have been observed. Conclusion: Primary SRCC of the bladder lacks distinctive clinical and imaging manifestations. The tumor grows very invasively. Radical cystcctomy is one of the optimal approaches for treatment of SRCC of bladder.

Background and purpose: The prognostic factors on survival for the patients with prostate carcinoma are still underdeterrnined. This study was to analyze the survival of three common treatment methods for prostate carcinoma and the prognostic factors on survival. Methods: 494 male patients who were diagnosed as prostate cancer were enrolled into the retrospective study. All of the data like age, stage, grade, PSA level, ALP, Hb and treatments were collected. Overall survival and disease specific survival rates for patients were analyzed by Kaplan-Meier method. Prognostic factors on disease specific survival were also analyzed by Log-rank test and Cox proportional hazards model. Results: Disease specific survival rates at 1, 3 and 5 year were 96.0%, 89.0% and 80.0% for all 494 patients, respectively. Disease specific survival rate at 3-year was 92.4% for brachytherapy, 100.0% for radical prostatectomy and 80.6% for hormonal therapy (P=0.008). Multivariate analysis by Cox model showed that stage, PSA level and age significantly impacted on disease specific survival. Conclusion: Brachytherapy and radical prostatectomy provides longer survival time than hormonal therapy for patients with prostate cancer. Clinical stage and PSA level and age of prostate cancer are independent factors impacting on survival significantly.

Objective To study the effect of electroacupuncture on the behavior of APP/PS1 transgenic mice of different age, and to explore the optimal intervention time of electroacupuncture in treating Alzheimer's disease (AD). Method APP/PS1 double-transgenic mice of 4 months, 6 months and 9 months old, 20 in each age group, were randomized into a model group and an electroacupuncture group, and ten C57BL/6 wild-type mice were taken as a control group; after 6-week electroacupuncture treatment, the Morris water maze was adopted for spatial memory and behavioral test, and the changes of behavior in each group were observed.Result Of the 5-month-old mice, there were no significant between-group differences (P>0.05), while the time factor (day) produced a statistical significance (P<0.01); of the 7-month-old mice, there were significant differences considering the different groups, time factor and interaction (P<0.01); of the 10-month-old mice, there were significant differences considering the different groups, time factor and interaction (P<0.05). The spatial probe test showed that there were significant between-group differences in comparing the platform crossings and swimming distance in platform quadrant in each age group (P<0.05).Conclusion Electroacupuncture can improve the learning and memory of APP/PS1 double-transgenic mice, the age of 6-7 months old is possibly the optimal intervention time of electroacupuncture for AD, but there still requires further mechanism studies.

Objective To investigate the intervention effects ofYinao Jieyu Prescription on the behaviors and damages in hippocampal CA1 area of the rats with post-stroke depression (PSD).Methods Totally 168 SPF male SD rats were randomly divided into normal group, sham-operation group, stroke group, PSD group, Western medicine group and TCM group. There were 24 rats in the normal group and sham-operation group, and 30 rats in the other groups. Rats in the normal group received no intervention. Rats in the sham-operation group received no suture. Rats in the stroke group were given middle cerebral artery occlusion operation and normally fed after operation. Rats in the PSD group, Western medicinal group and TCM group were made into PSD models by chronic immobilization stress for one week and individual battery to the end. At the inception of modeling, Western medicine group received fluoxetine hydrochloride for gavage; TCM group receivedYinao Jieyu Prescription for gavage; other groups received distilled water for gavage, once a day. At the end of week 2, 4, and 8, the morphology of the hippocampal CA1 area in each rat was observed by microscope after HE stained.Results Except for the week 2, at the same time point, the behavior scores of the rats in the TCM group were higher than those in the PSD group. At the same time point, the CA1 region of the hippocampus in the TCM group was more complete than the PSD group, and the cells were arranged neatly and in normal morphology.ConclusionYinao JieyuPrescription can improve the symptoms of PSD rats, and has protective effects on hippocampal CA1 area.