Treating from liver is an important thought to treat esophageal cancer.Regulating the liver has very important significance in the process of treating esophageal carcinoma,which embodies at regulating liver is the key of soothing emotional injuries of esophageal carcinoma,removing esophageal pathology product and coordinating rising-descending function of spleen and stomach,and improving accompainedg symptoms of esophageal cancer.The thought of treating from liver should be used throughout the whole process of the treatment.So we must pay morn attention to regulate the liver and prevent liver injury during the differentiation and treatment of esophageal carcinoma.

Objective To explore ultrasound performances and misdiagnostic causes of aggressive fibromatosis (AF).Methods Ultrasound performance and misdiagnostic causes of 45 patients (47 tumors) with AF confirmed by histopathology were analyzed retrospectively.Results Of 45 patients,ultrasound showed lesions of varying size,and the maximum diameter of 36 masses (36/47,76.60％) were more than 3 cm;37 masses (37/47,78.72％) were irregular pale leaf;45 masses (45/47,95.74％) had no complete capsule;45 masses (45/47,95.74％) were shown as interogeneous internal echo mixed with hyperechoic area in the hypoechoic internal;29 cases were diagnosed correctly,16 cases were misdiagnosed,the diagnostic accordance rate was 64.44％ (29/46).Conclusion AF has certain ultrasonic characteristics.Combined with the patient's medical history and physical sign,ultrasound can significantly improve the preoperative detection rate and diagnostic accuracy of AF.

Objective To evaluate the quality of Isatidis Radix from different ecotypes by using projection pursuit model. Methods Totally 11 batches of Isatidis Radix from different ecotypes in Gansu Province were used as evaluation samples. With the contents of epigoitrin, uridine, guanosine, adenosine, benzoic acid, salicylic acid, indigo, indirubin, and alcohol extract as evaluating indexes, combined with projection pursuit model established by DPS V 9.50 statistics software, the quality of Isatidis Radix was evaluated. Results Based on the evalution of nine main indexes, quality order of the 11 batches of Isatidis Radix was acquired: S2>S1>S9>S7>S8>S3>S5>S10>S11>S4>S6. Conclusion The projection pursuit model was available for the quality evaluation of different ecotype Isatidis Radix. The quality of Isatidis Radix from different ecotypes is different significantly, and the quality of tetraploid Isatidis Radix of Shijiazhuang is the best.

Objective To observe the expression of bone matrix proteins and the change of intima-tunica media thickness ratio in diabetic rat small renal artery and to explore their correlation and effects on diabetic nephropathy. Methods Seventy healthy SD rats were randomly divided into diabetic group(DN,n=40)and normal control group(N,n=30).DN rat model was induced by streptozotocin(STZ)intraperitoneal injection and the N group rats were given the same dose of citrate buffer.Thirty-five rats were successfully induced in DN group.The rats were sacrificed at week 4,12 and 24,respectively.The protein and mRNA expression of core-bind factor alpha 1(Cbfcd).bone morphogenetic protein 2(BMP-2)and matrix Gla protein(MGP)in smallrenal artery were detected by immunohistochemistry,in-situ hybridization and real-time PCR at each time point. Results Cbfctl and BMP-2 were expressed obviously in small renal artery of DN group by immunohistochemistry stain and in-situ hybridization from 4 to 24 weeks compared with N group at each time point,reaching the peak at week 24.Real-time PCR showed that the MGP mRNA was evidently increased at week 4,slightly decreased at week 12,lowest at week 24in DN group.The BMP-2 mRNA began to increase from week 4 onward,being peak at week 24in DN group.The ratio of intima to tunica media thickness had no significant difference in DN group compared with N group at week 4,but at week 12 and 24 there were significant difference between them.There was a positive correlation between Cbfα1 and BMP-2 expression,but they were negatively correlated with the expression of MGP.The ratio of intima to tunica media thickness was significantly-correlated with the expression of Cbfα1 and BMP-2. Conclusions The ratio of intima to tunica media thickness is positively correlated with Cbfα1 and BMP-2 in small renal artery of early DN.Cbfα1,BMP-2 and MGP may be involved in the progression of vascular lesions in DN.

Objective:To survey the status of illness and consultation within two weeks among residents in a community in Chengdu.Methods:A multi-stage stratified random sampling was used to carry out a questionnaire survey among the residents in a community in Chengdu during March to April 2019. The disease status, disease severity and consultation within two weeks were surveyed, and influencing factors of two-week illness were analyzed with logistic regression.Results:Among 2 714 participants, 715 had illness (900 times) within two weeks, with a two-week prevalence rate of 26.3%. The main symptoms were dizziness (6.4%, 58/900), cough (6.2%, 56/900), lumbago and leg pain (4.9%, 44/900), palpitations (3.3%, 30/900) and headache (3.1%, 28/900). The three most common diseases were hypertension (38.3%, 345/900), diabetes (19.3%, 174/900) and common cold (6.4%, 58/900). In this survey, the rate of two-week in bed was 20.6‰(56/2 714), and the rate of two-week off work was 4.8‰(13/2 714). Age, gender, education level and work status were the influencing factors of the illness in two weeks ( P<0.05). The choice of medical institution was also different among residents. Conclusion:The survey suggest that primary care should focus on the key groups of residents in the community such as elderly, women, low education level, retirement and unemployed; and it is necessary to strengthen the primary care institutions and two-way referral system of health care.

Objective:To investigate the clinical effects of Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction on post-stroke depression in patients. Methods:Sixty-two patients with post-stroke depression who received treatment in Zhongda Hospital of Southeast University from October 2020 to April 2022 were included in this study. They were randomly treated either with traditional Chinese medicine decoction (control group, n = 31) or Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction (combined group, n = 31) based on routine medication. All patients were treated for 4 weeks. Depressive state, neurological function, and activities of daily living were compared between the two groups. Results:Before treatment, there were no significant differences in the Hamilton Depression Scale (HAMD) score, National Institutes of Health Stroke Scale (NIHSS) score, and Barthel index between the two groups (all P > 0.05). After 4 weeks of treatment, the HAMD and NIHSS scores in the control group were (13.88 ± 3.92) points and (8.56 ± 1.82) points, respectively, and they were (8.72 ± 2.48) points and (6.67 ± 1.14) points in the combined group. There were significant differences in HAMD and NIHSS scores between the two groups ( t = 2.14, 2.43, both P < 0.05). The Barthel index in the combined group was (69.53 ± 13.29) points, which was significantly higher than (62.34 ± 15.67) points in the control group ( t = 2.23, P < 0.05). Conclusion:Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction can reduce depressive symptoms and improve neurological function and activities of daily living in patients with post-stroke depression. The combined therapy has obvious efficacy in the treatment of post-stroke depression.

Chronic subdural hematoma (CSDH) is a collection of blood, blood clots and their degradation products, encapsulated by membrane and located within dural border cell layer. Pathophysiological processes such as inflammatory responses within hematoma cavity, coagulation abnormalities, and abnormalities in neovascularization play significant roles in CSDH development. High mobility group box 1 (HMGB1) can mediate processes such as inflammation, angiogenesis, and hemostasis, while thrombomodulin (TM) can bind with HMGB1 and rely on thrombin to degrade HMGB1. Current research has confirmed that the expressions of TM, HMGB1, and their downstream related factors are abnormally increased in the hematoma fluid of CSDH; however, the role of TM-thrombin-HMGB1 pathway in CSDH development is not fully clear. This article reviews the role of TM-thrombin-HMGB1 pathway in CSDH development, aiming to provide some references for pathogenesis and new therapeutic targets of CSDH.

BACKGROUNDTo investigate the indication, complication and efficacy of bronchial artery embolization for the management of lung cancer with massive hemoptysis.

METHODSThirty-eight cases of lung cancer with massive hemoptysis were retrospectively analyzed in our hospital from January 1996 to January 2003. All cases presented with acute hemoptysis from 220 to 980 ml daily, with a mean of 290 ml daily. A digital subtracted bronchial arteriogram was perfomed and bleeding arteries were embolized.

RESULTSHemoptysis decreased gradually in all cases and ceased in 3 or 4 days after embolization. Recurrence was found only in one case 2 months after embolization and second embolization was applied to control hemoptysis. No serious complications occured.

CONCLUSIONSBronchial artery embolization is safe and efficient for the management of lung cancer with massive hemoptysis.

The knowledge and clinical skill competition scores of 331 general practitioners (GPs),who attended the grassroots health posts training in Sichuan Province and Chengdu Municipality in 2016 and 2017,were documented.The factors influencing the competition results were analyzed.The mean knowledge test score of 331 participants were higher than the clinical skill score [(76.89±6.56) vs.(54.13±10.91),P＜0.01].The mean operational score in the clinical skill competition was higher than that of medical history collection,physical examination and clinical interview abilities [(32.31 ±3.28) vs.(21.82±5.09),P＜0.01].There were significant differences in knowledge and clinical skill scores among doctors from different regions or with different professional ranks (P＞0.05).The levels of clinical skills of general practitioners at the grass-roots level need to be further improved,according to relevant influencing factors.

Objective: To evaluate the clinical efficacy and adverse events of recombinant human interleukin-11(rhIL-11) in the prevention of thrombocytopenia induced by craniospinal irradiation. Methods: In this randomized control study, 100 patients were randomly divided into A (rhIL-11 group, n=50) and B groups (control group, n=50). In the A group, subcutaneous injection of rhIL-11 was delivered at a dose of 50 μg/kg/d, once daily when the platelet count was< 100×10⁹/L during radiotherapy or decreased by> 50% compared with the baseline level. The administration of rhIL-11 was terminated when the platelet count was ≥ 200×10⁹/L. In the B group, the same protocol was conducted when the platelet count was< 50×10⁹/L and terminated until the platelet count was ≥ 100×10⁹/L. The clinical efficacy was assessed in 92 patients. Subcutaneous injection of rhIL-11 could significantly elevate the minimal platelet count during craniospinal irradiation (P<0.01), considerably shorten the duration of thrombocytopenia (P<0.01) and effectively shorten the duration of radiotherapy (P<0.01). Main adverse events included mild pain at the injection site, sclerosis, redness and fatigue, etc. Conclusions Injection of rhIL-11 can significantly enhance the platelet count, effectively reduce the incidence of thrombocytopenia throughout craniospinal irradiation, guarantee the success of radiotherapy and yield mild adverse events.