72 cases of treatments on insomnia were recorded in the medical books of Ming and Qing dynasties(A.D.1368～1911 years).The compatibility regularity of treating insomnia in these 72 cases were statistically analyzed with frequency and the R type cluster analysis methods. Combining the data and modern recognition, compatibility and medication regularity of treating insomnia was further analyzed.

Adult ; Female ; Humans ; Maxillary Sinus Neoplasms ; Middle Aged ; Neoplasms, Muscle Tissue

Objective:To study the relationship between telomerase activity and the expression of proliferating cell nuclear antigen(PCNA) in oral squamous cell carcinoma (OSCC). Methods:Telomerase activity and expression of PCNA in 68 cases of OSCC,34 cases of epithelium immediately adjacent to carcinomas and 12 cases of normal oral mucosa were detected by TRAP-PCR-ELISA and immunohistochemical SP method. Results:The positive rate of telomerase in OSCC, the epithelium immediately adjacent to carcinomas and the normal oral mucosa was 67.65%(46/68), 8.82%(3/34) and 0(0/12) respectively. Telomerase activity in OSCC was related to the grade of the clinicopathology(P

Objective To investigate the protective effects and molecular mechanism of peroxisome proliferate-activated receptor α(PPARα) activation on acute myocardial damage induced by isoproterenol (Iso) in rats. Methods Thirty male Wistar rats, weighting 160～180 g, were randomly divided into control group, Iso group, fenafibrate(FF) group(each n=10) according to physique quantity. Acute myocardial injury caused by Iso abdomen cavity injection induced ischemia was established and the protective effects of peroxisome proliferate-activated receptor α activation were accessed by the level of ereatine kinase(CK), lactic dehydrogenase(LDH) in serum as well as the activities of myoperoxidase(MPO) in myocardium, and the protein expressions of PPABα in myocardium by Western blot. Results The level of serum CK in control group, lso group and FF group, was (62.41±9.47),(101.71±11.05),(75.64±11.73)kU/L, respectively(F= 34.34, P<0.01). Whereas the level of serum CK in Iso group and FF group was higher than that in control group(P<0.01 or<0.05), the level of serum CK in FF group was lower than that in Iso group(P<0.01). The levels of LDH in these three groups were (5912.20±204.44), (6365.78±137.10), (6089.76±169.60) U/L, respectively(F= 17.54, P<0.01). Compared with the control group, the levels of LDH in Iso and Fir groups were significantly increased(P<0.01 or<0.05). But the level of LDH in FIr group was decreased compared with that in Iso group(P<0.01). The activities of myocardial MPO in these three groups were (1.95±0.10),(3.89±0.17),(2.49±0.19)U/g, espectively(F=391.68,P< 0.01). The activities of myocardial MPO in Iso and FF groups were higher than that in the control group (all P< 0.01), while the activities of myocardial MPO in FIr group were lower than that in lso group(P<0.01). The protein expressions of PPARα in myocardium of these three groups were 251.57±10.95,191.97±10.74,215.08±9.61, respectively(F=82.69, P<0.01). Conclusion PPARα activation by its actor FF can exert protective effects on the acute myocardial ischemia injury induced by lso in rats through inhibiting the release of inflammatory cell factors.

Objective:To analyze and evaluate the usage and tendency of quinolones before and after the special rectification of antibacterial in one grade III level A hospital in üanjing to provide evidence for the special rectification of antibacterial and manage-ment. Methods:The usage records of quinolones in 2010( before the special rectification)and in 2011-2013( after the special rectifi-cation)were collected,and the sales revenue,DDDs,defined daily cost( DDC),drug resistance and adverse drug reactions( ADR) were analyzed retrospectively. Results:Both the amount and ratio of the sales revenue of quinolones were declined dramatically after the rectification(2011-2013). Among all kinds of quinolones,the sales revenue and DDDs of lomefloxacin aspartate injections was the highest before the rectification while moxifloxacin injections and levofloxacine hydrochloride injections ranked the first and the second respectively in sales revenue after the rectification(2012-2013). As for the DDDs,levofloxacin hydrochloride tablets and levofloxacine hydrochloride injections were the highest after the rectification. Besides,moxifloxacin injections had the highest DDC after the rectifica-tion. Moreover,the drug resistance of the main drug-resistant bacteria( namely staphylococcus,enterobacteriaceae and non fermenta-tion bacteria)to levofloxacin,norfloxacin and ciprofloxacin was declined after the rectification. The adverse drug reactions of levofloxa-cin,lomefloxacin,enoxacin and moxifloxacin were declined year by year after the rectification,and the ADR ratio of quinolones in all anti-bacterial agents was also declined. Conclusion:After the special rectification of antibacterials,the hospital exhibits obvious im-provement in all the application indices of antibacterials,reflecting a good result of the special rectification. However,the hospital still needs to strengthen the inspection over the clinical application of the fourth generation of quinolones.

Objective To investigate the related factors of early liver cancer recurrence associated with elevated fasting glucose levels after radical resection of liver cancer.Methods The retrospective cohort study was adopted.The clinical data of 145 patients with liver cancer who were admitted to the Nanfang Hospital of Southern Medical University from October 2009 to June 2013 werc collected.After radical resection of liver cancer, 111 patients with average level of fasting blood glucose (FBG) ＜ 6.1 mmol/L and 34 patients with level of FBG ≥ 6.1 mmol/L were divided into the normal group and the hyperglycemic group, respectively.The blood glucose levels of patients during the period of hospital stay and follow-up were observed.The status of early recurrence and risk factors affecting recurrence in the 2 groups were analyzed.Follow-up of outpatient examination was applied to patients up to July 1, 2015 with the first recurrence as the end point.Patients had reexaminations once every month within postoperative month 6 and once every 3 months after 6 months.The general information [gender, age, FBG, underlying hepatopathy, preoperative AFP, alanine transaminase (ALT), aspartate aminotransferase (AST), Child-Pugh stage, Barcelona Clinic Liver Cancer (BCLC) stage, history of alcohol drinking], surgical data (surgical method, operation time, number of blood transfusion, volume of intraoperative blood loss), pathological data (histopathological differentiation, number of tumor nodules, diameter of maximal tumor, liver cirrhosis) and follow-up data (postoperative AFP, imaging findings, recurrence time, preventive chemotherapy) were collected.Measurement data with normal distribution were presented as-x ± s and analyzed by the t test.Measurement data with skewed distribution were presented as M (range) and analyzed by the non-parametric test.Count data were analyzed using the chi-square test.With the first recurrence as the end point, the tumor-free survival rate was drawn using the Kaplan-Meier method, and the comparison was analyzed by the logrank test.The risk factors affecting recurrence were analyzed using the Kaplan-Meier method for proportional hazards assumption test firstly, and then eligible factors were done using Log-rank test in the univariate analysis.The multivariate analysis was done using the COX model.Results The postoperative 1-, 2-year overall recurrence rates of liver cancer were 28.3％ (41/145) and 45.5％ (66/145).And 1-, 2-year recurrence rates of liver cancer were 21.6％ (24/111) and 36.9％ (41/111) in the normal group and 50.0％ (17/34) and 73.5％ (25/34) in the hyperglycemic group, respectively, showing significant differences between the 2 groups (x2=10.335, 14.053, P ＜ 0.05).The univariate analysis showed that FBG, Child-Pugh stage, volume of intraoperative blood transfusion and postoperative AFP were risk factors affecting tumor-free survival rate after radical resection of liver cancer (x2 =17.591,6.492, 10.690,12.820, P ＜ 0.05).The tumor-free survival rates at postoperative month 24 in the normal group and hyperglycemic group were 63.1％ and 26.5％ respectively, showing significant difference between the 2 groups (x2=17.591, P ＜ 0.05).The results of multivariate analysis showed that level of FBG ≥6.1 mmol/L, volume of intraoperative blood transfusion ＞ 200 mL and postoperative level of AFP ＞ 8.1 pg/L were independent risk factors affecting tumor-free survival rate after radical resection of liver cancer (RR =2.542, 2.028, 2.724, 95 ％ condifence interval : 1.529-4.225,1.183-3.479,1.635-4.538, P ＜ 0.05).Conclusions Elevated FBG level has a stimulative effect on early recurrence of tumor after radical resection of liver cancer.As a result, monitoring and controlling of blood glucose after operation is helpful in decreasing the early recurrence rate of patients with liver cancer.

To explore the effect of magnitude and duration on the performance of Cumulative Sum (CUSUM),with simulation method used on the subject after the insertion of 11 outbreak events into baseline data with Poisson distribution.Sensitivity fluctuated from 9.1％ to 100.0％ with specificities higher than 98.6％.Sensitivity was significantly correlated with magnitude,and increased along with the increase of magnitude.However,no significant correlation was observed between sensitivity and duration.A magnitude which was at least 2.6 times higher than that of the mean daily baseline could result in the sensitivity of 100.0％.Time-lag would be improved along with the increase of magnitude.Time between onset and detection of an outbreak was no longer than one day when magnitude was more than 1.8 of the mean daily baseline.In summary,the performance of CUSUM was influenced by magnitude,but not by duration.CUSUM had the advantage of good time-lag and high sensitivity when the outbreak magnitude was more than 2.4 time over the baseline data.

Objective To evaluate the clinical efficacy of infliximab (IFX) in Crohn′s disease (CD) and its effects on mucosal healing and promoting fistula closure.Methods Between September 2007 and February 2011,relevant clinical data of CD patients treated with IFX in the Department of Gastroenterology,Ruijin Hospital were collected and the efficacy and safety of IFX were retrospectively analyzed.After IFX therapy,the efficacy evaluation included laboratory index,clinical efficacy,efficacy of fistula closure and mucosal healing.The data were analyzed using t test and Wilcoxon signed-rank test.Results A total of 22 patients were enrolled in this study,11 males and 11 females; the mean age was 29.3 years.The dosage of IFX was 5 mg/kg to 10 mg/kg at week 0,2,6to induce remission,and every 8 weeks on maintenance therapy.Of 22 patients,16 patients were active CD.One case dropped out.At week 14,of the remaining 15 cases,11 cases achieved clinical remission,two cases achieved clinically effective and two cases were ineffective.Crohn′s disease activity index (CDAI) (112±80) and ESR [(13±11) mm/1 h] of week 14 decreased compared with that of week 0 [(186±88),(21± 15) mm/1 h,P=0.04 and 0.007].Two cases of 10 patients with fistula dropped out as a result of ineffective,while eight cases had a partial response and six patients sustained response during the maintenance therapy,but no fistula closed and completely disappear.Seven patients reviewed by endoscopy after five times IFX therapy (24 weeks),after therapy the simple endoscopic score for Crohn′ s disease (SES-CD) ( 3.21 ± 2.89 ) decreased compared with that before treatment (5.86±3.02) (Z＝-2.38,P＝0.018).Eleven times of adverse events were found in nine patients,infusion reaction and respiratory tract infection were more common and no severe adverse effect was observed.Conclusions IFX can rapidly improve clinical symptoms and with good safety.The effects in mucosal healing and fistula closure may occur at early medication.

ObjectiveTo investigate the clinical features and the efficacy of medium-and long-term immune suppression in the treatment of Crohn's disease (CD) in Chinese Han nationality.MethodsThe clinical data and diagnosis methods of 178 CD patients between 2003 and 2010 were analyzed.All patients received predinisone and immune suppression (azathioprine) treatment.The patients were followed up every 2 weeks.Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were reviewed every 4 weeks.CD activity index (CDAI) was scored every 3 to 6 months.ResultsThe peak age for onset of CD was between 18 to 30 years old,and the mean time from the appearance of symptoms to diagnosis was (8.3±3.7) months.About 34.8％ (62/178 cases) patients had corresponding complications at time of diagnosis due to the progress of the disease.The average dosage of azathioprine was (1.24±0.16) mg/kg,and the total withdrawal rate due to adverse effect was 15％ (25/167 cases).The surgical intervention rate was 15.1％ (22/146 cases) during long-term follow-up.ESR and CRP of patients decreased obviously and tended to normal after 3 months treatment.The CDAI score significantly decreased after 6 months treatment.Conclusions Most Chinese patients had a good tolerance of immune suppression and achieved better medium- and long-term clinical efficacy at the dosage lower than that recommended by European and United States guidelines.

AIM:To compare the clinical effects of 25G+ and 27G+ transconjunctival sutureless vitrectomy in treating idiopathic macular hole.METHODS: We retrospectively reviewed the clinical outcomes of 56 eyes (56 patients) with idiopathic macular hole which were treated with micro-incision vitrectomy from June 2015 to September 2016.Patients were divided into two groups, 28 patients (28 eyes) were treated with 25G+ vitrectomy and the rest (28 eyes) were treated with 27G+ vitrectomy.The operative time and intraoperative complications were recorded and patients were followed up for 3-6mo.During the follow up period, best correct vision acuity (BCVA), intraocular pressure, macular hole healing and postoperative complications were documented and statistically analyzed.RESULTS: BCVA in two groups were significantly improved after surgery(P<0.001) and there was no significant difference between the two groups(P=0.84).No serious complications occurred.No statistically significant difference was found between the two groups in surgical time and healing rate of macular hole (P=0.57, 0.64).The incidence of low intraocular pressure (IOP<10mmHg) in 27G+ group was lower than that in 25G+ group on the first day after surgery(P=0.31).There was no significant difference between preoperative and postoperative intraocular pressure at 1wk after operation in both groups (P=0.72, 0.92).CONCLUSION: Both 25G+ and 27G+ vitrectomy are safe and effective technique in treating idiopathic macular hole.Besides, 27G+ showed better superiority on the maintenance of intraocular pressure and reduce the trauma.