OBJECTIVE: To explore the relationship between the effect of acupuncture and layered localization of computed tomography (CT) in treatment of lumbar disc herniation. METHODS: Based on the CT layered localization, the herniated lumbar discs were positioned in 5 layers, A, B, C, D and E among 300 patients with lumbar disc herniation. Combined with the horizontal and the frontal planes, the three-dimensional location was formed. Acupuncture was delivered at acupoints including bilateral Shenshu (BL23), Dachangshu (BL25), and Huantiao (GB30), Weizhong (BL40) on the affected side. One intervention of acupuncture was 30 min, once daily; 1 course of treatment was composed of 10 interventions and 2 courses were required. Before and after treatment, Japanese orthopaedic association (JOA) score was recorded, and the effect was evaluated. The curative effect was classified and compared with the CT layered localization. RESULTS: Of 300 patients, 226 cases were effective and the effective rate was 75.33%. The JOA scores of all patients, and in the effective group and the non-effective group were higher compared with the scores before treatment (P<0.05). With the layered localization considered, acupuncture was more effective on the cases positioned in C layer. Regarding the horizontal plane, the effect was better on the cases with zone 1 and zone 1-2 involved. In terms of the grade of frontal plane, acupuncture was more effective on the cases graded Ⅰ and Ⅱ. CONCLUSION The clinical effect of acupuncture on lumbar disc herniation is related with the layer and the horizontal zone of herniated disc positioned, as well as to the grade of the frontal plane.
Humans ; Acupuncture Therapy ; Intervertebral Disc Displacement/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Tomography, X-Ray Computed ; Lumbar Vertebrae/diagnostic imaging* ; Acupuncture Points ; Aged ; Young Adult ; Treatment Outcome

Objective: To analyze the clinical characteristics of allergic reactions in patients with colorectal cancer after routine premed-ication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regimen and to provide a reference for reduc-ing the risk of oxaliplatin allergy. Methods: Retrospective analysis of 242 patients with colorectal cancer who received chemotherapy with an oxaliplatin-containing regimen at the Changzhou Cancer Hospital of Soochow University from January 2014 to October 2017 was performed, and the incidence of allergic reactions was calculated. The associations between multiple factors and allergic reactions were then assessed using univariate analysis. The independent factors of allergic reactions were assessed using multivariate Logistic analysis, and the treatment outcome of oxaliplatin rechallenge in allergic patients was discussed. Results: A total of 242 patients were studied. They received routine premedication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regi-men. Twelve (4.9%) patients had type I allergic reactions, with a median onset time of 6 (5.5-10.5) cycles and a median cumulative dose of 895 (716.5-1 075.0) mg. Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (P=0.04). Rechallenging patients with prophylactic agents was successful in 1 (33.3%) of 3 patients who completed their treatment. Conclusions: Routine low-dose dexamethasone premedication before oxaliplatin administration is safe and exhibited a lower inci-dence of hypersensitivity reactions than that reported in literature. An oxaliplatin-free interval may increase the risk of hypersensitivity reactions. Caution should be exercised while rechallenging allergic patients with oxaliplatin.

Objective:To establish a liquid chromatography tandem mass spectrometry ( LC-MS/MS) method for the determination of 5-fluorouracil (5-Fu) in patient’s plasma and apply it in clinics patients validation. Methods:5-Fu was analyzed on an Agela Inno-val NH2 (2. 1 mm × 50 mm, 5 μm) column. Methanol:ultra pure water (2 ∶98) was used as the mobile phase with isocratic elution. The flow rate was 0. 3 ml ·min-1 and the column temperature was set at 40℃. The ion transitions with electrospray ionization negative model were m/z 128. 8→42. 1 and m/z 188. 6→42. 1 for 5-Fu and 5-bromouracil (the internal standard), respectively. The LC-MS/MS method was verified according to the guideline of quantitative analysis validation of biological samples ( Chinese Pharmacopoeia, 2015 edition, the fourth part) . Results:The calibration curve of 5-Fu was linear within the range of 10-1 000 ng · ml-1 . The lower limit of quantification was 10 ng · ml-1 . The precision, accuracy, matrix effect and stability within the linear range were all in line with the requirements of method validation. Conclusion:The LC-MS/MS method developed in the study for the determination of 5-Fu is simple, rapid, accurate and reproducible, which can be used for the plasma concentration detection of 5-Fu in patients.

Objective To investigate the impact of transvaginal natural orifice transluminal endo-scopic surgery(NOTES)-assisted laparoscopic nephrectomy on female sexual function and quality of life . Methods This was a prospective study on the change of female sexual function and quality of life of female patients who underwent transvaginal NOTES-assisted laparoscopic nephrectomy from May .2011 to Nov. 2012.A total of 42 cases were included in this study (28 of them with severe hydronephrosis , non-functio-ning kidney , 11 with pyelonephrosis , 1 with renal tuberculosis , 1 with duplex kidney complicated with hy-dronephrosis, and 1 with renal angiomyolipoma ).The mean age was 36.9±5.3 (26-45) years, and the mean body mass index was 21.7±2.6 (14.7 to 27.1) kg/m2.Twenty-four cases were operated on the left side, 18 cases on the right .The female sexual function and quality of life were assessed before and 4 months, 7 months and 1 year after surgery using the Female Sexual Function Index (FSFI) questionnaire and the MOS 36-item Short-Form Health Survey (SF-36), respectively. Results The mean FSFI of 42 cases preoperatively and 4 months, 7 months and 1 yr postoperatively were 27.74 ±4.34, 27.19 ±4.49, 28.54±4.23, and 28.68 ±4.19, respectively.There was no statistically significant difference among them (F=1.111, P=0.346).Compared with that of preoperation , the physical function, vitality, metal health, body pain, and general health of the patients were improved , but the role-physical, role-emotion and social function were not improved at postoperative month 4 and month 7 (P<0.05).Each item of SF-36 was im-proved after postoperative 1 year ( P<0.05) . Conclusions Transvaginal NOTES-assisted laparoscopic ne-phrectomy does not cause negative effect on the female sexual function .The quality of life can be improved after operation .The physical function is improved at early stage , and the psychological function as well .

Objective To investigate the predictive value of class Ⅲ β-tubulin protein expression in tumor tissue for the efficacy of taxol combined chemotherapy in stage Ⅲ s/Ⅳ gastric carcinoma patients.Methods Tumor biopsy samples were obtained and class Ⅲ β-tubulin protein expression were examined by immunohistochemical staining before chemotherapy.According to different expression of class Ⅲ β-tubulin,the patients were divided into two groups,group A(low expression of class Ⅲ β-tubulin),group B(high expression of class Ⅲ β-tubulin).The patients were assigned to be received 4 to 6 cycles of Taxol and S-1 chemotherapy regimens and followed up until death or lost.Response rate(RR),overall survival(OS)and time to tumor progression(TTP)were assessed.Results There was no significant difference in clinical characteristics among patients with different expression rate.The RR was higher and TIP was longer in group A than in group B(53.3 ％ vs 36.7 ％,198 days vs 146 days,P ＜ 0.05 respectively),and no significant differences of OS in two groups(P ＞ 0.05).Conclusion The expression level of class Ⅲ β-tubulin in tumor tissue is probably a predictor for the efficacy of taxol in gastric cancer patients,taxol combined chemotherapy is more suitable for patients with lower expression of class Ⅲ β-tubulin.

The taxol s effect of inducing apoptosis is mainly related to its ability to promote tubulin polymerization and prevent tubulin chain depolarization. Drug resistance is the main restriction factor for clinical usage of taxol. Some basic and clinical studies support that poor response to taxol and poor prognosis are related to overexpression of β tubulin Ⅲ.