Heart failure is a fatal stage of end-stage cardiovascular disease,which brings a huge medical burden to the society because of its high mortality and re-hospitalisation rates.Intestinal microecology is the largest and most com-plex microecosystem of human body.It is inhabited by tens of thousands of microorganisms in human gastrointestinal tract.In recent years,with the deepening of the study of intestinal flora,more and more studies have found that the im-balance of intestinal microecology can cause changes of metabolites in heart failure patients,which is one of the key triggers for the development of heart failure,therefore,using the intestinal microbial homeostasis as a new entry point for the treat-ment of heart failure will be a hotspot in medical research.However,the theory of Chinese medicine,"the spleen is the guardian",covers the physiological functions of the spleen,such as the spleen's main function of transporting,spleen's main function of ascending and clearing,and its main function of hiding camping,etc.,and the functions of intestinal flora and the"spleen is the guardian"are similar to a certain extent.Therefore,this paper starts from a holistic viewpoint and takes the theory of"spleen as the guardian"in Chinese medicine as an entry point to elaborate on the pathogenesis of intes-tinal microecological imbalance and heart failure,so as to provide a reference for Chinese medicine treatment or drug re-search.

Tic disorder is a common neuropsychiatric disorder in children and one of the common serious chronic diseases that endanger children's health.According to YE Tianshi's theory of"yang transforms into internal wind",water fails to nourish wood(kidney yin deficiency can not nourish liver wood),spleen deficiency and liver hyperactivity,wood stagnation and intense fire cause internal wind,and leading to frenetic stirring of tendons.Insect drugs are considered to be"pathogenic wind"in terms of pathogenic factors,and the pain wanders unsteadily.They have the effects of tonifying the kidney and supplementing essence,calming the liver and suppressing wind,resolving phlegm and relieving spasm,dispelling wind and purging heat,dredging collaterals and removing blood stasis,which exert certain effects in treating children with tic disorder.Modern pharmacological studies have shown that insect drugs can treat children with tic disorders from multiple perspectives such as anti-convulsion,regulation of neurotransmitters,inhibition of neuroinflammation,and regulation of immunity.Based on the theory of"yang transforms into internal wind",this paper analyzes the application of insect drugs in the treatment of children with tic disorder,which can provide theoretical reference for the prevention and treatment of tic disorder by traditional Chinese medicine.

OBJECTIVE: To evaluate the effect of denosumab on bone mineral density around proximal femoral prosthesis after total hip arthroplasty(THA) in the postmenopausal osteoporotic patients. METHODS: Fifty-four consecutive patients underwent unilateral primary THA were included in this retrospective study. Twenty-five patients received denosumab for osteoporosis as the treatment group, and the twenty-nine without denosumab were the control group. At 1 week, 3month, 6 months, and 12 months after THA, bone turnover markers and proximal femoral periprosthetic bone mineral density (BMD) were measured. RESULTS: At 3, 6 and 12 months after operation, the level of TRACP-5b in the control group was significantly higher than that in the treatment group (P<0.05);the level of bone-specific alkaline phosphatase (BALP) between two groups showed significant difference in 12 months after operation (control group was higher than treatment group, P<0.05). The BMD of Gruen 1 and Gruen 7 decreased at 3, 6 and 12 months after operation compared with 1 week after operation. Comparing the treatment group and the control group, the differences of the the decrease of BMD in Gruen 1 and Gruen 7 were no significant at 3 months after surgery. In Gruen 1, Gruen 7 at 6 months after operation and Gruen 1, Gruen 7 at 12 months after operation, the decrease of BMD in the control group was significantly higher than that in the treatment group(P<0.05). It is suggested that desudumab could inhibit the loss of BMD after 6 months, and continuously show a protective effect on bone mass at 12 months after operation. CONCLUSION After THA in postmenopausal patients with osteoporotic femoral neck fracture, Desuzumab can reduce the loss of BMD around the proximal femoral prosthesis and effectively inhibit bone resorption.
Humans ; Arthroplasty, Replacement, Hip ; Bone Density ; Denosumab/therapeutic use* ; Retrospective Studies ; Postmenopause ; Absorptiometry, Photon ; Bone Remodeling ; Follow-Up Studies ; Hip Prosthesis

OBJECTIVE: To evaluate the effect on the inflammatory indexes of septic gastrointestinal dysfunction treated with acupuncture at Jiaji (EX-B 2). METHODS: A total of 118 patients of septic gastrointestinal dysfunction were randomized into an observation group and a control group, 59 cases in each one. In the control group, mosapride citrate was prescribed for oral administration, 5 mg each time, 3 times a day, bifidobacterium triple viable capsules, 420 mg each time, twice a day, intravenous drip with omeprazole, 40 mg, twice a day. Additionally, the antibiotics and the symptomatic treatment were selected rationally for maintaining the functions of the important organs, e.g. heart, lung, brain and kidney, and water-electrolyte balance. In the observation group, on the routine management as the control group, acupuncture at Jiaji (EX-B 2, T-T) was added, the needles were retained for 30 min in each treatment, once a day, 10 days as one course and 1 course was required. Separately, on the 1st, 3rd, 6th and 10th days of treatment, the white blood cell (WBC) count, the levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) were observed, the enteral nutrition feeding dose and gastrointestinal dysfunction score before and after treatment as well as the clinical effect were assessed in the two groups. RESULTS: The differences were not significant in the indexes mentioned above on 1st and 3rd days of treatment between the two groups (>0.05). On the 6th and 10th days of treatment, regarding the gastrointestinal dysfunction score and inflammatory indexes count, the results in the observation group were lower than the control group (all <0.05), and feeding dose in the observation group was higher than the control group (<0.05). After treatment, the gastrointestinal dysfunction scores and inflammatory indexes count were all reduced and feeding dose was increased as compared with those before treatment in the patients of the two groups (all <0.05). After treatment, the total effective rate was 91.5% (54/59) in the observation group, higher than 76.3% (45/59) in the control group (<0.05). CONCLUSION Acupuncture at Jiaji (EX-B 2) points achieves the satisfactory effect on septic gastrointestinal dysfunction and reduces the inflammatory indexes count.
Acupuncture Points ; Acupuncture Therapy ; Case-Control Studies ; Chlorophenols ; therapeutic use ; Gastrointestinal Diseases ; therapy ; Humans ; Needles ; Sepsis

Objective To analyze the survival,brain metastases and health-related quality of life (HRQOL) for small cell lung cancer patients after prophylactic cranial irradiation(PCI).Methods From Aug 2007 to Apr 2011,42 small cell lung cancer patients were eligible for analysis.Overall survival rate was estimated by the Kaplan-Meier method.The HRQOL scores before and after PCI were compared by the nonparameter wilcoxon test.Results The median survival time from the start of PCI was 23 months(95％ CI,15.05-30.95),progression free survival time was 17 months (95％ CI,14.33-19.67),1-,2-and 3-year survival rates were 85.5％,45.8％ and 36.6％,respectively.The median time from PCI to brain metastases was 15 months(95％ CI,12.44-17.56),1-and 2-year brain metastases rates were 77.6％ and 54.1％.PCI had a little influence on HRQOL scales except for cognitive function.Conclusions For patients with limited stage small cell lung cancer who achieve complete or nearly complete remission after initial treatment as well as patients with extensive stage who respond to initial chemotherapy,PCI is effective in decreasing the rate of brain metastasis and improving survival,while the adverse effects is acceptable.There is no significant impact on HRQOL scales during short term.

Objective To evaluate the therapeutic efficacy and treatment-related toxicity of stereotactic body radiation therapy(SBRT)in patients with medically inoperable stage Ⅰ/Ⅱ non-small cell lung cancer(NSCLC). Methods SBRT was applied to 30 patients, including clinically staged T1 ,T2(≤5cm)or T3(chest wall primary tumors only), N0, M0 ,biopsy-confirmed NSCLC. All patients were precluded from lobotomy because of physical condition or comorbidity. No patients developed tumors of any T-stage in the proximal zone. SBRT was performed with the total dose of 50 Gy to 70 Gy in 10 - 11 fractions during 12 - 15 days. prescription line was set onthe edge of the PTV. Results The follow-up rate was 100%. The number of patients who completed the 1-, and 2-year follow-up were 15, and 10, respectively. All 30 patients completed therapy as planned. The complete response(CR), partial response(PR)and stable disease(SD)rates were 37%, 53% and 3%, respectively. With a median follow-up of 16 months(range,4-36 months), Kaplan-Meier local control at 2 years was 94%. The 2-year overall survival was 84% and the 2-year cancer specific survival was 90%. Seven patients(23%)developed Grade 2 pneumonitis, no grade ＞ 2 acute or late lung toxicity was observed. No one developed chest wall pain. Conclusions It is feasible to deliver 50 Gy to 70 Gy of SBRT in 10 - 11 fractions for medically inoperable patients with stage Ⅰ / Ⅱ NSCLC. It was associated with low incidence of toxicities and provided sustained local tumor control.The preliminary investigation indicated the cancer specific survival probability of SBRT was high. It is necessary to perform similar investigation in a larger number of patients with long-term follow-up.

A broken metal handle accompanied by femoral trunk fracture, which would shorten service life of handles. Therefore, it is necessary to judge whether the notch is the main reason for handle broken. Some literatures thought that the pores of sintered porous coated anatomic (PCA) porous layer produce the notch on the handle surface and the notches lead to the handle broken being incorrect. The Apex of the pore is taken for the bottom of the notch, expanding into a crack, and it should also not grow to the base-alloy, accordingly, the above conclusion is wrong. Some reports pointed out the notch, apex of the pore, will expand into the crack, but it is not associated with the broken handle. Under the sintering temperature, the grain boundary apertures be generated on the base metal surface, the aperture is expanded into the crack, which leads to handle broken in the forced area. However, neither theoretical basis, nor a case of corroboration, can prove exist of notch. Actually, the broken handle is caused by the sintering technology. The high temperature of sintering joining results in grain boundary aperture, when encounter the largest forced area and expand into crack, it will break the handle.

INTRODUCTION: General joining techniques are at low level, which produces some potential problems in porous layer of porous coated anatomic (PCA).LIMITATIONS: The problems in general joining techniques are caused by limitations of each technique, which could not be solved using advanced measures.APPLICATION: The activated diffusion brazing technology is an effective way. Its many advanced processes can solve those potential problems.CONCLUSION: The stress-shielding problem caused by PCA porous layer can be solved by using small metal balls in the same diameter in combination with the advanced activated diffusion brazing technology. Moreover, the high performance brazing metals by activated diffusion brazing technology is harmless for humans.

OBJECTIVE: Sintering of porous coated anatomic porous layer bonding technology remains controversial because of poor understanding to its essence.ESSENCE: Sintering is a technology that the bonding temperature exceeds 5 ℃ or higher than the base-alloy solids temperature of 1 230 ℃, resulting in base-alloy produce a series of serious problems, such as grain boundary racks, handle broken and so on.HAZARDS: In sintering temperature, the low melting point eutectlc phase and the brittle metal compounds flow out of the grain boundary to bond the small metal balls and the handle, which greatly reduces the fatigue strength. The grain boundary cracks formed and expanded ultimately leading to handle broken.DISCUSSION: The cause of a handle broken is neither notch nor metallurgical defects but sintering process, because high sintering temperature results in grain-boundary lacunas.CONCLUSION: Sintering is not suitable for connecting the force components. High sintering temperature produces grain-boundary lacunas which can expand into cracks and ultimately result in handle broken under some condition.

ween WHO histological subtype and Masaoka clinical stage, and their combination is valuable for guiding postoperative treatment in thymoma.