Objective:To evaluate Zhuang medicine Fuzheng compound combined with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in the treatment of advanced epidermal growth factor receptor (EGFR) sensitive mutant non-small cell lung cancer (NSCLC).Methods:A total of 120 patients with advanced NSCLC who met the inclusion criteria from June 2019 to May 2020 in Guangxi International Zhuang Medical Hospital were divided into 2 groups according to the random number table method, with 60 in each group. The control group was treated with TKIs, and the observation group was treated with Zhuang medicine Fuzheng compound combined with EGFR-TKIs. TCM syndrome scores were compared, and the quality of life of the patients was assessed by the Quality of Life Scale (QLQ-C30). The serum levels of carcinoembryonic antigen (CEA), squamous cell carcinoma associated antigen (SCC-Ag) and carbohydrate antigen 50 (CA50) were detected by radioimmunoassay, and the levels of CD3 +, CD4 +, and CD8 + were detected by flow cytometry, and the CD4 +/CD8 + ratio was calculated. The adverse reactions during the treatment were observed and recorded. Results:The objective remission rate in the observation group was 66.7% (40/60) and the disease control rate was 81.7% (49/60), while in the control group were 48.3% (29/60) and 63.3% (38/60), respectively.The differences were statistically significant ( χ2 values were 4.13 and 5.06, P values were 0.042 and 0.025, respectively). After treatment, the scores of chest tightness, shortness of breath, blood in sputum, mental fatigue in the observation group were significantly lower than those in the control group ( t values were 8.72, 5.02, 5.47, all Ps<0.001), After treatment, QLQ-C30 score in the observation group was significantly higher than that of the control group ( t=5.21, P<0.01). After treatment, CEA [(31.45±4.56) mU/L vs. (38.98±5.71) mU/L, t=7.98], SCC-Ag [(4.87±0.93) μg/L vs. (7.29±1.25) μg/L, t=12.03], CA50 [(58.27±7.14) U/L vs. (66.48±7.94) U/L, t=5.96] levels were significantly lower than those in the control group ( P<0.01); CD3 +[(52.43±5.01)% vs. (48.56±4.87)%, t=4.29], CD4 + [(54.89±5.03)% vs. (51.09±5.22)%, t=4.06], CD4 +/CD8 + [(1.95±0.28) vs. (1.65±0.27), t=5.97] significantly higher than those in the control group ( P<0.01), CD8 + [(28.12±2.70)% vs. (31.23±2.64)%, t=6.38] significantly lower than that of the control group ( P<0.01). During the treatment period, the incidence of adverse reactions in the observation group was 13.3% (8/60) and that in the control group was 8.3% (5/60), with a statistically significant difference between two groups ( χ 2=0.78, P=0.378). Conclusion:The Zhuang medicine Fuzheng compound combined with EGFR-TKIs can reduce the level of tumor markers in patients with advanced EGFR-sensitive mutant NSCLC, improve patients' TCM syndromes, quality of life, enhance patient immunity, and improve efficacy.

Objective: To analyze the prevalence and risk factor of co-exiting pre-hypertension and pre-diabetes condition in middle to elder adults, and to provide the theoretical basis for preventing cardiovascular disease in relevant population in Chengdu area.
Methods: A total of 5240 middle to elder adults from (40-79) years of age in Chengdu area were enrolled for a stratiifed cluster sampling study. The blood pressure, glucose and other clinical information were collected by more than 30 medical professionals with uniifed training to investigate the prevalence of co-exiting pre-hypertension and pre-diabetes condition with the risk factors.
Results: The overall prevalence rate of coexisting pre-hypertension and pre-diabetes condition was at 12.5% in Chengdu area and the standardized prevalence was at 11.5%. The prevalence rate in urban area was 12.4% and in rural was 13.2%, P=0.47, the prevalence in male gender was 12.7% and in female was 12.4%,P=0.81. With the increased age, the prevalence trend was elevated accordingly. Multi-regression analysis indicated that the elder age, overweight or obesity (female with abdominal obesity), sibling history of hypertension, hyper-triglyceridemia, multiple childbirth and menopause had the higher risk of coexisting pre-hypertension and pre-diabetes condition, allP<0.05; the higher educational level could decrease the risk of prevalence in male gender,P<0.05 and the proper exercise could decrease the risk in female gender,P<0.05.
Conclusion: There is a high prevalence rate of coexisting pre-hypertension and pre-diabetes condition in middle to elder population in Chengdu area and the prevalence is closely related to age. It is important to prevent such condition by elevating educational level nationwide, controlling waist and body weight, adjusting diet structure with proper exercise.

Objective To investigate the clinical value of 64-slice spiral computed tomography(64-MSCT)triple-phase enhanced scan in diagnosis of lymphatic metastasis of gastric cancer.Methods Thirty patients with gastric cancer underwent plain and triple-phase enhanced scan by using 64-MSCT to analyze the relevant parameters of lymphatic metastasis.Results The four parameters de-termined metastatic perigastric lymph node as follows:①the short diameter ≥6 mm,②the ratio of short-to-long diameter ≥0.6,③the CT value in the portal venous phase≥ 65 HU,④the difference of CT values between portal venous phase and plain scan≥35 HU.The sensitivity and specificity of combining two parameters (①+②)in diagnosing metastatic lymph node were 90.5% and 29.0%,respectively.The sensitivity and specificity of combining three parameters (①+②+③)were 98.2% and 1 9.4%,respec-tively.The sensitivity and specificity of combining four parameters (①+②+③+④)were 99.7% and 13.2%,respectively.In ad-dition,metastatic lymph nodes were considered if they were ring-enhancement,or adhesions of several lymph nodes.Conclusion The use of 64-MSCT triple-phase enhanced scan and synthesis of various parameters of lymph nodes could lead to reliable diagnosis of lymphatic metastasis in gastric cancer with rapid,non-invasive,high sensitive and specific features.

Objective To study the levels of serum homocysteine(Hcy) ,high-sensitivity C-reactive protein (hs-CRP) and blood lipid and their correlation in the different age stage patients with cerebral infarction .Methods 352 patients with cerebral infarction receiving treatment in the hospital from December 2011 to November 2013 were selected as the study subjects and divided into the youth group ,middle age group and elderly group by age ,with contemporaneous 134 healthy individuals of physical examination as the control group .Serum lipids ,hs-CRP ,Hcy levels and the rate of abnormal test results were compared among 4 groups and the bi-variate correlation analysis was performed .Results The serum hs-CRP ,Hcy levels in the youth group were higher than those in the control group ,while the high density lipoprotein cholesterol(HDL-C) level was lower than tha tin the control group ,the difference was statistically significant (P<0 .05) .The serum low density lipoprotein cholesterol(LDL-C) ,total cholesterol (TC) ,hs-CRP and Hcy levels in the middle age and the elderly groups were significantly higher than those in the control group ,while the HDL-C level was significantly lower than that in the control group ,the difference was statistically significant (P<0 .05) .The abnormal rates of HDL-C ,hs-CRP and Hcy test results in the youth ,middle and elderly groups were significantly higher than those in the control group with statistical difference (P< 0 .05) .The abnormal rates of LDL-C detection results in the middle age group and elderly group were significantly higher than that in the control group ,the difference was statistically significant (P<0 .05) .Hcy ,hs-CRP and lipid in the youth group ,middle group and elderly group had no significant correlation ;HDL-C was negatively correlated with hs-CRP (P<0 .05);TC was positively correlated with LDL-C ,HDL-C and triglyceride(P<0 .05) .Conclusion Hyperhomocys-teinemia is an independent risk factor for cerebral infarction occurrence ,has no significant correlation with blood lipid and hs-CRP levels ,and can be used as a reliable indicator of the disease condition monitoring .

Objective To evaluate laparoscopic D2 lymph node dissection gastrectomy in the treatment of advanced gastric cancer.Methods The clinical data of 239 cases of advanced gastric cancer admitted from January 2004 to June 2011 were respectively analyzed,patients were divided into laparoscopic resection group and open surgery group.Data analysis was performed by SPSS 19.0 statistical software.Results There were 102 cases in laparoscopic group,and 137 cases in open group.The length of incision,operative blood loss,recovery time of gastrointestinal function,food-taking time and postoperative hospital stay in laparoscopic operation group were (5.0 ± 1.1) cm,(70 ± 44) ml,(57 ± 14) h,(68 ± 12) h,(7.1 ± 1.4) d and in open operation group were (17.4 ± 2.1) cm,(107 ± 59) ml,(75 ± 12) h,(91 ±15) h,(9.9 ± 1.8) d respectively.There were significant differences between the two groups (t =-58.86,-5.50,-10.72,-12.58,-12.58,all P =0.00).There was no significant differences between the two groups in operative time (t =1.63,P =0.11),with operative time in laparoscopic operation group of (192 ± 32) min,and (185 ± 30) min in open group.Average proximal,distal cutting edge and the average number of lymph node harvested were (5.0 ± 1.0) cm,(4.7 ± 0.8) cm,(27.6 ± 7.2) in laparoscopic operation group,and (5.1 ±0.9) cm,(4.7 ±0.9) cm,(27.0 ±6.5) in open group (t =-0.61,0.10,0.68,P ＞ 0.05).The 3-,5-,7 d white blood cell counts in laparoscopic group was (11.1 ± 1.3) ×109/L,(9.5 ± 1.4) × 109/L,(7.0 ± 1.5) × 109/L,and (12.8 ± 1.3) × 109/L,(11.1 ± 1.5) × 109/L,(8.6 ± 1.3) × 109/L,in open group (t =-9.83,-8.88,-9.40,all P =0.00).Complications developed in 9.8 ％ (10/102) in laparoscopic operation group,and 17.5 ％ (24/137) in open group (x2 =0.285,P =0.09).The 1-year,3-year,5-year survival rate of patients in laparoscopic group were 96.1％,74.1％,47.2％,and 95.6％,70.0％,50.9％ in open group (x2=0,0.04,0.21,P ＞0.05).Conclusions In selected cases,laparoscopic D2 lymph node dissection gastrectomy for advanced gastric cancer is safe and effective,and long-term outcomes are satisfactory.

Objective To evaluate the safety and feasibility of laparoscopic hepatectomy for hepatocellular carcinoma(HCC). Methods From January 2002 through December 2007,86 HCC cases were divided into laparoscopic hepatectomy group and open hepatectomy group.Clinical data were analyzed. Results There were 36 cases in LH group,and 50 cases in OH group.Significant differences were noticed in the length of incision,operative blood loss,food-taking time,postoperative hospital stays,and analgesic usage between the two groups (respectively t =-37.608、-2.396、-13.073、-4.283 、x2 = 35.765,all P＜0.05),in which LH group was superior to OH group.Differences appeared in ALT,AST,ALP,r-GT and LDH on post-op day 1,and 3.APTT,ALB response on the fifth day after operation were different in the two groups (separately t =-3.465,-3.236,-3.470,-6.812,-4.837 and-3.998,-2.894,-4.286,-7.887,-5.388,6.131,7.292; all P ＜0.05);ALT,AST,ALP,r-GT value on the fifth day post-operation,and T-BIL on the day 1,5 post-operation were different in two groups (separately t =-4.795,-2.155,-3.442,-4.194,-2.712,-1.600,all P ＜0.05),Meanwhile,as the results all showed that,injuries were all less severe in LH than OH group.There were no significant differences between the two groups in operative time,resection method,overall complications,1-year,3-year survival rate,disease free survival (t =-0.893,separately x2 =0.066,0.026,0.468,0.156,0.106,2.732,all P ＞0.05) while 3-year survival rate in LH group and OH group were 50.0%,25% respectively (x2=2.732,P = 0.098). Conclusion Laparoscopic hepatectomy was safe and feasible for treatment of HCC,and its short-term efficacy was better than open hepatectomy.Furthermore,laparoscopic hepatectomy had promising long-term effectiveness.

Objective To investigate management strategy of minimally invasive surgery for common bile duct stones. Methods Three hundred and four cases of common bile duct stones were divided into 3 groups receiving respectively endoscopic papillary balloon delation plus laparoscopic cholecystectomy ( EPBD group, 35 cases ), endoscopic sphincterotomy plus LC ( EST group, 138 cases), and Laparoscopic common bile duct exploration plus LC (LCBDE group, 131 cases). Results There was no significant difference in treatment success rate, short-term complications and bile duct retained stones among these three group ( x2 = 1. 930, 0. 038, and 0. 427 respectively, P > 0. 05 ). There was significant difference among these three groups in operation time ( F = 17.941, P = 0. 000 ), and the operation time in LCBDE group was shorter than that in other two groups( EPBD-EST: P = 0. 122, EST-LCBDE:P = 0. 000, EPBD-LCBDE:P = 0. 020 ). There was significant difference among these three groups in postoperative hospital stay (F =24. 016,P =0. 000) ,and the postoperative hospital stay in EPBD group was shorter than that in other two groups ( EPBD-EST: P = 0. 000, EST-LCBDE : P = 0. 198, EPBD-LCBDE : P = 0. 000 ). In EPBD group,bile duct recurrent stones was found in 2 cases(6. 7% ) and cholangitis in 1 case(33% ) and no duodenal papilla stenosis was encountered; In LCBDE group, bile duct recurrent stones were found in 7 cases (6. 0% ), cholangitis in 3 cases ( 2. 6% ), and there was no duodenal papilla stenosis; In EST group, bile duct recurrent stones were complicated in 18 cases ( 15.8% ), duodenal papilla stenosis in 9 cases (7.9%), and cholangitis in 14 cases( 12. 3% ). There were significant differences among these three groups for these three complications( x2 = 6. 482, 9. 160, and 12. 020 respectively,P < 0. 05 ), and the rate of complications in EST group was higher than that in other two groups. Conclusion For common bile duct stones, EPBD is the first choice followed by LCBDE while EST is only indicated for very few cases.

Objective To explore the value of Ligasure vessel sealing system(LVSS)during resection of retroperitoneal tumor.Methods Group 1 including 32 cases were performed resection of retroperitoneal tumor with LVSS and electrosurgical seapel from Jun.2004 to Oct.2008.group 2 including 26 cases were done with electrosurgieal seapel from Jan.2001 to Jun.2004.Operating blood loss,operating time,iatrogenic injury,postoperative blood loss and hospital stay were compared between the two groups.Results There was no significant difference in hospital stay[(11.7±0.7)d vs.(12.3±1.4)d)]and iatrogenic injury(9.38%vs.16.00%)between two groups statistically(P＞0.05),but the intraoperative blood lose[(403.1±37.1)ml vs.(704.0±129.0)m1)s,postoperative blood loss[(131.5±18.4)ml vs.(214.8±29.2)ml)]and operating time[(166.5±8.9)min vs.(186.8±15.4)min]were less in group 1 than that in group 2(P＜0.05).Conclusion Ligasure vessel sealing system has advantages of safe coagulation,shortening operation time in resection of retroperitoneal tumor.

Objective To observe the effects of Shenhong (SH) combined with chemotherapeutic drugs on curative effect, symptoms improvement, and immunology function in metaphase or terminal cancer patients.Methods All 598 patients were divided into two groups. The control group had 205 patients treated with chemotherapeutic drugs. The SH-treated group had 393 patients treated with SH combined with chemotherapeutic drugs. Results Compared with control patients, the total remission was 42.0% in SH-treated patients. The improvement rates of pain, cough, debilitation, and anepithymia were 71.9%. The Karnofsky grade was increased by 27.0%. CD+3 and CD+4 were increased by 11.6% and 19.3%, but CD+8was decreased by 22.6% at the same time. The patients CD+4 / CD+8 was enhanced by 54.2%, while the NK cell activity and marophage phagocysis were significantly improved. The content of Ig G and Ig A were increased in the same group. Conclusion The curative effect of SH combined with chemotherapeutic drugs was higher than that of control group. The therapeutic effect of SH is explained by its potential regulation activity on immun system.

Objective To investigate the safety and therapeutic effect of modified laparoscopic Dixon surgery for mid-low rectal carcinoma. Methods From September 2004 to April 2007,26 patients with mid-low rectal carcinoma were selected to receive modified laparoscopic Dixon surgery.Through the anus,the rectum was pulled out,the tumor was removed,and then colon-rectum anastomosis was performed.Results All the operation was completed successfully.The average operation time was(166.3 ? 48.1) min,and the mean blood loss was(235.4 ? 124.7) ml.No patient had urethral injury,dysuria,anastomotic leakage,or other complications after the operation.The patients expelled gas(2.9?0.7) days after the operation.Their mean hospital stay was(8.8?1.4) days.During a follow-up of 15.7 months(6 to 27 months),3 patients had local recurrence,5 patients showed increased frequency of stool,and 18 had satisfied anal function.Conclusion The short-term results indicate that the modified laparoscopic Dixon surgery is safe and effective for mid-low rectal carcinoma,and is associated with minimal invasion.