Gastric cancer is one of the most common malignant tumors of digestive system, which has the characteristics of strong heterogeneity, rapid progress and poor prognosis. Liver metastasis of gastric cancer is the main cause of death of advanced gastric cancer. At present, the clinical treatment of gastric cancer mainly includes systematic treatment (systemic chemotherapy, targeted treatment, immunotherapy), surgical resection, interventional treatment and radiotherapy, but the therapeutic effects are not good, and liver metastasis of gastric cancer is lack of standardized treatment strategy. At present, the multi-disciplinary comprehensive treatment mode has been widely used in the diagnosis and treatment of malignant tumors, and has achieved good results. According to the clinical characteristics and surgical accessibility of liver metastasis of gastric cancer, the Chinese Gastrointestinal Surgery Expert Group divides it into three clinical types: resectable type, potential resectable type and non-resectable type. All kinds of clinical types of patients need multidisciplinary comprehensive treatment cooperation group experts to discuss and formulate individualized treatment plan.

Objective To explore the efficacy ofTiaogan-Bushen-Xiaoji recipe (TGBSXJ Recipe) on overall survival and progression free survival (PFS) in patients with advanced breast cancer.Methods A total of 105 patients with advanced breast cancer, who received the first-line treatment, were divided into two groups, 56 cases in the control group and 49 in the experimental group. The control group received standard therapy according to guidelines, including chemotherapy, targeted therapy, endocrine therapy and treatment of bisphosphonates.The experimental group received the treatment of TGBSXJ Recipe besides the standard therapy. The overall survival (OS), progression-free survival (PFS) and Karnofsky (KPS) of the patients in two groups were observed and compared. The treatment ended with the sighs of the observation ending, the second progress for the disease or death.Results The overall survival of the experimental group was significantly higher than that of the control group [OS: 58.2(50.7-65.8)/monthsvs. 43.8(30.6-51.6)/months,P=0.040]. The PFS of the experimental group was significantly higher than the control group [PFS: 30.7(23.8-37.7)/monthsvs. 15.2(11.3-19.1)/months,P=0.001]. The KPS of the experimental group was significantly higher than the control group (88.6 ± 10.0vs. 80.5 ± 19.0,t=2.654). The PFS of the triple negative breast cancer (TNBC) in the experimental group was significantly higher than control group [(25.1(12.1-38.0)/monthsvs. 9.9(4.7-15.0)/months,P=0.038].Conclusions The TGBSXJ recipe could extend the OS and PFS and improve the life quality of the patients with advanced breast cancer. In this study, no severe adverse effects had been found in the experimental group.

OBJECTIVE:To observe clinical efficacy and safety of Compound xiongshao capsules in the treatment of diabetic peripheral neuropathy (DPN).METHODS:A total of 97 DPN patients selected from our hospital during Jun.2015-Apr.2016 were divided into group A (compound xiongshao treatment group,46 cases) and control group (51 cases) according to random number table.The latter was divided into group B (epalrestat+beraprost sodium group,12 cases),group C (fursultiamine+mecobalamin group,12 cases) and group D (epalrestat group,27 cases) according to clinical symptoms and economic situation of patients.Four groups were given antidiabetic drugs for blood glucose control.Based on it,group A was additionally given Compound xiongshao capsules 0.9 g,tid;group B was additionally given Epalrestat tablets 50 mg,tid+Beraprost sodium tablets 40 μg,tid;group C was additionally given Fursultiamine tablets 50 mg,tid+Mecobalamin tablets 0.5 mg,rid;group D was additionally given Epalrestat tablets 50 mg,tid.All groups were treated for 6 months.Clinical efficacies were observed.TCSS scores,motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),incubation period and amplitude of median nerve and common peroneal nerve,the levels of hemorheology indexes,blood glucose,glycosylated hemoglobin,blood lipid,serum creatinine were compared before and after treatment.The occurrence of ADR was recorded.RESULTS:Total response rates of group A and B (82.61％,83.33％)were significantly higher than those of group C and D (33.33％,66.67％),total response rate of group D was significantly higher than that of group C,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in TCSS scores,MCV,SCV,incubation period and amplitude of median nerve,MCV and amplitude of common peroneal never,SCV,incubation period and amplitude of common peroneal never or whole blood high-shear viscosity among 4 groups (P＞0.05).After treatment,TCSS scores of group A,B and D were decreased significantly compared to before treatment,and those of group A and B were lower than those of group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of median nerve in group A and B,amplitude of median nerve in group C,MCV and amplitude of median nerve in group D were significantly better than before treatment;MCV,incubation period and amplitude of median nerve in group A and B were significantly better than group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of common peroneal never in group A,B,C were significantly better than before treatment,MCV and amplitude of common peroneal never in group A,B were significantly better than group C,D;the improvement of incubation period of common peroneal never in group A,B,D were significantly better than group C,with statistical significance (P＜0.05).SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,B and D were significantly better than before treatment;SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,SCV,incubation period and amplitude of median nerve and amplitude of common peroneal nerve in group B were significantly better than group C and D;SCV of median nerve in group D was significantly better than group C,with statistical significance (P＜0.05).Whole blood high-shear viscosity of group A was decreased significantly compared to before treatment,and significantly lower than those of group B,C and D,with statistical significance (P＜0.05).There was no statistical significance in total response rate and TCSS score between group A and B,and in the levels of blood glucose,glycosylated hemoglobin,blood lipid or serum creatinine among 4 groups (P＞0.05).No obvious ADR was found in 4 groups.CONCLUSIONS:Compound xiongshao capsules shows significant therapeutic efficacy for DPN,and improves nerve conduction velocity,incubation period and amplitude of median nerve and common peroneal nerve,whole blood high-shear viscosity.Its effect is similar to that of epalrestat combined with beraprost sodium,and better than those of fursultiamine combined with mecobalamin,epalrestat alone.It does not affect the blood glucose,blood lipid and serum creatinine levels with good safety.

Objective To analyze the influencing factors for sleep duration of school children aged 6-12 years in school-day in 8 provinces in China.Methods The cross sectional study was conducted among 20 603 children aged 6-12 years and selected through stratified random cluster sampling in 8 provinces (municipality and autonomous region) with different geographic characteristics and economic development level in China from September to November,2010 to understand their sleep duration in school-day and related habits.t test and x2 test were used to compare the sleep duration of the children.Multivariate stepwise logistic regression analysis was conducted to identify the influencing factors.Results The survey indicated that the daily average sleep duration of the children in school days was 9.11 hours.The proportions of the children with serious insufficient sleep,insufficient sleep and sufficient sleep were 32.82％ (7 672/20 603),39.70％ (8 179/20 603) and 27.48％ (5 662/20 603),the children's sleep duration declined with age,so did proportion of children with serious insufficient sleep.There were no sex,urban or rural area and household income level specific significant differences in sleep duration among the children surveyed,and there were no sex specific differences in the proportion of children with serious insufficient sleep,insufficient sleep and sufficient sleep,however,these proportions were statistically different between urban area and rural area and among the regions with different economic level.The proportions of children with serious insufficient sleep and sufficient sleep was higher in rural area than in urban area (x2=59.96,x2=45.47,P＜ 0.05),while the proportion of children with insufficient sleep was lower in rural area than in urban area.In the economy developed region,the proportion of children with insufficient sleep was lowest,the difference was statistical significant.After adjusting for sex,weight,diet and exercise time,multivariate logistic regression analysis showed that the factors benefiting children to have 10 hours sleep every day included having high protein diet,exercise,high household economic status and living in urban area.Conclusion The problem of school children having insufficient sleep was serious in China,especially in the rural area.

Objective To understand the differences on sleeping-time between school-days and weekends among elementary school children.Methods This cross-sectional study was conducted from September to November,2010.A stratified random cluster sampling strategy was used to select the participants,under diverse geographical and economic levels in eight provinces,municipalities or autonomous regions,in mainland China.A total number of 20 603 elementary school children aged from 6-12 years old were chosen as research subjects to record their time of sleeping during school-days or weekends.Results Among the 6-12 year old,their time of sleeping was longer on weekends than that on school-days,while the average sleeping time during the weekends was longer in boys than in girls (t=3.35,P＜0.05).However,there was no linearly decreasing trend along with the increase of age regarding the time of sleeping on weekends,in girls.Proportions of serious lack of sleep,lack of sleep or with sufficient sleep during the weekends were 13.63％ (2 809/20 603),27.27％ (5 618/20 603) and 59.10％ (12 176/20 603).The proportion of sufficient sleep (over 50％) was significantly higher on weekends than that on school-days (less than 30％),however,nearly one third of the first grade primary school children were sleep insufficiently even on weekends.Nearly 10.00％ of the children under seriously or moderately lack of sleep on school-days were still in a serious lack of sleep state on weekends.The three groups who were categorized as serious lack of sleep (less than 9 h),lack of sleep (9-10 h) or having sufficient (over 10 h) sleep on school-days accounted for 29.75％,64.48％,86.44％,respectively,when compared with the national regulation set as 10 h daily sleep for the children in China.The proportions of those whose time of sleep on weekends was less than school-days in the three groups as the same,moderate (within 1 h),with 1 h caught-up or over,were 9.41％,22.77％,43.32％,24.50％,respectively.The percentage of pupils who caught up sleep appropriately (within 1 h) on weekends among those who were serious lack of sleep in school-days would exceed 40.00％ while the proportions among those who lack of sleep or having sufficient on school-days were 54.00％ and 30.00％.The percentage of children who slept less on weekends than on school-days among those having sufficient sleep on school-days appeared the highest,nearly 20.00％.However,the proportions among those who lack of sleep or seriously lack of sleep on school-days were 3.45％ and 8.16％,respectively.Conclusion We found that the elementary school children who could catch up time of sleep or lack of sleep on weekends coexisting in our study.This situation called for attention and the sleeping habit in primary school children should also be urgently improved.

OBJECTIVETo analyze the relationship between birth weight and elevated blood pressure among schoolchildren aged 6-11 years in 8 provinces of China.

METHODA stratified random cluster sampling was used from sampling frame of eight provinces in the mainland of China. A total of 18 920 students aged 6-11 years eventually participated in this study. Height, weight, waist circumference (WC) and blood pressure of all the subjects were measured. Korotkoff I and V were recorded as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Elevated blood pressure was considered for SBP and/or DBP equal to or above the reference sex-, age- and height-specific 95th percentile. Birth weight and family history of hypertension were collected by self-administered questionnaire. Analysis of variance was used to compare body measure indicators among 3 birth weight groups. Multivariate Logistic regression analysis was performed to identify the relationship between birth weight, current BMI and elevated blood pressure among children.

RESULTThe level of height, weight, WC, BMI, SBP and DBP were on the rise with the increase of the birth weight groups among boys (P < 0.05), except for WC among boys aged 6-8 years. The level of height, weight, WC, BMI and DBP showed a trend of escalation among girls (P < 0.05). But, SBP among 3 birth weight groups in girls was not significantly different (P = 0.099). After adjusting for age and family history of hypertension, compared with the normal birth weight group, the odds ratio and 95%CI of having elevated blood pressure among boys and girls in high birth weight group were 1.23 (1.06-1.43) and 0.89 (0.71-1.10), respectively; and the ORs(95%CI) were 1.06 (0.90-1.24) for boys and 0.73 (0.58-0.91) for girls after adjusting for age, family history of hypertension and current BMI of students. The relative risk of elevated blood pressure for boys and girls in low birth weight group were not significantly different as compared with normal birth weight group.

CONCLUSIONCurrent BMI but not birth weight was found to be a strong determinant of elevated blood pressure among children aged 6-11 years in China.

Birth Weight ; Blood Pressure ; physiology ; Blood Pressure Determination ; Body Mass Index ; Body Weight ; Child ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; prevention & control ; Male ; Overweight ; epidemiology ; physiopathology ; Risk Factors ; Sampling Studies ; Surveys and Questionnaires ; Waist Circumference

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) targeted treatment has been a standard therapy for advanced non-small cell lung cancer (NSCLC), but it is not tolerated well by all patients. In China, some studies have reported that traditional Chinese medicinal herbs (TCMHs) may increase efficacy and reduce toxicity when combined with EGFR-TKI, but outside of China few studies of this kind have been attempted.

Objective To summarize the experience of multidisciplinary consultation for prenatal fetal deformity, and to explore the mode suitable for China. Methods The Obstetrics and Gynecology Hospital of Fudan University and Children's Hospital of Fudan University established a joint multidisciplinary consultation center, including obstetrics, pediatrics, pediatric surgery, ultrasound and other departments. A total of 3 378 pregnant women visited the consultation center from July 31, 2003 to August 1, 2013. After consultation, treatment was divided into three classes:pregnancy termination, pregnancy continuation and perinatal treatment. Follow-up was made through correspondence and telephone communication. Retrospective analysis on reasons for consultation, fetal structural abnormalities of the classification system, chronological order of abnormalities, gestational weeks of diagnosis, maternal-related factors, treatment and prognosis was performed. Results (1) Reasons for consultation:Among 3 378 women undertaking prenatal multidisciplinary consultation, 3 243 (96.00%) were due to fetal factors, and 135 (4.00%) were due to maternal factors. (2) Classification of fetal structural abnormalities:Among the 3 243 cases undertaking consultation with fetal factors, fetal abnormality was found in 80.85%(2 622/3 243). The most common were neurological abnormalities(23.19%, 608/2 622), followed by urinary tract malformation (20.25%, 531/2 622) and cardiovascular malformation (15.48%, 406/2 622). These were followed by digestive system malformation, limb deformities and space-occupying lesions. There were 156 cases of multiple malformations. (3) Average gestational weeks for diagnosis of fetal deformity:The 2 622 cases of fetal deformity were diagnosed at a mean (26.7± 2.1) of gestational weeks (21.1–30.4 weeks). Urinary tract malformations were detected at (24.0±0.7) weeks, whereas digestive system malformations were detected at (28.3±2.6) weeks. (4) Induced labor:Induced labor cases accounted for 35.66% (935/2 622), among which, 92 cases were fetal intrauterine death and 843 cases were active choice. The several highest induced labor rates resulted from multiple malformations (75.64%, 118/156), abdominal wall defects (62.22%, 28/45), diaphragmatic hernia (61.54%, 24/39), cleft lip and palate (55.32%, 26/47) and cardiovascular malformations (49.51%, 201/406). For nervous system (27.80%, 169/608), urinary tract (25.80%, 137/531) and digestive system malformations (26.94%, 66/245), induced labor rates were <30%. For abdominal lesions (14.04%, 25/178) and sacrococcygeal teratoma (13.64%, 3/22), induced labor rates were<15%. (5) Continuation of pregnancy in 1 687 cases:Cesarean section was conducted in 1 046(61.94%). Neonatal death occurred in 117(6.94%).(6) Perinatal treatment:Twenty-one cases were treated during pregnancy, including thirteen cases with fetal ascites and hydrothorax treated by drainage, five cases with fetal anemia treated by intrauterine transfusion and three cases with fetal tachycardia treated by digoxin. Ten cases were treated by ex-utero intrapartum treatment. After birth, 297 newborns immediately underwent neonatal surgery. Among these, 259 cases underwent radical surgery, eleven palliative surgery, and sixteen elective surgery after follow-up. Conclusions Prenatal multidisciplinary consultation can make comprehensive multidisciplinary assessment of fetal prognosis and improve the diagnosis and treatment of structural malformations.

Objective To describe the distribution of body mass index (BMI) and evaluate the prevalence of overweight and obesity among first to sixth graders in 8 Chinese provinces.Methods Data came from the baseline survey of the Chinese Center for Disease Control and Prevention (CDC) funded project Study on Intervention Models for Main Chronic Diseases among children in China.A stratified random cluster sampling strategy was used to select study participants in 8 provinces,including Inner Mongolia,Jiangsu,Anhui,Shandong,Hunan,Guangxi,Gansu provinces,and Chongqing,with diverse geographical and economic level distributions in China.Counties in each province were stratified into three strata according to economic level,and one county was selected systematically from each stratum.In each county,one urban and one rural elementary school were randomly selected ; and in each school,2-3 classes were randomly selected from each of 1-6 grades.All students in these selected classes were invited for participation.Physical examination was performed by trained local CDC staff using standardized instruments to measure height and weight.Overweight and obesity were diagnosed based on the BMI classification standards for Chinese children and adolescents by Working Group for Obesity in China (WGOC).Results A total of 26558(14225 boy,12333 girl) students aged 6-12 years eventually participated in 8 provinces.The average age was 9.3 ±1.8 years old.Mean BMI among boys (17.0 kg/m2) was higher than that among girls (16.4 kg/m2,t =19.60,P＜0.01).There were statistically significant differences in mean BMI of each age group of boys and 6-11 age groups of girls between urban and rural regions and among those with three economic levels (P＜0.05).The 85th and 95th percentiles of BMI among boys aged 7-11 years in urban region were higher than BMI reference in the standards from WGOC.Lower percentiles were observed among girls aged 7-12 years in rural region.The prevalence of overweight and obesity were 9.3％ and 6.5％ among schoolchildren aged 7-12 years.The prevalence of overweight among boys (10.9％) was higher than that among girls(7.6％,x2 =88.89,P＜0.01) ; while prevalence of obesity were 8.0％ among boys and4.7％ among girls,respectively (x2 =107.17,P＜0.01).The prevalence of overweight was 11.3％ in urban and 7.4％ in rural children(x2 =131.94,P＜0.01).The prevalence of obesity was 8.7％ in urban and 4.3％ in rural children(x2 =188.99,P＜0.01).The prevalences of overweight were 10.3％,8.6％ and 9.0％ in individuals with high,medium,and low economic levels,respectively(x2 =10.76,P＜0.01) ; while the prevalences of obesity were 8.2％,5.6％,and 5.4％,respectively (x2 =51.71,P ＜ 0.01).Conclusions The overall prevalence of overweight and obesity in Chinese school children was high.The prevalence in urban region with high economic level was significantly higher than that in rural region with middle and low economic level.The nutritional and behavioral intervention programs are needed to control the rising trend of obesity in children.

Objective To assess the effectiveness of uterine arterial embolization for the treatment of hysteromyomas and to discuss the factors related to the clinical results.Methods Super-selective uterine arterial embolization was performed in forty-five patients with hysteromyomas.Of 45 patients,multiple hysteromyomas were seen in 36 and solitary lesion in 9.The lesion was located at the myometrium in 41 cases,among them coexisted endometrioma was found in 5 cases and coexisted submucosal myoma in 2.The lesion was located submucous layer in the remaining 4 cases.The diagnosis was confirmed by imaging study and gynecological examination.After the operation,ultrasonography and laboratory tests were carried out in all patients to observe the tumor size.hormone levels and hemoglobin concentration.Results A total of 91 uterine arteries were found in 45 patients.including double left uterine arteries in one case.Successful catheterization was obtained in 87 arteries(95.6%).All forty-five patients were followed up for 6-36 months.Six months after the procedure the mean reduction of the tumor size was 69.3%.and the lesion completely disappeared in two cases.In the anemic patients the hemoglobin concentration returned to normal level.The main side-effects included low fever and pain at lower abdomen.Conclusion Uterine arterial embolization is a safe and effective treatment for hysteromyomas.