Objective To investigate the effects of calcium levofolinate and 5-fluorouracil combined with epirubicin on stress response and vascular endothelial growth factor (VEGF) level in patients with gastric cancer.Methods A total of 160 patients with gastric cancer treated in Huxi Hospital Affiliated to Jining Medical College from April 2016 to March 2018 were selected as research objects.All the patients were divided into two groups according to the random number table method and each group consisted of 80 cases.The control group was treated with epirubicin,while the study group was treated with calcium levofolinate and 5-fluorouracil combined with epirubicin.The clinical efficacy and adverse reactions of the two groups were observed and compared.The levels of VEGF and quality of life were compared before and after the treatment.The stress response indexes such as cortisol (Cor),norepinephrine (NE) and total antioxidant capacity (TAC) were detected,and the stress levels of the two groups were compared.Results The total effective rate of the study group was 67.5％ (54/80),which was significantly better than that of the control group [45.0％ (36/80)],and the difference was statistically significant (x2 =8.229,P =0.004).The quality of life of the two groups after the treatment was significantly higher than that before the treatment,and the quality of life scores of the study group were significantly higher than those of the control group (all P ＜ 0.001).After the treatment,the levels of Cor,NE and TAC of the study group were (239.27 ± 19.63) μg/L,(258.46 ± 18.31) ng/L,(11.01 ± 0.77) KIU/L,which were significantly lower than those of the control group [(286.35 ± 20.63) μg/L,(294.18± 21.95) ng/L,(12.73 ± 1.58) KIU/L],and the differences were statistically significant (t =10.003,P ＜ 0.001;t =9.476,P ＜ 0.001;t =6.984,P ＜ 0.001).After the treatment,the VEGF levels of the two groups were lower than those before the treatment,and the VEGF level of the study group was significantly lower than that of the control group [(39.4 ±0.9) pg/ml vs.(42.3 ± 1.1) pg/ml,t =18.251,P ＜ 0.001].The total incidences of adverse reactions in the control group and the study group were 82.5％ (66/80) and 48.8％ (39/80),respectively.The incidence of adverse reactions in the control group was significantly higher than that in the study group,and the difference was statistically significant (x2 =20.197,P ＜ 0.001).Conclusion Calcium levofolinate and 5-fluorouracil combined with epirubicin has a good clinical effect in treating patients with gastric cancer.It can not only improve the level of VEGF in the serum of patients,but also can improve the quality of life of patients,reduce the incidence of adverse reactions and body stress response.It has broad application prospects and is worthy of further promotion and application in clinic.

Objective To investigate the neural mechanisms of speech motor control in individuals with Parkinson's disease (PD) under different strategies of motor execution control.MethodsThe techniques of the psychoacoustic and event-related potentials (ERPs) based on the altered auditory feedback paradigm were used in the present study. Two groups, including 17 PD patients and 17 healthy controls, were instructed to produce sustained vowels under the internal and external cueing tasks while hearing their voice randomly pitch-shifted downwards. The vocal responses and associated ERPs were recorded and compared across the groups and tasks.ResultsBehavioral results showed that the amplitude of acoustic compensation response was larger in PD patients than in the healthy controls (F=5.415, P=0.027), however, the main effect was not significant in the tasks (F=0.039, P=0.840). At the cortical level, PD patients produced significantly larger N1 responses to pitch perturbations in the internal cueing task related to the external cueing task (F=8.634, P=0.006), while such task effect was not observed in the healthy controls (F=1.550, P=0.231). Also, PD patients produced significantly larger N1 responses than the healthy controls in the internal cueing condition (F=5.476, P=0.026), but not in the external cueing condition (F=0.249, P=0.621). Conclusion Speech motor control in PD can be influenced by the strategies of motor execution control. Compared to the internal cueing task, the external cueing task can increase neural efficiency in the encoding of speech auditory feedback PD patients that improve auditory-motor integration for speech production.

Objective: To analyze the difference of bleeding frequency, plain radiographic (X-ray) , risk factors in hemophilic arthropathy progression and the Arnold-Hilgartner classification. Methods: A retrospective study was conducted in 211 hemophilia patients hospitalized in our medical center between January 2007 and December 2010, some patients with hemarthrosis were followed up for 5 years. Results: All patients were male, including 150 hemophilia A (HA) and 61 hemophilia B (HB) . The HA patients bled more frequently than HB patients with annualized total bleeding rate 20.5 (0-48) vs 13 (1-40) ; annualized joint bleeding rate 13.5 (0-38) vs 8 (0-33) , especially in moderate hemophilia [26 (1-48) vs 12 (1-36) , P<0.001; 18 (0-36) vs 7.5 (0-26) , P=0.001], but severe hemophilia had no difference in bleeding frequency [33 (1-41) vs 26 (1-40) , P=0.702; 22 (0-36) vs 18 (0-33) , P=0.429]. The condition of the affected joints of 108 HA and 54 HB was evaluated on roentgenography. In HA patients, the Arnold-Hilgartner classification increased with the severity ratings (r=0.063, P=0.004) . However, similar associations were not found in HB patients (r=0.045, P=0.082) . Five years later, 36 HA and 19 HB patients received the same joint X-ray, there were no significant differences in joints radiographic progression between the total HA and HB groups (z=1.941, P=0.052) . However, significant difference between moderate HA and HB was observed (z=0.076, P=0.002) . Multivariate unconditioned Logistic analysis showed that annualized joint bleeding rate [P<0.001, OR=1.166 (95%CI 1.097-1.239) ] and articular structural injuries [P=0.018, OR=2.842 (95% CI 1.196-6.755) ] were independent risk factors for the joints radiographic progression. Conclusion The study suggests that there was a difference in bleeding phenotype between HA and HB, especially in moderate hemophilia. HB patients showed mild but progressive development over time, compared with HA patients. Annualized joint bleeding rate and articular structural injuries were independent risk factors for the joints radiographic progression.

Objective Take frizzled class receptor 4(FZD4) as an example for exploring whether the transmembrane receptor protein is a suitable marker for wound age estimation. Methods A total of 78 Sprague-Dawley rats were divided randomly into the control group and the contusion groups of 4h, 8h, 12h, 16h, 20h, 24h, 28h, 32h, 36h, 40h, 44h, and 48h after injury (n=6). Using a drop-ball technique, a contusion was produced in the right lamb of rats. The samples were dissected from injury zones. Then the expression of FZD4 was detected using immunofluorescence, real-time PCR and western blot, respectively. Results FZD4 was located on the membrane of skeletal muscle cells. Compared to the control group, FZD4 mRNA showed a signiifcant increase (over 2-fold) in 8h, 12h, 36h, and 40h after injury by Real-time PCR (P<0.05), and FZD4 protein showed a statistical up-regulation (less than 2-fold) in 8h, 36h, 40h, 44h, and 48h post contusion by western blotting (P<0.05). Conclusion The expression of FZD4 mRNA and protein are both time-dependent during contused skeletal muscle repair. To some degree, FZD4 mRNA was more suitable than corresponding protein for determining wound age.

Objective To explore the use of queuing theory model combined with the dynamic allocation of nursing staff in the management of blood collection room in outpatient. Methods Queuing theory model combined with dynamic allocation of nursing staff were applied to scientifically allocate nurses in blood collection room. Three months before and after allocation, nursing staff, inspection personnel and patients were investigated through satisfaction questionnaire and the management effect was evaluated. Results Patients′satisfaction degree toward blood collection staff was increased from 80% to 95%; inspection personnel′s satisfaction degree toward blood collection staff was increased from 62.5% to 87.5%;nurses′satisfaction degree toward themselves was increased from 70% to 95% (χ2=20.571,13.333,5.22;P<0.05) . Patients′waiting time before blood collection was shorten to 20 min from 30 min. Conclusions The application of queuing theory model combined with dynamic allocation of nursing personnel can improve the rational use of blood collection personnel in outpatient and nursing quality, and it also can improve the satisfaction of inspection personnel to nurses, of patients and nurses to themselves.

Cyclosporine A( CsA) , as an immune inhibitor, is commonly used after organ transplantation.It has been found that the long-term use of CsA produced serious testicular toxicity and affected the fertility of organ transplantation patients.In order to investigate male reproductive damage induced by CsA, this article reviews its impact on reproductive organ development, its damage mechanism on the male reproductive system and drug research for alleviating its reproductive toxicity.It helps to make medical workers pay more attention to reproductive toxicity produced by CsA and make their efforts to develop some special drugs to lessen CsA reproductive toxicity.

Objective T o investigate the relationship betw een the expression of secreted frizzled-related protein 5 (SFR P5) m RNA and the tim e interval after skeletal m uscle injury in rats by real-tim e PC R . Methods A total of ninety SD rats w ere random ly divided into the contusion groups at different tim es including 4 h, 8 h, 12 h, 16 h, 20 h, 24 h, 28 h, 32 h, 36 h, 40 h, 44 h, 48 h after contusion, incision groups at different tim es including 4h and 8h after incision and the control group. T he sam ples w ere taken from the contused zone at different tim e points. T he total RNA w as isolated from the sam ples and re-versely transcribed to analyze the expression levels of SFRP5 m RNA . Results C om pared to the control group, the expression of SFRP5 m RNA in contusion groups w ere dow n-regulated w ithin 48 h after con-tusion and reached the low est level at 20 h, and the expression of SFRP5 m RNA gradually increased from 20 h to 48 h after contusion. T he expression of SFRP5 m RNA in the incised groups w ere signifi-cantly low er than that of the contusion groups at 4 h after injury. A t the tim e of 8 h, the expression levels betw een the contusion and incision groups show ed no statistically significant difference. Conclusion It is suggested that SFRP5 m RNA analysis m ay show regular expression and can be a m arker for estim ation of skeletal m uscle injury age.

Acupuncture Points ; Acupuncture Therapy ; Humans ; Male ; Meniere Disease ; therapy ; Middle Aged ; Treatment Outcome

Objective To investigate the protective effect and the possible mechanism of Wenshen Shengjing Decoction (WSSJD)(including Cornu Cervi Nippon Parvum , Panax ginseng, Cynomorium songaricum, Cistanche deserticola,Radix Astragali, Epimedium brevicornum, Angelica sinensis.) on cyclophosphamide induced testicular oxidative damage in mice . Methods Eight-week-old male Kunming mice were assigned .Mice in normal control group received intraperitoneally nor-mal saline, and mice in Western medicine group ,WSSJD group and model group were injected intraperitoneally with cyclo-phosphamide [80 mg/(kg? d) ]for five days.Then mice in Western medicine group and WSSJD group were gavaged with clomifene citrate or WSSJD for 30 days consecutively .The epididymal sperm count and sperm viability were recorded , and the structure of seminiferous epithelium was observed .The content of malondialdehyde (MDA) and glutathione (GSH), and activities of glutathione peroxidase ( GSH-Px) and catalase ( CAT) in testicular tissue were detected .Immunohisto-chemical technique was used to detect the expression of survivin in spermatogenic cells .The apoptosis of spermatogenic cells in the testes was detected by TUNEL assay .Results Compared with model and Western medicine groups ,the epidid-ymal sperm count and sperm viability rate , the development of seminiferous epithelium , and the activities of GSH-Px and CAT significantly increased , while the MDA content significantly decreased in WSSJD group .The expression of survivin in spermatogenic cells was significantly improved .The apoptotic indexes of seminiferous tubules and spermatogenic cells significantly decreased in WSSJD group .Conclusion These results suggest that WSSJD can significantly improve the impaired reproductive function induced by cyclophospamide in mice by enhancing the antioxidative capability in testes and reducing the apoptosis of spermatogenic cells .

Objective To analyze clinical effects of gastric tube operation for treatment of esophageal cancer in elderly patients and evaluate its clinical efficacy and safety.Methods A total of 171 patients aged 60-72 years with esophageal cancer in our hospital were selected.They were randomly divided into treatment group and control group.Treatment group was treated with gastric tube operation,and control group was traditionally treated with complete replacement of esophagus with stomach.The quality of life,patient satisfaction and safety of operation were evaluated after 3 weeks,6 months and 12 months after operation,respectively.Results The operation for esophageal cancer in 171 patients were successful.At 3 weeks after the operation,the score of life quality in treatment group and control group were both low [(67.3±9.6) vs.(65.3±8.4)],and there were no significant differences between the two groups (P＞0.05).At 6 months and 12 months after operation,the scores of life quality were (89.2±8.3) and (90.3±9.6) in treatment group,and (66.5± 10.4) and (60.5 ± 11.2) in contol group,respectively.There were statistical differences between the two groups after 6 months and 12 months of operation (P＜0.05).The complication rate in treatment group (6.9％) was much lower than that in control group (30.6％),and there were significant differences between the two groups (x2 =18.43,P＜0.01).The patient satisfaction was in no differences between the two groups at 3 weeks after operation (P＞ 0.05),while there were statistically significant differences at 6 and 12 weeks after the operation (P＜0.05).Conclusions Gastric tube operation in treatment of elderly patients with esophageal cancer,can effectively improve the life quality,and prevent the occurrence of postoperative complications,which is worthy of clinical application.