Objective: To investigate the effects of buccal acupuncture on analgesia, immune indicators, and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer. Methods: Eighty patients with advanced-stage primary liver cancer were selected and divided into control and treatment groups according to the difference in treatment modalities, with 40 patients in each group. The control group received transcatheter arterial chemoembolization (TACE), and the treatment group received buccal acupuncture in addition to TACE. The recent efficacy, analgesic effect, liver function, serum tumor markers, Survivin and Livin protein expression levels in liver cancer tissue, and immune indexes were analyzed and compared between the two groups. Results: The objective response rate (ORR) and disease control rate (DCR) of the treatment group were 37.5％ and 77.5％, respectively, which were significantly higher than those of the control group (22.5％ and 52.5％), and the recent efficacy of the treatment group was significantly better than that of the control group (P<0.05). The onset of analgesia in the treatment group was significantly faster than that in the control group (P<0.05), the duration of analgesia was significantly longer than that in the control group (P<0.05), and the numeric rating scale (NRS) score of pain after treatment was significantly lower than that in the control group (P<0.05). In the treatment group, the aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin/globulin (A/G) were significantly lower than those in the control group (P<0.05), and the serum levels of alpha-fetoprotein (AFP), alpha-L-fucosidase (AFU), and carcinoembryonic antigen (CEA) were significantly lower than those in the control group (P<0.05), and the expression levels of Survivin and Livin in liver cancer tissue were significantly lower than those in the control group (P<0.05); CD4+ and CD4+/CD8+ in the treatment group were significantly higher than those in the control group, and CD8+ was significantly lower than that in the control group after treatment (P<0.05). Conclusion: Buccal acupuncture can reduce the degree of pain and liver function damage in patients with advanced- stage primary liver cancer and lower the serum tumor marker levels, and its mechanism of action may be related to the down-regulation of Survivin and Livin protein expression levels in the liver cancer tissue and the regulation of the immune function.

Objective:To analyze the clinical efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced NSCLC.Methods:We collected 23 cases of NSCLC advanced patients, who were treated in the affiliated Cancer Hospital of Guangzhou Medical University from January 2015 to March 2020. And these 23 cases of patients with first-generation EGFR-TKIs resistance were treated with the third-generation EGFR-TKI drugs. We analyzed their clinicopathological characteristics, studied their therapeutic effects, and followed up their progression-free survival (PFS).Results:It is showed that 16 of 23 cases (69.56%) were got local progression and 7 of 23 cases (31.43%) were found with systemic progression. Briefly, the median PFS of the 23 patients was 17.5 months. A total of 7 cases occurred rashes after taking EGFR-TKI, and 3 cases got abnormal liver function. Fortunately, they were all improved after symptomatic treatments. Additionally, no bone marrow suppression (granulocytes, neutropenia, thrombocytopenia, anemia) and digestive tract reactions (nausea, vomiting, diarrhea) were occurred in 23 cases of NSCLC patients. The mental and physical improvement of EGFR-TKI in the third generation of 19 patients was more obvious than that in the first generation of EGFR-TKI. Among them, 15 cases showed more obvious lesion shrinkage after third-generation EGFR-TKI treatment. 4 patients with GGO had cleaner disappearance than that of the first-generation EGFR-TKI.Conclusions:Compared with traditional chemotherapy, the first-generation EGFR-TKI resistance treatment with three-generation EGFR-TKI treatment has better efficacy with reduced toxic and side effects, and significantly improved the life quality of advanced NSCLC patients.

Objective To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. Methods A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled. The patients were randomly divided into two groups (n = 46). The PPI group was defined using PPI < 1.4 as diagnosis of septic shock standard, and PPI > 2 as treatment guide target. Control group was defined according to the traditional diagnostic criteria of shock which systolic blood pressure was less than 90 mmHg (1 mmHg = 0.133 kPa) or systolic blood pressure value decrease> 40 mmHg baseline and bundle treatment was performed. The volume of fluid resuscitation, organ dysfunction, the sequential organ failure score (SOFA), acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score,continuous renal replacement therapy (CRRT) time, mechanical ventilation (MV) time, the length of ICU stay and 28-day mortality were observed. Results There were 39 and 27 septic shock patients in PPI group and control group respectively. The diagnostic criteria of traditional septic shock with blood pressure as "gold standard", the sensitivity of PPI < 1.4 for septic shock was 94.3%, the specificity was 28.2%, the authenticity was 66.3%, the positive predictive value was 64.1%, the negative predictive value was 78.6%, the positive likelihood ratio was 1.31, the negative likelihood ratio was 0.18. The per capita fluid replacement within 24 hours in the PPI group was significantly higher than that in the control group (mL: 4 601±1 250 vs. 3 458±1 006, P < 0.01), but there was no significant difference in the per capita volume of the patients diagnosed as septic shock (mL: 4 596±1 320 vs. 4 205±1 058, P > 0.05). Compared with the control group, the PPI group treated patients within 48 hours with less vascular active drugs (cases: 6 vs. 15), APACHE Ⅱand SOFA score were lower (48 hours: APACHE Ⅱ was 10.2±2.1 vs. 12.0±3.2; 72 hours: SOFA was 5.1±1.8 vs. 6.0±2.1, APACHE Ⅱ was 8.9±1.8 vs. 9.8±2.2), the period of CRRT and the length of ICU stay were shorter [the period of CRRT (days): 3.0±0.9 vs. 3.6±1.4, the length of ICU stay (days): 5.2±2.1 vs. 6.3±2.9), the difference was statistically significant (all P < 0.05). There was no significant difference in the liver and kidney function index, arterial blood lactic acid (Lac), MV time (days: 3.3±1.4 vs. 3.5±1.2) and 28-day mortality (15.22% vs. 19.57%) between two groups (all P > 0.05). Conclusions The inadequacy of microcirculatory perfusion by oximetry-derived PPI is more sensitive to the diagnosis of septic shock than hypotension of systemic circulation. With PPI guiding the fluid resuscitation of septic shock patients, vasopressors can be withdrawn earlier and the duration of the CRRT and ICU can be decreased.

Oxaliplatin, a third-generation platinum-based compound with significant activity against tumors, has become pivotal for the therapy of cancer after cisplatin and carboplatin.The digestive tract reaction, myelosuppression and nephrotoxicity have been alleviated, however, oxaliplatin induced neurotoxicity occurs prominently.Therefore, how to effectively eliminate and prevent chemotherapy-induced side and toxic effects becomes a great challenge for oncologists.plenty of evidence has hinted that combination of Chinese herbal medicine and oxaliplatin can not only reduce the toxicity, but also improve the actual efficacy, clinical research and experimental researches on increasing off cacy and decresing foxcity of Chinese herbal medicine combined with oxali-platin in the treatment of cancer in recent years were rewewed.to provide reference for the clinical use of oxaliplatin-based chemotherapy regimen.

Objective To compare the effects of different spleen-strengthening recipes on water-electrolyte metabolism and water transport in rat model of spleen-deficiency syndrome. Methods The male Wistar rats were randomly assigned into the normal group and spleen-deficiency model group. The rat model of spleen-deficiency was established by overstrain plus disordered diet method. On the 15th modeling day, the model rats were randomly assigned into model group , Buzhong Yiqi Tang(BYT) group, Si Junzi Tang(SJT) group, Shenling Baizhu San(SBS) group, and the rats except for the model group were treated with gastric gavage of the corresponding medicine in the dosage of 4.05 g·kg-1·d-1. Rats of normal group and model group were given equal volume of normal saline. The medication lasted for 14 days. On the 29th experimental day, we detected serum Na+ and K+, plasma antidiuretic hormone(ADH) and aldosterone(ALD), aquaporin 3(AQP3) in the small intestine and colon, and renal AQP2. Results Compared with the normal group, plasma ADH and ALD levels, serum Na+ level, renal AQP2 content in the model rats were increased significantly, serum K+ and AQP3 content of small intestine and colon mucosa was decreased significantly(P<0.01). Compared with the model group, plasma ADH and ALD levels, serum Na+ level, renal AQP2 content in the three medication groups were decreased significantly, serum K+level and AQP3 in the small intestine and descending colon mucosa was increased significantly(P<0.05 or P<0.01). Of the three medication groups, SBS group had lower ADH, ALD, Na+levels, and higher serum K+level and AQP3 in the small intestine and descending colon mucosa than BYT group and SJT group(P<0.01); SBS group and BYT group had lower renal AQP2 than SJT group(P<0.05 or P<0.01). Conclusion Rat model with spleen-deficiency syndrome has disordered water-electrolyte metabolism and abnormal water transport. The spleen-strengthening recipes, which have the actions of strengthening spleen, strengthening spleen to drain dampness, strengthening spleen to elevate yang, can improve the disorder of water metabolism to some degrees, and SBS has the best effect.

The charge management of medical consumables is the difficulty and weakness of price management in medical institutions. The establishment and application of the secondary database management system has realized precise management for materials fees. It has positive significance in ensuring the quality of medical charge and proving awareness and ability of cost management for departments.

Objective To evaluate the effect of combined multiple interventional methods in treatment of acute deep venous thrombi (DVT) in lower extremities caused by military training. Meth-ods All 25 patients with DVT were treated with embolectomy by using Fogarty catheter. Of all, three pa-tients were treated only with embolectomy, six underwent embolectomy plus percutaneous transluminal an-gioplasty (PTA), 11 received PTA plus ultrasound ablation and five were implanted with stent-grafts. The clinical results were analyzed retrospectively. Results Based on angiography during operation, the ob-structed iliofemoral vein received complete recanalization in 24 patients, with the perioperative luminal di-ameter ≥71%. Partial recanalization of the entrance of common iliac vein to inferior vena cava was failed in one patient. All 25 patients were followed up for an average 34 months after operation, which showed that 24 patients received satisfactory results with normal military training and that the other one with failed recanalization of vena iliaca still felt swelling pain in lower extremity after training. Conclusion Com-bined multiple interventional methods can remarkably improve the therapeutic effect for DVT caused by military training.

Objective To explore micro-trauma and hig h effective method in treating arterial and venous obstruction diseases. Methods Seven patients with lower limbs arterial sclerosis obstruction (ASO) and 33 patients with deep vein thrombosis (DVT) had been treated by ultrasound thrombus ablation. The short-term curative effects were observed. Results All patients achieved vessels recanalization without puncture. Arterial straightness of seven ASO cases was reduced from 93%?12% to 35%?6%. While observing from angiogram, their symptoms and signs ameliorated remarkably. Venous straightness in thirty-three DVT patients was reduced from 100% to 28%?8% by observing from angiogram and disappearance of their limb tumidness. Conclusions Ultrasound thrombus ablation is an effective , safe and micro-trauma method for arterials and venous obstructive diseases.

Objective To evaluate the result of staged arteriovenous shunts for the treatment of thromboangiitis obliterans(TAO) and arterial sclerosis obstruction (ASO). MethodsData of 176 cases undergoing this procedure were retrospectively reviewed. ResultsIn this group, 147 cases (83 5%) were followed up with a median of 9 8 years. Pain and/or claudication disappeared in 86 out of 90 cases (95 5%) treated by low positioned shunt one week postoperatively, with a limb salvage rate of 100%. Among 57 cases treated by high positioned shunts of the lower limbs, pain and claudication disappeared in 43 cases (75 4%) 2~3 weeks postoperatively. Postoperative amputation has to be performed in 5 cases with a limb salvation rate of 91%. ConclusionsThe clinical result of this staged arteriovenous shunts is satisfactory for the treatment of thromboangiitis obliterans(TAO) and arterial sclerosis obstruction (ASO).

AIM: A pharmacogostic study of Ipomo pes-caprae (linn.) was carried out. METHODS: Micro-scopic characteristics of the drug were examined and its chemical constituents were monitored by TLC and UV. RESULTS: Marked characteristics were discovered in the crossection of item and leaf. CONCLUSION: The characteristics and the cross sectional structure could provide evidences for the identification of the plant.