Objective:To explore the correlation between TCM Syndromes of small pulmonary nodules (SPN) and the features of CT imaging and tumor markers in the chest.Methods:With retrospective study, the clinical data of 420 patients with small pulmonary nodules who were included from June 2016 to May 2018 from the East China Hospital Affiliated to Fudan University and Shanghai TCM Integrated Hospital were analized. The correlation between TCM syndromes and clinical high-risk indicators was analyzed by frequency analysis and Pearson correlation analysis.Results:The TCM syndromes were mainly lung qi and spleen qi deficiency syndrome (28.8%), followed by qi and yin deficiency syndrome (27.6%), lung yin deficiency syndrome (22.9%), qi deficiency and blood stasis syndrome (12.4%) and liver depression and spleen deficiency syndrome (8.3%). Compared with the patients with qi deficiency and blood stasis, the patients with liver depression and spleen deficiency had carcino embryonic antigen (CEA) level decreased significantly ( P<0.01); compared with the patients with qi and yin deficiency, CYFRA21-1 level in the patients with lung yin deficiency increased significantly ( P<0.001) and CYFRA21-1 level decreased in the patients with qi deficiency and blood stasis ( P=0.014); compared with the patients with lung yin deficiency, the level of neuron-specific- enolase (NSE) in the patients with lung qi and spleen qi deficiency. The level of NSE decreased ( P=0.044), and the level of NSE increased significantly in patients with liver depression and spleen deficiency ( P=0.005); there was no significant difference in the level of SCC between different syndromes ( F=0.825, P=0.551). The syndrome of deficiency of lung yin was moderately correlated with chronic bronchitis, smooth margin and burr ( r=0.613, -0.628, 0.755). The syndrome of qi and yin deficiency was lowly correlation to the solidity ( r=-0.421). The syndrome of lung qi and spleen qi deficiency was moderately correlation with the solidity ( r=0.540), and were low correlation with the chronic bronchitis history, ground glass, round, quasi round, and smooth edge ( r value was 0.303, -0.495, 0.376, -0.337, 0.319 respectively); liver depression and spleen deficiency syndrome were correlated with smoking history, chronic bronchitis history, left lower lobe of lung, isolated focus, multiple focus, quasi circle, NSE ( r value was -0.099, -0.150, 0.120, 0.113, -0.113, -0.107, 0.133 respectively); qi deficiency and blood stasis syndrome was moderately correlated with lobular shape ( r=0.682), and slightly correlated with irregular edge ( r=0.470). Conclusions:There is a certain correlation between TCM syndrome differentiation and clinical indexes in patients with pulmonary nodules. The level of tumor markers was different in different syndrome types. Among them, the lung yin deficiency syndrome and qi deficiency and blood stasis syndrome are at high risk of developing malignant tumors, but the lung qi and spleen qi deficiency syndrome, qi and yin deficiency syndrome and liver depression and spleen deficiency syndrome are at low risk of developing malignant tumors.

Objective To study the MRI manifestations of foot injuries in amateur marathoners and the diagnostic value of MRI for foot injuries. Methods Forty?eight amateur marathoners were prospectively recruited from October 2018 to March 2019. Participants were grouped according to the FASS criteria. All participants underwent bilateral foot MRI examinations. The MRI features of foot in amateur marathoners with and without foot pain were analyzed.The association with gender, age, time to participate in marathon, amount of running per week, number of times to complete the whole marathon and the symptoms of foot pain was studied. Results There were 28 sides in FASS in grade 0, including 8 males and 20 females, 8 hydrocele of the first metatarsophalangeal joint, 6 edema of bone marrow, 4 edema of soft tissue, 4 hydrocele of tendon sheath, and 6 without abnormal manifestations of MRI. There were 68 sides in FASS grade 1, including 42 males and 26 females, 38 Achilles tendinitis, 14 plantar fasciitis, 12 Achilles tendon bursitis and 4 posterior ankle impingement syndrome. The incidence of foot pain in amateur marathoners was related to gender(OR=1.060, P=0.043), unrelated to age(OR=0.248, P=0.078), number of marathons completed(OR=1.006, P=0.956), time to participate in marathon(OR=1.008,P=0.944), amount of running per week (OR=0.971,P=0.407). Conclusion Among amateur marathon runners, the foot pain is mainly caused by Achilles tendon and plantar fascia, while those without foot pain are mainly characterized by joint effusion, tendon sheath effusion and bone marrow edema. Gender is the only factor affecting the incidence of foot pain in amateur marathoners. MRI examination is an effective method to determine foot injury and has important clinical application value in the diagnosis and treatment of foot injury.

Objective: To study the MRI manifestations of foot injuries in amateur marathoners and the diagnostic value of MRI for foot injuries. Methods: Forty-eight amateur marathoners were prospectively recruited from October 2018 to March 2019. Participants were grouped according to the FASS criteria. All participants underwent bilateral foot MRI examinations. The MRI features of foot in amateur marathoners with and without foot pain were analyzed.The association with gender, age, time to participate in marathon, amount of running per week, number of times to complete the whole marathon and the symptoms of foot pain was studied. Results: There were 28 sides in FASS in grade 0, including 8 males and 20 females, 8 hydrocele of the first metatarsophalangeal joint, 6 edema of bone marrow, 4 edema of soft tissue, 4 hydrocele of tendon sheath, and 6 without abnormal manifestations of MRI. There were 68 sides in FASS grade 1, including 42 males and 26 females, 38 Achilles tendinitis, 14 plantar fasciitis, 12 Achilles tendon bursitis and 4 posterior ankle impingement syndrome. The incidence of foot pain in amateur marathoners was related to gender (OR=1.060, P=0.043), unrelated to age (OR=0.248, P=0.078), number of marathons completed (OR=1.006, P=0.956), time to participate in marathon (OR=1.008, P=0.944), amount of running per week (OR=0.971, P=0.407). Conclusion Among amateur marathon runners, the foot pain is mainly caused by Achilles tendon and plantar fascia, while those without foot pain are mainly characterized by joint effusion, tendon sheath effusion and bone marrow edema. Gender is the only factor affecting the incidence of foot pain in amateur marathoners. MRI examination is an effective method to determine foot injury and has important clinical application value in the diagnosis and treatment of foot injury.

Objective : To investigate the short-term efficacy of implant in the treatment of patients with dentition defect caused by chronic periodontitis. Methods : 53 patients with mild to moderate chronic periodontitis treated in our hospital from June 2014 to May 2015 were selected as observation group, and 53 patients without periodontal diseases in the same period were selected as control group. The plaque index (PLI), sulcus bleeding index (SBI), periodontal probing depth (PD) and gingival papilla index (PIS) were measured at six months and one year after operation, respectively. Interleukin-6 (IL-6), interleukin-8 (IL-8), high sensitive C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were detected at six months and one year after operation, respectively. At the last follow-up, the survival rate of two groups were calculated. Results : One year after operation, 5 of the 64 implants in the observation group failed compared with 2 of the 71 implants in the control group. There was no statistical difference in the implant survival rate between the two groups (92.19% vs 97.18%, P=0.191). There was no significant difference in SBI (t=0.936, P=0.351)、 PLI (t=0.457, P=0.649)、PIS (t=1.132, P=0.217)、PD (t=0.957, P=0.341) between the two groups at six months after operation. One year after operation, the periodontal index of the observation group was higher than that of the control group SBI (t=5.297, P=0.000)、 PLI (t=2.341, P=0.021)、 PIS (t=8.218, P=0.000) and PD (t=6.492, P=0.000). The levels of IL-6 (t=6.463, P=0.000)、 IL-8 (t=7.202, P=0.000)、 hs-CRP (t=4.237, P=0.000) and TNF-α (t=6.194, P=0.000) in the observation group were higher than those in the control group at six months after operation. One year after operation, the level of inflammatory factors in the observation group was higher than that in the control group IL-6 (t=12.835, P=0.000)、 IL-8 (t=13.207, P=0.000)、 hs-CRP (t=11.319, P=0.000) and TNF-α (t=8.117, P=0.000). Conclusion Implant as the treatment of patients with dentition defect caused by chronic periodontitis obtained satisfied short-term effect, but its long-term efficacy remains to be further verified.

Objective:To explore clinical significance of sinus heart rate turbulence (HRT) phenomenon in aged pa‐tients with stable angina pectoris (SAP) .Methods :A total of 120 aged SAP patients ,who received 24h DCG in our hospital from Jan 2013 to Oct 2015 ,were selected as SAP group .Meanwhile ,another 144 aged patients ,who re‐ceived 24h DCG examination simultaneously and coronary angiography results were normal ,were regarded as nor‐mal control group .According to coronary lesion severity ,SAP group was further divided into single vessel coronary disease group (single vessel group ,n=35) ,double‐vessel coronary disease group (double‐vessel group ,n=48) and multi‐vessel coronary disease group (multi‐vessel group ,n=37) .The 24h DCG ,HRT indexes ,including turbulence onset (TO) and turbulence slope (TS) ,were measured and compared among all groups .Results:Compared with normal control group ,there was significant rise in TO [(0.77 ± 0.37)% vs .(1.26 ± 0.92)% ] and significant reduc‐tion in TS [(5.45 ± 4.02) ms/RR interval vs .(1.53 ± 0.70) ms/RR interval] ,P<0.01 both ;significant rise in ab‐normal rates of TO (19.44% vs .42.50% ) ,TS (15.97% vs .31.67% ) and TO + TS (11.11% vs .30.83% ) in SAP group ,P<0.01 all .Compared with single vessel group ,there was significant rise in TO [(0.66 ± 0.22)% vs .(1.28 ± 1.11)% vs .(1.46 ± 1.20)% ] and significant reduction in TS [ (2.04 ± 0.82) ms/RR interval vs .(1.66 ± 0.38) ms/RR interval vs .(1.29 ± 0.58) ms/RR interval] in double‐vessel group and multi‐vessel group ,and TO of multi‐vessel group was significantly higher than that of double‐vessel group ,TS of multi‐vessel group was significantly low‐er than that of double‐vessel group , P<0.01 all .Conclusion:Sinus heart rate turbulence can be used as risk predic‐tor for aged patients with stable angina pectoris ,which can provide basis for clinical effective treatment and progno‐sis assessment .

Objective To evaluate the therapeutic effect of nurse-led clinics ( NLCs) in patients with type 2 diabetes mellitus ( T2DM) . Methods We searched randomized controlled trials ( RCTs) related to the therapeutic effect of patients with T2DM in PubMed, EMBASE, CENTRAL, Web of science, CBM, CNKI, VIP, and Wanfang databases from the beginning to June 2016. The methodological quality assessment was used to assess the included studies according to “bias risk assessment” recommended by Cochrane Handbook 5. 1. 0 software, and the data were extracted and analyzed by using the RevMan 5.1 software. Results Totally 15 RCTs with 2 204 patients were included in this study. The Meta-analysis showed that:compared with the control group, NLC intervention can further decrease the HbA1c level of patients with T2DM [ MD=-1.11, 95%CI(-1.47,-0.75), P<0.001];improve patients′adherence to medication [RR=1.28, 95%CI(1.20,1.35)], diet control [RR=1.68, 95%CI(1.52,1.86)], exercise reinforcement [RR=1.32, 95%CI(1.22,1.43)], and regular blood glucose monitoring [ RR=1. 68, 95%CI ( 1. 30, 2. 17 ) ]; and improve patients′ quality of life. Meta-regression analysis showed that the effect of NLC were positively related to the baseline level of HbA1c ( r=-0.33, P<0.05). Conclusions The application of NLC can improve the therapeutic effect of patients with T2DM, and improve their treatment compliance and quality of life.

Objective To explore the clinical efficacy of reteplase(rPA) combined with reduced glutathione(GSH) for the treatment of acute ST-segment elevation myocardial infarction(STEMI).Methods 80 patients with STEMI received in our hospital from Feb 2010 to Feb 2013 were divided into observation group and control group according to the treatment type,with 40 cases in each group.The control group was treated with rPA for intravenous injection on the basis of conventional treatment,and the observation group was added reduced GSH intravenously on the basis of control group.The recanalization rate,myocardial enzymes levels,ventricular structure and function of the heart and major adverse cardiac events in the two groups of patients were compared.Results There canalization rate in observation group was 90％ after treatment,compared with the control group (82.5％) which showed no significant difference as compared with the control group(90％ vs.82％,P＞0.05).Serum creatine kinase-MB fraction(CK-MB),cardiac troponin(cTn) I and TcTnI and cTnT levels in observation group after 24h were significantly lower in observation group than in the control group after 24 h of treatment(t=10.44,6.008,29.63,respectively,all P＜0.05); left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVESd) in observation group were significantly shorter and left ventricular ejection fraction (LVEF) was significantly higher in observation group than in the control group after 1 month of treatment (t =4.543,5.605,4.652,respectively,all P＜0.05).The incidence of cardiogenic shock,reinfarction,angina and arrhythmia in observation group were significantly lower in observation group than in the control group(x2=5.128,7.825,6.000,4.669,respectively,all P＜0.05).Conclusions rPA combined with reduced GSH for the treatment of STEMI had is significantly effective,safe and reliable,has fewer complications,and is worthy of clinical promotion.