Malignancies are a difficult to treat disease in clinical practice.At present,there are many cases of differentiation and treatment based on qi and yin deficiency,the coagulation of phlegm,blood stasis and cancer toxin,there are few theories on the treatment of yang deficiency and yin excessiveness,as well as the coagulation of cold and dampness.On the basis of inheriting the cancer toxin theory of Chinese medicine master ZHOU Zhongying,combined with the theory of promoting yang and our own practice,we believe that malignancy is caused by yang deficiency as the foundation,cold dampness,phlegm-turbidity stagnation and toxin transformation as the manifestation,and the key pathogenesis can be summarized as yang deficiency and yin binding.Based on this,it is proposed to differentiate and treat malignancies from promoting yang and eliminating yin.The method of promoting yang and eliminating yin is people-oriented,with harmony as the value,based on the whole,with a focus on adjusting harmony,constantly promoting yang and timely eliminating yin.The specific differentiation and treatment strategies are as follows:in the early stages of malignancy,it is important to seize the opportunity to warm and dredge,or eliminate yin;malignancy is already present,balancing deficiency and excess,supplementing,eliminating,and harmonizing appropriately;after malignancy surgery,it is important to strengthen the foundation and regulate the spleen and kidney,and strengthen both congenital and acquired constitution;treating the zang-fu organs accordingly,elevating and lowering,and conforming to the physiology of the organs.Unlike simple malignancy treatment and detoxification,promoting yang and eliminating yin is a method of examining symptoms and identifying etiology and pathogenesis.It involves macroscopic regulation of yin and yang,dynamic management of medication,and orderly treatment,which can significantly improve the quality of life of patients and increase long-term survival rates.Exploring the theory and strategy of promoting yang and eliminating yin in the differentiation and treatment of malignancy can provide new ideas and references for the clinical differentiation and treatment of malignancies.

Objectives To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza.Methods This was a randomized,double-blind,double-dummy,placebo and positive control,multicenter clinical trial,comparing peramivir trihydrate with oseltamivir and placebo.The inclusive criteria were 15-70 years old,onset within 48 h,positive rapid influenza antigen test,and febrile(＞38℃) accompanied with at least two associated symptoms.The severe cases complicated with chronic pulmonary and cardiac diseases,malignancies,organ transplantation,hemodialysis,uncontrolled diabetes,immunocompromised status,pregnancy and coexistence of bacterium infections were excluded.All patients were randomized 2:2:1 to receive peramivir,oseltamivir and placebo respectively.The primary endpoint was the disease duration,the secondary endpoints included time to normal axillary temperature and normal living activities,viral response,and adverse effects.Results Following informed consent,133 patients were included in this study.Four patients were exclude due to missing medical records,not fitting inclusion or exclusion criteria and poor compliance.A total of 129 patients were finally analyzed,including 49 cases,54 cases and 26 cases in peramivir group,oseltamivir group and placebo group.The median disease duration were 96 (76,120)hours,105(90,124) hours,and 124 (104,172)hours in three groups respectively(P＞0.05).The time to normal axillary temperature,normal living activities and viral response were not significantly different in three groups(P＞0.05).Conclusion The value of antiviral therapy in patients with mild influenza needs to be further determined.

Objective To investigate the method and curative effect of the posterior cervical esophageal de-fect after the reconstruction of lower pharyngeal carcinoma by dissociation of the lower pharyngeal carcinoma. Meth-ods From August,2015 to June,2017, we used the jejunum segment. to reconstruct five patients' esophageal defect in the neck segment enlarged after the enlargement of the hypopharyngeal carcinoma. The length of the jejunum was 8.0 -15.0 cm, We used microvascular stapling to anastomosis vein in surgery. The morphological and functional changes of the graft tube were observed by endoscopic follow-up. Results All 5 patients were discharged from the hospital with an average of 12 days in hospital.The mean time of heat ischemia was 8 minutes,and the average oper-ation time was 5.2 hours. After endoscopic follow-up for 12 months, no stricture or anastomotic leakage occurred in the transplanted bowel, and the intestine moves downward autonomously, the morphological and functional remodeling of transplanted intestinal tract was observed. Conclusion Free jejunal reconstruction of hypopharyngeal carcinoma resection for cervical esophageal is a safe method with a good outcome in morphological and functional remodeling.It' s one of the ideal methods to reconstruct cervical esophageal defect.

Objective·To analyze changes in the type distribution and drug resistance of pathogenic bacteria isolated from burn wards and to provide evidence for rational use of antibiotics, reduction of drug-resistant isolates, and hospital infection control. Methods·Isolates from burn patients were collected from January 2011 to December 2014. Statistical analysis of infection sources, type distribution, and changes in resistance rates of main pathogens during the four year period was performed. Results·A total of 2399 isolates were collected, including 1286 (53.61%) gram-negative bacilli (G-b), 1088 (45.35%) gram-positive cocci (G+c), and 25 (1.04%) fungi. The most common G-b pathogens were Pseudomonas aeruginosa (447, 34.76%) and Acinetobacter baumannii (369, 28.69%). The most common G+c pathogen and fungus were Staphylococcus aureus (489, 44.94%) and Candida albicans (8, 33.33%), respectively. In the last two years, the detection rates of S.aureus and A.baumannii were significantly lower and the detection rate of P.aeruginosa was significantly higher than those in the first two years (P<0.05). P.aeruginosa and A.baumannii showed high resistance (>80%) to the third and fourth generation cephalosporins, carbapenems, aminoglycosides and quinolones, but the changes were not statistically significant (P>0.05). S.aureus was only highly resistant to penicillin (97.58%) and was 100% susceptible to vancomycin. Its resistance rates toward cefazolin, ampicillin/sulbactam, gentamicin, levofloxacin, and rifampin decreased significantly (P<0.05). The detection rate of methicillin-resistant S. aureus (MRSA) dropped from 72.28% to 63.00%. Conclusion·Many types of drug resistant bacteria were detected in burn wards. The drug resistance problem was serious. Improving management and rational use of antibiotics can reduce the occurrence of drug-resistant bacteria and increase the efficacy of clinical anti-infective treatment and nosocomial infection control.

OBJECTIVE To investigate the related factors of vocal cord adhesion after CO2 laser assisted laryngeal surgery.METHODS Clinical data of 219 patients who received CO2 laser assisted laryngeal surgery in our department from October 2012 to December 2016 were analyzed retrospectively.Correlation analysis of the vocal cord adhesion with patient's gender, age, lesion nature, lesion location,type of operation,laser power, and postoperative granulation hyperplasia were carried out. RESULTS Of the 219 cases, vocal cord adhesion occurred in 31 cases, accounted for 14.16%. The vocal cord adhesion were associated with the lesion nature, lesion location, the laser power, postoperative granulation hyperplasia (P<0.05). CONCLUSION According to the related factors, the appropriate surgical procedure and cutting power, perioperative measures can help to reduce the occurrence of postoperative vocal cord adhesion.

OBJECTIVE: To investigate the expression of CXCR4 in maxillary sinus carcinoma cells IMC3 under hypoxia. METHOD: IMC3 cells were cultured for 6 h, 12 h, 24 h and 48 h under normoxia and hypoxia. Real-Time PCR was applied to detect the expression of mRNA of CXCR4 and immunohistochemisrty was applied to investigate its protein level. RESULT: CXCR4 mRNA level was about 0.035 under normal conditions, which was obviously upregulated by hypoxia. The mRNA levels after culturing under hypoxia for 6 h, 12 h, 24 h and 48 h were 0.283, 0.313, 0.426, 0.510 respectively. There was statistically significant difference between the mRNA levels of each two groups (P < 0.05, Mann-Whiney Test) with a time dependent course, except for the difference between the groups of 6 h and 12 h. Immunohistochemistry showed that there was almost negative staining for CXCR4 in the cell cultured in nomoxia, while stong positive staining of CXCR4 was observed in cells cultured in hypoxia . The positive staining was located mainly in the cell membrane and cytoplasm and little in the nucleus. CONCLUSION Hypoxia could induce expression of CXCR4 in IMC3 cells at both mRNA and ptrotein levels. The upregulation of CXCR4 by hypoxia showed an obvious time dependent course.
Cell Hypoxia ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Humans ; Maxillary Sinus ; metabolism ; pathology ; Receptors, CXCR4 ; metabolism

Objective To analyze the emergency-event in patients with obstructive sleep apnea-hypopnea syndrome( OSAHS), and to discuss the risk factors and preliminary strategies for prevention of emergency-event. Method A total of 257 OSAHS patients in Zhejiang Provincial Peoples Hospital, were enrolled from January 2000 to December 2009 for the retrospective study. Demographics of patients include age, sex,height, weight, related diseases, AHI and LSaO2 before operation , the way of anesthesia and operation,when and how the emergency-events happened, the way to cure and the results. Risk facts of emergency-event were analyzed by using univariate analysis and multiple logistic regression analysis. Results Of the 257patients, the incidents of emergency-event was 7.3%. The independent risk factors of emergency-event were general anesthesia, multiple level surgery in one time, BMI and AHI. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event. Conclusions Emergency-event are more common in severe OSAHS patients, especially when they were operated under general anesthesia and multiple level surgery in one time. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event.

Objective:To investigate the correlation between intratumor microvessel density (IMVD) and lymph node micrometastases. Method: IMVD and lymph node micrometastases were stained with CD105 and CK19 antibody by immunohistochemical method of SABC respectively. Result:IMVD marked with CD105 antibody corre-lated with T stage and lymph node micrometastases(P<0.01). Conclusion: The result show that IMVD marked with CD105 antibody highly correlated with lymph node micrometastases. It could be a index to evaluate the prog-nosis of patients with pN_0 supraglottic laryngeal squamous cell carcinoma.

OBJECTIVE: To investigate the correlation between intratumor microvessel density(IMVD) and lymph node micrometastases. METHOD: IMVD and lymph node micrometastases were stained with CD105 and CK19 antibody by immunohistochemical method of SABC respectively. RESULT: IMVD marked with CD105 antibody correlated with T stage and lymph node micrometastases (P < 0.01). CONCLUSION The result show that IMVD marked with CD105 antibody highly correlated with lymph node micrometastases. It could be a index to evaluate the prognosis of patients with pN0 supraglottic laryngeal squamous cell carcinoma.
Adult ; Aged ; Carcinoma, Squamous Cell ; blood supply ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; blood supply ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Microvessels ; Middle Aged ; Neoplasm Staging

OBJECTIVE To investigate the frozen section and surgical margin predicting the prognosis of laryngeal carcinoma after partial laryngectomy and decides the circumscription of surgical margin because of the balance between the function of the larynx and the recurrence rate of cancer.METHODS 77 cases of laryngocarcinoma were reviewed in this retrospective study.All of the laryngocarcinoma patients were treated in our hospital during 1996.1～2001.12 frozen section, surgical margin, and pathological section were compared to the recurrence rate of cancer and the survival rate of patients.RESULTS To those Partial laryngectomy whose surgical margin are larger than 0.5 cm, whether carrying out the frozen section is not significant.But to those Partial laryngectomy whose surgical margin are smaller than 0.5 cm, we should carry out the surgical margin to decrease the positive rate of the pathological section.Recurrent rate of the negative group is lower than the positive group(P