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Starting from the inheritance and development of Chinese philosophy of life and Traditional Chinese Medicine (TCM) wisdom through the Chinese narrative medicine practice, this paper discussed the inheritance and correspondence relationship between the text reading ability in Chinese narrative medicine practice and the "four diagnostic" in TCM wisdom, narrative regulation and the "mind-body philosophy" in TCM, as well as the narrative wisdom and the "Tao produces one" in the Chinese philosophy of life. By analyzing the stories of contemporary doctors’ practice of narrative wisdom, this paper clarified that the Chinese narrative medicine system is a new model of medical education and clinical practice constructed by absorbing the essence elements of Chinese traditional life wisdom and TCM culture, and integrating the concept of western narrative medicine. It advocated for Chinese scholars to actively build the discipline of "narrative traditional Chinese medicine", constantly translate and introduce the achievements to foreign countries, and create a good narrative ecology of TCM.
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Objective:To investigate clinical efficacy of curved fenestration and drainage procedure for the treatment of nail root abscess.Methods:From June 2018 to October 2020, 72 patients with nail root abscess were included in Department of Dermatology, Henan Armed Police Corps Hospital. According to the size, location and severity of the abscess, minimally invasive curved fenestration and drainage procedure was performed under nerve block anesthesia to reduce the pressure and drain the pus. Dressing change was strengthened after surgery, and wound healing was monitored.Results:Among the 72 patients, there were 37 males and 35 females, and their ages varied from 39 to 80 years (average: 63 years) . They all received curved fenestration and drainage procedure. Fifteen days after surgery, 66 cases were cured, 6 obtained marked improvement, and the response rate was 100%. Lesions did not completely subside in 1 patient due to poor blood glucose control and small exposure area at the fenestration site, while the condition of other patients was effectively controlled. Telephone follow-up was conducted 3 months after surgery, and no obvious nail defects or deformed appearance was observed in any of the cases.Conclusion:Curved fenestration and drainage procedure is a simple approach for nail root abscess, with satisfactory efficacy.
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Surgery is the most effective way to cure non-small cell lung cancer currently. Although sleeve lobectomy, with less reduction of respiratory function and a lower mortality rate, would not compromise oncological results in well-selected patients with central lung cancer, pneumonectomy is still necessary when complete resection could not be achieved by other surgical procedures. Cardiopulmonary complications are the most common complication after pneumonectomy. Fully understanding the related complications after pneumonectomy can help surgeons make a diagnosis timely, and further take relevant measures to reduce the adverse effects of postoperative complications on patients. What's more, in order to avoid postoperative complications and improve the prognosis of patients as much as possible, it is necessary to fully understand the risk factors to minimize the risk and to make the patients benefit from pneumonectomy as much as possible.
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With the administration of antibacterial drugs , chemotherapy agents and corticosteroids , the incidence of candidemia in patients with hematological malignancies has been increased greatly in recent years.Due to the absence of typical symptoms , the high proportions of non-albicans candida, high antifungal resistance rate and high mortality, the candidemia in these patients remains a challenge in clinic practice.In this article we review the recent progress on the epidemiology , diagnosis and treatments , the antifungal resistance and its molecular basis of candidemia in patients with hematological malignancies .
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Objective@#To study the clinical features, therapeutic effects, prognostic factors of 140 patents with mantle cell lymphoma (MCL).@*Methods@#Clinical data of 140 MCL patients admitted from June 2009 to January 2016 in our hospital were retrospectively analyzed.@*Results@#The median age of 140 patients was 59 years with a ratio of 6∶1 for men and women. There were 134 cases (95.7%) in Ann-Arbor stage Ⅲ-Ⅳ, 37 cases (26.4%) with B symptoms, 61 cases (43.6%) with bone marrow involvement and 38 cases (27.1%) with enlarged spleen. The overall response rate (ORR), 3-year survival rate and progression-free survival rate in the treatment group with rituximab were 87.1%, 68.1% and 59.5% respectively, which were significantly higher than those in the rituximab-free treatment group (66.6%, 51.5% and 31.7%, respectively). The difference was statistically significant (all P<0.05). Among patients treated with rituximab, the complete remission rates (70.8% and 77.8%) of R-HyperCVAD/MA and VcR-CAP regimens were higher than those of R-CHOP regimen (39.0%, both P<0.05). However, there was no significant difference in the overall response rate, overall survival rate and progression-free survival rate (all P>0.05). Univariate analysis showed that age, Ki-67 index, B symptoms, bone marrow invasion, platelet count, LDH, β2-MG and MIPI scores were associated with overall survival (all P<0.05). Multivariate analysis showed that age (HR=4.940, 95% CI: 2.347 to 10.397), B symptom (HR=2.900, 95% CI: 1.517-5.544), β2-MG (HR=2.945, 95% CI: 1.656-5.238), Ki-67 index (HR=4.915, 95% CI: 2.554-9.456) and treatment with rituximab-containing regimen (HR=2.450, 95% CI: 1.352-4.440) were independent factors for OS.@*Conclusions@#Most patients with MCL were older adults and usually had bone marrow involvement and spleen involvement. Rituximab combined with chemotherapy (especially R-HyprCVAD/MA and VcR-CAP) had better clinical efficacy than conventional chemotherapy.
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<p><b>OBJECTIVE</b>To delineate the clinical features and prognostic significance of acquired trisomy 21 (+21) in 31 patients with acute myeloid leukemia (AML).</p><p><b>METHODS</b>Chromosome specimen was prepared from bone marrow samples using a direct method and (or) cultivation, and their karyotypes were analyzed with R banding. The clinical features, chemotherapeutic effect and survival status of patients with acquired +21 were evaluated.</p><p><b>RESULTS</b>Cytogenetic studies were successfully performed on 3 329 patients with newly diagnosed AML, among which 31 (0.93%) had acquired +21. And 16 (0.48%) of the 31 patients had +21 as the sole abnormality. The most frequent subgroup of bone marrow morphology was AML-M5b, and its total number was 12 (38.7%) of the total. Thirty patients among those with +21 received standard chemotherapy. The complete remission (CR) rate (63% vs. 80%, P< 0.05) and median overall survival (OS) (7 months vs. 15 months, P< 0.01) of AML patients with acquired +21 were both lower than those without. Age (60 years or older) was associated with a significantly lower CR rate (30% vs. 80%, P< 0.05) and shorter median OS (4 months vs. 12 months, P< 0.01). Comparing to acquired +21 with other additional abnormalities, acquired +21 solely was associated with a lower median OS (6 months vs. 12 months, P< 0.05), but did not affect the CR rate (60% vs. 67%, P> 0.05). Three patients undergoing allogenetic hematopoietic stem cell transplantation (allo-HSCT) were still alive at the end of follow-up. Their survival time have reached 56, 36 and 105 months, respectively, which were remarkably longer than those only received chemotherapy (P< 0.01).</p><p><b>CONCLUSION</b>The presence of acquired +21 in patients with AML has a adverse prognosis with or without other additional abnormalities. Older age (60 years or older) and +21 alone predicted relatively poorer outcome. Allo-HSCT was expected to prolong the survival time of AML patients with acquired +21.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Chromosome Aberrations , Down Syndrome , Genetics , Leukemia, Myeloid, Acute , Genetics , PrognosisABSTRACT
Andersson lesion is a destructive vertebral or disco-vertebral lesion that occurs in the late stage of the ankylosing spondylitis. According to the etiology, these lesions are usually classified into localized lesions and extensive lesions. The history of ankylosing spondylitis and characteristic imaging is the key to the diagnosis of Andersson lesion. Conservative treatment may be effective for localized lesions. However, surgical intervention is often required for the failure of conservative treatment and extensive lesions. Currently, the optimal procedure for this problem is spinal osteotomy through pseudarthrosis and debridement via posterior-only approach.
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Surgical site infection (SSI)following spinal surgery is the most common complications, which is devastating for both the patient and the surgeon.There is strong evidence in the literature that opti-mizing specific preoperative,intraoperative,and postoperative variables can significantly lower the risk of developing an SSI.Evidence-based approach will allow surgeons to minimize the risk of SSI and,therefore, significantly improve patient care.Here,we review the current evidence.
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Objective To introduce Curve Harmony Angle (CHA)to quantify the relationship between adjacent curves of the spine and pelvis and evaluate sagittal balance in spinal deformities. Methods Radiographic analysis of 93 asymptomatic vol-unteers and 95 patients including Degenerative Scoliosis(DS), Adolescent Idiopathic Scoliosis(AIS)and Ankylosing Spondylitis (AS)was performed by measuring sagittal parameters. Correlation study among parameters was further conducted. Curve Harmony Angles(CHAs)including the following three parameters were measured. Cervical-Thoracic Angle (CTA), Thoracic-Lumbar Angle (TLA) and Lumbar-Sacral Angle (LSA). Comparative study between normal population and different spinal disorders were per-formed in order to describe the characteristic changes of CHAs. Besides, according to Schwab SRS adult deformity classification, comparative study of CHAs in different balance status was performed to test the reliability of CHA on sagittal balance evaluation. Results All subjects showed typical changes of sagittal parameters. Different spinal disorders showed characteristic patterns of CHAs. In Schwab-SRS Adult Deformity Classification, Compensatory Balance group showed smaller LSA compared to Balance group;Imbalance group showed significantly smaller CTA, LSA and significantly greater TLA. Conclusion CHAs are parame-ters used to quantify the relationship between adjacent curves. Comparative study of CHA between normal population and different spinal disorder or among different balance status showed specific characters respectively. It is feasible to use CHA to evaluate the clinical sagittal balance and the results of deformity correction.
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This article presents the development and design of a new type intelligent high potential therapeutic apparatus, by using Atmega1280 as its controller. The circuit transforms voltage from 220 V ac to 110 V ac and constitutes different circuits with relays. In order to get different treatment waveforms, inductance of various values is used in different circuits. The circuit generates appropriate treatment voltage with the transformer booster. Simultaneously, the corresponding control software was composed. Finally the hardware and software designs of the high potential therapeutic apparatus were completed. Result of the experiment showed that the high potential therapeutic apparatus worked steadily and the effect of treatment was satisfactory.
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Humans , Electric Stimulation Therapy , Methods , Equipment Design , SoftwareABSTRACT
Discrimination of abnormal images from the numerous wireless capsule endoscope (WCE) video sequence images is laborious and time-consuming, so that a computer-based automatic image recognition system is desired for this task. We propose an algorithm to allow feature extraction from each image channel and decision fusion using multiple BP neural networks. The algorithm was tested and the results demonstrated its high efficiency and accuracy in identification of abnormalities in the WCE images.
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Algorithms , Capsule Endoscopy , Methods , Image Interpretation, Computer-Assisted , Methods , Pattern Recognition, Automated , MethodsABSTRACT
Objective To establish an orthotopic rat model of bladder cancer induced by N-methyl.nitrosourea (MNU)and to evaluate the diagnostic value of CT(computed tomography)scanning in this experimental model.Methods 50 SD rats were randomly divided into the control group(group A)with 15 rats and experimental group(group B)with 35 rats.Each rat of group B was treated with 2 mg MNU per dose every other week,totally 4 doses,by per urethra administration.Meanwhile,each rat of group A was treated with normal saline.Then,at the 14th week,all the rats were evaluated by CT scanning and pathological examination.Results Abnormal changes were detected in each of the 28 rats in group B by CT scanning,and manifested as local mass,thickening bladder wall accompanied with heterogeneous density.Bladder cancer was diagnosed by pathology.However,no bladder tumor was detected by CT scanning and pathologicalexamination in group A.Conclusion A rat model of orthotopic bladder cancer can be established by per urethra administration of MNU.CT scanning is a reliable diagnostic technique concerning this model.Furthermore,this technique can render US a more suitable rat model for further experimental studies on chemotherapy and radiotherapy of bladder Cancer.
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A persistent infection model was established after human hepatoma cells infected by Japanese encephalitis viruses were subcultured for several times. Viral titers of mutant viruses in persistently infected cells were examined by plaque methods using BHK cells. Nucleotides of the E coding region of two wild and two mutant viruses were amplified by RT-PCR. PCR products were sequenced by ABI-PRSMTM310 sequencing system. Compared to JaGAr-01 wild strains, four amino acids were replaced (E61Tyr→Asp, E219His→Tyr, E384Val→Glu, E418Pro→Ala) in the E sequence of JaGAr-01 persistently-infected mutant strains. Eleven amino acid replacement (E51Arg→Ser, E61Tyr→Asp, E83Lys→Glu, E123Ser→Arg, E209Arg→Lys, E227Pro→Ser, E276Asp→Ser,E290Arg→Lys, E387Lys→Arg, E418Leu→Pro, E454Arg→Gly) was also noted when we compared the E sequence between persistently infected Nakayama and its wild strains. A lot of similarities of amino acid sequence between mutant strains JaGAr-01 and Nakayama were also noted. It was concluded that geno-variation existed in E region of mutant viruses and the mutant protein encoded by E region, especially the mutation of E61 (Tyr→Asp) may contribute to the maintenance of the persistent infection of Japanese encephalitis virus.
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A persistent infection model was established after human hepatoma cells infected by Japanese encephalitis viruses were subcultured for several times. Viral titers of mutant viruses in persistently infected cells were examined by plaque methods using BHK cells. Nucleotides of the E coding region of two wild and two mutant viruses were amplified by RT-PCR. PCR products were sequenced by ABI-PRSM 310 sequencing system. Compared to JaGAr-01 wild strains, four amino acids were replaced (E61Tyr --> Asp, E219His --> Tyr, E384Val --> Glu, E418Pro --> Ala) in the E sequence of JaGAr-01 persistently-infected mutant strains. Eleven amino acid replacement (E51Arg --> Ser, E61Tyr --> Asp, E83Lys --> Glu, E123Ser --> Arg, E209Arg --> Lys, E227Pro --> Ser, E276Asp --> Ser, E290Arg --> Lys, E387Lys --> Arg, E418Leu --> Pro, E454Arg --> Gly) was also noted when we compared the E sequence between persistently infected Nakayama and its wild strains. A lot of similarities of amino acid sequence between mutant strains JaGAr-01 and Nakayama were also noted. It was concluded that geno-variation existed in E region of mutant viruses and the mutant protein encoded by E region, especially the mutation of E61 (Tyr --> Asp) may contribute to the maintenance of the persistent infection of Japanese encephalitis virus.
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Objective To study the influence of Yin-nourishing Qi-tonifying and blood-activating recipe(养阴益气活血方) on anticoagulation and fabrinolysis of cultured human umbilical vein endothelial cells(HUVEC).Methods Yin-nourishing Qi-tonifying blood-activating recipe was composed of three equal proportions of Radix Rehmanniae(生地黄),Radix Astragali(黄芪) and Rhizoma Chuanxiong(川芎);blood-activating recipe(活血方)contains Rhizoma Chuanxiong only.Serology pharmacology method was used to observe the effects of Yin-nourishing Qi-tonifying and blood-activating recipe on anticoagulation and fabrinolysis of cultured endotheliocytes of human umbilical vein.Results Compared with control group,both Yin-nourishing Qi-tonifying blood-activating and blood-activating recipes could obviously increase the content of 6-keto-prostacyclin 1?(6-keto-PGF1?) in HUVEC((412.5?42.7)ng/L and(231.7?30.1)ng/L vs.(137.6?13.5)ng/L),promote the activity of tissue plasminogen activator(t-PA)((0.920?0.072)kU/L and(0.679?0.062)kU/L vs.(0.516?0.052)kU/L),and inhibit the activity of tissue plasminogen activator inhibitor(PAI)((0.622?0.071)kAU/L and(0.851?0.085)kAU/L vs.(0.934?0.076)kAU/L),decrease the content of endothelin(ET)((35.7?4.9)ng/L and(46.8?5.1)ng/L vs.(58.6?6.2)ng/L),and increase the content of nitrogen monoxide(NO)((21.68?2.26)mmol/L and(15.15?1.73)mmol/L vs.(8.67?1.24)mmol/L) of cultured HUVEC(P
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Objective To investigate the correlation between TNF-β NcoⅠpolymorphism and PDR.Methods PCR-RFLP analysis of frequencies of allele in each group.Results The frequency of allele TNF-β2 was significantly higher in patients with PDR than that without PDR（P<0.05）.Conclusion This polymorphism of TNF-β can be served as a susceptible genetic marker of PDR.
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In spite of the relative success achieved in degree-oriented education program in clinical medicine during its preliminary trial stage, problems remain in regard to its recognition and understanding, administration policy, testing systems and the quality control. To further improve the Effects of the actual teaching, it is of high importance that we further our understanding, strengthen the administration, consolidate the testing system and implement better supervision of the teaching procedures of the program.
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Objective To investigate the correlation between TNF-? NcoⅠpolymorphism and PDR.Methods PCR-RFLP analysis of frequencies of allele in each group.Results The frequency of allele TNF-?_2 was significantly higher in patients with PDR than that without PDR(P