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The climate in the Lingnan area south China is characterized by high temperature and rainy days， and in terms of the eating habits， the local people are more addicted to raw， cold and savory food， all of which make Lingnan people prone to a constitution of upper heat and lower cold， and pathological manifestations of upper heat and lower cold. It is believed that the main pathogenesis of hyperthyroidism in Lingnan area is the upper heat and the lower cold， manifested as spleen yang deficiency and stomach fire excess， or kidney water depletion and heart fire hyperactivity， leading to upper heat and lower cold syndrome caused by disharmony of yin and yang and abnormal ascending and descending. Therefore， spleen cold and stomach heat and disharmony between the heart and the kidney are the main syndromes of hyperthyroidism in Lingnan area. Modified Huanglian Decoction （黄连汤） is commonly used. Additionally， for spleen cold and stomach heat syndrome， Fushen （Sclerotium Poriae Pararadicis） and Baizhu （Rhizoma Atractylodis Macrocephalae） can be added to supplement spleen and stomach， thereby treating both the root and the branch. In terms of the disharmony between the heart and the kidney syndrome， Muli （Concha Ostreae） is usually added to subdue yang and supplement yin， together with Wuweizi （Fructus Schisandrae Chinensis） to supplement kidney and calm heart and Shashen （Radix Adenophorae seu Glehniae） to nourish yin and engender liquid， thereby enriching kidney-water and moistening heart-yin. Modification of the formulas is suggested in accordance with the syndromes to achieve a better effect.
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Objective:To explore the role of active screening in the diagnosis and treatment of early lung cancer, and give health management recommendations.Methods:A retrospective study was conducted to collect lung cancer patients who had complete population sociology, clinical information, pathology and imaging characteristics in the Thoracic Surgery in Xiangya Hospital of Central South University from 2016 to 2019. According to different diagnostic modes, they were divided into an active screening group (1082 cases) and a passive case finding group (974 cases), to analyze their differences in demographic sociological, clinical information, pathology and imaging characteristics, and to discuss the key points of population management in the active screening group.Results:From 2016 to 2019, the proportion of lung cancer patients in the active screening group increased from 36.1% to 54.2%, and the proportion of patients found to have lung cancer by CT examination in the active screening group increased from 82.2% to 96.8%. Compared with the passive case finding group, the active screening group had a higher proportion of women, non-smokers, patients with precursor glandular lesions and adenocarcinoma, patients in stage 0 and stage I, patients with lesion diameter (d)≤1 cm and 1<d≤2 cm, patients with sublobectomy and lymph node sampling (46.9% vs 32.9%, 59.2% vs 43.8%, 4.0% vs 2.1%, 80.5% vs 56.8%, 4.0% vs 2.1%, 72.0% vs 56.8%, 14.5% vs 7.6%, 42.5% vs 33.3%, 6.3% vs 2.9%, 2.4% vs 1.0%, respectively, all P<0.05). Conclusion:Active screening is helpful to find early lung cancer, and the health management and physical examination center should pay attention to the management of such physical examination population.
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Diabetic macular ischemia (DMI) is one of the manifestation of diabetic retinopathy (DR).It could be associated with diabetic macular edema (DME),which may affect the vision of DR patients.FFA is the gold standard for the diagnosis of DMI,but with the advent of OCT angiography,a more convenient and diversified method for the evaluation of DMI has been developed,which makes more and more researchers start to study DMI.Intravitreal injection of anti-VEGF has become the preferred treatment for DME.When treating with DME patients,ophthalmologists usually avoid DMI patients.But if intravitreal anti-VEGF should be the contradiction of DME is still unclear.To provide references to the research,this article summarized the risk factors,assessment methods and influence of DMI.This article also analyzed the existing studies,aiming to offer evidences to a more reasonable and effective treatment decision for DME individual.
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Diabetic retinopathy (DR) is one of the microvascular complications of diabetes mellitus (DM).Like other macrovascular complications of DM,the development and progression of DR is influenced by a variety of systemic and local factors.It is essential to understand the importance of multidisciplinary collaboration.Systemic risk fators such as hyperglycemia,hypertension,dyslipidemia and diabetic nephropathy should be treated before effective DR management can be implemented.Through multidisciplinary collaboration,we can prevent the development of DR,slow the progression of DR,and improve the safety of perioperative care.Thereby enhancing the level of prevention and control of DM complications,including DR.
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Colorectal cancer is a kind of malignancies with high incidence in the worldwide, that is seriously harmed human health. So far the pathogenesis of the disease is not fully understood, this causing many difficulties to the diagnosis and treatment of the disease, and resulting in the cure rates of disease is not ideal. With the development of molecular genetics and molecular biology, many oncogenes and tumor suppressor genes have been found to be associated with the disease, and this made it is possible to reveal the pathogenesis of colorectal cancer at the molecular level. However, it is a complex and multi-step process from normal colorectal epithelial cells transformed to colorectal cancer cells, and it is the results of polygenic and multifactorial interactions. Now it is thought that the Wnt, TGF-beta, PI3K/Akt, MAPK and p53 signaling pathways are closely associated with pathogenesis of colorectal cancer. Based on the five kinds of signaling pathways as the main line, this article reviewed the roles of different signaling pathways and their related genes in the pathogenesis of colorectal cancer.
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Background Central retinal vein occlusion (CRVO) causes macular edema.The treatment options are limited.There have been a series of randomized controlled trials (RCTs) to investigate the effectiveness of anti-vascular endothelial growth factor (VEGF),but the systematic review of the literature to assess the strength of evidence supporting the interventions is lack.Objective This study was to evaluate the effectiveness of anti-VEGF therapy for improving vision and reducing macular edema in patients with CRVO associated with macular edema.Methods A systematic review and Meta-analysis was performed.According to guidelines of Cochrane collaboration,the literature of RCTs for anti-VEGF therapy treating CRVO with macular edema was searched from Cochrane Library,Pubmed,Embase,Wanfang databases and conference documents without the limiting of language or date.The literature was screened independently by two searchers,and the methodology quality of the included papers was estimated.The proportion of patients with the best corrected visual acuity (BCVA) ≥ 15 ETDRS letters,the change ranges of BCVA (LogMAR) and central fovea thickness (CFT) were analyzed.The overall effect size was analyzed using Review Manager 5.1 in The Cochrane Collaboration as weighted mean difference (WSD).Fixed effect mode was used to evaluate and compare the treating effectiveness between the anti-VEGF group and sham treating group.Results Six RCTs were incorporated with 948 eyes and generated 3 comparisons in the study,including 5 multi-central studies and 1 single central study.Pegaptanib was administered in 1 study,and ranibizumab was used in 2 studied,bevacizumab in 1 study and VEGF Trap-Eye in 2 studies.The results demonstrated that anti-VEGF therapy resulted in more patients who gained 15 ETDRS letters or more during one-year duration (Z =8.43,P＜0.000 01) in the 6th month after intravitreous injection.BCVA logMAR was significantly improved in the anti-VEGF therapy group in comparison with sham treating group during the initial 6 months of trial (Z=28.27,P＜0.000 01) with the maximal difference in the 6th month.CFT value was significantly lower in the anti-VEGF therapy group than that of the sham treating group during the first 6 months (Z=35.38,P＜0.000 01) in the 3rd month.Topical adverse events occurred occasionally,including vitreous hemorrhage in 19 eyes,cataract in 16 eyes,endophthalmitis in 8 eyes and iris neovascularization in 2 eyes.No system adverse event was found after administration of the drugs.Conclusions Anti-VEGF therapy is efficient in CRVO with macular edema with little side effect.However,in order to maintain the effect,multiple injections are needed.Early onset treatment of anti-VEGF drugs is recommended,but the delayed onset is still beneficial.
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Attenuated Salmonella can be used not only as live vaccines but also as vectors for exogenous genes. As vectors, attenuated bacteria can deliver genes directly to tumor tissues, leading to the expression of the cloned genes and induction of specific anti-tumor immunologic responses to inhibit tumor growth. Using attenuated Salmonella as a vector offers a new approach for vaccine development.
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Objective To clarify the correlation of alpha fetoprotein （AFP） half-life （T1／2） with relapse or／and metastasis of primary hepatocellular carcinoma （PHC） after treatment. Methods Determination of AFP content in serum with two steps double McAb sandwich ELISA.Calculation AFP T1／2 of the sufferers treated with intervention and radiofrequency ablation （RFA） according to T1／2=0.3 dT／log（AFP1／AFP2）. Results When AFP T1／2＞11.5 days， the sensitivity， specificity and accuracy of predicting the relapse or metastasis of PHC after treatment were 87.5％， 89.3％， 88.5％， respectively. Intervention group was 82.35％， 83.3％， 82.75％， respectively and RFA group was 93.3％， 93.75％， 93.5％， respectively. During 200 days，there was very significant difference of AFP T1／2 （P＜0.001） between non-relapsed／ non-metastasized and relapsed， metastasized and died. Conclusions AFP T1／2 can be used as a predictive index for relapse， metastasis of PHC after treatment. It is not only a reliable parameter for the later stage treatment， but also a useful index for the evaluation of effect.
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OBJECTIVE To determine the drug resistance phenotype and genotype of plasmid-mediated AmpC ?-lactamase in Klebsiella pneumoniae isolated from Harbin.METHODS Isolates of K.pneumoniae with an inhibition ring to cefoxitin of ≤18 mm diameter were used.Antimicrobial susceptibilities were determined by disc diffusion method.AmpC genes were detected by PCR with six pairs of primers.RESULTS Sixty-three isolates had an inhibition ring to cefoxitin of ≤18 mm diameter and 26(11.3%)were detected to be AmpC-producing in a total of 231 clinical isolates of K.pneumoniae.Seventy-six percent,70.2%,53.8%,50.5%,57.7%,38.5% and 7.7% of AmpC-producers were resistant to cefoxitin,cefotaxime,ceftazidime,amoxicillin/clavulanic cid,ciprofloxacin,amikacin and imipenem,respectively.ACT,DHA and CIT types of AmpC beta-lactamase were detected in 13,8 and 5 isolates,respectively.No ACC,MOX and FOX were detected.CONCLUSIONS The AmpC ?-lactamase in Harbin is mainly in the types of ACT,DHA and CIT.AmpC-producing K.pneumoniae shows decreased susceptibilities to cefoxitin and third generation cephalosporins.
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Objective To evaluate the efficiency of control measures of the noise from a boiler room. Methods The main noise sourcs of the boiler room for attendant apartment near Wuhu railway station including air-blower and water pump were isolated using sound absorptive materials,a kind of modified PVC as sound isulator.The noise levels of the operation table for boiler workers and rooms of attendant apartment were measured before and after adopting noise control measures,then were evaluated based on GB12348-1990,the Criteria for Evaluation on the Noise of Industrial Enterprises. Results The equivalent sound levels of day and night were 76.1 and 73.5 dB(A) for the operation table for boiler workers,68.4 and 54.6 dB(A) for rooms of attendant apartment before and after noise control. The noise levels of above two monitoring points met the requirement of GB12348-1990 after the noise control. Conclusion The modified PVC sound insulator could effectively screen the noise from the boiler room.