Comparison of the application of WOMAC, SF-36 scales and the "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) standard in the evaluation of efficacy in patients with Kashin-Beck disease / 中华地方病学杂志

Objective:To compare the application effect among Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scale, Medical Outcomes Study 36-item Short Form (SF-36) scale and "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) standard in the evaluation of therapeutic effect of patients with Kashin-Beck disease, which could provide basis for the treatment evaluation of patients with Kashin-Beck disease.Methods:A total of 213 patients with Kashin-Beck disease in Gansu Province were investigated. WOMAC scale, SF-36 scale and standard of WS/T 79-2011 were used to analyze the quality of life of patients before and after treatment. The reliability, construct validity, content validity, discriminant validity of WOMAC and SF-36 scales were compared. Correlation between WOMAC, SF-36 scales and standard of WS/T 79-2011 were evaluated.Results:Both WOMAC and SF-36 scales had good construct validity and content validity (construct validity showed WOMAC and SF-36 scales contained 1 and 2 common factors, respectively; content validity showed WOMAC and SF-36 scales contained 3 and 8 common factors, respectively). The reliability and discriminant validity of WOMAC scale were better than those of SF-36 seale (reliability showed WOMAC reliability coefficient ≥0.934, the reliability coefficient of SF-36 scale was ranged from 0.386 to 0.999. Discriminant validity showed there were differences in 3 dimensions of the WOMAC scale before and after treatment, while there were differences in 6 out of 8 dimensions of the SF-36 scale). The correlation coefficients between WOMAC scale and standard of WS/T 79-2011 ranged from 0.175 to 0.437, the correlation coefficients between SF-36 scale and standard of WS/T 79-2011 ranged from - 0.434 to - 0.099 ( P < 0.05). Conclusion:The reliability, discriminant validity and correlation with the standard of WS/T 79-2011 of WOMAC scale are better than those of SF-36 scale in efficacy evaluation of patients with Kashin-Beck disease.

Acupuncture is ineffective for chronic low back pain? A critical analysis and rethinking / 医学前沿

Acupuncture is a promising treatment for relieving pain and improving lower back function in clinical practice. However, evidence from randomized clinical trials (RCTs) remains controversial. Most RCTs conclude that acupuncture procedures for chronic low back pain (CLBP) had no significant difference in efficacy and belonged to placebo. We carefully reviewed and analyzed the methodology and implementation of sham acupuncture in RCTs. Controversial evidence of acupuncture for CLBP is only a microcosm of the evaluation methodological limitation of acupuncture. Inappropriate selection of sham acupuncture controls, rigorous RCT research models, and incorrect interpretation of results may contribute to negative evidence. Evaluating and disregarding the holistic efficacy of acupuncture with an explanatory RCT model based on evaluation drugs may be unwise. Moreover, sham acupuncture is often proven to be non-inert, unreasonable, and with low fidelity. Pitfalls of the explanatory RCT model and sham acupuncture design should be avoided. Establishing a new evaluation system that is in line with the clinical characteristics of acupuncture and obtaining high-quality evidence are difficult but promising tasks.

Clinical Efficacy of Modified Zengyetang Against Slow Transit Constipation Due to Qi-Yin Deficiency and Its Effect on Gastrointestinal Function / 中国实验方剂学杂志

Objective:To observe the clinical effect of modified Zengyetang in treating slow transit constipation （STC） due to Qi-Yin deficiency and its effect on gastrointestinal function. Method:One hundred and thirty eligible patients were randomly divided into a control group （<italic>n</italic>=65， 6 cases dropped out or were lost to follow-up and 59 completed the trial） and a treatment group （<italic>n</italic>=65， 3 cases dropped out or were lost to follow-up and 62 completed the trial）. Patients in the control group received oral mosapride citrate dispersible tablets， 5 mg per time， three times per day， while those in the treatment group were treated with modified Zengye Tang， one bag per day， for four successive weeks. The main symptom constipation， the Patient Assessment of Constipation Symptoms （PAC-SYM）， and traditional Chinese medicine （TCM） syndrome scores， colonic transit， as well as motilin （MTL）， vasoactive intestinal peptide （VIP）， and substance P （SP） levels before and after treatment were recorded， together with the frequency of spontaneous complete bowel movements （SCBMs） per week and STC recurrence during treatment. Result:The clinical efficacy （95.16%） of the treatment group was higher than that （81.36%） of the control group （<italic>χ</italic>²=5.631 4， <italic>P</italic><0.05）， whereas the recurrence rate （30.65%） of the treatment group was significantly lower than that （57.63%） of the control group （<italic>χ</italic>²=8.941 1， <italic>P</italic><0.01）. After treatment， the main symptom constipation， three sub-scale and total PAC-SYM， and TCM syndrome scores in the treatment group were obviously decreased as compared with those in the control group （<italic>P</italic><0.01）. The proportions of residual markers at 24， 48， and 72 h in the treatment group declined in contrast to those in the control group （<italic>P</italic><0.01）. The frequency of SCBMs per week in the 2^nd， 3^rd， and 4^th weeks of the treatment group was higher than that in the control group （<italic>P</italic><0.01）. Compared with the control group after treatment， the treatment group exhibited significantly elevated MTL and SP but lowered VIP （<italic>P</italic><0.01）. Conclusion:Modified Zengyetang relieves the clinical symptoms， regulates gastrointestinal hormone secretion， increases the frequency of SCBMs， enhances colonic transit， and decreases the recurrence of patients with STC due to Qi-Yin deficiency.

Therapeutic effects of number of BCD (bortezomib, cyclophosphamide, dexametha-sone) chemotherapy courses on newly diagnosed multiple myeloma / 中国肿瘤临床

Objective: To analyze the treatment effect of the number of bortezomib, cyclophosphamide, and dexamethasone (BCD) chemotherapy courses for newly diagnosed multiple myeloma. Methods: We retrospectively analyzed data of patients with newly diagnosed multiple myeloma from January 2014 to July 2016 in Peking University People's Hospital. All 70 patients received two or more courses of BCD chemotherapy. Patients with extramedullary disease or amyloidosis were excluded. Patients completed their follow-up, and the treatment effects were studied in those who only received two, four, and six chemotherapy courses. Results: Among the 70 patients, the ratio of male to female was 36 :34, the median age of disease onset was 58.4 y (range: 33-81 y), and the number of patients with ISS stagesⅠ,Ⅱ, and Ⅲ was 16, 18, and 36, respectively. The number of patients who received two, four, and six chemotherapy courses was 14, 20, and 36, respectively. The percentages of complete remission, equal or more than very good partial remission, equal or more than partial remission for patients who received two courses were 14.28%, 42.86%, and 71.42%, those for four courses were 30.00%, 60.00%, 80.00%, and those for six courses were 38.89%, 75.00%, 83.33%, respectively. During the median 15.37 (range: 2-32) months follow up, the estimated progression free survival (PFS) was 21.96 months (95% CI: 19.26-24.70). No statistically significant difference for PFS was observed among the three groups (P=0.700). Conclusions: For the BCD chemotherapy regimen, the maximum therapeutic effect occurred after four or more courses. As the number of induction courses after four chemotherapies increased, the depth of disease relief increased but overall remission did not show substantial improvement. Therefore, four or more BCD chemotherapies can be used for the first line of induction therapy.

The Research of Effects of Applying Cataplasm of Paris Polyphylla Smith Var. Yunnanensis (Franch.) Hand.-Mazz on Acute Gouty Arthritis and Inflammation / 昆明医科大学学报

Objective This study is designed to improve topical medication in the Department of Orthopedics in Kunming Municipal Hospital of Traditional Chinese Medicine by applying cataplasm made from the active ingredient (polyphyllin) of Paris polyphylla Smith var. yunnanensis (Franch.) Hand.-Mazz ("Dian Chonglou"in Chinese) and to study the mechanism of anti-inflammation. Methods SD male rats were randomly divided into two groups: control group and treatment group. The rats in two groups were all injected 50ul 5% sodium urate suspension into tibiotarsal joint cavity to duplicate the model of acute gouty arthritis.The rats in the control group were applied with cataplasm without polyphyllin, whereas those in the treatment group applied with cataplasm of polyphyllin. After 4,24,48,72 hours,the ankle diameter and circumference were measured. ELISA was used to test the interleukin-1β (IL-1β) andtumor necrosis factor (TNF) in peripheral blood. Western blotting was applied to detect the changes in TLR4 expression of monocyte.Results Compared with the control group, the added value of the diameter and circumference of ankle decreased significantly in the treatment group 4, 24,48 and 72 h after the treatment.IL-1β in the treatment group was lowered at 4,24 and 72 h. TLR4in the treatment group decreased at 48 h. Conclusion Cataplasm with polyphyllin can alleviate the acute inflammatory reaction in gouty joint of rat by reducing the expression of IL-1βand TLR4.

Clinical thinking and evidence-based for decompression of cystic lesions in the jaw bone / 口腔疾病防治

@#Decompression is an effective and widely used treatment for jawbone cystic lesions that can, to a great extent, preserve the function and appearance of the jawbone. However, some problems exist with its clinical application, such as the inappropriate determination of indication and the lack of standardized operational guidelines, resulting in treatment ineffectiveness or even failure. This paper aimed to summarize the clinical value of decompression for jawbone cystic lesions in terms of mechanism, scientific evidence, advancement, indications and effective evaluation by reviewing relevant literature and our clinical experience.

Novo século, antigo mal-estar: uma história recente da psicanálise na França / New century, old malaise: a recent history of psychoanalysis in France / Nuevo siglo, antiguo malestar: una historia reciente de la psicoanálisis en Francia / Nouveau siècle, vieille maladie: une histoire récente de la psychanalyse en France

No início do século XXI, a psicanálise deparava-se com um novo período de instabilidade, fruto das mudanças no cenário mundial somadas às crises das instituições psicanalíticas. Na França, país onde as características peculiares de implantação e difusão da psicanálise concederam-lhe o status de verdadeira "exceção" em relação ao restante do mundo, a situação de crise foi sentida de maneira ainda mais intensa devido à demanda do Estado em regulamentar a prática psicanalítica, discussão que chegou ao seu ápice em 2003. O contexto exigia respostas que articulassem psicanálise e política em ações que pudessem atestar a importância da psicanálise no mundo contemporâneo. A investigação teórico-bibliográfica, fundamentada em metodologia qualitativa, apontou para o entendimento de que a saída encontrada pelo movimento psicanalítico francês em resposta a crise instalada ocorreu pela via do retorno à psicanálise aplicada à terapêutica, colocando-a no centro dos debates e ações. O objetivo deste artigo é recuperar parte dessa história recente da psicanálise francesa e seus impactos para os psicanalistas em todo o mundo, trazendo as nuances dos movimentos que se constituíram no referido período. Destaca-se a organização do "Estados Gerais da Psicanálise", movimento que reuniu psicanalistas de diferentes abordagens e filiações institucionais a fim de discutir os desafios para a psicanálise no novo século. Por fim, trazemos a experiência dos Centros Psicanalíticos de Consulta e Tratamento (CPCTs), criados para ofertar tratamento psicanalítico gratuito, de forma a evidenciar a utilidade social da psicanálise.

At the beginning of the 21st century, psychoanalysis was faced with a new period of instability, the result of changes in the world scene combined with the crises of psychoanalytic institutions. In France, where the peculiar characteristics of the implantation and diffusion of psychoanalysis gave it the status of a true "exception" in relation to the rest of the world, the crisis situation was felt even more intense due to the State's demand to regulate Psychoanalytic practice, a discussion that reached its apex in 2003. The context required responses that articulated psychoanalysis and politics into actions that could attest to the importance of psychoanalysis in the contemporary world. The theoretical-bibliographic research, based on a qualitative methodology, pointed to the understanding that the way out found by the French psychoanalytic movement in response to the installed crisis occurred through the return to psychoanalysis applied to therapy, placing it at the center of debates and actions. The aim of this article is to recover part of this recent history of the French psychoanalysis and its impacts to the psychoanalysts around the world, bringing the nuances of the movements that constituted in the referred period. It is worth mentioning the organization of the "General States of Psychoanalysis", a movement that brought together psychoanalysts from different institutional approaches and affiliations in order to discuss the challenges for psychoanalysis in the new century. Finally, we bring the experience of the Centros Psicanalíticos de Consulta e Tratamento/Psychoanalytic Centers of Consultation and Treatment (CPCTs), created to offer free psychoanalytic treatment, in order to show the social utility of psychoanalysis.

Al inicio del siglo XXI, el psicoanálisis se encontró con un nuevo período de inestabilidad, fruto de los cambios en el escenario mundial agregado a las crisis de las instituciones psicoanalíticas. En Francia, país dónde las características peculiares de implantación y difusión del psicoanálisis le dieron el status de verdadera "excepción" en relación al resto del mundo, la situación de crisis fue resentida de manera aún más intensa por causa de la demanda del Estado en regular la práctica psicoanalítica, discusión que llegó al ápice en 2003. El contexto exigía respuestas que articulasen psicoanálisis y política en acciones que pudieran testificar la importancia del psicoanálisis en el mundo contemporáneo. La investigación teórico-bibliográfica, basada en metodología cualitativa, señaló para el entendimiento de que la salida encontrada por el movimiento psicoanalítico francés en respuesta a la crisis instalada ocurrió por la vía del regreso al psicoanálisis aplicado a la terapéutica, poniéndola al centro de los debates y acciones. El objetivo de este artículo es recuperar parte de la historia reciente del psicoanálisis francés y sus impactos para los psicoanalistas en todo el mundo, trayendo los matices de los movimientos que constituidos en el referido periodo. Se sobresale la organización del "Estados Generales de la Psicoanálisis", movimiento que reunió psicoanalistas de distintos enfoques y filiaciones institucionales para discutir los retos para el psicoanálisis en el nuevo siglo. Por fin, traemos la experiencia de los Centros Psicoanalíticos de Consulta y Tratamiento (CPCTs), creados para ofrecer tratamiento psicoanalítico gratis, para mostrar la utilidad social del psicoanálisis.

Au début du XXIe siècle, la psychanalyse faisait face à une nouvelle période d'instabilité en raison des modifications dans la scène mondiale, ajoutée aux crises dans les institutions psychanalytiques. En France, les caractéristiques particulières de mise en œuvre et diffusion de la psychanalyse ont lui accordé le statut de véritable «exception¼ concernant le reste du monde. La crise a été encore plus intense en raison de la demande de l'État sur la régulation de la pratique psychanalytique, discussion qui est arrivée à son apex en 2003. Le contexte exigeait des réponses qui articulaient psychanalyse et politique dans actions qui pourraient témoigner de l'importance de la psychanalyse dans le monde contemporain. La recherche téorique et bibliographique, basée sur une méthodologie qualitative, a indiqué que la solution trouvée par le mouvement psychanalytique français en réponse à la crise a eu lieu grâce au retour à la psychanalyse appliquée à la thérapeutique, en la plaçant au centre des débats et des actions. Le but de cet article consiste à récupérer une partie de cette histoire récente de la psychanalyse française et ses conséquences pour les psychanalystes du monde entier, en apportant les nuances des mouvements formés en cette période. On peut attirer l'attention à l'organisation des «États généraux de la psychanalyse¼, mouvement qui a réuni des psychanalystes de différentes approches et affiliations institutionnelles afin de discuter les défis pour la psychanalyse dans le nouveau siècle. Enfin, nous apportons l'expérience des Centres Psychanalytiques de consultation et de traitement (CPCTs), créés pour offrir un traitement psychanalytique gratuit, afin de mettre en évidence l'utilité sociale de la psychanalyse.

Avaliação de processo em psicoterapia psicanalítica na adolescência / Process evaluation in psychoanalytic psychotherapy in adolescence / Proceso de evaluación en la psicoterapia psicoanalítica en la adolescencia

As taxas de abandono psicoterápico na infância e adolescência são altas, entretanto, são poucos os trabalhos dirigidos para essas faixas etárias. Este artigo investiga o processo terapêutico de um caso de abandono de psicoterapia psicanalítica de uma adolescente. Para tal, foram avaliadas 20 sessões da psicoterapia através do Adolescent Psychotherapy Q-Set (APQ), instrumento que descreve atitudes e comportamentos do paciente e do terapeuta, bem como das interações terapeuta/paciente nas sessões terapêuticas. A análise do APQ foi integrada aos aspectos dinâmicos da paciente e associada às anotações clínicas fornecidas pela terapeuta para a elaboração do entendimento clínico do processo. Concluiu-se que a não aquisição de insight da paciente, aliado a um estilo defensivo imaturo constituíram fatores preditivos ao abandono psicoterápico.

Dropout rates from psychotherapy among children and adolescents are high, however there fewer studies targeting these age groups. This paper investigates the therapeutic process of a dropout case in psychoanalytic psychotherapy in adolescence. For this purpose, 20 sessions of psychotherapy were evaluated using the Adolescent Psychotherapy Q-Set (APQ), an instrument that describes attitudes and behaviors of the patient and the therapist, and the therapist/patient interactions during the therapeutic sessions. The analysis of the instrument was integrated into the dynamic aspects of the patient and also associated with clinical notes provided by the therapist to elaborate the clinical understanding of the process. It was concluded that the impossibility of the patient's insight acquisition combined with an immature defensive style, constituted predictive factors to psychotherapy dropout. Therefore, compared to many possibilities of understanding this phenomenon, there is the importance of conducting researches aimed at in-depth analysis of psychotherapeutic processes.

Las tasas de abandono de la psicoterapia Entre los niños y adolescentes son altos, sin embargo, hay pocos estudios dirigidos a estos grupos. El presente artículo investiga el processo terapêutico de um caso de abandono en psicoterapia psicoanalítica en la adolescência. Para tal se evaluaron 20 sesiones de psicoterapia por médio del Adolescent Psychotherapy Q-Set (APQ), instrumento que describe actitudes y conductas del paciente y del terapeuta, asi como las interacciones terapeuta/paciente durante las sesiones terapêuticas. El analisis del APQ fue integrada a los aspectos dinâmicos de la paciente y associada a las anotaciones clínicas realizadas por la terapeuta para la elaboracion del entendimento clínico del proceso. Se concluye que la no aquicision de insight por parte de la paciente, aliado a un estilo defensivo inmaturo constituyeron facteres predictivos al abandono terapêutico. Desta forma, frente a los diversos vértices de comprensión de este fenômeno, se verifica la importância de la realizacion de pesquisas que el analisis en profundidad de los procesos psicoterápicos.

Application of serum PGⅠ,CEA and G-17 in assessment of chemotherapy effect in patients with gastric cancer / 国际检验医学杂志

Objective To discuss the application value of serum pepsinogen Ⅰ(PGⅠ),carcinoembryonic antigen(CEA) and gastrin-17(G-17) in assessment of chemotherapy curative effect in patients with gastric cancer.Methods From Feb.2014 to Jun.2016,a total of 90 patients with gastric cancer were selected,and treated with docetaxe/cisplatin/5-fluorouracil(DCF) scheme for two courses.All patients were divided into effective group and ineffective group,according to the assessment criterion,proclaimed by World Health Organization.Serum levels of CEA,PGⅠand G-17 were detected before and after treatment.Curative effect was also assessed according to the changes of CEA,PGⅠand G-17.Receiver operating characteristic curve(ROC curve) was used to analyze the performance of PGⅠ,CEA and G-17 in the assessment of curative effect.Results Chemotherapy was effective in 29 cases,accounting for 32.22%.After chemotherapy,serum CEA and G-17 level of effective group were lower than ineffective group,while PGⅠ level was higher(P<0.05).ROC curve analysis showed that the area under ROC curve,sensitivity and specificity of combined detection for the assessment of curative effect were higher than single detection of serum PGⅠ,CEA and G-17,taking 70 g/L,7.35 g/L and 14.22 pmol/L as cut-off value(P<0.05).Conclusion Combined detection of serum PGⅠ,CEA and G-17 could be with high accuracy,specificity and sensitivity for the assessment of chemotherapy effect in patients with gastric cancer.

Current status of sorafenib in the treatment of advanced liver cancer / 中国医师进修杂志

Sorafenib is the only molecular targeted drug therapy for advanced liver cancer recommended by the European Association for the study of liver diseases (EASL), American Association for the study of liver diseases (AASLD) and the United States Food and Drug Administration (FDA). As a multi kinase inhibitors, sorafenib can inhibit multiple signal transduction pathways of tumor cell proliferation and angiogenesis and obviously prolong the late stage of disease progression time and overall survival in patients with hepatocellular carcinoma (HCC). Criteria for evaluation of the efficacy of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC) is increasingly perfect. The author gives a brief overview of the molecular mechanism, efficacy and safety and efficacy evaluation criteria of sorafenib in the treatment of advanced liver cancer.

Clinical study on intervention of shenfu decoction in critically ill patients with spleen-kidney yang deficiency type low triiodothyronine syndrome / 中草药

Objective To evaluate the efficacy of Shenfu Decoction in treatment of critically ill patients with spleen-kidney yang deficiency type low triiodothyronine syndrome (LT3S). Methods Totally 110 critically ill patients with spleen-kidney yang deficiency type LT3S were randomized into two groups. Control group used standard Western treatment; Treatment group was given the combination of Western treatment and Shenfu Decoction; each group was treated for 7 d. The therapeutic effect indexes were serum T3, serum T4, serum TSH, APACHE II score, hospital day, results of treatment, and therapeutic efficacy of TCM syndromes. Results After treatment, the APACHE II score in control and treatment groups have been significantly improved (P < 0.05, 0.001). Compared with control group, the score in treatment group declined more drastically, and difference between two groups was statistically significant (P < 0.05); The serum T3 levels have been significantly improved in both groups and improved more in treatment group, and the difference between two groups was statistically significant (P < 0.05); The hospital day of treatment group was shorter than control group after treatment, and the difference between two groups was statistically significant (P < 0.05); The symptoms score progressed in both groups after treatment and have been significantly improved in treatment group, and the difference between two groups was statistically significant (P < 0.05); The treatment group had more significant clinical curative effect after treatment (P < 0.05). Conclusion Shenfu Decoction in critically ill patients with spleen-kidney yang deficiency type LT3S could improve the clinical curative effect, progress the TCM syndromes and results of treatment, and shorten the hospital stay.

Relationship of clinicopathological characteristics with neoadjuvant chemotherapy efficacy and prognosis of inflammatory breast cancer patients / 中国肿瘤临床

Objective: To investigate the relationship of clinicopathological characteristics with neoadjuvant chemotherapeutic efficacy and prognosis of inflammatory breast cancer (IBC) patients. Methods: Medical records of 81 patients who underwent neoadjuvant chemotherapy for IBC in Tianjin Medical University Cancer Institute and Hospital between January 2010 and December 2013, were retrospectively analyzed. Clinicopathological features, response to neoadjuvant chemotherapy, and prognostic factors were studied by univariate and multivariate analyses. Results: The 3-year overall survival rate (OS) and disease-free survival rate (DFS) of patients were 53.1％ and 37.0％, respectively. The pathologic complete response (pCR) rate of patients after accepting neoadjuvant chemotherapy was 13.6％ (11/81). Statistically significant association was observed between pCR and pathological types in IBC (P0.05). Preoperative lymph node stage was an independent prognostic factor of overall survival (OS) and disease- free survival (DFS) in IBC patients (P<0.05). Neoadjuvant chemotherapy and lymph vessel tumor emboli were independent factors of DFS (all P<0.05). Conclusion: Clinicopathological characteristics of IBC patients affected chemosensitivity. We could predict the prognosis of these patients by preoperative lymph node stage and lymph vessel tumor emboli and select chemotherapy to achieve the best curative effect.

The effect of training method of point-line-plane on development quotient in premature infants with brain injury / 中华行为医学与脑科学杂志

Objective To evaluated the improving effect of training method of point-line-plane on development quotient in premature infants with brain injury.Methods 174 cases of premature children with brain injury were randomly divided into study group (89 cases) and control group (85 cases).Control group given Bobath and Vojta traditional rehabilitation training,and the study group was given training method of point-line-plane.Patients in both groups were evaluated synthetically based on The Evaluation Chart on Neu-robehavioral Development of Children Aged 0-6 Years,developed by Capital Institute of Pediatrics,prior to the treatment,and after the first,the second,and the third course of the training programs,respectively.Re-sults The score of developmental quotient ( DQ) between study group and control group was no significantly different(P>0.05).Compared with before treatment, the scores of DQ was significantly increased after the first, the second and the third course of training treatment in study group and control group((82.71±12.28) vs (81.17±9.63), t=0.859, P>0.05;(89.65±10.02) vs (87.02±7.39), t=1.747, P>0.05). Compared with the control group, the scores of DQ in study group was no significant difference after the first and the second course of treatment,but there was significantiy different after the third course treatment((95.26±8.87) vs (91.31±7.63), t=2.945, P=0.004).Conclusion The training method of point-line-plane can improve the clinical efficacy of premature infants with brain injury at the early phase, which is worth widely applying in clinical practice.

Progress of magnetic resonance imaging in radiotherapy for cancer / 中华放射医学与防护杂志

In recent years,there has been a considerable research effort concerning the application of magnetic resonance imaging (MRI) for the external radiotherapy.This paper reviewed the progress of MRI in radiotherapy for cancer,such as magnetic resonance simulator,target volumes,dose calculation and efficacy evaluation.Furthermore,the potential applications of 4D-MRI and MRI guided radiotherapy are summarized.

Joint development of evidence-based medical record by doctors and patients through integrated Chinese and Western medicine on digestive system diseases / 中国结合医学杂志

Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.

Percutaneous transcatheter renal artery thrombolysis for acute renal artery embolism：analysis of clinical efficacy / 介入放射学杂志

Objective To evaluate the clinical effect of percutaneous transcatheter renal artery thrombolysis in treating acute renal artery embolism. Methods A total of 23 patients with acute renal artery embolism underwent DSA-guided percutaneous transcatheter renal artery thrombolysis. Continuous urokinase thrombolytic therapy with micro pump was carried out in all patients; renal artery angiography was performed 3 days later; the therapeutic effect was evaluated with imaging manifestations and laboratory tests. Results Postoperative DSA showed that the renal artery was completely open in 21 patients and partially open in 2 patients; the effective rate was 91.3%. After thrombolysis treatment, complete remission of pain, oliguria, hematuria, fever and other symptoms was obtained in 21 cases, and relief of symptoms in 2 cases. Postoperative urine protein, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase isoenzyme MB (CK-MB) and serum creatinine (SCr) levels were obviously decreased. Conclusion For the treatment of acute renal artery embolism, DSA-guided percutaneous transcatheter renal artery thrombolysis is very effective, minimally-invasive and highly-safe.

The changes of serum tumor markers levels during anti-tuberculosis treatment in active tuberculosis patients / 中华传染病杂志

Objective To evaluate the changes of serum tumor markers of carbohydrate antigen 125 (CA125),carbohydrate antigen 199 (CA199),carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) during anti-tuberculosis treatment in patients with active pulmonary tuberculosis and tuberculous pleurisy.Methods This research was a prospective study.Sixty-three patients with active pulmonary tuberculosis and 24 patients with tuberculous pleurisy underwent blood samplings before treatment,2 and 6 months after treatment.Centaur XP chemiluminescent immunoassay was used to test serum levels of CA125,CA199,CEA and SCC.Thirty healthy subjects were included as controls.Student t-test was used to compare continuous variables,and chi-square test or Fisher exact test was used to compare categorical variables.Serial changes of serum tumor markers levels pre-and post-treatment were analyzed by repeated measures analysis of variance.Binary Logistic regression model was used for multivariate analysis.Results The mean serum CA125 level of the 63 patients with active pulmonary tuberculosis pre-treatment was (64.4± 30.4) U/mL,which was significantly higher than that of healthy controls ([12.7±5.5] U/mL,t=11.98,P＜0.01).The mean serum CA125 level decreased to (16.9±6.1) U/mL after 6 months standardized treatment,which was significantly lower than that before treatment (t=12.74,P＜0.01).While compared with healthy controls,the serum level of CA125 in patients who had completed the standardized treatment was not significantly different (t =0.94,P =0.348).When compared with the healthy controls,serum CA199,CEA,SCC levels in patients with active pulmonary tuberculosis before and after treatment showed no statistically significant difference (P＞ 0.05).Univariate analysis and multivariate analysis by Logistic regression analysis showed that bilateral pulmonary tuberculosis (x2 =7.746,P=0.006; OR=6.99,95％CI:1.73-28.22) and cavity pulmonary tuberculosis (x2 =6.254,P=0.012; OR=7.64,95％CI:1.64-35.35) were associated with increased serum CA125 level.The mean serum CA125 level of 24 cases of tuberculous pleurisy pre-treatment was (81.2 ± 37.6) U/mL,which was both significantly higher than that of patients with active pulmonary tuberculosis (t=2.153,P=0.034) and that of healthy controls (t=12.05,P＜0.01).Similarly,CA125 levels sharply decreased to (15.5 ± 7.3) U/mL after 6 months standardized treatment,which was not statistically significant compared with the control group (t=0.450,P=0.652).However,CA199,CEA and SCC levels in tuberculous pleurisy pre-and post-treatment were all not statistically different from those of healthy controls (all P＞0.05).Conclusion Serum CA125 can be used as a marker for assessing the disease progression and therapeutic efficacy for patients with active pulmonary tuberculosis and tuberculous pleurisy.

Effective analysis on the treatment of osteonecrosis of femoral head (ONFH) by stages with self designed Chinese medicine formula / 国际中医中药杂志

Objective To explore the clinical effects of treating osteonecrosis of femoral head(ONFH) by stages with self designed Chinese medicine formula. Methods 106 ONFH patients in Shantou municipal TCM hospital from July 2010 to July 2013 were recruited and divided randomly into a control group and a treatment group, 53 patients in each. The treatment group was treated with self-designed Chinese medicine formula with the functions of strengthening spleen and promoting blood circulation in the early stage, and self-designed Chinese medicine formula with the functions of supplementing kidney and promoting blood circulation in the middle stage of disease, one dosage daily. The control group was treated with Xianliang Gubao capsule (3 granules per time, twice daily) and lovastatin capsule (10-20 mg per time). Both groups were treated for two therapeutic courses of 8-12 weeks. X-ray and hemorheology indexes were observed after the treatment. Results The total effects was 90.6%(48/53) and 73.6%(39/53) in the treatment group and the control group respectively, with significant difference(χ2=6.731,P<0.05);Whole blood viscosity, PV, HCT, Arbe, ESR, FIB were obviously improved in the treatment group after the treatment, [after the treatment: whole blood viscosity high cut(3.42±0.72)mPa?S, middle cut(4.21±0.30)mPa?S, low cut(8.36±0.12)mPa?S, PV(1.39±0.16)mPa?S, HCT(38.34±2.37)%, Arbe(5.47±0.33), ESR(27.35±2.16)mm/h, FIB(3.83±0.47)g/L], [before the treatment:whole blood viscosity high cut(3.97±0.21)mPa?S, middle cut (4.71±0.24)mPa?S, low cut (9.58±0.31)mPa?S, PV(2.01±0.13)mPa?S, HCT(41.29±1.01)%, Arbe(6.51±0.21),ESR(14.62±0.92)mm/h, FIB(4.94±0.26)g/L, P<0.05]. After the treatment, the treatment group was obviously improved in such indexes as whole blood viscosity high cut(3.76±0.08)mPa?S, middle cut(4.47±0.16)mPa?S, low cut (8.99±0.07)mPa?S, PV(1.72±0.14)mPa?S, HCT(40.46±1.06)%, Arbe(6.11±0.38), ESR(24.98±1.42)mm/h and FIB(4.33±0.57)g/L than the control group(P<0.01 or 0.05). Conclusion Self-designed Chinese medicine formula stage-therapy had better results in treating ONFH than Xianling Gubao capsule and lovastatin.

Automated breast volume imaging with color doppler ultrasound in evaluating effect of neoadjuvant chemotherapy for breast cancer / 中国肿瘤临床

Objective: To explore automatic breast full volume imaging (ABVS) and color doppler ultrasound (CDFI) for breast cancer neoadjuvant chemotherapy (NCT) in the evaluation of curative effect. Methods:The application of a CDFI and ABVS 42 cases of breast cancer patients receiving NCT lesions imaging characteristics before and after observation and analysis. Results:ABVS from coronal distribution and audio-visual change according to the primary tumor, and CDFI images showing the primary tumors and blood flow changes within all have significant difference in patients with complete remission after NCT (P0.05). Conclusion:We use ABVS and CDFI for breast cancer before and after the NCT curative effect evaluation of great clinical significance and value.

Efficacy evaluation of modified dual plating and less invasive stabilization system in the complex fractures of tibial plateau / 中国医师进修杂志

Objective To evaluate the therapeutic effect of modified dual plating and less invasive stabilization system(LISS) in the complex fractures of tibial plateau.Methods One hundred and sixty-eight patients with complex fractures of tibial plateau were divided into two groups by the therapeutic methods,89 patients were in modified dual plating group while 79 patients were in LISS group.The advantages and curative effect of two groups were retrospectively analyzed.Results The excellent and good rate in modified dual plating group was slightly higher than that in LISS group [89.9％ (80/89) vs.86.1％ (68/79)],and there was no significant difference (P ＞ 0.05).No patient occurred deep site infection,severe nerve damage,phlebothrombosis in two groups.In modified dual plating group,the operation time and bleeding volume was (89.2 ± 13.6) min and (188.4 ± 45.6) ml,the hospital stay and healing time was (16.5 ± 1.8) d and (13.3 ±2.1) months.In LISS group,the operation time and bleeding volume was (74.3 ± 12.5) min and (236.5 ±65.5) ml,the hospital stay and healing time was (16.7 ± 2.1) d and (11.4 ± 1.5) months.There was no significant difference (P ＞ 0.05).Conclusion The therapeutic effect of modified dual plating and LISS have no significant difference for complex tibial plateau fractures.