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Background and rationale Idiopathic pulmonary fibrosis is a critical disease with a poor prognosis. Although different studies have been conducted for the treatment of idiopathic pulmonary fibrosis, limited treatments are available. Jin-shui Huan-xian granule (JHG), which is a Chinese medicine herbal compound, has shown promising efficacy in reducing frequencies of acute exacerbations, improving exercise capacity the quality of life of patients with idiopathic pulmonary fibrosis. This study is to evaluate the efficacy and safety of JHG for IPF. Subjects and methods This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 312 idiopathic pulmonary fibrosis patients will be enrolled and randomly allocated to one of the two groups with 1:1. After a 2-week washout period, 52-week treatment will also be performed for all the patients. Patients in the experimental group and the control group will be given JHG and JHG placebo, respectively. Outcome measures including acute exacerbations, pulmonary function, dyspnea, exercise capacity, and quality of life will be evaluated in this study. Discussion Based on our previous study, it is hypothesized that JHG will reduce acute exacerbations; improve exercise capacity, pulmonary function, and quality of life; and delay the disease progression-free. High-level evidence-based support for TCM in IPF will also be obtained in this study. Trial registration ClinicalTrials.gov NCT04187690. Register on December 11, 2019

Background At present, there is short of effective treatment for acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). The treatment of IPF with traditional Chinese medicine (TCM) has some advantages. However, the evidence is unclear whether TCM can be recommended as an effective therapy to treat AE-IPF. The purpose of the study is to explore the efficacy and safety of TCM for patients with AE-IPF. Methods A randomized, double-blind, placebo-controlled, exploratory clinical trial will be performed. A total of 80 patients diagnosed with AE-IPF will be randomized into the intervention or control group. In addition to conventional treatment, the intervention group will be treated with Kangxianhuanji granule, and the control group will be given a placebo granule. The administration frequency is 10 g each time and two times daily. After 4 weeks of treatment, the patients were followed up for 12 weeks. The primary outcomes are treatment failure rate and all-cause mortality. Secondary outcome measures will include the length of hospitalization, overall survival, acute exacerbation rate, intubation rate, Modified British Medical Research Council (mMRC) score, the St George’s Respiratory Questionnaire idiopathic pulmonary fibrosis (SGRQ-I) score, and arterial blood gas analysis. Discussion TCM may be beneficial in IPF. However, it has never been evaluated in patients with AE-IPF, who are incredibly prone to respiratory failure and have a high mortality rate. It is the first clinical trial to explore the efficacy and safety of TCM in the treatment of AE-IPF. This result will provide a basis for further study, which provides a high-quality evidence for the treatment of AE-IPF with TCM. Trial registration Chinese Clinical Trial Registry ChiCTR1900026289. Registered on 29 September 2019.

Vision navigation is an alternative to Global Position System (GPS) in environments where access to GPS is denied. Yet, the classical feature-based method has to extract feature observations from the image as input, which performs poor in environments with little features. To address this problem, a fusion of feature-based method and direct method is designed. The feature-based method is used in feature rich regions, while the direct method is used in regions with little features. Thus we utilize the fusion of two methods to improve the environmental adaptability of vision navigation. To improve the robustness to outliers, the Huber weight function is applied. Then the nonlinear optimization method is utilized to obtain the optimal camera pose. Experimental results demonstrate that the proposed method can meet the needs of real-time autonomous navigation.

The photosensitive polyoxometalate (POM) [PW11O39RhCH2CO2H]5− was first introduced into the liquid crystal material through the encapsulation of dimethyldioctadecylammonium (DODA+). The theoretical calculation was performed to simulate the distribution of DODA+ around the POM anion. The surface photovoltage spectroscopy (SPS) result indicated that the hybrid exhibits the photovoltaic effect upon optical illumination and displays the character of a p-type material, which paves a new way for their potential application in the optoelectronics.

Chronic obstructive pulmonary disease (COPD) is a major chronic disease that seriously endangers public health. Some remarkable results have shown that Chinese medicine has an obvious clinical effect in preventing and treating COPD. To further promote the normative use of Chinese medicine to better guide the clinical diagnosis and treatment of COPD, the World Federation of Chinese Medicine Societies developed a panel to establish the guidelines by systematically evaluating, based on the revision and transformation of Guidelines for Chinese Medicine Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease released by the China Association of Chinese Medicine in 2019 (Standard No: T/CACM 1319-2019), the latest clinical research evidence at home and abroad, formatting the International Clinical Practice Guideline of Chinese Medicine—Chronic Obstructive Pulmonary Disease, and publishing in both Chinese and English. The guidelines consist of 12 parts: preface, introduction, scope, normative references, terms and definitions, disease diagnosis and staging, severity assessment, etiology and pathogenesis, syndrome differentiation and treatment, other treatment, prevention and care, and appendix. They also standardize the contents of traditional Chinese medicine (TCM) etiology and pathogenesis, syndrome differentiation and treatment, and prevention and care of COPD. These guidelines are applicable to clinical respiratory physicians of TCM and integrated traditional Chinese and western medicine. The release of these guidelines will help improve the effect and level of Chinese medicine for COPD.

Chronic obstructive pulmonary disease (COPD) is a common, chronic, frequently occurring, and difficult disease of the respiratory system and is a huge disease burden. Pulmonary rehabilitation is an important part of clinical treatment. Chinese medicine lung rehabilitation (CMLR), which is based on Chinese medicine theory and practice, is a comprehensive rehabilitation measure that can prevent and treat pulmonary diseases and preserve physical and mental functions. Its aim is to promote the return of patients to society as soon as possible. To better guide the clinical practice of COPD rehabilitation, the Specialty Committee of Pulmonary Rehabilitation of World Federation of Chinese Medicine Societies established a panel for formulating guidelines, systematically retrieved domestic and foreign literature, performed systematic evaluation after expert consultation and on-site discussion, and finally, formed the guidelines in accordance with the development standard of international evidence-based guidelines. The guideline has seven parts, which are the preface, introduction, scope, normative references, terms and definitions, types of disease syndromes, diseases assessment, CMLR techniques, and annex. The techniques of CMLR include 11 techniques in seven species, such as Simplified Taijiquan, Baduanjin, and Liuzijue. The guideline defines the technical points (time, frequency, course, etc.), optimal applicable population, use of drugs, common acupoints, operation methods, and so on for each technique. The release of the guidelines is helpful to improve the rehabilitation technique standardization and to improve the curative effect and level of rehabilitation.

According to a TOM bushing faults, three typical 220kV cable-conductor bushings (COT, TOM and BRDLW) widely used in the power grid are analyzed about diversion structure. Bushing diversion structure, diversion contact surface, current path and installation sensitivity are discussed in the paper. The study found that installation accuracy of TOM bushing has greater effect on contact resistance of diversion path than others. The improper installation of TOM bushing caused overheating defects and finally developed into this bushing fault.

The high-nuclear cluster compound Na48[HxMo368O1032(H2O)240(SO4)48]·ca.1000H2O (denoted as {Mo368}) represents the known nanoscale hedgehog-type cluster anion with the diameter of approximately 6 nm. Herein, a TiO2@{Mo368} composite was prepared through a sol–gel process for the first time. SEM, XPS, and UV–vis spectra were employed to characterize their chemical composition and structures. Meanwhile, the as-obtained composite was further mixed with P25 (Degussa P25 titania photocatalyst) then applied as the photoanodes of dye-sensitized solar cells (DSSCs); the results showed that DSSCs with the P25-TiO2@{Mo368}-based photoanodes exhibited better performance than that with pure P25-based photoanodes, which was due to less carrier recombination and longer electron lifetime in the former DSSCs by the results from analysis of dark current measurement, electrochemical impedance spectroscopy, and open-circuit voltage decay curve.

To develop and validate a specific patient reported outcome (PRO) for chronic obstructive pulmonary disease (COPD) patients (COPD-PRO) at a set of standardized procedures. Literature analysis, interview and group discussion were performed to draft an initial model of COPD-PRO. Thereafter, 65 clinicians and experts throughout China reviewed the draft scale. Then cognitive debriefing interviews with 40 patients were conducted to assess respondent comprehension of the scale. After that, the revised scale was validated through pre-testing and field-testing. Finally, the psychometric properties of the COPD-PRO were evaluated by indicators such as validity, reliability and responsiveness based on the data from 230 patients. The COPD-PRO contained 17 items in 3 domains: amelioration of clinical symptoms, satisfaction of health condition and satisfaction of treatment effect. The Cronbach's α, Split-half coefficient and test-retest coefficient were 0.806, 0.744, 0.703, respectively; the correlation coefficients between domains and overall scale were 0.835–0.963; 5 factors were extracted according to the conceptual model. The differences of the scale scores before and after treatment were statistically significant (P=0.000). The COPDPRO has good validity, reliability and responsiveness. The COPD-PRO could provide patients' response to the treatments and then evaluate the effect of treatment in a standardized way.

Dawson-type heteropolyacid {P2Mo18VI} and its two-electron heteropoly blue {P2Mo2VMo16VI}-doped TiO2 composites have been successfully prepared by a simple sol–gel method and introduced into the photoanode of dye-sensitized solar cells (DSSCs), which results in a significant performance enhancement of DSSCs. The electrochemical impedance spectroscopy (EIS) and open-circuit voltage decay (OCVD) curve were employed to investigate the electron transport and carrier recombination behavior in DSSCs. The results show that doping with {P2Mo18VI} and {P2Mo2VMo16VI} could both suppress the dark current and increase the electron lifetime in DSSCs. The performance of DSSCs with both {P2Mo18VI}-doped and {P2Mo2VMo16VI}-doped photoanodes is better than that with pure P25 photoanodes and the overall conversion efficiency was improved by 24.48% and 17.19%, respectively.

A novel method for electrical equipments condition assessment is proposed based on Markov prediction. Firstly, the condition representation parameters are induced according to the general volt-ampere characteristics, which can be identified by least square method. Secondly, the number of samples falling into different intervals is counted and the state transition probability matrix is calculated. Last, the distribution of parameters in future detection periods is predicted and the equipments condition is assessed by the ratio of the length of current operation time and the estimated life. Take a single phase two-winding transformer as an example, Monte Carlo simulation is used to generate the leakage inductance data and the electrical data is derived by PSCAD. The equipment condition assessment results verify the effectiveness and feasibility of this proposed method.

Early detection of skull base invasion in nasopharyngeal carcinoma (NPC) is crucial for correct staging, assessing treatment response and contouring the tumor target in radiotherapy planning, as well as improving the patient's prognosis. To compare the diagnostic efficacy of single photon emission computed tomography/computed tomography (SPECT/CT) imaging, magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of skull base invasion in NPC. Sixty untreated patients with histologically proven NPC underwent SPECT/CT imaging, contrast-enhanced MRI and CT. Of the 60 patients, 30 had skull base invasion confirmed by the final results of contrast-enhanced MRI, CT and six-month follow-up imaging (MRI and CT). The diagnostic efficacy of the three imaging modalities in detecting skull base invasion was evaluated. The rates of positive findings of skull base invasion for SPECT/CT, MRI and CT were 53.3%, 48.3% and 33.3%, respectively. The sensitivity, specificity and accuracy were 93.3%, 86.7% and 90.0% for SPECT/CT fusion imaging, 96.7%, 100.0% and 98.3% for contrast-enhanced MRI, and 66.7%, 100.0% and 83.3% for contrast-enhanced CT. MRI showed the best performance for the diagnosis of skull base invasion in nasopharyngeal carcinoma, followed closely by SPECT/CT. SPECT/CT had poorer specificity than that of both MRI and CT, while CT had the lowest sensitivity.

To evaluate the efficacy of comprehensive interventions based on the three TCM patterns on symptoms and quality of life of COPD patients.An open-label, randomized, controlled trial.Four hospitals in China.352 patients were randomly divided into two groups. Patients in the trial group were given conventional Western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules respectively; patients in the control group were given conventional Western medicine. Data collection was performed at baseline, in the 3rd and 6th month during the treatment period, and the 12th month during the follow-up period.Symptoms, including cough, sputum, pant, chest tightness, short of breath, lassitude, cyanosis and symptom total score; quality of life, measured by the WHOQOL-BREF questionnaire and adult COPD quality of life questionnaire (COPD-QOL).Of the 352 patients, 306 fully completed the study. After treatment and follow-up, there were significant differences between two groups in the following: cough, sputum, pant, chest tightness, shortness of breath, lassitude score and symptom total score (P.05); physical, psychological, social and environment domain (P.05) of the WHOQOL-BREF; daily living ability, social activity, depression symptoms and anxiety symptoms domain (P.05) of the COPD-QOL. There were no differences between two groups in cyanosis and adverse events.Based on the TCM patterns, Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules have beneficial effects on symptoms and quality of life of COPD patients.

Aim of the study This study aimed to evaluate the efficacy of Bu-Fei Yi-Shen granule treatment combined with acupoint sticking therapy on self-efficacy and satisfaction with its effectiveness in COPD patients. Materials and methods A multi-centre, double-blind, randomised controlled study was conducted. A total of 164 patients were divided into the trial group ( n = 82, treated with Bu-Fei Yi-Shen granules combined with Shu-fei Tie acupoint sticking therapy and oral sustained-release theophylline dummy) and the control group ( n = 82, treated with oral sustained-release theophylline and Bu-Fei Yi-Shen granule dummy combined with Shu-fei Tie acupoint sticking therapy dummy). The COPD Self-Efficacy Scale (CSES) and the Effectiveness Satisfaction Questionnaire for COPD (ESQ-COPD) were employed during a 4-month treatment period and at the 6-month follow-up visit. Results Of the 164 patients, 158 were included in the full analysis set (FAS); 145 were in the per-protocol analysis set (PPS). After 4-month treatment and 6-month follow-up, the scores of the trial group all continued to increase overtime, and the mean scores of the trial group were significantly higher than those of the control group in the following domains of the CSES: negative affect ( P P P P P P P P P P Conclusions Bu-Fei Yi-Shen granule treatment combined with acupoint sticking therapy can improve the self-efficacy and satisfaction of COPD patients with its effectiveness.

Objective To evaluate the efficacy of Bufei Yishen Granule (补肺益肾颗粒, BFYSG) combined with Shufei Tie (舒肺贴) acupoint sticking therapy on quality of life of patients with stable chronic obstructive pulmonary disease (COPD).

Chitinase 3-like 1 (CHI3L1) is associated with poor prognosis of various human cancers. However, the clinical and prognostic significance of CHI3L1 in hepatocellular carcinoma (HCC) is largely unknown. The aim of the present study is to investigate the expression of CHI3L1 in human HCC cell lines, clinical HCC specimens and its association with expressions of phosphorylated-Akt (p-Akt), E-cadherin and prognostic significance.The protein level of CHI3L1 in HCC cell lines was evaluated by western blot. The mRNA and protein levels of CHI3L1 in 19 self-paired HCC specimens were assessed by RT-PCR and western blot assays. The clinical and prognostic significance of CHI3L1 in 70 cases of HCC patients was determined by immunohistochemistry. In addition, expressions of p-Akt and E-cadherin were also assessed.The protein level of CHI3L1 paralleled with increased malignant potential of HCC cell lines (P0.05). The mRNA and protein levels of CHI3L1 in HCC tissues were up-regulated compared with those in adjacent peritumoral tissues and further increased in tumors with metastasis (P0.05). Clinicopathological analysis showed that positive CHI3L1 expression was significantly associated with larger tumor size, capsular invasion, advanced TNM stages and status of metastasis (P = 0.035, 0.003, 0.023 and 0.003, respectively). Furthermore, CHI3L1 expression was positively correlated with high level of p-Akt (r = 0.293, P = 0.014), but inversely correlated with expression of E-cadherin (r = -0.267, P = 0.026). Additionally, Kaplan-Meier survival analysis showed that HCC patients with positive CHI3L1 expression had a worse overall survival and disease-free survival compared with those with negative CHI3L1 expression (P0.001, respectively). Multivariate analysis identified CHI3L1 as an independent prognostic predictor for overall survival and disease-free survival of HCC patients (P = 0.044 and 0.031, respectively).CHI3L1 plays an essential role in HCC malignancies and may be served as a valuable prognostic biomarker for HCC patients.

The efficacy and safety of polaprezinc combined with triple therapy was compared with triple therapy alone in the eradication of Helicobacter pylori. A randomized, parallel-group, open-label, controlled, prospective multicenter study was conducted in 11 cities in China. Treatment-naive patients with H. pylori–associated gastritis were randomly assigned to one of three arms for a 14-day treatment: Arm A triple therapy (omeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg, each twice daily) plus polaprezinc 75 mg twice daily; Arm B triple therapy plus polaprezinc 150 mg twice daily, or Arm C triple therapy alone. The rate of H. pylori eradication was the primary endpoint. Secondary endpoints were symptom improvement and lower incidence of adverse events. 303 patients completed the study– 106, 96, and 101 patients in Arms A, B, and C, respectively. Intention-to-treat (ITT) analysis showed that the rate of H. pylori eradication was significantly higher for Arms A (77.0%) and B (75.9%) compared to Arm C (58.6%) (P < 0.01), whereas there was no difference between Arms A and B (P = 0.90). Per-protocol (PP) analysis showed that the rate of H. pylori eradication was significantly higher for Arms A (81.1%) and B (83.3%) compared to Arm C (61.4%) (P < 0.01), whereas there was no significant difference between Arms A and B (P = 0.62). All three groups reported significant symptom improvement at 7, 14, and 28 days after treatment, compared to baseline (P < 0.0001). The adverse event rate for Arm B (5.1%) was higher than for Arms A (2.8%) (P = 0.04) and C (1.9%) (P = 0.02). There were no serious adverse events in any group. It appears that standard dose polaprezinc combined with triple therapy can significantly improve the H. pylori eradication rate, without an increase in toxicity.

Background Extracellular matrix protein 1 (ECM1) is a glycoprotein involved in many biologic processes. To determine the expression of ECM1 in hepatocellular carcinoma (HCC), and to study the role of ECM1 in inducing epithelia-mesenchymal transition (EMT) to analyze the effect of ECM1 on the migration and invasion of HCC cells. Methods The expression of ECM1 in HCC specimens was examined by immunohistochemistry staining, and the correlations were analyzed between the expression of ECM1 and the clinicopathological data. The ECM1 expression plasmid was transfected into Bel-7402 cells to induce exogenous overexpression of ECM1 protein. The changes of the expression of ECM1, EMT-related protein (E-cadherin, Vimentin), in Bel-7402 cells were detected by Western blot after transfection of ECM1; the wound healing and invasion assay in vitro were used to determine the role of ECM1 gene transfection on the ability of migration and invasive potential of Bel-7402 cells. Results Immumohistochemistry staining method displayed the ECM1 expression was positively associated with vascular invasion, TNM stage, and poor prognosis. A significant positive correlation was found between the expressions of ECM1 and Vimentin. After ECM1 overexpression, Western blot exhibited that the expression of E-cadherin was down-regulated and Vimentin expression was up-regulated in Bel-7402 cells; the wound healing and invasion assay showed that the migration and invasion potentials of Bel-7402 cells were significantly enhanced. Conclusions ECM1, which displayed a high expression in HCC specimens, was closely associated with clinicopathologic data and may promote migration and invasion of HCC cells by inducing EMT. Electronic supplementary material The online version of this article (doi:10.1186/s12957-016-0952-z) contains supplementary material, which is available to authorized users.

With the assistance of polyoxometalates (POM), ZnO polyhedra with the mean length of 200 nm and mean diameter of 100 nm are synthesized by a simple solvothermal route in an alkali solution. Parallel experiments without POM were carried out to investigate the formation process of ZnO polyhedra and the results showed that POM played a key role in the formation of ZnO polyhedra. A possible formation mechanism was also proposed. Meanwhile, the as-prepared ZnO powder was used to assemble dye-sensitized solar cells (DSSC) photoanodes, the overall solar-to-electric energy conversion efficiency was up to 2.45%, which were obtained using TiCl 4 post-treatment.

The paper analyzed the sulfur in steel for civil engineering in 150t converter in TangSteel. Based on the analysis of desulfurization process and the thermodynamic conditions in converter, the operation of desulfurization was optimized. The industrial tests for desulfurization were carried out, and the results were analyzed. The results were shown that the distribution coefficient would be the highest value, when the alkalinity of slag was 3.5 and the FeO content was 21% in making SPHD steel. The distribution coefficient would reduce, when the temperature was increased, especially more than 1700°C, so end point temperature should be best less than 1700°C.

Combining with the production experience in steel making and rolling plant, the oxide inclusions of IF steel were investigated. In the operation process, the inclusions of IF steel are main Al2O3-TiN. They are granular and dispersed in the steel, and most of sizes are 1~5μm. In the inclusion center, the Al2O3 plays the role of TiN heterogeneous nucleation center. So reducing the Al2O3 inclusion is essential to stabilize the Ti content and strengthen the fixtation to C and N in steel. The quantity of Al2O3 inclusion was closely relation to the operation process. The Al2O3 inclusions can be significantly reduced by taking some measure.

Ethnopharmacological relevance Bu-Fei Yi-Shen granule combined with acupoint sticking therapy has been used in the patients with stable chronic obstructive pulmonary disease (COPD) as major traditional interventions for the treatment of the disease. Aim of the study The objective of this study was to evaluate the efficacy and safety of traditional Chinese herbal medicine, the Bu-Fei Yi-Shen granule combined with acupoint sticking therapy in patients with stable COPD. Methods A 4-center, double-blinded, double-dummy and randomized controlled method was conducted. 244 patients who were divided into the trial group (n = 122, treated with Bu-Fei Yi-Shen granule combined with Shu-Fei Tie acupoint sticking therapy and oral placebo sustained-release theophylline) and the control group (n = 122, treated with oral sustained-release theophylline and placebo Bu-Fei Yi-Shen granule combined with placebo Shu-Fei Tie acupoint sticking therapy). The frequency and duration of acute exacerbation, lung function, clinical symptoms, six-minute walking distance, dyspnea grade and quality of life were observed during the 4-month treatment period, and for a further 6 months follow-up. Results Two hundred and twenty one patients fully completed the study, intent-to-treat (ITT) population was 234 and per-protocol (PP) population was 221. After treatment for 4 months and follow-up for 6 months, there were differences between the experimental and control group in frequency of acute exacerbation (ITT: P = 0.007, P = 0.013; PP: P = 0.045, P = 0.046); duration of acute exacerbation (ITT: P = 0.030, P = 0.005; PP: P = 0.048, P = 0.006); scores of symptoms (ITT: P = 0.000, P = 0.000; PP: P = 0.000, P = 0.000); six-minute walking distance (ITT: P = 0.002, P = 0.001; PP: P = 0.002, P = 0.001); dyspnea grade (ITT: P = 0.014, P = 0.009; PP: P = 0.018, P = 0.012); physiological aspects (ITT: P = 0.003, P = 0.000; PP: P = 0.001, P = 0.000); psychological aspects (ITT: P = 0.007, P = 0.001; PP: P = 0.001, P = 0.000) and environment aspects (ITT: P = 0.003, P = 0.000; PP: P = 0.001, P = 0.000) of the WHOQOL-BREF questionnaire. There were no differences between the experimental and control group in FVC, FEV1 and FEV1% and adverse events. Conclusions Bu-Fei Yi-Shen granule combined with acupoint sticking therapy showed beneficial effects for patients with stable COPD in the measured parameters over the 4-month treatment period and 6 months follow-up, with no relevant between-group differences in adverse events.

The environmental problems about destruction and pollution of water resource, destruction and occupation of land resource, and air pollution in coal mining was described. Green mining technology in terms of the solution in environmental problems caused by coal mining was introduced. The main content of green mining includes reduction of rock waste, simultaneous extraction of coal and coal-bed methane, water-preservation in mining areas, coal mining to retard surface subsidence, and underground coal gasification. Green mining harmonizing with resources and environment is the fundamental method to solve environmental problems caused by coal mining. In order to develop green mining technology, the economic evaluation of green mining and the establishment of relevant laws need to be further strengthened.

Background Chronic obstructive pulmonary disease (COPD) is a serious disease constituting a major threat to public health. Current popularity of traditional Chinese medicine (TCM) in treating COPD implies its potential advantage in improving symptoms, reducing the frequency of acute exacerbation and improving the patients' quality of life. This study is to evaluate the efficacy and safety of a comprehensive intervention, Bufei Yishen Granule combined with acupoint-sticking therapy, in patients with stable COPD. Methods and design A multicenter, double-blind, double-dummy and randomized controlled design will be adopted. A total of 244 cases meeting the inclusion criteria will be enrolled into this study with 122 cases in the trial group and 122 in the control group, respectively. Patients in the trial group will receive Bufei Yishen Granule combined with acupoint-sticking therapy and dummy sustained-release theophylline, while patients in the control group will receive sustained-release theophylline and dummy Bufei Yishen Granule combined with dummy acupoint-sticking therapy. The frequency and duration of acute exacerbation, lung function, clinical symptoms, six-minute walking distance, dyspnea grade and quality of life will be observed during a four-month treatment period and a further six-month follow-up. Discussion It is hypothesized that Bufei Yishen Granule combined with acupoint-sticking therapy will have beneficial effects in reducing the frequency and duration of acute exacerbation, ameliorating the symptoms, and improving the quality of life of patients with stable COPD. The results of this study will provide evidence for developing a TCM-based regimen for patients with COPD. Trial registration ChiCTR-TRC-11001409.

This study sought to evaluate the efficacy and safety of shenmai injection for chronic pulmonary heart disease (CPHD).A systematic review was conducted of clinical trials that compared shenmai injection plus conventional medicine treatment versus conventional medicine treatment alone. Randomized controlled trials of clinical therapeutic studies on CPHD by shenmai injection were included. Searches were applied to the following electronic databases: the PubMed (1977-2008), the Cochrane Library, EMBASE, AMED, Chinese BioMedical Literature Database, and CBM. No blinding and language restriction was used. Data were extracted independently by 2 reviewers. All trials included were analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.0 software was used for data analysis.Thirty-three (33) randomized clinical trials (2617 patients) with low methodological quality were included. Compared to conventional medicine treatment alone, shenmai plus conventional medicine treatment showed significant improvement in New York Heart Association classification of clinical status (odds ratio 0.24; 95% confidence interval 0.19-0.30), five studies had reported adverse events. No serious adverse effects were reported in any of the included trials.While there is some evidence that suggests potential effectiveness of shenmai plus conventional medical treatment for CPHD, the results of this study were limited by the methodological flaws, unknowns in concealment of allocation, number of dropouts, and blinding methods in the studies. Long-term and high-quality studies are needed to provide clear evidence for the future use of shenmai injection.

Available literature on the effects of interferon (IFN) treatment on development and progression of hepatocellular carcinoma (HCC) in patients with chronic virus infection reports controversial results. The primary objective of this meta-analysis was to evaluate the effect of IFN on HCC risk in patients with chronic hepatitis C virus (HCV) or hepatitis B virus (HBV) infection; IFN's efficacy on local tumor progression and survival of advanced HCC patients was also assessed. All randomized controlled trials (RCTs) comparing IFN with no antiviral treatment were selected. Finally, we identified 11 RCTs including 1,772 patients, who met our inclusion criteria to perform this meta-analysis. Our analysis results showed that IFN significantly decreased the overall HCC incidence in HCV-infected patients [relative risk (RR)=0.39; 95% confidence interval (CI)=0.26-0.59; p=0.000], subgroup analysis indicated that IFN decreased HCC incidence in HCV-related cirrhotic patients evidently (RR=0.44; 95% CI=0.28-0.68; p=0.000); but HCC incidence in nonresponders to initial antiviral therapy did not reduce by maintenance IFN therapy (RR=0.96; 95% CI=0.59-1.56; p=0.864). Analysis results also demonstrated that IFN did not significantly affect the overall rate of HCC in HBV-infected patients although there was a trend favoring IFN therapy (RR=0.23; 95% CI=0.05-1.04; p=0.056). Besides, IFN did not improve one-year overall survival of advanced HCC patients significantly (RR=1.61; 95% CI=0.96-2.69; p=0.072); however, a quantitative analysis on local tumor progression could not be performed owing to lack of unified definitions among trials included in our study. By this meta-analysis, we conclude that IFN therapy is effective in reducing overall HCC risk in chronic HCV-infected patients; using it in this subpopulation seems promising, but its administration in other subpopulations still requires further exploration.

To explore the essential characteristic of TCM syndromes for Chronic pulmonary heart disease (CPHD) The CPHD subjects were recruited from four TCM hospitalsrespirations department by means of clinical epidemiological method.The research dates were inputted with Epidata ver.3.1 and analyzed with dynamic Kohonen Network and Decision Tree adopted to analysis the common syndrome for CPHD. There were six common rules before rules transformed and main symptom and minor symptom for common syndrome setted. The diagnostic accuracy rate was72.2% The data mining technology could been used into the TCM syndrome characteristic research.

Evaluation of morphological changes in cells is key for study of epithelial to mesenchymal transition. In the paper, parameters for quantitative evaluation of the changes were explored and two suitable parameters were found, roundness and radius ratio., Evaluation of morphological changes in cells is an integral part of study on epithelial to mesenchymal transition (EMT), however, only a few papers reported the changes in quantitative parameters and no article compared different parameters for demanding better parameters. In the study, the purpose was to investigate suitable parameters for quantitative evaluation of EMT morphological changes. A549 human lung adenocarcinoma cell line was selected for the study. Some cells were stimulated by transforming growth factor-β1 (TGF-β1) for EMT, and other cells were as control without TGF-β1 stimulation. Subsequently, cells were placed in phase contrast microscope and three arbitrary fields were captured and saved with a personal computer. Using the tools of Photoshop software, some cells in an image were selected, segmented out and exchanged into unique hue, and other part in the image was shifted into another unique hue. The cells were calculated with 29 morphological parameters by Image Pro Plus software. A parameter between cells with or without TGF-β1 stimulation was compared statistically and nine parameters were significantly different between them. Receiver operating characteristic curve (ROC curve) of a parameter was described with SPSS software and F-test was used to compare two areas under the curves (AUCs) in Excel. Among them, roundness and radius ratio were the most AUCs and were significant higher than the other parameters. The results provided a new method with quantitative assessment of cell morphology during EMT, and found out two parameters, roundness and radius ratio, as suitable for quantification.

Objective To study the effects of Naomaitong Recipe, a compound Chinese herbal medicine, on the expressions of nuclear factor-kappaB (NF-kappaB) and nitric-oxide synthases (NOSs) in brain tissue after focal cerebral ischemia reperfusion in aged rats and the dosage-effect relationship. Methods We adopted the middle cerebral artery occlusion (MCAO) in aged rats as the focal cerebral ischemia model, with 3-hour ischemia and 12-day reperfusion, and observed the changes of the nerve dysfunction score, the water content of cerebral constitution and the expressions of NF-kappaB, heat-shock protein 70 (HSP70) and NOSs in cerebral cortex. Results The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-kappaB, HSP70, neuronal nitric-oxide synthase (nNOS), endothelial nitric-oxide synthase (eNOS) and inducible nitric-oxide synthase (iNOS) in the untreated group were higher than those of the sham-operated group. The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-kappaB, iNOS and nNOS were lower, while the expressions of HSP70 and eNOS were higher in the high-, medium- and low-dose Naomaitong-treated groups and nimodipine-treated group than those of the untreated-group. The nerve dysfunction score and the expression of nNOS were lower, while the expression of eNOS was higher in the medium-dose Naomaitong-treated group than those of the nimodipine-treated group. The expressions of HSP70 and eNOS were higher, while the other indices were lower in the medium-dose Naomaitong-treated group than those of the low-dose Naomaitong-treated group. Conclusion Naomaitong Recipe can protect the brain cells from damage after focal cerebral ischemia reperfusion injury by adjusting the expressions of NF-kappaB, HSP70 and NOSs, and the medium-dose Naomaitong Recipe is more effective.

Objective To explore the way of quantified diagnosis of blood stasis syndrome (BSS) and the essence of BSS. Methods Using t-test and logistic regression to analyze the symptoms, signs, and objective indexes of BSS in clinical test. Results (1) The levels of endothelin, nitric oxide, and t-PA between 182 patients with BSS and non-BSS had notable difference. (2) The stepwise regression analysis about hemoglobin, triglyceride, total cholesterol, endothelin, nitric oxide, and t-PA in 170 patients with BSS or non-BSS revealed that the order of these indexes considering their importance was: endothelin, hemoglobin, t-PA, nitric oxide. However, the triglyceride and total cholesterol could not enter the regression equations. (3) The stepwise regression analysis about 40 symptoms and signs in 601 patients with BSS or non-BSS revealed that the 18 items had the very contribution to diagnose the BSS when the F value was 6, and so a regression equation was available. The total coincidence ratio was 94.24% when the other quantified data about BSS were tested in the equation. Conclusion The standardized TCM syndrome, which accorded with the criteria of combining diseases with syndrome, was made up of symptoms, signs, and objective indexes. The standard could be obtained by multi-center, prospective, random and controlled clinical epidemiological survey and clinical test.

Since observational data in the urban residents are required to better assess the risk factors of colorectal neoplasm occurrence and the effectiveness of colonoscopy screening and surveillance, we conducted a case-control study at multicenters in China to identify patient characteristics and neoplasm features of colorectal adenoma (CRA) and colorectal carcinoma (CRC). A total of 4089 patients who had undergone a colonoscopy from 19 hospitals were enrolled, of which 1106 had CRA and 466 had CRC. They were compared with controls. The analysis provides features and risk factors of colorectal neoplasm using multivariate logistic regression. Increasing age, a family history of colorectal cancer or previous cases of colorectal adenoma or hypertension disease, gastrointestinal surgery, regular intake of pickled food (adjusted odds ratio [aOR] 1.42, 95 % confidence interval [CI], 1.048–1.924), consumption of alcohol, and a positive result of fecal occult blood testing (FOBT; aOR 2.509, 95 % CI 1.485–4.237) were associated with an increased risk of CRA. In the CRC group, increasing age, regular intake of pickled foods, and a positive FOBT result were risk factors. In addition, a positive abdominal computed tomography (CT) before a colonoscopy and physical signs of emaciation were also significantly associated with an increasing risk of colorectal carcinoma. Regular intake of vegetables decreased the risk of both CRA and CRC. Age, pickled foods, and a positive FOBT are risk factors for colorectal neoplasm. Vegetable intake was associated with a decreased risk of CRA and CRC.

HOXA13 is a member of homeobox genes that encode transcription factors regulating embryonic development and cell fate. Abnormal HOXA13 expression was reported in hepatocellular carcinoma (HCC), but its correlation with tumor angiogenesis and prognosis still remain unclear. This study was aimed to uncover the expression, diagnostic and prognostic significance of HOXA13 in HCC. Immunohistochemistry was performed to detect HOXA13 expression in HCC and corresponding paracarcinomatous tissues from 90 patients. Enzyme-linked immunosorbent assay was used to detect serum HOXA13 in 90 HCC patients and 20 healthy volunteers. Receiver operating characteristics was analyzed to calculate diagnostic accuracy of serum HOXA13, alpha-fetoprotein (AFP) and their combination. Immunoreactivity of HOXA13 was detected in 72.2% of HCC, and 12.2% of adjacent non-cancerous samples. HOXA13 expression was significantly associated with tumor size, microvascular invasion, pathological grade, tumor capsula status, AFP level, tumor-node-metastasis stage and positively correlated with VEGF (p < 0.001) and microvessel density (p < 0.001). The combination of serum HOXA13 and AFP had a markedly higher area under the curve than HOXA13 alone. HOXA13 expression was associated with unfavorable overall survival (OS) (p < 0.001) and disease-free survival (DFS) (p < 0.001). Multivariate analysis indicated that patients with HOXA13-expressing tumors had a significantly shorter OS (p = 0.030) and DFS (p = 0.005) than those with HOXA13-negative tumors. Thus, HOXA13 expression possibly plays an important role in tumor angiogenesis, progression and prognosis of HCC. Moreover, we demonstrate that serum HOXA13 may serve as a biomarker for early HCC diagnosing and predicting outcome.

Background Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce inflammatory pain and swelling in inflammatory bowel disease (IBD) patients with rheumatological manifestations. While these drugs effectively reduce musculoskeletal pain and stiffness, long-term use is limited by gastrointestinal (GI) adverse effects (AEs) and disease exacerbation. As an alternative to NSAIDs, selective cyclooxygenase 2 (COX-2) inhibitors were developed to improve GI safety and tolerability. COX-2 inhibitors include drugs such as celecoxib, rofecoxib, valdecoxib, etoricoxib, and lumiracoxib. Rofecoxib and valdecoxib have been withdrawn from the market worldwide due to safety concerns (most importantly for cardiovascular adverse events) and lumiracoxib has been withdrawn in many countries due to liver toxicity. However, celecoxib and etoricoxib continue to be available for use in many countries. Several studies have examined whether COX-2 inhibitors can be safely used for the treatment of rheumatological manifestations of IBD with inconsistent results. Some investigators report acceptable safety profiles associated with these drugs while others found that COX-2 inhibitors are associated with high rates of disease exacerbation. Objectives The objective of this systematic review was to evaluate the tolerability and safety of COX-2 inhibitors used for the treatment of rheumatological manifestations of IBD. Search methods We searched the following databases from inception to 19 September 2013: PubMed, EMBASE, MEDLINE and CENTRAL. The search was not limited by language. Additional trials were identified by manually searching the reference lists of relevant papers and conference proceedings and through correspondence with experts and pharmaceutical companies. Selection criteria Randomized controlled trials (RCTs) that compared COX-2 inhibitors to placebo were considered for inclusion. Participants were adult patients with IBD presenting with rheumatological manifestations of at least two weeks duration. Data collection and analysis Two authors independently assessed trial eligibility and extracted data. Methodological quality was assessed using the Cochrane risk of bias tool. The primary outcome measure was the proportion of patients with disease exacerbation as defined by the included studies. Secondary outcomes included GI adverse effects, renal toxicity, cardiovascular and thrombotic events. Data were analysed on an intention-to-treat basis where patients with missing final outcomes were assumed to have had an exacerbation of IBD. We calculated the risk ratio (RR) and corresponding 95% confidence interval (95% CI) for dichotomous outcomes. The overall quality of the evidence was assessed using the GRADE criteria. Main results There were no RCTs that assessed the tolerability or safety of the withdrawn COX-2 inhibitors rofecoxib, valdecoxib, or lumiracoxib. Two RCTs (n = 381 IBD patients with rheumatological manifestations) were included in the review. One study (n = 159) compared etoricoxib (60 to 120 mg/day) to placebo in IBD patients with quiescent or active ulcerative colitis or Crohn's disease. The other study (n = 222) compared celecoxib (200 mg twice daily) to placebo in patients with quiescent ulcerative colitis. Both studies were judged to be at low risk of bias. The two included studies were not pooled for meta-analysis due to differences in patient populations and treatment duration. There was no statistically significant difference in exacerbation of IBD between etoricoxib and placebo. After 12 weeks of treatment the IBD exacerbation rate was 17% (14/82) in the etoricoxib group compared to 19% (15/77) in the placebo group (RR 0.88, 95% CI 0.45 to 1.69). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was low due to very sparse data (29 events). There was no statistically significant difference in exacerbation of ulcerative colitis between celecoxib and placebo. After two weeks of treatment 4% (5/112) of celecoxib patients experienced an exacerbation of ulcerative colitis compared to 6% (7/110) of patients in the placebo group (RR 0.70, 95% CI 0.23 to 2.14). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was low due to very sparse data (12 events). The study comparing etoricoxib to placebo documented but did not report on AEs. The proportion of patients who experienced AEs was similar in the celecoxib and placebo groups (21% and 17%, respectively, P > 0.20). No patients in either group died or experienced serious adverse events. Eleven percent of patients in the celecoxib and placebo groups experienced GI AEs (RR 0.97, 95% CI 0.46 to 2.07). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was low due to very sparse data (24 events). GI AEs led to premature withdrawal from the study in 3% of patients in celecoxib and placebo groups respectively. GI AEs included increased stool frequency, rectal bleeding, and inflamed mucosa. No patients experienced any cardiovascular adverse events. Renal toxicity or thrombotic AEs were not reported. Authors' conclusions The results for disease exacerbation and AEs between the COX-2 inhibitors celecoxib and etoricoxib and placebo were uncertain. Thus no definitive conclusions regarding the tolerability and safety of the short term use of celecoxib and etoricoxib in patients with IBD can be drawn. The two included studies suggest that celecoxib and etoricoxib do not exacerbate IBD symptoms. However, it should be noted that both studies had relatively small sample sizes and short follow-up durations. Clinicians need to continue to weigh the risks and benefits of these drugs when treating patients IBD patients with rheumatological manifestations in order to avoid disease exacerbation and other adverse effects. Further RCTs are needed to determine the tolerability and safety of celecoxib and etoricoxib in these patients.

This study aimed to evaluate the efficacy of comprehensive therapy based on traditional Chinese medicine (TCM) patterns on older patients with chronic obstructive pulmonary disease (COPD) through a fourcenter, open-label, randomized controlled trial. Patients were divided into the trial group treated using conventional western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on TCM patterns respectively; and the control group treated using conventional western medicine. A total of 136 patients ≥ 65 years completed the study, with 63 patients comprising the trial group and 73 comprising the control group. After the six-month treatment and the 12-month follow-up period, significant differences were observed between the trial and control groups in the following aspects: frequency of acute exacerbation (P ≤ 0.040), duration of acute exacerbation (P = 0.034), symptoms (P ≤ 0.034), 6-min walking distance (6MWD) (P ≤ 0.039), dyspnea scale (P ≤ 0.036); physical domain (P ≤ 0.019), psychological domain (P ≤ 0.033), social domain (P ≤ 0.020), and environmental domain (P ≤ 0.044) of the WHOQOL-BREF questionnaire; and daily living ability domain (P ≤ 0.007), social activity domain (P ≤ 0.018), depression symptoms domain (P ≤ 0.025), and anxiety symptoms domain (P ≤ 0.037) of the COPD-QOL. No differences were observed between the trial and control groups with regard to FVC, FEV1, and FEV1%.

Background We investigated the clinical value of Doppler echocardiography for determining the optimal setting of atrioventricular interval in patients with dual chamber pacemakers (DDD). In 38 patients with complete atrioventricular block and DDD pacemakers, the atrioventricular interval was prolonged in a stepwise fashion by 20 ms, from 90 to 250 ms, and cardiac stroke volume and transmitral flow were measured by pulsed Doppler echocardiography. Methods The optimal atrioventricular interval at which the cardiac stroke volume was maximal was 168.9 ± 15.6 ms. The atrioventricular interval was 178.4 ± 23.4 ms when the end of the A wave coincided with complete closure of the mitral valve. Results There was a significant linear relationship between the optimal atrioventricular interval and the predicted optimal atrioventricular interval (Y = 86.2 ± 0.5X, r = 0.70, standard error of the estimate [SEE] = 11.5, P < 0.01). Conclusion The optimal atrioventricular interval setting for DDD pacing can be successfully determined using Doppler echocardiography, which is a noninvasive, repeatable, and simple approach. Copyright © 2009 Wiley Periodicals, Inc.

The association of aberrant expression of Kindlin-2 with tumor progression has been reported in recent years. The purpose of this study was to investigate the expression of Kindlin-2 in hepatocellular carcinoma (HCC), and to evaluate its clinical and prognostic significance. The mRNA and protein levels of Kindlin-2 in HCC and adjacent non-cancerous tissues were examined by real-time PCR and western blotting. The relationships between Kindlin-2 expression, clinicopathological features and postoperative survival of HCC patients were also evaluated. Kindlin-2 expression was higher in HCC tissues as compared to adjacent non-cancerous tissues at both mRNA and protein levels (P0.05, respectively). Positive expression of Kindlin-2 was significantly correlated with larger tumor size (P=0.034), capsular invasion (P=0.009), microvascular invasion (P=0.028) and poor prognosis of HCC patients (P0.001). Moreover, multivariate survival analysis identified Kindlin-2 as an independent prognostic factor for overall and disease-free survival of HCC patients (P=0.018 and 0.001, respectively). Taken together, our findings suggested that Kindlin-2 was highly expressed in HCC tissues and was closely related to clinical progression. Therefore, Kindlin-2 protein could be a potential biomarker for predicting poor prognosis of HCC patients after surgery.

The rational distribution of rural distance education sites related to smooth developmemt of rural distance education which had greater significance to eventual realization of the optimal allocation of state educational resources. First the article analyses the preferences of ant colony algorithm in rural distance education sites designment. Then by using improved ant colony algorithm, it uses the methods such as adjusting weighting factor and updating residence time to optimize the layout of rural distance education sites comparedly and it consideres significantly distance education requirement of areas which cultural foundation is relatively weak in optimized processes. After practice, the result demonstrates that using improved ant colony algorithm to optimize the layout of rural distance education sites can obtain the optimal solution or near optimal solution of planning problems effectively and quickly which has certain reference value to planning and designing rural distance education sites.

Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. Pulmonary rehabilitation (PR) is an established intervention for the management of patients with COPD. Exercise training is an important part of PR, and its effectiveness in patients with COPD is well established. However, alternative methods of PR training such as Daoyin have not been appropriately studied. Hence, alternative forms of exercise training that require less exercise equipment and no specific training place should be evaluated. This paper describes the study protocol of a clinical trial that aims to determine if pulmonary Daoyin training will improve the exercise capacity and psychosocial function of patients with COPD in China.A multicenter, randomized, controlled trial will be conducted. A total of 464 patients meeting the inclusion criteria will be enrolled into this study with 232 patients in each of the trial group and the control group. Based on patient education, patients in the trial group will receive pulmonary Daoyin and continue with their usual therapy for three months. In the control group, patients will continue with their usual therapy. The primary outcome measures are exercise capacity assessed by the six-minute walking distance test and lung function. Secondary outcomes include dyspnea and quality of life. Measurements will be taken at baseline (month 0) and after the study period (month 3).It is hypothesized that pulmonary Daoyin will have beneficial effects in improving exercise capacity and psychosocial function of patients with stable COPD, and will provide an alternative form of exercise training that is accessible for the large number of people with COPD.This trial has been registered in ClinicalTrials.gov. The identifier is NCT01482000.

Periostin (PN) is a kind of secreted glycoprotein, which is closely related to the metastatic potential and prognosis of many kinds of tumors in recent studies. However, the expression level of PN in hepatocellular carcinoma (HCC) and its correlation with tumor angiogenesis and prognosis remain unclear. Here Immunohistochemistry assay was used to determine the expression of PN in HCC and corresponding adjacent tissues from 71 patients. VEGF and CD34 were only examined in HCC tissues of patients mentioned above. Immunohistochemically, the expression of PN in HCC was judged to be positive in 73.2 % (52/71) compared with 19.7 % (14/71) in corresponding adjacent tissues, and it was associated with tumor nodules (P = 0.070), microvascular invasion (P = 0.013), Edmondson grade (P = 0.003), tumor capsula (P = 0.038) and TNM stage (P = 0.000); besides, tumors with PN-positive group expressed higher VEGF (82.7 vs. 26.3 %, χ (2) = 20.195, P = 0.000) and had higher MVD (80.5 ± 36.5 vs. 24.0 ± 19.9, t = -6.395, P = 0.000) than those in PN-negative group. Kaplan-Meier method was used for survival analysis, and Cox regression model was performed for multivariate survival analysis. In particular, the expression of PN was found to be an independent factor for predicting overall and disease-free survival of HCC. It is possible that the expression level of PN in HCC is associated with tumor metastatic potential and angiogenesis. Its abnormal expression could be a predictive factor to anticipate HCC patient's prognosis after surgery.

Background Traditional Chinese medicine (TCM) has been used to treat chronic obstructive pulmonary disease (COPD) for many years. This study aimed to evaluate the efficacy and safety of the comprehensive therapy based on the three common TCM patterns in stable COPD patients. Methods A four-center, open-label randomized controlled method was conducted. A total of 352 patients were divided into the trial group (n = 176, treated with conventional Western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on the TCM patterns respectively) and the control group (n = 176, treated with conventional Western medicine). The frequency and duration of acute exacerbation, lung function, clinical symptoms, 6-minute walking distance (6MWD), dyspnea scale and quality of life were observed during a 6-month treatment period and at a further 12-month follow-up. Results A total of 306 patients completed the study fully. The full analysis set (FAS) population was 350 and the per-protocol analysis set (PPS) population was 306. After the 6-month treatment and 12-month follow-up, there were significant differences between the trial and control group in the following: frequency of acute exacerbation (FAS: P = 0.000; PPS: P = 0.000); duration of acute exacerbation (FAS: P = 0.000; PPS: P = 0.001); FEV1 (FAS: P = 0.007; PPS: P = 0.008); symptoms (FAS: P = 0.001; PPS: P = 0.001); 6MWD (FAS: P = 0.045; PPS: P = 0.042); dyspnea scale (FAS: P = 0.002; PPS: P = 0.004); and physical domain (FAS: P = 0.000; PPS: P = 0.000), psychological domain (FAS: P = 0.008; PPS: P = 0.011), social domain (FAS: P = 0.001; PPS: P = 0.000) and environment domain (FAS: P = 0.015; PPS: P = 0.009) of the WHOQOL-BREF questionnaire. There were no differences between the trial and control group in FVC, FEV1% and adverse events. Conclusions Based on the TCM patterns, Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules have beneficial effects on measured outcomes in stable COPD patients over the 6-month treatment and 12-month follow-up, with no relevant between-group differences in adverse events. Trial Registration This trial was registered at Chinese Clinical Trial Register Center, ChiCTR-TRC-11001406.

Sclerosing epithelioid fibrosarcoma (SEF) is a rare and poorly defined variant of fibrosarcoma, but generally insensitive to chemotherapy and progresses with poor prognosis. We report the marvelous effect of irinotecan hydrochloride (CPT-11) chemotherapy in rescuing a patient with atypical SEF from emergent condition, who underwent recurrences after several treatment methods. Small dose of CPT-11 was administered to the patient, with which, the size of superficial mass (cervical lymph node) gradually decreased observed by the naked eyes in 5 days. X-ray and CT image proved a marked reduction in the size of the tumor. CPT-11 is valuable for the treatment of this aggressive sarcoma. In condition of emergency caused by sarcoma oppression, administering a tolerable small dose of topoisomerase I-inhibiting drug could be a beneficial choice.

Computed tomography (CT) has been approved for diagnosing chronic obstructive pulmonary disease (COPD). The diagnostic accuracy, however, has never been examined in a systematic review. Therefore, we conducted a meta-analysis to evaluate the accuracy of CT in diagnosing COPD.Articles reporting diagnostic accuracy of CT for COPD were searched from seven electronic databases and hand searching. Two reviewers independently extracted data and assessed methodological quality. Sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (LR+ and LR-, respectively), and diagnostic odds ratios (DOR) were pooled using a bivariate model. The diagnostic performance of overall test also was assessed using the visual power of the ROC plot to present the bivariate model. Potential between-study heterogeneity was explored using subgroup analyses.Data were extracted from 8 studies that met the inclusion criteria. All summary measures were grossly heterogeneous and therefore would not be appropriately summarized. These studies were further stratified by type of imaging technique and test index. The summary estimates of CT for COPD were as follows: SEN, 0.83(95% CI, 0.73-0.89); SPE, 0.87(95% CI, 0.70-0.95); LR+, 6.2(95% CI, 2.5-15.5); LR-, 0.20(95% CI, 0.12-0.34); and DOR, 31(95% CI, 8-116). The five summary estimates of CT on the lung density were 0.80 (95% CI, 0.74-0.84), 0.77(95% CI, 0.58-0.89), 3.5(95% CI, 1.8-6.9), 0.26(95% CI, 0.20-0.34) and 13(95% CI, 6-32), respectively.The current meta-analyses suggest that quantitative measures of CT may be useful to diagnose COPD. Developed CT technology may improve the accuracy of diagnosis. Further studies assessed diagnostic performance of CT are needed.

Background/aims Radiofrequency ablation (RFA) is a new treatment which is used to treat hepatocellular carcinoma (HCC). We performed this clinical trial to investigate whether it could reduce the damage of residual liver function. Methodology We studied 40 hepatitis-related chronic patients who underwent RFA for hepatocellular carcinoma. Indocyanine green (ICG) test was performed pre and postoperatively. Results There were 32 males and 8 females with an average age of 53.98+12.59 years who underwent RFA for HCC. The mean preoperative ICGR15 value of 40 of the patients was (10.17+9.54) lower than the postoperative ICG retention rate at 15 min (ICGR15) value (14.95+12.71).Differences between the preoperative ICGR15 and the postoperative ICGR15 values were not significantly different (p=0.074). The 1-, 2- and 3-year survival rates were 98.7%, 88.8% and 76.4%, respectively. Conclusions The results indicate that RFA is a minimally invasive treatment which provides a possible treatment modality for HCC patients with poor liver function and the efficacy is as well as the surgical treatment for HCC patients within the Milan criteria.