Objective To observe the clinical efficacy of Tong Du Wen Yang (unblocking the Governor Vessel and warming yang) in treating amyotrophic lateral sclerosis (ALS).Method Twenty-eight eligible ALS patients were randomized into two groups by following the visiting sequence. Thirteen patients in the control group were intervened by orally taking Riluzole tablets; 15 cases in the treatment group were by Tong Du Wen Yang needling in addition to oral administration of Riluzole tablets. Before treatment and after 6-month treatment, the therapeutic efficacies were evaluated by using the Chinese medicine syndrome and sign scoring for Wei-flaccidity diseases and Appel function scale.Result After the treatment, the Chinese syndrome and sign scoring scores for Wei-flaccidity dropped in both groups, and the decrease in the treatment group was more significant than that in the control group (P<0.05). The Appel scores dropped in both groups after the treatment, while the decrease in the treatment group was less significant than that in the control group (P<0.05).Conclusion Tong Du Wen Yang needling plus orally taking Riluzole tablets can produce a more significant efficacy than using Western medication alone in treating ALS.

Objective To investigate the effect of spironolactone combined with valsartan on renal function in patients with early diabetic nephropathy.Methods 158 early diabetic nephropathy patients from May 2014 to June 2015 in department of endocrinology of Nanxun People’s Hospital of Huzhou were selected and divided into control group (79 cases) and experimental group (79 cases).The control group were treated by valsartan and the experimental group were treated with spironolactone on the basis of control group.The changes of renal function, potassium ion and blood rheology were observed and compared after treatment.Results Compared with control group post-treatment, the systolic pressure and diastolic pressure levels were lower, plasma urinary albumin excretion rates (UAER) level was lower (P <0.05), albumin (Alb), serum creatinine (Scr), blood urea nitrogen ( BUN) , creatinine clearance ( Ccr) and K +levels had no significant differences, whole blood specific viscosity, plasma specific viscosity and whole blood specific reduced viscosity were lower ( P <0.05 ) in experimental group.Conclusion Spironolactone combined with valsartan could effectively improve clinical efficacy of patients with early diabetic nephropathy , improve the renal function of patients, recover ion disorder and reduce blood viscosity.

Objective To explore the molecular mechanism of hypophrenia induced by Down syndrome (DS).Methods Ts65Dn mice were used as DS animal model.Three female mice and three male mice of three to twelve weeks old were mated.Among the 17 first-generation mice alive,five mice remained Ts65Dn trisomy and 12 mice were normal.Five Ts65Dn mice and five normal mice were selected randomly as Ts65Dn group and control group,and bred till 16 to 18 weeks old for experiments.Differential proteins in hippocampus of mice were tested by isobaric tags for relative and absolute quantitation (iTRAQ).Expressions of the differential proteins in Ts65Dn group were detected compared with those in control group.Results A total of 2805 proteins were identified in hippocampus of Ts65Dn group and control group,and significant differences were observed in the expressions of 374 proteins.Compared with those in control group,expressions of 195 proteins increased and 179 reduced in Ts65Dn group.Sorted by P value from low to high,the seven proteins with the lowest P value were uncharacterized protein C2orf47 homolog,isoform 2 of filamin A-interacting protein 1-like,zinc finger protein,isoform 1 of pericentriolar material 1 protein,SEC23 interacting protein,BAG family molecular chaperone regulator 3 and serpin H1.Conclusions Differential proteins are observed in hippocampus of Ts65Dn mice,perhaps closely correlating to neurological defects.The new technology of iTRAQ helps to screen and identify differential proteins in hippocampus.

BACKGROUND: It has been obtained by the animal experimental and clinical researches that electroacupuncture promotes the regeneration of peripheral nerve, but its mechanism is still unknown. Neurotrophic factor (NF) maintains the survival of neurons in injured nerve and promotes the axonal regeneration. The observation of the changes of nerve growth factor (NGF) before and after electroacupuncture stimulation probably provides a new approach on revealing peripheral nerve disorder.OBJECTIVE: To observe the effects of electroacupuncture on NGF in regeneration microenvironment after facial nerve injury.DESIGN: Complete randomized-division and controlled animal experiment.SETTING: Department of Acupuncture-Moxibustion of West China Hospital affiliated to Sichuan University.MATERIALS: The experiment was performed in Animal Experiment Center of West China Hospital affiliated to Sichuan University from September to December 2001, in which, 50 New Zealand healthy adult rabbits were employed and randomized into 2 groups, named experiment group and the control, 25 rabbits in each one.METHODS:① After intravenous anesthesia on experimental animal,the upper buccal branch of facial nerve was separated and exposed. Under surgical magnifying glass, the nerve was cut off and a silica-gel tube was used to be inlayed in two broken ends and fixed with stitching, by which, a regeneration chamber is formed. In experiment group, on the day when the rabbit was completely resuscitated from anesthesia in the operation, electroacupuncture was applied. Points: Yifeng (TE 17), Dicang (ST 4), Jiache (ST 6) and Hegu (LI 4). Method of treatment: perpendicular puncture was applied on Yifeng (TE 17), 1 cm deep; penetrating puncture was from Dicang (ST 4) to Jiache (ST 6), 1.5 cm deep; and on Hegu (LI 4), 0.5 cm deep. The electrodes was attached on Yifeng (TE 17) and Dicang (ST 4) respectively, with dense-disperse wave, at 18-20 Hz, 1.5 V. The needles were retained for 30 minutes and the treatment was given once a day, totally for 14 days.In the control,no any management was applied.② On the 3rd, 5th 7th, 10th and 14th days after surgery, 10 animals were sacrificed, 5 rabbits in each of experiment group and the control. The fluid was collected from the regeneration chamber and double antibodies sandwiched enzyme-linked immunosorbent assay (ELISA) was used to determine NGF level in regeneration chamber. ③ t test was adopted for the difference comparison of measurement data.MAIN OUTCOME MEASURES: Comparison of NGF level in regenerated chamber on the 3rd, 5th, 7th 10th and 14th days after surgery RESULTS: Fifty rabbits were all in result analysis. From the 3rd day to 7th day after surgery, NGF level in regeneration chamber was not different remarkably between experiment group and the control (P ＞ 0.05). On the 10th and 14th days, NGF level in regeneration chamber in experiment group was higher remarkably than that in the control [On the 10th day after surgery: (2 793.0±163.1), (2571.1±91.6) ng/L; on the 14th day after surgery: (2 696.1±147.5), (2 243.7±271.2) ng/L, t=4.45, 3.44, P ＜ 0.01].On the 7th day after surgery, NGF levels in regeneration chamber in both experiment group and the control were up to the peak. But, since the 14th day after surgery, NGF level in the control began declining, that in experiment group was still kept at a relatively high level.CONCLUSION: Electroacupuncture improves and maintains the stable high level of NGF in regeneration microenvironment after facial nerve injury, which is probably one of the mechanisms of electroacupuncture on promoting the regeneration of peripheral nerve.

Objective To evaluate the clinical treatments and results of traumatic osteoarthritis of the hip joint after acetabular fracture. Methods One hundred and seven patients with acetabular fractures admitted from March 1995 to December 2003 were reviewed. Twenty-five cases of traumatic osteoarthritis were found during an average follow up of 2.5 years (8 month to 5.5 years). There were 18 male and 7 female with an average age of 42.7 years (28 to 71). According to Letournel classification, there were anterior-column fractures in 3 patients, anterior-wall in 2, posterior column in 3, posterior wall in 6, posterior wall and column in 3, transvers combined posterior wall in 5, and both-column in 1 patients. The operative related complication of heterotopic ossification was found in 6 , and bone defect in 3 patients. The pathological changes ofⅠ-stage was in 4,Ⅱ-stage in 5, Ⅲ-stage in 10,Ⅳ-stage in 5, and Ⅴ-stage in 1 patient. The mean Harris score of these patients was 52.6 points. Fourteen cases of traumatic osteoarthritis were treated with conservative treatment and 11 cases with total hip arthroplasty. Results Fourteen patients with conservative treatment were followed up 16 months in average (8 to 30 months) .The symptom of traumatic osteoarthritis in 12 cases had improved with the same initial radiographic findings and 2 cases deteriorated with narrowing of the joint space and hyperplasia. The latest mean Harris score for these patients was 61.8 points in average. Eleven patients with total hip arthroplasty were followed up for an average of 32 months(13 to 60 months) and the latest mean Harris score was 87.6 points in average. There were no complications related to the surgery occurred. Conclusion The traumatic osteoarthritis of acetabular fractures after operation is relative higher. The quality of reduction is an important factor influencing the long-term results of acetabular fractures and resulting traumatic osteoarthritis. For the patients with Ⅰ to Ⅲ-stage of pathological changes, conservertive treatment may obtain a relative good results. For the Ⅳ to Ⅴ-stage, total hip arthroplasty can gain an early satisfactory results.

[Objective] To analyze the clinical risk factors for the deep vein thrombosis(DVT)after the total hip arthoplasty(THA).[Methods]Fifty-one THA in 48 patients from February 2007 to July 2007 were evaluated.Color Doppler ultrasonography was used to detect DVT of bilateral lower extremities in all patients before operatioon and at 7 days after operation.Fifteen clinical factors were examined perioperatively in order to analyze their influences on DVT formation after surgery.[Results]Seventeen patients with DVT after operation were discovered through Color Doppler ultrasonic detection,and all of the DVT occurred at the calf intermuscular vein.The incidence of the DVT in all patients was 33.3%,and 41.7% of these DVT patients were asymptomatic.Logistic regression analysis indicated that patients older than 65(OR=116.597),large volume of blood transfusion(OR=1.01)and high level of triglycerides(OR=37.249)were the risk factors for the occurrence of DVT after the THA.[Conclusion]Female,old age,obesity,increase of the level of triglycerides and cholesteral,O blood type,large volume of blood transfusion and patients with diabetes or hypertension raised possibility the occurrence of DVT.Based on this research,it concludes that patients older than 65,large volume of blood transfusion and high level of triglycerides are the risk factors for the occurrence of DVT after the THA,doctors should control the total dose of blood transfusion,to reduce the dose per time and increase the times of massive blood transfusion.Besides these,both clinicians and doctors performing Color Doppler ultrasonography should pay attention to the calf intermuscular DVT.

By analyzing the situation that large general hospitals face at present in their development and the background of reform in the system of overall responsibility by the attending physician in the hospital, the authors offer an account of the guiding ideology for large general hospitals to adopt the system of overall responsibility by the attending physician, the specific steps taken and the initial results attained. They also discuss the impact of the system of overall responsibility by the attending physician on the hospital from the perspectives of human resources, technological innovation, managerial system, and information system. The positive significance of the system of overall responsibility by the attending physician in the management of the hospital reform is also identified.

Cancer stem cells are a new field with the gradual deep understanding of the stem cell research. Although its history is not long, the rapid development showed a good potential prospect. The existence of cancer stem cells and its use as tumor formation, growth and metastasis-based approach has been widely recognized. In theory, cancer stem cells derived from normal stem cells can transform. Cancer-causing factors can also be derived-from the dedifferentiation induced cells. Because it contains all-round, multi-and single stem cell, with the proliferation and differentiation potential of different directions, it is possible to explain the heterogeneity of tumor cells, and reasons for hypoxic environment, anti-cancer drugs and radiation resilience. In this area, it has been made a lot of progress in recent years. However, there are still some problems to be solved. Such as the identification of cancer stem cells, biological function and mechanism.

Objective To explore a simple and effective way of establishing a 30 % small-forsize liver transplantation in rats. Methods SD rats were selected as the donors and recipients. Smallfor-size orthotopic live transplantation was performed using Kamada's two-cuff method. Donor's liver was flushed via abdominal aorta and hepatectomy in situ was done. Animals were divided into 3 groups (40 pairs of rats in each): group Ⅰ , median lobe was used as graft; group Ⅱ, right of median lobe and right lobe were used as graft; group Ⅲ, median and right lobes were used as graft. The body weight of the donor was the same as the recipient in groups Ⅰ and Ⅱ , but 100～ 120 g less than in group Ⅲ. The operating time, 7-day survival and technical complications were compared among these 3 groups. Results The operating time of hepatectomy was shorter in group Ⅲ than in groups Ⅰ and Ⅱ (8. 8±0.7 vs 11.5± 1.1 vs 10.1 ±1.0 min, P＜0.01). The cold ischemia time of graft, the anhepatic time, the operating time of recipient and the transplanting successful rate showed no significant difference among the 3 groups. Compared with groups Ⅰ and Ⅱ , the incidence of bleeding,bile leakage and IVC stricture was significantly decreased in group Ⅲ (P＜0. 05). Other complications after operation showed no significant difference among the 3 groups (P＞0. 05). Group Ⅲ had more 7-days survivors and longer median survival time, but there was no significant difference among the 3groups. Conclusion Small for donor body weight with median and right lobes as graft was a more effective and simple way of establishing a 30 % small-for-size liver transplantation in rats with shorter hepatectomy time and less complications after operation.