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.

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.

Objective To summarize the experiences of total hip replacement in the treatment of osteoarthritis secondary to congenital dislocation of hip in adults. Methods From April 1998 to April 2000, fourteen hips in nine adult patients with osteoarthritis secondary to congenital dislocation of hip undergone total hip replacement were included in this study. There were seven females and two males. The age of the patients at surgery ranged from 27-53 years (mean, 45.56 years). Five patients underwent bilateral total hip replacements and 4 had unilateral total hip replacement. Results The incision healed smoothly. The duration of follow up ranged from 6 months to 2 years. All the patients could walk independently after the surgery. They could take care of themselves and restored to previous job. The average Harris score was increased from 33.93 to 89.21 points after the surgery. Conclusion Total hip replacement is an effective method in the treatment of osteoarthritis secondary to congenital dislocation of hip in adults. The four special problems encountered in the procedure such as the position of the acetabular component, the implantation of the femoral stem, the reconstruction of the abductor power, and correction of the leg length discrepancies should be considered. It is a challenging work to the orthopaedic surgeon and the careful preoperative planning is recommended.

AIM:Todetecttheeffectofspironolactoneonhyperthyroxine-inducedatrialremodeling.METH-ODS:New Zealand rabbits were divided into control group ( C ) , hyperthyroxine group ( H ) and spironolactone group ( S) .Thyroxin was given to the rabbits in group H and group S by intraperitoneal injection for 4 weeks , and then spirono-lactone was given in group S by gavage for 2 weeks.Atrial fibrillation (AF) was induced by burststimulation after ad-ministration.The inducing rate of AF and atrial effective refractory period ( AERP) were tested by intra-cardiac electro-physiologic instrument.The expression of AF-related Ca2+channel (Cav1.2), K+channels (Kv1.5 and Kv4.3) and con-nexins (Cx40 and Cx43) at mRNA and protein levels was detected by real-time PCR, immunohistochemistry and Western blot.RESULTS:Spironolactone reduced the inducing rate of AF .No significant difference of AERP between group H and group S was observed (P>0.05).Compared with group H, the protein expression of Cav1.2 was significant increased in group S (P<0.05).The expression of Kv1.5 at mRNA and protein levels in group S was significantly lower than that in group H (P<0.05), while the protein expression of Kv4.3 in group S was significantly decreased compared with group H (P<0.05).The mRNA expression of Cx43 in group S was significantly decreased compared with group H (P<0.01), whereas the protein expression of Cx 40 in group H was significantly higher than that in group S ( P<0.05 ) .CONCLU-SION:Spironolactone attenuates the hyperthyroxine-induced atrial remodeling in rabbits , and reduces the susceptibility of the myocardium to AF .

Objective To discuss the relationship between the expression of programmed death-1 (PD-1) in liver with traditional Chinese medicine (TCM) syndromes and pathological diagnosis in chronic hepatitis B.Methods 156 CHB patients treated in our hospital of infectious diseases department were recruited as an observation group. Based on the principle of informed voluntary and approved by the ethics committee, liver biopsy was adopted to make clear liver tissue pathology. According to TCM classification criteria, CHB patients were divided into five groups: a blood stasis group, a damp heat resistance group, a liver and spleen deficiency group, a liver and kidney yin deficiency group, and a spleen and kidney yang deficiency group. In the same period, 12 healthy persons were recruited as a control group. The PD-1 expression was detected with immunohistochemical SP method, and the correlation between expression of PD-1 in liver tissue and TCM syndrome type and liver pathology was analyzed.Results Different degrees of positive cell expression were found in the liver tissue. With the liver inflammation and fibrosis severity, the number of PD-1 positive cells also increased. The PD-1 expression levels varied with mild, moderate, and severe CHB patients (0.24 ± 0.03, 0.36 ± 0.05 vs. 0.43 ± 0.05) , which were statistically significant (P<0.05) . PD-1 expression levels also varied among different TCM type CHB patients, of which, PD-1 expression of blood stasis type was the highest (0.35 ± 0.04), while the liver and spleen deficiency type was the lowest (0.23 ± 0.03).Conclusion The expression levels of PD-1 has a certain correlation with the patients illness, chronic mechanism, and TCM syndromes. CHB patients can be treated by controlling the expression of PD-1.

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.

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.