This paper reviewed the domestic and foreign progress of needling Renying (ST 9) for hypertentsion in clinical and experimental researches. It has been confirmed that needling Renying showed the remarkable clinical effects, with bi-directional benign regulative action, protecting target organs, improving quality of life and so on. Based on the review, the author looks forward to offer the direction for the future researches.

Objective To summarize our experience in managing cerebrospinal fluid(CSF) rhinorrhea. Methods 82 cases of cerebrospinal fluid rhinorrhea treated in our department from 1995 to 1999 were reviewed retrospectively. 61 were male and 21 were female.They ranged from 2 to 82 years old.CSF leak was caused by trauma in 43 cases,iatrogenic injury in 18 cases and spontaneous leak occurred in 21 cases. Results 36 cases underwent surgical repair.The closure rate was 86 11%.Otorhinolaryngologists underwent 25 cases,and 23 cases succeeded (92%).The department of neurology underwent 11 cases,and 8 cases succeeded (72 7%). Conclusions The repair of CSF leak through transnasal extracranial approach can obtain better therapeutic results,especially through intranasal endoscopy.

BACKGROUND:Peripheral facial nerve injury first involves the retrograde reactions of central nervous system axons, and nerve regeneration wil depend on the survival and functional status of neuronal cel bodies. OBJECTIVE:To explore the expression of neuronal cadherin and placental cadherin in facial nuclei after facial nerve injury. METHODS:New Zealand white rabbits were randomly divided into model group (n=48) and control group (n=8). In the model group, every eight rabbits were used to carry out the test respectively at 1, 4, 7, 14, 21 days after the model of facial nerve injury (right side) was established. SP and real-time quantitative PCR methods were taken to test the expression of neuronal cadherin and placental cadherin in the facial nerve nucleus at mRNA and RESULTS AND CONCLUSION:The control group had neuronal cadherin-and placental cadherin-positive neurons. In the model group, neuronal cadherin and placental cadherin positively expressed in the facial motorneurons (right side), and their expressions were peaked at 14 days. Compared with the control group, the mRNA expression of neuronal cadherin in the facial motorneurons was increased significantly at 4-28 days after injury;the mRNA expression of placental cadherin in the facial motorneurons was decreased significantly at 1 day after injury, and then increased significantly at 7-28 days. It is suggested that the expression of neuronal cadherin and placental cadherin is positive in the early stage of facial nerve injury, and the expression of placental cadherin is always present, while the expression of neuronal cadherin relatively lasts for a short time. After facial nerve injury, the expression of neuronal cadherin and placental cadherin in the facial nerve nucleus is both increased, which indicates that the facial nerve regeneration may be related to the high expression of adhesion molecules.

Aim To investigate the effect of paeoniflorin(PF)on TLR2/4 pathway in AGEs-induced RAW264.7 macrophages.Methods RAW264.7 macrophages were incubated at different time points in AGEs stimulation,as well as different concentrations of PF,to optimize experimental conditions.RAW264.7 macrophages were randomly divided into five groups: control group(DMEM),bull serum albumin(BSA)group(200 mg·L-1 BSA),AGEs group(200 mg·L-1 AGEs),paeoniflorin group(200 mg·L-1 AGEs+10-5 mol·L-1 PF)and TLR2/4 inhibitor group(200 mg·L-1 AGEs+30 mg·L-1 OxPAPC).The expression of Toll-like receptor 2(TLR2),Toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),p-IRAK1,TIR-domain containing adaptor protein-inducing IFN-β(TRIF),interferon regulatory factor 3(IRF3),p-IRF3,NF-κB p-p65,NF-κB p65,inducible nitric oxide synthase(iNOS),tumor necrosis factor-α(TNF-α),interleukin-l β(IL-1β)and monocyte chemotactic protein-1(MCP-1)were measured by Western blot.Real-time PCR was used to detect the expression of TLR2 and TLR4 mRNA,while TNF-α,IL-1β and MCP-1 levels in cell supernatant were measured by ELISA.Results Compared with control group,AGEs significantly increased the expression of TLR2,TLR4,MyD88,p-IRAK1,TRIF,IRF3,p-IRF3,NF-κB p-p65,NF-κB p65,iNOS,TNF-α,IL-1β and MCP-1 proteins(P<0.01),as well as TLR2 and TLR4 mRNA(P<0.01).TNF-α,IL-1β and MCP-1 contents were also elevated in cell supernatant(P<0.01).The effects induced by AGEs were decreased significantly in PF and TLR2/4 inhibitor group(P<0.01).Conclusion PF plays an anti-inflammatory effect via inhibiting TLR2/4 pathway on macrophages,which may provide a new theoretical basis for the treatment of diabetic nephropathy.

Objective:To investigate the expression of HIF-1α, HIF-2αand MT in human papillary thyroid carcinoma ( PTC) and the association of their expression with clinicopathological indicators .Methods:Immunohistochemistry was used to analyze the ex-pression of HIF-1α, HIF-2αand MT in 70 PTC samples .The correlations of HIF-1α, HIF-2αand MT expression with one another , and with several clinicopathological indicators were statistically analyzed .Results:In 70 PTC samples, the positive expression rates of HIF-1α, HIF-2αand MT were 52.86%(37/70), 50.00%(35/70) and 44.29%(31/70), respectively.HIF-1α, HIF-2αand MT expression had significant correlations with cervical lymph node metastasis (P=0.034, P=0.022, and P=0.032, respectively). Meanwhile, HIF-1αexpression had a positive correlation with HIF-2α(rs =0.258, P=0.031) and MT (rs =0.266, P=0.026). HIF-2αand MT expression were positively correlated (rs=0.259, P=0.030).Concomitant expression of any two or all of the three molecules had stronger correlation with lymph node metastasis than did each alone ( P=0.004 for HIF-1α/HIF-2α, P=0.024 for HIF-1α/MT, P=0.029 for HIF-2α/MT, P=0.017 for HIF-1α/HIF-2α/MT).Conclusion:HIF-1α, HIF-2αand MT expression in PTC samples have a closely correlation , which are related to cervical lymph node metastasis .Therefore, the expression of HIF-1α, HIF-2αand MT might be used as biomarkers for cervical lymph node metastasis of PTC .

Objective To investigate the value of low-dose coronary artery imaging with flash dual-energy CT.Methods In total of 240 patients suspected with coronary heart disease were performed dual-energy CCTA(DE-CCTA)and were divided into four groups according to the A tube electric current and the methods of reconstruction,including group A(conventional group:180 mAs+FBP)and low-dose groups(including group B,C,D:1 50 mAs,120 mAs,90 mAs +SAFIRE,respectively).The mean of CT value, image noise,SNR,CNR,image quality and radiation dosage were compared among the four groups.Among the patients,52 cases with coronary artery stenosis which were diagnosised by DE-CCTA were also confirmed by CAG,and the consistency of these two methods in the diagnosis of coronary artery stenosis were compared.Results The scores of all image quality were more than 3 points and were statistically significant among the four groups(P <0.05).The mean of CT value is not statistically significant (P >0.05), while the image noise,SNR,CNR and the radiation dosage were statistically significant (P <0.05)among the four groups.The ED of group D was lower 55.62% than group A.DE-CCTA and CAG in the diagnosis of coronary artery stenosis had satisfactory consistency (Kappa=0.84,P<0.05).Conclusion Low-dose coronary artery DE-CCTA not only have none affect of image quality and diagnostic accuracy, but also can significantly reduce the radiation dosage.

Purpose To investigate the clinical application of iodine concentration using dual-energy contrast enhanced CT in distinguishing malignant from benign thyroid nodules. Materials and Methods Patients with a total of 90 pathology proven thyroid nodules (60 malignant, 30 benign) underwent dual-energy contrast enhanced CT scanning. The iodine concentration and CT value were measured in arterial phase and venous phase, then the normalized iodine concentration (NICnod) and the normalized CT value were calculated. All results were compared in each groups, while morphology and capsule of these nodules on iodine image were analyzed. Results The morphology and capsule of nodules on iodine image were significantly different between benign and malignant nodules (Z=- 4.55, P<0.05). On iodine image, the sensitivity of partial capsule diagnosing malignant nodules was 78.33% with specificity of 66.67%. The NICnod and normalized CT value for normal group, benign group and malignant group showed significant differences in arterial phase and venous phase (F=36.87-69.89, P<0.05); the NICnod and normalized CT value between benign group and malignant group showed statistic difference in arterial phase (Z=- 3.48- -2.33, P<0.05), and those among normal group, benign group and malignant group also showed statistic differences (Z= -7.01- - 4.87, P<0.05). NICnod had significant correlation with normalized CT value in each phases (r=0.89, 0.74 and 0.75, P<0.05). When using NICnod and normalized CT value of 0.76 and 0.79 to differentiate malignant thyroid nodules, the area under ROC curve values were 0.91 and 0.92. NIC and normalized CT value showed a good consistency with iodine map in venous phase (Kappa=0.762 and 0.768), Combining morphology and capsule of nodules on iodine image, the sensitivity was 90.01% and the specificity was 93.60%. Conclusion Iodine concentration with dual-energy contrast enhanced CT scanning can differentiate malignant from benign thyroid nodules; combining morphology and capsule of nodules improves the accuracy of diagnosis.

Objective To evaluate the inhibitory effect of asiaticoside on bleomycin-induced skin cicatrization. Methods Thirty male C57BL/6 mice were randomly divided into three groups:negative control group,model control group,and asiaticoside group,ten in each group.In model control group and asiaticoside group,1 mg·mL-1bleomycin was subcutaneously injected into the dorsal skin of mice every day;4 h later,1 mL 0.9% sodium chloride solution 1 mL asiaticoside(20 mg·mL-1) was injected into the lesion skin in the model control group and the asiaticoside group,respectively.In the negative control group, the same volume of 0.9% sodium chloride solution was subcutaneously injected into the dorsal skin of the mice at the two time points every day.After 21 days,skin specimens were harvested to observe the histomorphology and detect myofibroblast proliferation and expression of inflammatory factors. Results The skin scar was significantly attenuated in the asiaticoside group as compared with the model control group,and the dermal thickness measured exhibited a gradual decrease in asiaticoside group.The expression of α-antismooth muscle antisbidy and infiltration of inflammatory cells were significantly lower in the asiaticoside group than in the model control group. Conclusion Asiaticoside inhibits the development of skin scar of mice by regulating proliferation and differentiation of myofibroblasts and down-regulating inflammatory cells.

0bjective To explore the effects of narrative nursing on posttraumatic growth for patients with amputation. Methods From December 2016 to March 2018,a total of 62 hospitalized patients with amputation were randomly assigned into the control group and the intervention group by random number table.The control group received routine nursing,the intervention group received narrative nursing on the basis of control group.Two groups were evaluated by Posttraumatic Growth Inventory(PTGI) before and after intervention. Results Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the control group were (19.87 ± 5.22), (7.90 ± 2.53), (8.83 ± 3.62), (9.73 ± 3.13), (10.63 ± 3.01), (56.97 ± 17.21) points, respectively. After intervention,the scores were (20.80±5.89), (8.80±2.17), (8.90±3.39), (10.27± 2.75), (11.07 ± 3.12), (59.83 ± 16.91) points, respectively, except new possibilities, the scores of each dimension and total scores of posttraumatic growth in the the control group were higher than before,the differences were statistically significant(t=3.00- 5.34, P＜0.05).Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the intervention group were (20.28±4.94), (8.17±2.58), (8.59±3.48), (9.55± 2.90), (11.07±2.83), (57.66±16.42) points, respectively. After intervention, the scores were (23.79±4.70), (10.10±2.17), (10.72±3.34), (11.69±2.22), (12.79±3.28),(69.10±14.92) points, respectively, the scores of each dimension and total scores of posttraumatic growth in the intervention group were statistically higher than those in the control group and before intervention,the differences were statistically significant (t=10.61-16.75, P＜0.05). Conclusion Narrative nursing can effectively improve the level of posttraumatic growth and psychological state for patients with amputation.

Objective To investigate the current status of posttraumatic growth among digestive system cancer patient' families, and explore correlation of posttraumatic growth with social support, coping style in digestive system cancer patient' s families. Methods The Posttraumatic Growth Inventory, Perceived Social Support Scale and Simplified Coping Style Questionnaire were used to survey the 280 digestive system cancer patient' s families. Results The mean posttraumatic growth total score in families of the patients with digestive system cancer was (46.03 ± 15.83) points. The highest score was found for appreciation of life, the lowest was spiritual change. Meanwhile, posttraumatic growth was significantly correlated with perceived social support. The correlation coefficient was 0.730 (P<0.01). In the coping style, there was a positive correlation between positive coping style and post-traumatic growth. The correlation coefficient was 0.644, (P<0.01). While except personal relationship and mental change dimensions, there was a negative correlation between the post-traumatic growth with the negative coping style. The correlation coefficient was-0.155 (P<0.05). Conclusions Family of patients with digestive system cancer also experience posttraumatic growth when their loved ones are diagnosed with cancer, but the posttraumatic growth was at the lower level. Social support and positive coping are the positive factors of post traumatic growth, and negative coping is the negative influencing factor.