Objective To investigate the role of ERK signaling pathway in spinal cord in reduction of neuropathic pain (NP) by electro-acupuncture (EA) at Zusanli and Yanglingquan.Methods Fifty male SpragueDawley rats,weighing 180-220 g,in which the intrathecal catheter was successfully placed without complications,were randomly divided into 5 groups (n =10 each):sham operation group (S group),chronic constrictive injury (CCI) group,acupuncture at acupoint group (EA group),acupuncture at non-acupoint group (NA-EA group),and ERK inhibitor U0126 group (U0126 group).NP was induced by CCI in groups CCI,EA,NA-EA and U0126.The animals were anesthetized with intraperitoneal chloral hydrate 300 mg/kg.The right sciatic nerve was exposed and 4 ligatures were placed on the sciatic nerve at 1 mm intervals.EA (intensity ＜ 1.5 mA,frequency 2Hz) of Zusanli and Yanglingquan lasting 30 min was performed once a day for 6 days starting from 4th day after induction of NP in group EA.EA was performed at the points 5 mm lateral to the acupoints of Zusanli and Yanglingquan on the operated side in group NA-EA.Intrathecal U0126 5 μg was started on 4th day after induction of NP twice a day for 6 consecutive days.The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured at 1 day before CCI (T0,baseline) and at days 3,5,7 and 9 after CCI (T1-4).The rats were sacrificed on 10th day after induction of NP and the right lumbar segment (L4-6) of the spinal cord was removed for determination of the expression of P2X3 receptor protein and mRNA,ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in the spinal cord dorsal horn.Results Compared with group S,MWT was significantly decreased,TWL was significantly shortened,the expression of P2X3 receptor protein and mRNA,and p-ERK1/2 was up-regulated in the other 4 groups (P ＜ 0.01).Compared with CCI group,MWT was significantly increased,TWL was significantly prolenged,the expression of P2X3 receptor protein and mRNA,and p-ERK1/2 was downregulated in EA and U0126 groups (P ＜ 0.01),and no significant change in the parameters mentioned above was found in NA-EA group (P ＞ 0.05).Compared with EA group,MWT was significantly increased,TWL was significantly prolonged,the expression of P2X3 receptor protein and mRNA,and p-ERK1/2 was down-regulated in U0126 group (P ＜ 0.01).Conclusion ERK signaling pathway in spinal cord is involved in reduction of NP by EA at Zusanli and Yanglingquan.

Objective To evaluate CT manifestations and pathologic findings of thyroglossal cyst.Methods CT manifestations,clinical materials and pathological findings of 12 cases with thyroglossal defined by pathology were analysed.Results Of 12 cases,the the lesions were located at the center line of the neck in 8 cases and at left of the neck in 4 cases.The cysts were round or oblate in shape on CT scans.In 5 cases the walls of cyst were smooth and no enhanced;while in other 7 cases the cystic walls were coarse and enhanced evidently which there were infiltration of inflammatory cell microscopic examination.The nodules at cystic wall which were composed by blood vessel,striated muscle and connective tissue on pathology could be seen on CT scans while if these nodules were minor,they could hardly to be showed by CT.Conclusion CT can make a proper diagnosis of thyroglossal cyst.

With the development of laboratory medicine,more and more biomarkers have been discovered and applied in the diagnosis and treatment of acute myocardial infarction.For patients with suspected myocardial infarction,early diagnosis and timely treatment can save endangered myocardium and reduce fatality rate to a great extent.The proper use of biomarkers is of important value in preventing cardiovascular events and improving prognosis.This paper reviews the recent literature on new biomarkers in diagnosis of acute myocardial infarction,introduces the characteristics of these markers and their clinical diagnostic value.

Based on research of the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) and the related public websites of acupuncture educational institutions, the first hand information was studied, summarized and sorted on the status quo of the educational qualification or the relative authentication of education programs of ACAOM as well as the status of professional qualification and examination of NCCAOM. The education curriculum of the Master degree of Acupuncture, Master degree of Oriental Medicine Science as well as the Doctor degree of Acupuncture and Oriental Medicine were also introduced in this article including student enrollment and graduation in recent years. The developing tendency of the federal unified acupuncture education, management, professional qualification and examination system of U. S. A. were discussed and analyzed as well.
Acupuncture ; education ; manpower ; organization & administration ; Acupuncture Therapy ; standards ; Certification ; Humans ; United States

Objective:Surgery intervention and its effect on pregnancy heart disease were explored. Meth-ods:Retrospective review of 34 cases of pregnancy heart disease who needed surgery intervention from Jan, 2000 to Dec,2007 was done. Results:17 patients had percutaneous balloon mitral valve (PBMV) dilatation, the area of mitral valve enlarged markedly postoperatively ( P <0.01 ). 9 patients had open chest surgery un-der extracorpory circulation,7 of them had re-replacement mechanical valve due to mechanical valve throm-bosis. One patient had left atrium mucomamectomy. One patient had Wad's sinus breakout and repairmen. 5 patients had Radiofrequency catheter ablation (RFCA) for supraventricular tachycardia. 3 patients had int-racardiac device (ICD) for Ⅲ grade atrioventicular block. 22 patients had cardiac function as grade Ⅲ～Ⅳ and postoperatively recovered to grade Ⅰ～Ⅱ . All 34 patients were alive after treatment, 23 fetus were alive (67.6%), and no adverse results were found during the follow-up. Conclusions:When patients who had pregnancy heart disease need surgery intervention, individualized treatment plan should be made by multidis-cipline experienced doctors according to different heart disease and cardiac function.

Objective To detect clopidogrel effect with light transmission aggregometry (LTA)and flow cytometry (FC). Methods ①Venous blood samples were taken from 71 inpatient with acute corotary syndrome (ACS)in PLA General Hos-pital,including unstable anqina,ST segment elevation myocardial infarction and non ST segment elevation myocardial infarc-tion (46 males,25 females)by random number table from June 2011 to March 2012,whose average age was 69(57~92).②All of them were served 160 mg aspirin and 300 mg clopidogrel after they were in hospital in the beginning,and then served with 75 mg/d clopidogrel for 6 months.On some day,firstly,they were required withdrawing drug for 10 days,and then ve-nous blood samples were separately taken from them before their served-clopidogrel again and their severd-clopidogrel 2 hours later.③The samples were assayed with LTA and FC simultaneously and the platelet aggregation rates before served-clopidogrel (ADPLTA-before serving ),platelet aggregation rates after served-clopidogrel (ADPLTA-after serving ),inhibition rates (ADPLTA-INDU ),PAC-1 activity percentage before served-clopidogrel (PAC-1 before serving ),PAC-1 activity percentage after served-clopidogrel (PAC-1 after serving ),inhibition rates (PAC-1 INHI ),CD62p activity percentage before served-clopidogrel (CD62pbefore serving ),CD62pactivity percentage after served-clopidogrel (CD62pafter serving ),inhibition rates (CD62pINHI )weregotten.All volunteers were signed informed consents and the experiment was approved by the hospital ethics committee.Re-sults ①The paired samples t-test was (t=-2.082,P =0.041)between ADPLTA-before serving (0%~97%)and ADPLTA-after serving (12%~97%),the paired samples t-test was (t = 3.663,P < 0.01)between PAC-1 before serving (15.1% ~ 78.9%)and PAC-1 after serving (14.5% ~ 78.3%);the paired samples t-test was (t = 2.082 and P = 0.041)between CD62pbefore serving (1.5% ~80.8%)and CD62pafter serving (1.4%~41.4%).②The pearson coeffcient correlation results were:ADPLTA-INDU (0%~28.2%) and PAC-1 INHI (0.6%~ 9.1%)(r = 0.297,P = 0.012);ADPLTA-INDU (0% ~ 28.2%)and CD62pINHI (0.1% ~ 48.5%)(r =0.220,P =0.065);PAC-1 INHI (0.6%~9.1%)and CD62pINHI (0.1%~48.5%)(r=0.736,P <0.001).Conclusion Because the correlation was bad between the inhibition rates of clopidogrel detected by FC and them by LTA,FC didn’t apply to clin-ical routine examination of the platelet aggregation.But it could be used to scientific researchs and auxiliary confirmation of routine examination results.

Objective To investigate the characteristics and related risk factors of patients with lymphoma complicated with tuberculosis (TB), the possible pathogenesis and effective therapy. Methods Twenty-one cases of lymphoma combined with TB were retrospectively analyzed by clinical manifestations,pathological features,diagnostic methods,treatments and prognosis.Results Six cases were diagnosed as TB after the diagnosis of lymphoma,5 cases of which were undergoing chemotherapy for lymphoma; 13 cases were diagnosed as lymphoma after TB,including 6 of 10 obsolete pulmonary TB were reactivated during undergoing chemotherapy. Two cases were diagnosed lymphoma and TB simultaneously. Six cases of 21 cases were Hodgkin lymphoma, whereas the other 15 cases were non-Hodgkin lymphoma. Conclusion TB and lymphoma may exist in the same patient in areas where TB is endemic; among this population,the proportion of Hodgkin lymphoma was higher than in the general population.Therefore,the possibility of TB reactivation when undergoing chemotherapy must be focused on.

Purpose:To observe the effect of thalidomide combined with chemotherapy in the treatment of newly diagnosed multiple myeloma. Methods:34 patients were divided into two groups at random. 14 cases in the treated group were initially administered thalidomide at doses ranging from 100mg~200 mg/d,and the dosage was escalated by 100mg~200 mg every two weeks until patients could not tolerate the treatment.The maximal dose did not exceed 600mg/d.MP or M 2 protocol was delivered to those patients in the treated group concomitantly.20 cases in the control group received chemotherapy consisting of MP or M 2 protocol only.Evaluation of 3-months effective(partial remission plus progress)rate,one-year event free survival and two-years overall survival was done in both groups. Results:3-months effective rate is 85.7% in the treated group and 60% in control group.One-year EFS is 71.4% in the treated group while that in the control group is 35%.Two-years OS are 57.1% and 25% respectively.The side effects of thalidomide are tolerable,and constipation is the most common. Conclusions:The combination of thalidomide and chemotherapy is an effective treatment for newly diagnosed MM,and it demonstrates an improvement in effective rate,one-year EFS and two-years OS.

Based on the realistic circumstances at home and successful experiences from abroad,this paper holds the idea to introduce medical liability insurance into medical market to relieve the currently tense physician-patient conflict and analyzes the role and function of medical liability insurance.Meanwhile,some problems and countermeasures are also explained in the functioning process of medical liability insurance.

Objective To study the self-identity and security of patients with obsessive-compulsive disorder (OCD) Methods According to the Chinese Classification of Mental Disorder,Third Edition,63 inpatients and outpatients with OCD and 61 healthy controls were recruited to investigate with self-identity scale(SIS),security questionnaire (SQ),Yale-brown obsessive compulsive scale (Y-BOCS),and self-made questionnaire.Results Compared with controls,patients had lower self-identity (50.81 ± 7.52 vs 55.10 ± 6.86,P ＜ 0.01)and security(50.09 ± 11.65 vs 58.87 ± 10.22,P ＜ 0.01)than healthy controls.Female patients had lower self-identity (48.31 ±7.68 vs 52.57 ±6.98,P＜0.05) than male patients.There were correlation between self-identity and Y-BOCS (r =-0.404,P ＜ 0.01),security and Y-BOCS (r =-0.314,P ＜ 0.05),self-identity and course of disease (r =-0.284,P ＜ 0.05),security and course of disease (r =-0.259,P ＜ 0.05) self-identity and security (r =0.698,P＜ 0.01) Conclusion OCD patients have lower self-identity and security.The self-identity and security reduce with the symptoms getting worse.Low self-identity and security maybe characteristic of OCD patients.