OBJECTIVETo observe the effects between acupuncture combined with rehabilitation and simple rehabilitation for shoulder pain after stroke, and to select the best plan of acupuncture manipulations at different stages by orthogonal design.

METHODSNinety patients were treated with comprehensive rehabilitation, and nine cases without acupuncture were arranged into a control group. Eighty-one patients of orthogonal design were applied by acupuncture with the same acupoints and course. The VAS score and its weighted value were regarded as the observation indices,and the effects between the acupuncture group and the control group were compared. The optimal plans of acupuncture manipulations of the early stage and the later stage were chosen after the first course treatment and the third course treatment separately. The acupuncture depth (factor A:A: shallow depth less than 25 mm, A(II): modest depth 25-40 mm, A(III): deep depth 40-50 mm), the acupuncture angle (factor B:B(I): perpendicular insertion, B(II): horizontal insertion, B(III): oblique insertion), needle manipulated frequency (factor C: C(I): zero time, C(II): one time, C(III): three times) and needle retained time(factor D:D(I):20 min, D(II): 30 min, D(III): 60 min) were studied. The differences among all factors and the diversity among major factors at different stages were analyzed.

RESULTS(1) Acupuncture combined with rehabilitation at the early and the later stage acquired better improvement than simple rehabilitation (all P < 0.01). (2) The optimal acupuncture manipulation plan at the early stage was A(III) B(III) C(I) D(I), which was deep acupuncture and oblique insertion for 20 min with zero-time manipulation; the optimal acupuncture manipulation plan at the later stage was A(III) B(III) C(III) D(I), which was deep acupuncture and oblique insertion for 20 min with three-time manipulation. (3) There was significance for acupuncture depth and angle at the early stage (both P < 0.01) and there was significance for insertion depth, acupuncture angle and manipulating frequency at the later stage (all P < 0.05). (4) At the early stage, the insertion depth was statistically significant between A(I) and A(II), A(I) and A(III), A(II) and A(III) (P < 0.05, P < 0.01), and the statistical significance was existed between B(I) and B(III) (P < 0.01). At the later stage, the insertion depth was statistically significant between A(I) and A(III), A(III) and A(II), A(I) and A(II) (P < 0.05, P < 0.01), and the statistical significance was existed between C(I) and C(III), C(II) and C(III) (P < 0.05).

CONCLUSIONAcupuncture combined with rehabilitation acquire apparent effect for shoulder pain after stroke. At the early stage,the optimal plan is deep and oblique insertion for 20 min with zero-time manipulation. At the later stage, the best plan is deep and oblique insertion for 20 min with 3-time manipulation.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Shoulder Pain ; etiology ; rehabilitation ; therapy ; Stroke ; complications ; Treatment Outcome

Objective To investigate the effect of three kinds of skin external use in the prevention and treatment of radiation dermatitis in patients with nasopharyngeal carcinoma. Methods 120 patients with nasopharyngeal carcinoma who were treated form August 2014 to October 2015 were divided into three groups by random number table method, namely, aloe vera gel group, triethanolamine cream group, radiation treatment of skin protectants (lifuning) group. Except for different medications among the groups, the other conditions remained relatively consistent. 3 groups were compared in the radiotherapy classification, area, local pain score, and topical drug costs during the radiotherapy and the radiation dose when radiation dermatitis occurred the first time. Results Three kinds of skin external use had a preventive effect, but the effect was different. Three groups′ patients with radiation dermatitis incidence was 100%, but occurred at different levels. Aloe vera gel cream group and triethanolamine group were mainly for gradeⅡradiation dermatitis, grade IV radiation dermatitis occurred in 2 cases and 4 cases, lifuning group were mainly for grade Ⅰ and grade Ⅱ radiation dermatitis, grade Ⅲ radiation dermatitis only occurred 2 cases, noⅣgrade radiation dermatitis occurred. Comparison among the three groups, the difference was statistically significant (H=8.758,P<0.05). 3 groups of patients after treatment all suffered pain, 12 patients in triethanolamine cream group , 7 patients in lifuning group , only 2 cases in aloe vera gel group (H=8.586,P<0.05). The average cost of skin external used in 3 groups was different, triethanolamine cream group was 546.0 yuan, lifuning group was 458.2 yuan, and aloe vera gel group was 157.5 yuan. Among the three groups pairwise comparison, the differences in triethanolamine cream group and aloe vera gel group were statistically significant in pain (χ2=9.62,P<0.05), aloe vera gel group was better than the group of triethanolamine cream, the differences among radiation dermatitis grade, size and radiation dose of radiation dermatitis occurred the first time were not statistically significant (P>0.05). The difference between in lifuning group and triethanolamine cream group in pain had no statistically significant (χ2=2.47,P>0.05), other indexes had significant differences (P < 0.05). Lifuning was better than the triethanolamine cream to reduce and delay the onset and deterioration of radiation dermatitis and could prevent a widening of the area of radiation dermatitis;aloe vera gel group and lifuning group had a significant difference in radioepidermitis grade (χ2=6.32,P<0.05). Lifuning was better than the aloe vera gel and was more conducive to reduce and delay the occurrence of radiation dermatitis, other indexes differences had no statistically significant (P>0.05). Conclusions Considering the efficacy, pain and price three aspects which skin external use prevention and treatment radiation dermatitis patients with nasopharyngeal carcinoma, lifuning as the mixture of triethanolamine and aloe can effectively reduce and delay the chance of radiation dermatitis, reduce the radiation field experience of local pain, and affordable, the patients are more acceptable, it′s worthy of clinical use.

Human errors are errors found in planning or implementation, and those found in medical practice are often major causes of mishaps.To name a few, wrong-site surgery, medication error, wrong treatment, and inadvertent equipment operation.Errors of this category can be prevented by learning from experiences and achievement worldwide.Preventive measures include those taken in human aspect and system aspect, reinforced education and training, process optimization, and hardware redesign.These measures can be aided by multiple safety steps in risky technical operations, in an effort to break the accident chain.For example, pre-operative surgical site marking, multi-department co-operated patient identification, bar-coded medication delivery, read-back during verbal communication, and observation of clinical pathway.Continuous quality improvement may be achieved when both the management and staff see medical errors in the correct sense, and frontline staff are willing to report their errors.

Objective To understand the epidemic situation of Hepatitis B of the children and the situation of Hepatitis B vaccine injection in Maanshan city so as to provide the basis for the development of Hepatitis B vaccination strategy or adjustment in all of the people. Methods Two-stage sampling method was designed to survey 978 children under the age of 15 in 8 villages, with 3～5 ml of venous blood brawn and HBVM detected by ELISA. Results HBsAg positive rate of the children under the age of 15 was 10.12% in 1991 and, compared with the present rate at 0.92%, there was a significant difference. The protection rate of Hepatitis B vaccination was 90.91%. HBsAb positive rate of the children under the age of 15 was 40.49%, and the distribution was balanced among regional, urban and rural areas. With the in crease in age, the trend of Hepatitis B antibody levels declined, but the 1～5 age group had lower peak. The survey rate of Hepatitis B vaccine injection of the children under the age of 15 was 91.82%, and the report rate was 87.89%. The regional difference for them was significant. With the in crease in age, the rate of Hepatitis B vaccine injection declined for the survey and the report in all of the children under the age of 15. Conclusions The effect of Hepatitis B Control for 16 years is very significant in the city. It is necessary to administer charge-free Hepatitis B vaccination for the newborns and to strengthen the Hepatitis B vaccination in flowing children.

Objective To investigate the serum levels of uric acid (UA) in bipolar disorder patients and their clini?cal significance. Methods Serum levels of UA was measured in 126 bipolar disorder patients including 77 mania pa?tients and 49 depression patients, 69 first-episode schizophrenic patients and 126 healthy controls (control group). Bipo?lar disorder patients was assessed by using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAMD). Results The serum UA levels were significantly higher in bipolar group [(349.34 ± 107.21) μmol/L] than in schizophrenic group [(319.71±84.48)μmol/L] and in control group [(280.94±71.90)μmol/L] (P<0.01). There were signifi?cant differences in serum UA levels between manic episode and depressive episode [(366.45 ± 104.01) μmol/L vs. (322.45±107.69)μmol/L]. The serum UA levels were higher in both manic episode and depressive episode groups than in control group (P<0.01). The serum UA levels was not significantly different between patients with and without medication (P>0.05). Correlation analysis indicated that the correlation of serum UA levels with YMRS scores and HAMD scores was not significant in bipolar disorder patients (P>0.05). Conclusions Patients with bipolar disorder has elevated serum uric acid levels which may be a biomarkers of bipolar disorder.

Objective:To explore the relation of cognitive function correlates to P50 sensory gating in patients with schizophrenia.Methods:Totally 106 patients with drug-na¨ive first-episode schizophrenia and 86 healthy con-trol subjects matched for age,sex and education were recruited.All patients met the Diagnostic and Statistical Man-ual of Mental Disorders,Fourth Edition (DSM-IV)criteria for schizophrenia.Their cognitive function were assessed with the MATRICS Consensus Cognitive Battery (MCCB).The P50 auditory gating potential were recorded in all subjects using conditioning-testing stimulus paradigm and stimulus train paradigm.The P50 components were meas-ured in S1 S2 latency,S1 S2 amplitude and P50 suppression ratios.Results:Compared with the controls subjects, the patients with schizophrenia had significantly longer S1[60.8 ±7.8)ms vs.(56.3 ±7.0)ms,P <0.05]S2 la-tency [(59.1 ±10.2)ms vs.(55.7 ±10.7)ms,P <0.05],lower S1 amplitude [(2.8 ±1.8)μV vs.(3.5 ±1.6)μV,P <0.05],less amplitude difference (S1-S2)[(1.5 ±1.8)μV vs.(2.2 ±1.4)μV,P <0.05]and higher P50 suppression ratios (S2 /S1 )[(59.7 ±65.6)vs.(37.6 ±30.0),P <0.05].Schizophrenia patients had lower score than control subjects in all cognitive domains of MCCB (Ps <0.05).No differences in neurocognitive performance were found between subjects in the normal P50 ratio and the abnormal in healthy controls or patients with schizo-phrenia (Ps >0.05).No significant correlation was found between P50 gating measures (P50 ratio and P50 ampli-tude difference)and neuropsychological measures in MCCB scores (Ps >0.05).Conclusion:There may be no as-sociation between P50 deficits and cognitive measures in patients with drug-na¨ive first-episode schizophrenia.

Objective To clarify the role of transmembrane protein 66(TMEM66) in intima proliferation of carotid artery induced by balloon injury in rats.Methods SD rats were randomly divided into three groups (n=10), including control group, the left carotid artery balloon injury group and injury group added with lentiviruses, respectively.Accordingly, the intima proliferation of carotid artery were detected by H/E staining;the expressions of TMEM66 in carotid artery injuried by balloon were determined by Western blot,q-PCR and immunohistochemistry, and the migration and proliferation of VSMCs were measured by scratch test and CCK8 respectively.Results Compared with control group, the expression of TMEM66 in carotid artery was obviously decreased after balloon injury (P<0.05).Most importantly, the intima proliferation of carotid artery was significantly reversed by overexpression of TMEM66 via specific lentiviruses (P<0.05).Conclusions TMEM66 is able to attenuate the intima proliferation of carotid artery after balloon injury.It could be that upregulation of TMEM66 can alleviate the migration and proliferation of VSMCs by PDGF.

Objective To evaluate cognitive impairment and performance-based skills and to explore their rela?tionships with clinical phenotypes in drug-na?ve first-episode patients with schizophrenia. Methods One hundred and forty-five inpatients and 65 healthy controls matched for age, gender and education were recruited. The MATRICS Con?sensus Cognitive Battery (MCCB), Stroop, digit span test, emotional recognition test, University of California, San Diego, Performance-based Skill Assessment (UPSA) and Positive Negative Syndrome Scale scale (PANSS) were used to evaluate cognitive function, life skill and symptoms, respectively. Results Compared with the controls, total score of MCCB and scores of 10 subscales, scores of digit span, emotional recognition and Stroop were significantly lower in patients (all P<0.05). The UPSA total score and scores of financial skill and communication skill were lower in patients than in controls (all P<0.05). Verbal memory, visual memory , Stroop, communication skill scores and total UPSA standard score were sig?nificantly higher in patients with paranoid subtype of schizophrenia than in patients with non-paranoid subtype of schizo? phrenia (all P<0.05). The score of MCCB associated with education years (OR=1.29, 95%CI: 1.13~1.47) and PANSS (OR=0.95, 95%CI:0.92~0.97). Conclusions First-episode, drug-naive patients with schizophrenia have markedly cog?nitive and performance-based skills deficits, which are associated with clinical symptoms. These deficits are differences between paranoid subtype and non-paranoid subtype of schizophrenia.

OJECTIVE: To analyze the cinicopathological features, treatments, and prognosis of patients with papillary TDCa. METHOD: A retrospective study was conducted of the medical records of our hospital for cases of TDCa. General clinical information including diagnostic criteria and treatments was obtained and analyzed. A literature review was also conducted. RESULT: There were 160 cases of thyroglossal duct anomalies hospitalized in Peking Union Medical College Hospital in the past 20 years, and TDCa was diagnosed in 3 (1. 88%) cases. All 3 cases underwent local radical resections, and papillary TDCa was diagnosed based on the pathology examination. Selective neck dissection was chosen in one which was confirmed with cervical lymphatic metastasis. All patients were followed up with no recurrences or metastasis. CONCLUSION The incidence of TDCa is very low and the pathology examination is the only way to confirm the diagnosis. Surgery, especially Sistrunk's procedure, is the treatment of choice, with low complications and recurrence. In the presence of cervical lymphadenopathy, selective neck dissection should be considered.
Carcinoma ; Humans ; Lymphatic Metastasis ; Lymphatic Vessels ; Neck ; Neck Dissection ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Thyroglossal Cyst ; surgery ; Thyroid Neoplasms ; Thyroidectomy

Objective: To determine whether microtubule-associated protein 2 (MAP2) and microtubule-associated protein 1B (MAP1B) could be prognostic biomarkers for patients with pancreatic neuroendocrine tumors (PNETs). Methods:With immunohisto-chemical staining, the expressions of MAP2 and MAP1B were examined in 193 and 120 primary tumors and peritumoral tissues, re-spectively. Then, the relationship between the expression of each protein and clinicopathological characteristics, including prognosis was analyzed. Results:MAP2 and MAP1B were expressed in 88 of 193 (45.6%) and 77 of 120 (64.2%) tumors, respectively. The expres-sion of MAP2 was significantly associated with the favorable overall survival of patients with PNETs (P=0.012). Moreover, MAP2 expres-sion was associated with the improved overall survival in a subset of patients with stageⅡand stageⅢtumors (P=0.017). The MAP1B expression did not correlate with other clinicopathological features and prognosis. Conclusion:MAP2 could be a novel, independent prognostcbiomarker for PNETs.