Temperature dependent systematic circulatory changes by the pure thermal action were studied by means of footbath, which can neglect hydrostatic pressure and buoyancy. 14 healthy adult females (32±6 yeas old) took footbath at 38, 40, 42°C and control footbath after providing the written informed consent. The experiments started corthe permission of protocol of this experiment by the Ethical Committee of International Research Center for Traditional Medicine. They took footbath after 10 minutes' rest in a sitting position. Each footbath was 30 minutes long, followed by 10 minutes' rest. The same subject participated in the studies four times at the same time of the day before lunch. These experiments were in a random order four days apart each other except during menstruation periods. Their systemic circulatory changes and autonomic nervous balance calculated from FFT analysis of the R-R variability were monitored by the automatic sphygmomanometer, impedance cardiography and ECG, and their cerebral circulatory changes were monitored by the Near Infrared Spectroscopy (NIRS) and the Transcranial Doppler (TCD), and skin circulation was measured by the thermographic changes of the face and hand. Their subjective comfort was assessed by the face scale every 5 minutes. The results showed that their cardiac output and blood pressure increased, and tissue blood flow of the M. Trapezius and the skin temperature of both hand and face increased in temperature dependent manner. Simultaneously LF/HF or HF power changed depending on the temperature. Regarding cerebral circulation, total blood volume of the surface of the frontal lobe was suspected to be increased, however, elevation of PI values indicated an increase of the intracranial pressure. The same systemic and autonomic nervous changes of footbath were reported in full body bath. Considering the subjective comfort, the appropriate duration of footbath for healthy persons may be 20-25min at 38°C, 15min at 40°C, 10min at 42°C. Circulatory activation by footbath may support the clinical utility of footbath for the safe care of aged people who may be drawn in bath tub. High PI value at 42°C footbath which means high intracranial pressure may cause the accidents during lethal hot bathing.

We studied temperature-dependent effects of the footbath on heart rate variability, EEG (F3, F4, P3, P4 of 10/20 international method), cerebral circulation, and subjective comfort, using electrocardiography (ECG), electroencephalography (EEG), near-infrared spectroscopy (NIRS), transcranial Doppler (TCD) and face scale. Subjects were 14 healthy adult women (32±6 years old) who took 3 types of footbath (10cm below the knee at 38°C, 40°C, and 42°C) and the control sitting position without footbath in a randomized sequence after providing written informed consent. Their ECG, EEG, NIRS on the forehead, and TCD findings for the middle cerebral artery were monitored for 50min including a 30min footbath. Subjective changes were monitored every 5min using the face scale. LF (low frequency; 0.04-0.15Hz) and HF (high frequency; 0.15-0.4Hz) components and Lorenz plots parameters were obtained from ECG R-R variability. EEG power and EEG right-left coherence were also calculated.
At 42°C footbath, total hemoglobin (Hb) concentration of the forehead, LF/HF ratio, Pulsatility Index (PI: a marker of intracranial circulation and intracranial pressure obtained from TCD), and parietal β₁ wave power increased significantly. HF power and EEG coherence of θ and α₁ wave of the parietal and frontal leads decreased significantly with decline of comfort. At 40°C, cerebral circulation, LF/HF and PI changed less, but EEG power of the frontal α₁ and α₂, and parietal β₁ waves increased significantly after the cessation of footbath with simultaneous increase of comfort. At 38°C, transient but significant decrease of PI value after footbath was associated with significant increase of EEG power of the frontal θ and parietal α₂ waves after footbath. Parameters having statistically significant correlation with subjective comfort were HF power, Lorenz plots parameters, EEG power and coherence, and frontal Oxy Hb (r=0.150-0.231, p<0.0001 by Spearman's method). The EEG power of frontal α₁ waves had the largest correlation coefficient with subjective comfort (r=0.231, p<0.0001).
It was assumed that temperature-dependent changes of autonomic nervous activity and cerebral circulation caused changes of EEG and comfort during footbath. It was indicated that frontal α₁ wave power of EEG and Lorenz plots parameters obtained from R-R variability may be usable as indices of comfort in hot bathing.

One of the methods of external treatment is herbal bathing. We studied the usefulness of herbal bathing by investigating the physiological and biochemical changes that occurred during whole-body herbal bathing.
Eleven healthy adult males (36±9 years old) were subjected to two types of bathing, herbal bathing and plain water bathing, at an interval of four or more days at random sequence after giving written informed consents. Physiological and biochemical changes were monitored 10min before bathing, 10min during herbal bathing in the sitting position, and up to 60min after bathing.
The results showed that the skin temperature of the face (forehead) and hands decreased at a slower rate, fluctuations of the blood pressure were smaller, and the peripheral vascular resistance decreased more faster in herbal bathing than in plain water bathing. These results suggest that herbal bathing is more effective in maintaining peripheral skin temperature, stimulates peripheral circulations, and suppresses excessive fluctuations of blood pressure better than in plain water bathing. Analysis of the autonomic nervous activity by ECG R-R variability showed that the parasympathetic tone was more predominant in the herbal bathing than in plain water bathing, supporting the result showing a larger relaxing effect in herbal bathing. Although there was no significant difference between herbal bathing and plain water bathing in terms of changes in the total blood volume of the Musculus Trapezius, the increase in the total blood volume of the forehead was greater in herbal bathing than in plain water bathing. These results suggested that the herbal bathing might be able to increase the blood volume of the frontal lobe.
These differences of the physiological changes between herbal bathing and plain water bathing indicated that the herbal bathing may stimulate the circulation in the frontal lobe as well as the skeletal muscles. These results supported the health-promoting effects of herbal bathing.

To observe the clinical efficacy of diclofenac sodium eye drops for postoperative recurrence of pterygium, and to provide safer drug regimens to prevent the recurrence of pterygium.
● METHODS: From November 2011 to September 2013, 124 patients 134 eyes who underwent surgery because of pterygium in our hospital were randomly divided into trial group ( diclofenac sodium eye drops and sodium hyaluronate eye drops) and control group ( tobramycin dexamethasone eye drops and sodium hyaluronate eye drops), all patients were followed up for 3mo ( once a week ) and the cornea, intraocular pressure and recurrence of pterygium were observed and compared between the two groups.
●RESULTS: Followed up for 3mo, 43 cases (45 eyes) in the trial group and 38 cases (39 eyes) in the control group had done the follow up as planned, in which 14 cases (15 eyes) showed the signs of recurrence, 2 cases (3 eyes) recurred eventually in the trial group, and in the meantime there were 12 cases (13 eyes) with signs of recurrence and 2 cases ( 2 eyes ) with a recurrence eventually in the control group, but no statistical difference was found between the two groups (P>0. 05);there were 6 cases (9 eyes) dropped out of the study with a higher intraocular pressure in the control group, compared to trial group (0 cases of 0 eye), the difference was statistically significant ( P < 0. 05); cornea conditions between the two groups had no statistical significance (P>0. 05).
●CONCLUSlON:Diclofenac sodium eye drops is effective and safe in preventing the recurrence of pterygium.

Objective Mapping the responsible gene for congenital nuclear cataract in a family for five generations in Yantai City,Shandong Province,China.Methods Family history and clinical data were recorded.9 unaffected members and 13 affected members in this family were involved in the study.The genes of all the involved members were amplified by polymerase chain reaction(PCR).28 microsatellite polymorphism in the 15 reported disease loci were used as genetic markers.The PCR products from each DNA sample were separated on a 6% polyacrylamide gel and analyzed.Allele-sharing analysis was carried out for exclusion,and linkage analysis was calculated with the LINKAGE(Version 5.1)package.Direct sequencing was used for GJA3 gene.Results The clinical phenotype in this family was isolated congenital nuclear cataract,the pathogenic nutation of the phenotype of which has not been reported yet.For all the 28 markers around the 15 candidate loci,there was no allele-sharing between the affected family members.At the 0.00 recombination frequency,the LOD score was-∝ in 27 of the 28 microsatellite markers with exception of D11S898.No GJA3 gene mutation was found.It indicated that there was no linkage between these markers and the pathogenic gene in this family.Conclusion The responsible gene for the congenital nuclear cataract in this family is not located on the 15 reported loci,which further indicates the clinically and genetically heterogeneity of inherited cataract,and an important clue is provided for finding more cataract responsible genes.The pathogenic gene in this family should be identified through extensive scanning of genes.

BACKGROUND:Hip and knee replacement is a common surgery in the clinic; the procedure is relatively complex; and the risk of surgery is relatively high, so that postoperative analgesia is not satisfactory. Perioperative pain management has been a clinical concern. To find safe and effective analgesia has become one of the important tasks of joint surgeons. OBJECTIVE:To investigate the effect of celecoxib on multi-mode analgesia after hip and knee replacement. METHODS: A total of 80 cases undergoing hip and knee replacement in the Chongqing Dongnan Hospital from September 2012 to September 2013 were enroled in this study. These patients were randomly divided into two groups. In the control group, celecoxib was not used for analgesia after replacement. In the experimental group, celecoxib was used after replacement. The pain was observed at 1-5 days after surgery in the two groups. When the analgesic pump was removed, the drug dosage and opioid analgesics use were recorded. Side effects of drug use were also recorded. RESULTS AND CONCLUSION:In terms of analgesic efficacy, the analgesic effect was better in the experimental group than in the control group (95%, 85%, P < 0.05). 95% patients in the experimental group were satisfied with the analgesia, which was significantly higher than in the control group (65%;P< 0.05). No significant difference in pain visual analogue scale score was detected between the two groups immediately, 4 and 5 days after surgery (P > 0.05). Pain visual analogue scale score was significantly lower in the experimental group than in the control group at 1, 2 and 3 days post surgery (P< 0.05). The drug dosage was significantly more in the experimental group than in the control group after surgery (P < 0.05). The frequency of opioid use in the experimental group was significantly lower than in the control group (P < 0.05). The complication rate was significantly lower in the experimental group (8%) than in the control group (18%) (P < 0.05). These findings demonstrate that the analgesic effect of celecoxib was ideal after hip and knee replacement using multi-mode analgesia, which can reduce the dose of analgesic drugs and have smal adverse reaction.

Balneotherapy includes several modalities of treatments and wellness programs, such as physiological and pharmacological effects of hot spring bathing and aqua-exercise, relaxing and biorhythm adjusting effects of staying in the urban climates and educational instruction for healthier life style. We examined health promoting effects of the comprehensive balneotherapy as a whole by the randomized controlled study. 89 women, who had no medical care, and were aged 40-65 years (mean +/- SD age: 59.0 +/- 8.0 years), volunteered for this investigation. Subjects were assigned at random to three groups; group 1 was the control group without any intervention; group 2 with exercise for 60min and educational guidance; group 3 with exercise for 30min and balneotherapy including aquaexercise for 30min and bathing in hot spring for 30min in addition to educational guidance. Each group followed the prescribed program twice a week for 3 months. There was no significant difference in age, body mass index (BMI), blood pressure, heart rate, %FAT, diet/exercise custom and psychological conditions among the three groups. Before and after the program, the physiological, biochemical and psychological measurements were performed: body weight, blood pressure, heart rate, physical strength using ergometer, serum lipids, liver function and questionnaires with profile of mood state (POMS) and self relating depression scale (SDS). After excluding 4 subjects who were dropped out because of their convenience, the results were compared. In group 2 (N=28) and 3 (N=28), body weight, BMI, blood pressure and heart rate were significantly decreased and their physical strength and psychological condition were improved significantly (p<0.05). Furthermore only in group 3, serum total cholesterol, atherogenic index and triglyceride were significantly decreased (p<0.05). The difference between these two groups was not due to changing of their diet and estimated energy consumption by daily activities during 3 months. These data suggest the efficacy of balneotherapy with hot spring bathing and aqua-exercise for health promotion.

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Objective To analyze the clinical pathological characteristics of achalasia patients complicated by esophageal cancer.Methods From January 2005 to May 2013,among 658 patients with achalasia,the clinical data,pathological characteristics of tumor and the treatment of those complicated by esophageal cancer were collected and analyzed.At the same time,receiver operating characteristic (ROC) curve analysis was performed to analyze the relationship between the course of achalasia and esophageal cancer.Results Among the 658 patients with achalasia,297(45.1％) cases were male and 361(54.9％) cases were female.A total of 62 cases (9.4％) were lost to follow-up and of 596 cases who completed the follow-up,26 cases (4.4 ％) were complicated with esophageal cancer.Among the 26 patients complicated with esophageal cancer,69.2％ (18/26) were male;the course from achalasia diagnosed to esophageal cancer was (16.5±8.2) years.The patients with a disease duration more than 10 years accounted for 88.5％(23/26),and 80.8％ (21/26) underwent previous balloon dilatation or Heller surgery.The predilection site of esophageal cancer was in the middle esophagus of patients complicated by esophageal cancer (69.2％,18/26),the main type was squamous carcinoma (88.5％,23/26),65.4％(17/26) of the lesions invaded to muscular layer (stage T3 to T4),61.5％(16/26) had the late stage tumor (stage Ⅲ to Ⅳ),and 23.1％(6/26) had distant metastasis.The results of ROC curve analysis showed that when the duration was 10.5 years,the Youden index reached the maximum value (0.71).And 38.5％ (10/26) of patients with esophageal cancer could not be treated with esophageal cancer radical surgery,and their average survival time was (11.4±6.6) months.Conclusion The patients with the duration of achalasia over 10.5 years are required for regular endoscopic examination to improve the prognosis.

BACKGROUND: With the prevalence of total knee arthroplasty, periprosthetic joint infection as a serious complication has been an issue of concern.OBJECTIVE: To summarize the advances in the diagnosis and treatment of infection after total knee arthroplasty.METHODS: The first author searched the PubMed and CNKI databases for the literatures related to the diagnosis and treatment of infection after total knee arthroplasty using the keywords of total knee arthroplasty,infection in English and Chinese, respectively. The repetitive articles were excluded, and the risk factors,diagnosis, classification and treatment of infection after total knee arthroplasty were summarized.RESULTS AND CONCLUSION: (1) The infection after artificial knee replacement is closely related to the patient's preoperative condition, operation skills and postoperative status. (2) Diagnosis of infection is based on the detailed understanding of the patients' situation and complete auxiliary examinations. (3) The treatment methods include antibiotics, debridement and retention, reversion, arthrodesis, as well as amputation. (4) Periprosthetic infection is a serious complication after total knee arthroplasty, and early diagnosis and treatment are critical. Furthermore,choosing an appropriate individualized treatment scheme for different patients is important.