One hundred and twenty-eight cases of lumbar intervertebral disc protrusion were randomly divided into treatment group, in which 70 cases were treated with electroacupuncture, TDP plus Tuina, and control group, in which 58 cases were treated with electroacupuncture plus TDP. The curative rate in the treatment group was higher than that in the control group (64.3% vs 31.0%, P＜ 0.01). The total effective rate was 100% in the treatment group, 91.3% in the control group; the effect of the former was better than that of the latter (P＜ 0.05).

Objective To investigate the clinical effect of non-steroidal anti-inflammatory drugs and αl-adrenergic antagonist on treating patients with ureteral stones.Methods A total of 128 patients with ureteral colic due to ureteral stones were randomly divided into control and treatment group,and 64 cases in each group.Both two groups were treated with tamsulosin 0.4 mg oral,intravenous injection of saline 1000 mL Patients in treatment group were received intramuscular non-steroidal anti-inflammatory drugs(10 mg) and patients in control group were received pethidine hydrochloride(10 mg).Ultrasound exam were performed after 6-8 h to evaluate the stone expulsive rate.Extracorporeal shock wave lithotripsy and other treatment were underwent when the stone was still not discharge.Results The effective rate of analgesia was 96.9％ (62/64) in treatment group and 100％ (64/64) in control group(x2 =2.03,P =0.50).The stone expulsion rate in treatment group was 28.1％ (18/64),higher than that in control group(12.5％ (8/64),x2 =4.83,P =0.05).Conclusion It is effective to relive ureteral cohc with non-steroidal anti-inflammatory drugs only,and it is better than pethidine in promote stone expulsion when they both used with α1-adrenergic antagonist.

Objective To determine whether there is correlation between intracranial and extracranial arterial stenosis in patients with ischemic stroke,and to understand the difference of the main risk factors between them.Methods One hundred and sixty-eight patients with symptomatic ischemic stroke were selected in order to analyze the correlation and risk factors of intracranial arterial stenosis and extracranial arterial stenosis.Results In the 168 cases,123 patients(73.2%)were with abnormal artery(include intimal thickening)and 100 patients(59.5%)were diagnosed with artery stenosis,including 33 cases of intracranial artery stenosis,48 cases of extracranial artery stenosis and 19 cases of intracranial and extracranial stenosis.The rate of extracranial artery stenosis(39.9%)was higher than that of intracranial artery stenosis(31.0%),but there was no significant difference between them(χ2 =2.93,P=0.11).There was no definite correlation between them(χ2 =0.35,P=0.61)and there were statistically significant differences in age and arterial pressure between patients with intracranial and mean extracranial artery stenosis(t=1.98,P=0.05;t=5.42,P<0.001),but the gender,blood pressure,blood glucose and dyslipidemia rate showed no significant difference (χ2 =1.15,3.41,0.43,0.81,P>0.05).Conclusion Extracranial arterial stenosis may not predict the possibility of intracranial arterial stenosis,and extracranial arterial stenosis may be more likely to cause ischemic stroke.

Objective:To examine the distribution of syphilis antibody in pregnant women and newborns and to explore how to optimize the existing syphilis screening process by setting the diagnostic gray area.Methods:The results of syphilis testing obtained from 119 531 pregnant women and 21 275 newborns from 2015 to 2018 by automatic chemiluminescent immunoassay (CLIA) and the re-examination results determined by Treponema pallidum particle agglutination (TPPA) and the rapid plasma reagin test (RPR) were retrospective analyzed. Data analysis was performed by Chi-square, Fisher′s exact test and Chi-square test for trend. Results:The positive rates of Syphilis specific antibody (TPAb) in clinical specimens from pregnant women and newborns were 0.69% (825/119 531) and 1.24%(264/21 275). The total re-examination positive rates were 0.32% (380/119 531) and 0.90%(191/21 275), and the suspicious syphilis prevalence rates in these specimens were 0.13% (161/119 531) and 0.31%(67/21 275), respectively. The suspicious syphilis prevalence rates in specimens of pregnant women from 2015 to 2018 and newborns increased year by year (χ 2=9.860, P=0.002; χ 2=5.311, P=0.021). With the elevation of the optical density value of samples to cut-off ratio (S/CO) value, positive coincidence rate of TPPA and TPAb in pregnant women and newborns increased significantly (χ 2=614.833, P<0.001; P<0.001). When the S/CO value in newborns exceeded 7.00 or the S/CO value in pregnant women exceeded 15.00, the effectiveness of TPAb results is equivalent to TPPA. The prevalence of suspected syphilis in pregnant women and newborns also increased with the increase of S/CO value (χ 2=323.059, P<0.001; P<0.001). When the S/CO value in newborns bellowed 3.00 or the S/CO value in pregnant women bellowed 5.00, the prevalence rate of suspected syphilis was 0%, which could preliminarily exclude syphilis infection. Conclusions:The prevalence rates of suspected syphilis in pregnant women was increasing during the recent years. It is necessary to further strengthen syphilis screening and intervention treatment in early pregnancy to improve the rate of eugenics. Being a primary screening method for syphilis in pregnant women and newborns, CLIA has high false positive rate. According to the gray area established in this study, the syphilis screening process can be optimized to prevent missed detection, which may reduce the false positive rate and avoid clinical misdiagnosis.

Objective To study the association between serum testosterone level and insulin resistance (IR) in elderly male hypertensive patients.Methods One hundred and seven elderly male hypertensive patients were divided into IR group (n=44) and IR-free group (n=63).Their total TST level was measured,their FAI and TSI were assayed.The patients were further divided into TST≥14 nmol/L group (n=72) and TST＜14 nmol/L group (n=35).The association between serum testosterone level and IR in elderly male hypertensive patients was analyzed.Results The serum TST level,FAI and TSI were significantly lower in IR group than in IR-free group (12.02±2.66 nmol/L vs 15.98±3.98 nmol/L;20.16％±2.75％ vs 28.53％±4.74％;2.26±0.49 nmol/U vs 3.21±0.55 nmol/U,27.67％±5.49％ vs 25.98％±4.98％;2.95±0.39 nmol/U vs 2.78±0.64 nmol/U,P＜0.05).The FAI and TSI were significantly higher in hypertention grade 1 patients than in hypertension grade 3 patients (P＜0.05).The IR was significantly lower while the serum TST level,FAI and TSI were significantly higher in TST≥14 nmol/L group than in TST＜14 nmol/L group (33.3％ vs 57.1％,P=0.019;18.43±3.41 nmol/L vs 12.15±2.23 nmol/L,P=0.002;32.49％±5.67％ vs 24.57％±6.94％,P=0.036;3.53±0.87 nmol/U vs 2.55±0.62 nmol/U,P=0.016).TST,FAI and TSI were negatively associated with HOMA-IR (r=-0.406,r=-0.469,r=-0.429,P=0.000).Conclusion Low serum TST level is a risk factor for IRin elderly male hypertensive patients.

Objective To explore the role and mechanism of microRNA-204(miR-204) carried by the exosomes of human umbilical cord-derived mesenchymal stem cells(hUC-MSC) in regulating the polarization of macrophages in a mouse model of myocardial ischemia-reperfusion(I/R) injury. Methods After the hUC-MSCs were isolated,cultured,and identified,their adipogenic and osteogenic differentiation capabilities were determined.The exosomes of hUC-MSCs were separated by ultracentrifugation,and the expression of CD81,CD63,tumor susceptibility gene 101(Tsg101),and calnexin in the exosomes was determined by Nanoparticle Tracking Analysis software,transmission electron microscopy,and Western blotting.Three groups(hUC-MSC,miR-204 mimic,and negative control) were designed for the determination of the expression of miR-204 in the cells and their exosomes by qRT-PCR.The C57BL/6J mice were randomly assigned into a sham operation group,an I/R group,a hUC-MSC exosomes group,a negative control group,and a miR-204 mimic group.Except the sham operation group,the I/R model was established by ligating the left anterior descending artery.The echocardiography system was employed to detect the heart function of mice.HE staining was employed to observe the pathological changes of mouse myocardium.ELISA was employed to determine the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),arginase 1(Arg-1),and IL-10 in the myocardial tissue.After the macrophages of mouse myocardial tissue were isolated,flow cytometry was employed to determine the expression of CD11c and CD206,and ELISA to measure the levels of IL-1β,TNF-α,Arg-1,and IL-10 in the macrophages. Results hUC-MSCs had adipogenic and osteogenic differentiation capabilities,and the exosomes were successfully identified.Compared with the negative control group,the miR-204 mimic group showed up-regulated expression of miR-204 in hUC-MSCs and their exosomes(P<0.001,P<0.001).Compared with the sham operation group,the modeling of I/R increased the left ventricular end-diastolic diameter(LVEDD)(P<0.001),left ventricular end-systolic diameter(LVESD)(P<0.001),myocardial injury score(P<0.001),and the levels of IL-1β(P<0.001),TNF-α(P<0.001),and CD11c(P<0.001).Meanwhile,it lowered the left ventricular ejection fraction(LVEF)(P<0.001),left ventricular fractional shortening(LVFS)(P<0.001),Arg-1(P<0.001),IL-10(P<0.001),and CD206(P<0.001).Compared with those in the I/R group,the LVEDD(P<0.001),LVESD(P<0.001),myocardial injury score(P<0.001),and the levels of IL-1β(P<0.001),TNF-α(P=0.010),and CD11c(P<0.001) reduced,while LVEF(P<0.001),LVFS(P<0.001),and the levels of Arg-1(P<0.001),IL-10(P=0.028),and CD206(P=0.022) increased in the hUC-MSC exosomes group.Compared with those in the negative control group,the LVEDD(P<0.001),LVESD(P<0.001),myocardial injury score(P=0.001),and the levels of IL-1β(P=0.048),TNF-α(P<0.001),and CD11c(P=0.007) reduced,while the LVEF(P<0.001),LVFS(P<0.001),and the levels of Arg-1(P<0.001),IL-10(P=0.001),and CD206(P=0.001) increased in the miR-204 mimic group. Conclusion The hUC-MSC exosomes overexpressing miR-204 can inhibit the polarization of macrophages in the I/R mouse model to M1-type and promote the polarization to M2-type.
Animals ; Humans ; Mice ; Disease Models, Animal ; Exosomes/pathology* ; Interleukin-10/metabolism* ; Macrophages ; Mesenchymal Stem Cells ; Mice, Inbred C57BL ; MicroRNAs/genetics* ; Myocardial Reperfusion Injury ; Osteogenesis ; Stroke Volume ; Tumor Necrosis Factor-alpha/metabolism* ; Umbilical Cord/pathology* ; Ventricular Function, Left