Objective To observe the therapeutic effect of Jin's three-needle manipulation combined with rehabilitation training on spastic cerebral palsy children,and to explore its therapeutic mechanism.Methods One hundred and thirty-five spastic cerebral palsy children were equally randomized into three groups: the treatment group was given Jin's three-needle manipulation combined with rehabilitation training,control group 1 given Jin's three-needle manipulation,and the control group 2 given rehabilitation training.The improvement of symptoms,activities of daily living(ADL) and event-related potentials(ERP) P300 were observed in the three groups.Results ADL score was increased in the three groups after treatment(P

Objective To investigate the effect of continuous positive airway pressure therapy (CPAP) on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods Ninety seven patients with OSAHS and primary hypertension were randomly divided into treatment group (n =49) and control group (n =48).Patients in control group receive antihypertensive medication only,while patients in treatment group received antihypertensive medication in combination with CPAP therapy for 4 weeks.The dynamic electrocardiogram (ESG) and ambulatory blood pressure for 24 h were measured before and after treatment in both groups.Results After CPAP treatment,the night index of standard deviation of the average NN intervals (SDANNniGHt) in treatment group was (89.0 ± 21.4) ms,while the day and night index of square root of the mean squared differences of successive NN intervals (rMSSDday and rMSSDnight) was (35.9 ± 17.2) ms and (45.7 ± 18.3) ms respectively.Compared with those before treatment,the index of SDANNnight was decreased and the indexes of rMSSDday and rMSSDnight were increased (P ＜ 0.01).Compared with control group,the SDANNnight was decreased,and the rMSSDday and rMSSDnight were increased (P ＜ 0.01,P ＜ 0.05).After CPAP treatment,the night index of low-frequency power (LFnight) in treatment group was (15.3 ± 5.7) ms,which was lower than that before treatment,and the night index of high-frequency power (HFnigh) was (16.3-± 8.1)ms,which was higher than that before treatment (P ＜ 0.01);the LFnight in treatment group was decreased and the HFnight was increased (P ＜ 0.01).After CPAP treatment,the day and night indexes of systolic blood pressure (SBPday and SBPnight) and the night indexes of diastolic blood pressure (DBPnigh) t in treatment group were (136.1 ± 13.4) mmHg,(128.7 ± 9.8) mmHg (1 mmHg =0.133 kPa),and(83.7 ±7.2)mmHg respectivley,which were all lower than those in control group (P ＜ 0.05 or P ＜ 0.01).The incidences of morning peak blood pressure and non-dipper hypertension in control group were significantly higher than those in treatment group (P ＜ 0.01).Conclusion CPAP therapy can effectively adjust the heart rate and blood pressure levels in patients with OSAHS and primary hypertension,especially in the night.

Objective To explore the curative effect of family -based socialization management on patients with hypertension in community .Methods A total of 116 patients with hypertension were randomly divided into ob-servation group and control group , 58 patients in each group .Both groups received conventional drug treatment .The control group was given routine chronic disease management and the observation group implemented social manage -ment(patients, families, doctors).Blood pressure(BP),lifestyle and psychological condition were evaluated , and the serum triglyceride ( TG) , low density lipoprotein ( LDL) and homocysteic acid ( Hcy) were detected after one year . Results Blood pressure of patients was dropped significantly in the two groups , as compared with the control group . The BP of patients in the observation group was declined more obviously , the BP up to standard rates , control rates and treatment compliance were raised , the mode of life and mental status were improved obviously , and the serum contents of TG, LDL and Hcy were decreased significantly (p<0.05).Conclusion The use of hypotensorscombined with fam-ily-based social management can effectively help patients to control their blood pressure , raise treatment compli-ance, establish a healthy life style and improve their mental status .The mode is worth of spreading in community .

Objective To compare the hypnotic effect of propofol administered by target-controlled infusion (TCI) during day-time and night-time,in order to explore the effect of circadian rhythms on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing emergency minor hand surgery were divided into 2 gorups according to the time of the day when they received propofol TCI:day-time group (from 7:01 to 19:00) and night-time group (from 19:01 to 7:00).The pharmacokinetic parameters proposed by Schnider which predict effect-site concentration (Ce) were used.Four effect-site concentrations of propofol were set:0.8,1.2,2.0 and 4.0 μg/ml.Ce was increased step by step and each Ce was maintained for 5 min.The level of sedation at each Ce was assessed by BIS and OAA/S scores.BIS value and Ce of propofol were recorded and compared between the 2 groups when the patients lost consciousness (OAA/S score =2).Results There was 28 and 30 patients in day-time and nighet-time groups respectively.When Ce =1.2 and 2.0 μg/ml,the BIS values were significantly lower in night-time group than in day-time group.There was no significant difference in BIS value between the 2 groups when Ce =0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the 2 groups,but Ce was significantly lower in night-time group than that in daytime group.Conclusion The hypnotic effect of propofol is greater during night-time than during day-time.

To explore the safety of ropinirole in the treatment of Parkinson′s disease( PD).A total of 221 PD patients participated in a multi-center,12-week randomized,bromocriptine-controlled,double-blind, double-dummy and parallel-group trial.The safety was assessed on the basis of adverse reactions , blood pressure,pulse,laboratory parameters and electrocardiography recordings.The incidence of adverse reaction was 34.9%in ropinirole group and 34.8% in bromocriptine group.And the frequency of adverse reactions had no inter-group statistical significance (χ2 =0.000,P=0.995).Ropinirole has an excellent profile of safety in the treatment of Chinese PD patients.

One hundred patients with Parkinson's disease (PD) aged 60 and above treated with levodopa were enrolled in this cross section study.The general conditions,medication,unified Parkinson's disease rating scale (UPDRS) scores and the incidence of levodopa-induced dyskinesia (LID) were documented.The incidence rate of LID in this group of PD patients was 37.0％ (37/100).The incidence was significantly higher in patients with levodopa treatment ≥ 4 years than that in patients with levodopa treatment ＜ 4 years (55％ vs.26％,x2 =8.770,P =0.003).The incidence rate ofpeak dosage dyskinesia in tremor-dominant PD patients was lower than that in rigidity-dominant PD patients(x2 =4.399,P =0.036).The incidence rate of LID was correlated with the duration of levodopa therapy.Amantadine may reduce the incidence of off dystonia.

Objective To compare the hypnotic effects of propofol administered by target-controlled infusion (TCI in daytime and nighttime,in order to explore the effect of circadian rhythm on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients,aged 18-55 years,with the body mass index (BMI) of 18.5-24.9 kg/m2,undergoing emergency minor hand surgery were divided into two groups according to the time of the day when they received TCI of propofol:daytime group (from 07:01 to 19:00) and nighttime group (from 19:01 to 07:00).The pharmacokinetic parameters proposed by Schnider et al.which suggested the effect-site concentration (Ce) was used.Four Ces of propofol were set at 0.8,1.2,2.0 and 4.0 μg/ml,respectively.Ce was increased step by step and each Ce was maintained for 5 minutes.The level of sedation at each Ce was assessed by bispectral index (BIS) and observer's assessment of alertness/sedation (OAA/S) scores.BIS values and Ces of propofol were recorded and compared between the two groups when the patients lost consciousness (OAA/S score =2).Results There were 28 and 30 patients in daytime and nighttime groups,respectively.When Ces were 1.2 and 2.0 μg/ml,the BIS values were significantly lower in the nighttime group than in the daytime group.There was no significant difference in BIS values between the two groups when Ces were 0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the two groups,but Ce was significantly lower in the nighttime group than in the daytime group.Conclusion The hypnotic effect of propofol is greater during night time than during day time.

Objective To detect gene expressions of Uroplakin (UP) family in interstitial cystitis (IC). Methods Gene expression of UP Ia, Ib, II, III, and III-δ4 was quantitatively measured in bladder biopsy samples from patients with IC (n=29) and control subjects (n=16) using real-time RT-PCR. Results UP III-delat4, a splicing variant of UP III, was significantly up-regulated to 4.80 in IC samples (P<0.001). When IC patients were divided into two groups, one with and one without ulcerative changes, the UP Ia, UP Ib, UP II, UP III and III-δ4 genes were significantly up-regulated to 4.99, 3.31, 2.75, 15.38, 11.48 in nonulcerative IC patients, but decreased to 0.04, 0.29, 0.09, 0.11, 0.34 in ulcerative IC patients (P<0.01). The up-regulation of UP III-δ4 was more prominent than that of UP III: 26.5-fold versus 5.6-fold compared to the median values of normal subjects. Conclusion Although the clinical implications of the over-expression of UP III and III-δ4 in non-ulcerative IC bladders remain to be clarified, from the diagnostic viewpoint, UP III-δ4 is a potential marker for identifying nonulcerative IC.

Objective To conclude the results of electrophysiological (EP) mapping and ganglianated plexis (GPs) ablation during the minimally invasive atrial fibrillation (AF) surgery.Methods During the period of Sep 2007 to May 2010 to-tally 185 paroxysmal atrial fibrillation cases were recruited receiving the minimally invasive AF surgery with video assistance.The EP mapping was used to test the dual direction block after ablation and the distribution of GPs was recorded.The sinus rhythm rate was followed up after surgery.Results All the minimally invasive surgery were performed successfully withoutdeath in the hospital.There was no permanent pacemaker implant and other serious complications.EP mapping results showed92％ pulmonary vein (PV) potential to the left atrium (LA) could be isolated with the dual direction block for the paroxysmal atrial fibrillation cases.And there were 89％ GPs positive,higher rate than the persistent AF.There were more GPs positive in the right PV area than the left and 86％ GPs lied at the LA domain,not the PV orifice.At least 5 or 6 ablation lesions were needed to get the dual direction block and denervation of the GPs.The sinus rhythm rate after surgery after 3,6,12 and 24months is 83.7％,82.4％,85.4％ and 83.9％.The 12 months follow up data showed the cases with more GPs positive (＞6) had 81.3％ sinus rate and the less GPs positive (≤2) group with 52.6％.Conclusion The EP mapping and GPsablation techniques during the minimally invasive AF ablation surgery could get good sinus rhythm rate during the long term follow up.

Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.