OBJECTIVETo compare the differences in the clinical efficacy on insomnia between shujing massage therapy and medication with estazolam.

METHODSEighty patients of insomnia were randomized into a shujing mass age therapy group (40 cases) and a medication group (40 cases). In the shujing massage therapy group, the spreading massage manipulation was applied along the running course of the gallbladder meridian of foot-shaoyang on the temporal area. The pressing and kneading manipulation was done at Yangbai (GB 14), Benshen (GB 13), Toulinqi (GB 15), Zhengying (GB 17), Chengling (GB 18), Shuaigu (GB 8), and Fengchi (GB 20), etc, 1 min at each acupoint. In the medication group, 1 mg estazolam was taken orally half an hour before sleep. The treatment was given once every day in the two groups. After the continuous treatment for 1 month, every dimensional score and the total score in the Pittsburgh sleep quality index scale (PSQI) and the clinical efficacy were evaluated between the two groups.

RESULTSAfter the intervention, the each item score of PSQI was improved as compared with that before treatment in the patients of the two groups (all P<0. 05). The differences in sleep time and the time for falling into sleep were not significant between the two groups (both P>0. 05). In the shujing massage therapy group, the scores of sleep quality, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total score were all lower than those in the medication group (all P<0. 05). The total effective rate was 92. 1% (35/38) in the shujing massage group and was 84. 2% (32/38) in the medication group, indicating the significant difference (P<0. 05).

CONCLUSIONShujing massage therapy achieves the superior efficacy on insomnia compared with the oral administration of estazolam.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Male ; Massage ; Meridians ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

Objective To investigate the effects of adiponectin on angiotensin Ⅱ-induced extracellular matrix production of mesangial cells(MCs) and its possible signaling pathway.Methods RT-PCR and indirect immunofluorescence examination were performed to detect the adiponectin receptors in MCs.Quantitative real-time PCR and enzyme-linked immunosorbent assay (ELISA) were used to observe the effects of adiponectin on angiotensin Ⅱ-induced transforming growth factor β1(TGF-β1) and fibronectin production of MCs.Western blotting was used to measure the ratio of p-AMPK to total AMPK.Results(1)Adiponectin receptors 1 and 2 were found in MCs. (2)The up-regulated mRNA and protein expression of TGF-β1 and fibronectin in MCs induced with 10-7 mol/L angiotensin Ⅱ (Ang Ⅱ) was significantly inhibited by 10 mg/L adiponectin (P＜0.05).(3)The p-AMPK/AMPK ratio was significantly increased after incubation with adiponectin for 15 min and 30 min(vs 0 min, P＜0.05), which suggested that adiponectin could activate the AMPK signaling pathway in MCs.The activation of AMPK signaling pathway was blocked by 40 μmol/L compound C, a specific inhibitor of AMPK. (4)The inhibitory effects of adiponectinonangiotensin Ⅱ-upregulatedTGF-β1andfibronectinexpressioninMCswere significantly relieved by 40 μmol/L compound C (P＜0.05).Conclusions There are adiponectin receptors 1 and 2 in MCs.Adiponectin has inhibitory effects on the angiotensin Ⅱ-upregulated TGF-β1and fibronectin expression in MCs.AMPK signaling pathway may play an important role in the effects of adiponectin above-mentioned.

10.3969/j.issn.1000-8179.2013.12.004

Objective To evaluate the effect of mouse nerve growth factor on fracture healing.Methods Cochrane library, Pubmed, EMbase, CNKI,VIP,Wanfang Data and CBM were searched for the randomized controlled trials(RCTs)of mouse nerve growth factor on fracture healing from the date of establishment of the databases to May 2014.Three independent rese archers evaluated the included studies using GRADE,according to recommend classification method of GRADE system by three researchers,crtical evaluated and data extracted of the quality of the included studies,which conform to the quality standard of RCT was analyzed by Meta analysis.The extracted data were analyzed by RevMan 5.0 and GRAED proiler.Results A total 5 trials were discovered and all of these were in Chinese.Compared with conventional treatment was improved a lot[MD =-8.74,95%CI( -9.79,-7.68),P<0.0001].However, adverse drug reaction in patients with mouse nerve growth factor were increased[OR =14.66,95%CI(1.89, 113.99),P=0.01].The both outcomes were low quality in the GRADE system.Conclusion Mouse nerve growth factor can improve fracture healing and the side effects will also increase.

Objective To summarize the experience of tension-free repair for inguinal hernia in the preperitoneal space using modified surgical mesh. Methods From Dec 2008 to May 2010, 134 cases with 138 reducible primary inguinal hernia were randomly divided into two groups. Sixty-seven patients (70 hernias) in the study group underwent tension-free repair in the preperitoneal space by modified surgical mesh, while the control group (67 cases, 68 hernias) underwent Rutkow's herniorrhaphy by surgical mesh.Results Postoperatively 127 cases (95%) were followed up from 2 to 18 months with an average of 9. 2months[64 cases of the test group were followed up with an average of(9 ±4) months, 63 cases of the control group followed up with an average of (9 ± 5 ) months]. There was no recurrence. No significant differences were found between the two groups in the operation time (P = 0. 697), blood loss (P = 0. 318 ),hospital stay (P = 0. 116) and total postoperative complications (P = 0. 080). The visual analogue scale of the study group was lower than the scale of the control group ( P = 0. 048 ). Conclusions Modified surgical mesh is more comfortable in the treatment of inguinal hernia with tension-free repair in the preperitoneal space with a comparative result to Rutkow's herniorrhaphy by surgical mesh.

Objective To evaluate the expression of Gankyrin in gastric carcinoma and preancerious lesions (including chronic atrophic gastritis and gastric epithelial dysplasia)and its clinicopathological significance.Methods Immunohistochemical assay was performed to de-tect the Gankyrin expression in 30 casess of normal gastric mucosa,60 cases of chronic atrophic gastritis,30 cases of gastric epithelial dyspla-sia,and 84 cases of gastric carcinoma.Moreover,the relationship between Gankyrin expression and clinicopathological features of gastric car-cionma was analyzed.Results Gankyrin expression was detected in normal gastric mucosa,chronic atrophic gastritis,gastric epithelial dys-plasia,and gastric carcinoma tissues in varying degrees,and the difference of Gankyrin positive rates was significant in different gastric leions mentioned above (P <0.05).The rate of Gankyrin expression in gastric carcinoma was significantly related with the clinical stage and metas-tasis.There’s no relationship between Gankyrin expression and the age,gender of patients,size,histologic grade of gastric carcinoma.Con-clusion Gankyrin participates in both the carcinogenesis and development of gastric carcinoma.Moreover,Gankyrin is a potential target for the diagnosis,prevention and treatment of gastric carcinoma.

Objective To study whether Hirsutella sinensis (HS) can antagonize aristolochic acid (AA) induced fibrogenesis on human proximal tubular epithelial cells (HKC). Methods HKC were incubated with medium alone, medium with HS 10 mg/L, medium with AA-Na 40 mg/L or medium with AA-Na 40 mg/L and HS 10 mg/L, respectively. After 12 h (for mRNA) or 36 h (for protein) ,cells were lysed,and the mRNA and protein expression level of transforming growth factor-?1 (TGF-?1), connective tissue growth factor (CTGF), tissue inhibitor of metalloproteinase-1 (TIMP-1)and plasminogen activator inhibitor-1 (PAI-1) of HKC were measured by RT-PCR, ELISA (for TGF-?1, TIMP-1 and PAI-1) and Western blotting (for CTGF), respectively. Results The mRNA and protein expression of TGF-?1, PAI-1, CTGF and TIMP-1 were significandy up-regulated by AA-Na 40 mg/L. Compared with the control group, the mRNA expression of TGF-?1,.CTGF, TIMP-1 and PAI-1 was up-regulated to 1.24,1.31,1.27 and 1.36 times,respectively (P

Objective To systematically review articles about therapeutic drug monitoring of vancomycin in Chinese adults, so as to provide a reference of vancomycin trough concentrations for clinical evidence-based medicine.Methods Literature concerning vancomycin therapeutic drug monitoring were electronically retrieved in, CBM, Wanfang data, CNKI and Vip.Furthermore, the articles written in English by Chinese author in PubMed, EMbase were included.All the data were searched from inception of the database or network to Aug.2014.Two reviews independently screened literature according to the inclusion and exclusion criteria, and assessed the quality of literature using the Combieg and NOS.Analyzing the types of studies, the number of therapeutic monitoring of vancomycin, trough serum concentration, clinical outcome and renal function.Results A total of 35 studies including 32 cross-sectional studies and 3 cohort studies were included, all studies were observational studies.3099 patients with 5206 blood concentrations monitoring results were eligible for final analyses in all 32 cross-sectional studies.The rates of trough serum concentration in 5-15 mg/L was 53.6%.Compared with the trough concentrations between 5 and 15 mg/L, clinical cure rate was no significant difference in the trough concentrations of over 15μg/mL.However, the incidence rate was significantly reduced in renal toxicity in 5-15 mg/L trough serum concentration.Conclusions For adults, trough serum concentration of vancomycin should adopt the 5-15 mg/L in China.However, considering lack of high-level evidence, so it needs to be studied further.

The condition of birth defects in our country is very serious,which impose an enormous burdenon the families and society.Under the vision of care ethics,this paper emphasizes understanding and caring,analyzes the ethical dilemma in the prevention of birth defects and puts forward the prevention measures in line with the codes of ethics,aiming at strengthening the practical effect of birth defects prevention work,caring about the physical and mental health of child-bearing female,and promoting social development.

Objective To explore the clinical efficacy of transanal specimen extraction in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 47 patients who underwent Da Vinci robot-assisted anterior resection of rectosigmoid tumor using transanal specimen extraction in the Second Xiangya Hospital of Central South University from March to October 2016 were collected.Excisional intestinal canal was intraoperatively taken out from the anus instead of abdominal minor incision.Observation indicators:(1) operation and postoperative recovery;(2)postoperative pathological examination situations;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients and tumor recurrence or metastasis up to June 2017.Measurement data with normal distribution were represented as (x)±s.Results (1) Operation and postoperative recovery:47 patients underwent successful operations,without conversion to open surgery.Of 47patients,8 underwent coloanal ultralow anastomosis,3 underwent prophylactic terminal ilenm stoma fistulization and 1 underwent intersphincteric resection after turning inside out resectable specimen.Operation time,volume of intraoperative blood loss,time for out-of-bed activity,time to anal exsufflation and time of postoperative drainagetube removal were (222±73)minutes,(21±9)mL,(1.7-±0.8)days,(2.3±l.0)days and (6±5)days,respectively.Among 3 patients with postoperative complications,2 with anastomotic fistula were cured by conservative treatment,and 1 with urinary retention removed urethra catheter at 4 weeks postoperatively.All the 47 patients had good recovery,and duration of hospital stay was (10±4)days.(2) Postoperative pathological examination situations:number of lymph node dissected was 15-± 7,with R0 resection.Tumor pathological diagnosis:rectosigmoid adenocarcinoma was detected in 38 patients (1 with high-differentiated tumor,32 with moderate-differentiated tumor and 5 with low-differentiated tumor),mixed carcinoma in 4 patients,tubulovillous adenoma in 2 patients,mucinous adenocarcinoma in 1 patient,neuroendocrine carcinoma in 1 patient and focal cacinoma in 1 patient.The maximum diameter of tumor was (3.5± 1.5) cm.Postoperative pathological T stage:4,9,18 and 14 patients were detected in stage T1,T2,T3 and T4a.Postoperative pathological N stage:30,8 and 7 patients were detected in stage N0,N1 and N2.Postoperative pathological TNM stage:stage Ⅰ,Ⅱ and Ⅲ were respectively in 11,19 and 15 patients.There was no clinical stage in 2 patients with tubulovillous adenoma.(3) Follow-up:of 47 patients,42 were followed up for 7-15 months,with a median time of 11 months.During the follow-up,38 patients had tumor-free survival,3 had tumor recurrence or metastases and 1 died.Conclusion Transanal specimen extraction is safe and feasible in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor,with minimal invasion and satisfactory short-term outcomes.