Objective To explore the clinical feature and treatment method of the dopa responsive dystonia (DRD).Methods To observe the clinical manifestation,auxiliary test and the response on the treatment of levodopa in 6 patients from 4 families.Results 1 patient for childhood onset and 2 patients for adolescent onset with DRD, first symptom showed leg dystonia and toe walking with difficulty, whereas 3 patients of adult onset showed tremor and rigidity. Babinski sign was presented in 3 cases. Diurnal fluctuation in symptom severity occurred in all cases. All patients had obvious response to small dose levodopa in 1～6 days. In 2 cases, the effect was maintained for 7 years, without increasing the intake of levodopa.Conclusion The clinical feature of DRD was more remarkable,the therapeutic effectiveness of levodopa was rapid,sustained and obvious.

Osteoporosis complicated with fracture is a common and severe condition. This paper summarizes present advances and new concepts in its treatment. Since the secondary osteoporosis will likely develop after fracture treatment with immobilization, more and more bone mass will get lost in addition to primary osteoporosis. A vicious cycle will be established and influence the fracture healing. Therefore, the key to the treatment is to block the vicious cycle to stop or decrease the bone loss. As a routine measure, to do exercises and weight- bearing activities as early as possible is as important as to take medicines for osteoporosis treatment. Stable internal fixation and prosthetic replacement should be firstly chosen for treatment of most fractures. In drug treatment, calcitonin, bisphosphonate (alendronate), HRT (Livial), vitamins D2 and D3, and calcium are indicated.

Objective:To study the psychological he alth of the laid-off workers and its affecting factors in Changsha City. Methods:675 laid-off w orkers and 669 employed workers were interviewed with the Trait Coping Questionn aire (TCQ),the Social Support Rating Scale (SSRS),and the Life Event Scale(LES) .Demogra phic ,psychological and psychosocial factors that may affect psychological healt h of the subjects were analyed by stepwise regression method.Results: Psychological health condition was significantly affected by age ,marital status, educational level, economic status and duratio n of laid-off.Multiple stepwis e re gression analysis revealed that the major factors affecting psychological health were coping styles,recent life events ,perceived health impairment,educational level, economic pressure, and individual income.

Objective To determine the inhibitory effect of the synthetic Nrf 2 siRNA on the expression of Nrf2 gene in human laryngeal cancer cell lines Hep2 and to investigate the effects of Nrf2 siRNA on chemosensitivity of laryngeal carcinoma to cisplatin by detection growth and apoptosis in Hep2 cells .Methods The recombinant plas‐mid control siRNA and Nrf2 siRNA were transfected into Hep2 cells ,and western blot analysis of Nrf2 expression in Hep2 cells was performed 48 h after transfection .In order to determine whether Nrf2 siRNA can enhance the sensi‐tivity of Hep2 laryngeal cells to cisplatin ,we treated Hep2 cells with different concentrations of cisplatin after 24 h , and evaluated these cells for proliferation ,and apoptosis .CCK - 8 and flow cytometry assay were used for determi‐nation of cells proliferation and apoptosis in Hep2 cells .We calculated the inhibition rate and IC50 of the cell after treating with different concentrations of ciplatin .Results The laryngeal carcinoma cell stain Hep2 was transfected by Nrf2 siRNA and control siRNA respectively .The result of western blot showed the Nrf 2 expression was signifi‐cantly impeded at protein levels .CCK - 8 assay showed the proliferation of Hep2/Nrf2 siRNA and Hep2/ control siRNA was inhibited to 35 .55% to 46 .07% at 24 h respectively after treating with 4 μg/ml cisplatin .The chemo‐sensitivity to cisplatin in Hep2/Nrf2 siRNA was markly increased compared with Hep2/control siRNA .The IC50 in Hep2/Nrf2 siRNA was 5 .27 μg/ml contrast to 8 .107 μg /ml compared in Hep2/control siRNA .The result of flow cytometry analysis showed the apoptosis rate after Nrf 2 depletion was increased from 17 .1% to 26 .6% .Conclusion This study demonstrates that Nrf2 siRNA effectively inhibits Nrf2 gene expression in Hep2 cells leading to growth suppression and induction of apoptosis in Hep2 cells under cisplatin .The use of siRNA technique may pro‐vide a novel therapeutic approach to treat laryngeal cancer for enhance chemosensitivity .

Objective To investigate the clinical effect of oxytocin combined with misoprostol in preventing postpartum hemorrhage of cesarean section.Methods 86 patients with cesarean section who were treated and diagnosed in our hospital from March 2016 to October 2016 were randomly divided into experimental group and control group according to the time of hospitalization.The patients were randomly divided into experimental group and control group.43 cases.Preoperative two groups of patients with different treatment methods for science introduction, so that pregnant women mental stress to relax, ease the heart anxiety and nervous mood.On the basis of conventional treatment, the experimental group received the uterine injection of oxytocin, while the patients under the tongue to take drugs;the control group of patients with oxytocin injection for preventive treatment.Results In the two groups, 32 cases were effective in the experimental group, 1 case was ineffective, the effective rate was 97.67%, compared with 10 cases in the control group, 16 cases were ineffective, the total effective rate was 62.79 % was statistically significant(P<0.05).Conclusion Oxytocin combined with misoprostol has a good therapeutic effect on the postpartum hemorrhage in the prevention and treatment of uterine bleeding.Compared with the original conventional treatment, there is a high efficiency, and the patient's comfort is Higher to improve, to a certain extent, is the more excellent clinical treatment.

Objective To investigate the incidence of six virulence determinants and two phenotypes in clinical strains of Enterococci.Methods PCR and dot blot were used to detect the six virulence determinants in 145 clinical isolates. The two phenotypes , including ?-hemolysis and gelatin hydrolyze ,were performed on agar plate containing 7% rabbit blood and Todd-Hewitt agar plate supplemented with 3% gelatin, respectively.Results In E. faecalis and E. faecium ,the rates of detection of the six virulence determinants were gelE72.9% vs 30.6%,efaA79.2% vs 36.7%,cylA54.2% vs 34.7%,esp34.4% vs 36.7%,agg 18.8% vs 0, ace28.1% vs 0, respectively; the ? hemolysis was 45.8% vs 20.4%,the gelatin hydrolyze was 35.4% vs 16.3%.Conclusions E. faecalis possess more virulence determinants and phenotypes than E. faecium do. The virulence determinants are more common among the strains isolated from urine sample than those from among sputum . Most of the E. faecalis carry virulence determinants of gelE,efaA and cylA .

Objective To examine the effect of metformin on serum thyrotropin (TSH) level in diabetic patients with subclinical hypothyroidism (SCH).Methods The long-term effects of metformin on thyroid axis hormones were assessed in 55 diabetic patients with primary SCH who were untreated with L-T4(study group),as well as in 31 diabetic patients with normal thyroid function (control group).According to using metformin or not,patients of study group were divided into the metformin group (group 1,n =28),and the non-metformin group(group 2,n =27).Serum TSH levels were compared between baseline and follow-up in patients receiving metformin treatment.Results After 30 weeks of metformin administration,a significant TSH decrease(t =2.91,P ＜ 0.05) was observed in group 1 [from(6.98 ± 1.92) to(2.44 ± 0.61) mIU/L].After stopping metformin therapy,the level of TSH at 52 weeks fol low-up was back to the baseline level [(6.99 ± 1.76) mIU/L,P ＞ 0.05].There was no significant difference in TSH level between baseline and after 30 weeks follow-up in group 2[(6.01 ± 1.63) mIU/L vs(6.21 ± 1.71) mIU/L,P ＞0.05].At the end of 30 weeks follow-up,no significant differences were found in body mass index and thyroid func tion in both metformin group and non-metformin group.In control group,metformin administration for 30 weeks had no effect on TSH level(P ＞ 0.05).Conclusion Metformin administration influences TSH without change of FT4 level in type 2 diabetic patients with primary SCH.

Increasing cerebral blood flow in ischemic penumbra helps to promote neurological function recovery.Fibroblast growth factor is closely associated with angiogenesis after stroke;it may improve cerebral blood flow in ischemia penumbra,and thus contributes to neurological function recovery.Its application will become a novel approach in the treatment of ischemic stroke.

Objective To investigate the cognition and behaviors of sun-protection and the facial photoaging in a Nanjing population, and to analyze the relationships between them. Methods The objects being investigated in Nanjing (n=974) were divided into 10 groups according to age. The ordinary information, knowledge and behavior of sun-protection and Glogau photoageing type of face were studied by questionnaires. The results were analyzed by a logistic regression model to select the related factors to photoageing. Results The risk of skin photoageing increased with age. Most of the 46-65 years old crowds were type Ⅲ photoageing. Most of the objects being investigated had some knowledge and active awareness of sun-protection and could use some ways to protect themselves from sun. However, most people did not use the sunscreen correctly. Those who had higher level awareness and knowledge of sunprotection suffered less risk from skin photoageing. Sunbath without sunscreen for a long time outside activity was a high risk factor of development to skin photoageing. Shade, broad-brimmed hat and sun-protection in autumn were the protective factors. Conclusion Active awareness and correct methods could help prevent skin photoageing. In order to avoid the damages to skin from ultraviolet efficiently, the accurate ways of using sunscreens should be well understood.

OBJECTIVETo summarize and analyze rules for acupoint selection and prescription composition in clinical literature regarding acupuncture for polycystic ovary syndrome (PCOS).

METHODSCHKD, VIP and Wan-fang databases were retrieved. The clinical literature data included in the study was collected. The descriptive statistical analysis was conducted on the main acupoints, main meridians of main acupoints, distribution of main acupoints, application of special points and rules for acupoint composition.

RESULTSFifty-two articles were included, involving 55 main acupoints with a total frequency of 375. The most frequent acupoints of acupuncture for PCOS were Sanyinjiao (SP 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zhongji (CV 3) and Qihai (CV 6). The meridians of main acupoitns were conception vessel, spleen meridian of foot-taiyin and stomach meridian of foot-yangming. The main acupoints were distributed in the lower abdomen, lower limbs and back. In the special points, the use of front-mu points, five-shu points and back-shu points was more frequent. The prescription was usually consisted of 5 to 7 acupoints, (6. 9 ± 3. 6) acupoints in average.

CONCLUSIONIn the modern treatment of acupuncture for PCOS, Sanyinjiao (SP 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zhongii (CV 3) and Qihai (CV 6) are most used. With the theories of meridian and zang-fu as essential references, the acupoint selection is based on disease differentiation and meridian circulation. Additionally, the methods for selecting the adjacent points and the distant points are adopted.