OBJECTIVETo observe the clinical effect of Chinese medical (CM) syndrome differentiation based Chinese herbs and recombinant human tumor necrosis factor receptor II-antibody fusion protein (etanercept) for treating ankylosing spondylitis (AS) patients.

METHODSTotally 35 AS patients were treated with syndrome differentiation based Chinese herbs and etanercept. Reinforcing Shen and strengthening Du channel, activating meridians to stop pain was principle used in syndrome differentiation based treatment. Etanercept was subcutaneously injected, 25 mg each time; twice per week for the first three months and once a week for the latter three months. The clinical efficacy was evaluated after 3 and 6 months of treatment. Meanwhile, ASAS20 and ASAS50 standards arriving rates were also observed. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), visual analog score (VAS) for spine pain, VAS for night pain, patient global assessment (PGA), VAS for physician global assessment, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, cervical rotation, Schober improved test, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were observed before treatment, 3 and 6 months after treatment.

RESULTSCompared with before treatment, BASDAI, BASFI, VAS for spine pain, night pain, physician global assessment, PGA, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, Schober improved test, ESR, and CRP all decreased after 3 and 6 months of treatment, with statistical difference (P < 0.05). Cervical rotation also decreased after 6 months of treatment, with statistical difference (P < 0.05). Compared with 3 months of treatment, total effective rate of CM syndrome, ASAS20 and ASAS50 standards arriving rates increased after 6 months of treatment, with statistical difference (P < 0.05). There were statistical differences in all indices mentioned above between after 3 months of treatment and after 6 months of treatment (P < 0.05).

CONCLUSIONSyndrome differentiation based Chinese herbs combined etanercept could alleviate inflammatory reaction favorably, control the progression of active AS, and improve joint functions.

Disease Progression ; Drugs, Chinese Herbal ; therapeutic use ; Etanercept ; therapeutic use ; Humans ; Pain ; prevention & control ; Pain Management ; Spondylitis, Ankylosing ; drug therapy ; Treatment Outcome

Adolescent ; Blood Glucose ; analysis ; Diabetes Complications ; Diabetes Mellitus ; diagnosis ; Female ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; Treatment Outcome

Deafness ; diagnosis ; genetics ; Genetic Counseling ; Humans

Objective To analyze the effects of puerperium pelvic floor muscle training on pelvic floor muscle strength and its clinical significance. Methods One hundred postpartum women were included, with full-term singleton pregnancies and with complete follow-up records from Obstetrics Department of Peking University First Hospital between March 1, 2013 and October 31, 2013. Women with vaginal birth and cesarean birth commenced pelvic floor muscle training twice a day from 24 and 72 h after delivery, respectively. According to the different training frequencies, the subjects were divided into three groups: never-training group, occasional-training group (<6 times per week) and regular-training group (≥6 times per week). All patients received pelvic floor muscle strength measurement 6-8 weeks after parturition. And the strength of type Ⅰ and type Ⅱ pelvic floor muscle fiber was divided into 0, Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴgrade. The abnormal strength of typeⅠand typeⅡpelvic floor muscle fiber standed for the grades lower thanⅢ. We compared the general conditions, delivery modes and abnormal ratio of type Ⅰ and type Ⅱ pelvic floor muscle fiber among the three groups, analyzed the relativity between the level of pelvic floor muscle fiber strength and pelvic floor muscle training frequency, and analyzed the influential factors of pelvic floor muscle fiber strength. Statistical analyses were performed by one-way ANOVA, rank-sum test, Pearson χ2 test, Kruskal-Wallis nonparametric test, Nemenyi test, Spearman rank correlation analysis and multivariate Logistic regression analysis. Results There was no statistical difference in age, gestation at delivery, parity, body mass index before delivery, neonatal birth weight and delivery mode among the never-training group (21 cases), occasional-training group (30 cases) and regular-training group (49 cases) (all P > 0.05). There was no statistical difference in labor time of first, second and total stage and episiotomy rate among the vaginal birth cases of the three groups. The abnormal ratio of type Ⅰ muscle fiber strength among the three groups was 100% (21/21), 77% (23/30) and 6% (3/49), respectively, while that of type Ⅱ muscle fiber strength was 100% (21/21), 53% (16/30) and 20% (10/49), respectively. And there were significant statistical differences among the three groups (F=119.16 and 77.84, both P<0.01). Spearman rank correlation analysis indicated that the level of typeⅠand typeⅡmuscle fiber strength had a significant positive correlation with pelvic floor muscle training frequency (r=0.88 and 0.79, both P<0.01). Multivariate Logistic regression analysis showed that pelvic floor muscle training was an influential factor for pelvic floor muscle strength level (95%CI:0.000-0.193, P<0.01). Conclusions Puerperium pelvic floor muscle training can help enhance the tension force of pelvic floor muscle, might benefiting the postpartum recovery of pelvic floor muscle function.

Objective To study the impact of the peripheral neurotomy method combined with rehabilitation exercise on gross motor function and balance function of children with cerebral palsy.Methods Matched pair design was used in the study.Thirty children with spastic cerebral palsy hospitalized from May 2011 to Nov.2013 suffering from peripheral neurotomy were assigned as study group,who were conscious and treated by peripheral neurotomy com bined with rehabilitation exercise.In the meanwhile,30 children inpatients at the same time were employed as the control group,who were similar in age and symptoms,with the same gender and the same Gross motor function classification (GMFCS) grade,and the controls were treated only with ordinary rehabilitation exercise.Modified Ashworth score,Gross Motor Function Measure (GMFM) D and E regions scores,physicians rating scale score in the 2 groups were recorded after treatment for 2,4,6,8,10 weeks.Repeated measure analysis of variance method was introduced to analyze the differences between the 2 groups in improved Ashworth muscle tension,gait improvement,gross motor function and balance function.Results The study group was superior over the control group in muscle tension reduction (F =8.177,P =0.006) and gait improvement(F =24.284,P =0.000).The 2 groups were not different statistically in D region evaluation of GMEM (F =0.072,P =0.790) and E region evaluation of GMFM (F =0.000,P =0.985) ; For Berg balance scale,the 2 groups had also no difference(F =0.150,P =0.700).Conclusions Both peripheral neurotomy method combined with rehabilitation exercise and the ordinary rehabilitation exercise method both could improve the gross function and the balance function.Furthermore,the former was superior over the latter in muscle tension reduction and gait improvement.

Objective To discuss the diagnostic value of dynamic contrast-enhanced MRI in differentiating vertebral metastatic tumors from benign deseases after studying the early changes of signal intensity.Methods Twenty patients were scanned by dynamic contrast-enhanced MRI.The parameters of signal intensity were measured and calculated,and time-intensity cures(TICs)were drawn.Then,they were compared with those of normal verte- braes,the characteristics were analyzed.Results The parameters of vertebral metastatic tumors:peak signal intensi- ty,signal intensity minimum signal intensity of post-peak,peak slope,initial ratio of enhancement,maximum ratio of enhancement was respectively(50.61?11.38),(46.75?10.23),(0.73?0.12),(0.33?0.08),(1.03?0.31); that of normal vertebraes was respectively(40.53?12.12),(34.72?14.06),(0.31?0.11),(-0.25?0.05), (0.69?0.28);and ten normal cases showed negative in initial percent of enhancement,but only two abnormal ver- tebraes showed that.All of the above had significant statistical difference.Four types of TICs were concluded:early rapid rise and early rapid descent followed by steady phase(type A),persistently rise(type B),rise phase followed by steady phase(type C),rise phase followed by rapid descent phase(type D).TICs of abnormal vertebraes were respec- tively 6,5,5,5 cases;types of normal vertebraes were mainly type C,15 cases.Type A and type B and the type with the characteristic of early rapid descent phase were features of abnormal vertebraes;type C was the feature of normal ones.Conclusions Dynamic contrast-enhanced MRI could quantitatively show the characteristics of early changes of signal intensity of vertebral metastatic tumors,which were significant statistically different from those of normal ver- tebraes.Dynamic contrast-enhanced MRI was worth performing in the early diagnosis of vertebral metastatic tu- mors.

Objective To study the effect of Licofelone,a novel non-steroid anti-inflammatory drug,on the expression of Fractalkine induced by interleukin-18(IL-18) in mesangial cells.Methods Rat mesangial cells were cultured and divided into IL-18 stimulated group,Licofelone-treated group and normal control group.The cells in IL-18 stimulated group were stimulated by 10 ?g/L IL-18 for 24 h.In Licofelone-treated group,ahead of exposure of IL-18 for 24 h,cells were treated with Licofelone in the doses of 10,50 and 100 ?mol/L for 30 min.Additionally,the mesangial cells without treatment of IL-18 and Licofelone were used as normal control group.Reverse transcription-polymerase chain reaction(RT-PCR) was used to measure the level of Fractalkine mRNA.The expressions of Fractalkine protein in every group were detected with enzyme linked immunosorbent assay (ELISA).Results In normal control group,the expression level of Fractalkine mRNA was 179.0?21.0.After exposure of IL-18 for 24 h,the level of Fractalkine mRNA was 1 220.1?185.7,which was higher than that in normal control group (t=9.646 P

Targeting the key questions in the scale development process of TCM syndrome, such as the definition of the concept, the construction of the theoretical framework, the quantitative classification of the items, the rational use of the statistical methods and so on, this article put forward that on the basis of carefully distinguishing the three concepts of syndrome diagnosis, syndrome evaluation and disease diagnosis, and based on TCM dialectical thinking and mathematical validation to build theoretical framework. A scientific and reasonable quantitative classification method was established based on the reliability and validity as indexes. Non-linear intelligent mathematical statistics and symptomatic index groups were used to analyze the ideas and methods of data mining, with a purpose to improve and perfect the methodology of the development of syndromes scale and to improve the establishment and application of the syndrome scale.

Objectives To screen the differentially expressed proteins in serum of population chronically exposed to arsenic in drinking water,thus to provide candidate protein biomarkers for arsenic exposure and arsenicosis.Methods Subjects were selected from the drinking water type of endemic arsenicosis areas in Shanxi province,China.Demographic characteristics,history of arsenic exposure,cigarette smoking,alcohol drinking,health and other information were collected using questionnaire.The subjects were divided into low-arsenic group (with arsenic in drinking water ＜ 10 μg/L),medium-arsenic group( 10 - 50 μg/L),high-arsenic group( ＞ 50 μg/L),and arsenicosis group(the drinking water with arsenic ＞ 50 μg/L was replaced by low arsenic water ＜ 10 μg/L).The number of cases in each group was 30.The arsenicosis patients were diagnosed according to “Standard of Diagnosis for Endemic Arsenism” (WS/T 211-2001 ).With the principle of informed consent,blood samples were collected.Differentially expressed serum proteins of different arsenic exposure groups and arsenicosis group were screened by two-dimensional differential gel electrophoresis(2-D DIGE),and further identified by mass spectrometry (MS).Results An average of (1299 ± 167) protein spots were identified in 6 gel images and 688 protein spots were discovered repeatedly in at least 5 gels.There were 33 protein spots differentially expressed among low-,medium- and high-arsenic groups P ＜ 0.01).Fifty four protein spots were significantly different among low-,medium-,high-arsenic exposure groups and arsenicosis group(P ＜ 0.01 ).Twenty five protein spots were selected for MS analysis,and13 protein spots were identified.Compared with low-arsenic group,the expressions of apolipoprotein A-Ⅳ,retinol binding protein,and estrogen receptor hypothalamic isoform in medium- and higharsenic exposure groups were down regulated,and the expressions of component 4A and 4B were up regulated.Compared with low-,medium- and high-arsenic groups,the expressions of beta-2-glycoprotein Ⅰ,Keratin 1,hemopexin,complement C1r subcomponent,and ficolin-3 in arsenicosis group were down regulated,and the expressions of pigment epithelial-differentiating factor,alpha-1-microglobulin and carboxypeptidase N catalytic chain were up regulated.Conclusions Chronic arsenic exposure can significantly change population's serum protein expression.Differentially expressed proteins in arsenicosis patients will not decline with the decline of arsenic in a short term.Whether or not the differentially expressed proteins identified in this study can be used as biomarkers for arsenic exposure and arsenicosis needs to be further verified.

OBJECTIVETo investigate the pathogenesis of globozoospermia, fertilization ability of round-headed sperm, and the application value of assisted oocyte activation in intracytoplasmic sperm injection (ICSI) for the wives of glohozoospermia men.

METHODSWe collected oocytes from the wives of 2 globozoospermia patients and randomly divided them into two groups after ICSI to receive calcium ionophore A23187-activation and conventional treatment, respectively. We reviewed the relevant literature published at home and abroad, and discussed the etiology of globozoospermia, fertilization ability of round-headed sperm, and treatment options for this disease.

RESULTSQuality embryos were obtained in the A23187-activation group while no fertilized oocytes, oocyte cleavage, quality embryos, or blastular formation were found in the conventional treatment group. Both women achieved pregnancy and gave birth to healthy neonates after transfer of the quality embryos from the A23187-activation group.

CONCLUSIONCalcium ionophore A23187 can be applied to ICSI for the wives of globozoospermia men and bring about desirable clinical outcomes. Meanwhile, attention should be paid to its safety.

Calcimycin ; therapeutic use ; Calcium Ionophores ; therapeutic use ; Female ; Humans ; Infertility, Male ; drug therapy ; Male ; Oocytes ; Pregnancy ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; abnormalities