Objective To investigate the effects of fruit potassium supplement on hypokalemia at in the perioperative period of percutanous coronary intervention(PCI)? Methods Ninety cronary herat disease patients with hypokalemia undergoing PCI during July to December 2011 involved the study? Since admission,the patients were administered with oranges and bananas each 500 g daily until the third day after PCI,on the basis of oral administration of potassium? Serum potassium was assessed in all patients at time points of the day at PCI,the first day and third day after PCI? Results The time range for the patients to take potassium supplement by eating fruits was 12-45 hours,averaged(28?84 ± 11?70)hours? The serum potassium levels on days 1 and 3 were significantly higher than that on the day for the admission(P < 0?05 for both)and even maintained at the normal level? Conclusion The oral complement of potassium by eating bananas and oranges can help patients to correct and prevent hypokalemia during the perioperative period of PCI?

ObjectiveTo investigate the effects of budesonide inhaled on the levels of interleukin-8 (IL-8), C-reactive protein (CRP) and procalcitonin (PCT) in bronchoalveolar lavage fluid (BALF) of patients with AECOPD treated by using inhalation of budesonide in different doses or by using injection of dexamethasone. MethodsNinety AECOPD patients with mechanical ventilation in ICU ward were enrolled from Jan. 2008 through Sep. 2010. All patients were selected in this study as per the criteria of AECOPD set by the Chinese Medical Association. Ninety AECOPD patients treated with routine therapy were randomly (random number) divided into 3 groups. The patients of group A were given budesonide 2 mg inhaled 1 time/d. The patients of group B was given budesonide 4 mg inhaled 1 time/d. The patients of group C had dexamethasone 2. 5 mg injected 1 time/12h. The changes of IL-8, PCT and CRP in both BALF and serum were respectively detected in three groups at the beginning of treatment, and 3 days and 7days after treatment. The detected data of variables were analyzed by SPSS 13.0 package. ResultsThe level of IL-8 in BALF declined in 3days and 7days after treatment, and the magnitude of decrease in the following order:Group B ( budesonide 4mg/d) ＞ Group A ( budesonide 2 mg/d) ＞ Group C ( intravenous dexamethasone)with significant differences among them ( P ＜ 0. 05 ). The decrease in IL-8 in serum showed the similar trend, but there were no statistical differences among them. The CRP and PCT in both BALF and serum had no significant changes. There was a correlation between the concentration of IL-8 in BALF and the duration of mechanical ventilation.Conclusions The treatment with the inhalation of budesonide could more significantly reduced the IL-8 level in BALF compared with intravenous dexamethasone, whereas the CRP and PCT were not changed. The dynamic changes of IL-8 in BALF might be used as an indicator of prognosis in AECOPD patients with mechanical ventilation.

Cultivation of medical students' clinical practice is an important part of higher medical education.At present,the imbalance of teachers structure and the old and single teaching mode and method etc,have had a great impact on the clinical practice of medical students.Only by strengthening the construction of clinical teachers,establishing access and assessment system of clinical teachers,carring out diverse clinical education reform,such as Problem-Based Learning ( PBL )and Case-Based Learning ( CBL ),etc,and fully mobilizing the initiative of students and enthusiasm for learning to reach teaching and learning complement in virtuous circle.can we truly improve the quality of clinical practice.

Objective To explore the effect of Toll-like receptor 4 (TLR4) on the peripheral blood mononuclear cells(PBMCs) in the development of rheumatoid arthritis (RA) by inducing the differentiation of Th17 cells.Methods Forty two subjects were recruited to the study,including 22 patients with RA and 20 healthy controls (HC).The percentage of circulating Th17 cells were analyzed using flow cytometry.PBMCs were stimulated with LPS for two days.TLR4 mRNA of the PBMCs and the concentration of IL-6 and TNF-α in the supernatants were analyzed with the real-time qPCR and ELISA respectively.Supematants was then used for CD4+ cord blood mononuclear cells (CBMCs) culture,and IL-17 in the supernatants and the expression of IL-17 mRNA in cells were detected by ELISA and real-time qPCR respectively.The statistical analysis was carried out with t-test.Results The TLR4 mRNA expression in the PBMCs and the percentage of circulating Th17 ceils of RA patients were significantly higher than that of the HC group (P＜0.01).Stimulated by LPS,the expression of TLR4 mRNA increased 3.5 times in the RA group but decreased 0.11 times in the HC group.LPS also increased cytokines production in both groups,while PBMCs from RA patients produced more IL-6 and TNF-α than the cells from healthy subjects (P＜0.01).Compared to the HC group,the IL-17 mRNA expression and IL-17 secretion of CD4+ CBMCs induced by the supematants of RA patients' PBMCs stimulated with LPS was significantly higher(P＜0.01 ); but there was no significant difference between the RA group and the HC group without LPS stimulation (P＞0.05).Conclusion The expression of TLR4 on PBMCs from patients with RA and its response to LPS stimulation are increased,and it has demonstrated high capability in inducing the differentiation of Th 17 cells.

OBJECTIVETo observe the clinical effect of float needle therapy combined with reperfusion activity for pain induced by cyclomastopathy.

METHODSThirty-five female patients with cyclomastopathy were randomly divided into a comprehensive group (18 cases) and a float needle group (17 cases). In the comprehensive group, float needle manipulation was used at the centre of the biceps brachii belly or the ligature between the affected nipple and breast nodule, about 4 cm beside the exterior margin of the breast, and the reperfusion activity of the affected upper limb and breast was combined. In the float needle group, simple float needle therapy was adopted. In the two groups, treatment was started 7 ± 3 days before menstruation, once every other day. After 3-time treatment, the changes of short form McGill Pain Questionnaire (SF-MPQ) scores before and after treatment, the time of pain relieved during the first treatment, recurrence in 3 months after treatment and the adverse reaction were observed. Also, the clinical effects of the two groups were compared.

RESULTSImmediately at the end of the first treatment,after 3-time treatment and while followed up for one month, each item score and the total score of SF-MPQ were decreased apparently than the scores before treatment (all P < 0.05), and all the scores mentioned above of the comprehensive group were declined more obviously than those of the float needle group (all P < 0.05). The time of pain relieved during the first treatment of the comprehensive group was much shorter than that of the float needle group [(94.72 ± 33.67) s vs (162.06 ± 29.16) s, P < 0.01]. The recurrence rate of the comprehensive group in 3 months after treatment was 5.9% (1/17), which was better than 20.0% (3/15) of the float needle group (P < 0.01).

CONCLUSIONFloat needle therapy combined with reperfusion activity and simple float needle therapy can both safely and effectively improve cyclomastopathy, and the combination therapy is better than simple float needle therapy in the aspects of pain relieving effect at once and the long term effect.

Acupuncture Therapy ; Adult ; Breast Diseases ; pathology ; therapy ; Female ; Humans ; Hyperplasia ; Mammary Glands, Human ; pathology ; Middle Aged ; Needles ; Pain Measurement

BACKGROUND:The hemodynamics changes of aneurysm provide the basis for aneurysm treatment and ruptured aneurysm prevention, while finite element analysis is a good technical means.
OBJECTIVE:To construct the two-way flow-solid coupling model of internal carotid artery aneurysm, and thus simulate its flows.
METHODS:CT angiography data of internal carotid artery aneurysm were recorded with GE Lightspeed 64 spiral CT scanning, and the corresponding three-dimension model was constructed with mimics10.01 software. Then the fluid-solid coupled flow simulations were done depending on Ansys+Fluent software.
RESULTS AND CONCLUSION:The two-way flow-solid coupling model of internal carotid artery aneurysm was built, with the same morphology and anatomy as the three-dimensional CT imaging. In the whole cardiac cycle, the blood flow of aneurysm body was swirl typed and its velocity was slower than that of the aneurysm neck;the deformation, wal shear stress, pressure and von Mises stress of aneurysm wal were the maximum at the neck, and the minimum at the top. Their highest value was at the 0.16 s (rapid ejection period), and their lowest value at the 0.74 s (relaxation period). On the basis of CT angiography data, to construct the two-way flow-solid coupling model of internal carotid artery aneurysm is a simple and practical method. The blood flow simulation of aneurysm is close to the human physiological conditions, and the results wil provide new theoretical basis for the study on the occurrence and development of aneurysm.

Objective To investigate the blood pressure circadian rhythm in patients with IgA nephropathy by ambulatory blood pressure monitoring and explore its role in the disease progression. Methods A cross sectional study was carried out.Blood pressure rhythm was studied by ambulatory 24-hour monitoring with a portable oscillometric recorder in selected patients with primary IgA nephropathy.The term dipper was described as blood pressure during night dropped at least 10％ below daytime blood pressure.The term non-dipper referred to those in whom the nocturnal decline in blood pressure was less than 10％.Clinicopathological indices between dipper and non-dipper groups were compared. Results Ninety-three patients completed ambulatory blood pressure monitoring among whom 68 (73％) patients were non-dipper.The frequency of non-dipper was 70％,70％ and 81％ in the patients at chronic kidney disease stage 1,2 and 3 or more.The frequency did not differ among these three group patients (P=-0.587).77％ of patients with hypertension and 69％ of patients with normotension were non-dipper (P=0.373).The disappearance of blood pressure circadian rhythm in IgA nephropathy was not influenced by age,gender,blood pressure,proteinuria,renal function and renal pathology lesions.Among the patients who were followed up regularly for more than 12 months (n=54),patients in the dipper group had a trend of slower eGFR decline rate than those in non-dipper group albeit the difference was not significant (P=0.329).Subgroup analysis revealed that in patients with hypertension and non-dipper (n=29),the eGFR decline rate was much faster than that in dipper group[(-6.79±11.58 )vs (-0.34±1.74) ml ·min-1 ·(1.73 m2)-1·year-1,P=0.019]. Conclusions Most patients with IgA nephropathy present disappearance of blood pressure circadian rhythm,even among those at an early stage or without hypertension.The loss of blood pressure rhythm may be associated with a rapid renal function decline rate in those with hypertension.

Abdominal breathing is an effective training method for relaxation.It is applicable for resolving sub-health problems in autonomic nervous malfunction and curing some kinds of psychosomatic disorders.In order to improve its training effect,we develop a kind of abdominal breathing training instrument on the basis of the principle of biofeedback.With both features of biofeedback and breathing training apparatus,it may simultaneously feedback the training effect to the trainer during the abdominal breathing training,and the trainer may regulate his breathing mode for desirable effects.In this paper,the instrument is described in such aspects as the circuit design,composition and clinical application.It is an economical,safe and effective instrument,which can be used in Health Promotion Project.

OBJECTIVETo study retrospectively the clinical efficacy on pediatric recurrent pneumonia treated with point application in summer for the prevention in winter, as well as the relationship of age, sick duration, attack frequency and skin reaction with the clinical efficacy.

METHODSOne hundred and thirty-five cases of pediatric recurrent pneumonia were divided into a one-year group, a two-year group and a three-year group, 45 cases in each one according to the duration of treatment. The acupoints for the application were Dingchuan (EX-B1), Feishu (BL 13), Gaohuang (BL 43) and Danzhong (CV 17) with the same herbal plaster (prepared with rhizome corydalis, semen brassicae, euphorbia kansui and asarum sieboldii at the ratio of 2:2:1:1) on the first day of each of the three periods of the hot season, 2 to 4 h in each treatment. The attack frequency and change rate were observed before and after treatment in the three groups. The clinical efficacy was assessed in the three groups.

RESULTS(1) After treatment, the attack frequency of pediatric pneumonia was reduced apparently in the three groups (all P < 0.01). The result in the three-year group was less than that in the one-year group and the two-year group and the change rate was the highest (all P < 0.01). (2) After treatment, the sick duration was shortened apparently in the three groups (P < 0.05, P < 0.01). The result in the three-year group was the most remarkable, statistically and significantly different as compared with the other two groups (both P < 0.01). (3) The total effective rate in the three-year group was better than that in either of the other two groups [84.4% (35/45) vs 51.1% (23/45, P < 0.01), 84.4% (35/45) vs 71.1% (32/45, P < 0.05)]. (4) The total effective rate in the children aged from 4 to 7 years was better than that in the group aged from 8 to 10 years and the group aged from 11 to 14 years [79. 7% (47/59) vs 71.7% (33/46, P < 0.05); 79.7% (47/59) vs 43.3% (13/30, P < 0.01)]. (5) The total effective rate in the children with the sick duration ≥ 4 year was lower than that in the group with the sick duration <2 years and that 2 to 4 years (both P < 0. 01). (6) The total effective rate in the children with the annual attack frequency of 2 to 4 times was better than that with the frequency ≥ 4 times (P < 0.01). (7) For the cases with skin reaction after treatment, the total effective rate was better than that in the cases without reaction (P < 0.05).

CONCLUSIONThe point application in summer for the prevention in winter reduces the attack frequency of pediatric pneumonia, shortens the sick duration and has achieved the better significant efficacy in the cases of lower age, shorter sick duration, less attack frequency and moderate skin reaction.

Acupuncture Points ; Adolescent ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Pneumonia ; drug therapy ; prevention & control ; Seasons ; Treatment Outcome

Objective To observe the clinical effect of headless compression Screw (HCS)under arthroscope in the treat-ment of patella fracture.Methods Nineteen patients of patella transverse fractures were selected,all of them were treated with HCS fixation under arthroscope,reviewed and followed-up after surgery.Results X-ray examination after surgery of 3 -5 weeks found that the fracture lines blurred or disappeared,and the patella articular surface was smooth without displacement.The healing time of fracture was 8 weeks on average after operation;There was no statistical difference in the range of the knee joint in the af-fected side in (135.42±5.82)°and the contralateral side in (139.38±6.55)°(P >0.05);The knee Lysholm score of the last follow-up was 86-100 points[(93.7±4.14)points],which was significantly higher than the preoperative score of 65.7 (P <0.05);There was no fracture displacement in the period of followed-up,drop of internal fixator,fracture and other complications.Conclusion HCS fixation under arthroscope in treatment of patella fracture is effective.The joint function recovered quickly with less complica-tion.It could be one of the effective methods for the treatment of patella transverse fracture.