Objective To evaluate the therapeutic effect of limb ischemic preconditioning (LIPC) by observing the changes of brain glucose metabolism using positron emission tomography (PET) and statistical parametric mapping (SPM). Methods 40 patients with severe stenotic or occlusion cerebral artery lesions were enrolled and randomized into LIPC group (n=20) and control group (n=20). Brain lesions and cerebral hemorrhagic lesions were excluded after magnetic resonance imaging. The glucose metabolism of patients was analyzed before and after treatment in two groups, respectively, using the methods of radioactivity ratio and SPM. Results There were 5 patients drop-out in the control group. Comparison of the glucose metabolism ratio of the impaired area to the opposite area: LIPC group improved better than the control group (P<0.01) while the control group aggravated heavier than LIPC group (P<0.05). Comparing the glucose metabolism of patients before and after treatment in two groups, respectively, by paired-t test, 1) Setting the glucose metabolism of patients increased after therapy: There were 9 areas activated in LIPC group, including frontal, parietal, temporal, occipital lobes, basal ganglia and thalamus, and the KE=927, while there were only 3 areas activated in the control group, including frontal, parietal and occipital lobes, and the KE=289. 2)Setting the glucose metabolism of patients decreased after therapy: There was no area activated in LIPC group, while there were 2 areas activated in the control group, including parietal and temporal lobes, and the KE=115. Conclusion The improvement of glucose metabolism was observed in cerebral cortex, basal ganglia and thalamus of the patients with severe stenotic or occlusion cerebral artery lesions after LIPC by PET and SPM.

Objective To observe the brain glucose metabolism after limb ischemic preconditioning (LIPC) for ischemic moyamoya disease with positron emission tomography (PET) and statistical parametric mapping (SPM). Methods 62 patients with ischemic moyamoya disease were enrolled and randomized into LIPC group (n=31) and control group (n=31). The glucose metabolism of patients was analyzed with PET before and after treatment in both groups, using the methods of radioactivity ratio and SPM. Results The glucose metabolism ratio improved more in the LIPC group than in the control group (P<0.01), and aggravated less than in the control group (P<0.001). As setting the glucose metabolism increased after treatment, there were 7 areas activated in LIPC group, including frontal, temporal and parietal lobes, and the KE=1121; while there were 5 areas activated in the control group, including frontal and parietal lobes, and the KE=292. As setting the glucose metabolism decreased after treatment, there was only frontal area activated in LIPC group, while there were 8 areas activated in the control group, including frontal, parietal, occipital lobes, and the KE=629. Conclusion LIPC may improve the brain glucose metabolism in patients with moyamoya disease, which can be observed with PET and SPM.

BACKGROUND: Comparing with diabetic nephropathy and diabetic retinopathy, diabetic cardiomyopathy is put forward exceeded later and the research about it was not enough. It is difficult to detect diabetic cardiomyopathy in the earlier period so that it has usually been neglected.OBJECTIVE: To evaluate features of dysfunction of left ventricle in early diabetic cardiomyopathy by Doppler tissue imaging.DESIGN: Completely randomized and controlled experiment.SETTING: Ultrasound Department of General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out at Ultrasound Department of General Hospital of Chengdu Military Area Command of Chinese PLA from March to June 2002. Totally 56 New Zealand rabbits of either gender were selected.METHODS: ① Ten New Zealand rabbits was pulled out randomly from 56 as control group. The rest of 46 New Zealand rabbits were replicated diabetes mellitus by Streptozotocin (STZ), rabbits were absolute diet 18 hours and injected intravenously to ear marginal vein with 65 mg/kg of STZ. Then these rabbits were randomly divided into 4 groups as 2, 4, 6, 8th experimental group, with 10 rabbits in each group. ② Digit ultrasonic cardiogram equipment was used to examined interventricular motion of mitral annulus at 2nd,4th, 6th and 8th week in model groups and comparison group. The parameters such as systolic peak velocity (Sa), preejection period (PEP), local ejection time (ET), systolic mean velocity (Vm) of four various portions in mitral annulus and diastole early period velocity (Ea), diastole later period velocity (Aa), Ea/Aa were determined. ③ SPSS 11.0 was used for statistical analysis,one-factor analysis was adopted to compare difference of groups.MAIN OUTCOME MEASURES: The motion of lateral wall and posterior interventricular septum at mitral annulus were estimated by PW-DTI.RESULTS: Among 56 rabbits, 50 entered the final analysis and other 6 were lost because of failure modeling. Diastole dysfunction of left ventricle was discovered in STZ-inducod diabetic rabbits detected by tissue Doppler imaging at the 4th week. It showed that not only the tite of early period of diastole peak velocity (Ea) in mitral ring lateral wall and post-interval of left ventricle was reduced, but also the tite of Ea/Aa was reduced notably (P ＜ 0.05). Systolic dysfunction of left ventricle was discovered in STZ-in-duced diabetic rabbits detected by tissue Doppler imaging at the 6th week.It showed that local contraction peak velocity (Sa) of lateral wall and postseptum of mitral ring was decreased strikingly (P ＜ 0.05). Mean systole velocity of four various parts of mitral ring (Vm) was reduced at the 6th week (P ＜ 0.05). Pre-ejection period time (PEP) at post-septum and ejection time (ET) was elongated at lateral wall at the 8th week (P ＜ 0.05).CONCLUSION: ① Diastolic dysfunction of left ventricle is characterized by decrease of early period of diastole peak velocity and the tite of Ea/Aa.② Systolic dysfunction of diabetic cardiomyopathy is characterized by decrease of local contraction peak velocity and elongation of pre-ejection period time and ejection time.

Objective:To observe the impacts of herb-partitioned moxibustion,warm moxibustion and electroacupuncture on the basic fibroblast growth factor(bFGF)and collagen type Ⅰ(Col Ⅰ)in colons of rats with Crohn' disease(CD),and discuss the mechanism of acupuncture therapy on the intestinal fibrosis in CD.Methods:The model rats were developed by TNBS as multiple proinflammatory method.The rats were randomly divided into 5 groups:a normal group,a model group,a warm moxibustion group,an electroacupuncture group and a herb-partitioned moxibustion group.The treatments were carried out at Tianshu(ST 25)(bilateral)and Qihai(CV 6)in different treatments.The immunohistochemistry was used to detect the expression position of Col Ⅰ and bFGF.Results:The expressions of Col Ⅰ and bFGF in colons of rots in the model group significantly increased(compared with the normal group,P<0.01).After the herb-partitioned moxibustion,warm moxibustion and electroacupuncture,the expressions of Col Ⅰ and bFGF reduced markedly in the rats with CD(P<0.01).The expression of bFGF and Col Ⅰ in the colons had an obvious correlation in the Spearman rank correlation analysis.Conclusion:Acupuncture treatment reduced the abnormally high levels of expressions for Col Ⅰ and bFGF in colons.Col Ⅰ and bFGF participated in the fibrosis.Acupuncture treatment may reduce the bFGF expression in colons to regulate the excessive deposition,treating the intestinal fibrosis in CD.

Objective To evaluate the validity of botulinum toxin type A (BTXA) injections for the treatment of scar contracture.Methods 26 patients with scar contracture were randomly assigned into BTXA group and triamcinolone acetonide (TAC) group.Pinpoint tattooing was performed on each side of each scar in the plane of its longest axis.A template was used to ensure consistent length.These two tattoo points were measured to assess scar contraction at baseline,at every month for a total of 6 months.Histological analysis was conducted to study the physiological environment and immunohistochemistry to detect the expression of α-SMA and myosin-Ⅱ at different groups.Results Scar contraction was more relaxed in BTXA group than that in TAC group after 1 month (P＜0.05),especially in the 6th month (the D value in BTXA group and TAC group was (1.23±0.42) cm,and (0.56±0.33) cm respectively).For immunohistochemistry,the expression of α-SMA and myosin-Ⅱ also decreased in BTXA group (P＜0.05).Conclusions The treatment of scar contracture by suitable BTXA injections is safe and effective.

OBJECTIVETo investigate the effects of botulinum toxin type A (BTXA) on the expression of alpha smooth muscle actin(alpha-SMA) and myosin-II of fibroblasts in scars. Methods Fibroblasts were isolated from tissue specimens of scars contracture. Cells from passages 3-5 were randomly divided into 3 groups (control group, low BTXA group (1 U/10(6) Cells), and high BTXA group (2.5 U/ 10(6)Cells)). Growth condition of fibroblasts was observed at 1 , 4, 7 day after BTXA treated. Changes of alpha-SMA and myosin-II in fibroblasts were detected by Western blot.

RESULTSFibroblasts grew well in control group. The proliferation was decreased 4 days later in BTXA groups. Lots of apoptotic cells were seen in high BTXA group at 7th day. Proteins of alpha-SMA and myosin-II in fibroblasts were statistically different between BTXA group and control groups at 4th day (P < 0.05). The expression of alpha-SMA and myosin-II in low BTXA group was higher than that in high BTXA group at 7th day (P < 0.05).

CONCLUSIONSBTXA could induce the apoptosis of fibroblasts and decrease the expression of alpha-SMA and myosin-II in fibroblasts. The inhibitory effect was strengthened with BTXA concentration increase within a certain range.

Actins ; metabolism ; Botulinum Toxins, Type A ; pharmacology ; Cicatrix ; Fibroblasts ; drug effects ; metabolism ; Humans ; Muscle, Smooth ; metabolism ; Myosin Type II ; metabolism ; Random Allocation

Objective:To explore the prevalence of irritable bowel syndrome (IBS) based on a community population of Shanghai and the treatment of IBS by acupuncture therapy.Methods:A population of 1 685 subjects aged between 18-80 years were randomly selected by clustered sampling from the inhabitants in Changqiao Community of Shanghai to receive a questionnaire,for understanding the symptomatology and prevalence of IBS according to modified Manning and Rome II criteria,and the voluntary IBS patients were treated by acupuncture therapy.Results:The community- based prevalence of IBS was 11.45 % and 5.04% respectively according to modified Manning criteria and Rome II criteria.The ratio of male and female was 0.77:1 in IBS patients and the proportion was 10.62% and 12.19% respectively.But there were no significant difference in prevalence between different age groups (P＞0.05) .IBS is more common in subjects aged between 45-65 years (38.86%).Regarding the 62 IBS patients treated by electroacupuncture (EA),the total effective rate in Tianshu (ST 25) group (n=32) was 84.38%,and it was 56.67% in Daheng (SP 15) group (n=30),which showed a significant difference.(P＜0.05).Conclusion:IBS is a commonly encountered disorder in Changqiao Community of Shanghai and should be taken into consideration for human welfare,disease prevention and further epidemical investigation.Acupuncture treatment is recommended for treating IBS due to its satisfactory therapeutic effect.

Objective:In order to put forward relevant measures and suggestions to improve the quality of the Investigator-Initiated Trials of oncology in medical institutions.Methods:Through literature research, comparative study, combined with the implementation and management of investigator initiated trials, the current status and challenges of the administration of these trials were analyzed.Results:Investigator-Initiated Trials of oncology become increasingly important. However, its quality is poor compared with Industry-Sponsored Trials due to insufficient funds and lack of effective supervision. Besides, four main challenges as follows were identified: lack of clinical research professionals, the quality concerns of ethical review in some institutions, insufficient funding for clinical research, and imperfect quality management system.Conclusions:Based on the actual needs of IITs of oncology, medical institutions should strengthen the talent cultivation, establish electronic information management platform, increase project support, strengthen scientific research supervision and deepen the awareness of risk prevention to improve the quality of investigator initiated trials.

Objective:To analyze the current situation of Investigator-Initiated Trials in medical and health institutions in Shandong Province, the problems in the process of conducting clinical research, and put forward proposals for the establishment of a clinical research management system with effective supervision, sound systems and supporting services, taking into account the progress of the projects since the pilot work was carried out.Methods:A questionnaire was created, an online survey was conducted, a database was set up, a status analysis was conducted and a post-launch analysis of the progress of the pilot was carried out using the National Medical Research Registry Information System, culminating in recommendations using the literature summary method and empirical analysis.Results:Statistical analysis of the questionnaire found that 29.39% of the institutions have a dedicated clinical research management department, and 75.97% of the institutions have a management approach. 25.52%, 40.30%, and 43.07% of institutions established biobanks, clinical research centers, and follow-up centers. There was a statistically significant difference in the establishment of clinical research centers, biobanks, and follow-up centers in secondary and tertiary medical institutions ( P<0.05). The number of general clinical research projects filed, the number of submissions and the number of ethics committees filed in the filing system have all increased significantly after the pilot work, with growth percentages of 126%, 141% and 62% respectively. Conclusions:Shandong Province clinical research pilot work has begun to bear fruit, the current clinical research project still exists in the lack of special funding support, perfect service platform and system support and training system to be improved and other issues.