Objective: To observe the clinical effects of acupoint injection therapy plus massage on primary dysmenorrhea (PD).
Methods: Ninety patients with PD were randomly divided into a treatment group or a control group, 45 cases in each group. The treatment group was treated by injection of Vitamin K3into Sanyinjiao (SP 6) plus massage on Diji (SP 8). The control group was treated by oral administration of Ibuprofen sustained-release capsule. Before and after the treatment, visual analogue scale (VAS) was adopted to assess pain degree of the patients. The therapeutic effects were observed after continuous treatment of three cycles of menstruation.
Results: After treatment, VAS scores were obviously decreased in both groups and the differences were statistically significant (allP<0.05). The difference in VAS score after treatment was more significantin the treatment group than that in the control group (P<0.01). The total effective rate was significantl higher in the treatment group than that in the control group (P<0.05).
Conclusion: Acupoint injection therapy plus massage for PD is effective and better than simple oral administration of Ibuprofen sustained-release capsule.

Objective To compare the effectiveness and safety of radiofrenquency ablation(RFA) with other therapeutic methods for patients with early hepatocelluar carcinoma(HCC). Methods Randomized clinical trials(RCTs)which compared the efficacy or safety of RFA with other therapeutic methods for primary hepatocellular carcinoma in Cochrane library,EMBASE,PubMed,OVID and CBM were searched.Trials were considered of high quality if methodological quality score was 3 or more according to Jadad standard.Statistical heterogeneity between trials was evaluated bv STATA 9.0 and considered to exist when P＜0.1.Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Sensitivity analysis was performed and publication bias was investigated through visual inspection of funnel plots and Egger regression model.Results Six RCTs including 862 cases were analyzed.As compared with other therapeutic approaches,RFA significandy increased 3-year overall survival rate and reduced local recurrence rate of early hepatocelluar carcinoma:the total OR were 2.06(95%CI being 1.54-2.77,P=0.000)and 0.40(95%CI being 0.28-0.57,P=0.000)respectively.As compared with other therapeutic approaches,the total OR of new HCC recurrence rates,extrahepatic metastasis rate and major complications in patients with HCC treated with RFA were 0.92 (95%CI being 0.68-1.24),0.98(95%CI being 0.30-3.22),1.35(95%CI being 0.49-3.77)respectively,showing no significant differences(P＞0.05).Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias(P=0.670,0.160,0.884,0.087,0.317,respectively,by Egger regression model).Conclusions RFA is superior to other treatment methods with respect to local recurrence and 3 year overall survival in early HCC and is the preferred tberapeutic method for small HCC because it is minimally invasive,simple and convenient.

OBJECTIVE: To investigate effects of polysulphone membrane filter continuous blood purification (CBP) on decreasing pancreatic amylase and various inflammatory mediators in the treatment of severe acute pancreatitis.METHODS: A total of 47 elderly patients with severe acute pancreatitis, who received CBP therapy was included in the experiment, and the blood routine test, blood biochemistry indexes and blood-gas analysis were performed prior to CBP therapy and continuous for 12 and 24 hours. Meanwhile, APACHE Ⅱ, SAPS Ⅱ and MODS scores were graded by recorded the heart rate, mean arterial pressure (MAP), central venous pressure (CVP), respiratory frequency and body temperature.RESULTS: Compared with pre-treatment, APACHE Ⅱ, SAPS Ⅱ and MODS scores, serum creatinine, hemodiastase, as well as C-reactive protein were decreased after treatment. After treatment, the oxygen index, such as heart rate, MAP, and CVP were declined, and the levels were increased progressively with time prolonged. During the course of CBP, the levels of HCO_3~-, Ga~(2+),and Mg~(2+) were increased than that of pre-treatment. The level of Ga~(2+), Mg~(2+) could maintain in a normal range during CBP therapy, however, it would be decreased when stop treatment.CONCLUSION: The improvement of cardio-pulmonary function relates to interstitial edema of tissue and organs. The effect on removing pancreatic amylase and various inflammatory mediators will be better with time prolonged. It is affirmative to treat elderly patients with severe acute pancreatitis by using CBP therapy.

Objective To investigate the application of laparoscope,duodenoscope and choledochoscope in the treatment of intra-and extrahepatic bile duct stone.Methods The clinical data of 3 16 patients with intraand extrahepatic bile duct stone who were admitted to the Bethune First Hospital from April 2007 to August 2010were retrospectively analyzed.There were 269 patients with cholecystolithiasis and choledocholithiasis,10 patients with cholesystolithiasis,choledocholithiasis and hepatolithiagis,and 37 patients with choledocholithiasis.Laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)+choledochoscopy was applied to patients with hepatolithiasis or with the diameter of common bile duct≥10 mm;endoscopic sphincterotomy (EST)+LC or LC+EST was applied to patients with the diameter of common bile duct between 10 mm and 5 mm and the diameter of cystic duct<5 mm;LC+laparoscopic transcystic common bile duct exploration(TC-CBDE)+choledochoscopy wag applied to patients with the diameter of common bile duct≤5 mm and the diameter of cystic duct≥5 mm.Results The success rate of operation was 96.8%(306/316).A total of 163 patients received LC +LCBDE+T-tube drainage+choledochoscopy,and the mean operation time,expense,duration of hospital stay were 93.6 minutes,2.8×104 yuan and 9.8 days,respectively,and 5 patients had complications postoperatively.Fifty-four patients received EST+LC,and the mean operation time,expense,duration of hospital stay were 45.0minutes,6.6 days,2.3×104yuan,respectively,and 1 patient had complication postoperatively.Sixty-seven patients received LC+EST,and the mean operation time,expense and duration of hospital stay were 40.0minutes,6.1 days,2.4×104 yuan,respectively,and 2 patients had complication postoperatively.Thirty-two patients received one-stage repair of common bile duct and LC+TC-CBDE+choledochoscopy,and the mean operation time,expense and duration of hospital stay were 97.3 minutes,7.3 days and 2.5×104yuan,respectively,and 1 patient had complication postoperatively.A total of 272 patients were followed up for 12 months,except for 6 patients with recurrence of common bile duct stone,no residual stone or biliary stricture was etected.Conclusion Combined application of laparoscope,duodenoscope and choledochoscope has advantages of less trauma,quick ecovery and fewer complications in the treatment of intra-and extrahepatic bile duct stone.

MicroRNAs (miRs) play an important role in regulating diverse cellular processes.It has been reported that miRs are associated with the formation and maturation of erythrocytes, and the expression of globin genes at post-transcriptional level.Compared with normal human enrythrocytes, various miRs are altered in the patients with thalassemia.These changes also happen in the patients with diverse clinical manifestations.In this paper, we systematically summarized the recent progress about the expression dysregulation of miRs in β-thalassemia and their roles in regulating the levels of γ-globin and fetal hemoglobin.During β-like globin gene expression, miRs directly or indirectly regulate the levels of erythroid-specific transcription factors through post-transcriptional action, such as B-cell lymphoma 11A (BCL11A), myeloblastosis oncogene (MYB), specificity protein 1 (Sp1), Kruppel-like factor 3 (KLF3) and GATA1.These effects subsequently regulate the switch between γ-and β-globin gene expression and affect fetal hemoglobin production.Targeting miRs might be a novel therapeutic strategy for β-thalassmeia.

Objective To evaluate the effect of remifentanil on cell apoptosis during renal ischemia-reperfusion (I/R) in rats.Methods Seventy-five male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 3 groups (n =25 each):sham operation group (group S),I/R group,and remifentanil group (group R).Renal ischemia was induced by occlusion of the bilateral renal arteries for 45 min followed by reperfusion in groups I/R and R.Remifentanil was infused at 1.0 μg· kg-1 · min-1 via the caudal vein starting from 15 min before ischemia until 30 min of reperfusion in group R,while the equal volume of normal saline was given instead of remifentanil in groups S and I/R.At 15 min before ischemia (T0) and 3,6,12,24 h of reperfusion (T1-4),5rats were anesthetized and sacrificed,and renal specimens were obtained to detect the apoptotic rate and expression of Bax and Bcl-2 protein (by flow cytometry) and mRNA (by RT-PCR).The ratios between Bcl-2/Bax protein and mRNA expression were calculated.The pathological changes of renal tubules were scored.Results Compared with group S,the pathological scores and apoptotic rate were significantly increased at T1-4,and ratios between Bcl-2/Bax protein and mRNA expression were increased at T1,2,while decreased at T3,4 in groups R and I/R (P ＜0.01).Compared with group I/R,the pathological scores and apoptotic rate were significantly decreased at T1-4,while the ratios between Bcl-2/Bax protein and mRNA expression were increased in group R (P ＜ 0.05 or 0.01).Compared with the baseline value at T0,the pathological scores and apoptotic rates were significantly increased at T1 4,and the ratios of Bcl-2/Bax protein and mRNA expression were increased at T1,2,while decreased at T3,4 in groups R and I/R (P ＜ 0.01).Conclusion Regulation of Bcl-2/Bax expression and inhibition of cell apoptosis in renal tissues are involved in the mechanism by which remifentanil reduces renal I/R injury in rats.

Humans ; Hyperplasia ; etiology ; Male ; Middle Aged ; Prosthesis Failure ; Stents ; Tomography, Optical Coherence ; adverse effects ; Tunica Intima ; pathology

Objective To investigate the effect of remifentanil on nucleotide-binding oligomerization domain 1 (NOD1) mRNA expression in rats with renal ischemia-reperfusion (I/R) injury.Methods Sixty male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 3 groups (n =20 each):sham operation group (S group),I/R group and remifentanil group (R group).Renal ischemia was induced by occlusion of bilateral renal arteries for 45 min followed by 24 h reperfusion in groups I/R and R.Remifentanil 1.0 μg· kg-1 · min-1 was infused until 30 min of reperfusion starting from 15 min before ischemia in group R,while the equal volume of normal saline was given instead in S and I/R groups.The animals were sacrificed at 15 min before ischemia and at 3,6,24 h of reperfusion and the kidneys were removed for microscopic examination and polymorphonuclear leukocyte (PMN) count and for measurement of NOD1 mRNA expression (by RT-PCR).The apoptotic rate was determined by flow cytometry double staining method.Results Compared with group S,NOD1 mRNA expression was up-regulated,and the apoptotic rate and PMN count were significantly increased at each time point during reperfusion in group I/R,and the apoptotic rate and PMN count were significantly increased at each time point during reperfusion,and NOD1 mRNA expression was up-regulated at 6 and 24 h of reperfusion in group R (P ＜ 0.01).Compared with I/R group,NOD1 mRNA expression was down-regulated,and the apoptotic rate and PMN count were significantly decreased at each time point during reperfusion (P ＜ 0.05 or 0.01),and the pathological changes were significantly attenuated in group R.Conclusion Remifentanil can reduce the renal I/R injury by down-regulating the expression of NOD1 mRNA and inhibiting inflammatory response and apoptosis.

Objective To study the comprehensive quality of pre-hospital care of patients with acute coronary syndrome (ACS) in our country,and the factors affecting the efficiency of medical intervention of pre-hospital care.Methods An epidemiological investigation with target population-based cross-sectional study was carried out,and specifically designed questionnaire for determining the efficiency of pre-hospital care of patients with ACS was used to collect information of 272 patients from 13 emergency pre-hospital care centers.Results After analysis of the data from 13 majormedical centers,it could be classified into 4 patterns of pre-hospital care,namely directive pattern,pre-hospital pattern,dependent pattern and independent pattern.The results of analysis showed that the distance for ambulance driving in directive pattern was shorter than that in dependent pattern,but the call-response in directive pattern was quicker than that in pre-hospital pattern and dependent pattern,while the call-arrival time in directive pattern was longer than that in independent pattern and dependent pattern.The analysis of the on-site preliminary treatment in four patterns of pre-hospital care showed that there were differences in the establishment of intravenous access,aspirin,nitrate and ECG ( P ＜ 0.05 ).The total effective rate of pre-hospital care for ACS was 48％,while effective rate of independent pattern reached 70％.Factors affecting therapeutic effect on ACS resulting in better outcomes included pre-hospital pattern ( OR =4.097 ),directive pattern ( OR =5.158 ),and use of nitrate ( OR =3.045 ) and oral administration of medicine ( OR =8.215 ). Conclusions Independent pre-hospital pattern had the best therapeutic effect in the pre-hospital care of patients with ACS,and pre-hospital pattern had the best on-site preliminary disposal.Use of nitrate and oral administration of medicine showed the best benefit to the therapeutic effect.

Objective To investigate the epidemiologic features of HIV infections in voluntary blood donors in Zhejiang province.Methods A retrospective study was conducted in 206 cases of HIV-positive blood donors who were found from 2008 to 2010 by blood screening in Zhejiang Province,and the demographic data of those HIV carriers were analyzed using SPSS 16.0 software.Results The HIV-positive rates of voluntary blood donors in 2008,2009 and 2010 were 0.09‰(49/552 585 ),0.11‰( 64/601 639)and 0.15‰(93/600 893),respectively.There were five regions in Zhejiang province where HIV-positive rates exceeded 0.10‰,and the highest one was 0.21‰ in Wenzhou.HIV infection rate of male blood donors was 0.19‰,which was higher than that of female donors (0.02‰,x2 =96.21,P ＜ 0.01 ) ; donors with ages of ＞25-35 had the highest infection rate (0.19‰) among all age groups (x2 =41.94,P ＜0.01 ) ; blood donors with education of junior high school or lower had higher infection rate (0.21‰) than those with education of senior high school and undergraduate or above (0.11‰ and 0.02‰,x2 =78.62,P ＜0.01 ).Infection rate of first-time blood donors in 2008 was 0.12‰,higher than that of repeated donors (0.05‰,x2 =7.26,P＜0.01); while in 2009 and 2010,there was no difference between two groups (x2 =0.16 and 1.35,P ＞ 0.05 ).Blood donors who used mobile donation sites had higher infection rate than those using institutional donation (x2 =18.5,22.0 and 16.8 for 2008,2009 and 2010,P ＜0.01 ).Conclusions The risk of HIV infection is gradually increasing among voluntary blood donors in Zhejiang province.To ensure the blood safety,blood agencies should establish pre-donation health consultation for high-risk blood donors such as young men with low education.