OBJECTIVETo observe differences of therapeutic effect between acupuncture combined with bloodletting and regular western medication on chronic urticarial.

METHODSOne hundred and sixty patients were randomly divided into an acupuncture bloodletting group and a loratadine group, 80 cases in each group. In the acupuncture bloodletting group, Quchi (LI 11), Neiguan (PC 6), Xuehai (SP 10) and Sanyinjiao (SP 6) were selected and manipulated with reducing method, and pricking bloodletting with three-edge needle and cupping were given at Feishu (BL 13) and Geshu (BL 17), once every other day. The oral administration of 10 mg loratadine was applied in the loratadine group, once a day. The therapeutic effect in two groups was observed and compared after four weeks.

RESULTSThe cured and markedly effective rate was 91.3% (73/80) in the acupuncture bloodletting group, which was similar to 81.3% (65/80) in the loratadine group (P > 0.05). The scores of symptom-sign in the two groups were reduced after treatment (10.14 +/- 1.95 vs 2.12 +/- 40.32, 10.30 +/- 1.82 vs 3.21 +/- 0.28, both P < 0.01), but there was no statistically significant difference between two groups after treatment (P > 0.05). There was no obvious adverse effect in the acupuncture bloodletting group while 3 cases of mild somnolence were reported in the loratadine group.

CONCLUSIONThe acupuncture bloodletting is an effective method for chronic urticarial, which has similar effect to loratadine without adverse effect.

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Urticaria ; therapy ; Young Adult

Humans ; Suicide ; Forensic Pathology

Objective To investigate clinical efficacy and safety of the memantine and donepezil in the treatment of moderate to severe Alzheimer's disease,in order to provide the basis for clinical treatment.Methods One hundred and twelve cases of moderate to severe Alzheimer's disease patients were given memantine plus donepezil(observation group) ,and single use of memantine treatment(control group), and the treatment for 24 weeks.Respectively before and after treatment, Mini Mental State Scale (MMSE), Alzheimer' s disease assessment scale (ADAS-cog), Alzheimer' s disease collaborative learning, daily life ability questionnaire (ADCS-ADL) ,and neuropsychological questionnaire (NPI) score, and adverse reactions were observed in the process of two kinds of therapy, the efficacy and safety of two kinds of treatment methods were evaluated.Results After treatment, the patients in observation group with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.1 ± 2.1), (32.9 ± 8.3), (33.4 ± 5.0), (6.1 ± 3.1) scores, significantly improved compared with scoring (9.9±2.8), (46.2±7.6), (42.1±6.0), (10.5±2.9) scores before treatment,and the differences were statistically significant (t =2.138,-2.411,2.398, 2.107 respectively, P ＜ 0.05).The control group after treatment in patients with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.3±2.6), (33.1 ±7.2), (35.1 ±6.6), (6.7 ± 2.9) scores, significantly improved compared with scoring 11.0 ± 2.5,44.9 ± 6.9,42.2 ±6.6,10.9 ± 3.5 before treatment, and the difference had statistical significanc (t =2.101,-2.033,2.105, 2.400 respectively, P＜0.05).After treatment, the difference of patients in the two groups of MMSE, NPI score had statistical significance(t =2.553,2.176, P＜0.05).The adverse reactions in two group respectively were 32.14％ (18/56) and 26.79％ (15/56), less difference was no statistical significance (P＞0.05).Vital signs checks,regular laboratory examination and ECG examination showed no obvious abnormalities.Conclusion Memantine combined with donepezil in the treatment of moderate and severe AD patients is superior to the singleeffect of memantine, and long-term use will not increase the risk of adverse reactions, which is safe and effective in the combined application.

Objective To investigate the application value of procalcitonin(PCT) in fever of the patients with malignant tumor.Methods A total of 254 patients with malignant tumor complicating fever from January to October 2016 were collected and grouped after clearly diagnosing the causes of body temperature increase according to the clinical manifestations,laboratory examination and imaging examination results.The difference of PCT level was compared among various groups.Results Compared with tumor thermal group,the PCT level in the sepsis and non-sepsis groups was significantly increased(P<0.001).Moreover no matter which was bacterial infection,fungal infection or both mixed infection,the PCT level was significantly higher than that in the tumor thermal group;compared with the fungal infection group,the PCT level in the bacterial infection group was increased significantly(P<0.01).The PCT level distribution difference among the tumor thermal group,fungal infection group and bacterial infection group was statistically significant(P<0.01).The critical values of PCT for diagnosing fungal and bacterial infectious fever were 0.575,0.945 ng/mL respectively.The areas under ROC curve were 0.812(95%CI:0.805-0.934);0.951(95%CI:0.917-0.985).Conclusion It is priliminarily considered that PCT can serve as an effective clinical auxiliary diagnostic indicator for differentiating the fever cause in the patients with malignant tumor.

Objective To evaluate the diagnostic accuracy and reliability for coronary artery stenosis and in-stent restenosis detection using 64-slice spiral computed tomography(multislice CT,MSCT) angiography and digital subtraction angiography(DSA).Methods A pulsating cardiac phantom with two simulated coronary arteries was scanned on a 64- slice CT scanner and underwent DSA at static state,at 4 different sinus rhythms of 0,50,70,and 90 beats per minute(bpm).One simulated artery was 3 mm in lumen diameter with 3 segments of 25%,50%,and 75% stenoses.A stent with 2 segments of 50% and 75% stenoses was placed into the other artery with 4mm in lumen diameter.Images from MSCT were analyzed and compared with those from DSA.Results(1)The mean values of the 25%,50%,and 75% stenoses measured with MSCT were(30.0?1.4)%,(49.5?1.3)%,and(72.9?3.9)%,respectively (P values were 0.005,0.531,and 0.369 respectively).The mean values of the 25%,50%,and 75% stenoses measured with DSA were(24.8?2.0)%,(48.2?2.1)%,(75.3?2.4)% respectively (P values were 0.883,0.180,and 0.796,respectively).(2)MSCT was susceptible to heart rate,with artifact increasing as heart rate increasing,especially when the heart rate were ≥70 bpm.(3)There was a good correlation between 64-slice MSCT and DSA(r=0.995,P=0.000).(4)64-slice MSCT could show the stent and in- stent restenosis simutaneously.Its capability to depict in-stent restenosis was limited.The depiction rate of 50% in- stent restenosis were(46.4?4.5)%(0 bpm)and(43.6?5.7)%(50 bpm) respectively(P

Objective To study B lymphocyte subsets(na(?)ve B cells,memory B cells and plas- mablasts)of peripheral blood in patients with rheumatoid arthritis(RA)and its relationship with autoantibod- ies and clinical manifestation.Methods Blood samples and clinical data of 60 patients with RA were enrolled into this study.They were divided into three groups:active,inactive and refractory RA based on clinical mani- festations and 24 healthy controls were included.CD19 and CD27 of B cells in peripheral blood of RA patients and healthy controls were detected using flow cytometry at single-cell level.Frequence of na(?)ve B cells (CD19~+CD27~-),memory B cells(CD19~+CD27~(dim)),plasmablasts(CD19~+CD27~(high))and average fluorescence in- tensity of CD19 were analyzed,and their relationship with clinical manifestations and rheumatoid factor(RF), anti-typeⅡcollagen(anti-CⅡ),anti-cyclic citrullianted peptide(CCP)antibodies were investigatied.Results Frequence of na(?)ve B cells and plasmablasts in peripheral blood of patients with RA was increased compared with normal control.In contrast,memory B cells in patients with RA were decreased.The na(?)ve B cells subset in inactive and refractory RA was higher than that of healthy controls(P＜0.05),and the memory B cells subset in those groups was lower than that of healthy controls(P＜0.05).The plasmablasts in active and refractory groups of RA were higher than those of healthy controls(P＜0.05).The average fluorescence intensity of CD19 in peripheral blood in patients with RA was positively correlated with ESR,C-reactive protein(CRP),healthy assessment questionaire(HAQ),and plasmablasts was positively correlated with arthrocele index.Na(?)ve B cells,memory B cells and plasmablasts subsets had no relation with RF,anti-CⅡand anti-CCP antibodies. Conclusion B cell subsets in peripheral blood of patients with RA are significantly abnormal,characterized by expanded naive B cells and plasmablasts but diminished memory B cells.Plasmablasts are increasesd in active and refractory groups of RA,and have positive correlation with swollen joint index.B cells may play an important rote in the pathogenesis of RA.

Background Diabetic macular edema is the primary complication of diabetes.Becacizumab and triamcinolone acetonide(TA) have been intravitreally used to treat diabetic macular edema,but it is necessary to compare and evaluate their efficacy and safety.Objective The aim of this trial was to discuss and compare the safety and efficacy of intravitreal injection of becacizumab and TA for diabetic macular edema.Methods A case-controlled study was designed.In this pilot clinical trial,total 98 eyes of 98 patients determined as diabetic macular edema by optical coherence tomography(OCT) and fluorescine funds angiography(FFA) were assigned to becacizumab group and TA group according to the visiting time.Becacizumab of 0.05ml(1.25mg) was injected into vitreous via 4mm posterior to limbus in becacizumab group and TA of 0.1ml(4mg) was used at the same way.The visual acuity,central macular thickness(CMT) and intraocular pressure(IOP) were examined before and 4,8,12 weeks after injection.The complication after injection was compared between these two groups.This study was approved by Ethic Committee of Xi'an Central Hospital.Written informed consent was obtained from each patient prior to this protocol.Results All of the patients finished the medical procedure and follow-up.No significant differences were found in the demographic characteristics between two groups(P＞0.05).The vision was obviously improved in both becacizumab group and TA group in 4,8,12 weeks after injection in comparison with before injection(P＜0.01),but no evident differences were seen in vision at various time points between two groups (P＞0.05).The CMT values were reduced after injection compared with before injection in both two groups(P＜0.01),however,there was no any difference was found in CMT value between becacizumab group and TA group whatever before and after injection(P＞0.05).In 4,8,12 weeks after intravitreous injection,the IOPs were elevated in TA group compared with becacizumab group(P＜0.05,P＜0.01),and the IOP was higher after injection than that before injection in TA group(P＜0.01).The incidence of increased IOP after intravitreal injection of TA was 14.3%.No complication was observed in becacizumab group during the follow-up duration.Conclusion Both becacizumab and TA can treat diabetic macular edema by intravitreal administration.Intravitreal injection of TA may be the more favorable therapy for diabetic macular edema in comparison with becacizumab.However,this outcome indicate that IOP should be monitored during the follow-up period.

AIM: To analyze the genotype of the allele distribution of a polymorphic G-954C within the 5 upstream promoter region of the nitric oxide synthetase 2A gene (NOS2A) in samples of diabetic retinopathy in patients with cystoid macular edema in the mainland of China.METHODS: Eighty-nine patients with diabetic retinopathy and cystoid macular edema and 90 healthy controls were enrolled in this study. Nest polymerase chain reaction (PCR)was performed, and restriction endonudease digestion and gene fragments sequence were examined to detect the genotype of NOS24 G-954C.RESULTS: The genotypes of the sample population of 89 cases and 90 healthy controls were all detected as GG.CONCLUSION: The distribution of G-954C of NOS2A polymorphism are at a lower frequency in China, with little relevancy to the frequency of diabetic retinopathy combined with cystoid macular edema.

Objective To analyze the clinical manifestations of primary Sj(o)gren's syndrome (pSS)with peripheral neuropathies.Methods Eighty-six patients who fulfilled the 2002 American-European Consensus Group criteria for pSS were enrolled in the study.For each patient,medical data,including clinical,laboratory,immunologic and electromyography data were collected and analyzed.The clinical manifestations of primary Sj(o)gren's syndrome were compared between patients with and without peripheral neuropathy.Statistical methods used were t-test,chi-square test and Logistic regression.Results Eighty-six patients were analyzed,and neurological involvement was noted in 26％ (22/86) patients.The clinical spectrum of peripheral neuropathies encountered in Sj(o)gren's syndrome patients was wide,with sensory neuropathies being the most common.Median nerve,peroneal nerve and sural nerve were the most likely involved,and lower limb involvement accounted for 73％ (16/22).Peripheral neuropathy was diagnosed during the Sj(o)gren's syndrome course in all patients,and about 45％ patients' neurological involvement were diagnosed early in the course of the disease.The frequency of Raynaud's phenomenon was significantly higher (32％ vs 5％,P=0.002) as well as acroanesthesia (68％ vs 5％,P＜0.01) in pSS with peripheral neurological involvement than in pSS without peripheral neuropathy.The median values of EULAR Sj(o)gren's syndrome disease activity index (ESSDAI) were 5.3 (range 2.8-7.8) and 3.4 (range 1.5-5.3) in the PNS and non-PNS groups respectively (P＜0.01).We found a significant rise of peripheral neuropathy risk associated with Raynaud's phenomenon (relative risk 9.489,95％CI 2.191-41.093,P=0.003) and ESSDAI (relative risk 1.528,95％CI 1.179-1.979,P=0.001).Elevated titers of rheumatoid factor (P=0.023) and ANA (P=0.003) were common in patients with peripheral neuropathy.Conclusion Peripheral neuropathy is not a rare manifestation of pSS.Neurological involvement can be diagnosed early in the course of the disease.Raynaud's phenomenon and high disease activity may be the risk factors for peripheral neuropathy.

OBJECTIVETo compare the therapeutic effects of pricking blood therapy combined with acupuncture and routine western medicine on herpes zoster.

METHODSTwo hundred and forty cases were randomly divided into 2 groups, 120 cases in each group. The treatment group were treated with acupuncture combined with pricking blood therapy on the point with the most pain, and cupping and surround needling; the control group with external application and oral administration of Aciclovir plaster and Aciclovir tablets, respectively. Their therapeutic effects were compared.

RESULTSThe total effective rate was 92.5% in the treatment group and 55.8% in the control group with a very significant difference between the two groups (P < 0.01). The time of producing killing pain, stopping vesication and scabbing in the treatment group was shorter than that in the control group.

CONCLUSIONThe pricking blood therapy combined with acupuncture is an effective therapy for herpes zoster.

Acupuncture Therapy ; methods ; Adolescent ; Adult ; Aged ; Female ; Herpes Zoster ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phlebotomy ; methods