BACKGROUND: The osteoarthritis (OA) is attributed to Gubi of TCM,which is mainly caused by liver and kidney deficiency, deficiency and damage of both qi and blood and wind-cold-damp pathogen. Kidney-deficiency with coagulating-coldness syndrome is very common.OBJECTIVE: To explore the clinical effect of the treatment of OA by invigorating the kidney, dispelling the cold and activating collaterals.DESIGN: Randomized controlled clinical study.SETTING: Department of Traditional Chinese Medicine, Dongguan Shilong People's Hospital of Guangdong Province.PARTICIPANTS: Eighty-eight inpatients and outpatients who were most possible to benefit from the experiment were selected as the subjects from the Department of Rheumatism and the Clinic of Orthopedics from June 2005 to July 2006. All subjects were randomized into the experimental group (n=44) including 21 males and 23 females, whose ages ranged 42-70 years, and their average age was (62±8) years and the average course of diseases was (34±18) months, and the control group (n=44), including 24 males and 20 females, whose ages ranged 40-69 years, and their average age was (61±7) years and the average course of diseases was (34±16)months.METHODS: Patients in the experimental group were treated with Bushen Quhan Tongluo herbs by orally taken or externally washing. The prescription of Bushen Quhan Tongluo: Hutaorou (12 g), Buguzhi (12 g), Chaoduzhong (12 g), Shudi (15 g), Dahuixiang (9 g), Luoshiteng (15 g),Zhichuanwu (9 g), Sanqi (6 g), Wugong (3 g), Jixieteng (15 g). The prescription for external washing: Tuogucao (40 g), Danggui (15 g), Sumu (15 g),Shengdahuang (15 g), Shengnanxing (10 g), Ruxiang (10 g), Meyao (10 g),Bingpian (3 g). (Orally taken: The medicine shall be taken with water of 37 ℃ one dose a day. External washing: The medicine that dissolved in 500 mL of 100 ℃ boiled water was adopted to wash both knees while the temperature down to 35 ℃ one dose upon a time and twice a day). Patients in the control group were given sulfated glucosamine (Weiguli Capsule.Each capsule contains 314 mg of sulfated glucosamine crystal, which is equal to 250 mg of sulfated glucosamine) two capsules a time and 3 times a day as well as piroxicam (Yantong Xikang Pill) once a day and 20 mg each time. Patients in both groups were administrated for 12 weeks. Referring to the Western Ontario and McMaster Universities (WOMAC) OA index and the clinical effect criterion of OA, the curative effect was compared between the two groups.MAIN OUTCOME MEASURES: WOMAC pain score, stiffness score,physiological function score, total score and the clinical effect.RESULTS: A total of 88 patients were involved in the analysis of results.joint stiffness index, physiological function index and the total index after the treatment in both the experimental group and the control group than those before the treatment (The experimental group: 4.95±2.46,11.39±4. 10;0.70±0.88,1.57± 1.42; 13.16±5.71,31.16± 10.08; 18.82±7.96,44.11 ± 13.29;Control group: 6.64±1.81,11.59±3.07 ;0.68±0.86,1.52±1.34; 14.25±3.99,pain index in the experimental group after the treatment was lower than that in thecontrol group, and the difference was remarkable (P ＜ 0.05),The total effective rate was 95.5% in the control group and it was 93.2% in the experimental group, and there was no marked difference between the epigastric discomfort in the control group, while there was no haematemesis, hemafecia or aggregation due to continuous administration. No adverse effect was found in the experimental group.CONCLUSION: Satisfying effect can be achieved in the treatment of OA of cold coagulation due to kidney deficiency by invigorating the kidney,dispelling the cold and activating the collaterals, moreover, the effect of relieving pain is especially excellent.

Objective To observe the effect of salmeterol/flutieasone propionate on children with asthma. Methods Salmeterol/flutieasone propionate inhalation of different dosages were given according to different illness condition of asthma. Investigate the effects of 180 days inhalation of SM/FP among children. Results After 180 days' treatment, the PEFam and PEFpm of those children of asthma were significantly increased. The lung function has a perceptible improvement. In addition, the daytime and noctural symptom scores and asthma symptom were improved. Moreover, the shore-acting β2 agonist was used with decreasing frequency. The effects of SM/FP inhalation were marvelous after 1 week of treatment and should make a long persisting time alter six months of treatment. Conclusion SM/FP is an effective medicine for children with asthma and should be make more widespread.

ObjectiveTo analyze the clinical features and prognostic factors of occult breast cancer. MethodsThe clinical features and prognostic factors of 62 occult breast cancer patients,who were treated in Tianjin Cancer Hospital from October 1997 to October 2011,were retrospectively analyzed.ResultsThe 3-year,5-year and 10-year overall survival rates of 62 cases were 87.4％,76.4％,73.2％ respectively,a median of 53 months.The 3-,5-,and 10-year overall survival rates of the patients with ＞4 positive lymph nodes are lower than that of patients with ≤4 nodes (77.8％,64.8％,38.9％ vs.90.7％,86.7％,86.7％,P =0.015 ) ;The 3-year and 5-year overall survival rates of patients with primary cancer found in removed breast tissue are lower than that in those primary tumor was not found (60.0％,40.0％,40.0％ vs.92.0％,83.6％,79.2％,P =0.023).The 3-year,5-year and 10-year overall survival rates in patients with recurrence and metastasis are lower than that of patients without (63.5％,28.6％,19.0％ vs.97.1％,97.1 ％,97.1％,P =0.000). ConclusionsThe prognosis of occult breast cancer is related with the number of positive lymph node,pathology,recurrence and metastasis.

ObjectiveThe aim of this study was to evaluate and compare the surgical outcomes of endoscop ic and conventional open thyroidectomies in patients with thyroid disease.Methods116 patients with tyroid tumor were enrolled.56 patients underwent endoscopic thyroidectomy ( endoscopic group ),and 60 patients underwent conventional open thyroidectomy( conventional group).We analyzed the patients' clinic characteristics,surgical outcomes and complications between the two groups.ResultsThe blood loss was less in the endoscopic group than the open group[( 16.8 ± 9.6) ml vs ( 24.9 ± 14.2 ) ml,t =- 2.427,P ＜ 0.05].The degree of satisfaction for cosmetic outcome in endoscopy group( 96.4％ ) was higher than that in conventional group ( 16.7％ ) ( x2 =74.508,P ＜ 0.01 ).There was no significant difference in the operating time,volume of drainage and postoperative hospital stay between two groups,and there was no significant difference in the skin ecchymosis,redness and swelling and postoperative pain between two groups( all P ＞ 0.05).No severe postoperative complication was encountered,such as injuries of the re current or superior laryngeal nerve,parathyroid gland injury or massive hemorrhage.ConclusionEndoscopic thyroidectomy has less blood loss,mini-open and excellent cosmetic benefits compared with conventional open thyroidectomy.

Objective: To study the apoptosis mechanism of microwave ablation (MA) in tongue cancer Cal-27 cell transplanted tumor in nude mice. Methods: 20 nude mice with Cal-27 cell subcutaneously transplanted tumor were randomly divided into blank control group, 50 ℃ 1 min MA group, 50 ℃ 2 min MA group and 55 ℃ 2 min MA group (n = 5) respecitvely, and were treated with MA with indiated perameters respectively. The apoptosis of tumor cells was observed by HE staining. The expression of Caspase-3 and PCNA protein was detected by immunohistochemical SP method. Results: HE staining showed that microwave ablation induced apoptosis of the tumor cells. Immunohistochemical results showed that the expression of Caspase-3 protein was significantly up-regulated in the microwave ablation groups compared with the control group (P ＜ 0. 05), and the expression of PCNA protein was significantly decreased (P ＜ 0. 05) . In microwave ablation 55 ℃ 2 min group, the expression of Caspase-3 protein was increased more (P ＜0. 01), and the expression of PCNA protein was decreased more (P ＜ 0. 01) . Conclusion: Microwave ablation may inhibite the proliferation of tongue cancer cells by inducing apoptosis of the cells. The mechanism may be related to the up-regulation of Caspase-3 signaling pathway and down-regulation of PCNA signaling pathway.

ObjectiveTo observe the fine structure of the trunk kidney in zebrafish, and to identify its secreted exosomes. MethodsThe microstructure and ultrastructure of the trunk kidney in zebrafish were observed by light microscopy and electron microscopy, and the particle size of exosomes was detected by nanoparticle tracking analysis (NTA). ResultsThe trunk kidney was close and parallel to the spine in adult zebrafish. The nephron consisted of renal tubules and renal corpuscles. The renal tubules could be further divided into three types: proximal convoluted tubules, distal convoluted tubules, and cervical segments. The renal corpuscles were composed of glomerulus and renal capsules. The periodic acid-Schiff (PAS) staining results revealed that there were abundant glycogen granules in the proximal convoluted tubules, with brush-like outline in the apical surface of epithelial cells. Under transmission electron microscopy (TEM), there were exosomes distributed in the lumen of renal tubules, with numerous late endosomes and few number of multivesicular bodies (MVBs) in the cytoplasm of the epithelial cells concentrating on the apical side. Meanwhile, MVBs were also distributed in the apical regions of the renal tubules and the podocytes of the renal glomeruli. Immunohistochemical staining results showed that CD9, CD63 and TSG101 were strongly expressed in the lumen surface of the renal tubules, but weakly expressed in the corpuscles and lumen. NTA and TEM results showed that the exosomes isolated from zebrafish trunk kidney were saucer-like outline, and the particle size mode was 144.4 nm, which was consistent with the characteristics of morphological futures of exosome. ConclusionThe zebrafish somatic kidney has the typical structure of the mammalian kidney and is the urinary organ in the body. The renal tubules have the ability to secrete exosomes, and their formation is a process of releasing poly-vesicles to the free surface of epithelial cells into the extracellular space. This study laid a morphological foundation for further study of exosomes in urinary function in aquatic experimental animals as well as the development and application of related models.

With the accelerated aging society in China, the incidence of biliary surgical diseases in the elderly has increased significantly. The clinical characteristics of these patients indicate that improving treatment outcomes and realizing healthy aging are worthy of attention. How to effectively improve the treatment effect of geriatric biliary surgical diseases has attracted widespread attention. This paper reviews and comments on the hotspots and difficulties of biliary surgery in older patients from six aspects: (1) higher morbidity associated with an aging society, (2) prevention and control of pre-operative risks, (3) extending the indications of laparoscopic surgery, (4) urgent standardization of minimally invasive surgery, (5) precise technological progress in hepatobiliary surgery, and (6) guarantee of peri-operative safety. It is of great significance to fully understand the focus of controversy, actively make use of its favorable factors, and effectively avoid its unfavorable factors, for further improving the therapeutic effects of geriatric biliary surgical diseases, and thus benefits the vast older patients with biliary surgical diseases. Accordingly, a historical record with the highest age of 93 years for laparoscopic transcystic common bile duct exploration has been created by us recently.
Humans ; Aged ; Aged, 80 and over ; Biliary Tract Surgical Procedures ; Gallstones ; Laparoscopy ; Treatment Outcome ; Aging ; Retrospective Studies