BACKGROUND: Simple acupuncture therapy often fails to produce significant relief of pain induced by chronic soft tissue injury, but liquid acupuncture therapy, with its longer action on the acupoint and the synergistic effect of the drugs, may, at least theoretically, have better effect.OBJECTIVE: To observe the effect of fluid acupuncture therapy with compound Danshen injection solution combined with spectrum therapy for relieving pain caused by chronic soft tissue injury.DESIGN: A case-control observationSETTING: Health Clinic, College of Engineering of Nanjing Agricultural UniversityPARTICIPANTS: Ninety-four outpatients with chronic soft tissue injury treated in the Health Clinic of College of Engineering, Nanjing Agricultural University between May 2001 and November 2004 participated in this experiment on a voluntary basis. The patients were divided into liquid acupuncture therapy combined with spectrum therapy group (Combined treatment group)and acupuncture control group, with 47 patients in each group.METHODS: In combined treatment group, the acupuncture was administered on the acupoints offengchi (GB 20), tianzong (SI11), quyuan (SI13),ashixue, beishuxue, and jiajixue. Compound Danshen injection solution was injected into each acupoint 2 to 3 cm. Two acupoints were chosen from each region of pain for injection every other day, for 30 days for a treatment course. After the injection, the sites of injection were subjected to spectrum therapy for 30 minutes every other day, for 30 days for a treatment course. One course of acupuncture and spectrum therapy was administered separately. In the acupuncture control group, the above acupoints were chosen for simple acupuncture therapy in identical treatment course.Visual anologue score (VAS) was used for evaluation of the therapeutic effects before and 1 course after the therapy. Remarkable effect was defined by reduction rate of VAS ＞80% after therapy, improvement by VAS reduction by 20% and 80%, and no effect by VAS reduction by ＜ 20%.MAIN OUTCOME MEASURES: VAS score of the patients in the twogroups before and 1 course after therapy, and curative effect 1 treatment course after therapy.RESULTS: VAS of the patients in the acupuncture control group and combined therapy group was significantly decreased after 1 course of therapy in comparison with that before therapy (1.30±0.90 vs 6.57±1.21 for the former and 0.50±0.40 vs 6.64±1.13 for the latter, t=23.958 and 35.116, P ＜ 0.01).Reduction rate of the score was significantly higher in combined therapy group than in the control group [(93.14±10.12)% vs (80.13±11.08)%,t=8.764, P ＜ 0.01], and so was the total effective rate (remarkable effect rate and improvement rate, 93.6% vs 78.7%, χ2=4.644, P ＜ 0.05 )].CONCLUSION: Fluid acupuncture with compound Danshen injection solution in combination with spectrum therapy can significantly relieve the pain caused by chronic soft tissue injury, with better effect than simple acupuncture therapy.

BACKGROUND: There are many clinical applications of oral medication in treatment of primary osteoporosis, but there are few reports on integration of point injection and electric acupuncture in treatment of primary osteoporosis.OBJECTIVE: To observe the effects of intervention with point injection and electric acupuncture on the basis of western drug on primary osteoporosis and to compare the therapeutic effects with simple western medical treatment.DESIGN: Case comparison was designed.SETTING: Hygiene Clinic of Engineering College of Nanjing University of Agriculture and First Affiliated Hospital to Nanjing University of Medical Sciences.PARTICIPANTS: Totally 46 cases of primary osteoporosis were selected from the outpatients in Hygiene Clinic of Engineering College of Nanjing University of Agriculture from April 2000 to June 2004 and all of the cases were in the observation voluntarily. Two groups were randomized according to visiting sequence, named acupuncture+drug group (23 cases), aged (67±4) years and drug group (23 cases), aged (66±5) years.METHODS: ① In acupuncture+drug group, on the basis of medication of alfacalcidol and calcium carbonate, the integrative therapy of point injection and electric acupuncture was applied. Pont injection: Xue-saitong zhusheye was injected on zusanli (ST 36), iaixi (KI 3), sanyinjiao (SP 6) and xuanzhong (GB 39) 1.67-3.33 cm in depth. Two points were selected each time and 2 mL on each point, once/day and the points were injected bilaterally and alternatively. Electric acupuncture:The points were pishu (BL21), shenshu (BL 23) and qihaishu (BL24).Electric apparatus was attached on the points after arrival of qi, with continuous wave, 2 Hz, 30 minutes, once a day. One month treatment for either point injection or electric acupuncture was taken as one course.The second course was followed afterbreak for 5 days. Totally, 6 months were required. Western medical treatment: α Vit. D3 0.5 μg per day was administrated orally, onceaday and calcium carbonate, 1 tablet, once a day,continuously for 6 months. ② Drug control: Only western drugs were administrated orally and the usage was same as the acupuncture +drug group. The patients in two groups were treated for 6 months. Bone mineral density (BMD) of L2-4 and upper end of femur was assayed with X-Ray absorptiometry.MAIN OUTCOME MEASURES: BMD of L2-4 and upper end of femur before and 6 months after treatment in two groups.RESULTS: All of 46 cases of primary osteoporosis entered result analysis, no dropped out case. ① Comparison of BMD of lumbar vertebras before and 6 months after treatment in two groups: After 6-month treatment,in acupuncture +drug group, BMD of L2-4 was improved significantly [(0.829±0.049), (0.791±0.043) g/cm2, (t=2.80, P ＜ 0.01)] compared with that before the treatment. In drug control, BMD of L2-4 was improved significantly [(0.813±0.051), (0.788±0.048) g/cm2, (t=1.71, P ＜ 0.05)]compared with that before the treatment. Concerning to the variations of BMD between two groups, the variation in acupuncuture+drug group was more than that in drug control [(0.038±0.020), (0.025±0.025) g/cm2 (t=1.95,P ＜ 0.05)]. ②) Comparison of BMD of femur before and 6 months after treatment in two groups: There was no significant difference in BMD before and after treatment in two groups (P ＞ 0.05).CONCLUSION: Compared with simple western drug treatment, the integrative therapy of point injection and electric acupuncture improves very significantly BMD of lumbar vertebras, aiming at effective treatment of primary osteoporosis. But the change in BMD of femur is not obvious before and after treatment, which is probably associated with lack of adequate blood circulatiou in femoral region.

Objective Through utilizing the existing human resources and establishing stratified management modes based on the responsibility of the leader of nursing teamwork to reduce nursing de-fects and nursing disputes, and improve the quality of emergency care. Methods Nurses in the depart-ment of emergency were stratified, and the stratified management modes based on the responsibility of the leader of nursing teamwork was implemented. Then the results underwent analysis and feedback through assessment. Results Quality of care, the satisfaction degree of patients, doctors and the relevant depart-ments before and after the implementation had statistical significance by χ2 test. The cases of nursing de-fects reduced from 5 in 2005 to 1 in 2007 and nursing disputes reduced from 5 in 2005 to 0 in 2007.The intact rate of first aid materials increased from 98% in 2005 to 100% in 2007. Conclusions The strati-fied management modes can ensure that the quality of emergency care implemented in every hour and link, and can reduce the nursing defects and disputes, increase patient satisfaction degree and improve quality of care. So the stratified management modes are worthy of clinical reference in emergency department.

Objective To determine the expression profile of serum microRNAs(miRNAs) in early-onset familial Alzheimer's disease (EO-FAD) patients. methods miRNA microarrays were performed to detect the expression profile of serum miRNAs in 2 cases of EO-FAD patients,2 cases of EO-FAD carriers and 2 cases of normal controls.Preliminary bioinformatic analysis was conducted. Result sIt was found that 21 miRNAs were up-regulated and 22 miRNAs were down-regulated in serum of EO-FAD patients,the differences were statistically significant(P<0.05).miR-5704(P=0.0002),miR-4639-3p(P=0.0195),miR-107(P=0.0204) were markedly up-regulated,miR-5572(P=0.0008),miR-204-3p(P=0.0014),miR-542-5p(P=0.0106) and miR-155-5p(P=0.0240) were markedly down-regulated.Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that the dysregulated miRNAs may be involved in the mechanism of EO-FAD by affecting neurotrophin signaling pathway.Conclusion miR-5704,miR-4639-3p,miR-107,miR-5572,miR-204-3p,miR-542-5p and miR-155-5p may be used as potential biomarkers of EO-FAD,and involved in the mechanism of EO-FAD by affecting neurotrophin signaling pathway.

Objective To investigate the phenotypes and genetics of an early-onset familial Alzheimer′s disease ( EO-FAD ) family.Methods The clinical manifestations , brain MRI results and neuropathological findings of the proband and pedigree members of the EO -FAD family were evaluated. Autopsy was performed in the proband . Results Fifteen members of this family had a presenilin 1 (PSEN1) p.G378E mutation and nine of them had clinical manifestations or the MRI changes of EO -FAD. Neuropathological findings from autopsy of the proband disclosed moderate cortical atrophy throughout the brain, especially in frontal lobe and temporal lobe .Neuronal loss with gliosis was observed in the cortices of the frontal, temporal and occipital lobes , as well as in parahippocampal gyrus .Numerous senile plaques and neurofibrillary tangles were present in the cerebral cortex .The proband′s younger sister showed similar clinical presentations and MRI changes , and other members of this family demonstrated progressive memory loss.Conclusion A p.G378E mutation in the PSENl gene was identified in a Chinese EO-FAD pedigree.

Laparoscopic radical colectomies have been more widely used gradually, among which laparoscopic extended right hemicolectomy is considered as the most difficult procedure. The difficulty of extended right hemicolectomy lies in the need to dissect lymph nodes along the superior mesenteric vein (SMV) and disconnect numerous and possible aberrant vessels. To address this problem, we emphasize two points in key vessel assessment: getting familiar with the anatomy along the medial-to-lateral approach and having a good understanding about the preoperative imaging presentations. An accurately preoperative imaging assessment by abdominal enhanced CT can help the surgeon understand the relative position of the key vessels to be dealt with during operation and the situation of the possible aberrant vessels so as to guide the procedure more effectively and facilitate the prevention and management of the intraoperative complications. During operation, the operator should pay special attention to the management of the vessels in the ileocolic vessel region, Henle's trunk and middle colon vessels. The operation highlights of the key vessels are as follows: (1) The ileocolic vessels: identifying the Toldt's gap correctly and opening the vascular sheath of the SMV securely; making sure that the duodenum is well protected. (2) Henle's trunk: dissecting along the surface of the Henle's trunk; preserving the anterior superior pancreaticoduodenal vein (ASPDV) and main trunk of the Henle's trunk; disconnecting the roots of the right colic vein (RCV) and right gastroepiploic vein (RGEV), and then dissecting lymph nodes along the surface of the pancreas. (3) The middle colon vessels: identifying the root of the middle colon vessel along the lower edge of the pancreas; avoiding entering behind the pancreas; mobilizing the transverse mesocolon sufficiently along the surface of the pancreas. Finally, we discuss and analyze the disputes currently existing in laparoscopic extended right hemicolectomy, including dissection of No.6 lymph nodes, naking the SMA and dissecting lymph nodes around the roots of the branches of SMA. This article shares our experience about laparoscopic extended right hemicolectomy, hoping that it could help beginners master the technique more safely and skillfully.
Colectomy ; methods ; Colon, Transverse ; Colonic Neoplasms ; surgery ; Humans ; Laparoscopy ; Mesocolon ; surgery

Objective To study the association between the single nucleotide polymorphism (SNP) of SEPT14 (rs77231105,rs10241628,rs11981883,rs73701167) and sporadic PD in Chinese Han populationin of Southwest Shandong.Methods One hundred and eighty PD patients from Southwest Shandong served as PD patient group and 200 healthy subjects from Southwest Shandong served as control group in this study.The distribution frequencies of alleles and genotypes in SNP of rs77231105,rs10241628,rs11981883 and rs73701167 were compared by PCR and sequencing respectively.Results No significant difference was found in the distribution frequencies of alleles and genotypes in rs77231105,rs10241628,rs11981883 between the two groups (P＞0.05).The distribution frequency of rs73701167 was significantly higher in PD patient group than in control group (31.1％ vs 20.5％,OR=1.75,95％CI=1.261-2.428,P=0.001).Conclusion The SNP of SEPT14 rs77231105,rs10241628 and rs1198188 are not associated with PD,the SNP of rs73701167 is associated with PD in Chinese Han population of Southwest Shandong.The allele C is a risk factor for PD.

Objective: To analyze the occurrence and risk factors of various occupational hazard incidents in China's power grid enterprises. Methods: A total of 4 191 workers from eight power grid enterprises in Jilin Province, Shandong Province, and Chongqing City were selected using a convenience sampling method. Their exposure in workplace and the occurrence of various occupational hazard incidents from 2018 to 2020 were investigated. Results: Among the participants, 71.7% were engaged in outdoor operations. The incidence rates of occupational hazard emergency, ranking from high to low, were electric ophthalmia, acute mountain sickness, heatstroke, electro-flash dermatitis, sunburn, cold injury, solar ophthalmia, and gas poisoning in confined space, with the rate of 42.3%, 42.3%, 38.1%, 24.3%, 17.4%, 16.5%, 10.0%, and 1.3%, respectively (P<0.01). The results of multivariate logistic regression analysis showed that workers in Jilin Province had a higher risk of cold injury compared to those in Shandong Province and Chongqing City (all P<0.01). Workers in Chongqing City had a higher risk of solar ophthalmia than those in Jilin Province (P<0.01). Workers in inspection and maintenance positions had a higher risk of heatstroke and sunburn compared to those in substation positions (all P<0.05). Power grid workers with protective systems in enterprises had a lower risk of sunburn and solar ophthalmia compared to those without protective systems (all P<0.01). The risks of sunburn and solar ophthalmia among power grid workers increased with age and daily outdoor working time (all P<0.05). Taking protective measures was a protective factor against heatstroke and cold injury (all P<0.01). Conclusion: Power grid workers face the risk of various occupational hazard incidents. Relevant organizations should conduct targeted preventive measures based on regional and worker characteristics, and ensure the implementation of protective systems in different work environments.

Objective:To establish a mouse model of gastric cancer by inoculating MKN45 cells into mice with normal immune function utilizing microcarrier technology. Methods:A total of 60 male C57BL/6 mice were randomly divided into three groups, namely, 2D, con-trol, and 3D groups, according to the coculture system of MKN45 and microcarrier. The mouse models of gastric carcinoma were estab-lished by hypodermic injection. The time of tumorigenesis, rate of tumor formation, and pathological features were observed in each group. Results:In the 3D group, the time of tumor formation was short, whereas the rate of tumor formation was high (80%). No de-tectable tumor formations were observed in the 2D and control groups. HE and immunohistochemical staining of the transplantation tumor model showed evident characteristics of human gastric cancer. Conclusion:A human gastric cancer model in normal immune mice was successfully established. The onset and development mechanism of gastric cancer could be more effectively investigated in mice with normal immune function through this model. Moreover, a more valuable and new animal model for the research and devel-opment of anticancer drug was established.

OBJECTIVETo investigate the relationship between tumor regression grade (TRG) and lymph node regression grade (LRG) after neoadjuvant chemoradiotherapy (CRT) for rectal cancer and its clinical implication.

METHODSClinicopathological data of 176 rectal cancer patients undergoing radical excision after neoadjuvant CRT from January 2005 to December 2013 in our department were retrospectively analyzed.

INCLUSION CRITERIA(1) Radiology indicated locally advanced low rectal cancer and patients had strong desire to preserve the sphincter before neoadjuvant CRT; (2) there was no definite metastatic lesion before neoadjuvant CRT; (3) patients received whole course of neoadjuvant CRT (regular radiotherapy plus synchronous fluorouracil-like drugs chemotherapy); (4) patients underwent radical operation after neoadjuvant CRT. Patients with short-course CRT and emergency surgery were excluded. TRG and LRG of postoperative specimens (including tumor and lymph nodes) were carried out based on the percentage of the fibrosis and the cancer residue. No cancer residue was defined as TRG1 and LRG1; rare cancer cell residue as TRG2 and LRG2; fibrosis growth over residual cancer as TRG3 and LRG3; residual cancer growth over fibrosis as TRG4 and LRG4; absence of regressive changes as TRG5 and LRG5; and normal lymph nodes as LRG0. Spearman correlation test was used to assess the correlation between TRG and LRG.

RESULTSOf 176 patients, 111 were men and 65 were women. The mean age was (53.9±13.0) years. The number of patients with stage I(, II(, and III( before operation was 10, 49 and 62 while other 55 patients were unknown. Transabdominal low anterior resection (LAR) was performed in 118 cases and abdominal-perineal resection(APR) in 47 cases following the principle of total mesorectal excision (TME). Postoperative pathology of specimens revealed that the number of patients from TRG1 to TRG5 was 19 (10.8%), 25 (14.2%), 66 (37.5%), 47 (26.7%), 19 (10.8%), and from LRG0 to LRG5 was 35 (19.9%), 68 (38.6%), 10 (5.7%), 14 (8.0%), 15(8.5%), 34 (19.3%), respectively. TRG was correlated to LRG (P=0.005) while the Spearman correlation coefficient was only 0.24. The analysis of subgroup without LRG1 also showed that TRG was correlated to LRG(P=0.0005) and the Spearman correlation coefficient was 0.40.

CONCLUSIONSTRG can not represent LRG. Therefore, both TRG and LRG should be assessed when evaluating the response of rectal cancer to neoadjuvant CRT.