To observe the therapeutic effect of acupuncture plus TDP irradiation on proliferative arthritis, 304 patients with proliferative arthritis were randomly divided into treatment group and control group, and treated by acupuncture plus TDP irradiation and routine Tuina respectively. The clinical cure rate and total effective rate in the treatment group were both superior to those in the control group. This therapy has good therapeutic effect and short course of treatment in treating proliferative arthritis, and is one of better therapeutic means in clinic presently.

Irritable bowel syndrome(IBS)is a commonly seen functional gastrointestinal disorder. Its main clinical manifestations were abdominal pain,abdominal distention and altered bowel habits. Currently,the pathogenesis of IBS has not been clarified. Studies showed that IBS was caused by many factors,including life style,gene polymorphism,food hypersensitivity,psychological factors,brain-gut axis abnormality and intestinal flora disorder. This article reviewed the advances in study on pathogenesis of IBS.

During L-lactic acid fermentation with Rhizopus oryzae,there existed a branch pathway by which pyruvate was transformed to eth- anol catalyzed by pyruvate decarboxylase(PDC)and alcohol dehydrogenase(ADH),thus decreasing the flux of pyruvate to lactic acid.In this study,the spores of Rhizopus oryzae AS3.3462 mutagenized with nitrosoguanidine(NTG),the appropriate dosage was 0.15 mg/mL and the lethal rate was 70%～80%.Two mutants,named mut-1 and mut-2,with decreased ADH activity were screened out by yeast peptone dextrose(YPD)agar medium containing allyl alcohol.These two mutants had decreased ADH activities of 41.63% and 50.29% compared with the parent strain.The fermentation behavior after 72h showed that the yields of ethanol produced by mut-1 and mut-2 were 4.87g/L and 6.56g/L respectively,while the wild type strain was 28.9g/L,and the lactate concentrations of mut-1 and mut-2 also increased from 40.31g/L to 54.45g/L and 44.07 g/L,respectively.It is also found that mut-1 and mut-2 had a high reducing sugar consumption rate and biomass accumulation than its present strain

Objective To study the effects of different doses of UVA1 on the development of hypertrophic scar in rabbit ears induced by excision of full-thickness skin. Methods A hypertrophic scar model was established by excision of full-thickness skin (2 cm×5 cm) on the ventral surface of rabbit ears. A total of 18 New Zealand rabbits were randomly divided into 3 equal groups to receive UVA1 radiation on the left ears immediately, 1 month, and 2 months after the excision, respectively, and every group were classified into two subgroups to be irradiated with 60 and 110 J/cm2 of UVA1, respectively, for 30 sessions. The right ears served as control without irradiation. HE staining and Masson staining were used to examine the dermal thickness and collagen content in scar, respectively. Results Compared with pre-irradiation, the dermal thickness (t = 5.85, 4.94, respectively, both P＜0.05) and collagen content (t = 6.50, 8.02, respectively,both P＜0.05) significantly decreased in scar irradiated with UVA1 of 110 J/cm2 one and two months after the excision. The difference value in dermal thickness and collagen content at the beginning and at the end of the study significantly differed between irradiated and non-irradiated ears in the rabbits treated with UVA1 of 110 J/cm2 (P＜0.05). The effects of UVA1 on dermal thickness and collagen content were dose-dependent (P＜0.05). On the contrary, the dermal thickness and collagen content markedly increased in scars of rabbits irradiated with UVA1 immediately after the excision (P＜0.05 ). Conclusions To begin UVA1 exposure of hypertropic scar in rabbits after epithelialization may lead to the softening of scar, thinning of skin, and decrease of collagen content. However, immediate irradiation with UVA1 after wound could not prevent the development of hypertrophic scar in rabbits, in contrast, it exacerbated the severity of scar.

Stereotactic body radiation therapy (SBRT) adopts different tumor-killing mechanisms from the conventional fractionated radiotherapy.In SBRT,a single high-dose radiation can destroy the membrane of tumor cells and induce the release of tumor-associated antigen,also named in situ tumor vaccine,which stimulates the immune system to kill the residual tumor;a single-fraction radiation with a dose larger than 8-10 Gy can induce rapid apoptosis of vascular endothelial cells via the acid sphingomyelinase pathway at 1-6 hours after radiation,which causes tumor vascular occlusion and secondary tumor-killing effects.In order to understand whether SBRT improves the clinical treatment outcomes via the above mechanisms,this paper reviews the clinical research advances in SBRT for primary liver cancer.

Objective To explore the methods to reduce the occlusion of perforating arteries after intracranial stenting of the vertebral artery. Methods Clinical data of 32 cases of Gateway-Wingspan stent implantation for intracranial branch of vertebral artery were retrospectively analyzed. The postoperative stricture and perfusion improvement situation were evaluated, the reason of perforating artery occlusion was analyzed. Results Thirty-two patients were implanted with 33 pieces of Wingspan stent and 1 piece of Apollo bracket. The operation success rate were 100%, and the stenosis rate reduced from (76.6±6.1)%to (27.9±5.2)%. After three months, the transcranial doppler sonography (TCD) and CT angiography were checked, showing no in-stent restenosis in all patients. Two patients occurred the perforating artery occlusion within 24 hours after operation. The possible reason was the change of stability of atherosclerotic plaque at the stenosis and the plaque displacement caused by the mechanical action of the balloon or stent, which may lead to medulla oblongata artery block. After drug and rehabilitation treatment, the symptoms in patients were improved significantly. Conclusion The perforating artery occlusion after stent implantation in intracranial branch of vertebral artery can be prevented by strict evaluation and preoperative preparation, the right selection of intraoperative balloon and stent, which still needs larger sample data to prove.

Objective To analyze clinical features of primary hyperparathyroidism(PHPT)and to evaluate the diagnosis and treatment for PHPT.Methods 115 patients with PHPT undergoing surgery and confirmed by pathology from Jan.2006 to Mar.2014 were retrospectively analyzed.Results The clinical manifestations of PHPT were various.The rate of misdiagnosis was 70.0％(77/115).The positive rate of ultrasonography was 61.0％ (64/105),99Tcm-MIBI 88.3％(68/77)and CT 75.4％(46/61),respectively.The difference among the 3 tested methods had statistical significance (P＜0.05).89 cases with parathyroidoma underwent unilateral neck exploration,6 cases of parathyroid hyperplasia underwent bilateral neck exploration,3 cases with parathyroid carcinoma underwent carcinoma resection,ipsilateral thyroid lobe resection and ipsilateral central lymph node dissection,and 21 cases with thyroid benign or malignant lesions underwent suitable operations.97 cases developed hypocalcaemia of various degrees after operation,and the symptoms were relieved after use of calcium gluconate.Conclusions PHPT can be diagnosed according to the lever of serum calcium and PTH.Ultrasonography and 99Tcm-MIBI should be the first choice for preoperative localization.Unilateral neck exploration can be used for parathyroidoma with accurate localization.

Objective To study the epidemiological features of prevalence and distribution of diabetes mellitus (DM) and the injury glucose tolerance (IGT) in elder people in Beijing. Methods Cross over sectional epidemiological survey by random stratified sampling method in elder population was applied and the middle aged people was used as controls. The prevalent status of diabetes and IGT in the population more than 60 years old in urban area was compared with that in rural areas in Beijing in 1997. Results The aggregate age adjusted standardization prevalence of diabetes and IGT were 15 98% and 15 89% , respectively in old age population in Beijing in 1997. Diabetes prevalence in 60 69 years group (only comparable data) increased about 3 2 times from 4 27% in 1981 to 13 73% in 1997. Although it was no difference in IGT prevalence between urban and rural elders, there existed significant difference for diabetes standardized rates between them(17 74% vs 8 83%). The characteristics that diabetes occurrence increased with aging has been confirmed by the correlation of diabetes prevalence to the aging in both middle age( r =1 00, P

Good doctor-patient communication is the most effective way to build a harmonious doctor-patient relationship and reduce medical disputes, where the communication skill is the key. In communication with the hospitalized patients, it should pay attention to the communication object choice;the choice of the communicator;communication time, location and the form; pay attention to the communication protocol; using a comprehensible language communication;stand in the perspective of patients in order to enhance the doctor-patient trust and im-prove the doctor-patient relationship.