To Describe the current situation of Niger children receiving acupuncture treatment.Acupuncture has 30 years of development history in Niger.Chinese medical teams had established acupuncture department in the Central Hospital in Maradi,Niamey National Hospital,and National Hospital of Zinder,and presided over acupuncture work.But due to a variety of reasons,at present,only the Central Hospital in Maradi has reserved acupuncture therapy,and was combined with physical therapy,rehabilitation therapy to form exercise therapy and functional training division.Pediatric patients are the major subjects who received acupuncture,accounting for 2/3 of outpatients.Nervous system and motor system diseases were their main diseases.

Objective To explore the possible immunological mechanism of laminarin sulfate in the prevention of experimental atherosclerosis. Methods Serum soluble interleukin 2 receptor (sIL-2R) , circulating immuno-complex, sub units of T lymphocyte, inter leukin-6(IL-6) , in-terleukin-8(IL-8), tumor necrosis factor-a (TNF-a) and lipid metabolism were determined by ELISA, RIA in rats and quails. Results The lipid metabolism and immunologic function were prominent disturbance in animals after feeding with high-lipid food. However, Laminarin sulfate has obvious regulating effects on above-mentioned index. Conclusions The mechanism of laminarin sulfate in the prevention of atherosclerosis might be closely related to the regulation of the disturbance of lipid metabolism and to the regulation of the immunologic function of the body.

Objective To analyse the clinicopathological changes of Alport syndrome (AS) and to detect the deposition of type Ⅳ collagen within basement membrane of Alport patients. Methods Fourteen patients with AS (12 families) hospitalized from 1990. 1 to 1996. 6 were investigated. Eleven were male and 3 female (mean age 29. 4 years). Results Microscopic hematuria was found in 13, with recurrent gross hematuria in 7. All had proteinuria. Three patients presented nephrotic syndrome. Progressive renal failure occured in 10 of 11 male(11 - 39 years) and 1 female (40 years). Six patients were treated with hemodialysis, two of them with transplantation. Sensorineural deafness was observed in 9 patients particularly high frequency sound. Anterior lenticonus were presented in 2. It showed heterogeneitic, 50% transmitted as X-linked dominant(XD) trait. In 7 renal biopsies, the findings by light microscopy mostly revealed focal and segmental sclerosis glomerulonephritis (4/7). The results of immunofluorescenc e (IF) were ne gatt ye in 4. Ultrastructural studies showed variable thickening, thinning of glomerular basement membrane (GBM) in 7 specimens with lamellation and basket-weaving of GBM in 1. Using the iIF technique, the ?3, 4, 5 (Ⅳ) chains were absent within both GBM and EBM of 4 male XD-AS patients. Conclusions AS is not a rare hereditary disease characterized by hematuria, proteinuria and progressive renal failure with sensorineural deafness and ocular lesions. Type Ⅳ collagen within Alpori patients' basement membrane is abnormal and iIF study of type Ⅳ collagen chains distribution is useful to confirm the diagnosis of AS.

Objective To evaluate the clinical effects of sitagliptin and sitagliptin combined with glimepiride in the treatment of type 2 diabetes (T2DM).Methods Ninety-two patients with T2DM were randomly divided into sitagliptin group (group J),glimepiride group (group G) and sitagliptin combined with glimepiride group (group U),group J took sitagliptin,group G took glimepiride,group U took sitagliptin and glimepiride.Before and after treatments,blood glucose and insulin were determined in the fasting and 2-hour blood samples after taking glucose (fasting blood-glucose (FPG),2-hour postprandial blood glucose (2hPG),insulin (FIns),2-hour postprandial insulin (2hIns),and glycosylation hemoglobin (HBA1 c) were also determined and homeostasis model assessment was applied to estimate the functions index of islet β cell(HOMA-β).Results The levels of blood glucose and HBA1C in three groups decreased after treatments(FPG,(before treatment:(9.2±3.0),(9.2±2.8),(9.3±3.2) mmol/L),(after treatment:(7.7 ± 3.0),(6.9 ± 2.6),(6.0 ± 2.5) mmol/L),and t values are 2.205,3.203,3.691,P ＜ 0.01,P ＜ 0.05 ;2 hPG (before treatment:(14.1 ± 5.7),(14.8 ±6.3),(15.0±6.8) mmol/L),(after treatment:(7.9 ±2.9),(9.0 ±3.1),(7.1 ±3.1) mmol/L),and t values are 3.881,3.159,4.189,P ＜ 0.01 ; HBA1c (before treatment:(8.52 ± 2.01)％,(8.48 ± 1.94)％,(8.56 ±2.27)％,(after treatment:(7.64 ± 1.92)％,(6.81 ± 1.55)％,(6.19 ± 1.84)％),t values are 2.292,2.184,3.269,P ＜ 0.01,P ＜ 0.05) ; HOMA-β in the three groups increased after treatment ((before treatment:1.42 ± 0.07,1.44 ± 0.06,1.41 ± 0.11),(after treatment:1.76 ± 0.14,1.68 ± 0.20,1.85 ±0.17),t values are 2.180,2.073,2.882,P ＜ 0.01,P ＜ 0.05);levels of HBA1c and blood glucose in group U were lower than those in group J and G(HBA1 c:t values are 2.785,2.138,P ＜ 0.05,P ＜ 0.01 ;FPG:t values are 2.252,2.346,P ＜0.05;2hPG:t values are 2.147,2.829,P ＜0.01,P ＜0.05),HOMA-β in which was higher than that of group G(t =2.153,P ＜ 0.05),but with no significant difference compared with group J (t =1.796,P ＞ 0.05),levels of HBA1C,FPG and HOMA-β in group J were higher than those of group G (t values are 2.108,2.202,2.121,P ＜ 0.05),level of 2hPG of group J was lower than that of group G(t =2.307,P ＜ 0.05).Conclusion Sitagliptin provides significant glycaemic control,together with glimepiride,clinical effect of treatment of type 2 diabetes will be enhanced.

Objective To investigate the effects of lipnsomal prostnglandin E1 (Lipo-PGE1) on the renal function in patients undergoing cardiopulmonary bypass (CPB) .Methods Twenty ASA Ⅱ or Ⅲ patients of both sexes aged 34-56 yr weighing 48-81 kg scheduled for elective cardiac valve replacement with CPB were randomly divided into 2 groups (n = 10 each): normal saline group (group NS) and Lipo-PGE1 group. In group Lipo-PGE1, Lipo-PGE1 was infused at 3 ng·kg-1·min-1 from the initiation of CPB to the end of CPB, and then added into the priming solution of the extracorporeal circulation machine with its concentration set at 5 ng/ml. In group NS, the equal volume of normal saline was administered instead of Lipo-PGE1 . The concentrations of thromboxane B2 ( TXB2 ), 6-keto-prostnglandin F1α ( 6-Keto-PGF1α ), and free hemoglobin ( F-Hb ) in plasma, and α1-microgipbulin (α1-MG), β2-micmglobulin (β2-MG) and Cystatin C (Cys C) in serum were measured after heparinization and before CPB (T1), at 30 min of CPB (T2) and at 0, 1 and 24 h after termination of CPB (T3-5). Results Compared to T1, the concentrations of TXB2, 6-Keto-PGF1α, α1-MG and β2-MG and TXB2/6-Keto-PGF1α ratio at T2-4, and the concentrations of F-Hb and Cystatin C at T2-5 were significantly increased in both groups ( P < 0.05). The concentration of 6-Keto-PGF1α at T2-4 was significantly higher, and concentrations of TXB2, α1-MG and β2-MG and TXB2/6-Keto-PGF1α ratio at T2-4 and concentrations of F-Hb and Cys C at T2-5 were significantly lower in group Lipo-PGE1 than in group NS ( P < 0.05). Conclusion Lipo-PGE1 can obviously improve the renal function in patients undergoing CPB.

Objective To investigate the underlying mutation in a late-onset Chinese patient with classic Bartter syndrome. Methods The mutation analysis of CLCNKB gene was performed by the PCR direct sequencing. The patient's parents and siblings were studied as well. Fifty normal volunteers were analyzed as control group. Results The heterozygous deletion mutation cDNA 753delG and heterozygous missense mutation G433E were detected in the patient. Her father was found to carry heterozygous G433E and her mother to carry cDNA 753delG mutation respectively. Her brother carried heterozygous G433E and her sister was normal. Conclusions Two mutations of the CLCNKB gene in this Chinese patient with late-onset classic Bartter syndrome are identified. The cDNA 753delG mutation has not been reported previously.

Objective: To observe the clinical effects of Zhu Lian's type Ⅰ excitation needling technique for postpartum urinary retention. Methods: A total of 60 cases with postpartum urinary retention were recruited and divided randomly into an observation group and a control group, 30 cases in each group. The control group was treated with routine acupuncture, and stimulated with sparse and dense wave of electric acupuncture for 15 min after arrival of needling sensation, and then the needles were taken out. The observation group was treated with Zhu Lian's type Ⅰ excitation needling technique, by inserting the needles with the quick inserting method, swift and temporary lifting and thrusting technique for shallow insertion for 5 times, by an in-and-out technique, without retaining the needles. Results: The total effective rate was 96.7% in the observation group and 83.3% in the control group. The difference in the total effective rate between the two groups was statistically significant (P<0.05). After the treatment, the first urination time was shorter in the observation group than that in the control group, with a statistical significance (P<0.01). After the treatment, the volume of residual urine after the first urination was less in the observation group than that in the control group (P<0.01). Conclusion: Zhu Lian's type Ⅰ excitation needling technique can effectively promote the voluntary urination and bladder emptying in patients with postpartum urinary retention, and it takes effect faster.

Objective To screen the mutations in 30 exons of COL4A5 gene from X-linked Alport syndrome. Methods 20 Chinese X-linked Alport syndrome patients from 16 families were examined. Genomic DNA was extracted from peripheral leukocyte and exon-specific primers were designed for 30 exons(1-25、31、 32、41、 50、51) . Polymerase chain reaction amplification was performed and followed bydegenerating gel gradient electrophoresis (DGGE) analysis. All abnormal migration bands were sequenced and one hundred normal persons selected as control. Results Four abnormal bands were detected, which were all point mutations and predicted to be functionally pathogenic, in four unrelated patients. One patienthad a nonsense mutation in exon 1 (Glu 22 Term); one had a missense mutation in exon 3l(Gly852Val).Two patients carried splicing mutations in intron 1 and 25 respectively(283+1G→T、2150 + 1G→T) .Conclusions X-linked Alport syndrome is caused by various kinds of COL4A5 gene mutations without any hotspot. Paralleled with the significance of exon mutations, intron mutations also play a critical role in the pathogenesis. Furthermore, these four pathogenic mutations have never been reported in the genebank and showed good correlation with clinical manifestations.

Objective To observe the clinical efficacy of ZHU Lian's acupuncture activating method with type 1 manipulations in treating hypotonic cerebral palsy.Method Sixty patients with hypotonic cerebral palsy, aged 9-59 months, were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by ZHU Lian's acupuncture activating method with type 1 manipulations, while the control group was intervened by acupoint injection of vitamin B1 and B12. The two groups were treated once a day, 5 sessions as a treatment course. The Gross Motor Function Measure-88 (GMFM-88) was evaluated before the treatment and after 10 treatment courses.Result The GMFM-88 score was significantly changed after the treatment in both groups (P<0.05). After the intervention, the GMFM-88 score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion ZHU Lian's acupuncture activating method is an effective approach in treating hypotonic cerebral palsy.

Objective To evaluate the effects of doxofyline on intraoperative pulmonary function in patients receiving double lumen endotracheal intubation for one-lung ventilation. Methods Fifty patients who underwent elective pulmonary lo-bectomy under general anesthesia using double lumen endotracheal intubation were randomly divided into two groups ( n=25 each):control group (group C) and doxofyline group (group D).Doxofyline (4 mg?kg-1) was injected intravenously after double lumen endotracheal intubation in group D,while equal volume of 0.9% sodium chloride was intravenously given in group C.Total intravenous anesthesia with target controlled infusion was performed during the operation.Two milliliter blood samples were taken from the radial artery for blood gas analysis immediately before administration ( t0 ) ,at 30 min ( t1 ) ,60 min ( t2 ) after one-lung ventilation and at the moment of two-lung ventilation after chest closing ( t3 ) . The PaCO2 , PaO2 , peak airway pressure (Ppeak),airway plateau pressure (Pplat),airway resistance (Raw) and lung compliance (Compl) were recorded at t0-3. Results The Ppeak,Pplat and Raw were significantly decreased and the Compl and PaO2 significantly increased at t1-t3 in group D when com-pared with those in group C (P<0.05).The Ppeak,Pplat and Raw were significantly increased and Compl and PaO2 significantly de-creased at t3 as compared with those at t0 in group C ( P<0.05) . Conclusion Doxofyline can improve intraoperative pulmonary function in patients who undergo double lumen endotracheal intubation for one-lung ventilation.