The clinical data of 19 cases of giant cell arteritis (GCA) including 8 males and 11 females aged 21-92 y (average 62.2 y) from July 2002 to September 2008 were retrospectively reviewed.Among 19 patients,15 first visited the neurology department and 4 the rheumatism department;8 had fever and 16 had headache as primary symptom;the ESR ranged from 20 to 130 mm/1 h (average 71.1 mm/1 h).Fourteen patients were diagnosed as GCA at admission and 18 were treated with steroids hormone and all got remission except 1 death and 2 recurrences.If temporal artery biopsy is not acceptable,integrated analysis of signs,symptoms,laboratory tests,treatment effectiveness and follow-up is important for the correct diagnosis of GCA.

Objective:To observe the clinical effect of warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) in treatment of urinary retention after gynecological surgery. ＜br> Methods: Forty patients with urinary retention after gynecological surgery were randomly divided into two groups by the randomized method, 20 cases in each group. Patients in the treatment group were treated by warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36). Patients in the control group were treated by inductive urination. The therapeutic effects of the two groups were observed after one course of treatment. ＜br> Results:The total effective rate was 95.0%in the treatment group and 70.0% in the control group. The difference in the total effective rate between the two groups was statistically significant (P＜0.05). ＜br> Conclusion: Warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) is more effective than inductive urination in treating urinary retention after gynecological surgery.

Objective To observe and analyze the change state of serum inflammatory mediators of patients with secondary septic shock after chemotherapy for acute leukemia .Methods 56 patients with secondary septic shock after chemotherapy for acute leukemiawere were selected as the group A,56 patients without secondary septic shock after chemotherapy for acute leukemia were selected as the group B ,56 healthy persons of the same age were selected as the group C,then the serum inflammatory mediators levels of three groups were detected and compared,and the serum indexes of group A with different severity degree of shock were compared, then the detection results of group A and group B with different types ( lymphocytic leukemia and nonlymphocytic leukemia)were compared.Results The serum inflammatory mediators levels, including TNF-α, IL-4, IL-6, IL-10 and other inflammatory factors, including PGE2 , sICAM-1, sVCAM-1 and sCD44, there were group A >group B >group C, severe shock >moderate shock>mild shock ( all P<0.05 ) .The above serum inflammatory mediators and other inflammatory factors levels of different types in group A were higher than those in group B, and the above mediators in lymphocytic leukemia of group A and group B were higher than those in nonlymphocytic leukemia (all P<0.05).Conclusion The serum inflammatory mediators of patients with secondary septic shock after chemotherapy for acute leukemia show higher expression state,and the influence of shock degree and leukemia types for the expression are great.

Objective To observe the efficacy of Qingre Jiangzhuo prescription in the treatment of overweight subjects of type 2 diabetes mellitus. Methods Two hundred and four cases were divided into 2 groups in a randomized, paralleled, contrast, prospective study. The control group was treated with metformin tablet and the trial group was treated with Qingre Jiangzhuo prescription. The efficacy and safety of the two groups were compared on HbAlc, FBG, P2BG, TC, TG, BMI and AE after 12 weeks. Results After treatment, all indexes of the trial group were markedly improved compared with before treatment (P 0.05). The rate of AE in the trial group was less than that in the control group. Conclusion Qingre Jiangzhuo prescription has curative effect on type 2 diabetes mellitus patients with better safety.

Objective To explore the effect of applying functional movement screen (FMS) in the sport injury risk assessment of Chinese rugby athletes.Methods Rrugby athletes of Chinese national and provincial teams were selected and their data were collected using the standard FMS test.Their non-impact injury of the lower limbs and trunk were tracked and recorded.FMS diagnostic value and diagnostic cut-off value were evaluated using the receiver operating characteristic curve (ROC) and odds ratio (OR).Results The area under curve of all,male and female rugby athletes was 0.780 (P=0.000),0.877 (P=0.001) and 0.7130 (P=0.013) respectively,with significant differences from AUC=0.5.FMS score optimal cut-off point of all,male and female rugby athletes corresponding to the maxi mum Youden index was 13.5,15.5 and 13.5 respectively.Among all,male and female rugby athletes,the injury rates of the positive group (with FMS score less than the corresponding optimal cutoff point) were significantly higher than that of the negative group (with FMS total score greater than a corresponding cut-off point)(P＜0.01),and OR value of the positive group was 25.85 (95％CI:3.34～200.23),25 (95％CI:2.36～264.80) and 14.22 (95％CI:1.76～114.92) respectively.Conclusion In China,the average FMS score of rugby athletes had a strong correlation with non-contact sport injury,which might become an assessment index of non-contact sport injury risks.There is a significant difference in FMS score optimal cut-off points between the male and female rugby athletes,with that of the female being 13.5 points and the male being 15.5 points.

Objective To investigate the effect of early systemic nursing intervention applied by ward nurse on constipation among patients with depression. Methods A total of 144 participants were divided into the intervention group (72 cases) andthe control group (72 cases) by random number table. Except for a period of 4 weeks routine nursing and 4 weeks follow-up observation which were applied for control subjects, systemic nursing interventions werealso conducted inintervention patients. The incidence of constipation and constipation symptom scoreswere measured at the ends of the 4th and 8th week of treatment. Results The incidences of constipation and constipation symptom scores of the 4th and 8th weekend in the intervention group were 17.6% (12/68), 6.59 ± 4.08, 23.5% (16/68) and 6.81 ± 3.99 respectively. While in the control group they were 34.9%(22/63), 8.84 ± 4.45, 44.4%(28/63) and 10.52 ± 3.86 respectively. These differences between two groups at the 4th and 8th weekend were all significant (χ2=5.077, t=3.023, P < 0.05 and χ2=6.413, t=5.411, P < 0.05, respectively). Compared with the 4th weekend, in the 8th weekend, constipation rate and scores of constipation symptom were increased in thecontrol group (P < 0.05), but not in theintervention group (t=-1.965, P > 0.05). Conclusions In patients with depression, early systemic nursing intervention can effectively ameliorate the constipation caused by amitriptyline.

Objective To determine the correlation between serum asymmetric dimethylarginine (ADMA) and non-spoon-shaped blood pressure of non-dialysis chronic kidney disease (CKD) patients,also to observe the impact of the serum ADMA level on the structure and function of left ventricle.Methods One hundred and twenty cases of non-dialysis CKD patients underwent 24-hour ambulatory blood pressure monitoring were divided into three groups:CKD1-2,CKD3,CKD 4-5.Serum ADMA concentration was measured using liquid chromatograph and other clnical data such as uric acid (UA),left ventricular mass index (LVMI),24 h urine protein,and high-sensitivity C-reactive protein (hs-CRP) were collected for further statistical analysis.Results (1) With the decline of renal function,ADMA concentration was increased,from CKD 1-2 (1.70±0.48) μmol/L rose to CKD 4-5(4.46±1.56) μmol/L (P ＜ 0.05).(2)There were 42 cases of CKD patients with hypertension and 78 cases of CKD patients with normal blood pressure.The serum ADMA levels in hypertension group was significantly higher than those in non-hypertensive group [(3.53±1.70) μmol/L vs (2.01±0.65) μmol/L,P ＜ 0.05].(3)There were 50 cases of non-spoon-shaped normotensive CKD patients and 28 cases of spoon-shaped normotensive CKD patients.Serum ADMA level and LVMI in non-spoon-shaped group were significantly higher than that in spoon-shaped group when kidney functions appeared to be equal (P ＜ 0.05).(4)Serum ADMA level was positively correlated with UA(r=0.352,P ＜ 0.01),LVMI (r =0.345,P＜ 0.05),24 h urine protein(r =0.200,P ＜ 0.05),and high-sensitivity C-reactive protein (r =0.309,P ＜ 0.01),but negatively correlated with the left ventricular ejection fraction (LVEF)(r =-0.329,P ＜ 0.01) and estimated glomerular filtration rate (eGFR)(r =-0.011,P ＜ 0.01).Multiple regression results showed that eGFR,UA,LVMI,hs-CRP,24 h urine protein were associated with ADMA level.The regression equation was Y =1.991-0.011 × [eGFR] + 0.002 × [UA] + 0.008 × [LVMI] + 0.036 ×[hs-CRP]-0.084× [24 h urinary protein].Conclusions Serum ADMA level begins to increase in early stage CKD and it progressively increases with the decline of renal function,also the non-spoonshaped blood pressure ratio and the left ventricular damage increase.Kidney function,urine protein and microinflammatory state may impact on the serum ADMA level.

The paper analyzed legally the following predicaments of legitimization of rural doctors in China:no legitimacy protection for their practice,vague criteria for practicing medicine,conflicts between legal regulations for medical practice and rural realities,and lack of a liability insurance system.The authors,based on an exploration of the legislative framework for rural doctors,made four corresponding legislative proposals as follows:to clearly define the legal scope and identity of rural doctors,to establish a qualification and employment system for rural doctors,to develop practicing norms applicable for rural doctors,and to set standards for their income.

AIM To establish an HPLC method for the simultaneous content determination of calycosin-7-glucoside,ononin,calycosin,formononetin,oxypaeoniflorin,alibiflorin and benzoylpaeoniflorin in Sangqishouwu Tablets (Talxilli Herba,Astragali Radix,Polygoni multiflori Radix Praeparata,etc.).METHODS The analysis of methanol extract of this drug was performed on a 25 ℃ thermostatic Diamonsil C18 colmn (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.02％ phosphoric acid flowing at 0.9 mL/min in a gradient elution manner,and the detection wavelengths were set at 230 nm and 254 nm.RESULTS Seven constituents showed good linear relationships within their own ranges (r ≥ 0.999 2),whose average recoveries were 97.13％-100.03％ with the RSDs of 0.69％-1.47％.CONCLUSION This sensitive,accurate and specific method can be used for the rapid quality control of Sangqishouwu Tablets.