site C. As for the pulmonary function indexes, site A

Objective To discuss the causes and the prevention measures of the complications occurred after interventional therapy for different type of Budd-Chiari syndrome (BCS). Methods Based on the type of BCS, the corresponding interventional management was adopted in 204 patients with BCS. The interventional procedures included PTA and stent placement of inferior vena cava (IVC), percutaneous transhepatic recanalization and dilation (PTRD) of hepatic vein, percutaneous transjugular or transinferior vena cava recanalization, dilation and stent placement of hepatic vein and transjugular intrahepatic portal-systemic stenting shunt (TIPSS). Results The successful rate of interventional therapy was 95.5% (21 / 22) for type Ia, 81.8% (9 / 11) for type Ib, 97.3% (109 / 112) for type IIa, 92.9% (13 / 14) for type IIb, 88.9% (8 / 9) for type Ⅲa, 100% (2 / 2) type Ⅲb, 92% (23 / 25) for type Ⅳa and 88.9% (8 / 9) for type Ⅳb BCS. The main complications occurred during or after the operation included acute cardiac insufficiency (n = 2), pulmonary arterial embolization (n = 4), disseminated intravascular coagulation (n = 1), extravasation of contrast medium (n = 3), arrhythmia (n = 2), and cardiac tamponade (n = 1). Conclusion Interventional therapy is simple, safe and effective for the treatment of BCS, but its indications should be strictly considered and all kinds of effective prevention measures should be taken to avoid or to reduce the possible complications.

Objective To investigate the protective effect of wound in burn part of wound on nanometer silver dressing.Methods Selected 48 fleet Ⅱ degree and deep Ⅱ degree burn patients of burn deepness equality opposite nonarthrosis place.Two burn wound of deepness equality consistent of the each case were randomly divided in two comparison area.The treatment groups adopted nanometer silver dressing apply.The comparison groups adopted 1%SD-Ag cool frost apply on vaseline gauze.Put up wound secretion germiculture and judged with two groups wound at 3 postburn day(PBD3),PBD5,PBD9 and PBD14.Observed and noted the wound heal instance and speed.Observed the medicament badness responses.Results The wound germ tested rate compare: the masculine rate fleet Ⅱ degree 3.84% and deep Ⅱ degree 9.09% in the treatment groups.The masculine rate fleet Ⅱ degree(11.53)% and deep Ⅱ degree 18.18% in the comparison groups.The wound heal time compare: the treatment groups average shorter two-three days than the comparison groups in the fleet Ⅱ degree.The treatment groups average shorter four-five days than the comparison groups in the deep Ⅱ degree,P

Leukoencephalopathy with vanishing white matter(VWM) is one of the most prevalent inherited white matter disorders in childhood,and it′s the only known hereditary human disease due to the direct defects in protein synthesis process,with the gene defects in EIF2B1-5,encoding the five subunits of eukaryotic translation initiation factor(eIF2B ?,?,?,? and ?) respectively.eIF2B is essential for the protein translation initiation process,and its action is realized via eukaryotic translation initiation factor2(eIF2).Phosphorylation of eIF2? and eIF2B? is an important way to regulate eIF2B function,and thus play a key role in control of the protein translation level under physiological condition.Mutant eIF2B results in functional defects and decrease of the overall protein translation in cells,but in increase the translation of proteins with multiple upstream open reading frames,such as activating transcription factor 4(AFT4),which leads to the susceptibility to un-folded protein response under stress,and the following apoptosis.The exact pathogenic mechanisms of VWM are far from well understood.It′s suggested that level of AFT4 in cells with eIF2B mutations is higher than in wild type cells under physiological condition,which makes the mutant cells more susceptible to endoplasmic reticulum(ER) stress and unfolded protein response(UPR).Under stress,the defect eIF2B leads to a vicious cycle of UPR activation,which may underlie the neurological aggravation in VWM patients after minor stress,a specific cli-nical feature of VWM.Elucidating the pathogenesis of VWM will be helpful to further understand the protein translation process in eukaryotic cells,and provide a clue for possible therapeutic targets and treatment strategies in the future.Abstract:SUMM ARY Leukoencephalopathy with vanishing white matter(VWM) is one of the most prevalent in-herited white matter d isorders in childhood,and i′ts the only known hered itary human d isease due to the d irect defects in protein synthesis process,with the gene defects inEIF2B1-5,encod ing the five sub-units of eukaryotic translation initiation factor(eIF2B?,?,?,?and?) respectively.eIF2B is essential for the protein translation initiation process,and its action is realized via eukaryotic translation initiation factor2(eIF2).Phosphorylation of eIF2?and eIF2B?is an important way to regulate eIF2B function,and thus play a key role in control of the protein translation level under physiological cond ition.Mutant eIF2B results in functional defects and decrease of the overall protein translation in cells,but in increase the translation of proteins with multiple upstream open read ing frames,such as activating transcription factor 4(AFT4),which leads to the susceptibility to un-folded protein response under stress,and the following apoptosis.The exact pathogenic mechanisms ofVWM are far from well understood.I′ts sugges-ted that level ofAFT4 in cells with eIF2B mutations is higher than in wild type cells under physiological cond ition,which makes the mutant cellsmore susceptible to endoplasm ic reticulum(ER) stress and un-folded protein response(UPR).Under stress,the defect eIF2B leads to a vicious cycle ofUPR activa-tion,which may underlie the neurological aggravation in VWM patients afterm inor stress,a specific cli-nical feature ofVWM.E lucidating the pathogenesis ofVWM will be helpful to further understand the pro-tein translation process in eukaryotic cells,and provide a clue for possible therapeutic targets and treat-ment strategies in the future.

Objective To investigate the effects of levels of serum C-reactive protein (CRP), B-natriuretic peptide (BNP) and cholinesterase (ChE) on prognosis of elderly patients with pulmonary infection.Methods Sixty cases aged ≥ 65 years old with lung infection admitted to Departments of Infectious Diseases and Respiration of Hebei Provincial People's Hospital from March 2012 to March 2014 were enrolled. According to the diagnostic criteria of pulmonary infection and the severity score (PSI) of pneumonia, the patients were classified into three groups with different grades of infectious severity (PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups), 20 cases in each group; in the same period, 20 elderly healthy people having accepted the physical examination in this hospital were designed as the healthy control group. Furthermore, according to the difference in prognosis, the patients were divided into a survival group (52 cases) and a death group (8 cases). The PSI scores, the levels of white blood cell count (WBC), D-Dimer, CRP, BNP and ChE, mortalities, times of stay in hospital were compared between the PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups and the healthy control group as well as between the survival and death groups.Results The periods of stay in hospital of patients with PSI Ⅳ and Ⅴ were much longer than that patients with PSI Ⅰ-Ⅲ (days: 14.7±2.1, 18.3±2.6 vs. 9.2±1.7, both P < 0.05), the degree of increase in time in the PSI Ⅴ group being the most significant. Before treatment, compared with the healthy control group, the PSI score, the levels of WBC, D-dimer, CRP and BNP were significantly increased, the level of ChE was markedly decreased in patients with PSI Ⅱ-Ⅲ, Ⅳ and Ⅴ groups, and along with the rise of PSI score the changes were more remarkable [PSI score: 78.9±13.7, 117.4±20.2, 152.1±34.8 vs. 51.3±7.9; WBC (×109/L): 11.4±1.4, 13.6±1.9, 16.7±2.2 vs. 8.9±1.1; D-Dimer (μg/L): 779.6±46.1, 1 068.2±142.6, 1 846.2±215.0 vs.348.3±31.8; CRP (mg/L): 30.1±3.7, 58.2±6.7, 74.7±9.2 vs. 6.8±0.9; BNP (ng/L): 1 057.4±205.1, 1 976.7±333.7, 2 437.7±468.9 vs. 115.8±21.7; ChE (U/L): 6 260±826, 3 390±437, 1 861±268 vs. 7 804±904, allP < 0.05]. The mortalities of groups PSI Ⅳ and PSI Ⅴwere more than that in group PSI Ⅱ - Ⅲ [10.0% (2/20), 30.0% (6/20) vs. 0]; there was no statistically significant difference in age between the survival group and death group (P > 0.05). Compared with the survival group, the PSI score, the levels of WBC, D-dimer, CRP and BNP after treatment in death group were markedly higher [PSI score: 141.5±23.3 vs. 97.6±18.2; WBC (×109/L): 15.9±1.9 vs. 12.1±1.8; D-Dimer (μg/L): 1 373.9±179.4 vs. 627.4±69.6; CRP (mg/L): 69.8±9.8 vs. 42.6±7.3; BNP (ng/L): 2 745.6±374.9 vs. 1 022.2±171.3; allP < 0.05], the level of ChE was significantly lower (U/L: 2 569±309 vs. 5 692±777,P < 0.05).Conclusion The serum levels of CRP, BNP and ChE in aged patients with pulmonary infection are helpful to the early diagnosis of disease severity, so as they have guiding significance in predicting prognosis.

Objective To observe the clinical efficacy of hydro-medicinal cupping using Chinese medicinal granules in treating discogenic low back pain. Methods Sixty patients with discogenic low back pain were randomized into a treatment group and a control group, 30 in each group. The two groups were both intervened by hydro-medicinal cupping at Yaoyangguan (GV 3) and two sides of the point, while the Chinese medicinal granules were used in the treatment group and the conventional form of medicine was used in the control group. The pain score was observed before treatment and after 4 treatment courses, and the clinical efficacies were also compared. Results The pain scores were significantly changed after intervention in both groups (P<0.01). After intervention, there was no significant difference in comparing pain score between the two groups (P>0.05). The total effective rate was 93.3%in the treatment group versus 96.7% in the control group, and the difference was statistically insignificant (P>0.05). Conclusions Hydro-medicinal cupping is an effective approach in treating discogenic low back pain, and there is no marked difference in efficacy between the Chinese medicinal granules and conventional form of medicine.

AIM: To explore the effect of pulmonary arterial smooth muscle cell (PASMC) apoptosis on the reversal of hypoxic pulmonary arterial remodeling during reoxygenation and its possible mechanism.METHODS: Male SD rats (n=24) were randomly divided into normoxia for 4 weeks group, hypoxia for 4 weeks group, reoxygenation for 1 week after hypoxia for 4 weeks group and reoxygenation for 6 weeks after hypoxia for 4 weeks group.Right ventricular systolic pressure (RVSP), right ventricular hypertrophy index, pulmonary arterial medial thickness (MT) and medial area (MA) as well as autophagy and apoptosis in the pulmonary arterial medial layer were examined during hypoxia-reoxygenation.The rat primary PASMCs were divided into normoxia for 48 h group, hypoxia for 48 h group, reoxygenation for 24 h after hypoxia for 48 h group and normoxia for 72 h group to explore the changes of PASMC autophagy and apoptosis following hypoxia-reoxygenation.Finally, primary PASMCs were divided into normoxia for 72 h group, reoxygenation for 24 h after hypoxia for 48 h group and reoxygenation for 24 h after hypoxia for 48 h + chloroquine (inhibitor of autophagy) group to investigate the effect of PASMC autophagy during hypoxia on the apoptosis during reoxygenation.RESULTS: After hypoxia for 4 weeks, the RVSP, during right ventricular hypertrophy index, MT and MA increased significantly compared with normoxia group (P<0.05), and gradually decreased during reoxygenation.The expression of LC3 in the pulmonary arterial medial layer increased evidently after hypoxia and gradually reversed during reoxygenation.Moreover, the P62 and cleaved caspase-3 expression decreased after hypoxia compared with normoxia group, and increased markedly following reoxyge-nation.The expression of cleaved caspase-3/PARP in rat primary PASMCs decreased significantly under hypoxia (P<0.05), and increased evidently during reoxygenation.The expression of P62 and LC3-II decreased markedly under hypoxia (P<0.05).After inhibition of PASMC autophagy under hypoxia, the expression of cleaved caspase-3/PARP decreased remarkably during reoxygenation (P<0.05).CONCLUSION: The PASMC apoptosis participates in the reversal of hypoxic pulmonary arterial remodeling, and the PASMC autophagy under hypoxia might facilitate its apoptosis during reoxygenation.

Objective To observe the effect of acupuncture plus acupoint injection on the hyperhomocystinemia in the convalescent stage of cerebral infarction patients.Method A total of 120 patients in the convalescent stage of cerebral infarction with hyperhomocystinemia were randomized into group A, group B, and group C, 40 cases in each group. The three groups were intervened by conventional western medicine treatment and rehabilitation therapy, the group A was byXing Nao Kai Qiao acupuncture treatment in addition, the group B was by acupoint injection with cobamamide for injection and the group C was byXing Nao Kai Qiao acupuncture plus acupoint injection treatment. The change of the plasma homocysteine (HCY) level, the Barthel Index (BI) score and National Institutes of Health Stroke Scale (NIHSS) score were observed before and after treatment.ResultEach index(the HCY level, BI score and NIHSS score) in the three groups was significantly changed after treatment(P<0.01). Each index in the group C was significantly different from that in the group A and group B after treatment(P<0.05,P<0.01). The HCY level of the group B after the treatment was significantly different from that of the group A.Conclusion Acupuncture plus acupoint injection can significantly change the HCY level of the convalescent stage of cerebral infarction patients with hyperhomocystinemia, improve the activity of daily living and nerve function.

OBJECTIVETo compare the differences in the characteristic medicinal cupping therapy between the traditional cupping device and the innovated cupping device.

METHODSFifty patients of neck and low back pain were selected. The self-comparison was adopted. The cupping therapy was applied to the acupoints located on the left or right side with the traditional cupping device and the innovated cupping device. The cupping sites were centered at bilateral Quyuan (SI 13) and Dachangshu (BL 25). The cups were retained for 10 min. The traditional cupping device was the glass with smooth border, 100mL. The innovated cupping device was the vacuum-sucking cup. The operative time, medicinal leakage, comfort and cupping marks were observed for the two different cupping devices.

RESULTSThe operative time with the innovated medicinal cupping device was shorter obviously compared with the traditional one at Quyuan (SI 13) and Dachangshu (BL 25, both P<0. 05). The comfort with the innovated medicinal cupping device was remarkably improved as compared with the traditional one at the two acupoints (both P<0. 05). The medicinal leakage was similar between the two different devices during the cupping operation (both P>0. 05). The cupping marks with the innovated medicinal cupping device were much deeper than those with the traditional one after cupping therapy.

CONCLUSIONThe innovated cupping device is more convenent and comfortable in operation during the characteristic medicinal cupping therapy.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Medicine, Chinese Traditional ; instrumentation ; methods ; Meridians ; Middle Aged ; Neck Pain ; therapy ; Young Adult

Objective To explore the reliability of handgrip strength test for evaluating mobility in patients with stable chronic obstructive pulmonary disease.Methods Sixty-one COPD patients in stable stage were measured for handgrip strength and 6-minute walking test(6MWT).The receiver operating characteristic curve(ROC) was calculated to determine the best cutoff points of handgrip strength.Results Handgrip strength was (33.72-±7.47) kgf,6MWD was (437.06±97.96) m,handgrip strength was moderately correlated with 6MWD (r=0.404,P=0.001).6MWD≥350 m was used to classify two groups,and there was significant difference between two groups(P＜0.05).Area under the curv e was 0.722,and the best cutoff points was 32.8 kgf.Conclusion Handgrip strength test can be a useful tool to quickly identify mobility in patients with stable COPD.