OBJECTIVETo observe the clinical efficacy difference in the treatment of neonatal hypoxic ischemic encephalopathy (NHIE) between the combined therapy of acupuncture land acupoint injection of nerve growth fac-tor (NGF) and the combined therapy of the intravenous drop of citicoline sodium and intramuscular injection of NGF.

METHODSSixty-one cases of NHIE were randomized into an observation group (32 cases) and a control group (29 cases). In the observation group, acupuncture combined with acupint injection of NGF was adopted. The acupoints were Baihui (GV 20), Dazhui (GV 14) and Fengfu (GV 16), 0. 5 mL each acupoint, once a day. In the control group, the intravenous drop of citicoline sodium and intramuscular injection of NGF were used. The, treatment of 7 days made one session and 3 sessions were required. Separately, in 7, 14 and 21 days of treatment, the clinical efficacy, behavior nerve determination score and adverse reaction were observed in the two groups.

RESULTSIn 7, 14 and 21 days of treatment, the total effective rates were 50. 0% (16/32), 68. 8% (22/32) and 78. 1% (25/32) in the observation group and were 69. 0% (20/29), 72. 4% (21/29) and 82. 8% (24/29) in the control group. The result in the control group was better than that in the observation group in the 7 days (P< 0. 05). The behavior determination scores in 7, 14 and 21 days were all improved obviously as compared with those before treatment in the two groups (P<0. 05, P<0. 01). The score in the control group was better than that in the, observation group in the 7 days (P<0. 05). The differences were not significant in the scores between the two groups in 14 and 21 days (both P>0. 05). The incidence of adverse reaction in the observation group was lower than that in, the control group [14. 3% (5/35) vs 31. 4% (11/35), P<0. 05] and the severity was mild.

CONCLUSIONIn the treatment of NHIE with the combined therapy of acupuncture and acupint injection, the overall efficacy in 1 week; is inferior to that of the combined therapy of the intravenous drop of citicoline sodium and intramuscular injection of NGF. But the efficacy is improved gradually along with the treatment progression and the adverse reaction is less.

Acupuncture Points ; Acupuncture Therapy ; Female ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; drug therapy ; therapy ; Infant ; Infant, Newborn ; Male ; Nerve Growth Factor ; administration & dosage

Humans ; Infant ; Otitis Media with Effusion ; diagnosis

Objective To investigate the effects of hypertonic saline/hetastarch solution (HHS) on stress hormones and glucose metabolism in hemorrhagic shock rabbit.Methods Fourteen rabbits of both sexes weighing 2.2-2.6 kg were randomly divided into 2 groups : HHS group ( n = 7) and lactated Ringer's solution (LRS) group ( n = 7). The animals were anesthetized with intravenous 20% urethane 5 ml? kg-1 . Femoral artery was cannulated for BP monitoring and femoral vein was cannulated for removal of blood and fluid infusion. Hemorrhagic shock was induced according to Wiggers. MAP was maintained at 45 mm Hg for 45 min. Then the animals in HHS group received HHS 6 ml? kg-1 and those in LRS group LRS 6 ml? kg-1 . Venous blood samples were taken before shock (baseline), during shock before resuscitation, and 30, 60, 120 min after fluid resuscitation for determination of plasma epinephrine, glucagon, insulin and blood glucose concentration. The insulin sensitivity index (ISI) was calculated.Results After resuscitation MAP returned to baseline level in HHS group while in LRS group MAP was still lower than the baseline. The plasma epinephrine, glucagon and blood glucose concentration increased significantly while plasma insulin concentration decreased significantly during shock before fluid resuscitation compared to the baseline in both groups. After fluid resuscitation plasma epinephrine and glucagon concentration decreased significantly and plasma insulin concentration increased significantly in HHS group whereas in LRS group plasma epinephrine, glucagon and insulin concentration kept increasing. The blood glucose level was significantly lower at 60 and 120 min after resuscitation in HHS group than in LRS group. ISI was decreased after resuscitation in both groups but was significantly lower at 60 and 120 min after resuscitation in LRS group than in HHS group.Conclusion Resuscitation with HHS can reduce the stress response and ameliorate the decrease in insulin sensitivity during hemorrhagic shock.

Objective To explore the best opportunity of termination of pregnancy and conservative therapy in the treatment of lata trimester of pregnancy combining hypertension or preeclampsia.Methods The clinical data of 198 patients with pregnancy combining hypertension or preeclampsia were studied retrospectively.Among the total patients,107 patients performed conservative therapy (conservative therapy group),91 patients performed termination of pregnancy (termination of pregnancy group).The prognosis of two groups was compared,including maternal and neonatal complications and morbidity and mortality.ResultsThe cesarean section rate of conservative therapy group was 54.2％ (58/107),termination of pregnancy group was 51.6％(47/91 ),there was no significant difference between two groups(P＞0.05 ).The perinatal complication rate of conservative therapy group and termination of pregnancy group was 15.9％(17/107) and 17.6％( 16/91 ),there was no significant difference between two groups(P＞0.05).The rate of placental abruption,low platelet disease,hypoproteinemia,postpartum hemorrhage between two groups had no significant difference (P＞0.05).Conservative therapy group had 3 cases neonatal asphyxia,1 case neonatal death.Termination of pregnancy group had 7 cases neonatal asphyxia,1 case neonatal death.The rate of adverse events of conservative therapy group had no significant difference compared with termination of pregnancy group (P＞0.05 ).The perinatal average weight of conservative therapy group was (2.635 ± 0.446)kg,termination of pregnancy group was (2.014 ±0.721) kg,there was significant difference (P＜0.05).Conclusion Under the premise of control blood pressure,spasmolysis,ensure maternal and neonatal safety,expectant monitoring can give more chances for fetuses to get more mature so decrease the complications.

Objective To investigate the influence of propofol on the induction of inducible nitric oxide synthase (iNOS) expression in spinal cord after spinal cord injury (SCI) in rats. Methods SCI model was reproduced according to Allen′s method with modification. Seventy-four SD rats were randomly divided into three groups: normal group (n=4), SCI with propofol treatment group (n=35), and SCI with saline treatment group (n=35). Immunohistochemistry and Western blot were employed to detect iNOS expression in spinal cord at different time (1h, 3h, 8h, 1d, 3d, 7d, 14d). Results The results showed that iNOS expression in spinal cord of propofol treatment group was significantly decreased compared with that of saline treatment group (P

Objective To analyze the association between pre-pregnancy body mass index,pregnancy weight gain and gestational diabetes(GDM).Methods The pre-pregnancy body mass index,pregnancy weight gain and the incidence data of 345 gestational diabetes with full-term primiparae were analyzed.Results The GDM ratio of low-weight,ideal weight group,over-weight was 2.78％,2.96％,16.04％,respectively over-weight GDM pregnancy was significantly higher than the ideal weight group( x2 =4.269,P ＜0.05),and GDM over-weight before pregnancy was significantly higher than the low weight group the incidence of GDM,the difference was statistically significant( x2 =17.299,P ＜0.01 ) ;Pregnant women in different pregnancy weight gain A( ＜ 11.0kg),B( 11.0 ～ 17.9kg),C( 18.0～24.9kg),D(≥25.0kg) range,the GDM were 0％,1.75％,6.60％,11.02％,that GDM of A,B,C,D group were statistically different( P ＜ 0.05 ).Rate of weight gain during pregnancy on pregnancy size was proportional to the impact of diabetes.Conclusion Pre-pregnancy body mass index,pregnancy weight gain had clinical significance in evaluation of gestational diabetes.

OBJECTIVETo observe the clinical efficacy difference on vegetative state in children between acupoint injection combined with plum-blossom needle and western medication based on basic treatment.

METHODSForty-eight children of vegetative state were randomized into an observation group and a control group, 24 cases in each one. On the basis of the treatment of transcranial magnetic stimulation apparatus, balancing treatment apparatus and massage, the acupoint injection and tapping method with plum-blossom needle were adopted in the observation group, in which Xingnaojing injection, mouse nerve growth factor (mNGF) injection, monosialotetrahexosylganglioside sodium injection (MSI), compound Danshen injection were divided in 6 pairs and were injected respectively in Baihui (GV 20), Yongquan (KI 1), Fengfu (GV 16), Yamen (GV 15) and the others, 0.5 mL in each acupoint, once a day for continuous 10 days. Additionally, the tapping method with plum-blossom needle was used on the Governor Vessel and Jiaji (EX-B 2) on the back. In the control group, the intravenous infusion was adopted with citicoline sodium injection, mannitol injection and dexamethasone injection. The treatment was given once a day, 20 days of treatment made one session and totally 3 sessions were required in the two groups. The clinical efficacy, the vegetative state score and the mean curing time were observed after 20 days, 40 days and 60 days of treatment between the two groups.

RESULTSThe effective rates were 58.3% (14/24), 70.8% (17/24) and 79.2% (19/24) in 20 days, 40 days and 60 days of treatment in the observation group and 20.8% (5/24), 45.8% (11/24) and 58.3% (14/24) in the control group respectively. The efficacy in the observation group was superior to those in the control group (P < 0.01, P < 0.05). The vegetative state score was improved apparently after 20 days, 40 days and 60 days of treatment as compared with those before treatment separately (all P < 0.05). It was improved obviously at the each time point after treatment in the observation group as compared with that in the control group (3.34 +/- 2.41 vs 2.64 +/- 11.56, 6.20 +/- 1.46 vs 4.34 +/- 1.64, 11.26 +/- 2.63 vs 8.75 +/- 2.18, all P < 0.05). The mean curing time was (45.67 +/- 16.24) days in the observation group, which was shorter apparently than that of (55.34 +/- 4.57) days in the control group (P < 0.05).

CONCLUSIONBased on basic treatment acupoint injection combined with tapping method of plum-blossom needle achieve the reliable efficacy on vegetative state in children.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Animals ; Child, Preschool ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infant ; Male ; Mice ; Nerve Growth Factor ; administration & dosage ; Persistent Vegetative State ; drug therapy ; therapy ; Phenanthrolines ; administration & dosage ; Treatment Outcome

Objective To investigate the distribution and drug resistance of pathogenic bacteria in hospital ICU patients with lower respiratory tract infection , and provide scientific reference for clinical rational drug use . Methods The strains were identified by VITEK -32 automatic bacterial identification instrument , the bacterial sensitivity was determined by K -B disk diffusion method , and the statistical analysis was performed by WHONET 5.4 software.Results The total isolated pathogenic bacteria of lower respiratory tract infection in ICU patients was 453 strains.332 strains of gram negative bacteria accounted for 73.3%,and the former three ones were Pseudomonas aeruginosa (115 strains,accounted for 25.4%),Klebsiella pneumonia (90 strains,accounted for 19.8%),Acineto-bacter baumannii (38 strains,accounted for 8.4%).102 strains of gram positive bacteria accounted for 22.5%,and the top three were Staphylococcus aureus (31 strains,accounted for 6.8%),coagulase negative Staphylococcus (22 strains,accounted for 4.9%),Enterococcus (18 strains,accounted for 4%).Meropenem,imipenem (Stenotroph-omonas maltophilia was excepted ) ,Cefoperazone /sulbactam and Amikacin were most sensitive against gram negative bacteria;Teicoplanin and vancomycin were highly sensitive against gram positive bacteria .Conclusion The main pathogenic bacteria of respiratory tract infection in ICU patients was gram negative bacilli ,which were seriously resist-ant to commonly used antimicrobial drugs .So strengthening the infection management of ICU and the control for risk factors,and rationally using of antimicrobial drugs has great significance in reducing the drug resistance of pathogenic bacteria rate .

Objective To study the effect of Guipi Decoction on serum IL-1? and hippocampus IL-1RⅠ expression of depression model rats, and approach its mechanism of treating depression. Methods The depression model was established by received chronic unpredictable stress stimulus. Forty female Wistar rats were divided into four groups:control group, model group, saline group and Chinese medicine group. All rats were weighed and taken Open-field test on 0 and 22nd day, the serum IL-1? was detected with radio-immunity, and the expression of IL-1RⅠ was detected with immunohistochemical method. Result Compared with the control group, the weight, behavior points, serum IL-1?, expression of IL-1RⅠ of the model group and the saline group changed obviously while that in Chinese medicine group did not. Conclusion The anti-depressive mechanism of Guipi Decoction is related to maintaining the normal excretion of IL-1? and IL-1RⅠ expression from the chronic stress.

Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.