ObjectiveTo observe the clinical efficacy of acupuncture in treating musculospiral paralyses.MethodSixty patients with musculospiral paralyses were elected to receive acupuncture treatment. The motor function and electromyogram (EMG) were detected after 14-day treatment.ResultOf the 60 patients, 36 were recovered, 21 showed improvement, 3 failed in the treatment, and the total effective rate was 95.0%.ConclusionAcupuncture can produce a significant efficacy in treating musculospiral paralyses, and it benefits the recovery of motor function of the impaired nerve.

Objective To investigate the effect of adhesive membrane that has anti-side leakage and can be drained during the operation of cegarean section.Methods 300 cageg of lying-in women with cessrean section were randomly divided into three groups,the test 1 group,test 2 group and the control group.The test 1 group used adhesive membrane specially adopted in cerebral surgery,the test 2 group used the"U"shape adhesive membrane that had anti-side leakage and could be drained during the operation,the control group used the routine adhesive membrane,and then the contamination by amniotic fluid and blood of the thine groups was observed.Resulls Compared with test 1 group and the control group,the pollution by amniofic fluid and blood was significanfly decreased in the test 2 group,P＜0.01.Conclusiom This modified designed"U"shape adhesive membrane can drain amniotic fluid and blood during cesarean section in time and simply.

Objective To improve the nutritional knowledge and dietary habit of medical students in Lanzhou region for their health.Methods A self-designed survey of nutritional knowledge,attitude,and practice(KAP)was made on 329 medical students in Lanzhou region,with a subsequent nutritional education given to 195 volunteers in the form of lectures,consulting,publicizing materials issuing,among other things.An analysis was made on the effect of the nutritional education using the relevant KAP's self-comparision prior and subsequent to the nutritional education and using the students' response to the nutritional education.Results Before the education,the students in question scored 42.27?8.29 on knowledge,14.29?1.93 on attitude,and 16.39?2.17 on practice.After the education,the three scores rose to 46.52?6.78,15.20?0.98,and 18.39?2.17 respectively,and the students tended to acquire nutritional knowledge through ways of more variety.Their correct dietary practice increased by 15.75%.Their demand for nutritional knowledge became increasingly diversified,a case of which was that their demand for prevention knowledge of malnutrition rose by 20.75%.Through the education,the students in question had an obvious change in their dietary knowledge,attitude,and practice.Conclusions Giving nutritional knowledge education to the medical students in Lanzhou region in a flexible way has a good effect.Their healthful dietary practice should be intensified simultaneously with the improvement of their nutritional knowledge.

Objective To establish a rapid method for detection of drug-resistance mutation in HBV, based on PCR-MALDI-TOF MS, and to explore the influential factors on this method. Methods One hundred blood serum samples, which were collected from chronic HBV patients with single drug-resistance or multiple drug-resistance of Lamivudin, Adefovi, Entecavir and Telbivudine, and 10 kinds of mutant HBV plasmids were analyzed using PCR-MALDI-TOF MS and confirmed by PCR-based sequencing. Results Of 100 samples detected, thirty-one samples were positive for drug-resistance and 69 samples were negative. The PCR-MALDI-TOF MS results of 94 samples were completely consistent with PCR-based sequencing. Six samples were inconsistent , of which three samples were positive by the two methods, but more mutation loci were detected by PCR-MALDI-TOF MS than sequencing. The consistent rate of two methods was 94%,detection sensitivity was up to 100 copies/μl, and the cut off value of detectable mutation level was 5%.Conclusion PCR-MALDI-TOF MS could be used for rapid and simple analysis of the drug resistance for the clinical application with features of high sensitivity and accuracy, high throughput and automation.

Objective To investigate mutation spectrums of α- and β-haemoglobin genes in thalassemia patients and carriers in Yunnan province,and to establish procedures on prenatal gene diagnosis.MethodsTotally 10 033 counseling couples and pregnant women,and 22 cases of children with moderate or severe thalassemia were recruited from 5 parts of Yunnan Province,middle,western,eastern,southern and northern areas, during July 2009 to July 2011.Medical records, including results of haemoglobin electrophoresis,blood routine examination,and gene diagnosis of subjects were collected and saved in an database in Excel software by the Key Laboratory for Birth Defects and Genetic Diseases.Using multiple gap-PCR and PCR-reversed dot blotting kits, DNA samples collected from 1077 cases of haematological positive thalassemia patients and carriers were tested to determine common mutations of the α-or β-haemoglobin genes.The codon regions of haemoglobin genes were sequenced by the Sanger sequencing in cases that the mutation tests were negative.Mutation spectrums of α- and β-haemoglobin genes were concluded.Prenatal gene diagnosis was offered to fetuses who had risk of thalassemia major.Results( 1 ) In 1077 cases of haemological screen positive subjects,deletions and mutations of α-haemoglobin gene were tested in 119 subjects among 347 cases suspected as α-thalassemia patients and carriers.Five kinds of deletions and mutations on α-haemoglobin gene were found.In 104 subjects,four kinds of common deletions and mutations onα-haemoglobin gene were determined:--SEA, -α3.7, αCS α,-α4.2.Other 14 subjects were double heterozygotes with haemoglobin H disease and severe α-thalassemia phenotypes.A rare mutation of insertion and deletion in α2 haemoglobin gene intron,α301-24-301-23 indel,was found in one carrier subject.(2)In 1077 cases of haemological screen positive subjects,deletions and mutations of β-haemoglobin gene were tested in 297 subjects among 730 cases suspected as β-thalassemia patients and carriers.Sixteen kinds of β-haemoglobin gene mutations were found,including 7 cases of rare abnormal haemoglobinopathy patients with β-haemoglobin gene mutations.In one case with β + phenotype patient,the Codon 5 (-CT)mutation at β-haemoglobin gene was found (firstly reported in China ). (3) Three fetuses with high riskS of α-thalassemia were accepted for prenatal diagnosis.One case of Hb Bart's hydrops syndrome fetus with the genotype --SEA/--SEA,and one case of mild α-thalassemia fetus with the genotype αCS α/αα were found.Another one fetus was found with normal α-haemoglobin.In 6 fetuses accepted for prenatal diagnosis due to high risks of β-thalassemia,one case of β-thalassemia major with the genotype CD17( A→T)/-28 (A→G) was found,3 fetuses were heterozygote carriers,and 2 fetuses had normal genotypes without mutations found in their parents.Medical terminations for 2 fetuses with severe thalassemia were made according to the choice of pregnant women.Other 7 pregnancies continued to term.Anemia or growth retardation was not found in the 7 infants when following up after given-birth 6 to 12 months.Conclusions The mutation spectrums of α- and β-haemoglobin genes of thalassemia patients and αarriers.in Yunnan province are special,in which β-haemoglobin gene exits more polymorphism in the mutation spectrum.Carrier screening in pregnant women,and offering prenatal gene diagnosis to the high risk pregnancies should be an efficient strategy to prevent thalassemia major.

Objective This study was designed to explore the therapeutic effect of psoralen on type Ⅱ collagen-induced rheumatoid arthritis in mice and its molecular mechanism.Methods DBA/1J mice were immunized with type II bovine collagen to induce rheumatoid arthritis.The model mice were randomly divided into Psoralen group(PSO),methotrexate group(MTX) and model group(Vehicle).Clinical signs of arthritis in the mice were monitored.The spleen index was assessed.Splenic Th1 and Th2 cells were counted by flow cytometry.ELISA was used to detect the levels of inflammation-associated factors TNF-α,IL-6 and IL-1β in the serum.Results Compared with the vehicle group,the ankle swelling and limitation of joint activity in the PSO group were significantly reduced,the spleen index and Th1 cell percentage were significantly decreased,and the Th2 cell percentage showed no significant change in the PSO group.Expression of TNF-α,IL-6 and IL-1β in serum was notably decreased in the PSO group.All the indexes showed no significant difference between the PSO and MTX groups.Conclusions Psoralen may attenuate the severity of type II collagen-induced rheumatoid arthritis in mice by regulating the balance of Th1/Th2 cells and inhibiting the expression of TNF-α,IL-6 and IL-1β.

Objective:To investigate the effects of rituximab on lymphocytes and immunoglobulin in the treatment of focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD).Methods:The subjects were FSGS and MCD patients admitted to Ruijin Hospital affiliated to Shanghai Jiaotong University on July 1, 2014 and July 1, 2019. All the enrolled patients were confirmed by clinical examination and renal biopsy, and received rituximab treatment (4 infusions of 375 mg/m 2 with the interval of 7-14 d). The levels of immunoglobulin IgA, IgG, IgM, and lymphocytes of CD19 +, CD20 +, CD3 +, CD3 +CD4 +, CD3 +CD8 + and natural killer cells (CD56 +CD16 +) were compared between baseline and the third month, the sixth month, the ninth month and the twelfth month after treatment. Results:Ninety-six patients with FSGS or MCD were enrolled in this study. The midian age was 28 years old (14-77 years old). The ratio of men to woman was 1.8∶1. There were 65 cases of MCD and 31 cases of FSGS. After rituximab treatment, the 24 h-proteinuria was significantly lower than that before treatment, and the serum albumin level was increased (both P<0.05). After rituximab treatment of 3 months, 6 months, 9 months and 12 months, CD19 + and CD20 + lymphocyte counts were significantly decreased (all P<0.01), and gradually recovered after 6 months. Compared with baseline, at 3, 6, 9, 12 months after rituximab treatment, the level of blood IgG was significantly increased ( P=0.004,<0.001,<0.001,<0.001, respectively), and the level of blood IgM was significantly decreased ( P<0.001, =0.008, =0.005,<0.001, respectively) but the median level still within the normal range (400-3 450 mg/L). The level of blood IgA was not significantly changed (all P<0.05). T lymphocytes (CD3 +, CD3 +CD4 + and CD3 +CD8 +) and natural killer cells (CD56 +CD16 +) showed no significant difference from baseline (all P>0.05). Conclusions:Rituximab can effectively eliminate CD19 + and CD20 + lymphocytes, and has little influence on peripheral blood lymphocyte count and immunoglobulin level except CD19 + and CD20 + lymphocytes. The standard administration of rituximab is safe for patients with FSGS and MCD.

Clinical manifestations and genes of a case from a family with pseudoachondroplasia caused by COMP gene mutation treated in the Department of Pediatrics of the First People′s Hospital of Yunnan Province were retrospectively analyzed.The male patient aged 3 years and 3 months old had a history of slow growth for 1 year.Physical examinations showed that the patient′s height: 87.5 cm (less than -3 SD), 55.0 cm on top, 32.5 cm on bottom, mild O-leg, Nervous system physical examination suggested normal muscle strength of lower limbs and low muscle tone.Genetic examination revealed that the heterozygous gene variation of exon 11 of the COMP gene was chr19: 18897437 A >g [hg19], nm_000095.2, c.1159T >c, p.CY3 387 Arg, namely the transformation of cysteine to arginine at position 1159 of the translation product protein.Genetic testing is an important basis for the diagnosis of pseudoachondroplasia.It can avoid mistreatment, so as not to affect the predicted adult height of children.

Objective:Patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with severe type Ⅱ respiratory failure have a high probability of ventilation failure using conventional non-invasive positive pressure ventilation(NPPV).This study aims to investigate the clinical efficacy of high intensity NPPV(HI-NPPV)for the treatment of AECOPD combined with severe type Ⅱ respiratory failure. Methods:The data of patients with AECOPD combined with severe type Ⅱ respiratory failure(blood gas analysis pH≤7.25)treated with NPPV in the Second Affiliated Hospital of Chongqing Medical University from July 2013 to July 2023 were collected to conduct a retrospective case-control study.The patients were divided into 2 groups according to the inspired positive airway pressure(IPAP)used during the NPPV treatment:a NPPV group(IPAP<20 cmH2O,1 cmH2O=0.098 kPa)and a HI-NPPV group(20 cmH2O≤IPAP<30 cmH2O).Ninety-nine and 95 patients were included in the NPPV group and the HI-NPPV group,respectively.A total of 86 pairs of data were matched using propensity score matching(PSM)for data matching.The primary outcome indexes(mortality and tracheal intubation rate)and secondary outcome indexes[blood gas analysis pH,arterial partial pressure of oxygen(PaO2)and arterial partial pressure of carbon dioxide(PaCO2),adverse reaction rate,and length of hospitalization]were compared between the 2 groups. Results:The tracheal intubation rates of the NPPV group and the HI-NPPV group were 6.98％and 1.16％,respectively,and the difference between the 2 groups was statistically significant(χ2=4.32,P<0.05);the mortality of the NPPV group and the HI-NPPV group was 23.26％and 9.30％,respectively,and the difference between the 2 groups was statistically significant(χ2=11.64,P<0.01).The PaO2 at 24 h and 48 h after treatment of the HI-NPPV group was higher than that of the NPPV group,and the PaCO2 of the HI-NPPV group was lower than that of the NPPV group,and the differences were statistically significant(all P<0.05).The differences of pH at 24 h and 48 h after treatment between the 2 groups were not statistically significant(both P>0.05).The differences between the 2 groups in adverse reaction rate and hospitalization length were not statistically significant(both P>0.05). Conclusion:HI-NPPV can reduce mortality and tracheal intubation rates by rapidly improving the ventilation of patients with AECOPD combined with severe type Ⅱ respiratory failure.This study provides a new idea for the treatment of patients with AECOPD combined with severe type Ⅱ respiratory failure.

OBJECTIVETo establish a clinical classification of pulmonary embolism (PE), and to evaluate the optional treatment strategies for different types of PE.

METHODSFrom December 1995 to July 2001, 45 patients with acute PE were hospitalized, of which 33 received intravenous thrombolytic therapy or interventional treatment.

RESULTSMisdiagnostic rate in the 45 patients with acute PE during first visit was 62.2% and mortality rate was 28.9%. Misdiagnostic rate in acute PE patients who had undergone surgery was 82% and mortality rate was 73%. The effective rate of thrombolytic therapy was 77.7%. Clinical symptoms rapidly disappeared in massive PE patients treated with interventional therapies.

CONCLUSIONSIntravenous thrombolytic therapy is one of the most effective methods for treating acute PE. Application of interventional therapy for severe acute PE is also promising.

Acute Disease ; Adolescent ; Adult ; Aged ; Anticoagulants ; therapeutic use ; Diagnostic Errors ; Humans ; Middle Aged ; Pulmonary Embolism ; diagnosis ; therapy ; Thrombolytic Therapy