Objective To study gene polymorphisms (CC, CG, G-G) of macrophage migration inhibitory factor (MIF) in children of the Han nationality and Moggol nationality and to find that whether MIF-173 gene position is associated with HSP of the Han nationality and Moggol nationality, and differences between the Han nationality and Moggol nationality in MIF-173 gene position.Methods All cases were enrolled in Inner Mongolia Medical University Affiliated Hospital and Inner Mongolia International Mongolian hospital from December 2012 to December 2013.There are 105 cases of the Han nationality and Moggol nationality with HSP and control groups, Aged from 1 to 14 years old.There are four groups: Moggol nationality with HSP group (25 cases) and the group of the Han nationality with HSP (25 cases), Moggol nationality control group (25 cases) and the Han nationality control group (25 cases).Each sample was drawed from children's venous blood 2ml for inspection.We used DNA extraction kit to extract all DNA and used the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to detect the polymorphism of MIF-173 gene loci.SPSS17.0 statistical software was used for analysis.Results MIF-173 gene position could be detected out three genotypes, GG, CG and CC type.Compared to the group of the Han nationality with HSP and the Han nationality control group, there is mostly MIF-173 CC gene type.the difference is significant statistically in these two groups (x2 =10.46, P ＜0.05).Compared to Moggol nationality with HSP group and Moggol nationality control group, there was mostly MIF-173 CC gene type.The difference is significant (x2 =6.61, P ＜ 0.05).Conclusion MIF may play an important role in the occurrence and development of HSP.There were no significant differences between Moggol nationality with HSP group and the Han nationality with HSP group (x2 =2.299, P＞0.05).

Incidence of ankle fractures is relatively high.Malunited ankle fractures result from inappropriate nonoperative treatment and incorrect surgery as well.It is not difficult to diagnose a malunited ankle fracture when taking history,symptoms and imaging examinations into consideration.Orthopaedic surgeons used to do ankle fusion for this kind of patients as the effect of reconstructive surgery is not clear.This article summarizes the diagnostic and therapeutic methods for ankle fracture malunion based on the articles from 1976 to 2015.More detailed therapeutic methods for deformities involving lateral malleolus,tibiofibular syndesmosis,medial malleolus and posterior malleolus are also reviewed.

OBJECTIVETo compare the efficacy between the reducing technique with consciousness conduction involved and the reducing technique by needle rotation of acupuncture in the treatment of lunbar strain of cold damp pattern.

METHODSOne hundred and eight patients were randomized into group A and group B, 54 cases in each one. Ashi points were the main points in the two groups. In the group A, the reducing technique with consciousness conduction involved was applied to ashi points. In the group B, the reducing technique with needle rotation was adopted. Cupping and the irradiation specific electromagnetic wave apparatus (TDP) were used in the two groups as the adjuvant therapy. The treatment was given once every two days, and 10 treatments made one session. The treatment stopped till pain disappeared. The efficacy was evaluated in 1 session of treatment. The numerical rating scale (NRS) and the Oswestry disability index (ODI) were observed before and at the end of treatment. NRS of acupuncture itself was observed at the end of treatment. The recurrence rate was compared between the two groups.

RESULTSThe curative and remarkably effective rate was 87.0% (47/54) in the group A, better than 63.0% (34/54) in the group B (P < 0.01). After treatment, NRS and ODI scores were all reduced as compared with those before treatment in the two groups (both P < 0.01). The results in the group A were better than those in the group B (both P < 0.01). Three months after treatment, the recurrence rate was 3.8% (2/52) in the group A, better than 17.7% (9/51, P < 0.05) in the group B. Pain induced by acupuncture itself was mild in the two groups and NRS score in the group A was lower than that in the group B (P < 0.01).

CONCLUSIONAcupuncture with the consciousness conduction involved is superior to the reducing technique with needle rotation in the treatment of lumbar strain of cold damp pattern, in which, pain induced by acupuncture itself is much milder than that induced by the reducing technique with needle rotation.

Acupuncture Therapy ; methods ; psychology ; Adult ; Aged ; Back Muscles ; injuries ; Consciousness ; Female ; Humans ; Male ; Middle Aged ; Myalgia ; therapy ; Sprains and Strains ; therapy ; Young Adult

Objective To perform an acceptance test for the IMRT system with independent collimator. Methods An ion chamber dosimeter were used to measure the startup characteristics of the accelerator and the absolute dose at isocenter and given characteristic points for three clinical cases ( a lower nasopharyngeal carcinoma, a lung cancer and a cervical cancer). The characteristic points represented the organs at risk or the target. A Mapeheck2 was used to measure dose maps of basic test fields and the treatment fields for the clinical cases. The basic test fields were as follows: 1 ). Symmetric fields in size of 2 cm ×2 cm, 5 cm ×5 cm, 10 cm× 10 cm, 20 cm ×20 cm, 2 cm × 10 cm, 10 cm ×2 cm, 5 cm ×20 cm and 20 cm ×5 cm;2). Asymmetric fields in size of 2 cm ×2 cm (x1 =4 cm, y1 = 10 cm;x2 = -2 cm, y2 = -8cm) and 5 cm ×5 cm (x1 = -2 cm, y1 = -5 cm;x2 =7 cm, y2 = 10 cm) ;3) A 20 cm ×20 cm composite field composed of five 20 cm× 4 cm narrow bar fields side by side. Gamma Index was used to compare calculated and corresponding measured dose distributions. When the criterion was 3% dose difference or 3 mm distance-to-agreement, the pass rate was required to be more than 90%. Results The accuracy of machine output was better than 2% when machine monitor units increased to 4. Among all basic test fields and all the treatment fields of three clinical cases, the maximal absolute dose error was -3.67%, and only the composite test field and two treatment fields of the lower nasopharyngeal carcinoma case had a pass rate slightly less than 90%, which were 83.6%, 88. 3% and 89. 7% ,respectively. For the three clinical cases the treatment delivery times were 15, 14, and 27 minutes, respectively. Conclusions The overall commissioning results are acceptable, and the system can be used in clinic.

By analyzing the articles in Huangdi Neijing (Inner Canon of Yellow Emperor), combined with the verification of consciousness in vitro in clinic and modern science, it is found Huangdi Neijing has made special requirements of treating spirit for physicians using spirit-qi acupuncture. The physicians consciously use different methods to motivate the spirit of physician and patients, especially patients, to transform it to the physiological effect of patients, which could minimize the psychological factors that make negative influence on treatment; also the psychotherapy is considered as the most important principle of treating spirit. The reinforcing and reducing methods in later generations, mainly lifting-thrusting twirling method, unintentionally lead patients into a basic or strong status of treating spirit or keeping spirit during the process of achieving stimulation and needle sensation. To partially perform the special role of treating spirit for physicians in Huangdi Neijing on patients could cause the chages including patient-based using spirit to move qi. It not only inspires the body's natural resistance to disease and self-healing, but also motivates the self-protection mechanism of keeping spirit.
Acupuncture Therapy ; history ; instrumentation ; methods ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; Qi

By analyzing the acupuncture taboos in Neijing (Internal Classic) on clinical application of mind conduction of acupuncture therapy in going against the actual situation, astronomy and others, it is found that the relevant acupuncture taboo implies many subtle mysteries of human body, qi, mind and astronomy, which have not been discovered yet in modern science and are very significant in qi protection. In Neijing, the acupuncture physicians have been highly required in the mind treatment, in which, accurately regulating qi circulation is the target in the treatment. The mind conduction is used for qi circulation to accomplish accurately the reinforcing or reducing in the deficiency or excess condition. All of the taboos are provided to normalize the accuracy of reinforcing and reducing technique of acupuncture therapy and avoid the damage of qi in human body. Hence, those taboos must be obeyed so as to prevent from serious consequence and ensure the safety of this acupuncture therapy.
Acupuncture Therapy ; history ; psychology ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Mind-Body Therapies ; history ; psychology

Objective To study the characteristics of MR imaging and proton MR spectrscopy(~1H MRS)of stroke-like lesions in MELAS.Methods Clinical,MR imaging and proton spectroscopic findings of stroke-like lesions in 7 patients with confirmed MELAS were analyzed retrospectively.Results A total of 12 MR investigations had been performed in 7 patients.Stroke-like lesions showed by MR imaging included superacute in 12,acute in 12,subacute in 10 and chronic stage in 6.Early stroke-like lesions were demonstrated as focal edematous foci mainly involved cortex/subcotical areas of occipital,temporal and parietal lobes.At MR diffusion imaging,stroke-like lesions in the superacute(＜3 days)stage were showed as well-circumscribed lesions with high signal intensities for cytotoxic edema.During the acute(4～7 days),sub-acute(2～4 weeks)and chronic(＞4 weeks)stages,the lesions gradually expanded,and became blur,and presented with vasogenic edema mainly.Proton spectroscopy showed a prominently elevated lactate,varied decrease of NAA concentration and other brain motabolites in the stroke-like lesions early after onset,and depicted gradual decrease of lactate level and partial recovery of NAA concentration subsequently.Conclusion Stroke-like lesions in MELAS mainly involve the cerebral cortex and subcortical areas,in which cytotoxic edema appears early but for a short period.In ~1H MRS,the lesions are characterized by a double lactate peak with decrease of NAA concentration.

Objective To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effect of different therapy prospectively.Methods A hundred and three patients with spoke or tansient ischemic attack(TIA)suffering from severe carotid artery stenosis were included into this study consectively.They were given intra-artery intervention or antiplatelet therapy based on clinical factors and the intension of the patients or their Legally Autllorized Representative (LAR)and thus divided into 2 groups.Forty patients were transplanted with stent,63 were given only with antiplatelet drugs.The major outcome of end-point was the 2-year functional prognosis evaluated by modified Rankin score(mRS),while the minor one was the cardiovascular events in 1 year.2 year or longer after the index stroke or TIA,which was defined as stroke,TIA,acute myocardic infarction(AMI)and sudden death in this study.Results There were no statistical significances of sex,years,medical histories,blood pressure, total cholesterol,triglyceide in two groups at baseline.For the major outcome,intra-artery intervention was an independent protective factor for impaired function(mRS 3-6)with the method of binary Logistic(RR= 0.13,P=0.001,95%CI 0.036-0.460).For the minor outcome,the incidence of the cardiovascular events in 1 year and 2 year after the index stroke or TIA was lower in the intra-artery intervention group than in the antiplatelet therapy(For 1 year follow up,intervention group:antiplatelet therapy group= 12.5%:42.9%,OR=0.19,95%CI 0.07-0.55,P=0.001;For 2 year follow up,17.5%:47.6%,OR =0.23,95%CI 0.09-0.60,P=0.002).The median time of cardiovascular events in the two groups was further investigated in 55 months and 54 months separately. Kaplan-Meier analysis showed no significant difference.Survival analysis with Cox-regression showed that neither therapy of intra-artery intervention nor antiplatelet therapy was an independent factor for the cardiovascular events(RR=1.063,95%CI 0.40- 2.83,P=0.900).Conclusions For the stroke or TIA patients suffering from high-degree carotid artery stenosis,intra-artery intervention is superior pure drug therapy in achieving better theapeutical effect and reducing the incidence of the cardiovascular events after the index stroke or TIA.However,its long term effect needs further study.

Objective To investigate the relationship between the matrix metalloproteinase-3(MMP-3)and the stability of carotid artery plaque,and explore MMP-3's prediction role on the attack and relapse of acute ischemic cerebrovascular events.Methods 100 patients with the first ever acute cerebral infarction,100 patients with chronic cerebral circulation insufficiency(CCCI)and 40 persons without cerebrovascular diseases were enrolled in this study.According to the carotid ultrasound examination,100 cerebral infarction patients were divided into three subgroup: unstable plaque group(45 patients,mixed plaque,soft plaque),stable plaque group(35 patients,plaque Group)and endometrial coarse group(25patients).Matrix metalloproteinase-3(MMP-3)levels of all the subjects were measured by enzyme-linked immunosorbent assay(as basal level).All the subjects were followed up for one year to observe cerebral infarction events.Serum MMP-3 levels of each group,and the basic serum MMP-3 levels were compared among patients who were attacked or relapsed cerebral ischemic with those who had not been attack cerebral ischemic during this period of time.Results 5 patients in the cerebral infarction group had relapse (5%),2 patients in the CCCI group were attacked by cerebral ischemic(2%),and no one in the normal control group was attacked by cerebral ischemic.Serum MMP-3 levels in the acute cerebral infarction group were significantly higher than CCCI group,and both groups were significantly higher than normal control group (P ＜0.05).The basic serum MMP-3 levels in all patients who were attacked by cerebral ischemic were significantly higher than those who had not been attack by cerebral ischemic during this period of time(P ＜0.05).The serum MMP-3 levels of the unstable plaque group were significantly higher than stable plaque group.And both groups were significantly higher than endometrial coarse group(P ＜0.05).Conclusions Elevated levels of matrix metalloproteinase-3(MMP-3)might have something with the stability of carotid atherosclerotic plaque,and participate the attack and the relapse of acute cerebral infarction.Determination of MMP-3 might be used to predict the attack and relapse of acute cerebral infarction.

Objective To evaluate the role of complement receptor 3 (CR3) on murine macrophages in the recognition of Penicillium marneffei.Methods RAW264.7 murine macrophage cells were cultured in vitro,and divided into four groups to be cocultured with inactivated and live Penicillium mameffei yeast cells as well as inactivated and live Penicillium marneffei conidia respectively at 37 ℃ in 5％ CO2 for one hour.The RAW264.7 cells incubated with phosphate-buffered saline (PBS) served as the blank control group.Then,reverse transcription-PCR was conducted to detect CR3 mRNA expression,Western blot to measure CR3 protein expression,flow cytometry to determine phagocytosis rate,enzyme-linked immunosorbent assay (ELISA) to quantify cytokine levels in culture supernatant.Some RAW264.7 macrophages were transfected with a specific siRNA targeting CR3 gene and cocultured with inactivated Penicillium marneffei conidia,subsequently,phagocytosis rate and supematant cytokine levels were determined.Data were processed by the SPSS 16.0 software,and one-way analysis of variance (ANOVA) was conducted for inter-group comparisons of these parameters.Results No significant differences were observed in the mRNA or protein expressions of CR3 among the four groups of RAW264.7 cells cocuhured with different forms of Penicillium marneffei (both P ＞ 0.05).The phagocytosis rate was 95.14％,89.56％,91.03％ and 90.78％ in RAW264.7 cells cocultured with inactivated conidia and yeast cells,as well as live conidia and yeast cells of Penicillium marneffei,respectively (P ＞ 0.05).The levels of interleukin (IL)-2,interferon (IFN)-γ,IL-4 and IL-10 in culture supernatant were increased at different degrees after one-hour coculture in the four coculture groups compared with the blank control group,but no statistical difference was noted among the four coculture groups in the supernatant levels of these cytokines (all P ＞ 0.05).After coculture with inactivated Penicillium marneffei conidia,the siRNA-transfected RAW264.7 cells showed a statistical decrease in phagocytosis rate (10.89％ vs.92.78％,P ＜ 0.05) and supernatant levels of IL-2,IFN-γ IL-4 and IL-10 compared with untransfected RAW264.7 cells.Conclusions In early stage of innate immunity,CR3 on macrophages may be one of the pattern recognition receptors participating in the recognition and mediation of phagocytosis of Penicillium marneffei.It's possible that both Thl-and Th2-type cytokines,such as IL-2,IFN-γ,IL-4 and IL-10,are involved in the immune response of macrophages against Penicillium marneffei.