Objective: To establish the animal model of the compressed lumbar nerve and investigate the effect of acupuncture to the ultra-micro structure of the injured rat lumbar nerve and inflammatory medium. Method: Separate the laboratory rats into Group A (model group, n= 45) and Group B (model + electroacupuncture group, n = 45). observe injured lumbar nerve tissue with optic microscope and electron microscope and measure the content of PGE2 and 5-HT. Results: Hyperemia around the nerve tissue, edema and nerve root demyelination of electroacupuncture 15 day (Group B) is less than model group 15 day (Group A). The structure of Schwann cell is normal. Demyelination of electroacupuncture 30-day group (Group B) becomes slight and the nerve edema alleviates. In the Group B,contents of PGE2 and 5-HT after electroacupuncture obviously decrease compared to the Group A. Conclusion: Electroacupuncture can alleviates inflammatory reaction around the injured lumbar nerve and improve the ultra-micro structure of lumbar nerve root.

BACKGROUND: Lumbar spinal nerve root compression causes the damage of neural function and abnormal neural action of lumbar spinal nerve root, which is related not only to mechanical injury of the compressed but also to inflammatory reaction.OBJECTIVE: To establish the animal model of lumbar nerve root compression and investigate the effect of acupuncture on the ultramicrostructure of the injured lumbar nerve and inflammatory medium of rats.DESIGN: A randomized controlled trial.SETTING: Department of Acupuncture & Moxibustion, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University.MATERIALS: The study was conducted in the Experimental Animal Center of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University from January 2001 to January 2004. Totally 90 healthy male Wistar rats were randomly divided into model group and model + electroacupuncture group with 45 rats in each.METHODS: Clominorex was injected intraperitoneally for anesthesia.With interspace of spinous process of L5-6 as the center, the special silica gel slice was placed where the right side of L5 nerve root ran out of the dura mater sac, stabilized, sutured layer by layer, and covered with the aseptic gauze. Modeling group: No special disposal was made and the rats were fed regularly after modeling. Modeling + electro-acupuncture group:One day after modeling, a filiform needle of 28 gauge and 3.3 cm (1 inch)was used to puncture Huantiao and Yanglingquan points of the right hindlimb and Jiaji point of the right side of the oppressed nerve root. The oppressed injured lumbar nerve tissue was disposed after 15 days of modeling and 30 daysof modeling + electro-acupuncture, and observed with the optic microscope and electron microscope. The content of inflammatory medium such as prostaglandin E2 and5-hydroxy tryptamine was measured.MAIN OUTCOME MEASURES: [1] Results of damaged lumbar nerve root tissues under the electron microscope and light microscope; [2] content of inflammatory medium such as prostaglandin E2 and 5-hydroxy tryptamine.RESULTS: All the 90 rats entered the final analysis. [1] Hyperemia around the nervous tissues, edema and nerve root demyelination of electroacupuncture 15 days (model + electro-acupuncture group) were relieved.The structure of Schwann cells was normal. Massive inflammatory cells gathered around the nervous tissues in 30-day model group (model group).There was severe demyelination of nerve root tissues, and the gap between the nervous tissues widened and red blood cells leaked out. Demyelination of electro-acupuncture 30-day group (model + electro-acupuncture group)became mild and the edema in nerves was alleviated. [2] The content of prostaglandin E2 in the locally oppressed rat lumbar nerve tissues of 15-day and 30-day model + electro-acupuncture groups was obviously lower than that in 15-day and 30-day model groups [(61.17±9.77), (76.65±7.39) ng/L;(56.05±7.98), (71.04±6.99) ng/L, P ＜ 0.01], while the content of 5-hydroxy tryptamine in the locally oppressed rat lumbar nerve tissues of 15-day and 30-day model + electro-acupuncture groups was obviously lower than that in 15-day and 30-day model groups [(1 413.4±194.5), (2 587.7±214.7) ng/L;(780.4±133.0), (1 355.0±147.7) ng/L, P ＜ 0.01].CONCLUSION: Electro-acupuncture can alleviate inflammatory reaction around the injured lumbar nerves and improve the ultramicrostructure of lumbar nerve root. It has the effect of decreasing the content of prostaglandin E2 and 5-hydroxy tryptamine in oppressed lumbar nerve root tissues and partially inhibiting inflammatory reaction.

Objective To evaluate the levels of plasma coupling factor 6(CF6) and cytochrome C(Cyt-c) in neonatal sepsis,and to explore the clinical significance in neonatal sepsis.Methods A total of 88 neonates admitted to Hunan Children's Hospital from January 2015 to April 2015 were collected.Neonates were divided into non-sepsis group(n=42) and sepsis group(n=46).According to the severity of infection,the non-sepsis group was further divided into non-infection group(n=20) and common infection group(n=22);the sepsis group was further divided into general sepsis group (31 cases,no organ failure) and severe sepsis group (15 cases,combined with multiple organ failure).Femoral venous blood was collected in all patients before the use of antibiotics after admission.The levels of Cyt-c and CF6 in plasma were measured by ELISA,and the levels of C-reactive protein(CRP),procalcitonin (PCT) were measured.The changes of CF6 and Cyt-c between these groups were compared,and the sensitivity and specificity with the traditional sepsis index (CRP,PCT) were analyzed.The correlation between the levels of CF6,Cyt-c and neonatal critical illness score was analyzed.Results (1)In sepsis group,the levels of CF6 and Cyt-c[(109.7±8.9)pg/ml and (44.5±4.9)ng/ml] were significantly higher than those in the non-sepsis group[(46.3±6.0)pg/ml,(31.8±6.7)ng/ml,P<0.01,respectively].(2) In the non-infection group,common infection group,general sepsis group and severe sepsis group,the levels of CF6 were (32.1±8.9)pg/ml,(59.3±7.2)pg/ml,(79.3±5.9)pg/ml,and (172.6±6.1)pg/ml,respectively;the levels of Cyt-c were (29.3±8.6)ng/ml,(35.4±4.1) ng/ml,(43.1±5.9) ng/ml,and (44.5±5.9)ng/ml,respectively.The differences between these groups were significant(P<0.01).(3)The receiver operating characteristic curve showed that the sensitivity and specificity of CF6 were 0.761,0.732,and the Cyt-c were 0.739,0.714.(4)Cyt-C and CF6 were negatively correlated with the neonatal critical illness score(r=-0.599,P<0.001;r=-0.337,P<0.01).Conclusion The levels of CF6 and Cyt-c increase in neonatal sepsis.The damage of mitochondria may be one of the pathological mechanisms in neonatal sepsis.The levels of CF6 and Cyt-c were closely related to the severity of neonatal sepsis.

Objective To analysis the clinical outcome at discharge and its risk factors of extremely preterm infants.Method To retrospectively analysis the clinical outcome at discharge and it's risk factors of extremely preterm infants (less than 28 weeks gestation) admitted from September 2008 to August 2014 in our Hospital.Result A total of 179 cases were enrolled.Survival rate was 59.2％ (106/179).Unfavorable outcome rate was 74.3％ (133/179),among them 73 cases died.The top five causes of death were severe bronchopulmonary dysplasia (BPD) (28 cases),Ⅲ ～ Ⅳ o intraventricular hemorrhage (IVH) (19 cases),sepsis (16 cases) and necrotizing enterocolitis (NEC) (6 cases).Among the 60 survivals with unfavorable outcomes,35 cases had either severe neurologic or ophthalmological sequela,and 25 cases had severe pulmonary sequela.Univariate analysis showed that,comparing with improved group,unfavorable outcome group had higher rates of not receiving prenatal steroids,placental abruption,male,small for gestation age,resuscitation with chest compression,admission age older than 72 hour,severe respiratory distress syndrome (RDS),without pulmonary surfactant (PS) usage,mechanical ventilation beyond 2 weeks and sepsis (P ＜ 0.05).Logistic regression analysis showed that those without prenatal steroids (OR =9.402,P =0.002),small for gestational age (OR =8.271,P =0.018),resuscitation with chest compression (OR =6.325,P =0.023),admission age older than 72 hour (OR =4.174,P =0.028) were independent risk factors for unfavorable outcome of extremely premature at discharge.Conclusion Extremely preterm infants have a higher rate of unfavorable outcome at discharge.Avoid small for gestational age,transfer properly and in time both in utero and after birth,and conduct prenatal steroids could improve their clinical outcome at discharge.

Objective: To determine the correlation of IgM deposition with clinic-pathological features and outcomes of IgA nephropathy patients. Methods: A total of 1060 patients, who were diagnosed as IgA nephropathy by renal biopsies between 2001 and 2007 in Guangxing Hospital were enrolled. According to immunofluorescent test, patients were divided into patients with mesangial IgM deposition and patients without IgM deposition. Renal survival curves were assessed by Kaplan-Meier method. The effect of IgM deposition on outcomes of IgA nephropathy patients was examined by univariate and multivariable Cox proportional-hazards regression. Results: Among 1060 IgA nephropathy patients, there were 750 patients with IgM deposition and 310 patients without IgM deposition. (1) Urinary protein and uric acid in patients with IgM deposition were significantly higher than those in patients without IgM deposition (all P<0.05). Other clinical indicators shown no statistical difference (all P>0.05). Moreover, IgM deposition patients had higher serum IgA, serum IgG and serum IgM (all P<0.05). (2) In pathological indicators, IgM deposition patients had more segmented sclerosis or adhesions (S1 of Oxford classification), activity lesions as inflammatory cell infiltration and mesangial proliferation, and chronic pathological changes as tubular atrophy, segmented glomerular damage than patients without IgM deposition (all P<0.05). (3) All patients were followed-up for a median of 89.7(61.8, 113.4) months, Kaplan-Meier analysis revealed that kidney survival rate was significantly lower in IgM deposition patients compared with patients without IgM deposition (Log-rank χ²=4.95, P=0.026). In a univariate Cox hazards regression mode, IgM deposition was a risk factor for poor prognosis of IgA nephropathy patients (HR=1.597, 95% CI 1.053-2.422, P=0.027). However, in a multivariable Cox analysis, IgM deposition shown no influence on outcomes of IgA nephropathy patients (HR=1.409, 95% CI 0.921-2.156, P=0.114). Conclusions IgA nephropathy patients with IgM deposition have higher urinary protein, and more serious pathological damage and immune fluorescence deposition. IgM deposition affects renal survival of IgA nephropathy, while IgM deposition is not an independent risk factor for prognosis of IgA nephropathy.

Objective To investigate the expression and clinical significance of AGR2 and Lgr5 in CRC and the corre-lation with clinical pathologic features. To evaluate the significance with combined detection of the clinical and patho-logical diagnosis of CRC. Methods AGR2 and Lgr5 expression were assessed in 70 cases of CRC and 20 cases of nor-mal tissues near the cancer by immunohistochemistry. Results ①The expression of AGR2 was significantly higher in CRC than that in normal tissue(68.57%vs 25.00%,P<0.01). The AGR2 expression in CRC was correlated with the de-gree of tumor differentiation and lymph node metastasis(P<0.05).②The expression of Lgr5 was significantly higher in CRC than that in normal tissue (74.29%vs 40.00%, P<0.01). The Lgr5 expression in CRC was correlated with the de-gree of tumor differentiation﹑depth of invasion and lymph node metastasis(P<0.05). ③The Area Under Curve(AUC) of combined detection of AGR2 and Lgr5 were significantly higher than detection of both alone. the difference was statis-tically significant (P all <0.05). Conclusion AGR2 and Lgr5 played an important role in the occurrence and develop-ment of CRC, the combined detection not only contribute to the judgment of tumor progression, but also provide theo-retical support for molecular diagnosis and treatment of patients with CRC .