BACKGROUND: Geshu (BL 17) is one of eight influential points of blood, acting on tonifying blood, nourishing blood, activating blood circulation and resolving stasis.OBJECTIVE: To explore the effect of Geshu (BL 17) on activating blood circulation and resolving stasis in blood stagnation syndrome with acupuncture.DESIGN: Randomized controlled and normal controlled observations were designed.SETTING: Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.PARTICIPANTS: Totally 65 cases of blood stagnation syndrome were selected from inpatients in Department of Acupuncture and Moxibustion in Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.METHODS: Totally 65 cases were randomized into experiment group (33cases) and the control (32 cases). In the control, the patent Chinese drug,longxuejie was administrated orally for activating blood circulation and resolving stasis, 4 tablets/time, 3 times/day, 15 days made 1 course of treatment. In experiment group, Geshu (BL 17) was localized bilaterally; after routine sterilization on the points, a filiform needle, 25 mm in length was inserted and manipulated with even technique after arrival of qi for 5 minutes. In 15 minutes of needle retaining, the needle was manipulated for another 5 minutes and retained for 10 minutes, and then, the needle was withdrawn. The treatment was given once a day. Radioimmunoassay (RIA)was applied to determine the levels of 6-K-P and thromboxane B2 (TXB2)in plasma. Criteria on clinical therapeutic effects: Being cured is determined by slight red tongue, retarded and forceful pulse, disappearance of limb pain, skin and mucosal ecchymosis and dysmenorrhea, basic recovery of motor function in hemiplegia and disappearance of numbness. Being effective is by dark red tongue, slightly hesitant pulse, alleviation of limb pain, reducing of skin and mucosal ecchymosis, alleviation of dysmenorrhea, partial recovery of motor function in hemiplegia and alleviation of numbness. No effect is by none of any change of clinical symptoms in comparison before and after treatment.MAIN OUTCOME MEASURES: ① Observation of therapeutic effects between two groups. ② Observation of plasma 6-K-P and TXB2 levels and 6-K-P/TXB2RESULTS: Totally 65 cases were all in the result analysis. ① Observation of therapeutic effects between two groups: The therapeutic effect in experiment group was higher remarkably than that in the control [be cured:(15,10); be effective: (13,11)]. ② Comparison of plasma 6-K-P levels: In experiment group, it was higher remarkably after treatment compared with that before treatment [(159.28±16.48), (117.25±16.47) μg/L, P ＜ 0.05]. In the control, it was higher remarkably after treatment compared with that before treatment [(133.51±13.97), (114.64±16.39) μg/L, P ＜ 0.05]. ③Comparison of plasma TXB2 level: In experiment group, it was lower remarkably after treatment compared with that before treatment [(98.21±11.38), (110.45±1067) μg/L, P ＜ 0.05]. In the control, it was lower remarkably after treatment compared with that before treatment [(101.15 ±12.14), (109.21±11.58) μg/L, P ＜ 0.05]. ④ Plasma 6-K-P/TXB2: In experiment group, it was higher remarkably after treatment compared with that before treatment (1.621±0.203, 1.101±0.316, P ＜ 0.05). In the control,it was higher remarkably after treatment compared with that before treatment (1.322±0.216, 1.234±0.305, P ＜ 0.05).CONCLUSION: Acupuncture on Geshu (BL 17) increases 6-K-P level and 6-K-P/TXB2 and reduces TXB2 level. It is explained that acupuncture on Geshu (BL 17) regulates imbalance of PGI2-TXA2 system in blood stagnation syndrome so that the blood circulation is activated and stasis is resolved.

Objective To investigate training of the ultrasound-guided modified Seldinger technique(MST)for cannulation of PICC.Method Twenty-nine nurses trained with the traditional training on ultrasound-guided MST during December 2009 to December 2011 were set as control group and another 29 nurses trained with the systematic training during December 2011 to December 2013 were as experiment group.The training effect were compared between the two groups after 2 months training.Results The theoretical knowledge in the experiment group was improved significantly compared with the control group. Moreover, the success rate of catheterization in the experiment group was 100.0%,significantly higher than that in the control group(both P<0.01).Conclusion Systematic training system is more effective than the traditional training.It can improve the nurses’technical and theoretical knowledge on ultrasound-guided MST for PICC.

Objective To investigate the effect of reserpine,an efflux pumps inhibitor,on the activities of fluoroquinolones (FQNs) against Enterococci,and the distribution of efflux pump genes emeA and its correlation with the resistance of Enterococci.To elucidate the relationship between FQN resistance in Enterococci and active efflux.Methods One hundred isolates of enterococci were identified by VITEK microbe automatic system.The antibacterial agent susceptibility tests were performed by the disc diffusion method (K-B) in accordance with the CLSI standards.The minimum inhibitory concentration (MIC) of each FQN was tested by the agar dilution method,and the MIC changes were detected after adding reserpine.The distribution of emeA in 100 isolates of Enterococci was determined by PCR.Thex2 test was used to compare the differences of statistical results.Results After reserpine was used,three-FQN resistance in Enterococci was reduced.Ciprofloxacin,gatifloxacin and levofloxacin resistance was reduced from 42％ (42/100) to 28％ (28/100),from 30％ (30/100) to 17％ (17/100),and from 33％ (33/100) to 23％ (23/100),respectively.The positive rate of emeA gene in 100 strains of Enterococci was 55％ (55/100).There were 45 positive strains(72.6％) in 62 E.faecalis and 10 positive strains (26.4％) in 38 E.faecium.The positive rate of emeA gene in the resistant strains against ciprofloxacin,gatifloxacin and levofloxacin was 73.8％ (31/42),76.7％ (23/30),75.8％ (25/33),respectively,and the positive rate of emeA gene in the susceptible strains against above 3 antibacterials were 41.4％ (24/58),45.7％ (32/70),44.8％ (30/67).Efflux pump genes emeA in resistant strains is higher than the sensitive strains,with the statistically significant difference(x2 =13.02,8.13 and 8.57,P ＜ 0.005).Conclusions Reserpine could inhibit the active efflux of in FON Enterococci and reduce the MIC for drug-resistant strains in vitro.Multidrug-resistant efflux pump gene emeA was relevant to antimicrobial drug resistance in Enterococci.

Objective To investigate the effects of sufentanil,remifentanil and fentanyl oH cellular immune function in patients undergoing radical resection of esophageal cancer.Methods Forty-five ASA Ⅰ or Ⅱpatients aged 45-64 yr undergoing radical resection of esophageal cancer were randomly divided into 3 groups(n=15 each):sufentanil group(SF);remifentanil group(RF)and fentanyl group(F).The patients were premedicated with iv atropine 0.5 mg.Anesthesia was induced with midazolam 0.04 mg/kg,propofol TCI(CT=3μg/ml)and TCI of sufentanil,remifentanil or fentanyl(CT=0.5,5 and 5 ng,ml respectively in the 3 groups).Endobronchial intubation was facilitated with vecuronium 0.1 mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 30-40 mm Hg.Anesthesia was maintained with inhalation of sevoflurane(0.7-1.5 MAC)and TCI of sufentanil,remifentanil or fentanyl(CT=0.5,5 and 5 ng/ml respectively).Venous blood samples were taken from peripheral vein before anesthesia(T0,baseline),60 min after skin incision(T1),immediately(T2),24 h(T3)and 72 h(T4)after the end of operation for determination of the expression of CD3+,CIM+,CD8+on T cells and CD3-CD16+CD56+on natural killer cells by flow cytometry,CD4+/CD8+ratio,serum concentrations of IL-2 and IL-10 by ELISA.Results Compared with the baseline values,the CD4+T-lymphocytes and CIM+/CD8+ratio were significantly decreased at T2,while the CD3-CD16+CD56+NK cells were significantly increased in all 3 groups.The CD3+T-lymphocytes were significantly decreased at T2 as compared to the baseline value at T0 in SF and RF groups.The CIM+and CD3+T-lymphocytes were significantly decreased at T3 as compared with the baseline value in all 3 groups.Serum IL-2 concentration was significantly higher at T3 in SF group than in RF group.Serum IL-10 concentration was sismficantly higher at T4 in RF group than in SF group.Conclusion Sufentanil,remifentanil and fentanyl can depress cenular immune function to some extent in patients undergoing radical resection of esophageal cancer.

Objective To evaluate the effects of gender and age on median-effective target plasma concentration(EC50)of propofol administered by target controlled infusion(TCI)causing respiratory depression.Methods Eighty ASA Ⅰ or Ⅱ patients aged 40-79 yr,with body mass index 18-25 kg/m2.undergoing general anesthesia were divided into 4 groups(n=20 each):1 middle-aged male group(MA);Ⅱ middle-aged female group(FA);Ⅲold male group(MO) and Ⅳo ld female group(FO).No premedication was administered.Propofol Was administered by TCI for 15 min,using TCI system incorporating Marsh pharmacokinetic model.EC50 Was determined by up-end-down sequential trial.The target plasma concentration(Cr)was set at 3.1μg/ml in the first Patient in each group.Each time Cr increased/decreased by 10%in the next patient depending on whether or not the respiratory depression occurred.Respiratory depression was defined as RR<8 bpm,Vr≤5 ml/kg,end-tidal PCO2≥50 mm Hg,SaO2≤94%and/or apnea≥15s.Results The EC50 and 95%confidence interval of propofol TCI causing respiratory depression were 6.40(6.09-6.72)μg/ml in group MA,5.93(5.54-6.34)μg/ml group FA,4.58(4.32-4.91)μg/ml in group MO and 4.37(4.14-4.61)μg/ml in group FO.EC50 was significantly lower in group FO than in group FA and in group MO than in group MA,but there Was no significant difference in EC50 between group MA and group FA or between group MO and FO. Conclusion The potency of propofol given by TCI causing respiratory depression is increased in the old patients as compared with the middle-aged patients and is not related to sex.

This article was aimed to survey the use of Chinese minority medicine, in order to provide differences and similarities among different Chinese minority medicine, and to analyze the relations among species resources, using range, functions and indications. It provided a basic scientific platform for the development, research and use of minority medicine. The books and journals published since the late 1970s (the country after the reform and opening up) had been collected, classified. And reference books on current Chinese minority medicine had been compiled. The results showed that the first draft of the book had been completed and delivered to the press. The dictionary had cited 53 traditional medicine used by minority groups. The total number of minority medicine was 7 734. The total characters amount in the book was 1 700 000 words. It was concluded that the species of minority medicine were various. There was rich information on their harvest, medicinal parts, functions and indications with prominent features. The existing major problems were to clarify the standard of the species as well as their major functions and indications.

Objective To explore the impact of berberine on serum levels of insulin resistance and cytokines in schizophrenia patients treated with risperidone. Methods Sixty-four schizophrenia patients treated with risperidone were randomized to berberine group (n=31) and control group (n=33). The fasting plasma blood glucose (FBG) and fasting insulin (Fins) were detected before and after treatment in two groups. The homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. The serum levels of interleukin (IL)-1β, IL-6, tumor necrosis factor-alpha (TNF-α) were evaluated by enzyme linked immunosorbent assay before and after the treatment. Results Compared with control group and pre-treatment group, the levels of FBG, Fins, HOMA-IR, IL-1β, IL-6 and TNF-α were significantly decreased after treatment in berberine group (P<0.05). The FBG level was significantly higher, the levels of IL-1β, IL-6 and TNF-αwere significantly lower, after treatment in control group (P < 0.01). There were no significant changes in Fins and HOMA-IR after treatment (P > 0.05). There was positive correlation between HOMA-IR and IL-1β, IL-6 and TNF-α in berberine group (r=0.316, 0.351 and 0.401, P<0.01). Conclusion Berberine can significantly decrease FBG, Fins, HOMA-IR, IL-
1β, IL-6 and TNF-α levels in schizophrenia patients treated with risperidone. The HOMA-IR level is closely correlated with IL-1β, IL-6 and TNF-αlevels.

Objective To investigate the effects of fentanyl and remifentanil on the viability of human adenocarcinoma cell line A549.Methods Human adenocarcinoma A549 cells cultured in logarithmic growth phase were seeded in 75 ml culture bottles or 96-well plates.After being cultured for 24 h,the cells were randomly divided into 9 groups (n =30 each):4 fentanyl groups (groups F1-4 ),4 remifentanil groups (groups RF1-4 ) and control group (group C).Groups F1-4 were exposed to fentanyl with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.Groups RF1-4 were exposed to remifentanil with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.The viability of the cells was determined by methyl thiazolyl tetrazolium assay after being incubated for 24,48 and 72 h.The cell cycle progression and apoptosis were determined by flow cytometry after being incubated for 24 h.Results Compared with group C,the viability of A549 cells were gradually decreased at 72 h of incubation,the proportion of the cells in S phase was gradually decreased at 24 h of incubation,and the proportion of the cells in G2/M phase and apoptotic rate were gradually increased in groups F2-4 and in groups RF2-4 ( P ＜ 0.05).Conclusion Fentanyl and remifentanil with the final concentration ≥5 ng/ml can inhibit the viability of human adenocarcinoma cell line A549 in a dose-independent manner by inducing cell apoptosis and cell cycle arrest in G2/M phase.

Objective To evaluate the effect of chemotherapy on sedation with propofol in breast cancer patients.Methods One hundred female patients,of ASA physical status Ⅰ or Ⅱ,aged 20-60 yr,scheduled for elective modified radical mastectomy,were divided into 2 groups (n =50 each) according to whether receiving neoadjuvant chemotherapy before operation:non-chemotherapy group (group Ⅰ) and neoadjuvant chemotherapy group (group Ⅱ).The breast cancer patients received operation directly in group Ⅰ.The breast cancer patients received neoadjuvant chemotherapy in group Ⅱ.Epirubicin 75-100 mg/m2 was injected intravenously on 1st and 2nd days,docetaxel 75 mg/m2 was injected intravenously on 3rd day,and 3 weeks were considered as 1 course of treatment.The patients received operation at 3 weeks after the end of 4 courses of treatment in group 1.Anesthesia was induced with propofol given by target-controlled infusion and the target plasma concentration of propofol was 3.5 μg/ml.The time for loss of consciousness and consumption of propofol at loss of consciousness were recorded.Results Compared with group Ⅰ,the time for loss of consciousness was significantly shortened,and the consumption of propofol at loss of consciousness and BIS value were decreased in group Ⅱ.Conclusion Chemotherapy can enhance propofol-induced sedation and promote the onset of propofol in breast cancer patients.

Objective To evaluate the effect of sleep dysfunction on sedation induced by propofol in the patients undergoing radical mastectomy.Methods One hundred breast cancer patients,aged 25-60 yr,with body mass index of 19-23 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective modified radical mastectomy,were randomly divided into 2 groups according to sleep quality.The patients with global Pittsburgh Sleep Quality Index (PSQI) score ≤7 served as regular sleep quality group (Ⅰ group,n =59).The patients with global PSQI score ＞ 7 served as sleep dysfunction group (group Ⅱ,n =41).Anesthesia was induced with propofol given by target-controlled infusion (target plasma concentration of 3.5 μg/ml),and then with remifentanil 4 μg/kg and rocuronium 0.6 mg/kg after loss of consciousness.The consumption of propofol at loss of consciousness was recorded.Results Compared with group Ⅰ,the consumption of propofol at loss of consciousness was significantly decreased in group Ⅱ.Conclusion Sleep dysfunction can enhance propofol-induced sedation in the patients undergoing radical mastectomy.