Objective To observe the treatment effect of acupoint massage and auricular point sticking of cowherb seeds on blood pressure of hypertensive patients.Methods 100 cases of hypertensive patients were randomly divided into the observation group and the control group,50 cases in each.The observation group was given routine application of antihyportensive drags combined with acupoint massage and auricular point sticking of cowherb seeds.The control group received routine drug therapy.The blood pressure changes were compared between the two groups before and after treatment.Results The systolic blood pressure and diastolic blood pressure of both groups were lower after treatment compared with those before treatment.The total effective rate of blood pressure control was 98％ in the observation group,88％ in the control group,which showed no significant difference.Symptom control results showed that the total effective rate of the observation group was higher than that of the control group.Conclusions Acupoint massage and auricular point sticking of cowherb seeds in hypertensive patients can be an auxiliary pressure relief means,it can not only effectively lower blood pressure,but show good effect in alleviation of headache,vertigo,irritability.

Objective To evaluate the clinical application of Hawkeye VG SPECT/CT imaging on diagnosing and locating lower gastrointestinal bleeding using in vivo labeling 99Tcm-RBC.Methods Fiftysix patients (42 males,14 females,age ranging from 10 to 76 years) who had definite lower gastrointestinal bleeding were studied retrospectively.All patients had intravenous injection with 370 MBq 99Tcm-RBC and then underwent planar,SPECT,and CT imaging respectively in the abdomen before exploratory laparotomy.Images from SPECT and CT were fused thereafter to locate the active bleeder,if any.x2 test was performed to show the differences of diagnostic sensitivity and accuracy between planar and SPECT/CT imaging.Results In 56 patients with lower gastrointestinal bleeding,50 patients showed abnormally concentrated radionuclide activity with planar images and 52 patients showed the similar imaging pattern with SPECT/CT.Among these patients,concordant bleeding with operation findings was found in 31 patients with planar images and 48 patients with SPECT/CT images.The sensitivity and accuracy were 89.3％ (50/56) and 73.8％ (31/42) in planar images,and 92.9％ (52/56) and 92.3％ (48/52) in SPECT/CT images (x2 =0.11,P＞0.05 ;x2 =4.63,P＜0.05).Conclusion Hawkeye VG SPECT/CT imaging shows an effective,simple and accurate method and could be used for diagnosing and locating lower gastrointestinal bleeding.

Objective To investigate the clinical and laboratory characteristics of anticentromere antibody (ACA)and anti-SSA antibody expressions in patients with Primary Sj(o)gren's Syndrome (PSS). Methods Twelve PSS patients with ACA positive but SSA negative(ACA PSS)and 19 PSS patients with SSA positive but ACA negative(SSA PSS)were enrolled into the study and classified into two groups. We compared the age,laboratory data,occurrence of Raynaud's phenomenon(RP),and histological changes in minor labial salivary glands biopsies of the patients from two group. Results The mean age of the ACA PSS group(68.4 ± 7.9)years was significantly higher than that of the SSA PSS(54. 6 ± 16. 2)years group(P ＜ 0. 05). Serum IgG level of ACA PSS group(17. 89 ±4. 08)g/L was close to the normal range,which was significantly lower than that of SSA PSS(27.90 ±6. 72)(P ＜0. 01). Leukocytopenia was less frequently observed in ACA PSS than in SSA PSS(P ＜ 0. 05),the difference between two groups was statistically significant. We also found more frequent RP in the ACA PSS group than SSA PSS group(P ＜ 0. 05). Conclusions Our data confirm that ACA positive PSS differs from SSA positive PSS at several clinical respects and laboratorial examinations.

Objective To explore the cause of the thyroid reoperation ,methods,surgical approach ,and the prevention of complications .Methods 39 cases of thyroid reoperation in patients with clinical data were reviewed and analyzed.Results Thyroid papillary carcinoma in 11 cases,follicular carcinoma in 2 cases,nodular 22 cases of thyroid,thyroid adenoma 1 case,3 cases of primary hyperthyroidism .The incidence of transient hypoparathyroidism ac-counted for 2 cases,temporary laryngeal recurrent nerve injury in 2 cases,chyle leakage in 1 case,in total of 12.8%of postoperative complications .Conclusion Improper operation method choice for the first time and the misdiagnosis was the main cause of reoperation , The reoperation of thyroid is difficult and has more complications .Preoperative evaluation and careful operation can prevent the occurrence of complications .

Objective To study the theraputic effect of cyclophosphamide,glucocorticoid combined with sildenafil on pulmonary hypertension in systemic lupus erythematosus(SLE?PAH) patients,and to analyze the prognosis adverse factors. Methods Forty?six cases patients with SLE?PAH from Tangshan Gongren Hospital from January 2009 to January 2015 were selected as research subjects. All patients were treated with prednisone, cyclophosphamide and sildenafil,and the course of treatment was 24 weeks. The treatment effect was observed, the systemic lupus erythematosus disease activity score(SLEDAI),6 minutes walk distance and heart function before and after the treatment were compared. The effective and uneffective patients'clinical and test information were compared,and the prognosis adverse factors were analyzed. Results After 24 weeks treatment,the total ef?fective rate was 78. 3%(36/46). Pulmonary artery systolic pressure(PASP) dropped from (59±16) mmHg be?fore treatment to (45±15) mmHg after treatment,there was significant statistical difference(t=-4. 539,P<0. 01). SLEDAI dropped from (6. 6±2. 3) points to (2. 4±0. 8) points,,there was significant statistical differ?ence(t =11. 680,P<0. 01). The 6 minutes walk distance rose form (402±96) minutes to (465±97) minutes, there was significant statistical difference( t=-3. 137,P<0. 01) . Cardiac function improved significantly,there was significant statistical difference( P<0. 01) . There were 10 cases uneffective and deterirated patients,with the age of (42±6) years,36 cases effective patients with the age of (33±4) years,the difference was statistically significant( t=-5. 423, P<0. 01 ) . Uneffective and deterirated patients' anti?RNP antibody positive rate was 90. 9%( 9/10 ) , significantly higher than the effective patients ( 52. 8%( 19/36 ) ,χ2 = 4. 552, P<0. 01 ) . Conclusion Cyclophosphamide, glucocorticoid combined with sildenafil has obvious effect on patients with SLE?PAH. PASP,heart function and 6 minutes walk distance are the important indicators of prognosis. Anti?RNP antibody and age are the adverse prognostic factors.

Objective To investigate the relevance between protein expression and methylation of MG-MT and hMSH2 in glioma patimts.Methods Immunohistochemical and methylation specific PCR were adopted respectively to test on 275 cases of glioma patients for the protein expression and methylation situation of MGMT and hMSH2.Results The negative protein expression rate of MGMT and hMSH 2 in the tissue of brain golima were 47.2% and 62.5% respectively;the occurrence of methylation in gene promoter region were accordingly 41.8% and 22.4%.Statistical analysis revealed that MGMT promoter methylation in peripheral blood gene groups was related with the protein negative expression of tumor tissue (P<0.05),while there was no relationship between the protein expression of hMSH2 and its gene promoter methylation(P>0.05).Conclusion The meth-ylation of MGMT is a common molecular situation in the generation of brain glioma ,which may be connected with that of tumor.However,hMSH2 promoter methylation might not the main reason for inactivation of hMSH 2 pro-tein,there may be other important factors affecting its expression .

BACKGROUND:The non-specific immune suppression method is generaly used for treatment of systemic lupus erythematosus, but poor prognosis, such as infection and high recurrence rate, exists.
OBJECTIVE:To evaluate the therapeutic effect of bone marrow mesenchymal stem cel transplantation on systemic lupus erythematosus in mice.
METHODS:Sixteen mice with systemic lupus erythematosus were equivalently randomized into control and experimental groups, or then subjected to passage 3 bone marrow mesenchymal stem cel transplantation or the equal volume of normal saline via the tail vein, respectively. Mouse urine samples were colected to detect urine protein levels by Bradford method. Blood samples from the tip of the mouse tail were extracted to detect serum anti-ds-DNS antibody concentration by radioimmunoassay. Mouse kidney tissues were taken and observed pathohistologicaly through hematoxylin-eosin staining and immunohistochemistry staining under microscope. Flow cytometry was used to detect the expression of CD4+CD25+T cels in the inner canthus blood, fresh spleen and thymus.
RESULTS AND CONCLUSION:Within 10 weeks after cel transplantation, the urine protein levels in the two groups were gradualy increased, and the rising velocity was higher in the control group than in the experimental group. From the 4th to 10th week, the urine protein levels in the experimental group were significantly lower than those in the control group (P < 0.05). In the control group, lymphocyte infiltration was visible in the kidney tissues with a few of plasmocytes, and pathological findings showed the mice presented with interstitial nephritis; in the experimental group, the mice had no pathological changes in the kidney. In the two groups, immune complexes were found in the mesangial area, which showed a patch-like distribution in the control group and a punctate distribution in the experimental group; the relative proportion of the occupied area in the experimental group was significantly lower than that in the control group. The expression level of CD4+CD25+T cels in the blood and thymus were significantly higher in the experimental group than the control group (P < 0.05), and the expression level of CD4+CD25+T cels in the spleen was slightly higher in the experimental group than the control group with no significant difference (P > 0.05). The serum anti-ds-DNA antibody concentration in the experimental group was significantly lower than that in the control group (P < 0.05). Taken together, bone marrow mesenchymal stem cel transplantation can improve the pathological damage in systemic lupus erythematosus mice, and has a certain therapeutic effect on systemic lupus erythematosus.

Objective To discuss the clinical outcomes of old fracture-dislocation of proximal interphalangeal joint treated with a self-made distraction external fixator which consists of 3 pins and rubbers.Methods From March 2005 to August 2011,8 cases of old fracture-dislocation of proximal interphalangeal joint treated with a pins-rubber distraction external fixator were retrospectively reviewed.There were 6 males and 2 females,aged from 17 to 58 years,averaged 23.2 years.The middle finger was involved in 5 cases and ring finger was involved in 3 cases.The right hand was affected in six patients,and the left hand was affectd in two patients.The mechanism of injury was sports injury in 6 cases,traffic injuries in 1,and sprain in 1.All of the cases were closed injury.The mean time from injury to surgery was 58 d (range,45-90 d).According to Schenck classification of the proximal interphalangeal joint fracture-dislocation,there were 4 cases of type Ⅰ,3 of type Ⅱ,I of type Ⅲ.Based on the Michigan Hand Outcomes Questionnaire (MHQ) for subjective hand function score,the average preoperative score was 56; the range of motion of proximal interphalangeal joint was 0°.Grip strength was 60％-80％ of the contralateral hand.Results The follow-up lasted 6-51 months,with a mean period of 20.5 months.Solid bone healing was eventually achieved in all patients.The average healing period was 3 months (range,2-5 months).The mean normalized MHQ score was 88 (range,84-92).Grip strength was 85％-100％ of the contralateral hand.Extension of proximal interphalangeal joint was -10°-0° (average,-5°).Flexion angle was 75°-100° (average,89.4°).Postoperative complications included slight joint space narrowing (2 cases),joint incongruity (＜ 1 mm) (2 cases) and fusiform arthrocele (2 cases).No infection,pin loosening,and pin breakage was encounted.Conclusion A pins-rubber distraction external fixator is a minimally invasive,reliable and effective treatment for old fracture-dislocation of proximal interphalangeal joint.

BACKGROUND: For patients with myocardial infarction occupied most of the heart, the effect of coronary artery bridge is not obvious. Currently, myocardial and vascular regeneration by stem cells has become a focus of ischemic cardiovascular disease. Myocardial survival directly correlates with improvement of blood perfusion following stem cell transplantation.OBJECTIVE: To investigate the feasibility of ~(18)F-FDG and ~(99)Tc~m-MIBI single photon emission computed tomography imaging in assessing myocardial glucose metabolism and perfusion with old myocardial infarction after coronary artery bypass grafting (CABG) and CD34~+ stem cell transplanting. METHODS: Bone marrow was extracted from the anterior superior iliac spine 1 day before surgery. Mononuclear cells were isolated by Ficoll density gradient centrifugation. CD34~+ cells were isolated and purified by immunomagnetic bead system. Coronary artery pathological changes were examined under general anesthesia. The end-to-side anastomosis of graft vessel and coronary artery was performed. 1×10~(11)/L CD34~+ cell suspension was extracted, and injected into the surrounding and center of the infarct (blood flow/metabolism matching depletion) at 6 points, with 0.2 mL in each point. According to preoperative perfusion/metabolism imaging, myocardium segments were divided into two groups: match group: blood perfusion and metabolism images were sparse or normal, i.e. infarction or normal myocardium; mismatch group: blood perfusion image displayed depletion, but metabolism images were normal or radially distributed, i.e. surviving myocardium. ~(18)F-FDG and ~(99)Tc~m-MIBI dual-isotopic imaging were performed before and 4 months after CABG. Circumferential count profiles from ~(18)F-FDG and ~(99)Tc~m-MIBI short axis slices were generated to assess myocardial blood perfusion and glucose metabolism. RESULTS AND CONCLUSION: The 31 patients were divided into 279 segments, and 145 segments were in myocardial perfusion-metabolism mismatch (MM). ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction was significantly increased 4 months before operation (P < 0.01); match group without transplanting had 81 segments, and the ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction remained unchanged after operation (P > 0.05). Match group undergoing transplanting had 54 segments, and their ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction increased remarkably 4 months after operation (P < 0.01). CABG can improve the function of survival myocardial segments, but it is helpless to infraction myocardium. The autologous CD34~+ stem cell transplantation can improve myocardial blood perfusion and glucose metabolism of the distributions of infract myocardium.

Objective To evaluate the value of multi-modality imaging (PET/CT+CAG+CMRI) in post myocardial infract (MI) patients followed coronary artery bypass graft (CABG) and autologous bone marrow stem cell (BMSC) therapy.Methods A total of 43 patients with MI (27 males, 16 females, age range: 47-72 years) were prospectively enrolled in the year 2012 between January and December.All patients underwent CABG+BMSC transplantation and were divided into 3 groups according to the time interval between two treatments (group 1: 0-3 d;group 2: 4-14 d;group 3: 15-30 d).All patients were orderly scanned with CMRI, PET/CT (13N-NH3·H2O/18F-FDG) and CAG at different time-points pre-/post-treatment.The quantitative parameters included vascular stenosis degree(VSD), LVEF, percentage size of infarction (PSI), the number of segments in mismatched myocardial perfusion/metabolic and the K value for radioactive distribution grading.One-way analysis of variance and the least significant difference t test were used to compare parameters before and after treatment in the same group and among three different groups.Results Regarding PET/CT diagnostic efficacy of abnormal myocardial segments, the sensitivity, specificity, positive predictive value and negative predictive value were 95.4%(540/566), 87.3%(144/165), 96.3%(540/561) and 84.7%(144/170), respectively.After CABG and BMSC transplantation treatments for 12 months, VSD decreased significantly((69.1±9.5)%;F=12.854, P<0.05), comparing with the baseline ((74.8±7.9)%;t=3.074, P<0.05).Comparing to the baseline, LVEF in 3 groups increased slightly(F values: 0.906,0.298,0.059, all P>0.05).PSI of patients in group 2 decreased greatly after 12 months treatment ((35.70±12.59)%;F=3.792, t values:-2.916-4.059, all P<0.05).K values for radioactive distribution grade decreased obviously after 1 month and 12 months treatment comparing to the baseline (11.79±1.87,12.39±2.35,14.05±2.15;F=4.212, t values:-4.619,-0.989, all P<0.05).Number of myocardial perfusion/metabolic abnormal segments in group 2 after 1 month treatment was lower comparing to the baseline and 24 months treatment (10.17±0.66, 12.92±0.99, 14.17±1.21;F=3.543, t values:-2.146,-2.898, all P<0.05).The PSI, mismatched segments and K values post-treatment were not significantly different between group 1 and 3 (F values: 0.093-1.364, all P>0.05).Conclusions Multi-modality imaging may be used for accurately detecting abnormal myocardium and predicting prognosis.CABG+BMSC therapy during day 4-14 post-MI may temporarily improve perfusion and metabolism in viable myocardium, but the long term prognosis seemed not be improved.