OBJECTIVETo observe the efficacy difference in the treatment of breast hyperplasia between the combined therapy of auricular point sticking and Xiaopijian and the simple application of Xiaopijian.

METHODSNinety-one patients were randomized into an observation group (46 cases) and a control group (45 cases). In the observation group, the sticking therapy on the auricular points was applied in combination with the oral medication of Chinese herbal medicine, Xiaopijian. Auricular points included Ruxian, Neifenmi (CO18), Luanchan, Shenmen (TF4), Gan (CO2), Pi (CO13). The auricular point sticking therapy was applied once a week on the auricular points of one side alternatively. Xiaopijian was the self-prepared decoction. The main ingredients are radix bupleuri Bupleurum chinense, spica prunellae prunella vulgaris and radix peoniae alba Paeonia lactiflora, 30 mL each time, three times a day. In the control group, Xiaopijian was simply prescribed for oral administration, 30 mL each time, 3 times a day. The treatment was discontinued during menstruation in the two groups. The menstrual cycle of one month made one session of treatment. The treatments for 3 sessions were observed. The scores of symptoms and physical signs, including the degree of breast pain, hardness and size of breast masses as well as the scores of general and supplementary symptoms were compared before and after treatment in the patients of the two groups. The clinical efficacy was compared between the two groups.

RESULTSAfter treatment, the scores of symptoms and physical signs were reduced apparently as compared with those before treatment in the patients of the two groups (both P<0. 05). The score reduction in the observation group was much more than that in the control group (11.02±1. 78 vs 9.82±1. 53, P<0. 05). The total effective rate was 95.7% (44/46) in the observation group, higher apparently than 80. 0% (36/45, P<0. 05).

CONCLUSIONThe combined therapy of auricular point sticking and Xiaopijian achieves the superior efficacy on breast hyperplasia as compared with the simple application of Xiaopijian.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Breast ; pathology ; Breast Diseases ; drug therapy ; pathology ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hyperplasia ; drug therapy ; pathology ; therapy ; Middle Aged ; Young Adult

ObjectiveTo observe the clinical efficacy of acupoint application plusXiao Pi Jianin treating hyperplasia of mammary glands.MethodTotally 103 patients with hyperplasia of mammary glands were randomized into a treatment group of 52 cases and a control group of 51 cases. The treatment group was intervened by acupoint application plus oral administration ofXiao Pi Jian, while the control group was by oral administrationofXiao Pi Jianalone. The criteria for diagnosis and therapeutic evaluation of hyperplasia of mammary glands were adopted in the study.ResultThe total effective rate was 94.2% in the treatment group, significantly higher than 82.4% in the control group(P<0.05).ConclusionAcupoint application plusXiao Pi Jiancan produce a significant efficacy in treating hyperplasia of mammary glands.

In view of the deficiency of traditional teaching methods and teaching resources in clinical practice, our department has designed cases according to diagnosis, diagnosis basis, laboratory examination and treatment, and deploys the case based learning with PPT files according to such teaching process as case introduction, guiding discussion, summary and teaching, introspection and expansion as well as homework. Meanwhile contrast experiment was carried out. The results have showed the case based learning probably has the positive impact on improving teaching quality of clinical practice , mainly reflected in: ①contributing to the completion of the teaching outline;②contributing to the transform of theoretical knowledge from systemic structure to applied structure;③contributing to establishing the teaching model and assessment system which are more complete and standard than the traditional teaching methods; ④contributing to improving students' interest and mo-tivation;⑤contributing to improving the teaching efficiency, which makes students have more time to participate in the application and training of clinical skills.

Background:In the treatment of many gastric diseases,eradication of Helicobacter pylori( Hp)is important. With the increasing in antibiotic resistance of Hp,the eradication efficacy of conventional triple and quadruple therapy for Hp is decreasing in recent years. Aims:To assess the efficacy and safety of quadruple therapy combined with astragalus membranaceus for Hp eradication. Methods:A total of 395 Hp-infected patients with chronic gastritis/dyspepsia and peptic ulcer diagnosed by gastroscopy were enrolled,of them 185 patients were of chronic gastritis/dyspepsia group and 210 patients were of peptic ulcer group. Patients in the two groups were subdivided into trial group and control group. Patients in trial group were given quadruple therapy combined with astragalus membranaceus for 14 days,and patients in control group were given quadruple therapy only for 14 days. Hp eradication was assessed by 13 C-urea breath test 4 weeks after treatment. Results:A total of 358 patients(90. 6%)completed the study. In chronic gastritis/dyspepsia group,the eradication rate was significantly higher in trial group than in control group by PP analysis(P<0. 05),but no significant difference was found by ITT analysis(P>0. 05). In peptic ulcer group,the eradication rates by PP and ITT analysis showed no significant differences between trial group and control group(P>0. 05). In control group,the eradication rates by PP and ITT analysis were significantly higher in peptic ulcer group than in chronic gastritis/dyspepsia group( P <0. 01). In trial group,the eradication rates by PP and ITT analysis were not significantly different between chronic gastritis/dyspepsia group and peptic ulcer group( P >0. 05 ). The incidence of adverse effects was not significantly different between chronic gastritis/dyspepsia group and peptic ulcer group as well as trial group and control group( P>0. 05). Conclusions:Quadruple therapy combined with astragalus membranaceus could increase the eradication rate of Hp in chronic gastritis/dyspepsia group safely.

Objective To evaluate nasal carriage and antimicrobial resistance of bacteria in health care workers (HCWs)in an intensive care unit (ICU),and provide basis for making prevention and control measures of health-care-associated infection(HAI).Methods From April 2014 to March 2015,nasal swabs from HCWs in ICU were collected,carriage and antimicrobial resistance of bacteria were detected.Results A total of 450 nasal swab speci-mens were taken,137 strains were isolated,isolation rate was 30.44%.There were no significant difference in na-sal carriage rates of bacteria in HCWs with different genders,ages,types of work,length of service,and education-al level (P >0.05);nasal carriage rates in HCWs at different seasons were significantly different (P <0.05 ).82 strains (59.85%)were gram-negative bacteria,the major were Klebsiella pneumoniae (21 .16%)and Enterobacter aerogenes (18.98%);55 strains (40.15% )were gram-positive bacteria,the major were Staphylococcus aureus (18.98%)and Staphylococcus epidermidis (15.33%).38 (27.74% )strains were multidrug-resistant strains. 7.69% (2/26)of Staphylococcus aureus were methicillin-resistant strains,3.45%(1/29)of Klebsiella pneumoniae and 3.85%(1/26)of Enterobacter aerogenes were imipenem-resistant strains.Conclusion Nasal carriage rate of bac-teria and detection rate of multidrug-resistant organisms in HCWs in ICU is high.

Objective To study the effect of tranilast on cyclosporine A (CsA)-induced epithelial-to-mesenchymal transition in human renal tubular epithelial cells, and investigate the mechanism of its antifibrotic effect. Methods Cultured HK-2 cells were divided into four groups: (1)In the control group, cells were treated without any medicine; (2) The cell were treated with CsA (4. 2μmol/L) for 72 h; (3) The cells were treated with a combination of CsA (4. 2 μmol/L) and tranilast (100μmol/L); (4) The cells were treated with tranilast (100 μmol/L) alone for 72 h.Morphological changes of the cells were assessed by phase-contrast microscopy. The immunofluorescence and Western blotting were adopted to detect the expression of E-cadherin, α-SMA and OPN mRNA and proteins respectively. Results Tranilast could markedly ameliorate the morphological changes of HK-2 cells stimulated by CsA. The irmmunofluorescence staining revealed the expression of E-cadherin was markedly decreased in HK-2 cells stimulated with CsA for 72 as compared with the control group, while the expression of α-SMA and OPN was significantly higher in CsA group than the control group. The expression of E-cadherin in the CsA + Tranilast group was higher than the CsA group, while the expression of α-SMA and OPN in the CsA + Tranilast group was lower than the CsA group. Western blotting showed that protein expression level of E-cadherin in CsA group was dramatically lower than that in the control group (P＜0. 05), while that of α-SMA and OPN in CsA group was significantly higher than in the control group (P＜0.05). The protein expression level of E-cadherin in HK-2 cells in the CsA + Tranilast group was markedly higher than in the CsA group (P＜0.05), and that of α-SMA and OPN in CsA + Tranilast group was significantly lower than in the CsA group (P＜0. 05). Conclusion Tranilast can block the CsA-induced epithelialto-mesenchymal transition in HK-2 cells probably by suppressing the expression of OPN.

BACKGROUND: Some studies in vitro have reported that there are CD30 positive T cells in immunological response of allogenic transplantation.OBJECTIVE: To detect the relationship between the level of serum CD30 (sCD30) and clinical rejection in the patients with or without kidney transplantation, and analyze the importance of sCD30 in the estimation of immune state, monitor of acute rejection, and judgment of prognosis. DESIGN, TIME AND SETTING: Clinical case analysis study was performed at Jiangsu People's Hospital between April 2004 and March 2007. PARTICIPANTS: 153 kidney transplantation cases comprising 103 males and 50 females, averagely aged 37 years. METHODS: 3 mL peripheral blood was obtained from recipients before transplantation (without immunosuppressive agent) and at 0, 1, 3, 5, 7, 14, 21, and 28 days. Serum was isolated from obtained blood and placed at -20 ℃. Soluble CD30 levels were detected using CD30 cytokine ELISA kit supplied by BenderMedSystems. MAIN OUTCOME MEASURE: The relation between the soluble CD30 levels and rejection prior to and following transplantation.RESULTS: There was a significant relation in the sCD30 level between the patients with (n=17) and without acute rejection (n=136). The CD30 levels were 113.2 U/mL in the rejection group and 83.2 U/mL in the non-injection group (P < 0.01). No significant difference was determined between both groups in 5 days following surgery (P > 0.05). Significant difference were detected between both groups from 5 days following surgery (P < 0.01). There was no relation between the soluble CD30 level and the time of rejection and release after kidney transplantation (P > 0.05). Receiver operating characteristic (ROC) curve demonstrated that soluble CD30 levels on day 5 post-transplantation could predict acute rejection (area under ROC curve: 0.850). Meanwhile, 100 U/mL was the optimal operational cut-off level to predict rejection (specificity: 85.0%; sensitivity: 83.6%). The patients with positive of soluble CD30 level showed a lower survival rate than those with negative CD30 level (P < 0.01). CONCLUSION: The soluble CD30 levels contributed to predictive the acute rejection and prognosis of kidney transplantation.

Objective: To investigate the status of iodine nutrition and prevalence of goiter among children at ages of 8 to 10 years in Zhejiang Province in 2021, so as to provide insights into the management of iodine deficiency in children. Methods : A total of 90 counties (districts) were sampled as field survey sites from 11 cities of Zhejiang Province using a multi-stage stratified random sampling method in 2021, and non-residential children at ages of 8 to 10 years in these sites were sampled as study subjects. Subjects' household edible salt samples and random urine samples were collected. The iodine content in salt and urinary iodine level were determined using the direct titration method and arsenic-cerium catalytic spectrophotometry for evaluation of iodine nutrition among children. In addition, the lateral lobe of the thyroid gland was measured using ultrasound, and the prevalence of goiter was estimated. Results: A total of 19 363 children were recruited, including 9 710 male children and 9 653 female children, with a male to female ratio of 1.01︰1, and there were 10 704 urban children (55.28%) and 8 659 rural children (44.72%), 9 149 children living in coastal areas (47.25%) and 10 214 children in inland regions (52.75%). The mean iodine content was (19.79±9.25) mg/kg in salt, and the coverage of qualified iodized salt (15 252) was 78.77%. The coverage of qualified iodized salt was significantly lower in urban children than in rural children (76.70% vs. 81.21%; χ2=68.301, P<0.001), and was lower in children living in coastal regions than in inland regions (68.05% vs. 88.27%; χ2=1 270.769, P<0.001). The median urinary iodine concentration was 195.1 μg/L, and the household iodine content in salt correlated positively with urinary iodine concentration in children (rs=0.383, P<0.001). There were 2 885 children with iodine deficiency (14.90%), 7 137 children with adequate iodine (36.86%), 5 414 children with excessive iodine intake (27.96%), and 3 927 children with iodine overdose (20.28%), and the distribution of iodine nutrition in children varied significantly in regions (χ2=283.277, P<0.001) and gender (χ2=126.349, P<0.001). The prevalence of goiter was 2.45% among 7 195 children receiving ultrasound examinations, and a higher prevalence rate of goiter was detected in urban children than in rural children (2.76% vs. 2.00%; χ2=3.962, P=0.047). Conclusions The overall urinary iodine nutrition was adequate among children at ages of 8 to 10 years in Zhejiang Province in 2021, and the prevalence of goiter in children fell within the threshold defined in the criteria of elimination of iodine deficiency. However, the supervision of the iodized salt quality remains to be improved and iodine deficiency control remains to be reinforced.

Objective To investigate effective approach to decrease portal venous hypertension and high perfusion of portal vein caused by small-for-size (SFS) liver graft transplantation with the aim of improving hepatocellular microcirculation.Methods Rat models with SFS liver graft (n =62) were well estab lished and divided into SFS group and trans-portal intrabepatic portosystemic shunt (TPIPSS) group.Hemodynamic parameters,histopathologically morphologic changes,postoperative complications,accumulated survival rate were recorded and analyzed.Venous filling time after liver reperfusion,hemodynamic parameters were evaluated using t test and Kruskal-Wallis test.Kaplan-Meier method was performed for survival analysis.Results Venous filling time after liver reperfusion was remarkably prolonged with the application of multihole cone-shaped tubes.Compared with SFS group,the filling time was 4-second longer in TPIPSS.At each endpoints of reperfusion within 90 mins,the portal vein pressures were lowered in the TPIPSS group than those of SFS group.Liver grafts were present with more regular structures in TPIPSS group,with no sign of hepatic sinusoid congestion or irregular clearance extension.In the aspect of postoperative complications,all the rat receivers showed ascites in the SFS group.Nevertheless,there was no ascites observed in TPIPSS rats,and 50％ rats (5/10) experienced clinical manifestations of hepatic encephalopathy.Persistent fever over 7 days was showed in 10％ rats (1/10) of SFS group and 40％ rats (4/10) of TPIPSS group,respectively.The mean survival was superior in TPIPSS group (37.2 ± 23.5) d than SFS group (17.7 ± 13.5) d,P ＜ 0.05.Conclusion TPIPSS could be a safe and feasible approach to improve portal venous hypertension caused by SFS liver graft and hepatocellular reperfusion.

OBJECTIVETo study the adaptive alterations of elastic fibers in the bilaminar zone (BZ) of rabbit temporomandibular joint (TMJ) following disc displacement.

METHODSTwenty-eight Japanese white rabbits were used in this study. The right temporomandibular joints of 20 of 28 rabbits were subjected to the surgical procedure of anterior disc displacement (ADD). Four rabbits in the surgical group were sacrificed at 2, 4, 6, 8 and 12 weeks after operation. Their temporomandibular joints were studied histochemically.

RESULTSElastic fibers were reduced in number and ran irregularly in the superior lamina of BZ from ADD rabbits. The jungly elastic fibers (EFs) could still be seen at 2 weeks after operation. At 4 weeks, the number of EFs decreased significantly; EFs lost their jungly arrangement and were shaped like rough dots, of which the arrangement and the lengths were different. Six weeks after operation, many EFs were replaced by distorted, uneven, non-oriented fine EFs, distributed unevenly and some thick or fine EFs that ran irregularly. The number of EFs decreased further and their arrangement was more deranged at 8 weeks. At 10 and 12 weeks, EFs in the superior lamina of BZ were similar to those at 8 weeks.

CONCLUSIONOur results show that EFs lost their function as well as their distribution and arrangement after disc displacement.

Adaptation, Physiological ; Animals ; Behavior, Animal ; Elastic Tissue ; pathology ; Extracellular Matrix ; pathology ; Joint Dislocations ; pathology ; Rabbits ; Temporomandibular Joint Disc ; pathology ; Temporomandibular Joint Disorders ; pathology