Objective:To study the expression of angiotensin-converting enzyme(ACE),extracellular signal-regulated kinase(ERK),and the changes of atrial fibrosis in patients with rheumatic heart disease(RHD) and atrial fibrillation(AF) treated with angiotensin-converting enzyme inhibitor(ACEI).Methods:Atrial tissues were obtained from the right appendage during open surgery in 35 patients with RHD.The mRNA of ACE and ERK2 were semi-qualified by reverse transcription-ploymerase chain reaction(RT-PCR) and normalized to the glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Western blotting analysis was employed to examine the expressions of ACE and phosphorylated ERK(pERK).Atrial collagen volume fraction(CVF) was detected by Masson's stain.Results:The mRNA of ACE and ERK2 or the protein of ACE and pERK were significantly increased,and CVF was significantly increased in patients with chronic atrial fibrillation(CAF) compared with sinus rhythm group(SR)( P 0.05).Conclusion:The expressions of ACE,ERK2 and pERK increase,and fibrosis is more severe in RHD patients with CAF as compared with those with SR.Compared with CAF patients treated without ACEI,the expressions of ERK2 and pERK significantly decrease( P 0.05)in CAF patients treated with ACEI.This suggests that the increasing expression of ERK2 and pERK resulting from local renal angiotensin-converting enzyme system activation mediates the development of atrial fibrosis,and ACEI may contribute to lesser atrial fibrosis in RHD patients with AF.

Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. PH progresses rapidly to right ventricular (RV) failure and even death without treatment. Cardiac magnetic resonance (CMR) is an accurate and reproducible tool for the assessment of RV morphology and function, which plays an important role in the prognosis of patients with PH. The aim of this study is to review the clinical application and research progress of CMR in evaluation of PH.

According to the sera aquaporin-4 antibody (AQP4), neuromyelitis optica (NMO) can be classified into two types as AQP4 antibody positive (AQP4+) and negative (AQP4-). However, the NMO patients with AQP4- are prone to delayed treatment, and may have a different pathogenesis compared to that in patients with AQP4+. Scientific researches and the clinical trials on NMO with AQP4- will deepen the understanding of NMO pathogenesis and help to make an early accurate diagnosis and rational therapy for NMO with AQP4-. This review aims to summarize the progress in clinic diagnosis for NMO patients with AQP4-.

The acupuncture medical literature during the Republic of China is divided into four categories, including theoretical literature, acupuncture channels and acupoints drawing literature, translations, and teaching materials and medical cases. It is found that the theoretical literature focuses on inheriting the traditional theories as well as combining traditional Chinese and Western medicine. The drawings are becoming more and more precise, and in these drawing works anatomy begins to appear at that time. Translations are the achievements of communication between TCM and Western medicine, which promote the scientization of acupuncture greatly. Teaching materials are also influenced by Western medicine, presenting a rough frame of modern acupuncture disciplinary system. As important clinic data, medical cases have great clinical value. Overall, acupuncture medical literature during the Republic of China is widely published, which is influenced greatly by the Western medicine and presents a significant tendency of scientization.
Acupuncture Points ; Acupuncture Therapy ; history ; Books ; history ; China ; History, 20th Century ; Humans ; Translations

Acupuncture scientization was a consensus of most of acupuncture scholars who had long-term perspectives in the 20th century, among them Ms. ZHULian was the important one. Ms. ZHU Lian built a systemic new acupuncture" academic structure in practice and theory aspects. At the same time, as the main architect of Institute of Acupuncture-moxibustion of China Academy of Traditional Chinese Medicine, Ms. ZHU Lian was the first one who began to carry out the acupuncture clinical trail and laboratory experiment in modern way, which meant "acupuncture therapy" was transformed into "acupuncture science" by Ms. ZHULian's endeavor.
Acupuncture ; education ; history ; standards ; Acupuncture Therapy ; history ; methods ; standards ; China ; History, 20th Century ; History, 21st Century ; Humans ; Science ; history

Objective To assess the informed consent about risks of pressure ulcers so as to effectively prevent pressure ulcers and reduce the disputes between the nurses and patients.Method An in-depth interview was conducted among 12 senior nurses in the operating room,the interview content recorded and analyzed to summarize some themes.Results In the link of informed consent on pressure ulcers,6 problems were found,e.g.,the standardization of methods for informed consent and the content,pressure ulcer risk assessment scale special for clinical specialties,lack of complementarity of assessment and prevention measures,importance of clear signature on the informed consent,time for informed consent signature,attitude of the families and the skills on answering related questions.Conclusions The implementation of the informed consent about the risk assessment of the pressure ulcer for surgical patients depends on the specification of the conversation,and the assessment scale special for the clinical specialties.Both improved preventive measures and preventive ability of the pressure ulcers are of great importance.

Small GTP binding protein Rho and its downstream Rho-kinase pathway play an important role in the various cellular functions, including contraction, migration, proliferation, adhe-sion and apoptosis, etc. This article reviews the role of Rho/Rho-kinase pathway in the pain generation and development and clinical application of Rho/Rho-kinase inhibitors. It discusses the feasibility of Rho/Rho-kinase as a target for analgesics. Ac-cumulating experimental and clinical evidences indicate that Rho/Rho-kinase pathway is involved in the neuropathic pain, inflammatory pain, diabetic painful neuropathy, cerebral vaso-spasm, vasospastic angina and cancer pain, etc. Therefore, Rho/Rho-kinase is a potential drug target of the pain, and it provides new therapeutic treatments and strategies for pain in clinic.

Objective To explore the clinical value of combined detection of serum human epididymal secretory protein E4 (HF4) and CA125 in the diagnosis of endometrial carcinoma.Methods From Jan 2010 to Apr 2011,the serum specimens were collected from124 cases of endometrial carcinoma,97 cases of benign disease of uterus and 109 cases of healthy women.HE4 levels in the serum were detected by ELISA,and CA125 levels in the serum were detected by the electro- ehemiluminescent immunoassay.Those results were shown with median level.Accuracy of the diagnosis was evaluated by the area under the receiver operating characteristic curve ( ROC-AUC ).ResultsThe median levels of HE4 and CA125 were 78.09 pmol/L and 33.43 kU/L in serum of endometrial carcinoma group.The median levels of HE4 and CA125 were 46.37 pmol/L and 18.26 kU/L in serum of benign disease of uterus group.The median levels of HE4 and CA125 were 31.75 pmol/L and 12.64 kU/L in serum of healthy women group.The HE4 and CA125 levels in serum of endometrial carcinoma group were significantly higher than those of benign disease of uterus group or healthy women group ( all P ＜ 0.05 ).Compared with that benign disease of uterus group,the ROC-AUC of HE4 and CA125 in endometrial carcinoma group were 0.913 and 0.801,respectively.When the specificity was 95.0％,the sensitivities of HE4,CA125,and combined detection of HF4 and CA125 in endometrial carcinoma group were 41.1％,22.6％ and 46.0％,respectively.The positive rates of HE4 and CA125 were 31％ (27/86) and 12％ (10/86) in stage Ⅰ - Ⅱ of endometrial carcinoma,while the positive rates were 63％ (24/38) and 47％ (18/38) in stage Ⅲ -Ⅳ of endometrial carcinoma,in which there were significant difference between patients in stage Ⅲ - Ⅳ and stage Ⅰ - Ⅱ (P ＜ 0.01 ).ConclusionsThe combined detection of serum HE4 and CA125 is helpful to the diagnosis of endometrial carcinoma.The sensitivity,specificity and early diagnosis of HE4 are better than that of CA125.The positive rates of HF4 and CA125 in endometrial carcinoma are related to the clinical staging.

ObjectiveTo study the curative effect of axillary osmidrosis,that incision in armpit wrinkle,orthoptic cut off the gland to thick skin flap.MethodsCollected double-sided axillary osmidrosis 163 patients,all of them accepted armpit wrinkle incision,the scope of surgical operation super the armpit hair distribute 1 cm,swelling anaesthesia,orthoptic cut off the armpit organization 5 mm under skin included apocrine sweat gland,kept the operation scope to vessel net flap under skin.Hematischesis thoroughly used a double pole electricity hemostasis,kept drainage after operation,bandaged in pressure,took out sutures after 9 days.The foul smell standard referenced the Tung-Chain standard of axillary osmidrosis curative effect evaluation.ResultsThree hundred and twenty armpits (98.16％,320/326) were cure,6 armpits (1.84％,6/326) were excellence.The armpit hair variety:obvious reduce 322 armpits(98.77％,322/326),general reduce 4 armpits(1.23％,4/326).Perspire condition:obvious reduce 324 armpits(99.39％,324/326),improve but no obvious reduce 2 armpits ( 0.61％,2/326).The average surgical operation recovery time was about 9 days.Complication:necrosis on the edge of the skin was 8 armpits,scar formation on the incision was 3 armpits,hematoma was 1 armpit,shoulder joint limitation of activity was 0 armpit.ConclusionThe method of axillary osmidrosis treatment useing thick skin flap in armpit wrinkle,which has extermination foundation of anatomy and pathology,which can cause axillary osmidrosis,this operation is simple,curative effect is credible,the wound is small,complication is little etc,utmost matching the principle of orthopedic surgery,worthy of clinical application.

ObjectiveTo assess the effect of modified minimally-invasive transverse-vertical epicanthoplasty in double-eyelid plastic with three points at the same period.Methods87 cases with mild or moderate epicanthus and oriental eyelid were involved in our research.Epicanthoplasty was performed based on the principle of transversevertical plasty.The curvilinear incision of epicanthoplasty was made between the desired point of the new medial canthus and the lower lacrimal point,the malpositioned orbicularis oculi muscle excised after skin undermining,the superficial head of the medial canthal tendon plicated or anchored to the lateral nasal aponeurosis and the incision closed after skin redraping.Double-eyelid plastic with three points was performed as usual,however,the incision of eyelid plastic was connected with the incision of epicanthoplasty by skin tunnel in which a strip of orbicularis oculi muscle was excised.Results87 cases were followed-up for 3 to 24 months.The cosmetic results of the new medial canthi were satisfactory with new figure and inconspicuous scar.The contours of the double eyelids were natural.No incisional scar presented between the medial canthi and the upper eyelids.No recurrence of epicanthus was observed.ConclusionThe modified mini-incisional transverse-vertical epicanthoplasty together with double-eyelid plastic with three points is a simple and effective feasible surgical approach for correction of epicanthus and oriental eyelid.