Method of selecting points in foot-hand same-name meridians was used to treat 24 cases of Osteoarthritis of knee joint, and the therapeutic results showed 15 cases were cured, 4 cases got significant effect and 4 cases got improvement.

Acupuncture was performed at points in the upper-jiao and lower-jiao areas of two eyes and scalp acupuncture, in the motor area on the healthy side. Thirty-four patients with apoplectic sequela were treated. The total efficacy rate was 97.0%.

Background p21 is a cyclin-dependent kinase inhibitor,and it can prevent cells from going through the G1/S phase checkpoint and inhibit cell proliferation.Stuies determined that the expression level of p21 WAF1/CIP1 is associated with proliferative diseases.Traumatic proliferative vitreoretinopathy (PVR) is a proliferative response of eye.Understaining the relationship of dynamic expression levels of p21 WAF1/CIP1 in PVR is of significance for the prevention and management of PVR.Objective This study was to investigate the expression of p21 WAF1/CIP1 during the course of experimental traumatic PVR in rabbits.Methods Fifty-four pigmented rabbits were randomized into the normal control group and different experimerital groups,and one lateral eye of each rabbit served as experimental eye.PVR models were established by intravitreal injection of human platelet-rich plasma (PRP) (0.4 ml)combined with cryotherapy for 5 seconds,and vitreous and retinas were examined with B type sonography.The rabbits were sacrificed in 7,14,21 and 28 days after operation,and histopathological examination of the retinas was performed by haematoxylin and eosin stain.The expression levels of p21WAF1/CIP1 protein and gene were detected by immunohistochemistry,Western blot and reverse transcription-PCR (RT-PCR).The use and care of the rabbits complied with Statement of ARVO.Results B type sonography showed that the retinal morphology was normal in the normal control group.However,the proliferative membrane was gradually thickened 1 to 7 days after operation.Retinal folds of rabbits were seen in 7 days,and tractional retinal detachment was found in 14 days and 28 days after operation.The histopathological examination of the retinas showed epiretinal membrane and infiltration of inflammatory cells 7 days and fixed ruffle 28 days after operation.The p21WAF1/CIP1 was strongly expressed in the cell nucleus of retinal ganglion cell layer (GCL) and inner nuclear layer (INL) in the normal control group,and the expression was gradually weakened after modeling,with the weakest expression in the retinas in 14 days after modeling.The relative expression levels of p21 WAF1/CIP1 protein was 0.74±0.08,0.60±0.05,0.56±0.03,0.74±0.02 and 0.65 ±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,showing a significant difference among the groups (F =20.55,P =0.00),and the expression levels of p21WAF1/CIP1 protein were significantly lower in the postoperative 7-day group and postoperative 14-day group than those of the normal control group,postoperative 21-day group and postoperative 28-day group (all at P＜0.05).The relative expression levels of p21 WAF1/CIP1 mRNA was 0.65 ± 0.09,0.57 ± 0.05,0.45 ±0.04,0.46±0.02 and 0.47±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,with a significant difference among the groups (F =18.06,P =0.00),and the expression levels were significantly lower in the postoperative 14-day group,postoperative 21-day group and postoperative 28-day group than those of the normal control group and postoperative 7-day group (all at P＜0.05).Conclusions The dynamic expression of p21WAF1/CIP1 in the retinas is consistant with the prograssion of traumatic PVR,and the reduce tendency of p21 WAF1/CIP1expression is similar to cell prolieration change,indicating that reduce of p21WAF1/CIP1 expression in the retinas may promote the development of traumatic PVR.

Serum levels of CXC chemokine ligand 10 (CXCL10) and chemokine receptor 3 (CXCR3) were determined in 50 patients with type 1 diabetes mellitus (T1 DM) and 30 normal control subjects by ELISA method.The results showed that serum levels of CXCL10 and CXCR3 in T1DM patients were significantly higher than those in normal subjects [(258.17 ± 39.12 vs 96.47 ± 26.91) ng/L,(851.87 ± 70.04 vs 441.82 ± 72.24) pg/ml,both P＜0.05].Serum level of CXCL10 in patients dropped sequentially with durations of diabetes ＜6 weeks,≥6 weeks or ＜3 years,and ≥ 3 years,being statistically significant between groups (P＜0.05).These results suggest that serum levels of CXC10 and CXCR3 may reflect the immune activity in T1DM.

Objective To explore the clinical value of AFP-L3,GP73 and GGT as biomarkers in diagnosis of hepatocellular carcinoma (HCC).Methods According to the pathological diagnosis,141 patients were divided into two groups,HCC group were 74 cases,benign liver disease group were 67 cases.Use ELISA method tested the serum AFP-L3 and GP73 levels.The GGT level was detected by the automatic biochemical instrument of all the 141 patients.AFP-L3,GP73 and GGT concentration difference was compared between the two groups.ROC curve was used to determine the cut-off level to diagnose HCC.The value of single use AFP-L3,GP73,GGT and joint the three indexes to diagnose HCC were analyzed.Results The average level of AFP-L3 in the patients with HCC was (113.58±63.62) μg/L,it was significantly higher than that in the patients with benign liver diseases [(23.19±34.54) μg/L] (P ＜ 0.001).The area under the ROC curve of AFP-L3 level was 0.802.Taking AFP-L3 level ≥ 38.47 μg/L as diagnostic criteria,the sensitivity of AFP-L3 level in HCC diagnosis was 81.08 ％ and the specificity was 88.06 ％.The average level of GP73 in the patients with HCC was (126.55±49.56) μg/L,it was significantly higher than that in the patients with benign liver diseases [(56.97±26.48) μg/L] (P ＜ 0.001).The area under the ROC curve of GP73 level was 0.811.Taking GP73 level≥69.44 μg/L as diagnostic criteria,the sensitivity of GP73 level in HCC diagnosis was 75.68 ％ and the specificity was 91.04 ％.The average level of GGT in the patients with HCC was (173.20±179.18) U/L,it was significantly higher than that in the patients with benign liver diseases [(90.77±81.53) U/L] (P ＜ 0.001).The area under the ROC curve of GGT level was 0.713.Taking GGT level ≥ 110.77 U/L as diagnostic criteria,the sensitivity of GGT level in HCC diagnosis was 74.32 ％ and the specificity was 77.61％.Joint use AFP-L3,GP73 and GGT to diagnose HCC,the sensitivity was 83.78 ％,specificity was 92.53 ％.Conclusion Combined detection of tumor markers AFP-L3,GP73 and GGT can improve the positive rate of HCC,which has good clinical application value.

Background Clinical work found that triamcinolone acetonide (TA)bleeding during vitrectomy in proliferative diabetic retinopathy (PDR),but its mechanism is not clear.Objective This study was to explore the anastalsis of TA in vitrectomy for PDR.Methods A prospective study was performed.Twelve eyes of 12 patients who received vitrectomy combined with the intraocular use of TA for PDR were in cluded in Tianjin Medical University General Hospital from 2011 to 2014 and served as TA group.Thirty-two eyes of 32 patients who underwent vitrectomy for epimacular membrane or macular hole were enrolled as control group.The vitreous specimens of 0.6 ～0.8 ml was collected during the surgery.The concentrations of urokinase plasminogen activator (u-PA),tissue plasminogen activator (t-PA) and plasminogen activator inhibitors 1 (PAI-1) in vatreous were measured by ELISA.Results The mean contents u-PA,t-PA and PAI-1 in the vatreous were 25.45,127.44 and 0.42 ng/ml respectively in the TA group,and those the mean contents in the control group were 22.94,142.37 and 0.27 ng/ml respectively,shouwing a significant difference between the TA group and the control group (Z=-2.268,P＜0.05).NO significant difference was found in vitreous t-PA and PAI-1 between TA and control groups (Z =-0.092,-1.847,both at P＞0.05).Conclusions Vitreous u-PA content is increased in PDR eyes,which is more likely to lead bleeding.Anastalsis of TA during vitrectomy for PDR may be relatived to decreasing vitreous t-PA and u-PA contents as well as increasing PAI-1 contents.

Both diabetes mellitus and liver cirrhosis have high incidence rate and mortality rate around the world, and in recent ten years, scholars in China and globally have conducted many studies on the association between diabetes mellitus and liver cirrhosis. This article systematically reviews the advances in the basic and clinical research on the influence of diabetes mellitus on liver cirrhosis and its complications and summarizes possible mechanisms. The results show that diabetes mellitus can accelerate the process of liver fibrosis, increase the risk of complications and progression to liver cancer in patients with liver cirrhosis, and reduce their survival rate.

Hepatogenous diabetes (HD) is a common complication of end-stage liver disease, and many studies have confirmed its adverse effect on prognosis. In recent ten years, a great number of studies have been conducted on the pathogenesis of HD and some progress has been made. This article reviews the research advances in the pathogenesis of HD, in order to provide a reference for the diagnosis and treatment of HD by clinicians.

With the development of the times, the comprehensive treatment technology of breast conserving or modified radical mastectomy plus radiotherapy for breast cancer has become more mature and perfect. As the first station of lymphatic drainage of breast, internal mammary lymph nodes have been paid much attention. At present, there is a controversy about whether the internal mammary lymph nodes are irradiated or not. Previous studies have shown that local lymph nodes irradiation containing internal mammary lymph nodes has survival benefit value. However, as a part of regional lymph nodse irradiation, internal mammary lymph nodes irradiation has also been proved to increase the toxicity of heart and lung, which leads to some research institutions and scholars to remain skeptical about internal mammary lymph nodes irradiation. In recent years, with the improvement of radiotherapy technology and equipment and the accumulation of clinical experience, more and more scholars tend to accept internal mammary lymph nodes radiotherapy. But we should pay attention to the indications of internal mammary lymph nodes irradiation, in order to select appropriate treatment options to achieve real benefits.

OBJECTIVETo compare the acute kidney injury classification systems of RIFLE,AKIN,KDIGO and conventional criteria for determining prognosis of acute-on-chronic liver failure (ACLF) patients.

METHODSPatients with ACLF admitted to our hospital between July 2008 and March 2014 were enrolled in the study. The incidence, stages, and outcomes of acute kidney injury were determined according to the RIFLE, AKIN,KDIGO and conventional criteria.ROC curves were generated to compare the predictive ability for 30-day mortality of the four systems.Chi-square test and Fisher's exact test were used for statistical analyses, as well.

RESULTSAll four classification systems detected acute kidney injury among the patients in the study population (n =358), but the detection rates were not consistent (expressed as % of total): KDIGO criteria: 45.0%, AKIN: 38.8%, rIFLE: 35.5%, conventional criterion: 20.4%. The KDIGO and AKIN criteria showed higher sensitivity (72%), especially to early kidney injury, but the conventional criterion showed higher specificity (92%). The AUC for 30-day mortality was highest for the conventional criteria (0.75), followed by AKIN (0.72), rIFLE (0.70) and KDIGO (0.69) (all, P less than 0.05). In-hospital mortality increased with severity of AKI in a stepwise manner.

CONCLUSIONAmong the four common evaluation systems for acute kidney injury, the conventional criteria has the highest specificity for predicting short-term prognosis of patients with ACLF, while the AKIN and KDIGO criteria have the highest sensitivity for the presence of acute kidney injury, especially at the early stage.

Acute Kidney Injury ; classification ; diagnosis ; Acute-On-Chronic Liver Failure ; diagnosis ; Hospital Mortality ; Humans ; Incidence ; Prognosis ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity