For the treatment of primary dysmenorrhea, professor ZHAO Jiping focuses on meridian diagnosis and inspection, and uses pressing methods to locate the response points along the meridian, including acupoints and aishi points. During the stage of attack, it is essential to press along the spleen meridian, mainly Sanyinjiao (SP 6), Diji (SP 8) and Yinlingquan (SP 9); during the stage of remission, it is essential to press along the bladder meridian and stomach meridian, mainly Ganshu (BL 18), Pishu (BL 20), Weishu (BL 21), Shenshu (BL 23) and Zusanli (ST 36). The differences between deficiency syndrome and excess syndrome lead to the different feelings of doctors and patients. Combined with the results of meridian diagnosis and inspection, the aim of treatment can be achieved by different acupuncture methods. Professor ZHAO pays attention to the treatment of accompanied symptoms and timing of treatment, since the relief of accompanied syndromes and selection of timing are keys to relieving patient's pain.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Diagnosis, Differential ; Dysmenorrhea ; diagnosis ; therapy ; Female ; Humans

Objective To explore the role of TLR2 and TLR4 in the pathogenesis of Henoch-Schonlein purpura ( HSP) by investigating their expression at mRNA and protein levels in peripheral blood mononuclear cells ( PBMCs ) and their influences on Th 1/Th2 immune response in children with HSP . Methods 64 hospitalized children with HSP in the Affiliated Hospital of Qingdao University Medical Col -lege from October 2011 to November 2012 were enrolled in the study .They were further divided into non-He-noch-Schonlein purpura nephritis ( NHSPN ) group ( n =36 ) and Henoch-Schonlein purpura nephritis (HSPN) group (n=28).30 age-matched healthy children from Child Health Division of the same hospital were selected as controls .The expression of TLR2 and TLR4 at mRNA level in PBMCs were detected by re-al-time fluorescent polymerase chain reaction .The expression of TLR2 and TLR4 at protein level and T cells subset were detected by flow cytometry .The levels of IFN-γ, IL-4 and IL-6 in plasma were determined by enzyme-linked immunosorbent assay (ELISA).Results (1)Compared with the control group , the expres-sion of TLR2 and TLR4 at mRNA and protein levels were remarkably increased in children with HSP , espe-cially in HSPN group.(2)Compared with the control group, the percentage of CD3+T cells and CD3+CD4+T cells were down-regulated in HSP group , but the percentage of CD 3+CD8+T cells and CD3+HLADR+T cells were up-regulated.(3)The level of IFN-γand the ratio of IFN-γ/IL-4 in plasma from children with HSP were significantly lower than those of the controls , while the level of IL-4 and IL-6 were remarkably higher than those of the controls .(4)The expression of TLR2 and TLR4 at protein level in PBMCs from chil-dren with HSP showed significant positive correlations with the expression of TLR 2 and TLR4 at mRNA level and plasma concentration of IL-4 and IL-6, but a negative correlation with the ratio of IFN-γ/IL-4.Conclu-sions The aberrant activation of TLR 2 and TLR4 might be correlated with the immunological pathogenesis of HSP by enhancing Th2 immune response.The hyper-activation of TLR2 and TLR4 might result in renal injury in patients with HSP .

Objective To discuss the influence of preventive calcium supplementation on the recovery of parathyroid glands function after total thyroidectomy.Methods 232 patients meeting the selected criteria were randomly assigned to group A and B,and then divided into group A1 (87 cases,PTH ＞8 pg/ml)and A2 (30 cases,PTH ＜8 pg/ml),group B1(83 cases,PTH＞8 pg/ml)and B2(32 cases,PTH ＜8 pg/ml) based on the lowest parathyroid hormone( PTH )value within 3 days after surgery.All patients in group A were immediately supplemented 10％ calcium gluconate intravenously 6 g/d after operation.For group B,post operative calcium supplementation was not given,however,anyone whose PTH ＜ 8 pg/ml was supplemented 10％ calcium gluconate intravenously 6 g/d no matter hypocalcemia occurred or not.The level of serum calcium and PTH of all patients were assayed before operation and at the 1st,2nd,3rd day,1st week and 1st month after operation.In additon,patients with hypocalcemia received serum calcium and PTH detection at the 2nd and 3rd week.Whether hypocalcemia and hypoparathyroidism occurred or not was recorded.Results ( 1 )The serum PTH was obviously higher in group A1 than in group B1 at the 1st week after operation( P ＜0.05 ).The serum calcium was obviously higher in group A1 than in group B1 at the 1st,2nd,3rd day and 1st week after operation(P ＞0.05).The hypocalcaemia and symptomatic hypocalcaemia incidence were obviously lower in group A1 than in group B1 (P ＜ 0.05 ).(2)① Group A2 had obviously higher level of serum PTH than group B2 at the 1 st,2nd,and 3rd week after operation ( P ＜0.05 ) and returned to normal level of serum PTH earlier than group B2.② Group A2had obviously higher level of serum calcium than group B2 from the 1 st day to the 3rd week after operation ( P ＜ 0.05 ) and returned to normal level of serum calcium earlier than group B2.③ The hypocalcaemia and symptomaic hypocalcaemia incidence ware obviously lower in group A2 than in group B2 (P ＜ 0.05 ).Conclusion The preventive calcium supplementation is beneficial for the recovery of the function of parathyroid glands after total thyroidectomy.

AIM:To study intravenous transplantation of human mesenchymal stem cells (hMSCs) on the life span and pathological change of SOD1-G93A amyotrophic lateral sclerosis (ALS) mice. METHODS:hMSCs were cultured and expanded from heparinized bone marrow cells from healthy donors and the purity and features were identified with FCM. hMSCs (3×10~6) resuspended in 0.3 mL DMEM or 0.3 mL DMEM only were injected into the tail vein of genotyped SOD1-G93A ALS mice. The mice were evaluated for signs of motor deficit with 4-point scoring system according to Weydt and the onset and life span were assessed. The pathological change was observed with Nissl staining and number of motor neuron was counted. RESULTS:The onset symptoms in untreated SOD1-G93A ALS mice appeared at (156.6±3.6) d of age and the average life span was (188.3±3.5) d. hMSCs transplantation delayed the onset of ALS type symptoms about 14 d and prolonged the life span about 18 d compared to the untreated SOD1-G93A littermates. The loss of motor neurons in untreated mice was much faster and severer than that in hMSCs transplanted mice. At 16 th week and 20 th week,motor neurons of untreated mice were significantly fewer than those of transplanted mice. β-globin gene in brain was detected in transplanted ALS mice. CONCLUSION:hMSCs migrate to central nervous system after intravenous transplantation,prolong the life span and delay the onset and motor neuron loss in SOD1-G93A ALS mice.

Objective To investigate the relation between serum asymmetric dimethylarginine (ADMA) level and endothelial function before and after living donor kidney transplantation in uremic patients.Methods A total of 38 renal transplant patients (21males and 17 females) and 36 healthy controls (20 males and 16 females) were enrolled. Plasma ADMA, symmetric dimethylarginine (SDMA), malondialdehyde (MDA), glutathione peroxidase (SeGSHPx), C-reactive protein (CRP) were mea-sured before transplantation and on Days 1, 3, 7, 14, and 28 posttransplantation. The brachial artery flow mediated dilatation (FMD) was studied before transplantation and on the 28th day after the transplantation. Results Serum levels of ADMA,SDMA,MDA and CRP were significantly increased, and the activities of nitric oxide (NO) and SeGSHPx were decreased in uremic patients compared with age matched healthy subjects (all P＜0.01). Serum levels of ADMA,SDMA,MDA and CRP decreased while the activities of NO and SeGSHPx increased significantly at the first day after the transplantation (all P＜0.01). The decrement of plasma SDMA normalized on the 28th day (P＞0.05). The FMD was lower in the patients than the control group (P＜0.01) and improved significantly on the 28th day of posttransplantation (P＜0.05). Serum levels of ADMA were positively correlated with MDA (r=0.412, P＜0.01;r=0.342,P＜0.01) and negatively correlated with the values of SeGSHPx (r=-0.345, P＜0.01;r=-0.315, P＜0.01) and FMD (r=-0.452,P＜0.01;r=-0.416,P＜0.01) both before and after kidney transplantation. Conclusion The level of serum ADMA is associated with endothelial function improvement in uremic patients both before and after kidney transplantation.

Objective To study the changes of life span and pathology in superoxide dismutase 1 (SOD1)-G93A mice after intracardiac transplantation of human mesenchymal stem cells (hMSCs).Methods hMSCs were isolated from bone marrow cells obtained from healthy donors and cultured.The purity and morphology were assessed by flow cytometry (FCM).hMSCs (3×10~6) resuspended in 0.2 ml DMEM was injected into the heart of 8 week-old SOD1-G93A mice.In non-transplantion control SOD1-G93A mice, only DMEM was injected.The mice were evaluated for signs of motor deficit with 4-point scoring system previously described by Weydt et al.The age of onset and life span in mice were assessed.The pathological change including number of motor neurons was investigated by Nissl staining.Immunofluorescence staining with specific human nuclear antibody was used to confirm the transplant of hMSCs in mice.Results The onset symptoms in untreated SOD1-G93A mice appeared at (156.56±3.60) days of age and the average life span was (188.32±3.51) days.hMSCs transplantation delayed the onset of ALS type symptoms about 16 days (x~2=10.888, P=0.001) and prolonged the life span about 14 days compared to the untreated SOD1-G93A littermates((202.19±4.09) days vs (188.32±3.51) days, x~2=3.917, P=0.04).The loss of motor neurons in untreated mice was earlier and more severe than in hMSCs transplanted mice.At 20 weeks, the number of motor neurons in transplanted mice was significantly higher than those in untreated mice.Human specific nuclear antigen in brain and spinal cord was detected in transplanted SOD1-G93A mice.Conclusion hMSCs can be implanted for a long-term into central nervous system by intracardiac transplantation and the transplantation can prolong life span, and delay the onset of the disease and motor neuron loss in SOD1-G93A mice.

Objective To investigate the cause of reoperation for high differentiated thyroid carcinoma and the risk factors of neck lymph node metastasis in reoperation. Methods Retrospectively reviewed the clinical data of 54 high differentiated thyroid cancer patients from 1998 to 2005, who received reoperation and neck lymph node dissection simultaneously. Results The residual thyroid carcinoma rate and lymph node metastasis rate were higher in 39 patients who initially received partial thyroidectomy than in 15 who previousely underwent radical operation(P <0. 05). Age less than 45 years, lymphadenectasis before initial operation, tumor residued or relapsed, muhicentricity of primary cancer and blurred boundary between cortex and medulla of lymph node were the risk factors for ipsilateral lymph node metastasis(P <0. 05), while mul-ticentricity of primary cancer and contralateral thyroid cancer were the risk factors for contralateral lymph me-tastasis (P < 0. 05). Conclusions Individual standard radical operation and necessary lymph node dissection are important measures to prevent recurrence and reoperation. Completion thyroidectomy and modified or selec-tive neck dissection are recommended for reoperation patients with the risk factors of lymph node metastasis.

BRAFV600E mutation is the most common genetic alteration in the papillary thyroid carcinoma.It plays an important role in the tumorigenesis,invasiveness and metastasis of the papillary thyroid carcinoma.Testing of BRAFV600E mutation is of great value in diagnosis,which also can be used as a prognostic maker of papillary thyroid cancer.Inhibitors treatment targeted to BRAF kinase and its downstream effectors is a new area in the treatment of BRAFV600E mutated thyroid cancer.

BACKGROUND:Airway epithelial regeneration can effectively inhibit submucosal hyperblastosis and the occurrence of obliteration. Studies demonstrated that ventilation could accelerate the regeneration of airway epithelium. OBJECTIVE:To establish and improve an orthotopic tracheal transplantation model and to further observe the effects of ventilation on trachea in alogeneic mice. METHODS:C57BL/6 mouse's tracheal served as donor, and BALB/c mouse's tracheal as recipient. This experiment contained two groups. In the experimental group, the membranous part of trachea was longitudinaly dissected in two donors and sutured into an enlarged trachea, which was implanted in the recipient. In the control group, donor's trachea was implanted into the recipient in situ. Samples were obtained and detected at 28 days after surgery. RESULTS AND CONCLUSION: Hematoxylin-eosin staining results demonstrated that compared with the control group, wel-differentiated ciliated epithelium was visible in the epithelial lamina of tracheal lumen, accompanying a few non-ciliated single or stratified squamous epithelium, mild submucosal fibrosis and inflammatory cel infiltration. Morphological analysis revealed that ciliated epithelial proportion in the experimental group was higher than in the control group (P < 0.05). The ratio of lamina propria to the tracheal cartilage, submucous fibrous tissuearea and the degree of lymphocyte infiltration were lower in the experimental group than in the control group (P < 0.05). Immunohistochemical staining demonstrated that the transplanted tracheal epithelium in both groups was recipient epithelial phenotype. Results verified that a modified orthotopic tracheal transplantation model was successfuly established. The increased ventilation of the tracheal alografts can accelerate the differentiation of tracheal epithelium. The wel-differentiated airway epithelium inhibited the proliferation of fibroblast.

Objective To study the clinical value of peritoneal cavity non-drainage after the operation of acute perforating appendicitis.Methods 196 patients with perforating appendicitis were randomly divided into drainage group and non-drainage group.The incidence rates of wound infection and ankylenteron and hospital durations in the two groups were observed and compared with each other.Results The incidence rate of wound infection and ankylenteron were 19.0%,10.7% in the drainage group and 8.0%,4.5% in the non-drainage group respectively(P0.05).The mean postoperative hospital stay of the drainage group was(9.3?2.7)days,which was significantly longer that of the non-drainage group(5.1?1.9)days,P