Objective To observe the clinical efficacy of electroacupuncture in treating severe functional constipation. Method Seventy patients with severe functional constipation were randomized into a treatment group (35 cases) and a control group (35 cases). The treatment group was intervened by deeply needling bilateral Tianshu (ST25) and Fujie (SP14) with electrical stimulation in addition to ordinary acupuncture at bilateral Shangjuxu (ST37);the control group was by superficially needling the areas beside bilateral Tianshu, Fujie and Shangjuxu with sham electroacupuncture. The two groups were both treated for successive 8 weeks and were followed up for another 3 months. The complete spontaneous bowel movements (CSBMs), Bristol stool form Scale (BSFS) and difficulty in bowel movements were observed every week. Result The two groups both showed significant improvements in average weekly CSBMs (P<0.05,P<0.01), and the CSBMs at the end of the treatment were better in the treatment group than in the control group (P<0.05); the two groups were both effective in improving BSFS and difficulty in bowel movements, without significant between-group differences(P>0.05). Conclusion Electroacupuncture can improve CSBMs in severe functional constipation, but it’s insignificantly different from sham acupuncture in improving stool form and defecation difficulty.

Objective: To study the infectious state of 3 kinds of viruses (CVB, CMV and EBV) in respiratory tract infection and its significance. Methods: Among 290 patients studied, there were 158 boys and 132 girls, aged from 6 months to 12 years. The antigen of coxsackievirus B (CVB-Ag) and antibody of coxsackievirus B (CVB-IgM), antibody of cytomegalovirus (CMV-IgM) and antibody of EB virus (EBV- IgM) were detected by ELISA method. Results: (1) The positive incidence of upper respiratory tract infection, bronchitis, pneumonia was higher than that of noninfectious disease group (P<0.01). The positive incidence of CVB was higher than that of CMV and EBV(P＜0.01). (2)There were cross viruses positive, especially in pneumonia group (P<0.05), usually CVB cross other virus infection. (3) The course of pneumonia was long in single CVB (P<0.01) and longer in cross infection of viruses (P<0.01). Conclusion: CVB infection is the most common one in the 3 viruses. Attention should be paid to multiple viruses infections in pneumonia children.

Objective To evaluate diagnostic accuracy based on patient history and physical examinations in medical outpatients.Methods Totally, 145 consecutive patients visiting general internal medicine clinic at a university-affiliated teaching hospital during October 10 to 17, 2008 were recruited into the study and followed-up for 12 months.Results Eighteen of 145 patients ( 12.4% ) were lost to followup.Diagnosis was confirmed by follow-up for 45 ( 35.4% ) of those with medically unexplained symptoms (MUS).Sensitivity of physical diagnosis for those with MUS was 82.2 percent, with specificity of 95.1 percent, likelihood ratios of positive and negative results of 16.9 percent and 0.19 percent, its positive and negative prediction values of 90.2 percent and 90.7 percent, and overall accuracy of 90.6 percent,respectively.Conclusions MUS was common in medical clinical practice.Preliminary diagnosis for MUS based on patient history and physical examinations has been proved remarkably reliable.Carefully selected auxiliary laboratory evaluation combined with physical diagnosis is important for management of MUS.

BACKGROUND: Amniotic fluid cells have been widely used in antenatal diagnosis for gene mutation-related diseases. However,there are few reports concerning isolation, culture, surface character identification, differentiation and application perspective of fetal mesenchymal stem cells (MSCs) derived from amniotic fluid.OBJECTIVE: To investigate the differentiation of fetal mesenchymal stem cells (MSCs) derived from second-trimester amniotic fluid into osteoblasts in vitro.DESIGN, TIME AND SETTING: The cytological/n v/tro study was conducted at the Experimental Center of Xinhua Hospital from August 2005 to May 2006.MATERIALS: Ten amniotic fluid samples were obtained from pregnant women (18-22 weeks after conception) or aborted women,The informed consents were obtained from pregnant women.METHODS: Fetal MSCs were separated mechanically from amniocyte culture system and expanded in medium in vitro. At passage 3, fetal MSCs were induced in 100 nmol/L dexamethasone, 10 mmol/L β-glycerophosphoric acid and 50 mg/L vitamin C for 14 days.MAIN OUTCOME MEASURES: Collagen Ⅰ and alkaline phosphatase expression was detected by immunohistochemistry.Collagen Ⅰ protein expression was determined by Western Blot analysis. Calcium tuberoses were measured by Von Kossa staining. The cytoskeletal protein was detected by laser confocal microscopy.RESULTS: The isolated fetal MSCs were uniformly positive for CD44 and HLA-ABC, negative for CD34, CD45 and HLA-DR. After being induced with osteogenic medium for 14 days, 91% cells were positive for alkaline phosphatase, and 87% cells for collagen Ⅰ.Cells expressed collagen Ⅰ protein. Number of calcium tuberoses was increased and became big over time. Cytoplasm microfilament presented green fluorescence and the microfilament surrounding cells formed dense bundle.CONCLUSION: Fetal MSCs derived from amniotic fluid could be induced into osteeblasta and displayed a typical osteoblastic morphology and biological characteristic.

Objective To observe the effect of Sachet-therapy on prevention of infant upper respiratory tract infection. Methods A cluster sampling was conducted for quantitative investigation. Hangzhou urban infants were randomly treated with either wearing Sachet or not wearing Sachet for 12 weeks′ observation.We then analyzed statistically the incidence of the two groups. Results The incidence was 14.42 % in the infant observer group and 54.98% in the contrast group with statistical significance(P

Objective To investigate the clinical outcome of patients who underwent whole embryo vitrification freezing and thawed frozen embryo transplantation, and to compare it with the patients at the same period in the fresh cycle to explore the value of vitrification technology in the whole embryo freezing combined with recovery transplantation. Methods The whole embryo freezing group included 40 untransplanted cases of in-vitro fertilization (IVF), while another 300 patients in the fresh cycle with in vitro fertilization and embryo transfer (IVF-ET) at the same period served as the fresh cycle group. The average number of transferred embryos, high-quality embryos, endometrial thickness, estradiol (E2) level, and clinical pregnancy rate were compared.Results The average number of transferred embryos, high-quality embryos, difference in endometrial thickness were not significant between the 2 groups (P>0.05); the E2 level of the fresh cylcle group was significantly higher than that of the whole embryo freezing group (P<0.05), and the clinical pregnancy rate in the fresh cylcle group was significantly lower than that of the whole embryo freezing group (P<0.05). Conclusion Vitrification technology is a simple, reliable, and efficient embryo freezing technology. For patients who meet the requirements, whole embryo vitrfication freezing and thawed frozen embryo transplantation is feasible. It is worth for further clinical research.

Objective:To conduct health economic evaluation of Chinese population-based screening and opportunistic testing strategies for the prevention of Helicobacter pylori ( H. pylori)-related diseases. Methods:The Markov models of H.pylori infection caused non-ulcer dyspepsia, peptic ulcer (PU) and gastric cancer were established. The cost and effects of the population-based screening, opportunistic testing, and non-intervention strategies in 100 000 population of our country were simulation calculated. Wilcoxon signed rank test was used for statistic analysis. Single factor sensitivity analysis was performed to analyze the impact of single parameter uncertainty on cost-effectiveness. Probability sensitivity was used to analyze the impact of common uncertainty of all parameters on cost-effectiveness. Results:Compared with opportunistic testing strategy and non-intervention strategy, the total cost of population-based screening strategy was reduced by 0.43 million yuan(-6.63 million yuan to 7.19 million yuan) and 4.45 million yuan(-8.60 million yuan to 27.93 million yuan), quality adjusted life years (QALY), life years and asmptomatic months were prolonged by 888.00 (479.86 to 1 574.10) and 3 032.78 (1 756.04 to 5 007.84), 651.82 (294.73 to 1 211.94) and 1 868.64 (1 045.88 to 3 148.34), 28 381.91 (19 109.54 to 43 736.72)and 102 537.13 (58 649.18 to 176 868.77) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 115 cases(52 cases to 232 cases) and 464 cases(266 cases to 803 cases), 74 cases(33 cases to 148 cases) and 260 cases(149 cases to 453 cases), 46 cases(25 cases to 72 cases) and 369 cases(210 cases to 710 cases), 80 cases(42 cases to 126 cases) and 501 cases(331 cases to 772 cases) respectively, and the differences were statistically significant ( Z=1.99, 10.54, 27.39, 27.39, 27.37, 27.39, 27.39, 27.39, 27.21, 27.28, 27.22, 27.28, 27.38, 27.39, 27.39 and 27.39, all P<0.05). Compared with the non-intervention strategy, the opportunistic testing strategy reduced the total cost by 3.89 million yuan(-2.79 million yuan to 18.18 million yuan), QALY, life years and asymptomatic months were prolonged by 1 764.77 (888.70 to 3 406.62), 1 044.16 (524.46 to 1 912.75) and 62 568.69 (30 054.07 to 129 892.76) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 311 cases(164 cases to 563 cases), 164 cases (87 cases to 301 cases), 325 cases(162 cases to 644 cases) and 399 cases(234 cases to 684 cases) respectively, and the differences were statistically significant ( Z=14.20, 27.39, 27.38, 27.39, 27.25, 27.25, 27.39 and 27.39, all P<0.01). The results of singlefactor sensitivity analysis showed that the uncertainty of any parameter did not affect the cost-effectiveness of three strategies. The results of probability sensitivity analysis indicated that the probability of cost-effectiveness advantage of the population-based screening strategy was 100% and the common uncertainty of all parameters had no effect on cost-effectiveness. Conclusions:For preventing H.pylori-related diseases, the population-based screening strategy has the lowest average cost and the best average effect. However, non-intervention strategy has the highest average cost and the worst average effect. Population-based screening strategy is worthy of promotion throughout China, and opportunistic testing strategy has a higher clinical practical value.

AIM: To select differentially the expressed gene,glucose regulated protein 78(GRP78),to observe the expression of GRP78 in atherosclerosis tissue and to elucidate the mechanism for anti-atherosclerosis of puerarin.METHODS: The model was established by using homocysteinemia in vitro.The vascular endothelial cells were incubated with various concentrations of puerarin(10 -7 mol/L,10 -6 mol/L,10 -5 mol/L) for 48 h.The apoptosis rate was detected by flow cytometry using Annexin/PI-staining.GRP78 gene was amplificated by PCR.These differentially expressed fragments were cloned,selected,confirmed,and sequenced.Digoxigenin-labeled DNA Probe and cholesterol-rich rabit model were prepared,GRP78 mRNA was determined by in situ hybridization in atherosclerotic lesions and normal tissue.RESULTS: Three concentrtions of puerarin significantly inhibited the apoptosis of endothelial cells.The early apoptosis rate was decreased magnificently in a dose dependent manner compared with that of HCY group (P

0.05).Conclusion: P14ARF and E2F1 can suppress colorectal tumorigenesis.The protein dysfunction is merely an early event in the tumorigenic process,correlated neither with such invasive activities as lymphonode and distant organ metastases nor with clinicopathologic characteristics.P14ARF and E2F1 have a synergenic action in suppressing cell growth and inducing cell apoptosis,and therefore can be used as potentially active gene therapeutic agents for colorectal cancer.

Objective To investigate the effect of different doses of dexmedetomidine combined with intercostal nerve block in regional adenomammectomy.Methods 112 patients receiving regional adenomammectomy and meeting criterions were selected from Oct.2013 to Oct.2016.And they were divided into control group and low,medium,and high dose group according to table of random number,with 28 cases in each group.Patients of the control group only received intercostal nerve block.Patients of low dose group received low dose of dexmedetomidine (0.7 μg/kg load dose and 0.25μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of medium dose group received medium dose of dexmedetomidine (0.7 μg/kg load dose and 0.5 μg·kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of high dose group received high dose of dexmedetomidine (0.7 μg/kg load dose and 1 μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Mean arterial pressure,heart rate,VAS score and sedation score of the four groups were detected and compared at T0,T1,T2,T3 and T4.Results The mean arterial pressure and heart rate of medium and high dose group were lower than those of the control group and low dose group at T1,T2,T3 (P＜0.05).The mean arterial pressure and heart rate of high dose group were lower than those in medium dose group at T1,T2,T3 (P＜0.05).VAS score of medium and high dose group were lower than those of the control group and low dose group (P＜0.05),while the difference was not statistically significant between medium and high dose group(P＞0.05).The sedation scores of low,medium and high dose groups were higher than those of the control group at T1,T2,T3 and T4 (P＜0.05),while the sedation score of high dose group were higher than those of low and medium dose groups at T1,T2,T3 and T4 (P＜0.05).Conclusion Medium and high dose of dexmedetomidine combined intercostal nerve block can effectively relieve pain for patients undergoing regional adenomammectomy,while high dose of dexmedetomidine is likely to cause bradycardia,hypotension and excessive sedation.Appropriate dosage should be chosen in clinical practice.