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 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.

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.

Thirty-three infants with muscular torticollis were treated by Tuina techniques, and the size of the hardened sternocleidomastoid muscle in the affected side was B-ultrasonographically observed before and after treatment. Results: 27 cases were cured, 5 cases got effectiveness, 1 case failed and the total effective rate was 97.0%; B-ultrasonography, in the palpable cord-like or ovary-like lumps,showed low echo in 28 cases, moderate echo in 2 cases and high echo in 3 cases; there were significant differences in the length, thickness and width of the lumps between before and after treatment, P＜0.01. It is indicated that Tuina is quite effective against infantile muscular torticollis; that ultrasonography can be adopted as an objective item for the evaluation of the clinical efficacy of Tuina in the treatment of infantile muscular torticollis, and it is a simple, convenient and inexpensive method and should be extensively popularized in clinical practice.

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.

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.

Transforming growth factor-?(TGF-?) is a kind of multifunctional cytokine that regulates cell growth,differentiation,cellular senescence,apoptosis,wound healing and embryo development.As a tumor suppressor,deregulated or aberrant TGF-? signaling has been strongly implicated in human solid tumors,as well as in normal and malignant hematopoiesis.TGF? exerts an inhibitory role during the whole procedure of hematopoiesis.As a cell cycle inhibitor,it maintains cells in a quiescent state and can downregulate expression of hematopoiesis activators and oncoproteins.In malignant hematopoiesis,altered expression of coactivators or corepressors involve in TGF-?-induced transcriptional responses and loss/disruption of TGF-? target gene expression.Then malignant cells grow and differentiate abnormally.In acute promyelocytic leukemia,PML-RAR? may inhibit TGF-? signaling through inhibition of cPML and nPML.Degradation of PML-RAR? by ATRA restores this signaling pathway.

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.

OBJECTIVE:To compare the pharmacoeconomic efficacies of 5 drug therapeutic regimens for children pneumonia.METHODS:Using retrospective study and cost-effectiveness analysis to compare the pharmacoeconomic efficacies among the following 5 regimens in treating children pneumonia:amoxicillin sodium/clavulanate potassium(Group A),cefotaxime sodium(Group B),cefoperazone sodium/sulbactam sodium(Group C),cefuroxime sodium(Group D),and azithromycin(Group E).RESULTS:The effective rates of the 5 groups(A,B,C,D and E) were 80.43%,76.09%,65.12%,77.27%,and 91.30%,respectively,and the cost-effectiveness ratios were 1 595.06,1 225.38,1 669.69,1 284.83,and 697.84,respectively.CONCLU-SION:The regimen of azithromycin(group E) is the optimal one among the 5 groups for children pnemonia.