Objective To investigate the medium-and long-term clinical efficacies of superficial needling therapy for lumbodorsal myofacial pain syndrome.Method Three thousand two hundred and fifty-one patients with lumbodorsal myofacial pain syndrome were randomly allocated to a superficial needling group of 1753 cases and an acupuncturegroupof 1498 cases.Seventy-threepatients in the superficial needling group and 105 patients in the acupuncture group did not complete the required courses of treatment and were lost to follow-up.The others in the two groups completed therequiredcourses of treatment and were followed up.After three courses of treatment, the clinical therapeutic effects were compared using the pain score at the end of treatment and at three and six months and one year after.Thereturn visit rates were also compared.Result There was a significant difference in the pain score (NRS score) between the two groupsat the end of treatment (P<0.01), which was significantly lower in the superficial needling group than in the acupuncturegroup, and a difference between the twogroupsat three months after.There was no significant difference in the pain score between the two groupsat six months after and no difference between the two groupsat one year after.There were no differences in clinical the rapeutic effect and the return visit rate between the two groupsat six months and one year after.Conclusion A clinical observation with a large sample shows that superficial needling has a good short-term therapeutic effect on lumbodorsal myofacial pain syndrome and is a safe and effective method, but its medium-and long-term the rapeutic effects are notgood enough.

Objective To investigate the effects of ulinastatin on renal ischemia/reperfusion (I/R) in rats and assess the possible mechanism. Methods Seventy-five male SD rats weighing 210-250 g were randomly divided into three groups with 25 animals in each group : (Ⅰ) control group received sham operation; (Ⅱ)renal I/R group and (Ⅲ) ulinastatin + I/R group. The animals were anesthetized with intraperitoneal ketamine 50 mg?kg-1 . Bilateral kidneys were exposed through midline incision and bilateral renal pedicles were occluded with atraumatic mini-clamp. The kidneys turned pale. In control group the kidneys were exposed but their pedicles were not clamped, while in ulinastatin group (Ⅲ) ulinastatin 12 500 u was given i. v. 30 min before ischemia and at the beginning of reperfusion. Blood samples and kidneys were obtained at 0, 2, 6, 12, 24 h of reperfusion for determination of blood urea nitrogen (BUN) and serum creatinine (Cr) concentrations and the expression of heat shock protein 70 (HSP 70) and bcl-2 in kidney and for microscopic examination. Paller scoring system was used to evaluate the severity of histological changes ( the higher the score, the worse is the change) .Results BUN and serum Cr levels were significantly lower at 12 and 24 h of reperfusion in group Ⅲ than in group Ⅱ (P 0.05) . Conclusion Ulinastatin can reduce the risk of renal dysfunction and injury associated with renal I/ R. The protective effect of ulinastatin may be associated with the up-regulation of bcl-2 expression.

Aim To explore the relationship between Mre11/Rad50/Nbs1 ( MRN ) complex focus formation and DNA double-strand breaks( DSBs) caused by cinob-ufagin in human hepatocellular carcinoma HepG2 cells. Methods The Na+,K+-ATPaseα1 subunit expression level in liver cancer tissues was detected by immunohis-tochemistry. After HepG2 cells were treated with 5μmol·L-1 cinobufagin for 6, 12 and 24 h, the drug-in-duced DSBs were assessed by single cell gel electro-phroesis ( SCGE ) , the gene transcription and protein levels of Mrel1, Nbs1, Rad50 and p53 were evaluated by Real time-PCR and Western blot. The cell cycle in parallel was analyzed by flow cytometry. Results The Na+, K+-ATPase α1 subunit expression level in liver cancer tissues was significantly increased compared with the tissue adjacent to carcinoma ( P <0. 05 ) . The 5μmol · L-1 cinobufagin could induce the DSBs in a time-dependent manner (P <0. 05), and it could up-regulate the gene expression levels of Mre11, Nbs1, Rad50 and p53 in HepG2 cells ( P<0. 05 ) . The pro-portions of HepG2 cells in S phase were ( 21. 32 ± 4. 21) % in the control group, and (33. 25 ± 5. 72) %, (56. 72 ± 6. 29) % and (67. 32 ± 9. 42) % in HepG2 cells treated with 5 μmol · L-1 cinobufagin for 6, 12 and 24 h, respectively. The proportions of cells in S phase in cinobufagin groups were significantly increased compared with the control group ( P<0. 05 ) . Conclu-sion Cinobufagin could induce the cell cycle arrest in liver cancer HepG2 cells by activation of Mre11/Rad50/Nbs1 Complex.

Objective To study the effect of operative timing on clinical outcomes in elderly hip fracture. Methods Two hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008. The patients who had an operation within two days (the early surgery group) were compared with the outcome for those who had an operation more than two days (the later surgery group). Outcomes measured were mortality, post-operative complications, operative details, the comorbidity and the activities of daily living of patients. Results One hundred and sixteen patients were included in the study. There were 45 cases in the early surgery group, including 13 males and 32 females. The patients ranged from sixty-five to eightyeight years old, with an average age of 78.76 years. While there were 71 patients in the late surgery group,including 24 males and 47 females. The patients ranged from sixty-six to one hundred and three years old,with an average age of 80.00 years. The demographic data of patients show no significant difference in two groups. There was no difference in intraoperative conditions such as anesthesia, amount of bleeding, type of fixation between two groups. Patients in early surgery group experienced shorter length of hospital stay, and fewer pulmonary complications. The mortality of early surgery group do not show a significant increase at discharge, 6 month, 12 month postoperatively compared to that of the later surgery group. However patients in the early surgery group show a significant increase of ADL scores at discharge, 6 month postoperatively,but not at 12 month. Conclusion The timing of surgery has an impact on clinical outcome in elderly hip fracture. Early surgery was associated with improved function in the first 6 month postoperatively, but not 12months, but it was not associated with mortality.

Objective:To improve the effectiveness and safety of drugs and the compliance of patients with anaphylactoid purpura through the participation of clinical pharmacists in the practice of pharmaceutical treatment .Methods:In the treatment of one patient with anaphylactoid purpura , clinical pharmacists took part in the whole process and provided the individualized regimen , adverse reac-tion monitoring , relative indices monitoring and drug education after the discharge .Results:Through the participation of clinical phar-macists in the medication development , the rational use of drugs was strengthened and the treatment process was monitored .As a re-sult, the infection of the patient obtained effective control .Conclusion:The participation of clinical pharmacist in the treatment of pa-tients with anaphylactoid purpura reflects the patient-oriented pharmacy service concept , which improves the efficiency and safety of treatment.

IgA vasculitis (IgAV) is a common systemic small-sized vessel vasculitis.It's characterized by non-thrombocytopenic palpable purpura,arthralgia/arthritis,bowel angina,and nephritis,but some details of etiology and pathogenesis is not very clear.The disease course is usually benign and self-limited,however,it is necessary to discuss the therapy of severe or chronic cases,especially there is not enough evidence-based basis for using key drugs to IgAV.Excellent clinical trails is expected to establish scientific system of prediction and evaluation of disease course,which will be helpful to individualize treatment of IgAV.

BACKGROUND:Currently, the treatment of proximal humeral fractures mainly contains joint preservation (conservative treatment, open reduction and internal fixation) and arthroplasty, but how to choose the treatment is stil controversial. OBJECTIVE:To evaluate and compare the clinical outcomes of joint preservation versus arthroplasty in the treatment of displaced 3-or 4-part humeral fractures in randomized control ed trials using meta-analysis. METHODS:Medline (January 1966 to December 2013), PubMed (January 1980 to December 2013), Embase (January 1990 to December 2013), Science (January 1990 to December 2013), Springer (January 1990 to December 2013), China National Knowledge Infrastructure (1994 to 2013), and Wanfang database (1982 to 2013) were searched for randomized control ed trials addressing joint preservation and arthroplasty for 3-or 4-part proximal humeral fractures. Articles meeting the inclusion criteria were included. The related data were extracted and loaded onto Comprehensive Meta-Analysis Software for meta-analysis. RESULTS AND CONCLUSION:Seven articles with 320 patients (165 patients undergoing joint preservation and 155 patients receiving arthroplasty) were accepted in this mete-analysis and al of them were high-quality English researches by modified Jadad Scale. Meta-analysis results displayed that the random-effects mean Constant score across al types was 55.9 (95%CI:50.7-61.1;P<0.001). Constant score was higher in the joint preservation group than in the arthroplasty group (P<0.01). The study displayed significant heterogeneity (I2 0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized control ed trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3-or 4-part proximal humeral fractures.=88%, Q statistic=107.6, Q=13;P<0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized controlled trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3- or 4-part proximal humeral fractures.

Objective To investigate the incidence and clinical characteristics and look for assay or examination indexes or indicators with higher sensitivity and specificity of heart damage induced by exhaustive exercise in order to establish its preliminary clinical classification and diagnostic criteria. Methods In a military region for training staff,the clinical data of 88 soldiers who were admitted to the departments of cardiology in 6 general or central hospitals because of exhaustive exercise from January 2000 to December 2010 were analyzed. The myocardial enzyme, electrocardiogram(ECG),echocardiography and other related examination indexes or indicators were observed,and the changes of symptoms,signs and other relevant assay and examination indexes before and after treatment were recorded. Results Exhaustive exercise could cause the symptoms such as chest tightness,palpitations,chest pain, dizziness,shortness of breath,fatigue,syncope and other symptoms,as well as cardiac auscultation abnormalities. After treatment, aspartate aminotransferase〔AST(U/L):20.34±6.33 vs. 35.43±25.25〕,α-hydroxybutyrate dehydrogenase〔α-HBDH(U/L):130.47±9.04 vs. 168.93±62.69〕,lactate dehydrogenase〔LDH(μmol?s-1?L-1):2.48±0.62 vs. 3.58±1.34〕,creatine kinase〔CK(U/L):125.58±67.56 vs. 556.42±381.89〕,creatine kinase isoenzyme〔CK-MB(U/L):11.20±4.08 vs. 23.09±15.61〕were significantly lower than those before treatment(P<0.05 or P<0.01);cardiac troponin T(cTnT)was detected in 5 patients,its level after treatment was significantly lower than that before treatment(μg/L:0.07±0.05 vs. 1.26±0.78,P<0.05). The ECG abnormalities included primarily sinus bradycardia (16 cases),sinus arrhythmia (13 cases) and premature ventricular contractions (11 cases). Echocardiographic abnormalities appeared in 18 cases,they were chiefly as follows:valvular regurgitation, cardiac dysfunction,cardiac enlargement,etc,among which the most common one was valvular regurgitation(all the refluxes were of small amount). Based on the above clinical manifestations and examination results,the exhaustive cardiac injuries were preliminarily divided into common type(20 cases),arrhythmia type(56 cases),heart failure type(2 cases)and sudden death(10 cases). Conclusions The clinical manifestations of exhaustive heart damage may appear in different types. Abnormal changes of myocardial enzymes,ECG and echocardiography are the strong evidences for the damage. Clinicians should pay attention to its prevention and treatment.

Based on the doctor-patient interaction forum of Haodaifu Online,Xunyiwenyao and Youwenbida,taking advantage of the text mining technologies and methods such as Chinese word segmentation,data cleaning and filtering,word frequency statistics,semantic network map and visualization,extract and summarize the symptoms,causes,common drugs,complications,non-drug therapy and nursing method of Deep Vein Thrombosis (DVT),the paper verifies the availability of text mining method in exploring the prevention law and method of diseases and the feasibility of application of doctor-patient interaction Q&A network data source in medical research.

BACKGROUND:Tissue-engineered biomaterials have the similar structure and function with autologous tissues. OBJECTIVE:To explore the osteoinduction of the bone biomaterial composited with rat bone marrow mesenchymal stem cel s in the treatment of large costal defects. METHODS:Forty Wistar rats were enrol ed used for the preparation of right large costal defect models, and then randomized into two groups, fol owed by the implantation of calcium chloride-sodium alginate gel (control group) or chloride-sodium alginate-bone marrow mesenchymal stem cel s (experimental group). At 2, 4 and 8 weeks after implantation, chest X-ray radiograph and histological examination of the defect region were conducted. RESULTS AND CONCLUSION:X-ray showed that in the experimental group, the defect area had no significant changes at the 2nd week after implantation until the formation of few bones at the 4th week;and at the 8th week, both ends of the defect region gradual y connected, and newly formed bones were ful of the defect. In contrast, the defect region in the control group showed no obvious bone healing, and both ends of the defect closed and osteosclerosis occurred. In the experimental group, there were a smal amount of fibrous tissues and numerous inflammatory cel s infiltratied in the material compartment, and no connection occured between the material and broken ends;there were numerous inflammatory cel s but no bone tissues in the control group at the 2nd week. At the 4th week, the scaffold degraded gradual y and abundant bone tissues were seen in the experimental group;the scaffold degraded little, and bone tissues aggregatied at the both defect ends in the control group. Up to the 8th week, the two kinds of scaffolds degraded mostly. A large number of bone tissues and trabeculae formed and the both defect ends were connected with the newly formed bones in the experimental groups, while in the control group, osteosclerosis appeared at both ends of the defect. To conclude, the bone biomaterial composited with rat bone marrow mesenchymal stem cel s promotes the repair of large costal defects.