ObjectiveTo observe the clinical efficacy ofShu Feng An Shen(expelling wind and calming mind) needling plus distal points selection in treating cluster headache.MethodForty patients with cluster headache were divided into two groups by using random number table, 20 cases in each group. The treatment group was intervened byShu Feng An Shenneedling plus distal points selection, while the control group was by acupuncture with conventional points selection. The pain intensity score (Visual Analogue Scale, VAS), lasting duration and attack frequency were observed.ResultThe VAS score, lasting duration and attack frequency were significantly reduced after treatment in the two groups (P<0.01), and the reduction was more significant in the treatment group (P<0.01).ConclusionShu Feng An Shenneedling plus distal points selection can produce a more significant efficacy in reducing pain intensity, lasting duration, and attack frequency in treating cluster headache compared with acupuncture with conventional points selection.

Objective The study was aimed to investigate the effects of transforming growth factor beta1(TGF-?1)on acute graft-versus-host disease(aGVHD)after allogeneic bone marrow transplantation(allo-BMT).Methods The recipient was male BABL/C.The donor was male C57BL/6.The murine model of aGVHD had been established by allo-BMT with donor derived T cells.There were four groups in this study:control group,radiation group,transplantation control group and TGF-?1 group.The mice in TGF-?1 group were administered TGF-?1[1 ?g/(kg?d)]subcutaneously two days before transplantation until seven days after it.Results The study showed that the survival time of TGF-?1 group was significantly longer than the transplantation control group,and the aGVHD pathological changes were milder in TGF-?1 group than in transplantation control group.Seven days after transplantation,the level of IL-2 of TGF-?1 group was higher than control group,but significantly lower than transplantation control group.The level of IL-10 of TGF-?1 group was significantly higher than transplantation control group.Conclusion TGF-?1 can prevent the lethal aGVHD and raise the survival rate after allo-BMT in murine model.It may prevent the lethal aGVHD by accommodating the Th1 and Th2 cytokine level in vivo.

Objective To investigate the relationship between self-efficacy and quality of life of patients with type 2 diabetes mellitus.Methods A convenient sample of 116 patients with type 2 diabetes was investigated by diabetes management self-efficacy scale(DMSES)and diabetes quality of life scale(DQOL)and the results underwent analysis.Results Both the level of selfefficacy and quality of life of patients with type 2 diabetes mellitus were low generally.Score of self-efficacy and quality of life of patients with different type of type 2 diabetes mellitus were statistically different.The level of diabetes self efficacy was moderately positivdy correlated with the level of diabetes quality of life(r=0.43,P＜0.01).Conclusions The improvement of self-efficacy and quabty of life of patients with type 2 diabetes mellitus must be thought highly of in the clinical practice which should be based on self-efficacy theory.Various methods should be adopted to arouse the potential ability of patients in order to increase their self-efficacy,so that the quality of life of patients can he improved.

Objective To study the changes of plasma endothelial microparticles (EMP) in children with Kawasaki disease (KD) and its relation to coronary artery lesions (CAL).Methods The participants in this study were 30 children with KD (24 children with typical KD and 6 cases with incomplete KD).All KD patients met the diagnostic criteria established by the Japanese Kawasaki Disease Research Committee.According to the course of KD,3 phases were divided:the acute phase,the subacute phase and the convalescent phase.We evaluated the presence of CAL using two-dimensional echocardiographic examination,and then the KD children were divided into two groups,including 24 children without CAL and 6 children with CAL.Ten children with fever and rash and 10 healthy children were studied as control.The levels of CD31+/CD42b- EMP were measured by flow cytometry.Results The level of EMP was significantly higher in the acute phase [ (8.18 ± 2.29) ％ ] than those either in the convalescent phase [ (2.77 ± 0.85 ) ％ ] of KD or the healthy children [ ( 1.34 ± 0.38 ) ％ ] (P ＜ 0.01 ).The level of EMP was also significantly higher in the subacute phase [ (5.93 ± 1.05 )％ ] than those either in the convalescent phase of KD or the healthy children (P ＜0.01 ).The level of EMP was higher in the children with fever [ (3.66 ± 1.16) ％ ] than that in the healthy children ( P ＜ 0.05 ).Furthermore,the level of EMP during the acute phase was also higher in KD patients with CAL than in those without CAL(P ＜0.01 ).Conclusion The measurement of EMP may be useful for the early diagnosis of KD and the identification of CAL.

Objective To explore the clinical features of hepatolenticular degeneration (HLD) with hemolytic anemia as the first manifestation, and its relationship with ichthyosis.Method The clinical manifestations, course, diagnosis, and treatment of HLD combined with ichthyosis in one child who presented with hemolytic anemia as the ifrst manifestation, were retrospectively analyzed.Results In ten-year-old girl, the ifrst symptom was fatigue and jaundice, and then progressed to abdominal distension 5 days after admission. The reticulocyte percentage was 8.5%. Coombs test was negative. The K-F rings appeared on the cornea. The CT scan of Abdomen showed pleural and peritoneal effusion, abnormal substance deposition in liver and splenomegaly. There were mutations inATP7B andTGM1 genes, both of which were located on fourteenth of chromosomes. The diagnosis of HLD combined with ichthyosis was conifrmed. After symptomatic and supportive treatments such as removal of copper, prevention of the copper absorption and supplement of vitamin A, the disease was brought to remission.Conclusion HLD with hemolytic anemia as the ifrst manifestation, combined with ichthyosis was extremely rare.

Objective To investigate antimicrobial prophylaxis in clean operation,and provide evidence for formu-lating antimicrobial management measures.Methods 12 types of clean operation cases who discharged from a tertia-ry first-class hospital in May of 2011 -2014 were selected,120 cases were selected each year,patients were divided into group I and group II according to the types of operation,survey forms were designed,assessment criteria for the rationality of antimicrobial use was formulated, antimicrobial use in different years was compared. Results Prophylactic use of antimicrobial agents for clean operation decreased from 93.33% in 2011 to 35.00% in 2013 and 2014;rates of correct medication time increased from 43.75% in 2011 to 97.62% in 2013 and 92.86% in 2014 respectively;rates of medication according to indications,rational choice of antimicrobial agents,and rational treatment course increased from 42.86%,60.71 %,and 21 .43% in 2011 to 100.00% in 2014 (all P < 0.05 ). Conclusion Special rectification activities of antimicrobial use effectively promoted the standard application of anti-microbial agents for clean operation.

Objective To explore the significance of NK cell activity,interleukin-2 receptors (sCD25) and glycosylated ferritin in the early diagnostic of acquired hemophagocytic lymphohistiocytosis (HLH).Methods 57 patients suspected of HLH from June 2005 to May 2008 and 25 healthy subjects were enrolled in the study.The patients suspected of HLH were divided into three groups i.e.(1) a group with diagnosis confirmed at first visit;(2) a group with diagnosis confirmed at subsequent visit and (3) a group with diagnosis unconfirmed according to HLH-2004 diagnostic criteria.Healthy subjects were enrolled as control.NK cell activity was determined with a released LDH assay.The percentage of glycosylated ferritin was determined with phytohemagglutinin adsorption assay,sCD25 was examined with ELISA double antibody sandwich assay.We compared the coincidence of each diagnostic index before and after diagnosis.Results The median percentage of NK cell activity was significantly lower in the first group ( 18.3±5.6) % and the second ( 16.7±6.7)% than that in the third group (33.4±6.8)% or in the controls (36.6±5.0)%.The median percentage of glycosylated ferritin was also significantly lower in the first group ( 15,4 ± 2.0)% and the second group (16.9 ± 3.4)% than that in the third group (40.4 ± 3.0)% or in the controls (45.2±2.2)%.Meanwhile,the median level of sCD25 was significantly higher in the first group (12 916±4328) ng/L and the second group (12 117 ± 5465) ng/L than that in the third group (4728±1482) ng/L or in the controls (3841 ± 993) ng/L.Furthermore,NK cell activity,sCD25 and glycosylated ferritin were abnormal in all the patients in the early stage of HLH.Conclusion NK cell activity,sCD25 and glycosylated ferritin may be helpful markers for the early diagnosis of HLH.

OBJECTIVETo investigate the ability of invasion and migration of breast cancer MDA-MB-231 cells under serum starvation and hypoxia, and the effect of antiangiogenic drugs, rh-endostatin and bevacizumab, on the ability of invasion and migration of breast cancer cells under serum starvation and/or hypoxia, in order to explore the potential risk of antiangiogenic therapy in clinics.

METHODSThe cells were randomized into 4 groups, i.e., group A: 10% fetal bovine serum (FBS) group; group B: hypoxia + 10% FBS group; group C: serum starvation group; group D: hypoxia + serum starvation group; each group was further divided into three subgroups as blank control, treated with rh-endostatin and bevacizumab, respectively. Cell counting kit-8 (CCK-8) was used to assess the inhibition rate of cell growth induced by endostatin and bevacizumab, in order to determine the proper working concentration and time of the two drugs. Transwell assay was conducted to detect the cell invasion and migration in vitro. The expressions of c-Met and MMP-9 were detected by Western blot. The cells treated with rh-endostatin or bevacizumab under serum starvation were tested by hybridization using Exiqon miBase 18.0 microarray. The miRNAs which exibited significant differences (P < 0.05) in miRNA hybridization were verified by real-time PCR assay.

RESULTSCCK-8 assay showed that the inhibition rates of MDA-MB-231 cells cultured with 800 mg/L rh-endostatin for 48 h and 24 h were (32.2 ± 2.5)% and (27.0 ± 1.3)%, respectively, showing a significant difference (P = 0.023). The inhibition rates of MDA-MB-231 cells cultured with 80 mg/L bevacizumab for 48 h and 24 h were (30.5 ± 1.4) % and (26.1 ± 2.4) %, respectively, showing also a significant difference (P = 0.015). The Transwell assay showed that in the starvation blank group, the number of invaded and penetrated cells were 28.8 ± 2.2 and 31.4 ± 1.5, respectively, significantly different from that in the rh-endostatin and bevacizumab groups (P < 0.05). The relative expressions of c-Met and MMP-9 were 0.213 ± 0.017 and 0.542 ± 0.048, respectively, with a significant difference from those of the groups treated with each drug (P < 0.05 for both). The numbers of penetrated cells in the Transwell assay treated with rh-endostatin in hypoxia were 17.5 ± 2.1 and 16.5 ± 2.8, respectively, and the numbers of penetrated cells in the Transwell assay treated with bevacizumab were 16.3 ± 3.5 and 17.5 ± 2.4, respectively, showing no significant difference among them (P > 0.05 for both). The ability of migration and invasion of MDA-MB-231 cells and the expression of c-Met and MMP-9 were not impacted by hypoxia (P > 0.05). Real-time PCR assay showed that only the levels of miR-2355 and miR375 were significantly and stably decreased in the cells which had increased ability of invasion and migration. The relative expression levels of miR375 and miR-2355 in the serum starvation blank group were 0.550 ± 0.036 and 0.852 ± 0.121, respectively, significantly lower than that in the groups treated with rh-endostatin or bevacizumab (P<0.05). In the serum starvation group, the expression levels of miR375 and miR-2355 of cells treated with rh-endostatin were 0.295 ± 0.012 and 0.253 ± 0.011, and the expression levels of cells treated with bevacizumab were 0.234 ± 0.020 and 0.309 ± 0.022, respectively, (P > 0.05 for all). Compared with the serum starvation blank group, the expression levels of miR2355 and miR375 were significantly decreased when cells were treated with rh-endostatin/bevacizumab under serum starvation, but no significant difference was found between the two drugs (P > 0.05). However, hypoxia did not affect the expressions of miR2355 and miR375 (P > 0.05).

CONCLUSIONSThe results of this study suggest that serum starvation can increase the ability of invasion and migration of breast cancer cells. Furthermore, both rh-endostatin and bevacizumab may enhance their invasion and penetration ability under serum starvation condition.

Angiogenesis Inhibitors ; adverse effects ; Bevacizumab ; adverse effects ; Breast Neoplasms ; pathology ; Cell Hypoxia ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Culture Media, Serum-Free ; Endostatins ; adverse effects ; Female ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; MicroRNAs ; analysis ; Neoplasm Invasiveness ; Proto-Oncogene Proteins c-met ; metabolism ; Random Allocation ; Real-Time Polymerase Chain Reaction ; Time Factors

Objective To evaluate the efficacy of etanercept in active ankylosing spondylitis (AS) pa-tient for 48 weeks by tapering the dosage of etanercept every 12 weeks. Methods 52 patients with active AS were enrolled in this study , and 47 patients finished 48 Weeks of observation. 50 mg etanercept was applied subcutaneously once a week for 12 weeks , and was tapered to 50 mg every two weeks for another 12 weeks , and then 25 mg every two weeks for another 24 weeks. BASDAI, BASFI, BASMI, ASDAS, as well as Serum levels of CRP and ESR were doaunented at week 0, 12, 24 and 48, respectively. Result Among the 47 active AS patients, 40 (85.1%) were male, with mean disease duration of 4.1 ± 3.8 years. After 12 -week treatment with 50 mg etanercept weekly, the scores of BASDAI, BASFI, BASMI, ASDAS, as well as levels of ESR and CRP, declined significantly compared to the baseline (P < 0.05, respectively). Despite of tapering the dosage of etan-ercept gradually, most of the patients (87.2%, 41/47) kept in ASAS 40 response during the following 36 weeks. No severe adverse events were observed during the treatment period. Conclusion This study demonstrat-ed the clinical efficacy of etanercept in patients with active AS. A dosage reduction strategy could maintain the clinical efficacy of etanercept during 48 weeks , which indicates that gradually tapering etanercept might be a po-tential effective, economic and safe way for active AS patients.

Tumor associate macrophages ( TAMs) play a significant role in the interaction of tumor inflam-mative microenvironment and tumor cells .TAMs originate from monocytic precursors ,recruiting into tumor tissue by colony stimulating factor ( CSF) .This review summarized that TAMs promote tumor progression and metastasis though angiogenesis ,lymphogenesis , immunosuppression , matrix remodeling and affecting cancer stem cells .The article pointed that targeting TAMs is a new strategy for future tumor therapy .