OBJECTIVE: To compare the effect difference between the thermosensitive moxibustion (TSM) and conventional mild moxibustion (CMM) at Yifeng (TE 17) plus acupuncture intervention in the treatment of facial paralysis patients. METHODS: The prospective cohort study design was used in the present study. A total of 183 patients were divided into a thermosensitive moxibustion (regional heat penetrating, heat extending, warmer in deep-tissue, etc.) group (n＝132) and a CMM group (n＝51) according to the patients' subjective feeling to moxibustion stimulation of TE 17. After propensity score matching (PSM, a statistical matching technique of observational data) processing by using SPSS 19. 0 software, outcomes of 33 cases in the TSM group and 33 cases in the CMM group were analyzed. In the 1st course (10 days) of treatment, TSM was applied to TE 17 till the thermosensitive feelings disappeared for patients in the TSM group, or CMM employed to TE 17 for 45 min for patients in the CMM group, followed by manual acupuncture stimulation of Cuanzhu (BL 2), Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Jiache (ST 6), etc. on the affected side (shallow needling, uniform reinforcing-reducing needle-manipulation) for 30 min, once daily. In the 2nd course (10 days), only manual acupuncture was performed, the same acupoints were stimulated with the same methods used in the 1st course, and in combination with bilateral Zusanli (ST 36) which was stimulated with reinforcing-needling technique. The interval between the 2 courses was 2 days. The modified Portmann scale (for movements of eyebrow raising, eye closing, cheek bulging, pouting, teeth showing and nostril widening, and symetry during resting state) was used to evaluate the severity of the facial palsy before and after the treatment. RESULTS: After the treatment, the Portmann scores were significantly higher than those of their own pre-treatment in each of the two groups (P < 0.01), being markedly higher in the TSM group than in the CMM group (P < 0.01), suggesting a better therapeutic effect of TSM. CONCLUSION: The thermosensitive moxibustion is considerably superior to the conventional mild moxibustion in improving the symptoms of facial paralysis patients.

OBJECTIVETo observe the effect of Qiju Dihuang Pill (QDP) on changes of Chinese medical syndrome types in pregnant women of Gan-Shen yin deficiency syndrome (GSYDS), and to explore the correlation between imbalanced cytokine levels and GSYDS.

METHODSThis was a random controlled trail. A total of 163 pregnant women of GSYDS at 12 -16 gestational weeks were randomly allocated into the experimental group (86 cases) and the control group (77 cases). Patients in the experimental group took QDP for 2 -4 weeks. Changes of Chinese medical syndrome types and serum interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) levels were observed and compared between the two groups before and after treatment.

RESULTS(1) Totally 41 patients (47.7%) in the experimental group were transformed to normal Chinese medical syndrome type. In the same period of the follow-ups, 9 patients (11.7%) in the control group were transformed to normal Chinese medical syndrome type, showing statistical difference (P < 0.05). (2) In the experimental group, the serum level of IFN-gamma and the ratio of IFN-gamma/IL-4 in the peripheral blood were obviously lower after treatment than before treatment (P < 0.01), and obviously lower than those in the control group (P < 0.01). The level of IL-4 after treatment in the experimental group was higher than that before treatment, and also higher than that in the control group, but with no statistical difference.

CONCLUSIONSThese results indicated that there was imbalanced IFN-gamma/IL-4 ratio in the peripheral blood of pregnant women of GSYDS. QDP might play a role in immunoregulation by affecting the IFN-gamma level.

Adult ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Medicine, Chinese Traditional ; Phytotherapy ; Pregnancy ; Yin Deficiency

Objective: To integrate the best evidence of venous thromboembolism (VTE) prevention into practice, improve nurses′ compliance, and reduce the incidence of VTE in orthopaedic department. Methods: Guided by the standard procedure in the JBI-Paces program, collected the best evidence from online databases and set the standards. Collected data through field observation, interviews and review of nursing records. A total of 167 patients and 36 nurses we recruited in the study and audited twice. We judged the result by the knowledge level of nurses and patients, nurses′ compliance with the evidence and the incidence rate of VTE. Results: In baseline review, three criteria of poor compliance, "the correct situation of daily inspection of VTE risk assessment", "Wear gradient pressure stockings correctly for VTE high-risk patients", "Intermittent pneumatic compression device (IPCD) used twice a day for 30 minutes each time", were significantly improved after the application of evidence, increased from 47.22% (17/36) ,36.11% (13/36) ,36.11% (13/36) to 86.11% (31/36) , 86.11% (31/36) , 91.67 (33/36) respectively (χ²=12.25, 18.94, 24.08, all P < 0.05); The incidence of VTE decreased from 2.7% to 0 (P=0.195); the correct rate of VTE risk assessment, awareness rate of health education among patients, implementation rate of physical preventive measures and qualified rate of VTE-related knowledge and skills among nurses increased from 82.43% (61/74) ,74.32% (55/74) ,83.78% (62/74) ,77.03% (57/74) to 97.85% (91/93) ,91.40% (85/93) ,97.85% (91/93) ,96.77% (90/93) respectively (χ²= 8.86-15.24, all P < 0.01) . Conclusion The integration of best evidence standardize nurses′ behaviors, reduce the incidence rate of VTE, improve the quality of clinical care and promote the satisfaction of patients continuously.

From original concept and literature of acupoint, the concept and clinical significance of ashi method is discussed, which clarifies that the essence of ashi method is to locate the acupoints by patients' sensitivity on force. The clinical application of heat-sensitive moxibustion has illustrated that positioning method of this therapy is based on the appearance of heat-sensitive moxibustion sensation. Although both types are based on patients' feeling, positioning method of heat-sensitive moxibustion stands on a new angle and uses a new method to locate acupoint. Therefore, it is believed that the positioning method of heat-sensitive moxibustion is the inheritance and development of ashi method.
Acupuncture Points ; China ; History, Ancient ; Humans ; Medicine in Literature ; Moxibustion ; history ; methods ; Sensation

OBJECTIVETo investigate the relationship between G1958A gene polymorphism of methylenetetrahydrofolate dehydrogenase (MTHFD) and occurrence of congenital heart disease (CHD) in North China.

METHODSOne hundred and ninety-two CHD patients and their parents were included in this study as case group in Liaoning Province by birth defect registration cards, and 124 healthy subjects (age and gender matched) and their parents were simultaneously selected from the same geographic area as control. Their gene polymorphism of MTHFD G1958A locus was examined with PCR-RFLP, and serum folic acid and homocysteine (Hcy) levels were tested with radio-immunoassay and fluorescence polarization immunoassay (FPIA).

RESULTSThere existed gene polymorphism at MTHFD G1958A locus in healthy subjects living in North China. The percentages of GG, GA, and AA genotype were 57.98%, 35.57%, and 6.45% respectively, and the A allele frequency was 24.23%, which was significantly different from Western population. No difference was observed when comparing genotype distribution and allele frequency between the case and control groups, so was the result from the comparison between genders. The A allele frequency of arterial septal defect patients' mothers (10.87%) was significantly lower than that of controls (28.15%) (P=0.014), with OR=0.31 (95% CI: 0.09-0.84), and no difference in the other subgroups. The percentage of at least one parent carrying A allele in arterial septal defect subgroup (43.48%) was significantly lower than that in controls (69.64%) (P=0.017), with OR=0.34 (95% CI: 0.12-0.92). The analysis of genetic transmission indicated that there was no transmission disequillibrium in CHD nuclear families. Their serum folic acid level was significantly higher than that of controls (P=0.000), and Hcy level of the former was higher than that of the latter with no statistical significance (P>0.05). Serum Hcy and folic acid levels of mothers with gene mutation were lower than those of mothers with no mutation.

CONCLUSIONNo significant difference of genotype distribution and allele frequency existed between CHD patients and healthy population. MTHFD G1958A mutation in parents (particularly in mother) can decrease the risk of arterial septal defect in offspring. The possible mechanism of protection might be mutation, which can increase MTHFD enzyme activity, folic acid metabolism and homocysteine remethylation, and decrease Hcy level.

Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Folic Acid ; blood ; Gene Frequency ; Genotype ; Heart Defects, Congenital ; blood ; genetics ; Homocysteine ; blood ; Humans ; Infant ; Infant, Newborn ; Male ; Methylenetetrahydrofolate Dehydrogenase (NADP) ; genetics ; Mutation ; Polymorphism, Genetic

Objective To explore the nursing intervention on cognitive behavior of patients with highrisk of diabetic feet.Methods A total of 52 patients with high risk of diabetic feet were selected.Structural interview were used to collect the data of cognitive behavior and performed a systematic intervention approach.Indicators including diabetic feet related knowledge,cognitive behavior and blood glucose were compared before and after intervention.Results The patients with apparent lack of the knowledge were account for 98.08%and unhealthy behavior were account for 66.91%before intervention.However.the changes of cognitive level and unhealthy behavior were significant after intervention.In addition.84% of those people had formed good health behavioral habits.the blood glucose control well and without diabetic feet ulcers occurred after discharge 3 to 6month.Conclusions The systematic nursing intervention can improve patients'recognition of diseases,change their unhealthy behaviors,perform good health habits and reduce incidence of diabetic feet ulcers or amputation.

Objective To explore the cognition of medical personnels on the contents of high quality nursing care demonstration project.Methods A self-designed questionnaire was used to investigated 189 doctors and 211 nurses from one hospital in terms of their opinions towards high quality nursing care demonstration project.Results The total scoring rate of doctors was 92％ and nurses' was 89.25％.There were no significant differences in the total scores between doctors and nurses( P ＞ 0.05 ).But the average score of five items such as establishing rules and regulations,establishing nurse job responsibility system,patients are informed about contents of high quality nursing care demonstration project and other notes when patients admitted to hospital,nurses could provide health guidance and psychological care for patients during hospital in doctors was(3.84 ±0.40),(3.75 ±0.49),(3.75 ±0.44),(3.77 ±0.51),(3.75 ±0.43)in order,and that in nurses was (3.59±0.65),(3.69±0.57),(3.59±0.61 ),(3.59 ±0.59),(3.54 ±0.64),and the difference was statistically significant (t =3.05,2.03,2.02,2.20,2.49,respectively; P ＜ 0.05 ).Conclusions Medical personnels have better understanding about the importance of the high quality nursing care demonstration project,but cognitive deviation of some contents exist in them,To ensure the implcmentation of high quality nursing care,nurse managers should strengthen their conviction and take some measures such as increasing propaganda,clearing the meaning of high quality care and cooperating with other departments.

OBJECTIVETo summarize the clinical experience in repair of deep burn and traumatic wounds with combined transplantation of different types of pedicled skin flaps in lower extremities.

METHODSTwo hundred and thirty-six patients with 271 deep wounds in lower extremities after burn or trauma were repaired with muscular skin flaps, local fascial flaps and island flaps with vascular pedicle (more than 20 types) in our department from Jan. 1998 to Sept. 2008.

RESULTSComplete necrosis of skin flaps occurred in 1 case, congestion and necrosis over the edge of skin flaps occurred in 3 cases, which were healed after grafting, and other skin flaps survived well with soft texture. Skin flaps were too bulky in 26 cases, among them 17 cases were thinned, and the appearance of other skin flaps were satisfactory. In 68 patients with functional region injury were recovered to certain extent without contracture.

CONCLUSIONSSkin flaps with pedicles, multiple transplantations if necessary, can repair deep wounds satisfactorily in lower extremities after deep burn or trauma injury.

Adolescent ; Adult ; Aged ; Burns ; surgery ; Buttocks ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Lower Extremity ; injuries ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Wound Healing ; Young Adult

OBJECTIVETo observe the effect of compound Puerarin on collagen IV of streptozotocin-induced diabetic rats.

METHODSDiabetic nephropathy rats were induced by intraperitoneal injection of streptozotocin (STZ). Rats were allocated randomly to control group (10), diabetes model group (10), Vitamin C group (10), Puerarin group (10), vitamin C plus Puerarin group (10). The study period lasted for 12 weeks. During and after the treatment, the general state, blood glucose levels, glycosylated hemoglobin, blood urea nitrogen, serum collagen IV, blood urea nitrogen, serum creatinine, urinary albumin excretion rate of the 24-hour, and clearance rate of creatinine collagen IV protein were determined by immunohistochemistoche analysis as well as type the gene expression of collagen IV alpha 1 mRNA were determined by in situ hybridization analysis in the kidney tissue of different groups.

RESULTS(1) Diabetes mellitus and renal function lesion occurred in the four groups. (2) Vitamin C and Puerarin could improve the general conditions of diabetic Rats, decrease blood urea nitrogen [(8.68 +/- 0.43), (7.98 +/- 0.47) and (5.76 +/- 0.82) micromol/L, serum creatinine [(74.68 +/- 8.20), (75.52 +/- 7.98) and (58.66 +/- 6.65) mmol/L], and urinary albumin excretion rate of the 24-hour [(18.40 +/- 0.37), (17.24 +/- 0.30) and (9.97 +/- 1.27) mg/24 h x 10(-3)]; increase clearance rate of creatinine [(0.59 +/- 0.21), (0.61 +/- 0.14) and (0.69 +/- 0.32) ml/min], the expression of collage IV absorbance [(111.56 +/- 14.61), (110.78 +/- 9.69) and (95.44 +/- 9.97) ] in the diabetic Rats were significantly inhibited at the same time.

CONCLUSIONThe compound Puerarin might have some functions on preventing ren by inhibiting expression of type IV collagen.

Animals ; Collagen Type IV ; antagonists & inhibitors ; biosynthesis ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Diabetic Nephropathies ; drug therapy ; metabolism ; Isoflavones ; pharmacology ; therapeutic use ; Male ; Phytotherapy ; Rats ; Rats, Sprague-Dawley

AIMTo improve the profile of 20 (S)-camptothecin, a series of 20-O-linked camptothecin phenoxyacetic acid ester derivatives have been designed.

METHODSThese derivatives were synthesized by the method of acylation. Their chemical structures were confirmed with 1HNMR, IR, MS, and HRMS. The cytotoxicities of the compounds were tested by MTT assay. The in vivo antitumor activities of these esters were evaluated against mouse liver tumor H22 in mice.

RESULTSTwelve derivatives of camptothecin ester are new compounds.

CONCLUSIONIn vitro and in vivo antitumor activity has indicated that some derivatives appeared significantly more effective than topotecan in the H22 mouse liver tumoral model.

Animals ; Antineoplastic Agents ; chemical synthesis ; chemistry ; pharmacology ; Camptothecin ; chemical synthesis ; chemistry ; pharmacology ; Cell Line, Tumor ; drug effects ; Esters ; chemistry ; Female ; Humans ; Inhibitory Concentration 50 ; Liver Neoplasms ; pathology ; Mice ; Mice, Inbred ICR ; Molecular Structure ; Neoplasm Transplantation ; Topotecan ; analogs & derivatives ; chemical synthesis ; chemistry ; pharmacology ; Tumor Burden ; drug effects ; Xenograft Model Antitumor Assays