OBJECTIVETo compare the difference in the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication.

METHODSOne hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency electric-pulsing apparatus was used at Dazhui (GV 14) and Shenshu (BL 23), once a day; the treatment of 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time. In the placebo group, starch capsules were taken orally, 1 capsule each time. All the drugs were taken before sleep every night, continuously for 15 days as one session, and 2 sessions were required. PSQI changes and clinical efficacy were observed before and after treatment in each group.

RESULTSPitlsburgh sleep quality index (PSQI) score was reduced in every group after treatment (all P < 0.01). In the low-frequency electric stimulation group and medication group, the score was reduced much more significantly as compared with the placebo group (both P < 0.01). In the placebo group, 1 case was rejected. The total effective rates were 95.0% (38/40), 92.5% (37/40) and 17.9% (7/39) in the low-frequency electric stimulation group, medication group and placebo group separately. The efficacy in the low-frequency electric stimulation group and medication group was better apparently than that in the placebo group (both P < 0.01).

CONCLUSIONThe low-frequency electric stimulation at the acupoints effectively and safely treats post-stroke insomnia and the efficacy of it is similar to that of estazolam.

Acupuncture Points ; Aged ; Aged, 80 and over ; Electric Stimulation ; Female ; Humans ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; etiology ; therapy ; Stroke ; complications ; Treatment Outcome

Asian Continental Ancestry Group ; China ; epidemiology ; Fatty Liver ; epidemiology ; Humans ; Hyperlipidemias ; epidemiology

Brain metastasis is among the most common complications of non-small celllung cancer (NSCLC) and may obviously influence the survival and quality of life in the NSCLC patients. Recently, the development in traditional treatments, the widely-used micro-molecular targeted drugs, and the combined treatment have improved the overall survival and the quality of life of these patients. In addition, the exploration of new therapeutic targets and cognitive function protective methods for current treatments also deserves at-tention. This review emphasizes the relevant clinical and basic problems and the therapeutic strategies in NSCLC with brain metastases.

Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; pathology ; surgery ; Humans

Objective To detect the expression and activation level of nuclear factor ?B (NF-?B) in synovium of rheumatoid arthritis (RA).Method Forty-six specimens including 17 RA, 24 osteoarthritis (OA) and 5 normal synovial tissues were subjected to RT-PCR to determine the mRNA level of NF-?B p65,p50,inhibitor of NF-?B (I?B),interleukin-1? (IL-1?) and matrix metalloproteinase 9 (MMP-9).Thirty-nine sections including 14 RA,21 OA and 4 normal synovium were subjected to immunohistochemistry to determine the expression level of NF-?B p65.Synoviocytes from 14 synovial specimens including 8 RA and 6 OA were cultured and the nuclear protein was extracted and reserved for western blot.Results The mRNA level of p65,IL-1(,MMP-9 were higher in RA group than that of control (P

Objective To explore the expression of SLAM gene in the CD4+ and CD8+ T cells from SLE patients.Method The CD4+ and CD8+ T cells from peripheral blood of 20 SLE patients and 10 healthy blood donors were separated using magnetic cell sorting system(MACS).We detected the expression of SLAM mRNA in CD4+ and CD8+ T cells by RT-PCR.Results The CD4+ and CD8+ T cells from SLE patients showed significantly higher SLAM expression than those from healthy blood donors.Conclusion The SLAM signal pathway may play an important role in contributing to the abnormal activation of T cells in SLE patients.

Objective To explore the expression of caspase-3 and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) receptors in the CD4+ and CD8+ T cells of systemic lupus erythematosus (SLE)patients. Methods The CD4+ and CD8+T cells from peripheral blood of 20 SLE patients and 10 healthy volunteers were separated using magnetic cell sorting system (MACS), reverse transcription-polymerase chain reaction (RT-PCR) was used to test the expression of caspase-3 and TRAIL receptors in CD4+ and CD8+T cells of SLE patients and healthy volunteers. Results The CD8+T cells from SLE patients had significantly higher caspase-3 (P=0.003) and TRAIL-R2 (P=0.024) expression than those from healthy volunteers. Conclusion The TRAIL-R2 signal pathway may be a possible important pathway to the apoptosis of T cells in SLE patients.

Objective To investigate the abnormality of CD4 and CD8 subsets of T lymphocytes in the peripheral blood of systemic lupus erythematosus patients. Methods The CD4 + and CD8 + T lymphocytes from 20 SLE patients and 10 healthy controls were separated using magnetic activated cell sorting (MACS). Results The numbers of CD4 + T cells in the peripheral blood and CD4 +/CD8 + ratio of SLE patients were significantly lower than those in healthy volunteers(CD4,P=0.001;CD4/CD8 ratio,P=0.046). Conclusion There exist abnormalities in the CD4 and CD8 subsets of T lymphocytes in the peripheral blood of SLE,especially the decreased numbers of CD4 + T cells.

OBJECTIVETo compare the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication in the patients so as to explore the effect mechanism.

METHODSOne hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency pulse electric apparatus was applied to stimulate Dazhui (GV 14) and Shenshu (BL 23), once every day. The treatment for 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time; and in the placebo group, the starch capsules were taken, one capsule each time; in the two groups the treatment was adopted before sleep every night, continuously for 15 days as one session, and 2 sessions were required. The levels of plasma 5-hydroxytryptamine (5-HT) and norepinephrine (NE) were compared before and after treatment in the patients of the three groups and: the efficacy was compared.

RESULTSIn the placebo group, 1 case was dropped out. The total effective rate was 95. 0% (38/40), 92. 5% (37/40) and 17. 9% (7/39) in the low-frequency electric stimulation group, the medication group and the placebo group respectively. The effects in the low-frequency electric stimulation group and the medication group were better apparently than that in the placebo group (both P<0. 01). The effect was not different significantly between the low-frequency electric stimulation group and the medication group (P>0. 05). The levels of plasma 5-HT and NE were not different significantly between before and after treatment in the placebo group. The level of plasma 5-HT was increased (both P<0. 05) and thelevel of NE was decreased (both P<0. 05) as compared with that before treatment in the low-frequency electric stimulation group and the medication group. But the differences were not significant between the two groups (P>0. 05).

CONCLUSIONThe low-frequency electric stimlaton a the acupoints is safe and effective in the treatment of post-stroke insomnia, which is similar to oral medication of estazolam. The outcome of the increase of plasma 5-HT level and the decrease of plasma NE level is probably one of the effect mechanisms.

Acupuncture Points ; Aged ; Aged, 80 and over ; Electric Stimulation ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Norepinephrine ; blood ; Serotonin ; blood ; Sleep ; Sleep Initiation and Maintenance Disorders ; blood ; etiology ; physiopathology ; therapy ; Stroke ; blood ; complications ; physiopathology ; Treatment Outcome

Objective To investigate the safety of vaginal delivery in gravidas with previous cesarean section and its influencing factors.Methods Four hundred and seventy-four full-term gravidas who received cesarean section at the Department of Obstetrics and Gynecology of Peking University First Hospital from January 1,2012 to August 31,2014 were enrolled in this study.Among those subjects,38 who underwent successful vaginal delivery were grouped into vaginal birth after cesarean (VBAC) group,and the other 436 accepting repeated cesarean section were grouped into cesarean group.Delivery outcomes and maternal/neonatal complications of the two groups were retrospectively analyzed with two-sample t-test and Chi-square test.Results Among the 45 patients (9.5％) who attempted VBAC,seven underwent cesarean section for suspected fetal distress and the other 38 (84.4％) succeeded in vaginal birth without uterine rupture.The amount of postpartum hemorrhage in patients of cesarean group was more than that of VBAC group [(330.8±94.8) vs (257.7± 199.7) ml,t=2.021,P＜0.01] after exclusion of three patients with dangerous placenta previa,and the postpartum hospital stay was shorter than that of cesarean group [(2.5± 1.4) vs (4.5± 1.3) d,t=7.952,P＜0.01].There were three newborns with neonatal asphyxia,twelve with neonatal infections and forty transferred to the Pediatrics Department following cesarean section.Besides,complications of headache and urinary retention occurred in 20 and 32 mothers after cesarean section,respectively.However,no complication occurred in VBAC group.Sixty-three cesarean sections were indicated as thin lower uterine segment and among them,fourteen (22.2％) had muscular rupture.Among the six patients who complained of tenderness in lower uterine segment,three were found having muscular rupture during cesarean section.Conclusion VBAC is an option for gravidas with history of cesarean section only if they meet the criteria for VBAC attempt.VBAC could lower the cesarean section rate without increase the incidence of complications.The rate of trial of labor after cesarean was low,patients education should be strengthened to increase it.