ObjectiveTo investigate the applicability and superiority of modified Seldinger technique (MST).MethodsTotally 108 patients receiving peripherally inserted central catheter (PICC) through vascular ultrasound combined with MST technology were enrolled as MST group and another 108 patients receiving PICC using traditional direct vision method as control group.The first puncture success rate,PICC succesa rate,catheterization time required,and early complication rate were compared between these two groups.ResultsThe first puncture success rate was 88.89％ in MST group and 72.22％ in control group (P=0.002) ; the catheterization success rate was 82.41％ in MST group and 57.41％ in control group ( P =0.000).In the MST group,there were two cases where the catheter within neck was ectopic ( P =0.003 ),two cases experienced bleeding at the puncture sites (P =0.017),three cases had phlebitis (P =0.001 ),and one case suffered from catheter blockage (P=0.010).In the eontrol group,the corresponding numbers were 13,10,18,and 9.However,the time required for PICC showed no significant difference between these two groups (P=0.685).In the MST group,15 cases were catheterized in less than 15 minutes,72 cases between 15 and 25 minutes,and 21 cases for more than 25 minutes.In the control group,12 cases were catheterized in less than 15 minutes,70 cases between 15 and 25 minutes,and 26 cases for more than 25 minutes.ConclusionPICC through MST can be more effective in positioning the targeting blood vessels,increasing the success rate of catheter insertion,reducing various tissue damages,and lowering potential complications.

The effects of all-trans-retinoic acid (ATRA) in low doses supplementation on concentrations of polar retinoid metabolites (PRM) and retinoids in the ethanol-fed rat liver, and on hepatocyte injury were investigated. The rat model of alcoholic liver disease (ALD) was induced by intragastric infusion of ethanol, and then the rats were administrated with ATRA in two different doses (150 microg/kg body weight and 1.5 mg/kg body weight) for 4 weeks. Concentrations of retinoids in rat liver and plasma were determined by using HPLC. Liver tissues pathologic changes were observed under the light microscopy and electron microscopy. The serum transaminases concentrations were measured. The results showed that the HPLC analysis of retinoids revealed that retinoids (vitamin A, RA, retinyl palmitate) concentrations in ethanol-fed rat liver and RA concentration in ethanol-fed rat plasma were markedly diminished (P<0.01) after ethanol feeding for 12 weeks. Furthermore, obvious peaks of PRM were formed in livers of ethanol-fed rats. ATRA 150 microg/kg supplementation in ethanol-fed rats for 4 weeks raised RA concentration in both liver and plasma, and also raised vitamin A concentration in liver to control levels, partially restored retinyl palmitate concentration (P<0.05) in liver. ATRA 1.5 mg/kg supplementation raised not only RA concentrations in liver and plasma but also retinyl palmitate concentrations in liver. However, the vitamin A concentration in liver of ATRA-supplemented rats (1.5 mg/kg) was higher than that of controls (P<0.05). The histologic observation of liver tissues indicated that ATRA treatment notably alleviated hepatocellular swelling, steatosis, the swelling of mitochondria and proliferation of smooth endoplasmic reticulum (SER). ATRA treatment greatly decreased levels of serum transaminases as compared with the only ethanol-fed group (P<0.05). It was concluded that low-dose ATRA treatment could restore retinoids concentrations and abolish the PRM formation in liver of ALD rats, and then ameliorate the injury of liver cells.

TheStandardized Manipulations of Acupuncture and Moxibustion has been published and gradually standardized the clinical practice. It provided a solid foundation for the standardization of acupuncture and moxibustion therapeutic effects. It also provided powerful convictable effects on the accuracy and scientificity of acupuncture and moxibustion clinical practice, which gained well-acceptance from patients. In the treatment of certain diseases, acupuncture and moxibustion have become irreplaceable so that acupuncture and moxibustion can be strongly promoted both at home and abroad. There were some common problems occurred during the establishment of the national standardization onStandardized Manipulations of Oral and Lip Acupuncture. This article reviewed, analyzed and discussed questions occurred during the standardization establishment. The results showed that according to the principle of standardized production, a rigorous, scientific and reasonable text standard can be established. Advices or opinions gained during the process can be used as references for future standardization establishment. It was concluded that the standardization of acupuncture had great guidance in the acupuncture clinical application. It is an arduous and long-term mission to achieve and strengthen the position of international standardization of acupuncture and moxibustion. The government should increase the effort on investment and promotion of acupuncture and moxibustion standardization. Conversation and cooperation should also be strengthened with international communities to promote the standardization implementation.

Objective: To investigate the awareness of hepatitis C prevention and control knowledge and its influencing factors among female sex workers (FSWs) in Jiaxing City, Zhejiang Province. Methods: According to the HIV/AIDS Sentinel Surveillance Plan, FSWs at ages of 15 to 65 years monitored by the national AIDS surveillance sentinel in Jiaxing City were recruited, and demographic information, awareness of hepatitis C prevention and control knowledge and related behaviors were collected by questionnaire surveys. Factors affecting the awareness of hepatitis C prevention and control knowledge were identified by a multivariable logistic regression model. Results: A total of 430 questionnaires were allocated, and 412 were valid, with an effective rate of 95.81%. The respondents had a mean age of (28.58±4.93) years, and included 258 unmarried FSWs (62.62%), 344 with registered residence outside Zhejiang Province (83.50%), 212 with junior high school education or below (51.46%) and 243 from high-end entertainment places (58.98%). The overall awareness of hepatitis C prevention and control knowledge among FSWs was 20.39%, and the awareness of "Transfusion of blood containing hepatitis C virus may acquire hepatitis C" (38.83%) and the awareness of "tattooing, eyebrow tattooing and ear piercing in streets or small shops may infect hepatitis C" (38.11%) were relatively low. Multivariable logistic regression analysis identified marital status (divorced or widowed, OR=0.161, 95%CI: 0.054-0.482), educational level (high school or technical secondary school, OR=2.568, 95%CI: 1.446-4.560; junior college or above, OR=6.110, 95%CI: 2.658 -14.045) and grade of entertainment places (high-end entertainment places, OR=2.756, 95%CI: 1.525-4.982) as factors affecting the awareness of hepatitis C prevention and control knowledge among FSWs. Conclusion FSWs in Jiaxing City have a low awareness of hepatitis C prevention and control knowledge, especially lacking of knowledge about the transmission routes and prognosis of hepatitis C.

Objective To investigate the expression of Toll-like receptors 2 (TLR2) mRNA,p38 mitogen activated protein kinase(p38 MAPK) mRNA and cytokine in peripheral blood of children with measles and to study the effect and possible mechanism for TLR2-p38 MAPK signal pathway defects on immune suppression in the children with measles during acute phase.Methods Thirty children with measles hospitalized in the department of infectious diseases from June 2012 to July 2013 were enrolled into the measles group,and 30 healthy children were chosen as the healthy control group.The mRNA expressions of TLR and p38 MAPK in peripheral blood mononuclear cells (PBMC) were detected by reverse transcription-polymerase chain reaction (RT-PCR).The protein levels of interferon-γ (IFN-γ),tumor necrosis factor-β (TNF-β),interleukin (IL)-12,IL-6 and IL-10 in plasma were measured by using enzyme linked immunosorbent assay (ELISA),and flow cytometry (FCM)was applied to detect the percentage of lymphocyte subpopulation.The serum IgG,IgA and IgM levels were detected by velocity scatter turbidimetry.Results (1) The expressions of TLR2 mRNA and p38 MAPK mRNA in the measles group were both significantly lower than those in the healthy control group (all P ＜ 0.05).(2) Compared with the healthy control group,the protein levels of IFN-γ,TNF-β and IL-12 in the plasma of the measles group decreased significantly (all P ＜ 0.05),and the levels of IL-6 and IL-10 increased significantly(all P ＜ 0.05).(3)Compared with the healthy control group,the percentage of CD3 +,CD4 +,CD4 +/CD8 + ratio and the level of IgG and IgA in the measles group decreased significantly(all P ＜ 0.05),and the percentage of CD19 + increased significantly(P ＜ 0.05),but there was no any significant change in the percentage of CD8 + and the level of IgM (all P ＞ 0.05).Conclusions The mRNA expressions of TLR2 and p38 MAPK are low in PBMC in the measles children during acute phase.There are different degrees of suppression of cell immunity,humoral immune and cytokines disorder in children with measles.Defects of TLR2-p38 MAPK signal pathway may cause the formation of measles immune suppression.

On account of the dense cuticles of the fresh stem and the light, hard and pliable texture of the dried stem, Dendrobii Caulis is difficult to dry or pulverize. So, it is very important to the ancient doctors that Dendrobii Caulis should be properly treated and applied to keep or evoke its medicinal effects. The current textual research results about the preliminary processing, processing and usage methods of Dendrobii Caulis showed that: (1) In history the clinical use of fresh or processed Dendrobii Caulis as teas and tinctures were very common. (2) Its roots and rhizomes would be removed before using. (3) Some ancillary approaches were applied to shorten drying times, such as rinsing with boiling mulberry-ash soup, washing or soaking with liquor, mixing with rice pulp and then basking, etc. (4) According to the ancients knowledge, the sufficient pulverization, by means of slicing, rasping, hitting or pestling techniques, was necessary for Dendrobii Caulis to take its effects. (5) The heat processing methods for Dendrobii Caulis included stir-baking, stir-frying, steaming, decocting and stewing techniques, usually with liquor as an auxiliary material. Among above mentioned, steaming by pretreating with liquor was most commonly used, and this scheme was colorfully drawn in Bu Yi Lei Gong Pao Zhi Bian Lan (Ming Dynasty, 1591 CE) ; moreover, decocting in advance or long-time simmering so as to prepare paste products were recommended in the Qing Dynasty. (6) Some different processing programs involving stir-baking with grit, air-tightly baking with ondol (Kangs), fumigating with sulfur, which appeared in modern times and brought attractive outward appearance of the drug, went against ancients original intentions of ensuring drug efficacy.
Dendrobium ; History, Ancient ; Medicine, Chinese Traditional ; history ; Technology, Pharmaceutical ; history

Objective To investigate the diagnostic value of echocardiography in arrhythmogenic right ventricular cardiomyopathy (ARVC) by summarizing and comparing the electrophysiological and the imaging features.Methods The echocardiography and MRI were performed in the 65 cases of ARVC to measure the right ventricle and the free wall,noted as TTE-RV,MRI-RV and TTE-RVFW.The velocity of tricuspid valve regurgitation (TRmax) and left ventricular ejection fraction (LVEF) were measured.The three-dimensional electric anatomical model of right ventricular was get by the Carto system,and the right ventricular area (Area-RV),the scar area (Area-Scar) was calculated.Results Twenty-seven cases (41.5 ％) was confirmed by the echocardiography,21 cases (32.3 ％) was suspiciously diagnosed,14 cases (32.3％) was miss diagnosed,and 3 cases (4.6％) was misdiagnosed.Statistically significant difference could be detected among the echocardiography confirmed groups and the other two groups for the parameters TTE-RV,MRI-RV,Area-RV,Area-Scar,and TTE-RVFW (P ＜ 0.05).Also there was a statistically significant difference of the parameters of Area-RV and Area-Scar between the suspiciously and miss diagnosed groups (P ＜0.05).Different echocardiographic findings was found in ARVC with different stages,but myocardial fibrosis and low voltage scar could be detected in all patients on the MRI imaging and and electrophysiological mapping.Conclusions The diagnosis of typical ARVC can be confirmed by echocardiography,but for the patients with early and middle stages,comprehensive evaluation should be refered to the clinical data.

The individual intervention control of risk factors in high-risk population is one of key preventive measures of chronic disease.A total of 312 volunteers consulted physicians in one selected community.And 23 high-risk individuals of chronic disease were screened.The physicians customized the limit or requirement of diet,activity,tobacco and alcohol for each individual and made interventions of life behaviors according to the plans.The results showed that physical state of 20 (87％) of them converted from high-risk to health after interventions.Therefore customized control plan of individual risk factors is an effective control method of chronic disease.

BACKGROUND:Notch singling pathway is very important for cellproliferation and differentiation, but its role is stil unknown during chondrogenesis of human umbilical cord mesenchymal stem cells. OBJECTIVE:To investigate the effect of N-[N-(3,5-difluorophenacetyl-L-alanyl)]-(S)-phenylglycinet-butyl ester (DAPT) on inducing human umbilical cord mesenchymal stem celldifferentiation into chondrocytes. METHODS:Human umbilical cord mesenchymal stem cells were isolated from human umbilical cord, then were induced to differentiate into chondrocytes. There were four experimental groups:non-induced group, high-glucose Dulbecco’s modified Eagle’s medium containing 5%fetal bovine serum and 1%double antibody;induced group, induced medium containing 6.25 mg/L insulin, 6.25 mg/L transferrin, 10μg/L transforming growth factor beta 1, 0.1μmol/L dexamethasone, 50 mg/L vitamin C, 5%fetal bovine serum and 1%double antibody;dimethyl sulfoxide group, induced medium containing 0.1%dimethyl sulfoxide;DAPT group, induced medium containing 5μmol/L DAPT. RESULTS AND CONCLUSION:After chondrogenic induction, the morphology of human umbilical cord mesenchymal stem cells became polygon and positive for toluidine blue and immunofluorescence staining;the expression of Jag-1, PS-1, Notch-1 and Hes-1 decreased significantly (P<0.01). After the addition of DAPT, compared with the induced group, the relative gene expression of Jag-1, PS-1 and Hes-1 decreased markedly (P<0.01), the relative gene expression of Notch-1 decreased obviously as wel (P<0.05), and the contents of proteoglycan and col agen type II proteins decreased significantly (P<0.01). At the same time, the relative gene expression of proteoglycan decreased obviously (P<0.05), and the relative gene expression of col agen type II decreased in part. Notch signaling pathway exists in human umbilical cord mesenchymal stem cells, once chondrogenesis begins, the signaling strength wil decline rapidly. DAPT may prevent human umbilical cord mesenchymal stem cells from differentiating into chondrocytes by Jag-1-Notch-1-Hes-1 pathway.

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