Objective To establish a method for determination of trace lead in drinking water by intermittent flow HG-AFS was developed. Methods The conditions for K3Fe(CN)6-KBH4-HCl system of generation of PbH4 were optimized and interference of coexisting ions were tested. Results The fluorescence signal of blank solution was decreased evidently by treating K3Fe(CN)6 with activated carbon and the detection limit was effectively improved. The interference of coexisting ions could be suppressed in some degrees in the presence of K3[Fe(CN)6]. Under the optimized conditions, the detection limit of this method was 0.10 ?g/L and RSD(n=6) was in the rang 0.4%-3.8%. The recovery rate was 95.0%-112.0%. Conclusion This method was accurate, simple, sensitive and suitable for determination of trace lead in drinking water.

OBJECTIVETo compare the differences in the efficacy on speech and swallowing dysfunction of medulla oblongata palsy (MOP) after brainstem infarction between electroacupuncture at eight-neck-occiput points and routine acupoints.

METHODSSeventy-two patients were randomized into a neck-occiput points group and a meridian points group, 36 cases in each one. In the neck-occiput points group, the eight-neck-occiput points (Neck 1-4 points, Occiput 1-4 points) were selected. In the meridian points group, Lianquan (CV 23), Futu (LI 18), Tongli (HT 5), Hegu (LI 4) and the others were selected. Electroacupuncture was used in the two groups, dense-dispersion wave, retaining for 30 min. The treatment was given once a day, 5 treatments a week. Totally, 4 weeks were required. The symptom scores of speech and swallowing dysfunction were observed before and after treatment in the two groups. The efficacy was compared between the two groups.

RESULTSThe scores of speech and swallowing dysfunction were improved significantly after treatment in the two groups (P < 0.05, P < 0.01). The results in the neck-occiput points group were better than those in the meridian points group (both P < 0.01). The curative rate of speech dysfunction was 30.6% (11/36) and that of swallowing dysfunction was 22.2% (8/ 36) in the neck-occiput points group, which were better than 11.1% (4/36) and 5.6% (2/36) in the meridian points group, respectively. The differences were significant in comparison of the two groups (P < 0.01, P < 0.05).

CONCLUSIONElectroacupuncture at eight-neck-occiput points achieves a better efficacy on speech and swallowing dysfunction of MOP after brainstem infarction as compared with the routine acupoints. This therapy is characterized as more accurate point localization and safer operation.

Acupuncture Points ; Adult ; Aged ; Brain Stem Infarctions ; complications ; Bulbar Palsy, Progressive ; etiology ; physiopathology ; therapy ; Deglutition ; Electroacupuncture ; Female ; Humans ; Male ; Medulla Oblongata ; physiopathology ; Middle Aged

Objective To explore the evaluation value of modified USA National Institutes of Health Stroke Scale (mNIHSS) score combined with bedside transcranial Doppler ultrasonography (TCD) on the early prognosis of ischemic stroke (AIS).Methods One hundred and thirty-six anterior circulation AIS patients were collected,mNIHSS score was evaluated on admission,and emergency bedside TCD examination was performed to evaluate vascular anomalies.After active treatment after discharge,the modified Rankin scale (mRS) score was recorded to evaluate 90 d prognosis.The value of mNIHSS score combined with TCD examination analysis on the prognosis was analyzed.Results If the mNIHSS score ＞ 8 scores was judged to be poor prognosis,the sensitivity was 0.684,the specificity was 0.806,the positive predictive value was 0.578,the negative predictive value was 0.868.If related macro vascular abnormalities in bedside TCD examination were evaluated for clinical prognosis,the sensitivity was 0.736,the specificity was 0.643,the positive predictive value was 0.444,the negative predictive value was 0.863.If both,the specificity was 0.918,the positive predictive value was 0.714,the positive likelihood ratio was 6.41 ;and the two were not available,the negative predictive value was 0.928,negative likelihood ratio was 0.20.Conclusion mNIHSS score combined with TCD examination in evaluating the prognosis of AIS patients can improve the positive or negative predictive value.

Objective To evaluate the effect of dexmedetomidine and small dose of ketamine on the expression of P2X4 receptor (P2X4 R) mRNA and P2X7 receptor (P2X7R) mRNA in the dorsal root ganglion of rats with neuropathic pain.Methods Ninety male Sprague-Dawley rats,aged 6-9 weeks,weighing 180-220 g,were randomly divided into 5 groups (n =18 each):sham group (group S),chronic constrictive injury group (group CCI),dexmedetomidine group (group D),ketamine group (group K) and dexmedetomidine + ketamine group (group DK).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 400 mg/kg.Neuropathic pain was induced by CCI in CCI,D,K and DK groups.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1mmintervals with 4-0 silk thread.In group S,the sciatic nerves were only exposed but not ligated.In D,K and DK groups,dexmedetomidine 50μg/kg,ketamine 10 mg/kg and dexmedetomidine 25μg/kg + ketamine 5 mg/kg were injected intraperitoneally,respectively,while the equal volume of normal saline was injected in S and CCI groups,once a day for 14 consecutive days after CCI.Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI,and 3,7 and 14 days after CCI.Six animals were sacrificed after measurement of pain threshold at 3,7 and 14 days after CCI and the lumbar segments (L4-6) of the dorsal root ganglion were removed for determination of P2X4 R mRNA and P2X7 R mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased at 3,7 and 14 days after CCI in groups CCI,D,K and DK,the expression of P2X4R mRNA and P2X7R mRNA was up-regulated at 3,7 and 14 days after CCI in groups CCI,D and K,and the expression of P2X4 R mRNA and P2X7 R mRNA was up-regulated at 3 and 7 days after CCI in group DK (P ＜ 0.05).Compared with group CCI,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in groups D,K and DK (P ＜ 0.05).Compared with D and K groups,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in group DK (P ＜ 0.05).Conclusion The mechanism by which the combination of dexmedetomidine and small dose of ketamine produces a synergistic antinociception in rats with neuropathic pain may be related to down-regulation of the expression of P2X4 R mRNA and P2X7 R mRNA.

Objective To observe the regularities of distribution of TCM syndrome types and correlation between TCM syndrome types and cardiovascular prognosis risk factors of elderly hypertensive patients in three different urban and rural communities.Methods Totally 299 elderly hypertensive patients who conformed to the hypertensive diagnostic criteria from 896 respondents which participated in the health monitoring questionnaire drafted by health management team of China Academy of Chinese Medical Sciences were screened. The syndrome types were differentiated according to Guiding Principle of Clinical Research on New Drugs of Traditional Chinese Medicine (for Trial Implementation). The levels of some risk indicators, such as blood glucose, blood lipid, CREA, ET, Hcy and mALB were measured by radioimmunoassay, enzymatic cycling assay and other methods. Age, gender, BMI and pulse pressure were recorded.Results The TCM syndrome types of 299 elderly hypertensive patients were deficiency of yin and yang type (74 cases), hyperactivity of yang due to yin deficiency type (65 cases), blood stasis syndrome type (62 cases), stagnation of phlegm-dampness type (61 cases), hyperactivity of liver-fire type (37 cases). Single factor analysis showed that there existed statistical significance among BMI, FBG, GHbA1c, CREA, TC, LDL-C, ET, Hcy and mALB in the 5 TCM syndromes (P<0.05,P<0.01), and the statistical significance was more apparent in the stagnation of phlegm-dampness type, blood stasis syndrome type and hyperactivity of yang due to yin deficiency type. Discriminant analysis showed BMI and Hcy have certain reference value for the diagnosis of TCM syndrome types in elderly hypertensive patients. Binary-Logistic regression analysis showed that the course of disease had a positive correlation with syndrome of deficiency of yin and yang.Conclusion Compared with other types of elderly hepertensive patients, stagnation of phlegm-dampness type and blood stasis syndrome type are more closely related to hypertension cardiovascular prognosis risk factors.

This systematic review was aimed to evaluation the effectiveness and safety of supplementingqi and activating blood circulation prescriptions in the treatment of cerebral ischemic stroke. Dtabases both at home and abroad were electronically searched for randomized controlled trials (RCTs) on supplementingqi and activating blood circulation prescriptions in the treatment of cerebral ischemic stroke. And meta-analyses were performed using RevMan 5.0 software. The results showed that 27 studies were included, which contained 2 908 cases. There were 1 490 cases in the treatment group, and 1 418 cases in the control group. The results of meta-analyses indicated that supplementingqi and activating blood circulation prescriptions combined with routine treatment of modern medicine had significant differences in the effective rate for cerebral ischemic stroke compared with the single using of routine treatment of modern medicine with significant difference (OR = 5.39, 95%CI (4.03, 7.22),P < 0.000 01). The treatment of supplementingqi and activating blood circulation prescriptions combined with routine treatment of modern medicine had better treatment effect on neurological function defects for cerebral ischemic stroke compared with the single using of routine treatment of modern medicine with significant difference (WMD = -2.99, 95%CI (-3.26, -2.72),P < 0.000 01). In addition, the treatment of supplementingqi and activating blood circulation prescriptions combined with routine treatment of modern medicine had better treatment effect on improving the activity of daily living (WMD = 9.65, 95%CI (8.36, 10.93),P < 0.000 01). Adverse reaction and event was mild in 2 included research reports. It was concluded that the treatment of supplementingqi and activating blood circulation prescription or it combined with routine treatment in modern medicine was quite effective in the treatment of cerebral ischemic stroke by the existed limited evidences. It can also improve the nerve dysfunction and the ability of daily living. Due to the limited quantity of the included studies and the evidence with limited strength, further high-quality RCTs were needed to verify the forementioned conclusion.

Objective To evaluate the effects of dexmedetomidine on the activity of cAMP response element binding protein (CREB) and c-fos in the spinal dorsal horn in a rat model of neuropathic pain.Methods Fifty-four adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =18 each):sham operation group (group S),chronic neuropathic pain group (group C) and dexmedetomidine group (group D).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The sciatic nerve was exposed and 4 ligatures were placed on the right sciatic nerve at 1 mm intervals with 4-0 silk thread in C and D groups.In group D,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until 1 day before the animals were sacrificed,while the equal volme of normal saline was injected instead of dexmedetomidine in S and C groups.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured on 1 day before operation and 3,7 and 14 days after operation.The animals were sacrificed after measurement of MWT and TWL.Their lumbar segments (L4-6) of the spinal cord were removed for measurement of the expression of phosphorylated CREB (pCREB) and c-fos by immunohistochemistry.Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of pCREB and c-fos was up-regulated on 3,7 and 14 days after operation in C and D groups (P ＜ 0.05).Compared with group C,MWT was significantly increased,TWL was prolonged,and the expression of pCREB and c-fos was down-regulated on 3,7 and 14 days after operation in group D (P ＜ 0.05).MWT was significantly lower,and TWL was shorter on 3,7 and 14 days after operation than on 1 day before operation in C and D groups (P ＜ 0.05).MWT was significantly lower,TWL was shorter,and the expression of pCREB and c-fos was higher on 7 and 14 days after operation than on 3 days after operation in C and D groups (P ＜ 0.05).MWT was significantly higher,TWL was longer,and the expression of pCREB and c-fos was lower on 14 days after operation than on 7 days after operation in C and D groups (P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine reduces neuropathic pain is related to inhibition of the activity of CREB and c-fos in the spinal dorsal horn of rats.

ObjectiveTo explore the optimal method of protecting bone marrow in postoperative concurrent chemoradiotherapy of stage Ⅱ - Ⅲ rectal cancer by comparing two techniques of intensitymodulated radiotherapy (IMRT). MethodsFifteen patients with stage Ⅱ - Ⅲ rectal cancer after surgery had CT simulation. Clinical target volume, small bowel, bladder and bone marrow were contoured. Two IMRT treatment plannings with and without bone marrow-sparing (BMS-IMRT and IMRT) were separately designed. The dose distribution was compared based on that 95％ of the planning target volume received the prescribed dose. ResultsBMS-IMRT had an advantage over IMRT in terms of conformity indices ( 1. 06∶1. 04, t =- 2. 61, P =0. 023 ), but inferior to I M RT for homogeneity indices ( 0. 81 : 0. 75, t =- 2. 34, P =0.037)).Compared with IMRT, BMS-IMRT reduced the V5, V10, V20, V30, V40 of bone marrow (97.09％∶98.72％, t=-2.34, P=0.037;92.38％∶96.46％, t=-2.41, P=0.033;83.36％∶91.70％, t=-3. 18, P=0.008;51.47％∶69.65％, t=-4.92, P=0.000;36.34％∶49.57％, t=-2.66, P =0. 021 ). The doses received by small bowel and bladder were similar between BMS-IMRT and IMRT, except that the V20 of bladder was lower in BMS-IMRT (77. 32％∶92. 39％, t =-3.52, P=0. 004). Conclusions BMS-IMRT reduces low dose volume of bone marrow without increasing dose to other risk organs.BMS-IMRT might reduce acute hematologic toxicity and increase the feasibility of postoperative concurrent chemoradiotherapy in stage Ⅱ -Ⅲ rectal cancer.

Objective To investigate the expressions of claudin-5 and claudin-10 in colorectal carcinoma(CRC) and its significance.Methods Pathological verified 50 colorectal tissue (CRT),25 colorectal adenoma (CRA),25 non lymph node metastasis CRC (non-LNM CRC) and 25 lymph node metastasis CRC (LNM CRC) were detected for the expression of claudin-5 and claudin-10 by immunohistochemical SP(streptavidin perdcidase) method.Results The positive expression rate of Claudin-5 was 82%,76%,68% in CRT,CRA,CRC,respectively.The positive expression rate of claudin-5 in different groups was not significantly different(X~2 =2.638,P＞0.05).claudin-5 expression was correlated with LNM (P＜0.05),but was not correlated with gender,age,tumor,location,differentiation,tumor diameter and serous membrane invasion(P＞0.05).The positive expression rate of claudin-10 was 54%,56%,72% in CRT,CRA,CRC,respectively.The positive expression rate of claudin-10 in different groups was not significantly different(X~2 = 3.839,P＞0.05).claudin-10 expression was correlated with tumor diameter,serous membrane invasion and LNM (P＜0.05),but was not correlated with gender,age,location and differentiation (P＞0.05).There was no significant correlation between claudin-5 expression and claudin-10 expression in CRC (r = 0.050,P = 0.732).Conclusions claudin-5 and clandin-10 are expressed in CRT,CRA,and CRC.They are not involved in CRC occurrence,claudin-5 and clandin-10 abnormally expressions are significantly associated with the incidence of LNM.Meanwhile,claudin-10 expression is correlated with tumor diameter and serous membrane invasion.There was no significant correlation between claudin-5 expression and claudin-10 expression in CRC.

Objective To establish and confirm the hepatitis B surface antigen(HBsAg) enzyme linked immunosorbent assay(ELISA) high specificity S/CO limit as blood donor deferral criterion.Methods A total of 783 HBsAg ELISA reactive and 588 non-reactive samples were collected, and confirmed by HBsAg electrochemiluminescence detection and neutralization test.Receiver operating characteristic curve (ROC curve) was used to evaluate the S/CO limit under 95% and 99% specificity.Another 124 HBsAg ELSIA reactive samples were tested for five kinds of hepatitis B virus(HBV) markers by using electrochemiluminescence detection to verify the blood donor deferral limit.The blood donor deferral limits of 3 laboratories, using the same reagents, were compared.Results The 95% specificity S/CO limit of two reagents were 0.24 and 0.65, the 99% specificity S/CO limit of two reagents were 3.89 and 3.62.The 99% specificity S/CO limit was set as the blood donor deferral criterion.Verify test indicated that the samples, with S/CO higher than the blood donor reentry limit of reagent 1 and 2, were all from HBV infected donor.The 99% specificity S/CO limits of reagent 1 in the other three laboratories were 3.77, 3.60 and 13.42 respectively.And the 99% specificity S/CO limits of reagent 2 in the other three laboratories were 27.73, 31.75 and 1.17.Conclusion The blood donor deferral limit of HBsAg ELISA could identify the true positive blood donor, and reduce the number of blood donor, entering the reentry process.It might not suit to adopt a unified donor deferral limit in different laboratories, even using the same reagents.