OBJECTIVETo observe the difference in the therapeutic effects on knee osteoarthritis (KOA) among auricular electroacupuncture therapy plus isolated moxibustion with Lingxian herbal paste (combined therapy), electroacupuncture (EA) and TDP irradiation.

METHODSEighty-nine cases were randomized into three groups. In the combined therapy group (30 cases), the auricular electroacupuncture therapy was adopted together with the isolated moxibustion with Lingxian herbal paste. The auricular points were xi (AH4), pizhixia (AT4), shenmen (TF4), etc. The Lingxian herbal paste was applied at Yanglingquan (GB 34), Dubi (ST 35), Zusanli (ST 36), Neixiyan (EX-LE 4), Heding (EX-LE 2) and Ashi points. In EA group (29 cases), EA was applied at the acupoints that were same as those in the isolated moxibustion with Lingxian herbal paste. In TDP group (30 cases), TDP irradiation was given at the affected knee. The treatment was given once every day, 10 treatments made one session and there was 1 week at the interval among sessions. Totally, 3 sessions of treatment were required. KOA clinical symptom and physical sign score and the single item pain symptom score of Lequesne index were observed before treatment and 1 week after treatment in the patients of each group separately. The efficacies were compared among the three groups.

RESULTSOne week after treatment, the total score of symptoms and physical signs of the patients in each group was reduced significantly as compared with that before treatment (all P < 0.05). The improvements in the symptoms and physical signs in the combined therapy group were better than those in the other two groups (1.50 +/- 1.57 vs 2.52 +/- 1.82, 2.63 +/- 1.97, both P < 0.05). The improvement in pain in the combined therapy group was also better than that in the other two groups (2.37 +/- 0.81 vs 2.83 +/- 0.92, P < 0.05; 2.37 +/- 0.81 vs 3.03 +/- 0.77, P < 0.01). The curative rate in the combined therapy group was 40.0% (12/30), which was higher than 17.2% (5/29) in EA group and 20.0% (6/30) in TDP group separately (both P < 0.01). The overall efficacy in the combined therapy group was superior to the other two groups (P < 0.05).

CONCLUSIONThe auricular electroacupuncture therapy plus isolated moxibustion with Lingxian herbal paste is advantageous at the total score of the symptoms and physical signs and the overall efficacy in the patients of KOA as compared with EA at the local acupoints and local TDP irradiation.

Aged ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Electroacupuncture ; Female ; Humans ; Knee Joint ; drug effects ; Male ; Middle Aged ; Moxibustion ; Osteoarthritis, Knee ; drug therapy ; therapy ; Treatment Outcome

Objective:To investigate the problems and improve the quality of clinical education.Method:A questionnaire was made among 200 medical students at Ji'ning medical college.Results:About eighty-eight percent of the students were satisfied with their clinical education,but there were still some problems:absence of clear objectives in clinical practice;shortage of enthusiasm of the students;lack of responsibility of some teachers and too many factors affecting clinical practice.Conclusion:The key points to improve clinical education quality are to set up clear education objectives,develop appropriate clinical practice methods,improve teaching staff quality and reform the teaching content.

OBJECTIVETo explore the curative effect and safety of acupuncture for mild cognitive disorders after stroke.

METHODSRandomized controlled trial was adopted and one hundred cases conforming to criteria were divided into a combined acupuncture and medication group (group A) and a medication group (group B), 50 cases in each group. The basic treatment of cerebrovascular disease was applied in two groups. The group A treated was with acupuncture at Baihui (GV 20), Shenting (GV 24) and Qucha (BL 4) etc. and oral administration of Nimodipine. In group B, Nimodipine was taken orally. The treatment lasted for 3 months, the scores of Mini-Mental State Examination (MMSE), modified Hasegawa Dementia Scale (HDS-R) and Barthel Index (BI) were observed before and after treatment in two groups.

RESULTSThe total effective rate in group A was 66.7% (32/48), which was superior to 30.4% (14/46) in group B (P < 0.05). The scores of MMSE, HDS-R and BI after treatment were apparently improved as compared with those before treatment in two groups (all P < 0.01). The improvements in group A were superior to those in group B (all P < 0.05). There was no adverse event reported during the treatment in two groups.

CONCLUSIONAcupuncture can improve activity of daily living and has significant effect in treating mild cognition disorders after stroke without adverse reactions.

Acupuncture Therapy ; Aged ; Cognition ; Cognition Disorders ; etiology ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome

With the rapid development of medical imaging technique, iodinated contrast media (IOCM) has become the most commonly used agent in performing imaging diagnosis and interventional therapy. The use of IOCM, especially the use of non-ionic iodine contrast media, has been swiftly increased in recent years. The accompanying untoward reactions, such as allergic reactions, cardiovascular reactions, contrast media nephropathy, thyroid toxicity, etc. prove to be the new problems that greatly perplex the medical circle. With the continuous improvement of the knowledge to the untoward reactions, more and more physicians have paid attention to contrast media induced thyroid toxicity. At present, researches concerning iodine contrast media thyroid toxicity are still few, and the relevant research is particularly rare in China. This paper aims to make a review about the influence of different kinds of iodine contrast media on thyroid function.

Objective To summarize our surgical experience in repair and functional reconstruction for compound defects of proximal phalanx and dorsal skin at multiple digits,Methods Six patients with multiple digital defects were treated in our department between June 1996 and March 2005.At the first stage,free iliac bone grafts were used to repair defects of proximal phalanges and temporary syndactyly between adjacent affected fingers was created through digital palmar skin sutures.The defects were covered with free flap transfer finally.Dorsalis pedis flaps were used in four patients,a lateral arm flap in one and a lateral thoracic flap in one respectively.At the second stage,a partial debulking procedure and division of syndaetyty followed three to six months later.Additional procedures were performed in three eases to reconstruct the digital extensor function through tendon transfer.The follow-ups ranged from six months to nine years.Results The flaps survived uneventfully in the six patients postoperatively.The dorsal aspects of reconstructed fingers demonstrated an aesthetically pleasing effect after the flap debulking procedures and division of syndactyly.Follow-up X-Ray examinations showed good lilac bone union and nearly normal structure of digital bone.The distal interphalangeal extension restored to normal in the three cases after extensor reconstruction.Conclusions Iliac bone graft to repair phalangeal defects and free flap transplantation to cover skin defects can be a good treatment for compound defects of proximal phalanx and dorsal skin at multiple digits.Secondary plastic procedure may greatly improve the appearance of a reconstructed digit,and extensor re- construction the function of distal interphalangeal extension too.

Objective:To observe the clinical efficacy of Ba-pulling and Qian-traction manipulation with neck suspension and movement for acute cervical radiculopathy. Methods: A total of 85 patients who met the inclusion criteria were randomized into an observation group and a control group by random numbers, with 43 cases in the observation group and 42 cases in the control group. The observation group was treated with Ba-pulling and Qian-traction manipulation with neck suspension and movement;while the control group was treated with Bashen-pulling and stretching manipulation in a supine position. The treatment was performed once a day, 10 times as a treatment course. The therapeutic efficacy was evaluated after 1 treatment course, and the changes in the scores of visual analog scale (VAS) and neck disability index (NDI) were observed. Results: The total effective rate was 97.7% in the observation group, and 83.3% in the control group, and the difference between the two groups was statistically significant (P＜0.05). After treatment, the VAS and NDI scores of both groups were significantly decreased (both P＜0.01), and the differences in the VAS and NDI scores between the two groups were statistically significant (both P＜0.01). Conclusion: Both Ba-pulling and Qian-traction manipulation with neck suspension and movement and Bashen-pulling and stretching manipulation in a supine position can relieve pain and improve cervical function in patients with acute cervical radiculopathy, and Ba-pulling and Qian-traction manipulation with neck suspension and movement can produce more significant efficacy than Bashen-pulling and stretching manipulation in a supine position.

OBJECTIVETo culture rat prostate glandular epithelial cells and study their barrier functions in vitro.

METHODSRat prostate glandular epithelial cells were cultured in vitro. The expression of the tight junction protein claudin-1 was determined by immunohistochemistry, the structure and composition of the epithelial cells observed under the inverted microscope and transmission electron microscope. The transepithelial electrical resistances (TEERs) were monitored with the Millicell system. The permeability of the prostate glandular epithelial cells was assessed by the phenol red leakage test.

RESULTSCompact monolayer cell structures were formed in the prostate glandular epithelial cells cultured in vitro. Immunohistochemistry showed the expression of the tight junction protein claudin-1 and transmission electron microscopy confirmed the formation of tight junctions between the adjacent glandular epithelial cells. The TEERs in the cultured prostate glandular epithelial cells reached the peak of about (201.3 ± 3.5) Ω/cm2 on the 8th day. The phenol red leakage test manifested a decreased permeability of the cell layers with the increase of TEERs.

CONCLUSIONThe structure and function of rat prostate glandular epithelial cells are similar to those of brain capillary endothelial cells, retinal capillary endothelial cells, and intestinal epithelial cells. In vitro cultured prostate glandular epithelial cells have the barrier function and can be used as a model for the study of blood prostate barrier in vitro.

Animals ; Cell Membrane Permeability ; Cells, Cultured ; Claudin-1 ; metabolism ; Electric Impedance ; Epithelial Cells ; pathology ; physiology ; ultrastructure ; In Vitro Techniques ; Male ; Microscopy, Electron, Transmission ; Phenolsulfonphthalein ; pharmacokinetics ; Prostate ; metabolism ; pathology ; Rats ; Tight Junctions

Objective To explore the effect of macrolide antibiotics(erythromycin) on tumor necrosis factor(TNF)-α and interleukin(IL)-8 in hyperoxia-induced lung tissue of premature newborn rats,and to study the intervention effect of erythromycin on hyperoxia-induced lung injury.Methods One-day old preterm Sprague Dawley rats were randomly divided into four groups by random number table method:air + sodium chloride group,air + erythromycin group,hyperoxia + sodium chloride group,hyperoxia + erythromycin group.Hyperoxia groups were continuously exposed to oxygen (oxygen ＞ 0.85) and air group in room air.After 1,7,14 days of exposure,the preterm rats of four groups were sacrificed,whole lung of these rats were isolated,the lung histological changes were observed by hematoxylin-eosin staining,TNF-α and IL-8 in pulmonary tissue homogenate were detected by ELISA.Results The results showed that:(1) Compared with air + sodium chloride group,TNF-α and IL-8 expression in hyperoxia + sodium chloride group were significantly increased(P ＜ 0.05) after 1,7 days of exposure [1 d:TNF-α:(16.163 ± 0.574) ng/ml vs.(21.923 ±2.066) ng/ml,IL-8:(18.214 ±3.649) ng/ml vs.(23.546 ± 5.240) ng/ml ;7 d:TNF-α:(15.940 ±0.821) ng/ml vs.(19.688 ±0.764) ng/ml,IL-8:(18.541 ± 4.114) ng/ml vs.(24.255 ±4.692) ng/ml],in particular,TNF-α expression appeared to increase earlier,their expression became significantly weak in 14 days (P ＜ 0.05).(2) Compared with hyperoxia + sodium chloride group,TNF-α and IL-8 expression in hyperoxia +erythromycin group became significantly weak after 1,7,14 days of exposure(P ＜0.05) after the intervention of erythromycin [1 d:TNF-α:(21.923 ± 2.066) ng/ml vs.(18.903 ± 1.851) ng/ml,7 d:IL-8:(24.255 ±4.692) ng/ml vs.(23.508 ±3.543) ng/ml,14 d:TNF-α:(16.443 ±5.466) ng/ml vs.(14.453 ±0.963)ng/ml],but their expression became weaker in 14 days than that in 1,7 days.Conclusion The release of inflammatory mediators TNF-α and IL-8 induced by oxidation outbreak participates in the development of hyperoxia induced lung injury,erythromycin may regulate immune function,inhibits the levels of oxidant-mediated TNF-α and IL-8 induced by oxidation outbreak,and alleviate hyperoxia lung injury in premature rats.

Objectives To explore the effect of erythromycin on glutathione hormone (GSH) and γ-glutamyl cysteine synthetase (γ-GCS) in premature newborn rats exposed to hyperoxia, to study the intervention effect of erythromycin on hype-roxia-induced lung injury. Methods One-day old preterm SD rats were randomly divided into four groups:control group, eryth-romycin group, hyperoxia group, erythromycin+hyperoxia group. Hyperoxia group and hyperoxia+erythromycin group were continuously exposed to oxygen (oxygen concentration>0.85), control group and erythromycin group were in room air. Via cau-dal vein, the preterm rats was injected with erythromycin in erythromycin group and hyperoxia+erythromycin group, sodium chloride in control group and hyperoxia group daily. After 1,7,14 day(s) of hyperoxia (or air ) exposure, the preterm SD rats of four groups were killed, whole lung of these rats were isolated and histological changes were observed by hematoxylin-eosin (HE) staining, GSH andγ-GCS of pulmonary tissue homogenate were detected by double antibody sandwich enzyme linked im-munosorbent assay. Total lung RNA was extracted andγ-GCS mRNA was detected by reverse transcription polymerase chain re-action. Results The results showed that:After 1 and 7 day(s) of exposure, the expression of GSH、γ-GCS andγ-GCS mRNA in four groups showed significant differences(P<0.05). Among them, GSH expression in erythromycin + hyperoxia group was higher than that in the other three groups in 1,7,14 day(s) of exposure with significant differences (P<0.05);GSH expression in erythromycin+hyperoxia group and hyperoxia group reached the peak after 7 days of exposure. The expression ofγ-GCS andγ-GCS mRNA in erythromycin+hyperoxia group and hyperoxia group were higher than the other two groups after 1and 7 day(s) of exposure, the expression ofγ-GCS mRNA in erythromycin+hyperoxia group were higher than that of hyperoxia group with significant differences (P<0.05). Conclusions The expressions of GSH andγ-GCS in the lung of premature SD rats were abnor-mal by oxidation outbreak. Erythromycin may increase the activity ofγ-GCS, improve the anti-oxidation ability of GSH, and al-leviate hyperoxia mediated lung injury in premature rats.

BACKGROUND:Animal experimental studies have confirmed that cell transplantation,neurotrophic factor infusion or transplantation as well as other methods can alter the local environment of injured spinal cord and promote its partial function recovery. OBJECTIVE:This study aimed to assess the clinical efficacy of olfactory ensheathing cell transplantation for the treatment of the sequel of myelitis,and to explore whether it would promote the recovery of the spinal cord function. DESIGN:A non-randomized self-control study. SETTING:Ward of Second Department of Surgery of Taian Disabled Soldiers Hospital of Shandong Province. PARTICIPANTS:Thirty-two patients with obsolete myelitis,who come from all over China and suffered from disease for 0.5 to 7 years,admitted to our hospital between June 2004 and July 2007 were recruited in this study.The involved patients,including 21 males and 11 females,were aged 5-48 years.Their neurological functions were not obviously improved after various conventional treatments and limb function exercise.Meanwhile,various sensorimotors and autonomic nerve functional impairments were left.Among the patients,18 suffered from acute viral myelitis,8 from acute purulent myelitis and 6 from tuberculous myelitis.After onset,they were all given large doses of radiosonde, dexamethasone,anti-inflammatory and immunomodulatory drugs and various neurotrophic drugs.Twenty-six patients presented complete injury and six patients incomplete injury.Informed consent of treatment was obtained from each patient.The therapeutic protocol was approved by the Ethics Committee of the hospital.Embryonic olfactory bulbs were harvested from aborted embryo,which was donated voluntarily by the patients or their relatives. METHODS:Cells were isolated from embryonic olfactory bulbs,cultured and purified for 7 to 14 days,and finally they were digested into single-cell suspension.Under the surgical miscroscope,the cells were transplanted onto the regions which were above or below the spinal cord injury site.Two weeks to 2 months postoperatively,neurological function of spinal cord was assessed by using the American Spinal Injury Association(ASIA)Scoring Standard formulated in 2000,and was compared to pre-operation function. MAIN OUTCOME MEASURES:①Sensory function change.②Motor function change. RESULTS:Half a year to 2 years after olfactory ensheathing cell transplantation,the sensory and motor functions of 32 patients were all obviously improved(motor function:55.72?10.50 vs.51.53?13.41;light touch:69.53?11.68 vs. 63.06?15.98;pain sense:69.50?12.20 vs.64.03?15.0,all P