Positive outcomes have been reported about the transcranial magnetic stimulation for aphasia. This paper reviewed the relat-ed literatures about repetitive transcranial magnetic stimulation used in clinical and research, and discussed the possible mechanisms in the recovery of aphasia, and the roles of hemispheres in brain.

Objective To observe the effect of Bupiyichang pills combined with levocetirizine in the treatment of 56 patients with chronic urticaria,so as to provide clinical guidance and basis.Methods 118 patients with chronic urticaria were selected for our study,and after informed consent they were randomly divided into observation group and control group.The observation group were was treated by Bupiyichang pills combined with levocetirizine,and the control group were was treated by levocetirizine.When they were curingAfter treatment for 10,20,and 30 days,the effective rates in the two groups were calculated and compared with each other.And at the day before treating and the day after treating for 20 days,the serum IgE levels in each group was detected and compared.The falling ranges between the two groups were calculated and compared.Results When they were curing treated for 10,20,and 30 days,the effective rates in the observation group were 76.79％,94.64 ％,85.71％,respectively,which in those of the control group were 59.68％,74.19％,64.52％,respectively,the differences between the two groups were statistically significance significant (x2 =3.94,9.11,6.97,all P ＜ 0.05).At the day before treating and the day after treating for 20 days,the serum IgE levels in the observation group were (384.71 ± 65.62) U/mL and (214.59 ±40.71) U/mL respectively,the difference was statistically significance significant (t =10.93,P ＜ 0.05);and the serum IgE levels in the control group were (380.25 ± 67.81)U/mL and (256.99 ± 53.21)U/mL respectively,the difference was statistically significancesignificant (t =9.37,P ＜ 0.05).The falling ranges in the observation group and the control group were (170.12 ± 35.59) U/mL and (123.26 ± 53.31) U/mL respectively,the difference was statistically significance significant between the two groups (t =7.82,P ＜ 0.05).Conclusion Bupiyichang pills combined with levocetirizine is more effective than single medication of levocetirizine.

Objective To investigate the level of self-perceived burden(SPB) and analyze the influencing factors in continuous ambulatory peritoneal dialysis(CAPD) patients.Methods One hundred and ten CAPD patients were investigated by a self-designed demographic questionnaire and Self-Perceived Burden Scale (SPBS).Results The total score of SPBS was (30.27±7.88) points,being in a middle level,and 85.45％ of the patients showed different levels of burden.Single factor analysis showed the influencing factors of self-perceived burden were marital status,family per capita income,the main caregivers and selfcare ability.Conclusions Most CAPD patients have obvious self-perceived burden,nursing staff should use the relevant nursing measures to reduce the SPB with CAPD patients and improve their quality of life.

Objective To explore the clinical effects of the packet therapy combined with Chinese prescrip-tion soaking in the treatment of patients with verruca plantaris,so as to provide clinical guidance and basis.Methods 101 patients with verruca plantaris were chosen as study objects,and they were divided into two groups,namely obser-vation group and control group.Observation group was treated by the packet therapy combined with Chinese prescrip-tion soaking,and control group was treated by Chinese prescription soaking.When they were cured for 4 weeks,the main symptoms and effective rate in the two groups were calculated and compared.For the recovery patients,when their drugs were withdrew for 8 weeks,the recurrence rate between the observation group and control group was compared.Results After being treated for 4 weeks,both of the skin lesion and pain degree between the observation group and control group had significant differences (Z=4.48,P<0.05;Z=4.18,P<0.05).The effective rates in the observation group and control group were 85.71% and 48.08%,respectively,and the difference between the two groups was statistically significant (χ2 =16.00,P<0.001).The recurrence rates in the observation group and control group were 13.33% and 27.27%,respectively,and the difference between the two groups was no statistically signifi-cant (P>0.05).Conclusion The packet therapy combined with Chinese prescription soaking is more effective than Chinese prescription soaking.

Objective To investigate the protective effects of tanshinone-IIA sodium injection post-conditioning combined with controlled low central venous pressure on hepatic ischemia-reperfusion injury during liver resection.Methods Eighty patients scheduled for liver resection, 46 males and 34 females, aged 30-65 years, BMI 20-26 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into four groups: tanshinone-IIA sodium post-conditioning (group D), tanshinone-IIAsodium post-conditioning combined with controlled low central venous pressure (CVP 1-5 cm H2O) group (group DL), controlled low central venous pressure (CVP 1-5 cm H2O) group (group L) and control group (group C) that took the static-compound anesthesia and maintained CVP 6-12 cm H2O, 20 cases in each group.The venous blood samples were drawn from internal carotid vein at different time point: pre-occlusion ten minutes (T0), post-occlusion 2 h (T1), 6 h (T2), 12 h (T3), 24 h after operation (T4), and then detected the levels of NF-κB, intercellular cell adhesion molecule-1 (ICAM-1), ALT and AST.The MAP was detected, HR and CVP were recorded.Results Compared with group C and group D, CVP were significantly lower at T0and T1in group L and group DL (P＜0.01).Compared with T0, levels of NF-κB, ICAM-1, ALT and AST in four group at T1-T4were significantly increased (P＜0.01).Compared with group C, levels of NF-κB, ICAM-1, ALT and AST in group DL, group L and group D at T1-T4 were significantly decreased (P＜0.05).Compared with group DL, levels of NF-κB, ICAM-1, ALT and AST in group D and group L at T1-T4 were significantly increased (P＜0.01).Conclusion Tanshinone-IIA sodium injection post-conditioning, combined with controlled low central venous pressure in patients with partial hepatectomy, can reduce the degree of ischemia-reperfusion injury.

Objective To investigate the effect of pre-treatment of ginkgo biloba extract from portal vein on oxidative stress in liver surgery.Methods Sixty cases of hepatic portal occlusion for hepatectomy surgery in patients (38 males, 22 females, ASA grade Ⅰ or Ⅱ, cardiac function Ⅰ or Ⅱ, Child-Pugh class A), were randomly divided into three groups (n=20 each): portal vein injection group (group P), jugular vein injection group (group J) and control group (group C).Patients in group P were injected with ginkgo biloba extract injection 5 ml slowly from portal vein after freeing the portal vein, patients in group J were injected with ginkgo biloba extract injection 5 ml slowly from the jugular vein after freeing the portal vein, while patients in group C were injected with normal saline 5 ml slowly from the jugular vein after freeing the portal vein.Venous blood samples were drawn from jugular vein at the following time points: pre-occlusion ten minutes (T0), 1 h (T1), 6 h (T2), 24 h (T3) after reperfusion respectively, and then detected the levels of ALT, AST, tumor necrosis factor(TNF-α), manlondialdehyde (MDA) and the activity of superoxide dismutase (SOD).Results Compared with T0, the serum levels of ALT, AST, TNF-α and MDA at T1-T3 were significantly increased,the activity of SOD was significantly decreased in all groups (P＜0.05).Compared with group C, serum levels of ALT, AST, TNF-α and MDA at T1-T3 were significantly decreased, the activity of SOD was significantly increased in groups J and P (P＜0.05).Compared with group J, serum levels of ALT, AST, TNF-α and MDA at T1-T3 were significantly decreased, the activity of SOD was significantly increased in group P (P＜0.05).Conclusion The pre-treatment of ginkgo biloba extract from portal vein can increase the SOD activity, inhibit the activation of Kupffer cells, reduce the release of TNF-α, enhance the ability of anti-oxidative stress and produce significant protective effect on liver ischemia-reperfusion injury.

Objective To compare the rates of regimen modification between patients with different initial antiretroviral therapy, and to investigate risk factors associated with drug toxicity-related regimen modification.Methods A two-years retrospective cohort study was conducted in 14 060 patients who initiated antiretroviral treatment with Zidovudine (AZT)/Tenofovir disoproxil (TDF)+Lamivudine (3TC)+Efavirenz (EFV) since 2012.There were 5 126 patients initiated TDF+3TC+EFV therapy (TDF group) and 8 934 patients initiated AZT+3TC+EFV therapy (AZT group).Chi-square test was used to compare the rate of first-line regimen modification and the rate of toxicity-related regimen modification between two groups.Cox proportional hazard model was used to investigate the risk factors associated with regimen modification.Results A total of 14 060 acquired immunodeficiency syndrome patients were observed for a median period of 1.85 person-years.There were 2 795 patients who changed their initial antiretroviral regimen and the rate of initial regimen modification was 19.9%.Two hundred patients who changed their initial regimen due to pregnancy were excluded.There were 2 070 patients in AZT group who changed their initial regimen with a rate of 23.5%.Among them, 1 652 patients changed their regimen due to drug toxicity and the rate was 18.8%.There were 525 patients in TDF group who changed their initial regimen with a rate of 10.4% and the rate of toxicity-related regimen modification was 6.2%.The differences between two groups were statistical significance (χ2=366.68 and 416.89, respectively, both P<0.01).The risk of regimen modification in AZT group were significantly higher than that in TDF group (aHR=2.89, 95%CI: 2.57-3.24).The risk of toxicity-related regimen modification in AZT group was also significantly higher than that in TDF group (aHR=3.85, 95%CI: 3.34-4.45).Conclusions Patients initiated antiretroviral treatment with AZT+3TC+EFV are more likely to change their initial regimen than those who initiated treatment with TDF+3TC+EFV.Female, age >45 years old, BMI<18.5 kg/cm2 and baseline CD4+ T cell count<200/mL were risk factors associated with regimen modification.

Objective To investigate the effects of human IL-18 gene combined with diterpenoid alkaloids in inhibiting the proliferation and inducing the apoptosis of tongue squamous carcinoma cells Tscca.Methods We constructed recombinant plasmid pEGFPN3-IL-18 and tranfected it into tongue squamous carcinoma cells Tscca.The transduction efficiency of the target cells was detected by fluorescent microscopy,cytotoxic effect of IL-18 gene with diterpenoid alkaloids on Tscca was detected by MTT assay,and apoptosis was detected by flow cytometry. Western blot was employed to examine the expression level of cellular signal-regulated kinase Akt/p-Akt.Results The tongue squamous cells Tscca which transfected pEGFPN3-IL-18 had significantly increased apoptosis compared with non-transfected cells (P<0 .05 ).Tongue carcinoma squamous cells cultured with diterpenoid alkaloids at the concentrations of 0 .2 ,0 .4 and 0 .6 mg/mL had significantly increased apoptosis in a dose-dependent manner (P<0.05).Human IL-18 gene combined with diterpenoid alkaloids for 48 hours inhibited significantly Tscca in a concentration-dependent manner compared with diterpenoid alkaloids alone (P<0 .05 ).The two in combination could also decrease the protein level of p-Akt dose-dependently.Conclusion The combination of pEGFPN3-IL-18 and diterpenoid alkaloids has a synergistic effect in inhibiting the growth of tongue squamous carcinoma cells Tscca.

Objective To investigate the effects and mechanism of pre-treatment with an Nrf2 inducer dh404 on renal ischemia reperfusion injury in rats.Methods Thirty SD rats were divided into three groups using completely randomized digital table,dh404 was dissolved in sesame oil and was given orally 1.5 mg/kg the night before procedures and 5 hours before procedures.Rats in group Sham received no treatment of ischemic reperfusion.In group IR and group dh404,the renal ischemia reper-fusion (IR)model was established,24 hours after IR,the levels of serum creatininc (Cr)and urea ni-trogen (BUN),the activities of superoxide dismutase (SOD)and the content of malonaldehyde (MDA)in serum were measured,and hematoxylin eosin(HE)staining observe the changes in renal structure,the levels of γ-glutamate-cysteine ligase catalytic (GCLC)and modifier (GCLM)subunit, the expression of NF-κB,COX-2 and eNOS were measured.Results Compared with group Sham,the values of Cr,BUN in group IR and group dh404 were significantly higher (P <0.05).Compared to the group IR,the group dh404 Cr,BUN values significantly decreased after reperfusion for 24 h(P <0.05 ).Compared to group Sham,group IR SOD activity decreased,while the value of MDA increased(P <0.05 ).Compared to group IR,group dh404 had much higher SOD activity,while the value of MDA significantly decreased.Observed with optical microscopy,compared to group Sham, the renal tubular injury of group IR was obvious.Compared to group IR,group dh404 significantly reduced tubular injury.Compared to group IR,the levels of GCLC and modifier GCLM subunit were higher,while there were no significant differences of levels among NF-κB,COX-2 and eNOS. Conclusion Pre-treatment with an Nrf2 inducer dh404 can protect the kidney from IRI through possi-bly reducing IRI kidney oxidative stress.

ObjectiveTo investigate the correlation of the serum and synovial fluid interleukin (IL)-1β,IL-6,tumor necrosis factor(TNF)-α and bone marrow edema with osteoarthritis of the knee (KOA).MethodsThe clinical data of 331 KOA patients were included and all patients had knee MRI.Bone marrow edema were detected in 172 cases and 159 cases had non-bone marrow edema.The clinical symptoms,WOMAC score,and the serum and synovial fluid IL-1β,IL-6,TNF-α levels were compared using One-way ANOVA analysis and Spearman's correlation analysis.Results① The serum and synovial fluid IL-1β,IL-6,TNF-α in osteoarthritis was positively correlated(serum r=0.24,0.38,0.31; synovial fluid r=0.20,0.29,0.33 ; all P＜0.05) ; ② The serum and synovial fluid IL-6 and TNF-α levels of osteoarthritis with bone marrow edema were significantly higher than those of the osteoarthritis without bone marrow edema(serum F=8.139,7.172; synovial fluid F=9.201,7.001; all P＜0.05); ③ The serum and synovial fluid TNF-α,IL-6 levels was associated with osteoarthritis with bone marrow edema in volume (serum r,=0.27,0.26; synovial fluid rs=0.29,0.32; all P＜0.05) and severity(serum rs=0.29,0.27; synovial fluid rs=0.29,0.31; all P＜0.05); ④ The serum and synovial fluid IL-1β,IL-6,TNF-α of osteoarthritis with synovitis was significantly higher than that of osteoarthritis without synovitis group (group of bone edema:serum F=3.931,5.866,5.514; synovial fluid F=4.211,5.202,5.972; all P＜0.05.non-bone edema patients:serum F=3.513,3.114,7.112; synovial fluid F=3.722,3.965,8.891; all P＜0.05).ConclusionIL-1β,IL-6,TNF-α are elevated in osteoarthritis with synov-itis.IL-6 and TNF-α are elevated significantly in knee osteoarthritis with bone marrow edema in particular.