Educational Measurement ; Humans ; Inservice Training ; Pneumoconiosis ; diagnosis ; Reference Standards

OBJECTIVETo observe the clinical efficacy difference in treatment of functional dyspepsia (FD) between syndrome differentiation based acupuncture and ordinary acupuncture.

METHODSSeventy FD patients were assigned to a syndrome differentiation based acupuncture group (Group A) and an ordinary acupuncture group (Group B) by Excel Software randomization. Zhongwan (RN12 ), Tianshu (ST25), and Zusanli (ST36) were needled as main points for patients in Group A. Meanwhile, different combined acupoints were needled according to syndrome differentiation. Only the same main points were needled for patients in Group B. All patients were needled once per day, 30 min each time, 6 days as one treatment cycle, 2 treatment cycles in total. Fasting serum levels of gastrin (GAS) and motilin (MTL) were determined before treatment and after 2 treatment cycles. 36-item Short-form Heath Survey (SF-36) and Nepean Dyspepsia Index [NDI, including Nepean Dyspepsia Symptom Index (NDSI) and Nepean Dyspepsia Life Quality Index (NDLQI)] were assessed before treatment, after 2 treatment cycles, and one month after treatment.

RESULTSCompared with before treatment in the same group, serum levels of GAS and MLT increased in the two groups after 2 treatment cycles (P <0. 05), but changes were more obvious in Group A (P <0. 05). Compared with before treatment in the same group, SF-36 and NDLQI score increased, and NDSI score decreased in the two groups after 2 treatment cycles and 1 month after treatment (all P <0. 05). Compared with Group B, SF-36 and NDLQI score increased in Group A after 2 treatment cycles and 1 month after treatment (P <0. 05, P <0. 01). But NDSI score at 1 month after treatment was lower in Group A than in Group B (P <0.01).

CONCLUSIONSyndrome differentiation based acupuncture could evidently improve dyspeptic symptoms of FD patients, and significantly improve their quality of life with remarkable curative effect.

Acupuncture Points ; Acupuncture Therapy ; Dyspepsia ; therapy ; Humans ; Motilin ; Needles ; Quality of Life ; Surveys and Questionnaires ; Syndrome

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.

Objective To investigate the effect of lung protective ventilation regimen on regional cerebral oxygen saturation(rSO2)during one-lung ventilation(OLV)in elderly patients undergoing radical esophagus cancer resection.Methods Forty ASA Ⅰ-Ⅲ patients,aged 65-76 yr,weighing 45-75 kg,undergoing radical esophagus cancer reseclion,were randomly divided into 2 groups(n =20 each):conventional ventilation group(group CV)and prolective ventilation regimen group(group PV).Anesthesia was induced with midaaolam 0.05 mg/kg,sufentanil 0.4 μg/kg,rocuronium 1 mg/kg and propofol 1.5 mg/kg and maintained with 2％ sevoflurane and intermittenl iv boluses of rocuronium 0.5 mg/kg.Double lumen tube was inserted.Correct positioning was verified by fiberoptic broncboscopy.The patients were mechanically ventilated.In group CV,PEEP was set at 0,Vt was set at 10 ml/kg,and I:E was set at 1:2 during two-lung ventilation(TLV)and OLV.In group PV,PEEP was set at 5 cm H2O,Vt was set at 6 ml/kg,and I:E was set at 1:2 during TLV and OLV.PETCO2 was maintained at 35-40 mn Hg in both groups.Arterial blood samples were taken before induction of anesthesia,at 10 min of TLV and at 30 min of OLV for blood gas analysis.Qs/Qt was calculated and rSO2 was recorded at the same time.Low rSO2 (rSO2 score ＞ 3000％)was recorded during OLV.Results Compared with group CV,PaO2 and rSO2 were significantly increased,and Qs/Qt was significantly decreased at 30 min of OLV,and the incidence of low rSO2 was significanfly decreased in group PV(P ＜ 0.05).Conclusion Lung protective ventilation regimen can improve oxygenation,decrease intrapulmonary shunt,and reduce the occurrence of low rSO2 during OLV in elderly patients undergoing radical esophagus cancer resection.

Objective To compare the effects of different medications of fentanyl during anesthesia induction on fentanyl-induced cough.Methods Four hundred and twenty ASA Ⅰ or Ⅱ patients aged 18-60 yr undergoing selective operations under general anesthesia,were randomly divided into 4 groups ( n =105 each):group Ⅰ (control group) received successive intravenous injection of midazolam 0.05 mg/kg,fentanyl 2 μg/kg,propofol 2 mg/kg,and rocuronium 1 mg/kg,group Ⅱ (pre-injection group) received successive intravenous injection of midazolam0.05 mg/kg,fentanyl 0.5 μg/kg,propofol 2 mg/kg,rocuronium 1 mg/kg,and fentanyl 1.5 μg/kg,group Ⅲ (dilution group) received successive intravenous injection of midazolam 0.05 mg/kg,fentanyl 2 μg/kg (20 μg/ml),propofol 2 mg/kg,and rocuronium 1 mg/kg,and group Ⅳ (last injection group) received successive intravenous injection of midazolam 0.05 mg/kg,propofol 2 mg/kg,rocuronium 1 mg/kg,and fentanyl 2 μg/kg.Fentanyl concentration was 50 μg/ml in each group except group Ⅲ.Endotracheal intubation was performed 2 min after anesthesia induction.The incidence and severity of fentanyl-induced cough before intubation were recorded and the incidence of propofol-induced pain was recorded.Invasive arterial blood pressure (ABP) and heart rate (HR) were observed before induction (T1 ),immediately after induction (T2 ),at time of coughing (T3 ),and at time of endotracheal intubation (T4).Results ABP and HR had no significant differences at T1,T2,T3,and T4between the four groups (P ＞ 0.05).The incidence of propofol-induced pain had no significant differences between the four groups (P ＞ 0.05).The incidences of cough was 7.6％ in group Ⅱ,9.5％ in group Ⅲ,and 1.9％ in group Ⅳ,which were significantly lower than 35.2％ in group Ⅰ ( P ＜ 0.01).The incidence of cough in group Ⅳ was significantly lower than that in groups [ and Ⅲ (P ＜ 0.05).In the four groups,ABP and HR were significantly higher at T3 than that at T1 and T2 ( P ＜ 0.01 ).Conclusion Different medications of fentanyl including last injection,pre-injection,and dilution of fentanyl can significantly reduce the incidence of fentanyl-induced cough during anesthesia induction,and injection has the best effect.

Objective To observe the expression of phosphoinositide 3-kinase(PI3K) and protein kinase B1 (Akt1) in PI3K/Akt signaling pathway in rat bones with fluorosis, and to reveal the mechanisms of the skeletal fluorosis. Methods Thirty-six SD rats were randomly divided into 3 groups (control group, low-dose fluorosis group, high-dose fluorosis group) and 12 rats were in each group according to body weight. The rats were fed with different concentrations of fluoride (NaF) to establish fluorosis models. Controls were fed with tap water( < 0.5 mg/L), experimental animals in low- or high-dose groups were fed with water containing NaF 5.0,50.0 mg/L, respectively. Rats were sacrificed after 6 months of treating with fluoride and the serum was kept for testing the bone metabolic markers of none gla protein(BGP) and cathepsin K(Cath-K) by enzyme-linked immunosorbent assay(ELISA), the proteins and mRNA levels of PI3K and Akt1 in rat bones were detected by immunohistochemistry and real time PCR, respectively. Results Each group of serum BGP and Cath-k were compared, the difference was statistically significant(F = 73.45,39.36, all P < 0.05). The contents of BGP[(1.99 ± 0.62), (2.38 ± 0.16)μg/L] and Cath-K [(89.07 ± 19.66), (110.16 ± 9.81)pmol/L] in the low-and high-dose fluorosis groups were higher than those in the control group[(0.15 ± 0.03)μg/L,( 18.32 ± 2.27)pmol/L], and the high fluorosis group was obviously higher than the low fluorosis group (all P < 0.05). Each group of serum PI3K and Akt1 protein and mRNA were compared, the difference was statistically significant(F- 178.16,118.08,38.81,52.31, all P< 0.05). Compared to the control group (181.55 ± 4.24,188.46 ± 2.18,3.84 ± 1.69,4.33 ± 0.89), the protein and mRNA expressions of PI3K(171.66 ± 2.85,154.12 ± 4.15,11.31 ± 4.18,20.54 ± 6.68), Akt1(177.47 ± 3.16,156.42 ± 3.18,12.52 ± 3.13,19.43 ± 5.36) were higher in the low- and high-dose fluorosis groups (all P < 0.05), and the high fluorosis group was obviously higher than the low fluorosis group (all P < 0.05). Conclusions BGP and Cath-K contents could be used as bone metabolic indices in the endemic fluorosis disease. Fluoride can increase the expression of PI3K and Akt1 mRNA and protein in bone tissue of fluorosis rats, and PI3K/Akt1 signaling pathway may be involved in the pathogenesis of bone injury caused by fluoride.

ObjectiveTo investigate the expression of nuclear factor kappa B(NF-kB)-related mRNA and protein in bone tissue of rats with chronic fluorosis.MethodsThirty-six healthy SD rats,weighting 100 - 120 g,were randomly divided into three groups (twelve in each group ).Rats of control group were fed with tap water (NaF ＜ 1 mg/L) and the experimental rats were exposed to NaF(low-dose group:5 mg/L,high-dose group:50mg/L) through drinking water.All rats were killed at the eight month and metaphysic of femoral was collected.Bone tissues were stained with hematoxylin-eosin and observed under optical microscope.Bone fluorine was detected by ashing-fluorin ion selective electrode method.Serum content of tartrate-resistant acid phosphatase 5b(TRACP 5b)was detected by enzyme-linked immunosorbent assay(ELISA).The expressions of p50,p65 and IkBα's mRNA and protein in bone tissue was detected by real-time PCR and immunohistochemistry.ResultsBone sclerosis was observed under optical microscope.The contents of bone fluorine in both the low and high doses fluoride groups [(6.32 ± 1.23),( 10.89 ± 1.56) mg/kg] were significantly higher than that of the control [(3.06 ± 1.01 ) mg/kg,all P ＜ 0.05],and of that the high fluoride group was significantly higher than that of the low fluoride group(P ＜ 0.05).Serum content of TRACP 5b of the low fluoride group[(3.45 ± 1.85)U/L] was significantly higher than that of the control[(1.26 ± 0.23)U/L,P ＜ 0.05],but that of the high fluoride group[(2.74 ± 1.85)U/L] was lower than that of the low dose group(P ＜ 0.05).The mRNA expressions of p50 and IkBα in the low fluoride group(4.41 ± 0.44,1.15 ± 0.25) were significantly higher than that of the control(1.46 ± 0.10,0.26 ± 0.07,all P ＜ 0.05),but that of the high fluoride group(0.69 ± 0.09,0.14 ± 0.03) was lower than that of the low dose group(all P ＜ 0.05).The protein expressions of p50 and IkBα in the low fluoride group(152.96 ± 7.87,156.20 ± 9.75) were significantly higher than that of the control( 125.63 ± 9.85,118.97 ± 6.94,all P ＜ 0.05),but the high fluoride groups' ( 120.56 ±9.57,114.50 ± 7.61 ) was significantly lower than that of the low dose group(all P ＜ 0.05).ConclusionFluoride can lead to altered gene expression of NF-kB pathway,and the latter may be involved in fluoride induced bone damage.

Objective To investigate the relationship between change of relevant gene of nuclear factor kappa B(NF-κB) and osteoclast apoptosis in bone injury of rats with chronic fluorosis,and to reveal the mechanism of skeletal fluorosis.Methods Thirty-six healthy SD rats,weighting 100-120 g,were randomly divided into three groups(twelve in each group).Rats of control group were fed with tap water(NaF ＜ 1 mg/L) and the experimental rats were exposed to NaF(low-dose group:5 mg/L,high-dose group:50 mg/L) through drinking water to established chronic fluorosis model.All rats were killed at the eight month and metaphysic of femoral was collected.Bone tissues were stained with hematoxylin-eosin and observed under optical microscope.Serum content of tartrateresistant acid phosphatase 5b (TRACP 5b) was detected by enzyme-linked immunosorbent assay (ELISA).Osteoclast was identified and counted by tartrate-resistant acid phosphatase staining(TRAP).The expression of p50,IκBα,Bcl-2 and Bax's mRNA and protein of bone tissue was detected by Real-time PCR and immunohistochemistry.Results Bone sclerosis was observed under optical microscope.The content of TRACP 5b in serum and the number of osteoclast in the low fluoride group[(3.45 ± 1.85)U/L,(6.75 ± 1.29)/slice]were significantly higher than that of the control[(1.26 ± 0.23)U/L,(3.92 ± 1.38)/slice,all P ＜ 0.05],but that of the high fluoride group [(2.74 ± 1.85)U/L,(3.33 ± 1.07)/slice]were lower than that of the low dose group(all P ＜ 0.05).The mRNA expressions of p50,IκBα,Bcl-2 and Bax in low fluoride group(4.41 ± 0.44,1.15 ± 0.25,2.02 ± 0.11,1.25 ± 0.22) were significantly higher than that of the control(1.46 ± 0.10,0.26 ± 0.07,1.00 ± 0.06,0.74 ± 0.09,all P ＜ 0.05),but the high fluoride groups' (0.69 ± 0.09,0.14 ± 0.03,0.95 ± 0.08,0.62 ± 0.08) were lower than that of the low dose group(all P ＜ 0.05).The protein expressions of p50 and IκBα in the low fluoride group (152.96 ± 7.87,156.20 ± 9.75) were significantly higher than that of the control(125.63 ± 9.85,118.97 ± 6.94,all P ＜ 0.05),but the high fluoride group(120.56 ± 9.57,114.50 ± 7.61) were lower than the low dose group(all P ＜ 0.05).The protein expressions of Bcl-2 and Bax(170.61 ± 6.60,160.77 ± 7.66) and the ratio of Bcl-2/Bax (1.07 ± 0.08) were higher than the control(l10.73 ± 5.27,114.64 ± 5.83,0.96 ± 0.04,all P＜ 0.05),but the high fluoride group(81.70 ± 8.00,99.93 ± 3.83,0.81 ± 0.08) were lower than that of the control and the low dose group (all P ＜ 0.05).There was a significant positive correlation between protein expression of p50,IκBα and Bcl-2/Bax (r =0.587,0.676,all P ＜ 0.05).Conclusions Chronic fluorosis can cause change of the relevant gene of NF-κB in rat bone tissues and osteoclast apoptosis.The mechanism of skeletal fluorosis might be related to the abnormal of osteclast apoptosis caused by changes of NF-κB p50 and IκBα.

Akt1 is a serine-threonine protein kinase that has been implicated in the control of cellular metabolism,survival and growth.Elevated expression of Akt1 has been noted in a significant percentage of human tumors,promoting cellular metastasis.Conversely,some studies have revealed hyperactivated Akt1 inhibited the invasiveness and metastasis of breast cancer cells.To clarify the definite effect of Akt1 on tumorigenesis and development,Akt1 was silenced by RNAi in the highly metastatic murine breast cancer 4T1 cells.Akt1 silencing didn't affect the proliferation of breast cancer cells in MTT assay,while reduced the migration in Transwell assay.Consistent with the above results,Akt1 silencing didn't change the primary tumor weight,but significantly suppressed lung metastasis of 4T1 cells.These observations indicated Akt1 plays an important role in murine breast cancer metastasis,and suggested that Akt1 might be a therapeutic target for breast cancer metastasis.