Objective] To study the effect of needle warming moxibustion and electroacupuncture in treatment of knee osteoarthritis. [Methods] 171 cases of patients with knee osteoarthritis were randomly divided into 3 groups: acupuncture and moxibustion group, electroacupuncture group, control group of 57 cases in each. The efficacy of the 3 groups was compared after 2 courses of post. [Results] Efficiency of the 3 groups of patients had no significant difference(P>0.05); The cure rate and significant efficiency rate of 3 groups were significantly different( P<0.05), it showed that the improvement of curative effect of each group was different;on the efficacy of the 3 groups through Kruskal-Wallis H, P<0.05, there was statistically significant difference among 3 groups. [Conclusion] The needle warming moxibustion has a best treatment effect and the electroacupuncture takes the second place. We should expand the use of acupuncture and moxibustion for the disease in clinic, the therapeutic effect of electroacupuncture has a gap with the needle warming moxibustion.

Objective To investigate the effects of rehabilitation training on hippocampal amyloid-beta peptide (Aβ) and insulin-degrading enzyme (IDE) levels in vascular dementia (VD).Methods Thirty female Sprague-Dawley rats were randomly assigned to a rehabilitation group (n =10),a model group (n =10) or a sham-operation group (n =10).An experimental VD model was established in the rats of the first 2 groups by bilateral common carotid artery permanent ligation.The rats in the rehabilitation group then received 1 h of rehabilitation training daily.Learning and memory were assessed at 4 weeks aftet the operation.Immunohistochemical staining was used to detect Aβ and IDE expression in the hippocampus dentate gyrus (DG) area.Results The rats in the rehabilitation group showed significantly better learning ability compared with the model group.The expression of Aβ in the rehabilitation group was significantly less than in the model group.The expression of IDE in the rehabilitation group was significantly greater Conclusion Rehabilitation can accelerate the recovery of learning and memory in VD,at least in rats The mechanism is possibly related to decreased accumulation of Aβ in the hippocampus due to up-regulation of the expression of IDE.

ObjectiveTo study the effect of exercise training on β-amyloid polypeptide (Aβ) and β-secretase(BACE) in the hippocampus of the rats with vascular dementia (VD).Methods 30 Sprague-Dawley (SD) rats were carried out to an exercise group (n =10 ),a model group (n =10 ),and a sham-operation group ( n =10 ).VD rat models were made by the ligation of bilateral common carotid arteries.Morris water maze test were carried out 4 weeks after the operation to assess the ability in learning and memory of the rats and Aβ and β-secretase (BACE)expression was detected in the hippocampus of the rats using immunohistochemical techniques.ResultsIn the Morris water maze test,the model group showed reduction in the learning and memorizing ability,with obvious longer escape latencies ( ( 101.34 ± 19.67 ) s,(95.42 ± 23.89 ) s,( 89.39 ± 22.67 ) s,( 90.12 ± 19.77 ) s,respective-ly) than that of sham-operation group ( ( 62.13 ± 11.38 ) s,( 24.84 ± 13.69 ) s,( 16.98 ± 12.51 )s,( 11.41 ± 8.93 ) s,correspond-dingly) (P ＜ 0.05 ),and the exercise group was improved in the learning and memorizing ability ( corresponding to ( 80.15 ± 21.56 ) s,( 51.24 ± 20.91 ) s,( 43.78 ± 22.36) s,( 45.67 ± 20.87 ) s ),compared with the model group(P＜0.05).The grey values of Aβ in the hippocampus of the rats for the exercise group was ( 130.12 ± 19.01 ),( 116.77 ± 23.67 ) for the model group and ( 148.44 ± 17.67 ) for the sham-operation group(P＜ 0.05).The grey values of BACE in the hippocampus of the ratsfor the exercise group were( 131.21± 25.25 ),( 120.53± 10.21 ) for the model group(P＜ 0.05 ) and ( 162.38 ± 28.11 ) for the sham-operation group (P ＜ 0.05).ConclusionExercise training can lower the expression of BACE and Aβ in the hippocampus of rats with VD,therefore improving the learning and memory ability of rats with VD.

Objective To investigate the role of renin angiotensin system (RAS) in pathogenesis of nonalcoholic fatty liver disease (NAFLD).Methods Twenty-four Wistar rats were evenly divided into control group and model group.The rats of control group were fed with normal diet,and model group were with high-fat diet.Rats were killed at the eighth week and serum liver function,blood lipid,glucose and insulin were tested.The liver tissues were stained with HE and Picro acid-Sirius red for pathological observation.The liver tissue concentration of angiotensin Ⅱ was determined by ELISA method and the expression of TGF-β1 in liver tissue was examined by immunohistochemistry.Results After eight weeks high fat feeding,weight,liver index,liver function,blood lipids and serum insulin of model group were significantly higher than those of control group (weight:(463.50±22.72) g vs.(404.29±10.32) g; liver index:(3.75±0.21) g vs.(2.66±0.15) g; ALT:(79.8±8.6) U/L vs.(58.8±11.6) U/L; AST:(200.01±51.72) U/L vs.(150.30±37.27) U/L; total cholesterol:(3.67±0.48) mmol/L vs.(1.50±0.23) mmol/L; triglycerides:(2.06±0.40) mmol/L vs.(0.71±0.34) mmol/L; insulin:(17.37±2.89) pmol/L vs.(11.08±2.12) pmol/L),and all the differences were statistically significant (P＜0.01).The histopathological results of model group indicated liver steatosis,inflammatory reaction in part of lobule and portal area and significant fibrosis in part of liver tissue.The liver tissue angiotonin Ⅱ concentration of model group [(32.80 ± 2.81)pg/ml] was higher than that of control group [(22.83 ± 1.75) pg/ml,t =9.559,P＜0.01].The immunohistochemistry results showed that the expression of TGF-β1 of model group was obviously higher than that of control group (Z=-2.540,P =0.011 ).Spearman correlation analysis revealed that the increasing degree of angiotensin Ⅱ concentration was positively correlated with liver steatosis scores (r=0.644,P=0.002) and the expression of TGF-β1 (r=0.470,P=0.037).Conclusion The concentration of angiotensin Ⅱ and TGF-β1 increased in the livers of model rats,which indicated that RAS may participate in the pathogenesis and progress of NAFLD.

Objective To investigate the health-related quality of life (HRQoL) and its influencing factors in patients with gastric remnant cancer (GRC).Methods A total of 130 patients received gastrectomy more than 10 years ago because of early gastric cancer.According to the gastric remnant canceration after the surgery,patients were divided into GRC group (80 cases) and gastric remnant group (50 cases).Both the patients of these two groups accepted questionnaires of cancer patients' quality of life questionnaire (QLQ) C30 and gastric cancer specific questionnaire QLQ-STO22,the HRQoL were evaluated.The comparison between two groups with normal distribution of data was aralyzed by t test.Wilcoxon rank sum test was applied for the comparison between two groups with non-normal distribution of data.Optimal scaling regression analysis was used for screening HRQoL related clinical influencing factors.Results All the research objectives finished the questionnaires survey.Compared with health control group,the scores of GRC group were lower,which included quality of life evaluation,physical function,role function,emotional function,cognitive function and social function,and the differences were statistically significant (t =-6.678,-7.111,-10.605,-5.748,-4.765 and-21.170,all P＜0.01).The scores of fatigue,pain,diarrhea,nausea and vomiting,loss of appetite,economic difficulties,dysphagia,abdominal pain,reflux symptoms,diet restricted,anxiety,physical appearance and hair loss were higher,and the differences were significant (t=6.925,4.218,4.728 and Z=-5.236,-7.890,-7.698,-10.058,-3.612,-6.914,-9.711,9.940,-7.987 and-4.966,all P＜0.01).Compared with gastric remnant group,the scores of GRC group were lower,which included quality of life evaluation,physical function,role function,emotional function,cognitive function and social function,and the differences were statistically significant (t=-5.861,-5.821,-7.077,-7.999,-2.808and-5.710,all P＜0.01).However the scores of fatigue,pain,diarrhea,nausea and vomiting,loss of appetite,economic difficulties,dysphagia,diet restricted,anxiety,physical appearance and hair loss were higher,and the differences were significant (t=9.363,6.842 and Z=-2.654,-6.256,-3.266,-4.132,-2.854,-7.996,-4.258 and-2.005,all P＜0.01).Compared with health control group,the score of social function of gastric remnant group was lower and the difference was significant (t =-9.820,P＜ 0.01); the scores of diarrhea,nausea and vomiting,economic difficulties,dysphagia,reflux symptoms,diet restricted,physical appearance and hair loss were higher,the differences were statistical significant (t=3.020 and Z=-1.981,-3.775,-6.505,-6.098,-8.032,-3.369 and-3.147,all P＜0.05) ; the symptom scores of fatigue and pain were lower,the differences were significant (t=-2.890 and-2.439,all P＜0.05).HRQoL of patients was positively correlated with education degree,marital status,family income and the disease course of gastric remnant.Conclusions HRQoL of GRC patients decreased to certain degree.Education degree,marital status,family income and the disease course of gastric remnant were the influential factors of HRQoL in GRC patients.

OBJECTIVE: To investigate the effect of rehabilitation training on insulin-resistance and insulin degrading enzyme (IDE) in the hippocampus in rats with vascular dementia. METHODS: A total of 45 female Sprague-Dawley rats were randomly assigned into a rehabilitation group (n=15), an immobilization group (n=15), and a sham-operation group (n=15). The rats in the former 2 groups were operated on to establish the experimental vascular dementia model by bilateral common carotid artery permanent ligation. The rats' learning and memory were assessed 4 weeks after the operation. The plasma level of insulin was determined by ELISA at different time points after the operation. Immunohistochemical staining was used to detect the IDE expression in the hippocampus area. RESULTS: The rats in the rehabilitation group showed significantly better learning ability than that in the immobilization group (P<0.05). The plasma level of insulin in the rehabilitation group was lower than that in the immobilization group (P<0.05), IDE expression in the rehabilitation group was higher than that in the immobilization group (P<0.05) at 7 d and 28 d after the operation. CONCLUSION Rehabilitation can accelerate the recovery of learning and memory in rats with vascular dementia, and the mechanism is possibly related to the amelioration of insulin resistance and increase of IDE expression in the hippocampus.
Amyloid beta-Peptides ; analysis ; Animals ; Dementia, Vascular ; therapy ; Drugs, Chinese Herbal ; Female ; Hippocampus ; enzymology ; Insulin ; blood ; Insulin Resistance ; Insulysin ; analysis ; Learning ; Memory ; Rats ; Rats, Sprague-Dawley

Objective To explore the death risk factors of septic myocardial depression (SMD) and their predictive effect, and to set up a death early-warning model. Methods A retrospective analysis was conducted. The patients with SMD admitted to emergency department and rescue room of Beilun Branch of the First Affiliated Hospital of Zhejiang University Medical College from January 2015 to November 2017 were enrolled. The patients were divided into survival group and non-survival group according to 28-day outcome, and the gender, age, and the initial examination parameters [white blood cell (WBC) count, neutrophil (Neut) count, activated partial thromboplastin time (APTT), procalcitonin (PCT), D-dimer, C-reactive protein (CRP), cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left atrium diameter (LAD)] of both groups were compared. Binary logistic regression analysis was conducted on the factors with statistically significant difference analyzed in univariate analysis, and death early-warning model was set up subsequently. For parameters in early-warning model after variable screening, receiver operating characteristic curve (ROC) was applied to evaluate the predictive effect of death. Results A total of 129 patients were enrolled, 34 patients died within 28 days with the mortality of 26.4%. Univariate analysis showed that the PCT, cTnI and NT-proBNP in non-survival group were significantly higher than those of the survival group. However, there was no statistical difference in gender, age, WBC, Neut, APTT, D-dimer, CRP, LVEF, LVEDD or LAD between the two groups. Logistic stepwise regression analysis showed that PCT and cTnI were the independent factors influencing the death of patients with SMD [PCT: odds ratio (OR) =1.495, 95% confidence interval (95%CI) = 1.192-1.876, P = 0.001; cTnI: OR = 11.154, 95%CI = 5.709-17.264, P = 0.004], and the death early-warning model was logP =-3.737+0.402×PCT+2.412×cTnI. According to the statistics of Homser-Lemeshow, the effect of this model was good (χ2= 6.258, P = 0.617). The analysis of ROC displayed that the area under ROC curve (AUC) of the combination of PCT and cTnI for predicting the prognosis of SMD patients was 0.851, and it was significantly higher than that of PCT and cTnI alone (0.738 and 0.719, respectively, both P < 0.05). When the combination of PCT and cTnI was 0.26, the sensitivity was 79.97%, the specificity was 87.01%, the positive predictive value was 71.3%, and the negative predictive value was 91.7%. Conclusions PCT and cTnI are independent factors influencing the death of SMD patients. The combination of PCT and cTnI has predictive value for the prognosis of SMD patients. The death early-warning model of SMD patients can be used to predict the prognosis of SMD patients.

Objective To compare the complications and outcomes of urgent?start peritoneal dialysis (PD) and hemodialysis (HD) in end?stage renal disease (ESRD) patients, and explore the safety and effectiveness of PD which was as an urgent?start dialysis modality in ESRD patients. Methods All patients for urgent?start dialysis, who initiated dialysis without a long?term dialysis access or had the long?term dialysis access under 30 days in Renji Hospital from January 1st 2013 to December 31st 2014, were enrolled. According to the dialysis modalities, patients were divided into PD group and HD group. Participants were followed up until death, transferred to other centers, lost of follow up or January 1st 2016. Dialysis?related complications within 30 days of implantation, complications of reimplantation and the occurrence of bacteremia between two groups were compared, and their survival rates were tested by Kaplan?Meier curves. Results Among 178 patients in this study, there were 96 (53.9%) patients in PD group and 82 (46.1%) patients in HD group. Compared with those of HD group, patients of PD group presented more cardiovascular disease [21(21.9%) vs 8(9.8%), P=0.029], higher serum potassium [(4.5±0.8) mmol/L vs (4.3±0.8) mmol/L, P=0.038], but less heart failure (NYHA Ⅲ?Ⅳ) [26(30.2%) vs 40 (48.8%), P=0.014], lower brain natriuretic peptide (BNP) [328.5 (129.5, 776.8) ng/L vs 503.5(206.0, 1430.0) ng/L, P=0.008], higher hemoglobin [(81.5 ± 17.7) g/L vs (75.3 ± 22.5) g/L, P=0.039], higher serum albumin (33.5±5.7) g/L vs (31.3±6.7) g/L, P=0.022] and higher serum pre?albumin (304.5±78.0) mg/L vs (257.0 ± 86.1) mg/L, P<0.001]. PD group presented less dialysis?related complications [5 (5.2%) vs 20(24.4%), P<0.001], less dialysis?related complications requiring reimplantation [1(1.0%) vs 20(24.4%), P<0.001] and less bacteraemia [3(3.1%) vs 11(13.4%), P=0.011]. The 3?, 6?and 12?month patient survival rates of PD and HD group were 97.9% vs 98.4%, 97.9% vs 98.4%, and 92.1%vs 93.0% respectively, and no significant difference was found (Log ? rank=0.004, P=0.947). Conclusions Patients with urgent?start PD have less complications within 30 days of implantation and occurrence of bacteremia than patients with urgent?start HD, and the same survival rates. PD may be a feasible and safe urgent?start dialysis modality for ESRD patients.