BACKGROUND: Hanshibi granule indicates rheumatism due to blockage of cold and damp.OBJECTIVE: To observe the effects and safety of intervention of hanshibi granule on rheumatism due to blockage of cold and damp and the comparative observation was carried on by taking zhengqingfengtongning as the control drug.DESIGN: Case randomized-controlled observation was designed.SETTING: Luoyang Bone-setting Hospital of Henan Province.PARTICIPANTS: Totally 400 cases of rheumatism due to blockage of cold and damp visited in Luoyang Orthopedic Hospital of Henan Province were volunteered in the observation from May 2000 to February 2002.Hanshibi granule was composed of fuzhi (Radix Aconiti Praeparata),huangqi (Radix Astragali), weilingxian (Radix Clematidis), more than 10 herbs, 10 g each bag. Zhengqing fengtongning tablet is 20 mg each tablet.METHODS: Based on the randomization and sequence of visiting, the cases were divided into observing group and the control at the ratio of 3:1.In the observing group, hanshibi granule was administrated, 1 bag/time,3 times/day, infused with water. In the control, zhengqing fengtongning tablet was administered orally, 2 tablets/time, 3 times/day; 1 week later,if there was no harmful reaction, it was administered 3 tablets/time,3 times/day. For rheumatic arthritis (RA) and ankylosing spondylitis (AS),the drugs were taken for 2 months as 1 course, and for knee osteoarthritis,the drugs were taken for 1 month as 1 course. The changes of ESR, C-reactive protein (CRP) and rheumatic factor (RF) and uric acid (UA) were determined and recorded. Criteria on evaluation: ① Evaluation on therapeutic effects on syndromes: Remarkable effect: the symptoms were improved remarkably after treatment and symptom integral was 0-1 score or decreased by ≥ 2/3. Effect: the symptoms were improved after treatment and the symptom integral was decreased by≥1/3.② Evaluation on therapeutic effects on symptoms: Remarkable effect: The symptom integral was reduced to 0 score or reduced by 2 scores after treatment, such as joint pain, swelling, tender pain, morning stiffness and functional impairment. Effect: the integral was reduced by 1 score after treatment. ③ Evaluation on total therapeutic effects on diseases: Remarkable effect: the symptoms and physical signs disappeared basically, the main laboratory indexes were improved remarkably and reduced by ≥ 50%. Effect: The symptoms and physical signs were alleviated and the main laboratory indexes were improved.MAIN OUTCOME MEASURES:① Total clinical therapeutic effect,therapeutic effect on different symptoms and diseases between two groups.②Safety of hanshibi granule.RESULTS: Totally 400 cases were employed, of which, 300 cases were in observing group and 100 cases in the control. In observing group, 19 cases were dropped out and 281 cases were in the statistics. In the control,6 cases were dropped out and 94 cases were in the statistics.①Comparison of total clinical therapeutic effects between two groups: The total effective rate in the observing group was higher significantly than that in the control (94.31％, 84.04％, P ＜ 0.01). ② Comparison of therapeutic effects on different symptoms between two groups: There was no significant difference in the therapeutic effects on joint pain, swelling,tender pain, functional disturbance and morning stiffness between two groups (P ＞ 0.05). ③ Comparison of therapeutic effects on different diseases between two groups: There was no significant difference in the therapeutic effects on RA, AS and knee osteoarthritis (P ＞ 0.05). ④ Safetyof hanshibi granule: abnormal urine routine for a part of cases before treatment was improved after treatment. ST-T wave alternation in ECG for a part of cases before treatment was not aggravated obviously after medication.CONCLUSION: Both hanshibi granule and zhengqingfengtong tablet, the control drug improves significantly joint pain, swelling, tender pain, functional impairment and morning stiffness in rheumatism due to blockage of cold and damp, in which, the effect of intervention of hanshibi granule is superior to that of the control drug, without obvious harmful reactions;therefore, such drug can be taken as a safe and effective one for rheumatism due to blockage of cold and damp.

ObjectiveTo investigate the effect of soluble β-amyloid protein (Aβ) oligomers on the expression levels of insulin signaling transduction cascades-associated proteins including insulin receptor ( InsR),insulin receptor substrate-Ⅰ( IRS-Ⅰ) and protein kinase B (PKB) of rat hippocampal neurons,and the pathogenesis of Alzheimer's disease (AD) in depth.MethodsSoluble Aβ oligomers (5 μl) were injected into the lateral ventriculus of the AD group by a microinjector under the stereotaxic apparatus.Normal saline solution ( NS,5 μl) was injected into the NS group in the same way,and the control group received the puncture without injection. It was repeated after 1 week and the behavior of all rats was evaluatedbyY-mazetestafter2weeks.Thenhippocampuswasremovedandunderwent immunohistochemical staining to detect the expression of proteins associated.ResultsCompared with the other groups,learning and memory ability of the Aβ-treated rats were impaired.To be specific,the times of learning were increased and the times of memory were decreased. However,there was no significant difference between the NS group and the control group.Besides,the expression levels of InsR,IRS-Ⅰ,and PKB were decreased in AD group showing that a mean optical density of staining on these proteins ( InsR:0.12 ± 0.0l ; IRS-Ⅰ:0.14 ± 0.02; PKB:0.12 ± 0.03 ) was reduced in contrast with that in the NS group and the control group.Whereas there was no significant difference between the NS group (0.40 ± 0.02,0.39 ± 0.06,0.38 ± 0.03,mean difference:- 0.13,- 0.13,- 0.17,all P ＜ 0.05 ) and the control group (0.38 ± 0.07,0.35 ± 0.03,0.35 ± 0.06,mean difference:- 0.15,- 0.07,- 0.73,all P ＜ 0.05 ).ConclusionsSoluble Aβ1-42 induced learning and memory disability of the rats.The mechanism might be that Aβ can lead to disorders of the insulin signaling transduction pathway of hippocampal neurons and decrease the expression levels of the proteins in the pathway.

Objective To identify major factors which affect the completion quality of projects and build predictive models,and to propose strategies and suggestions for total process quality management of clinical research projects of the hospital.Methods Collect relevant literatures from home and abroad;consult completion reports of various research projects completed from 2003 to 2010 and sum up problems found in such projects.Carry out in-depth interviews with principal investigators,supervisors of scientific research of the hospital as well as administrators of sponsor institutions.A questionnaire survey was made on completed clinical research projects undertaken from 2003 to 2010.Results Six key factors affecting implementation of such projects were derived from factor analysis,which are research technology and external environment,project teamwork,research subject availability,project organization,manpower input,and research design.A multiple logistic regression analysis found project internal management and manpower input as two leading predictive factors for project completion outcomes,while the former has a greater impact than the latter.Conclusion Project management should focus on the 6 key factors affecting project quality.The two main predictive factors should attract greater attention and resources in both supervision and management.

To evaluate the efficacy and safety of limbal relaxing incision ( LRl) for correcting corneal astigmatism during implantable collamer lens ( lCL) surgery.METHODS:A total of 185 eyes of 105 patients with high myopia and corneal keratometric astigmatism were included in the study. lCL surgery with concomitant relaxing incision was performed in 105 eyes of 60 patients in LRls group ( Group A) . Eighty eyes of 45 patients only underwent lCL surgery were in control group ( Group B) . All patients undergone ophthalmic examination that included uncorrected visual acuity ( UCVA ) , best -corrected visual acuity ( BCVA ) , Pentacam analysis system to observe the changes of corneal astigmatism before and 1wk, 1 and 3mo after surgery.RESULTS: Respectively comparing UCVA between two groups in 1 and 3mo postoperatively, the P values were considered statistically significant ( P < 0. 05 ). But, respectively comparing BCVA between two groups in 1wk, 1 and 3mo postoperatively, the P values were considered no statistically significant ( P > 0. 05 ). Preoperative corneal astigmatism was 1. 52 ± 0. 55D in group A and 1. 48 ± 0. 57D in group B, there was no statistically significant difference (P>0. 05). One week postoperatively, the astigmatism was 0. 55 ± 0. 41D in group A and 1. 20 ± 0. 48D in group B. One month postoperatively, the astigmatism was 0. 60 ± 0. 38D in group A and 0. 93 ± 0. 47D. Three months postoperatively, the astigmatism was 0. 51 ± 0. 32D in group A and 0. 96 ± 0. 40D in group B. The difference between the two groups were statistically significant ( P<0. 05 ). The difference value of corned astigmatism before surgery and 1wk, 1 and 3mo after surgery had statistical significance ( P<0. 05). ln LRls group, at preoperative and postoperative time points, the average corneal astigmatism changes were also considered statistically significant difference (P<0. 05). CONCLUSlON: LRls performed during lCL surgery appeared to be an effective and safer procedure to reduce pre-existing corneal astigmatism and improve UCVA as well as the visual quality.

Objective To investigate the correlation between serum insulin,lipid expression substances and breast cancer.Methods From January to August 2002,blood samples were collected from 90 patients with breast cancer,40 patients with breast benign disease and 100 healthy control subjects in Shanxi Province People Hospital.Serum insulin was measured by ELISA,serum leptin was measured by radioimmunoassay (RIA) and serum lipid substances were measured by Biochemistry Auto-machine.Results The serum insulin,leptin and TG concentration were significantly higher,but the HDL level was significantly lower in breast cancer group than in the groups of breast benign disease and healthy control(P＜0.01,respectively);There was no statistically significant difference between postmenopausal and premenopausal women in patients with breast cancer and breast benign disease(P＞0.05);There was no statistically significant difference in serum insulin level between positive lymph node breast cancer and negative lymph node breast cancer(P=0.642);The relative risk (RR) of serum insulin level and body mass index(BMI) in breast cancer group was 0.164(P＞0.05).The increased serum insulin level was independent of diet and other known risk factors for breast cancer;Multiple logistic regression analyses observed a statistically significant association between serum insulin,leptin,TG and HDL levels and breast cancer,OR=1.120(95% CI:1.017～1.209),1.117(95% CI:1.046～1.193),OR=1.879(95% CI:1.148～3.076),OR=0.035 (95% CI:0.007～0.162),respectively.Conclusion The increased serum insulin,leptin and TG levels may be the risk factors of breast cancer.The increased serum HDL level maybe the protective factor of breast cancer.

Objective To explore the effect of peritoneal dialysis to treat renal failure in children.Methods There were 11 admitted patients of renal failure in our department from July 2003 to April 2008.Their clinical data and follow-up results were analyzed.Results No patient was dead during treatment.The average time of peritoneal dialysis treatment in the children with acute renal failure was 15.5 days in hospital,which was 22.8 days in the chronic patients.After treatment the levels of serum nitrogen and creatine were decreased significantly from (34.03±8.44)mmol/L and (710.09±167.54)μmol/L to (15.94±4.93)mmol/L and (233.87±92.71)μmol/L (P＜0.01).The serum sodium and bicarbonate ion were increased from (130.91±9.15)mmol/L and (14.56±2.07)mmol/L to (139.46±3.98)mmol/L and (22.47±3.29)mmol/L (P＜0.05,P＜0.01).The duration of follow-up were from one month to 5 years.The level of serum nitrogen and creatine in 5 patients of acute renal failure were normal and the analysis of urine was also normal during follow-up.One patient had renal transplantation after peritoneal dialysis.Three patients still regularly underwent peritoneal dialysis.Conclusion The peritoneal dialysis combining with multi-modality treatment was the better style of renal replacement therapy in renal failure patients.

Objective To study the role of glutamate receptor subtypes in nucleus tractus solitarius(NTS)in cardiac-somatic motor reflex (CMR)induced by intrapericardial administration of capsaicin,and to clarify the modulation mechanism of NTS to cardiac nociceptoion.Methods 60 SD rats were randomly divided into ibotenic (IBO)group, glutamate group, MK-801 group, MCGP group, MK-801 + MCPG group and DNQX group. The NTS microinjected with 130 mmol·L-1 IBO 100 nL,100,200,500 mmol·L-1 L-glutamate 100 nL,NMDA receptor antagonist 40 and 60 mmol · L-1 MK-801 100 nL, metabotropic glutamate receptors antagonist 25 and 50 mmol·L-1 MCPG 100 nL,25 mmol· L-1 MCPG 50 nL plus 40 mmol· L-1 MK-801 50 nL,non-NMDA receptor antagonist 20 and 50 mmol·L-1 DNQX 100 nL,respectively.The changes of CMR of the rats in various groups were observed.Results Compared with control group,the CMR of the rats in IBO group was decreased (P<0.05);the CMR was increased as the concentration increased in glutamate group(P<0.05);the CMR in MK-801 and MCPG groups were decreased (P<0.05);the CMR in MK-801+MCPG group was decreased (P<0.05);the CMR in DXQX group had no changes (P>0.05).Conclusion NTS play an facilictory role in cardiac nociception,and the NMDA receptors and mGluRs receptors mediate this facilitory modulation.

Objective To explore the role of metabotropic glutamate receptors (mGluRs)group Ⅲ and its subtypes mGluR7 and mGluR8 in nucleus tractus solitarius(NTS)in cardiac-somatic motor reflex (CMR),and to clarify the modulation role of mGluR Ⅲ and its subtypes in NTS in cardiac nociceptoion.Methods 40 SD rats were randomly divided into L-AP4 group,microinjection of mGluRs Ⅲ agonist L-AP4 0.1,1.0,10.0 or 20.0 nmol in NTS;AMN082 group,microinjection of mGluR7 agonist AMN082 1,2 or 4 nmol;DCPG group,microinjection of mGluR8 agonist DCPG 4, 6 or 8 nmol;MSOP group, microinjection of mGluR Ⅲ antagonist MSOP 20 or 100 nmol,20 nmol MSOP+410 nmol L-AP,20 nmol MSOP+2 nmol AMN082,20 nmol MSOP+6 nmol DCPG. The changes of CMR of the rats in various groups were observed.Results Compared with control,the CMR in L-AP4 and AMN082 groups was decreased (P<0.05);the CMR in DCPG group was increased (P<0.05);the CMR in MSOP group after injection of 20 nmol MSOP had no change (P>0.05);the CMR in MSOP group after injection of 100 nmol MSOP was increased (P<0.05);the CMR in MSOP group after injection of 20 nmol MSOP followed L-AP4 or AMNO82 had no change (P>0.05).Conclusion The group Ⅲ mGluRs in the NTS play an inhibitory role in cardiac nociception, and mGluR7 has anti-nociceptive effects while mGluR8 has pro-nociceptive effects.

Objective To investigate the effect of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) in the treatment of oral ulcer caused by chemotherapy.Methods 108 patients of oral ulcer caused by chemotherapy were randomly divided into two groups.54 cases in the control group were treated with cydiodine buccal tablets at first,then received the aerosol treatment which was prepared by mixing gentamicin,dexamethasone,2 ％ lidocaine and physiologic saline,three times per day.54 cases in the treatment group firstly received the gargle which was prepared by mixing rhGM-CSF,dexamethasone and physiologic saline,then were treated with rb-bFGF by spraying on the oral ulcer surface,three times per day.Results The effective rate of the treatment group was 96.30 ％ (52/54),which was significantly higher than that of the control group [64.81％ (35/54)],there was a significant difference between the two groups (x2 =17.08,P ＜ 0.05).Conclusion The effect of rhGM-CSF combined with rb-bFGF in the treatment of oral ulcer caused by chemotherapy is very significant.

Objective To investigate the clinical and imaging features of aortic dissection(AD) with damage in nervous system.Methods The clinical data were retrospectively analyzed in 14 cases of AD with damage in nervous system.Results 13 patients(92.9%) were over age 40.All cases were acute onset and 9 cases had history of hypertensive disease.During onset,the blood pressure was elevated in 9 cases,decreased in 3 cases and could not be measured in 2 cases.The clinical manifestations of patients presented severe pectoralgia in 5 cases,chest-back complaint in 4 cases,bellyache,lumbago with emesia in 2 cases,shock in 2 cases.The appearances of nervous system:circumgyration in 5 cases,conscious disturbance in 4 cases,hemiparalysis in 2 cases,barylalia in one case,paraplegina in 2 cases and hypesthesia in 3 cases(meta-body in 1 case,below T 4 or T6 in 2 cases).The breast and abdominal part CT and CTA of all cases showed clearly the true and false lumens,the position of intimal slit(according Debakeys,2 cases were typeⅠ,7 cases were typeⅡ,5 cases were type Ⅲ) and mural thrombosis.The breast and abdominal part MRI in 8 cases could show conspicuous true and false lumens.The true lumen was presented flow and inane signals but the false lumen was presented higher signals in T1 and T2 WI.Conclusions The clinical manifestations of AD with damage in nervous system are main the ischemic impaired symptoms and signs of brain and spinal cord.Both CT and MRI can show the false lumen and vascular intimal slit of AD.