Acupuncture Therapy ; instrumentation ; methods ; standards ; China ; Humans ; Moxibustion ; instrumentation ; methods ; standards ; Needles ; standards ; Reference Standards

It is important to explore the fundamental medical concepts which can enhance the overall quality of medical students in the department of geriatrics during clinical practice. These funda-mental medical concepts include medical humanistic spirit,holistic medicine,health management and patient-physician communication. Specific measures include improving emotional communication of clini-cal interns in department of geriatrics with elderly patients,training student's thinking as a whole towards multiple system disease in the elderly,training students to assess and manage elderly patients from a vari-ety of perspectives and improving doctor-patient communication skills by routine clinical teaching and teaching ward round. All these concepts will help improve the working ability and medical ethics of clini-cal interns and enable them to adapt to the clinical work quickly. So they can become qualified doctors.

China ; Humans ; Pulmonary Medicine

Objective To comparatively observe features of choroidal osteoma by multimodal fundus imaging methods.Methods This is a retrospective case study.Sixteen patients (16 eyes) with choroidal osteoma were enrolled in this study.The patients included 6 males (6 eyes) and 10 females (10 eyes),with an average age of (30.5±2.4) years.All patients received examination of best-corrected visual acuity,slit lamp microscope,indirect ophthalmoscopy,fundus color photography,fundus autofluorescence (AF),fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (SD-OCT).The tumors were classified as fresh lesion (clear boundary and rosy tumor with smooth surface) and obsolete lesions (pale and flat tumor with obvious patches).The tumor features of color fundus photography,AF,FFA and SD-OCT were comparatively observed.Results There were 5 fresh lesions and 11 obsolete lesions.Color fundus photography showed the tumor color was orange-red or yellow-white with clear boundary and retinal blood vessels on the surface of the tumor.The color of fresh lesion was rosy.In general,choroidal osteoma shown weak AF,however AF of fresh tumor was slightly stronger than the obsolete tumor,and retinal detachment region showed relatively stronger AF.FFA of fresh tumor indicated uniform intense fluorescence with clear boundary at late stage,much stronger than obsolete tumor.SD-OCT showed mesh-like reflected signal in the choroidal layer,but different from the surrounding choroidal vascular structures.Conclusions The tumor color is orange-red or yellow-white in color funds photography,which shown weak AF.FFA showed mottled hyperfluorescence in the early stage and tissue staining at the late stage.SD-OCT showed mesh-like reflected signal in the choroidal layer.

Objective To continually observe the monocyte chemoattraetant protein-1(MCP-1) expression in rats with anilateral ureteml obstruction, and to explore the relationship between MCP-1 and p38MAPK, and as well as the nuclear transcription faetor-кB (NF-кB). Method Thirty-six rots were randomly assigned to sham op-eration group (contorl group) and unilateral ureteral obstruction group (UUO group). Renal tissues were examined under light microscope 8 h,24 h and 72 h after operation, Immunhistochemistry was used to measure the expression of MCP-1 and NF-кB. RT-PCR and Western bot were employed to determine MCP-1 mRNA and p38MAPK pro-tein,respectively.Serum creatinine and ure nitrogen were examined with biochemistry methods. Results Com-pared with control group, the expression of MCP-1 mRNA in UUO group dramatically increased (control group:0.401±0.039;UUO group 8 h:0.894±0.137;24 h: 1.416±0.135;72 h: 1.894±0.14, P<0.05).The explosion of MCP-1 protein in renal interstitium of UUO group also markedly increased (control group: 50.08±3.210. UUO group 8 h:108.25±4.325;24 h: 179.34±3.237;72 h: 230.12±3.026, P<0.05),and the expressions of NF-кB and p38MAPK in UUO group were also stimulated (p38MAPK: control group: 110.65±9.734. UUO group 8 h:200.15±8.326; 24 h:272.74±7.244;72 h:549.11±9.544, P<0.05). There were positive correlations between MCP-1 and p38MAPK as well as NF-кB(r=0.74,r=0.81,P<0.01).Conclusions Tne increased expression of MCP-1 may participate in the injury mechanisms of renal tubulointesti-tinm in UUO rats. The increased expression of p38MAPK may induce NF-кB expression in the tubules, and then NF-кB promotes the expression of MCP-1.

Adrenoleukodystrophy ; genetics ; therapy ; Humans ; Lovastatin ; pharmacology

Objective To study the therapeutic efficacy of Chinese botulinum toxin type A (CBTX- A) in masticatory spasm patients.Methods 16 patients with masticatory spasm were treated with CBTX-A local injection.12 patients showed jaw clench with masseter and temporalis affected (type Ⅰ).Four showed jaw clench and deviation to one side with pterygoid muscle affected unilaterally or bilaterally (type Ⅱ).All patients showed paroxysmal clenched jaw with difficulty in opening their mouths.There were no other clinical manifestations.CT and MRI did not reveal any intracerebral abnormalities.The efficacy and adverse effects were observed.Results CBTX-A were injected into 16 patients,resulting in a significant improvement of symptoms in 13 cases (4 cases of unilateral type Ⅰ,7 of 8 cases bilateral type Ⅰ,2 of 4 type Ⅱ).The spasms ceased within 3-10 days after the injection,and the effects lasted for 8-26 weeks.Four patients were observed to have slight masseter weakness after the injections,which recovered within a few weeks.The benefit persisted after identical repeated injection.Conclusion CBTX-A injection is an effective and safe treatment for masticatory spasm.

OBJECTIVETo observe the effects of moxibustion and treadmill exercise on transcutaneous oxygen tension and exercise capacity in lower limbs of peripheral arterial disease (PAD).

METHODSTotally 58 mild-to-moderate PAD patients were assigned to the control group (18 cases), the moxibustion group (20 cases), and the treadmill exercise group (20 cases) by random digit table. Patients in the control group received conventional drug therapy for 12 weeks. Patients in the moxibustion group and the treadmill exercise group additionally received moxibustion [at Zusanli (ST36), Sanyinjiao (SP6), Yongquan (KI1)] and treadmill exercise respectively, once per day, 5 times per week for 12 weeks in total. Ankle-Brachial Index (ABI) , transcutaneous oxygen tension (TcPO₂), 6-min walking test (6MWT), and walking impairment questionnaire (WIQ) were assessed before and after treatment.

RESULTSCompared with the control group and the same group before treatment, there was no statistical difference in ABI in the moxibustion group and the treadmill exercise group (P > 0.05). But TcPO₂, 6MWT, and WIQ were obviously elevated (P < 0.01). Besides, 6MWT and WIQ assessment of the treadmill exercise group were better than that of the moxibustion group (P < 0.01) after intervention.

CONCLUSIONMoxibustion and treadmill exercise could improve the exercise capacity and TcPO₂of lower limbers in PAD patients.

Exercise Test ; Exercise Therapy ; Exercise Tolerance ; Humans ; Lower Extremity ; physiopathology ; Moxibustion ; Oximetry ; Oxygen ; blood ; Peripheral Arterial Disease ; therapy ; Surveys and Questionnaires ; Walking

BACKGROUND: With the development and application of molecular biology and molecular genetic techniques,people research the production of human insulin by means of genetic engineering,and consider from the molecular level to reconstruct the cloning cell line which excretes insulin,so as to replace insulin injection and islet transplantation to treat diabetes mellitus.OBJECTIVE: To construct and screen human insulin gene eukaryon expression carrier of high performance.DESIGN: A randomized control experiment.SETTING: Experimental Animal Department of China Medical University.MATERIALS: Forty healthy adult Kunming mice of clean degree, weighing 20-30 g, half males and half females, were provided by the experimental animal center of Munitions University of Chinese PLA,and they were free to the access of the artificial granule food and water,and all the mice were lighted for 14 hours every day. Escherichia coli DH5α and BHK cell line were preserved by the experimental animal center.METHODS: Recombinant plasmid pEF1α-ImINS was constructed with routine method.The baby hamster kidney (BHK) cells were transfected with recombinant plasmid pEF1α-ImINS and other 3 recombinant plasmids of insulin, then screened with G418, and the positive clone cells were passaged to the 20th generation, the expressions of insulin and/or proinsulin in BHK cells were detected with radioimmunoassay and immunohistochemical technique. The PBS suspension (5×107) and the supernatant (0.5 mL) of the 20th generation BHK positive cells trasnfected with pEF1α-ImINS were injected intraperitoneally to each mice, the blood glucose was detected before and after injection to analyze the biological effect of the transgeneic product in decreasing blood glucose.MAIN OUTCOME MEASURES: The integration and expression of insulin gene in BHK cells and the changes of blood glucose before and after injection were mainly observed.RESULTS: The highest insulin expression was 7.984 mIU/L,the gray value of insulin expression was 177.50±5.10 in the cytoplasm of BHK cells, and 150.30±1.43 in the nuclear. The blood glucose at 6 hours after injection of the suspension of pEF1α-ImINS transfected BHK clone cell strain was obviously decreased,which was very significantly different from that at 24 hours before injection (P ＜ 0.01).CONCLUSION: The recombinant plasmid pEF1α-ImINS is the plasmid with the highest expression of insulin in BHK cells.The pEF1α-ImINS transfected clone cell strain has insulin expressions in the mice, and plays a role in decreasing the blood glucose of normal mice.

Background The study on normal stem cell markers provides a new way of thinking of that pathogenesis of cancer research and looking for specific markers of cancer stem cells.Importin13 (IPO13) is a novel nucleus-cytoplasm transport receptor protein of importin β family,the study on the biological behavior of IPO13 in ocular tissue and limbal neoplasms is lacking.Objective This study was to investigate the differential expression of IPO13 and p63 in human benign and malignant conjunctiva-cornea neoplasms.Methods The specimens of normal donor limbal and conjunctival tissues (6),conjunciva-cornea papilloma (CCP) (6) and conjunctiva-cornea intraepithelial neoplasia(CCIN) (6)were collected from Xiangya Hospital of Center South University.The expressions of IPO13 and p63 in the corresponding tissue were qualitatively and quantitatively detected using immunochemistry.The A values of IPO13 and p63 positive response were calculated and compared among the 3 types specimens.Results The immunohistostaining on frozen sections showed that IPO13 was expressed in nuclei of basal cells of limbal and conjunctival epithelium and the cellular nuclei of basal cells and suprabasal cells of CCP and CCIN epithelium.The A values of IPO13 positive expression were 1687± 1014,3546± 1375 and 7635 ±2854 in the normal limbal specimen,CCP and CCIN,respectively,showing a significant difference among them (F =7.23,P＜0.05),and the A value was higher in the CCP and CCIN than that in the normal limbal tissue (q =4.02,5.13,P＜0.05),and that in the CCIN was significantly elevated in comparison with CCP(q =3.45,P＜0.05).p63 was expressed in nuclei of basal cells and suprabasal of limbal,conjunctival and CCP epithelium,and was expressed in nuclei of the entire CCIN epithelium.The expressions of p63 in the normal conjunctiva-cornea tissue,CCP and CCIN were 2110± 1229,3966± 2129 and 6650± 2136 respectively,with significant difference among the three different specimens (F =6.17,P＜ 0.05),and the A value of p63 positive expression was significantly elevated in the CCP and CCIN compared with normal limbal specimen (q =4.33,5.01,P＜0.05),and that in the CCIN was significantly elevated in comparison with CCP(q=3.83,P＜0.05).Conclusions IPO13 is more specifical in marking the poorly differentiated cells in limbal epithelial proliferative lesions than p63.Compared with the normal limbal specimen,the expressions of IPO13 and p63 in CCP and CCIN specimens gradually upregulat,which suggests that IPO13 and p63 may play a positive regulatory role in conjunctiva-cornea proliferative lesions.The differential expression of IPO13 and p63 is predominant between benign and malignant limbal epithelial proliferative lesions,indicating that IPO13 and p63 may play an important role in regulating the abnormal proliferation and differentiation of limbal epithelial proliferative lesions.