OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

The crude toxin was extracted from hypha and culture solution of Phyllosticta commelimecola through three different polarity solvent: benzinum, puncificatum ethyl acetate and chloroform. The result indicated that the toxin secreted by Phyllosticta commelimecola not only was in hypha but also in culture solution and the extracting effect of ethyl acetate was the best. The soybean median and PSK media can be respectively used as solid and liquid culture media to produce toxin and grow mycelium. The optimal cultural conditions for producing toxin were temperature 32℃,cultured period 14d, cultured ways shaking of 150r/min.

Objective To evaluate a method named “one-step procedure”,i.e.,combined duode-noscopy,laparoscopy and choledochoscopy for choledocholithiasis accompanied with cholecystolithiasis.Meth-ods Fifty-three cases with gallbladder stones combined with common bile duct stones diagnosed from February 2012 to February 2014 were assigned to two groups,29 cases in “one-step procedure”group,who underwent duodenoscopy,laparoscopy and choledochoscopy in one operation,and 24 cases in the control group,who first-ly underwent endoscopic sphincterotomy to remove common bile duct stones,and then LC was performed after several days.The rate of complications related to the procedure,success rate of complete stone removal,length of hospital stay and hospitalization expenses were compared between the two groups.Results All 53 patients underwent the surgery and ERCP procedure successfully.There were no significant differences between the“one-step procedure”group and the control group in complication rates[3.4%(1 /29)VS 12.5%(3 /24),P =0.21],complete stone removal rates[96.6%(28 /29)VS 100.0%(24/24),P =0.37].Differences were sig-nificant in length of hospital stay (6.7 ±1.3d VS 10.9 ±1.6d,P <0.01 )and hospitalization expenses (15 724 ±1 613 yuan VS 19 829 ±2 433 yuan,P <0.05)between the “one-step procedure”group and the control group.Conclusion The “one-step procedure”,the combined duodenoscopy,laparoscopy and chole-dochoscopy,is safe,effective,and has smaller length of hospital stay and lower hospitalization expenses.

Objective To explore a new model of medical humanity education in new situation. Methods Extensive survey was carried out among medical students,and discussion and consultation were hold to faculty and education administers.A new teaching model was established. Results A curriculum system with 1 or 2 core courses supported by some elective courses and social practice is under the process of implementation and achieved preliminary success.Conclusion The medical humanity education should pay attention to the development of connotation instead of pursuing the extension of quantity blindly,which means that students' school work must be eased by focusing on self-study and self-education.Medical students'life path with high-minded personality training should be strengthened.

OBJECTIVETo observe the clinical efficacy difference between segmentation scraping and conventional acupuncture for cervical spondylosis (CS) so as to provide effective treatment method.

METHODSEighty-five cases of cervical type of CS were randomly divided into a scraping group (44 cases) and an acupuncture group (41 cases). The segmentation scraping therapy was used in the scraping group. The scraping group was treated with focusing on scraping the head and joint part of neck and occiput in the upper cervical spine injury, and focusing on scraping the lower section of cervical and shoulder in the lower cervical spine injury, once every seven days, totally for 3 times. In the acupuncture group, Fengchi (GB 20),Wangu (TE 5), Tianzhu (BL 10),Neck-Jiaji (EX-B 2), etc. were selected,once daily,for 15 days. The visual analogue scale (VAS) was used to evaluate the immediate analgesic effect after the first treatment and the clinical efficacy was observed after the end of treatment.

RESULTSAfter the first treatment, the score of VAS was decreased significantly in the scaping group (P < 0.01), but there was no significant difference in the acupuncture group compared with those before treatment (P > 0.05); the score of VAS in the scaping group after the first treatment was lower than that in the acupuncture group (3.66 +/- 0.74 vs 5.43 +/- 0.35, P < 0.01). Compared with before treatment, the scores of VAS were decreased significantly after treatment in two groups (both P < 0.01), but without significant difference between two groups (P > 0.05); the effective rate was 95.5% (42/44) in the scaping group and 87.8% (36/41) in the acupuncture group, the curative effects were similar (P > 0.05).

CONCLUSIONBoth of scraping and acupuncture therapies have good analgesic effect for cervical spondylosis, and overall effects are similar, but the immediate analgesic effect of scraping thrapy is better than that of conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Neck Pain ; therapy ; Spondylosis ; therapy ; Treatment Outcome

OBJECTIVETo explore the clinical effect of Agkistrodon antithrombogenase (AAT) in the treatment of rheumatoid arthritis (RA) and its possible mechanism.

METHODSBesides the conventional non-steroid anti-inflammatory agents and disease-modifying anti-rheumatic drug, patients were treated supplementally with intravenous injection of AAT. The intracutaneous test showed allergic to AAT patients were treated with Salvia injection and taken as control group. Changes of related clinical indexes in the two groups were observed.

RESULTSAfter 3 weeks treatment, condition of patients in both groups were improved clinically in joint swollen index, joint tenderness index, morning stiffness time, pain assessment (VAS) and health assessment questionnaire (HAQ) on daily life activity as well as ESR level (P < 0.05 or P < 0.01), with the VAS, HAQ and fibrinogen levels more significantly improved than those of control (P < 0.05 or P < 0.01), and the total effective rate higher in the AAT treated group than those in the control group (P < 0.05).

CONCLUSIONAAT has good effect on easing clinical symptoms of RA possibly through anti-inflammation and improving the microcirculation with less toxic and adverse reaction, so is worthy of recommendation.

Adult ; Ancrod ; therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Crotalid Venoms ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

Objective To investigate the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.Methods Two hundred and sixteen ASA Ⅰ-Ⅲ patients aged 18-80 yr undergoing vascular free flap reconstruction surgery were enrolled in this study.Patient characteristics before and during operation were recorded.The patients were followed up for 5 days after operation.Their level of consciousness,severity of pain and sleep quality were evaluated daily.The patients were divided into 2 groups according to the occurrence of delirium during the 5 days after operation:delirium group and non-delirium group.The method of CAM-ICU was reed in the diagnosis of postoperative delirium.Multivariate logistic regression was used to analyze the risk factors for postoperative delirium.Results logistic regression analysis showed that old age,history of alcohol abuse and sleep diacrder after operation were risk factors for delirium developed after free flap surgery.Conclusion Old age,history of alcohol abuse and sleep disorder after operation were the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.

Adolescent ; Adult ; Aged ; Cerebellar Neoplasms ; physiopathology ; Cerebellopontine Angle ; Child ; Humans ; Male ; Middle Aged ; Vestibular Evoked Myogenic Potentials ; Young Adult

Purpose: Neoadjuvant chemotherapy (NAC) can effectively downstage locally advanced breast cancer; however, in some cases the cancer remains clinically stable and in others, there is disease progression. Although factors predictive of the response to NAC have been established, those for a non-response remain unknown. This study investigated factors predicting a stable or progressive disease course, and the extent of the response, after NAC based on anthracycline and cyclophosphamide (AC), with or without taxane. Methods: Data were collected retrospectively by reviewing medical records of patients who received NAC for breast cancer using AC, with or without taxane between January 2013 and December 2017. Patients with clinically stable or progressive disease after NAC were compared statistically with those who achieved a partial or complete response. Results: In total, 297 patients received NAC with AC and 196 patients received AC followed by taxane. Of these, 45 (15.2%) and 64 (32.6%) patients respectively, showed no response (i.e., stable or progressive disease). Factors related to non-response after AC included large pretreatment tumor size, clinical T3 status, and high histologic grade. Factors related to non-response after taxane included clinical T3 status and estrogen receptor or progesterone receptor positivity. Conclusion Clinical T3 stage, grade III histological grade, and estrogen or progesterone receptor positivity were predictors of no response to NAC for breast cancer.

Adult ; Bone Neoplasms ; diagnosis ; surgery ; Female ; Humans ; Osteoblastoma ; diagnosis ; surgery ; Patella