OBJECTIVETo compare the difference in the efficacy between acupuncture and oral administration of trazodone and the expressions of neurotransmitters in patients of insomnia differentiated as liver stagnation transforming into fire.

METHODSSeventy patients of insomnia differentiated as liver stagnation transforming into fire were randomized into an observation group and a control group, 35 cases in each one. In the observation group, acupuncture therapy was adopted at Shenmen (HT 7), Baihui (GV 20), Yintang (GV 29), Hegu (LI 4), Taichong (LR 3), etc. The needles were retained for 20 min each time. The treatment was given once a day, the treatment of 2 weeks made one session. In the control group, trazodone, 100 mg, oral administration, once a day, the treatment of 2 weeks made one session. Two sessions were required in the two groups. The scores in Pittsburgh sleep quality index (PSQI) and Asberg rating scale for side effects (SERS), the levels of neurotransmitters such as 5-hydroxy tryptamine (5-HT) and norepinephrine (NE) and the expressions of protein kinase C (PKC) and brain-derived neurotrophic factor (BDNF) in peripheral blood were observed before and after treatment in the two groups.

RESULTSPSQI score and SERS score after treatment were all decreased compared with those in both groups before treatment (both P<0. 05). After treatment, PSQI score and SERS score in the observation group were lower apparently than those in the control group (both P<0. 05). After treatment NE content and PKC level were decreased; 5-HT content and BDNF mRNA were increased compared with those in both groups before treatment (all P<0. 05). NE content and PKC level in the observation group were lower apparently than those in the control group (both P<0. 05). The serum 5-HT content and BDNF mRNA expression in the observation group were higher than those in the control group separately (both P<0. 05).

CONCLUSIONAcupuncture therapy improves the sleeping quality of patients of insomnia differentiated as liver stagnation transforming into fire, and reduces serum NE level and increases 5-HT content and BDNF expression, which achieves the better efficacy as compared with the oral administration of trazodone. It is one of the effective approaches to the treatment of insomnia differentiated as liver stagnation transforming into fire.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Brain-Derived Neurotrophic Factor ; genetics ; metabolism ; Female ; Humans ; Liver ; physiopathology ; Male ; Neurotransmitter Agents ; genetics ; metabolism ; Norepinephrine ; genetics ; metabolism ; Serotonin ; metabolism ; Sleep Initiation and Maintenance Disorders ; genetics ; metabolism ; physiopathology ; therapy ; Treatment Outcome

Objective To investigate and analyze the effect and insulin dosage of continuous subcutaneous insulin infusion(CSII) in type 2 diabetes.Methods 106 hospitalized patients with type 2 diabetes,who had poorly controlled blood glucose,were treated by insulin pump for 8 days,without oral hypoglycemic agents.The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed.The related foctors for the therapeutic effects were analyzed.Results When blood glucose were well controlled,the mean time was 5.4±1.8 days,the(basal) insulin was 0.23±0.07(u/kg,day),the bolus before breakfest was 0.12±0.05(u/kg),the bolus before dinner was 0.14±0.06(u/kg),the bolus before supper was 0.14±0.06(u/kg).The dosage of insulin was decreased after blood glucose were well controlled.The frequency of hypoglycemia was 0.04±0.21(times/per patient),the frequency of biochemical hypoglycemia was 0.07±0.25(times/per patient) and reaction of hypoglycemia was 0.96±1.18(times/per patient).Conclusions The hyperglycemia of type 2 diabetes could be corrected by intensive insulin pump within 5-6 days.Multiple regression showed that fasting blood glucose and age were the factors that affect the time for blood glucose to be targeted.Duration of diabetes,fasting and postprandial blood glucose levels before treatment affect the required insulin dosage.

OBJECTIVE:To establish a method for quick content determination of clobetasol propionate in temeifu pigmentum.METHODS:UV spectrophotometry was used,and the determination was performed at the wavelength of 240nm.RES-ULTS:The detectable concentration of clobetasol propionate have a good linear relationship with its absorbability in the range of 12～18?g/ml.The inter-day and intra-day average recoveries were 99.87%(RSD=1.21%) and 99.79%(RSD=1.01%),respectively.CONCLUSIONS:The present method is rapid and accurate,which can be widely used in small hospitals not equipped with high performance liquid chromatography.

ObjectiveTo explore the value of acupuncture in treating insomnia due to stagnated liverqi transforming into fire and its theoretical foundation, by observing the treatment effect of acupuncture in treating insomnia due to stagnated liverqi transforming into fire and its influence on 5-hydroxy tryptamine (5-HT) content.MethodTotally 187patients with insomnia due to stagnated liver qi transforming into fire were selected and randomized into two groups. The 93 cases in the control group were intervened by orally taking Trazodone, 100 mg for each dose, twice a day, 10 d as a course, totallyfor 2 courses; the 94 cases in the observation group were intervened by acupuncture at Shenmen (HT7), Baihui (GV20), Yintang (GV29), Hegu (LI 4), and Taichong (LR 3), once a day, 10 d as a treatment course, totally for 2 courses. Peripheral blood was collected from the two groups before and after intervention to detect the change of 5-HT content. Meanwhile, the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD, 24-item version), Asberg Rating Scale for Side Effects (SERS), and clinicalefficacies were assessed.ResultThe difference in 5-HT content between the two groups was statistically insignificant before intervention (P>0.05); 5-HT contents were significantly increased in both groups after intervention (P<0.05), while the content in the observation group was markedly higher than that in the control group (P<0.05); after treatment, the PSQI and HAMD scores were decreasedin both groups (P<0.05), while the PSQI, HAMD, and SERS scores in the observation group were markedly lower than those in the control group (P<0.05);the total effective rate was 92.6% in the observation group, significantly higher than 81,7% in the control group (P<0.05). ConclusionAcupuncture can significantly down-regulate 5-HT content in insomnia patients, and its total effective rate is higher than that of medication.

Objective To investigate the effects of metabolic syndrome (MS) and the cardiocerebrovascular risk factors such as essential hypertension (EH), diabetes mellitus (DM), and lipid metabolise disturbance on the subtypes of acute cerebrovascular disease (ACVD). Methods A total of 502 ACVD patients were studied, including 121 cases of intracerebral hemorrhage (ICH) and 381 cases of cerebral infarct (CI). The effects of MS, EH, DM, and blood lipids on the subtypes of ACVD were analyzed. Results The ratio of all subtypes of ACVD combined with EH was significantly higher than that of the control group ( P 0.05). Additionally, the concentration of total cholesterol in the ischemic group was significantly lower than that in the control group ( P

Abdominal Neoplasms ; genetics ; metabolism ; pathology ; Chromosomes, Human, Pair 20 ; genetics ; Chromosomes, Human, Pair 8 ; genetics ; Fibromatosis, Aggressive ; etiology ; genetics ; metabolism ; pathology ; Genes, APC ; Humans ; Mutation ; Trisomy ; beta Catenin ; genetics ; metabolism

Objective To evaluate the features of pelvic lymph node metastasis and the significance of lymph node dissection in bladder cancer patients treated with radical cystcetomy. Methods The data of 77 bladder cancer patients(58 males and 19 females with mean age of 57 yrs)treated with radical eystectomy and pelvic lymph node dissection from Jan. 1990 to Dec.2008 were analyzed retrospectively.Preoperative TNM staging showed stage T1 tumor of 9 cases,stage T2 of 24 cases,stage T3 of 39 eases and stage T4 of 5 cases.The pelvic lymph nodes were divided into 5 groups according to the anatomic sites.The metastatic rate and dissected lymph node positive rate in these patients were compared. Results The metastatic rate and dissected lymph node positive rate were 27.3%(21/77)and 14.8%(233/1576),respectively.The metastatic rate in these patients from higher to lower were as follows:obturator group 19.5%(15/77),internal iliac group 19.3%(11/57),external iliac group 13.7%(10/73),common iliac group 5.3%(3/57)and presacral group 3.8%(1/26),with a significant difference in those groups,P<0.01.The dissected lymph node positive rates from higher to lower were as follows:external iliac group 23.0%(83/361),obturator group 22.1% (103/467),common iliac group 9.5%(17/179),internal iliac group 6.8%(28/411)and presacral group 1.3 % (2/158), with a significant difference in those groups, P<0.01. There was no metastasis in 9 eases with stage T, tumor. Conclusions In the radical cystectomy for the treatment of bladder cancer, it is suggested that the regional lymph nodes with higher metastatic rate should he resected accordingly, and the group with a higher metastatic rate should be dissected completely. The operation extent may be adjusted according to the result of sentinel lymph node biopsy in the obturator or presacral groups. The pelvic lymphadenectomy is not suggested in the cases of stage T1 tumor.

As an endogenous organism protective measure in vivo, preconditioning/ postconditioning in the process of ischemia/reperfusion may play common protective mechanisms, such as reducing the generation of oxygen free radicals, activating adenosine receptor, increasing endogenous nitric oxide and heat shock protein, inhibiting immune inflammatory response and neuronal apoptosis, activating intracellular signal transduction pathways, opening mitochondrial ATP-sensitive potassium channels, as veil as closing mitochondrial permeability transition pores. Investigating the common target of these mechanisms may provide a new theoretical basis for developing new drugs and reducing ischemia/reperfusion injury.

Objective To investigate the effect of dexmedetomidine on minimum alveolar concentration (MAC) of isoflurane required to inhibit the body movement during skin incision. Methods Forty-eight ASA Ⅰ or Ⅱ patients aged 40-60 yr with body mass index of 22-27 kg/m2 undergoing elective upper abdominal surgery under general anesthesia were randomly divided into 3 groups: control group (group C, n = 15);low dose dexmedetomidine group (group D1, n = 17) and high dose dexmedetomidine group (group D2, n = 16). The patients were unpremedicated. Dexmedetomidine 0.4 and 0.8 μg/kg in normal saline (NS) 15 ml was infused over 15 min before induction of anesthesia in D1 and D2 groups respectively. Anesthesia was induced with fentanyl-propofol-succinylcholine. The patients were mechanically ventilated after tracheal intubation. Anesthesia was maintained with isoflurane. MAC of isoflurane was determined by up-and-down technique. The initial end-tidal isofiurane concentration was set at 1.0%, 0.8% and 0.6% in C, D1 and D2 groups respectively. Each time the end-tidal isoflurane concentration was increased/decreased by 0.2%. Skin incision was made after 15 min of equilibration, when the twitch height returned to more than 90% of its control value. Movement of body and limbs including swallowing and coughing were carefully looked for when skin incision was made. MAC of isoflurane was the mean of end-tidal concentration of isoflurane of each crossover pair, and 95 % CI was calculated. Results MAC of isoflurane was significantly decreased in D1 and D2 groups as compared with group C and in group D2 as compared with group D1( P ＜ 0.05 or 0.01 ). Conclusion Dexmedetomidine can significantly decrease MAC of isoflurane required to inhibit the body movement during skin incision in a dose-dependent manner.

To compare the characteristics of the traditional Chinese medicine (TCM) syndromes of gallbladder heat attacking the stomach and stagnant heat of the liver and stomach in patients with reflux esophagitis (RE), in terms of clinical symptoms, combination of gallbladder conditions, esophageal mucosal inflammation, gastric bile reflux under endoscopy and helicobacter pylori (HP) infection.