BACKGROUND: Fibromyalgia is a kind of non-articular rheumatism,manifested as pain and stiffness in various parts of body, associated with sleep disturbance, fatigue, etc. But, the therapeutic effects of common therapies are not satisfactory.OBJECTIVE: To compare dermal neurological electric stimulation and electric acupuncture with routine medication and explore the therapeutic effects on fibromyalgia syndrome (FS).DESIGN: Randomized controlled experiment was designed, in which the patients were taken as the objects in observation.SETTING: First and Third Hospital Affiliated to Xinxiang Medical College.PARTICIPANTS: Totally 66 cases of FS were selected in Clinic of Rehabilitation Center of the First Affiliated Hospital of Xinxiang Medical College from July 1994 to May 2002, all of which were the followed-up cases.They were randomized as dermal-neurological eleetric stimulation group (DE group), electric acupuncture group (EA group) and medical group, 22cases in each one. The patients were aged varied from42 to 55 years and sick in range from 7 to 13 months.METHODS: ① DE group: FZ-1 low-frequency pulsating apparatus was used. Two pairs of electrodes were attached to two pairs of main points that were near to the most distinct pain points and another pair was attached to 1 pair of supplementary points. Continuous wave was selected, pulsating width was 6-150 ms, high frequency 100 Hz and 15 minutes later,changed to low frequency 2 Hz, for another 15 minutes, intensity about (14±3) mA, once/d, continuously for 20 days as one session, totally 2 sessions were required. 4-day rest was demanded between two sessions. ② EA group: No.28 filiform needle was used to be inserted on the points deeply,after qi arrival; G-6805 electric apparatus was applied on the points. Point selection, operation and time 9f treatment were same as DE group. ③ Medical group: Oryzanol and Vit B1 were administrated orally, 30 mg/tablet,3 times a day. Amitriptyline was administrated, 10 mg every day at beginning, increased by 10 mg every day till to 20-30 mg. It was taken orally once before sleep, totally for 45 days.MAIN OUTCOME MEASURES: ① Comparison of therapeutic effects on analgesia in each group. ② Comparisons of follow-up visits of cured cases and cases with remarkable effects in 6, 12 and 24 months after treatment.RESULTS: Totally 66 cases all entered the result analysis. ① Comparison of total effective rate of analgesia: The rates in DE group and EA group were higher significantly than medical group (100% ,95.5% ,68.2%;X2=18.03,17.27,P ＜ 0.01). ② Comparison of recurrence rate: The rates in DE group and EA group in 24 months after treatment were lower remarkably than medical group (7.1%,6.1%,50.0%;X2=7.01,6.91 ;P ＜ 0.05). CONCLUSION: Both dermal electric stimulation and electric acupuncture present strong analgesia and low recurrence rate. Dermal neurological electric stimulation on acupoints is a kind of non-traumatic method in treatment of fibromyalgia syndrome.

Objective To observe the effect of treadmill training on metabotropic glutamate receptor of a middle cerebral artery occlusion model in rat and its underlying mechanisms. Methods Sprague-Dawley male rats of 2 or 3 months old were randomly divided into 3 groups: a sham operation group, an iscbemia-reperfnsion group and a treadmill training group (subject to 2 weeks of training after the ischemia-reperfusion). All the animals were sacri-ficed after 2 weeks of training and their brains were sampled for measurement of the expression level of the striatum mGluR Ⅰ-mRNA, using RT-PCR technique. Results The striatum mRNA of mGluR1 and mGluR5 was signifi-cantly elevated in the ischemia-reperfusion group(P<0.01), but treadmill training significantly suppressed the ele-vation of the expression of mRNA of mGluR1 and mGluR5 (P<0.01). Conclusions Treadmill training can signif-icantly downregulate mGluR Ⅰ-mRNA expression. This might be one of the important mechanisms for inhibition of the excitatory glutamate production.

The present article introduced the current medical education of the Feinberg School of Medicine in Northwestern University.Thmugh the comparisons on edueation system and carriculums design between United States of America and China,advices were made to the medical education in China.The article shed light on the current reform of medical education in China.

Objective To explore the relationship between the endovascular aortic repair (EVAR)in patients with abdominal aortic aneurysm (AAA) and postoperative systemic inflammatory response syndrome (SIRS).Methods In this study,93 AAA patients undergoing EVAR were enrolled.Analysis was performed to evaluate the incidence of SIRS during peri-operation period.Logistic multiple regression analysis was performed to determine the parameters predicting SIRS.Results The incidence of SIRS was 58.1％.Aneurysm size,mural thrombus,iliac artery lesion,number of stent,operating time,volume of contrast agent,blood loss and length of stay were all significantly correlated with SIRS (P ＜ 0.05).In a logistic regression model,history of kidney disease or operation,aneurysm size,ruptured aneurysm and number of stents were strongly and independently associated with SIRS.Conclusions SIRS is common in AAA patients after EVAR.Optimizing treatment strategies avoiding risk factors for SIRS benefits AAA patients.

This paper introduced vascular surgery residency program in Northwestern Memorial Hospital including application process,training mode,program content and scientific training.This paper also made comparison in surgical residency program between United States and China and put forward the proposal for the implementation of Chinese main land vascular surgery residency training program.

This study compared the decoction's HPLC figures of the different processed rhizomes of Cibotium barometz including the raw, the sand-baked, the wined, the steamed and the salted, on the basis of which, with the sand-baked Drynaria fortunei decoction as the positive control group, comparingall groups' decoction, concentration of which was 104.2 g x L(-1), for 4 weeks, by their effects (s-TRAP and total scores of OPG, Ca, P, IL-6, TNF-alpha and IL-1) on retinoic acid induced male rats osteoporosis. The experiment results showed the sand-baked and the wined were better than the steamed, the salted and the raw;in the processing methods' selection, the sand-baked was a better heating method than the steamed and the rice wine was the better excipient than the salt. It provided a reference to explain the processing principle of rhizomes of C. barometz and work mechanism of anti-osteoporosis.
Animals ; Biomarkers ; blood ; Chromatography, High Pressure Liquid ; Drug Compounding ; methods ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; therapeutic use ; Male ; Osteoporosis ; blood ; chemically induced ; drug therapy ; Pteridophyta ; chemistry ; Rats ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; Tretinoin ; adverse effects

Objective To characterize the changes in the dimensions during systolic and diastolic periods in the aorta with ECG-gated multi-detector CTA scans.Methods The CT angiograms of 115 patients (78 males,mean age 55.2 ± 9.4 years;37 females,mean age 60.1 ± 8.5 years) both in systolic and diastolic periods were obtained on a 64-slice ECG-gated multi-detector CT scanner.The diameters were measured at four anatomic levels of the aorta.(Level A:1 mm proximal to the innominate artery;Level B:1 mm distal to the left common carotid artery;Level C:1 mm distal to the left subclavian artery;Level D:10cm distal to the left subclavian artery).On each level,the maximal and the minimal diameters were measured both in systolic and diastolic periods.Results The paired sample t test results showed a significant difference between the systolic and diastolic diameters in all individual subjects on every level (P ＜0.001).The mean maximum diameter changes were 1.95％ (range-2.0％ to 7.0％),2.12％ (range-3.0％ to 6.0％),1.88％(range-1.0％ to 8.0％)and2.47％(range-3.0％ to 10.0％)at level A,B,C and D,respectively.The mean minimum diameter changes were 1.43％ (range-3.0％ to 5.0％),2.67％ (range-2.0％ to 11.0％),1.75％ (range-14.0％ to 9.0％)and 2.99％ (range -2.0％ to 11.0％) at level A,B,C and D,respectively.Conclusions The differences of the aortic diameters between systolic and diastolic periods are significant.The pulsatility of aorta in Chinese population may be different from published Western literature.

Objective To analyze the effect of Shuxuetong injection on microcirculation in patients with septic shock and its therapeutic effect. Methods A prospective study was conducted. Eighty patients with septic shock treated in Department of Critical Care Medicine of Hebei Provincial Traditional Chinese Medical Hospital were randomly divided into a Shuxuetong group and a conventional therapy group according to random number table, 40 cases in each group. The conventional treatment in the two groups was energetically carried out in accord to the sepsis shock guidelines, such as positive fluid resuscitation, anti-infection, etc. In the Shuxuetong group, additionally Shuxuetong injection 6 mL in 5% glucose injection 250 mL intravenous drip was given once a day for 7 days. The levels of urine output, lactic acid (Lac), blood urea nitrogen (BUN), creatinine (Cr), aspartate aminotransferase (AST), alanine aminotransferase (ALT), left ventricular ejection fraction (LVEF), and cardiac index (CI) in the two groups were observed before and after treatment; the total dosages of dopamine, dobutamine, noradrenaline, etc. vascoactive agent used for the patients and 28-day mortality in the two groups were also recorded. Results The comparisons of levels of urine output, Lac, BUN, Cr, AST, ALT, LVEF, and CI before treatment between the two groups were of no statistical significant differences (all P>0.05). After treatment in the two groups, the urine output, LVEF, and CI were increased compared with those before treatment, whereas the Lac, BUN, Cr, AST, and ALT were significantly decreased, and the changes were more obvious in Shuxuetong group [urine output (mL/h):112.1±39.8 vs. 73.3±28.5, LVEF:0.49±0.15 vs. 0.44±0.14, CI (mL·s-1·m-2):66.2±5.7 vs. 54.2±6.2, Lac (mmol/L):3.83±1.65 vs. 4.72±2.25, BUN (mmol/L):7.1±2.7 vs. 9.3±3.5, Cr (μmol/L): 73.9±16.2 vs. 95.7±15.8, AST (U/L): 39.8±9.5 vs. 45.8±12.7, ALT (U/L):34.3±9.7 vs. 41.7±11.3, all P<0.05]. The total dosages of all kinds of vascoactive agent of Shuxuetong group were remarkably less than those in the conventional therapy group [dopamine (mg): 993.1±261.7 vs. 1 340.9±356.4, dobutamine (mg):776.2±281.0 vs. 1 049.2±364.3, noradrenaline (mg):56.4±34.6 vs. 107.6±51.3, all P<0.05]. The 28-day mortality of Shuxuetong group was obviously lower than that of conventional therapy group [40.0%(16/40) vs. 60.0%(24/40), P<0.05]. Conclusion Shuxuetong injection can improve the microcirculation perfusion in patients with septic shock and reduce their mortality.

In order to analyze the immunogenicity of the recombinant EG95s protein ,the recombinant plasmids of pET-1EG95s ,pET-2EG95s and pET-3EG95s which containing respectively 1 ,2 ,and 3 copies EG95s were induced to express HIS-1EG95s ,HIS-2EG95s and HIS-3EG95s ,and then the proteins were purified and identified by western-blotting .The same im-mune process was used ,and 8 weeks-old BALB/c mice were immunized ,then its immunogenicity was analyzed by detecting an-tibody levels in mice by indirect ELISA method .Results showed that for recombinant EG95s proteins after transformation , HIS-1EG95s ,HIS-2EG95s ,and HIS-3EG95s also retained immunogenicity and could induce specific antibodies in mice .One week's late after the first immunization with HIS-1EG95s ,the antibody level of was significantly higher than HIS-2EG95s and HIS-3EG95s .But began from 2 weeks after immunization ,the antibody level of HIS-3EG95s was always higher than that of HIS-1EG95s group during the period of the immune .Both the final antibody titers after immunization of HIS-1EG95s and HIS-2EG95s groups was 1∶819 200 ,while HIS-3EG95s group was 1∶163 840 0 .HIS-1EG95s ,HIS-2EG95s and HIS-3EG95s all induced IFN-γin immune mice ,but the difference was not significant .The HIS-1EG95s showed lower response to Echinococ-cus granulosus positive serum than HIS-2EG95s and HIS-3EG95s .It’s indicated that the HIS-1EG95s and HIS-3EG95s also had good immunogenicity .HIS-3EG95s make recombinant protein immunic effects more lasting ,and benefit to generate more long-lasting protective immunity .This study provides the scientific basis for the immunization of echinococcosis (hydatidosis) .

Objective To detect and analyze thyroid tumor by two-dimensional sonogram and Doppler parameter, and evaluate the value of high-frequency ultrasound in diagnosing thyroid benign and malignant tumors. Methods The ultrasonic images of 104 thyroid tumor from 80 patients with typical features were collected. Thyroid tumor was classified into benign and malignant nodules, based on the shape, border, or the rear wall echo, echo attenuation loss, internal echo, and microcalcifications in two-dimensional sonogram and systolic blood peak velocity (Vmax) and resistant index (RI) in Doppler examination. The expected results of high frequency ultrasound were compared with pathological results on consistency and error rate. Results Prediction of benign tumor by high frequency ultrasound was 66, and pathology 61, consistency rate of the two was 92.4%. Prediction of malignant lesions was 38, and pathological examination 32, consistency rate of the two was 84.2%. The total coincidence rate was 89.4%(93/104) and the error rate was 11.6%( 11/104). Conclusions The typical features of thyroid tumor on high-frequency ultrasound are helpful in diagnosis of benign or malignant nodules, which is valuable in guiding clinical treatment.