Objective:To observe the clinical effects of acupuncture at Jiaji (EX-B 2) points plus tuina manipulation for thoracic facet joint disorder, and get new clinical evidence for treatment of thoracic facet joint disorder. Methods:Totally 106 patients with thoracic facet joint disorder were randomly allocated into an observation group and a control group based on the random number table. Patients in the control group were treated by tuina manipulation, while those in the observation group were treated by acupuncture at Jiaji (EX-B 2) points before tuina manipulation. Patients in the two groups were treated once a day. The improvements of signs and symptoms and the efficacy were observed after 3 treatments. Results:After treatment, there were intra-group statistical differences in scores of 8 signs and symptoms in both groups (P<0.01); the score of each item in the observation group was lower than that in the control group, and there was statistical significance in the inter-group difference (P<0.05). The cure rate of the observation group was 50.9%, versus 26.4% in the control group, and there was a significant difference between the two groups (P<0.05). Conclusion:In treating thoracic facet joint disorder, acupuncture plus tuina manipulation can restore the biomechanical balance of thoracic vertebrae, fully maximized the combined effect, and significantly improve the clinical efficacy.

0. 05), and were closely correlated to the clinical stage and the curative effect(P 0. 05). Conclusions: VEGF expression was contributes to the tumor neovascularization and tumor metastasis. Local control rate of VEGF positive tumor patients can be increased but their survival can not be prolonged by mono-chemotherapyonly only.

Objective To observe the expression of matrix metalloproteinase(MMP-2, MMP-9 and vascular endothelial growth factor (VEGF) in retinoblastoma (RB) and its relationship with the differentiation and optic nerve infiltration of RB. Methods Forty paraffin specimens of pathological confirmed RB were studied. They were divided into differentiated group (15 cases) and undifferentiated group (25 cases) , optic nerve infiltration group( 13 cases) and without optic nerve infiltration group(27cases). The expression of MMP-2, MMP-9 and VEGF were detected by immunohistochemistry, their relationships with the differentiation and optic nerve infiltration were also analyzed. Results The positive rate of MMP-2, MMP-9 and VEGF expression in 40 RB cases were 52.5%, 57.5% and 72.5%respectively. The expression of MMP-2, MMP-9 and VEGF in the undifferentiated group were significantly higher than those in the differentiated group (χ2= 9. 037, 9. 253, 8. 095;P＜0. 05). The expression ofMMP-2, MMP-9 and VEGF in RB with optic nerve infiltration group were significantly higher than those in RB without optic nerve infiltration group (χ2=11.045,10. 243, 8. 956;P＜0. 05). The expression of MMP-2,MMP-9 had a positive correlation with the expression of VEGF in RB (r= 0. 126, 0. 314;P ＜ 0. 05).Conclusions MMP-2, MMP-9 and VEGF expressed in RB tumor tissues. The expression of MMP-2,MMP-9 has a positive correlation with the expression of VEGF. The levels of MMP-2, MMP-9 and VEGF expression are related to optic nerve infiltration of RB cells.

Objective The purpose of this study was to assess the effectiveness and safety of distal filtration protection devices during carotid artery stenting.Methods Between June and July in 2002, carotid artery stenting (CAS) were performed in 4 patients with asymptomatic severe carotid artery stenosis. Self-expendable stents (Smart, Cordis) and distal filtration devices (Angioguard XP, Cordis) were used in all patients. Primary endpoints were perioperative neurologic complications and mortality. Data were collected prospectively.Results All patients were male, their age were 59?4 years old. One patient had history of transient ischemic attacks(TIAs); and another had inferior myocardial infarction, and right coronary intervention was performed before CAS, and another one underwent CABG 6 months ago. There were two right internal carotid and two left internal carotid severe lesions (82.5?6.0)% were treated. The filtration devices and stents were delivered and deployed successfully in all target artery (technical success rate was 100%) and

Objective To investigate the safety and feasibility of carotid artery stenting (CAS) and evaluate its clinical outcomes. Methods From July 1998 to December 2003, 30 consecutive patients with 32 lesions underwent extracranial CAS procedures. Thirteen patients had a history of stroke or TIAs, 22 were hypertensive, 11 were diabetic and 8 had history of MI. Neurological assessment, Carotid duplex ultrasound, carotid and intracranial angiography were done before CAS in all patients. All the cases were done percutanously from femoral arteries and stenting was applied in all procedures. Carotid duplex ultrasound, cardiac and neurological elevation were performed post procedure. Results 30 patients (26 male and 4 female) underwent a total of 32 CAS procedures. Total 32 self-expandable stents and 1 tubular stent were implanted in all the cases. Direct stenting technique was applied in 9 cases. The other 21 procedures were performed with distal filtration supporting devices. The device can not be delivered due to tortuous target vessel in one case (success rate 95%) and CAS success rate was 97%. The particles were found in all filter baskets. Four patients underwent coronary artery bypass grafting 1 month later post CAS without perioperative neurological and cardiac events. One patient had contralateral cerebral hemorrhage during CAS and died three days later. Another patient died three days after CAS due to acute pulmonary edema. No restenosis was found by means of carotid duplex ultrasound during the follow-up (3-60 months) study. Conclusion CAS is safe and feasible in preventing ischemic stroke. This new alternative has satisfied clinical outcomes in managing cardiac and neurological ischemic diseases. Operative embolic complication can be potentially prevented by neurological protective device.

Background and purpose:Angiofollicular lymphoid hyperplasia(Castleman's disease,CD) is a rare kind of abnormal disease with lymphoid hyperplasia. We analyzed the clinical data of 21 patients with pathologically-confirmed CD. Methods:Twenty-one cases,including 10 males and 11 females with a mean age of 38.6 years,with CD were collected from January 1971 to December 2007 in this study. The disease was divided into localized type(n=19) and disseminated type(n=2) . The clinical data,CT images and pathological and surgical results were restrospectively analyzed. Results:All cases were categorized as hyaline vascular type. In 19 cases with localized type of CD,the lesion presented as a solitary soft-tissue mass with a mean diameter of 5.2 cm,located at the left and right hilus of the lung(n=3 and 2 respectively) or in the interior lung(n=3) ,in the thoracic wall(n=2) or in the mediastinum(n=9) . Two cases of disseminated type were characterized by many groups of thoracic lymphadenopathy with a mean diameter of 2.3 cm,without other organ involvement. On plain CT scan,the mean CT value was 42 Hu. After contrast administration,obvious homogeneous enhancement was observed in arterial phase with CT value of 112 Hu. The preoperative misdiagnosis by CT was 90.5%. Conclusion:CD have no specifi c CT characteristic,its verifi cation is mainly based on pathologic examination. Surgical resection for localized type of CD is curative,but for disseminated CD,multidisciplinary therapies are recommended.

Objective To study the status of prevalence of hyperlipidaemia among rural residents aged from 30 to 59 in Changzhou and provide evidence for taking prevention measures.Methods By the means of the cluster random sampling,a questionnaire survey and medical examination were conducted among 10 018 permanent residents in rural areas of Changzhou.The fasting plasma cholesterin(TC),triglycerides(TG),high density lipoprotein-C(HDL-C) were measured.Age-standardized prevalence rates were calculated by using the direct standardization method according to 2000 China population census.Results The prevalence of hyperlipidaemia of this population was 32.3%,the age-standardized prevalence was 31.3%,and the prevalence among men was significantly higher than women(P

Objective To construct the short hairpin RNA (shRNA)-expressing plasmid vectors specific for BRAF gene, and to test their effects in BRAF knockdown in human melanoma cell lines. Methods Two pairs of specific BRAF shRNA oligoes and a pair of randomly synthesized non-specific shRNA oligo were synthesized and inserted into plasmid pGenesil-1. Their fidelity was confirmed by double endonuclease digestion and sequencing. The constructed plasmids were transfected into human melanoma cell lines A375 and M14. The expression of BRAF mRNA and BRAF protein were detected by RT-PCR and Western blotting, respectively. Results The designed shRNA oligoes were precisely cloned into the plasmid pGenesil-1. The expression of BRAF mRNA and protein were down-regulated by specific plasmid braf 1 and braf 2, except to non-specific plasmid neg. The plasmid braf 1 was more effective, reducing BRAF gene expression by 90 per cent. Conclusions Plasmid mediated shRNA could successfully knockdown BRAF expression in human melanoma cells, and the suppression of the gene expression could maintain for 1 month at least.

Objective To study the inhibitory effects of siRNA targeting survivin on the expression of survivin,as well as the apoptosis,proliferation and invasion of a human melanoma cell line,M14.Methods Two siRNAs targeting survivin were designed,chemically synthesized,and used to construct the recombinant plasmids,pRAT-H1.1/neo-survivin-siRNA1 and pRNAT-H1.1/neo-survivin-siRNA2.Then,recombinant plasmids were transfected into M14 cells mediated by Lipofectamine 2000 reagent.Those cells untransfected or transfected with empty vector served as the control.After culture over various periods of time.cells were collected for the detection of mRNA and protein expression of survivin with RT-PCR and Western blotting,respectively,and for the examination of apoptosis and proliferation of M14 cells by flow cytometry and MTT methods,respectively.Also,Transwell assay was performed to detect the invasive capability of M14 cells.Results A statistical decrease in the mRNA and protein expressions of survivin was observed along with an increase in apoptotic rate(x2=31.55,P＜0.01)in M14 cells transfectcd with siRNA-containing plasmid compared with untransfected and empty vector-transfected cells.As MTT assay indicated,on day 4 after the transfcorion,the proliferation of M14 cells was inhibited by(55.4±4.3)%,(34.5±4.3)%and(13.3±4.6)%,with pRNAT-H1.1/neo-survivin-siRNA1,pRNAT-H1.1/neo-survivin-siRNA2 and empty vector,respectively:there was a significant difference among the three groups(P＜0.05).Decreased invasive capability was noticed in M14 cells transfected with siRNA-containing plasmid compared with untransfected cells(all P＜0.05).Conclusions The plasmid containing siRNA against survivin can specifically inhibit the expression of sarvivin,proliferation and invasion of tumor cells,and induce cell apoptosis.The inhibition of survivin expression by siRNA may be a rational approach to the gene therapy for malignant melanoma.

Objective To predict the effectiveness of gentamicin combined with trisodium citrate for locking solution in preventing catheter-related bloodstream infection.Methods This is a retrospective study,ten kinds of common pathogens in catheter-related bloodstream infections were selected from medical intensive care unit (n =9) and cardiac care unit (n =1) between July 2011 and July 2012,and the diffusion method was used to analyze the inhibitory effect of gentamicin combined with trisodium citrate against tested pathogens.Results When trisodium citrate was tested alone,a certain antimicrobial activity could be detected from 10％ trisodium citrate,only Staphylococcus aureus and Staphylococci haemolyticus were inhibited,and then Enterococcus faecium was inhibited by 30％ trisodium citrate.Compared with trisodium citrate,gentamicin showed stronger antimicrobial activity.Staphylococcus aureus,Staphylococci haemolyticus,Enterococcus faecium and Escherichia coli could be inhibited by 0.32 g/L gentamicin and the antimicrobial activity was enhanced by increasing concentrations.The maximum activity was in 5 g/L gentamicin with 7-17 mm diameters.However,the antimicrobial activity of gentamicin didn't increase when combined with trisodium citrate,especially in 4％ trisodium citrate,the Staphylococci haemolyticus was not inhibited by all of the combinations with any concentration of gentamicin.In 0.32 g/L gentamicin,only the combination with 50％ trisodium citrate could inhibit the four kinds of pathogens (Staphylococcus aureus,Staphylococci haemolyticus,Enterococcusfaecium and Escherichia coli) with 8-21 mm diameters,while in 1 g/L,2 g/L,and 5 g/L gentamicin,these pathogens could be inhibited by the combination with only 10％ trisodium citrate,and the diameters were 5-24 mm,12-27 mm,and 17-28 mm,respectively.Conclusion Based on the data,gentamicin combined with trisodium citrate lock solution may play an important role in preventing catheter-related bloodstream infections caused by Gram-positive bacteria and Escherichia coli.