OBJECTIVETo observe the clinical efficacy on constipation predominant irritable bowel syndrome (IBS-C) treated with acupuncture for regulating the mind and strengthening the spleen and the impacts on the quality of life in the patients.

METHODSSixty patients of IBS-C were randomized into two groups. In the acupuncture group (30 cases), acupuncture was applied to Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Taichong (LR 3), Sanyinjiao (SP 6), Yintang (GV 29) and Baihui (GV 20), once a day, 5 treatments a week and 4 weeks treatment as one session. In the western medication group (30 cases), lactulose oral solution was prescribed, 15 mL each time, three times a day, 4 weeks treatment as one session. The symptom grade scale and the quality of life scale (IBS-QOL) were adopted to observe the changes in clinical symptoms and quality of life before treatment, after treatment and 2-month follow-up after treatment in the patients of the two groups separately.

RESULTS(1) Clinical symptom score: the difference in the symptom score at each time point was significant statistically in intra-group comparison (P < 0.01). In 1 week, 4 weeks of treatment and 2 months after treatment, the clinical symptom scores in the acupuncture group were lower than those in the western medication group (P < 0.05, P < 0.01). (2) IBS-QOL score after treatment was improved as compared with that before treatment in the two groups (P < 0.01). The improvement of IBS-QOL at 2 months after treatment in the acupuncture group was apparently superior to the western medication group (P < 0.05). (3) The total effective rate was 90.0% (27/30) in the acupuncture group and was 83.3% (25/30) in the western medication group. The overall efficacy in the acupuncture group was better than that in the western medication group (P < 0.01).

CONCLUSIONAcupuncture for regulating the mind and strengthening the spleen significantly relieves the clinical symptoms of IBS-C and improves QOL of patients. The total efficacy is superior to lactulose oral solution and presents a certain of long-term efficacy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Constipation ; physiopathology ; therapy ; Female ; Humans ; Irritable Bowel Syndrome ; physiopathology ; therapy ; Male ; Middle Aged ; Quality of Life ; Spleen ; physiopathology ; Treatment Outcome ; Young Adult

Objective To clear the clinical efficacy of using early rehabilitation nursing model in the course of clinical nursing in patients with cerebral infarction.Methods Divided 60 patients with cerebral infarction into the observation group (30 cases) and the control group (30 cases) randomly,traditional nursing measures were used in the control group,the early rehabilitation nursing model was used in the observation group in addition.Compared the clinical efficacy,ADL scores,NIHSS scores and the satisfaction between the two groups.Results In the observation group,the satisfaction was 93.33％ (28/30),the efficiency was 90.00％(27/30),which were significantly higher than those in the control group [76.67％(23/30),[66.67％(20/30)].The ADL and NIHSS scores in the observation group was (91.25±11.38) and (8.01±1.05) respectively,which were significantly different with those of in the control group,the ADL and NIHSS scores was (79.37±10.27) and (10.22±1.27) respectively in the control group.Conclusions Early rehabilitation nursing model can effectively improve the never function of patients with cerebral infarction,and then improve their quality of life.

Objective:To explore effect for isoproterenol rising detection rate of paroxysmal supraventricular tachy‐cardia by transesophageal atrial pacing (TEAP) .Methods :A total of 85 patients with suspected PSVT attack history received routine TEAP ( basic stimulate ) ,for those failed to evoke PSVT ,they received additional intravenous infusion of isoproterenol to make heart rate rise to 120 beats/min ,then TEAP was repeated .Results :Routine TEAP evoked PSVT in 29 cases (34.1% ,29/85) ;among the remaining 56 cases un - evoked PSVT ,after intravenous infusion of isoproterenol PSVT was evoked in 54 cases (96.4% ,54/56) by TEAP ,and this detection rate was significantly higher than that of routine TEAP (96.4% vs .34.1% , P = 0.039) .Conclusion :Intravenous infusion of isoproterenol can greatly raise the detection rate of paroxysmal supraventricular tachycardia by transesophageal atrial pacing .

The application of placebo acupuncture in randomized controlled trials in the past 10 years (2004-2014) in foreign countries was systematically reviewed to summarize the design of placebo acupuncture; according to category of diseases, advantages and disadvantages were analyzed to explore an ideal placebo acupuncture set. By retrieval in PubMed, EMBASE and OVID databases, the clinical study literature which met the inclusion criteria was searched, and the category of diseases, design of placebo acupuncture and clinical efficacy were analyzed. Totally 29 articles were included. The pain was the leading disease in category of diseases; the most commonly used application of placebo acupuncture design was telescopiform sliding blunt needle, accounting for 45. 16%; the treatment locations were non-acupoints mostly; in the needling depth, approximately 60. 00% selected non-penetrating needling and 26. 67% selected superficial needling; 28 articles indicated that acupuncture and placebo acupuncture had clinical effects, accounting for 96. 55%; 37. 93% of articles indicated acupuncture was superior to placebo acupuncture and 37. 93% of articles indicated acupuncture was not superior to placebo acupuncture. It is concluded that the design of placebo acupuncture should consider multiple factors, including main symptoms, operability, security, blinding and specific effects, and the objective indices should be selected for outcome evaluation.
Acupuncture Therapy ; instrumentation ; methods ; standards ; Humans ; Internationality ; Needles ; Placebo Effect ; Randomized Controlled Trials as Topic ; standards

Objective To elevate diagnosis level and improve treatment for retroperitoneal chemodectoma. Methods Clinical data of 21 cases with retroperitoneal chemodectoma in four hospitals of Songhua river drainage area were analyzed retrospectively. Results CT, Ultrasonography and arteriography delineated retroperitoneal tumor in all 21 cases including 2 cases diagnosed as having retroperitoneal chemodectoma by MRI and arteriography, 19 cases were misdiagnosed (90.5%). All cases underwent surgical resection, with tumors removed completely in 16 cases (76. 2% ) , and 5 were irresetable. Four cases who were not resected died within 11 months postoperatively and 1 died intraoperatively in an resection attempt. In tumor resected cases, 11 have survived more than 12 years, 3 died 8 years later, 2 were still alive at the follow-up of 2 years. Conclusion Surgical treatment is the only effective method to treat the retroperitoneal chemodectoma.

Objective To summarize our experience in the diagnosis and treatment of thyroid Hurthle cell neoplasms. Methods Clinical data of thyroid Hurthle cell neoplasm patients admitted from 1972 to 2003 were analyzed retrospectively. Results The main symptoms were thyroid solitary node or mass (37 cases) and multiple nodule (9 cases). 4 cases had cervical lymph node metastasis. With BUS、CT、ECT and FNAC,only 10 cases were diagnosed as HCNs preoperatively, 36 cases were misdiagnosed as nodular benign single or multiple node. Twenty-eight cases were diagnosed by FNAC and quick freezing pathology. Benign HCNs was treated by isolateral thyroidectomy and malignant HCNs by additional contralateral subtotal thyroidectomy. Eighteen cases were diagnosed by postoperative paraffin pathology, and retrival second operation was performed according to the benignity or malignancy of the thyroid lesion. All cases were followed-up for 2 to 10 years and doing well without recurrence. Conclusions We should realize thyroid Hurthle cell neoplasms fully, if HCNs is suspected intraoperatively, quick freezing pathology is helpful. With appropriate therapy, the prognosis is satisfactory.

Objective To study the gene homology of intestinal colonized and infectious bacteria in ICU patients to provide the epidemiological and molecular biological basis for formulating the control measures of multi resistant bacterial hospital infection. Methods The multi-drug resistant colonized bacteria isolated from the anal swabs and the same multi-drug resistant bacteria isola-ted from the clinical samples in the same patients were matched.The Diversilab automatic repetitive extragenic palindromic(REP)-PCR typing system was adopted to analyze the gene homology of multi-drug resistant colonized bacteria and infectious bacteria in the intestinal tract.Results 4 pairs of multi-drug resistant colonized bacteria and the same multi-drug resistant bacteria isolated from the clinical samples on admission in the same patients were selected and performed the homology detection,2 pairs had the ho-mology and 2 pairs had no homology;4 pairs of multi-drug resistant colonized bacteria and the same multi-drug resistant bacteria isolated from the clinical samples in the patients with hospital infection were performed the homology detection,4 pairs all showed the homology.Conclusion The multi-drug resistant colonized bacteria and the infectious bacteria in ICU patients have the homolo-gy.The multi-drug resistant colonized bacteria can cause the occurrence of hospital infection,so their management should be strengthened in clinic.

Objective To investigate the value of tumor necrosis factor (TNF)-α receptor gene,TNFRSF1A+36A/G(rs767455) and-383A/C(rs2234649),TNFRSF1B+196T/G(rs1061622) single nucleotide polymorphism (SNP) for the susceptibility to ankylosing spondylitis (AS) and the relationship between SNP and AS.T test,Chi-square test,and ANOVA were used for statististical analysis.Methods Two hundred and fifteen patients who had definite diagnosis of AS and 216 healthy blood donors were involved in this study.SNPs of TNF-α receptor gene:TNFRSF1A +36A/G(rs767455),-383A/C(rs2234649) and TNFRSF1B+196T/G (rs1061622) were detected with the ligase detection reaction (LDR-PCR) method.Results ① Distribution frequencies of A alleles(86.8％,91.5％) and G alleles (13.2％,8.5％) of TNFRSF1A(rs767455) in AS and controls were significantly different with each other (x2=4.627,P=0.0315),while the distribution frequency in group of homozygotes (AA or GG genotype) in AS and controls were 74.6％(150/201) and 83.9％(177/211),the frequencies in group of heterozygotes (AG) were 25.4％ (51/201) and 16.1％(34/211)(x2=5.390,P=0.020).Frequency of alleles and the genotypes of TNFRSF1A (rs2234649) and TNFRSF1B (rs1061622) between AS and control group were similar(P＞0.05).It also demonstrated that TNF-αreceptor gene haplotype (rs1061622T-rs2234649A-rs767455G) carriers apparently increased the susceptibility to AS (11.5％ vs 6.9％)(OR:1.753,95％CI:1.078～2.852,P=0.022).② Analysis of variance found that the duration of morning stiffness (F=3.168,P=0.044) and peripheral joint tenderness counts (F=4.598,P=0.011) among the three genotype groups of TNFRSF1B (rs1061622) in patient with AS were evidently differed with each other.Bath AS functional index (BASFI) among different genotype groups of TNFRSF1A (rs2234649) in AS had remarkable diversity (F=5.783,P=0.004).None of above indicators among groups of different genotypes of TNFRSF1A (rs767455) in AS were uniform (P＞0.05).③ Forty-four patients were treated with TNF-α antagonist (entanercept),25 mg,subcutaneous injection,twice weekly for 3 months,then followed with Sulfaslazine (SASP) 2.0 g/d and Celecoxib 0.4 g/d for another 9 months.ASAS20 was the primary endpoint for the evaluation of therapeutic effect at the visit of 3 month and 12 month.No associations were found between SNP and short or long term outcome of treatment with TNF-α antagonist in AS (P＞0.05).Conclusion TNFRSF1A (rs767455) SNP correlates with susceptibility to AS in Anhui Han local patients.Carriers of TNF-α receptor gene haplotype (rs1061622T-rs2234649A-rs767455G) may increase the susceptibility to AS.SNP of TNFRSF1B (rs1061622) is associated with disease activity in AS,while SNP of TNFRSF1A(rs2234649)relates to functional index of the disease.There is no association between SNP of TNFRSF1A / TNFRSF1B and short or long term outcome of treatment with TNF-α antagonist in AS.

Objective To investigate the clinical features and related risk factors of osteoporosis (OP) and osteoporotic fracture (OPF) in patients with rheumatoid arthritis (RA).Methods Two hundred and seventytwo in-patients with RA between 2010-2011 were surveyed,X-ray was detected for the diagnosis of fracture.Bone mineral density(BMD) of proximal femur and lumbar vertebrae (L2-4) in 203 patients were measured by dual energy X-ray absorptio-metry (DEXA),and the radiographic changes in both hands of 169 RA patients were assessed by Sharp scoring system.All the clinical and laboratory factors of RA were recorded in detail by rheumatologists.The results of 120 normal people were used as controls.T-test,Mann-whitney test,x2 test and Logistic regression were used for statistical analysis.Results ① Compared to the normal group,the BMDs of RA patients at each measured location were significantly lower (P＜0.01),the OP incidence was 32.0％ (65/203),which was significantly higher than that of the normal group,which was 15.0％ (18/120) (x2=11.442,P=0.001).There were 33 cases of OPF among all 272 RA patients,and the occurrence rate was 12.1％.BMDs of the femur in RA with OPF were lower than those in RA without OPF (P＜0.01).② Incidence of OP in RA with glucoco-rticoid was 42.2％(46/109),which was higher than that in RA without glucocorticoid (20.2％,18/89) (x2=10.818,P=0.001).Compared with RA without glucocorticoid,the incidence of OPF in RA with glucocorticoid elevated evidently [7.2％ (9/125) vs 17.5％ (24/137)] (x2=6.321,P=0.012).③ Logistic regression (back-ward LR method) analysis found that the risk factors for OP in RA patients were age [OR=1.050,P=0.001,95％CI(1.020,1.080)],HAQ [OR=1.966,P=0.031,95％CI (1.064,3.631)],and glucocorticoid average daily dosage [OR=1.075,P=0.031,95％CI (1.007,1.148)].The risk factors for OPF in RA patients were age [OR=1.041,P=0.046,95％CI (1.001,1.084)] and OP [OR=3.484,P=0.016,95％CI (1.258,9.646)].Conclusion RA patients have higher incidence of OP and OPF than general population.The incidence of OP and OPF are closely correlated with age,diseases activity,local bone erosion and the use of glucocorticosteroid.

Objectlve To investigate the value of basic and contrast-enhanced ultrasound in the diagnosis of superficial cervical lymph nodes.Methods Five hundred and forty-five cases of superficial cervical lymph nodes were sacned by basic ultrasound,in which 52 cases were also scaned by contrast-enhanced ultrasound.All cases were performed ultrasound-guided biopsy.Lymph nodes were divided into benign group and malignant group according to pathology reports.The differences of the two groups were analysed,and statistical analysis was performed.Results Two hundred and thirty cases were benign,315 cases were malignant.S/L(P＜0.01),RI(P＜0.01),vascular pattern(P＜0.01)and contrast enhancement pattern(P＜0.01)between benign and malignant group showed statistical significant differences,while no statistical difference in coefficient correlation of the time-intensity curve between the two groups was found.Conclusions A combination of basic and contrastenhanced ultrasound can significantly enhance the ability to identify malignant lymph nodes from benign lymph nodes.