Objective:To observe the clinical effect of acupuncture combined with copper-tube moxibustion on peripheral facial paralysis. Methods:A total of 39 recurrent Bell’s palsy patients were treated with acupuncture plus self-made copper-tube moxibustion, once a day. Ten days made up a course of treatment. The patients were treated for 4 courses of treatment. There was a 3-day interval between two courses. The therapeutic efficacies were statistically analyzed after 4 courses of treatment. Results:Of the 39 cases, 18 cases obtained recovery, 15 cases got improvement and 6 cases failed. The total effective rate was 84.6%. Conclusion:Acupuncture combined with copper-tube moxibustion is effective for recurrent peripheral facial paralysis.

Budd-Chiari Syndrome ; complications ; Humans ; Seizures ; complications

The medical staff's ability to apply medical statistics is deficient at present.In order to bring up eligible students and improve the teaching quality of medical statistics,the author has advanced his thoughts and opinions on teaching contents,teaching ways and examination ways.

Objective: To investigate the inhibitory effects on m yeloperoxidase (MP O) oxidation activity by affinity-purified anti-MPO antibodies from patients w it h microscopic polyangiitis (MPA) and to further investigate the interaction betw een MPO, ceruloplasmin and anti-MPO antibodies. Methods: Human IgG fractions wer e purified from plasma of 11 patients with anti-MPO antibody positive MPA and s e ra of 12 normal controls. Anti-MPO antibodies were further purified from anti- MP O antibody containing IgG fractions using MPO affinity chromatography. The enzym e activity of MPO was measured, in the presence of anti-MPO antibodies and norm a l IgG preparations, using a classical MPO oxidation assay. Interaction between c eruloplasmin, MPO and anti-MPO antibodies was further investigated using ELISA. Results: Anti-MPO antibodies from 7/11 patients with MPA could inhibit the MPO a ctivity as non-competitive inhibitors in a dose-dependent manner. Ceruloplasmi n could competitively inhibit the oxidation activity of MPO in a dose-dependent an d time-dependent manner. Anti-MPO antibodies could inhibit the binding between M PO and ceruloplasmin to a maximum of (75.4?11.6)%. Conclusion: Anti-MPO antibod ies, from the majority of patients with MPA, could inhibit the oxidation activity of MPO and interfere with the binding between MPO and ceruloplasmin.

Hemifacial Spasm ; etiology ; surgery ; Humans ; Trigeminal Neuralgia ; etiology ; surgery

Objective To investigate clinical efficacy and safety of the memantine and donepezil in the treatment of moderate to severe Alzheimer's disease,in order to provide the basis for clinical treatment.Methods One hundred and twelve cases of moderate to severe Alzheimer's disease patients were given memantine plus donepezil(observation group) ,and single use of memantine treatment(control group), and the treatment for 24 weeks.Respectively before and after treatment, Mini Mental State Scale (MMSE), Alzheimer' s disease assessment scale (ADAS-cog), Alzheimer' s disease collaborative learning, daily life ability questionnaire (ADCS-ADL) ,and neuropsychological questionnaire (NPI) score, and adverse reactions were observed in the process of two kinds of therapy, the efficacy and safety of two kinds of treatment methods were evaluated.Results After treatment, the patients in observation group with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.1 ± 2.1), (32.9 ± 8.3), (33.4 ± 5.0), (6.1 ± 3.1) scores, significantly improved compared with scoring (9.9±2.8), (46.2±7.6), (42.1±6.0), (10.5±2.9) scores before treatment,and the differences were statistically significant (t =2.138,-2.411,2.398, 2.107 respectively, P ＜ 0.05).The control group after treatment in patients with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.3±2.6), (33.1 ±7.2), (35.1 ±6.6), (6.7 ± 2.9) scores, significantly improved compared with scoring 11.0 ± 2.5,44.9 ± 6.9,42.2 ±6.6,10.9 ± 3.5 before treatment, and the difference had statistical significanc (t =2.101,-2.033,2.105, 2.400 respectively, P＜0.05).After treatment, the difference of patients in the two groups of MMSE, NPI score had statistical significance(t =2.553,2.176, P＜0.05).The adverse reactions in two group respectively were 32.14％ (18/56) and 26.79％ (15/56), less difference was no statistical significance (P＞0.05).Vital signs checks,regular laboratory examination and ECG examination showed no obvious abnormalities.Conclusion Memantine combined with donepezil in the treatment of moderate and severe AD patients is superior to the singleeffect of memantine, and long-term use will not increase the risk of adverse reactions, which is safe and effective in the combined application.

OBJECTIVEThis study observed the curative effect of sustained negative pressure drainage application on treatment of severe maxillofacial and neck space infection.

METHODSIncision and drainage were performed to treat 18 patients with severe maxillofacial and neck space infection. A small incision was made on the site of the most obvious swelling or fluctuations, and localized negative pressure was applied with a drainage device on the wound during suturing.

RESULTSAmong the 18 patients, 14 were healed, whereas 4 underwent dehiscence of the wound after the operation. Negative pressure was lost as the drainage tubes were removed, and non-negative pressure drainage method was used instead. During the negative pressure treatment, swelling and pain did not increase after the operation. Other complications, such as asphyxia, septic shock, or mediastinal abscess, did not occur. All the patients were healed and eventually discharged from the hospital.

CONCLUSIONSustained negative pressure drainage, which is a modified version of the traditional method of incision and drainage, is an alternative treatment for severe maxillofacial and neck space infection. Such treatment reduces patient pain and eases doctor exertion. Thus, this method provides a new therapeutic strategy for severe maxillofacial and neck space infection.

Objective To evaluate the overall failure rate of one or two-stage exchange arthroplasty for infections in total knee arthroplasty (TKA) and the predictors affecting the outcome of exchange.Methods Thirty-nine cases received one or two-stage exchange arthroplasty for periprosthetic joint infections after primary TKA in Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine and Southeast Hospital affiliated to Xiamen University from January 2012 to November 2014 were reviewed.Periprosthetic tissue and articular fluid of all patients were analyzed by bacterial culture.All patients were followed up for more than one year.C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),procalcitonin (PCT) and blood routine were tested every four weeks,and the evaluation on pain,total periprosthetic function,range of motion and deformation of arthroplasty were conducted.Differences between groups were analyzed using chi-square test or Student's t test when appropriate.A stepwise selection approach in logistic regression analysis was used to screen key predictors for outcome of one or two-stage exchange for infections in TKA.Results There were 39 patients who had undergone one or two-stage exchange for infections in TKA,including 20 males (51.3％) and 19 females (48.7％) with an average age of (62.4±11.7) years.Among the 39 patients,18 gram-positive strains were isolated from specimens,and 6 gram negative strains,2 Mycobacterium tuberculosis and 1 candida albicans.Ten of 39 reimplantations developed reinfection.Between the success and failure groups,there were significant differences in the time from primary TKA to revision (P =0.023),operative time (P =0.029),multidrug resistant organisms (P =0.045),the preoperative and post-operative ESR (P=0.002 and P＜0.001,respectively) and post-operative CRP (P=0.018).Multivariable logistic regression analysis demonstrated that time from primary TKA to revision (OR =0.96,95％CI:0.92-1.00,P=0.025),preoperative ESR (OR=0.97,95％CI:0.95-1.00,P=0.045) and post-operative ESR (OR =0.94,95％ CI:0.91-0.98,P =0.002) were independent indicators associated with the outcome of one or two-stage revision.Conclusions The failure rate after revision for infected TKA is relatively high.The time from primary TKA to revision,preoperative and post-operative ESR could predict the outcome of one or two-stage revision effectively.

For more than 40 years primary hepatocytes culture technique has been utilized extensively for assessing effects of drug on metabolizing enzymes (especially cytochromes P450), drug metabolism, drug-drug interactions, and the mechanisms of cytotoxicity and genotoxicity. Human derived primary hepatocytes reserve the metabolism function and enzyme activity of liver. Therefore, this technique has been widely used as a reliable and efficient tool in the drug and xenobiotics evaluation and screen in vitro. This review focuses on primary culture technique of hepatocytes and its application in drug metabolism and toxicology research and evaluation.

Objective To investigate the effects of COMT G472A genetic polymorphism on postoperative analgesia with fentanyl.Methods One hundred and twenty-nine ASA I or Ⅱ patients aged 19-71 yr undergoing operation on lumbar vertebrae under general anesthesia were enrolled in this study.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphism of COMT G472A.The patients were assigned into 2 groups according to their genotypes:wild group and mutation group.Pain was assessed using VAS after the patients regained consciousness.When VAS score ＞ 3,the patients were given fentanyl 20μg iv every 5 win until VAS score was decreased to ≤ 3.PCIA was then started.The PCIA solution contained fentanyl 20 μg/kg + flurbiprofenaxetil 150-250 mg or propacetamol 4-6 g in normal saline 75 ml.The patients received a background infusion of 1 ml/h after a loading dose of 3 ml.The PCIA pump was programmed to allow a 0.5 ml bolus with a 15 min lockout interval.The amount of fentan yl infused in 24 h and 48 h was recorded.The amount of flurbiprofen (1 mg=fentanyl 1 μg) or propacetamol (1 g =fentanyl 37.5 μg) was transformed into fentanyl.Results Significantly less fentanyl was consumed in 48 h in mutation group ( n =49) than in wild group ( n =80).Conclusion COMT G472A is a factor contributing to the individual variation in patient' s response to postoperative analgesia with fentanyl.