OBJECTIVETo compare the clinical efficacy difference between electroacupuncture (EA) at qijie area combined with spine balance-regulating massage and medication for posterior circulation ischemia (PCI).

METHODSOne hundred cases of PCI were randomly divided into a treatment group (50 cases) and a medication group (50 cases). The treatment group was treated with EA at Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Shenshu (BL 23), Danzhong (CV 17), etc. in qijie area combined with spine muscle-relieving massage and comprehensive chiropractic. The medication group was treated with oral administration of nimodipine (30 mg per time, three treatments per day) and vinpocetine injection with 500 mL of glucose injection or intravenous drip of 500 mL 0.9% sodium chloride injection, once a day. Ten treatments were taken as one course in both groups, and two courses were given. The symptom score, mean resistance index (RI) of vertebral artery (VA) and basilar artery (BA), mean velocity of blood flow (Vm) and comprehensive clinical efficacy were compared before and after treatment in two groups.

RESULTSThe cured and markedly effective rate was 79.6% (39/49) in the treatment group, which was superior to 54.7% (23/42) in the medication group (P<0.05). The symptom score was both significantly improved after treatment in two groups (both P<0.05), which was more obvious in the treatment group (P<0.05). The RI of VA and BA, Vm of VA and BA were significantly improved after treatment in two groups (all P<0.05), which were more obvious in the treatment group (all P<0.05).

CONCLUSIONThe electroacupuncture combined with spine balance-regulating massage has superior effect on improving mean velocity of blood flow and resistance index of vertebral artery and basilar artery as well as symptom score to medication, and is believed to be a safe and effective treatment for posterior circulation ischemia.

Acupuncture Points ; Aged ; Blood Circulation ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Ischemia ; physiopathology ; therapy ; Male ; Massage ; Middle Aged ; Treatment Outcome

Objective To investigate the diagnostic value of determination of the genotypes in codon 12 and 13 of K-ras oncogene in blood samples of patients with pancreatic carcinoma(PC).Methods Blood samples were obtained from 54 patients with pathologically confirmed PC,and 33 healthy controls.The DNAs were obtained in these samples.and then genotype of K-ras mutation was detected by using the PNA-clamping real-time quantitative PCR.Then the correlation between the K-ras genotypes of blood DNA and the clinical characteristics was analyzed.Results K-ras mutations were found in 74.1%(40/54)of patients with PC.There was no such mutation in control samples.The mutations of K-ras was associated with age,lymph node and vessel invasion.poorly differentiated tumor,CA19-9,while it was not associated with sex,tumor location,size of tumor,clinical staging and pathological type.Conclusions The one-step method was highly sensitive for detecting K-ras mutation in blood samples.Detection of circular blood cells harboring K-ras mutation suggested the tumor was highly invasive with poor prognosis.

0.05). Significant difference in diffused carbon monoxide percentage and change of heart rates before and after stair climbing test was found in LPF group (P0.05).Conclusions Patients of lung cancer intolerable for lobectomy by static pulmonary function test can be screened by stair climbing test before surgical operation,which can make some of them regain opportunity of surgical operation.

Objective To evaluate the clinical efficacy of ultrasonic ablation in patients with chronic deep vein thrombosis of lower extremities. Methods Fifty-six patients with chronic deep vein thrombosis resulting in total occlusion of iliac-femoral veins accepted intra-venous ultrasonic ablation. The time for ultrasonic ablation was 12-24 minutes with the mean being 18 minutes. After the procedure, anti-coagulation was performed through the retaining catheters and venous propeller was utilized for promoting blood reflow. Results Ultrasonic ablation easily created a channel within the occlusive iliac-femoral veins and achieved successful recanalization in 49 of 56 patients (87.5%). Five patients (8.9%) were partially re-canalized and 2 (3.6%) had no recanalization. Thirty-eight of the 49 re-canalized patients were followed up, including 22 with no stent placement showed 9 (40.9%) re-occlusion and 16 received stent placement, and 2 had (12.5%) re-occlusion. Conclusions Intravascular ultrasonic ablation is an effective therapeutic modality to recanalize chronic thrombosed occlusion of iliac-femoral veins and can lay down a foundation for further balloon-expansion or stent-placement with long term patency.

Objective To compare the efficacy between three-dimensional radiotherapy (3DRT) combined with chemotherapy and radiotherapy alone for patients with esophageal squamous cell carcinoma.Methods A retrospective analysis was performed for 1257 patients with esophageal squamous cell carcinoma who were admitted to our hospital from July 2003 to June 2012 and met the inclusion criteria;362 patients were treated with 3DRT combined with chemotherapy (chemoradiotherapy group) and 895 patients were treated with radiotherapy alone (radiotherapy group).The short-term outcome, overall survival (OS) rate, and causes of death were analyzed.The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The response rate was 99.1%(346/349) in the chemoradiotherapy group and 99.0%(813/821) in the radiotherapy group (P=0.397).The 1-, 3-, and 5-year OS rates were 74.0%,42.0%,and 32.9% in the chemoradiotherapy group and 65.9%,33.0%,and 23.3% in the radiotherapy group (P=0.000), and were 75.6%,43.5%,and 33.2% in the concurrent chemoradiotherapy group and 65.9%,33.0%,and 23.3% in the radiotherapy group (P=0.000).There were no significant differences in 1-, 3-, and 5-year OS rates between the concurrent chemoradiotherapy group and the sequential chemoradiotherapy group (P=0.583).The sequential chemoradiotherapy group had an insignificant increase in 1-, 3-, and 5-year OS rates compared with the radiotherapy group (P=0.065).Tumor recurrence and local control failure were the main causes of death, followed by distant metastasis.The chemoradiotherapy group had a significantly lower proportion of patients who died of local control failure than the radiotherapy group (7.4% vs.14.7%, P=0.003).Conclusions For patients with esophageal squamous cell carcinoma, chemoradiotherapy leads to significantly improved overall survival compared with radiotherapy alone;compared with radiotherapy alone, sequential chemoradiotherapy results in an increasing trend in OS rates, while concurrent chemoradiotherapy results in significantly increased OS rates.Chemoradiotherapy can reduce the deaths due to local control failure compared with radiotherapy alone.

Objective To investigate the biocompatibility and safety of nanoscale brain-targeting-carrier micelles [poly (ethylene)-b-poly (lactic acid)/OX26 conjugate micells (copolymer/OX26)],and to explore its possibility as brain-targeted-drug carrier for brain glioma.Methods The C6 glioma cells were cultured in vitro and divided into experimental groups with different concentrations (10, 20, 40, 80 mg · L-1 )of nano micelle, and the medium without micelle was used as control group.The inhibitory effect of nano-micelles on the rat brain glioma C6 cells was examined by Trypan blue cell counting assay.Flow cytometry (FCM)was used to detect the changes of apoptosis and cell cycle of C6 cells,and confocal laser scanning microscope (CLSM)was performed to analyze the distribution of copolymer/OX26 into C6 cells. Results The results of Trypan blue cell counting assay showed copolymer/OX26 didn’t affect the growth of C6 cells,and there were no significant differences in the number of C6 cells between control group and expreimental groups (P >0.05).The results of FCM showed that the cell cycle and and the apoptotic rates of C6 cells had no changes compared with control group (P > 0.05).The results of CLSM showed that the fluorescence intensities in experimental groups were higher than those in blank micelles group and blank control group (P < 0.05 ), and they were increased in dose- and time-dependent manner (P <0.05).Conclusion Copolymer/OX26 has no effect on the growth and apoptosis of glioma cells.By bonding OX26,copolymer/OX26 can significantly increase the intake of C6 cells on the nano micelles.

Objective To investigate the risk factors of post-ERCP pancreatitis( PEP). Methods Data of 4,234 patients who underwent ERCP in Nanjing Drum Tower Hospital were retrospectively analysed. Information of patients and operations,including age,gender,operation history,major disease history,labora-tory examination before operation,abdominal ultrasound,CT,MRCP,detailed ERCP operation process,com-plications and treatment were carefully recorded. Then Chi-square test was used for univariate analysis,and stepwise multivariate Logistic regression for variate analysis. Linear correlations between risk factors were de-tected. Results There were totally 226 PEPs,with 5. 3% incidence rate. Univariate analysis showed that the female(χ2 =9. 715,P=0. 002),young( <60 years)(χ2 =6. 108,P=0. 013),chronic pancreatitis(χ2 =14. 703,P=0. 001),initial ERCP(χ2 =14. 899,P=0. 000),hypertension(χ2 =4. 489,P=0. 034),nor-mal bilirubin levels before operation(χ2 =19. 159,P =0. 000 ),difficult cannulation(χ2 =45. 824,P =0. 000),pancreatic guide wire(χ2 =30. 223,P=0. 000),papillary pre cut(χ2 =45. 928,P=0. 000),pan-creatography(χ2 =20. 170,P=0. 000)may be risk factors for PEP. Non conditional Logistic regression analy-sis showed that female(OR=1. 449,P=0. 011),initial ERCP(OR=1. 745,P=0. 003),normal bilirubin levels before operation(OR=1. 917,P=0. 000),difficult cannulation(OR=3. 317,P=0. 000)and pancre-atography(OR=1. 823,P=0. 004)were independent risk factors for PEP. Linear correlation analysis sugges-ted that pancreatic duct guide wire and papillary precut were related to the difficult cannulation,and the corre-lation coefficients were -0. 788 and -0. 699. Conclusion Female,young(<60 years),chronic pancreati-tis,initial ERCP,hypertension,normal bilirubin levels,difficult cannulation,pancreatic duct guide wire,pa-pillary precut,pancreatography may induce PEP. Female,normal bilirubin levels before operation,initial ER-CP,difficult cannulation and pancreatography are independent risk factors for PEP,while pancreatic duct guide wire,papillary precut are not,as they were linear correlated to difficult cannulation.

Objective To evaluate the effects of propofol on apoptosis and invasiveness of human lung cancer cell line A549 cells.Methods Human lung cancer cell line A549 were seeded onto 96-well plates (100 μl/well) and 6-well plates (2 000 μl/well) at a density of 2× 105 cells/ml,and cultured for24 h at 37 ℃ in 5％ CO2.The cells were randomly divided into 2 groups (n =60 each) using a random number table:dimethyl sulfoxide (DMSO) group and propofol group (group P).In group P,propofol with the final concentration of 100 μmoYL was added.In group DMSO,0.5％ DMSO with the final concentration of 0.5％ was added.At 24 h of incubation with drugs,caspase-3 expression was detected by high content screening (HCS); the expression of matrix metalloproteinase (MMP-2) was detected by Western blot analysis.At 0.5,1 and 5 h of incubation,ERK1/2 expression was also measured using Western blot analysis.Results Compared with group DMSO,the expression of caspase-3 was up-regulated,the expression of MMP-2 was down-regulated,ERK1/2 expression was up-regulated at 0.5 of incubation and down-regulated at 1 h of incubation,and no significant change was found in ERK1/2 expression at 5 h of incubation in group P.Conclusion Propofol can promote apoptosis in A549 cells and inhibit invasiveness of human lung cancer cell line A549 cells.

Objective To investigate the effect of electroacupuncture on the expressions of in-terleukin(IL)-33 and ST2 in spinal cord and dorsal root ganglion in rats with neuropathic pain. Methods Forty adult female SD rats were randomly divided into sham operation group (group Sham),model group (group MC),ipsilateral electroacupuncture group (group SE)and contralateral electroacupuncture group (group VE).Each group had 10.The sciatic nerve injury models were es-tablished.The rats in group SE and group VE were respectively accepted electrical acupuncture treat-ment in Yanglingquan and Zusanli in the right and left limbs.Respectively,before treatment (T0 ), treated for 7 d (T1 ),3 d (T2 )and 7 d (T3 )after treatment,the MWT and TWL of rats in the four groups were measured.At T3 ,the expressions of IL-33 in spinal cord and dorsal root ganglion in rats were detected by using quantitative PCR.Results Compared with T0 ,MWT and TWL in group MC, group SE and group VE at T1-T3 were decreased significantly (P < 0.05).Compared with sham group,MWT in group SE and group VE,TWL in group MC,group SE and group VE at T1-T3 were decreased significantly (P <0.05).Compared with group MC,MWT and TWL in group SE and group VE at T2 ,T3 were increased significantly (P <0.05).Compared with sham group,the relative expression levels of IL-33 mRNA and ST2 mRNA in spinal cord and dorsal root ganglion in the group MC,group SE and group VE were elevated,the differences were statistically significant (P <0.05). Compared with group MC,the relative expression levels of IL-33 mRNA and ST2 mRNA in spinal cord and dorsal root ganglion group SE and group VE were decreased,the differences were statistical-ly significant (P <0.05).Conclusion The electroacupuncture treatment could significantly reduce the pain symptoms of neuropathic pain in rats,possibly via inhibiting the expressions of IL-33 and ST2 in spinal cord and dorsal root ganglion and blocking the IL-33/ST2 mediated inflammatory to play role.

ObjectiveToinvestigatetheprotectiveeffectandmechanismofscutelarincombinedwith paeoniflorin after permanent cerebral ischemia in rats. Methods Forty-eight adult male SD rats w ere randomly divided into four groups: sham-operation, cerebral ischemia, scutelarin+ paeoniflorin, and cyclopamine (n=12 in each group). A model of permanent middle cerebral artery occlusion w as induced by suture method. The intraperitoneal injection of cyclopamine 6 mg/kg, a specific inhibitor of sonic hedgehog (SHH) pathw ay, at 15 min before ischemia in the cyclopamine group, w hile other groups w ere intraperitoneal y injected an equal volume of saline. At 0 hour and 3 hours after ischemia, the scutel arin+paeoniflorin group and cyclopamine group w ere intraperitoneal y injected scutel arin ( 20 mg/kg ) and paeoniflorin (30 mg/kg), while other groups were intraperitonealy injected an equal volume of saline. Neurological deficit scores w ere performed at 24 hours after ischemia, and then the rats w ere decapitated. The cerebral infarct volume w as measured by using 2,3,5-triphenyltetrazolium chloride (TTC) staining. Real-time fluorescent quantitative polymerase chain reaction and Western blotting w ere used respectively to detect the expression levels of SHH, Patched-1, Gli-1 mRNAs and proteins in the ischemic cortex. Results The neurological deficit scores in the cerebral ischemia group, scutel arin+paeoniflorin group, and cyclopamine group w ere 3.33 ±0.52, 1.50 ±0.55, and 3.67 ±0.52, respectively. The neurological deficit score in the scutel arin+paeoniflorin group w as significantly low er than that in the cerebral ischemia group ( P<0.05), and the neurological deficit score in the cyclopamine group w as significantly higher than that in the scutelarin+paeoniflorin group ( P<0.05). The infarct volume percentage in the cerebral ischemia group, scutelarin+paeoniflorin group, and cyclopamine group were 31.77%±1.19%, 22.94%±2.65%, and 35.53%±0.20%, respectively. The infarct volume in the scutel arin+paeoniflorin group w as significantly less than that in the cerebral ischemia group ( P<0.05), and the infarct volume in the cyclopamine group was significantly larger than that of the scutelarin+paeoniflorin group (P<0.05). The expression levels of SHH, Patched-1, Gli-1 mRNAs and proteins in the cerebral ischemia group, scutelarin+paeoniflorin group, and cyclopamine group w ere significantly higher than those in the sham -operation group (al P<0.05). The expression levels of SHH, Patched-1, Gli-1 mRNAs and proteins in the scutelarin+paeoniflorin group were significantly higher than those in the in the cerebral ischemia group (al P<0.05), and the expression levels of Gli-1 mRNA and protein in the cyclopamine group were significantly lower than those in the scutelarin+paeoniflorin group ( al P<0.05 ). Conclusions The scutel arin combined w ith paeoniflorin has certain protective effect on focal cerebral ischemia injury in rats. Its mechanism is associated w ith the activation of SHH signaling pathw ay.