Objective To investigate the protective effect of mucopolysaccharide polysulfate cream(MPC) and micro needle array drug delivery technologarray(MNADDT) on the blood vessel of arteriovenous fistula.Methods Eighty cases maintenance hemodialysis patients with autogenous arteriovenous fistula were randomly divided into control group(with the treatment of MPC) and study group(with the treatment of MPC plus MNADDT),40 patients in each group.Both groups were studied for the duration of 12 months.The vascular complications of puncture pain sense,puncture failure times,phlebitis,hardening of the arteries,internal fistula stenosis or embolism,pseudoaneurysm,swollen hands comprehensive syndrome of two groups were observed,and the changes of arteriovenous fistula blood flow,blood vessel diameter by Doppler ultrasound were observed in the two groups for 12 months.Results (1)The incidence of puncture pain(2.71±0.11 vs.2.76±0.14,t=2.21,P<0.05),puncture failure times(38 times vs.73 times,χ2=11.425,P<0.05),phlebitis(2 cases vs.8 cases,χ2=4.341,P<0.05) and blood vessel sclerosis(2 cases vs.9 cases,χ2=5.446,P<0.05) of the treatment group were significantly lower than that of the control group during the study(P<0.05).(2)Blood flow of arteriovenous fistulain of control group before and after treatment were (859.7±148.3) ml/min and (946.5±169.2) ml/min respectively,and the difference was significant(t=2.356,P<0.05).While blood flow of arteriovenous fistulain,cephalic vein diameter,head of venous flow velocity of study group before and after treatment were (824.6±171.5) ml/min and (1 218.1±241.9) ml/min,(5.59±0.74) mm and (6.02±0.57) mm,(94.23±27.35) cm/s and (115.85±36.63) cm/s,respectively,and the differences were significant(t=8.212,2.382,2.877,P<0.05),there were no significantly changes in the above indexes in the study group after treatment(t=5.3612,2.152,2.281,P<0.05).Conclusion MPC plus MNADDT can reduce the vascular complications of arteriovenous fistula,improve blood vessel diameter and increase blood flow.

Objective To obserVe the clinical efficacy and safety of yiqing caPsule in the treatment of acne with concomitant constiPation. Methods A randomized controlled method was used. One hundred and forty_fiVe Patients with acne and concomitant constiPation were randomized into treatment grouP (n=75) and control grouP (n=70). Patients in the treatment grouP receiVed yiqing caPsule orally and comPound tretinoin gel toPically, while Patients in the control grouP receiVed toPical comPound tretinoin gel only. Both grouPs were treated for 3 weeks. Results The theraPeutic effect of the treatment grouP was much better than that of control grouP (P<0. 01). No obVious adVerse reactions were obserVed in either grouP. In the treatment grouP,77.4%of Patients were relieVed from constiPation,the ratio being much higher than the control grouP (P<0.01). The chance of acne relief was remarkably higher in Patients whose constiPation were relieVed (P<0. 01). The SPearman correlation index between acne relief and constiPation imProVement was 0. 699 (P<0. 01). Conclusion Combination theraPy of yiqing caPsule and comPound tretinoin gel is effectiVe in the treatment of acne with no significant adVerse reactions. The constiPation imProVement from yiqing caPsule can contribute to the efficacy towards acne.

Objective: To observe the clinical efficacy of combining auricular point sticking and a healthy diet to treat simple obesity in children aged 6-9 years old.Methods: A total of 190 eligible obese kids were divided into an observation group and a control group using the random number table method, with 95 cases in each group. The observation group was intervened by auricular point sticking plus guide on a healthy diet, while the control group was only provided with the guide on a healthy diet. The therapeutic efficacy was observed after intervention for three consecutive months, as well as the changes in body mass (BM), body mass index (BMI), waist circumference (WC), hip circumference (HC), and subcutaneous fat thickness. Results: After the 3-month intervention, the total effective rate was 91.6％ in the observation group, versus 74.7％ in the control group, and the between-group difference was statistically significant (P<0.01); in both groups, the BM, BMI, WC, HC, and subcutaneous fat thickness all decreased significantly (P<0.05), and were lower in the observation group than in the control group, showing statistical significance (P<0.05). Conclusion: Auricular point sticking plus a healthy diet is safe and effective in treating simple obesity in children, producing more significant efficacy than healthy diet intervention alone.

Objective To establish a one-step recombinase polymerase amplification (RPA) method for pathogen screening and rapid detection in the field targeting for five hemorrhagic fever related viruses (Zaire ebola virus, Sudan ebola virus, Marburg virus, Lassa virus and Yellow fever virus). Methods The specific nucleic acid (NA) fragments of each virus were selected as target genes by genome sequence analysis, and the primers and probes for RPA assays were designed according to the sequence. A series of diluted template genes were used for RPA detection to determine the sensitivity. The hemorrhagic fever-related viral nucleic acids were used for RPA detection to determine the specificity. The amplification experiments were carried out at different temperature ranging from 37℃ to 42℃ to validate the reaction temperature range. Results The RPA reaction systems of the five hemorrhagic fever viruses could effectively amplify the target genes, the sensitivities were between 1.5×102 and 1.5×103 copies. No cross reactions existed with the other hemorrhagic fever-related viral genes. Meanwhile, RPA assay could effectively amplify the target genes at 37-42℃. Conclusion The isothermal RPA assays of five hemorrhagic fever viruses are established, which may amply target genes fast and react at a wide temperature range, and be potentially useful for in field pathogens detection.

Objective To investigate the prevalence and risk factors of mild cognitive impairment (MCI) among the old people in Chongqing, China. Methods From October to November, 2015, 1850 persons more than 60-year-old in Chongqing were cluster sampled. They were investigated with self-made general situation questionnaire, Mini-Mental State Examination (MMSE), Instrumental Activity of Daily Living Scale (IADL) and Geriatric Depression Scale (GDS) through face-to-face interview. Enumeration data were tested withχ2 test and multiple Logistic regression. Results MCI prevalence was 11.73%in the old people in Chongqing, and various with the residential re-gions, ages, marital status, literacy, career, smoking, drinking, seafood-eating, egg-eating, exercising, intensive labor, low intensity of labor, housework, outdoor activities, Mahjong/chess/cards playing, TV-watching/radio-listening/newspaper-reading, social activities, obesity, hy-pertension, diabetes, stroke, hyperglycemia, cerebrovascular insufficiency and depression (χ2>4.092, P<0.05). According to multiple Logis-tic regression, living in rural areas, aging, celibacy, obesity, hypertension and depression were the risk factors of MCI;while middle school and above years of schooling, mental workers, smoking cessation, frequent seafood-eating and egg-eating, exercising, daily intensive labor and low intensity of labor, daily and sometimes housework, daily and weekly outdoor activities at least once, daily Mahjong/chess/cards playing and daily TV-watching/radio-listening/newspaper-reading were the preventing factors. Conclusion The morbidity of MCI is high in the old people in Chongqing. It is necessary to take effective intervention in view of the related factors of MCI as early as possible, to delay or prevent the development of MCI to dementia.

BACKGROUND: Endothelin and nitrogen monoxide (NO) which are regarded as a pair of factors to maintain equilibrium between vascular stress and hemodynamics have different responses during various diseases. It is the key point for the treatment of atherosclerosis to find out the effect and pathophysiological mechanism of hyperlipemia on endothelial cells, and seek the methods and drugs for protecting vascular endothelin.OBJECTIVE: To observe the effect of herbal cake-separated moxibustion on contents of plasma endothelin and NO and analyze its regulative mechanism.DESIGN: Randomized controlled animal study.SETTING: College of Acupuncture and Moxibustion, Hunan University of Traditional Chinese Medicine.MATERIALS: A total of 60 healthy New Zealand white rabbits weighing 1.5-2.5 kg of both genders were selected in this study. Herbal cake was made of danshen, shanzha, yujin, dahuang and zexie, which were crushed into powder according to a certain ratio. Then, vinegar was added to make paste which was 5-8 mm in diameter and 2-3 mm in depth. Moxa cone:(Shenjiu 300) was provided by Suzhou Dongfang Airong Factory (type:Dongfang I; batch number: 20021212).METHODS: The experiment was carried out in the Experimental Animal Center of Hunan University of Traditional Chinese Medicine between November 2003 and October 2004. All rabbits were randomly divided into 4 groups: blank control group, hyperlipemia model group, direct moxibustion group and herbal cake-separated moxibustion group with 15 in each group. Except blank control group, rabbits in other three groups were fed with high fat forage to establish hyperlipemia models. Two groups of acupoints were acupunctured alternatively: Group Ⅰ: Juque (CV14), Tianshu (ST25) at bilateral sides, and Fenglong (ST 40) at bilateral sides; Group Ⅱ:Xinshu(BL15),Ganshu(BL18) and Pishu(BL20), at bilateral sides respectively.On the first day, moxa cone was directly adherent to acupoints of rabbits in direct moxibustion group and lighten for acupuncture, but in herbal cakeseparated moxibustion group, moxa cone which was gotten rid of the carriage was adherent to herbal cake which was put on acupoints and lighted for acupuncture. Each acupoint was acupunctured for 4 successive dosages for once a day. On the next day, the other group of acupoints was acupunctured.The course was 40 days. Rabbits in other two groups were not treated with any ways. On the 41st day, contents of plasma endothelin and NO were measured in each group with radio-immunity method and nitrate-reductase reduction method, respectively.MAIN OUTCOME MEASURES: Contents of plasma endothelin and NO of rabbits after 40-day treatment.RESULTS: Five rabbits died because of diarrhoea or other reasons, including 2 in blank control group, 1 in model group, 1 in direct moxibustion group and 1 in herbal cake-separated moxibustion group. Therefore, 55 rabbits were involved in the final analysis. ① Content of plasma endothelin was lower in herbal cake-separated moxibustion group than that in model group [(431.57±63.68), (500.14±75.41) ng/L, P ＜ 0.05], but there was no significant difference between herbal cake-separated moxibustion group and direct moxibustion group [(431.57±63.68), (429.08±77.07) ng/L, P ＞ 0.05]. ② On NO content, there was an increasing tendency of model group ＜ blank group ＜ herbal cake-separated moxibustion group ＜ direct moxibustion, but there was no significant difference between any two groups [(27.17±16.55),(29.39±13.24), (30.24±20.25), (30.47±19.62) μmol/L, P ＞ 0.05].CONCLUSION: Effects of both two methods of moxibustion in the rabbits with hyperlipemia on content of endothelin are significant and similar, but there are no significant effects on NO content.

Objective To explore exenatide in the treatment of metformin(MET)alone,sulfonylurea (SU)alone or MET + SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures.Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group.In the exenatide group,exenatide 5μg twice a day for 4weeks,then 10μg twice a day for 12 weeks.Changes of HbAlc,body weight,BMI,FBG,P2hBG,and rate of adverse reaction were compared between two groups.Results Glycosylated hemoglobin (HbAlc),body weight,BMI,FBG,P2hBG in the control group before and after treatment showed no significant difference,while the exenatide group showed better results compared with those before treatment and the control group.Nursing intervention played evident effect on reducing adverse effect such as nausea,vomiting,diarrhea,low blood sugar,headache.Conclusions For patients with type 2 diabetes,using MET,SU alone or MET + SU combination therapy showed poor results of blood sugar control,addition of exenatide therapy can effectively control blood sugar,nursing intervention can significantly alleviate the adverse effects of patients.

Facing current situation of integrative medicine (IM), authors put forward that clinical and diagnosis program of IM could be carried out from clinical path, pathogenesis, treatment theory and philosophy, and so on, but with different integration degrees. Meanwhile, formulation of concrete program should be disease-targetedly set up, and adjusted from person to person, from place to place, from time to time. As for settled IM program , authors could evaluate it from whether Chinese medicine and Western medicine have formed complementary, synergistic, excitatory actions, and toxicity attenuation; whether more problems could be solved in efficacy, safety, practicability, and economy than previous single mode.
Critical Pathways ; Integrative Medicine ; trends ; Medicine, Chinese Traditional ; trends

Objective To observe the effect of the electroacupuncture ( EA) on the expression of cyclin-de-pendent kinase 5 ( Cdk5 ) in rats with muscle contusion and to explore its mechanism. Methods Thirty-two Sprague-Dawley rats were randomly divided into a normal group of 4, a model group of 4, a natural recovery group ( NR) of 12 and an EA group of 12. All except those in the normal group had acute skeletal muscle contusion induced through a heavy blow. The EA group was treated with 15 minutes of EA daily beginning 48 h after the injury while the other rats received no EA. The model group was sacrificed 24 h after modeling, and rats from the NR and EA groups were sacrificed on the 7th, 14th and 21st day after the modeling to collect tissues. Hematoxylin eosin ( HE) staining, Western blotting and quantitative real-time fluorescence PCR were used to observe any histological changes, as well as Cdk5 protein and mRNA expression. Results The HE staining showed that the other 3 groups displayed larger a-mounts of muscle fiber fracture, dissolution and inflammatory cell invasion than was observed in the normal group. Compared with the NR group, quicker recovery was seen in the EA group as evidenced by faster muscle satellite cell proliferation and more new muscle fiber generation. The average Cdk5 protein expression in both the NR and EA groups was higher than in the normal group, and that of the EA group was significantly lower than that of the NR group. Conclusions Muscle contusion can increase Cdk5 expression in skeletal muscles, at least in rats. EA can promote the restoration of skeletal muscle function, probably by inhibiting CDK5 protein and mRNA expression.

Objective To observe the efficacy and adverse reactions of intensity-modulated radiotherapy (IMRT) with or without chemotherapy in the treatment of esophageal carcinoma,and to explore the influencing factors for prognosis.Methods The short-term outcomes and acute adverse reactions in 349 patients with esophageal carcinoma who received IMRT with or without chemotherapy from 2006 to 2012 were retrospectively analyzed.The 1-,3-,and 5-year local control (LC) rates and overall survival (OS) rates were calculated with the Kaplan-Meier method.The influencing factors for survival were analyzed using the Cox regression model.Results The sample sizes at 3 and 5 years were 174 and 63,respectively.For all patients,the 1-,3-,and 5-year LC rates were 72.9％,61.2％,and 58.4％,respectively,and the 1-,3-,and 5-year OS rates were 66.5％,39.1％,and 24％,respectively.According to the results of subgroup analysis,the 1-,3-,and 5-year LC and OS rates in patients with a tumor volume of ＜ 54.73 cm3 were significantly higher than those in patients with a tumor size of ≥54.73 cm3 (P =0.001 and 0.000).There were no significant differences in 1-,3-,and 5-year LC rates between patients with and without lymph node metastasis (P =?).However,the 1-,3-,and 5-year OS rates were significantly lower in patients with lymph node metastasis than in patients without lymph node metastasis (62.7％ vs.83.1％;35.9％ vs.53.3％;20.4％ vs.38.3％;P =0.003).There were significant differences in the 1-,3-,and 5-year LC and OS rates between patients with complete response,partial response,and no response (P =0.000 and 0.000).The incidence rates of grade ≥ 2 acute radiation pneumonitis and grade ≥ 3 acute radiation esophagitis were 11.3％ and 9.0％,respectively.The tumor volume,short-term outcome,and lymph node metastasis were the influencing factors for OS (P =0.038,0.000,and 0.008).Conclusions IMRT with or without chemotherapy is effective and safe in the treatment of esophageal carcinoma.The prognosis becomes poor along with increased tumor volume and regional lymph node metastasis.The evaluation of short-term outcomes is closely correlated with LC and OS.