【Objective】To observe the therapeutic effect of water-extract of Herba Portulacae Mixture(HPM) for genital herpes.【Methods】One hundred and twenty patients with genital herpes were equally randomized into groups A and B.Group A received water-extract of MSP,and group B received acyclovir.Seven days constituted one treatment course.The therapeutic effect was evaluated after 4 continuous treatment courses.【Results】In group A,33 were cured,13 markedly effective,11 effective,3 ineffective and the total effective rate was 95.00%;in group B,19 were cured,14 markedly effective,18 effective,9 ineffective and the total effective rate was 85.00%.The total effective rate in group A was better than that in group B(P

Objective To learn the status quo of core competency of registered nurses in tertiary level first-class hospitals in Liaoning Province and compare the level and characteristics of core competency of registered nurses in different working years in order to supply evidence to establish contrapuntal training protocol.Methods "The Competency Inventory for Registered Nurse scale"(CIRN,by LIU Ming)was distributed to investigate the core competency of registered nurses,the data underwent analysis.Results The overall score of core competency level was (174.11±31.89),the score of the nurses with 16～20 years of working experience was the highest,while the score of nurses working for 1～5 years was the lowest.The core competency varied with working years,evident difference existed in different dimensions and total scores.Conclusions The overall core competency is at the upper middle level for registered nurses from five tertiary level first-class hospitals in Liaoning Province.They are competent enough to provide health care.With the increasing length of working time,nurses' core competency level will strengthen gradually.

Background and purpose:Although intermittent endocrine therapy is a treatment strategy for new patients with advanced prostate cancer, the use of hormonal therapy is still controversial. This study aimed to investigate the efficacy of intermittent hormonal therapy for the patients with advanced prostate cancer and determine the factors influencing efficacy of the treatment.Methods:From Jul. 2009 to May 2015, patients with advanced prostate cancer were treated with 6 months of hormonal therapy, and then efficacy was assessed. A hundred and twenty-eight hormone sensitive patients were randomly divided into intermittent and continuous treatment groups, and were observed with efficacy, side effects, quality of life scores and other indicators. The prognostic factors for intermittent group were analyzed.Results:A total of 128 patients with advanced prostate cancer were enrolled in the study. Prostate-specific antigen (PSA) levels were significantly decreased in 96 patients after endocrine therapy. Among those, 43 patients received intermittent endocrine therapy while 53 patients received continuous endocrine therapy. The score of KPS in the intermittent treatment group was 82.6±7.4, which was significantly higher than that of the continuous group (KPS score was 69.8±8.7). There was a sig-nificant difference between them (P<0.05). The incidence of treatment related side effects and the proportion of developing hormone independent tumor in the intermittent group were significantly lower than that in the continuous treatment group (P<0.05). The 5-year survival rate in intermittent group was 72.1%, higher than that in the continuous group (63%). How-ever, the difference was not statistically significant (P>0.5). PSA level in the early stage of endocrine therapy and G1eason score before treatment were important factors affecting the prognosis of patients. The patients in the intermittent group were followed up for 13-70 months, and received 1 to 4 cycles of treatment. The number of patients in the treatment was declined during the extension of the treatment, and the treatment interval was shorter.Conclusion:Intermittent endocrine therapy is an effective treatment for advanced prostate cancer. It is safe and reliable. It can improve the quality of life for patients and reduce the economic burden on them.

The clinical efficacy and safety of auricular acupuncture (AA) for treatment of primary insomnia was evaluated. After a comprehensive retrieval in domestic and foreign databases, literatures were strictly screened and Revman 5.2 software was applied to perform a Meta-analysis on eligible randomized controlled trials (RCTs). The evidence quality was assessed with GRADE profiler 3.6 software. As a result, 8 articles were included involving 894 patients. Compared among AA and sham AA, placebo AA, blank control, there was significant difference in Pittsburgh sleep quality index (PSQI) [WMD = -3.48, 95% CI (-3.96, -3.00)], sleep latency LWMD = -10.14, 95% CI (-17.16, -3.12)] and sleep awakening times [WMD = -9.98, 95% CI (-1.10,-0.48)]. Compared between AA and western medication, there was significant difference in PSQI [WMD = -3.62, 95% CI (-4.59, -2.65)]. The evidence quality was moderate in AA vs. sham AA, placebo AA or blank control, while that of the rest was extremely low. No reports of adverse events were described in all studies. In conclusion, for the treatment of primary insomnia, AA could effectively improve sleep quality, but due to the low evidence quality, cautious attitude should be taken on this conclusion, and clinical trials with large sample and high quality were needed in the further.
Acupuncture, Ear ; Humans ; Randomized Controlled Trials as Topic ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy

Objective To explore the effect of in utero exposure to inlfammation on innate immune response in preterm infants. Methods Forty-seven premature infants with gestational age<35 weeks were recruited in this study. According to his-tological evidence of placental infection, all neonates were divided into intrauterine inlfammation positive group and negative group. Mononuclear cells and monocytes were isolated from umbilical cord blood, and were cultured in vitro in the presence or absence of LPS (100 ng/ml). The levels of interleukin 1β(IL-1β), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) and interleukin 10 (IL-10) in cord blood plasma and monocyte cultural supernatants were measured by ELISA respectively. The level of IL-1β, TNF-α, IL-6 and IL-10 mRNA were detected by Real-time PCR. Expression of HLA-DR on surface of CD14+monocytes and ratio of CD3+CD4+/CD3+CD8+T was analyzed by lfow cytometry. Results (1) The level of cord plasma IL-6 in intrauterine inlfammation positive group was signiifcantly higher than in negative group. (P=0.02). (2) After stimulation of LPS, levels of IL-1β, IL-6, TNF-α, IL-10 in supernatants were increased signiifcantly, in consistence with their mRNA expression (P<0.05) in both groups. (3) Expression of HLA-DR on surface of monocytes was signiifcantly decreased after stimulation with LPS in intrauterine inlfammation positive group (P=0.012), but was signiifcantly increased in negative group (P=0.0305). Con-clusions In utero exposure to inlfammation does not suppress the response of monocytes to LPS in preterm neonates, but impairs the antigen presenting function in monocytes.

Objective To investigate subtle structural changes of white matter in patients with amnestic mild cognitive impair-ment (aMCI)using a tractography-based method.Methods Thirty patients with clinical diagnosis of aMCI and thirty-one cases of normal control(NC)and undergone diffusion tensor imaging.Cingulum (CG),corpus callosum (CC),uncinate fasciculus (UNC) and inferior occipitofrontal fasciculus (IOFF)were reconstructed,and fractional anisotrophy (FA)values were measured along these tracts using dTV II software.Differences of white matter tracts’FA values were explored between aMCI group and NC group.In addition,correlation analyses were also done between FA values and the MMSE(mini-mental state examination)scores in the aMCI patients.Results ① aMCI patients exhibited significant lower FA values in the bilateral CG,bilateral UNC and CC than NC group. Although there were no statistically significant differences,aMCI patients exhibited lower FA values than NC group in the left IOFF.② The FA values of right CG were positively correlated with MMSE scores.Conclusion Abnormal changes of FA values in CG,UNC and CC of aMCI patients suggest that subtle damages of white matter tracts related to memory exist in the prodromal phase of Alzheimer’s disease (AD).Fiber tractography has high sensitivity in detecting early damages of white matter.

Objective To study the pre-transplant serum level of anti-endothelial cell antibody(AECA)in kidney allograft recipients and its impact on the episode of acute rejection (AR) within 6 months after transplantation. Methods A total of 495 kidney allograft recipients with pre-transplant serum between December 1998 and August 2003 in our center and 40 healthy controls(negative controls)were enrolled in the study.Clinical data including AR within 6 months after transplantation were analyzed retrospectively.The serum AECA level was measured by cyto-ELISA using EA.hy926 cells as substrate,which was shown as the ratio of P (patient)/N (negative control)=(A_(petient)-A_(blank contrnal)/(A_(negative contral)-A_(blank contral).AECA was considered positive when P/N value Was greater than the average A_(negative control)value plus two times the standard deviation.Results Positive rate of AECA was 18.8%(93/495).AECA level in hemodialysis patients who had been on hemodialysis more than 12 months was 1.43±0.37,greater than those less than 12 months(1.27± 0.32,P=0.013)and those of non-dialyzed patients(1.31±0.32,P=0.029).Correlation coeffieient between AECA level and hemodialysis duration was 0.218 (P=0.018).AR incidence in AECA positive recipients was 38.7%,greater than that in AECA negative recipients (23.4%,P=0.002). Incidence of acute T cell-mediated rejection and acute antibody-mediated rejction increased significantly (P=0.035,P=0.002 respectively).Multifactor logistic regression analysis indicated that AECA positive,PRA greater than 1 0%and high CDC level were risk factors of AR with odds ratio of 2.056,1.751 and 1.764 respectively(P=0.004,0.029,0.050). Conclusions The AECA positive in pre-transplant serum indicates the elevated risk of acute allograft rejection.The AECA level increases with prolonged hemodialysis duration.

Objective To investigate the effect of non-alcoholic fatty liver disease (NAFLD) on virologic response in chronic hepatitis B patients treated with nucleos(t)ide analogues.Methods Three hundred and thirty-two treatment-naive patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) who visited clinic or hospitalized in the First Affiliated Hospital of Wenzhou Medical College from January 2007 to December 2009 were enrolled and finally 316 patients completed the research.Among them,106 patients were diagnosed with CHB complicated with NAFLD by ultrasonography (NAFLD group),and the remaining 210 patients were diagnosed with simple CHB (CHB group).Patients in both groups were treated with combination therapy of lamivudine (LAM) plus adefovir dipivoxil (ADV) or entecavir (ETV) monotherapy for 96 weeks.Alanine aminotransferase (ALT) levels,virologic response and serological response were compared pre-and post-treatment in both groups.Enumeration data was compared using x2 test,and correlation analysis was performed using Logistic multivariate regression analysis.Results Rates of hepatitis B virus (HBV) DNA clearance in the NAFLD group at week 12,24 and 48 were 46.2％,61.3％ and 74.5％,respectively,which were all significantly lower than those in CHB group (61.9％,73.8％ and 83.8％,x2 =7.051,5.195,3.895,respectively; all P＜0.05).However,rates of HBV DNA clearance were 85.8％ in the NAFLD group and 91.9％ in the CHB group at week 96.This difference did not reach the level of significance (x2 =2.838,P＞0.05).Rates of HBeAg loss in the NAFLD group were 27.4％ at week 48 and 37.7％ at week 96,compared to 33.3％ and 44.8％ in the CHB group.There was no significant difference in these two groups (x2 =1.169,1.424,both P＞0.05).Rate of HBeAg seroconversion in the NAFLD group was significantly lower than that in the CHB group at week 96 (17.9％ vs29.5％,x2=4.972,P＜0.05).Rates of ALT normalization were also found to be significantly lower in the NAFLD group than those in the CHB group at week 48 (69.8％ vs 80.5％,P＜0.05) and at week 96 (82.1％ vs 91.0％,P＜0.05).Multivariate regression analysis demonstrated that serum levels of triacylglycerol (OR=3.725,P=0.000),uric acid (OR=1.005,P=0.040) and fasting blood-glucose (OR=3.067,P=0.000) were independent risk factors associated with NAFLD.NAFLD was found to be a risk factor of virologic response at each time point throughout the treatment.(week 12,OR=2.749,P=0.001; week 24,OR=1.981,P=0.030; week48,OR=2.348,P=0.021; week 96,OR=8.053,P=0.001).Conclusions During antiviral therapy,NAFLD may affect biochemical and serological responses in CHB patients treated with nucleos(t) ide analogues,and may affect early virologic response in these patients.

Objective To compare the relative efficacy and quality of extraction of human fecal DNA using four methods.Methods Real-time PCR were utilized for analysis both quantification and quality of the fecal targeted bacteria(including gut all eubaeterium,Bacteriodes-PrevoteUa group,Bifidobacterium spp Enterobacteriaceae and Enterococcus spp)by using 16s rRNA gene-targeted genus or group-specific primer sets.Results The negative rat of PCR product from method 3(phenol-chloroform plus bead-beating) was about 40%(4/10)by using universal primers,the PCR inhibition disappeared after fecal DNA purified with column.The total fecal 16s rRNA gene copy numbers(per gram of wet weight of feces)as well as the numbers of Bacteriodes-Prevotella group from method 1(QIAamp~DNA stool mini kit)and 4(QIAamp~ DNA stool mini kit combined with bead-beating)was higher significantly than that from method 2(FastDNA ~Kit,Biol01)and 3(P

Objective To elucidate the effects of erythromycin derivative,9(S)-hydroxyerythromycin, on the expression of NF-?B in active T lymphocytes,and evaluate the potential role in the treatment of rheuma- toid arthritis(RA).Methods Jurkat T cells were exposed to 100 pmol/L tumor necrosis factor(TNF)-?with or without pretreatment with 3,10,30 or I00?g/ml of erythromycin or 9(S)-hydrnxyerythromycin 1 h at 37℃. The expression of NF-?B was measured by reverse transcription-polymerase chain reaction(RT-PCR)and Western blot.Results Erythromycin and 9(S)-hydroxyerythromycin decreased the expression of NF-?B mRNA and protein in a dose-related fashion.The treatments with erythromycin(100?g/ml)and 9(S)-hydrox- yerythromycin(100?g/ml)resulted in about 36%,45% reduction of NF-?B mRNA(P