Objective To observe the clinical efficacy of deep needling the points around the ear plus scalp acupuncture in treating neurosensory tinnitus.Method Totally 210 patients with neurosensory tinnitus were randomized into a treatment group and a control group, 105 cases in each group. The treatment group was intervened by deep needling the points around the ear plus scalp acupuncture, while the control group was by conventional acupuncture. The clinical efficacies were compared between the two groups after 3 treatment courses.Result The total effective rate was 82.9% in the treatment group versus 63.8% in the control group, and the difference was statistically significant (P<0.05).Conclusion Deep needling the points around the ear plus scalp acupuncture is an effective method in treating neurosensory tinnitus.

Adolescent ; Adult ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; therapy ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neck ; Young Adult

Castleman Disease ; Humans ; Male ; Middle Aged ; Neck ; Young Adult

Objective To investigate the mechanism of disturbed immunological function induced by Epstein-Barr virus(EBV) infection through evaluating NKG2D expressions in NK cells and CD8+ T lymphocytes from children with infectious mononucleosis.Methods Twenty-nine children with infectious mononucleosis (IM) and twenty-five age-matched healthy children were enrolled in the study.NKG2D/NKG2A expressions in NK cells and CD8+T lymphocytes,and NKG2D ligand MHC Ⅰ chain-related molecules A(MICA) and UL-16binding proteins (ULBP-1) expressions on CD14+ mononuclear cells (MC) were analyzed by flow cytometry.The concentrations of cytokines such as IL-7,IL-12,IL-15,IFN-γ,TGF-β and soluble MICA(sMICA) in plasma were determined by enzyme-linked immunosorbent assay (ELISA).Results (1) Compared with the control group,NKG2D expression was significantly decreased in both NK cells and CD8+T lymphocytes from children with IM (P＜0.05),especially in the three cases of suspected EVB-HLH children.(2)There was no difference in the expression of MICA and ULBP-1 in CD14+ MC between the children with IM and the normal control(P＞0.05).(3)The concentrations of IL-15 and TGF-β in plasma were lower than those of the control group (P＜0.05),while the levels of IL-7,IL-12,IFN-γ and sMICA were up-regulated(P＜0.05) in children with IM.(4)NKG2A expression in NKcells in children with IM was significantly increased as compared with healthy controls(P＜0.05),however,there was no differences in the expression of NKG2A in CD8+ T lymphocytes between the two groups (P＞0.05).Conclusion Remarkable down-regulated expressions of NKG2D in NK cells and CD8+T lymphocytes might be one of the factors causing disturbed immunological function in children with EBV infection,which might have a close relationship with abnormal cytokine milieu of IL-15 and IL-12or high concentration of sMICA.

Objective To investigate protective effects and mechanism of folic acid on brain neural cells in preeclampsia rat model.Methods Adult pregnant Wistar rats were randonly divided into 4 groups (n = 10 in each group).Rats in model group were injected intraperitoneally with homocysteine (Hcy,200 mg · kg-1 · d-1) daily and were injected subcutaneously every other day with monosodium glutamate (MSG,1 g · kg-1 · 48 h-1) from the 10th day of pregnancy to establish the model of preeclampsia. Lowdose folic acid (low dose group 10 ng · kg-1· d-1) and high-dose folic acid (high dose group 20 mg · kg-1 · d-1 ) were given intragastric administration with folic acid tablets dissolved in saline daily at the same time of establishing model.Rats in control group were injected or intragastric administration with the same dose of saline as above up to the 20th day of pregnancy.Brain tissue was fixed on the 20th day of pregnancy, so was that plasma folic acid was measured with automatic electro-chemiluminescence.Rats' immunohistochemical staining.bcl-2 mRNA and protein expression changes were observed by using reverse transcription(RT) -PCR and western blot.Results ( 1 ) Plasma folate concentrations were ( 39.5 ± 3.4 )nmol/L in low dose group and (40.1 ±5.4) nmol/L in high dose group, which were all significantly higher than (26.9 ± 6.7 ) nmol/L in model group( P ＜ 0.01 ).Plasma folate in low dose and high dose group did not show significant difference( P ＞ 0.05 ); ( 2 ) Apoptosis cell were 48.2 ± 9.1 in low dose group and 44.7 ±8.3 in high dose group, which were significantly lower than 75.8 ± 10.1 in model group (P＜0.01).However, apoptosis cell in low dose and high dose group did not show significant difference( P ＞0.05 ) ;(3 )significant difference( P ＞ 0.05 ); (4) bcl-2 mRNA and protein expression were 0.98 ± 0.49 and 0.89 ±0.52 in low dose group and 0.95 ± 0.38 and 0.92 ± 0.47 in high dose group which was significantly higher than 0.62 ± 0.20 and 0.45 ± 0.37 in model group ( P ＜ 0.01 ); bcl-2 expression in low dose and high dose group showed no significant difference ( P ＞ 0.05 ).Conclusions Folic acid has a protective role on neural activation and promoting bcl-2 gene and protein expression.

ObjectiveAim at the problems in the treatments of the children malignant bone tumor of distal femur,we put forward the concept of the dual mobility hemi-knee prosthesis and try to perform the motion parameters analysis and the pilot clinical trials.MethodsBase on the CT data from samples of knee joint in adult,we adopted the Mimics/Geomagic/Pro-E software and computer numerical control milling machine technology to design and produce the dual mobility hemi-knee artificial prosthesis,and then motion parameters was analyzed in vitro test,and at last pilot clinical trial was performed.ResultsIn vitro experiment showed that the displacement of the internal femoral condyle flexion facet center was(2.59±0.43) mm in normal knee group,(2.22±0.52) mm in dual mobility hemi-knee prosthesis group,and (1.18±0.43) mm in total knee arthroplasty group; the displacement of the external femoral condyle flexion facet center was (11.95±6.62) mm in normal group,(11.25±6.19) mm in dual mobility hemi-knee prosthesis group,and (1.26±0.42) mm in total knee arthroplasty group; the maximum relative rotation angle was 13.17°±7.58° in normal knee group,11.69°±6.49° in dual mobility hemi-knee prosthesis group,and 5.40°±1.29° in total knee arthroplasty group.After that,we accomplished the pilot clinical trials successfully for a patient with malignant bone tumor in distal femur.The patient recovered well and the treatment outcome was satisfactory.ConclusionThe motion parameters analysis showed that the motion mode of the dual mobility hemi-knee prosthesis is similar with that of the normal knee.The dual mobility hemi-knee prosthesis provides a whole new concept and method for the treatment of malignant bone tumor of distal femur in children,and the device and concept of ligament reattachment provide a solution to the reconstruction of knee ligament.

Objective To evaluate the use of spiral enteroscopy in diagnosis and treatment of smallbowel diseases.Methods The data of 8 patients who underwent spiral enteroscopy from July to September 2009 were retrospectively studied.The variables including maximal insertion depth,total procedure time,complications,and outcome were evaluated.Results The average maximal depth of intubation was 2.2 m beyond the Ligament of Triez (0-3.6 m beyond Ligament of Triez),with a mean procedure time at 41 min (25 to 77 min).Small bowel Crohn's disease was diagnosed in 2 cases with biopsy suggesting active inflammation and granular formation.Small intestinal tumor was detected in 1 patient with pathological finding of high grade dysplasia.Jejunal ulcer was detected in 1 patient.Multiple polyps were found in 1 patient after jejunal anastomosis,which were then treated with endoscopic argon plasma coagulation (APC).No abnormalities were found in 3 other patients.No complications occurred during and after the procedure.The maneuver of spiral enteroscopy and APC were same as that of balloon enteroscopy.Conclusion Spiral enteroscopy is simple and convenient to operate,which is of great potential in clinical use.

lem and direct necessary intervention to improve the completion rate of whole small intestine examination.

Objective To evaluate the clinical effect of capsule endoscopy(CE)followed by a directed double-balloon enteroscopy(DBE)in diagnosis of patients with suspected small bowel disease.Methods Two hundred and ninety-nine consecutive patients with obscure gastrointestinal bleeding or other various indications for CE examination were analyzed.DBE was recommended after negative or indeterminate evaluation on CE.The diagnostic and follow-up data were collected and analyzed.Resails A total of 296 patients completed CE examination.Of whorn,138(46.6%)cases had positive findings,68(23.0%)cases were suspected for small bowel disease and 90(30.4%)cases had negative finding,Those who were suspected(45 cases)and negative(7 cases)for CE examination were performed DBE examination and small bowel lesions were found in 31 cases and 1 case,respectively.The false-negative diagnosis was probably made by DBE in 8 patients,whereas no false-positive case was found by DBE.The false-negative diagnosis was probably made by CE in 2 patients,whereas 8 false-positive cases were found by CE.With the results of CE examination,lesions were found by only one-side procedure of DBE in 90.3%(28/31)of patients.The results that followed up for median 17 months indicated that 93.5% of patients with positive findings by DBE were received optimal therapy.Both CE and DBE procedures were well tolerated and no severe complications occurred.Conclusions The detection rate of sinall bowel lesions with CE was high,whereas the indetermination of CE findings was also significant.Majority of suspected findings by CE may be further confirmed by DBE.The strategy that start with CE and followed by DBE may increase diagnostic yield in patients with suspected small bowel disease and improve the prognosis.

Objective To evaluate the guiding role of capsule endoscopy (CE) in choosing the access route of double-balloon enteroscopy (DBE) for small bowel diseases. Methods Patients with complete CE and with small bowel diseases confirmed by DBE were enrolled. The lesion location found on CE was represented by the time index, which was the ratio of access time from pylorus to lesion over access time from pylorus to ileocecal valve. Based on our previous retrospective evaluation, oral approach was selected when the index was ≤0. 6, otherwise the anal access would be chosen. Accuracy of time index predicting DBE access rout was evaluated. Results Data of 60 patients undergoing both CE and DBE were evaluated. All lesions detected by CE were confirmed by DBE, with 41 via oral route and 19 via anus. Based on the time index with threshold of 0.6, the accuracy of selecting the insertion route of DBE was 100%. Conclusion DBE is an effective approach to confirm CE results. In patients with complete small bowel investigation by CE, the insertion route for DBE can be reliably indicated with time index based on the CE results.