OBJECTIVETo summarize laws of acupoint selection of prescriptions for treatment of cervicogenic headache by acupuncture in modern literature.

METHODSRandomized controlled trials (RCTs) involving acupuncture and moxibustion for treatment of cervicogenic headache were recruited from CBM (1978-2012), VIP (1989-2012), Wanfang Database (1998-2012), CNKI (1979-2012), PubMed (1966-2012), EMbase (1980-2012), and Cochrane Library (Volume 4, 2012). Hand recruitment was also auxiliarily used. The frequency and percentage of common acupoints, the distribution of acupoints along 14 meridians and across each part of the body, the application of specific acupoints, and features of using prescriptions for specific acupoints were statistically described.

RESULTSTotally 37 recruited papers included 42 acupoints and 159 times. Common acupoints covered Fengchi (GB20, 28 times), Jingjiaji (EX-B2, 21 times), Baihui (DU 20, 12 times), Tianzhu (BL9, 1 times), and Ashi point (11 times). Meridians along which acupoints were used mainly covered Foot-shaoyang Gallbladder Meridian, Foot-taiyang Bladder Meridian,and DU meridian. Acupoints were mainly needled from head, neck, and upper limbs. Eight confluence points and luo-connecting point were commonest used as specific acupoints. Acupuncture prescriptions were mostly composed of multiple acupoints. Filliform needle was mainly used in acupuncture methods, followed by electro-acupuncture needle.

CONCLUSIONSModern acupuncture treatment of cervicogenic headache focuses on local specific points and acupoints along meridians. Acupoints were mostly selected from head, neck, and upper limbs by syndrome typing of Chinese medicine.

Acupuncture Points ; Acupuncture Therapy ; methods ; Humans ; Post-Traumatic Headache ; therapy ; Randomized Controlled Trials as Topic

Objective To observe the effect of the application of peripherally inserted central catheter (PICC) network platform in the information management of the patients with PICC.Methods Altogether 17 254 outpatients receiving PICC maintenance in Peking Union Medical College Hospital from April 2012 to April 2013 were enrolled as the control group,including 7 227 males and 10 027 females,with the median age of 58 years (12-85 years).A total of 20 384 outpatients from April 2013 to April 2014 with PICC were selected as the observation group,including 8 188 males and 12 196 females,~th the median age of 59 years (13-86 years).Those patients all received PICC maintenance in outpatient clinic during the intermission of therapy after PICC insertion.The time of data entry,the integrity of the data,description accuracy about complications,and normalization of wording were compared between the two groups.Results The average time of data entry in the control group was (46 ± 6) seconds,significantly longer than that in the observation group [(12 ± 5) seconds,t =562.660,P ＜ 0.05].In terms of the integrity of the data,there were 11 732 cases of complete data,3 623 cases of less complete data,and 1 899 cases of incomplete data in the control group;while the numbers of cases of complete data,less complete data,and incomplete data in the observation group were 19 568,725,and 91,respectively,showing significant difference compared with the control group (x2 =5 312.000,P ＜ 0.05).In the description accuracy about complications,the control group had 11 840 accurately described cases and 5 414 inaccurately described cases,while the observation group had 18 427 accurately described cases and 1 957 inaccurately described cases (x2 =2 814.000,P ＜ 0.05).The wording was standard in 15 280 cases but not standard in 1 974 cases in the control group,and standard in 19 659 cases and not standard in 725 cases in the observation group,with significant inter-group difference (x2 =872.600,P ＜0.05).Conclusion Simple and convenient data summary could help quality control and quality analysis,preferably guarantee the safety of catheter insertion and reduce the incidence of complications.

A comprehensive physician authorization management system has been established at Renmin Hospital of Wuhan University in its effort of promoting the clinical standardization.This system covers authorization of prescription,disposition,surgery,and medical report among others,adhering to the principle of clear,complete quantitative competence-based,authorization.The training and assessment of physicians in parallel canimprove physicians' competence and quality of care.

OBJECTIVETo investigate the expressions of hepatitis B virus x protein (HBx) and hypoxia-inducible factor-1alpha (HIF-1alpha) in hepatocellular carcinoma (HCC) tissues and HepG2 cells under normoxic and hypoxic conditions.

METHODSImmunohistochemistry was used to detect the expressions of HBx and HIF-1alpha in 78 hepatic carcinoma tissues, and their possible relationships were analyzed using SPSS 10.0 statistical software. Immunofluorescence and Western blot were used to investigate the expression of HIF-1alpha in HepG2 and HepG2-X cells under normoxic and hypoxic conditions. Flow cytometric analysis was used to measure reactive oxygen species (ROS) in HepG2 and HepG2-Xd cells under normoxic and hypoxic conditions.

RESULTSThe positive rate of HBx in the hepatocellular carcinoma tissues was 74.36% (58/78), while the positive rate of HIF-1alpha was 69.23% (54/78). Under normoxic condition, HIF-1alpha was mainly localized in the cytoplasm and partially translocated into the nuclei of most HepG2-X cells, while under hypoxic condition the expression of HIF-1alpha was positive in the cytoplasm and nuclei of HepG2 and HepG2-X cells. Under normoxic condition the expression of HIF-1alpha was negative in the HepG2 cells while it was positive in HepG2-X cells, but HIF-1alpha was upregulated time-dependently in both HepG2 and HepG2-X cells under hypoxia condition. Furthermore, HepG2-X cells had a higher level of ROS than HepG2 cells under normoxic condition, while under hypoxic condition, the levels of ROS in HepG2 and HepG2-X cells were not significantly different, but the levels of ROS in HepG2 and HepG2-X cells under hypoxia condition were higher than those under normoxia condition.

CONCLUSIONHBx and HIF-1alpha were widely expressed in HCC tissues and there is a positive relationship between them. HIF-1alpha can be upregulated by HBx in HepG2 cells under normoxic and hypoxia conditions. Regulation of HIF-1alpha by HBx in HCC might be via the ROS pathway.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Hep G2 Cells ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; Trans-Activators ; metabolism

It is well accepted that umbilical cord blood has been a source for mesenchymal stem cells. However, there was less success in culturing these cells by using traditional method. Lots of studies showed that CD271 (low affinity nerve growth factor receptor LNGFR) and CD133 could be used to positive sort of bone marrow-derived mesenchymal stem cells (MSC) in recent years. The present study was designed to explore whether the method of positive sorting of umbilical cord blood-derived MSC (UCB-MSC) was effective by using CD271 and CD133 immunomagnetic beads. The ability of forming CFU-F and differentiation capacity of the four kinds of cells, namely CD271+, CD271-, CD133+ and CD133- were analysed. The results indicated that the purities of immunomagnetically selected CD271+ and CD133+ cells were (87.58±0.48)% and (89.89±8.10)% respectively. More than 99% of CD271+ and CD133+ cells expressed CD34 and CD45, the markers of hematopoietic stem cells. CFU-F assay showed that CD271+ and CD133+ cells could not form any CFU-F and only few single fibroblast-like cells could be found in the dishes. However, part of the negative samples (27%) could form CFU-F. Phenotype of cells (passage 3) isolated by the two methods was the same, that was CD34-, CD45-, CD14-, CD29+, CD44+, CD73+, CD105+ and CD90+. They both had osteogenic and adipogenic differentiation potential. It is concluded that nearly all the CD271 and CD133 positive cells are hematopoietic cells, MSC can be effectively collected by negative selection with immunomagnetic beads against CD271 and CD133.
AC133 Antigen ; Antigens, CD ; immunology ; Bone Marrow Cells ; cytology ; immunology ; Cell Differentiation ; Cell Proliferation ; Cell Separation ; methods ; Cells, Cultured ; Fetal Blood ; cytology ; immunology ; Glycoproteins ; immunology ; Humans ; Mesenchymal Stromal Cells ; cytology ; immunology ; Peptides ; immunology ; Receptor, Nerve Growth Factor ; immunology

OBJECTIVETo explore effects and possible mechanisms of curcumin on hypoxia induced epithelial-mesenchymal transition (EMT) in hepatocellular carcinoma cell line HepG2.

METHODSHepG2 cells were divided to 3 groups, i.e., the normal control group, the CoCl2 group, and the CoCl2 plus 10 micromol/L curcumin group. The proliferation of HepG2 was determined using MTT assay. The migration of HepG2 was detected by wound healing assay.The mRNA expression of hypoxia-inducible factor-1 (HIF-1alpha) was evaluated with real-time RT-PCR. The protein expressions of HIF-1alpha, epithelial-cadherin (E-cadherin), and vimentin were determined using Western blot.

RESULTSCompared with the normal control group, the proliferation and migration of HepG2 cells under CoCl2-induced hypoxia significantly increased, the expression of HIF-1alpha was up-regulated, and the expression of E-cadherin protein was obviously down-regulated, and the expression of vimentin significantly increased (all P < 0.05). Intervention by curcumin significantly inhibited the proliferation and migration of hypoxic HepG2 cells, and expressions of HIF-1alpha and vimentin decreased, and the expression of E-cadherin was up-regulated, showing statistical difference when compared with those of the CoCl2 group (P < 0.05). There was no statistical difference in HIF-1alpha mRNA expression among the 3 groups (P > 0.05).

CONCLUSIONCurcumin could reverse the proliferation and migration of HepG2 cells under CoCl2-induced hypoxia condition, which might be associated with inhibiting up-regulated expressions of HIF-1alpha protein and EMT.

Cadherins ; metabolism ; Carcinoma, Hepatocellular ; pathology ; Cell Hypoxia ; Curcumin ; pharmacology ; Epithelial-Mesenchymal Transition ; Hep G2 Cells ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Liver Neoplasms ; pathology ; Vimentin ; metabolism

Objective:To evaluate the reliability and validity of the Chinese version of the Orebro musculoskeletal pain questionnaire (OMPQ-CHN) using patients with non-specific lower back pain.Methods:The OMPQ was translated into simplified Chinese according to the Beaton cross-cultural translation guidelines, and then 186 patients with acute or subacute lower back pain were asked to respond to its questions. Based on the results, the internal consistency and test-retest reliability were quantified, and its validity was assessed using content, criterion-related and predictive validity.Results:The Cronbach′s α for the instrument was 0.804. Its ICC was 0.833 (95% CI: 0.683-0.915). I-CVI ranged from 0.86 to 1, S-CVI/Ave=0.99. The correlation between the OMPQ-CHN and other questionnaires ranged from r=0.419 to r=0.646. The AUCs predicting pain, dysfunction and sick leave ranged from 0.723 to 0.810. Conclusions:The OMPQ-CHN has good reliability and validity, and suitably assesses the psychosocial risk factors of Chinese patients with low back pain.

OBJECTIVETo analyze the relationship between the expression of FasL, Perforin and Granzyme B and the development of acute graft versus host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSThe peripheral blood mRNA expression of granzyme B, perforin, fasL from 17 patients after allo-HSCT was detected by competitive quantitative RT-PCR and the relationship between FasL, Granzyme B and Perforin expressions and clinical symptom of aGVHD was analyzed.

RESULTSThe expression level of Granzyme B, Perforin and FasL was 4.6 +/- 0.2, 4.5 +/- 0.1, 1.4 +/- 0.1 before aGVHD occurrence respectively, and was 98.7 +/- 2.5, 91.8 +/- 3.4, 61.5 +/- 2.2, after the occurrence in 14 patients (P < or = 0.05). Over expressions of Granzyme B, Perforin, and FasL during acute GVHD were detected in 13 of 14, 12 of 14, and 12 of 14 patients respectively. The upregulated expressions occurred prior to clinical symptom of aGVHD.

CONCLUSIONThe expressions of Granzyme B, Perforin, and FasL were significantly high in patients with acute aGVHD. Monitoring of the expressions, might predict the occurrence of clinical aGVHD and it severity and prognosis.

Acute Disease ; Adult ; Fas Ligand Protein ; genetics ; Female ; Gene Expression ; Graft vs Host Disease ; blood ; diagnosis ; etiology ; Granzymes ; genetics ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Male ; Perforin ; genetics ; Postoperative Complications ; blood ; diagnosis ; etiology ; Prognosis ; RNA, Messenger ; blood ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transplantation, Homologous

OBJECTIVE: To assess segmental liver stiffness (LS) with MRI before and after endovascular intervention in patients with Budd-Chiari syndrome (BCS). MATERIALS AND METHODS: Twenty-three patients (13 males and 10 females; mean age, 42.6 ± 12.6 years; age range, 31–56 years) with BCS as a primary liver disease were recruited for this study. Two consecutive magnetic resonance elastography (MRE) examinations were performed before the endovascular treatment. Fifteen patients who underwent endovascular intervention treatment also had follow-up MRE scans within three days after the procedure. LS was measured in three liver segments: the right posterior, right anterior, and left medial segments. Inter-reader and inter-exam repeatability were analyzed with intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Segmental LS and clinical characteristics before and after the intervention were also compared. RESULTS: Within three days of the endovascular intervention, all three segmental LS values decreased: LS of the right posterior segment = 7.23 ± 0.88 kPa (before) vs. 4.94 ± 0.84 kPa (after), LS of the right anterior segment = 7.30 ± 1.06 kPa (before) vs. 4.77 ± 0.85 kPa (after), and LS of the left medial segment = 7.22 ± 0.87 kPa (before) vs. 4.87 ± 0.72 kPa (after) (all p = 0.001). There was a significant correlation between LS changes and venous pressure gradient changes before and after treatments (r = 0.651, p = 0.009). The clinical manifestations of all 15 patients significantly improved after therapy. The MRE repeatability was excellent, with insignificant variations (inter-reader, ICC = 0.839–0.943: inter-examination, ICC = 0.765–0.869). Bland-Altman analysis confirmed excellent agreement (limits of agreement, 13.4–19.4%). CONCLUSION: Segmental LS measured by MRE is a promising repeatable quantitative biomarker for monitoring the treatment response to minimally invasive endovascular intervention in patients with BCS.
Budd-Chiari Syndrome ; Elasticity Imaging Techniques ; Female ; Follow-Up Studies ; Humans ; Liver Diseases ; Liver ; Magnetic Resonance Imaging ; Male ; Venous Pressure

OBJECTIVETo investigate the expression of HBx and COX-2 in hepatitis B virus-related hepatocellular carcinoma, and Its correlation with microangiogenesis and metastasis, and possible mechanism.

METHODSImmunohistochemistry was used to detect the expression of hepatitis B virus X, cyclooxygenase-2 and CD34 in hepatitis B virus related hepatic carcinoma and 22 non-HBV related hepatic carcinoma tissues. The expression of hepatitis B virus x protein and cyclooxygenase-2 in hepatitis B virus-related hepatocellular carcinoma correlated with microangiogenesis and metastasis was tested by Spearman correlation analysis. The expression of COX-2 in HepG2-X was detected by Western blot and RT-PCR. PGE2 was detected by ELISA in clear supernatant liquid of HepG2-X. Trypan blue exclusion was performed to examine the inhibitory effects of COX-2 selective inhibitor (celecoxib).

RESULTSIn Hepatitis B carcinoma tissue, HBx and COX-2 were expressed at high level. The positive rate of COX-2 expression was 88.87% (55/62) in HBx positive expression group, which was significantly higher than that of the positive expression 31.82% (7/22, x2=27.188, P<0.01) in HBx negative expression group and 40.91% (9/22, x2=20.453, P<0.01) in non-HBV related hepatic carcinoma tissues, but it had no statistical difference (x2=0.393, P=0.531) between the HBx negative expression group and non-HBV related hepatic carcinoma tissue group. The expressions of HBx and COX-2 in metastasis group were higher than that in non-metastasis group (P<0.01), MVD in HBx or COX-2 positive expression group was significantly higher than that in negative expression group and non-HBV related hepatic carcinoma tissues (P is less than 0.01). MVD with metastasis was higher than that without metastasis (P<0.01) and MVD with portal vein invasion was higher than that without invasion (P<0.05). Spearman correlation analysis showed that the expression of COX-2 was significantly correlated with the expression of HBx (Rs=0.568, P<0.01). Celecoxib suppressed the growth of both cells in a dose-dependent manner. HepG2-X was significantly susceptible to celecoxib as compared to the HepG2-PC cells. COX-2 protein and mRNA were upregulated in HepG2-X cells than in HepG2-PC. Moreover, PGE2 was upregulated in clear supernatant liquid of HepG2-X than in HepG2-PC.

CONCLUSIONThe expressions of HBx and COX-2 were higher in HBV-related hepatocellular carcinoma. COX-2 was significantly correlated with HBx in HCC and it could be a key factor involved in HBx contributed hepatocellular carcinoma's microangiogenesis and metastasis. The possible mechanism of the dual effects might be through HBx, COX-2 and PGE2 pathways in infiltration involved metastasis and microangiogenesis involved metastasis.

Carcinoma, Hepatocellular ; blood supply ; etiology ; metabolism ; virology ; Cell Line, Tumor ; Cyclooxygenase 2 ; metabolism ; Hepatitis B ; complications ; Hepatitis B virus ; metabolism ; Humans ; Liver Neoplasms ; blood supply ; metabolism ; virology ; Neoplasm Metastasis ; Neovascularization, Pathologic ; Trans-Activators ; metabolism