OBJECTIVETo observe the clinical efficacy difference on vegetative state in children between acupoint injection combined with plum-blossom needle and western medication based on basic treatment.

METHODSForty-eight children of vegetative state were randomized into an observation group and a control group, 24 cases in each one. On the basis of the treatment of transcranial magnetic stimulation apparatus, balancing treatment apparatus and massage, the acupoint injection and tapping method with plum-blossom needle were adopted in the observation group, in which Xingnaojing injection, mouse nerve growth factor (mNGF) injection, monosialotetrahexosylganglioside sodium injection (MSI), compound Danshen injection were divided in 6 pairs and were injected respectively in Baihui (GV 20), Yongquan (KI 1), Fengfu (GV 16), Yamen (GV 15) and the others, 0.5 mL in each acupoint, once a day for continuous 10 days. Additionally, the tapping method with plum-blossom needle was used on the Governor Vessel and Jiaji (EX-B 2) on the back. In the control group, the intravenous infusion was adopted with citicoline sodium injection, mannitol injection and dexamethasone injection. The treatment was given once a day, 20 days of treatment made one session and totally 3 sessions were required in the two groups. The clinical efficacy, the vegetative state score and the mean curing time were observed after 20 days, 40 days and 60 days of treatment between the two groups.

RESULTSThe effective rates were 58.3% (14/24), 70.8% (17/24) and 79.2% (19/24) in 20 days, 40 days and 60 days of treatment in the observation group and 20.8% (5/24), 45.8% (11/24) and 58.3% (14/24) in the control group respectively. The efficacy in the observation group was superior to those in the control group (P < 0.01, P < 0.05). The vegetative state score was improved apparently after 20 days, 40 days and 60 days of treatment as compared with those before treatment separately (all P < 0.05). It was improved obviously at the each time point after treatment in the observation group as compared with that in the control group (3.34 +/- 2.41 vs 2.64 +/- 11.56, 6.20 +/- 1.46 vs 4.34 +/- 1.64, 11.26 +/- 2.63 vs 8.75 +/- 2.18, all P < 0.05). The mean curing time was (45.67 +/- 16.24) days in the observation group, which was shorter apparently than that of (55.34 +/- 4.57) days in the control group (P < 0.05).

CONCLUSIONBased on basic treatment acupoint injection combined with tapping method of plum-blossom needle achieve the reliable efficacy on vegetative state in children.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Animals ; Child, Preschool ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infant ; Male ; Mice ; Nerve Growth Factor ; administration & dosage ; Persistent Vegetative State ; drug therapy ; therapy ; Phenanthrolines ; administration & dosage ; Treatment Outcome

Objective To determine whether the cross-sectional area (CSA)of the calf measured with MRI could stage lower ex-tremity lymphedema (LEL)secondary to gynecological cancer treatments.Methods 148 patients were enrolled in this research.116 females with unilateral LEL and 32 without LEL after gynecological cancer treatments underwent calf MRI and water displacement. Total soft tissue CSA (T),muscle CSA (M)and subcutaneous tissue CSA (S)of affected calf,and difference of T (DT),M (DM) and S (DS)between calves were obtained on MRI at mid-calf level.Volume of affected calf and difference of volume (DV)between calves were obtained by water displacement.Statistical analysis was performed to determine feasibility of MRI measurements for ac-cessing LEL.Results There were close correlations between volume and T or S of affected calf,and between DV and DT or DS of calves.The correlations of stages of LEL with T and S of affected calf as well as DT and DS were stronger than the volume of affect-ed calf and DV (P< 0.01).Multivariate analysis showed more significant differences in T and S than in volume of affected calf,and in DS than in DV between LEL stages (P< 0.05).No difference was found in volume of affected calf and in DV between stage 0 andⅠ. For staging LEL,DS showed the most profound discrimination ability among all measurable parameters.Conclusion DS of calves could be the most reliable parameter recommended for staging and early diagnosis of LEL.

Adult ; Afibrinogenemia ; chemically induced ; Humans ; Intracranial Hemorrhages ; chemically induced ; Male ; Valproic Acid ; adverse effects

OBJECTIVETo compare the difference in the clinical efficacy on infantile Tourette syndrome between the integrated therapy of acupuncture and pingganjianpi decoction and haloperidol tablets.

METHODSForty-seven children were randomized into an observation group (25 cases) and a control group (22 cases). In the observation group, acupuncture was applied to Taichong (LR 3), Baihui (GV 20), Zhongwan (CV 12), Zusanli (ST 36), etc. The needles were retained for 30 min. Acupuncture was given once a day and there were 5 days at intervals after 10 times of acupuncture. Additionally, pinggan jianpi decoction was prescribed. In the control group, haloperidol tablets were prescribed, starting from the small dose, 0. 05 mg/kg per day, twice a day. The treatment of 30 days made one session and 3 sessions were required. Yale global tic severity scale (YGTSS) was adopted to observe tic time, tic frequency and tic severity score before treatment and in 30 days, 60 days and 90 days after treatment in the two groups. The efficacy and adverse reactions were compared between the two groups.

RESULTSThe total effective rates were 40. 0% (10/25), 64.0% (16/25) and 76.0% (19/25) in the observation group and were 59.1% (13/22), 68.2% (15/22) and 77.3% (17/22) in the control group in 30 days, 60 days and 90 days after treatment respectively. The effect in 30 days after treatment in the control group was better than that in the observation group (P<0. 05). The differences at the other time points were not significant between the two groups (all P>0. 05). The tic time, tic frequency and tic severity score at the each time point after treatment were reduced obviously as compared with those before treatment (all P<0. 05). Each item score in the control group was reduced obviously as compared with that in the observation group in 30 days after treatment (all P<0. 05). The differences at the other time points were not significant between the two groups (all P>0.05). The probability of adverse reaction in the observation group was less than that in the control group.

CONCLUSIONThe integrated therapy of acupuncture and medicine achieves the similar effect on infantile Tourette syndrome to haloperidol tablets and the side effects of it are less.

Acupuncture Therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Tourette Syndrome ; drug therapy ; therapy ; Treatment Outcome

Neonatal hypoxic-ischemic encephalopathy as a standard term has been used for over 30 years,but now increasingly being questioned.Most experts recommend using neonatal encephalopathy instead of hypoxic-ischemic encephalopathy.The American College of Obstetricians and Gynecologists and The American Academy of Pediatrics published separately the report of Task Force on Neonatal Encephalopathy Neonatal Encephalopathy and Neurologic Outcome,Second Edition in 2014.Definition,diagnosis and treatment of neonatal encephalopathy and other content have been updated in the report.It is recommended that a comprehensive multidimensional assessment be performed of neonatal encephalopathy.This article will introduce the controversy about neonatal encephalopathy or hypoxic-ischemic encephalopathy and contents of the report of Task Force on Neonatal Encephalopathy.

Objective To build the county level hospital nursing assistance need indicator system in Jiangxi province.Methods Literature review,qualitative research method and Delphi expert consultation method were adopted to build the county level hospital nursing assistance need indicator system.The indicator system was revised through trial test.Results Two rounds of expert consultation showed that expert authority degree coefficients were 0.79,0.83; Coordination coefficient(Kendall's W) was 0.11～0.16; content experts consistency coefficient was 0.78,reliability Cronbach's α coefficient was 0.85.Through expert advice and pre-examinaion,the county level hospital nursing assistance need indicator system was built,consisting of 3 level Ⅰ indicators,8 level Ⅱ indicators,43 level ⅠⅡ indicators,including assistance contents,assistance ways and assistance time.Conclusions This study established the county level hospital nursing assistance need indicator system with better scientific and feasible characteristics.It can provide experience and guidance for the relevance and effectiveness of the implementation of follow-up care aid work.

Objective To investigate the association between the single nucleotide polymorphisms (SNP)in-308 loci of tumor necrosis factor-α(TNF-α)gene promoter region and chronic hepatitis B (CHB).Methods Genotypes of-308 loci of the TNF-αpromoter were examined by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP)in 142 patients with chronic hepatitis B (CHB group)and 150 healthy controls (HC group).The indexes for evalua-ting the curative effect were the ALT,AST,HBeAg,HBV-DNA and the viral load weight,HBV-LP and HBV-PreS1,mean-while,the correlations between related indexes and SNP in TNF-α308 loci were explored as well.Results There was no sta-tistical significance in frequency distribution difference of the genotypes and alleles of-308 loci between CHC and HC groups (P>0.05),the protective factors of TNF-α308 allele A may be not associated with CHB (OR=1.529,OR95%CI:0.872~2.684).There was no association between TNF-αgene promoter-308G/A polymorphism and the positive rates of AST, ALT,HBV-LP and HBV-PreS1 (P>0.05),however,TNF-α-308G/A polymorphism associates with the positive rates of HBeAg and HBV-DNA,and A-allele of 308 loci may increase the risk of HBeAg and HBV-DNA positive expression (HBeAg:OR=3.256,OR95%CI=1.105~9.594;HBV-DNA:OR=2.847,OR95%CI=1.059~7.655).Furthermore,A-allele compared with Gallele,statistically significant differences were observed in the certain HBVDNA viral load range of104~107 copies/ml (P <005).Conclusion TNFαgene promoter308G/A polymorphism would not be associated withCHB,but the TNFα308 gene G mutation of Aallele,which was associated with HBVDNA viral load,may be the susceptible factors of HBV infection.

Objective To investigate and analyze the nursing assistance requirements and the influencing factors of county hospital of Nanchang city.Methods A total of 327 nurses in 6 country-level hospital of Nanchang city were surveyed by the self-made questionnaire.Results The total demand score of county hospital was (4.29±0.47) scores,which was in a high level.The helping content demand was the highest,the form of assistance needs was the lowest.From the specific items of view,prevention of incision infection,nursing training,critically ill patients with bedsore nursing were higher in the content of assistance.Send a nurse to support education,nursing training,hospital experts on-site guidance were higher in the form of assistance.Long term assistance for 1 years,short-term assistance for 4-6 months were the highest in demand of helping times.The main factors of influencing county hospital nursing assistance were work area,department,degree,title etc.The work area was the important influencing factor of nursing assistance of county hospital.Conclusion The relevant departments are recommended to develop personalized assistance scheme according to the recipient hospital needs.

BACKGROUND:Many foreign studies confirm that recombinant human growth hormone (rhGH) is a safe and effective agent for treatment of idiopathic short stature (iSS), but there are no long-period and systematical researches reported in China.OBJECTIVE: To observe the promoting effect of rhGH on the growth of children with ISS.DESIGN: Case-control observation.SETTING: Department of Pediatrics, the Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: Ninety-eight children with ISS who were treated in the Department of Pediatrics, the Affiliated Hospital of Medical College of Qingdao University during December 2004 to March 2006 were involved in this study.Informed consents were obtained from the guardians of these children with ISS. According to the etiological factors, the children were assigned into 2 groups: ISS group (n =30) and growth hormone deficiency (GHD) group (n =68).METHODS : The children in ISS group and GHD group received subcutaneous administration of home-made rhGH (Jinsai Pharmaceutical Co.,Ltd., Changchun at 0.15 IU/(kg ·d) and 0.1 IU/(kg ·d) respectively before sleeping within 6 months.The body height, body mass and bone age were measured before, 3 and 6 months after treatment. The local region of injection was observed and the growth rate was calculated. Bone age was calculated by graphic atlas method and body height was predicated by BP method.MAIN OUTCOME MEASURES: Body height, body mass, bone age and growth rate of children in two groups before, 3 and 6 months after treatment.RESULTS: All the 98 children wereinvolved in the result analysis, without deletion. ①Intragroup comparison: The body height, growth rate of children in two groups 3 and 6 months after treatment were significantly superior to those before treatment [ISS group: body height:(126.5±9.4), (129.1±8.6), (121.1 ±11.0) cm (P ＜ 0.01), growth rate: (7.3±2.9), (7.5±2.7),(3.5±2.1) cm/year (P＜ 0.01); GHD group: body height: (111.0±13.0),(114.0±13.0),(108.0±12.0) cm(P＜ 0.01),growth rate: (13.2±3.5), (13.5±3.6), (4.0±2.9) cm/year(P ＜ 0.01)]. Six months after treatment, body height was increased in 27 of 30 children in ISS groups, and in all the 68 children in GHD group. ② Intergroup comparison: The growth rate of children in GHD group was concurrently higher than that in ISS group 3 and 6 months after treatment. ③Adverse reaction and side effect: During the treatment, hypothyroidism was observed in 2 children within 1 to 3 months of treatment,but there was no influence on growth rate after oral administration of thyroxin tablets. Local red swelling of skin was observed in another patient, which stopped automatically after one week duration, but the injection continued.CONCLUSION: Home-made rhGH is a safe and effective reagent for treatment of ISS. It can obviously enhance the body height and growth rate of children. Whereas the inhomogeneity of treatment effect does exist, what's more, therapeutic effect in ISS children is inferior to that in GHD children.

Pre-graduation practice is an important part of teaching work for preventive medical science.The article is about investigation on the pre-graduation practice of 85 preventive medical students just graduated,and some suggestions for improvement.It is found that the overall teaching effect is good,but there are some problems,mainly on the construction of practice base,practice contents and time,and also graduation design.