Objective To observe the effect of acupuncture on the expressions of serum corticotropin-releasing hormone (CRH), pituitary adrenocorticotropic hormone (ACTH) and its mRNA, to discuss the predominant and secondary factors that influence the efficacy of acupuncture, and to explore the optimal combination of acupuncture parameters.Method The rat model of kidney yang deficiency was made by muscular injection with hydrocortisone. Serum CRH, pituitary ACTH and its mRNA expressions were taken as the observation indexes, and 4 influential factors (i.e. selection of acupoints, angle of needle twisting, frequency of needle twisting, and time of needle twisting) plus 3 levels of each factor were arranged to L9(34) orthogonal table. A computer-controlled acupuncture manipulation device was used to treat the kidney yang rats. Serum CRH and pituitary ACTH were detected by enzyme-linked immunosorbent assay (ELISA) and pituitary ACTH mRNA expression by real time fluorescent quantitative PCR, to illustrate the primary and secondary factors that affect the acupuncture effectiveness.Results Regarding the effect on acupuncture effectiveness, the time of needle twisting ranked the top, followed by frequency of needle twisting, angle of needle twisting, and selection of acupoints. Angle of needle twisting, frequency of needle twisting, and time of needle twisting should be the predominant factors or secondary factors in influencing acupuncture effectiveness (P<0.01 orP>0.05). Selection of acupoints should be an important factor or secondary factor in influencing acupuncture effectiveness (P<0.05 orP>0.05).Conclusion For rats with kidney yang deficiency, the optimal acupuncture parameters combination should be acupuncture at Shenshu (BL 23), with twisting angle by 90°, twisting frequency at 180/min, and needle twisting time 120 s. Different factors can produce different effects on the therapeutic efficacy of acupuncture in treating rats with kidney yang deficiency; among the factors, the time of needle twisting produces the most significant effect, followed by frequency of needle twisting, angle of needle twisting, and selection of acupoints.

Objective To investigate the clinical efficacy of mallet needle plus acupuncture in treating stiff neck. Method Eighty patients with stiff neck were randomly allocated to treatment and control groups, 40 cases each. The treatment group received mallet needle therapy plus acupuncture and the control group, acupuncture alone, for three consecutive days. In the two groups, the Pain Rating Index (PRI) score and the Visual Analogue Scale (VAS) score were recorded before and after treatment and the clinical therapeutic effects were evaluated after treatment. Result The PRI score and the VAS score decreased in both groups after treatment compared with before (P<0.05) and decreased more in the treatment group than in the control group at the end of treatment (P<0.05). The total efficacy rate was 95.0% in the treatment group and 87.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). Conclusion Mallet needle therapy plus acupuncture is more effective than acupuncture alone in treating stiff neck.

Objective To explore the clinical significance of prenatal diagnosis for absence of fetal cavum septum pellucidum (CSP) by ultrasonography. Methods The ultrasonographic characteristics were retrospectively analyzed in 63 fetuses, whose CSPs were not detected in prenatal two and three dimensional ultrasonography in Nanjing Medical University Affiliated Suzhou Hospital. Results In 63 fetuses with absent CSP, the related malformations included:(1) Five cases were diagnosed as agenesis of corpus callosum (ACC, including four complete ACC and one partial ACC);(2) Twenty-seven cases were diagnosed as holoprosencephaly (HPE, including 18 alobar HPE, ifve semilobar HPE and four lobar HPE);(3) One case was diagnosed as schizencephaly;(4) Two cases were diagnosed as porencephaly;(5) Five cases were diagnosed as hydranencephaly;(6) Twenty-three cases were diagnosed as severe hydrocephalus, among which ifve cases were caused by aqueductal stenosis and the other 18 cases were caused by open spina biifda (Chiari Ⅱ malformation). These absent CSP fetuses had other abnormalities including one case of Dandy-Walker Malformation, one case of Dandy-Walker Variation, 14 cases of median cleft lip, ifve cases of single naris, two cases of proboscis nose, three cases of talipes foot and four cases of single umbilical artery, etc. These 63 cases were all followed up after prenatal ultrasonography but 4 cases were missed and one case of septo-optic dysplasia was misdiagnosed as lobar HPE. The diagnoses of other 58 fetuses by ultrasonography were conifrmed by follow up. Conclusions CSP is considered as an essential part in prenatal evaluations of the fetal central nervous system during second-and third-trimester. Absence of CSP is always accompanied with an extremely wide spectrum of fetal neuroanatomic malformations, including prosencephalon diseases, intracranial midline anomalies, etc. Prenatal ultrasonography is the best choice for the observation of CSP.

Objective To compare clinical outcomes in eyes with macula-off rhegmatogenous retinal detachments (RRD) with peripheral breaks managed by surgical protocols that result in either complete (CSFD) or partial subretinal fluid drainage (PSFD).Methods Following the clinical detection of a maculaoff RRD with peripheral retinal breaks,patients were offered the opportunity to enroll in the study,and those patients who signed the consent were evaluated for eligibility based upon the inclusion and exclusion criteria for this clinical study,and if fully eligible they were assigned prospectively to one of the two surgical designs (PSFD or CSFD,1∶ 1) using a random number table.Seventy-two eyes of 72 patients were enrolled and studied.Patients were treated with 25G plus vitrectomy,endolaser or transscleral cryopexy,either complete (n=36),or partial (n=36) subretinal fluid drainage,and 14％C3F8 (PFO) was used for intraocular tamponade.After surgery,all patients were kept in a supine position for 24 hours,and then in a clinically optimal position for 6-10 days.The study patients were examined at 1,3 and 6 months after surgery with thorough ophthalmic examinations.Macular optical coherence tomography (OCT) imaging was acquired in 1 month.Anatomical and visual outcomes as well as intra-operative and postoperative complications of the two groups were compared.Furthermore,the persistence of subfoveal fluid in OCT images and the symptoms of distortion at 3 months were measured and recorded.The primary study endpoint of anatomic retinal reattachment for each group was based upon the 6-month time-point.Results The preoperative baseline characteristics between the two groups were not significantly different.The single-operation success rates were 88.9％ and 91.6％ respectively for the CSFD and the PSFD groups (x2 =0.158,P＞0.05).The mean best corrected visual acuity (BCVA) at 6 month endpoint were 0.99± 0.52 minimum resoluation angle in logarithmic (logMAR) for the CSFD group and 1.07±0.34 logMAR for the PSFD group(t=0.580,P=0.564).The mean operative time was longer in the CSFD group (62.25± 4.32) minutes than that in the PSFD group (47.9 ± 5.0) minutes (t =0.580,P=0.564).seven of 29 (24.1％) phakic eyes in the CSFD group had lens injury during SRF drainage,and none of the 31-phakic eyes in the PSFD group sustained lens damage.Residual PFO was present in 6 of 36 CSFD cases (16.7％).Successful retinal reattachment after primary surgery was achieved in 33) PSFD eyes and in 32 CSFD eyes based upon OCT imaging at 1 month demonstrated reattached foveae with no residual subfoveal fluid.Among these patients,22 patients (62.5％) in the CSFD group and 23(69.7％) patients in the PSFD group reported distortion in the operated eye or/and a difference in image size between the two eyes at the 6 month visit (P=1.00).Conclusions Partial subretinal fluid drainage during pars plana vitrectomy for the repair of macula-off RRD with peripheral breaks is effective.The success rates are not statistically different.Additionally,PSFD procedures can simplify the surgery procedure,shorten operative time and,and to some extent,reduce the incidence of complications relevant to the CSFD approach.

Objective To compare the effects of electroacupuncture at points Shangjuxu(ST37), Zusanli(ST36), Xiajuxu(ST39) and Yanglingquan(GB34) on colonic expressions of interleukin-1b (IL-1b) and nicotinic acetylcholine receptor a7 mRNA (nAchRa7mRNA) in ulcerative colitis rats and investigate if large intestine lower He-Sea point Shangjuxu has relative specificity to fu organ diseases. Method Seventy healthy SD rats were randomized into blank, model, Shangjuxu, Zusanli, Xiajuxu, Yanglingquan and Chengjin groups, 10 rats, half male and half female, each. A rat model of ulcerative colitis was made by induction of 2-4-6 three nitrobenzene sulfonic acid/ethanol solution enema in every group except the blank group. After successful model making and ten days of treatment, rat colonic mucosal ulcers and inflammation were observed macroscopically, colonic IL-1bcontent was measured by ELISA and the expression of nAchRa7mRNA was determined by RT-PCR. Result Compared with the model group, colonic lesions were reduced in varying degrees, colonic IL-1b content was significantly lower and the expression of nAchRa7mRNA was higher in every acupoint group (P<0.05, P<0.01);the colonic ulcer score was lower in the Shangjuxu and Zusanli groups (P<0.05, P<0.01). Compared with the Shangjuxu group, colonic expression of nAchRa7mRNA was lower in the other four acupoint groups (P<0.01); colonic mucosal ulcers and inflammatory lesions were more severe and the colonic ulcer score and the IL-1bcontent were higher in the Xiajuxu, Yanglingquan and Chengjin groups (P<0.05, P<0.01). Conclusion The mechanism of electroacupuncture treatment for ulcerative colitis may be that it regulates abnormal immunologic function by modulating IL-1b and nAchRa7mRNA and reduces mucosal lesions. The overall therapeutic effect of Shangjuxu is better than those of Zusanli, Xiajuxu, Yanglingquan and Chengjin, indicating that Shangjuxu has relative specificity to fu organ large intestine.

Objective To explore the effect of social medical treatment in improving the quality of life for patients with nasopharyngeal carcinoma.Methods 32 patients with nasopharyngeal carcinoma were mentioned with social medical treatment (including psychological treatment,family visit,family tend,social healing service,etc).The result was measured by using the SQOL-NPC.and the different stages of the results were compared.Results All the patients were tracked in 2 years.All the scores were mark down in a table.Conclusion After analyzing the results,it was found that social medical treatment played an important role in improving the quality of life for patients with nasopharyngeal carcinoma.

Objective To explore the clinical value and typing characteristic of prenatal ultrasonography for fetal cystic adenomatoid malformation of the lung(CAML).Methods Ultrasonographic features and typing of fetal CAML in 41 cases detected by prenatal ultrasonography were analyzed retrospectively.All cases were followed up until to the induction of labor or birth.Results (1)Site of tumor: in the 41 cases,there were 22 cases on the left side,15 on the right side and 4 on bilateral.(2)Typing diagnosis of prenatal ultrasonography: three cases were CAML type Ⅰ,14 were type Ⅱ,and 24 cases were type Ⅲ.(3)Pathology diagnosis: thirty two cases were induced abortion.CAML was confirmed in 29 cases by autopsy and the classifications were consistent with the prenatal diagnosis of ultrasonography.Three pulmonary sequestration cases were prenatally misdiagnosed as CAML type Ⅲ by ultrasonography.(4)The other nine cases were followed up to birth.Three masses decreased gradually and then disappeared.Six newborns were confirmed as CAML by CT.Their typings were consistent with the postnatal diagnosis.(5)The diagnostic accuracy rate of prenatal ultrasonography for CAML was 92.7%(38/41).Its misdiagnostic rate was 7.3%(3/41).Conclusions Prenatal ultrasonography has a high accuracy rate for the diagnosis and classification of CAML and is the first choice to detect CAML early in pregnancy.It has an important clinical value.Pulmonary sequestration should be distinguished from CAML type Ⅲ because they tend to be confused.

Objective To compare the efficacy of concurrent chemoradiotherapy versus radiotherapy alone for T3-4 N0-1 M0 and T14 N2-3 M0 nasopharyngeal carcinoma (NPC) after induction chemotherapy.Methods From 2002 to 2005,400 patients with stage Ⅲ and Ⅳa NPC were randomly divided into 2 groups :induction chemotherapy followed by concurrent chemoradiotherapy group (IC/CCRT,201 patients),and induction chemotherapy followed by radiotherapy alone group (IC/RT, 199 patients).Subgroup analysis was conducted for 197 patients with stage T3-4N0-1M0 NPC and 203 with stage T1-4N2-3M0 NPC.Results The follow-up rate were 96.2%, with a median followg-up time of 3.9 years.For T3-4N0-1 M0 NPC patients in IC/CCRT group (104 patients) and IC/RT group (93 patients), the 3-year overall survival, disease-free survival, locoregional recurrence-free survival and distant metastasis-free survival rates were 84.0% and 85.9% (χ2=0.08,P =0.780) ,77.0% and 72.0% (χ2=0.44,P =0.510) ,89.5% and 92.3% (χ2=0.65 ,P = 0.420), and 84.9% and 77.0% (χ2= 1.59, P = 0.210), respectively; For T1-4 N2-3 M0 NPC patients in IC/CCRT group (97 patients) and IC/RT group (106 patients), the corresponding rates were 67.4% and 82.2% (χ2=3.48,P=0.060), 61.5% and 68.0% (χ2= 1.86,P=0.170), 86.2% and 87.0% (χ2=0.57 ,P =0.450) and 66.2% and 75.6% (χ2=2.07 ,P =0.150), respectively.Acute sideeffects were similar except more leucocytopenia in IC/CCRT group than IC/RT group.Conclusions Compared with IC/RT, IC/CCRT dose not improve the overall survival in patients with T3-4N0-1 M0 and T1-4 N2-3 M0 NPC.

Objective To investigate the fetal ultrasonographic features in pregnancies with Toxoplasma (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplex virus (HSV) infection. Methods From January 2011 to March 2013, prenatal ultrasound examination was performed in 545 fetuses with mothers of speciifc positive IgM of TOX, RV, CMV and HSV, detected by enzyme-linked immune sorbent assay (ELISA) in Nanjing Medical University Affiliated Suzhou Hospital. Ultrasonographic features were summarized and pregnancy outcome was followed up in fetuses with abnormal ifndings. Results Among the 545 fetuses, 56 cases with abnormal sonographic ifndings:6 cases with central nervous systerm abnormalities (2 intracranial calcifications, 4 hydrocephaly);9 cases with digestive system abnormalities (1 intrahepatic calcifications, 8 echogenic bowel);2 cases with heart abnormalities (1 interventricular septal defect, 1 right heart enlargement);17 cases with abnormal amniotic fluid volume (16 polyhydramnios, 1 oligohydramnios);3 cases with placental abnormality (1 thick placenta, 2 placenta abnormal calciifcation);13 cases with urinary systerm abmormality appearing as renal sinus separation;and 6 cases with other systerm abnormalities (1 neck lymphatic hygroma, 1 single umbilical artery, 1 sacrococygeal teratoma and 3 intrauterine growth restriction);2 cases of complicated abnormalities. Conclusions Prenatal ultrasonography is signiifcant in detecting serious fetal malformations, such as hydrocephaly, heart abnormalities and characteristic ultrasound features such as intracranial calciifcations, echogenic bowel, placenta abnormal calciifcation complicated with TOX, RV, CMV and HSV infection, providing valuable information for further clinical treatment, such as induced labour.

BACKGROUND:Study shows that margarita liquid has effect on promoting histiocyte regeneration and removing scars.OBJECTIVE:To observe the effects of margarita liquid on the proliferation of fibroblasts in human skin scar tissues.DESIGN,TIME AND SETTING:A grouping contrast observational experiment was performed in the Experiment Centre of Guangxi Medical University from September to December in 2008.MATERIALS:Scar tissue samples were obtained from patients in the Department of Plastic Surgery,Guangxi Medical University.Margarita liquid was the digest of margarita purchased from Beihai Gofar Marine Biological Industry Co.,Ltd and rich in multi-amino acids,polypeptides,vitamin,mineral matters and natural enzymes.METHODS:Human skin scar cell line was established by removing non-fibroblasts through repeated primary culture and serial subcultivation of scar fibroblasts with reference to Veelken method. The 3-5 generation human skin scar fibroblasts on exponential phase of growth were made into single cell suspension by trypsin digestion which was then inoculated on plastic 96-well cell culture plate,with the density of 0.5×10~4/well as well as 100 μL cell suspension and 100 μL DMEM medium in each well. After culture for 24 hours,primary medium was discarded. The grouping of the experiment:200 μL mediums with 125.00,62.50,31.30,15.60,7.80,3.90,1.95,0.98 mg/L margarita liquid were used respectively in margarita liquid group;200 μL pure medium was added into each well in control group.MAIN OUTCOME MEASURES:MTT and TUNEL assay were used to examine the proliferation and the apoptosis of fibroblastsrespectively.RESULTS:The 50% inhibiting concentration (IC_(50)) of margarita liquid on fibroblasts was 15 mg/L. Margarita liquid at any other concentration but 0.98 mg/L was effective in inhibiting fibroblast growth in a dose-dependent way,i.e. the higher margarita liquidconcentration,the higher inhibition ratio on fibroblast growth. Fibroblasts cultured with 15 mg/L (IC_(50)50) margarita liquid had got reduced volume,lessened cytoplasm,decreased density,increased apoptosis rate and buffy colour. Fibroblasts in control group were large,rich in cytoplasm and compact. Apoptotic index was higher in the margarita liquid group than in the blank control group CONCLUSION:Margarita liquid could inhibit the proliferation of skin scar fibroblasts cultured in vitro and induce the apoptosis of them.