ObjectiveTo investigate the effect of bone marrow-derived mesenchymal stem cells (MSCs) on collagen-induced arthritis(CIA) and the possible mechanisms. MethodsMSCs from C57BL/6 mice bone marrow were isolated and expanded. Three DBA-I mice were as normal control group (Sodium Chloride injected on day 0 and 21) after primary immunization. After the bovine collagen Ⅱ induced-CIA models were established, fifteen male mice were randomly divided into 3 groups according to treatment regi-mens: CIA control group(0.2 ml Sodium Chloride injected through caudal vein on day 0 and 21), prevention group(1×10+6 cells MSC on day 0) and treatment group. (1×10+6 cells MSC on day 21 after primary immun-ization). The observed parameters included arthritis index (Al), articular pathology changes, levels of serum TNF-α, IL-1β detected hy ELISA. In addition, the percentage of CD4+CD25+Foxp3+Treg cells(Tregs) in CD4+ T cells of spleen or lymphoid node from mice were also analyzed by flow cytometry(FCM). Results①The Al and articular pathological score of the prevention group and treatment group were lower than the CIA control group(P<0.05). ②The levels of serum TNF-α and IL-1β of normal control, prevention group and treatment group were significantly decreased compared with CIA control group(P<0.05), and positively correlated with Al or articular pathological score (P<0.05). ③The percentage of Tregs from spleen and lymph nodes was significantly increased in MSCs treated mice(P<0.05). Conclusion MSCs transplantation is effective for CIA and suppression of TNF-α, IL-1β and up-regulation of Tregs by MSCs may be the possible mechanism in CIA.

Objective To investigate the clinical efficacy of combined acupuncture and medicine in treating kidney deficiency and phlegm dampness syndrome in obese polycystic ovary syndrome. Method Sixty-four patients were randomly allocated to two groups. The treatment group received combined acupuncture and medicine and the control group, oral administration of metformin. The course of treatment was three months. Pre-treatment and post-treatment indicators were statistically analyzed in the two groups of patients. Result BMI, waist to hip ratio, fasting insulin, fasting blood glucose and HOMA-IR improved significantly in the treatment group of patients after treatment; there were statistically significant pre-/post-treatment differences (P<0.05). Post-treatment BMI and waist to hip ratio improved more markedly in the treatment group than in the control group (P<0.05). Conclusion Combined acupuncture and medicine has a better therapeutic effect on kidney deficiency and phlegm dampness syndrome in obese polycystic ovary syndrome.

ObjectiveTo investigate the clinical efficacy of pricking-medicinal cupping bloodletting therapy for knee osteoarthritis.MethodSixty patients with knee osteoarthritis were randomly allocated to pricking-cupping bloodletting (treatment) and conventional treatment (control) groups, 30 cases each. In the treatment group, specific points around the knee were pricked with bloodletting needles and blood was removed by cupping with decoction. In the control group, the same points were given acupuncture and the affected part was given microwave treatment. The WOMAC score was recorded in the two groups of patients before treatment and after the end of treatment course. The therapeutic effect was evaluated by comparing the pre-and post-treatment scores between the two groups.ResultThere was a statistically significant pre-/post-treatment difference in the WOMAC total score in the two groups (P<0.01). The range of decrease in the WOMAC total score was significantly larger in the treatment group than in the control group. There was a statistically significant post-treatment difference in the WOMAC total score between the two groups (P<0.01). The WOMAC item scores decreased in varying degrees in both groups after treatment (P<0.01). The total efficacy rate was statistically higher in the treatment group than in the control group; there was a statistically significantdifference (P<0.05). The clinical therapeutic effect was statistically better in the treatment group than in the control group.Conclusion Pricking-medicinal cupping bloodletting is statistically better than conventional treatment in treating knee osteoarthritis. It can effectively relieve the pain and stiffness and improve knee function and the quality of life in the patients.

Objective To investigate the effect of medical student involvement on the quality of actual cardiopulmonary resuscitation (CPR).Methods A digital video-recording system was used to record and analyze CPR procedures for adult patients from March 2011 to September 2012.Results Twenty-six student-involved and 40 non-student-involved cases were studied.The chest compression rate in the studentinvolved group was significantly higher than that in the non-student-involved group (P ＜ 0.01).The proportion of compressions atabove 110 cpm was higher in the student-involved group (P =0.021),whereas the proportion at 90 ～ 110 cpm was lower in the student-involved group (P =0.015).The ratio of hands-off time to total manual compression time was significantly lower in the student-involved group than in the non-student-involved group (P ＜ 0.05).In contrast,the student-involved group delivered a higher ventilation rate compared with the non-student-involved group (P ＜ 0.05).The observed time delay to first compression and first ventilation was very similar between the groups.There were no significant differences between groups in either return of spontaneous circulation or time from survival to discharge.Conclusions Student-involved resuscitation teams were able to perform good CPR,with higher compression rates and fewer interruptions.However,the supervision from medical staff is still needed to ensure appropriate chest compression and ventilation rate in student-involved actual CPR in the emergency department.

A service system was created that the tertiary hospitals as the leader, the secondary hospitals as the core and the basic hospi-tals as the foundation, formed the one-stop three level medical rehabilitation service system. It made the referral process more convenient with the operation of the one-stop service, along with the integrated management, the homogenization treatment and the one-stop three level medical institutions;and also solved the problems of the inadequate of rehabilitation medical institutions, the lackage of rehabilitation profes-sionals and the uneven professional and technical condition, that realized hierarchical rehabilitation and two-way referral to meet the rehabil-itation needs of patients.

Objective To explore the necessity and effect of the motivational interviewing/MIcurriculum in medical school students. Methods Helping smoking cessation in standard patients with coronary heart disease was assumed as the expected goal. MI was carried out for medical school students to master basal knowledge and skills of MI and help using MI methods in persuading smoking quitting. The teaching mode of MI curriculum was comprised of a lecture series and small group dis-cussion with videotaped practice in role plays. Motivational Interviewing Treatment Integrity (MITI) scoring tool was applied to assess the teaching effect of MI curriculum with students' performance videotapes. Questionnaire was used to evaluate the quality and efficacy of the MI curriculum, and SPSS 13.0 was used to t test measurement data. Results Analysis of the MITI scores showed students had general mastery of MI knowledge. Nevertheless, they did not reach recommended professional profi-ciency level. The scores of empathy and MI spirit in global ratings were (4.11 ±0.32) and (5.82 ± 0.17), respectively (recommended level, 6 score). In the videotape evaluation of behavior counts, MI adherentreached (70.96%±24.34%) (recommended level, 90%). Open question reached (31.42%±8.51%) (recommended level, 70%). Total refection counts were (7.84±3.22) counts per video (recom-mended level, 10). The standard questions recommended in MI for behavior change were better used by students. 93.75%and 87.50%students used ranking questions to evaluate the importance and con-fidence of smoking quitting. Nevertheless, the exploration questions about importance and confidence were less used to know the reason behind their ranking . The results of questionnaire showed that 83.33%students felt MI curriculum effective to help them improve confidence and skills in counseling with patients. 97.91%students thought the mastery of MI methods as an important skill for physicians to have. Conclusion The teaching practice of MI curriculum in medical school students is necessary and feasible with good teaching results. It is worth for professional counseling regarding unhealthy be-havior change in patients.

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

Objective Peritoneal dialysis can be done at home , however , its clinical follow-up quality is lower compared with hemodialysis due to the lack of detailed follow-up system and professional management team for post-discharge nursing care .The article aimed to explore the effect of a nurse-led integrated specialized disease management model in the follow-up of peritoneal dialysis patients . Methods Nurse-led integrated specialized disease management model was provided for 270 patients with peritoneal dialysis (PD) from January 2012 to May 2013.Self-designed questionnaire on diasease knowledge and self-care assement questionnaire were used for patients to evaluate their self-care ability and understanding of disease knowledge .Regular follow-up continued . Results The patients′understanding of disease knowledge was on the rise at 1st day before discharge, 1st month and 3rd months after discharge. After the application of nurse-led integrated specialized disease management model , the patients′regular clinical follow-up rate was in-creased from 78.3% to 88.6%.The patients′self-care ability improved gradually at 1st day before discharge , 1st month and 3rd months after discharge , which was of significant differences . Conclusion The nurse-led nurse-led integrated specialized disease management model can improve peritoneal dialysis patients′self-care ability and reduce their medical expense , which is of clinical sig-nificance .

Objective To determine the occurrence rate of liver toxicity and related risk factors after receiving highly active an-tiretroviral-therapy(HAART)by the non-nucleoside reverse transcriptase inhibittor.Methods To observe the changes of liver func-tion indexes before and after antiviral therapy in 102 patients receiving HAART,the incidence rates of the liver toxicity were com-pared between nevirapine(NVP)and efavirenz(EFV)and the risk factors of liver toxicity after treatment were analyzed.Results A-mong 102 patients,73 cases accepted the treatment of NVP,the incidence rate of hepatotoxicity was 35.6%,29 cases accepted the treatment of EFV,the incidence rate of hepatotoxicity was 13.8%,the hepatotoxicity incidence rate had statistically significant difference between the two treatment methods(χ2 =4.761,P =0.029).Co-infected by hepatitis C virus(HCV)and baseline ALT el-evation were the independent risk factors of hepatotoxicity occurrence(P <0.05).Conclusion The patients receiving the treatment of NVP are more likely to have hepatotoxicity than the patients receiving the treatment of EFV.Co-infected by HCV and baseline ALT elevation are the independent risk factors of hepatotoxicity occurrence.

Objective To establish Beagle dogs’model of abducens nerves injury and to observe the clinical therapeu?tic effect of electroacupuncture treatment. Methods Twenty-four Beagle dogs were randomly divided into simple crush group (control group) and crush with electrical stimulation group (experimental group). Cisternal segment of the abducens nerve was given a crush injury, then electrodes were implanted to stimulate the abducens nerve and lateral rectus muscle. Distance between the center of the pupil to medial margin of extraocular adjoin was measured from 1 to 12 weeks after opera?tions. Results All procedures used in the study were well tolerated by Beagle dogs. Electrode implantation to stimulate the lateral rectus muscle and the abducens nerve behind of cavemous sinus was successful. There was no statistical significance of the distance between the two groups from 1 to 2 weeks after operations, and the distance was shorter in experimental group than that in control group from 4 to 12 weeks after operations (P<0.01). Conclusion The animal models established to study electroacupuncture treatment of the injured abducens nerves was successful. Electroacupuncture can promote the re?covery of the injured abducens nerves obviously.