Objective To research effect of esomeprazole,mosapride,hydrotalcid treatment of gastroesophageal reflux disease(GERD),and find effective treatment methods.Methods 90 cases diagnosed as GERD patients were divided into the three groups:group A(30 cases),B group(30 cases),C group(30 cases).A group was treated with esomeprazole 40mg qd,B group was treated with esomeprazole 40mg qd,mosapride 5mg tid,C group was treated with esomeprazole 40mg qd,mosapride 5mg tid,three scenarios Hydrotalcid 1.0g tid treatment.The treatment methods remained for 4 weeks and 8 weeks and symptom remission were evaluated.Results The clinical remission rates were 66.7％,83.3％ and 90.0％ after four weeks treatment in A group,B group,C group; the clinical remission rates were 73.3％,90.0％ and 96.7％ after eight weeks treatment in A group,B group,C group.The total effective rate of group A and group C in eight weeks were significantly difference (P ＜ 0.05),A group and B group,B group and C group showed no significant difference(P ＞ 0.05).Conclusion Esomeprazole combined with mosapride,Hydrotalcid treated with GERD can get better efficacy,which can improve symptom relief rates.

Objective To observe the effect of cervical plexus block combined with cervical vertebra traction treatment of cervical spondylosis of nerve root type .Methods 60 cases of nerve root type cervical spondylosis were divided into two groups by coin tossing:group A(n=32) cervical plexus block combined with cervical traction thera-py, group B( n=28) treated by cervical traction therapy ,according to the severity of pain compared two groups of treatment effect.Results after treatment,20d group 10d,30d,90d pain scores were (4.61 ±0.70)%,(3.71 ± 0.57)%,(3.30 ±0.65)%,(4.44 ±1.04)%,group B respectively (5.88 ±1.47)%,(5.61 ±1.35)%,(4.83 ± 0.86)%,(5.50 ±0.87)%,the difference between two groups was statistically significant (t=5.85,1.06,1.30, 7.51,all P<0.01).Conclusion The cervical plexus block combined with cervical traction for treatment of nerve root type of cervical spondylosis is better than the routine treatment of cervical traction ,which is suitable for promotion of primary health care units .

OBJECTIVETo explore the mechanism of electroacupuncture at Zusanli (ST 36) on regulation of intestinal inflammatory reaction in rats with acute pancreatitis.

METHODSFifty-four SD rats were randomly divided into a severe acute pancreatitis (SAP) group, an electroacupuncture (EA) group and a sham-operation (SO) group, 18 cases in each group. 3.5% sodium cholate was used to made SAP model by retrograde injecting in cholangiopancreatic duct. After the success of model making, the EA group was treated with EA at bilateral Zusanli (ST 36) for 30 min. The SO group and the SAP group were fixed at the same time for 30 min without treatment. All the rats were killed at 3 h, 6 h and 12 h after modeling in batches. The pathological changes of pancreatic tissue and intestinal epithelium were observed, and the expression of small intestinal occludin protein and nuclear factor kappa-B (NF-kappaB) were detected by immunohistochemical SP method.

RESULTSThe pathologic score and the expression of small intestinal NF-kappaB p65 at 3 h, 6 h and 12 h after modeling in the EA group and the SO group were significantly lower than those in the SAP group (all P < 0.05), and the expression of small intestinal occludin protein in the EA group and the SO group were significantly higher than that in the SAP group (all P < 0.05).

CONCLUSIONElectroacupuncture at Zusanli (ST 36) can alleviate pancreatic injury by reducing the expression of NF-kappaB p65 and enhancing the expression of occludin protein in the intestinal epithelium in the SAP model rats.

Acupuncture Points ; Acute Disease ; therapy ; Animals ; Electroacupuncture ; Humans ; Intestine, Small ; metabolism ; Male ; NF-kappa B ; genetics ; metabolism ; Occludin ; genetics ; metabolism ; Pancreatitis ; genetics ; metabolism ; therapy ; Rats ; Rats, Sprague-Dawley

Objective To observe the effect of Shujinkeli on stroke patients with spastic hemiplegia. Methods The double blind test was applied in this study. 77 stroke patients with spastic hemiplegia were randomly divided into the group A (n=38) and the group B (n=39). Under the guidance of the criterion and routine treatment, patients of the group A were treated with Shujinkeli A and patients of the group B were treated with Shujinkeli B. After treatment, curative effect of patients was evaluated. Results The group A was the treatment group, and the group B was the control group. After treatment, the treatment group was superior to the control group in the improvement of muscular tension, Fugel-Meyer score and Barthel index. Conclusion The Shujinkeli can make the high muscular tension lower, which will accelerate the disabled limbs' recovery and improve patients' motor function and self-care ability of daily life.

Objective To report the clinical outcome and prognostic factors for locally recurrent nasopharyngeal carcinoma(NPC)treated with intensity modulated radiotherapy(IMRT).Methods From January 2001 to August 2004,the data of 132 such NPC patients were analyzed retrospectively;104 male and 28 female with a median of 44.5 years(range 21-73 years).Ninety-eight patients(74.2%)were confirmed by biopsy as having NPC:9 with WHO TypeⅡand 89 WHO TypeⅢ.The other 34 patients were only diagnosed by MRI scan because of the extension/invasion was in the base of skull and/or cavernous sinus.Median interval time were 24 months(range 6-184 months).According to the 1992 Chinese Fuzhou Staging System:stageⅠ3.8 %,Ⅱ10.6 %,Ⅲ22.0% andⅣa 63.6%;T1 5.3%,T2 10.6%,T3 22.7% and T4 55.3%.Twenty-two patients had recurrence in the neck lymph nodes.IMRT was given with the sequential tomotherapy system(NOMOS Peacock systems)of 6 MV X-rays.Prescription dose was 60-70 Gy in GTV,with the fractional dose of 1.94-2.8 Gy.Sixty patients were also supplemented with two to six courses of cisplatin-based chemotherapy.Results The median volume of GTV was 39.5 cm~3(range 0.8-158.9 cm~3).The D95,V95,mean dose and fractionation dose of GTV was 66.9 Gy,98.3%,69.8 Gy and 2.32 Gy,respectively.The median follow-up time was 12 months(range,2-47 months).The 1-,2-and 3-year local progression-free rate was 96.4%,88.4% and 85.3%,respectively.The overall 1-,2-and 3-year survival rate was 6.5.9%,49.6% and 41.6%,respectively.Eleven patients developed distant metastases.Forty-seven patients were observed to devdop mucosa necrosis and/or massive hemorrhage in the nasopharynx.On univariate and multivariate analysis,fractional dose and vohane of GTV were significant prognostic factors for overall survival(P=0.016,0.009).Conclusions The local control and survival rate can be improved for patients with locally recurrent nasopharygeal carcinoma after treatment of intensity modulated radiotherapy.The fractional dose and volume of GTV are independent prognostic factors for the overall survival. The main death reasons are mucosa necrosis and/or massive hemorrhage in the nasopharynx.

OBJECTIVE: To explore the clinical evaluation system reflecting the superiority and characteristics of comprehensive traditional Chinese medicine (TCM) therapy for acute stroke. METHODS: A randomized controlled trial with single blind in various therapeutic centers was applied on the patients with the acute stage of hemorrhagic stroke due to hypertension, who were allocated to the trial group and the control group. The trial group accepted the general Western medicine therapy and differential treatment of traditional Chinese medicine based on stage classification. Patients in the control group were treated with the general Western medicine and the placebo of traditional Chinese herbal medicine. The treatment effect was assessed at the 7th day, 14th day, 21st day, and 28th day of post-treatment and after 3-month follow-up. The clinical evaluation system included the syndromes of TCM (ZH), Glasgow coma standard (GCS), nerve functional failure (NF), activity of daily living (ADL), Barther index (BI), quality of life index (QLI) and functional activities questionnaire (FAQ). RESULTS: Four hundred and four patients with acute stroke were included. There were 178 cases with yang-syndrome and 21 cases with yin-syndrome in the trial group (n=199), and there were 165 cases with yang-syndrome and 40 cases with yin-syndrome in the control group (n=205). The rates of recovery and obvious improvement after 3-month treatment in the trial group and the control group were 86.5% and 73.6% respectively. There was significant difference between the two groups (P<0.01). The response sensitivity of the effect items indicated that the sensitivity of GCS began to increase from the 7th day and was high at the 14th day and the 21st day for all patients. The response sensitivity of the NF scale was high for all patients at the 14th day, the 21st day and the 28th day. The BI scale and the QLI scale were sensitive to the patients with light and middle stage of stroke at the 21st day, and were sensitive to the patients with light stage of stroke after 3-month follow-up. The FAQ scale was sensitive to the light stroke at the 21st day and after 3-month follow-up. The ADL scale was sensitive to all patients at the 28th day and the patients with light stage of stroke after 3-month follow-up. The ZH scale was sensitive to all patients from 0 to 7d, the 14th day, and the 28th day. The principle components analysis indicated these 7 items could reflect the condition of stroke from 0-7d, the 21st day and after 3-month follow-up, and could be used to evaluate the therapeutic effect of hemorrhagic stroke. ZH scale and FAQ scale were more sensitive than other effect items at the 28th day. CONCLUSION: The seven items (GCSbNFbBIbQLIbFAQbADLbZH) have high sensibility to all patients in the acute stage of hemorrhage stroke especially at the 21st day. The ZH score will change in accord with the condition of stroke, and is appropriate to reflect the condition of stroke. It is believed that the seven items can form the system of effect evaluation in different stages of stroke, and the ZH scale is a very important item.

Objective To explore the relationship between IL-1?-511C/T and IL-1?+3953C/T site polymorphisms and the susceptibility of pediatric epilepsy.Methods Under the case-control study,IL-1?-511C/T and IL-1?+3953C/T site polymorphisms in 117 patients with pediatric epilepsy and 95 healthy individuals controls(healthy control group) were analyzed with polymerase chain reaction restriction and fragment length polymorphism(PCR-RFLP),the relationship between IL-1?-511C/T,IL-1?+3953 C/T site polymorphisms and the risk of pediatric epilepsy were analyzed.SAS 8.0 software was used to analyze the data.Results Multiple variate logistic regression analysis revealed that compared with healthy control group,there was no relationship between the IL-1?-511C/T site polymorphisms and the susceptibility of pediatric epilepsy individuals,carrying at least one +3953T variant allele(CT and TT genotypes) had a significantly increased risk for pediatric epilepsy(adjusted OR=2.46,95%CI 1.03-5.87),compared with the wild-type genotype(+3953CC).Furthermore,individuals with epilepsy or febrile seizures family history had a significantly higher risk(adjusted OR=4.12,95%CI 1.28-29.34),compared with those with both CC genotypes.Conclusions These findings support the hypothesis that IL-1?-511C/T site polymorphisms have no relationship with epilepsy,but the IL-1?+3953C/T polymorphism may contribute to the risk of developing pediatric epilepsy.

Objective To understand the prevalence,drug resistance and clinical features of children with acute lower respiratory tract infection(ALRI) caused by escherichia coli.Methods From Oct. 2005 to Oct. 2006,659 patients with ALRI who were admitted to hospital were chosen and their nasopharyngeal secretions were obtained and cultured.K-B disc diffusion for antibiotic susceptibility were performed for these clinical isolates.Results Among 659 patients,118 cases were isolated escherichia coli,the rate was 17.99% which had 90 boys and 28 girls.Eighty-seven of 118 E.coli strains were with extended-spectrum ?-lactamase(ESBLs),the rate was 73.73%.All of strains were sensitive to imipenem.For ESBLs-producing strains,the ratio of resistance tocefotaxime,ceftriaxone,cefuroxime,ampicillin,piperacillin were 78.81%,73.73%,73.73%,76.27%,78.81%,respectively.Conclusions The positive rate of ESBLs producing E coli in Kunming area is high and drug resistance is severe gradually.Imipenem can be the first selection for treatment on these infections.

Objective To explore the changes of contents of glutamate (Glu) and aspartate (Asp) in hippocampus formation and cerebrospinal fluid (CSF) in kainite acid(KA) induced epilepsy rats.Methods SD rats(n=40) were divided into 2 groups randomly:the KA group [intracerebroventricular injection(icv) of KA, 2 ?g/kg] and control group(icv of NS). KA group were divided into 4 groups at 6 h,1,3 and 7 d,each group 8 rats.High pressure liquid chromatgraphy(HPLC) was used to assess the concentrations of Glu and Asp in hippocampus formation and CSF.Results In the hippocampus, the contents of Glu and Asp increased continuously 1 d after seizure , but not different from those of control group.Three days later, only Glu became significantly different from control group. However, the contents of Glu and Asp in the CSF were significantly different from the control 6 h after seizure.Conclusion The contents of excite amino acid (especially Glu)in CSF increase immediately after KA injection, which are earlier than those in hippocampus formation.