The method of acupuncture combined with rehabilitation training in the treatment of shoulder hand syndrome after stroke is reliablet, quick, with simple operation and less adverse reactions. Among them, characteristic acupuncture could focus on the targeted points with obvious effect than ordinary acupuncture, and the combination with rehabilitation training could greatly improve the curative effect. However, there still exist some problems in the current research, such as the difficulty of conducting blind clinical trials of acupuncture therapy; the lack of follow-up data in the evaluation of curative effect, the uncertainty of long-term curative effect; the small sample size of clinical research, etc., so multi-centered and large sample RCT research are still needed.

Objective To investigate the efficacy of escitalopram combined with psychoanalysis in the treatment of refractory depression. Methods A total of 63 patients were randomly divided into escitalopram group ( n = 32) and escitalopram combined with psychoanalysis group( n = 31 ). All patients were evaluated with Hamilton depression Rating Scale(HAMD). Results After treatment,the scores of HAMD in two groups were both significantly lower than those before treatment. In the 8th ( ( HAMD ( 17.35 ± 2.98 ) ), 12th ( ( HAMD (9. 26 ±3.46) )weekend of treatment, the scores of HAMD in study group were significanlly lower than those in control group(8 th:21.97 ± 3.26; 12 th: 15.28 ± 3. 18 ). There were no significant differences in side effects between study group and control group. Conclusion Escitalopram angumented with psychoanalysis takes effects better than escitalopram single and doesn't increase side effects in the treatment of refractory depression.

The first metatarsophalangeal joint bending plays an important role in the foot movement. However, the existing researches mainly focused on the movement scope of the joint and the clinical treatments of related foot diseases. In order to investigate the effects of the first metatarsophalangeal joint bending on human walking gait stability, the present researchers recruited 6 healthy young men to perform the first metatarsophalangeal joint constraint (FMJC) and barefoot (BF) walking tests. Data of the temporal and spatial parameters, the joint angles of lower limbs, the ground reaction forces (GRF) and utilized coefficients of friction (UCOF) were collected and analyzed. The results showed that, since hip and knee could produce compensation motions, the FMJC had no significant effects on waking gait, but the slip and fall probability increased significantly.
Friction ; Gait ; Humans ; Male ; Metatarsophalangeal Joint ; physiology ; Walking

Objective To investigate the function of triggering receptor expresses on myeloid cells receptor-1 (TREM-1) in lymphocyte differentiation and regulation of Aspergillus infected immunosuppressed rats.Methods Cyclophosphamide (CTX) was intraperitoneally injected and Fumigatus spore suspension was inhaled by percutaneous tracheostomy to establish the immunosuppressive invasive pulmonary aspergillosis (IPA) rat model.After 24 h, 48 h, 72 h and 96 h inoculation, rats were sacrificed.Lung tissue specimens, bronchoalveolar lavage fluid (BALF) , and plasma samples were collected.Plasma and BALF sTREM-1, plasma T cell-specific transcription factor (T-box expressed in T cells, T-bet) and eomesodermin(Eomes) were detected by ELISA.Biopsy specimens of lung tissue were used for periodic acid-schiff (PAS) staining and culture.Results The mortality rate of immunosuppressed rats after Aspergillus inhalation for 96 h was as high as 54.4％.Biopsy of lung tissue suggested acute inflammatory cell infiltration, interstitial lung congestion, alveolar structural damage, and visible Aspergillus hyphae in alveoli.Compared with normal control group[(110.50 ± 7.70)ng/L], plasma sTREM-1 in study groups were significantly increased [IPA : (146.77 ± 10.41) ng/L;CXT + IPA at 24 h : (226.00 ± 11.88) ng/L;CTX + IPA at 48 h : (200.77 ± 10.63) ng/L;P ＜ 0.05], so were T-bet levels [IPA : (561.17 ± 7.23) μg/L;CXT + IPA at 24 h : (647.00 ± 33.03) μg/L;CTX + IPA at 48 h : (619.23 ± 87.44) μg/L;control group : (340.03 ± 26.32) μg/L;respectively, P ＜0.05].However, plasma Eomes levels in IPA group, CTX + IPA at 24 h and 48 h were significantly lower compared with that in normal controls [IPA : (7.96 ± 0.65) ng/L;CXT + IPA at 24 h : (3.97 ± 0.35) ng/L;CTX + IPA at 48 h : (4.00 ± 0.74) ng/L;control group : (8.38 ± 0.51) ng/L;respectively,P ＜0.001].Compared with those in CTX + IPA vaccination after 24 h and 48 h, plasma sTREM-1 [(106.67 ±7.64)ng/L;(133.27 ± 32.79) ng/L] and T-bet [(299.64±63.07)μg/L;(398.02 ± 109.22) μg/L] in CTX + IPA at 72 h and 96 h inoculation were significantly lower (P ＜ 0.001).While Eomes [(8.38 ± 0.54) ng/L;(8.40 ± 0.70) ng/L] raised significantly higher (P ＜ 0.001).Compared with the control group, sTREM-1 levels in BALF of IPA + CTX 24 h, 48 h, 72 h, and 96 h groups were consistently high (P ＜ 0.05).Pearson correlation analysis showed that sTREM-1 and T-bet had a significant positive correlation (r =0.91, P ＜ 0.001), yet Eomes was negatively correlated with them (r =-0.788, P ＜ 0.001).Conclusions sTREM-1 in rat plasma and BALF appears highly expressed in immune compromised Aspergillus infected rat model.Plasma sTREM-1 is closely correlated with T-bet and Eomes levels, which suggests that TREM-1 may be involved in lymphocytic regulation and differentiation during fungal infection.

By participating in the national medical colleges and universities students' clinical skill competition and summarizing the experiences after the competition,we reflected on problems and weakness in the past clinical teaching including weak sterile concept and lack of clinical thinking,humanities,communication skills,teamwork awareness,etc.We should take methods to future improve medical students' clinical training capabilities including strengthening the concept of sterile and clinical skills,promoting training of comprehensive clinical thinking ability and problem-solving ability,emphasizing on humane care and communication between doctors and patients; cultivating teamwork awareness thus to comprehensively enhance the overall quality of medical students.

Objective To observe the distribution of sentinel nodes(SN) in gastric cancer,and investigate their clinical significance.Methods The extent and features of intraoperatively stained sentinel nodes in 288 cases of gastric cancer were analyzed retrospectively.Methylene blue was injected intraoperatively into the(subseral) muscle and submucosa of the normal gastric wall adjacent to the neoplasms,then lymphadenography was performed,and the nodes were resected for histopathological examination.Results The pathological(diagnosis) of the 288 cases with gastric cancer was T_1 in 102 cases,T_2 106 cases and T_3 60 cases.Stained nodes were detectable in 270 cases(success rate: 93.8%).One hundred and two cases were found to have lymph node metastasis;66 cases had metastasis in both SNs and non-SNs;18 cases in SNs alone;and 18 cases in non-SNs alone.Conclusions Sentinel lymph nodes can accurately predict the lymph node metastatic status of gastric cancer patients during operation.Intraoperative sentinal lymph node mapping can avoid routine lymph node dissection in patients with gastric cancer with negative lymph node metastasis.

Objective To investigate the efficacy of sling-exercise therapy on cervicogenic headache. Methods 60 patients with cervicogenic headache were divided into 2 groups with 30 patients each. Group I received paravertebral block of C2 once a week for 4 weeks, and Group II received sling-exercise therapy 3 times a week in addition. The Visual Analogue Score (VAS), frequency of pain (per month) before and 1, 3, 6 months after treatment were recorded, and the incidence of improvement was observed. Results In group I, VAS significantly improved 1 and 3 months after treatment (P<0.001), while it lasted 6 months in group II (P<0.001). The VAS improved more in group II 3, 6 months after treatment (P<0.001). It was similar in pain frequency. The incidence of improvement was 33.3% (10/30) and 73.3% (22/30) in group I and group II, respectively (P<0.01). Conclusion Sling-exercise therapy may improve the efficacy of paravertebral block on cervicogenic headache, especially for the long-term.

A total of 118 patients with type 2 diabetes mellitus were divided into acarbose treatment group ( A group,n =58 ) and no acarbose treatment group ( B group,n =60),and 57 healthy subjects were used as control group (C group).The quantification of fecal bifidobacteria and enterococcus faecalis in these subjects was made by realtime PCR.The results showed that fecal bifidobacteria contents in A and B groups were lower and enterococcus faecalis contents were higher compared with C group.After four weeks of intervention,fecal bifidobacteria contents in A and B groups increased ( P＜0.01 ),especially in A group,while enterococcus faecalis contents decreased ( P＜0.05 )compared with the baseline.Univariate correlation analysis showed that bifidobacteria content was negatively associated with lipopolysaccharides(LPS),advanced glycation index,high sensitive C reactive protein ( hs-CRP),and body mass index ( BMI ) at baseline ( P＜0.05 or P＜0.01 ).The enterococcus faecalis content was positively associated with levels of monocyte chemoattractant protein-1,LPS,tumor necrosis factor-α,hs-CRP,plasminogen activator inhibitor-1,BMI,and HbA1c (P ＜0.01 ).After four weeks of intervention,the above associations disappeared.Stepwise multivariate regression showed that basal BMI,HbA1c,and age contributed to the increase in the number of enterococcus faecalis,and BMI negatively contributed to the decrease in number of bifidobacteria.

Objectives To understand current situation in national prevention and control of iodine deficiency disorders (IDD),and to evaluate the progress in eliminating IDD in 31 provinces and Xinjiang Production and Construction Corps (Corps) in China.Methods In 2011,30 units were sampled in each of 31 provinces and Corps in China based on the sampling method of Probability Proportional to Size.After excluding townships of water iodine level higher than 150 μg/L,1 primary school was chosen in each unit,by the randomized sampling method,40 students in cach school were sampled for examining their thyroid volume,among them,12 students were tested for their urinary iodine level and for their household salt iodine level and per capital daily salt intake.Near the location of these primary schools,3 townships were chosen,5 pregnant women and 5 lactating women in each township were sampled to test their urinary iodine level.Besides,1 water sample was sampled according to the location in each village (east,west,south,north,and middle) in non-central water supplying villages,and 2 tap water samples in central water supplying villages.The ultrasound was used to detect goiter size according to the diagnostic criteria for endemic goiter; As3+-Ce4+ catalytic spectrophotometry using ammonium per sulfate digestion (WS/T 107-2006) was used to test the urinary iodine level; the testing method recommended by the National Iodine Deficiency Disorders Reference Lab was applied to test the water iodine level,the direct titration method among the generic methods of iodide testing for salt production industry (GB/T 13025.7-1999) was used to determine the salt iodine level; and the arbitration method was adopted for quantitative determination in case of well salt or special salts and the salt intake was estimated based on three-day weighed food record.Evaluation standards are as follows:urinary iodine level of children:deficient is the median of urinary iodine (MUI) less than 100 μg/L,adequate is MUI at 100-199 μg/L,more than adequate is MUI at 200-299 μg/L,and excessive is MUI equal to or greater than 300 μg/L;salt iodine:definition of qualified iodized salt is (35-± 15) mg/kg; non-iodized salt (GB 5461-2000) is iodine less than 5 mg/kg; definition of unqualified iodized salt is iodine between 5-＜ 20 mg/kg or higher than 50 mg/kg.The total population of the sixth national census was used for statistical data correction.Results Among 31 provinces and Corps,children's goiter rate was 2.4％,which was obviously lower than the IDD elimination standard at the national level (＜ 5％); the national iodized salt coverage rate was 98.0％ and the consumption rate of qualified iodized salt was 95.3％,both figures had achieved the national standard (the iodized salt coverage should be greater than 95％ and the consumption rate of qualified iodized salt greater than 90％).The median of salt iodine was at 30.2 mg/kg; the MUI of children,pregnant women and lactating women was 238.6,184.4 and 174.4 μg/L,respectively.Urinary iodine of children was higher than adequate level,of both pregnant women and lactating women were at adequate level.The surveillance results of water iodine in 25 provinces revealed that the median was at 5.6 μg/L; the salt intake surveillance results among students' households in 24 provinces and the Corps revealed that the daily intake was 10.1 g per person a day.Conclusions National IDD prevention and control strategy integrated with universal salt iodization as a key measure has achieved remarkable impacts.IDD has been eliminated at the national level.

Objective To study the current prevention and control status of iodine deficiency disorders (IDD) and learn the current situation of iodized salt consumption at household level in non-high iodine areas in 2015,this surveillance was conducted.Methods In 2015,according to National Surveillance Program on Iodine Deficiency Disorders,the surveillance was conducted at county level in 31 provinces,municipalities,autonomous regions (provinces) and Xinjiang Production and Construction corps (Xinjiang Corps).In each county city,district,banner (county),5 townships were randomly selected according to their sub-area positions of east,west,south,north and center;4 villages were randomly sampled in each chosen township;15 households were randomly selected in each chosen village.Edible salt sample was collected from each household.The iodine level in salt was determined by direct titration;the salt samples from Sichuan and other enhanced salt samples were detected by arbitration.Results There were totally 2 840 counties that reported the surveillance data.In total,849 193 salt samples were examined,including 845 906 salts determined by direct titration and 3 287 samples determined only by semi-quantitative detection.Weighted by population,the national coverage rate of iodized salt was 98.37％.At provincial level,the coverage rate of iodized salt was higher than 95％ except Tianjin,Shanghai and Shandong.At county level,2 669 counties had a coverage rate of iodized salt higher than or equal to 95％,171 counties were lower than 95％,and 31 counties were less than 80％.The national consumption rate of qualified iodized salt was 94.57％ (except 11 counties in Tibet).At provincial level,the consumption rate of qualified iodized salt was higher than 90％ except Shanghai (66.84％),Tianjin (79.14％),Tibet (82.09％) and Qinghai (89.22％).At county level,totally 2 633 counties had a rate of qualified iodized salt higher than 90％,and 196 counties were lower than 90％.The mean of iodine content in iodized salt was (25.37 ± 4.57) mg/kg.At provincial level,the means of iodine content in iodized salt were in the range of 23.51-28.95 mg/kg and the variable coefficient (CV) was in the range of 12.17％-27.37％,the CV was higher than 15％ in 24 provinces and Xinjiang Corps.Conclusions The coverage rate of iodized salt and the qualified iodized salt at national level are in a good condition.However,the problem of non-iodized salt is still serious in some provinces.