目的观察以针灸为主结合按摩、康复训练等方法治疗儿童交通性脑积水的效果。方法 26例儿童交通性脑积水患者接受针灸、按摩、康复训练及引导式教育。结果26例患者,治愈 5例(随访4例)、显效4例、有效10例、无效7例,总有效率73.07%。结论以针灸为主结合康复训练等方法可改善儿童交通性脑积水患者的症状。

Objective To determine the toxicity, maximal dose and clinical practicality of VM26 (teniposide) plus radiotherapy for postoperative brain neurospongioma. Methods Twenty patients were alloted in phase Ⅰ trial. The total dose was 60 Gy for the field radiotherapy (30 fractions of 2 Gy over six weeks). Teniposide at three dose levels (50 mg/m2, 75 mg/m2 and 100 mg/m2) was given intravenously once a week, totally five weeks. Dose escalation was based on each level, with a minimum of five patients in cohort if severe toxicity was not observed until the maximum tolerance dose(MTD). Results The predominant form of toxicity was hematologic toxicity. Four patients developed grade 3, 4 leucopenia when a second level of MTD (75 mg/m2) was given. Conclusion Combined radiotherapy and teniposide for postoperative brain neurospongioma is well tolerated. The dose of 50 mg/m2 for phase Ⅱ clinical trial was recommended.

Objective To investigate the effects of acupuncture on gene expression profile of neurotrophin and its receptors in cerebral cortex of neonatal rats after cerebral hypoxic-isehemic injury,and to explore the molecu- lar mechanism of acupuncture in treatment of neonatal hypoxic-ischemic encephalopathy.Methods The model of cerebral hypoxic-ischemic injury was established with 10 neonatal Sprague-Dawley(SD)rats,who were subjected to acupuncture once daily for 14 days.The animals were sacrificed on the next day of the last acupuncture and their brain cortex was sampled for examination of gene expression,using GEArray Q series neurotrophin and receptors gene array.Results After 14 days of acupuncture,it was found that 48 genes(50% of total genes on the microarray) were expressed differently between the two groups,of which 40 genes(83.3% of differently expressed genes),such as those of the brain-derived neurotrophic factor(BDNF),ciliary neurotrophic factor(CNTF),ciliary neurotrophic factor receptor(CNTFR),basic fibroblast growth factor(bFGF)and fibroblast growth factor receptor type 1 (FGFR1)were up-regulated,and 8 genes(16.7% of differently expressed genes),such as genes of neuregulin-1 (Nrg1),neuregulin-4(Nrg4)and tyrosine kinase C(TrkC)were down-regulated.Conclusion Acupuncture can regulate the expression of various genes of neurotrophin and receptors in cerebral cortex of neonatal rats after cerebral hypoxic-ischemic injury,which might be the mechanism of acupuncture facilitating the recovery of the rats from hy- poxic-ischemic encephalopathy.

Objective To investigate the combination effect of curcumin and γ-ray irradiation on PANC-1 cells in vitro.Methods PANC-1 cells were exposed to γ-rays in the presence or absence of curcumin.MTT assay was performed to evaluate cell viability.The expression of P21 was evaluated with RT-PCR and Western blot.Cell cycle distribution and apoptosis were tested by flow cytometry.Results Compared with the γ-ray irradiation group,combination treatment of curcumin and irradiation decreased the cell viability (t =6.72,P ＜ 0.01) and increased the percentage of cells in S-phase (t =4.78,P ＜ 0.05),apoptosis rate (t =6.58,P ＜ 0.01),P21 protein and mRNA expression (t =5.72,5.63,P ＜ 0.01) in PANC-1 cells.Conclusions Curcumin increases the radiosensitivity of PANC-1 cells,which may have clinical implication on radiotherapy of pancreatic cancer.

Objective To train health care workers (HCWs)by method of conventional training plus survey of hand contamination status,the influence of two kinds of methods in hand hygiene compliance of HCWs was evalua-ted.Methods From November 2013 to April 2014,all HCWs in a cardiovascular internal medicine department were as trained subjects,they were divided into two groups (trial group and control group).Hand hygiene compli-ance status was investigated 1 month before training.In the first month after training,conventional training method was adopted by both groups,from the second to fifth month,conventional training plus hand contamination survey was adopted by trial group,hand hygiene compliance between two groups were compared.Results Hand hygiene compliance rates of trial group and control group was 42.63% (107/251 )and 41 .80% (102/244)respectively be-fore training,there was no significant difference(P >0.05 ).In the first and second month after training,hand hygiene compliance rate of trial group was 55.70% (132/237)and 63.11 % (154/244)respectively,control group was 56.52% (130/230)and 62.61 % (149/238)respectively,compared with pre-training,the differences were sig-nificant (both P <0.05),but the difference was not significant between two groups(P >0.05);From the third to fifth month,hand hygiene compliance rates of trial group was 60.73%(150/247),61 .44%(145/236),and 61 .22%(150/245)respectively,control group was 51 .68%(123/238),51 .02%(125/245 ),and 52.32% (124/237)respec-tively,there was significant difference between two groups(P <0.05).Conclusion Conventional training combined with survey of hand contamination status can promote hand hygiene compliance of HCWs.

ObjectiveTo evaluate the assistant effct of electroacupuncture on acute incomplete spinal cord injury treated with routine therapy.Methods9 cases who accepted routine therapy, including operation and medicine, were in control group, while other 7 cases who accepted electroacupuncture other than routine therapy were in treating group.ResultsThere were 2 cases were effective, 4 cases were improved and 3 cases were not improved in control group, while 6 cases were clinical recovery, 1 case was effective in treating group.ConclusionElectroacupuncture can improve the effect of routine therapy on acute incomplete spinal cord injury.

目的观察神经外科与针刺联合治疗急性脊髓不完全损伤的疗效。方法神经外科治疗组根据指征确定是否进行手术,药物治疗均给予激素、脱水、抗去甲肾上腺素类药物、神经营养药物,高压氧。神经外科与针刺联合治疗组除上述神经外科治疗外,采用针刺治疗,针刺处方:电针刺激夹脊穴,根据不同辨证配合远端取穴。结果神经外科治疗组9例,持续治疗 3—6个月,出院后随访6个月,6例好转,肌力有所改善,最好者可达到肌力IV—IV+级,3例无效,甚至退步,瘫痪进一步加重。神经外科与针刺联合治疗组病人5例,经针刺及电针治疗10—80天时间后,4例临床治愈,1例经针刺治疗好转后,因转入骨科手术治疗腰椎压缩性骨折时脱离针刺治疗。结论神经外科与针刺联合治疗急性脊髓损伤效果好,并能抑制脊髓损伤的进一步恶化。

Objective To observe the effect of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on the prevention and treatment of oral mucositis induced by concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma. Methods A total of 64 patients with locally advanced nasopharyngeal carcinoma from April 2015 to April 2017 in the Second Affiliated Hospital of Xi'an Jiaotong University were enrolled. The patients were randomly divided into the observation group (32 cases) and the control group (32 cases) according to the random number table method. Both groups were treated with intensity modulated radiotherapy (IMRT) and synchronized with TP regimen (docetaxel + cisplatin) chemotherapy for 2 cycles. Both groups were treated with mouthwash at the beginning of radiotherapy to prevent oral mucositis. The observation group was given rhGM-CSF mouthwash, and the control group was given compound borax mouthwash. The oral mucositis and the oral pain during the treatment and the end of the treatment were evaluated by using American Radiation Oncology Group (RTOG) grading criteria and visual analogue scoring method(VAS) grading criteria. The time of onset of oral mucositis and the total time of radiotherapy in both groups was also recorded. Results All the patients were treated with concurrent chemoradiotherapy. The total radiotherapy time in the observation group was less than that in the control group [(46.4±1.6) vs. (48.2±3.2) d, t= -2.720, P= 0.009]. The clinical total effective rate was 93.8 %(30/32) in the observation group and 96.9 %(31/32) in the control group respectively (χ2= 0.35, P =0.554).The occurrence of grade 1,2 and 3 oral mucositis in the observation group was(20.9±2.5), (29.3±2.4), and (34.5±1.8) d respectively, which was latter than that in the control group [(16.3 ±2.0), (24.2 ±2.2) and (31.0 ±2.2) d] respectively (t= 8.125, P= 0.000; t= 8.840, P= 0.000; t= 6.944, P= 0.001). During concurrent chemoradiotherapy,the incidence of grade 3 oral mucositis in the observation group was lower than that in the control group[31.2 %(10/32)vs.56.2 %(18/32);Z=-2.197,P=0.028].At the end of concurrent chemoradiotherapy, the total incidence of grade 2 and grade 3 oral mucositis in the observation group was lower than that in the control group [53.1 % (17/32) vs. 81.2 % (26/32); Z= -2.708, P= 0.007]. The incidence of moderate and severe oral pain caused by oral mucositis in the observation group was lower than that in the control group[46.9 %(15/32)and 6.2 %(2/32)vs.59.4 %(19/32)and 15.6 %(5/32),respectively;Z= -2.009, P= 0.045]. Conclusion rhGM-CSF mouthwash can delay the occurrence of oral mucositis, reduce the incidence of oral mucositis and oral pain to effectively prevent and treat oral mucositis induced by concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma, which is worthy of clinical application.

Objective To improve the recognition of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome by investigating its clinical features and imaging manifestations. Methods The data of 14 patients with SAPHO syndrome (8 males, 6 females, age range: 18-61 years) between January 2014 and January 2017 were retrospectively analyzed. The clinical features, the results of laboratory (erythrocyte sedimentation rate (ESR), C reaction protein (CRP), complement component 3 (C3) and component 4 (C4), human leukocyte antigen (HLA)-B27) tests, pathology and imaging examinations (CT and whole-body bone im-aging) were collected. Results SAPHO syndrome was mainly characterized by skin damage and bone joint damage. The main manifestations of skin lesions were pustules, desquamation and erythema. Those of bone and joint injury were sternocostoclavicular hyperostosis, stiff spinal hyperostosis, peripheral arthritis, and sacroiliitis. There were 5 with fasting ESR, 5 with abnormal CRP, 3 with abnormal C3, and 1 with abnormal C4 among 14 patients. HLA-B27 was negative in all patients. Whole-body bone imaging revealed that 14 pa-tients had abnormal radioactivity, mainly involving the anterior chest wall, spine, pelvis and long bone. Chest CT manifestations of the patients were the destruction of joint bone, the fusion of the hypertrophy and the narrowing of the joint space. Symmetric lesions accounted for the majority. Pathology examination showed non-specific inflammation in 9 patients. Conclusions SAPHO syndrome is a disease characterized by skin, bone and joint abnormalities. Whole-body bone imaging can find systemic bone damage in early stage, and CT can detect bone changes and soft tissue lesions.

Senile dementia is a disease that gradually develops with age. At present, the etiology, pathogenesis and treatment of senile dementia cannot be completely determined clinically. Therefore, it is extremely necessary to prevent and treat senile dementia from prevention and disease management. For the non-ill people, this article analyzed the susceptible groups of senile dementia from the perspective of TCM constitution, combined with the current prevention plan of Alzheimer's disease, from the aspects of examination, nutritional supplementation, adjustment of work and rest, exercise, etc., early physical fitness prevention targeting populations at different stages was conducted; the early onset of senile dementia is not obvious, and the early prevention of senile dementia can be carried out from various aspects in combination with constitution identification and inspection of senile dementia; for the exact sick population, disease management guidance can be added on the basis of the above aspects to provide definite and feasible recommendations for disease prevention and management of the elderly.