BACKGROUND:Pain is the extremely common disease in clinic. At present, acupuncture provides good therapeutic effect on it. But, there are many methods in acupuncture with various advantages individually.To understand the differences in therapeutic effects on pain with various needling techniques is significant in clinic. In 1999, the relevant observation was carried on in the demand of Ecuadorian Medical Pain Association.OBJECTIVE: To observe the differences in therapeutic effects on pain with various needling techniques.DESIGN: Randomized controlled observation was designed.SETTING: Department of Pain, Hospital General de las FF. AA. Quito, Ecuador, Department of Traditional Chinese Medicine and 1st Department of Surgery, General Hospital of Chengdu MilitaryArea Command of Chinese PLA.PARTICIPANTS: Totally 360 cases of lumber strain and hyperplastic spondylitis were selected in Department of Pain, Clinic of Ecuadorian 3rd Military General Hospital from May 1999 to November 2000, in which,179 cases were lumber strain and 181 cases were hyperplastic spondylitis.The groups were randomized in two kinds of diseases, named for lumber strain, dermal-needling group (88 cases) and body-acupuncture group (91cases); for hyperplastic spondylitis, dermal-needling group (92 cases) and body-acupuncture group (89 cases).METHODS: Dermal needling and body acupuncture were used to treat the diseases respectively and the symptom changes were observed before and after treatment simultaneously. The treatment was given once every two days. 5 treatments made one basic course for lumber strain and 7 treatments for hyperplastic spondylitis. The treating results were evaluated according to Budzynski grading criteria on pain. MEPS statistical software was used for statistical management of data.MAIN OUTCOME MEASURES: Pain relieving before and after treatment with dermal needling and body acupuncture for lumber strain and hyperplastic spondylitis was evaluated. Correlative analysis on therapeutic effects and course of treatment for different diseases with same therapy and on same disease with different therapies were carried on.RFSULTS: Altogether 366 cases were observed and 6 of them were excluded. Totally, 360 cases finished the experiment. ① The severity was alleviated in pain grading after treatment with dermal needling and body acupuncture compared with that before the treatment (P ＜ 0.01). ② In treatment of lumber strain and hyperplastic spondylitis with dermal needling, the therapeutic effects on lumber strain were more remarkable (P ＜ 0.01). The therapeutic effects of dermal needling on lumber strain were superior to that of body acupuncture (P ＞ 0.05). ③ The therapeutic effects of body acupuncture group on pain of Ⅰ grade in hyperplastic spondylitis were remarkably better than that of dermal needling group,but the significant difference in the total therapeutic effects of two techniques did not present (P ＞ 0.05). ④ When pain grading was reduced by 1 level in two groups, the average times of treatment in dermal needling group were less than that in body-acupuncture group (P ＜ 0.05).CONCLUSION: Good therapeutic effects of dermal needling and body acupuncture are achieved for both hyperplastic spondylitis and lumber strain,in which, the therapeutic effects of dermal needling are remarkable on injury of soft tissue and achieved swiftly; body acupuncture improves pain in hyperplastic spondylitis more radically compared with dermal needling.

Objective To study protective effects of acanthoic acid ( AA) against acute liver injury. Methods Sixty mice were randomly divided into six groups (n=10 each),including normal control group,model control group,positive control group (N-acetyl -L- cysteine,NAC,300 mg·kg-1),and AA at small (50 mg·kg-1),middle (100 mg·kg-1),and high (200 mg·kg-1 ) dose groups. Each group received respective treatment for 3 days and fasted for 16 h before the last dose. All animals except of the normal control group were treated with tacrine (35 mg·kg-1 ) 1 h after the treatments. Hepatic pathological and serum biochemical changes were observed. Results The high-dose of AA significantly reduced the levels of AST (143±46) U·L-1 ,ALT (32±9) U·L-1 ,LDH (1 218±312) U·L-1 ,MDA (3. 24±0. 48) μmol·g-1 ,and GSH (417±15) mg·g-1 compared with the model control group (P<0. 05 or P<0. 01). Liver injury was also ameliorated in AA high dose group.Conclusion AA has a protective effect on acute liver injury in mice.

Deep venous thrombosis (DVT) is initiated intraoperatively and may display symptoms postopera- tively following total hip or total knee arthroplasties. Pulmonary embolism (PE) and DVT cause morbidity and mortality. It has been established that patients who undergo a major lower-extremity joint replacement should receive prophylaxis due to the increased risk of DVT. Despite use of thrombo-prophylaxis, elective replacement surgery carries a high risk of venous thromboembolic complications. The early detection of DVT and treatment with systemic anticoagulation to pre- vent DVT are essential in the management of patients undergoing total joint arthroplasty. Extended medical throm- bo-prophylaxis is indicated for some high-risk patients. Routine postoperative duplex surveillance for DVT may be clinically useful. In the early post-operative phase, combined prophylaxis such as low-molecular-weight heparins and mechanical methods may be more effective than single intervention measures. However, the efficacy and safety of an- ticoagulation therapy, using various medicines administered after total arthroplasty of large joints are still undetermined and controversial.We should also be alert to the frequency and extent of postoperative hematomas. There are still many uncertainties in treatments to prevent DVT in terms of safety and cost-effectiveness. Therefore, prospective, ran- domised, controlled and multicenter studies may be necessary to obtain valuable information according to evidence based medicine.

A 38-year-old male patient presented with multiple papules on the scalp with itching and tingling for 3 years. Skin examination showed multiple millet- to soybean-sized red papules on the scalp. Histopathological examination showed epidermal hyperkeratosis, mildly thickened prickle cell layer, proliferation of a large number of capillaries in the dermis, and perivascular infiltration of closely distributed lymphocytes and scattered eosinophils. The blood vessels were lined by hyperplastic and hypertrophic endothelial cells, some of which projected into the vascular cavity. The patient was diagnosed with angiolymphoid hyperplasia with eosinophilia. After 1 session of Nd:YAG laser therapy, all the skin lesions were removed, and no obvious adverse reactions were observed. No relapse occurred during 5 months of follow up.

OBJECTIVETo investigate the differential plasma protein profiles in patients with hyperlipidemia & atherosclerosis (H&A) of different patterns of phlegm-stasis syndrome (PSS) for seeking their biomarker proteins.

METHODSTwo-dimensional gel electrophoresis and gel screening graphical analysis were performed on plasma proteins got from 146 patients; corresponding protein spots were fetched from the gel for two-stage mass-spectrometric analysis by quadruple time-of-flight mass spectrometry; then the differential proteins for PSS were discriminated by Fisher discriminate analysis.

RESULTSExcepting two uncertain proteins, 7 differential proteins were screened out from the 11 differentially expressed plasma protein spots with variability over 100% in the inter-block matching. Classic analysis found that haptoglobin precursor and fibrinogen gamma chain were possibly the plasma biomarker proteins for H & A; fibrinogen beta chain and apolipoprotein A-I precursor were that set apart PSS from non-PSS; fibrinogen gamma chain, albumin and apolipoprotein A-I precursor were for phlegm syndrome; haptoglobin precursor, adrenomedullin binding protein precursor, albumin and complement component C4 were for stasis syndrome; albumin and adrenomedullin binding protein precursor were for the phlegm-stasis mutual blocking syndrome. Moreover, the above mentioned expressions of possible marker proteins had their own special rule of changing in the transforming progress of PSS.

CONCLUSIONThis study reported, for the first time, the existence of evident variation of functional protein constitution in different patterns of PSS, and definite compatibility being detected in some functional proteins, which may be the marker proteins for making diagnosis and prognosis of PSS in H&A. Besides, preliminary proof for the transformation of PSS has gained at the functional protein level.

Adult ; Atherosclerosis ; blood ; diagnosis ; Blood Proteins ; analysis ; Case-Control Studies ; Gene Expression Profiling ; Humans ; Hyperlipidemias ; blood ; diagnosis ; Medicine, Chinese Traditional ; Middle Aged ; Proteomics

Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Carcinoid Tumor ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism

Objective To analyze the outcomes of radiotherapy for keloids by high energy electron beams and the factors influencing the treatment outcome.Methods From Jan 1998 to Jun 2012,846lesions in 578 patients received radiotherapy.The median age is 29 years old (range 5-80 years old).There are 841 lesions with postoperative radiotherapy and 39 lesions with skin-grafting.656 lesions treated within 1 day after operations.The max diameter of 348 keloids are ＞ 5 cm.We used 6 MeV and 7 MeV electron-beam radiation therapy.The total dose ranging from 16-18 Gy/2f (interval 1 week).Treatment fields including entire keloid scars,and any suture/puncture holes with a 1 cm-margin around the lesion were used.The skin grafting patients need radiotherapy after the flap survived (about 10-15 days after the operation).The median follow-up period was 36 months (range 8-185 months).Results There are 736 (87.0％) of 846 lesions with radiotherapy effective.Other 89 (10.5％) lesions relapse in 4-33 months (median 12 months).21 lesions were of no avail.The univarate analysis shows that keloids length,keloids location,skin-grafting,interval between operations and irradiations are the influencing factors of outcomes (P =0.007,0.000,0.000,0.001).The multivariate analysis shows that keloids location and skin-grafting remained statistically significant differences (P =0.001,0.001).Most of the recurrence cases are large and bent scars.Conclusions High-energy electron-beam radiotherapy for keloids can receive good outcomes.Treatment fields flat is very important for electron-beam radiotherapy.

Objective To investigate the effect of progressive neurological deterioration ( PND) of cerebral watershed infarction on early prognosis. Methods The consecutive patients with cerebral watershed infarction admitted in the Department of Neurology,Jinling Hospital,Nanjing University School of Medicine and their cerebral watershed infarctions confirmed by the imaging examination from March 2009 to March 2014 were enrolled. The clinical features, laboratory indicators and imaging features of internal watershed infarction,cortical-type watershed infarction,and mixed watershed infarction were identified and analyzed. The National Institutes of Health Stroke Scale was used to score neurological deficit. The modified Rankin scale ( mRS) was used to score the prognosis of patients. Single factor analysis was used to compare the differences between the groups. At the same time,the correlation between PND and poor prognosis of cerebral watershed infarction at day 90 was analyzed by multivariable Logistic regression analysis. Results A total of 89 patients with cerebral watershed infarction were enrolled,including 43 cortical-type watershed infarctions,36 internal watershed infarctions, and 10 mixed watershed infarctions. Single factor analysis indicated that the incidences of PND of internal watershed infarction and mixed watershed infarction were significantly higher than the cortical-type watershed infarction (36. 1% [n=13],50. 0% [n=5], and 16. 3% [n=7],respectively;P=0. 018). At day 90,28 patients had poor prognosis,and mRS was (3.4±1. 0) scores at day 90. There was significant difference in the types of infarction between the patients with poor prognosis and patients with good prognosis (P<0. 05). In patients with poor prognosis, most of them were internal watershed infarctions,accounting for 50. 0% (14/28),while in patients with good prognosis,most of them were cortical-type watershed infarctions(57. 4% [35/61]). The incidence of PND in patients with poor prognosis was significantly higher than that in patients with good prognosis (57.1% [16/28] vs. 14. 8% [9/61];P<0. 05). The result of multivariate Logistic regression analysis showed that after adjustment for confounding factor, PND was independently associated with the poor prognosis of cerebral watershed infarction at day 90 (OR 6. 969,95%CI 2. 451-19. 869;P<0. 01). Conclusion Compared with the cortical-type watershed infarction, the patients with internal watershed infarction is more prone to have PND, and PND is independently correlate with the poor prognosis at day 90.

Objective To establish a simple diabetic peripheral neuropathy (DPN) rat model with the high fat-fed in GK rats. Methods A total of 30 GK rats (7-8 weeks) were fed with high-fat diet to establish the DPN model. Thirty normal Wistar rats were fed with ordinary diet (control group). The blood-sugar value, body mass, water-intake and food-intake were monitored every week in two groups. The serum level of glycosylated hemoglobin, the right sciatic nerve conduction velocity were detected at 8, 12 and 16 weeks respectively. The left sciatic nerve was used for HE and TUNEL staining. Results The manifestations of polydipsia, polyphagia and growth retardation were gradually appeared in GK rats. After 12 and 16 weeks, the blood-sugar and glycosylated hemoglobin were significantly increased in GK rats compared with those of normal Wistar rats (P < 0.01). The sensory nerve conduction velocity decreased obviously (P < 0.01). And motor nerve conduction velocity showed a certain decline trend (12 week P < 0.05,16 week P > 0.05). The sciatic nerve pathological features and Schwann cell apoptosis suggested that the model of DPN was successfully established (apoptosis index, P <0.01). Conclusion GK rats fed by high-fat diet are the satisfactory models of the DPN in experimental research. And 12-week is a suitable and economical time for molding.