OBJECTIVETo observe the life quality improvement of spastic hemiplegia of stroke treated with fire-needle.

METHODSSixty patients were randomly divided into a fire-needle group and a rehabilitation group, 30 cases in each one. In the two groups, the conventional treatment of neurology and rehabilitation strengthening limbs function were applied. In the fire-needle group, fire-needle was used at Jianyu (LI 15), Binao (LI 14), Quchi (LI 11), Yanglingquan (GB 34), Xuehai (SP 10) and Sanyinjiao (SP 6), etc. , once two days and continuously for 30 days (15 times). In the rehabilitation group, conventional rehabilitation exercises were given five times a week for 4 weeks (20 times). Before treatment, at the end of treating program and one month later after treatment, spasticity of upper and lower limbs was assessed by Ashworth scale and clinic spasticity index (CSI); limbs function was evaluated by Fugl-Meyer (FM) scale; life quality was estimated by patient-reported outcome (PRO). Clinical effects were compared between the two groups.

RESULTS(1) At the end of treating and one month later after treatment, the Ashworth scales were better than those before treatment in the two groups (P < 0.05, P < 0.01), and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group (both P < 0.05). (2) At the end of treating and one month later after treatment, the CSIs were better than those be fore treatment in the fire-needle group (both P < 0.01), but not changed apparently in the rehabilitation group (both P > 0.05). And the indices of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01). (3) The FM scales of upper and lower limbs at the end of treating and one month later after treatment were better than those before treatment in the two groups (all P 0.01), except the lower limbs at the end of treating in the rehabilitation group (P > 0.05). The FM scales of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01). (4) At the end of treating and one month later after treatment, the PRO scales were better than those before treatment in the two groups (all P < 0.01), and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01).

CONCLUSIONFire-needle can effectively relieve spastic hemiplegia of stroke, and improve limbs motor function and life quality. It is better than rehabilitation.

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Hemiplegia ; Humans ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; physiopathology ; therapy ; Needles ; Quality of Life ; Stroke ; complications ; therapy ; Treatment Outcome ; Upper Extremity ; physiopathology

Objective:To investigate the efficacy of Zhongjiefeng dispersible tablets combined with ranitidine in the treatment of recurrent oral ulcer and its effec on inflammatory factors. Methods:Eighty-six patients who received recurrent oral ulcer in Yiwu Hospital of Traditional Chinese Medicine from January 2019 to January 2020 were included in this study. They were randomly assigned to receive treatment with either ranitidine (control group, n = 43) or Zhongjiefeng dispersible tablets combined with ranitidine (observation group, n = 43) for 4 weeks. Before and after treatment, visual analogue scale score and inflammatory factor were compared between the control and observation groups. Change in main symptom score after treatment relative to before treatment and the curative effect were also compared between the two groups. Results:After treatment, the visual analogue scale score in the observation group was significantly lower than that in the control group [(1.32 ± 0.37) vs. (3.06 ± 0.54), t = 17.430, P < 0.05]. After treatment, serum interleukin-2 [(16.42 ± 3.18) μg/L], interleukin-6 [(6.56 ± 1.28) ng/L], tumor necrosis factor-α [(7.69 ± 1.34) μg/L] levels in the observation group were significantly lower than those in the control group [(25.97 ± 5.24) μg/L, (9.84 ± 1.62) ng/L and (11.86 ± 1.83) μg/L, t = 10.217, 10.4617 and 12.056, all P < 0.05]. After treatment, ulcer area score [(0.76 ± 0.14) points] and ulcer number score [(0.68 ± 0.19) points] in the observation group were significantly lower than those in the control group [(1.21 ± 0.20) points and (1.24 ± 0.30) points, t = 12.087, 10.341, both P < 0.05]. Total effective rate in the observation group was significantly higher than that in the control group [93.02% (40/43) vs. 72.09% (31/43), χ 2 = 6.541, P < 0.05]. Conclusion:Zhongjiefeng dispersible tablets combined with ranitidine exhibits obvious curative effect on recurrent oral ulcer in patients through reducing pain and inflammatory reaction.

Objective To evaluate the clinical value of endoscopy for the treatment of acute obstructive suppurative cholangitis. Methods Data of 182 patients suffering from acute obstructive suppurative cholangitis, in whom endoscopic treatment was undertaken, were retrospectively analysed. Results All patients received endoscopic sphincterotomy (EST). Among them, 25 patients underwent endoscopic retractor-biliary drainage (ERBD), 140 patients received endoscopic naso-biliary drainage (ENBD), and in 17 cases endoscopic metal retractor-biliary drainage (EMBD) was done. The treatment was successfully in all patients. The clinical findings were markedly improved after treatment in all of them. Conclusion Endoscopic treatment was a fast, safe, effective and economic method for the treatment of acute obstructive suppurative cholangitis.

Objective To evaluate the clinical curative effects of pancreatic stents on chronic pancreatitis.Methods 18 cases of chronic pancreatitis were diagnosed by clinical symptoms,by lab tests and by relative examinations.All cases had received pancreatic stents endoscopic treatment,and were followed up postoperatively about the change of the clinical symptoms and the lab tests.Results All cases were placed successfully pancreatic stents.Abdominal pain relieved completely within one month.The remissive rate of abdominal pain was a hundred percent.The clinical symptoms such as marasmus and fatty diarrhea were markedly improved.The serum amylase level recovered to the normal range within 1 to 14 days,except one case in which the serum amylase level recovered slowly for the dysfunction of pancreatic external secretion.The stent was replaced in 1 case after 10 days because of obstruction.Conclusion Pancreatic stents endoscopic treatment of chronic pancreatitis is a preferred method which is secure,low-traumatic,low-expenditure,convenient and effectual,and it is of prominent clinical application value.

Objective To evaluate the effects of endoscopic treatment on chronic pancreatitis. Methods 33 cases with chronic pancreatitis having received endoscopic treatment in a 2 years' period were retrospectively analyzed. The diagnosis was confirmed in all the patients by clinical examination, lab tests, CT, ultrasonography and endoscopic retrograde cholangiopancreatography (ERCP). According to the patients' condition, various treatment measures including endoscopic pancreatic sphincterotomy (EPS), endoscopic papillo-sphincterotomy (EST), pancreatic stenting (PS), pancreatic stone extraction, naso-pancreatic drainage (ENPD), pancreatic duct stricture dilation, etc, were used individually or jointly. Results 18 cases received EPS and 27 underwent EST. Pancreatic duct stone extraction by basket or balloon was performed in 6 cases, PS in 13, ENPD in 5, and pancreatic duct dilatation in 9 cases. The endoscopic drainage by transgastric placement of a stent was done in a patient with a huge pseudocyst. Abdominal pain disappeared or markedly relieved in 29 cases after treatment. Marked improvement after treatment was shown by lab examination and imaging. Conclusion The combined application of various treatment measures for chronic pancreatitis through endoscopic approach is a safe, minimal-invasive and effective procedure.

Development of small molecule drugs is important for targeted and personalized therapy for cancers.However,it is staggering to take new compounds from the research bench to clinical trial pipelines and eventually to the clinical practice,due to the time,effort and costs.Most drugs need five years of development after discovery in the laboratory before they are ready to be tested for efficacy and safety.Compared to development of new drugs from scratch, increasing research efforts have been made to turn existing drugs to new uses to treat cancers, which may bypass years of costly work.Metformin used in cancer care is a good example of giving old drugs a new life.The activity of metformin on anti-cancer has recently drawn significant attention.Epidemiological and experimental studies have shown that metformin can cut down the incidence of cancer in diabetic patients and reduce metabolism-related cancers.Meanwhile, recent study has found metformin can induce autophagy of esophageal cancer cells by inhibiting inflammatory signaling pathway.In recent years, increasing studies have shown that metformin plays a major role in suppressing cancers via multiple mechanisms.In this mini-review,we summarize the updates of the research on metformin in cancer prevention and treatment.

Objective To evaluate the clinical results from different endoscopic treatments of patients with chronic pancreatitis. Methods Thirty-seven cases of chronic pancreatitis had accepted endoscop-ie treatments were analvzed retrospectively. Results All cases were diagnosed clearly by ERCP showing different degree of pancreatic duct dilatation. Among them 21 cases had pancreatic duct stricture, 9 cases pancreatie duet ealeification. EPS in 18 cases and EST in 37 cases, basket extraction pancreatic duct stones in 6 eases, PDSD in 17 cases, NPD in 5 cases were conducted. The abdominal pain in 34 cases disappeared or markedly relieved alter treatment. Conclusion Endoseopie treatments have the advantages of safe, less-trauma and effectiveness. The combination of different endoscopic treatments improved evidently the current state of chronic pancreatitis treatment, thereby the therapeutic results.

Objective To analyze the susceptibilities of Escherichia coli isolates collected from blood and the prevalence of ESBLs encoding genes.Methods A total of 121 Escherichia coli isolates collected from blood during 2012 were analyzed for antimicrobial susceptibilities by software of WHONET 5.6,the production of ESBLs was confirmed by confirmatory pheno-typic testing,PCR and DNA sequence were further implemented to analyze the ESBLs-encoding genes.Results 121 E.coli isolates displayed high resistance towards broad spectrum penicillin and 2nd or 3rd generation cephalosporins,levofloxacin and cotrimoxazole,with the resistance rates being more than 40%,susceptibilities to imipenem,piperacillin/tazobactam,ami-kacin were observed,with the resistance rates to be less than 12%,86(88.7%)out of 121 isolates were found to produce ESBLs.Among them,59.5% (72),38.8% (47)and 4.1% (5)were confirmed to carry blaCTX-M,blaTEM and blaSHV genes.Additionally,2(1.7%)isolates carried all the genes detected,30(24.8%)isolates carried both of blaCTX and bla-TEM,1(0.8%)isolate carried both of blaSHV andblaTEM.Conclusion Most of the E.coli isolates from the blood culture in Nanjing Gulou Hospital produce ESBLs,and displayed resistance towards most of the penicillins,cephalosporins and sin-gle amide antimicrobial agents should be chosen according to susceptibility results.

Objective To assess the curative effect of endoscopic resection for patients with duode-nal bulb carcinoid.Methods Data of 17 patients with duodenal bulb submucosal tumor who underwent en-doscopic dissection in our department and confirmed as duodenal bulb carcinoid by postoperative pathology from Jun 2009 to Jun 2012 were retrospectively analyzed.Seventeen patients included 1 1 men and 6 women with the mean age of 36. 3 ±8. 4.Results All patients underwent preoperative diagnosis of endoscopic ultrasonography(EUS).Four cases were diagnosed as heterotopic pancreas and 13 cases carcinoid.The size of tumor was from 4 to 10 millimeter.Cap-assisted endoscopic mucosal resection (EMR-C)were used in all patients successfully.No complications were found during or after the operation.Postoperative pathology con-firmed 6 cases of duodenal bulb carcinoid.The accuracy of EUS preoperative diagnosis was 76. 5%.The average follow-up time was 20. 5 ±12. 4 months.Metastases and recurrence had not been found.Conclusion EUS can confirm the invasive depth of duodenal submucosal tumors and estimate the indication of endo-scopic excision.EUS can not give a preoperative qualitative diagnosis of duodenal submucosal tumors.Endo-scopic hyaline cap excision is a safe and sufficient method for duodenal bulb carcinoid.

objective To summarize the clinical characteristics of AIDS phobia patients and establish the preliminary clinical diagnostic criteria.Methods The clinical information of 46 AIDS phobia patients was collected and summarized.General demographic data,clinical manifestations and laboratory results were analyzed.Results The clinical characteristics of AIDS phobia patients include:(1)With or without high-risk behavior of HIV-1 infection;(2)Patients repeatedly demanded HIV/AIDS related laboratory tests,suspected or believed in HIV-1 infection with daily life affected;(3)The main complaints were non-specific including influenza-like symptoms(headache,sore throat and so on),fasciculation,formication,arthrodynia,fatigue and complaint of fever with normal body temperature;physical examination did not reveal any positive physical sign except white coated tongue;(4)Symptoms mainly appeared 0-3 months after the high-risk behavior while HIV-1 antibody kept negative;(5)T lymphocyte subsets test was carried out in 23 patients and showed 19(82.6%)with CD4+ T lymphocyte count>500/μl,the remaining 4 were 300-500/μl,with the lowest count of 307/μl.Few patients had inversed CD4+/CD8+ ratio but without excessive CD8+T lymphocyte activation.Conclusion AIDS phobia is a complicated physical and mental disease,whose diagnosis and treatment still need further investigation.