Objective To observe clinical effect of treating primary dysmenorrhea of congealing cold and blood stasis type with menstruation regulating method.Methods 56 cases of primary dysmenorrhea of congealing cold and blood stasis type were divided into 30 cases as a treatment group and 26 cases as a control group with random number table.The treatment group took Buyang Huanwu decoction in ovulatory period,and took Tongjing decoction in menstrual period.Moderate and severe patients took Jinkui shenqi pill for reinforcing kidney qi for 10 days after menstrual period.The control group took Shaofu Zhuyu granules and stopped to take it until the third day of menstrual period.All patients took the medicines for 3 continuous menstrual cycles.The dysmenorrhea score pre and post treatment,pain degree and effect were observed and compared.Results Menstruation regulating method and Shaofu Zhuyu granules could both improve the clinical symptoms,but the cured and markedly effective rate and total effective rate of menstruation regulating method was better (x2=8.813,P＜0.05),especially for moderate and severe dysmenorrhea.Conclusion Menstruation regulating method can improve symptoms of primary dysmenorrhea of congealing cold and blood stasis type.

OBJECTIVE To study the detectable rate and the antibiotic resistance of Staphylococcus aureus from detention needles of burn patients,and provide instruction of clinic reasonably using antibiotics and clinical treatment.METHODS Totally 175 specimens detention needles of from burn patients were collected to isolate pathogenic organisms.Identification of bacterial strains and susceptibility tests were performed by ATB system.RESULTS S.aureus isolated from the detention needles of burn patients was the predominant pathogen,accounted for 60.3%,and all of them were MRSA.Among these flora,all were resistant to penicillins,oxacillin and gentamicin and more than 50.0% were resistant to lincomycin,tetracyc1ine,rifampicin and so on,2.3% were resistant to minocycline and teicoplanin,and none was resistant to vancomycin, fusidic acid,and quinupristin-dalfopristin.CONCLUSIONS S.aureus isolated from the detention needles of burn patients is the predominant pathogen, which is resistant to many antibiotics.So we should identify the bacterial strains and give susceptibility tests of detention needles from burn patients promptly,in order to provide best instruction on clinic reasonably using antibiotics and slow the development of the resistant bacterial flora.

Objective To evaluate clinical features, therapeutic regimen and prognosis of unexplained rhabdomyolysis. Method Clinical manifestations, therapeutic regimen and prognosis were recorded in 23 patients,who were admitted to The First Affiliated Hospital of Nanjing Medical University 13 to 27 August,2010.The 23 patients were diagnozed as unexplained rhabdomyolysis. Results The patients all presented myalgia of upper body,like neck,waist and back,maybe with asthenia, nausea,dyspnea,abdominal pain, red urine or changed color of urine. Laboratory examination: obviously step-up of creatine kinase [CK: (4655 ± 2556) U/L( normal: 25 ～ 190U/L) AST:(141 ±78) U/L(normal:10～45 U/L),LDH:(348± 127) U/L(normal: 110～ 250 U/L)]and myoglobin[( Mb ＞ 1000 μg/L (normal: 0 ～ 50 μg/L)]. Therapeutic regimen included treatment of the underlying diseases, volume repletion, alkalization and dealing with the complications. No patients developed acute renal failure.All the patients recovered. Conclusions Rhabdomyolysis is a syndrome with different clinical manifestations.However, early diagnosis, proper treatment could prevent serious complications,and prognosis is good.

Objective To evaluate three different tracer-kinetic models used for dynamic contrast-enhanced MRI (DCE-MRI) data processing in the prediction of the histopathologic grade of cerebral gliomas.Methods Forty-one patients with histopathologically graded gliomas (grade Ⅱ 13,grade Ⅲ 14,grade Ⅳ 14)were imaged with DCE-MRI from March,2013 to November,2014.The values of Ktrans of gliomas were obtained by three tracer-kinetic models,which were Patlak model,Tofts model and Extended Tofts Linear model.All data were analyzed statistically by a Graphpad 6.0 statistical software.Comparison of the differences of Ktrans among different grades of gliomas was conducted using the Kruskal-Wallis test and Dunn's multiple comparisons test for the data not conform to normal distribution.Correlations of Ktrans values among those three models were analyzed using linear regression analysis,The differences of Ktrans between low grades and high grades of gliomas was conducted using the Mann-Whitney U test.Receiver operating characteristic (ROC) curve analyses were performed to determine the cut-off values for Ktrans to distinguish different low grades and high grades of gliomas.Results The Ktrans values obtained by Patlak model was 0.008(0.004-0.043) min-1for grade Ⅱ,0.021(0.005-0.088) min-1 for grade Ⅲ,and 0.035(0.017-0.061) min-1 for grade Ⅳ.The Ktrans values obtained by Tofts model was 0.085 (0.041-0.158)min 1for grade Ⅱ,0.140 (0.063-0.315) min-1for grade Ⅲ,0.229 (0.126-0.419)min 1 for grade Ⅳ.The Ktrans values obtained by Extended Tofts Linear model was 0.012 (0.004-0.092) min 1 for grade Ⅱ,0.048 (0.010-0.188) min-t for grade Ⅲ,0.094 (0.036-0.215)min 1 for grade Ⅳ.All the Ktrans values obtained by three models increased when the histological grades increased,with statistical significance between grade Ⅱ and Ⅲ (H=18.31,18.09,20.18,P＜0.05).Ktrans values among the three models had good linear correlations.The Ktrans obtained by Extended Tofts Linear model had good linear correlations with both Patlak model and Tofts model (r=0.933,0.893,P＜0.05),and the Ktrans obtained by Patlak model had less linear correlation with Tofts model (r=0.822,P＜0.05).The K values were statistically different between LGG and HGG (P＜0.01).The cut-off value of K provided good combination of sensitivity and specificity in the differentiation between LGG and HGG,and the K obtained by Extended Tofts Linear model had the best sensitivity and specificity among the three models (sensitivity 92.3％,specificity 85.7％).Conclusions K from DCE-MRI has a high performance in predicting the histopathologic grade of brain glioma,and the Extended Tofts Linear model is more suitable for the evaluation of cerebral glioma.

Objective The effectiveness of Zhuang nationality medical lotus needle plus back cupping therapy ( Zhuang needle-cupping therapy) , Flixonase aqueous nasal spray and cetirizine tablets in treating allergic rhinitis (AR) was compared for the exploration of the therapeutic mechanism of Zhuang needle-cupping therapy. Methods A total of 200 recruited AR patients were randomly divided into four groups in the proportion of 1:1:1:1. The four groups were Zhuang needle-cupping therapy group, cetirizine group, Flixonase group and blank control group. The blank control group had no medication, and the patients of the other three medication groups were given the corresponding treatment. Ten days constituted one treatment course, and interval between two courses lasted one week. After two courses, the therapeutic effect was evaluated. The changes of specific IgE (S-IgE), leukotriene (LT), interleukin 4(IL-4), IL-9 mRNA, interferon gamma (IFN-γ), Thl / Th2 cells, and Th17 cytokine ( IL-17) were observed before and after treatment. Results ( 1) After two treatment courses, Zhuang needle-cupping therapy group had better therapeutic effect than cetirizine group , Flixonase group and blank control group, and the therapeutic effect of cetirizine group and Flixonase group was better than the blank control group (P<0.05). However, the therapeutic effect of cetirizine group was similar to that of Flixonase group ( P>0.05). ( 2) After treatment, the levels of S-IgE, LT, IL-9 mRNA, IL-4 and IL-17 were decreased, and IFN-γ and Th1/Th2 levels were increased in the three medication groups ( P<0.05 compared with those before treatment) . The differ ences of the laboratory indexes in the blank control group were insignificant before and after treatment ( P>0.05). The results of inter-group comparison after treatment showed that Zhuang needle-cupping therapy group had better effect on improving S-IgE, LT, IFN-γand Th1/Th2 than cetirizine group and Flixonase group (P<0.05). (3) During the trial, no adverse reaction was found. Conclusion Zhuang needle-cupping therapy exerts certain therapeutic effect for AR, and the mechanism may be related with the inhibition of S-IgE, LT, IL-9 mRNA and IL-17 expression, and with the regulation of Th1/Th2 imbalance by decreasing TH2 cytokine level and increasing Th1 cytokine level.

Objective To investigate the effects of epidural spinal cord electrical stimulation (ESCES) on spinal cord reflexes in normal adult rats, and to find out where and how the spinal cord reflexes are generated. Methods Ten adult female Sprague Dawley rats were anaesthetized and an electrode was placed at the S, spinal cord segment. Single electric pulses with 200 μs pulse width and voltages of 400 mV, 600 mV and 1200 mV were used in the ESCES. 1200 mV voltages with 50 Hz, 60 Hz, 80 Hz, 100 Hz frequency were also tested. EMG signals were re-corded with concentric needle electrodes in the rats' semitendinosus muscles to observe the characteristics of spinal cord reflexes. Results The voltage threshold for generating semitendinosus muscle response was 300 mV. The three ESCES voltages induced 2 kinds of spinal cord reflexes. The 400 mV and 600 mV stimulation induced spinal cord reflexes with short latency (5.27±0.36 ms and 5.19±0.67 ms respectively). The 1200 mV stimulation volt-age induced spinal cord reflexes with long latency (2.57±0.23 ms). Spinal cord reflexes could be generated by 50 Hz, 60 Hz, 80 Hz, and 100 Hz ESCES. At the higher frequencies, spinal cord reflexes declined late in the ex-periments and then appeared irregular. In some of the rats, spinal cord reflexes vanished entirely late in the stimula-tion experiments. The latency and duration of the spinal cord reflexes induced by 50 Hz ESCES were (4.46 ± 1.07) ms and (7.33±1.00)ms respectively. These were significantly different from the latency and duration initia-ted by 60 Hz, 80 Hz or 100 Hz ESCES. Conclusions Different ESCES voltages induce different spinal cord refle-xes generated differently. The long latency reflexes might be monosynaptic responses mediated by dorsal root excite-ment, while the short latency reflexes might be sarcous exciting electric activity mediated by direct excitement of mo-tor neurons or motor fibers. The irregular spinal cord reflexes induced by higher frequency ESCES might be one kind of monosynaptic response. Irregularly appearing spinal cord reflexes induced by higher frequency stimulation might due to the inhibitory effect of higher frequency stimulation.

Objective To investigate the relationship between serum transforming growth factor- β1(TGF- β1) levels and early diabetic nephropathy and clarify whether valsartan plays a role in renal protection by reducing the level of serum TGF-β1. Methods The study subjects were divided into four groups:control group (30 cases); normal albuminuria group 1 (NA1 group with 12 cases, U MA/Cr < 10 μg/mg combined with type 2 diabetes);normal albuminuria group 2 (NA2 group with 19 cases,UMA/Cr 10-30 μg/mg combined with type 2 diabetes); microalbuminuria group ( MA group with 35 cases, U MA/Cr 31-300 μg/mg combined with type 2 diabetes). All these type 2 diabetic patients were suffering from diabetic retinopathy, and valsartan ( 80 mg/d) were medicated for those combined with hypertension. The serum TGF-β1 levels were measured by enzyme-linked immunosorbent assay in all subjects. Results Serum TGF- β1 levels in three diabetes groups were (7.41 ± 2.68 ), ( 10.52 ± 4.10), (22.98 ± 43.74) ng/L, respectively, all of which were higher than those in control group [(4.25 ± 5.82) ng/L] (P < 0.05). There were significant differences in serum TGF- β1 levels among MA group, NA2 group and NA1 group (P < 0.05 ). Serum TGF-β1 levels in NA1 group with valsartan treatment significantly decreased compared with those without valsartan treatment (P < 0.05), whereas there was no significant reduction in NA2 and MA group with valsartan treatment (P > 0.05). Conclusions High serum TGF-β1 level may be associated with type 2 diabetes and early diabetic nephropathy. Early intervention of valsartan may be delay the onset and development of diabetic nephropathy by decreasing the serum TGF-β1 level.

Objective:To investigate the effects of epidural spinal cord stimulation (ESCS) and treadmill training on the locomotion function and ultrastructure of spinal cord anterior horn after moderate spinal cord injury in rats. (IT, n=3). All rats received a moderate spinal cord injury surgery. Four weeks after surgery, rats in SE group received an electrode implantation procedure, with the electrode field covering spinal cord segments L2-S1. Four weeks after electrode implantation, rats received subthreshold ESCS for 30 min/d. Rats in TY group received 4cm/s treadmill training for 30min/d. Rats in SI group received no intervention, as a control group. All procedures in these three groups lasted four weeks.The open field Basso,Beattie and Bresnahan (BBB) scale was used before and after intervention to evaluate rats' hindlimb motor function. Result:After four weeks intervention, rats in TT group improved their open field locomotion scores to 20. In contrast, no significant improvement was observed in groups SI and SE. The morphology of synapses and neurons were similar regardless of whether rats had undergone ESCS, treadmill training or not. Conclusion:ESCS alone was not sufficient to improve the walking ability of spinal cord injured rats. ESCS or treadmill training alone might not contribute to the changes of ultrastructure in anterior horn of spinal cord that underlie the recovery of walking ability. Further research is needed to understand the contributions of combination of ESCS and treadmill training to the rehabilitation of spinal cord injured rats.

Objective To investigate the effect of Sirt1 gene knockout on chronic kidney disease induced by 5/6 nephrectomy in mice and vascular endothelial growth factor (VEGF)/fetal liver kinase-1 (Flk-1) signaling pathway.Methods Twenty four male Sirt1 +/+ and Sirt1 +/-mice wererandomly divided into four groups:Sirt1+/+ mice with sham-operation (WT-Sham,n=6),Sirt1+/-mice with sham-operation (KO-Sham,n=6),Sirt1 +/+ mice with 5/6 nephrectomy (WT-Nx,n=6) and Sirt1 +/-mice with 5/6 nephrectomy (KO-Nx,n=6).Proteinuria was determined by urine collection from 8:00 to 8:00 the next day at 20 weeks.Serum creatinine (Scr),urea nitrogen (BUN) and the renal pathological changes were measured after 20 weeks.Expressions of Sirt1,collagen Ⅰ and transforming growth factor β(TGF-β) were used to analyze the changes of renal fibrosis by immunohistochemistry staining.Real-time PCR and Western blotting were used to measure the mRNA and protein expressions of Sirt1,fibronectin,collagen Ⅰ,VEGF and Flk-1 in kidney.Results Sirt1 expressed in glomernlar endothelial cells,podocytes,mesangial cells and renal tubular epithelial cells in Sirt1 +/+ mice,while Sirt1 expression intensity was significantly reduced in Sirt1 +/-mice.Compared with the WT-Sham group,WT-Nx group had increased proteinuria,BUN,Scr,glomernlar sclerosis index and tubulointerstitial fibrosis index at 12 weeks after operation (all P ＜ 0.01),and KO-Nx group had exacerbated the above up-regulations (all P ＜ 0.01).Compared with those in WT-Sham group,the expressions of fibronectin,collagen Ⅰ and TGF-β were up-regulated in WT-Nx group (all P ＜ 0.01),and were significantly augmented in KO-Nx group (all P ＜ 0.01).Compared with those in WT-Sham group,renal mRNA and protein expressions of VEGF and Flk-1 were decreased in WT-Nx group,and KO-Nx group aggravated their down-regulation (all P ＜ 0.01).Conclusions Sirt1 gene knockout can increase proteinuria and Scr,and aggravate renal pathology and renal fibrosis in 5/6 nephrectomized mice,which is associated with the inhibition of VEGF/Flk-1 signaling pathway.It is suggested that Sirt1 may be a potential therapeutic target of chronic kidney disease.

OBJECTIVE:To provide reference for the classification of the specification grade of Dioscorea opposite.METHODS:Using the Delphi method,17 experts,who were associated with the study of the distribution and clinical application of D.opposite,were selected to conduct two rounds of consultation on 18 samples of medicinal herbs.The importance of the sensory evaluation indexes of D.opposite was screened and the overall satisfaction was evaluated.The specification grade of D.oppositewas determined preliminarily.RESULTS:Totally 17 questionnaires were issued for each round of consultation,and 17 were recovered with recovery rate of 100％.According to statistical analysis,the average value of expert's authority coefficient was 0.77 +0.07,and average recurrence rate of individual review was (91.18 + 7.64)％.The average recurrence rates of group review in two rounds of consultation were (66.67 + 13.50)％ and (65.97 + 14.01)％.The influence of working life,business background and educational background on recurrence rates of group review for interviewed experts was comprehensive.The full score ratio of appearance and cross-sectional characteristics importance was more than 80％,and the average value was more than 0.8.The full score ratio and average value of iron yam were higher.CONCLUSIONS:It is accurate and scientific to evaluate the specification grade of Chinese medicinal herbs with sensory experience.The most important evaluation indicators of D.opposite were the appearance,shape and cross-sectional characteristics.And it is divided into iron yam and non-iron yam preliminarily.The iron yam grade in descending order:Henan sandy iron yam,Shandong sandy iron yam,Henan loquat iron yam.The non-iron yam grade in descending order:Henan Huaiqingfu D.opposite,Hebei Xiaobaizui D.opposite,Hebei Ma D.opposite and Shanxi Chang D.opposite.