Objective To systematically review the clinical efficacy of sling exercise therapy(SET)on patients with chronic non-specif-ic low back pain (CNLBP). Methods Randomized controlled trials (RCT) about SET for CNLBP were electronically searched in CNKI, VIP,Wanfang Data,PubMed,Web of Science,The Cochrane Library and Embase from June,2007 to June,2017.After literatures screening, data extraction,quality evaluation and risk assessment,the results of meta-analysis were conducted by RevMan 5.3 software.Results Final-ly, 15 RCTs involving 789 patients were included. SET was better in improving Visual Analogue Scale (VAS) score (MD=-1.15, 95% CI[-1.41,-0.90],Z=8.82,P<0.00001)and Oswestry Low Back Pain Disability Index(ODI)score(MD=-1.29,95%CI[-1.80,-0.78],Z=4.94, P<0.00001) than physical therapy, and was better than other exercise therapies in improving the VAS score (MD=-0.94, 95% CI[-1.52,-0.37],Z=3.21,P=0.001)and ODI score(MD=-5.96,95%CI[-9.41,-2.51],Z=3.38,P=0.0007).However,no significant dif-ference was found in improving the NPRS score between SET and other exercise therapies(MD=0.35,95%CI[-0.23,0.93],Z=1.19,P=0.23),nor in improving VAS score between SET and traditional Chinese medical therapies(MD=-5.29,95%CI[-20.27,9.70],Z=0.69,P=0.49).Conclusion SET may play a role in relieving pain and functional limitations in patients with CNLBP.Due to the limited quantity and quality of the included studies,larger scale and high quality RCTs are needed to verify the aforementioned conclusion.

Objective To compare the differences in the clinical application of Sijunzi Decoction,a classical formula for tonifying qi,in ancient and modern literature,so as to provide a reference for its clinical application and research and development.Methods The clinical application of Sijunzi Decoction in ancient times was analyzed by retrieving the database of Zhong Hua Yi Dian(Collection of Traditional Chinese Medical Books),and the clinical application of Sijunzi Decoction in modern times was analyzed by retrieving the database of China National Knowledge Infrastructure(CNKI).Results In the record of ancient traditional Chinese medicine books,Sijunzi Decoction was indicated for the syndromes characterized by the pathogenesis of"deficiency of nutrient qi and defensive qi,and weakness of zang-fu organs",and was widely used to treat various diseases related to internal medicine,surgery,gynecology and pediatrics,including dysentery,consumptive disease,diarrhea,jaundice,smallpox,metrorrhagia and carbuncle.Moreover,Sijunzi Decoction was used for the management of patients who was weakness due to chronic diseases,elderly and insufficiency of qi,or at the late stage of exogenous cold disease,cholera,and malaria.In the modern clinical practice,Sijunzi Decoction was indicated for digestive system diseases,surgical diseases,tumor-related diseases,pediatric diseases,gynecological diseases,respiratory diseases and hepatobiliary diseases,in particular for chronic gastritis,adverse reactions related to radiotherapy and chemotherapy for tumors,postoperative period of cancer and diabetes mellitus during pregnancy.Conclusion The analysis of ancient and modern literatures indicated that the indications of Sijunzi Decoction is expanded from the predominated spleen-stomach system diseases(digestive system diseases)in antient times to multiple system diseases such as surgical diseases,tumor-related diseases,pediatric diseases,gynecological diseases,respiratory diseases and hepatobiliary diseases in modern times.And the pathogenesis of the indications of Sijunzi Decoction is characterized by the"deficiency of nutrient qi and defensive qi,and weakness of the zang-fu organs".

We report a case of an 18-year-old woman with systemic antibiotic anaphylaxis who presented anasarca and bilateral visual loss two weeks after the intravenous use of pazufloxacin. Ancillary fundus tests revealed bilateral cotton-wool spots, Purtscher flecken, edema, and retinal arteriolar occlusion around the optic disc. After pulse corticosteroid, administration of anti-anaphylactic agent, and general support therapy for one month, the patient showed a favorable change, with the symptoms lessened or free systemically, except the continuous aggravation of fundus ischemic change. After two intravitreal injections of Ranibizumab, there were still a large area of capillary non-perfusion and neovacularizations in the binocular retina, resulting in vitreous hemorrhage. The patient's visual acuity had still light perception after right-eye vitrectomy and presented no improvement during the postoperative follow-up of two years. Literature review revealed that there were many causes associated with Purtscher-like retinopathy, and the consequent visual impairment varied significantly. Prompt management of the underlying condition is crucial in giving the patient the best chance to restore vision.

OBJECTIVETo study the effects of p38 MAPK signaling pathway and aldose reductase (AR) on the transforming growth factor (TGF)-β1-induced expression of fibronectin (FN).

METHODSHuman mesangial cells (HMCs) were cultured, and transfected with pCDNA3-AR. AR gene silencing was induced by small interfering RNA (siRNA). AR expression in HMCs was examined by immunofluorescence analysis. RT-PCR and real-time PCR were performed to detect the mRNA expression of AR in the HMCs and Western blotting was used to detect the protein expression of AR, FN and p38. AR inhibitors (ARIs), Sorbinil and Zopolrestat were added and co-incubated, followed by addition of TGF-β1. Western blotting was used to document protein expression of FN and p38 mitogen-activated protein kinases (p38 MAPKs) in the HMCs.

RESULTSImmunofluorescence analysis showed a stronger expression of AR in HMCs transfected with AR than that of normal HMCs and HMCs transfected with blank vector. In comparison with normal HMCs and those transfected with blank vector, HMCs transfected with AR showed stronger protein expression of FN (P<0.05). After incubation of ARIs, protein expression of FN decreased in HMCs transfected with AR (P<0.05). After stimulation of TGF-β1, FN protein expression increased in both normal HMCs and those transfected with AR (P<0.05). After preincubation with ARI, FN protein expression in HMCs transfected decreased significantly (P<0.05). After stimulation of TGF-β1, naïve HMCs showed increased expression of phosphor-p38. In contrast, HMCs preincubated with ARIs showed reduced expression of phosphor-p38, and HMCs transfected with AR showed increased expression of phosphor-p38 (P<0.05).

CONCLUSIONSAR regulates the expression of FN through the stimulation of TGF-β1, which may involve the activation of p38-MAPK signaling pathway. AR may play a role in the pathogenesis of glomerulosclerosis.

Aldehyde Reductase ; metabolism ; Cells, Cultured ; Fibronectins ; metabolism ; Humans ; MAP Kinase Signaling System ; Mesangial Cells ; metabolism ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction ; Transfection ; Transforming Growth Factor beta1 ; pharmacology ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo investigate the risk factors of the serious complications related with double-J ureteral stent placement following percutaneous nephrolithotomy (PCNL).

METHODSClinical data were reviewed for 272 patients treated with PCNL and indwelling double-J stents between January, 2014 and April, 2016. The risk factors of serious complications were identified using univariate and multivariate logistic regression analysis.

RESULTSSerious complications of double-J ureteral stenting occurred in 63 patients (23.1%). Univariate and multivariate logistic regression analysis indicated that the ureter abnormalities (β=1.735, P=0.000, OR=5.670), stent indwelling duration (β=1.206, P=0.028, OR=3.340), gender (β=0.895, P=0.016, OR=2.446), preoperative urinary tract infection (β=0.849, P=0.020 , OR=2.338) and stent size (β=0.847, P=0.011, OR=2.333) were all risk factors of serious complications related with the procedure.

CONCLUSIONMale patients are exposed to a higher risk of serious complications following PCNL. Effective management of urinary tract infection and choice of appropriate stent size in cases of ureteral abnormalities help to reduce these complications. The double-J stent should be withdrawn as soon as possible in patients with good postoperative recovery.

Female ; Humans ; Kidney Pelvis ; Logistic Models ; Male ; Nephrostomy, Percutaneous ; Postoperative Period ; Risk Factors ; Stents ; adverse effects ; Ureter ; surgery ; Ureteral Obstruction ; surgery

OBJECTIVETo investigate foot biomechanics characteristic of patients with type 2 diabetes mellitus.

METHODSThis study was conducted among 303 patients with type 2 diabetes. The whole foot was divided into 10 regions, namely the first toe (T1); the second to fifth toes (T2-5); the first, second, third, fourth, and fifth metatarsals (M1, M2, M3, M4, and M5, respectively); midfoot (MF), and the heel medial (HM). Foot arch index, foot angle and maximum peak pressure (MPP) of the 10 regions were measured using a Footscan gait system.

RESULTSThe maximum peak pressure of 10 regions decreased in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the left foot, and in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the right foot. The MPP in M1 region was higher in the right than in the left foot (P<0.05). The MPP in M3, M4, M5, and MF was higher in the left than in the right foot (P<0.05). The percentage of high-risk foot (defined by a total plantar pressure ≥70 N/cm) was 34% on the left and 17.7% on the right. An increased BMI was associated with a significant increase in high-risk foot, but not for the right foot in underweight patients. Foot flat phase was extended and forefoot push-off phase shortened in stance phase in the patients. Compared with the right foot, the left foot showed a significantly increased foot arch index and increased low and high arch rates with a decreased normal arch rate. Total plantar pressure was higher in of the left high arch foot than in normal arch foot. The foot angle was significantly larger on the right than on the left. The bilateral total plantar pressures were significantly greater in male patients (P<0.05) and increased with age but were not associated with the duration of DM, foot angle, or glycosylated hemoglobin level.

CONCLUSIONDiabetic patients have obvious alterations in foot biomechanics with abnormalities of the plantar pressure, and the percentage of high-risk foot increases in overweight and obese patients, suggesting the need of body weight control in these patients when administering offloading treatment for prevention of diabetic foot ulcer.

Biomechanical Phenomena ; Diabetes Mellitus, Type 2 ; physiopathology ; Diabetic Foot ; prevention & control ; Female ; Foot ; physiopathology ; Gait ; Heel ; physiopathology ; Humans ; Male ; Obesity ; physiopathology ; Overweight ; physiopathology ; Pressure

Primary breast lymphoma(PBL) is a rare and unique type of lymphoma. Female patients are the majority, but its pathogenesis is not clear, and the estrogen may be related with the pathoganesis. Women who have breast implants have more chance to be suffered. The painless breast masses are the most common clinical manifestations, which is similar to breast cancer. Surgical resection of the mass and core needle biopsy are helpful for the diagnosis. The most common pathological type of PBL is diffuse large B cell type, with non GCB type, and it is prone to extranodal relapse in which central nervous system relapse is common which has poor prognosis. Therapy combined with surgery, chemotherapy and radiotherapy are requied, but rituximab added failed to improve its survival. Small molecular targeted drugs may be beneficial to PBL. In this article, the pathogenesis, clinical characte ristics, diagnosis and treatment of PBL are briefly summarized.

Purpose To investigate the expression of insulin-like growth factor Ⅱ mRNA-binding protein 3 (IMP3) and its differential diagnostic significance in benign and malignant thyroid tumor. Methods The fluorescent quantitative PCR and immunohistochemical staining were used to detect the IMP3 expression in 71 cases of thyroid tissue of different pathological types. The differential diagnostic significance of IMP3 expression in benign and malignant thyroid tumor was analyzed. Results Compared with normal thyroid tissue, thyroid tumors including follicular variant of papillary thyroid carcinoma (FVPTC ), follicular thyroid carcinoma (FTC), papillary thyroid carcinoma(PTC), nodular goiter (NG), and follicular adenoma (FA) had significantly higher IMP3 mRNA expression levels with10.13, 8.81, 8.52, 2.46, and 1.49 holds, respectively. The positive expression rate of IMP3 protein in thyroid tumors were significantly higher, with the positive rate from high to low was FTC (100％ ), PTC (96.77％ ), FVPTC (90％ ), FA(20％ ), and NG (0). The expression level of IMP3 protein was positively correlated with the expression of mRNA (P＜0.01). The IMP3 expression level of malignant thyroid tumor(8.82 holds) was significantly higher than that of benign thyroid tumor (1.94 holds) (P＜0.01). The IMP3 expression level of malignant thyroid follicular lesions (9.36 holds) was higher than that of benign thyroid follicular lesions (1.49 holds) (P＜0.01). Conclusion IMP3 may be an effective and useful molecular maker for diagnosis of benign and malignant thyroid neoplasms, as well as the differential diagnosis between benign and malignant thyroid follicular lesions.

Objective To investigate the efficacy and tolerability of a recombinant human tumor necrosis factor:Fc fusion protein (rhTNFR:Fc,with a trade name of Yisaipu) in the treatment of moderate to severe psoriasis vulgaris.Methods A multicentre,randomized,double blind,and parallel-controlled trial was performed.One hundred and forty-four patients with moderate to severe psoriasis vulgaris from four centres were randomly assigned and treated with either once-weekly subcutaneous injection of rhTNFR:Fc (50 mg) or oral methotrexate (MTX)(7.5 mg) for 12 weeks.Patients were followed up at 2,4,8,12 weeks after the treatment.Results One hundred and twenty-four patients finished the 12-week course of treat- ment.At 12 weeks after the treatment,a 50%,75%,90% improvement in psoriasis area and severity index (PASI) was achieved by 86.11%,76.39%,52.78% respectively of rhTNFR:Fc-treated patients,and by 63.89%,44.44%,22.22% respectively in MTX-treated patients,and all the three improvement rates were of significant difference between the two groups of patients (all P0.05).Conclusion Compared with MTX,rhTNFR:Fc acts more quickly with a higher cure rate and less toxic reactions in the treatment of psoriasis vulgaris.

OBJECTIVETo investigate the role of mitochondrial permeability transition pore (MPTP) opening in mediating the effect of endomorphine-1 postconditioning to alleviate myocardial ischemia-reperfusion (IR) injury in rats.

METHODSForty-five male SD rats were randomized equally for sham operation, myocardial IR injury, endomorphin-1 postconditioning, atractyloside (a MPTP opener) postconditioning, or endomorphin-1 + atractyloside postconditioning. The hemodynamic param-eters of the rats were monitored in real time via carotid artery cannulation to the left ventricle. After reperfusion, plasma samples were collected for biochemical analyses. The size of myocardial infarct area was detected using Evans blue and TTC double staining, and the myocardial expressions of apoptosis-related proteins Bax, Bcl-2 and cleaved caspase-3 were analyzed using Western blotting.

RESULTSMyocardial IR injury resulted in significantly decreased heart rate and blood pressure in the rats (P<0.05). Compared with those in IR group, the rats with endomorphin-1 postconditioning showed significantly increased heart rate and blood pressure (P<0.05), lowered contents or activities of LDH, CK-MB, cTnI, IL-6, TNF-α, Cyt-C and MDA in the plasma (P<0.05), increased plasma SOD activity (P<0.05), reduced size of myocardial infarction, decreased myocardial expression of Bax and cleaved caspase-3 protein (P<0.05), and increased myocardial expression of Bcl-2 protein (P<0.05). All these changes induced by endomorphin-1 were obviously reversed by atractyloside postconditioning (P<0.05).

CONCLUSIONEndomorphin-1 postconditioning protects against myocardial IR injury in rats probably by inhibiting the opening of MPTP and reducing cardiac myocyte apoptosis via down-regulating cleaved caspase-3 expression.