Objective To observation the effect of treating wind-cold type periarthritis of shoulder with acupuncture with warmed needle. Methods Study the influence of acupuncture with warmed needle on clinical indexes as total therapeutic effect, pain, and range of activity of 60 patients with wind-cold type periarthritis of shoulder. Result The total effective rate was over 80%. Conclusion acupuncture with wanned needle is a good method in treating wind-cold type periarthritis of shoulder clinically.

Objective To investigate the value of Real-time PCR in the diagnosis of invasive aspergillosis(IA) and to compare it with galactomannan antigen assays.Methods A retrospective study was performed on 110 episodes of hospitalization of 88 patients who were at risk of invasive aspergillosis at Peking University First and Renmin Hospital from May 2008 to December 2010.23 cases with diagnosis and clinical diagnosis IA were classified as infection group and 87 cases with suspected diagnosis and non-IA were classified as non-infeciton group according to the international criterion.Real-time PCR and gaiactomannan antigen detections were performed on 257 serum samples.A receiver operating characteristic curve (ROC)was developed based on the quantitative cycle numbers and an optimal cut off value of quantification cycle (Cq) was determined.The sensitivity (Se),specificity (Sp),positive predictive value (PPV) and negative predictive value (NPV) were calculated under different considerations among which McNemar chi-square tests were used for statistical analyze.Results The area under ROC curve of Real-time PCR for the diagnosis of IA was 0.91 (95％ CI:0.825-0.995) and the optimal cut off value of Cq was 39.45.The Se and Sp of one positive PCR,two positive PCR,one positive GM and two positive GM were 87.0％,79.3％ ; 58.3％,97.8％ ; 78.3％,63.2％ ; and 58.3％,82.6％,respectively.When one positive PCR was considered as the diagnostic criterion of IA,Real-time PCR was able to diagnose 100％ and 84.2％ of proven and probable IA cases,respectively.The Sp of one/two positive PCR were statistically higher than one/two positive GM (P ＜ 0.05),respectively.The Sp of two positive PCR was statistically higher than one positive PCR (P ＜0.05).The Se and Sp were 65.2％,89.7％ and 100％,52.3％ for one positive PCR combined one positive GM and one PCR or GM positive,respectively.Conclusions Real-time PCR assays have better sensitivities and specificities than GM in the diagnosis of invasive aspergillosis.When two PCR positive were considered,better specificity and positive predictive value were achieved.

Objective To investigate the effect and its underlying mechanism of repetitive transcranial magnetic stimulation(rTMS)on dopaminergic neurons and glial cell line-derived neurotrophic factor(GDNF)in the substantia nigra(SN)in mice with Parkinson's disease(PD). Methods Thirty-two male C57 BL/6J mice were randomly divided into a normal saline group,a sham-rTMS group,a PD model group and an rTMS group,with 8 mice in each group. All the mice except those in the normal saline group were administered with 4 times of subcutaneous in jection of 1-methyl,4-phenyl-1,2,3,6 tetrahydropyridine(MPTP)15 mg/kg at 2-hour intervals in 1 day to induce neuronal injury in the SN and to establish acute mice PD model.The mice in the rTMS group received 5 trains of 1 Hz rTMS for 25 s,at the intensity of 1 Tesla(T)daily for 2 weeks.After rTMS,the effect of rTMS on PD mice was observed by immunohistoehemieal technique with regard to the expression of tyrosine hydroxylase(TH)and GDNF in the SN,and the quantitative analysis was performed by an advanced image-analysis system. Results Compared with normal saline group,the number of TH and GDNF immunoreaetive(TH-ir and GDNF-ir)cells and the corrected optical density(COD)values of PD model group and sham-rTMS group were significantly lower(P＜0.01);Com pared with PD model and sham-rTMS groups,the numbers of TH and GDNF positive cells and COD values in rTMS group were significantly higher(P＜0.05).There was a significant positive correlation between the count of TH-ir and that of GDNF-ir cells(r=0.836,P＜0.01).The correlation between the COD values of TH-ir and that of GD-NF-ir cells was also significant(r=0.921,P＜0.01).Conclusion rTMS markedly increased the number and the COD values of TH-positive dopaminergic neurons and simultaneously increased the number and the COD value of GD NF-ir cells in the SN of PD mice.These findings suggest that rTMS has neuroprotective effects on dopaminergic neurons in the MPTP-induced PD mice,which might be mediated by up-regulation of the expression of GDNF protein in the SN.

Objective To analyze the changes and clinical significance of live function in advanced non-small cell lung cancer after chemotherapy.Methods The data of 164 patients histopathologically confirmed as advanced nonsmall cell lung cancer with complete medical history data from January 2007 to September 2010 were retrospectively analyzed.All the patients received chemotherapy by docetaxel or gemcitabine plus nedaplatin,regular liver function hematological monitoring and liver color ultrasound examination,which revealed the changes of liver function and liver morphology.Results Docetaxel or gemcitabine plus nedaplatin could induce liver function indexes abnormality in patients with advanced nonsmall cell lung cancer.The main symptoms were the rise of ALT,AST with different extent (ALT:29 U/L vs 30 U/L,AST:54 U/L vs 39 U/L,P ＜ 0.05),which were not related with the sex,age,tumor pathologic types and the clinical stages (P ＞ 0.05).Patients received chemotherapy by gemcitabine were inclined to experience liver function indexes abnormality (P ＜ 0.05).Patients with hepatic metastases and hepatitis B surface antigen positive before chemotherapy were inclined to experience liver function indexes abnormality (P ＜ 0.05).The ALP,γ-GT,TBL,ALB levels after treatment were almost the same as those before treatment (P ＞ 0.05).Conclusions Taking docetaxel or gemcitabine plus nedaplatin could induce liver function indexes abnormality in patients with advanced nonsmall cell lung cancer.Patients treated by chemotherapy complicated with hepatic metastases,hepatitis B surface antigen positive and treatment by gemcitabine were inclined to experience liver function indexes abnormality,which is value to research.

Humans ; Occupational Health ; Occupational Health Services ; standards ; Population Surveillance ; Program Evaluation

OBJECTIVETo ascertain whether a coding mutation (Ile93Met) in ubiquitin carboxy-terminal hydrolase (UCH-L1) gene plays a role in idiopathic Parkinson's disease (IPD).

METHODSPolymerase chain reaction-restriction fragment length polymorphism assay (PCR-RFLP) was used to distinguish the wild-type (two DNA fragments of 34 and 126 bp) from the variant allele (three fragments of 34, 60 and 66 bp) because the mutation created a new site for restriction endonuclease BsmF1. DNA was isolated from various blood samples using a phenolchloroform extraction.

RESULTSIle93Met substitution was found neither in PD patients nor in controls.

CONCLUSIONSOur study suggested that Ile93Met of UCH-L1 gene did not influence risk of IPD.

Aged ; Amino Acid Substitution ; Female ; Humans ; Male ; Middle Aged ; Mutation ; Parkinson Disease ; genetics ; Thiolester Hydrolases ; genetics ; physiology ; Ubiquitin Thiolesterase

Objective To investigate the diagnostic value of head-up tilt test (HUT) in cough syncope (CS).Methods Forty-seven outpatients or inpatients with CS and 79 patients with suspected vasovagal syncope(SVVS) due to syncope history in our hospital from January 2011 to May 2015 served as the observation group and control group respectively.HUT was performed in the two groups.The cough response during HUT,changes of systolic pressure and diastolic pressure caused by cough,HUT positive results and hemodynamic type were observed,Results In the observation group,4 cases(8.51％) were cough caused syncope,26 cases (55.32 ％) were presyncope and 17 cases (36.17 ％) had no symptoms,while 79 cases in the control group had no symptoms,the differences were statistically significant (P＜ 0.05).The total positive rate of cough response in the observation group was 63.83％,and the specificity was 100.00％.The systolic blood pressure had statistical difference between the two groups(.P＜0.05).The diastolic pressure had statistical difference between the cases of non-symptoms with the cases of syncope and cases of presyncope in the observation group (P＜0.05),but had no statistical difference compared with the cases of non-symptoms in the control group(P＞0.05).The heart rate(HR) had no statistical difference among various groups(P＞0.05).The HUT positive rate in the observation group was lower than that in the control group(P＜0.05).The hemodynamic type had no statistical difference between the two groups(P＞0.05).Conclusion Severe coughing during HUT may cause the blood pressure decrease,induces syncope or presyncope,can increase the diagnostic sensitivity of CS patients,which is very useful in the suspected diagnosis of CS patients,especially for CS patients with a unclear history.

Objective To detect the levels of neutrophil extracellular traps (NETs) in patients with antiphospholipid syndrome (APS) and to preliminarily explore its formation mechanism.Methods Plasma samples from 27 APS patients and 30 healthy controls were collected.The circulating free DNA (cf-DNA) in plasma was detected by the PicoGreen nucleic acid quantitative assay kit,and the concentration of citrulline histone 3 (CitH3) was analyzed by enzyme-linked immuno sorbent assay (ELISA).The association of cf-DNA/NETs with thrombotic events in APS patients was further analyzed.The neutrophils in healthy controls were separated by density gradient centrifugation and stimulated with anti-β2GPl/β2GPI complex (100 μg/mL) for 4 h,and the cf-DNA/NETs in the culture supernatant was determined.TLR-4 inhibitor-TAK242 (5 μmol/L) was further used to observe whether the stimulation of the anti-β2GPI/β2GPI complex on cells could be intervened.The differences between groups were analyzed by analysis of variance (ANOVA) or rank sum test,Sidak or Dunnett's test were used to compare the mean of multiple samples and the correlation between variables was analyzed by Spearman's correlation test.Results The concentration of cf-DNA/NETs and CitH3 were significantly increased in plasma of APS patients compared with that in healthy controls [175.7(70.6,205.7) ng/ml vs 29.8(7.6,115.7) ng/ml,Z=-3.654,P＜0.05;19.5(7.8,26.4) ng/ml vs 3.3(0.84,10.3) ng/ml,Z=-3.932,P＜0.05],and there was a significant positive correlation between the cf-DNA/NETs and CitH3 (r=0.447,P=0.019).In the APS group,there was no significant difference in cf-DNA/NETs between patients with arterial thrombosis and those with venous thrombosis [177.1(67.8,297.2) ng/ml vs 184.7(82.4,233.9) ng/ml,Z=-0.301,P=0.786],whereas cf-DNA/NETs in the patients who experienced a new thrombotic event in 1 month was significantly higher than those with a history of thrombosis [192.1(83.6,328.8) ng/ml vs 90.0(42.8,184.7) ng/ml,Z=-2.006,P=0.046].In vitro,anti-β2GPI/β2GPI complex (100 μg/ml) stimulated the release of cf-DNA/NETs from neutrophils,which was significantly increased compared with the control group (t=10.39,P＜0.05),while TAK242 significantly inhibited the stimulating effects of anti-β2GPI/β2GPI complex on cells (t=4.22,P＜0.05).Conclusion The level of cf-DNA/NETs in peripheral blood of APS patients is significantly increased,which may play an important role in APS thrombosis.Anti-β2GPI/β2GPI complex induces the formation of cf-DNA/NETs through TLR4 and participates in the pathological process of APS.

Objective To investigate dermoscopic features of onychomycosis and nail psoriasis.Methods From March 2017 to March 2018,128 patients with onychomycosis and 128 with nail psoriasis were enrolled from Department of Dermatology,Xiangyang Central Hospital.Dermoscopic images of the lesional nails were compared.Enumeration data were analyzed by chi-square test and Fisher's exact test.Results There were 7 kinds of dermoscopic patterns in onychomycosis,including jagged edge (69/128,53.91％),longitudinal striae (72/128,56.25％),cone-shaped keratosis (30/128,23.44％),nail plate thickening (21/128,16.41％),black dots (5/128,3.91％),onycholysis (26/128,20.31％),and nail discoloration (23/128,17.97％).The jagged edge and longitudinal striae occurred more frequently in distal/ lateral subungual onychomycosis (DLSO) than in the other 3 clinical subtypes of onychomycosis (all P ＜ 0.001),and cone-shaped keratosis occurred more frequently in total dystrophic onychomycosis (TDO) than in the other 3 clinical subtypes of onychomycosis (x2 =42.020,P ＜ 0.001).There were no significant differences in the prevalance of nail plate thickening,black dots,onycholysis and nail discoloration among the 4 clinical subtypes of onychomycosis (all P ＞ 0.05).There were 7 kinds of dermoscopic patterns in nail psoriasis,including pitting corrosion (61/128,47.66％),oil drop sign (41/128,32.03％),splinter hemorrhage (41/128,32.03％),dilated hyponychial capillaries (23/128,17.97％),nail plate thickening (20/128,15.63％),onycholysis (20/128,15.63％),and nail discoloration (13/128,10.16％).The oil drop sign occurred more frequently in psoriasis vulgaris and psoriasis arthropathica than in the other 2 clinical subtypes of psoriasis (P =0.019).The dilated hyponychial capillaries occurred more frequently in pustular psoriasis than in the other 3 clinical subtypes of psoriasis (P =0.047).There were no significant differences in the prevalance of pitting corrosion,splinter haemorrhage,nail plate thickening and nail discoloration among the 4 clinical subtypes of psoriasis (all P ＞ 0.05).Conclusions The dermoscopic features of onychomycosis include jagged edge,longitudinal striae,cone-shaped keratosis and black dots,and the dermoscopic features of nail psoriasis include pitting corrosion,oil drop sign,splinter haemorrhage and dilated hyponychial capillaries.Their common dermoscopic features include nail plate thickening,onycholysis and nail discoloration.

OBJECTIVE：To study the current situation of pharmacovigilance work in large ，medium and small-scale pharmaceutical manufacturers in Jiangsu Province ，and to provide reference for the pharmacovigilance development of drug manufacturers with different scales. METHODS ：The situation of pharmacovigilance work in 108 manufacturers in Jiangsu province was investigated through a questionnaire survey and related websites. The pharmacovigilance work （organization，personnel and training，document，computer system ），drug safety monitoring （case report ，regular safety update report ，post-marketing safety research） and drug risk management （signal management ， risk management plan ， risk control measures ， drug safety communication）of different manufacturers were investigated to put forward the suggestions. RESULTS & CONCLUSIONS ：There was no significant difference in the organizational structure （independently established specialized agencies ）among manufacturers of different scales （P＝0.60）. Most of the manufacturers had less than 50％ of the proportion in the independent establishment of specialized institutions for pharmacovigilance. There was significant difference in personnel and training （situation and number of full-time staff in charge ，medical and clinical pharmacy personnel number ），document（formulating training management system ， entrusted management and key monitoring procedures ），computer system （P＜0.05）. There was no difference in the main collection ways of case reports among manufacturers of different scales ；however，the number of independent reports in 2019（P＜ 0.01），the proportion of quality control process for regular safety update reports （P＝0.01），and the proportion of carrying out post-marketing safety research in recent five years （P＜0.01）in large-scale manufacturers were all significantly higher than small- and medium-scale manufacturers. The proportions of large-scale manufacturers （70.00％） and medium-scale manufacturers （84.38％），which considered “lack of technical guidelines ”as an important factor affecting signal management ，were higher than that of small-scale manufacturers （53.57％）（P＝0.01）；the proportions of large-scale manufacturers （60.00％）and medium-scale manufacturers（50.00％），which had carried out risk management plans in the past five years ，were higher than that of small-scale manufacturers（30.36％）（P＝0.04）；the proportion of large-scale manufacturers （50.00％），which adopted the measures in recent 5 year，was higher than medium-scale manufacturers （37.50％）and small-scale manufacturers （25.00％）；the proportions of large-scale manufacturers （70.00％ ） and medium-scale manufacturers （59.38％ ）， which carried out communication for pharmacists，were higher than small-scale manufacturers （32.14％）（P＜0.01）. Large-scale manufacturers outperformed small- and medium-scale manufacturers in terms of pharmacovigilance system ，drug safety monitoring and drug risk management. Large-scale manufacturers had a certain degree of lack of initiative on performing risk management plans ，medium-scale manufacturers on full-time staffs in charge ，and small-scale manufacturers on pharmacovigilance system. So ，it is recommended that large-scale manufacturers take effective control of variety risk as the goal and actively risk management ；medium-scale manufacturers should continuously enhance the awareness of responsibility and improve the investment of resources on pharmacovigilance work ； small-scale manufacturers should pay more attention to improving the pharmacovigilance system and the compliance of specific work.