Objective To investigate the efficacy of normative ankle balance training on chronic ankle instability (CAI).Methods Ninety patients were randomized into control group (17 males,28 females;13-26 years,mean 19.6 years) and experiment group (18 males,27 females;14-27 years,mean 20.3 years) according to the random number table.There were 19 left ankles and 26 right ankles injured in control group,and 19 left ankles and 26 right ankles injured in experiment group.Patients in control group only completed routine muscle strength training.Besides the routine muscle strength training,balance training (rubber band,spongy cushion,balance pedal,rubber balance ball and jump ball) were added in experiment group.The two groups were compared with respect to foot and ankle disability index (FADI),anterior,posterior-median and 45° to posterolateral direction reach distance of star excursion balance test (SEBT) and visual analogue score (VAS).Results After training,comparison of experiment and control groups showed significant differences in FADI (35.16 ± 3.23 and 22.33 ± 1.36),SEBT distance in posterior median direction [(78.59 ± 7.22) ％ and (71.89 ±7.11)％],SEBT distance in 45° to posterolateral direction [(75.79 ± 8.27)％ and (68.95 ±8.03) ％] and VAS [(3.01 ± 0.91) scores and (3.42 ± 1.02) scores] (P ＜ 0.05).For intragroup comparison,FADI,SEBT and VAS in experimental group showed significant differences before and after training (P ＜ 0.05),but only FADI in control group differed significantly before and after training (P ＜0.05).Conclusion Normative balance training can improve CAI patients' self-feelings of dynamic balance and instability with satisfactory therapeutic efficacy,and is worthy to be popularized.

Objective To explore the anti-inflammatory mechanisms of purslane by evaluating its effects on the expression of tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule 1 (ICAM-1).Methods A model of inflammation was developed in 45 mice by painting xylene to the auricle of the right ears,which were then divided into 3 groups to receive no treatment (negative control group),be topically treated with the extraction of purslane from South Korea (positive control group) or Yunnan province (experimental group).Fifteen mice receiving no sensitization nor treatment served as the blank control group.Two hours after the single topical treatment,skin tissue samples were obtained from the site of experimental inflammation and subjected to pathological examination by using hematoxylin and eosin (HE) staining.Immunohistochemistry was performed to quantify the expression of TNF-α and ICAM-1 in the tissue samples.Results Pathological examination showed blood vessels and a small quantity of lymphocytes in murine dermis of the blank control group as well as loose and edematous dermis infiltrated with massive lymphocytes in the negative control group.However,there was only mild edema and perivascular infiltration with some inflammatory cells in the dermis of the positive control group and experimental group.Neither TNF-α nor ICAM-1 was expressed in the skin tissue of the blank control group,but an intense expression was observed for TNF-α in the vascular endothelial cell membrane and for ICAM-1 in the vascular endothelial cell membrane and lymphocyte membrane in the negative control group,which was significantly downregulated by the purslane from South Korea in the positive control group and by the purslane from Yunnan province in the experimental group (all P ＜ 0.01).Rank sum test showed a statistical difference in the expression level of TNF-α and ICAM-1 between the blank control group and experimental group (both P ＜0.01).Conclusion The purslane from Yunnan province may counteract inflammation by affecting the expression of TNF-α and ICAM-1.

Through analysis of the anatomic and physiological characteristics and the pathophysiological changes of 84 obstructive sleep apnea syndrome (OSAS) patients,the risks and key points of nursing care during general anesthesia were summarized,such as careful assessment of the patient situation,preparations of first aid materials and drugs,close observation and cooperation with the procedure of anesthesia,timely detecting and dealing with the abnormal changes during anesthesia.

Mutations detection of circulating tumor DNA can be divided into quantitative and qualitative classifications:the forumer mainly detects the total amount of circulating DNA (serum or plasma),whereas the latter mainly detects the specific genetic variations in serum or plasma DNA,such as gene mutations,methylations of tumor suppressor genes,and microsatellite alterations,etc.Both of them may reflect the tumor presence and disease severity.In this paper,mutations detection and its clinical significance of circulating tumor DNA in patients with hepatocellular carcinoma are reviewed.

Objective To investigate the clinical effect of Clostridium butyricum powder in treating infantile indigestion diarrhea.MethodsFrom February 2013 to October 2015 in our hospital 76 cases of pediatric indigestion diarrhea as the research object, randomly divided into experimental group and control group with 38 cases in each group, two groups were given Bao,er ning granule, combined group plus live bacteria powder for the treatment of Clostridium butyricum, three days for a course of treatment, continuous treatment of two courses.ResultsBefore treatment, there was no significant difference in clinical symptom scores between the experimental group and the control group,after treatment,the scores of loss of appetite, abdominal pain, diarrhea, abdominal distension and stool of the experimental group were lower than those of the control group, the difference was statistically significant (P<0.05);Before treatment, there was no significant difference in serum motilin, gastrin and somatostatin levels between the experimental group and the control group.After treatment, the levels of serum motilin and gastrin in the experimental group were lower than those in the control group, and the level of serum somatostatin was higher than that of the control group, the difference was statistically significant (P<0.05);After treatment, the total effective rate of experimental group was 92.11% higher than that of control group 73.68%, the difference was statistically significant (P<0.05).ConclusionClostridium butyricum powder with Bao,er ning granule in the treatment of infantile dyspeptic diarrhea effect is good, worthy of clinical application.

Objective To evaluate the effects of Prinsepia utilis Royle oil (PURO) on the synthesis of ceramide and expression of acid ceramidase N-acylsphingosine amidohydrolase 1 (ASH1),and to explore the mechanisms underlying its moisturizing and skin barrier-repairing effects.Methods Keratinocytes from human foreskin tissue were classified into 2 groups to be cultured in keratinocyte-serum free medium (K-SFM) with or without the presence of PURO.Enzyme linked immunosorbent assay (ELISA) was performed to measure the level of ceramide in the culture supernatant of keratinocytes at 0,3,8,24 and 48 hours.The back of nude mice was divided into 4 areas,i.e.,test area,matrix area,blank control area and negative control area.Acetone and ether were used to destroy the epidermal barrier in the test,matrix,and blank control areas,then,the former 2 areas were topically treated with emulsions containing 1％ PURO and matrix,respectively,and the blank control area remained untreated.The epidermal barrier remained intact and untreated in the negative control area.Noninvasive methods were used to determine transepidermal water loss (TEWL),epidermal moisture content and skin lipid content in these areas on day 0,1,3,and 7.Skin tissue was obtained from these areas on day 0 and 7 followed by an immunohistochemical study for the quantification of ASH1 expression.Results The level of supernatant ceramide increased with time in the PURO-treated keratinocytes,which was significantly higher at 24 hours and 48 hours than at 0 hour (1.3817 ± 0.100 and 1.3737 ± 0.047 vs.0.7630 ± 0.143,both P ＜ 0.05).The supernatant ceramide was also elevated in the PURO-treated keratinocytes compared with untreated keratinocytes at 24 and 48 hours (both P ＜ 0.05).Noninvasive skin tests showed a gradual decrease in the TEWL,but an increase in the epidermal moisture content and skin lipid content with time in the 3 epidermal barrier-destroyed areas.As far as the test area was concerned,TEWL value was significantly lower on day 3 and 7 than on day 0 (10.85 ± 0.64 and 8.01 ± 0.58 vs.12.65 ± 0.71,both P ＜ 0.05),while a significant increment was observed in the skin lipid content on day 3 and 7 compared with day 0 (29.14 ± 0.40 and 31.30 ± 0.88 vs.27.02 ± 0.65,both P ＜ 0.05),as well as in the epidermal moisture content on day 1,3 and 7 compared with day 0 (13.98 ± 0.28,15.00 ± 0.38 and 15.86 ± 0.18 vs.11.74 ± 0.62,all P＜ 0.05).On day 7,there was a statistical decline in TEWL value,but an elevation in epidermal moisture content,skin lipid content and ASH1 expression in the test area compared with the matrix area and blank control area (all P ＜ 0.05).Also,the expression of ASH1 was upregulated on day 7 compared with day 0 in the 3 barrier-destroyed areas (all P ＜ 0.05).Conclusion PURO may exert skin-moisturizing and barrier-repairing effects by enhancing the synthesis of ceramide and expression of acid ceramidase ASH1.

Objective To compare skin barrier function among patients with facial acne,subacute eczema,melasma and solar dermatitis.Methods Three hundred patients,including 80 patients with facial acne,60 subacute facial eczema,80 facial melasma and 60 facial solar dermatitis,as well as 60 healthy controls were recruited in this study.Skin sebum content and transepidermal water loss (TEWL) were measured by a sebmeter and Tewameter TM 210 (Courage and Khazaka,Germany),respectively.Stratum comeum hydration was measured with a Scalar Moisture Checker (Scalar Corporation,Japan).Statistical analysis was carried out using analysis of variance and t test.Results Compared with the healthy controls,patients with facial acne showed increased skin sebum content and TEWL value but decreased stratum corneum hydration (all P ＜ 0.01),and patients with subacute eczema,solar dermatitis and melasma displayed lower sebum content and stratum corneum hydration but higher TEWL value (all P ＜ 0.01).Skin sebum content was significantly higher in patients with facial acne than in patients with subacute eczema,solar dermatitis and melasma ((184.65 ± 83.07) vs.(21.86 ± 18.94),(25.10 ±14.22) and (36.05 ± 32.84) μg/cm2,all P ＜ 0.01),but was similar between the patients with subacute eczema,solar dermatitis and melasma (P ＞ 0.05).In terms of stratum corneum hydration,patients with subacute eczema and solar dermatitis were statistically lower than those with acne and melasma (18.66％ ± 7.85％ and 20.91％ ± 8.05％ vs.24.32％ ± 8.16％ and 28.02％ ± 4.67％,all P ＜ 0.01),patients with facial subacute eczema were similar to those with solar dermatitis (P ＞ 0.05),and patients with facial acne were statistically lower than those with melasma (P ＜0.01).TEWL value was significantly higher in patients with melasma than in patients with acne,solar dermatitis and subacute eczema ((13.80 ± 4.t 3) vs.(20.86 ± 8.78),(22.85 ± 9.84) and (22.48 ± 10.37) μg/m2 h,all P ＜ 0.01),but similar between patients with acne,solar dermatitis and subacute eczema (P ＞ 0.05).Conclusions Skin barrier function is somewhat impaired in patients with facial acne,subacute eczema,melasma and solar dermatitis.Therefore,to recover skin barrier function may facilitate the treatment of these diseases.

ObjectiveTo seek experimental evidence of epidermal barrier dysfunction in psoriasis,and to provide a basis for adjuvant therapy of psoriasis.MethodsPhysiometric methods were used to determine the value of sebum content,transepidermal water loss(TEWL) and water content of stratum corneum in 60 patients with psoriasis and 48 normal human controls.The ultrastructure of lamellar bodies was observed with transmission electron microscopy,and the expression of acid ceramidase in normal skin and psoriatic lesions was detected by using immunohistochemical techniques.ResultsCompared with the normal skin,TEWL value was increased(P ＜ 0.01),but water content of stratum corneum decreased(P ＜ 0.01 ) in psoriatic lesions,and sebum content was similar between normal skin and psoriatic lesions.As electron microscopy showed,lamellar bodies in keratinocytes were reduced in number with a disorganized arrangement and irregular size in psoriatic lesions.The expression of acid ceramidase also decreased in psoriatic epidermis.Conclusions The function of epidermal barrier in psoriasis is impaired,and to restore epidermal barrier function and enhance hydration may serve as an important adjuvant therapy of psoriasis.

Objective To investigate the relationship between serum levels of surfactant protein( SP)-A,SP-C and lung function impairment in coal workers with pneumoconiosis(CWP) in order to provide evidence for the biomarker study of pneumoconiosis.Methods Thirty-two coal workers with pneumoconiosis snd 41 healthy controls were included in this study.Serum levels of SP-A and SP-C were measured.Grading assessment of dyspnea and pulmonary function including predicted percentages of FVC,FEV1,FEV/FVC,MVV,and DLCO were conducted.Results Among the 32 participants with CWP,the severity of dyspnea was rated as level Ⅲ for 14 and level Ⅳ for 18 individuals.The pulmonary function was significantly impaired in CWP patients with level Ⅳ dyspnea compared with the healthy controls (FEV1％ predicted:[69.38 ± 15.17 ]％ vs.[96.35 ±10.24 ] ％ ; MVV％ predicted:[ 65.89± 8.14 ] ％ vs.[ 94.13 ± 10.38 ] ％ ; DLCO％ predicted:[ 96.51 ±11.37 ] ％.The serum levels of SP-A and SP-C were significantly higher in CWP patients than that in the healthy controls (SP-A:[4.02 ± 1.22] μg/L vs.[2.41 ±0.68 ] μg/L,t =6.480,P =0.001 ;SP-C:[3.58 ±0.67 ] ng/L vs.[ 2.31 ± 0.29] ng/L,t =9.290,P ＜ 0.001 ).Serum SP-A and SP-C levels in CWP patients were found to be significantly correlated with exposure to dust,dyspnea severity,FEV1％ predicted and DLCO％ predicted.Conclusion Serum SP-A and SP-C levels in CWP patients are closely associated with lung function,suggesting their role as candidate biomarkers for CWP.

Objective To study clinical application and complication of heavy silicon oil (Densiron68) in the treatment of traumat- ic proliferative vitreoretinopathy.Design Non-comparatives,retrospective case series.Participants Twenty patients with proliferative vitreoretinopathy resulting from ocular trauma were recruited,whose retinal detachment arising from inferior or posterior retinal breaks. Methods Heavy silicon oil was applied to patients during vitrectomy.Silicone oil or gas was applied to patients with redetachment after heavy silicon oil was removed.Main Outcome Measures The rate of retinal attachment,vision,intraocular pressure,inflammatory re- action of anterior segment and silicone oil emulsification period.Results The rate of retinal attachment with one operation using heavy silicon oil was 50%(10/20 eyes)and 15%(3/20 eyes)with further surgery.The average follow-up time was 3.90?1.41 months.At the end of the follow-up,all tamponade agents were removed in 50% patients.Patients' logMAR vision after the surgery was 2.19?0.86,which was better than before the surgery (2.63?1.00) (P=0.037).There was little evidence of high intraocular pressure,excessive inflammatory reaction of anterior segment and cornea endothelial cell damage,but cataract became more serious without exception.Emulsification rate was 100% and the average emulsification period was 2.18?0.87 months.Conclusions Heavy silicon oil tamponade in vitreoretinal surgery for traumatic proliferative vitreoretinopathy has good efficacy and relatively few complications.However,its emulsification period is relatively short,which may constraint its application to a certain extent.