Objective:To systematically evaluate the therapeutic efficacy of tuina therapy for primary insomnia.Methods:Nine Chinese and English databases were searched from the inception to May 2017 to identify randomized controlled trials (RCTs) studying tuina therapy for insomnia.The enrolled articles were all RCTs with tuina as the monotherapy or major therapy in the experiment group,with clear diagnostic criteria for primary insomnia well recognized worldwide or in China,and Pittsburgh sleep quality index (PSQ I) as one of the outcome measures.Two researchers evaluated the risk of bias and quality of the enrolled studies by following Cochrane Handbook version 5.1.0.The meta-analysis was performed by RevMan version 5.3.Results:Eleven studies were included with a total of 1 076 participants.The Western medication adopted in the control groups were benzodiazepine receptor agonists.The studies were all assessed as high risk of bias for blinding since blinding method was unable to be performed due to the specificity of tuina therapy;no study reported the support of fund or potential interest conflict,so they were all rated unclear for selective reporting.The meta-analysis showed that compared with other traditional Chinese medicine therapies,tuina worked more effectively in reducing the PSQI score (MD=-4.11＜0,95％ confidence interval (CI)-6.01 to-2.22,P＜0.0001);compared with oral administration of Western medication,tuina showed more significant efficacy in reducing the PSQI score (MD=-3.42＜0,95％CI-5.19 to-1.66,P＜0.0001).Subgroup analysis showed that head tuina alone showed no significant difference compared with oral administration of Western medication regarding the change of PSQI score (MD=-4.19＜0,95％CI-8.87 to 0.50,P＞0.05);a combination of head and back tuina could more effectively reduce the PSQI score compared with oral administration of Western medication (MD=-2.08＜0,95％CI-3.09 to-1.06,P＜0.0001).Conclusion:Tuina can produce more significant efficacy in treating primary insomnia compared with other traditional Chinese medicine therapies and oral administration of Western medication,especially the combination of head and back tuina.

Objective To evaluate the correlation between left ventricular function and arterial stiffness of left femoral artery in patients with lower extremity atherosclerotic disease (LEAD).Methods Thirty-three patients with LEAD and 37 healthy subjects (control group) were enrolled in this study.The intima-media thickness (IMT),diameter and parameters of arterial stiffness [dispensability coefficient (DC),compliance coefficient (CC),stiffness α,stiffness β,pulse wave velocity (PWVβ) ]were measured by ultrasonography with the technology of QIMT and QAS.The thickness of the interventricular septum (IVSd),end-diastolic left ventricular diameter (LVDd) and left ventricular mass (LVM),and parameters of the left ventriculsr function (EF,E/A,E'/A',E/E' and Tei index) were measured by echocardiography.These parameters were compared between two groups.Correlations between the parameters of the arterial stiffness and those of the cardiac function were evaluated by Pearson correlative analysis.Results ①The IVSd,LVM and E/E' ratio were significantly higher in LEAD group than those in control group ( P ＜0.05).There were no significant differences in EF,E/A,E'/A',and Tei index between two groups ( P ＞0.05).②The IMT,α,β,PWVβ of left femoral artery were significantly higher in LEAD group than those in control group,while DC and CC were significantly lower in LEAD group than those in control group ( P ＜0.05).③The E/E' ratio,one of the parameters representing the left ventricular diastolic function,was correlated negatively with CC and positively with α,β,and PWVβ ( P ＜0.05 or P ＜0.01 ).The E'/A' ratio was correlated positively with DC and CC,and negatively with α,β,and PWVβ ( P ＜0.05 or P ＜0.01 ).Both EF and Tei index were not significantly correlated with the above parameters of arterial stiffness ( P ＞0.05).Conclusions Patients with LEAD have thickened femoral IMT,higher arterial stiffness of left femoral artery,as well as impaired left ventricular function.There is a close correlation between the atherosclerosis of the femoral artery and the early left vcntricular dysfunction.

Objective To evaluate the association between the left carotid arterial stiffness and left ventricular diastolic function in patients with lower extremity atherosclerosis (AS).Methods ①A total of 32 patients with AS and 34 control objects were enrolled.The carotid arterial stiffness parameters:compliance coefficient (CC),distensibility coefficient (DC),stiffness parameter (α,β),pulse wave velocity β (PWVβ) were measured by using quality arterial stiffness(QAS) technology.And the values were compared between the two groups.②The parameters of left ventricular (LV) structure and function:LV end-diastolic interventricular septal thickness (IVSd),LV end-diastolic diameter (LVDd),LV end-diastolic wall thickness (PWd),LV ejection fraction (EF),systolic velocity (s'),early-diastolic velocity (e'),Tei index and E/e' ratio were measured by using two-dimensional echocardiography and tissue Doppler.These parameters were compared between the two groups.The association between the carotid arterial stiffness parameters and LV function parameters were analyzed by correlative analysis.Results ①Compared with the control group,the DC and CC were lower,and α,β,PWVβ,IMT were higer than the control group,with statistically significant differences(P ＜0.05).②The IVSd,Tei index and E/e'was significantly higher in the AS group than those in the control group.And the PWd,s',e' were lower than those in the control group (P ＜ 0.05).There was no significant difference in EF between the two groups (P ＞0.05).③The e' was correlated positively with DC and CC (r =0.39,0.36,P ＜0.01),and negatively with α,β,and PWVβ (r =-0.42,-0.42,-0.49,P ＜0.01).Tei index was correlated negatively with DC and CC (r =-0.50,-0.52,P ＜0.01),and positively with α,β,and PWVβ (r =0.58,0.58,0.62,P ＜0.01).The E/e' was correlated regatively with CC (r =-0.27,P ＜0.05),and positively with PWVβ (r =0.28,P ＜0.05).There were no significant correlation between s',EF and the stiffness parameters of carotid artery (P＞0.05).Conclusions In patients with AS,the left carotid artery stiffness increases and left ventricular systolic and diastolic function are impaired.The carotid artery stiffness and left ventricular diastolic function is correlated.Changes in carotid artery stiffness reflect the change in left ventricular diastolic function.

Objective To find out the importance of human bocavirus (HBoV) as an infectious agent for population in Beijing, China. Seroprevalence study was conducted by using expressed recombinant major capsid VP2 protein as an antigen.Methods Serum specimens collected from infants and children who visited the Children's Hospital Affiliated to the Capital Institute of Pediatrics for health check-up and adults visiting the Xuanwu Hospital, Beijing for diseases other than respiratory infections from April 1996 to March 1997 were used for the investigation. The major capsid protein VP2 from HBoV was expressed in E. coli strain BL21 (DE3) with the transformed PET30b vector inserted with full-length VP2 gene of HBoV and the specific antigenicity of this expressed protein was validated by previous study. Western blotting was used to detect specific IgG antibody against HBoV in collected serum specimens diluted to 1:200. Mock expressed protein was E. coli cells strain BL21 (DE3) with the transformed PET30b vector without insert. Anti-His monoclonal antibody and rabbit anti-HBoV VP2 polypeptides hyper-immune serum were used as positive control for antibody detection.Results Out of 677 serum specimens tested, 400 (59.1% ) were positive for HBoV by Western blotting. About 45.3% (34/75) of the newborns under 1 month of age had anti-HBoV antibodies, and antibody positive rates were decreased in age groups of 1 and 2 months (41.4% and 31.3%, respectively) then increased in the following ages from 6 months to 7 years old ( from 45.6% to 69.7% ). The antibody positive rates were maintained at a relatively constant level ( about 70% ) in the age groups from 7 years to 40 years of age and became lower ( 61.8% - 62. 8% ) in those over 50 years.Conclusions The high seroprevalence of antibody against recombinant HBoV VP2 protein and early age antibody acquisition indicate that HBoV has been circulating in population of Beijing, China as early as in 1996 and most of children had been exposed to HBoV by the age of 7 years. Infants under the age of 6 months were susceptible to this virus.

The cry gene family, produced during the late exponential phase of growth in Bacillus thuringiensis, is a large, still-growing family of homologous genes, in which each gene encodes a protein with strong specific activity against only one or a few insect species. Extensive studies are mostly focusing on the structural and functional relationships of Cry proteins, and have revealed several residues or domains that are important for the target recognition and receptor attachment. In this study,we have employed a maximum likelihood method to detect evidence of adaptive evolution in Cry proteins, and have identified 24 positively selected residues, which are all located in Domain Ⅱ or Ⅲ. Combined with known data from mutagenesis studies, the majority of these residues, at the molecular level, contribute much to the insect specificity determination. We postulate that the potential pressures driving the diversification of Cry proteins may be in an attempt to adapt for the "arm race" between δ-endotoxins and the targeted insects, or to enlarge their target spectra, hence result in the functional divergence. The sites identified to be under positive selection would provide targets for further structural and functional analyses on Cry proteins.

Objective To observe the effect of full-responsibility nursing model in rehabilitation exercise on patients with chronic heart failure (HF).Methods Eighty-six patients with HF were randomly divided into observation group and control group,with 43 cases in each group.sixteen nurses were randomly divided into A and B group ; A group carried out full - responsibility nursing model and was in charge of the rehabilitation exercise of observation group,B group carried out routine holistic nursing model and was in charge of the rehabilitation exercise of control group.After 4 weeks,the effects including EF,6MWT,the knowing of rehabilitation exercise,satisfaction to the hospital were evaluated.Results Before rehabilitation exercise,there were no significant differences in EF and 6MWT( P ＞ 0.05 ).After 4 weeks,EF was( 54.13 ± 9.12 ) and 6MWT was (402.63 ± 74.81 ) in the observation group,while EF was (43.26 ± 8.57 ) and 6MWT was ( 336.16 ±75.82) in the control group.There were significant differences between the two groups ( t =2.093,2.145 ; P ＜0.05).there were significant differences before and after rehabilitation exercise in two groups ( P ＜ D.05 ).After 4 weeks,EF and 6MWT of the two groups were both increased,but the effect of the observation group was better (P ＜ 0.05 ). After 4 weeks,there were significant differences in the knowing of rehabilitation exercise and the satisfaction to the hospital in the two groups ( P ＜ 0.05 ).Conclusions Full-responsibility nursing model in rehabilitation exercise can make an effective effect.

OBJECTIVETo characterize the HA1 regions of hemagglutinin gene of influenza viruses (H3N2) isolated from children in Beijing from 1998 - 2004.

METHODSThe HA1 regions of hemagglutinin gene were amplified by RT-PCR from the viruses isolated and identified as A3 (H3N2) from clinical samples collected from infants and children during the peak seasons of influenza between 1998 and 2004. PCR products were sequenced or cloned into T-A vector and were analyzed after being sequenced.

RESULTSThe HA1 regions of hemagglutinin genes amplified from those isolates were 987 bp in length, encoding a protein of 329 amino acids in length. The identities of nucleotides and amino acids among these H3N2 isolates in Beijing and vaccines strains from 1998 - 2004 were 95.5% - 100.0% and 93.0% - 100.0%, respectively. The homology of the HA1 regions were related to the date of virus isolation, meaning the homology was higher among those strains isolated in nearer dates than others. Seven potential N-linked glycosylation sites in the HA1 regions located at amino acid positions 8, 22, 38, 63, 126, 165 and 285 were conserved in all the viruses analyzed. Two sites at 122 and 133 were inserted in those virus isolated after 1997, and another site at 144 appeared in those isolated after 1999. More amino acid substitutions located in the five putative antigenic sites or receptor binding sites were found more in the isolates than the isolates from previous year. Phylogenetic analysis showed new branches appeared continuously during 1998 - 2004. The strains isolated during winter in 2004 belonged to different branches, suggesting the appearance of new variants.

CONCLUSIONAmino acid substitutions continuously occurred in the HA1 regions of hemagglutinin genes in influenza virus (H3N2) isolated from children in Beijing from 1998 - 2004, which might have resulted in antigenic drift and led to the appearance of new variants.

Amino Acid Substitution ; China ; DNA, Viral ; analysis ; Gene Amplification ; Hemagglutinins ; genetics ; Humans ; Influenza A Virus, H3N2 Subtype ; genetics ; Influenza, Human ; virology ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVETo find out the importance of human bocavirus (HBoV) as an infectious agent for population in Beijing, China, seroprevalence study was conducted by using expressed recombinant major capsid VP2 protein as an antigen.

METHODSSerum specimens collected from infants and children who visited the Children's Hospital Affiliated to the Capital Institute of Pediatrics for health check up and adults visited the Xuanwu Hospital, Beijing for diseases other than respiratory infections from April 1996 to March 1997 were used for investigation. The major capsid protein VP2 from HBoV was expressed in E. coli strain BL21 (DE3) with the transformed PET30b vector inserted with full-length VP2 gene of HBoV and the specific antigenicity of this expressed protein was validated by previous study. Western blot was used to detect specific IgG antibody against HBoV in collected serum specimens diluted to 1:200. Mock expressed protein was E. coli cells strain BL21 (DE3) with the transformed PET30b vector without insert. Anti-His monoclonal antibody and rabbit anti-HBoV VP2 polypeptides hyper-immune serum were used as positive control for antibody detection.

RESULTSOut of 677 serum specimens tested, 400 (59.1%) were positive by Western blot. About 45.3% (34/75) of the newborns under 1 month of age had anti-HBoV antibodies, and antibody positive rates were lower in the age groups of 1 and 2 months (41.4% and 31.3%, respectively) and were higher in the following ages from 6 months to 7 years (from 45.6% to 69.7%). The antibody positive rates were at a relatively constant level (about 70%) in the age groups from 7 years to 40 years and became lower (61.8% - 62.8%) in groups of age over 50 years.

CONCLUSIONThe high seroprevalence against recombinant HBoV VP2 protein and early age antibody acquisition indicate that HBoV has been circulating in Beijing, China as early as in 1996 and most of children had been exposed to HBoV by the age of 7 years. Infants under the age of 6 months were susceptible to infection with this virus.

Adolescent ; Adult ; Antibodies, Viral ; blood ; Blotting, Western ; Bocavirus ; immunology ; Capsid Proteins ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Immunoglobulin G ; blood ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Parvoviridae Infections ; epidemiology ; immunology ; Prevalence ; Seroepidemiologic Studies ; Young Adult

OBJECTIVETo characterize the prevalence of influenza B virus infection in infants and young children in Beijing.

METHODSMDCK cell culture, indirect fluorescence assay (IFA) and hemagglutination inhibition (HI) assay were used to isolate and identify type B influenza viruses from clinical samples collected from outpatients and inpatients who visited the Affiliated Children's Hospital because of acute respiratory infections from Nov. 2000 to Jun. 2006.

RESULTSOut of 10,770 clinical samples collected during this surveillance period, 384 (3.57%, 384/10,770) were positive for influenza B viruses. Circulation of influenza B viruses was revealed in the later epidemic season of influenza viruses each year. The detection rate for influenza B virus was higher than 10% each year during the survey, except in the period from 2003--2004 which was 2.91%. The highest detecting rate was 23.69% of the specimens collected in Mar. 2006. During the period of this study, most of the influenza B virus were identified from children who visited the outpatient department of the Affiliated Children's Hospital. Among those outpatients who were positive for influenza B, 77.6% (264/340) were older than 3 years of age, whereas the inpatients positive for influenza B, 66.0% (29/44) were under 3 years of age. Coinfection of influenza B virus with other respiratory viruses was not common, only one of the influenza B virus positive specimen was found also positive for influenza A3. There was no significant difference in positive rate between influenza virus B and A3. A significantly higher positive rate of influenza B virus than that of influenza A3 virus was seen from Sep. 2005 to May 2006 (23.9% vs 1.1%). B/Yamagata/16/168 lineage viruses were dominant during 2000--2002, and B/Victoria/2/87 lineage viruses became dominant during 2002--2003. After 2003, co-circulation of Victoria and Yamagata lineages of influenza B viruses was identified with predominance of Yamagata lineage viruses, while Victoria lineage viruses predominated during the 2005--2006 epidemic season.

CONCLUSIONInfluenza B viruses were identified from February to May in every influenza season during this surveillance period of 2000--2006. Most of the positive specimens were those collected from outpatient department. Victoria and Yamagata lineages of influenza B viruses co-circulated in Beijing, China in recent years.

Adolescent ; Age Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Influenza B virus ; classification ; isolation & purification ; Influenza, Human ; epidemiology ; virology ; Male ; Prevalence

OBJECTIVETo investigate clinicopathological features of DiGeorge syndrome (DGS).

METHODThe clinical features, histological and immunohistochemical findings were analyzed in 5 cases of DGS by autopsy.

RESULTSFive cases of DGS in male infants aged 4 days, 1 month, 7 months, 10 months, and 13 months respectively. Gross and microscopic observations revealed that thymic cortex was depleted of lymphocytes or showed few, dispersed lymphocytes. The thymic medulla showed predominantly epithelial cells with calcified Hassall bodies as well as lymphocyte depletion. T lymphocytes were also scarce in the tonsils, lymph nodes, spleen, and mucosa-associated lymphatic tissue of ileum. In addition, 3 of the 5 patients also showed parathyroid aplasia or dysplasia, and congenital hypertrophy of the ventricular septum.

CONCLUSIONSThe pathological changes indicate that clinicians should be aware of defects of immune system if the infants suffer from severe infections. Pathologists should recognize the importance of abnormalities of lymphohematopoietic tissues in the diagnosis of primary immunodeficiency diseases such as DGS.

Autopsy ; DiGeorge Syndrome ; immunology ; pathology ; virology ; Hepatitis, Viral, Human ; pathology ; Humans ; Hypertrophy, Left Ventricular ; pathology ; Infant ; Infant, Newborn ; Lymphocyte Count ; Male ; Parathyroid Glands ; pathology ; Pneumonia, Viral ; pathology ; T-Lymphocytes ; immunology ; pathology ; Thymus Gland ; pathology