Treatment based on syndrome differentiation is an essential feature of traditional Chinese medical diagnosis. The interventions based on changes of syndrome types in randomized controlled trials are complicated, leading to the difficulty of blind method enforcement. This article described a double-blind method. It could be used in randomized controlled trials under the condition of different syndrome types and different medications. It numbered drugs in two stages, and in two phases to achieve double-blind. This method not only guaranteed investigators and subjects to be in blinded conditions, but also achieved using different medications for patients of different syndromes. It also caused no drug waste. It was scientific and feasible.
Double-Blind Method ; Humans ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic ; Single-Blind Method

Objective To evaluate the diagnostic value of the metabolic parameters for differentiating focal autoimmune pancreatitis (F-AIP) and pancreatic cancer (PC) by dual time 18F-FDG PET/CT scan.Methods Ten F-AIP patients and 20 PC patients in Changhai Hospital from May 2011 to November 2014 were enrolled in this study.All the AIP patients were histological confirmed or diagnosed by clinical follow up.The PC patients were histological confirmed and gender-and age-matched with F-AIP patients.50％ SUVmax was set as the threshold to fine-tune the boundary of interest.The extracted parameters included SUV SUV metabolic tumor volume (MTV),total lesion glycolysis (TLG),target-to-background ratio (TBR) and the retention indexes(RI) of all the parameters above.The PET/CT imaging features were also observed.Results The high metabolic lesions were observed in both F-AIP patients and PC patients.There were 6 F-AIP patients whose lesion was located in pancreas head,4 F-AIP patients whose lesion was located in pancreas body and tail.There were 12 PC patients whose lesion was located in pancreas head,8 PC patients whose lesion was located in pancreas body and tail.In F-AIP patients,2 cases had dilated pancreatic duct,6 had dilated biliary duct,8 had increased metabolism in mediastinal lymph node and 2 had abdominal lymphadenopathy,which were 8,5,5 and 14 cases in PC patients.The positive rate of mdeiastinal lymphadenopathy in F-AIP patients was statistically higher than that in PC patients,while the positivity rate of abdominal lymphadenopathy in AIP patients was lower than that in PC patients.The difference was statistically significant (both P ＜ 0.05).There were no statistical differences on the positivity rate of the dilated pancreatic duct,intra-and extra-hepatic bile duct between two groups.SUVmax,SUVmean and MTV in F-AIP were 5.37 ± 0.88,3.48 ± 0.66,21.79 ±15.60 in early stage and 6.45 ±1.51,4.23 ± 1.10,19.36 ± 14.63 in delayed stage,and those in PC were 8.31 ±3.08,5.41±1.95,9.26±8.35 in early stage,and 9.75±3.86,6.36±2.56,9.09±10.71 in delayed stage.SUVmax and SUVmean in F-AIP were lower than those in PC,whereas MTV were larger in F-AIP than that in PC.ROC curves for SUVmax,SUVmean and MTV were made.The AUC of SUV was the highest at 0.85,the cut-off value was 4.45,the corresponding sensitivity was 65％ and the specificity was 90％.TLG,TBR and RI of all the parameters were not statistically different in F-AIP and PC.Conclusions The 18F-FDG PET/CT metabolic parameters,such as SUVmax,SUVmean,MTV,could be of special diagnostic significance in discriminating F-AIP from PC.

OBJECTIVE To explore the risk factors of gas gangrene after open trauma for its early diagnosis and precaution.METHODS The data of 42 patients with gas gangrene after open trauma from Aug 2003 to Aug 2008,were collected.The risk factors of gas gangrene after open trauma had been retrospectively analyzed from the cause of the injuries,the distribution of latent period,wound,systemic symptoms,laboratory examination and treatment.RESULTS Gas gangrene after injury was related with open wounds for various reasons.Latent period of gas gangrene was 24-72 h.Early risk factors of gas gangrene among them mainly included degloved or avulsed skin-injury(100%),musce trauma(100.00%),contaminated wound and retained foreign bodies(95.24%),weak pulse of peripheral artery(95.24%),nervous injury(90.48%),and lower temperature of skin aound the wound(83.33%).There were obviously systemic symptoms in infective stage but in early stage were not.CONCLUSIONS Gas gangrene is extremely rare in injury patients but it is life-threatening.So more attention should be paid to the risk factors in order to decrease the incidence of gas gangrene after trauma.Improving the prognosis of patients;the wounded locations should be effectively treated early so as to improve the prognosis.

Through protein-protein BLAST of homologous sequences in different species in NCBI database and preliminary simulating molecular docking and molecular dynamics by computer software discovery studio 3.1, three amino acids R25K26K27 of natural human parathyroid hormone (1-34) with Q25E26L27 were mutated and the biological activity of the mutant peptide was evaluated. Result showed that: root mean superposition deviation RMSD value between PTH (1-34)-(RKK-QEL) and PTH (1-34) peptide main chain was 2.509 3, indicating that the differences between the two main chain structural conformation was relatively small; the interaction energy between PTH (1-34)-(RKK-QEL) and its receptor protein PTH1R had been enhanced by 7.5% compared to nature PTH (1-34), from -554.083 kcal x mol(-1) to -599.253 kcal x mol(-1); the number of hydrogen bonds was increased from 32 to 38; PTH (1-34)-(RKK-QEL) can significantly stimulate the RANKL gene expression (P < 0.01) while inhibiting the OPG gene expression (P < 0.01) in UAMS-32P cells; in the co-culture system of UAMS-32P cells and mouse primary femur bone marrow cells, PTH (1-34)-(RKK-QEL) stimulated the formation of osteoclasts (P < 0.01) and had a higher biological activity than PTH (1-34) standard reagents.

This study was aimed to investigate the survival rate and difference of transfused modified and unmodified RBC at 24 hours. The modified and unmodified RBC from mice, monkey, pig and human were labeled by using FITC, then these blood RBCs were transfused to homogeneous and heterogeneous animals. The result showed that 24 hour survival rate of unmodified mice RBC transfused to mice was 74%, while survival rate of 2.0 mmol/L mPEG-SPA modified mice RBC transfused to mice was 45%, difference between them was significant. The 24 hour survived rate of unmodified human RBC transfused to mice was 8%, while 24 hours survival rate of 2.0 mmol/L mPEG-SPA modified human RBC transfused to mice was 5% without statistical difference. The 24 hour survived rate of homogeneous transfusion of modified monkey RBC was 90%, while survival rate of modified human and pig RBC was zero on 24 hours after transfusion to monkey. It is concluded that RBC labeling methods and mice species are unrelated to 24 hours survival rate, but mPEG variety and concentration are related to mouse RBC life-span. It is incredible to use mouse RBC homogeneous transfusion result instead of human RBC to evaluate longevity and safety of modified human RBC. But modified human RBC transfused to mice can be a model to evaluate longevity of modified human RBC. It is very difficult to get the result about modified RBC life span by RBC transfusion among great heterogeneous mammal animals. So evaluation in large mammal animal models needs to be further studied.
Animals ; Cell Survival ; drug effects ; Erythrocyte Transfusion ; methods ; Humans ; Macaca mulatta ; Male ; Mice ; Polyethylene Glycols ; pharmacology ; Swine

OBJECTIVETo discuss a method for reconstruction of deeply burned of extremities' functional regions with local skin flaps.

METHODSNinety-eight cases (with 126 place) of deeply burned wound of extremities were reconstructed with fasciocutaneous flaps.

RESULTSThe survival rate of 162 flaps was 93.2%. The movement of 112 joints (88.9%) was restored to normal, and the movement of 14 joints was mild limitation, none of the cases was severe obstacle.

CONCLUSIONSThe method is simple and with satisfactory results, which can decrease the rate of disability suffered from burn.

Adolescent ; Adult ; Burns ; surgery ; Child ; Extremities ; surgery ; Fascia ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply

Adaptor Proteins, Signal Transducing ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Case-Control Studies ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Membrane Proteins ; metabolism ; RNA, Messenger ; genetics

Objective To investigate the using status of thymopentin injection (1 mL/10 mg) in our hospital.Methods Medical records of 903 inpatients receiving thymopentin injection therapy from January to March in 2016 in Beijing Chaoyang Hospital,Capital Medical University were collected from the hospital informati.on system.The indications,dosage,efficacy and combined medication were analyzed and evaluated.Correction was made to the existing problems through the intervention of relative departments by clinical pharmacists and issuing rational drug use bulletin.Results After the intervention,irrational use of thymopentin injection,for examples:indications were not clear,dosage and course of treatment were not standardized or therapeutic effect was equivocal,got obviously improved.The consumption of thymopentin injection in the second quarter dropped to 10142 from 12449 in the first quarter.Conclusion The intervention of clinical pharmacists in wards and issuing rational drug use bulletin are effective measures.Clinical pharmacists play an important role in promoting the rational use of drugs in hospitals.

Abstract?AlM:To investigate the influence of lOL refractive index ( Rl ) on measurement of straylight following cataract surgery.?METHODS:ln this case-control study, 77 eyes of 77 age-related cataract patients who underwent cataract phacoemulsification with posterior chamber aspherical arylic lOL implantation surgery in the Eye Hospital of China Medical University from Aug 2013 to Mar 2014, with a best corrected visual acuity ( BCVA) of 0. 5 or better, were classified into 3 groups randomly using 3 types of lOL: Tecnis ZCB00 Group ( Rl = 1. 47, 22 eyes of 22 subjects); Hoya PY60AD Group ( Rl=1. 52, 24 eyes of 24 subjects);Alcon SN60WF or lQ Group ( Rl=1. 55, 31 eyes of 31 subjects ) . BCVA, pupil size, astigmatism, axial length, intraocular straylight were measured respectively.? RESULTS: Age, axial length, BCVA, pupil size, astigmatism of the three groups were not significant difference (P>0. 05). The straylight of Tecnis, Hoya, lQ group were 1.04±0. 15, 1. 19±0. 14, 1. 14±0. 18. Straylight levels had significant differences among three groups ( F=5. 352, P = 0. 007 < 0. 05 ). There was no significant correlation between BCVA and straylight value (r=-0. 133,P=0. 124>0. 05).?CONCLUSlON:Patients chosen the higher Rl lOL may have a higher straylight level after the surgery.

Objective: To investigate the value of ¹⁸F-fluorodeoxyglucose (FDG) PET/CT in differentiation of noninvasive and malignant pancreatic cystic lesions (PCL). Methods: A total of 125 PCL patients (66 males, 59 females, age range: 13-83 years), who had pathology or typical imaging performance with ≥12 months follow-up between August 2010 and December 2015, were enrolled in this retrospective study. The diagnostic effects of ¹⁸F-FDG PET/CT were calculated. The size, maximum standardized uptake value (SUV_max), delayed SUV_max and retention index (RI) of noninvasive and malignant PCL were analyzed. The results of pathological examination and follow-up were used as the gold standard, and Mann-Whitney u test was used to analyze the data. Receiver operating characteristic (ROC) curves of SUV_max, delayed SUV_max and RI were drawn and compared. Results: A total of 132 PCL were found in 125 patients, including 71 malignant PCL and 61 noninvasive PCL. The size, SUV_max, delayed SUV_max, RI of noninvasive and malignant PLC were 2.2 (1.4, 3.8) cm vs 3.9 (3.0, 5.0) cm, 1.5 (1.2, 1.8) vs 6.4 (4.4, 9.3), 1.5 (1.2, 1.9) vs 6.4 (5.4, 11.7), -6.3%(-19.4%, 5.6%) vs 17.5%(7.6%, 29.4%), respectively. All parameters were significantly different between 2 groups (z values: from -9.267 to -4.904, all P<0.05). The area under curve (AUC) and cut-off value of SUV_max were 0.969 and 2.5, and the corresponding accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 92.4%(122/132), 93.0%(66/71), 91.8%(56/61), 93.0%(66/71), 91.8%(56/61), respectively. The AUC and cut-off value of delayed SUV_max were 0.969 and 2.7, and the accuracy, sensitivity, specificity, PPV, NPV were 94.3%(99/105), 96.7%(58/60), 91.1%(41/45), 93.5%(58/62), 95.3%(41/43), respectively. ROC curves of SUV_max and delayed SUV_max were not significantly different (z=1.799, P>0.05). Conclusion ¹⁸F-FDG PET/CT has good performance in differentiation of noninvasive and malignant PCL, but the delayed scan cannot further improve the efficacy of differential diagnosis.