Acupuncture is widely used as an alternative therapy with few side effects because of its simple manipulation and low cost. However, accidents may occur if the practitioner uses it improperly. Early in the Qin dynasty, the Canon of Medicine mentioned that improper use of acupuncture could cause injury to the body and even death, and it systematically described the occurrence and prevention of acupuncture accidents. Physicians in the successive dynasties frequently reported it, and realized that the manipulation skills were significantly important in preventing the occurrence of acupuncture accidents. Since the 1950s, acupuncture accidents had been effectively prevented because of the improving of acupuncture instruments, enhancing of the quality of the practitioners, popularizing of sterilization and disseminating of anatomic knowledge. Nevertheless, with the renovating of acupuncture techniques, new accidents may occur constantly. The prevention of acupuncture accidents still should be an arduous task for acupuncturists. Nowadays, acupuncture therapy is being used in more than 140 countries, and acupuncture accidents due to improper application are increasing. Prevention of acupuncture accidents has become a global issue deserving of great attention.

Moxibustion is an important invention of the Chinese nation, which originated as early as in the clan commune period of the primitive society. The literature records on moxibustion can be traced back to the Warring States Period (475 B.C. to 221 B.C.). Doctors through the ages made considerable progress and published a great number of books on moxibustion. Moxibustion has been applied in treating a great range of diseases. Since the 1950s, the treatment scope of moxibustion has been expanded, and the therapeutic methods of moxibustion are becoming increasingly rich and varied, and great progress in research on the mechanism of moxibustion has been made. Moxibustion was once popular in Europe after its dissemination to the West in the seventeenth century, and the practitioners invented some new methods of moxibustion. Japan is the country in the West where fruitful efforts have been made in research on moxibustion. In modern times, moxibustion has been used for health protection, and the scientists are paying great attention to the experimental research on moxibustion.

Acupuncture Therapy ; adverse effects ; Adolescent ; Adult ; Eye ; blood supply ; Eye Diseases ; therapy ; Hemorrhage ; etiology ; Humans ; Male

Objective To study the different periods of childhood bronchial asthma induced sputum of the percentage change of inflammatory cells,and to explore part of the pathogenesis of asthma in children.Methods 69 children with asthma(the age ≥5 years old) were selected.By clinical symptoms,they were divided into acute exacerbation and clinical remission of 3 months and 6 months.At the same time,in the same groups of hospital pediatric clinic,22 healthy children were chosen as control group.The percentage of neutrophils and eosinophils in induced sputum was detected.Through the comparison,we can explore the correlation between the two kinds of inflammatory cells in different periods of asthma.Results Comparing the percentage of neutrophils among the four groups,acute exacerbation group was compared with clinical remission three months group,clinical remission six months group and the normal control group,acute exacerbation group was higher than the clinical remission group of three months,clinical remission of six months and normal control group [(57.905 ± 11.615)％ vs (40.137 ± 11.668)％,(33.825 ± 12.457) ％,(23.836 ± 13.585) ％,P =0.039,0.000,0.000].The clinical remission of three months and clinical remission six months group were higher than the normal control group(P =0.000,0.032).The clinical remission of three months group and 6 months group had no significant difference (P =0.538).The percentage of eosinophils in acute exacerbation group was higher than the clinical remission of three months group,clinical remission of six months and normal control group [(4.090 ± 1.452) ％ vs (2.685 ± 1.190) ％,(2.151 ± 1.417) ％,(1.848 t 0.887) ％,P =0.002,0.000,0.000].The clinical remission of three months group and the normal control group had no significant difference (P =0.937).Conclusion Asthma in children induced sputum neutrophil percentage and eosinophil percentage are significantly higher in acute exacerbation.The study shows that neutrophils and eosinophils are involved in the part of the pathogenesis of bronchial asthma in children.

Objective To compare the differences of serum sclerostin (SOST) levels between hyperthyroidism pa-tients and euthyroidism healthy individuals, and the relationship between SOST levels and bone metabolism markers, bone mineral density (BMD) in hyperthyroidism patients. Methods Sixty hyperthyroidism patients were enrolled into the study, and 30 health individuals were allocated to control group. Sixty hyperthyroidism patients were sub-divided into normal BMD group and osteopenia/osteoporosis group according to the T-scores of BMD. The blood samples were collected for measuring thyroid function and serum SOST in all three groups. Values of thyroid autoimmune antibodies, parathyroid hormone (PTH), N-MID osteocalcin (N-MID), total of type 1 collagen amino terminal extension of the peptide (tP1NP) andβ-collagen spe-cial sequence (β-CTX) were also detected in 60 hyperthyroidism patients. Radius BMD, femoral neck BMD and lumber spine BMD were determined by dual-energy X-ray absorptiometry (DEXA) in hyperthyroidism patients. Results The lev-el of serum SOST was significantly higher in hyperthyroidism group than that in control group (P<0.01). The serum levels of SOST, N-MID, tP1NP,β-CTX and FT4 were significantly higher, and the value of PTH was significantly lower in osteopenia/osteoporosis group than those of normal BMD group (P<0.05). The serum level of SOST was positively correlated with free triiodothyronine (FT3) andβ-CTX (rs=0.380 and 0.296,P<0.01), and it was negatively correlated with PTH, total radius BMD, femoral neck BMD and lumber spine BMD in hyperthyroidism patients (rs=-0.485,-0.322,-0.266 and-0.455,P<0.05). Conclusion The higher serum SOST levels may be associated with the abnormalities of bone metabolism in hyperthy-roidism patients.

Objective To evaluate the expression and its clinical significance of serum LCN-2 and MMP-9 in human breast cancer.Methods 96 patients with breast cancer,42 patients with benign breast diseases and 27 healthy controls were recrui-ted in this study.The LCN-2 and MMP-9 levels were measured by ELISA in the serum of 96 patients with breast cancer,42 patients with benign breast disease,and 27 health controls.Results The level of serum LCN-2 in the breast cancer group (89.76±28.38 ng/ml)was significantly higher than those in benign breast diseases (56.44±21.15 ng/ml)and healthy controls (44.32±16.84 ng/ml)(P<0.05).The level of serum MMP-9 in the breast cancer group (96.34±23.26 ng/ml) was significantly higher than those in benign breast diseases (28.16±11.57 ng/ml)and healthy controls (23.54±13.61 ng/ml)(P<0.05).No obvious difference in the levels of serum LCN-2 and MMP-9 was observed between benign breast disease and healthy controls (P>0.05).Correlation analysis showed that a positive correlation was found between the levels of serum LCN-2 and MMP-9 in breast cancer patients (r=0.513 5,P<0.05).The levels of serum LCN-2 and MMP-9 were significantly associated with tumor size,lymph node metastasis,the expression of ER and PR,TNM stage,but were not asso-ciated with tumor differentiation (P>0.05).The correlation analysis showed that the LCN-2 level was positive correlated with the MMP-9 level (P<0.05).Conclusion LCN-2 and MMP-9 could play a role in the tumorigenesis and development of breast cancer.Measuring of serum LCN-2 and MMP-9 may be a useful tool for diagnosis,effect monitoring and prognosis in breast cancer.

Sorafenib is a novel oral multikinase inhibitor that inhibits Raf kinase because of its anti-proliferative property. Sorafenib also inhibits receptor tyrosine kinases of multiple proangiogenic factors, such as VEGFR-1/2/3 and PDGFR-β. The combina-tion of both its anti-proliferative and anti-angiogenic properties makes sorafenib an attractive agent in cancer treatment. To date, sorafenib is the only approved systemic treatment for patients with hepatocellular carcinoma. The most common adverse events of this inhibitor included hand-foot skin reactions, nausea, diarrhea, weight loss, and hypertension. These adverse events can severely affect patient compliance, which may negate the effect of therapy. Correct understanding and treatment of these adverse events can improve clinical outcome. This paper discusses the clinical aspect of sorafenib-induced adverse events and the molecular basis behind their toxic-ity. Recommendations for the management of the adverse effects are also provided.

Objective:To explore the medical undergraduate teaching method of ECG. Methods:random sampling in the practice of medical undergraduates in our hospital ,2013 medical undergraduates as the experimental group, 2012 medical undergraduates as control group, two groups of 40 (male, female 20), age 22~23 years old, the experimental group internship period adjustment of ECG in 2 week internship, ECG during the internship period, by the junior high the doctor, according to a set of prior to the development of the teaching plan, practice teaching, the control group had no ECG internship content; in the two groups before and after the end of internship, were an ECG, theory of knowledge, operation and map reading test. Results:In the experimental group in the ECG theoretical knowledge, operation method, normal electrocardiogram, abnormal electrocardiogram exam scores, were more than that of the control group, there was significant difference in two groups(x2=22.321, x2=37.883, x2=31.179, x2=10.66;P<0.001). Conclusion: According to undergraduate medical situation, summarize the clinical teaching process ideas, enhance the practice ability, is before the practice was significantly increased in the reading and analysis abilities of ECG, far more than the control group. The teaching plan is feasible and effective;it is worth further exploration and promotion.

Adrenal crisis is a life-threatening emergency caused by the destruction or altered function of the adrenal gland with a primary deficit in cortisol secretion(primary adrenal insufficiency)or by hypotha-lamic-pituitary pathologies determining a deficit of adrenocorticotropic hormone(secondary adrenal insuffi-ciency).Infection and abrupt end glucocorticoid treatment are the major precipitating causes of adrenal crisis. Patients with adrenal crisis typically present with hypovolemic shock or hypotension,nausea,vomiting,and fe-ver responding well to parenteral hydrocortisone administration.The main laboratory findings include lower serum cortisol concentrations,hyponatremia,hypoglycaemia and/or hyperkalemia.Delay diagnosis of adrenal insufficiency leads to adrenal crisis which is potentially lethal complication.Empirical glucocorticoid replace-ment should be initiated as soon as the suspicious of adrenal crisis,or sooner if the patient presents in adrenal crisis in critically ill children.

BACKGROUND : Chitosan, derived from chitin, has a poor solubility which limits its application greatly. For improving its dissolubility, according to the feature that intramolecular hydroxy and amino group in chitosan are easy to be chemically modified, and functional groups are introduced to improve its solubility and functionality to widen the range of its application, which has become one of the new trend of development for investigating the application of chitosan. OBJECTIVE: To sum up the research advancements in the application and modification of chitosan in carboxylation,acylation, alkylation, etherification, etc.RETRTEVE STRATEGY: The relevant articles published in English between 1998 and 2007 were searched for in Pubmed database with the key words of "chitosan, modification", and the relevant articles published between 1998 and 2007 were searched for in Elsevier Science database with the key words "chitosan, modification" and search "derivate" within search results in English. Articles closely related to the structural modification and application of chitosan were involved, and repetitive and old studies were excluded.LTTERATURE EVALUATION: Totally 154 articles were selected, and 30 of them are accorded with the inclusive criteria,including 5 are reviews, and the others are clinical or experimental studies.DATA SYNTHESTS: The intramolecular hydroxy and amino groups in chitosan are mostly modified because they are easy to be chemically modified. Recently, reports lay particular emphasis on the modification in carboxylation, acylation,alkylation, etherification, etc. Functional groups are introduced to improve its solubility and functionality to widen the range of its application.CONCLUSTON: The water-solubility of chitosan can be improved through structural modification and introducing multifunctional group, which can also bring about much more special efficacies.