OBJECTIVETo study the effects of Kuntai Capsule (KTC), a Chinese herbal preparation, on the quality of life (QOL), breast distending pain and vaginal bleeding in women at early stage of menopause.

METHODSA total of 104 women at early stage of menopause, 54 had their uterus existed (Ue) and 50 in-existed (Ui), were enrolled, and they were randomized to the KTC group and the control group, with equal cases of Ue and Ui in each. The KTC group was treated with KTC 4 capsules twice a day; the control group treated with premarin 0.45 mg per day and for those of Ue 2 mg medroxyprogesterone additionally, with the remedies medicated orally for 1 year. All the testees were asked to record everyday their own condition of breast pain and vaginal bleeding and followed-up every 3 months to fulfill the Menopause Specific Quality of Life questionnaire. Ultrasonic examination on pelvis and breast as well as endocrine hormone assays of estradiol (E2) and follicle-stimulating hormone (FSH) were performed before and after the medication term.

RESULTSEffects of treatment in the two groups were different insignificantly in terms of QOL. The women were benefited in vasomotor and physical domains from the 3rd month of medication, and the psychosocial domain was also improved (for Ui initiating from the 3rd month and for Ue from the 6th month). In the domain of sexual life, KTC showed its favorable effect only on Ue beginning from the 9th month, but not on Ui; while all subjects in the control group had their sexual life improved from the 3rd month. In domain of breast pain, the occurrence at various time points between the two groups was insignificantly different, only that the severity in Ue of the control group was more significant from the 1st to 3rd month than that in the KTC group. As for the domain of vaginal bleeding, the uterine membrane was basically normal in both groups either before or after medication, but the incidence and lasting days from the 1st to 3rd month in Ue of the KTC group were significantly lower than those of the control group. Levels of E2 and FSH were not significantly changed after medication in the KTC group, while in the control group, E2 significantly increased and FSH significantly decreased in the women of Ue (P <0.05).

CONCLUSIONKTC could evidently improve the QOL of women at the early stage of menopause, and is of high safety, with less adverse reaction of breast pain and vaginal bleeding, and shows few impact on sexual hormones.

Adult ; Breast ; pathology ; physiology ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemorrhage ; drug therapy ; pathology ; Humans ; Menopause ; drug effects ; psychology ; Middle Aged ; Pain ; drug therapy ; pathology ; Quality of Life ; Vaginal Diseases ; drug therapy ; pathology ; psychology

ObjectiveTo investigate the protective effect of transfected microRNA-146a (miR-146a) on mice with sepsis-induced acute lung injury (ALI) in vivo.Methods Twenty-four healthy male BALB/C mice were randomly divided into sham group, sepsis group, transfection group and transfection control group, eachn = 6. Mice in transfection group were given miR-146a agomir loaded by in vivo-jetPEITM via airway before reproduction of model, and mice in transfection control group were given negative control loaded by in vivo-jetPEITM only via airway. The septic model was reproduced by cecal ligation and puncture (CLP) 12 hours after transfection , and the mice in the sham group underwent laparotomy and closure only without ligation and puncture of the cecum. The mice of each group were sacrificed at 24 hours post-operation. The expression of miR-146a in lung tissue was determined by real time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-qPCR), and the quantity of tumor necrosis factor-α (TNF-α) in the bronchial alveolar lavage fluid (BALF) was determined with enzyme-linked immunosorbent assay (ELISA). The wet/dry ratio of lung (W/D) was determined. The pathohistological changes in the lung were observed and scored. Results The expression of miR-146a showed a significant increase in sepsis group, transfection group and transfection control group, which were (3.56±0.43), (27.64±3.46) and (3.72±0.54) folds of that in sham group, respectively (P< 0.05 orP< 0.01). The miR-146a expression in transfection group was significantly increased compared with sepsis group and transfection control group (bothP< 0.01), but no statistical difference in the expression was found between sepsis group and transfection control group (P> 0.05). Compared with the sham group, higher level of TNF-αin the BALF was found in the sepsis group, transfection group and transfection control group (ng/L: 511.65±43.47, 305.74±34.76, 492.27±42.21 vs. 50.72±7.23, allP< 0.01). The level of TNF-α in transfection group was significantly lower than that in sepsis group and transfection control group (bothP< 0.01). Compared with the sham group, the W/D ratio of lung in sepsis group, transfection group and transfection control group showed a significant increase (6.11±0.32, 5.02±0.29, 6.05±0.43 vs. 4.18±0.10, allP< 0.01). The W/D ratio of lung in transfection group was significantly lower than that of sepsis group and transfection control group (bothP< 0.01). The lung injury score of transfection group was significantly lower than that of sepsis group and transfection control group (6.12±0.75 vs. 10.53±1.52, 9.73±1.08, bothP< 0.01).Conclusions miR-146a agomir loaded by in vivo-jetPEITM instillation into airway was able to increase the expression of miR-146a in the lung tissue of septic mice. Up-regulation of miR-146a inhibit the release of the inflammatory cytokine TNF-α stimulated by sepsis, and alleviate inflammatory reaction and lung tissue injury in mice with sepsis-induced ALI.

BackgroundHuman retinal gliocytes play an important role in proliferative diseases,which are the basis of in vitro studies.Researchers have cultured human retinal gliocytes in the past.In our study,we found that the cells we cultured presented a unique shape different from those by other researchers.ObjectiveThis study was to design to produce a new culture and purification method for retinal gliocyte in vitro.Methods Retinal tissue was isolated from human eyeballs and digested using the two-step digestion method (2％ pancreatin and 0.133％collagenase Ⅵ) to harvest the retinal glio cytes.The cells were collected and cultured in endothelial cell-targeted nutrient culture containing 10％ fetal calf serum and supplemented with β-endothelial cell growth factor (ECGF) and sodium heparin,and the culture dishes were coated with fibronectin(FN) to promote the attachment of retinal gliocyte.During the culturing process,the gliocytes were identified by the observation of morphological characteristic and regular histological examination.The identification of the cells also was performed by immunochemistry targeting glial fibrillary acidic protein (GFAP),Vimentin,neuron specific enolase ( NSE ),S-100,CD34,and Ⅷ factor.Results Retinal gliocytes were isolated successfully from the human retina by the two-step digestion method.Primary cultured cells attached after 72 hours and achieved confluency between day 9 and 10 that were aligned petaliform in shape.Regular histological examination after H&E staining showed blue cell nuclei and light red cytoplasm.The target cells presented with strong responses for GFAP and Vimentin and no response for NSE,S-100,CD34 and Ⅷ factor.ConclusionsLarge amount of purified human retinal gliocytes can be obtained by two-step digestion and cultured in endothelial cells-targeted culture medium supplemented with β-ECGF and sodium heparin in plates coated with FN.The cultured cells expressed markers for retinal gliocytes.However,specific features of these cells remain to be further elucidated.

Objective To analyze the relationship between the catheter to vein ratio and the formation of peripheral insertion of central venous catheter (PICC) related upper extremity deep venous thrombosis (PICC-UEDVT) in cases having undergone PICC in patients at intensive care unit (ICU) and further identify the best optimal ratio cut-off point to reduce the incidence of PICC-UEDVT.Methods A retrospective study was conducted, including 69 patients having undergone PICC with complete clinical data admitted to the Department of Critical Care Medicine of the First Affiliated Hospital of Nanchang University from August 2013 to December 2016; their ages were > 18 years old and catheter indwelling times were > 1 week; the patients' basic information, disease related laboratory parameters and catheter insertion situation were collected. According to the occurrence of PICC-UEDVT, they were divided into PICC-UEDVT group and non PICC-UEDVT group; the receiver operating characteristic (ROC) curve of the catheter to vein ratio versus the incidence ofPICC-UEDVT was plotted to assess the optimal ratio to reduce the incidence of PICC-UEDVT.Results In the 69 patients, there were 7 patients in the PICC-UEDVT group and 62 patients in the non PICC-UEDVT group, the incidence of PICC-UEDVT being 10.14%. Four, 5 and 6 French (Fr) catheters were indwelled in 43, 23 and 3 cases respectively, and the range of catheter to vein ratio was 20% - 67%. The comparisons between PICC-UEDVT group and non PICC-UEDVT group in various aspects were as follows: the incidence of DVT in the PICC-UEDVT group was significantly higher than that in non PICC-UEDVT group [42.9% (3/7) vs. 6.5% (4/62)], the rate of using vasopressor drugs [57.14% (4/7) vs. 17.74% (11/62)], D-dimer level [mg/L: 9.0 (3.0, 12.3) vs. 1.8 (1.0, 3.6)], patients of indwelling 5Fr catheter [71.4% (5/7) vs. 29.0% (18/62)] and the percentage of patientsapplying catheter to vein ratio 45%-67% [57.14% (4/7) vs. 17.74% (11/62)] in PICC-UEDVT group were all higher than those in the non PICC-UEDVT group, the differences being statistically significant (allP < 0.05). ROC analysis showed that the catheter to vein ratio 44% was the optimal cut off or critical point, the area under the ROC curve (AUC) at that point was 0.755, 95% confidence interval (95%CI) = 0.554-0.955, sensitivity = 71.4% and specificity = 79.0%; compared with the patients using 45%-67% catheter to vein ratio, the incidence of PICC-UEDVT was 6.182 times higher than those using the ratio 20%-44% [odds ratio (OR) = 6.182, 95%CI = 1.208-31.634,P = 0.036]; however, there was no significant difference in incidence of PICC-UEDVT between 20%-32% and 33%-44% (P = 1.000).Conclusion It is found that the 44% catheter to vein ratio was the optimal critical point to reduce the incidence of PICC-UEDVT, possessing relatively high sensitivity and specificity; applying <44% catheter to vein ratio can decrease the risk of PICC-UEDVT occurrence in patients at ICU.

Professor SHAO Jing-Ming devotes his life in clinical practices for more than 80 years. He is an eminent specialist acupuncture with abundant clinical experiences. He establishes the unique method of needling of tri-points and penta-needles which achieves significant effectiveness for the treatment of asthma. He has taught for more than 50 years with unique educational method. A great amount of experts appear in the circle of TCM after receiving his unique training. He devotes his life to composing books on acupuncture and moxibustion. He devotes his life and his heart to promoting the development of acupuncture and moxibustion, and makes remarkable contribution in this field.
Acupuncture Therapy ; history ; China ; History, 20th Century ; History, 21st Century ; Humans ; Moxibustion ; history

OBJECTIVETo explore the role of treg cells and its functional markers in pathogenesis of chronic hepatitis B, and the correlation with disease progression.

METHODS20 cases of healthy control people,53 cases of chronic hepatitis B patients and 24 cases of liver cirrhosis patients were enrolled into the groups. Detecting the frequencies of CD4+ CD25+ Fox3+ cells, CD4+ CD25+ CD127(low) cells, CD39+ treg cells and CTLA-4+ treg cells in treg cells by flow cytometry. Clinical parameters were investigated in the same time.

RESULTSThe frequencies of treg cells, CD4+ CD25+ CD127(low) cells and CD39+ treg cells were significant different among healthy control group, CHB group and LC group (P < 0.01). The frequencies of treg cells, CD4+ CD25+ CD127(low) cells and CD39+ treg cells were significantly different in moderate-severe CHB group compared with mild CHB group (P < 0.05, P < 0.05, P < 0.01). In CHB group the frequencies of CD4+ CD25+ Foxp3+ cells were positively correlated with ALT (r = 0. 289, P < 0.05) and AST (r = 0.302, P < 0.05), the frequencies of CD4+ CD25+ Foxp3+ cells had a significant positive correlation with the frequencies of CD4+ CD25+ CD127(low) cells (r = 0.478, P < 0.01).

CONCLUSIONThe frequencies of treg cells and its functional markers probably had a dynamic tendency in the process of chronic hepatitis B and were closely related with the change of liver function parameters. CD39+ treg cells may be a group of functional treg cells, which indicated that CD39 be a sensitive marker to react treg cells function. In some sense, CD4+ CD25+ CD127(low) cells frequency could represent treg cell frequency.

Adult ; Biomarkers ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; immunology ; virology ; Humans ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo simplify the methods of transcatheter mapping and ablation in the pediatric patients with left posterior fascicular tachycardia.

METHODWhile in sinus rhythm, the fascicular potential can be mapped at the posterior septal region (1 - 2 cm below inferior margin of orifice of coronary sinus vein), which display a biphasic wave before ventricular wave, and exist equipotential lines between them. When the fascicular potential occurs 20 ms later than the bundle of His' potential, radiofrequency was applied. Before applying radiofrequency, catheter position must be observed using double angle viewing (LAO 45°RAO 30°), and it should be made sure that the catheter is not at His' bundle. If the electrocardiogram displays left posterior fascicular block, the correct region is identified and ablation can continue for 60 s. Electrocardiogram monitoring should continue for 24 - 48 hours after operation, and notice abnormal repolarization after termination of ventricular tachycardia. Aspirin [2 - 3 mg/(kg·d)] was used for 3 months, and antiarrhythmic drug was discontinued. Surface electrocardiogram, chest X-ray and ultrasound cardiography were rechecked 1 d after operation. Follow-up was made at 1 month and 3 months post-discharge. Recheck was made half-yearly or follow-up was done by phone from then on.

RESULTFifteen pediatric patients were ablated successfully, and their electrocardiograms all displayed left posterior fascicular block after ablation. None of the patients had recurrences during the 3 to 12 months follow-up period. In one case, the electrocardiogram did not change after applying radiofrequency ablation and the ventricular tachycardia remained; however, on second attempt after remapping, the electrocardiogram did change. The radiofrequency lasted for 90 seconds and ablation was successful. This case had no recurrences at 6 months follow-up.

CONCLUSIONTranscatheter ablation of the fascicular potential in pediatric patients with left posterior fascicular tachycardia can simplify mapping, reduce operative difficulty and produce a distinct endpoint for ablation.

Adolescent ; Bundle-Branch Block ; physiopathology ; surgery ; Catheter Ablation ; methods ; Child ; Electrocardiography ; Female ; Humans ; Male ; Tachycardia, Ventricular ; physiopathology ; surgery

OBJECTIVETo explore safety, indications and advantages of mapping and ablation of arrhythmia in children guided by Carto and Ensite system.

METHODSGuided by Carto system, radiofrequency catheter ablation (RFCA) was performed on 8 pediatric patients with tachycardia whose mean age was (6.2 + or - 1.7) years, mean weight was (18.0 + or - 2.0) kg. Guided by Ensite system, RFCA was performed on 10 pediatric patients with arrhythmia, 8 of them were ablated guided by Ensite Array system: 6 cases with premature ventricular contractions (PVCs), 2 cases with right atrial tachycardia, their mean age was (11.3 + or - 1.2) years, and mean weight (40.0 + or - 5.0) kg. The other two cases with W-P-W syndrome were ablated guided by Ensite Navx system.

RESULTGuided by Carto system, 8 cases were successfully mapped and ablated: 6 cases had incision atrial tachycardia, 1 case had left atrial tachycardia and 1 case had right atrial tachycardia. In 1 case with incision atrial tachycardia the condition recurred after 3 months, and was ablated again successfully. Guided by Ensite Array system, 6 cases with PVCs (in 2 originating from the right ventricular inflow tract and in 4 originating from the right ventricular outflow tract) and 2 cases with right atrial tachycardia were successfully mapped and ablated, PVCs of the first 6 cases were reduced from (32 333 + or - 4509) 24 h to (0-4)/24 h after ablation. In 1 case with automatic atrial tachycardia, mapping could not be done by Ensite Array system, because P wave could not be identified from T wave. Single bolus of adenosine 20 mg was given within 30 s to let ventricles stop for 2 s (cardio-ventricular pacing standby) until T wave vanished, mapping and ablation were operated again successfully, but another atrial tachycardia occurred 1 day later. Guided by Ensite Navx system, 2 cases with W-P-W syndrome were successfully ablated, operation under X-rays lasted for 8 and 10 min. In none of the 9 patients the disease recurred after follow-up for 6 months.

CONCLUSIONCarto system is suitable for mapping and ablation in pediatric patients with continuous tachycardia, especially with incision atrial tachycardia; Ensite Array system fits children older than 10 years with right heart discontinuous arrhythmia; and Ensite NavX system can set up model and display endocardial anatomic structure quickly. Compared with two-dimensional mapping system, the three-dimensional mapping system (Carto and Ensite) can display the origin of arrhythmia and activation sequence clearly, decrease difficulty of operation efficiently and diminish operation time under X-ray.

Arrhythmias, Cardiac ; physiopathology ; surgery ; Catheter Ablation ; methods ; Child ; Child, Preschool ; Electrophysiologic Techniques, Cardiac ; methods ; Humans ; Imaging, Three-Dimensional ; Treatment Outcome

AIMTo explore an accurate neurophysiological technique that demonstrates small functional differences after spinal cord injury and assesses therapeutic interventions.

METHODSA modified weight drop (WD) technique was used at T8 in rats to build graded spinal cord injury model. Rubrospinal MEPs were recorded at T13 epidurally to monitor spinal cord function in end week 4 after graded spinal cord injury. The efficacy of this techniques to monitor spinal cord function was compared to BBB locomotor rating scale and histologic evaluation.

RESULTSA characteristic peak complex of rubrospinal MEPs in sham-operated group consisted of 5-7 positive waves and 4-5 negative waves emerging after red nucleus stimulation. The summed peak to peak amplitude (for practical reasons, called peak amplitude) was (195.25 +/- 34.35) microV and decreased following spinal cord injury. The latency of the first peak (positive wave) was (1.57 +/- 0.15) ms and prolonged following spinal cord injury. Significant Linear relationship existed between the peak amplitude and the BBB scores (r = 0.79) and between the peak amplitude and the residual matter obtained from the section with maximum tissue damage( r = 0.87). The close relationship between the latency of the first peak and the BBB scores (r = -0.88) and between the latency of the first peak and residual matter (r = -0.86) were observed.

CONCLUSIONAmplitudes and latencies of rubrospinal MEPs are very valuable parameters to demonstrate small function differences. Rubrospinal MEPs can be used as a reliable measure for motor function prognosis after spinal cord injury.

Animals ; Evoked Potentials, Motor ; Male ; Rats ; Rats, Wistar ; Red Nucleus ; physiopathology ; Spinal Cord Injuries ; pathology ; physiopathology

OBJECTIVETo compare the time-effect rule of pain-relieving in moderate dysmenorrhea in the treatment between acupuncture on single-point and acupuncture on multi-point so as to determine the best time of needle retaining on single-point and multi-point as well as provide the reference evidences of acupuncture frequency in the treatment.

METHODSSixty-three cases of moderate dysmenorrhea were randomized into a single-point group (31 cases) and a multi-point group (32 cases). During the attack of dysmenorrhea, in single-point group, Shiqizhui (EX-B 8) was punctured; in multi-point group, Shiqizhui (EX-B 8), Diji (SP 8), Ciliao (BL 32) and Sanyinjiao (SP 6) were punctured and the needles were retained for 30 min. Visual Analogue Scale (VAS) values were recorded in the immediate time before acupuncture, in 5 min, 10 min, 20 min and 30 min after needle insertion, as well as in 30 min, 60 min and 120 min after needle withdrawal separately.

RESULTSAfter needling, analgesia was generated rapidly in either group. During 30 min of needle retaining, analgesia was enhanced persistently till needle withdrawal in either group. In 10 min after needle insertion, the immediate analgesia in multi-point group was superior obviously to single-point group (P < 0.05) and this effect was maintained in 2 h after needle withdrawal. In 30 min after needle withdrawal, acupuncture analgesia was declined to the maximum.

CONCLUSIONEither single-point acupuncture at Shiqizhui (EX-B 8) or multi-point acupuncture at Shiqizhui (EX-B 8) and other acupoints has apparent immediate analgesia on primary dysmenorrhea of moderate degree, but the effect of multi-point acupuncture is better than that of acupuncture at Shiqizhui (EX-B 8). No matter with acupuncture at Shiqizhui (EX-B 8) or at multi-point, the time of needle retaining should not be shorten than 30 min. It is suitable to give acupuncture, twice per day for the patients with moderate and persistent pain.

Acupuncture Analgesia ; Acupuncture Points ; Adolescent ; Adult ; Dysmenorrhea ; therapy ; Female ; Humans ; Pain Management ; Young Adult