Objective To investigate the efficacy of triple needling at muscle insertions plus moxibustion in treating acute carpometacarpal joint injury. Method Forty patients were randomly allocated to acupuncture and medication groups, 20 cases each. The therapeutic effects were evaluated after one course of treatment. Result The total efficacy rate and the cure rate were 100.0%and 80.0%, respectively, in the acupuncture group and 90.0% and 50.0%, respectively, in the medication group. There were statistically significant differences in the total efficacy rate and the cure rate between the two groups (P<0.01). The VAS score decreased significantly in both groups of patients after treatment compared with before (P<0.01). The post-treatment VAS score was lower in the acupuncture group than in the medication group (P<0.01). Cooney wrist joint score increased in both groups after treatment compared with before (P<0.01). The post-treatment Cooney score was higher in the acupuncture group than in the medication group (P<0.01). Conclusion Triple needling at muscle insertions plus moxibustion has clinically a marked therapeutic effect on acute carpometacarpal joint injury.

OBJECTIVE: To explore strategies for Chinese chemical pharmaceutical enterprises in the practice of international business. METHODS: Based on the theory of international business, the international business of global chemical pharmaceutical enterprises was analyzed in terms of business time, real strength and business procedures, etc. RESULTS & CONCLUSION: The success of international business of the global chemical pharmaceutical enterprises is closely related to their long business time, real strength and the successful internationalization of the mix of investment,research & development, production and sales. Striving to carry out international business strategy, Chinese chemical pharmaceutical enterprises should draw advanced experiences by acting from improving management strategy, comprehensive competitive power, high grade products with high added value and making good use of the global resources.

Coronary Stenosis ; diagnostic imaging ; Humans ; Ultrasonography, Interventional ; methods

ObjectiveTo observe the effects of mechanical ventilation with different tidal volumes (VT) on coagulability and fibrinolytic characteristics in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hits with oleic acid (OA) and lipopolysaccharide (LPS).Methods Forty healthy adult male rabbits were randomly divided into five groups (8 rabbits in each group): sham operation group, model group, low VT group (6 mL/kg), rontine VT group (10 mL/kg), high VT group (15 mL/kg). ARDS model was reproduced by sequential injection of 0.1 mL/kg OA and 500μg/kg LPS via auricular vein, and the rabbits in sham operation group received normal saline in same volume. Mechanical ventilation was performed in different VT groups after model reproduction, and the end of the experiment was determined as 6 hours after LPS injection. Blood was collected from the carotid artery at 30 minutes and 360 minutes after LPS injection, with which arterial partial pressure of oxygen (PaO2) was determined, and oxygenation index was calculated. Internal jugular vein blood was collected at 5, 120, 240, and 360 minutes after LPS injection, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib) and antithrombinⅢ(AT-Ⅲ) were determined. The blood was collected at the end of the experiment, and then the rabbits were sacrificed, and serum levels of procollagen typeⅢ (PⅢP), plasminogen activator inhibitor-1 (PAI-1) as well as PⅢP level in lung tissue were determined. The wet/dry weight ratio (W/D) of lung tissues was calculated.Results Compared with sham operation group, oxygenation index at both 30 minutes and 360 minutes were significantly decreased in model group, while W/D ratio was significantly increased. PT and APTT at 5 minutes were significantly shortened followed by a gradual increase. Fib and AT-Ⅲ showed no change at 5 minutes followed by a gradual decrease, while serum PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly increased. There was no significant difference in oxygenation index between all VT groups and model group, with a tendency to increase in low VT group. W/D ratio in low VT group was the lowest (5.09±0.19), and it was significantly lower than that of the model group (6.02±0.27, P< 0.01), while it was the highest in high VT group (6.27±0.32). PT and APTT in all VT groups were gradually prolonged, and Fib and AT-Ⅲ were gradually decreased. PT and APTT in low VT group were significantly shorter than those in model group from 120 minutes on [PT (s): 120 minutes: 8.90±0.28 vs. 11.43±0.28, 240 minutes: 9.18±0.21 vs. 11.99±0.50, 360 minutes: 9.25±0.15 vs. 12.49±0.29; APTT (s): 120 minutes: 69.09±3.91 vs. 76.08±4.21, 240 minutes: 67.53±2.14 vs. 79.71±2.25, 360 minutes: 66.95±1.13 vs. 83.21±4.01, allP< 0.05], Fib (g/L) was significantly elevated (120 minutes: 3.80±0.09 vs. 3.38±0.15, 240 minutes: 3.91±0.05 vs. 2.47±0.16, 360 minutes:4.06±0.13 vs. 2.39±0.16, allP< 0.05), and no significant difference was found in AT-Ⅲ. Serum contents of PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly lowered [serum PAI-1 (ng/L): 1.14±0.26 vs. 1.63±0.91, serum PⅢP (ng/L): 1.62±0.52 vs. 2.91±0.64, lung PⅢP (ng/L): 4.40±0.58 vs. 5.75±0.47, allP< 0.01]. The change tendency of all parameters in routine VT group was lower than that in low VT group, PT at 120 minutes and 360 minutes, APTT at 240 minutes and 360 minutes was significantly shorter than that in model group, and Fib at 120 minutes and 240 minutes were significantly higher than those in model group (allP< 0.05). No significant difference was found in AT-Ⅲ, serum PAI-1 and PⅢP as well as lung PⅢP as compared with model group. PT and APTT at 360 minutes in high VT group were significantly longer than those in model group, Fib at 360 minutes was significantly lower than that in model group, and lung PⅢP was significantly higher than that in model group. Conclusions There are some important changes in coagulability which changes from a hyper state into a hypo coagulate state, while fibrinolysis is inhibited during the pathological process of ARDS produced by two-hit of OA and LPS. Mechanical ventilation with low VT can obviously improve coagulability and fibrinolytic status, while ventilation with routine VT has little effect on coagulability and fibrinolytic status. Mechanical ventilation with high VT, however, will greatly deteriorate the coagulability and fibrinolytic function in ARDS.

Objective To investigate the utility of urodynamic testing in the evaluation of neurogenic vesicoureteral reflux in patients with thoracolumbar spinal cord injury at the T10 to L2 level.Methods Twenty-six patients with thoracolumbar spinal cord injury at the T10 to L2 level and who displayed vesicoureteral reflux were enrolled and divided into a detrusor hyper-reflexia group (n =21) and a detrusor a-reflexia group (n =5)according to their cystourethrograms and urodynamic test results.Their bladder volume,detrusor pressure (Pdet) and compliance were observed and analyzed at the vesicoureteral reflux point and the leak point.Results The bladder volume and compliance of the detrusor hyper-reflexia group at the vesicoureteral reflux point were (122.46 ± 87.89) ml and (5.94 ± 4.96) ml/H2 O respectively,significantly different from the detrusor a-reflexia group (P ＜ 0.01).At the leak point,the average bladder volume of the detrusor hyper-reflexia group was (210.81 ± 69.72)ml,while the average bladder compliance was (9.53 ± 5.43)ml/H2O and the average detrusor pressure was (42.29 ± 9.57)cm H2O.All were significantly different from the detrusor a-reflexia group's averages.Moreover,there was a significant difference in the Pdet between the leak point and the vesicoureteral reflux points in the detrusor hyper-reflexia group.Conclusions Patients with thoracolumbar spinal cord injuries at the T10 to L2 level with neurogenic bladder and detrusor hyper-reflexia have low bladder volumes and compliance,and vesicoureteral reflux tends to occur at an early stage after injury with a destrusor pressure lower than 40 cm H2 O.For patients with detrusor a-reflexia,vesicoureteral reflux and bladder leakage may occur when detrusor pressure is low.

Objective To observe the influences of infusion with normal saline (NS), Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride on blood coagulation/fibrinolysis in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hit of oleic acid (OA) and lipopolysaccharide (LPS).Methods According to random number table, 40 healthy adult male rabbits were divided into sham operation, model, NS, Ringer and colloid groups (8 rabbits in each group). The ARDS model was replicated by sequential injection of OA (0.1 mL/kg) and LPS (500μg/kg) into the ear marginal vein of rabbit. Immediately after injection of LPS, the NS, Ringer and colloid groups were treated by intravenous infusion of NS, lactate Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride, respectively at a speed of 7 mL·kg-1·h-1 for 210 minutes. There was no liquid infusion in model and sham operation groups. At 30 minutes and 210 minutes after LPS injection, the arterial blood was collected and the partial pressure of arterial blood oxygen (PaO2) was measured and the oxygenation index (PaO2/FiO2) was calculated. At 5, 30, 120 and 210 minutes after LPS injection, venous blood was collected, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib), antithrombase Ⅲ (AT-Ⅲ), serum procollagen peptide Ⅲ (PⅢP), tissue plasminogen activator (t-PA) were measured, respectively. After the rabbits were killed by bloodletting at the end of experiment, the lung tissues were obtained, collagen Ⅰ and collagen Ⅲ in lung tissues were detected by immunohistochemistry staining, lung wet/dry weight ratio (W/D) and pathologic score of lung tissues were calculated.Results Compared with sham operation group, at 30 minutes and 210 minutes in model group the levels of PaO2/FiO2 were significantly decreased, and the lung W/D ratios as well as pathologic scores of pulmonary tissues were increased. In model group, the APTT began from 30 minutes while the PT began from 120 minutes to gradually prolong, and the value of Fib was progressively decreased; with a tendency of mild decline, the levels of AT-Ⅲ at all time-points were lower in model group than those in sham operation group (allP < 0.05). The levels of t-PA and PⅢP at all time-points were significantly higher, and the expression levels of collagen Ⅰ and collagen Ⅲ in model group were obviously more strengthened compared to those in sham operation group. Among the three infusion groups, the improvement degrees of PaO2/FiO2, lung W/D ratio and pathologic score of pulmonary tissues were the highest in NS group, lowest in colloid group, and no significant changes in Ringer group. APTT in NS group except 120 minutes was longer, the APTTs at 30 minutes and 210 minutes were shorter in NS group than those in model group (s: 30 minutes: 52.26±18.65 vs. 76.22±16.64, 120 minutes: 90.60±10.66 vs. 83.01±15.88, 210 minutes: 70.44±17.80 vs. 77.04±13.32, allP < 0.05); the prolongation of amplitudes of APTT in Ringer and colloid groups were greater than that in model group, particularly in colloid group, the greatest; the PT in three infusion groups were gradually prolonged, and at 120 minutes and 210 minutes were all longer than that in model group (allP < 0.05). The levels of Fib in those treatment groups were all gradually decreased, the amplitude descent of Fib in NS group was the smallest and that in colloid group, the biggest; the levels of AT-Ⅲ in three infusion groups and model group had similar decline tendency, the descending amplitude being the most significant in colloid group. The levels of t-PA at all time-points in the three treatment groups were lower than those in model group (allP < 0.05). The levels of PⅢP in serum at all time-points were lower in Ringer and NS groups than those in model group (μg/L: Ringer group: 5 minutes: 250.60±36.53 vs. 285.77±65.55, 30 minutes: 248.73±44.41 vs. 302.16±37.73, 120 minutes: 249.14±43.16 vs. 296.09±38.64, 210 minutes: 246.62±44.72 vs. 295.45±42.75; NS group: 5 minutes: 261.89±50.74 vs. 285.77±65.55, 30 minutes: 247.71±50.40 vs. 302.16±37.73, 120 minutes: 246.58±42.27 vs. 296.09±38.64, 210 minutes: 222.73±18.51 vs. 295.45±42.75, allP < 0.05), but there were no statistically significant differences between the colloid group and model group. The expression levels of collagen Ⅰ and collagen Ⅲ in all liquid infusion groups were lower than those in model group (P < 0.05 orP < 0.01), whereas in colloid group were higher than those in NS and Ringer groups (allP < 0.05).Conclusions The infusion of NS, lactate Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride have different influences on the blood coagulation function in ARDS rabbits, among which the effect of NS is the least, while of the hydroxyethyl starch 130/0.4 sodium chloride appears the greatest. The infusion of these three liquids can all decrease the pulmonary fibrous tissue in rabbits with ARDS, and in the mean time can alleviate the lung tissue pathological lesion for a certain degree, the effect of NS and Ringer solution being greater than that of hydroxyethyl starch 130/0.4 sodium chloride.

Objective To observe the effects of low molecular weight heparin (LMWH) combined with dexamethasone (Dex) on coagulation and fibrinolysis at the early stage in rats with acute respiratory distress syndrome (ARDS) induced by two-hit of oleic acid (OA) and lipopolysaccharide (LPS).Methods Forty healthy adult male Sprague-Dawley (SD) rats were randomly divided into sham operation, ARDS model, Dex, LMWH and combining therapy groups (8 rats in each group). The rat ARDS model was established by sequential two-hit with intravenous injection of OA 0.2 mL/kg in a tail vein and intra-peritoneal injection of LPS 5 mg/kg. After model establishment, the rats in Dex group were intra-peritoneally injected with 10 mg/kg Dex, and those in LMWH group were intravenously injected with 200 U/kg LMWH, while the rats in combining therapy group were given Dex and LMWH simultaneously with the same dosages and methods as above mentioned respectively. In sham operation group, however, the rats were intravenously injected with 0.4 mL of normal saline (NS) and were given 2 mL/kg of intra-peritoneal NS injection, and they accepted another 1 mL/kg NS intra-peritoneal injection 4 hours later, the other procedures being the same as those in the model group. The experiment was ended at 6 hours after the establishment of ARDS model. A light microscope was used to observe the pathological changes in lung tissues, partial pressure of arterial blood oxygen (PaO2) was measured, and the oxygenation index (PaO2/FiO2) was calculated. Wet to dry weight (W/D) ratio of lung tissues was also checked. Coagulation indexes were measured by solidification method, and the serum level of plasminogen activator inhibitor-1 (PAI-1) as well as the content of procollagen type Ⅲ (PC-Ⅲ) was determined by enzyme linked immunosorbent assay (ELISA).Results Under the light microscope, effusion of red blood cells, fibrin deposit in the lung interstitium and alveoli, formation of transparent membrane at alveolar wall, inflammatory cells infiltration in pulmonary interstitial tissue, and fibrinous thrombi in lung capillaries or lung arterioles were seen in the model group. Compared with model group, the red blood cells effusion and fibrin deposition in the lung interstitium and alveoli were less, inflammatory cells infiltration in pulmonary interstitium was alleviated and the fibrinous blood emboli in the lung capillaries or lung small arterioles were also decreased in Dex, LMWH and combining therapy groups, among the three groups, the best results being in the combining therapy group. Compared with sham operation group, the PaO2/FiO2 was significantly lowered [mmHg (1 mmHg = 0.133 kPa): 272.02±28.28 vs. 420.24±35.52,P < 0.01], the lung W/D ratio was obviously higher (5.59±0.40 vs. 3.82±0.28,P < 0.01), prothrombin time (PT) as well as thrombin time (TT) were markedly longer [PT (s): 18.78±1.57 vs. 16.36±0.97, TT (s): 39.02±5.03 vs. 29.22±8.83, bothP < 0.05], fibrinogen (Fib) content was significantly decreased (g/L: 1.82±0.26 vs. 2.69±0.40,P < 0.01), but both the serum contents of PAI-1 and PC-Ⅲ were remarkably elevated in model rats [PAI-1 (ng/L): 719.04±103.74 vs. 517.25±119.18, PC-Ⅲ (μg/L): 29.93±3.24 vs. 22.97±6.26, bothP < 0.01); Compared with model group, the level of PaO2/FiO2 was significantly elevated, and the lung W/D ratio was obviously decreased in Dex, LMWH and combining therapy groups respectively, the most significant changes being in combining therapy group [PaO2/FiO2 (mmHg): 376.78±25.25 vs. 272.02±28.28, lung W/D ratio: 4.14±0.42 vs. 5.59±0.4, bothP < 0.01] , in LMWH group, the prolongation of TT was the longest (s: 52.00±4.24 vs. 39.02±5.03,P < 0.05), while Fib contents in the three treatment groups were all obviously increased (g/L: 2.37±0.38, 2.59±0.51, 2.59±0.24 vs. 1.82±0.26,P < 0.05 orP < 0.01); meanwhile, the decrease of PAI-1 in combining therapy group was the greatest (ng/L: 546.02±93.94 vs. 719.04±103.74,P < 0.01). The indexes showed no statistically significant differences among the three treatment groups, except that PT in combining therapy group which was significantly longer than that in Dex and LMWH groups (s: 19.98±1.61 vs. 17.20±1.48, 17.02±2.34, bothP < 0.05). Conclusions The rats with ARDS induced by two-hit of OA combined with LPS have coagulation dysfunction and fibrinolytic inhibition. Using LMWH early can improve coagulation and fibrinolytic status in the rats with ARDS, and the therapeutic effects of LMWH plus Dex for treatment of ARDS are better than those of using each of them alone.

Objective To observe the effect of penehyclidine hydrochloride (PHCD) combined with mechanical ventilation on inflammatory response in rats with acute respiratory distress syndrome(ARDS)induced by hydrochloric acid(HCl)inhalation. Methods 32 adult healthy male Sprague-Dawley(SD)rats were randomly divided into four groups:sham operation group,ARDS model group,PHCD group(intraperitoneal injection of 0.5 mg/kg PHCD at 30 minutes before HCl instillation)and mechanical ventilation group〔mechanical ventilation was given after PHCD treatment,ventilator settings were as follows:tidal volume(VT)=4 mL/kg,respiratory rate(RR)= 70 beats/min,the time ratio of inspiration to expiration(I:E)=1:2,fraction of inspired oxygen concentration(FiO2)=0.21〕,8 rats in each group. The rat ARDS model was created by HCl(0.1 mol/L,1.2 mL/kg) intratracheal instillation. After mechanical ventilation for 4 hours,the experiment was stopped. Arterial partial pressure of oxygen(PaO2)was measured,and the oxygenation index as well as lung wet/dry weight ratio(W/D)were calculated respectively. The pathological changes in lung tissues were observed under light microscope,and the pathological score was evaluated. The levels of myeloperoxidase(MPO),interlukin-8(IL-8)and nuclear factor-κB (NF-κB)in homogenate of lung tissues were all measured respectively by enzyme linked immunosorbent assay (ELISA). Results In rats of ARDS model group, there were significant infiltration of inflammatory cells, collapse of extensive pulmonary alveoli and hyaline membrane formation in lung tissues,but the edema in pulmonary mesenchymal tissue and congestion of micro vessels were not obvious. Compared with sham operation group,the lung tissue pathological score(9.88±2.03 vs. 1.38±0.92),lung W/D ratio(7.67±0.96 vs. 4.08±0.65)were significantly increased(both P<0.01),while oxygenation index〔mmHg(1 mmHg=0.133 kPa):213±29 vs. 428±28〕was markedly decreased in model group(P<0.01);and the concentrations of MPO(μg/L:34.18±3.99 vs. 20.92±1.40), IL-8(ng/L:864±53 vs. 583±91)and NF-κB(ng/L:1 229±133 vs. 803±130)in homogenate of lung tissues were significantly higher in model group(all P<0.01). The pathological changes in lung tissues including inflammatory cell infiltration,collapse of alveoli and pulmonary edema,etc. were obviously improved when treated by PHCD or mechanical ventilation and the lung pathological score and W/D ratio were significantly decreased compared with those of model group,oxygenation index in these two groups were both significantly increased,meanwhile, the concentrations of MPO,IL-8 and NF-κB were sharply decreased when compared with those of model group (all P<0.05). The degree of improvement in all above indexes were greater in mechanical ventilation group than those in PHCD group(lung injury score:5.63±1.85 vs. 7.63±1.67,lung W/D ratio:5.35±1.05 vs. 6.46±1.17, oxygenation index:325±57 vs. 272±44,MPO:25.80±3.36 vs. 29.88±3.93,IL-8:736±53 vs. 802±53, NF-κB:984±75 vs. 1 109±118,all P<0.05),however they did not reach the levels of the sham operation group (P<0.05 or P<0.01). Conclusion PHCD can inhibit the inflammatory response in ARDS rats induced by HCl inhalation,thus it may protect the lung tissue from injury induced by HCl,and the protective role of PHCD plus menchanical ventilation is superior to that of PHCD only.

Objective　The conditional hierarchical clustering for 1-dimensional(1-d) ordinal data was discussed.Methods　Because the individuals are ordered in 1-d,the conditional matrix was constructed with all elements in the second-diagonal are 1 and the others are 0.Distance matrix of individuals defined by some particular definition.Then the conditional-distance matrix was made for the hierarchical clustering by connecting the conditional matrix and distance matrix.This method was called 1-dimentsional conditional hierarchical clustering.An example was illustrated by this method and a Monte Carol study showed that method was feasible and robust.Results　Compared with the least-squares partition,this method is easy to understand,easy to practice and easy to compute.It also can give us a stable result.Conclusion　Because of the austere theory,the simple thought and the convenient application,it's a good method for the 1-d ordinal data.

Objective To determine the level of anticyclophilin A auto-antibodies (ACA) in sera of patients with psoriasis. Methods Cyclophilin A (CyPA) was extracted and purified from bovine thymus. The level of anticyclophilin A auto-antibodies (ACA) was detected by enzyme-linked immunosorbent assay (ELISA) and immunoblotting test (IBT) in sera of patients with psoriasis. Results It was shown that the level of ACA was significantly higher in the sera of patients with psoriasis than those in control group (IBT:P<0.01,ELISA:P< 0.01). ACA was found to be positive in 41.3％ of the patients by ELISA. In psoriatic group, the serum level of ACA was higher during the progressive stage than that in the stationary stage, however, no significant difference was observed (IBT:P>0.05,ELISA:P >0.05). Conclusion The results suggest that there is autoimmunological mechanism in the pathogenesis of psoriasis.