Objective To observe the clinical efficacy of navel acupuncture in treating lumbar spinal stenosis. Method A total of 120 patients with lumbar spinal stenosis were randomized into a treatment group and a control group, 60 cases each. The treatment group was intervened by navel acupuncture based on syndrome differentiation of traditional Chinese medicine, while the control group was intervened by oral administration of Bulleyaconitine A tablets, 10 d as a treatment course, for successive 2 courses. The Visual Analogue Scale (VAS) was observed before and after the intervention, and the clinical efficacies were compared.Result The total effective rate was 98.3% in the treatment group versus 76.6% in the control group, and the between-group difference was statistically significant (P<0.01). The VAS scores were significantly changed after the intervention in both groups (P<0.05); the VAS score in the treatment group was significantly different from that in the control group after the treatment (P<0.05).Conclusion Navel acupuncture is an effective approach in treating lumbar spinal stenosis.

OBJECTIVETo investigate the prevalence and psychopathological characteristics of anxiety and depression in patients with chronic rhinosinusitis (CRS) and to find the risk factors leading to psychological problems.

METHODSBetween August 2013 and April 2014, 117 consecutive patients with the diagnosis of CRS who had been scheduled for endoscopic sinus surgery were prospectively enrolled. Somatic and psychological symptoms were evaluated using a series of questionnaire instruments. The instruments included symptom checklist-90 (SCL-90), self-rating depression scale (SDS), self-rating anxiety scale (SAS) and the visual analogue scale (VAS) and the sinonasal outcome test 20 (SNOT-20) and Lund-Mackay computed tomography score. The results of SAS, SDS, SCL-90 were compared with the standard, obtained from healthy Chinese population. Multivariate Logistic regression was used to analyze the factors that might cause anxiety and depression. SPSS 19.0 software was used to analyze the data.

RESULTSThe scores of SAS and SDS (39.40 ± 11.55, 54.05 ± 10.96) were significantly higher than those of our country's normal standard (29.78 ± 10.46, 41.88 ± 10.57, t equals 5.648, 7.529, all P < 0.01). The SCL-90 scores were significantly higher than those of the normal standard population, including dimension of somatization, anxiety, depression, psychosis and total average score of the factors ( all P < 0.01), the result of somatization, anxiety, depression had positive correlation with the scores of SAS and SDS (r equals 0.681, 0.781, 0.531, 0.866, 0.674, 0.557, all P < 0.05). Multivariate Logistic regression showed that gender and CRS complicated with asthma or allergic rhinitis (AR) and the symptom of nasal obstruction were related to the incidence of anxiety depression comorbid. In addition, the gender and concurrent asthma had positive correlation with incidence of any anxiety or depressive disorder. To compare the abnormal psychological state group and healthy group, the SNOT-20 scores had no statistical significance (all P > 0.05).

CONCLUSIONSHigh prevalence of anxiety and depression was found in CRS patients. Such factors as gender, nasal obstruction and concurrent with asthma or AR are high risk factors for anxiety and depression in patients with CRS.

Anxiety ; epidemiology ; Chronic Disease ; Depression ; epidemiology ; Endoscopy ; Humans ; Pain Measurement ; Prevalence ; Prospective Studies ; Rhinitis ; epidemiology ; surgery ; Sinusitis ; epidemiology ; surgery ; Surveys and Questionnaires ; Tomography, X-Ray Computed

OBJECTIVE:To study the effects of Akt inhibitor MK-2206 on the proliferation and apoptosis of lung adenocarcino-ma A549 cells. METHODS:The optical density of A549 cells was detected by MTT assay after treated with 0(blank control),0.5, 1,2.5,5,10,20 and 30 μmol/L MK-2206 for 24 h;after pretreatment with 0(blank control),5,10 and 20 μmol/L MK-2206 for 24 h,morphological changes of A549 cells were observed with inverted microscope. Cell cycle and apoptosis rate were analyzed by flow cytometry. Western blot was used to detect the expression of cell cycle-related proteins Cyclin D1,p21 and p27 and apopto-sis-related protein PARP(cf-PARP),cf-caspase-3,Bcl-2 and Bax. RESULTS:Compared with blank control,the optical density of A549 cells decreased,cells shrank and presented vesicular state after treatment of MK-2206;A549 cells arrested in G0/G1 stage, the protein expression of p21 and p27 strengthened while that of Cyclin D1 decreased;the apoptotic rate of cells increased,the ex-pression of cf-PARP,cf-caspase-3 and Bax in cells increased while that of Bcl-2 decreased. All reponse were in concentration-de-pendant manner (P<0.05 or P<0.01). CONCLUSIONS:MK-2206 can inhibit the proliferation of A549 cells,and induce the apoptosis of A549 cells by adjusting the expression of activating caspase-3,down-regulating Bcl-2 and up-regulating Bax.

Objective: To investigate the effects of different concentrations of vitamin E (VE) on angiogenesis and its possible mechanism. Methods: The rings of rat aorta were embedded in gels of collagen and cultured in a serum free medium for 28 days. Curves of microvessels growth were generated by counting the number of newly formed microvessels every day with an inverted microscope. Photos were taken at the same time. Expression of factor FVIII related antigen (FVIII RAg) in newly formed microvessels was detected by immunohistochemistry. Concentration change of FVIII R in medium was evaluated by ELISA. Results: Both 0.2 g/L and 0.1 g/L VE showed significant inhibitory effect on angiogenesis (P0.05). The inhibitory effect of VE was expressed in the phases of microvessel growth and decline (10-25 d). Conclusion: 1.Three dimensional collagen gels culture of microvessel in serum free medium can be used as a sensitive assay for study of soluble and solid phase angiogenic agonists and antagonists. 2. Both 0.1 g/L and 0.2 g/L VE inhibit angiogenesis, and VE has no toxicity and no drug resistance.

Objective To explore the effect of quality control circle(QCC) activities for improving the autonomous learning ability of the maxillofacial surgical nurses .Methods Twenty maxillofacial surgical nurses used the steps and methods of QCC activ‐ities .The factors affecting the autonomous learning ability were analyzed and the effective intervention measures were adopted .The activity cycle was 12 months ,including 40 times of theory classes and 40 times of classroom interaction .The scores of nurse autono‐mous learning ability scale ,satisfaction of doctors and patients on surgical nurses were compared between before and after activities . Results The scores of 2 dimensions ,including self motivational belief and self assessment ,after conducting QCC activities were in‐creased compared with before conducting QCC activities ;the doctor′s satisfaction degree and patient′s satisfaction degree were in‐creased ,the differences were statistically significant (P<0 .05) .Conclusion The QCC activities can motivate the working enthusi‐asm and responsibility ,help nurses to increase the autonomous learning ability ,thus enhance the nurses overall quality .

[Summary] In this study, PubMed, Embase, China National Knowledge Infrastructure, databases VIP Chinese Periodical Database, and Wanfang Chinese Periodical Database were systematically searched for the case-control study related β3-adrenergic receptor ( ADRB3 ) Trp64Arg gene polymorphism to overweight/obesity among children from 1962 to 2014.Twelve eligible studies with 2 222 overweight/obese children and 1 955 normal children were included according the uniform inclusion and exclusion criteria.Meta-analyses showed that Trp64Arg polymorphism was associated with significantly increased overweight/obesity risk in Arg carriers among children( OR=1.34,95%CI1.17-1.53).Afterstratificationforethnicity,highlysignificantcoorelationofTrp64Argpolymorphism to overweight/obesity in Asian children(OR=1.44, 95%CI 1.23-1.68) but not significant in Europe(OR=1.05, 95%CI 0.79-1.40).It suggested that Trp64Arg polymorphism is associated with overweight/obesity susceptibility in children.Our results support an strong association between Trp64Arg polymorphism and overweight/obesity among the Asian children investigated.

Objective To investigate the effects of intravitreal injection of conbercept on diffuse macular edema (DME) of diabetes mellitus.Methods Together 51 diabetic patients (51 eyes) with diffuse macular edema were collected between July 2016 to July 2017,and randomly divided into three groups (n =17):group A,in which patients received solely intravitreal injection of 0.5 mg conbercept,group B,those who was intravitreally injected with 0.5 mg of conbercept and modified macular grating photocoagulation,and group C,patients undergoing modified grid photocoagulation (GPG).Then,before treatment and 1 week,1 month,3 months and 6 months after treatment,all patients were examined by optical coherence tomography for determining central macular thickness (CMT),followed by fundus fluorescein angiography (FFA),the best corrected visual acuity (BCVA),slit lamp,intraocular pressure for compare the efficacy and safety of the three procedures.Results All the three treatments improved BCVA,CMT,retinal neovascularization (RNV) leakage in diffuse DME patients,but group A and B were better than group C (both P ＜ 0.05),while there was no significant difference in BCVA improvement between A and B group (P ＞ 0.05),whereas the improvement in CMT of group B patients was better than that of group A [(197.47 ±45.26) μm vs.(205.59 ± 47.33) μm] (P ＜ 0.001),and this was true of RNV leakage [(9.91 ±3.18)mm vs.(13.24 ±4.87) rnm] (P＜0.001),without related complications.Conclusion Combination of modified macular grid photocoagulation and intravitreal injection of conbercept can quickly relieve diabetic macular edema and alleviate neovascularization,thus improving the patients' vision acuity,of which the efficacy is superior to the pure modified macular grid photocoagulation and conbercept injection.

Objective:To investigate the relationship between expression of programmed cell death 1 ligand 2 (PD-L2) in colorectal cancer and prognosis, and explore the feasibility of application of PD-L2 in confocal laser endomicroscopy in the diagnosis of colorectal cancer. Methods:Immunohistochemistry was used to detect the expression of PD-L2 in 100 patients with colorectal cancer. The relationship between the expression levels and the prognosis of patients was analyzed. The expressions of PD-L2 in 30 cases of early colorectal cancer and adjacent normal mucosa were detected by immunohistochemistry and Western blotting. Confocal laser endomicroscopy was used to observe the difference in fluorescence intensity between early colorectal cancer and adjacent normal mucosa after being incubated with PD-L2 fluorescent antibody. Results:There were statistically significant differences in T-stage and distant metastasis between the patients with low and high expression of PD-L2, and they were both positively correlated with expression of PD-L2 (r=0.274, P=0.009; r=0.216, P=0.039). There was also a positive correlation between PD-L2 membrane expression and T stage (r=0.201, P=0.037). Survival analysis showed that the survival rate of patients with high PD-L2 expression was significantly lower than that of patients with low PD-L2 expression (P=0.000). The protein expression of PD-L2 in early colorectal cancer was significantly higher than that in adjacent normal mucosa. Under confocal laser endomicroscopy, the fluorescence intensity of early colorectal cancer was higher than that of adjacent normal mucosa. Conclusion:High expression of PD-L2 in colorectal cancer predicts poor prognosis in patients. Application of PD-L2 in confocal laser endomicroscopy may contribute to the diagnosis of colorectal cancer.

Objective To investigate the effects of asymmetric dimethylarginine (ADMA) on apoptosis and phosphorylation of c-jun N-terminal kinase (JNK) in endothelial outgrowth cells (EOCs). Methods The mononuclear cells were harvested from umbilical cord blood by ficoll density gradient centrifugation, and induced into EOCs and then expanded in vitro. The identified EOCs were treated with different concentrations of ADMA (0, 1, 5, 10, 20 μmol/L) for 48 h. The adherent cells were treated with 10 μmol/L ADMA,then different concentrations of JNK specific inhibitor SP600125 (0, 5,10,20 and 40 μmol/L) were added and incubated for 48 hours. Caspase-3 activity was measured by microplate reader. Apoptotic incidences of EOCs were quantitatively determined by flow cytometry. The expression of Caspase- 3 and phosphorylase-JNK (p-JNK) were detected by Western blot assay. Results The treatment of ADMA (1-20 μmol/L) significantly induced apoptosis in EOCs by enhancing Caspase-3 express and also induced phosphorylation of JNK (P<0.05). Meantime, the JNK specific inhibitor SP600125 could attenuate the apoptosis induced by ADMA during this process (F=6.733,P<0.05) and inhibit the expression of Caspase-3 and p-JNK. Conclusion ADMA can induce apoptosis in EOC, which may be achieved by activating JNK signal transduction pathway.

Objective To summarize the management of immature testicular teratomas in children.Methods The clinical data of 19 children (age between 16 days to 13 months) with immature testicular teratomas were retrospectively analyzed.There were 10 cases in left and 9 cases in right side.The main presentation was painless scrotal mass.The size of the tumor was 1.5 cm × 1.2 cm × 0.5 cm-6.0 cm × 5.0 cm × 4.5 cm.Abnormal alpha fetopmtein (AFP)concentrations were detected in 17 patients before surgery.Results Testis-sparing surgeries were done in 11 patients,and the other 8 patients underwent testicle resection because of tumor severely invading testis.Fifteen cases were followed up for 1-10 years.All of them were alive.Conclusions Immature testicular teratomas was rare and almost presenting in children younger than 1 year old.The biological behavior of immature testicular teratomas in children was benign.Testicular-sparing surgery was possible.Close follow-up should be done postoperatively.