To observe the therapeutic effect of acupuncture plus TDP irradiation on proliferative arthritis, 304 patients with proliferative arthritis were randomly divided into treatment group and control group, and treated by acupuncture plus TDP irradiation and routine Tuina respectively. The clinical cure rate and total effective rate in the treatment group were both superior to those in the control group. This therapy has good therapeutic effect and short course of treatment in treating proliferative arthritis, and is one of better therapeutic means in clinic presently.

Irritable bowel syndrome(IBS)is a commonly seen functional gastrointestinal disorder. Its main clinical manifestations were abdominal pain,abdominal distention and altered bowel habits. Currently,the pathogenesis of IBS has not been clarified. Studies showed that IBS was caused by many factors,including life style,gene polymorphism,food hypersensitivity,psychological factors,brain-gut axis abnormality and intestinal flora disorder. This article reviewed the advances in study on pathogenesis of IBS.

During L-lactic acid fermentation with Rhizopus oryzae,there existed a branch pathway by which pyruvate was transformed to eth- anol catalyzed by pyruvate decarboxylase(PDC)and alcohol dehydrogenase(ADH),thus decreasing the flux of pyruvate to lactic acid.In this study,the spores of Rhizopus oryzae AS3.3462 mutagenized with nitrosoguanidine(NTG),the appropriate dosage was 0.15 mg/mL and the lethal rate was 70%～80%.Two mutants,named mut-1 and mut-2,with decreased ADH activity were screened out by yeast peptone dextrose(YPD)agar medium containing allyl alcohol.These two mutants had decreased ADH activities of 41.63% and 50.29% compared with the parent strain.The fermentation behavior after 72h showed that the yields of ethanol produced by mut-1 and mut-2 were 4.87g/L and 6.56g/L respectively,while the wild type strain was 28.9g/L,and the lactate concentrations of mut-1 and mut-2 also increased from 40.31g/L to 54.45g/L and 44.07 g/L,respectively.It is also found that mut-1 and mut-2 had a high reducing sugar consumption rate and biomass accumulation than its present strain

Objective To study the effects of different doses of UVA1 on the development of hypertrophic scar in rabbit ears induced by excision of full-thickness skin. Methods A hypertrophic scar model was established by excision of full-thickness skin (2 cm×5 cm) on the ventral surface of rabbit ears. A total of 18 New Zealand rabbits were randomly divided into 3 equal groups to receive UVA1 radiation on the left ears immediately, 1 month, and 2 months after the excision, respectively, and every group were classified into two subgroups to be irradiated with 60 and 110 J/cm2 of UVA1, respectively, for 30 sessions. The right ears served as control without irradiation. HE staining and Masson staining were used to examine the dermal thickness and collagen content in scar, respectively. Results Compared with pre-irradiation, the dermal thickness (t = 5.85, 4.94, respectively, both P＜0.05) and collagen content (t = 6.50, 8.02, respectively,both P＜0.05) significantly decreased in scar irradiated with UVA1 of 110 J/cm2 one and two months after the excision. The difference value in dermal thickness and collagen content at the beginning and at the end of the study significantly differed between irradiated and non-irradiated ears in the rabbits treated with UVA1 of 110 J/cm2 (P＜0.05). The effects of UVA1 on dermal thickness and collagen content were dose-dependent (P＜0.05). On the contrary, the dermal thickness and collagen content markedly increased in scars of rabbits irradiated with UVA1 immediately after the excision (P＜0.05 ). Conclusions To begin UVA1 exposure of hypertropic scar in rabbits after epithelialization may lead to the softening of scar, thinning of skin, and decrease of collagen content. However, immediate irradiation with UVA1 after wound could not prevent the development of hypertrophic scar in rabbits, in contrast, it exacerbated the severity of scar.

Objective To study the possible mechanisms of influence of different doses of UVA1 on the development of hypertrophic scar in rabbit ears induced by excision of full-thickness skin. Methods A hypertrophic scar model was established by excision of full-thickness skin on the ventral surface of rabbit ears.A total of 24 New Zealand white rabbits were randomly and equally divided into 4 groups to receive UVA1 radiation on the left ear immediately (U0 group), 1 month (U1 group), 2 months (U2 group) and 3 months (U3 group) after the excision, respectively, and each group were classified into two subgroups to be irradiated with UVA1 of 60 (middle) and 110 (high) J/cm2, respectively, for 30 sessions. The right ears served as the control without irradiation. Skin samples were obtained from the ears of rabbits before the first and after the last irradiation, transmission electron microscopy (TEM) was used to observe the ultra-structure and morphology of collagen fiber and fibroblasts, and immunohistochemical staining was performed to measure the expressions of matrix metalloproteinases (MMP)-1, tissue inhibitor of metalloproteinase (TIMP)-1, transforming growth factor (TGF)-β1, proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) in skin samples. Results Compared with the unirradiated skin, irradiated skin showed higher expression levels of MMP-1 (P ＜ 0.05), which were 10.43 ± 1.61 and 11.16 ± 1.57 in middle- and high-U1 group, 8.63 ± 2.61 and 7.33 ± 1.58 in middle- and high-U2 gorup, 5.74 ± 1.43 and 3.11 ± 0.27 in middle- and high-U3 group respectively. The expression level of TGF-β1 in irradiated skin was 12.51 ± 4.13 and 12.02 ± 5.02 in middle- and high-U1 group, respectively, 18.74 ± 6.42 and 19.69 ± 4.52 in middle- and high-U2 group, respectively, 20.51 ± 1.78 and 29.45 ± 6.55 in middle- and high-U3 group, respectively. A significant decrease was observed in the expression of PCNA in irradiated skin in middle- and high-U1 group (2.67 ± 0.44 and 2.04 ± 0.65), middle- and high-U2 group (4.50 ± 0.97 and 5.82 ± 0.68), middle- and high-U3 group (7.45 ± 1.47 and 8.16 ±1.07) in comparison with unirradiated skin (all P＜ 0.05). There was a lower expression of TIMP-1 in irradiated skin of high-U1, -U2, and -U3 group (12.74 ± 4.58, 15.17 ± 3.26, 20.72 ± 3.31, all P＜ 0.05) as well as α-SMA in that of high-U1, middle-U1 and high-U2 group (1.33 ± 0.34, 2.04 ± 0.20, 3.60 ± 1.75, all P＜ 0.05) compared with the unirradiated skin. Further more, a significant increment was observed in the expressions of TGF-β1 (23.90 ± 2.92, P ＜ 0.05) in irradiated skin of high-U0 group, PCNA(7.42 ± 0.65 and 7.59 ± 0.31 ),TIMP-1 (29.82 t 1.94 and 33.51 ± 1.19) and α-SMA (6.31 ± 0.61 and 2.97 ± 0.56) in irradiated skin of middle- and high-U0 group, but a decline in the expression of MMP-1 (.25 ± 0.38, P＜ 0.05) in irradiated skin of high-U0 group in comparison with the unirradiated skin. TEM showed that the collagen fiber diameter turned small, and fibroblasts, most of which were quiescent, showed a reduction in cytoplasm volume with the presence of immature organelles, after high-dose UVA1 irradiation. Conclusions The therapeutical effect of UVA1 on scar may be realized by accelerating the degradation of matrix proteins and decelerating the proliferation of fibroblasts and myofibroblasts via downregulating the expressions of TGF-β1, TIMP-1 and α-SMA and upregulating the expression of MMP-1. However, the results would be opposite if the interference with UVA1 irradiation is given at the early stage of wound healing.

Good doctor-patient communication is the most effective way to build a harmonious doctor-patient relationship and reduce medical disputes, where the communication skill is the key. In communication with the hospitalized patients, it should pay attention to the communication object choice;the choice of the communicator;communication time, location and the form; pay attention to the communication protocol; using a comprehensible language communication;stand in the perspective of patients in order to enhance the doctor-patient trust and im-prove the doctor-patient relationship.

AIM: To explore the effect of early posterior approach vitrectomy in the treatment of penetrating ocular trauma with intraocular foreign body.METHODS: Totally 10 cases of penetrating ocular trauma with intraocular foreign bodies(IOFB) in the past two years were included.Emergency vitrectomy, intraocular foreign body removal and silicone oil tamponade were performed by the same surgeon.Antibiotics and steroids were given after surgeries.Retinal photocoagulation was done according to fundus conditions after surgeries.RESULTS: One patient combined with preoperation endophthalmitis and severely damaged retina failed to recover, eventually came to phthisis bulbi.Vitrectomy and IOFB removal were all successfully performed in the other patients.The postoperation follow-up time was 3-18mo.Two of the patients received secondary vitrectomy and silicone replacement surgeries due to recurrent retinal detachment.The remaining patients had no further bleeding with intraoclar pressure(IOP) 8-21mmHg.At the last follow-up, three of them gained best corrected visual acuity better than 0.1, two patients had visual acuity of 0.01 to 0.1 and four patients had poor visual acuity of light perception to FC/50cm because of macular damage.The patient with phthisis bulbi had no light perception.CONCLUSION: Early vitrectomy, foreign body removal and silicone oil tamponade is an effective treatment for patients with penetrating eyeball injury with IOFB.

Objective To investigate the molecular biological mechanism of deposition of triglyceride(TG)in hepatocytes in alcoholic fatty liver disease(AFLD)and the pathogenesis of this condition by detecting the contents of serum tumor necrosis fac-tor-α(TNF-α),liver triglyceride(TG),peroxisome proliferator-activated receptorα(PPARα)and acyl-CoA oxidase(Acox1)mR-NAs,and liver PPARαprotein after intervention with bezafibrate,a PPARαagonist.Methods Sixty Wistar rats were randomly divided into three groups:control group(n=20),AFLD group(n=20),and bezafibrate group(n=20).Animals in control group were given distilled water by gavage once a day for 8 weeks.Those in AFLD group were given ethanol and fish oil(2.5 mL/kg) by gavage daily for the same period of time.In bezafibrate group,rats were treated by gavage with ethanol and fish oil(2.5 mL/kg)for the first 4 weeks and then with bezafibrate(100 mg/kg)for another 4 weeks.TG in the liver was measured by colorimet-ric method,serum TNF-αlevels by enzyme linked immunoabsorbent assay (ELISA),the mRNA expression of PPARαand Acox1 in hepatocytes by reverse transcription polymerase chain reaction(RT-PCR)and the expression of PPARαprotein in hep-atocytes by Western blot.Results A significant increase in TG[AFLD group(0.72±0.09)mmol/L vs.control group(0.28± 0.07)mmol/L,P<0.01]and TNF-α[AFLD group(3.01±0.31)ng/mL vs.control group(1.07±0.28)ng/mL,P<0.01]was found in AFLD group when compared with control group.After bezafibrate intervention,the contents of liver TG and serum TNF-αwere significantly decreased.The mRNA expression of PPARα[AFLD group(0.22±0.08)vs.control group(0.68± 0.13),P<0.01]and Acox1[AFLD group(0.43±0.12)vs.control group(1.14±0.21),P<0.01]was suppressed in AFLD group,which was significantly reversed by bezafibrate treatment[bezafibrate group(0.59±0.13)for PPARαmRNA vs.AFLD group,P<0.01;bezafibrate group(0.83±0.17)for Acox1 mRNA vs.AFLD group,P<0.01].The expression of PPARαpro-tein in hepatocyts was also found to decrease in AFLD group[AFLD group(0.19±0.07)vs.control group(0.48±0.11),P<0.01].After bezafibrate intervention,it was profoundly increased.Conclusion The down-expression of PPARαand Acox1 in the liver of rats with AFLD may suppress the fatty acid metabolism and lead to the TG deposition in the liver.The increase in serum TNF-αcontents also contributes to the development of AFL.Bezafibrate can prevent and treat AFL by activating PPARα,increasing the expression of PPARαand Acox1 ,promoting the metabolism of fatty acids,decreasing the TG deposition and the serum TNF-αcontents.

Objective To analyze clinical features of primary hyperparathyroidism(PHPT)and to evaluate the diagnosis and treatment for PHPT.Methods 115 patients with PHPT undergoing surgery and confirmed by pathology from Jan.2006 to Mar.2014 were retrospectively analyzed.Results The clinical manifestations of PHPT were various.The rate of misdiagnosis was 70.0％(77/115).The positive rate of ultrasonography was 61.0％ (64/105),99Tcm-MIBI 88.3％(68/77)and CT 75.4％(46/61),respectively.The difference among the 3 tested methods had statistical significance (P＜0.05).89 cases with parathyroidoma underwent unilateral neck exploration,6 cases of parathyroid hyperplasia underwent bilateral neck exploration,3 cases with parathyroid carcinoma underwent carcinoma resection,ipsilateral thyroid lobe resection and ipsilateral central lymph node dissection,and 21 cases with thyroid benign or malignant lesions underwent suitable operations.97 cases developed hypocalcaemia of various degrees after operation,and the symptoms were relieved after use of calcium gluconate.Conclusions PHPT can be diagnosed according to the lever of serum calcium and PTH.Ultrasonography and 99Tcm-MIBI should be the first choice for preoperative localization.Unilateral neck exploration can be used for parathyroidoma with accurate localization.