Acupuncture Therapy ; Adult ; Aged ; Anesthetics ; administration & dosage ; Combined Modality Therapy ; Female ; Humans ; Intervertebral Disc Displacement ; drug therapy ; physiopathology ; therapy ; Male ; Middle Aged ; Nerve Block ; Spinal Nerve Roots ; drug effects ; physiopathology

Objective To observe any change in the laterality index (LI) in the active volume of the hand motor cortex during rehabilitation after acute cerebral infarction and to analyze the mechanisms involved in the rehabilitation of motor function.Methods Sixteen patients with acute cerebral infarcts were administered standard but individualized rehabilitation training.Blood oxygenation-dependent functional magnetic resonance imaging (BOLD-fMRI) was used to evaluate the active volume of their hand sensorimotor cortex (SMC) and the LI,at admission and after 14 days of rehabilitation.The Fugl-Meyer motor assessment for the hand (FMA) was used to evaluate hand function.Ten healthy volunteers were recruited as a control group and subjected to a single BOLD-fMRI examination to confirm the location and the volume of the active area when performing the same rehabilitation exercises.Results The baseline LI of affected hand SMC activation was significantly smaller than that of the unaffected hand [(0.010 ±0.808) versus (0.789 ± 0.157)],but no significant difference was observed between the affected and the unaffected hands after treatment.Rehabilitation therapy significantly increased the SMC LI of affected hand activation when compared with the baseline,but no such effect was observed with the unaffected hand.In 12 patients with dysfunction of the right hand as evaluated by the FMA,the baseline LI of the affected hand was smaller than that of the unaffected hand and that of the healthy volunteers.Conclusion Rehabilitation after acute infarction can promote functional recovery.The LI of the affected hand reflects cerebral plasticity during rehabilitation after acute cerebral infarction.

ObjectiveTo explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. MethodsEligible studies assessing the effects of BMI ranges on all-cause mortality(published from 1966 to 2012 )were searched, using hemodialysis/haemodialysis and obese/body mass index/overweight andmortality/surwival/reverse epidemiology/obesity paradox in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.ResultsWith no significant heterogeneity ( I2 =0％,P =0.45 ),a fixed-effects model was used for analysis.Four studies with a total of 81 423 patients met final inclusion criteria.Compared to individuals with non-elevated BMI levels,the elevated group (BMI ≥25 kg/m2) was associated with lower all-cause mortality ( OR 0.67,95％ CI 0.65-0.68 ). In a risk-adjusted sensitivity analysis,elevated BMI levels remained protective against mortality( adjusted HR 0.94,95％ CI 0.92-0.96 ).ConclusionsHigh BMI levels are associated with lower all-cause mortality rate in HD patients.More stable hemodynamic status,cytokine and neurohormonal alternations,and nutritional status maybe contribute to the protective effects of BMI on the mortality of HD patients.There is a need for more prospective studies to elucidate underlying mechanisms.

Objective To observe the outcome of the implementation of personalized enteral nutrition of severe acute pancreatitis patients. Methods 24 patients with severe acute pancreatitis admitted from June 1, 2013 to March 31, 2014 were divided into experimental group and control group according to the random number table method. Control group calculated the energy supply according to the basic energy expend formula while experimental group according to the actual enery expend formula. Hemoglobin, albumin, C-reactive protein, serum and urine amylase, complication rate, hospitalization time and cost changes were compared. Results 7 days after enteral nutrition, hemoglobin content and albumin content of experimental group were higher than those of control group [(130.50±17.60) g/L vs.(126.33±23.96) g/L, t=-4.231, P<0.05; (40.88±4.66) g/L vs.(36.29±3.45) g/L, t=-2.263, P<0.05]. And C-reactive protein of experimental group were lower than that of control group [(47.62±9.89) mg/L vs.(58.22±11.23) mg/L, t=3.618, P<0.05]. Hospitalization time and cost of experimental group were lower than those of control group [(22.50±5.85) d vs.(16.75±6.47) d, t=12.272, P<0.01; (36 364.76±2 162.08) yuan vs.(14 143.44±3 921.78) yuan, t=9.421, P<0.01]. Conclusions The implementation of personalized enteral nutrition is more hepful for the physiological requirements of individual patients, and not affect the pancreatic secretion. At the same time, inflammatory mediators can be reduced and also reduce the economic burden of patients and society.

BACKGROUND: Angiogenesis in atherosclerotic plaque occurred on the basis of atherosclerotic lesions, and the new formed blood vessels promoted the development of angiogenesis. Soluble vascular endothelial growth factor receptor 1 (sFlt-1) gene transfection reduces neointimal formation after vascular injury in rabbits, also reduces early vascular inflammation and proliferation, and the formation of neointima lately.
OBJECTIVE: To observe the effects of highly expressed sFlt-1 on atherosclerotic plaque.
METHODS: A total of 48 male New Zealand rabbits were divided into four groups randomly: normal control group (n=8), sham operation group (n=8), bal oon injury+high lipid diet+pEGFP-N1 group (n=16) and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group (n=16). Normal control group and sham operation group were supplied with normal diet. Bal oon injury+high lipid diet+pEGFP-N1 group and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group were supplied with high lipid diet and injured by bal oon 2 weeks later. Bal oon injury+high lipid diet+pEGFP-N1 group was transfected with pEGFP-N1 and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group was transfected with pEGFP-N1-sFlt-1.
RESULTS AND CONCLUSION: In the bal oon injury+high lipid diet+pEGFP-N1 group and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group, blood lipid levels apparently increased. At 3 days after model establishment, sFlt-1 expression levels noticeably increased, and atherosclerotic plaque formed to different degrees. Plaque area, plaque perimeter, plaque maximum thickness and the number of positive-cel s within the plaque were significantly less in the bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group than in the bal oon injury+high lipid diet+pEGFP-N1 group. These results confirm that sFlt-1 gene may express effectively in iliac artery wal of rabbit, inhibited the formation of atherosclerotic plaque and delayed the development of atherosclerotic plaque.

OBJECTIVE:To establish the talent training mode for pharmaceutical specialty in retail pharmacies based on mod-ern apprenticeship,and improve the teaching quality of pharmacy major in vocational colleges. METHODS:According to the basic content of talent training program,the contents including the talent training goal orientation,the recruitment mode,the teaching plan formulation,the curriculum system development,the teaching arrangement,the length of schooling and the certificate acquisi-tion were studied to analyze the feasibility of carrying out the modern apprenticeship of pharmaceutical specialty in retail pharma-cies. RESULTS:Pharmaceutical talents should master the necessary medicine theory,knowledge of relevant laws,regulations and stores management;the trained people could be an enterprise recruitment of employees,enrolled high school students or the two-screening-students;the practical skills training should be highlighted,both sides of school and enterprise should work together to develop the teaching plan formulation;and the curriculum development committee was established to determine the level of knowledge and ability that the retail pharmacies must know and to give the formation of the course;double subject education,dou-ble tutor teaching,work and study alternation were used in the teaching implementation;and flexible educational system was de-signed. CONCLUSIONS:The establishment of talent training mode for pharmaceutical specialty in retail pharmacies based on mod-ern apprenticeship can improve the teaching quality of pharmacy major in vocational colleges. However,the establishment of course system should consider the sustainable development of students,and cautiously set targeted courses based on the characteris-tics of talents requirements in retail pharmacies.

Objective To evaluate the clinical value of the regional wall motion in patients with suspected coronary artery disease by real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI). Methods A total of 143 hospitaized patients with suspected coronary artery disease and normal wall motion de?tected by two-dimensional echocardiography (2DE) were enrolled and devided into group A (coronary stenosis ≥75%) 73 cases and group B (coronary stenosis<75%) that include 70 cases according to coronary angiography results. Left ventricu?lar segmental ejection fraction (sEF) was measured by RT-3DE and peak systolic longitudial strain (SL) was measured by 2D-STI. ROC curves of the two measurements were generated and compared. Differences in sEF and SL between group A and group B were respectively analyzed. Results (1)Both sEF of RT-3DE and SL of 2D-STI in group A were significantly low?er than those in group B (P<0.05);(2)sEF was positively correlated with SL(r=0.689,P<0.05);(3)Compared with SL, sEF had larger area under ROC curve in some segments of left ventricle where both parameters are abnormal for the diagnosis of the coronary stenosis ≥75% (0.922 vs 0.874). Conclusion Regional wall motion of left ventricular can be measured by both RT-3DE and 2D-STI which can be both used to estimate the extend of stenosis of coronary artery. And RT-3DE is su?perior over 2D-STI.

Purpose To observe the curative effect of acupuncture on female urethral syndrome. Method A treatment group of 30 patients were treated with acupuncture at points Zhongji ( CV 3 ), Zusanli ( ST 36), Sanyinjiao ( SP 6), Shenshu ( BL 23 ), Pangguangshu ( BL28), Guanyuan (CV 4), Zhaohai (KI 6) and Zhonglushu ( BL 29). A control group of 28 patients were treated with capsule Norfloxacini and capsule Cystocaps.Results Of the treatment group, 26 patients had effectiveness and 4 had ineffectiveness; of the control group,2 patients had effectiveness and 26 had ineffectiveness.There was a significant difference in effective rate between the two groups (P＜0.01). Conclusion The curative effect of acupuncture on female urethral syndrome is better than that of routine treatment.

Objective To detect the distribution of site-174G/C,site-572C/G and site-597G/A of interleukin-6 gene promoter regions in patients with endometriosis,and to analyze polymorphism of the promoter.Methods Interleukin-6 gene promoter region polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism in patients with endometriosis(n=98)and normal controls(n=99).Among the 98 patients with endometriosis,22 were defined as stageⅡ,35 as stage Ⅲ and 41 as stage Ⅳ.Comparisons between the two groups on the genotype of IL-6 gene promoter and the distributed allele frequency were done,and also among the patients of stage Ⅱ,Ⅲ and Ⅳ once significant differences were detected in genotype frequency or allele frequency in disease group and control group.Results At the site-174,the frequencies of GG,GC and CC genotypes were 100%,0% and 0%,respectively,in patients with endometriosis,while 98.99%,1.01% and 0%,respectively,in normal controls.No significant difference was found in the distribution frequency of IL-6 genotype between patients with endometriosis and normal controls.At the site-572,the frequencies of CC,CG and GG genotypes were 55.10%,42.86% and 2.04%,respectively,in patients with endometriosis,while they were 70.71 %,28.28% and 1.01%,respectively,in normal controls.A significant difference existed between the two groups.At the site-597 of IL-6 gene,no GA and AA genotypes were found in the two groups.At the site-572,the frequencies of CC,CG and GG genotypes were 59.09%,40.90% and 0%,respectively,in patients with endometriosis of stage Ⅱ,54.29%,42.86% and 2.85% in patients of stage Ⅲ,and 53.66%,43.90% and 2.44% in patients of stage Ⅳ.No significant difference was found among the three groups.Conclusion Mutations at the sites-174 and-597 of IL-6 gene promoter region were rare.Their distribution frequencies have nothing to do with morbidity of endometriosis.While at the site-572,its distribution frequency of genotype shows correlation with morbidity of endometriosis but does not show correlation with the extent of endometriosis.

Objective To study the changes in pulmonary diffusing capacity (DL), alveolar capillary membrane diffusing capacity (Dm) and pulmonary capillary blood volume (Vc) in patients with severe acute respiratory syndrome (SARS), and to elucidate the underlying pathophysiogical mechanism of reduction of pulmonary diffusing capacity. Method Spirometry was performed in 26 SARS patients and 12 healthy individuals in resting condition. DLco were measured by single breath method, estimations of Dm and Vc were done by the method of Roughton and Forster. Results DLco in SARS patients was significantly lower than that in normal control, the same was true for Dm and Vc. The severer the pulmonary lesion, the heavier the damage to the pulmonary diffusing funetion. Conclusion The changes in Dm and Vc were both found in patients with SARS. Their measurements were helpful for detecting pulmonary involvement in SARS and defining the reason of DL abnormality in SARS. Dm and Vc were important and sensitive for monitoring pulmonary diffusing function in SARS patients