Introduce the procedure and contents of qualified doctor tests for acupuncture and moxibustion in USA. The contents include 3 parts, examination of clean needle technique, point location examination and comprehensive examination including basic theories, basic knowledge, syndrome differentiation, diagnosis, treatment of commonly-seen diseases and so on in TCM, and illustrate with examples.
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Humans ; Medicine, Chinese Traditional ; Meridians ; Moxibustion

Research on the association between maternal periodontal disease and the risk of preeclampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the association between maternal periodontal disease and the risk of preeclampsia. A literature search of PubMed and Embase was performed to identify relevant papers published before March 2013. Only observational studies that assessed maternal periodontal disease and the risk of preeclampsia were selected. Patients' periodontal status was examined at different time points during pregnancy or after delivery (at 14-32 weeks of gestation, within 48 h prior to or within 5 days after delivery). Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated for cases and controls. Cases were defined as women with concurrent hypertension and proteinuria after 20 weeks of gestation. Eleven studies involving 1118 women with preeclampsia and 2798 women without preeclampsia were identified and analyzed. Women with periodontal disease before 32 weeks of gestation had a 3.69-fold higher risk of developing preeclampsia than their counterparts without periodontal disease (OR=3.69; 95% CI=2.58-5.27). Periodontal disease within 48 h prior to delivery was associated with a 2.68-fold higher risk of preeclampsia (OR=2.68; 95% CI=1.39-5.18). Pregnant women with periodontal disease within 5 days after delivery had a 2.22-fold higher risk of preeclampsia than women without periodontal disease (OR=2.22; 95% CI=1.16-4.27). In conclusion, this meta-analysis suggests that maternal periodontal disease is an independent predictor of preeclampsia.

Animals ; Animals, Newborn ; Cyclic AMP Response Element-Binding Protein ; analysis ; Hippocampus ; blood supply ; chemistry ; pathology ; Hypoxia-Ischemia, Brain ; physiopathology ; Immunohistochemistry ; Proto-Oncogene Proteins c-fos ; analysis ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; physiopathology ; Time Factors

BACKGROUNDA quantitative and accurate measurement of the range of hip joint flexion (RHF) is necessarily required in the evaluation of disordered or artificial hip joint function. This study aimed to assess a novel method to measure RHF more accurately and objectively.

METHODSLateral radiographs were taken of 31 supine men with hip joints extended or flexed. Relevant angles were measured directly from the radiographs. The change in the sacrofemoral angle (SFA) (the angle formed between the axis of the femur and the line tangent to the upper endplate of S1) from hip joint extension to hip joint flexion, was proposed as the RHF. The validity of this method was assessed via concomitant measurements of changes in the femur-horizontal angle (between the axis of the femur and the horizontal line) and the sacrum-horizontal angle (SHA) (between the line tangent to the upper endplate of S1 and the horizontal line), the difference of which should equal the change in the SFA.

RESULTSThe mean change in the SFA was 112.5 ± 7.4°, and was independent of participant age, height, weight, or body mass index. The mean changes in the femur-horizontal and SHAs were 123.0 ± 6.4° and 11.4 ± 3.0°, respectively. This confirmed that the change of SFA between hip joint extension and hip joint flexion was equal to the difference between the changes in the femur-horizontal and SHAs.

CONCLUSIONSUsing the SFA, to evaluate RHF could prevent compromised measurements due to the movements of pelvis and lumbar spine during hip flexion, and is, therefore, a more accurate and objective method with reasonable reliability and validity.

Adult ; Hip Joint ; diagnostic imaging ; surgery ; Humans ; Male ; Radiography ; Range of Motion, Articular ; physiology ; Sacrum ; diagnostic imaging ; surgery ; Young Adult

To screen an efficient recombinant Staphylococcus aureus protein A (SpA) for preparing matrix for affinity purification of immunoglobulin G (IgG), a genetic engineering approach was used to obtain monomer, two, three, four and five tandem repeats genes of the Z domain of SpA, then the genes were cloned into expression vector pET-22b and subsequently expressed in Escherichia coli BL21 (DE3). After induction with lactose, the target proteins were purified by Ni2+ affinity chromatography. The proteins with two, three, four and five tandem repeats of the Z domain were then coupled to CNBr-activated Sepharose 4B as an affinity chromatography matrix for affinity purification of human IgG. Furthermore, the differences in protein yield and IgG-binding capacity at different recombinant proteins were analyzed. The target proteins with monomer and tandem repeats of the Z domain had an effective expression in the genetic engineering bacteria. IgG could be specifically absorbed from human plasma by affinity chromatography. The protein yield and amount of IgG absorption of per mole protein could be improved by increasing the tandem repeats number of the Z domain. Compared with other tandem repeats, four tandem repeats of the Z domain exhibited more protein yield (160 mg/10 g wet cells) and higher level of IgG absorption (34.4 mg human IgG/mL gel). Therefore, four tandem repeats of the Z domain is more suitable for preparing matrix for affinity purification of IgG.
Adsorption ; Bacterial Proteins ; biosynthesis ; genetics ; Chromatography, Affinity ; methods ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Humans ; Immunoglobulin G ; isolation & purification ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; metabolism ; Staphylococcal Protein A ; biosynthesis ; genetics ; Tandem Repeat Sequences

OBJECTIVETo investigate the proper anticoagulation intensity in patients after mechanical heart valve replacement in china.

METHODSThe anticoagulation therapy intensity and the complications in 480 patients after mechanical heart valve replacement were studied.

RESULTSThe follow-up rate was 89.17%, the total patient-years (Pty) was 2,110.04 years, the mean oral import warfarin dosage was (2.81 +/- 0.95) mg/day, and native warfarin dosage (2.38 +/- 0.46) mg/day. The mean PTR value of 2 116 samples was 1.43 +/- 0.26, and the INR value of 1 195 samples was 1.63 +/- 0.49. The total hemorrhage rate was 4.60% Pty, and the hemorrhage death rate was 0.38% Pty. The PTR and INR values were higher in the hemorrhage group than in the no-hemorrhage group. (t = 1.816, P < 0.05; t = 2.407, P < 0.01). The thromboembolism rate was 0.66% Pty, and the thromboembolism death rate was 0.05% Pty. There were 15 pregnancies in 14 women patients and no malformed newborns were found.

CONCLUSIONSThe most important complication of anticoagulation therapy after mechanical heart valve replacement is hemorrhage in china; The proper anticoagulation intensities of this group are INR 1.5-2.0 and PTR 1.3-1.5. It is beneficial to adopt the low intensity anticoagulation therapy for decreasing the death rate from hemorrhage, protecting pregnant women and newborns from hemorrhage and malformation, and improving the life qualities of the patients.

Adolescent ; Adult ; Aged ; Anticoagulants ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Follow-Up Studies ; Heart Valve Prosthesis Implantation ; adverse effects ; methods ; Hemorrhage ; chemically induced ; prevention & control ; Humans ; Male ; Middle Aged ; Postoperative Care ; Postoperative Complications ; etiology ; prevention & control ; Pregnancy ; Thromboembolism ; chemically induced ; prevention & control ; Warfarin ; administration & dosage ; adverse effects ; therapeutic use ; Young Adult

OBJECTIVETo investigate the expressions of vascular endothelial growth factors (VEGF)-A, -C and -D and their prognostic significance and relation to angio- and lymphangiogenesis in gastric cancer.

METHODSThe expression of VEGF-A, -C and -D in 123 primary gastric cancers was detected by immunohistochemical staining. The lymphatic vessel density (LVD) and microvessel density (MVD) were assessed after immunohistochemical double-staining with D2-40 and CD34, respectively. The correlation between the expression of those VEGF factors and clinicopathological parameters were analyzed by univariate method. The overall survival was evaluated by Kaplan-Meier method and log-rank test. Multivariate analysis was carried out using Cox proportion hazard model.

RESULTSThe positive expression rate of VEGF-A, -C and -D in primary gastric cancer samples were 64.2%, 65.9% and 41.5%, respectively. High expression of VEGF-A, or -C or -D, or any two of them was correlated with high LVD (P < 0.05). High expression of both VEGF-A and -C was associated with high MVD, lymph node metastasis, LVI and MVI (P < 0.05). Both VEGF-C and -D high expression was correlated with LVI and lymph node metastasis (P < 0.05). The patients with high expression of these factors had a statistically shorter overall survival (P < 0.05). The patients with both VEGF-A and -C expression had the shortest survival (56 months). Multivariate analysis showed that VEGF-A high expression, MVD, lymph node metastasis and depth of tumor invasion were independent survival predictors (P = 0.033, 0.002, 0.019 and P < 0.001, respectively).

CONCLUSIONHigh expression of both VEGF-A and -C imply high potential of lymphangiogenesis, metastasis and poorer survival in gastric cancer patients. High expression of VEGF-C and -D may induce lymphangiogenesis and promote lymph node metastasis, but only VEGF-A is an independent predictor of survival.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Microvessels ; pathology ; Middle Aged ; Neovascularization, Pathologic ; Proportional Hazards Models ; Stomach Neoplasms ; metabolism ; pathology ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor C ; metabolism ; Vascular Endothelial Growth Factor D ; metabolism

Research on the association between maternal periodontal disease and the risk of preeclampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the association between maternal periodontal disease and the risk of preeclampsia. A literature search of PubMed and Embase was performed to identify relevant papers published before March 2013. Only observational studies that assessed maternal periodontal disease and the risk of preeclampsia were selected. Patients' periodontal status was examined at different time points during pregnancy or after delivery (at 14-32 weeks of gestation, within 48 h prior to or within 5 days after delivery). Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated for cases and controls. Cases were defined as women with concurrent hypertension and proteinuria after 20 weeks of gestation. Eleven studies involving 1118 women with preeclampsia and 2798 women without preeclampsia were identified and analyzed. Women with periodontal disease before 32 weeks of gestation had a 3.69-fold higher risk of developing preeclampsia than their counterparts without periodontal disease (OR=3.69; 95% CI=2.58-5.27). Periodontal disease within 48 h prior to delivery was associated with a 2.68-fold higher risk of preeclampsia (OR=2.68; 95% CI=1.39-5.18). Pregnant women with periodontal disease within 5 days after delivery had a 2.22-fold higher risk of preeclampsia than women without periodontal disease (OR=2.22; 95% CI=1.16-4.27). In conclusion, this meta-analysis suggests that maternal periodontal disease is an independent predictor of preeclampsia.
Adult ; Female ; Humans ; Observational Studies as Topic ; Odds Ratio ; Periodontal Diseases ; physiopathology ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications ; physiopathology ; Risk Assessment ; statistics & numerical data ; Risk Factors

The paper is aimed to investigate the effect of cyclosporine A (CyA) on the pharmacokinetics of ginkgolide B (GB) in rats, and to look for the mechanism of the changes in pharmacokinetic behaviors of GB. GB concentration in plasma, brain homogenate and urine samples of rats was determined by LC-MS. Effects of CyA on plasma levels, brain distributions as well as urinary excretions after intravenous administration of GB were evaluated. CyA co administrated intravenously at 10 mg kg(-1) or 20 mg kg(-1) significantly increased AUC(0-360 min) (P < 0.01) and decreased total CL of GB in rats. While co administrated CYP3A inhibitor itraconazole (ICZ) has no appreciable effect on the pharmacokinetic behavior of GB. CyA increased the brain uptake of GB in a dose-dependent manner. The brain distribution of GB was significantly increased at 5 min by different doses of CyA (P < 0.001), while at 20 and 60 min only high dose of CyA could significantly increase the levels of GB in the brain (P < 0.01 and P < 0.001). Different P-gp inhibitors CyA or verapamil (VER) or digoxin (DGX) decreased the urinary GB excretion, the urinary excretion of GB in 0-8 h were about 34.8% (P < 0.001), 59.4% (P < 0.001) and 79.7% (P < 0.05) of the control, separately. No appreciable effect of ICZ was observed on urinary excretion of GB. Coadministration of P-gp inhibitors CyA could significantly increase the plasma level, accelerate the brain distribution and decrease the urinary excretion of GB.
Animals ; Cyclosporine ; pharmacology ; Ginkgolides ; pharmacokinetics ; Herb-Drug Interactions ; Lactones ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Tissue Distribution

Objective To compare the diagnostic results and values among Duke criteria,St Thomas criteria,the modified Duke criteria and domestic criteria for the diagnosis of infective endocarditis (IE) in children.Methods Forty-five children were clinically diagnosed IE,the surgical or the pathologic or autopsy findings were served as the golden criteria for the diagnosis of IE.The children were classified by Duke criteria,St Thomas criteria,the modified Duke criteria and domestic criteria respectively,so as to compare the sensitivity and specificity and accuracy of all criteria for the diagnosis of IE.Results During the forty-five children were clinically diagnosed IE,of whom 32 cases with IE were confirmed by the surgical or the pathologic or autopsy findings; 13 cases were ruled out from the diagnosis of IE.The specificity of Duke criteria,the modified Duke criteria and domestic criteria were all 100％,but the specificity were 92.3％ in St Thomas criteria for the 45 cases with clinically diagnosed IE and 26 cases with negative blood culture.For the children with clinically diagnosed IE,the sensitivity and the accuracy were 90.6％ and 93.3％ in domestic criteria,62.5％ and 73.3％ in Duke criteria and the modified Duke criteria,87.5％ and 88.9％ in St Thomas criteria.For the children with negative blood culture,the sensitivity and the accuracy were 76.9％ and 88.5％ in domestic criteria,7.7％ and 53.8％ in Duke criteria and the modified Duke criteria,69.2％ and 80.8％ in St Thomas criteria.The Youden index had no significant difference among domestic standard and Duke standard,Duke modified standard,St Thomas standard for children clinically diagnosed IE (P ＞ 0.05) ; however,the significant difference of the Youden index among domestic standard and Duke standard,Duke modified standard for children with negative blood culture were found(P ＜ 0.01),no significant difference of the Youden index between domestic standard and St Thomas standard was found (P ＞ 0.05).Conclusions With the addition of echocardiographic evidence of endocardial involvement,2 minor criteria as definite diagnostic criteria and some clinical minor criteria,the sensitivity and accuracy of the domestic criteria is superior to those of the Duke criteria,St Thomas criteria and the modified Duke criteria,and the domestic criteria is more suitable for the diagnosis of IE in Chinese children.