The administration status of enteric coated aspirin in 348 diabetic patients aged over 40 from Xujiahui Subdistrict of Shanghai was surveyed. One hundred and two out 348 patients ( 29. 3% ) used aspirin regularly, among them only 36 cases used the correct dosage (75 - 162 mg/d), accounting for 10. 3% (36/348) of all patients surveyed. The results indicate that aspirin was not used properly in diabetic patients to prevent the heart and cerebrovascular diseases,and it is necessary for medical providers to promote health education for diabetic patients.

Objective To investigate the clinical features of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and the significance of anti-NMDAR antibody assay in clinical diagnosis.Methods Sixty-two patients were divided into 3 groups of encephalitis,encephalopathy and other central nervous system diseases based on their affliction. Anti-NMDAR antibody was detected by transfected cell-based indirect immunofluorescence assay in the serum and cerebrospinal fluid. The clinical features,laboratory tests,treatment and prognosis of NMDAR encephalitis were analyzed.ResultsAnti-NMDAR antibody was positive in serum and (or) cerebrospinal fluid of 9 patients (9/32,28％ ) from encephalitis group.The positive rate of anti-NMDAR antibody in cerebrospinal fluid was higher than that in serum of these patients.Among them,5 patients with higher antibody titer had impaired blood-brain barrier.No tumor was detected in these 9 patients.The most predominant symptoms of anti-NMDAR encephalitis include fever,psychiatric disturbances,seizures,dystonia and autonomic dysfunction.Brain MRI and electroencephalography were also abnormal. Patients were responsive to early immunotherapy. Conclusion Detection of the anti-NMDAR antibody may be important for early diagnosis and treatment of autoimmune encephalitis.

In the situation of global completion, collaborative innovation is becoming increasingly important because its advantage in risk avoiding and innovation efficiency. In order to explore the model of collaborative innovation and its evolution in traditional Chinese medicine of China, the cooperation in traditional Chinese medicine patents of China from 1985 to 2013 has been analyzed by using the method of scientometrics and social network analysis. It is proved that, though the number of grated cooperative patents has increased sharply during the last thirty years, the degree of cooperation innovation in traditional Chinese medicine of China is still not high. Moreover, in spite of the individual subject' s leading role in the past domestic collaborative innovation in traditional Chinese medicine of China, the institutions have been more and more powerful and achieved great improvement. At last, core institutions, represented by universities have played an important role in the collaborative innovation of domestic institutions, because they are key links between many institutions and promote the transferring and diffusion of knowledge.
Biomedical Research ; China ; Humans ; Medicine, Chinese Traditional ; psychology ; trends ; Nonprescription Drugs

Objective: To observe the efficacy of mild moxibustion combined with functional exercise in the treatment of upper-limb lymphedema after breast cancer surgery and its effect on serum vascular endothelial growth factor C (VEGF-C). Methods: Seventy-eight patients were divided into a control group and an observation group by the random number table method, with 39 cases in each group. The control group received functional exercise and the observation group received mild moxibustion plus functional exercise. The differences in circumference between the two upper limbs, the lymphatic flow of the affected upper limb, the disability of arm, shoulder and hand (DASH) score, the functional assessment of cancer therapy-breast (FACT-B) score and serum VEGF-C level between the two groups were compared before and after treatment. Efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). The difference in circumference between the two upper limbs of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The lymphatic flow of the affected upper limb of the two groups increased significantly after treatment (both P<0.05), but it was significantly greater in the observation group than in the control group (P<0.05). The DASH scores of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The FACT-B scores of the two groups increased significantly after treatment (both P<0.05), but it was significantly higher in the observation group than in the control group (P<0.05). After treatment, the serum VEGF-C level increased significantly in the observation group (P<0.05), whereas the control group did not show significant change (P>0.05). The post-treatment serum VEGF-C level was significantly higher in the observation group than in the control group (P<0.05). Conclusion: The efficacy of mild moxibustion combined with functional exercise for upper-limb lymphedema after breast cancer surgery is certain, which can reduce the difference in circumference between the two upper limbs, increase the lymphatic flow of the affected upper limb, improve the limb function and the quality of life, and regulate the serum VEGF-C level.

Adrenocorticotropic Hormone ; therapeutic use ; Brain-Derived Neurotrophic Factor ; physiology ; Child, Preschool ; Female ; Humans ; Methyl-CpG-Binding Protein 2 ; genetics ; Mutation ; Rett Syndrome ; drug therapy ; genetics

Combined with the features of clinical practice teaching of cardiothoracic surgery ,we discuss how to improve the quality of clinical practice teaching of cardiothoracic surgery and strengthen the cultivation of medicos'capability and diathesis,thus correctly guiding medicos to finish their interim study commendably and change their roles from students to doctors.

Objective To investigate the percentage of Th17 cells and regulatory T cells in patients with myasthenia gravis (MG) and observe the effects of methylprednisolone infusion on these cells.Methods The circulating Th17 cells and CD4+ CD25highT cells of 66 MG patients and 35 healthy controls were detected using four colour cytometry. The relationship between these cells and MGFA score in 18 MG patients and in 8 MG patients after methylprednisolone was infusion were also analyzed in this study. Results There was significant difference in the percentage of circulating Th17 cells between MG patients (2. 61% ±0. 28% ) and the healthy controls (0. 94% ± 0. 12%, Z = 4. 059, P = 0. 0001 ). Methylprednisolone therapy significantly reduced the percentage of circulating Th17 cells from 4. 72% ± 1.21% to 1.81% ± 0. 69%(Z = 1. 995,P = 0. 0460). In addition, the percentage of Th17 cells showed a positive correlation with MGFA score(r =0. 5359, P =0. 0219). Conclusions Circulating Th17 cells are elevated in MG patients.Methylprednisolone therapy can reduce such elevation, and this may be important in mediating symptomatic improvement in MG patients.

Objective To demonstrate the manifestations on positron emission tomographycomputed tomography (PET-CT) at different stages in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods PET-CT was performed in 10 patients with anti-NMDAR encephalitis at different clinical stages,and the images were analyzed to investigate the relation of metabolic patterns in the images with clinical presentations.Results Except for normal PET-CT images in 2 patients,images in 8 patients at early stage of the disease showed generally increased 2-[18F] fluoro-2-Deoxy-D-glucose(18F-FDG) uptake at frontal and temporal lobe,basal ganglion and cerebellum,indicating hyper-metabolism in these areas,while 2 of them also had mixture of hyper-and hypo-metabolism in parietal-occipital region.In longitudinal analysis of PET-CT images in these 8 cases,starting at basal ganglion,18 F-FDG uptake gradually decreased bilaterally,prominently at left dominant hemisphere and right cerebellum.Conclusions During the course of anti-NMDAR encephalitis,18F-FDG metabolism markedly increases at early stage and then gradually declines at late stage,at frontal,temporal,parietal and occipital lobes,basal ganglion and cerebellum,predominantly at left dominant hemisphere and right cerebellum.However,in relapsing anti-NMDAR encephalitis,18 F-FDG metabolism in brain does not show these characteristics.

Objective To evaluate the efficacy of midazolam combined with remifentanil for lower eyelid blephamoplasty.Methods In a double-blind study,200 patients undergoing lower eyelid blephamoplasty were randomly and equally divided into 2 groups (100 cases each):test group (midazolam 0.05 mg/kg and remifentanil 0.5 μg/kg followed by remifentanil 0.05 μg/(kg·min) and control group (midazolam 0.05 mg/kg).Heart rate (HR),mean arterial pressure (MAP),and pulse oxygen saturation (SpO2),respiratory rate (RR),SpO2 change,operation time,recovery time,the incidence of adverse reactions and the satisfactory rate of both patients and surgeons were monitored and recorded before the medication,3 min after the medication,at beginning of the surgery,during and immediately after the surgery,and 30 min after surgery.Results Two groups of patients had no obvious difference in intraoperative MAP,HR,RR,SpO2 and postoperative recovery time (P＞0.05);the incidence of postoperative nausea and vomiting in the test group was significantly higher than that in control group (P＜0.05); Patients and surgeons satisfaction in the test group was higher than that in control group (91.3±11.6)vs (52.7±10.4) (P＜0.05).Conclusions Midazolam combined with remifentanil for lower eyelid blephamoplasty has less inhibitory effect on circulatory and respiratory functions and the patients come round fast after surgery.But there are risks of respiratory inhibition in the induce phase and nausea and vomiting in the recovery stage.

Objective To explore the clinical feature,diagnosis,treatment and prognosis of Hashimoto′s thyroiditis(HT) combined with hyperthyroidism in children.Methods The clinical features of 56 children with HT combined with hyperthyroidism,including clinical features,complications,thyroid hormone,thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),the detection of ultrasonic imaging and fine needle aspiration biopsies,diagnosis,treatment and prognosis were analyzed.Results The proportion of men to women was 16 in all 56 children,and the mean age at diagnosis was(9.95?2.09) years.The percentage of positive TGAb and TPOAb were 93% and 98%,respectively in all the 56 children.One child was diagnosed as HT combined with hyperthyroidism coexistent and myasthenia gravis type Ⅰ.The duration of hyperthyroidism ranged from 3 to 24 months.There were 14 children who had hypothyrodism and 8 children were euthyroid in all the 56 children.Conclusions Children with HT hyperthyroidism are more frequent in young females.TGAb and TPOAb are important markers for the diagnosis of HT.Pharmacotherapy is the first choice to treat HT hyperthyroidism.Hyperthyroidism is a clinical process of HT,and the percentage of children with hypothyrodism is increasing along with the development of disease.