OBJECTIVETo probe factors of influencing therapeutic effects of acupuncture in the patient of insomnia.

METHODSAccording to scores of degrees of anxiety and depression, 52 cases of insomnia were divided into 3 groups, group I (mild or less degree) and group II (moderate degree) and group II (serious degree). The Pittsburgh sleep quality index (PSQI) were compared before and after treatment in the 3 groups, and between two groups after treatment. Results There were significant differences in the therapeutic effect as the groups I, II compared with the group III (P < 0.01). The total sleep quality in the group I was better than that in the group II (P < 0.05).

CONCLUSIONThe degree of anxiety and depression in the patient of insomnia is one of important factors influencing therapeutic effect of acupuncture on insomnia.

Acupuncture Therapy ; Anxiety ; Depression ; Depressive Disorder ; Humans ; Sleep Initiation and Maintenance Disorders

OBJECTIVETo investigate the hearing change when chronic tinnitus acute aggravated and the affect of prognosis due to hearing change.

METHODSThe pure tone threshold and acoustic immittance were used for every case in the acute aggravation of chronic tinnitus (AACT) group, and for some of AACT group members the auditory brainstem response (ABR), distort-product otoacoustic emission (DPOAE), electrocochleogram (EcochG), glycerin test and MRI were used at the same time for further diagnosis. For the chronic tinnitus, the patients accepted the intervention of tinnitus retraining therapy (TRT) both for the AACT group and the control group. As for the recent hearing loss appeared in the AACT group members, the patients were treated the cases as the sudden deafness, and then the hearing characteristic of the AACT group was analyzed and the effect of the chronic tinnitus both for the AACT group and control group after the TRT for 3, 6, 9 and 12 months was evaluated.

RESULTSThree kinds of hearing changes appeared when chronic tinnitus acute aggravated. Based on the dated high frequencies hearing loss ranged 4-8 kHz, recent hearing loss appeared in 1-2 middle frequencies near the impaired high frequencies; Based on the dated single middle frequency hearing loss, another middle frequency hearing impaired near the dated hearing loss frequency, the sawtooth-like audiogram changed to groove-like audiogram; Hearing fluctuation in low frequency area, hearing threshold increased 10-30 dB in 125-1000 Hz but kept unchanged in the high frequency area. The recent local frequency hearing loss healed after the vasodilator and neurotrophic drugs therapy, but the dated hearing loss can't rehabilitate. Along with the rehabilitation of recent local hearing loss, 25 of 32 cases chronic tinnitus victims get to habituation; this finding showed that the experience of tinnitus aggravation and relief accelerated the habituation. Until the 12 months after the TRT, the curative effect difference between AACT group and control group showed statistical significance.

CONCLUSIONSWhen the chronic tinnitus acute aggravated, 3 kinds of local area hearing impaired. Timely diagnosis and effective treatment had brought not only hearing rehabilitation but also promotion to habituation of chronic tinnitus.

Adult ; Audiometry, Pure-Tone ; Auditory Threshold ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Tinnitus ; diagnosis ; physiopathology ; therapy ; Treatment Outcome

OBJECTIVETo observe mid- and long-term changes in the histopathology and electron microscopic characteristics of the acellular dermal matrix engrafted with thin split-thickness skin autograft.

METHODSTwenty-three biopsy samples were collected from 17 patients undergoing extremity scar resection, who received subsequent grafting using allogenic dermal matrix dressed with thin split-thickness skin autografts. Six months to 2 years after the grafting, the grafts were sampled for histopathological and electron microscopic observations of the layer of the epidermis, thickness of the basal membrane, structural components of the dermis, and infiltration of fibroblasts and revascularization. The data were compared with those of the normal skin samples from the patients.

RESULTSOnly the number of epidermal layers showed statistically significant difference between the skin grafts and the normal skin (16.33-/+5.89 vs 26.57-/+3.46, P=0.007). The thickness of the basal membrane of the skin grafts was similar to that of normal skin, and no significant difference was found in the number of fibroblasts and newly generated capillaries between them.

CONCLUSIONThe mid- and long-term histopathology and ultrastructures of the composite skin graft in the extremities are similar to those of normal skin, suggesting satisfactory effect of the skin grafts.

Adolescent ; Burns ; surgery ; Child ; Child, Preschool ; Cicatrix ; surgery ; Dermis ; transplantation ; ultrastructure ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Male ; Skin ; ultrastructure ; Skin Transplantation ; methods ; Skin, Artificial ; Transplantation, Autologous

BACKGROUNDT-cell receptor (TCR) plays an important role in the development of autoimmune diseases. Recently, it was reported that immunization of animals with TCR peptide derived from the pathogenic cells could prevent autoimmune diseases. The aim of this study was to investigate whether vaccination with a synthetic peptide from the hypervariable region of TCR V(beta) 8.3, an experimental autoimmune uveoretinitis (EAU)-associated gene, was able to prevent the disease.

METHODSEAU was induced in Lewis rats by immunization with IRBP R16 peptide emulsified in complete Freund's adjuvant (CFA). The clinical and histological appearances were scored. Delayed type hypersensitivity (DTH) and lymphocyte proliferation were detected. Cytokine levels of aqueous humour, supernatants of cells from spleen and draining lymph nodes were measured by enzyme linked immunosorbent assay (ELISA). Gene expression of TCR V(beta) 8.3 on CD(4)(+) T cells was examined by real time quantitative polymerase chain reaction (PCR).

RESULTSAfter vaccination, the intraocular inflammation was significantly mitigated, antigen specific DTH and lymphocyte proliferation responses were suppressed, interleukin (IL)-2 in aqueous humour, interferon (IFN)-gamma and IL-2 produced by the spleen and draining lymph node cells were significantly decreased, whereas the production of IL-4 and IL-10 were increased. The response of draining lymph node cells to TCR V(beta) 8.3 peptide was enhanced after vaccination. Inoculation with CFA alone did not affect the severity of EAU and the above parameters. The suppression of EAU was much stronger in the group of four fold inoculations than the group of two fold inoculations. The expression of TCR V(beta) 8.3 gene was significantly reduced in the group of fourfold inoculations.

CONCLUSIONVaccination with the synthetic TCR V(beta) 8.3 peptide could remarkably inhibit the development of EAU.

Animals ; Autoimmune Diseases ; prevention & control ; Cytokines ; biosynthesis ; Female ; Genes, T-Cell Receptor beta ; Rats ; Rats, Inbred Lew ; Receptors, Antigen, T-Cell, alpha-beta ; immunology ; Retinitis ; prevention & control ; Retinol-Binding Proteins ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Uveitis ; prevention & control ; Vaccination

OBJECTIVETo evaluate the efficiency, feasibility and safety of gasless endoscopic thyroid surgery through compared research.

METHODSFrom July 2001 to Oct. 2005, 83 cases that had received gasless endoscopic thyroid surgery were compared with 80 cases that had received conventional surgery and analyzed on operating time, blood loss, cosmetic effects, complications and costs.

RESULTSCompared with conventional thyroid surgery, endoscopic thyroid surgery group had better cosmetic effects. There was only minimal neck wound or even no neck wound. The cost of hospitalization in the endoscopic group was higher than that in the conventional group (10,844 +/- 2373) RMB and (7585 +/- 1081) RMB respectively (t = -7.23, P < 0.001). The endoscopic group had less blood loss than the conventional group (25 +/- 21) ml and (36 +/- 23) ml respectively (t = 3.160, P < 0.01), but had longer operating time (107 +/- 30) min and(79 +/- 19) min respectively (t = -7.225, P < 0.01). However, when the surgeon had got more experiences and applied the advanced harmonic scalpel, the operative time and blood loss reduced obviously.

CONCLUSIONSCompared with conventional thyroid surgery, gasless endoscopic thyroid surgery has the major advantage that it has cosmetic effect and has small or no scar left on neck. It can be concluded that this technique was efficiency, feasibility and safety. It can offer another choice for the thyroid neoplasms patients.

Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Thyroid Diseases ; surgery ; Thyroid Gland ; surgery ; Thyroidectomy ; methods ; Young Adult

OBJECTIVESTo investigate the effect of four types of neck dissections for the recurrent and persistent lymph nodes of NPC after radiotherapy.

METHODSThe clinical data of 88 cases of nasopharyngeal carcinoma with recurrent and persistent lymph nodes after radiotherapy were analyzed retrospectively, the 5-year survival rate, recurrent rate, distant metastatic rate and surgical complications were analyzed. The survival rate and recurrent rate of the radical neck dissection (RND), modified radical neck dissection (MRND), selective neck dissection (SND) and lymph node resection (LNR) were compared. The survival and recurrent rate between those with and without postoperative radiotherapy were investigated as well.

RESULTSThe 5-year survival rate and recurrent rate of whole group were 42.8% and 22.7%, respectively. As for the patients with disease staged II, III, IV, the 5-year survival rates were 56.7%, 36.1% and 32.4%, respectively. The 5-year survival rate of groups of RND, MRND, SND and LMR were 39.8%, 60.0%, 37.9% and 44.1%, respectively, the differences were insignificant (Log Rank = 1.0, P = 0.8011), the recurrent rate of the lymph node among the 4 groups were insignificant either (chi2 = 0.470, P = 0.493). The 5-year survival rates of those with and without postoperative radiotherapy were 39.1% and 45.3%, respectively, the differences were insignificant (Log Rank = 0.06, P = 0.8138), the recurrent rate of the two groups were insignificant (chi2 = 0.593, P = 0.441).

CONCLUSIONSThe four types of neck dissection were effective and safe to control the recurrent and persistent lymph nodes in the neck after radiotherapy, as long as choosing patients rationally and gave postoperative radiotherapy if necessary.

Adult ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; surgery ; Neck Dissection ; methods ; Neoplasm Recurrence, Local ; surgery ; Neoplasm, Residual ; surgery ; Treatment Outcome

OBJECTIVETo explore the difference between familial and sporadic nasopharyngeal carcinoma patients on risk factors and family history and provide evidence on genetic counseling and screening strategy for relatives of nasopharyngeal carcinoma patients in Guangdong province.

METHODSThe Cantonese nasopharyngeal carcinoma patients diagnosed in Cancer Center, Sun Yat-sen University from October, 2005 to October, 2007 were recruited as subjects. 1877 patients were collected, including 181 familial nasopharyngeal carcinoma patients and 1696 sporadic nasopharyngeal carcinoma patients. The demographic characteristics, clinical characteristics, risk factors and family history between two groups were compared. Moreover, the distribution of nasopharyngeal carcinoma patients in first-degree relatives and the time interval between proband and the affected first-degree relatives in familial nasopharyngeal carcinoma patients was analyzed.

RESULTSAll 9.64% of 1877 nasopharyngeal carcinoma patients had affected relatives in first-degree relatives, among them, 58.49% (124/212) were siblings and 41.51% (88/212) were parents. The mean time interval between siblings and proband were (7.40 +/- 5.41) years while the mean time interval between parents and proband were (15.55 +/- 10.61) years when nasopharyngeal carcinoma occurred, and the difference was statistically significant (t = -5.78, P < 0.01). More than 80% patients of the two group were at advanced stage when they were diagnosed. There were no difference (P values were all > 0.05) both in adulthood and childhood in salted fish (OR = 1.01; 95% CI: 0.59 - 1.75 vs OR = 1.31; 95% CI: 0.92 - 1.86), preserved vegetables (OR = 0.93; 95% CI: 0.58 - 1.49 vs OR = 1.12; 95% CI: 0.80 - 1.57), fermented pastes (OR = 0.37; 95% CI: 0.14 - 1.01 vs OR = 1.61; 95% CI: 0.99 - 2.48), fresh fruits (OR = 0.87; 95% CI: 0.60 - 1.26 vs OR = 0.65; 95% CI: 0.20 - 2.12) and cured meat (OR = 1.26; 95% CI: 0.87 - 1.83 vs OR = 1.28; 95% CI: 0.71 - 2.30) diet. No significant difference (P > 0.05) was obtained on smoking (OR = 0.99; 95% CI: 0.68 - 1.45) and incidence of other cancers in first-degree relatives (OR = 0.85; 95% CI: 0.56 - 1.28) in the two groups.

CONCLUSIONFamilial nasopharyngeal carcinoma was 9.64% in the observed subjects. In the familial nasopharyngeal carcinoma, the time interval at diagnosis was shorter between proband and siblings as compared with parents. Most of the patients were at advanced stage. So, we recommend the first-degree relatives of nasopharyngeal carcinoma patients, especially siblings, should be screened regularly according to the specific conditions.

Adult ; China ; epidemiology ; Female ; Genetic Predisposition to Disease ; Humans ; Incidence ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; epidemiology ; genetics ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo evaluate the diagnosis and surgical treatment of obstructive azoospermia.

METHODSWe analyzed the clinical data of 56 cases of obstructive azoospermia, 43 of them with ejaculatory duct obstruction (EDO), and the other 13 suspected of epididymal obstruction. The diagnostic methods included semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, transrectal ultrasonography (TRUS), and vasography when necessary. The 43 patients with EDO were treated by transurethral resection of the ejaculatory duct (TURED), and 11 of the 13 cases of suspected epididymal obstruction were confirmed by scrotal exploration and underwent either bilateral or unilateral vasoepididymostomy. The patients were followed up for 3 -51 months for postoperative semen quality and impregnation.

RESULTSOf the 43 azoospermia patients with EDO treated by TURED, 36 (83.7%) showed improved semen parameters and 11 (25.6%) achieved pregnancies. Among the 11 cases of azoospermia with confirmed epididymal obstruction treated by vasoepididymostomy, 6 (54.5%) had sperm in the semen assay and 3 (27.3%) achieved pregnancies.

CONCLUSIONSemen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, TRUS and vasography are important diagnostic methods for obstructive azoospermia. TURED is effective for azoospermia with EDO, while vasoepididymostomy is preferable for the treatment of azoospermia with epididymal obstruction.

Adult ; Azoospermia ; etiology ; surgery ; Epididymis ; pathology ; surgery ; Humans ; Male ; Radiography ; Rectum ; diagnostic imaging ; Treatment Outcome ; Ultrasonography ; Vas Deferens ; diagnostic imaging ; surgery

No abstract available.
Humans ; Interferon-gamma* ; Pityriasis Rosea*

OBJECTIVETo determine the value of concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma from the mainland of China.

METHODSData were extracted from randomized trials comparing chemotherapy plus radiotherapy with radiotherapy alone in locally advanced nasopharyngeal carcinoma. Actuarial rates of survival and distant metastases were calculated. The followed electronic databases were searched the Chinese Biomedicine database, Pubmed, Medline, Embase and Cochrane library; Data were extracted by tow reviewers and Review manager 4.1 software was applied for statistical analysis.

RESULTSEighteen trials with 1993 patients were include according to the including criterion. The 3-year overall survival rate of the chemoradiotherapy group and the radiotherapy group were 68.47% and 56.38% respectively, and the 5-year overall survival rate of the two groups above were 51.91% and 41.09% respectively, while the distant metastases rate of the chemoradiotherapy group and the radiotherapy group were 26.19% and 38.71% respectively. The result demonstrated that chemoradiotherapy increased overall survival by 12% at 3 years, and 11% at 5 years after treatment. After chemoradiotherapy, the rate of distant metastasis was reduce by 12%.

CONCLUSIONSIn patients with locoregionally advanced nasopharyngeal carcinoma, chemoradiotherapy significantly improves overall survival at 3 years, and 5 years compared with radiotherapy alone.

Antineoplastic Combined Chemotherapy Protocols ; China ; Combined Modality Therapy ; Humans ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Radiotherapy ; Randomized Controlled Trials as Topic ; Survival Rate