Objective To explore the clinical effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke depression (PSD). Methods Sixty PSD patients were randomly divided into an rTMS group and a control group, each of 30 patients. In addition to conventional treatment, rTMS group members were given high-frequency rTMS treatment for 10 d while the control group were given sham stimulation. In order to test the efficacy, the two groups were compared using the Hamilton depression rating scale (HAMD) before and after 10 and 30 days treatment. Results After 10 days of treatment the rTMS group had significantly lower HAMD scores than before treatment, and average HAMD scores differed significantly between the rTMS group and the controls, with the former performing significantly better. There was no obvious difference in HAMD scores after 30 days of treatment between the two groups. Conclusions High-frequency rTMS is a safe and effective treatment for PSD.

Background Leber hereditary optic neuropathy (LHON) is a disease characterized by maternal inheritance.A number of mitochondrial DNA (mtDNA) mutation has been thought to be associated with this disease.Objective This study was to investigate the clinical and molecular genetic properties of LHON in two Chinese families.Methods Forty subjects from two Chinese families with LHON were enrolled in Affiliated First Hospital of Zhengzhou University,including 28 maternal members (10 of these members are LHON and 12 controls from two families.All the participants had a complete ophthalmic examination including visual acuity,direct ophthalmoscopy,color sensation and visual evoked potentials.MtDNA was extract from the whole blood sample of all participants.PCR-DNA sequencing was performed to detect the point mutation of the G11778A,T14484C,and G3462A for each subject.Written informed consent was obtained from each subject prior to this study.Results Only G11778A point mutation was identified in all 28 maternal members from the two families.No point mutation of G11778A was identified in non-maternal members,and no point mutation of the T14484C and G3462A were found in the two families.Conclusions The inherited pattern of these two families shows typical clinical and genetic features of LHON.LHON patients with G1 1778A mutation have a poor prognosis of visual acuity.

Objective To investigate the antimicrobial resistance of Gram-positive cocci isolated from 17 hospitals located at different areas in China. Methods All the Gram-positive cocci isolated from 17 hospitals from October 1 st, 2004 to September 30th, 2005 were collected for susceptibility test using standard agar dilution method issued by The Clinical and Laboratory Standards Institute (CLSI,2004). The minimal inhibitory concentration (MIC)50 and MIC90 were detected for antibacterial activity in vitro of 35 antimicrobial agents. The rates of resistance, intermediate and susceptiblity of bacteria to the agents were calculated. Results Totally, 925 Gram-positive cocci strains were collected during the period, which included Staphylococcus 536, Enterococcus 249, Streptococcus 137 and other Gram-positive cocci 3; the rates of oxacillin resistant Staphylococcus aureus (ORSA) and oxacillin resistant Staphylococcus epidermidis (ORSE) were 62.9% and 82.9%, respectively. The penicillinnonsusceptible Streptococcus pneumoniae (PNSP) was 40.7 % including 10.5 % resistant and 30.2intermediate. All strains of Enterococcus were susceptible to teicoplanin. No Enterococcus was resistant to vancomycin. Five strains of Enterococcus were found intermediate to vancomycin, which were 1 E.faecalis, 2 E. faecium, 1 E. gallinarum and 1 E. avium. No glycopeptides resistant Gram-positive coccus was detected. Conclusions The antimicrobial resistance of Gram-positive cocci is increasing with higher isolate rate of penicillin-resistant Streptococcus pneurnoniae (PRSP) and methicillinresistant Staphylococcus aureus (MRSA). All the investigated Gram-positive cocci are highly resistant to macrolides. No glycopeptide resistant strains are detected during the surveillance.

Objective To discuss the imaging characteristics of renal cyst of high density.Methods Nine cases (5 women and 4 men; mean age,48 years; age range,31-79 years) with high density renal mass(>30 HU) were reviewed.For all patients,the symptom was intermittent lumbar pain in 2 patients,gross hematuria with lumbar pain in 1 patient,gross hematuria without pain in 1 patient.The other 5 patients were detected during routine physical examination without symptom.Preoperative examination included CT,MRI and DSA.Results All the patients had solitary and unilateral high density renal cysts,which size ranged from 2 to 5 cm in diameter.The cysts displayed predominantly hypoechoic or irregular internal echoes on sonography.Excretory urography showed an unenhanced round mass without further distinguishing characteristics.Their cystic features were con-firmed on nonenhanced and contrast-enhanced CT scans.MRI showed a round mass with long T1 and long T2 signal.Angiography revealed lack of vessels around the mass.All patients were operated by partial nephreetomy.There was no recurrence in all patients during the follow-up for 1-5 years.Conclusion Renal cyst of high density has many special features of imageology.

Sheng's acupuncture manipulation at bone-nearby acupoints is a set of needling manipulation of the chief physician of TCM, SHENG Xie-sun, summarized through his over 50 years clinical experiences and on the basis of Internal Classic. Regarding this manipulation, on the premise of acupoint selection based on syndrome differentiation, the acupoints close to bone are possibly selected and punctured, with the needle tip toward bone edge, and followed by the technique to achieve reducing purpose. Clinically, the significant immediate analgesia can be achieved in pain disorders such as headache and toothache. Professor Sheng thought, corresponding to the location of needle insertion and needling depth, the tissue layers of needle tip passing through should be considered specially. The site of needle insertion should be changeable so as to ensure the needle tip reaching the bone. This manipulation for analgesia provides a certain guide for acupuncture study, especially for the mechanism study on acupuncture analgesia.
Acupuncture ; education ; history ; Acupuncture Points ; Acupuncture Therapy ; history ; methods ; Bone and Bones ; physiopathology ; China ; History, 20th Century ; Humans ; Meridians ; Pain Management ; history ; methods

Objective To investigate the clinicopathological features ,diagnosis and differential diagnosis of primary leiomyo‐sarcoma of the thyroid gland .Methods The pathological characteristics and immunohistochemical features in a case of primary leio‐myosarcoma of the thyroid gland were analyzed and the relevant literatures were reviewed .Results Grossly ,the mass measured 5 .5 cm × 4 .0 cm × 3 .5 cm ,gray and yellow in cut surface and partial hard quality .Histologically ,the tumor was composed of spin‐dle cells ,arranging in bundles with obvious dysplasia ,nuclear mitosis was easily found .The tumor infiltrated thyroid follicles and in‐vaded surrounding tissues .The immunohistochemical study showed that Vimentin ,SMA ,Caldesmon and Actin were positive ,and CK ,CK8 ,EMA ,TTF‐1 ,P53 and LCA were negative .Conclusion Primary leiomyosarcoma of thyroid gland is extremely rare ,its diagnosis should be combined with clinical and imageologic data ,histological characteristics and immunohistochemistry .

Objective To compare fentanyl and sufentanil in total intravenous anesthesia for liver resection. Methods 100 patients undergoing liver resection were randomly received either sufentanil (group S, n = 50) anesthesia or fentanyl (group C, n = 50). Hemodynamic variables, time to spontaneous eye opening and extubation were recorded. VAS-scale was used to assess postoperative pain. The incidence of nausea & vomiting, agitation and respiratory depression was recorded and compared. Results Patients in group S had a more stable hemodynamic variables, and the incidence of postoperative pain (VAS: group S 4. 2± 1.1, group C 6. 1 ± 1.2), agitation (group S 2 cases, group C 11 cases) and respiratory depression (group S 1 case, group C 5 cases)was lower. Conclusions Both sufentanil and fentanyl were safe and efficacious in total intravenous anesthesia for liver resection. Compared with fentanyl, Sufentanil had higher hemodynamic stability, and lower incidence of postoperative pain, respiratory depression and agitation.

The infrastructure of Liberia has been destroyed due to the prolonged civil war.In this situation,it's critical for the Medical Contingent to have a good self-communication to carry out medical support for the United Nations Mission in Liberia.The communication instruments,their management and maintenance are introduced in this paper.The communication support for large-scale movement is emphasized on.The methods for using effectively the restricted Internet connection are discussed in detail.To cope with the problems of poor communication between the Medical Contingent and homeland,an Internet connection system is put forward which is based on VSAT(very small aperture terminal)hardware platform and subscription of international Internet connection.The system is believed to be reliable,economical,flexible and convenient.

Objective To evaluate the efficacy and safety of topotecan(TPT) in the treatment of advanced epithelial ovarian carcinoma. Methods 84 patients with advanced epithelial ovarian carcinoma received TPT(1.25mg/m~2) as a 30-minute infusion daily for 1-5 days,21 days for a cycle.The efficacy was evaluated after 2 cycles of chemotherapy.Response was confirmed 4 weeks later.Results In 84 selected patients,72 were assessable for response and 84 for toxicity.The overall response was 22.2%,including 2 CR and 14 PR.The response rate for untreated and recurrent advanced epithelial ovarian carcinoma was 25.0% and 20.8%,respectively.The main side effects were neutropenia and leukopenia.WHO grade III-IV of them were 26.1% and 26.1%,respectively.The non-hemotological toxicity was mild.Conclusion TPT is effective and well-tolerated in the treatment of advanced epithelial ovarian carcinoma,especially in recurrent patients.

Objective To prove the application of bilingual teaching in the child health care curriculum. MethodsEnglish dubbing and Chinese subtitling DVD coursewares of child growth and development were played to medical interns.The interns were asked to do questionnaires to examine feasibility and effectiveness. Results In 8-year program medical students,77.8% of them and 64.8% of the 5-year nutrition professional students could understand the contents of more than 90%.If there was no Chinese subtitles,the ratio were only 5.6% and 6.4%.Most students preferred English subtitles and dubbing,and endorsed the model of bilingual teaching. Conclusion DVD coursewares with Chinese subtitles and English dubbing can be widely used in the teaching of child health care.