Objective: To observe the effect of muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting in improving nail fold microcirculation in the patients with shoulder-hand syndrome (SHS) after stroke, and the effects on hemorrheology, calcitonin gene-related peptide (CGRP) and serum substance P (SP). Methods: A total of 72 patients were randomized into an observation group and a control group by the random number table method, with 36 cases in each group. The control group was treated with physical rehabilitation training, and the observation group was treated with additional muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting treatment. The treatment course lasted for 4 weeks. After treatment, the clinical efficacy of the two groups was compared. The changes in shoulder-hand syndrome scale (SHSS), simplified Fugl-Meyer assessment-upper extremity (FMA-UE), visual analog scale (VAS), activities of daily living (ADL), traditional Chinese medicine (TCM) syndrome score, nail fold microcirculation hemorheology indictors [whole blood viscosity (high-shear, low-shear), hematocrit, erythrocyte sedimentation rate (ESR)], CGRP and SP levels were observed. Results: The total effective rate in the observation group was 86.1％, higher than 63.9％ in the control group (P<0.05). The overall curative effect in the observation group was better than that in the control group (P<0.05). After treatment, the scores of pain sensation, edema, external turn and rotation of the arm in SHSS, and the total score were significantly decreased in both groups (all P<0.05), and each score in the observation group was lower than that in the control group (all P<0.05). After treatment, the scores of VAS and TCM syndrome in both groups decreased significantly (all P<0.05), and the scores of FMA-UE and ADL increased significantly (all P<0.05). The scores of VAS and TCM syndrome in the observation group were lower than those in the control group (both P<0.05), and the scores of FMA-UE and ADL were higher than those in the control group (both P<0.05). After treatment, the whole blood viscosity (high-shear and low-shear) and hematocrit in both groups decreased obviously (all P<0.05), and ESR increased obviously (both P<0.05), and the whole blood viscosity (high-shear and low-shear) and hematocrit in the observation group were lower than those in the control group (all P<0.05), and ESR was higher than that in the control group (P<0.05). After treatment, the peritubular state, loop shape, blood flow and total score of nail fold microcirculation in both groups decreased significantly (all P<0.05), and each score in the observation group was lower than that in the control group (all P<0.05). After treatment, SP in both groups decreased obviously (both P<0.05), CGRP increased obviously (both P<0.05), and SP in the observation group was lower than that in the control group (P<0.05), CGRP was higher than that in the control group (P<0.05). Conclusion: Compared with conventional physical rehabilitation training, muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting treatment can significantly reduce the clinical symptoms of SHS, promote the recovery of physical functions, improve the nail fold microcirculation and hemorrheology indictors, and regulate the serum cytokine levels such as CGRP and SP.

Objective To evaluate beam-hardening (BH) artifact reduction of myocardium in coronary computed tomography angiography(CCTA)with single-source dual-energy CT. Methods Thirty patients received CCTA on single-source dual-energy CT with findings of coronary artery stenosis<50%were enrolled in this study prospectively. Scanning mode was gemstone spectral imaging (GSI), single-source instantaneous(0.5 ms)kVp(140 kVp and 80 kVp)switch. The original images acquired by scanning were
reconstructed into monochromatic energy (60,70,80,90,100,110,120,130,140 keV) left vertical short-axis images via 40% ASIR and the polychromatic left vertical short-axis images were conventionally reconstructed. CT values were measured across multiple segments (basal anterior, basal lateral, basal inferior , basal septal, mid anterior, mid lateral, mid inferior , mid septal, apical anterior, apical lateral, apical inferior , apical septal and apex)of left ventricle wall at varying monochromatic energy levels and polychromatic images, and then the left ventricular myocardial average CT value and BH objective value were calculated retrospectively:BH1=CT value of mid inferior wall-CT value of basal inferior wall ,BH2=CT value of mid septal wall-CT value of mid inferior wall. BH subjective rating were evaluated by two radiologists independently. Single sample t test was used to compare the difference of myocardial CT values among 13 segments with the left ventricular myocardial average CT value on polychromatic images ;Kruskal-Wallis test was used to compare the difference of CT values among thirteen different segments of myocardium on fixed monochromatic energy images; Wilcoxon rank test was used to compare the difference of BH objective value and subjective rating between monochromatic images with polychromatic images. Results On polychromatic images, the mean myocardial CT value was(73 ± 25)HU, the CT value of basic inferior[(58±23)HU], basic septal[(85±21)HU], mid septal[(89±24)HU], apical anterior[(64±23)HU]and apex [(61 ± 24)HU ] were different from the mean myocardial CT value(t value were -3.76,2.89,3.50,-2.30, -2.86,P all<0.05),the differences of CT value between other myocardial segments and the mean myocardial CT value had no statistical significance(P all>0.05). The differences of CT value of different myocardial segments had statistical significance at 60 to 80 keV images(P all<0.05), the differences of CT value of different myocardial segments had no statistical significance at 90 to 140 keV images(P all>0.05), suggesting that the non-uniformity of CT value among different segments was improved. On polychromatic images,BH1 M(P25,P75)was 11(6,28),BH2 M(P25,P75)was 19(1,29) HU. BH1 was improved on 90 to 140 keV images while BH2 was improved on 70 to 140 keV images, the difference had statistical significance compared with the polychromatic images(P all<0.05). BH1,BH2 decreased with the increasing of monochromatic energy level on 60 to 100 keV images, then increased a little on 110,120 keV images, and hit bottom on 130 keV images with the value of 5.20,0.34 HU ,finally exist a slight increase on 140 keV images again. On polychromatic images,BH1,BH2 subjective rating M(P25,P75)both were 1(1,2), BH1 subjective rating was improved on 70 to 140 keV images while BH2 subjective rating was improved on 90 to 140 keV , the difference had statistical significance compared with the polychromatic images(P all<0.05). Conclusion Compared with the polychromatic images,monochromatic energy images of CCTA with dual-energy CT resulted in significant BH artifact reduction and improvements in the uniformity in the myocardium, and 130 keV is the optimal Monochromatic energy.

Background The retina microglia play a eliminating effect on apoptotie cells in the neural retinal layer of normal rats during postnatal development.Milk fat globule epidermal growth factor 8(MFG.E8)can combine specifically with phosphatidylinositol serine of the surface of apoptotie cells and enhance macrophage phagoeytosis of apoptotic cells.Objective Present study was to evaluate the localization and expression of MFG-E8 and its relevant cytokines in the neural retinal layer of normal rats during postnatal development Methods Normal royal college of surgeon(RCS)rats were divided into P0,P3,P7,Pi4,P30,P45 groups according to their postnatal days,and the 30-day-old RCS rats(2 rats)served as controls.Double stain of M FG.E8 and microglial cells marker(CD11b)was performed by immunofluorescence.Expressions of MFG-E8,integrin β5,CD11b and interleukin-6(IL-6)mRNA in the neural retina were analyzed by real-time quantitative reverse transcription polymerase chain reaction(RT-PCR).The utilization of animals complied with the Regulation for the Administration of Affair Concerning Experimental Animals by State and Science and Technology Commission.Results MFG-E8 and CD11b were positively co-expressed in retinal ganglion cell layer and external plexiform layer with the green fluorescence for FITC-labeled IgG and red fluorescence for cy3-labeled lgG respectively in normal adult rats.RT-PCR showed that the mRNA of MFG-E8,integrin 85,CD11b and IL-6 was detectable at P0 rats.The expression level of these eytokines began to rise fterward and reached peak value at P14 rats and then declined gradually,showing significant differences among different ages groups in various cytokines mRNA expression(all P<0.05).Conclusion MFG-E8 can be specifically expressed in the neural layer of retina microglia in RCS rat.

OBJECTIVETo observe the differential effect of joint ultrasound on the syndrome differentiation of rheumatoid arthritis (RA) by observing the high frequency ultrasound performances among inactive stage and different syndromes in active stage.

METHODSTotally 83 RA patients in the active stage were assigned to the dampness heat syndrome group (DHS, 59 cases)and the cold dampness syndrome group (CDS, 24 cases) according to Chinese medicine (CM) syndrome typing. Besides, 20 RA patients in the remission stage were recruited as the control group (abbreviated as the remission group). By using high frequency ultrasound and power Doppler ultrasound technology, a comparative observation of synovitis, tenosynovitis, synovial blood flow, and bone erosion in the 2nd-5th metacarpophalangeal (MCP) joints, proximal interphalangeal (PIP) joints, wrist joints, knee joints, the second and the fifth metatarsophalangeal (MTP) joints (a total of 24 joints) was performed in all patients. Correlation analyses were performed between the ultrasound performance, laboratory indices, and the disease activity. Ultrasound data of each RA patient were analyzed by their total scores. Χ2 test was used for enumeration data. The measurement data was expressed as x ± s. One-way ANOVA was used for data of normal distribution, while non- parametric test was used for data of non-normal distribution. Correlation analysis of two variables was performed for clinical indicators and ultrasound indicators. Its significance was detected using Pearson correlation.

RESULTSCompared with the remission group, the severity degree of synovitis, tenosynovitis, synovial blood flow, and bone erosion significantly increased in the DHS group (P < 0.01). There was statistical difference in ESR, CRP, anti-CCP, DAS28 score, and the positive rate of RF (P < 0.05, P < 0.01). There was statistical difference in the severity degree of synovitis and synovial blood flow, and DAS28 score in the CDS group (P < 0.05). Compared with the CDS group, there was statistical difference in the four ultrasound indices (P < 0.05, P < 0.01), ESR, CRP, anti-CCP, DAS28 score, and the positive rate of RF in the DHS group (P < 0.05, P < 0.01). There was no statistical difference in G, IgG, IgA, or IgM among the three groups (P > 0.05). There existed positive correlation between ESR and the synovitis degree, synovial blood flow, and bone erosion in the DHS group (r = 0.444, 0.397, 0.486, P < 0.05).There existed positive correlation between ESR and the synovitis degree, bone erosion, and synovial blood flow in the DHS group (r = 0.378, 0.270, P < 0.05). There existed positive correlation between the DAS28 score and the synovitis degree and synovial blood flow in the DHS group (r = 0.304, 0.351, P < 0.05).

CONCLUSIONSThe inflammation degree was the most severe in RA patients of DHS. High frequency ultrasound could provide better evidence for Chinese medical syndrome differentiation of RA patients.

Arthritis, Rheumatoid ; diagnostic imaging ; Humans ; Medicine, Chinese Traditional ; Metacarpophalangeal Joint ; ultrastructure ; Syndrome ; Synovitis ; diagnostic imaging ; Ultrasonography

Objective To investigate the epiderniology of fungemia and provide evidence for clinical therapy.Methods A retro- spective survey was done with the 31 cases of fungemia in our hospital from August 2004 to November 2005.Results More than 80% of the patients suffered from two and more underlying diseases.Over a half of infections developed following placement of catheters.And 83.9% of the patients had a history of antimicrobial agents use before blood culture.The pathogens of 24 (77.4%) cases were associated with Candida spp.Only 3 strains were C.albicans.The mortality rate of candidemia was 45.8%.Different Candida species had different resistance rates to antifungal agents.Conclusions Fungemia patients often have serious underlying diseases.Most fungemia cases were candidemia caused by non-C.albicans.Some fungal pathogens are re- sistant to fluconazole and itraconazole.

OBJECTIVETo study a feasible method of measuring right ventricular pressure by catheterization in mice.

METHODSMeasuring the right ventricular pressure and the pulmonary artery pressure by homemade PE pipe through venous cannula in external jugular vein, using catheterization in mice with powerlab multimodal biometric signal recording system.

RESULTSForty-six out of 51 mice were experimented with this method smoothly and got a total success rate of 90.2%. Thirty of 33 normal mice and 16 of 18 mice with pulmonary arterial hypertension (PAH) were catheterized successfully. The right ventricular pressure were as follow: systolic blood pressure: (23.4 +/- 5.7) mmHg in normal group vs (32.2 +/- 2.8) mmHg in mice with PAH, diastolic blood pressure: (3.7 +/- 2.6) mmHg vs (3.8 +/- 2.0) mmHg, mean pressure: (12.0 +/- 3.7) mmHg vs (14.9 +/- 2.3) mmHg. After autopsy for those 5 failed cases, we found that 2 cases were into the inferior vena cava, another 2 cases pierced the right auricle and the last one punctured the axillary vein into the chest wall.

CONCLUSIONMeasuring the right ventricular pressure through venous cannula in external jugular vein with homemade PE pipe in mice gets not only a high success rate but also help to save time. Moreover, this method can be popularized easily. It is a good and feasible method for measuring right ventricular pressure in mice.

Animals ; Cardiac Catheterization ; methods ; Jugular Veins ; Male ; Mice ; Mice, Inbred BALB C ; Ventricular Pressure

Objective To investigate the apoptosis inducing effect of peroxisome proliferator-activated receptor r(PPARr)agomst on leukemic K562 cells and its mechanisms of action.Methods K562 cells in culture medium in vitro were given different concentrations of PPARragonist rosiglitazone(RGZ)(20-80 umol/L)for O,24,48 and 72h The inhibitory rate of the cells were measured by MTT assay,cell apoptosis was detected by Annexin V/PI staining,and the expression of P53 protein as well as the activity of caspase-3 were also detected.Results RGZ(over 40umoL/L)could inhibit the growth of K562 cells and cause apopto-sis remarkably,the suppression Was both in time-and dose-dependent manner.The expression of P53 pmtein was upregulated and the activity of caspase-3 Was increased concomitantly after the cells werle treated by RGZ.Conclusion PPARr agonist RGZ(over 40 umol/L)can induce apoptosis on K562 cells signifieantly,upregu-lation the expression of P53 protein as well as increasing caspase-3 activity may be one of its most important mechamisms.

Objective To quantitatively assess the cardiopulmonary exercise function of spinal cord injury (SCI) patients and observe the effect of aerobic exercise on cardiopulmonary function, motor function and activities of daily living. Methods From December, 2014 to June, 2016, 34 incomplete SCI patients (ASIA C and D) and 23 healthy controls received cardiopulmonary exercise test (CPET). SCI pa-tients were randomly divided into conventional rehabilitation group (n=17) and aerobic exercise group (n=17). The aerobic exercise group received aerobic exercise for four weeks. They were assessed with CPET, motor and sensory function, walking index for spinal cord injury II (WISCI II) and spinal cord independence measure (SCIM) before and four weeks after training. Results Oxygen uptake (VO2)peak, anaerobic threshold (AT), metabolic equivalent of energy (METpeak), VO2/heart rate (HR)peak, respiratory exchange rate (RER)peak, minute ventilation (VE)peak, work rate (WR)peak and systolic blood pressure (SBP)peak were lower in the patients than in the controls (t>2.714, P<0.05). VO2peak、AT、METpeak、VO2/HRpeak、WRpeak increased in the aerobic exercise group after training (t>2.431, P<0.05). METpeak and WRpeak improved in the conventional rehabilitation group after training (t>3.282, P<0.01). The scores of motor in ASIA and SCIM improved in both groups after training (t>2.985, P<0.05). Conclusion The cardiopulmonary function decreased in incomplete SCI patients, which could be improved by moderate intensity aerobic exercise.

Objective To investigate the clinical characteristics and treatments of endometrioid carcinoma patients with preoperative diagnosis of endometrial hyperplasia.Methods From 2005 to 2010, 404 patients were diagnosed with endometrioid carcinoma after hysterectomy.Among these patients,44 of them were diagnosed atypical endometrial hyperplasia(AEH) preoperatively.Retrospectively analysis the characteristics of these patients with SPSS13.0.Results Among the 44 cases, all of them were grade G1 disease, and 39 of them received comprehensive staging surgery.14(32%)young cases preserved bilateral ovaries.9 cases(20%) were given adjuvant radiology.No recurrence was detected during the median follow up of 52 months.Compared to the premenstrual group, although no statistical difference was detected, more patients with risk factors of deep myometrium invasion(4/22 vs 1/22) and lymph-vascular space invasion(LVSI, 3/22 vs 0/22) in the postmenstrual group.Compared to the patients who diagnosed with endometrioid cancer(EC) preoperatively, there are more patients with grade G1(P=0.000), fewer patients received adjuvant chemotherapy(P=0.003) and fewer recurrence(P=0.019) in AEH group.Conclusions The endomtrioid cancer patients who diagnosed with atypical hyperplasia preoperatively have better prognosis.Hysterectomy with bilateral ovaries preserved is acceptable in young patients.Post menopause patients have more risk factors of deep myometrium invasion and LVSI.

Objective To understand the hypertension prevalence situation and its associated factors among residents in Hu‐bei Province to provide a reference basis for preventing and controlling residents′ hypertension .Methods The residents aged 15 years old or more were sampled from 20 counties (cities and districts) by adopting the multi‐staged stratified cluster sampling .The unified questionnaire was adopted to conduct the face to face interview by entering home .The multivariate Logistic regression was used to analyze the influencing factors of hypertension .Results A total of 28 555 respondents were investigated ,4 135 respondents reported hypertension and the hypertension prevalence rate was 14 .48% .The hypertension prevalence rate in urban residents was 18 .41% ,which was higher than 11 .71% in rural residents(P<0 .01) .The prevalence rates in males and females were 14 .10% and 14 .83% respectively ,showing no statistically significant difference between males and females (P>0 .05) .The multivariate Logistic regression results revealed that the risk of hypertension was increased with age ;compared with job‐hololers ,the retired(OR=1 .44 , 95% CI:1 .25-1 .65)and the unemployed(OR=1 .29 ,95% CI:1 .15-1 .46)had more possibility to suffer from hypertension ;higher income earners had lower risk of hypertension ;obese people(OR=3 .09 ,95% CI:2 .63~3 .63)and diabetes(OR= 3 .87 ,95% CI:3 .30-4 .52)were more likely to suffer from hypertension .Conclusion The prevalence rate of hypertension among residents aged 15 years old or more in Hubei Province presents the increasing trend ,which needs the corresponding departments and institutions to adopt the measures to actively prevent and control hypertension .