Objective To explore the characteristics of TCM syndromes of acute coronary syndrome(ACS). Methods Clinical data of 127 ACS patients were collected and then a database was established.After that,the distribution of syndrome patterns was analyzed.Results The incidences of the following excess syndrome patterns were in a decreasing sequence:stasis syndrome,phlegm syndrome,cold syndrome and heat syndromes.The incidence of stasis syndrome was 90.5%,which was much higher than other excess syndromes.The incidences of the following deficiency syndrome patterns were in a decreasing sequence:heart-Qi deficiency syndrome,heart-Qi exhaustion syndrome,heart-yin deficiency syndrome,heart-Qi depletion syndrome,heart-kidney deficiency syndrome and heart-blood deficiency syndrome.The incidence of heart-Qi deficiency syndrome was 75.6%,which was much higher than other deficiency syndromes.The incidences of the stasis syndrome and cold syndrome in acute myocardial infarction(AMI)were higher than those in unstable angina(UA),and the incidences of heart-Qi deficiency syndrome and heart-Qi exhaustion syndrome in AMI were higher than those in UA(P

Objective To investigate the species distribution and the difference of virulence gene spectra of Aeromonas isolated from intestinal tract and extraintestinal body fluid,and the correlation of their pathogenicity with infection sites.Methods A total of 156 Aeromonas strains isolated from the fecal specimens of patients with acute diarrhea and extraintestinal specimens were collected during May 2013 and September 2015.Eighteen virulence genes in these strains,including hlyA,aerA,act,alt,ast,aexT,ascV,aopP,ascF-G,gcat,tapA,fla,Ser,exu,ahyB,eprCAl,lip and laf,were detected by polymerase chain reaction(PCR).Last,the differences of virulence gene spectra between intestinal and extraintestinal Aeromonas were analyzed.Results Among 156 Aeromonas strains,79 were from fecal specimens,and 77 from extraintestinal specimens.Aeromonas caviae(A.caviae,51.9％) was the most common species in the intestinal strains,while Aeromonas hydrophila(A.hydrophila,48.1％) and A.caviae(39.0％) were the main pathogens in extraintestinal infections.The most prevalent virulence genes in intestinal and extraintestinal Aeromonas were gcat,act,fla,ahyB,exu and lip (＞ 45.57 ％),while aexT,aopP,ascF-G and ascV were less frequently detected (＜ 20.78％).The detection rates of gcat,ahyB,laf,ast,exu,lip,hlyA and aerA genes in intestinal Aeromonas were significantly lower than those in extraintestinal isolates (P ＜ 0.05).The detection rates of gcat,ahyB,exu,lip,eprCAl and hlyA genes in extraintestinal A.hydrophila were significantly higher than those in intestinal A.hydrophila (P ＜ 0.05).The detection rates of lip and hlyA genes in extraintestinal A.caviae were significantly higher than those in intestinal A.caviae (P ＜ 0.05),while that of aopP gene was just the reverse.There was no significant difference in the detection rates of virulence genes between intestinal and extraintestinal Aeromonas veronii.Conclusion There are significant differences in the species distribution and virulence genes of Aeromonas isolated from intestinal and extraintestinal specimens,indicating that clinicians should treat them differentially.

Objective To evaluate the reliability and validity of a medication dependence questionnaire in mi?graineurs of the Chinese version. Methods One hundred fifteen migraine patients with drug dependence syndrome were included and their clinical data were then collected. All the subjects were interviewed with the medication dependence questionnaire in migraineurs of the Chinese version. The reliability and validity of the questionnaire were evaluated ac?cording to test-retest reliability and internal consistency reliability, and the content validity and construct validity respec?tively. Results The test-retest reliability of the questionnaire items was 0.725~1.000 except item 11 (0.558) and item16 (0.443). The internal consistency coefficient of the questionnaire was 0.820, internal consistency coefficient of each di?mension was above 0.7. Every item score was positively correlated with corresponding dimension score (r=0.595~0.962). Seven factors with latent roots greater than 1 could explain 76.3%of total variance, and these factors were relatively pow?erful in related items. Conclusions The medication dependence questionnaire in migraineurs of the Chinese version shows preferable reliability and validity. Thus, this is a promising assessment tool to evaluate the medication dependence in Chinese migraineurs in future clinical practice.

Objective To analyze the clinical features and risk factors of migraine patients with white matter le-sions (WMLs). Methods One hundred ten clinically diagnosed migraine patients who underwent magnetic resonance im-aging (MRI) scans from October, 2010 to August, 2013 were enrolled in Shandong Provincial Hospital. One hundred ten migraine patients were divided into two groups:WMLs group and non-WMLs group based on the presence or absence of WMLs in MRI scans. The clinical features of the patients and location and number of WMLs were investigated. Noncondi-tional multivariate stepwise logistic regression after univariate analysis was used to analyze the data. Odds ratio (0R) and 95 confidence interval after adjustment for possible confounding variables were calculated. Results①There were 36 patients with WMLs among the 110 migraine patients. The incidence of WMLs in migraine patients was 32.7%. The WMLs in migraine patients were predominantly present in the frontal and parietal lobes (59.1%). ② Compared with non-WMLs group, there were significant increases in disease duration (5.3±3.7 vs. 7.6±4.9, P﹤0.01), frequency of head-ache attack (3.5 ± 2.3 vs. 4.6 ± 2.2, P﹤0.05), aura (18.9%vs. 36.1%, P﹤0.05) and family history of migraine (12.2%vs. 44.4%, P﹤0.01) in WMLs group.③The independent risk factors of WMLs in migraine patients were family history of mi-graine (OR=5.995), aura (OR=3.067) and long disease duration (OR=1.165). Conclusions Family history of migraine, au-ra and disease duration are the predictive risk factors of WMLs in migraineurs.

Therapeutic approaches to brain metastases from non-small cell lung cancer ( NSCLC ) include corticosteroids, anticonvulsants, surgery, radiotherapy and chemotherapy. In recent years, molecular targeted therapy such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) has become a new option. This article discussed the roles of surgery, brain radiation, chemotherapy, targeted therapy , and other new directions in the treatment of patients with brain metastases from NSCLC.

Background Diabetic retinopathy (DR) is a common complication of diabetic mellitus,but its pathogenesis is still unclear.Adiponectin may restrain inflammatory reaction and reduce adhesion of vascular endothelial cell to influence diabetic microangiopathy.Relation between adiponectin and nitric oxide synthase (NOS)is less reported.Objective This study was to observe the effect of adiponectin on the expression of NOS in the retinas of diabetic rats.Methods Forty 8-10 weeks Sprague-Dawley (SD) female rats were collected.The rats were randomized into the normal control group (10 rats),adiponectin group (15 rats) and diabetic model control group (15 rats) using the random number table method.Tetraoxypyrimidine was intraperitoneally injected to establish the diabetic model in the rats of the adiponectin group and diabetic model control group,and 10 μg/kg of adiponectin was then injected into the rats of the adiponectin group.Western blot was used to detect the expression of the adiponectin protein in the rat retinas,and the expression of NOS in rat retina was located by immunochemistry.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The relative amount of adiponectin (adiponectin/β-actin)in the retinas was 0.85 ± 0.21,0.79 ± 0.17 and 0.42 ± 0.08,respectively,in the normal control group,adiponectin group and diabetic model control group,with significant differences among the 3 groups (F =4.236,P =0.000).The adiponectin/β-actin ratio in the retinas of the diabetic model control group was significantly declined in comparison with the normal control group and adiponectin group (q =6.615,P =0.000 ; q =6.026,P =0.000).The NOS levels (A value) in the retinas were 0.244 ± 0.035,0.262 ± 0.032 and 0.367 ± 0.066,respectively,in the normal control group,adiponectin group and diabetic model control group,showing a significant difference among them (F =3.752,P =0.001).The A value of NOS in the diabetic model control group was significantly increased in comparison with the normal control group and adiponectin group (q =3.488,P =0.002 ; q =3.079,P =0.005).NOS expression was localized to the inner nuclear layer and retinal ganglion cell layer.Conclusions Adiponectin reduces NO content in diabetic rat retinas by regulating NOS expression.

Objective:To observe the clinical efficacy of electroacupuncture in the treatment of type 2 diabetes mellitus combined with mild and moderate carpal tunnel syndrome.Methods:Eighty patients with type 2 diabetes mellitus combined with mild to moderate carpal tunnel syndrome were randomly divided into two groups with 40 patients in each group ( n=40). In the course of the treatment, 2 patients in each group dropped out, which means 38 patients in each group were included. All patients were instructed to actively control blood glucose The control group was given Mecobalamin tablets orally, while the treatment group was given electroacupuncture of Daling and Neiguan on the affected side based onthe control group for 6 weeks. The degree of pain was assessed by VAS, and the severity of clinical symptoms was assessed by the symptom scale of Boston carpal tunnel questionnaire (BCTQ). The sensory nerve conduction velocity (SCV), the amplitude of sensory nerve action potential (SNAP) and the distal motor latency (DML) were detected by EMG evoked potential instrument. The clinical efficacy was evaluated and adverse events were recorded. Results:The total effective rate was 81.6% (31/38) in the treatment group and 60.5% (23/38) in the control group, and the difference was statistically significant ( χ2=5.094, P=0.024). After the treatment, the scores of VAS and BCTQ in the treatment group were lower than those of the control group ( t=2.639, 2.790, P=0.010, 0.007); DML (3.62 ± 0.19 ms vs. 4.00 ± 0.17 ms, t=68.891) in the treatment group was lower than that of the control group ( P<0.01), while SCV (47.36 ± 0.18 m/s vs. 42.34 ± 0.14 m/s, t=97.163) and SNAP (14.74 ± 0.18 μV vs. 12.10 ± 0.16 μV, t=51.434) in the treatment group were higher than those of the control group ( P<0.01). During the treatment, no serious adverse events occurred in two groups. Conclusions:Electroacupuncture is safe and effective in the treatment of mild and moderate carpal tunnel syndrome with type 2 diabetes. It can reduce the degree of pain and improve the symptoms of wrist joint.

Objective To investigate the effect of tetrandrine (Tet) on experimental choroidal neovascularization and the effect of Tet on retinal structure and function. Methods Choroidal neovascularization was induced in 20 Brown Norway (BN) rats (40 eyes) by diode laser (wavelength: 810 nm; exposal time: 0.1 second; facular diameter:100 ?m; energy: 120 mW), and the rats were divided randomly into experimental and control group with 10 rats (20 eyes) in each group. In experimental group, 0.05 ml Tet with the concentration of 3.21 ?mol/L was injected intravitreously 0 and 3 days after laser photocoagulation; in the control group, the rats underwent an intravitreous injection with the same volume of sodium chloride solution. The incidence of CNV was evaluated by fundus fluorescein angiography (FFA) 14 days after laser photocoagulation. Five right eyes of another Five healthy BN rats underwent intravitreous injection with 0.05 ml Tet with the concentration of 3.21 ?mol/L, and an intravitreous injection with the same volume of sodium chloride solution was performed on the left eyes. Before injection, 1 hour, and 1 day after the first injection, and 1 hour, 1 day, 7 days, 14 days after the second injection the electroretinography (ERG) was performed on these 5 rats; 14 days after the second injection, the retinae were examined by light microscopy and transmission electron microscopy. Results The incidence of CNV was 23.26% in experimental group,which was obviously lower than that in the control group (63.33%) (P0.05). There were no structural changes of retinal tissues examined by light and electron microscopy. Conclusion Tet may inhibit choroidal neovascularization in rats; there isn′t any significant toxic effect of intravitreous injection with Tet on retina at the dosage of 3.21 ?mol/L.

Objective To study clinical effect of transplantation with vascularized ilium bone and free fibulae, and internal fixation of titanium plate on reconstruction of maxillary defect. Methods Nine cases of maxillary defect were repaired by 7 iliac muscle flaps with deep circumflex iliac artery and vein, 2 cases of fibulae muscle flap with peroneal artery and vein, meanwhile, fixed internally by titanium plate. The vessels were anastomosed with arteria and vena maxillaries externa. Results Nine patients were confirmed by 99m TcMDP 2-4 weeks after operation that the supply of blood was well and the graft bones were survival. By follow-up from 6 months to 3 years after operation, the fixations of graft bones were good. Conclusion Vascularized bone graft and internal fixation of titanium plate is one of the best ways for reconstruction of maxillary defect.

Objective To investigate the effects of rapid colloid and crystalloid infusions on the plasma concentration of propofol( Cp) during target-controlled infusion.Methods Thirty-six patients were randomly assigned to three interventions(12 patients per group).At least 30 min after the start of propofol infusion,the hydroxyethyl starch solution group(HES)received HES of 24 mL/(kg· h),on the former 20 min,the sodium acetate Ringer’s injection group(AR)received AR of 24 mL/(kg· h),while HES group and AR group of later 20 min and the control group of whole course received AR of 2 mL/(kg· h).The plasma concentrations of propofol were recorded per 2 min and a half.The cardiac outputting,blood volume and clearance of indocyanine green were measured by pulsed dye density analyzer,the effective hepatic blood flow( EHBF) were obtained.Results The varying of Cp with time showed a significant treatment factor(F[2,33] =14.14,P<0.001)and time factor(F[16,528] =10.37,P<0.001)and interaction between the above factors(F[32,528] =2.82,P <0.001) by ANOVA for repeated measurement;the difference of Cp among each group,Cp in HES group was significantly lower than AR group(5-40 min)or control group(10-40 min),with significant difference(P<0.05).The varying of EHBF with time showed a significant treatment factor(F[2,28] =3.68,P=0.038)and time factor(F[2,56] =5.37,P=0.007)and interaction between the above factors(F [4,56] =3.67,P=0.010);while there was no significant difference in other groups.Conclusion Rapid HES infusion increases the effective hepatic blood flow,resulting in a decrease of propofol concentration during target-controlled infusion.Rapid HES infusion should be used cautiously as it may decrease the depth of anesthesia.