Objective: To investigate the clinical efficacy of remissive stage-reinforcing and acute stage-reducing acupuncture for treating apoplectic myospasm. Methods: Sixty patients with apoplectic hemiplegia were randomly divided into a treatment group of 30 cases and a control group of 30 cases. The treatment group was treated by remissive stage-reinforcing and acute stage-reducing acupuncture and the control group by modern rehabilitation training. Before and after treatment, the degree of spasm, the level of motor function and ability for daily life were evaluated by modified Ashwordth spasm grading, Brunnstrom grading and Barthel index now often used in the rehabilitation field. Results: Remissive stage-reinforcing and acute stage-reducingacupuncture was superior to modern rehabilitation training in relieving apoplectic myospasm. Conclusion: Remissive stage-reinforcing and acute stage-reducingacupuncture has a unique advantage in relieving spasm.

To explore the adhesion of peripheral blood lymphocytes and eosinophils and lung microvascular endothelial cells (LMEC) in asthma. Guinea pigs were divided into asthma model group and control group; the adhesion rates of isolated peripheral lymphocytes, eosinophils and the cultured LMEC monolayers were assayed.The mRNA expressions of VCAM 1 and eotaxin in LMEC were determined by RT PCR.The DNA binding activities of NF ?B and AP 1 of LMEC were detected by electrophoretic mobility shifts assay (EMSA). Under the stimulation with serum of asthma group:①the adhesion rates of lymphocytes, activated eosinophils and LMEC were significantly elevated( P

OBJECTIVE To investigate the methods of promoting nosocomial infection administration in laminar airflow(LAF) operation department,based on the theory of air microbe and object surface microbe. METHODS To begin with the construction standard of LAF operation department,to discuss difficult,complicating,professional and legal characteristics of nosocomial infection administration of LAF operating room. RESULTS It was a solid base of promoting nosocomial infection administrition to specify strictly the standard for the LAF operation department built;it was a vital link of promoting nosocomial infection administrition to take part in inspecting the engineering quality of LAF operation department;it is an effective means of LAF nosocomial infection administrition to carry out the supervision and control to the LAF operation department daily;it was the essense of promoting nosocomial infection administrition to make efforts to innovate the modern administration pattern in LAF operation department. CONCLUSIONS The management of hospital infection in the LAF operation department must emphasize the comprehensive measure of the all-directional germ control,make standard of decontamination of air conditioning guarantee system and carry out the whole process supervision.

OBJECTIVE To raise the sci-tech components of the infection control work guided by evidence-based medicine.METHODS To apply the basic principle of evidence-based medicine in the actual work and carry on the argument and analyses. RESULTS The implement of these measures under the guidance of evidence-based medicine could raise the level of the infection control work effectively,which included consult rule of the Hospital Infection Committee,collection of information in network,evaluation and analysis of the examination result of clinical microbiological laboratory,integreted and individualized dynamic monitoring method and diversity and whole process intervention measure.CONCLUSIONS The infection control work guided by evidence-based medicine can reduce the occurrence of the hospital infection effectively.

Objective To investigate the clinical characteristics of young rectal carcinomain in order to improve the diagnostic level and therapeutic efficacy at the early stage.Methods Clinical data,including clinical manifestations,misdiagnosis,clinical pathology and prognosis which from 47 cases of young rectal carcinoma were analyzed retrospectively and compared with those from 99 cases of old rectal carcinoma.Results The average course of disease was 6.98 months in young patient group,it was shorter than that in old patient group(9.16 months).The misdiagnosis rate of young group(61.70%) was significantly higher than that in old group(28.28%)(P 0.05).Conclusion Compared with the old patients,advanced stage and poorly differentiated carcinoma are more common in young patients with rectal carcinoma.But the 5-year survival rates of the young and old patients are similar.In addition,T stage and lymph node metastasis are the independent prognostic factors.Therefore,early diagnosis and treatment are crucial to improve the survival rate in young patients with rectal carcinoma.

Objective To investigate the effect of Jinqi Jiangtang tablet on the activation of T helper type 17 (Th17) and the expressions of interleukin (IL)-17 and IL-23 in kidney of diabetic rats. Methods A total of 45 male SD rats were randomly divided into normal control group (NC, n=15) and experimental group (n=30). Diabetes was induced by tail vein injection with streptozotocin (STZ, 45 mg/kg). The well-established 28 diabetic model rats were then randomly divided into diabetes group (DM, n=14) and Jinqi Jiangtang tablet administration group (Jinqi, n=14). The rats in Jinqi group were given Jinqi Jiangtang tablet solution by gavage at a single dose of 2.1 g·kg-1·d-1 for 18 weeks, while NC group and DM group were given 0.9%NaCl in the same way. All rats were sacrificed after 18 weeks. The circulating Th17 frequencies were assessed using flow cytometry. Serum IL-17 and IL-23 levels were measured by enzyme-linked immunosorbent assay. The pathological changes in kidney were studied by electron microscope. The expressions of IL-17 and IL-23 in kidney were detected using immunohistochemistry. Results (1) Compared with the group NC, the circulating Th17 frequencies were significantly increased in group DM and group Jinqi. The circulating Th17 frequencies were significantly lower in group Jinqi than those in group DM. (2) Compared with the group NC, the serum IL-17 and IL-23 levels were significantly increased in group DM and group Jinqi. The serum IL-17 and IL-23 levels were significantly lower in group Jinqi than those in group DM. (3) In group DM, irregular thickening of glomerular basement membrane, fusion of epithelial cell foot processes and mesangial expansion were observed by electron microscope. The above-mentioned pathological changes were improved inthe group Jinqi. (4) Compared with the group NC, the expressions of IL-17 and IL-23 in the renal cortex were significantly increased in group DM and group Jinqi, and those were significantly lower in group Jinqi than those in group DM. Conclusion The activation of Th17 and the increased expressions of IL-17 and IL-23 in kidney play a potential role in diabetic nephropathy. Jinqi Jiangtang tablet can improve diabetic nephropathy through inhibiting the activating Th 17 and decreasing the expression of IL-17 and IL-23 in kidney.

Objective Partial hepatectomy, liver transplantation, and radio frequency ablation for hepatocellular carcinoma (HCC) were compared to select the most suitable method for HCC. Methods 1198 patients with HCC in 3 hospitals in Guangzhou were divided into 3 groups: group Ⅰ , small HCC; group Ⅱ > HCC without vascular invasions and group Ⅲ , HCC with vascular invasion. The patients either received partial hepatectomy, transplantation or ablation. The 1-, 2- or 3-year survival rates, the 3-year recurrent rates and Child-Pugh grades in the 3 groups were compared. Results For small HCC, there was a significant increase in the 3-year survival rate (P<0. 05) and a significant decease in the recurrent rate (P<0. 05) in patients who received transplantation, compared with those who received hepatic resection. Patients who received ablation had a higher 3-year survival rate and a lower recurrence (P<0. 05) in comparison with those who received hepatectomy. There was no significant difference(P<0. 05) between transplantation and ablation, but there were more Child A patients who received hepatectomy and ablation, and more Child B and C patients who received transplantation. For advanced HCC, there was no significant different in the 3-year survival rates for the 3 therapies, but the 3-year recurrence was lower (P<0. 05) in the transplantation group. Conclusions For small HCC, superiority of transplantation versus resection was obvious. Ablation (diameter <3 cm) was also superior to resection, whereas ablation was as effective as transplantation. There were more Child B and C patients in the transplantation group than the ablation and resection groups. Therefore, small HCC with hepatic decompensation should receive liver transplantation. Transplantation was advantageous in having less tumor recurrent but there was no difference in the 3 therapies for advanced HCC.

OBJECTIVE To study the correlation between the expression level of Cyclin G2 and the laryngeal squamous cell carcinoma.METHODS The clinical data and paraffin-embedded tumor samples of 81 patients with LSCC treated at Shenyang 463 Hospital between Jan. 2000 to Dec.2000 were retrieved.Cyclin G2 expression was analyzed immunohistochemically in tumor tissues and adjacent normal laryngeal mucosa.The relationship between Cyclin G2 expression and clinical data including age,gender,tumor stage,pathological type,and prognosis were analyzed using software SPSS12.0.RESULTS The positive rate of Cyclin G2 in laryngeal squamous cell carcinomas was 66.7% and it was correlated with tumor differentiation,lymph node metastasis(both P value less than 0.05).CONCLUSION The expression of CyclinG2 correlates with the malignant degree and development tendency of LSCC negatively.Cyclin G2 is an important biological factor affecting the prognosis.

Objective To investigate the influence of social support on the depression and anxiety of standardized training residents.Methods Three hundred and eighteen standardized training residents selected by random sampling method from 4 training bases in Shanghai participated in this survey.ResultsThe average score of PHQ-9 was(7.24±5.20), and 67.30%(n=214)of participants had different degrees of depression;the average score of GAD-7 was(5.57±4.55), and 55.03%(n=175)of participants had different degrees of anxiety.One-way analysis of variances showed that standardized training residents who had work experience, longer training years and less salary satisfaction got higher scores in PHQ-9 and GAD-7.Male physicians had higher scores in GAD-7 than female ones.The scores of PHQ-9 (r=-0.390, P<0.01) and GAD-7 (r=-0.376, P<0.01) were both negatively correlated with social support.Regression analysis showed that training years,salary satisfaction,objective social support and the availability of support were significant for predicting the scores of PHQ-9(adjusted R2=0.242,F=17.893), work experience, salary satisfaction,objective social support and the availability of support were significant for predicting the scores of GAD-7(adjusted R2=0.228,F=14.390).After controlled the demographic variables, social support explained the variation rate of 0.119 to the score of PHQ-9 and 0.126 to the score of GAD-7.Conclusion The depression and anxiety of standardized training residents in this study is in a serious situation.Providing the objective social support and the availability of support as well as improving the salary satisfaction of standardized training residents may relieve the depression and anxiety and enhance their mental health.

Objective To observe the effect of vitamin A(VitA) on T help 17(Th17) and regulatory T cells (Treg) in the peripheral blood in children with asthma and their dose effect relationship,and to investigate the immunoregulation mechanism of VitA.Methods Twenty children with asthma (asthma group) and 16 healthy children (healthy control group) were selected.Peripheral blood mononuclear cells(PBMC) were isolated from venous blood by density gradient centrifugation in the aseptic condition.Different concentrations of VitA [0.0μmol/L (blank control),0.5μmol/L,1.0μmol/L,2.0μmol/L] were added into the cultures in the asthma group.The healthy control group were not interfered with VitA.The supernatant was collected after 72 h.The levels of interleukin 17 (IL-17),interleukin 10(IL-10) and transforming growth factor-β1 (TGF-β1) in the supernatant were determined by enzyme-linked immunosorbent assay.Results (1) IL-17 levels produced by PBMC in the asthma group were significantly higher than those in the healthy control group [(960.53±75.59) ng/L vs (425.07±70.71) ng/L,P＜0.01],and the levels of IL-10 and TGF-β1 were significantly lower than those in the healthy control group [(53.13±6.94)ng/L vs (84.41±6.02) ng/L,(304.51±51.52) ng/L vs (489.45±73.68) ng/L,all P＜0.01].(2) IL-17 levels produced by PBMC in the 0.5μmol/L,1.0μmol/L and 2.0μmol/L VitA concentration of the asthma group [(588.95±44.18)ng/L,(573.13±27.43) ng/L,(686.71±38.98) ng/L] were significantly lower than those in the blank control group[(960.53±75.59) ng/L,all P＜0.01],and IL-17 levels in the 2.0 μmol/L VitA concentration were significantly higher than those in 0.5μmol/L and 1.0μmol/L concentration groop (P＜0.01).(3) IL-10 levels produced by PBMC in the 0.5μmol/L,1.0μmol/L and 2.0μmol/L VitA concentration of the asthma group [(105.35±10.79) ng/L,(111.21±16.11) ng/L,(81.09±6.05) ng/L] were significantly higher than those in the blank control group[(53.13±6.94) ng/L,all P＜0.01],TGF-β1 levels produced by PBMC in the 0.5μmol/L,1.0μmol/L and 2.0μmol/L VitA concentration of the asthma group[(933.01±73.98) ng/L,(1223.31±105.99)ng/L,(776.98±145.44) ng/L] were significantly higher than that in blank control group[(304.51±51.52) ng/L,all P＜0.01],and the levels of IL-10 and TGF-β1 in the 0.5 μmol/L and 1.0μmol/L concentration group were significantly higher than those in the 2.0μmol/L concentration group(all P＜0.01).The level of TGF-β1 in the 1.0μmol/L concentration group were significantly higher than that in the 0.5μmol/L concentration group (P＜0.01).Conclusions The function of Th17 in children with asthma during asthma attack was enhanced,and the function of Treg cells was reduced.The balance disorder of the functions of Th17 and Treg cells occurred.VitA can reduce the function of Th17 in peripheral blood,and enhance the activity of Treg cells in the children with asthma.The physiological level of VitA has the best effect,if high VitA concentration is high its effect is significantly decreased.