Crohn's disease(CD) is a lifelong disease and the precise aetiology is still unknown.Differences in the definitions and diagnosis between clinicians make direct influence on therapeutic efficacy on CD.This article overviewed the progresses on the definitions such as staging,relapse,and diagnosis of Crohn's disease in these years in order to decrease the mistakes and be helpful to institute sensible and effective therapeutic regimen.

TNF-?,a pleiotropic cytokine with strong proinflammatory and immunomodulatory properties is known to play an important role in inflammatory bowel disease(IBD).The biological effects of TNF-? are elicited by binding to its two cognate recepters,TNFR1 and TNFR2.For a long time,TNF-R1 was considered to be the predominant mediator of TNF-signaling,whereas TNF-R2 was ascribed only auxilliary function.However,there is increasing clinical and experimental evidence for an important independent role of TNF-?/TNFR2 signaling in chronic inflammatory conditions of IBD.The elucidation of the different effects of TNF-signaling in IBD will lead to a better understanding ot the pathogenesis of these diseases and will be the basis for the development of more specific and more efficient therapeutic approaches.

Objective To evaluate the clinical value of CT-guided interstitial implantation of ~(125)I seeds for the treatment of pulmonary carcinoma. Methods A total of 18 patients with pulmonary carcinoma underwent CT-guided interstitial implantation of ~(125)I seeds. According to the size of tumor,effective dose, and optimal quantity of ~(125)I seeds to the patient that were computed by a developed algorithm in Treatment Planning System (TPS), the ~(125)I seeds were implanted into the tumor tissues under the guidance of spiral CT. The patients were reexamined by CT 2 months after the operation and were followed up for 6 months. Results A total of 812 seeds were implanted into the 18 lesions in the 18 cases (45.1 seeds per case in average). The CT scan performed 2 months after the operation showed CR in 7 cases, PR in 10, and NC in 1. The total effectiveness (CR+PR) rate was 94% (17/18). Conclusions CT-guided interstitial implantation of ~(125)I seeds is a effective, minimally invasive, and low toxic method for valid and minimally traumatic treatment for middle- and late-stage lung cancer. Further application and long-term observation are necessary.

Objective To observe the clinical efficacy of Tiao Shen Ding Zhi (mind-regulating) needling method in treating anxious neurosis. Method Fifty-eight patients with anxious neurosis were randomized into a treatment group and a control group, 29 in each group. The treatment group was intervened by Tiao Shen Ding Zhi needling method, while the control group was by conventional needling. The total effective rates of the two groups were observed. Result The total effective rate was 96.5% (28/29) in the treatment group versus 82.8% (24/29) in the control group, and the difference was statistically significant (P<0.05). Conclusion Tiao Shen Ding Zhi needling method can produce a higher total effective rate than conventional acupuncture in treating anxious neurosis.

Objective To observe the clinical efficacy of skin needling plus flash cupping for hemifacial spasm. Method Forty patients were randomized into a treatment group and a control group, 20 in each group. For both groups, the following acupoints were selected: Baihui (GV20), Sishencong (EX-HN1), Yifeng (TE17), Xiaguan (ST7), Cuanzhu (BL2), Yangbai (GB14), Taiyang (EX-HN5), Quanliao (SI18), Jiache (ST6), Dicang (ST4), Hegu (LI4), and Waiguan (TE5). Skin needling plus flash cupping was used for the treatment group, while even reducing-reinforcing needling method was used for the control group. Seven-day treatments were considered as a treatment course, and the therapeutic efficacy was analyzed after 3 courses. Result The cure rate was 65.0%in the treatment group versus 45.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Skin needling plus flash cupping can produce a significant efficacy in treating hemifacial spasm, better than ordinary needling method.

Objective To explore the influence on the JNK signal transduction pathway by BaiHui-QuBin Scalp-acupuncture in rats of experimental acute intercerebral hemorrhage. Methods 192 healthy Wistar male rats were assigned into 3groups randomly:model group, model add pinprick group (to abbreviate:pinprick group), model add suppressor group(to abbreviate:suppressor group) ,containing 60 rats in each. All rats were induced be the intercerebral hemorrage model. Another 12 rats were assigned as the matched blank group. The pinprick group were acupunctured on the "Baihui" penetrating "Qubin". The influence surrounding the hamatoma of the proteinum expression of p-JNK of each group in deferent time phase point with the method of Western blot was observed. Results The results of expression of the proteinum p-JNK with the method of Western blot: all the rats after being made model appeared the phenomenon of the expression of p-JNK of rat's brain tissue surrounding the hematoma and increased to the peak in 2 days,but decreased gradually in 7days. In the same time phase point,compared with the model group,the expression of p-JNK of the pinprick group and the suppressor group were lower obviously (P ＜ 0.01). The pinprick group compared with the suppressor group, the expression of p-JNK showed no significant difference (P ＞ 0.05). Conclusion The therapy of BaiHui-QuBin Scalp-acupuncture could block the JNK signal tranaduction pathway, inhibit the expression of the proteinum p-JNK and so on have the function of protecting the nerve cell and inhibiting apoptosis.

Objective To study abnormal defecation in patients with posterior vaginal prolapse combined with anorectal manometry. Methods From Jan. 2008 to Nov. 2009, clinical documents and examination of anorectal manometry of 40 patients with posterior vaginal prolapse were studied retrospectively. Anal physiologic testing was performed for 40 patients. These patients were classified into group A ( stage 0 and [posterior vaginal prolapse, represented normal) and group B ( stage Ⅱ - Ⅳ ).Results of anorectal manometry, constipation and symptoms of defecation were compared. Results The average anal canal resting pressure and squeeze pressure of 40 patients were (40 ±21 ) and (96 ±33) mm Hg (1 mm Hg =0. 133 kPa). In group A, the anal canal resting pressure and squeeze pressure were (37 ±21) and (78 ±43) mm Hg, rectal sensation threshold and rectal maximum volume were (106 ±61 ) and (183 ± 51 ) ml. In group B, the anal canal resting pressure and squeeze pressure were (42 ± 21 ) and (102±30) mm Hg, rectal sensation threshold and rectal maximum volume were (90±44) and (171 ±61) nl.Apart from maximum squeeze pressure ( P = 0. 039 ), the other clinical index did not show statistical difference (P ＞ 0. 05 ). Rectal sensation threshold, intended volume and maximum capacity of (116 ± 69 ),( 170 ± 90), ( 191 ± 75 ) ml in patients with constipation were higher than (84 ± 31 ), ( 121 ± 37 ), ( 169 ±45) ml in patients without constipation. In addition to maximum capacity (P = 0. 281 ), the other clinical index reached statistical difference between patients with and without constipation (P ＜ 0. 05 ). Patients with defecation symptoms have higher rectal sensation threshold, intended volume and maximum capacity than those of patients without defecation symptoms. Conclusions As gradually increased in the degree of prolapse, resting pressure and squeeze pressure tend to be increased, while the rectal sensation threshold and rectal maximum volume tend to be decreased. Patients with defecation symptoms and constipation have increased the initial feeling of volume and maximum tolerated volume.

Objective To assess the usefulness of left ventricular contrast echocardiography in diagnosis of left ventricular myocardium noncompaction.Methods Contrast echocardiography was done in ten patients who were diagnosed or suspected with left ventricular noncompaction by common transthoracic echocardiography,for further study of the trabecular muscles extent,the continuity of the endocardium,the compact myocardium thickness,and the contrast agent in the trabecula recessus.Results By contrast echocardiography,noncompaction myocardium thickness can be perspicuously observed,the turgor of the contrast agent was vividly detected in the trabecular recessus.Especially for the measurement of compaction myocardium,the contrast echocardiography was more accurate than in the condition of the common echocardiography.Conclusions Left ventricular contrast echocardiography can be used in the diagnosis of left ventricular noncompaction,it was a good added method of conventional echocardiography.

Objective To detect the expression of type Ⅰ collagen, type Ⅲ collagen, prolyl-4-hydroxylases (PH4) and matrix metalloproteinase 1 (MMP-1) in sacral ligament fibroblasts under stress, to understand the collagen synthesis and metabolism in stress situations change. Methods Eight patients who underwent abdominal hysterectomy for uterine benign disease were enrolled in this study. Primary sacral ligament fibroblasts were isolated by explant. After mechanical loading, gene expression of type Ⅰ , Ⅲ collagen, PH4 and MMP-1 were measured. Results Stress of 8% continuing for 24 hours, collagen Ⅰ (1. 13 ± 0.24), collagen Ⅲ (1.05 ± 0. 31) mRNA expression and PH4 expression (1.11 ± 0. 31) compared with static groups (1) showed increasing trends;when the stress were 4% and 12%, collagen Ⅰ (0. 86 ± 0. 26 and 0. 85 ± 0. 25), collagen Ⅲ showed increasing trends (0. 74 ± 0. 29 and 0. 83 ± 0. 38) mRNA expression were decreased. After removal of the stress, in the stress of 4% for 1 hour, collagen Ⅰ (0.79±0.40, 0.97±0.24 and 1.46 ±0.75), collagen Ⅲ (0.86±0.40, 0.99±0.60 and 1.59±0.82) and PH4 (1.11 ±0. 51, 1.17 ±0. 54 and 1.37 ±0. 39) mRNA expression increased gradually. In 8% stress group, collagen Ⅰ mRNA expression (1.16 ± 0. 62, 1.01 ± 0. 51 and 1.05 ± 0. 80) reached the peak in day 1, and collagen Ⅲ (0.99 ±0.69, 1.59 ±0.55 and 1.03 ±0.91) and PH4 (1.05 ±0.31, 1.07 ±0. 80 and 0. 85 ±0. 31) mRNA expression reached the peak in day 2, then decreased. 4% and 8% of the stress with time after the change, MMP-1 mRNA expression have peaked at day 1. Conclusions Moderate stress could contribute to pelvic floor collagen synthesis, too much or too little stress is not conducive to the synthesis of collagen. Collagen Ⅰ and collagen Ⅲ on the stress response may be different, the former have faster reaction than the latter. PH4 were involved in the synthesis of collagen, while MMP-1 may play a role in collagen degradation.

BACKGROUND:Lithium chloridecan promote the proliferation and osteogenic capacity of bone marrow mesenchymal stem cels in the necrotic region after avascular necrosis of the femoral head, which has become an issue of concern. OBJECTIVE:To compare the advantages and disadvantages of bone marrow stem cel transplantation combined with lithium chloride in the treatment of rabbit femoral head necrosis. METHODS: Passage 2 bone marrow mesenchymal stem cels from 1-week-old New Zealand rabbits were cultured in 0, 5, 10, 20, 40 mmol/L lithium chloride. Forty-eight healthy adult New Zealand rabbits were selected to make femoral head necrosis models in the right femoral head using liquid nitrogen freezing method and then randomized into four groups: model group with no implantation; lithium chloride group given lithium chloride treatment at 3 days after modeling; cel transplantation group given gelatin sponge implantation and bone marrow mesenchymal stem cel suspension injection into the femoral head after modeling; combined group given bone marrow mesenchymal stem cel suspension injection and lithium chloride treatment. Intraperitoneal injection of lithium chloride (45.2 mg/kg) was given daily beginning at the postoperative 3rdday, and the treatment duration was 4 weeks. RESULTS AND CONCLUSION:Lithium chloride at 10 mmol/L had the maximum effect on the proliferation of rabbit bone marrow mesenchymal stem cels, and if the concentration of lithium chloride was > 10 mmol/L, the promotion role of lithium chloride began to decline. After combined treatment, the morphology of the femoral head was restored a little, with increased bone density and thickened trabecular bone; the level of β-catenin in the femoral head was significantly increased in the combined group compared with the cel transplantation group or the lithium chloride group. These findings show that bone marrow stem cel transplantation combined with lithium chloride treatment can promote the recovery from femoral head necrosis by increasing bone mass of the trabecular bone and bone density of the femoral head in the necrotic region.