This article summarizes recent years’ advances in the study of the immunoregulatory mechanism of acupuncture-moxibustion treatment for rheumatoid arthritis (RA) and shows that RA occurrence involves a complex process in which immunocytes, cytokines, Immunoreactive substances and neuro-endocrino-immune network participate together. The article proposes that the future study should utilize the newest achievements in modern medical development and conduct a thorough and systematic investigation from multiple disciplines, levels and angles to promote the study of the immunoregulatory mechanism of acupuncture and moxibustion in RA treatment and make traditional acupuncture-moxibustion therapy still play its unique advantages in the RA field.

Objective To explore the relation between glucose fluctuation state and diabetic chronic compli-cations in type 2 diabetes mellitus. Methods 169 cases with type 2 diabetes mellitus were divided into two groups: 78 cases with constant high glucose(group Ⅰ) and 91 cases with glucose fluctuation state( group Ⅱ ). The clinical data such as fasting plasma glucose(FBG) ,fasting blood insulin(FINS) ,fasting blood C peptide,2 hours postprandial plasma glucose (2hPG) ,2 hours postprandial blood insuline (2hINS) ,2 hours postprandial blood C peptide, glycosy-lated hemoglobin A1c (HbA1c), and blood pressure (BP), body mass index ( BMI ), urinary albumin excretion rote (UAER) ,triglyeeride(TG) ,total cholesterol(TC) ,high density lipoprotein cholesterol(HDL-C) ,low density lipopro-tein cholesterol(LDL-C) were measured. Results 2hPG in group Ⅱ was much higher than that in group Ⅰ (P<0.01) ,but 2 hours postprandial blood insuline and 2 hours postprandial blood C peptide in group Ⅱ were much lower than those in group Ⅰ (P<0.01). The incidence of diabetic chronic complications was higher in group Ⅱ compared with that in group Ⅰ (P<0.01). Conclusion These findings suggest that glucose fluctuation state with type 2 dia-betes mellitus had increased diabetic chronic complications.

Objective To comprehend the metabolic disorder of the obese patients with type 2 diabetes mellitus(T2DM).Methods According to body mass index( BMI),176 cases of T2DM were divided into 2 groups;obesity(95 cases) and non-obesity(81 cases),the waist circumference(W) ,hip circumference(H) ,fasting plasma glucose(FBG) ,2-hour postprandial plasma glucose(2hBG) ,fasting blood insulin(FINS),2 hours postprandial blood insuline(2hINS), renal function, triglycetide(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C ), glycosylated hemoglobin(HbA1c) and blood pressure(BP) were tested.Results The BMI,the ratio of W/H (WHR), serum uric acid (BUA), FINS, 2bINS, FCP and 2hCP in the obese group were higher than those in non-obese group(P <0.01);systolic blood pressure and diastolic blood pressure in obese patients were higher than those in the non-obese group(P >0.05) ,while the prevalence of abdorminal obesity.Hypertension significantly increased in obese group than those in non-obese group.Conclusion Among the T2DM ,metabolic disorder in obese patients is even more serious.It is very improtant for obese patients with T2DM to be given combined treatment to improve the metabolic disorder,that includes controlling blood glucose, decreasing weight and lightening insulin resistance.

Objective To explore main risk factors of post-operative severe complications in elderly patients with gastric cancer.Methods From January 2006 to June 2011,a total of 236 elderly patients to receive gastrectomy for gastric carcinoma were retrospectively analyzed in this casecontrol study.The factors affecting post-operative severe complications were analyzed by multivariate logistic regression analysis.Results Age was younger in patients without than those with postoperative complications [(72.9±5.8) years vs.(80.6±6.7) years,t=-9.194,P=0.000].Serum levels of hemoglobin and albumin were higher in patients without than with post-operative complications [(109.94±18.72) g/L vs.(98.75±18.82) g/L,(38.37±5.52) g/L vs.(33.69± 3.35) g/L,t=4.391,7.080,both P=0.000].Operation time was shorter in patients without than with post-operative complications [(3.1 ± 1.0) hours vs.(3.6 ± 1.1) hours,t =-3.507,P =0.001)].Intraoperative blood transfusion volume was less in patients without than with post-operative complications [(2.5±4.4) L vs.(2.8±5.5) L,t=-4.901,P=0.000)].The long diameter of tumor was shorter in patients without than with post-operative complications [(4.5 ± 2.8) cm vs.(5.3± 2.7) cm,t =-2.111,P =0.036)].Logistic regression analysis revealed that chronic obstructive pulmonary disease (COPD),serum albumin level,age,operation time and blood transfusion volume were associated with postoperative severe complications.Logistic regression equation was as follow:P=1/[1+e(16.22-033X1+0.99X3-390X4-192X5-493X9)].Conclusions COPD,operation time,blood transfusion volume,serum albumin level and age are the main independent risk factors for post-operative severe complications in elderly patients with gastric cancer.

BACKGROUND: At present, many scholars make improvements to the UW solution composition, aiming to further explore the principle of organ preservation, improve preservation techniques and to extend the preservation time limit; simplified composition of UW solution can further meet the clinical transport, storage and ease of use; suitable alternatives should be found to reduce the cost of UW solution to satisfy the needs of the market.OBJECTIVE: To discuss the effectiveness of self-prepared PV solution for preserving rat's liver at a lower temperature, and to compare the results with UW solution.METHODS: A total of 90 Wistar rats were randomly divided into three groups: UW group, PV group and normal saline (NS) group. Rats in each group were prepared for non-circulated isolated perfused rat liver models, and preserved for 0, 6,12, 18, and 24 hours respectively, with 6 animals in each subgroup. The changes of hepatic enzymology (alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase) in corresponding time period, amount of metabolic production of oxyradicals from perfusion effluent liquid, and the bile secretion and changes in hepatic morphology under the microscope were observed. RESULTS AND CONCLUSION: Amounts of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase and superoxide dismutase in perfusion effluent liquid were close between the PV group and UW group, and the difference was not significant (P > 0.05). After 6 hours of preservation, tumor necrosis factor a titre in the PV fluid group was greater than that in the UW group (P< 0.05); after 12 hours of preservation, amount of malonaldehyde in the UW group was evidently increased than that in the PV group (P < 0.05); after 18 hours of preservation, bile secretion in the PV group was lower than that in the UW group (P < 0.05); morphological changes of hepatic cells were similar in the two groups under the optical and electron microscope. The results demonstrated that PV solution and UW solution have a similar effect on protecting Wistar rat's liver function, and PV solution is superior to UW solution in antioxidation and scavenging oxygen free radicals.

Objective To systematically assess the effectiveness and safety of acupuncture and moxibustion for treatment of rheumatoid arthritis. Methods Articles were searched from databases, i.e., CNKI, VIP, WanFang Data, CBM, Embase, and PubMed. Articles about RCT on acupuncture and moxibustion for rheumatoid arthritis and traditional medicine therapy were under meta-analysis. Results Totally 24 articles involving 2006 patients were included. The results of meta-analysis indicated that the overall effective rate of treatment in the group receiving acupuncture and moxibustion was higher than that in the drug group, with statistical significance [OR=2.73, 95%CI (2.18, 3.41), Z=8.78, P<0.000 01]. Sub-group analysis showed that:acupuncture and moxibustion showed statistical significance in decreasing serum RF levels compared with drug therapy [MD=-2.92, 95%CI (-5.60, -0.25), P<0.05]. Acupuncture and moxibustion showed statistical significance in decreasing serum ESR levels compared with drug therapy [MD=-2.99, 95%CI (-4.78, -1.21), P<0.05]. Acupuncture and moxibustion showed statistical significance in decreasing serum CPR levels compared with drug therapy [MD=-1.44, 95%CI (-2.44, -0.44), P <0.05]. Conclusion The overall effective rates of acupuncture and moxibustion for rheumatoid arthritis and the decreasing levels of RF, ESR, CRP are superior to drug therapy, but it still needs larger samples, multi-center, and high quality RCT to verify.

Objective To investigate the regulating effect of heat reinforcing acupuncture manipulation on body energy metabolism enzymes in rheumatoid arthritis (RA) and preliminarily explain the mechanism of heat-producing action of heat reinforcing acupuncture manipulation. Method Forty chinchilla rabbits were randomized into normal, model, equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups. A model of cold syndrome-type RA was made by ovalbumin induction and exposure to low temperature in the other four groups not including the normal group. From two days after successful model making, the normal and model groups were grabbed and fastened (bound) by the same way as for the acupuncture groups, 30 min once daily. The equal reinforcement and reduction group received even reinforcing-reducing method;the twirling reinforcement group, twirling reinforcement method;the heat reinforcing group, heat reinforcing acupuncture manipulation. The needle was manipulated for 1 min and retained for 30 min once daily, for a total of seven days. The RA rabbit knee joint circumference was measured and the inflammation score was recorded according to synovial histopathological sections before and after treatment. After the completion of intervention, the rabbits were sacrificed and the articular synovium was rapidly separated for frozen sections. Articular synovium lactate dehydrogenase (LDH), succinate dehydrogenase (SDH) and cytochrome oxidase (CCO) activities were measured by histochemical staining. Result After acupuncture intervention, the RA rabbit knee joint circumference was shortened in all the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups, but the shortening effect on the RA rabbit knee joint circumference was better in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05);the inflammation score recorded according to the RA rabbit synovial histopathological sections was also decreased more in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Synovial LDH integral optical density, total positive area and area percentage were significantly higher in the model group than in the normal group (P<0.05), and significantly lower in the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups than in the model group(P<0.05) and also in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Rabbit synovial SDH and CCO activities were significantly higher in the model group than in the normal group (P<0.05). Rabbit synovial SDH and CCO integral optical density, total positive area and area percentage were significantly higher in the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups than in the model group (P<0.05) and also in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Conclusion Heat reinforcing acupuncture manipulation has a definite therapeutic effect on RA and can increase SDH and CCO activities to enhance aerobic metabolism and produce more local energy in a rabbit model of RA. That may be the mechanism by which heat reinforcing acupuncture manipulation produces heat.

Objective To investigate the clinical characteristics of the tympanic membrane atelectasis and treatment methods ,and to provide a reference value for future clinical diagnosis and treatment .Methods A retro‐spective analysis of 86 patients(104 ears) with tympanic membrane atelectasis treated in our hospital from June 2011 to August 2013 .Disease severity was classified according to the erasmus classification of atelectasis by Sade ,and pre- and post -operative air -bone gaps (ABG) were compared .Results There was no statistical difference of mastoid gasification on CT scan between mild and sever tympanic membrane atelectasis (P>0 .05) .While the sta‐tistical difference was found in two groups of whether there were soft tissues in middle ear and mastoid cavity on CT scan(P<0 .05) .There was an improvement in the average ABG for all stages .Conclusion This study demonstrated that surgical intervention had a favorable effect on hearing level across all stages .The treatment of atelectatic ears should be taken and individualized .

Objective To observe the trend of temperature changes after ventriculoperitoneal shunt and its relation with postoperative infection.Methods A retrospective cohort study was conducted on 272 patients underwent ventriculoperitoneal shunt in our hospital from January 2015 to December 2018.Patients were divided into infected group and non-infected group according to whether intracranial infection occurred after surgery.According to the occurring time of postoperative intracranial infection,patients were divided into early infection group and delayed infection group.Temperature levels of all patients were monitored on the surgery day,and on the first,yd,5th and 7th d of surgery,and the temperature changes and fever rate of the two groups were compared.Results Among 272 patients,intracranial infection occurred in 25 (9.19％),including 21 with early infection and 4 with delayed infection,and un-infection in 247 (90.81％).As compared with those in the non-infected group,the fever rate and body temperature of the infected group were significantly higher on the 3rd,5th and 7th d after surgery (P＜0.05).There was no significant difference in fever rate and body temperature changes between the early infection group and the delayed infection group on the surgery day and on the first,3rd,5th and 7th d of surgery (P＞0.05).Conclusions The fever rate is higher and the body temperature decreases faster after ventriculoperitoneal shunt.The fever since the third d of surgery is closely related to postoperative intracranial infection,which has a certain predictive significance for postoperative infection,so we should consider anti-infection treatment in time.

Objective To evaluate the myocardial protective effects of Histidine-TryptophanKetoglutarate (HTK) solution on infants with tetralogy of fallot in cardiac operation through comparison with St.Thomas Ⅱ cardioplegia(STH) and HTK cardioplegia in the operation of tetralogy of fallot.Methods Forty infants with tetralogy of fallot(TOF) were enrolled in this study.Their age ranged from 7 to 35 months,and body mass from 5.3 to 9.5 kg.The infants were randomly divided into HTK (n =20) group and STH (n =20) group who received HTK or STH solution respectively.Then 3 ml blood sample were got at 1,2,4,8,24 and 48 h after the opening of ascending aorta.The serum levels of cardiac troponin Ⅰ(cTnI),creatine kinase(CK) and creatine kinase MB(CK-MB) were measured.Results There was significant difference between two groups in terms of the level of cTnI at different time (F(inner group)=49.94,P＜0.001;F(between group) =10.23,P＜0.001;F (across group) =28.49,P＜0.001),and the level of cTnI in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK at different time (F(inner group) =58.85,P＜0.001;F(between group) =16.43,P＜0.001;F(across group)=18.32,P＜0.001),and the level of CK in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK-MB at different time (F(inner group)=34.51,P ＜0.001;F(between group)=11.03,P＜0.001;F(across group)=10.28,P＜0.001),and the level of CK-MB in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P ＜0.05).Conclusion HTK is more valid than STK for improving the ability of anti ischemia of myocardium and cardiac function,reducing arrhythmia and ischemia reperfusion injury on infants with TOF in cardiopulmonary bypass.