Objective: To observe the clinical efficacy of acupuncture in treatment of chronic urticaria and the change in the content of serum immunoglobulin E (IgE), and to discuss the effect of acupuncture on the imbalance of T helper (Th)1/Th2 cell function via observing the changes in the contents of interferon-γ (IFN-γ) and interleukin-4 (IL-4). Methods: Ninety patients meeting the inclusion criteria of chronic urticaria were randomized into an acupuncture- medication group, an acupuncture group and a Western medication group by the random number table method. The acupuncture-medication group was intervened by acupuncture, cupping, collateral-pricking bloodletting and oral administration of cetirizine hydrochloride tablets; the acupuncture group was treated with acupuncture, cupping and collateral-pricking bloodletting; the Western medication group only received oral administration of cetirizine hydrochloride tablets. Before treatment and after 6-week treatment, the changes in the symptom scores and the contents of serum IgE, IFN-γ and IL-4 in the three groups were observed. Results: There were no significant differences in the total effective rate among the three groups (all P>0.05), but the cured and markedly effective rate was significantly higher in the acupuncture-medication group than that in the Western medication group (P<0.05). After treatment, the total symptom score decreased in the three groups (P<0.05), and the improvement of total symptom score in the acupuncture-medication group was more significant than that in the Western medication group (P<0.05). The component symptom scores all decreased after treatment in the three groups (all P<0.05); the improvements of the scores of itch intensity, and skin lesion size and number were more significant in the acupuncture-medication group than in the Western medication group (all P<0.05); the improvement of the skin lesion size score was more significant in the acupuncture group than in the Western medication group (P<0.01). The contents of IgE and IL-4 dropped (all P<0.05) and the content of IFN-γ increased (P<0.05) after treatment in the three groups; the post-treatment changes in the serum contents of IgE and IFN-γ were more significant in the acupuncture-medication group than in the Western medication group (both P<0.05). The incidence rate of adverse reactions was significantly lower in the acupuncture-medication group and acupuncture group than in the Western medication group (both P<0.05), and the relapse rate was significantly lower in the acupuncture-medication group than in the Western medication group (P<0.05). Conclusion: Combined acupuncture and medication can enhance the cured and markedly effective rate in treating chronic urticaria. Acupuncture is equivalent to cetirizine hydrochloride tablets comparing the clinical efficacy in treatment of chronic urticaria. Acupuncture plus medication and acupuncture alone both can effectively mitigate the clinical symptoms, with low incidence of adverse reactions. The relapse rate is low when using acupuncture together with medication. Acupuncture plus medication can work better in regulating the contents of IgE and IFN-γ and improving the imbalance of Th1/Th2 cell function.

Objective To explore the effect of folic acid on neural stem cells(NSCs) proliferation from fetal rats in vitro.Method NSCs were isolated and cultured by microdissection,mechanical blowing and serum-free suspension culture,and identified by immunofluorescent staining using antibody against nestin.BrdU(5’bromo-2’deoxyuridine) was used to mark dividing neural stem cells.Cultured NSCs were divided into four groups:control group,low,high dose group(liquid media with added 4,40 mg/L folic acid),and deficiency group(liquid media with added 0.4 mg/L methotrexate,MTX).Monotetrazolium(MTT) and double-label immunofluorescence technique detected NSCs proliferation under the condition of folic acid.Results In the serum-free suspension medium,neurospheres that consisted of a great number of nestin-positive cells could be obtained.The proliferative ability of NSCs were observed by BrdU labeling methods.MTT assay and double-label immunofluorescence for nestin+BrdU showed that the growth tendency was increased with folate concentration in the medium.Compared with control group,NSCs growth rate of folate group was significantly increased in vitro.Conclusion The culture of NSCs isolated from fetal rats possesses the abilities of proliferation and self-regeneration.Folic acid may stimulate proliferation of NSCs efficiently.

Objective To investigate the rationality and safety of dengzhanxixin injection used in elderly inpatients. Methods The clinical data of 986 inpatients including 620 males and 366 females were collected, and questionnaires containing age, sex, discharge diagnosis, symptoms, drug dosage, course of treatment, laboratory examination, adverse drug reaction and drug effect were analyzed. Results For the 986 cases, the average age was(74.3±7.5)years. The average dose of dengzhanxixin injection was (38.2±4.4) ml, once daily by intravenous drip, and the average period of treatment was (10.8±5.2) days. The adverse reaction rate was 0.81%. The levels of blood glucose and hemoglobin were decreased after treatment(t orμ=1226.5,2620.0, both P<0.05), but there were no statistical differences in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (CREA), blood urea nitrogen (BUN) and white blood cell count (WBC) before and after treatment (t or μ=122.5, 405.0, 513.5, 996.5, 956.5, all P>0.05). Conclusions It is safe to use dengzhanxixin injection according to the medication description for elderly inpatients.

Objective To explore the surgical procedures and effects for recurrent scalp dermatofibrosarcoma protuberans (DFSP).Methods Retrospective review was conducted in 7 scalp recurrent DFSP cases in the past 3 years.Intraoperative frozen section analysis of surgical margins was performed.Wide local excision with margins of 3 cm or more was applied,and excision of the skull external lamina or the entire layer of the cranial bones was performed once the skulls under the tumors were invaded.Frozen section analysis was again performed on all the margins.Secondary wound was repaired with local skin flap or fascial pedicled flaps.Surgically removed tumor was paraffin-embedded for HE-staining and immunohistochemical analysis.Results All of 7 tumor specimens were proved recurrent DFSP with histologic findings of intraoperation or postoperation.7 patients were all performed with wide local excision with margins of 3 cm or more,also with skull excision (5 cases with excision of skull external lamina and 2 cases with excision of the entire layer of skull).Negative margins were confirmed with intraoperative frozen sections or postoperative paraffin-embedded sections analysis were confirmed.Immunohistochemical analysis demonstrated that Ki-67 was all positive and CD34 was partially positive in 7 cases.No tumor recurrence or metastasis had been observed in any of our patients after a median follow-up duration of 17 months (range 15-41).Conclusions Wide local excision together with the skull invaded by tumors completely is effective surgical treatments for recurrent scalp DFSP; Use of scalp transferring technique could improve wound repair after complete tumor excision.

Objective To investigate the effects of different doses of dexmedetomidine on the anesthetic efficacy of propofol and remifentanil in patients undergoing plastic surgery.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 45-75 kg,scheduled for elective plastic surgery,were randomly assigned into 3 groups (n =20 each):control group (C group),low loading dose dexmedetomidine group (D1 group) and high loading dose dexmedetomidine group (D2 group).Dexmedetomidine was infused at a rate of 0.4 μg· kg-1 · h-1 until 30 min before the end of surgery after a loading dose of dexmedetomidine 0.6 (group D1) or 1.0 μg/kg (group D2) was infused at 10 min before induction of anesthesia in groups D1 and D2.Anesthesia was induced with target-controlled infusion of propofol (target plasma concentraiton 4.0 μg/ml) and remifentanil (target effect-site concentraiton 2.0 ng/ml).After the patients lost consciousness,rocuronium 0.6 mg/kg was injected intravenously.The patients were mechanically ventilated after tracheal intubation.Anesthesia was maintained with target-controlled infusion of propofol (target plasma concentraiton 2.0-3.5 μg/ml) and remifentanil (target effectsite concentraiton 1.5-2.5 ng/ml).Narcotrend index was maintained at Class D.Narcotrend index,systolic pressure (SP),diastolic pressure (DP) and HR were recorded before anesthesia (baseline),at 10 min of dexmedetomidine infusion,at 0,1 and 5 min after tracheal intubation,at the end of dexmedetomidine infusion,and at 0,1and 5 min after removal of the endotracheal tube.The induction time,consumption of propofol and remifentanil,time for recovery of spontaneous breathing and orientation,extubation time,and Richmond Agitation Sedation Scale score at 10 min after removal of the endotracheal tube were recorded.The development of sinus bradycardia during operation and complications during recovery from anesthesia were also recorded.Results Compared with group C,the total consumption of propofol and remifentanil,Richmond Agitation Sedation Scale score at 10 min after removal of the endotracheal tube,and incidences of nausea,bucking and agitation during recovery from anesthesia,and Narcotrend index and HR at 10 min of dexmedetomidine infusion were significantly decreased in groups D1 and D2,and induction time was shortened in D2 group (P ＜ 0.05 or 0.01).The incidence of sinus bradycardia during operation was significantly higher in group D2 than in groups C and D1 (P ＜ 0.05).There was no significant difference in the time for recovery of spontaneous breathing and orientation,and extubation time between the three groups (P ＞ 0.05).There was no significant difference in SP,DP and HR before and after tracheal intubation and before and after removal of the endotracheal tube between groups D1 and D2 (P ＞ 0.05).Conclusion Infusion of dexmedetomidine at a rate of 0.4μg·kg-1 · h-1 after a loading dose of 0.6 μg/kg infused before induction of anesthesia can shorten the induction time,reduce the consumption of propofol and remifentanil,effectively inhibit the stress responses to tracheal intubation or removal of the endotracheal tube,and decrease the occurrence of side effects in patients undergoing plastic surgery.

Data is the basis and soul of clinical trials. To obtain accurate data, strict and standard data management is essential, which can be effectively supported by quality control in statistical analysis. In this paper, we briefly introduce the concept of the quality control in clinical trials, and describe its contents and methods. We hope that this work will be helpful to the application of statistical quality control in data management of clinical trials.
Clinical Trials as Topic ; standards ; Data Collection ; standards ; Quality Control ; Statistics as Topic

Objective To assess the efficacy and safety of ketogenic diet(KD) on refractory epilepsy in children.Methods KD treatment was designed to observe the effects for 12 weeks.Totally 22 children with 16 boys and 6 girls were enrolled in the study.The epileptic syndromes included infantile spasms(13 cases),Lennox-Gastaut syndrome(4 cases),Dravet syndrome(2 cases),and the unclassified(3 cases).The KD was prepared according to the modified Johns Hopkins regimen.Urinary ketones were measured every day to ensure that ketosis state and parents′ diaries were kept to find out when it started to work and the change of seizure frequency.Effects of KD was evaluated by Engel standard.Blood chemistry was done at baseline,4 weeks and 12 weeks to analyze the effects of KD on metabolism.Side effects were monitored and treated.Results All cases completed the KD regimen for at least 2 weeks,19 cases for at least 4 weeks,and 10 cases for at least 12 weeks.Sixteen out of 22 children experienced the seizure reduction within 3 weeks(1-15 d),especially in the first week,and seizure free appeared within 5 weeks(1-32 d) in 8 cases.Overall,the diet achieved the seizure-free in 36.4%(8/22 cases) and an over 90% of seizure frequency reduction in 22.7%(5/22 cases).The efficacy of KD seemed not correlated with the sex,age,etiopathogenisis,and syndromes and so on.Blood chemistry suggested a normal range of glucose level at 4 weeks,though higher than that at the baseline.The blood triglyceride and total cholesterol level at 12 weeks increased strikingly,even beyond the normal range compared with the baseline.The side effects mainly including transient gastrointestinal symptoms and metabolic disturbances were mostly tolerable.Conclusions KD is probably a feasible therapy on refractory epilepsy in children,with quick and high efficacy and few side effects.

This paper discusses the mechanism of cellobiose in fungal cellulase induction a nd repression, and its inhibition of cellulases hydrolytic activity. Depending on the research result of cellulose binding domain, our hypothesis is that the main function of Exo-1,4-?-glucanase is to destroy th e crystal structure of cellulose to facilitaty hydrolyzing of ?-1,4 glucosidic bonds. A new strategy for the efficient transformation of cellulose material is advanced at t he end.

Objective To investigate the impact of hyper-homocystinemia (Hcy)on cardiac remolding in spontaneously hypertensive rat(SHR)and the protective effects of folic and vitamin B12 on the remolding.Methods The seven-week-old SHR were divided into four groups according to different diet for 20 weeks.The control group was fed a perfect compound diet without methionine,the methionine group was fed a perfect compound diet added with 2 ％ methionine,the treatment group was fed as that of methionine group,but added with vitamin B12 0.09 mg/(kg.d)and folate 4 mg/(kg.d)in the last 12 weeks,the mixture group was fed as that of methionine group in the first 8 weeks,and as that of control group.At the end of the intervention period,plasma levels of Hcy and matrix metalloprotease(MMP)-9 were measured.The blood pressure was detected by the non-invasive blood pressure sensing device.The cardiac structure and function were detected using echocardiography and invasive hemodynamic method.Picro-sirius red(PSR)staining was used to check the fibrosis in paraffin embedding ventricle section.Results Plasma levels of Hcy and MMP-9 were increased in the methionine group,while there was no significant difference in plasma levels of Hcy and MMP-9 among the treatment group,the mixture diet group and control group.Rats in methionine group had the largest heart weight among four groups,and systolic blood pressure was lower in methionine group than in the control group(P＜0.05).Compared with the other three groups,the methionine group showed that the left ventricular end-diastolic pressure(LVEDP)was increased and-dp/dt maxwas decreased.Meanwhile,LVEDP and-dp/dt m,x had no significant difference between the control group,treatment group and mixture group.The methionine group showed the most severe decrease in the left ventricular fractional shortening(LVFS)and +dp/dt While LVFS and + dp/dt max had no statistical significance between the treatment group and control groups,but the mixture group had lower LVFS and +dp/dt max values as compared with the control group(both P＜0.05).Perivascular fibrosis was increased significantly in methionine group as compared with the other three groups,while the treatment and control groups had similar perivascular fibrosis,but the mixture group had higher perivascular fibrosis than did the control group,and had similar perivascular fibrosis to the treatment group.Fibrosis deposition in myocardium mesenchymal was similar to those observed in perivascular fibrosis,but the treatment group showed a more improvement of collagen deposition as compared with the mixture group.Conclusions Hyper-homocystinemia can accelerate systolic and diastolic dysfunction through accumulating fibrosis in myocardium and perivascular wall which lead to adverse cardiac remolding.Folate and vitamin B12 have protective effects on heart function by reversing the adverse changes through decreasing Hcy level.

Objective:To investigate the efficacy, safety, and overall survival of advanced upper gastric cancer patients who received preoperative chemoradiation therapy. Methods:A total of 62 patients who received preoperative chemotherapy or chemoradiation therapy in the Department of Gastrointestinal Surgery of Beijing Cancer Hospital&Institute were retrospectively observed to determine the efficacy and safety and to perform survival analysis of preoperative chemoradiation therapy. Results:Results of the postoperative pathology showed that the number of patients with T4 and N3 stages was significantly lower in the preoperative chemoradiation therapy group than in the preoperative chemotherapy group (P<0.05). In addition, the differences between the two groups in terms of safety and toxicity were not significant (P≥0.05). Analysis also showed that the differences between the two groups in terms of survival were not significant (P≥0.05). Conclusion:Patients with advanced upper gastric cancer can gain a potential survival advantage from preoperative chemoradiation therapy. Compared with preoperative chemotherapy, preoperative chemoradiation therapy was performed without increased risk of toxicity and insecurity. Preoperative chemoradiation therapy can also improve the local control ratio, especial y the control ratio of lymphatic metastasis. However, the final results of survival analysis depend on long-term follow-up of patients.