Objective To compare the effective difference of the flying needle with intradermal needle among the shu-acupoint group , the estazolam group and the non- point acupuncture group. Methods Three undred and fifteen patients who met the inclusion criteria were randomly enrolled into three groups for the insomnia severity index (ISI) and rating changes detection. After 2-week treatment,the patients were followed up at 4 weeks later. Results The ISI decreased gradually at 1 week, 2 weeks, and 4 weeks after treatment.The therapeutic effects of the three groups were all better than ever before at 1 week, 2 weeks, and 4 weeks after treatment (P<0.05). The follow-up therapeutic effect of the flying needle acupuncture group was better than that of the estazolam group and of the non-point acupuncture group (P<0.05). The curative effect of flying needle acupuncture is better than that in the other two groups (P < 0.05). Conclusion The subjective sleep quality of insomnia patients received flying needle with intradermal needle in shu-acupoint is beter than that of insomnia patients of the Estazolam group and of the non-point acupuncture group.

Background Sulforaphane (SFN) is an effective chemopreventive agent and can regulate the biological molecular mechanisms to inhibit the overgrowth of cells.Autophagy is a biological process of maintaining cellular internal environment.Understanding the affection of SFN to biological behavior of human lens epithelial cells (LECs) and the association of SFN with autophagy is helpful for the prevention and target treatment of posterior capsule opacification (PCO).Objective This study was to investigate the eradication effeccts of SFN on residual lens cell population in vitro posterior capsule opacification (PCO) model and evaluate the mechanism of SFN-induced cell death.Methods In vitro human capsular bag models were generated from fresh donor eyes by phacoemulsification and were cultured in EMEM containing 2％ fetal bovine serum (FBS).Different concentrations of SFN (0,1,10 and 100 μ mol) were added in the medium for 30 days respectively according to grouping,and the growth of LECs was observed by optical microscope and immunofluorescence technique.FHL124,a human LEC line,was cultured with EMEM containing 5％ FBS and divided into 0,1,10,30 and 100 μmol SFN groups.Lactate dehydrogenase (LDH) release rate in the medium was detected to evaluate cell damage/death.The migration of the cells on capsular bags was assessed by scratch test.The ultrastructure and number of autophagosomes were examined under the transmission electron microscope.The expression of LC3 in the cells were detected using Western blot in the presence or absence of autophagy inhibitors.Results The cell coverage rates on the capsular bags were significantly lower in the 10 and 100 μ mol/L SFN groups than those in the 0 and 1 μmol/L SFN groups,with a statistically significant difference among the groups (F =48.57,P ＜ 0.01).Immunofluorescence showed that the density of F-actin-and Vimentin-positive cells was evidently decreased in the 10 and 100 μmol/L SFN groups compared with 0 and 1 μ mol/L SFN groups.The releasing levels of LDH (absorbancy) were 0.19± 0.03,0.39±0.06,0.56±0.07,0.68±0.08 and 0.89±0.09 in the 0,1,10,30 and 100 μ mol/L SFN groups,respectively,and the releasing level of LDH was gradually increased in the 10 and 100 μ mol/L SFN groups in comparison with the 1 μmol/LSFN group (all at P＜0.01).With the increase of SFN concentration,the reduction rate of scratched area decreased with the increase of SFN concentration,and the decrease of scratch area was significantly lower than that of adjacent low mass concentration group and the differences were statistically significant (P＜0.05).The relative expressions of LC3-Ⅱ protein were 0.423±0.003,14.543±0.024,0.668±0.024 and 0.576±0.056 in the blank control group,SFN group,SFN + 3-MA group and 3-MA group,respectively,and the relative expressions of LC3-Ⅱ protein were significantly lower in the SFN+3-MA group and 3-MA group than those in the SFN group (all at P＜0.01).The number of autophagosomes was 4.07±0.32,4.13±0.34,9.21 ±0.53 and 21.02± 1.34 in the blank control group,and 1,10,100 μmol/L SFN groups,and the number of autophagosomes in the 10 and 100 μ mol/L SFN groups was significantly higher than that in the blank control group and 1 μmol/L SFN group (all at P＜0.01).Conclusions SFN mediates LECs death by promoting autophagy in ex vivo capsular bags,and SFN may be a novel agent of potential chemopreventive and target treatment for PCO.

With the rapid development of new media,medical students' ideological and moral qualities,physical and mental health have been unprecedentedly affected.Traditional ideological and political education modes for medical students encounter great challenges.In order to strengthen the ideological and political education for medical students,we need to focus on three aspects,namely enhancing information qualities of the subjects of ideological and political education,enhancing the supervision of public opinion and guidance on new media and building new interactive environment.

Objective To evaluate the values of clinical application of color Doppler ultrasound in the diagnosis and treatment of iatrogenic femoral artery pseudoaneurysm (IFAP) in the elderly following percutaneous transluminal coronary angioplasty(PTCA). Methods A tota.of 35 patients aged(73.8±1.3) years with IFAP after PTCA were examined by color Doppler ultrasound.All cases were treated by compression simply for blocking blood flow with probe guided by ultrasound,and the failed cases were injected Reptilase into the lumen of pesudoaneurysm. Results 35 patients were diagnosed as IFAP by color Doppler ultrasound and the coincidence rate with clinical diagnosis was 100％ (35/35).Among all patients,31 cases were cured by simply compression guided by ultrasound and 3 cases were cured hy the injected reptilase into lumen,the cure rate was 97.15％(34/35).One cases was cured by surgery after failure to treat by the two above methods.34 cases (97.2％)were verified into occlusio by ultrasound after 24-48 h of treatment. Recurrence and other serious complications were not found during follow-up of 3-6 months. Conclusions Color Doppler ultrasound can be used for the preferred method in accurate diagnosis and effective cure of IFAP following PTCA in the elderly.

Objective To investigate the pathogens and their drug resistance of neonatal skin infection in Maternal-Neonatal Unit to provide evidence for rational selection of antibiotics.Methods Secretions of skin lesions from newborns with skin infections delivered in Maternal-Neonatal Unit,Department of Obstetrics of Beijing Daxing People's Hospital from Jan.2009 to Dec.2010 were collected,cultured and identified for bacterial serotype.Antibiotic resistances of pathogens were determined.Enumeration data was presented by frequency and rate.The difference between groups was compared with Chi-square test.Results Two hundred and six newborn skin infection cases were diagnosed,which accounted for 2.3％ of all newborns (n=9131) delivered in the hospital during the study period.Two types of skin infection were identified,impetigo (n=192,93.2％) and omphalitis (n=14,6.8％).Totally 154 pathogens were found,including 95 (61.7％) Gram-positive cocci and 59 (38.3 ％) Gram-negative bacilli.The major pathogens among Gram-positive cocci were Staphylococcus aureus (45/154, 29.2％), followed by Staphylococcus epidermidis and Staphylococcus haemolyticus.Staphylococcus was sensitive to Cefazolin,Amoxicillin/clavulanic acid and Piperacillin/tazobactam,while resistant to Penicillin,Ampicillin and Erythromycin.The major pathogens among Gram-negative bacilli were Enterobacter cloacae (19/154,12.3％),followed by Escherichia coli and Klebsiella pneumoniae.Drug resistance rate of Gram-negative bacilli was high in penicillin,aminoglycosides and cephalosporins,while they were sensitive to piperacillin/tazobactam,Ampicillin/sulbactam,carbapenems and Quinolones.Conclusions Gram-positive cocci are the main pathogens of neonatal skin infection in the Maternal-Neonatal Unit,and among which Staphylococcus aureus is the major pathogen.Multi-drug resistance is common in the identified pathogens.Attentions should be paid to use antibiotics reasonably according to drug sensitivity test.

Objective To establish the reference intervals of neuron specific enolase (NSE) in tumor markers in cerebrospinal fluid .Methods According to National Committee for Clinical Laboratory Standards document C 28‐A2 ,120 samples were collected to establish reference intervals .Then ,the established intervals were evaluated according to China National Accreditation Service for Conformity Assessment document CL38 :2012 .Results The biological reference interval of NSE in cerebrospinal fluid was 0-3 .14 ng/mL .There was no significant correlation between cerebrospinal fluid NSE level and age ,sex (P> 0 .05) .Conclusion Method used in this study could be ensured reliable ,accurate ,scientific and practical ,desirable for clinical requirement and with great poten‐tial for clinical application .

Objective To develop an LC-MS/MS method for simultaneous determination of metolazone and valsartan in beagle dog plasma.Methods The chromatographic separation was achieved on an Agilent Poroshell 120(2.1 mm ×30 mm × 2.7 μm)analytical column.The multiple reaction monitoring mode operating in positive ion was adopted in MS detection, and precursors to the product ion transitions of m/z 366.2/259, 436.2/291 and 423.4/207 were used to measure metola-zone, valsartan and internal standard ( losartan potassium) .Results The method was linear over the concentration range of 0.5 ng/ml-100 ng/ml for metolazone and 5-5000 ng/ml for valsartan, with the correlation coefficients ( r2 ) of 0.9937 and 0.9939, respectively.The average intra-day precision values ( RSD) were 2.09% -8.85% for metolazone and 2.36%-13.12%for valsartan.The matrix effect values were 87.73%-98.62%for metolazone and 99.03%-137.35%for valsartan.The average recovery was 75.74%-81.82%for metolazone and 83.89%-95.64%for valsartan.Conclu-sion This analytical method for metolazone and valsartan is simple, accurate and sensitive, so it can be used for pharma-cokinetic research of metolazone and valsartan immediate release tablets in beagle dogs.

Objective: To evaluate the long term efficacy of treating the primary dysmenorrhea of cold-damp stagnation type by Acupuncture of Liji therapy. Methods: In this study, a total of 76 cases of primary dysmenorrhea of cold-damp coagulation type were randomly divided into the acupuncture of Liji therapy group, and the body acupuncture group, with38 cases in each group. Both groups were continuously treated 3 menstrual cycles, and followed up in the third and six menstrual cycles after the end of the treatment. Visual analogue scale for abdominal pain and Dysmenorrhea Symptoms scale were used as therapeutic indexes. Remove shedding cases, the long-term effects and scores of the 2 groups were compared. Besides, untoward and side effects needed to be recorded. Results: There were 2 cases lost in the acupuncture ofLiji therapy group and 1 cases in the body acupuncture group. After treatment, The clinical comprehensive efficacy of acupuncture ofLiji therapy group was better than that of body acupuncture group (P ＜ 0. 05) . Both groups of VAS scores and dysmenorrhea symptom scores were decreased to different degrees during treatment and follow-up period (P ＜ 0.05) .The follow-up data of the body acupuncture group after six menstrual cycles were higher than that of the third menstrual cycles after treatment. Compared with the two groups, the acupuncture of Liji therapy group was superior to the body acupuncture group during the third menstrual cycles follow-up (P ＜ 0.05) and six menstrual cycles follow-up (P ＜ 0.01) .The treatment satisfaction of acupuncture of Liji therapy and body acupuncture was 91.67％ and 72.97％. There were no adverse reactions in the two groups during the study period. Conclusion: Acupuncture of Liji therapy can effectively relieve dysmenorrhea symptoms and the general discomfort caused by dysmenorrhea, the long-term effect is stable and durable. primary dysmenorrhea of cold-damp stagnation type with acupuncture of Liji therapy has definitely long term curative effect. In addition, the treatment of patients with acupuncture of Liji therapy is more satisfactory, it is worthy of cilnlcal application.

OBJECTIVETo improve the oral bioavailability of patchoulic alcohol in rats by using self-microemulsifying drug delivery systems (SMEDDS).

METHODPatchoulic alcohol was separated and purified from patchoulic oil, and the SMEDDSs including patchoulic alcohol or patchoulic oil were optimized by pseudo-ternary phase diagrams via central composite design-response surface methodology. Pharmacokinetics of both SMEDDSs and patchoulic alcohol itself in rats were investigated.

RESULTThe patchoulic alcohol SMEDDS (Cremophor EL-Tween 80-PEG 400-isopropyl myristate-patchoulic alcohol, 2:2:0.8:1.95:0.65) was considered as the optimized formulation. The mean drop size of the system was 30. 1 nm after diluted 100 folds in water. The average self-microemulsifying time was 142 s. Patchoulic alcohol SMEDDS and patchoulic oil SMEDDS showed no signficant difference in Tmax compared with patchoulic alcohol with around 60 minutes, while the AUCs of both SMEDDSs (2001 745.6 +/- 329 663.6) and (1594 005.6 +/- 280 150.3) microg x min x L(-1) were significantly higher than that of patchoulic alcohol (1 163 153.3 +/- 232 324.3) microg x min x L(-1).

CONCLUSIONSMEDDS can effectively improve the oral bioavailability of patchoulic alcohol in rats.

Administration, Oral ; Animals ; Biological Availability ; Chemistry, Pharmaceutical ; Drug Delivery Systems ; methods ; Drug Stability ; Emulsifying Agents ; chemistry ; Ethanol ; chemistry ; Female ; Particle Size ; Rats ; Rats, Sprague-Dawley ; Self Administration ; Sesquiterpenes ; chemistry ; Solubility

Objective To explore the clinical significance of integrated screening of RET in a Chinese multiple endocrine neoplasia type 2A(MEN 2A)family and to evaluate the feasibility and effectiveness of prophy-lactic total thyroidectomy to MEN 2A-related medullary thyroid carcinoma ( MTC).Methods Medical history was obtained from 10 family members in a 3-generation south China family .Systemic investigations including bio-chemical tests, imaging examinations and germline RET screening were performed .3 asymptomatic mutation car-riers underwent prophylactic total thyroidectomy .Results RET screening showed a heterozygous missense muta-tion of TGC to CGC at codon 634 on exon 11 in 6 members(p.C634R), which was completely consistent with the clinical manifestations.There were 4 males and 2 females.The initial mean diagnostic age of 33.5 years(ranging from 19 years to 65 years) and the mean maximum diameter of MTC was 2.3 cm(ranging from 0.7 cm to 5.2 cm). Among them 3 members had palpable neck masses (1 case with diarrhea).Right total thyroidectomy +right level Ⅵlymph-node dissection with modified right neck dissection in one case , and bilateral total thyroidectomy +bilat-eral level Ⅵlymph-node dissection in 2 were performed .In other 3 asymptomatic mutation carriers , prophylactic total thyroidectomy +bilateral level Ⅵ lymph-node dissection were also performed .Among them, 1 case of a-symptomatic pheochromocytom ( PHEO) underwent cortical-sparing adrenalectomy before MTC .After the first op-eration, 4 patients still presented a high value of calcitonin , among whom 1 patient( T3N 1bM 0-1) underwent re-operation for 3 times after the initial operation and presented metastasis to bone after 130 months, taking vandet-anib orally up to now;2 patients underwent reoperation at 6 and 7 months after initial operation respectively (T1N 1bM0 and T2N 1bM0), and the other one patient was closely monitored and followed up for 22 months(T2N 1b M0).Moreover, The calcitonin levels dropped to normal in the other 2 asymptomatic cases(T1N0M0) who were followed up for 20 months.Conclusions Pedigree screening can work up an early diagnosis and improve the prognosis of MEN 2A.Integrated screening of RET and pre-operative calcitonin level measurement and prophylac-tic thyroidectomy for asymptomatic RET mutation carriers are reasonable and effective .