BACKGROUND: Fibromyalgia is a kind of non-articular rheumatism,manifested as pain and stiffness in various parts of body, associated with sleep disturbance, fatigue, etc. But, the therapeutic effects of common therapies are not satisfactory.OBJECTIVE: To compare dermal neurological electric stimulation and electric acupuncture with routine medication and explore the therapeutic effects on fibromyalgia syndrome (FS).DESIGN: Randomized controlled experiment was designed, in which the patients were taken as the objects in observation.SETTING: First and Third Hospital Affiliated to Xinxiang Medical College.PARTICIPANTS: Totally 66 cases of FS were selected in Clinic of Rehabilitation Center of the First Affiliated Hospital of Xinxiang Medical College from July 1994 to May 2002, all of which were the followed-up cases.They were randomized as dermal-neurological eleetric stimulation group (DE group), electric acupuncture group (EA group) and medical group, 22cases in each one. The patients were aged varied from42 to 55 years and sick in range from 7 to 13 months.METHODS: ① DE group: FZ-1 low-frequency pulsating apparatus was used. Two pairs of electrodes were attached to two pairs of main points that were near to the most distinct pain points and another pair was attached to 1 pair of supplementary points. Continuous wave was selected, pulsating width was 6-150 ms, high frequency 100 Hz and 15 minutes later,changed to low frequency 2 Hz, for another 15 minutes, intensity about (14±3) mA, once/d, continuously for 20 days as one session, totally 2 sessions were required. 4-day rest was demanded between two sessions. ② EA group: No.28 filiform needle was used to be inserted on the points deeply,after qi arrival; G-6805 electric apparatus was applied on the points. Point selection, operation and time 9f treatment were same as DE group. ③ Medical group: Oryzanol and Vit B1 were administrated orally, 30 mg/tablet,3 times a day. Amitriptyline was administrated, 10 mg every day at beginning, increased by 10 mg every day till to 20-30 mg. It was taken orally once before sleep, totally for 45 days.MAIN OUTCOME MEASURES: ① Comparison of therapeutic effects on analgesia in each group. ② Comparisons of follow-up visits of cured cases and cases with remarkable effects in 6, 12 and 24 months after treatment.RESULTS: Totally 66 cases all entered the result analysis. ① Comparison of total effective rate of analgesia: The rates in DE group and EA group were higher significantly than medical group (100% ,95.5% ,68.2%;X2=18.03,17.27,P ＜ 0.01). ② Comparison of recurrence rate: The rates in DE group and EA group in 24 months after treatment were lower remarkably than medical group (7.1%,6.1%,50.0%;X2=7.01,6.91 ;P ＜ 0.05). CONCLUSION: Both dermal electric stimulation and electric acupuncture present strong analgesia and low recurrence rate. Dermal neurological electric stimulation on acupoints is a kind of non-traumatic method in treatment of fibromyalgia syndrome.

OBJECTIVE:To observe therapeutic efficacy of dexmedetomidine combined with propofol for sepsis infection deliration in patients underwent continuous intravenous blood replacement,and to study pharmacokinetic study. METHODS:60 patients with sepsis infection deliration underwent continuous intravenous blood replacement were selected and randomly divided into observation group and control group with 30 cases in each group. Control group was given propofol 0.5 mg/kg,and observa-tion group given dexmedetomidine and propofol. Therapeutic efficacy of 2 groups were analyzed comparatively,and pharmacoki-netic parameters of propofol were studied. RESULTS:The pharmacokinetic parameters of propofol as elimination half-life period (t1/2β),slow distribution half-life period (t1/2α) were shorter than literature reference value,with statistical significance (P<0.05),while the distribution rate constants(K21,K13,K10),the central compartment volume of distribution(VC),systemic clear-ance(CL),rapid distribution half-life period(t1/2pi)had no statistical significance,compared with literature reference value(P>0.05). After treatment,ICDSC score of 2 groups were decreased significantly,with statistical significance(P<0.05),while the observation group was significantly higher than the control group,with no statistical significance before and after treatment(P>0.05);the average hospital stay of observation group was significantly shorter than that of control group,with statistical signifi-cance(χ2=6.263 4,P=0.000);the incidence of ADR in control group was significantly higher than the observation group,with statistical significance(P<0.05). CONCLUSIONS:Dexmedetomidine combined with propofol have good effect on sepsis infec-tion deliration in patients underwent continuous intravenous blood replacement,and can reduce the length of hospital stay and the incidence of ADR.

Objective To examine the association between glycemia in COPD and pulmonary function. Methods 124 cases were divided as COPD and COPD with type 2 diabetes mellitus. COPD patients with diabetes were stratified according to the course of diabetes. The main pulmonary function measures included TLC,FVC, FEV_1, FEV_1/FVC%, FEF25%～75% and DLCO, DLCO/VA . Results DLCO and DLCO/VA in diabetic COPD were significantly lower than those of COPD ( P

Objective To investigate the influences of Bi-level positive airway pressure(BiPAP)to night-time hy- poxemia and change of sleep structure in the patients with overlap syndrome(OS).Methods 25 patients with OS,19 with primary snoring(PS)were monitored and diagnosed by nocturnal polysomnography(PSG)for parameters of sleep efficiency(SE)and sleep architecture.The data of patients with OS were rechecked after 2-month's BiPAP treatment. Results In OS group,the level of FEV1%,FEV1/FVC,SaO2 A,SaO2 L,SE,REM and S3+4 were significantly lower than those in PS(P

Objective To evaluate the efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) and septal myectomy (SM) for treatment of hypertrophic obstructive cardiomyopathy.Methods We searched all clinical controlled trials of PTSMA and SM in treatment of hypertrophic obstructive cardiomyopathy in Cochrane Library,PubMed,Web of Science,Wanfang Database and CNKI update to August,2012.The selected studies in Chinese and English were used for Meta-analysis with software RevMan 5.0.Results Five studies including 286 cases (PTSMA:149,SM:137) were included in the study.Left ventricular outflow tract pressure was significantly reduced by SM treatment compared with PTSMA (OR =9.07,95％ CI:0.96-17.18,P =0.030).There were no significant differences in interventricular septum thickness (OR =1.15,95％ CI:-0.79-3.10,P =0.240),left atrial diameter (OR =1.95,95％ CI:-0.16-4.07,P =0.070),left ventricular end-diastolic (OR =0.70,95％ CI:-0.79-2.19,P =0.360),end systolic diameter (OR =1.14,95 ％ CI:-1.65-3.93,P =0.420),degree of symptom improvement (chest pain:OR =1.07,95 ％ CI:0.35-3.23,P =0.910;syncope:OR =0.32,95％ CI:0.08-1.23,P =0.100),and postoperative mortality (OR =1.63,95％CI:0.46-5.76,P =0.450) between PTSMA and SM treatment; but the rates of pacemaker implantation (OR =5.91,95％ CI:2.04-17.11,P =0.001) and reintervention treatment (OR =6.62,95％CI:1.20-36.62,P=0.030) in patients with PTMSA were significantly higher than those with SM.Conclusions There is no evidence to indicate that PTSMA can completely replace SM,as an alternative choice the therapy can be used according to left ventricular out flow tract pressure,symptoms,anatomy of target vessel and other conditions.

OBJECTIVE: To evaluate function and application of various biomaterials in tissue engineering repair skull defect, and to seek a reasonable skull substitutes. METHODS: Using "tissue engineering, skull defect, stem cells, cytokines, composite" as key words in Chinese, and using "tissue engineering, skull defect, mesenchymal stem cells, cytokines, materials" as key words in English, a computer-based online search was performed for publications from January 1993 to October 2009. Articles concerning biomaterials and tissue engineering skull defect repair were included. Articles describing repetitive study or Mete analysis were excluded. Function of various biomaterials in tissue engineering repair skull defect was assess in 17 articles. RESULTS: Stem cell technique is to obtain seed cells from a few myeloid tissues. Following in vitro induction and amplification, cells at a certain number could compound with stents, and construct tissue-engineered bone in vitro. The cells could sustain the biological features of osteoblasts, and fuse with bone tissue in the recipient site. Simultaneously, it could avoid the occurrence of immunological rejection. Two or over materials were compounded together, or biomaterial surface received various modification. These could promote adhesion between cells and materials, elevate cell bioactivity and maintain biological function. Following moved into seed cells using some vectors, the latter ossified in bone defect site, and secreted suitable bone growth factor, induced the differentiation of peripheral non-oriented osteogenitor cells into oriented osteogenitor cells, which could harvest adequate seed cells with osteogenic activity in a short time, and accelerate the healing of skull defects. The composite made by using three-dimensional virtual imaging and computer numerical control modeling techniques has the advantages of medical composite, precise anatomical consistency with surrounding tissues of skull defects, and perfect appearance. CONCLUSION: At present, no material can be accorded with the requirement of bone tissue engineering. Combination of some materials or modification of biomaterial surface can promote adhesion of cells and materials, elevate cell biological activity, and maintain biological function, which are presently hot focus of tissue engineering research of biomaterials.

BACKGROUND: A middle cerebral artery occlusion and reperfusion(MCAO/R) model in rats with suture has been widely used in the researches of acute focal ischemic cerebral infarction, while the model in rabbits by the same method is relatively rare. Magnetic resonance diffusion weighted imaging (MR DWI) has been paid close attention recently for its sharp sensitivity of cerebral ischemia.OBJECTIVE: To establish rabbit models of MCAO/R by intraluminal thread, and study the characteristics of MR DWI after cerebral ischemia and reperfusion.DESIGN: Random controlled animal experiment.SETTING: Institute of Cerebrovascular Diseases, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiment was accomplished at the Key Laboratory of Brain Diseases Prevention and Cure of Shandong Province from March to June in 2005. A total of 103 adult healthy New Zealand rabbits of either sex, 10-12 weeks old and 1.8-3.3 kg weight were provided by the Experimental Animal Center of Shandong Agricultural Academy (SCX20040013).They were bred at quiet, sanitary and dry conditions.METHODS: Animal groups: 103 rabbits were divided randomly into group A (n=53) and group B (n=50). The rabbits in group A were treated with suture of 0.51-0.55 mm as the diameter of thread, while group B was reassigned into B1 (0.46-0.50 mm), B2 (0.51-0.55 mm) and B3 (0.56-0.60 mm).The successful MCAO/R models in 57 cases were randomly divided into permanent ischemia group (n=30, ischemia 1, 3, 6, 12, 24 andl 48 hours, 5ones at each time point) and ischemic reperfusion group (n=27, reperfusion 0, 2 and 5 hours, 5 ones at each time point; reperfusion 11, 23 and 47hours, 4 ones at each time point). Another 10 rabbits receiving sham operations were regarded as contrasts for permanent ischemia group and ischemia reperfusion group, with 5 ones in each.MAIN OUTCOME MEASURES: The changes of hyperintensity area on DWI and apparent diffusion coefficient (ADC) were measured in permanent ischemia group and ischemic reperfusion group.RESULTS: The data of 57 successful model rabbits were involved in the result analysis.①The successful rate in group A (26 cases, 49.1%) was significantly lower than that in group B (31 cases, 62.0%).②In ischemia group:The hyperintensity area on DWI with declined ADC appeared at ischemia 1 hour. The hyperintensity areas on DWI at different times increased gradually from ischemia 1 hour and unchanged within 24 hours. The mean ADC at different times declined at first and then gradually increased.③In reperfusion group: Comparing with ischemia 1 hour, the hyperintensity area on DWI reduced while ADC increased at reperfusion 2 hours and 5 hours, and enlarged with ADC high at reperfusion 11 hours, then continued to enlarge with ADC reduced significantly at 23 hours and 47 hours.CONCLUSION: The diameter of thread tip and the inserting distance of thread are main factors for establishing successful MCAO/R models. The hyperintensity area on DWI and the decreasing ADC after acute cerebral ischemia can be improved by early reperfusion, but the secondary decreasing ADC may be induced by continuously reperfusion.

Objective To systematically evaluate the effectiveness and safety of renal sympathetic denervation (RSD) for treatment of patients with resistant hypertension.Methods English and Chinese literatures of controlled clinical trials on RSD in treatment of resistant hypertension were searched from the Cochrane Library,PubMed,Web of Science,Wanfang Database and CNKI up to February 2013.Metaanalysis was performed with the selected studies by using software Rev.Man 5.0.Results Seven studies involving 354 cases with RSD and 146 controls were included for analysis.Compared with control group,RSD significantly lower both systolic and diastolic blood pressure in patients with resistant hypertension (systolic,1 month:MD =-18.04,95％ CI:-19.94--16.14,P ＜0.01; 3 months:MD =0.01,95％CI:-28.10--17.98,P＜0.01; 6 months:MD=-25.59,95％CI:-34.08--17.11,P＜0.01; diastolic,1 month:MD=-7.53,95％ CI:-8.60--6.45,P＜0.01; 3 months:MD =0.01,95％CI:-12.5--4.47,P ＜ 0.01; 6 months:MD =-10.54,95％ CI:-16.44--4.63,P =0.000 5).In addition,there was no significant difference in adverse reactions between RSD treatment group and control group (OR =1.13,95 ％ CI:0.34-3.76,P =0.84).Conclusions Renal sympathetic denervation can effectively reduce blood pressure in patients with resistant hypertension 1-6 months postoperatively,without increase of adverse reactions.The long-term efficacy and safety need to be further observed.

Objective To evaluate the applicability of small molecular markers of nephrotoxicity that in prediction of drug toxicity.Method Extracts of five kinds of traditional Chinese medicines (Tripterygium wilfordii,Strychni semen,Aristolochiafangchi,Rhei Radix et Rhizoma,and Xanthium sibiricum) that had known as nephrotoxicity were ig given to rats to establish renal injury models,and the blood samples were collected after administration for 1 and 7 d.Then blood samples were analyzed by UPLC/Q-TOF-MS for five kinds of small molecule biomarkers-thymidine,lyso-phosphatidylcholine (LPC 16:1),LPC (18:4),LPC (20:5),and LPC (22:5).The support vector machine (SVM) prediction model was established to determine the toxicity.The levels of Cr and BUN in serum were determined by automatic biochemical analyzer.The rats in each group were sacrificed after blood collection,and the kidneys were taken for HE staining.Result No toxicity was observed in the control group,and the biochemical test results showed no renal injury after mentioned five kinds Chinese herbs were given for 1 d,while SVM model of nephrotoxicity had been found abnormal.After administration for 7 d,the results of SVM model show renal toxicity,which were consistent with biochemical and pathological examination.Conclusion Metabonomics combined with the earlier established SVM model enabled prediction of drug nephrotoxicity more sensitively,quickly and \ccurately,and it is of great significance for the discovery of drug toxicity as well as the prevention and treatment of drug-induced renal injuries in clinic.

Objective To evaluate the clinical application value of Hopkins endoscope on removal of esophageal foreign bodies. Methods The clinical data of 96 patients with esophageal foreign body were analyzed retrospectively. Then the differences of the operation time between the visual surgery guided by Hopkins endoscope and conventional surgery of removal of esophageal foreign bodies were compared. Results Improved surgical operation time is significantly shorter than the traditional operation group. In addition,the operation time of improved surgery in the denture group,≥50 years old age group,≥24 h course group and the first stenosis of esophagus group is significantly shorter than the traditional ones. Conclusion Compared with the traditional surgery,the visual surgery of removal of esophageal foreign bodies guided by Hopkins endoscope with rigid esophago?scope has more advantages,especially for complex esophageal foreign body,which can significantly short the operation time and improve the opera?tion efficiency.