OBJECTIVETo investigate the effectiveness of polycystic ovary syndrome (PCOS) of damp-phlegm constitution treated with embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10).

METHODSEighty-five patients were randomly divided into 2 groups of observation group (42 cases) and control group (43 cases). Embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10) were applied to the observation group. Points such as Zhongwan (CV 12), Guanyuan (CV 4), Tianshu (ST 25), Zhangmen (LR 13), Jingmen (GB 25), Qimen (LR 14), Ganshu (BL 18), Weishu (BL 21), Pishu (BL 20), Shenshu (BL 23), Dachangshu (BL 25) and Xiaochangshu (BL 27), etc. were adopted for embedding therapy. At the same time, needle-pricking therapy on Sifeng (EX-UE 10) was also applied once a week. 0. 5 g metformin hydrochloride tablet was given to the control group, once a day for the first week, and twice a day from the second week. Estimation on therapeutic effect was made for both groups after 3 months treatment. Change of symptoms and signs scores, fasting insulin (FINS), 2 hour insulin after meal (2hINS) and insulin resistance index (HOMA-IR) of both groups before and after treatment were observed, and therapeutic effect estimated.

RESULTSThe total effective rate of the observation group is 97. 6% (41/42), and that of the control group was 95. 4% (41/43). There was no significant difference between the two groups (P>0. 05). Scores of symptoms and signs after treatment were significantly improved in both groups (all P<0. 01), and the observation group was better than the control group (7.01+/-4.23 vs 8. 47+/-2. 82,P<0. 05). Compare with those before the treatment, FINS, 2hINS and HOMA-IR after the treatment were all decreased in both groups (all P<0. 05). The comparison between the two groups showed that differences of FIN had no statistic significance (P>0. 05) after the treatment, while both differences of 2hINS and HOMA-IR had statistic significance [ 2hlNS: (443. 531+/- 93. 90) pmol/L vs (621.29+/-93. 87) pmol/L ; HOMA-IR: 4. 88+/-0. 30 vs 5.06+/-0. 32, both P<0. 05]. The improvement of 2hINS and HOMA-IR in the observation group was better than that of the control group.

CONCLUSIONTreatment of PCOS of damp-phlegm constitution with embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10) have positive effect, which can effectively reduce the insulin resistance, meanwhile, reduce the side-effects of western medication.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Polycystic Ovary Syndrome ; therapy ; Treatment Outcome ; Young Adult

AIM: To investigate the clinical effect for treating bullous keratopathy ( BK ) by anterior corneal stromal acupuncture combined with amniotic membrane transplantation.
METHODS: Totally 35 patients ( 35 eyes ) with bullous keratopathy were treated by corneal stromal acupuncture combined with amniotic membrane transplantation. All patients preoperative and postoperative underwent anterior segment OCT, corneal topography, corneal sensitivity and confocal microscopy. To observe postoperative ocular symptoms in patients with BK, recurrence of bulla, changes in corneal thickness, corneal sensitivity and changes in the organizational structure of the layers of the cornea.
RESULTS: Thirty-five were followed up for 6-18mo. The symptom of pain disappeared in 32 cases ( 91%) in the first day after operation and did not recur during follow-up. The symptom of pain relieved in 3 cases (9%) in the first day after operation and disappeared in 3 days. Corneal epithelium of 9 cases ( 26%) were all healed within 1wk, 21 cases (60%) were all healed within 2wk, and 5 cases (14%) were all healed within 3wk. Following up for 6-18mo, there was no recurrence of symptoms or bulla. A small amount of tiny bubbles in the surrounding area appeared in 2 cases after 3 and 4wk. All patients had no neovascularization, and had smooth corneal surface. The amnions of 30 cases (86%) were thinning after 2mo, partially dissolved and absorped, not seen with the naked eye after 3mo. Thirty-four cases (97%) had no changes in vision, one case (3%) was from the light to front of the manual. After 2mo, corneal sensation decreased in 30 cases ( 86%) , corneal thickness increased from preoperative 788±35μm to 940±43μm. After 12mo, corneal thickness increased to 1060±27μm. Results of confocal microscopy: after 3mo, the number density of the trigeminal nerve fibers under corneal basement membrane reduced, shallow stromal cells became into fibrotic stroma, deep stroma was more loose, and cells swelled significantly. The number of endothelial cells reduced and form swelled more obviously compared with preoperatively.
CONCLUSION: Corneal acupuncture combined with amniotic membrane transplantation can effectively control the symptoms of BK, prevent the recurrence of BK, and especially it is a simple, safe and practical way for patients with poor visual function.

Brain delivery of drugs remains challenging due to the presence of the blood-brain barrier (BBB). With advances in nanotechnology and biotechnology, new possibilities for brain-targeted drug delivery have emerged. Biomimetic nano drug delivery systems with high brain-targeting and BBB-penetrating capabilities, along with good biocompatibility and safety, can enable 'invisible' drug delivery. In this review, five different types of biomimetic strategies are presented and their research progress in central nervous system disorders is reviewed. Finally, the challenges and future prospects for biomimetic nano drug delivery systems in intracerebral drug delivery are summarized.

OBJECTIVETo explore the technique and therapeutic effect of bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral shaft fractures in young children. Methods:From June 2006 to June 2012,45 young children with femoral shaft fractures were treated by bridge wire splint fixation with ankle dorsiflexion,which was designed according to arch bridge mechanical principle and structure. There were 31 males and 14 females with an average age of 3.2 years old ranging from 8 months to 5.5 years old; 14 cases were upper 1/3 femoral fractures,26 cases were middle 1/3 femoral fractures,5 cases were lower 1/3 femoral fractures; 20 cases were transverse fractures, 14 cases were oblique fractures,6 cases were spiral frac- tures, and 5 cases were comminuted fractures. X-ray, follow-up imaging changes,clinical curative effect and complications were assessed.

RESULTSForty-five patients were followed up for 6 to 21 months (averaged 12 months). All fractures were reached clinical bone healing after 5 to 7 weeks (averaged 6 weeks) fixation. Seven cases appearred limb soft tissue complications, including buttocks bedsore,dorsal foot and Achilles tendon epidermal necrosis, and healed after dressing and removal of external fixation. During follow-up,the original overlap angle and lateral displacement were remodeled, and limbs were restored to the normal line of force and bone structure. According to Flynn standard, 35 cases got excellent results, 8 cases good, 2 cases fair.

CONCLUSIONThe bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral. shaft fractures in young children (less than 6 years old) is safe,feasible, simple,and has raliable effect, which can be applied in primary hospitals.

Ankle ; surgery ; Bone Wires ; Child ; Child, Preschool ; Female ; Femoral Fractures ; surgery ; Femur ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; Humans ; Infant ; Male ; Treatment Outcome

Chlorophenols are typical priority pollutants listed by USEPA (U.S. Environmental Protection Agency). The removal of chlorophenol could be carried out by a combination of electrochemical reduction and oxidation method. Results showed that it was feasible to degrade contaminants containing chlorine atoms by electrochemical reduction to form phenol, which was further degraded on the anode by electrochemical oxidation. Chlorophenol removal rate was more than 90% by the combined electrochemical reduction and oxidation at current of 6 mA and pH 6. The hydrogen atom is a powerful reducing agent that reductively dechlorinates chlorophenols. The instantaneous current efficiency was calculated and the results indicated that cathodic reduction was the main contributor to the degradation of chlorophenol.
Chlorine ; chemistry ; isolation & purification ; Chlorophenols ; chemistry ; isolation & purification ; Electrochemistry ; methods ; Industrial Waste ; prevention & control ; Oxidation-Reduction ; Water Pollutants ; isolation & purification ; Water Purification ; methods

OBJECTIVETo evaluate the feasibility and safety of total colonic exclusion plus side to side antiperistaltic ileorectal anastomosis in the treatment for elderly patients with slow transit constipation (STC).

METHODSClinical data of 13 patients with severe idiopathic STC undergoing the above novel procedure in Zhongnan Hospital of Wuhan University between May 2009 and September 2012 were retrospectively analyzed. The Wexner constipation score and gastrointestinal quality of life index (GIQLI) before and 6 months after operation were compared.

RESULTSThere were 8 female and 5 male patients, with a mean age of 74 years (range 63-82 years). No procedure-related deaths or any serious complication occurred. The length of follow-up ranged from 6 to 29 months (median,12 months). The duration of surgery was (55±4) min. Blood loss was (30±2) ml. The postoperative hospital stay ranged 10 to 16 days (mean 11.4 days). The first bowel movement occurred in the 4th day (range 2nd-8th day) after operation. There was no intestinal occlusion and anastomotic leakage that required surgery in all the patients. No fecal incontinence or constipation recurrence was found. One patient developed blind loop syndrome 14 months after operation. Postoperative complications included incision fat liquefaction in 2 cases, anorectal bearing-down while bowel movement in 2 cases, and minor defecate difficulty needed glycerin enema in 1 case. Wexner scores was significantly improved from 22.8±3.3 before operation to 5.4±2.1 six months after operation (P<0.05). GQLI was significantly increased from 93.6±20.5 before operation to 120.8±13.0 six months after operation (P<0.05). At 6 months after operation, the outcome was excellent in 11 patients and good in 2 patients.

CONCLUSIONTotal colonic exclusion plus side to side antiperistaltic ileorectal anastomosis is easy, safe and effective in the treatment for selected elderly patients with STC.

Aged ; Aged, 80 and over ; Anastomosis, Surgical ; methods ; Colon ; surgery ; Constipation ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies

Objective To determinate the prognostic value of etiology in patients with chronic systolic heart failure (CSHF).Methods Data of in-hospital patients with CSHF were investigated between 2000 and 2010 from 12 hospitals in Hubei province.All patients were followed up through telephone calls.Univariate and multivariate Cox proportional hazards analyses were then used to explore the differences in the all-cause mortality,heart failure (HF) mortality and sudden cardiac death (SCD) among patients caused by different etiologies.Kaplan-Meier curve were then constructed and Univariate and multivariate Cox regression analyses were used to select demographic and clinical variables in predicting the all-cause mortality,HF mortality and SCD in CSHF patients.Multivariate logistic models and ROC curve were developed with or without the cinfirmed etiology to assess the incremental additive information related to different etiologies.Results (1)Over the median 3 (2-4) years follow-up program,6453 (38.69％) patients died,including 5505 (33.00％) due to HF prognosis and 717 (4.30％) died of SCD.All-cause mortality rates accounted for 34.50％,54.30％,41.48％ and 15.76％,with HF mortality rates as 30.11％,44.95％,36.25％ and 13.10％.SCDs accounted 8.46％,8.45％,9.84％ and 1.05％ in patients with CHD,DCM,HHD and RHD,respectively.(2) Compared with RHD patients,the adjusted HRs for all-cause mortality were 1.554 (1.240 to 1.947;P＜0.001),1.405(1.119 to 1.764;P=0.003) and 1.315(1.147 to 1.467;P=0.005) while the adjusted HRs and 95％CIs for HF mortality were 1.458( 1.213-1.751 ;P＜0.001 ),1.763( 1.448-2.147;P＜0.001 ) and 1.281 ( 1.067-1.537; P=0.008),in patients with CHD,DCM and HHD,respectively.There were no significant differences in CHD (HR 3.345; 95％ CI,1.291 to 8.666; P=0.013 ) or HHD (HR 2.062; 95％CI,0.794 to 5.352; P=0.137 ),while only DCM ( HR 4.764; 95％CI,1.799 to 12.618;P=0.002) remained significant in SCD despite of the multivariate adjustment.(3) Etiology increased the sensitivity and specificity of predicting models for all-cause mortality(AUC 0.839,95％CI,0.832to 0.845 vs.0.776,95％CI,0.768 to 0.784) and HF mortality(AUC 0.814,95％CI,0.806 to 0.822 vs.0.796,95％CI,0.788 to 0.804) but not with SCD (AUC 0.777,95％CI,0.749 to 0.809 vs.0.747,95％CI,0.727 to 0.766).Conclusion CSHF due to CHD,DCM and HHD carried a worse prognosis than that of RHD.Different etiologies provided significant incremental prognostic information beyond readily available clinical variables for all-cause mortality and HF mortality.

Objective To investigate the prevalence and related factors of medicinal therapy in patients with chronic systolic heart failure (CSHF).Methods Data on in-hospital patients with CSHF were studied from 12 hospitals in Hubei province,in 2000 and 2010.Differences on gender and age were calculated and Multivariate Cox regression analysis was performed to determinate the independent risk factors of all-cause mortality.Results (1) 16 681 patients were enrolled in this study.Among which,6453 died during the 5.82 ± 1.63 years of follow-up.The annual medical expenditure was larger in the survival group than in the dead ones (3.19 ± 0.65 vs.3.32 ± 0.57,P＜0.01).(2)The prevalence of Angiotensin Ⅱ receptor blocker increased along with age which accounted as 7.73％,7.35％,12.26％,14.29％,17.19％,19.87％ and 20.49％,respectively,in the ＜30,30-39,40-49,50-59,60-69,70-79 and ≥80-year groups.The distribution of digitalis,diuretics,β-receptor blocker,Angiorensin- converting enzyke inhibitors showed inversed U shape.(3)The annual medical expenditure increased as patients got older,with age groups ＜30,30-39,40-49,50-59,60-69 and 70-79 years old as 2.96 ± 0.70,3.09 ± 0.62,3.15 ± 0.58,3.30 ± 0.59 and 3.25 ±0.58,respectively (P＜0.01).It reduced to the same level as in the 50-59 year-old group.The distribution of annual medical expenditure showed similar pattern in males.However,the trends were only found in patients at 50-59,60-69,70-79 and ≥80 years-old groups in female.Conclusion More attention should be paid to medicinal therapy in patients with CSHF.Medicinal therapy shifted with age and gender,of which females had more adverse trend than in males.

OBJECTIVETo study the effect of hyperbaric oxygenation (HBO) on the differentiation of the implanted human neural stem cells (hNSCs) into neurons in neonatal rats following hypoxic-ischemic brain damage (HIBD).

METHODSHIBD model was prepared by ligation of the left common carotid artery, followed by 8% hypoxia exposure in 7-day-old Sprague-Dawley rat pups. Three days later, the rats received implantation of hNSCs into the left cerebral ventricles. Then the survived rats were randomly divided into two groups: transplantation alone and transplantation+HBO (n=8 each). HBO treatment was administered (1.8 ATA, 1 hr once daily for 10 days) in the transplantation+HBO group 1 hr after hNSCs transplantation. Brains were removed 10 days after transplantation. Frozen coronal sections were prepared for immunofluorescence analysis to detect the neural differentiation of the transplanted cells in the cerebral cortex and hippocampus.

RESULTSDifferentiated neurons of implanted cells distributed mainly in the cortex and the hippocampus of the injured side. There was no difference in the number of neurons in the cortex between the two groups, while the number of neurons in the hippocampus significantly increased in the transplantation+HBO group compared with that in the transplantation alone group (231.4+15.1 vs 162.6+5.6; P<0.05).

CONCLUSIONSHBO treatment may promote the differentiation of implanted hNSCs into neurons in the hippocampus of neonatal rats following HIBD.

Animals ; Animals, Newborn ; Cell Differentiation ; Female ; Humans ; Hyperbaric Oxygenation ; Hypoxia-Ischemia, Brain ; therapy ; Male ; Neurons ; cytology ; Rats ; Rats, Sprague-Dawley ; Stem Cell Transplantation

BACKGROUNDThe effects of anxiety and depression on the recurrence of persistent atrial fibrillation (AF) after circumferential pulmonary vein ablation (CPVA) are not clear. Whether CPVA can alleviate the anxiety and depression symptoms of persistent AF patients is unknown.

METHODSOne hundred and sixty-four patients with persistent AF, of which 43 treated with CPVA (CPVA group) and 103 treated with anti-arrhythmics drugs (medicine group), were enrolled. The Zung Self-Rating Anxiety Scale (SAS), and Zung Self-Rating Depression Scale (SDS) were assessed before and 12 months after treatment in all patients.

RESULTSThe scores of SAS (40.33 ± 7.90 vs. 49.76 ± 9.52, P < 0.01) and SDS (42.33 ± 8.73 vs. 48.17 ± 8.77, P < 0.01) decreased 12 months after CPVA. Over 12 months follow-up, AF relapsed in 17 patients in CPVA group. Compared with the data in the recurrent group (17 patients), the scores of SAS and SDS were significantly lower in the non-recurrent group (26 patients) at baseline. The results of multivariate Logistic regression analysis showed normal scores of SAS and SDS were the independent risk factors of AF recurrence after CPVA.

CONCLUSIONSAnxiety and depression increase the recurrence risk of persistent AF after CPVA. CPVA can ameliorate the anxiety and depression symptoms in patients with persistent AF.

Aged ; Anti-Asthmatic Agents ; therapeutic use ; Anxiety ; complications ; Atrial Fibrillation ; drug therapy ; pathology ; psychology ; surgery ; Catheter Ablation ; Depression ; complications ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; surgery ; Treatment Outcome