ObjectiveTo observe the effect of electroacupuncture at Neiguan (PC6) and Shenmen (HT7) on heart rate variability (HRV) in patients with post-cerebral-infarction sequelae.MethodEighty patients were randomized into two groups, 40 cases in each group. The control group was intervened by anti-platelet aggregation and other ordinary symptomatic treatment based on Western medicine, while the treatment group was by electroacupuncture at Neiguan and Shenmen in addition to the treatments given to the control group.ResultThere were no significant differences in comparing the HRV indexes between the two groups before intervention (P>0.05); while the HRV indexes in the treatment group were superior to that in the control group after intervention (P<0.05). HRV indexes were improved after intervention in the treatment group (P<0.05); of the indexes, only SDNN was improved after intervention in the control group (P<0.05), and the rest indexes were insignificantly changed (P>0.05).Conclusion Electroacupuncture at Neiguan and Shenmen can significantly reduce HRV in patients with post-cerebral infarction sequelae.

Alport syndrome (AS) is a hereditary glomerular basement membrane disease characterized by hematuria, progressive renal hypofunction, usually with nervous deafness and ocular lesions, and its pathogenesis is the mutation in genes encoding the type Ⅳ collagen. Diagnosis of AS should combine with clinical manifestations, renal pathologic changes, immunofluorescence examination and gene diagnosis. At present, AS hasn t had any cure measure yet. As the pathogenesis of AS is much clearer in recent years, the researches of gene diagnosis and gene therapy have got some gratifying achievements.

Objective To explore ladder and compensation system of nurse-staffing which is suitable for the situation of our country.Methods The ladder management and compensation system to nursestaffing of National Health Service (NHS) in UK were given detailed introduction and analysis through the official documents,references and personal study experiences,and summarize its scientific and referenced aspects.Results NHS has formed a set of mature competency-based ladder system,and linked the ladder system to compensation system,made a relative scientific performance appraisal system,realized the scientific competency matches the level,salary changes along with the level model.Conclusions It provides references and thinking to the in-depth reform of public hospitals in our country,and the development of high quality nursing service,as well as the implementation of nursing ladder management and compensation reform.

Macrophages play an important role in the pathogenesis of rheumatoid arthritis (RA). Previously, studies have shown that changes in the metabolism of glucose, choline, amino acids and lipids in macrophages of patients with RA can lead to the accumulation of metabolic intermediates which can act as inflammatory signaling molecules to aggravate the inflammation and cause complications. Therefore, a full understanding of the metabolic process of macrophages in RA patients will lay the foundation for macrophage-targeted therapy of RA. In this review, not only the role of macrophage abnormal metabolism in the pathogenesis of RA but also the research progress on macrophage-targeted drugs in RA treatment will be discussed.

Kynurenine 3-monooxygenase (KMO) is a key rate-limiting enzyme in the downstream catabolism of kynurenine pathway (KP). Under the catalysis of KMO, the intermediate product kynurenine is metabolized into various active metabolites, including 3-hydroxykynurenine (3-HK), quinolinic acid (QA) and nicotinamide adenine dinucleotide (NAD⁺). More and more studies have shown that abnormal KMO expression activity mediates KP metabolic disorders, and is involved in the occurrence and development of nervous system diseases, autoimmune diseases, infectious diseases and tumors, suggesting that KMO can be used as a potential and effective drug therapeutic target. This article focuses on the role of KMO in the pathological mechanism of various diseases, and summarizes the existing KMO inhibitors to provide methods and ideas for targeted KMO therapy.

There are many different kinds of drugs which can treat ischemic stroke. This study aims to analyze the clinical treatment of ischemic stroke using Chinese and western medicines and their combination scheme. Data abstracted from 15 national 3a grad hospitals' hospital information system (HIS) databases were collected, then were used frequencies to find the common used drug and type, and were used association rules to anylizs the common combined medication scheme of Chinese and western medicines. It was found that the Shuxuetong (9 015 cases, 22.66%), Danhong (7 369 cases,18.53%) and Xueshuaitong (5 302 cases,13.33%) injections were the most frequently used drugs, and blood-activating and stasis-dissolving prescription (30 384 cases, 76.39%), resuscitative prescription (6 850 cases,17.22%) and tonic prescription (5 997 cases,15.08%) were the most commonly used types of Chinese medicine. The oral dose of aspirin (20 924 cases, 52.60%), Guangxi pp injection (10 771 cases, 27.08%) and insulin injection (10 599 cases, 26.65%) were frequently used. And the types of antiplatelet agents (23 049 cases, 57.95%), vasodilator (19 608 cases, 59.29%) and antihypertensive drug (15 475 cases, 39.90%) were commonly used. The drug combination of aspirin, twenty five pearl pill, Danhong and Xueshuaitong injection were the most frequently used group and its confidence coefficient is 97.5%. The type combination of blood-activating and stasis-dissolving prescription, thrombolytic drug, insulin and vasodilator was the most commonly used group and its confidence coefficient is 97.424%. This study concludes that the drug combination of aspirin, twenty five pearl pill, Danhong and Xueshuaitong injection and the type combination of blood-activating and stasis-dissolving prescription, thrombolytic drug, insulin and vasodilator were commonly used in clinical.
Adult ; Aged ; Aged, 80 and over ; Aspirin ; therapeutic use ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fibrinolytic Agents ; therapeutic use ; Humans ; Insulin ; therapeutic use ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; therapeutic use ; Stroke ; drug therapy ; Vasodilator Agents ; therapeutic use

Objective　To study the radiographic findings in the diagnosis of pulmonary lymphoma and pseudolymphoma. Methods　Eight patients with pulmonary lymphoma and 2 with pseudolymphoma were examined by X-ray film, tomography, and CT. Results　Single or multiple nodules or masses were observed in 8 patients with pulmonary lymphoma, shaggy borders or halo of ground-glass attenuation in 7 patients, 2 patients had multiple patchy infiltrates bilaterally, 2 had diffuse interstitial infiltrates and 1 had miliary nodules. Multiple consolidations with air bronchogram and without hilar and mediastinal lymphadenopathy were observed in 2 patients with pulmonary pseudolymphoma. Conclusion　Radiographic findings of pulmonary lymphoma were varied, the most common findings were the nodules or masses with shaggy borders or halo of ground-glass attenuation. The specific findings of pulmonary pseudolymphoma were multiple consolidations with air bronchogram and without hilar and mediastinal lymphadenopathy. The final diagnosis relied on pathology.

Objective To explore the surgical safety and clinical efficacy of combined anterograde and retrograde method exposing porta hepatis for the treatment of the intrahepatic cholangiocarcinoma invading porta hepatis.Methods The retrospective descriptive study was conducted.The clinicopathological data of 3 patients with left intrahepatic cholangiocarcinoma invading porta hepatis who were admitted to the Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine from February 2015 to May 2016 was collected.All the 3 patients underwent left hemihepatectomy combined with caudate lobectomy after preoperative lab and imaging examinations and the evaluations of liver function and residual liver volume.The surgical procedures followed as:anterograde dissection of porta hepatis,exposure of hilar plate,left hemihepatectomy combined with caudate lobectomy,right artery resection and reconstruction,hilar cholangioplasty and bilioenteric anastomosis.Observation indicators included:(1) surgical situations:operation time,time of hepatic artery~ anastomosis and volume of intraoperative blood loss;(2) postoperative pathological examinations;(3) postoperative situations:postoperative complications (biliary fistula,hemorrhage,abnormal liver function,gastroplegia) and postoperative chemotherapy;(4) follow-up:postoperative patients' survival and carcinoma occurrence.Follow-up was performed to by outpatient examination up to December 2016.The follow-up included clinical symptoms such as abdominal pain,chills,fever and jaundice,liver function and tumor marker examination,and color ultrasound Doppler or abdominal enhanced computed tomography (CT) was performed to detect carcinoma recurrence.Measurement data was represented as average (range).Results (1) Surgical situations:all the 3 patients underwent successful left hemihepatectomy combined with caudate lobectomy using combined antegrade and retrograde method exposing porta hepatis,including 1 combined with right hepatic artery resection and reconstruction,without perioperative death.The average operation time,average time of hepatic artery anastomosis and average volume of intraoperative blood loss of 3 patients were 493 minutes (range,430-570 minutes),11 minutes and 526 mL (range,450-600 mL),respectively.(2) Postoperative pathological examination showed 3 patients were diagnosed with cholangiocarcinoma,2 with nerve bundles invaded and 2 with No.12 lymph node metastasis,with negative margins of bile duct and hepatic artery.(3) Postoperative situations:3 patients are not complicated with biliary fistula and gastroplegia.One patient with postoperative liver dysfunction after right artery resection and reconstruction underwent anti-infection,hepatoprotection and anti-hepatic encephalopathy therapies,and then was improved and discharged from hospital at 4 weeks postoperatively.The other 2 patients recovered steadily without complications such as hypohepatia,and then respectively discharged from hospital at 17 and 20 days postoperatively.All the 3 patients underwent chemotherapy of gemcitabine combined with S-1 for 8 courses at week 4 or 5 postoperatively.(4) Follow-up:all the 3 patients were followed up for 7-20 months,with good general conditions and normal liver function and without cholangitis symptoms.One patient received right artery reconstruction,and CT reexamination at postoperative month 3 showed fine imaging of right hepatic artery.There was no sign of carcinoma recurrence.Conclusion The combined anterograde and retrograde method exposing porta hepatis for the treatment of the intrahepatic cholangiocarcinoma invading porta hepatis can increase the radical resection rate and surgical safety.

Objective To establish an efficient, effective hepatocyte isolation technique in order to increase cell production and decrease the prime cost. Methods The inferior vena cava below diaphragm was dissected and ligatured, and the inferior vena cava below liver was separated. Subsequently, the liver was perfused with EGTA through the portal vein while the inferior vena cava below liver was opened, and then the liver was harvested. The liver tissue was cut into 1 mm?1 mm?1 mm and digested at 37 ℃ water bath with Ⅳ collagenase for 30-40 minutes, then the hepatocytes were purified and cultured in CO 2 incubator. The production and function of hepatocytes were assessed. Results The isolated hepatocytes using this technique were more than 95% among the all isolated cells. No statistic difference was found in cell production and cell function comparing with traditional technique. But this technique was simplified and more economically. Conclusion This modified hepatocyte isolation technique is efficient and effective. It can ensure the amount of production and purity of hepatocytes.

[Objective]To study the curative effect and superiority of one stage anterior-posterior approach total spondylectomy and spinal reconstraction in the treatment of thoracolumbar malignant neoplasms.[Method]Twenty-four thoracolumbar malignant neoplasms patients treated by anterior approach total spondylectomy,spinal reconstractin with titanium mesh cage associated with bone graft or bone cement and posterior approach transpediuclar screw fixation.[Result]The follow-up of postoperation was from 9 to 35 months.All patients achieved relieve of pain after surgery,9 cases with incomplete paraplegia improved by 1.8 grades in average with Frankel neurological classifications,2 cases with dysfunction of urination and defecation were recovered,4 patients decease for metastasis in critical organ,all the patients showed bony fusion at 6~9 months,no internal fixation loosening or breakage case was found,1 case was recrudescent after one year.[Conclusion]Treatment of thoracolnmbar malignant neoplasms by one stage anterior-posterior approach total spondylectomy and spinal reconstraction can remove the neoplasms efficiently,reconstraction the spinal stabilization and improve the quality of life.