Acupuncture Therapy ; Adolescent ; Humans ; Male ; Sleep Wake Disorders ; therapy ; Treatment Outcome

The clinical and electrocardiographic data of 35 cases with CAVB were analyzed. They could be divided into two groups: chronic (28 cases) and transcient(7 cases). The primary diseases of the patients in the chronic group were coronary heart disease(CHD) in 11 cases, a condition of unknown cause in 12, and miscellaneous diseases in 5.The clinical and ECG manifestations of the 12 cases with unknown cause were suggestive that the disorder was most likely to be primary degeneration of conduction bundles(PDCB). PDCB differed from CHD by the following:(1) In PDCB, there was neither history of chest pain nor factors vulnerable to CHD being found. No ischemic changes cound be found on the ECG of PDCB cases.(2) The duration of CAVB was longer in PDCB cases (mostly over 3 years) than in CHD cases (all under 2 years).(3) The onset of CAVB occurred at a younger age in PDCB(an average of 50.6 years) than in CHD(an average of 66.3 years).The difference between the two was significant(P

Objective To investigate the clinical effect and safety of EEG biofeedback therapy combined with mirtazapine in the treatment of depressive disorder.Methods 124 patients with depressive disorder were selected and randomly divided into the observation group and the control group,62 cases in each group.The control group was given mirtazapine treatment,while the observation group was given EEG biofeedback therapy combined with mirtazapine.All the two groups were treated for 8 weeks.Before and 2,4,8 weeks after treatment,the clinical effects in the two groups were evaluated by Hamilton depression scale (HAMD),Montgomerie depression rating scale (MADRS) and the clinical global impression scale (CGI).The side effects scale(TESS) assessment was used to assess the side effects.And the serum norepinephrine (NE),5-hydroxytryptamine (5-HT) and dopamine (DA) levels were measured before and 8 weeks after treatment.Results The total effective rate of the observation group was 87.5％,which was significantly higher than 66.1％ in the control group (x2 =7.213,P ＜ 0.05).In the two groups,2,4,8 weeks after treatment,the HAMD scores were significantly lower than those before treatment (t =9.391,19.349,26.349,5.026,12.610,19.518,all P ＜ 0.05),the M ADRS scores were significantly lower than those before treatment (t =8.646,22.190,33.101,4.986,13.185,25.959,all P ＜ 0.05),and the CGI scores were significantly lower than those before treatment(t =17.471,29.482,42.256,13.136,28.358,35.661,all P ＜ 0.05).In the observation group,after treatment for 2,4,8 weeks,the HAMD scores were significantly lower than those in the control group(t =4.093,4.537,5.655,all P ＜ 0.05),and the MADRS scores were significantly lower than those in the control group (t =3.622,9.740,7.490,all P ＜ 0.05),while the CGI scores were significantly lower than those in the control group(t =8.608,11.024,12.598,all P ＜ 0.05).After treatment,the levels of 5-HT,NE and DA were (148.5 ± 4.9) ng/mL,(60.6 ± 4.2) ng/L and (78.0 ± 4.1) ng/L in the observation group,which were significantly higher than before treatment [(79.8 ± 4.3) ng/mL,(30.3 ± 4.0) ng/L and (43.5 ± 4.0) ng/L,t =82.977,41.134,46.837,all P ＜ 0.05].In the control group after treatment,the levels of 5-HT,NE and DA were (125.4 ± 4.1) ng/mL,(40.2 ± 4.0)ng/L and (50.3 ± 4.3)nig/L,which were significantly higher than those before treatment [(79.2 ± 3.9)ng/mL,(30.5 ±4.1)ng/L and (43.2 ±3.6)ng/L,t =64.287,13.334,9.969,all P ＜0.05],but which those in the observation group increased more significantly (t =28.469,27.695,36.286,all P ＜ 0.05).4 weeks and 8 weeks after treatment,the TESS scores in the observation group were (3.0 ± 1.0) points and (4.3 ± 1.2) points,which in the control group were (2.8 ± 1.2) points and (4.1 ± 1.3) points,there were no significant differences in terms of TESS scores (t =1.150,0.846,all P ＞ 0.05).Conclusion EEG biofeedback therapy combined with mirtazapine in the treatment of depression is better,the adverse reactions is not significantly increased,and it also has higher clinical safety compared with mirtazapine alone.

Objective To study the feasibility of renal hypothermia achieved by retrograde icecold saline infusion with perfusion pump. Methods Twenty-one patients who received the open radical nephreetomy were divided into three groups,A group with ice-slush renal hypothermia,B group with gravitational retrograde ice-cold infusion,C group with retrograde ice-cold infusion by perfusion pump.After the kidney was dissected and the ureter was divided,the renal vasculars were clamped.The kidney was cooled by three methods respectively.The temperature of renal parenchyma was monitored for 15 min. Results Fifteen minutes later,the temperature of renal parenchyma of A group declined from 34.4℃ to 5.4℃,B group from 34.8℃ tO 23.8℃,C group from 35.1℃ to 22.3℃.Coneiusions Renal hypothermia can be achieved by retrograde cold saline infusion and the perfusion pump may accelerate the speed of cooling.

Objective To investigate the protective effects of reducing average radiation dose and increasing protective weight on the auditory system (tympanic cavity,the bony portion of eustachian tube,vestibule,and cochlea) during intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods The planning system (ADAC Pinnacle3 8.0m) with direct machine parameter optimization was used to optimize the IMRT planning for 40 patients with NPC (stage Ⅰ + Ⅱ:20 patients ;stage Ⅲ + Ⅳ:20 patients).Without reducing the radiation dose for target volume,the IMRT planning was optimized by limiting the average dose administered to the auditory system or increasing the protective weight for the protected organs in auditory system.The protective effects were assessed by analyzing the average dose received by the auditory system.Results After limiting the average dose administered to the auditory system without reducing the radiation dose for target volume,the average dose received by the auditory system was significantly reduced (3855.5-5391.3 Gy vs 2960.3-4559.6 Gy,P =0.000 for all) ; when the protective weight for the auditory system was increased,the average dose received by the auditory system was even more reduced (3855.5-5391.3 Gy vs 2725.4-4271.4 Gy,P =0.000 for all).For all three regimens,the average dose was significantly higher in stage Ⅲ + Ⅳ patients than in stage Ⅰ + Ⅱ patients (P =0.000 for all).Conclusions For the IMRT planning for NPC,limiting the average dose administered to the auditory system can greatly reduce the average dose received by the auditory system,and increasing the protective weight for the auditory system can further reduce the average dose received by the auditory system.However,the protective effect on the auditory system may be reduced as the stage of NPC increases.

AIM: To investigate the signaling mechanisms involved in the priming effects of lipopolysaccharide(LPS) on heat killed Staphylococcus aureus(HKSa)-induced nitric oxide(NO) production in macrophages.METHODS: Murine macrophage RAW264.7 was used in the experiment.Griess reagent was used to measure the content of nitrite in culture medium.Real-time PCR and Western blot was utilized to examine the mRNA and protein levels of toll-like receptor 2(TLR2),respectively.Dual luciferase reporter assay was used to assess the transcriptional activity of nuclear factor of activated T cells(NF-AT).RESULTS: The RAW264.7 cells pretreated with LPS for 24 h significantly enhanced NO production induced by HKSa,suggesting that LPS primed the macrophages and increased the reactivity of the cells to HKSa.LPS increased the mRNA and protein levels of TLR2 in a dose-dependent manner in RAW264.7 cells.The RAW264.7 cells pretreated with LPS enhanced NO production induced by peptidoglycan,one of the specific ligand of TLR2.The priming effect of LPS on HKSa-induced NO production was partly blocked by TLR2 neutralizing antibody.LPS significantly enhanced the transcriptional activity of NF-AT,which was inhibited by BAPTA/AM(a cell-permeable cytosolic calcium chelator) and cyclosporine A(CsA,an inhibitor for calcineurin).Both BAPTA/AM and CsA inhibited the priming effect of LPS on HKSa-induced NO production in RAW264.7 cells.CONCLUSION: The present study confirms the priming effect of LPS on the reactivity of RAW264.7 cells to HKSa.Pattern recognition receptor TLR2 and calcium/calcineurin/NF-AT signaling pathway may be involved in the priming process initiated by LPS.

Objective To investigate the effects of sIL-2R in plasma on regulatory T cells (Treg) in children with Kawasaki disease ( KD ) .Methods Thirty-three children with KD and fourteen age-matched healthy children were enrolled in this study .The proportions of CD4+CD25+Foxp3+Treg cells in pe-ripheral blood and mean fluorescence intensity (MFI) of phosphorylated-STAT5 (pSTAT5) protein in CD4+CD25+T cells were analyzed by flow cytometry .The concentrations of sIL-2R, IL-2, IL-7 and IL-15 in plas-ma were measured by cytometric bead array ( CBA ) .Real-time PCR was performed to detect the gene ex-pressions of Foxp3, GITR, CTLA4, IL-2Rα, IL-2Rβand IL-2Rγat mRNA level as well as the expressions of IL-17A and ROR-γt at mRNA level in CD4+CD25-T cells.Results (1) Compared with the control group, the proportions of CD4+CD25+Foxp3+Treg cells in peripheral blood from patients with KD and the expressions of associated factors including Foxp 3, GITR and CTLA-4 at mRNA level were significantly down-regulated (P<0.05).However,the expressions of IL-17A and ROR-γt at mRNA level in Th17 cells were markedly up-regulated (P<0.05), which could be recovered to some extent after treatment with IVIG (P<0.05).(2)The expressions of pSTAT5 protein in CD4+CD25+T cells from patients with acute KD were sig-nificantly decreased (P<00.5 ), but increased with IVIG intervention (P<0.05).(3)The concentrations of sIL-2R in plasma were elevated during acute KD (P<0.05), but decreased after treatment with IVIG (P<0.05).Moreover, KD patients with coronary artery lesion ( KD-CAL+) presented a high level of sIL-2R than those without coronary artery lesion (KD-CAL-) (P<0.05), but there was no significant difference in the concentrations of IL-2, IL-7 and IL-15 in plasma between two groups (P>0.05).(4)The expressions of IL-2Rαand IL-2Rβat mRNA level in CD4+CD25+T cells from patients with acute KD were lower than those of the healthy subjects (P<0.05), but up-regulated to some extent with IVIG treatment (P<0.05).There was no significant change in the expression of IL-2Rγat mRNA level (P>0.05).The concentrations of sIL-2R in plasma were negatively correlated with the expressions of IL-2Rβand Foxp3 at mRNA level and pSTAT5 at protein level (P<0.05).The expression of pSTAT5 protein had positive correlation with the ex-pression of Foxp3 at mRNA level (P<0.05).Conclusion Aberrant IL-2/STAT5 signaling pathway media-ted by significantly increased concentration of sIL-2R in plasma might be one of the factors leading to down-regulation of Treg cells in patients with acute KD .

Objective To analyze the safety and effectiveness of ambulatory surgery in inguinal herniorraphy.Methods The clinical data of 3 852 cases of inguinal hernia repair patients admitted from January 2009 to December 2013 in this single center was analyzed retrospectively.Cases of emergency surgery were excluded.Results All patients had long-term follow-up (12-60 months).1 575 patients underwent day-surgery,mean operation time was (43.84 ± 12.35) min,mean time of ambulation was (1.12 ± 0.91) d,mean time of recovery was (5.78 ± 1.12) d,mean hospitalization was (1.34 ± 0.48) d,mean hospitalization cost was (7 546.49 ±2 962.57) RMB.In contrast,there were 511 patients underwent a non day-surgery,mean operation time was (48.59 ± 14.52) min,mean time of ambulation was (2.43 ± 1.38) d,mean time of recovery was (7.46 ± 2.62) d,mean hospitalization was (4.8 ± 2.91) d,mean hospitalization cost was (9 165.16 ± 4 281.83) RMB.Patients with day-surgery were significantly superior to those with non day-surgery in operation time (P =0.000),mean time of ambulation (P =0.000),mean hospitalization (9 =0.000),mean hospitalization cost (P =0.000) and mean time of recovery (P =0.000).Infection and readmission in non day-surgery patients was higher than that in day-surgery (P =0.000).There was no difference in postoperation pain and hernia recurrence.Conclusions Ambulatory surgery in inguinal herniorraphy is safe with similar recurrence rate;but significantly lower cost and shorter hospitalization.

Objective:To establish a method for the content determination of triptolide, total diterpenoids and total alkaloids in Leigongteng oral solution to provide basis for the quality control. Methods:An HPLC analysis was used to detect the content of triptol-ide, which was carried out on an Eclipse XDB-C18 column (150 mm × 4. 6 mm, 5μm) with the mobile phase consisting of acetonitrile-water with gradient elution. The flow rate was maintained at 1. 0 ml·min-1 , the column temperature was kept at 40℃ and the detec-tion wavelength was set at 218 nm. Using triptolide and wilforine as the contrast, the total diterpenoids and total alkaloids were deter-mined by UV-Vis spectrophotometry. Results:There were good linear relationship in the determination of triptolide, total diterpenoids (caculated as triptolide) and total alkaloids (caculated as wilforine) (r≥0. 999 8), the average recovery were 91. 96%, 90. 56%, 99. 18%, and the RSD were less than 3%. Conclusion:The method is with good reproducibility and stability, which can be used for the quality control of Leigongteng oral solution.

Objective To analyze the efficacy and safety of CT-guided percutaneous injection of the fibrin glue bv double needle technique to treat sacral cyst.Methods Clinical data of 20 cases with double-needle injection of fibrin glue technology to treat sacral cyst were retrospectively analyzed.All patients had varying degrees of sacral nerve root compression symptoms.The treatment for sacral cyst was carried out after clear diagnosis was made.On the basis of CT-guided percutaneous injection of fibrin glue,the improved CT-guided percutaneous injection of fibrin glue by double-needle technique was used to treat these patients.The average dose of fibrin glue was(5.9 ± 2.4)ml.The clinical results of improvement as to pain and neurological function were evaluated after follow-up of an average of 17 months.The assessment criteria were as follows:excellent,complete resolution of signs and symptoms,with the patient returning to his or her regular employment and no recurrence of cysts during 1 year of follow-up,good,symptoms and signs in the legs and perineal region resolved but with persistent pain in the lumbosacral region,which did not interfere with the patient' s regular work (the cysts did not recur for 6 months during follow-up),fair,no improvement in clinical symptoms,but a decrease in cyst size on the imaging study,poor,no improvement in clinical symptoms and no observed changes in cyst size in imaging studies or recurrence.Results Most patients experienced some degree of pain relief and functional improvement after fibrin glue therapy,with most experiencing complete or marked resolution of clinical symptoms.Nine patients reported excellent recovery,8 reported good recovery,2 reported fair recovery,and 1 reported poor recovery.The overall percentage of positive outcomes (excellent and good recovery) was 85％.No serious postoperative complications were discovered.Conclusions CT guided percutaneous injection of the fibrin glue bydouble needle technique to treat sacral cyst is an ideal method.Double needle technique is simple,safe and reliable.