Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Hot Temperature ; Humans ; Male ; Mumps ; therapy ; Sulfur ; chemistry ; Young Adult

Objective To analyze the correlation of gamma-glutamyl transpeptidase (GGT)level with alpha-fetoprotein (AFP)level and to re-evaluate the diagnostic value of GGT for hepatocellular carcinoma (HCC).Methods Four hundred and seventy-two patients with HCC or liver cirrhosis,who were hospitalized in China-Japan Friendship Hospital from January 2003 to June 2009,were included in the study.The correlation between GGT and AFP was analyzed by Spearman nonparametric test.The cut-off values for the two parameters were determined based on their receiver operating characteristics (ROC)curves,areas under the ROC curve (AUCs),sensitivity,and specifici-ty,and the diagnostic values were presented using their sensitivity,specificity,and correct index.Statistical analysis was performed using SPSS 17.0.Normally distributed continuous data were analyzed by independent-samples t test,while non-normally distributed continuous data were analyzed by Mann -Whitney U test.Categorical data were analyzed by Pearson chi -square test,continuity-corrected chi -square test,or Fisher’s exact test.Results Among 472 patients,224 were diagnosed with HCC,and 248 with liver cirrhosis.Compared with cirrhotic patients,HCC patients had a significantly higher GGT level (113 (58-254)U/L vs 38 (22-72)U/L,Z=-11.037,P<0.001)and a significantly higher AFP level (429.5 (15.7-1210.0)ng/ml vs 5.7 (3.4-18.2)ng/ml,Z=-10.157,P<0.001).A significant correlation was found between GGT and AFP (r=0.449,P<0.001).The AUC was 0.784 for GGT and 0.788 for AFP.The cut-off value was 60 U/L for GGT and 20 ng/ml for AFP.The sensitivity was 74.1%for GGT,71.8%for AFP,and 90.7%for a combina-tion of the two parameters,the specificity was 70.2%,77.6%,and 58.7%,respectively,and the correct index was 0.443,0.494,and 0.494,respectively.Conclusion GGT may be regarded as one biomarker for HCC,and its level is significantly correlated with AFP level. The diagnostic value of AFP may not be improved when used in combination with GGT.

Objective To report the medium-term follow-up results for deep venous thrombosis(DVT) after total knee arthroplasty(TKA).Methods Between July 2003 and March 2004,55 patients(63 knees)who had had TKA were followed up for DVT.In follow-ups 1 to 2 weeks after TKA,their clinic symptoms,Doppler ultrasonograms and venograms were analyzed.In the following out-patient follow-ups done at every six months,we observed their clinic symptoms and Doppler uhrasonograms for the operated lower extremity.Venography was done only for those who had severe DVT symptoms.Results The venography one week after TKA conformed that DVT occurred in 34 patients(41 knees,61.8%).Two weeks after operation,DVT vanished in 12 cases,but deterio- rated to the proximal part in two cases.The follow-ups averaged 36.6 months(range,32 to 40 months).The results at five time points showed that the incidence of DVT did no decrease with lapse of time(P＞0.05).Conclusion No matter whether DVT occurs in the perioperative period,incidence of DVT in the medium term varies little.

Objective:To analyze 3 123 cases of medical device adverse events(MDAE)and provide some suggestions for the MDAE monitoring.Method:By the retrospective case study,3 123 MDAE reports were analyzed in Hunan Province in 2007.Result:The reports mainly came from medical institutions and other drug-use units.Intrauterine devices (IUD),medical suture thread and orthopedic implants caused a higher proportion of adverse events.The quantities of MDAE reports were imbalanced in different regions.Conclusion:The MDAE monitoring should be promoted by propaganda and training in order to ensure the safe use of medical devices in public.

OBJECTIVE:To investigate inhibitory effects of matrine on the proliferation of human bladder cancer BIU-87 cells and its mechanism. METHODS:The cell viability was detected by MTT assay and inhibitory rate of cell proliferation was calculat-ed after human bladder cancer BIU-87 cells were treated with 0(negative control),0.5,1.0,2.0 and 4.0 mg/ml matrine for 24,48 and 72 h,respectively. After treated with 0 (negative control),0.5,1.0,2.0 and 4.0 mg/ml matrine for 48 h,the cell cycle and apoptotic rate were detected by flow cytometry;the expression of Survivin,Caspase-3 and Caspase-7 protein were detected by Western blot assay. RESULTS:Compared with negative control,the proliferation of BIU-87 cells were significantly inhibited after incubated with 1.0-4.0 mg/ml matrine for 24,48 and 72 h(P<0.05 or P<0.01),and inhibitory rate of cell proliferation increased in concentration and time-dependant manner;after treated for 48 h,the percentage of G0/G1 phase cells and apoptotic rate in-creased,while the percentage of cells at S phase and G2/M phase were decreased (P<0.05 or P<0.01);the expression of Cas-pase-3 and Caspase-7 protein increased,while the expression of survivin protein decreased after incubated with 0.5-4.0 mg/ml ma-trine for 48 h. CONCLUSIONS:Matrine can inhibit the proliferation of human bladder cancer BIU-87 cells,block the cell cycle and induce apoptosis;its mechanism may be related to the expression regulation of Survivin,Caspase-3 and Caspase-7.

Objective To investigate the relationship between preterm delivery and anterior myometrial (MA) thickness measured by ultrasound in the second trimester. Methods The general information and pregnancy outcome of singleton pregnant women who had antenatal visit in the Hunan Provincial People′s Hospital between Oct 2010 and Sep 2013 were collected prospectively. The MA thickness was measured at 20-27+6 gestational weeks. The cases were divided into preterm delivery group and term delivery group. Results (1)A total of 1 031 pregnant women were recruited in this study. 147 pregnant women were in the preterm delivery group(14.26%,147/1 031) and 884 women were in the term delivery group(85.74%,884/1 031). The gestation age at delivery of the preterm delivery group was significantly earlier than the term delivery group [(34.57 ± 2.39) vs (39.23 ± 0.92) weeks,P<0.05]. No significant difference was observed in the age, gravidity, parity, history of preterm delivery, cesarean delivery rate and gestational age at the time of MA measurement between the two groups(P>0.05). The incidence of premature rupture of membrane(PROM) in the preterm delivery group and in the term delivery group were 49.0%(72/147) and 15.8%(140/884),respectively, with statistically significant diffrence(P<0.01). (2) The mean value of MA thickness in the term delivery group was (5.49±1.39) mm, while in the preterm delivery group it was (5.60 ± 0.87) mm. There was no statistically significant difference between the two groups(P>0.05). The mean value of MA thickness in the spontaneous preterm delivery group was(5.15±0.75) mm, and was (5.61±1.38 ) mm in the term delivery group, with statistically significant difference(P<0.01). The mean value of MA thickness in the preterm premature rupture of membrane (PPROM) cases was( 5.96±0.78 ) mm, and in term delivery group with PROM it was(5.38±1.12) mm. The difference between the two groups were statistically significant (P< 0.01). (3) Among the 1 031 pregnant women, 212 women had PROM, with the mean value of MA thickness of (5.67±1.32) mm. For those who did not have PROM, the mean value of MA thickness was (5.56±1.10) mm. There was no statistically significant difference between the two groups(P>0.05). No correlation was found among PROM and MA thickness(r=0.058,P>0.05). However, in the preterm delivery group, the mean value of MA in PPROM was significantly thicker than the spontaneous preterm delivery cases(P<0.01). There was a positive correlation between the MA thickness and PPROM (r=0.457,P<0.01). Conclusion The MA thickness had some correlation with spontaneous preterm delivery and PPROM, while the MA thickness should not be considered as an independent factor of preterm delivery.

Objective To evaluate the efficacy of telbivudine in HBeAg-positive chronic hepatitis B (CHB) patients by comparing the efficacy of initial telbivudine therapy in treatment-naive patients with sequential telbivudine therapy in patients with poor response to adefovir.Methods A total of 90 HBeAg-positive CHB patients were assigned to receive sequential telbivudine therapy following poor response to adefovir dipivoxil (n=45),or initial telbivudine therapy in antiviral treatment-naive patients (n=45).All patients were treated with telbivudine 600 mg daily for 104 weeks.The efficacy was evaluated in terms of liver function tests,serum HBV markers,HBV DNA and antiviral drug resistance.Results Telbivudine showed good overall efficacy after treatment for 104 weeks in terms of alanine aminotransferase normalization rate (91.1％),HBV DNA negative conversion rate (80.0％),HBeAg loss rate (57.8％),and HBeAg/HBeAb seroconversion rate (30.0％).The HBV DNA negative conversion rate in initial treatment group was significantly higher than that in sequential treatment group (P＜0.05).However,among the patients with early response,the efficacy did not show significant difference between groups (P＞0.05).The patients with early response showed significantly better efficacy than those without early response,in terms of higher HBV DNA negative conversion rate,higher HBeAg loss rate and HBeAg/ HBeAb seroconversion rate (P＜0.000 1 or P＜0.05),but lower virological breakthrough rate (P＜0.05).Conclusions Telbivudine has shown reliable efficacy in CHB patients.Initial telbivudine therapy is better than sequential therapy in CHB patients with poor response to adefovir.However,for patients with early response to telbivudine,no statistical difference is found between initial and sequential therapy in long-term treatment efficacy (104 weeks).The patients receiving sequential telbivudine therapy should be monitored closely for early antiviral response to optimize treatment.

The article analyses the current situation of the unbalanced development of Chinese higher medical education and the reasons for it,and points out that to promote its development,gradation and diversify development of education must be realized.

Objective To study the effect of morphine used in epidural anesthesia on puerpera after cesarean section and the safety of morphine to neonate. Method One hundred puerpera undergone cesarean section were randomly divided into test group and control group with continuous 2% lidocaine epidural anesthesia, as soon as the operation were finished, 2 mg morphine was injected into vacum epidurale for test group, nothing for control group. Colostrum and plasma, urine samples of puerpera and neonate were collected, morphine and metabolite level were tested by GC-MS and FPIA. Result Morphine concentrations ranged from 0.05). Conclusion As the epidural analgesia medicine after cesarean section, morphine has no side-effect to neonate and is safe to neonate.

The Halliwick concept is a kind of aquatic kinesitherapy concept to reduce disability and improve quality of life through activities in water such as swimming. It mainly includes the Halliwick Ten-Point-Programme aimming at teaching siwmming and the Water Specific Therapy focusing on impairments of body functions or body structure. The Halliwick concept can be relatead to the International Classification of Functioning, Disability and Health very well, and its therapeutic effects has been supported by more and more evidence-based-studies.