Acute Kidney Injury ; blood ; physiopathology ; therapy ; Blood Pressure ; Critical Illness ; therapy ; Electrolytes ; blood ; Female ; Hemofiltration ; methods ; Humans ; Infant ; Male ; Prognosis

OBJECTIVETo systematically review the clinical efficacy of acupuncture on the patients with low back pain (LBP).

METHODSRandomized controlled trials (RCTs) about pure acupuncture therapy versus other treatments in treating LBP were electronically searched in PubMed, CBM, EMbase, The Cochrane Library, CNKI, VIP and Wanfang Data from January 2004 to May 2014. The observed index on the results were the changed scores of VAS, ODI, JOA and RMDQ. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as the extracted data, and assessed the methodological quality. The results of Meta-analysis was conducted by RevMan 5.2 software.

RESULTSTen RCTs involved 751 patients were finally included. The results of Meta-analysis indicated that the role of pure acupuncture group in improving the VAS score was better than that of the control group, and the combined effect size was RR = -.32, 95% CI (-1.41, -1.22); Z=27.28, P<0.00001; the role of pure acupuncture group in improving the ODI score was better than that of the control group, and the combined effect size was RR = -5.07, 95% CI (-7.50, -2.65); Z=4.10, P<0.0001; the role of pure acupuncture group on improved JOA score was better than that of the control group and the combined effect size was RR=2.83, 95% CI (2.02, 3.63), Z=6.90, P<0.00001. The role of pure acupuncture group in improving the RMDQ score was better than that of the control group, and the combined effect size was RR = -2.80, 95% CI (-3.49, -2.11), Z=7.95, P<0.00001.

CONCLUSIONThe result of meta-analysis demonstrates that pure acupuncture may have a favorable effect on self-reported pain and functional limitations in LBP patients.

Acupuncture Therapy ; Humans ; Low Back Pain ; therapy ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To investigate magnetic resonance imaging(MRI) characteristics of autoimmune pancreatitis(AIP) in middle-aged and elderly patients. Methods MRI were performed in 17 middle-aged and elderly patients with AlP proved histopathologically or clinically. All clinical and MRI data were reviewed. Results Of 17 cases, MRI showed diffuse enlargement of the pancreas in 13 cases, and focal lesions in 4 cases. Swelled pancreas was hypointense on T1-weighted images, mildly hyperintense on T2-weighted images, decreased enhancement on artery phase of dynamic imaging, and moderate enhancement on delayed phase images. Capsule-like enhanced rim was found around swelled pancreas in 13 patients. Stricture of distal common bile duct was present in 15 patients, and diffuse irregular narrowing of the main pancreatic duct was showed in 5 cases. The mean apparent diffusion coefficient(ADC) value of AIP was 1.64×10~(-3) mm~2/s in 13 cases. Conclusions AIP occurs more often in middle-aged and elderly people. AIP shows some characterized MRI findings including swelled pancreas looking like banana or sausage, delayed enhanced capsule-like rim around the lesion and diffuse irregular narrowing of pancreatic duct. MRI will play an important role not only in the diagnosis of AIP, but also in evaluating curative effect of AIP.

Objective To assess the diagnostic predictive value of Wells score and modified Geneva score for acute pulmonary embolism by prospective case series and to explore a more suitable scoring system for Chinese population.Methods All the patients suspected of pulmonary embolism (PE) and received CT pulmonary angiography (CTPA) were enrolled consecutively in Fuxing Hospital,Capital Medical University,China,from June 2009 to August 2011.Before CTPA test or on condition that test results were unknown,clinical scoring was assessed prospectively by the Wells score and the modified Geneva score.The probability of PE in each patient was assessed and the patients were divided into low,moderate and high probability groups according to the clinical scores.The result of CTPA was used as the diagnostic gold standard for PE.Diagnostic accuracy in each group was analyzed.The predictive accuracy of both scores was compared by AUCROC curve.Results A total of 139 patients met our enrollment criteria and 117 eligible patients entered our study at last.PE was diagnosed in 47 patients by CTPA with an overall prevalence of 40.2％.Prevalence of PE in the low,moderate and high pretest probability groups assessed by the Wells score and by the simplified modified Geneva score were 7.1％ (3/42),42.9％ (21/49),88.5％ (23/26)and 10.0％ (3/30),48.1％ (37/77),7/10,respectively.AUCROC curves for the Wells score and the simplified modified Geneva score were 0.872 ( 95％ CI 0.810-0.933 ) and 0.734 ( 95％ CI 0.643-0.825 )respectively,with a significant difference ( P =0.005 ).Conclusion The Wells score is more accurate for clinical predicting acute PE than the modified Geneva score.

Objective To explore the therapeutic effect and medication safety of low-dose erythromycin treatment on intractable allergic rhinitis(AR) associated with bronchus asthma.Methods Totally 173 cases of children received outpatient treatment because of AR associated with asthma,their ages ranging from 3 to 14 years.Among them,78 cases developed intractable AR with symptoms of asthma having been controlled or satisfactorily controlled after 2 courses of conventional treatment.Seventy-six children with intractable AR received full follow-up and were randomly divided into observation group and control group.The control group was given different second-generation antihistamines,when necessary,supplemented by nasal glucocorticoids.In the observation group,the same treatment as it was done in control group was continued,plus oral treatment with erythromycin enteric-coated capsules(10 mg?kg-1?d-1,which were taken 3 times a day for 1 month) to the observation group.Both observation group and control group were in accordance with the norms of the treatment of asthma.Results The improvement rate,inefficiency and the total efficiency were different between observation group and control group,and the diffe-rence was statistically significant(?2=12.629,8.412,8.412,Pa0.05).Their liver function was also monitored and was found normal before treatment and after the replacement of drugs for 1 month,including alanine ami-notransferase,aspartate aminotransferase,albumin,globulin,and were found normal.Conclusions On the basis of conventional treatment,low-dose erythromycin treatment of intractable AR is effective and safe.However,the treatment must be limited to the refractory cases,and the appropriate indications must be strictly observed.

Trypanosoma is a human parasite severely affecting poor tropical areas.However,current frontline drugs for Trypanosoma treatment have severe side-effects with decreased effectiveness.Based on the fact that aminoacyl-tRNA synthetase is a bonafide drug target for several microorganisms,including bacteria and fungi,it is plausible that it may also be effective target of Trypanosoma.The Trypanosoma brucei leucyl-tRNA synthetase(tbLeuRS)was cloned,expressed and purified to develop an in vitro enzymatic assay system.The assay conditions were further optimized for the effective screening of tbLeuRS inhibitors thus establishing an anti-Trypanosoma drug screening system targeting tbLeuRS.The results indicated that this system can be employed for the effective screening of anti-Trypanosoma drugs with satisfactory specificity.In addition,this system can also be used for compound optimization,as well as IC50 testing.Using this system a series of compounds are identified that are effective Trypanosoma inhibitors without toxicity to human cells.Therefore,targeting tbLeuRS may represent a new venue for the development of anti-Trypanosoma drugs.

Degraded guar was prepared by acid with guar as the main material, which was then brought into reaction with chlorosulfonic acid under proper conditions, the sulfonated degraded guar was obtained successfully. The effects of sulfonation conditions on the SO4(2-) content were investigated, and the proper reaction conditions were determined. The results of infrared spectrometry showed that this sulfated derivative is a novel heparin-like polysaccharide. At the same time, the selective removal of low density lipoprotein (LDL) and fibrinogen (Fib) by degraded guar gum sulfate was studied. The experimental results showed that degraded guar gum sulfate is a novel LDL/ Fib purifying agent. When pH= 5.15 and the initial concentration of the degraded guar gum sulfate is 2500 mg/L, the reduction percentages were about 60%-66% for total cholesterol, about 76%-89% for LDL and very low-density lipoproteins (VLDL), and almost 100% for fibrinogen. There were no significant changes regarding the level of high-density lipoproteins and total proteins.
Fibrinogen ; analysis ; isolation & purification ; Galactans ; chemistry ; Hyperlipidemias ; blood ; Lipoproteins, LDL ; blood ; isolation & purification ; Mannans ; chemistry ; Plant Gums ; chemistry ; Sulfates ; chemistry

[Summary]_ This is a pedigree of multiple endocrine neoplasia type 1(MEN1). The proband pursuit medical assistance because of hypertension and weakness. Adrenal cortical carcinoma with possible Cushing's syndrome was diagnosed after a series of tests. During this process, the proband was found to have hypercalcemia, and he was diagnosed as primary hyperparathyroidism. Adrenal carcinoma plus primary hyperparathyroidism suggested MEN1, which was confirmed by MEN1 gene 400_401insC mutation. Pedigree investigation found six additional patients, including one with high parathyroid hormone level and two without clinical evidence of any MEN1 diseases. The proband died of metastatic malignancy 7 months after diagnosis while the other 3 patients with clinically confirmed MEN1 tumor responded well to surgery, including one with adrenal cortical carcinoma.

Salvia miltiorrhiza is a highly valued traditional chinese medicine for the treatment of atherosclerosis-related disorders in china, such as cardiovascular and cerebrovascular diseases in China. The wilt disease is serious in the culture of S. miltiorrhiza. Wilt disease cause biomass of plant shoots and roots is lessened, active components are decreased. To solve these problems, we research the pathogen causing wilt disease of S. miltiorrhiza. The suspected pathogen is identified by morphology and etiological test. The identification was further confirmed by alignment the sequences of internal transcribed spacer (ITS) amplified by PCR. Our result show the wilt disease of S. miltiorrhiza mostly occurred in July and August, which is hot and wetter. The wilt disease rate of S. miltiorrhiza continuous cropping for one year in S. miltiorrhiz stubble is 10%, but the wilt disease rate of S. miltiorrhiza continuous cropping for three years in S. miltiorrhiz stubble is 60%-70%. The root rot of S. miltiorrhiz caused by the wilt disease, so the wilt disease was mistaken for the rot root in production. Morphological characteristics show the pathogen is Fusarium oxysporum. The sequence of ITS wes determined and found by BLAST shared 99% identity to that of F. oxysporum f. sp. cucumerinum. So it comes to the conclusion that the causing agent of wilt disease on S. miltiorrhiza belongs to F. oxysporum.
DNA, Intergenic ; genetics ; Fusarium ; genetics ; isolation & purification ; physiology ; Plant Diseases ; microbiology ; Polymerase Chain Reaction ; Salvia miltiorrhiza ; microbiology ; Seasons

BACKGROUNDRecent studies have revealed that the reason for the low surgical resection rate of pancreatic carcinoma partly lies in its biological behavior, which is characterized by neural infiltration. This study aimed to investigate the clinical significance of radical pancreatoduodenectomy combined with retroperitoneal nerve, lymph, and soft-tissue dissection for carcinoma of the pancreatic head.

METHODSForty-six patients with pancreatic head cancer were treated in our hospital from 1995 to 2005. The patients were divided into two groups: radical pancreatoduodenectomy combined with retroperitoneal nerve, lymph and soft-tissue dissection (group A, n = 25) and routine Whipple's operation (group B, n = 21). There were no significant differences between the two groups in relation to age, gender and preoperative risk factors, and perioperative conditions, pathological data and survival rates were studied.

RESULTSThere were no significant differences in tumor size, surgical procedure time, postoperative complications, and time of hospitalization. However, the number and positive rate of resected lymph nodes in group A were significantly higher than those in group B (P < 0.05). The 1- and 3-year survival rate in group A were 80% and 53%, respectively, which was higher than those in group B (P < 0.05). There were significant differences in the survival rates between patients with and without nerve infiltration in group A (P < 0.05).

CONCLUSIONSRadical pancreatoduodenectomy combined with retroperitoneal nerve, lymph and soft-tissue dissection, can effectively remove the lymph and nerve tissues that were infiltrated by tumor. Meanwhile, this method can reduce the local recurrence rate so as to improve the long-term survival of patients.

Cause of Death ; Humans ; Lymph Node Excision ; Pancreatic Neoplasms ; pathology ; surgery ; Pancreaticoduodenectomy ; adverse effects ; methods ; mortality ; Retroperitoneal Space ; innervation ; pathology ; surgery ; Survival Rate