Objective: To observe the clinical efficacy of acupoint injection with salmon calcitonin for back pain in elderly patients with primary osteoporosis. Methods: A total of 76 patients were selected and randomly divided into two groups by the random number table method, with 39 cases in the treatment group and 37 cases in the control group, respectively. Patients in both groups received routine anti-osteoporosis treatment. Patients in the treatment group received additional acupoint injection with salmon calcitonin at bilateral Pishu (BL 20) and Shenshu (BL 23), while patients in the control group received additional intramuscular injection with salmon calcitonin. The treatments for both groups were given once a day and lasted for 4 weeks. Visual analog scale (VAS) and Chinese Oswestry disability index (CODI) scores were observed before treatment, after 2 weeks and 4 weeks of treatment, and the use of analgesics during the treatment were recorded. Results: After treatment, the clinical efficacy in the treatment group was more significant than that in the control group (P<0.05). After 2 weeks and 4 weeks of treatment, the VAS scores in both groups showed significant intra-group and between-group differences (all P<0.05), and the CODI scores in both groups showed significant intra-group differences (all P<0.05). After 2 weeks of treatment, the CODI score showed no significant between-group difference (P>0.05). After 4 weeks of treatment, the improvement of CODI score in the treatment group was more significant than that in the control group (P<0.05). During the treatment, 2 cases in the treatment group took analgesics versus 8 cases in the control group, and the result showed a significant between-group difference (P<0.05). Conclusion: For back pain in elderly patients with primary osteoporosis, based on the routine treatment of oral medication, the clinical efficacy of acupoint injection with salmon calcitonin at bilateral Pishu (BL 20) and Shenshu (BL 23) is more significant than that of intramuscular injection. Acupoint injection treatment can improve patients' conditions and reduce the use of analgesics.

Objective To investigate the expression of aquaporins-3 (AQP3) in amniotic epithelial cells regulated by cyclic adenosine monophosphate-protein kinase A (cAMP-PKA) signal pathway and to explore the mechanisms of its expression.Methods The amniotic epithelial cells were collected from 30 patients who underwent elective caesarean sections at term with normal amniotic fluid volume and primarily cultured.The cultured cells were treated with (1) forskolin groups: different concentration (0,2.5,5,50 or 100 μmol/L) of forskolin treated cells for 2 hours,and the optimal concentration of forskolin treated cells with different time (0,1,2,10 or 20 hours) ; (2)SP-cAMP groups: different concentration (0,2.5,5,50 or 100 μmol/L) of SP-cAMP treated cells for 2 hours,and the optimal concentration of SP-cAMP treated cells with different time (0,1,2,10 or 20 hours); (3)H-89 groups: different concentration (0,5,10,50 or 100 μmol/L) of H-89 treated cells for 2 hours,and the optimal concentration of H-89 treated cells with different time (0,1,2,10 or 20 hours).The level of intracellular cAMP and activity of PKA were detected by using ELISA,and immunohistochemistry was used to detect the localization of AQP3,the protein expression of total cAMP-response element binding protein (CREB) and phospho-CREB (p-CREB) and AQP3 were assessed by western blot analysis.Cell proliferation was assessed by cell counting kit-8 (CCK-8)assay.Results (1) The brown staining of AQP3 was detected in both cell membrane and cytoplasm in each group.(2) There was no significant change of the cell proliferation rate among groups with different concentration of forskolin,SP-cAMP and H-89 treatment (P ＞ 0.05).(3) After different concentration of forskolin treated 2 hours,the expression of total CREB had no significant difference among them(P ＞ 0.05).While the expression of cAMP level,PKA activity,p-CREB and AQP3 protein were significantly changed,which were higher in 2.5 μmol/L,5 μmol/L,50 μmol/L forskolin group when compared with 0 μmol/L (P ＜ 0.05).Their expressions in 5 μmol/L forskolin group were higher than that in 2.5 μmol/L and 50 μmol/L (P ＜ 0.05).The optimal forskolin concentration was 5 μmol/L.(4) After different concentration of SP-cAMP treated 2 hours,the expression of total CREB and cAMP level had no significant difference among them (P ＞ 0.05),while the expression of PKA activity,p-CREB and AQP3 protein were significantly changed,which were higher in 5 μμmol/L,50 μmol/L SP-cAMP group when compared with 0 μmol/L (P ＜ 0.05).Their expressions in 50 μmol/L SP-cAMP group were higher than that in 5 μmol/L (P ＜0.05).The optimal SP-cAMP concentration was 50 μmol/L (5) After different concentration of H-89 treated 2 hours,the expression of total CREB and cAMP level had no significant difference among them (P ＞ 0.05),while the expression of PKA activity,p-CREB and AQP3 protein were significantly changed,which were lower in 10 μmol/L,50 μmol/L and 100 μmol/L H-89 group when compared with 0 μmol/L (P ＜ 0.05).Their expressions in 10 μmol/L H-89 group were lower than that in 50 μmol/L,100 μmol/L (P ＜ 0.05).The optimal H-89 concentration was 10 μmol/L.(6) p-CREB and AQP3 protein expression were significantly lower in 5 μmol/L forskolin combined 10 μmol/L H-89 incubating 2 hours group when compared with 5 μmol/L forskolin,but higher than that in 10 μmol/L H-89 treated group (P ＜ 0.05).Total CREB was no significant difference among the three groups (P ＞ 0.05).Conclusion cAMP-PKA signal transduction pathway may regulate AQP3 protein expression in human amniotic epithelial cells.

Cytomegalovirus Infections ; complications ; Female ; Humans ; Infant, Newborn ; Male ; Skin Diseases ; etiology

BACKGROUND: Child neglect is one of the most important aspects of child abuse and has become a serious problem influencing children's development all over the world. Therefore, it is necessary to nderstand the current conditions and influential factors of child neglect and establish effective evaluation methods in China.OBJECTIVE: To investigate the current conditions and influential factors of urban child neglect in Suzhou city.DESIGN: A comparative analysis of sampling survey.SETTING: Department of Children's Health Care, Soochow University Affiliated Children's Hospital.PARTICIPANTS: This study was conducted in one public kindergarten and two private kindergartens of urban areas in Suzhou city between March and October 2003. Totally 370 children (196 boys and 174 girls) aged between 4 to 6 years old without obvious physical and mental diseases were voluntarily investigated, and they had been living with the person that answered the questionnaire regarding to child neglect in China in the recent 1 year. METHODS: Questionnaire regarding to child neglect in China was sent to each volunteer.he questionnaire evaluates the current conditions of child neglect by 20 items of 5 aspects including physical care (buy fruit for child, consider the nutritional need of child, care about the body height and body mass of child), emotional care (chat with child, play and tour with child, encourage child to do the things whatever they can, listen to what the child feels, introduce the child to the guests when they come to your home, let him or her stop immediately when child cries, care about the activities in kindergarten), education care (buy books for child, tell stories to child, recognize and correct the bad behavior of child, answer the questions asked by child seriously), safety care (protections against fire and electricity at home, warn child against matches, knives and other sharp things, teach child how to cross the road) and health care (prepare the common medicine for child at home, urge child to brush teeth, correct the bad posture). The volunteers were asked to answer each question objectively according to the conditions of child within the recent 1 year, and each question should be answered by selecting only one choice (never, occasionally, usually, always), and anyone should not be omitted. Meanwhile,the educational background and occupation of the parents were also investigated.MAIN OUTCOME MEASURES: The general status of child neglect and the effects of different family educational background and occupation of parents on child neglect were observed. RESULTS: Totally 370 questionnaires were sent out, and 370 qualified ones were recollected, the effective rate was 100%. ① In Suzhou city, the children were given better regards and good care in the aspects of education, medicine and safety, but neglects on children's physical and mental care still exists in a few families. ② Families of different educational background could think highly of the medical care, safety and psychical care of children, but neglects on education and emotional development more commonly existed in the families with the educational background under university. ③ All the families with different occupation could think highly of the medical care, safety and physical care of the children, but education and emotional development were better in the cadre families than in the ordinary families.CONCLUSION: In Suzhou city, the children are given better regards and good care in the aspects of education, medicine and safety, but some bad manifestations of child neglect exist in education and emotion, which are associated with the educational background and occupation of the parents.Further studies about the evaluation, prevention and intervention are needed for child neglect in China.

Objective To evaluate the effect of off-pump coronary endarterectomy (CE) plus off-pump coronary artery bypass grafting (off-pump CABG) on patients with chronic total occlusion (CTO) combined with diffuse distal atherosclerosis. Methods From October 2006 to August 2009,65 CTO patients with 176 angiographically confirmed vascular stenosis or occlusive lesions, 70 of which were complete occlusion, underwent off-pump CABG. During the operation, diffuse intimal thickening distal to occlusive lesion was found, and blood flow of the bridges was unfavorable.Results Therefore endarterectomy was performed, followed by CABG. The blood flow in the bridges were 2-10 ml/min versus 14-37 ml/min before versus after endarterectomy. Pulsatility index (PI) was 5.1-15.6 versus less than 5 before versus after endarterectomy. Left ventricular ejection fraction was also improved significantly [before operation: (0.47±0.12)%, after operation: (0. 52±0.15)%, t=2.17, P＜0.05]. Peri-operative myocardial infarction occurred in 2 cases, but without significant cardiac homodynamic changes. And 23 patients underwent coronary angiography to evaluate graft patency 3-18 months after operation, all of them had favorable blood flow. Conclusions It is feasible to perform off-pump CABG plus coronary endarterectomy for patients of chronic coronary total occlusion combined with diffuse distal atherosclerosis. This treatment is safe and effective.

Objective To investigate the effect and mechanism of the formation of intrauterine adhesion (IUA) at different dose of estrogen. Methods Thirty-three New Zealand female rabbits were randomly divided into low estrogen group, normal physiological estrogen group, moderate estrogen group and high estrogen group. Animals of the low, moderate and high groups were ovariectomized (OVX) while normal group underwent sham operation. The moderate and high group animals received 0. 5 mg or 1.0 mg estradiol benzoate after OVX twice a week respectively. Two weeks later, all animals received curettage under direct vision. Serum was collected regularly to determine levels of estradiol (E2), transforming growth factor β1 (TGF-β1) and basic fibroblast growth factor (bFGF). Two weeks after curettage, we cut open cavity to collected endometrium for HE and Masson staining to score extent of endometrial fibrosis and IUA.Results The score of extent of endometrial fibrosis in high group (6. 1 ± 1.5) was higher than those in low estrogen group, normal estrogen group, moderate estrogen group (2. 7 ± 2. 1, 1.2 ± 1.8, 2. 7 ± 2. 0; all P <0. 05). The score of extent of IUA in high group (4. 0 ±2. 5) was higher than that in any other groups (0. 3 ± 0. 8, 1.0 ± 1.6, 1.7 ± 1.9; all P < 0. 05). The levels of TGF-β1 and bFGF was correlated with the level of E2 positively (P < 0. 01) and they had positive relationship with extent of endometrial fibrosis and IUA (P <0. 05). Conclusion High estrogen could accelerate endometrial fibrosis and IUA by promoting expression of TGF-β1, bFGF.

Adult ; Diagnosis, Differential ; Female ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Ki-1 Antigen ; metabolism ; Leukocyte Common Antigens ; metabolism ; Leukosialin ; metabolism ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; surgery ; Melanoma ; metabolism ; pathology ; Mucin-1 ; metabolism ; Receptor Protein-Tyrosine Kinases ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery

Antibodies, Monoclonal, Murine-Derived ; metabolism ; Brain Neoplasms ; metabolism ; pathology ; Child ; Choriocarcinoma ; metabolism ; pathology ; Chorionic Gonadotropin, beta Subunit, Human ; metabolism ; Diagnosis, Differential ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; Pineal Gland ; pathology

Health management plays an important role in the control of medical costs and in maintaining people' s health.Since the beginning of health management performance in our country,the major problems were:inadequacy of govement's support;imperfect laws;irregular marketing operation;lack of feasible health management model;controversy over long-term economic benefits;lack of awareness on health in common people and so on.To solve these problems,it is necessary to strengthen government support,and enhance people's health awareness,and explore the health management model consistent with the actual situation in China.

Objective To analyze the clinical efficacy,adverse events and corresponding preventive measures of high dose methotrexate in the treatment of acute lymphoblastic leukemia(ALL).Methods Ninety-two patients with ALL who hospitalized in Heamotology Department of Jinshan Hospital Affiliated to Fudan University were randomly divided into observation group and control group,and each group had 46 cases.Patients in observation group were given high dose melhotrexate + vincristine + cytoxan + pirarubicin chemotherapy treatment,and in control group were given soft red enzyme + vincristine + metacortan dracin + L-asparaginase treatment.The clinical efficacy,adverse events and the required course of remission of two groups were compared.Results The total effective rate in the observation group was 84.78％,while it was 80.43％ in the control group,and there was no statistically significant difference (x2 =0.45,P ＞ 0.05).The average remission was (1.26 ± 0.28) in the observation group,while (1.31 ± 0.31) in the control group,and no significant difference was observed (t =2.13,P ＞ 0.05).The complete remission rate of initial treatment,retreatment and refractory were 75.00％ (24/32),50.00％ (4/8) and 33.33％ (2/6) respectively in observation group,while 76.67％ (23/30),50.00％ (4/8) and 25.00％ (2/8) respectively in control group,and there was no statislically significant difference between two groups (x2 =0.98,P ＞0.05).The rate of bone marrow suppression in the observation group(23.91％) was lower than that in the control group(43.48％),while the rate of liver and kidney injury(54.35％) was higher than that inthe control group(17.39％),which showed significant difference (P ＜ 0.05).The survival rate of 5 years in observation group was 67.39％,while 45.65％ in control group,and there was statistically significant difference between two groups (P ＜ 0.05).Conclusion The high dose methotrexate in the treatment of acute lymphoblastic leukemia was proved to be effective and the adverse reactions could be tolerated.