Objective: To observe the therapeutic results of Acupuncture and Tuina combining with laxative suppository in treating constipation caused by antisychotic drugs. Methods: 240 patients were randomly divided into Group A, B, C, and D, 60 in each group. Group A were treated with Acupuncture and Tuina combining with laxative suppository, Group B with Acupuncture, Group C with Tuina and Group D with laxative suppository. Results: The effective rate in Group A was 98.3%, Group B 95.0%, Group C 91.7% and Group D 60.0%. Univariate χ2 was used for analysis. There were significant differences among the 4 groups. Group A was compared with Group B and C (P＜0.05) and compared with D (P＜0.01). The efficacy time( (-χ)± S) was 2.41 ± 1.87h in Group A, 2.47 ± 1.89h in Group B,9.81 ± 6.12h in Group C and 15.13 ± 6.17h in Group D. The t-test was used for analysis. The efficacy time was significant different in Group A and B (P＜0.05), significant different in Group A and C (P＜0.05), marked different in Group A and D (P＜0.01) and no significant different in Group B and C (P＞0.05). Conclusion: Acupuncture and Tuina were effective, yet Acupuncture and Tuina combined with laxative suppository were more effective, and induce quick defecation.

Objective To study the correlation between 8-Iosmerie Porastglnadin-2a(8-iso-PGF2α) 、hypersensitive C-reactive protein(hs-CRP) and coronary heart disease(CHD). Methods 153 CHD patients were divided into 3 groups,including 52 cases of acute myocardial infarction(AMI) ,50 cases of unstable angina(UAP) ,51 cases of stable angina(SAP) and control group consisted of 50 healthy people. The levels of hs-CRP and 8-iso-PGF2α were measured. Person correlation analysis was used to analyze the relationship between the level of hs-CRP and 8-isoPGF2α. Results The levels of hs-CRP and 8-iso-PGF2α were significantly higher in AMI, UAP and SAP group than those in control group(all P ＜0.05). Compared with SAP group,the levels of hs-CRP and 8-iso-PGF2α were increased in AMI and UAP groups (all P ＜ 0. 05) . The level of hs-CRP was positively associated with the level of 8-iso-PGF2α. Conclusion hs-CRP and 8-iso-PGF2α should be the markers of coronary atherosclerosis and involved in the process of CHD. The levels of serum hs-CRP and 8-iso-PGF2α were correlated with the severity of CHD.

[ ABSTRACT] AIM:To investigate the effect of storage temperature in renal biopsy tissue frozen section on immu-nofluorescence results.METHODS:One hundred renal biopsy samples of Zhejiang Province People’ s Hospital from Janu-ary to June, 2015 were enrolled.Two sets of cutting slices were stored in -70 ℃ low temperature refrigerator as experi-mental group and in -12 ℃ freezing cryostat as control group.The immunoglobulins ( IgG, IgA and IgM) and comple-ments (C3, C4 and C1q) as well as fibrinogen were detected with direct immunofluorescence in the next day.The typeⅣcollagen a3 and a5 chains were also detected by indirect immunofluorescence, and the qualitative and semi-quantitative re-sults were observed under the fluorescence microscope.RESULTS:There were 16 cases of 3+~4+IgG in the experi-mental group, while the corresponding IgG was all 1+~2+in control group, significantly weaker than that in experimen-tal group.There were 99 cases of 3+~4+a3 and 3+~4+a5 in experimental group, white there were 92 cases of 1+~2+a3/a5 and 8 cases negative in control group.The positive intensity was decreased in control group with statistical difference between the 2 groups ( P<0.05) .There were 15 cases of 4+IgA, 19 cases of 3+IgA, 15 cases of 3+IgM, 11 cases of 2+IgM, 13 cases of 4+C3, and 12 cases of 3+C3 in experimental group.The control group were similar to the results of experimental group, and no difference between the 2 groups was observed.CONCLUSION:The immunoflu-orescence results of renal biopsy frozen sections are highly affected by the section storage temperature, which has greater in-fluence on the immunofluorescence positive intensity of IgG and typeⅣcollagen.The renal biopsy frozen section should be stored in -70 ℃low temperature refrigerator.

Objective To explore the clinical value of MRI in diagnosing and treating cesarean scar pregnancy (CSP).Methods A retrospective analysis was conducted on the clinical manifestations of 54 patients diagnosed with CSP between January 2009 to January 2013 in Peking University Third Hospital.Based on the patients' MRI image and other clinical datas,we did transvaginal operation on patients with CSP1,and transvaginal combined with abdominal operations on patients with CSP2.The intraoperative blood loss,operation time,postoperative hospital stay,and the length of time required for of serum hCG dropping to normal of the patients were analyzed.Results The average age of the 54 patients was (34±5) years and the average duration of gestation was (56± 16) days,all patients' vital sign were stable,the hCG level was 23-142 962 U/L before treatment.Twelve patients were diagnosed with CSP1 by MRI,and 5 of them had focus of 1-2 cm in diameter,the 5 patients' serum hCG level was 436-1 159 U/L and 23-32 days after drug administration,their hCG level returned to normal; the other 7 patients had focus of 2.0-4.4 cm in diameter,and their hCG level was 2 218-63 446 U/L,lesion resection was done on the 7 patients by hysteroscope or under B-uhrasound monitor.Forty-two patients were diagnosed with CSP2,and their focus were 1.0-7.1 cm in diameter,and serum hCG level were 23-142 962 U/L.We did bilateral uterine artery occlusion by laparoscope or laparotomy during operation for 22 patients or bilateral uterine artery embolization (UAE) before operation for 20 patients,then we did lesion resections.The blood loss during operation of CSP1 or CSP 2 was 50.1,267.2 ml; operation time was 30,128 minutes; postoperative hospital stay was 4.6,6.7 days;their serum hCG returned to normal 13-30 days after the surgery.All the 54 patients' uterus were preserved,and the patients undergoing operations were all cured without the second operation.Conclusion MRI is an effective method to conduct clinical treatment in CSP.

Objective:To investigate the clinical and molecular genetic characteristics of 6q24-related transient neonatal diabetes mellitus (6q24-TNDM).Methods:The clinical data of two neonates with 6q24-TNDM admitted to Shanghai Children's Hospital, Shanghai Jiao Tong University in 2017, were retrospectively collected. The methylation levels of 16 cytidine-phosphate-guanosine (CpG) sites from the methylated differentially modified region (DMR) in 6q24 were quantitatively analyzed by pyrosequencing.Results:Case 1, aged 5 d, was born at 37 +4 gestational weeks due to fetal growth restriction, and case 2 was 11-days old and born at 38 +2 gestational weeks. Both infants were male and small for age. They were born through a cesarean section. The birth weight of case 1 and case 2 were 2 340 g and 2 600 g, respectively. They were admitted due to hyperglycemia with blood glucose of 12.95 and 8.00 mmol/L on admission, respectively. Physical examination showed slightly poor skin elasticity and thin subcutaneous fat. Laboratory examination revealed lower serum insulin (<1.39 and 3.94 pmol/L) and peptide C (0.05 and 0.14 nmol/L) levels, positive results of urine glucose, negative tests for urine ketone, serum anti-glutamic acid decarboxylase antibody, anti-insulin antibody, and islet cell antibody in both cases. Normal size of the pancreas was observed by ultrasonography. The infants were improved and were discharged after subcutaneous insulin infusion for more than two weeks. The treatment was discontinued at 69 d and 42 d postnatally for case 1 and case 2. Prenatal diagnosis of the two infants showed normal karyotypes and uniparental disomy of chromosome 6 indicated by single nucleotide polymorphism chip. No pathogenic mutations were detected by next-generation sequencing after admission. The methylation levels of 16 CpG sites in DMR of 6q24 in the two cases, which were quantitatively analyzed by pyrosequencing, were lower than 10% (normal value in healthy matched controls: 40%), indicating an obvious hypomethylation. Conclusions:For children with TNDM who are small for gestational age at birth, presenting hyperglycemia with decreased serum insulin and C-peptide levels, pyrosequencing can be used to quantitatively analyze the methylation levels of CpG sites in 6q24 DMR, which can quickly and directly assist in the diagnosis of 6q24-TNDM, thereby contributing to the treatment and prognosis assessment.

OBJECTIVE:To provide references for rational use of human serum albumin.METHODS:The inpatients receiving human serum albumin in the hospital during Jan.-Dec.2014 were investigated retrospectively and analyzed in respects of general information of patients,serum albumin level before medication,drug dosage,drug cost and reasons.RESULTS:Eight thousand seven hundred and sixty patients from top 8 departments in the list of the number of patients of human serum albumin were included in the study,accounting for 64％ of total.There were 5 244 male (59.9％) and 3 516 female (40.1％);patient's age mainly ranged ＞ 30-60 year-old (52.6％).The number of patients of albumin was the largest in general surgery department (2 588 cases) and cardio vascular surgery department (2 348 cases).Referring to domestic package inserts,8 210 patients (about 93.7％) were in accor dance with indications,and hypoproteinemia was the most common medication indication (35.6 ％).The drug dosage per capita of ICU was the highest (152.5 g);total drug cost was the highest in general surgery department (13 334 396.4 yuan);treatment course per capita of infection disease department was the longest (10.7 d).CONCLUSION:There is irrational use of human serum albumin in our hospital and difference of drug use among departments.It is necessary to strengthen human serum albumin use monitoring and establish rational medication evaluation system so as to promote standard drug use and realize rational distribution of medical resources.

Objective To compare the efficacy and safety of tranexamic acid(TA)and norethisterone(NET)for the treatment of patients with ovulatory menorrhagia in China. Methods Onehundred and thirty one patients with proven ovulatory menorrhagia from gynecologic clinics of 5 teaching hospitals located in 4 different cities in China were enrolled during Jul 2004 to Dec 2006.Ameng them 128 completed the study.Patients were randomly divided into two therapeutic regimen groups:TA 1g thrice daily during menstrual cycle days(D)1-5,69 cases;or NET 5 mg twice daily on D19-26.59 cases.The drugs were administered for 2 consecutive cycles,then withdrawn and patients were followed-up for 1 more cycle.Data on menstrual blood loss [ estimated by pictorial blood assessment chart(PBAC)],length of menstrual periods,quality of life(QOL)evaluated by a 6 item health-related questionnaire were collectedbefore,during each cycle and were compared.Results Both treatments led to significant decreases of mean PBAC scores and shorter duration of menstrual periods,and improved the QOL ranking during the twotreatment cycles.The mean percentages of PBAC decrements in the TA first and second cycles were significantly greater than those in the NET corresponding cycles(35%VS 17%,P=0.004;4J4%VS 34%,P=0.04 respectively).The success rate of TA second cycle was higher than that of the NET second cycle (41%VS 24%,P=0.04).Improvement of QOL ranking in the TA first cycle was also significantly better than those in the NET first cycle ( P=0.03).The percentage of patients with at least 1 adverse event in TA group(19%)was significantly lower than that in NET group(35%,P=0.04).Patients'willingness tocontinue the treatment in the TA second and follow-up cycles(94%,79%respectively)were significantly higher than those in the corresponding cycles of NET groups(79%,59%respectively;P=0.01,P=0.02).Conclusion The regimen of TA 3 g daily during menstrual days 1-5 is a more effective and tolerable treatment than luteal phase norethisterone for patients with ovulatory menorrhagia.

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire;sleep information were collected via the Brief Infant Sleep Questionnaire (BISQ);Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86%(59/116) were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91%of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03%of children over one year old. The frequency of night waking was signiifcantly different between children under one year old and children over one year old (P<0.01). The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was signiifcantly different (Z=4.35, P<0.001). In children over one year old, the more frequent night waking, the lowered MDI scores (F=3.98, P=0.024). The waking duration was negatively correlated with MDI scores in children over one year old (r=-0.26, P=0.035). Neither night waking duration nor night waking frequency had signiifcant correlation with MDI scores in children under one year old. Multivariable linear regression conifrmed that night waking was an independent inlfuential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.

Objective To study the genotoxicity of triptolide ,an important active component of Tripterygium wilfordii Hook f .Methods Ames test ,in vitro chromosomal aberration test of CHO cell and in vivo micronucleus assay were per-formed to investigate the genotoxicity of triptolide .Results The Ames test showed that triptolide did not increase mutagenicity for TA97 ,TA98 ,TA100 ,TA102 and TA1535 strains at the dosage of 1 .6~1000 μg per plate with and without metabolic ac-tivation system S9 .Results of in vitro CHO cell chromosomal aberration test indicated that there was no statistical difference between the triptolide groups (doses of 0 .01 ,0 .02 and 0 .04 μg/ml) and the solvent control group with and without metabolic activation system S9 .However ,triptolide significantly increased polychromatophilic erythrocyte micronucleus formation at the dosage of 720 μg/kg in ICR mice .Conclusion Triptolide did not induce genetic toxicity based on the Ames test and chromo-somal aberration test ,but could increase micronucleus formation at the dosage of 720 μg/kg .These results indicated that trip-tolide may have potential genotoxicity on human health .

Objective In order to assess the structure damage of hip joint in ankylosing spondylitis (AS), a new radiograph-based scoring method was developed according to the radiological characteristics of hip involvement in AS, as well referring to prior existing scoring indexes. Methods A new scoring method consti-tuted of erosion, sclerosis and joint space narrowing was developed, pelvis anterior-posterior plain films acquired from patients with AS at baseline and follow-up were collected and assessed by two physicians who were trained in image reading by radiologists. All films were scored independently and blindly. Intra- and inter-reader reliability were assessed by intra-class correlation coefficient (ICC), the feasibility of this new scoring method was assessed by the mean time acquired to score a plain (two hips), its ability to detect the change of structure damage was assessed by the comparison of score differences between baseline and different follow-ups. The date were analyzed by paired-t test or nonparametric tests. Analysis of Variance (ANOVA) or nonparametric tests were utilized for the comparison of means of quantitative variables among the three groups, while Chi-square test for rates of categorical variables. Results No statistically significant differences existed in demographic data and suspected risk factors among the three groups at baseline (P>0.05). Intra-observer reliability was good (0.84 and 0.89), as well as the inter-observer reliability (0.72), the mean time needed to score was (33 ±10) seconds. Score changes were not statistically significant in the groups with follow-up duration of 1-2 and 3-4 years, but in the group of over 5 years, baseline/final scores assessed by the two observers were (6.0±2.7/7.5±3.7) and (5.6±2.1/7.1±3.6), respectively, both changes were statistically significant (t=2.86, Z=-2.99; P<0.01). Conclusion This new method is not only reproducible and easy to operate in clinic practice, but also can tell the changes of hip joint structure damage in the interval of over 5 years, further validation is requeired to demonstrate its discriminability in large populations.