Objective Imaging and clinical manifestations of melioidosis were analyzed in order to improve our understanding of the disease and to reduce the rate of misdiagnosis.Methods From 2001 to 2006,12 melioidosis cases were confirmed by blood,pus and sputum culture.All cases were examined with radiography,and nine of them with CT and 2 with US.The imaging and clinical data were assessed retrospectively.Results Ten of 12 cases revealed lung abnormalities,the main organ involved by melioidosis in the body.The appearances were observed as follows:diffused sheets and sheets fused partly in bilateral fields of the lungs can be seen on chest radiograph;homogeneous dense shadow of the lobe or segment were observed on plain chest film and CT;blurred strips radiated from hilum were revealed on plain chest film;multitude nodules in 2 lungs showed on CT;cavity with air and liquid be seen on plain chest film and CT;patches and granules in superior and middle fields or(and)inferior fields be seen on plain chest film and CT;arc shadow of water attenuation in dorsal thorax showed on CT.Infections outside the lung can be observed in orbital,lumbar muscle,liver and spleen in 1 case,and thighbone osteomyelitis with multi abscesses in one case.Conclusion Alhough medioidosis has no characteristic imaging appearances,the disease's location,extent,severity and quantity objectively can be demonstrated by imaging,final confirmation is necessary using the culture of blood,pus and sputum.

Intracerebral delivery of drugs for the treatment of central nervous system disorders is usually limited by the blood-brain barrier (BBB). Transdermal drug delivery systems (TDDS) have the advantage of improving patient compliance and avoiding first-pass effects compared to intravenous, oral and intranasal drug delivery, and are an emerging non-invasive drug delivery route that facilitates long-term drug delivery to patients. The discovery of direct subcutaneous targeting of lymphatic pathways to brain tissue has made TDDS a new brain-targeted drug delivery strategy. At the same time, the development of nano-delivery technology has further facilitated the application of TDDS for targeted drug delivery to the brain. This review summarizes the mechanism of transdermal drug delivery into the brain and the application of TDDS in the treatment of brain diseases, providing new ideas and methods for the treatment of central nervous system diseases.

Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

Objective To systematically evaluate the safety of high dose atorvastatin (80 mg daily) in Chinese patients. Methods Randomized controlled trials (RCTs) investigating 80 mg/ d atorvastatin vs. low-dose atorvastatin or placebo or blank were electionically retrieved in date bases of EMbase, PubMed, the Cochrane Library, WanFang, CNKI and WeiPu. Meta-analysis was performed using RevMan 5. 2 and Stata 11. 0 software. Results A total of 20 RCTs involving 2282 cases were included. The results of meta-analysis showed no significant differences betweent the 80 mg/ d atorvastatin group and the control group in the incidence of gastrointestinal adverse events (RR 1. 53, 95% CI 0. 85-2. 76, P = 0. 16), hepatic adverse events (RR 1. 53, 95% CI 0. 99 - 2. 36, P = 0. 05), muscular adverse events (RR 1. 51, 95% CI 0. 92 -2. 49, P = 0. 10), serious hepatic injuries ( RR 2. 33,95% CI 0. 88 - 6. 20, P = 0. 09) and serious muscular myopathies (RR 1. 40, 95% CI 0. 46 - 4. 30, P = 0. 56). Subgroup analysis by type of cotrast media used and durations of taking 80 mg/ d atorvastatin showed there were higher risks of gastrointestinal adverse events in the 80 mg/ d group when compared to blank control ( RR 4. 22, 95% CI 1. 11 - 16. 04, P = 0. 03). Conclusions The current evidence shows that 80 mg / d atorvastatin may be relatively safe in terms of adverse events in gastrointestinal tract, liver and muscular system, and relatively has risk in causing severe liver injuries and myopathies. With limited quantity and quality from the RCTs available, more high quality RCTs are needed to verify the above conclusion.

Objective To observe the effect of exhaustive exercise on the function of the kidney in rats and explore the mechanism. Methods Fourteen male Sprague-Dawley rats were divided into sedentary control group (group C) and exhaustive exercise group (group E). They were measured the urine protein, uric acid, glucose, and blood urea nitrogen after exercise. The reactive oxygen species, inducible ni-tric oxide synthase, nitro tyrosine in kidney, and nephrin protein in the kidney were detected with fluorescent probe and Western blotting, re-spectively, and observed under Harris staining. Results There were significant differences between groups C and E in urine protein, uric ac-id, glucose, blood urea nitrogen, reactive oxygen species, inducible nitric oxide synthase, nitrotyrosine and nephrin protein (P<0.05). The glomerular morphology and the deformation of capillary basement membrane were found under the fluorescence microscope in group E. Conclusion Exhaustive exercise may damage the structure of kidney in rats, which may associate with oxidative stress.

Objective To construct a full-length cDNA library of human normal kidney tissues and identify the quality of the library. Methods By using the template-switching mechanism at 5′end of mRNA technique to construct the library, a powerscript reverse transcriptase was used to transcribe, and a 5′-oligo fragment as an extended template was added to 5′ end of mRNA to enrich full-length cDNAs. After amplification, the ds cDNAs digested by sfi I and size-fractionated by columns were recombined into ?TripIEx 2 vectors. After package, the recombinant vectors were titered and the recombinant rate (blue/white) was determined,then the library was amplified. We identified the library using PCR reaction to determine the size of the inserts. Results The titer of cDNA library was 2.6?10 6pfu?mL -1, the rate of recombinant was above 95%, and the titer of amplified library was 9?10 11pfu?mL -1. The insert size ranged from 0.7 to 2 kb. Conclusion The cDNA library of human normal kidne we constructed is a highly efficient one and can be used for screening by probe and antibody to find the genes related to kidney diseases.

Objective To compare the efficacy of patient-controlled epidural analgesia (PCEA) with different concentrations of sufentanil plus levobupivacaine after caesarean section.Methods Ninety ASA Ⅰ or Ⅱ nulliparous patients who were at full term with a singleton fetus,aged 22-35 yr,weighing 60-85 kg,undergoing elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 3 groups (n =30each):0.125％ levobupivacaine plus sufentanil 0.4,0.6 and 0.8μg/ml groups (groups Ⅰ,Ⅱ and Ⅲ).The patients received 48 h of PCEA after operation.PCEA pump was set up with a background infusion of 2 ml/h,and a bolus dose of 2 ml with a lockout-interval of 15 min after a loading dose of 5 ml.VAS score was used to assess the intensity of pain (0 =no pain,10 =worst pain).VAS score ≤ 3 was considered as effective analgesia.VAS score ≥4 was considered as failure of analgesia,and the rescue analgesic was given.Venous blood samples were taken before operation and at 24 and 48 h after operation to detect the serum prolactin (PRL) concentration using radioimmunoassay.The degree of motor block of lower extremities was assessed and scored using modified Bromage scale.Maternal colostrum time,the number of attempts,and adverse effects including nausea and vomiting,pruritus,somnolence,respiratory depression,bradycardia,hypotension and urinary retention were recorded after operation.Results Compared with group Ⅰ,the number of attempts and rate of failure of analgesia were significantly decreased,the maternal colostrum time was shortened,and the serum PRL concentration at 24 and 48 h after operation was significantly increased in groups Ⅱ and Ⅲ,and the incidences of adverse effects such as nausea,vomiting and bradycardia were increased in group Ⅲ (P ＜ 0.05).Compared with group Ⅱ,no significant change was found in the number of attempts,rate of failure of analgesia,maternal colostrum time,and serum PRL concentration at 24 and 48 h after operation (P ＞ 0.05),and the incidences of adverse effects such as nausea,vomiting and bradycardia were increased in group Ⅲ (P ＜ 0.05).There was no significant difference in the modified Bromage scores among the three groups (P ＞ 0.05).Conclusion When sufentanil plus 0.125 ％ levobupivacaine are used for PCEA,the recommonded concentration of sufentanil is 0.6 μg/ml.

Objective To evaluate the value of 18 F?NaF PET/CT and MRI in the diagnosis of skull?base bone invasion ( SBBI) in patients with nasopharyngeal carcinoma( NPC) . Methods Sixty?three NPC patients (45 males, 18 females;age range 23-72 years) were enrolled in this prospective study. Pa?tients underwent 18 F?NaF PET/CT and MRI to confirm whether the skull base was invaded. The reference standard was based on the follow?up imaging in 6 months. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two imaging modalities were calculated. χ2 test was used to analyze their difference. The SBBI foci and their distribution detected by the two imaging modalities were compared. Results Thirty?four NPC patients demonstrated SBBI in follow?up imaging. The diagnostic sen?sitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18 F?NaF PET/CT were 97.1%(33/34), 89.7%(26/29), 91.7%(33/36), 96.3%(26/27) and 93.7%(59/63), respective?ly. For MRI, the parameters were 91.2%(31/34), 86.2%(25/29), 88.6%(31/35), 89.3%(25/28) and 88.9%(56/63), respectively. The diagnostic efficiency of the two imaging modalities had no significant difference (χ2=0.162-1.062, all P>0.05) . 18 F?NaF PET/CT detected 133 lesions and MRI detected 97 le? sions, and the clivus was the most common site of SBBI. Conclusions 18 F?NaF PET/CT and MRI have similar diagnostic efficiency in detecting SBBI. 18 F?NaF PET/CT can detect more lesions than MRI do, and has potential advantage for detecting tiny bone lesions in skull base.

Objective To investigate the effects of low frequency ultrasound (LFU) on the proliferation and apoptosis of smooth muscle cells (SMCs) in rabbits with carotid atherosclerosis(CA).Methods CA models were established in 30 New Zealand rabbits using a high fat diet and air-drying.They were randomly divided into a control group and four LFU groups:group A received 0.5 W/cm~2 LFU for 5 min/d,group B 0.5 W/cm~2 for 10 min/d, group C 1 W/cm~2,5 min/d,and group D 1 W/cm~2,10 min/d.The rabbits' carotid arteries were autopsied after 20 d of the LFU treatment.The expression of PCNA and TUNEL staining were used to explore the proliferation and apopto- sis of SMCs,and the proliferation rates (PRs) and apoptosis rates (ARs) were calculated.Results Compared with the control group,the PRs in groups B,C and D were significantly lower,while the ARs in groups B,C and D were significantly higher.There was no significant difference in ARs or PRs among groups B,C and D.Con- clusion LFU can induce SMC apoptosis and inhibit SMC proliferation in rabbits with CA.

Objective To evaluate the effect of gabapentin for treatment of neuropathic pain induced by bilateral sciatic nerve chronic constriction injury (bCCI) of rats.Methods Forty-eight female SPF Sprague-Dawley rats,weighing 180-200 g,aged 7-9 weeks,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C group),sham operation group (S group),bCCI group,and bCCI + gabapentin group (G group).Gabapentin 100 mg/kg was intraperitoneally injected once at 15 min before operation and twice a day during 7-13 days after operation for 7 consecutive days.The bilateral mechanical paw withdrawal threshold (MWT),thermal paw withdrawal latency (TWL) and number of cold-stimulated paw withdrawal were measured before operation (baseline) and at 1,3,6,8,10,14 days after operation.Results Compared with C group,the bilateral MWT was significantly decreased,and the bilateral TWL was shortened in bCCI and G groups,and no significant change was found in MWT and TWL in S group.Compared with bCCI group,the bilateral MWT was significantly increased,the bilateral TWL was prolonged,and no significant change was found in the number of cold-stimulated paw withdrawal in G group.Conclusion Gabapentin can relieve thermal and mechanical hyperalgesia induced by bCCI,however,it exerts no effect on cold allodynia in rats.