Objective:To investigate efficacy of paroxetine in the treatment of diarrhea-predominant irritable bowel syndrome(D-IBS).Methods:In a self-controlled trial,45 patients with D-IBS symptoms according to the Rome Ⅱ criteria were treated with paroxetine 10mg Qd for 12 weeks.The efficacy measures included D-IBS gastroin- testinal symptoms,abnormal frequency or consistency of defecation,Hamilton Depression Scale(HAMD)and Hamil- ton Anxiety Scale(HAMA).Results:42 cases completed 12 week therapy.The overall IBS symptoms,the Bristol stool consistency,stool frequency and abdominal pain were relieved significantly at week 2(P

Objective:To investigate the efficacy of mirtazapine in patients with anorexia nervosa.Methods: A randomized,controlled study was undertaken in 42 patients with anorexia nervosa.Subjects were treated with mir- tazapine or selective serotonin reuptake inhibitor(SSRIs)for 12 weeks and followed up to 12 weeks.The clinical out- come measures included body weight,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and the side effects of medications.Results:38 subjects completed the trial,20 in mirtazapine group,18 in SSRIs group. The weight gain in mirtazapine group was significantly more that that in SSRIs group at week 6 but the difference was not significant at week 12.The scores of HAMD and HAMA at endpoint were significantly lower than those at base- line(P0.05).No severe adverse events were observed in both groups.Common side effects of SSRIs were gastroenterological discomfort,while those of mir- tazapine included somnolence and weight gain.Conclusion:Mirtazapine can improve appetite and weight gain in pa- tients with anorexia nervosa in addition to relieve anxiety and depression.It is well tolerated and has ealier onset of effect than SSRIS.

Objective To develop an approach for a rapid extraction of genomic DNA fragments from serum.Methods Serum specimen from human was processed using high temperature denaturation and was centrifuged, then using various primer sets to amplify the DNA fragment extracted, so as to verify the efficiency of this DNA extraction method.Results The templates preparing from this DNA extraction method were able to guarantee the amplification of fragments shorter than 400 base pairs.Conclusion This method is simple, rapid and inexpensive.These genomic DNA fragment extracted can be utilized to amplify definite DNA template for polymerase chain reaction.

Objective To assess the disease severity and prognosis value by observing the kinetic change of serum procalcitonin(PCT)and PCT clearance rate(PCTc)in the patients with ventilator associated pneumonia (VAP). Methods A single-center prospective observational study was conducted. A total of 128 patients with VAP admitted into intensive care unit(ICU)of First Affiliated Hospital of Xinjiang Medical University from February 2012 to June 2014 were enrolled. The patients were divided into recovery group(n=88)and deterioration group(n=40) according to the therapeutic outcome. The acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores were estimated within 24 hours when VAP was diagnosed. The serum PCT(PCT1,PCT5,PCT7,PCT9)and PCTc(PCTc5, PCTc7,PCTc9)were examined at 1,5,7 and 9 days after the VAP was diagnosed. The diagnostic and predictive performance of PCT,PCTc and APACHEⅡ scores were assessed by the receiver operating characteristic curve (ROC). Results APACHEⅡscores in recovery group were significantly lower than those in the deterioration group (14.49±5.30 vs. 18.90±5.30,t=-4.349,P=0.000). There was no significant difference in PCT level(μg/L)at 1 day after VAP was diagnosed between recovery group and deterioration group〔2.84(0.81,6.43)vs. 3.50(0.97,10.27), Z=-1.431,P=0.152〕. With prolonged treatment,PCT was gradually decreased in recovery group,while remained at higher level in deterioration group,which was significantly lowered at 5 days after VAP diagnosed in recovery group compared with that in the deterioration group〔1.28(0.65,3.13)vs. 2.39(0.78,9.35),Z=-2.012,P=0.044〕. PCTc maintained higher level in recovery group which was gradually increased with the improvement of the disease, and PCTc in deterioration group was lowered which was gradually decreased with the development of the disease. PCTc at 5,7,9 days in recovery group was significantly higher than that in deterioration group〔5 d:50.43(20.39,80.60)%vs. -56.68(-286.28,172.92)%, Z=-2.250, P=0.024;7 d:54.01(5.70,102.30)% vs. -76.91(-335.03, 181.21)%,Z=-2.561,P=0.010;9 d:63.88(25.93,101.80)%vs.-133.49(-547.20,280.16)%,Z=-3.133, P=0.002〕. The area under ROC curve(AUC)of PCT5,PCT7,PCT9 predicting the prognosis was 0.591,0.683, 0.746,respectively〔95% confidence interval(95%CI)was 0.456-0.726(P=0.161),0.557-0.808(P=0.005), 0.631-0.860(P=0.000)〕. When PCT9 was 5.65μg/L,the sensitivity of 95%and the specificity of 61%. The AUC of PCTc5,PCTc7 and PCTc9 was 0.648,0.685,0.729,respectively〔95%CI was 0.513-0.783(P=0.028),0.555-0.815(P=0.006),0.607-0.851(P=0.001)〕. When PCTc9 was 92%,the sensitivity was 98%and the specificity was 71%. The AUC of APACHEⅡscore was 0.693(95%CI 0.578-0.808,P=0.003). When APACHEⅡscore was 19.5,the sensitivity was 77%and the specificity was 58%. Conclusions The increased levels of PCT in patients with VAP were associated with the poor control of infection and may indicate the deterioration of VAP,it also can reflect the activity of lung infection in time. Keep observing the dynamic change of PCT and analyzing PCTc is more useful. The PCTc levels may provide evidence of disease progression and helpful in risk stratification in patients with VAP,and lower level of PCTc may accompany serious infection and predict poor prognosis.

Background Essential hypertension (EH) and type 2 diabetes mellitus (T2DM) are frequently co- existed.Previous studies proved that EH can cause arrythmia,whereas,the arrythmia and the structure changed in hypertensive patients coexisted with T2DM are scarely reported.Objective To study the characteristics and mech- anism of arrhythmia in essential hypertension (EH) patients with type 2 diabetes mellitus (T2DM).Methods One hundred sixty eight patients were groupped as follows:EH group (n=65),T2DM group (n=31),EH+T2DM group (n=52),and normal group (n=20).The clinical data,echocardiographies and 24-hour dynamic eletroear- diogram were determined in all patients.Results 1)Arrhythmia incidence in EH+T2DM group was a statistically higher compared to EH group and T2DM group(P

Objective To evaluate the role of large conductance calcium-activated potassium (BKCa) channels in vascular hyporesponsiveness in rats with obstructive jaundice.Methods Eighteen male Sprague-Dawley rats,weighing 180-200 g,were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),sham operation group (group S),and bile duct ligation group (group BDL).Obstructive jaundice was produced by common bile duct ligation.At 7 days after surgery,blood samples were collected for determination of the levels of serum total bilirubin (TBL),direct bilirubin (DBL),indirect bilirubin (IBL),alanine aminotransferase (ALT),and aspartate aminotransferase (AST).Thoracic aortic rings were prepared,and the endothelium was removed.The aortic rings were sequentially perfused with different concentrations of norepinephrine (NE) and sodium nitroprusside (SNP),and the maximum amplitude of contraction and dilatation of aortic rings was recorded.The aortic rings were then perfused with BKCa channel blocker Chtx with the final concentration of 10 7 mol/L,followed by perfusion with different concentrations of NE and SNP again,and the maximum amplitude of contraction and dilatation of aortic rings was recorded under each concentration.The percentage of maximum contraction and dilatation (maximum amplitude after Chtx administration÷maximum amplitude before Chtx administration× 100％) was calculated.Results Compared with C and S groups,the levels of TBL,DBL,IBL,ALT and AST in serum were significantly increased,the maximum amplitude of NE-induced contraction of aortic rings was decreased,and the percentage of the maximum NE-induced dilatation of aortic rings was increased,the maximum amplitude of SNP-induced contraction of aortic rings was increased,and the percentage of the maximum SNP-induced dilatation of aortic rings was decreased in group BDL.Conclusion Excessivc opening of BKCa channels may be involved in the mechanism of vascular hyporesponsiveness in rats with obstructive jaundice.

Toutianliang manipulation is the most representative compound needling technique of traditional reinforcing and reducing and has the remarkable efficacy on heat syndrome with muscle and bone involved for example. Professor ZHANG Jin is one of the famous acupuncture master in China and has contributed his lifelong to the research of acupuncture manipulation techniques. He has summarized 24 single-type manipulations and has given the comprehensive explanation of the manipulations for meridian conduction, reinforcing or reducing techniques for the excess or deficiency. In the paper, Toutianliang manipulation was introduced briefly and the key operation steps had been discussed.
Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans

[ ABSTRACT] AIM:To investigate the molecular mechanism and the immunosuppressive phenotype of macropha-ges under long-term exposure to lipopolysaccharide ( LPS) .METHODS:We used Ficoll-Hypaque density gradient centri-fugation combined with MicroBeads Separation Kits to separate peripheral blood mononuclear cells from human blood, and then induced the monocytes into macrophages.We observed the morphology of the macrophages by treating the cells with LPS for 48 h, in comparison with a negative control and IFN-γtreatment.ELISA was used to detect the levels of cytokines, such as IL-10, IL-12, IL-6 and TNF-α, and flow cytometry was used to detect the expression of the surface molecules (HLA-DR, CD14, CCR7, HLA-ABC and CD40).To observe the effect of macrophage on T cell proliferation, co-culture experiment was carried out for 6 d.Real-time PCR was used to validate the expression levels of molecules related to MyD88-independent pathway in Toll-like receptor 4 ( TLR4) signal pathway.RESULTS:The antigen-presenting ability of the macrophages was reduced and the IL-10 expression level was increased after the cells were treated with LPS for 48 h. We observed a poor proliferative capacity of CD8 +T cells after co-culturing of LPS-induced macrophages with CD3+T cells for 6 d.The results of real-time PCR indicated that TRIF, IRF3 and CIITA were down-regulated in LPS-induced macropha-ges.CONCLUSION:We successfully established a macrophage model in vitro and observed that LPS-induced macropha-ges into an immunosuppressive phenotype with poor CD8 +T cell proliferative capacity, in which MyD88-independent TLR4 signaling pathway was impaired.

Objective To investigate the optimum target plasma concentration of propofol in preventing the adverse effects of carboprost tromethamine in the patients undergoing caesarean section.Methods One hundred and twenty-eight nulliparous parturients who were at full term with a singleton fetus,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 24-37 yr,weighing 54-78kg,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 4 groups (n =32 each) using a random number table:control group (group C),and different concentrations of propofol groups (P1-3 groups).Carboprost tromethamine 250 μg was injected into the body of the uterus,and propofol with the target plasma concentrations of 0.8,1.2 and 1.6 μg/ml was simultaneously given by target-controlled infusion in P1,P2 and P3 groups,respectively,and normal saline was infused at a rate of 0.5 ml · kg-1 · h-1 in group C.The occurrence of cardiovascular events was recorded from the end of carboprost tromethamine administration until the end of surgery.The relatedadverse effects after carboprost tromethamine administration,and Ramsay sedation score at 15 mm after carboprost tromethamine administration were recorded,and satisfactory sedation was defined as Ramsay sedation score of 2.The occurrence of complications associated with combined spinal-epidural anesthesia was recorded during the postoperative follow-up.Results Compared with group C,the incidence of carboprost tromethamine-related adverse effects was significantly decreased in P2 and P3 groups,the rate of satisfactory sedation was significantly increased in P1 and P2 groups,the incidence of hypotension and tachycardia was significantly decreased in group P1 (P＜0.05),and no significant change was found in the incidence of carboprost tromethamine-related adv erse effects in group P1,and in the rate of satisfactory sedation in group P3 (P＞ 0.05).Compared with group P1,the incidence of carboprost tromethaminerelated adverse effects was significantly decreased in P2 and P3 groups,the rate of satisfactory sedation was significantly increased in group P2,and the rate of satisfactory sedation was significantly decreased in group P3 (P＜0.05).Compared with group P2,the rate of satisfactory sedation was significantly decreased (P＜0.05),and no significant change was found in the incidence of carboprost tromethamine-related adverse effects in group P3 (P＞0.05).No cardiovascular events were found in group P2,and the incidence of hypotension was 9％ in group P3.Conclusion The optimum target plasma concentration of propofol in preventing the adverse effects of carboprost tromethamine is 1.2 μg/ml in the patients undergoing caesarean section.

Objective To explore the role of androgen receptor (AR) and estrogen receptor (ER) on male pattern baldness (MPB). Methods The contents of AR and ER in donor and recipient sites of scalps after hair autografting were determinated in 13 cases of MPB. Fluorescent steroid hormone conjugate technique was employed in this study. Results There was no statistical difference in the contents of AR and ER between donor site and grafted scalps in recipient site. Conclusion After the donor tissues are transplanted to the recipient site (the former baldness site), there is no change in contents of AR and ER. The abnormal change of the content of AR and ER in scalp plays an important role in MPB development.