Objective: To observe the clinical efficacy of electroacupuncture (EA) plus long-snake moxibustion for rheumatoid arthritis (RA) due to kidney deficiency and cold coagulation. Methods: A total of 60 patients in active stage of RA were randomly divided into an observation group and a control group, with 30 cases in each group. Patients in the control group took methotrexate tablets and nimesulide dispersible tablets orally for treatment, while those in the observation group received additional treatment of EA plus long-snake moxibustion. Both groups were treated for 12 weeks. The post-treatment changes in symptomatic grading and quantifying score, disease activity score with 28 joint counts (DAS28), and inflammatory indicators erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were observed, and the efficacy was evaluated. Results: The total effective rate in the observation group was 89.9％, versus 76.6％ in the control group, and there was a significant difference in the total effective rate between the two groups (P<0.05). After treatment, the symptomatic grading and quantifying score and DAS28 in both groups were significantly improved (all P<0.05), and the improvements in the observation group were more significant than those in the control group (both P<0.05). Besides, there were 11 cases with low disease activity index (DAI) and in remission in the observation group versus 5 cases in the control group, showing a statistically significant between-group difference (P<0.05). The ESR and CRP scores in both groups were significantly reduced after treatment (all P<0.05), also showing statistically significant between-group differences (both P<0.05). Conclusion: The efficacy of additional EA plus long-snake moxibustion based on oral medications for RA due to kidney deficiency and cold coagulation is better than that of the oral medications alone.

Based on JCI standard,conduct nursing practice area activities themed as the Warmness,Safe and Painless in the emergency department and outpatient department,deepen the connotation of nursing service.Use PDCA to achieve improvement simultaneously.In all these ways,we improved nursing quality,decreased sentinel event and increased satisfactory rate of the patients,enhance the nursing staff ＇s overall image,promote harmonious relations between nurses and patients.

Objective To investigate the relationship between insulin level and mild cognitive impairment(MCI) of type 2 diabetes and analyze the risk factors for MCI. Methods We collected 101 type 2 diabetes subjects who were divided into two groups:MCI and normal cognition(NC).All subjects were evaluated with cognition scores of MMSE,GDS,CMS,ADL.Insulin,glycosylated hemoglobin,blood routine test,blood pressure,ECG,brain CT were detected.Independent t-test,correlation and multiple regression analysis were performed. Results 1. The diabetic patients with MCI showed the higher levels of insulin at fasting, 2hr and 3hr after meal than did NC(P

Objective To investigate the effect of intravenous injection of parecoxib before operation on the efficacy of postoperative analgesia in patients undergoiag thoracic surgery.Methods Ninety ASA Ⅰ -Ⅲ patients,aged 38-76 yr,weighing 44-82 kg,scheduled for thoracic surgery under general anesthesia combined with thoracic epidural block,were randomly divided into 3 groups(n = 30 each): group A,B and C.Epidttral anesthesia was performed at the T6-7 interspace before general anesthesia. Anesthesia was induced with sufentanyl 0.4 μg/kg,vecuronium 0.12 mg/kg and propofol 1.5-2.0 mg/kg.Double-lumen bronchial tube was inserted and the patients were mechanically ventilated.Group A received iv injection of normal saline 2 ml 30 min before skin incision.Group B received iv parecoxib sodium 40 mg after extubation.Group C received iv parecoxib sodium 40 mg 30 min before skin incision.Anesthesia was maintained with propofol,vecuronium,sufentanyl and lidocaine.The patients received patient-controlled epidural analgesia(PCEA)with ropivacaine and 0.5 μg/ml sufentanil after surgery.The VAS score was maintained≤ 3.The comfort level was evaluated with Bruggrmann comfort scale(BCS)at 4,12,24 and 48 h after operation.The consumption of sufentanil during operation and within 48 h after operation was recorded.The adverse reactions were also recorded.Results Compared with group A,the consumption of sufentanil was significantly decreased in group B and C,the BCS score was significantly increased at 4 h after operation in group B,and the BCS score was significantly increased at each time point and the consumption of sufentanil during operation was significantly decreased in group C(P ＜ 0.05).The BCS score was significantly higher,and the consumption of sufentanil during operation and within 48 h after operation was significantly lower in group C than in group B(P ＜ 0.05).There was no significance difference in the adverse reactions among the 3 groups(P ＞ 0.05).Conclusion Intravenous injection of parecoxib 40 mg before operation reduces the perioperative sufentanil consumption in patients undergoing thoracic surgery.

ObjectiveTo evaluate the effectiveness of setting PEEP and tidal volume (VT ) according to pressure-volume (P-V) curve during one lung ventilation (OLV) in patients undergoing thoracic surgery.Methods Twenty-five ASA Ⅰ or Ⅱ patients of both sexes aged 44-64 yr weighing 57-75 kg undergoing lobectomy under general anesthesia were enrolled in this study.Double-lumen tube was inserted.Correct positioning was verified by flberoptic bronchoscopy.The patients were mechanically ventilated.P-V curve was measured by SSS system during OLV.Lower inflection point (LIP)and upper inflection point (UIP) were determined.The pressure at LIP (PLIP) and volume at UIP (VUIP) were measured.Bilateral lungs were ventilated for 30 min (T0) at first before OLV was started.PEEP was set at PLIP + 0.196 kPa and VT was set at VUIP,and the patients were ventilated for 30 min (T1).VT was then reduced to 80％ of VUIP.OLV was performed for another 30 min (T2).VT was then further reduced to 60％ of VUIP and the patients were ventilated for 30 min (T3).PEr CO2 was maintained at 4.67-6.00 kPa.Arterial blood and central venous samples were taken at T0-3.Blood gas analysis was performed.Qs/Qt was calculated.MAP,HR,CVP,peak airway pressure (Peak),airway resistance (Rsw) and lung compliance (CL) were measured and recorded at T0-3.ResultsHR,Ppeakk,Rsw and Qs/Qt were significantly increased while CL and PaO2 decreased at T1-3,CVP was significantly increased at T1.2 and MAP and PaCO2 were increased at T3 as compared with the baseline values at T0.Ppeak and Rsw were significantly decreased at T2.3 and PaO2 was significantly increased while Qs/Qt decreased at T2,CVP was decreased,MAP and PaO2 were increased at T3 as compared with the values at T1.ConclusionsMechanical ventilation with VT set at 80％ of VUIPandPEEPatPUIP+0.196kPa provides best ventilatory efficacy for OLV in terms of PaO2 and hemodynamics.

Objective: To explore the law of apoptosis of lumbar spinal cord neurons in cauda equina syndrome (CES). Methods: Cauda equina of rats was compressed by a piece of silica gel stick. From day 1 to day 28, the lumbar spinal cord specimens were harvested and assessed by Nissl's staining and TUNEL staining. Results: Compression of cauda equina caused lesion and apoptosis of neurons in lumbar spinal cord, and the extent of apoptosis reached the peak on 7th day after compression. Conclusion: Apoptosis of neurons in lumbar spinal cord might be one of the reasons why patients with CES get poor prognosis.

Objective: To explore the law of apoptosis of lumbar spinal cord neurons in cauda equina syndrome (CES). Methods: Cauda equina of rats was compressed by a piece of silica gel stick. From day 1 to day 28, the lumbar spinal cord specimens were harvested and assessed by Nissl's staining and TUNEL staining. Results: Compression of cauda equina caused lesion and apoptosis of neurons in lumbar spinal cord, and the extent of apoptosis reached the peak on 7th day after compression. Conclusion: Apoptosis of neurons in lumbar spinal cord might be one of the reasons why patients with CES get poor prognosis.

ObjectiveTo explore the role of CXCL16/CXCR6 axis on the metastasis of human lung cancer.MethodsImmunohistochemistry and immunocytochemistry analysis were performed to detect the expression of CXCL16/CXCR6 in human lung cancer samples as well as A549,95D and H292 cell lines,respectively.The effects of CXCL16 on the viability and invasiveness of the three lung cancer cell lines were examined by MTT and in vitro invasion assay,respectively.ResultsHuman native lung cancer cells co-expressed CXCR6 and CXCL16 protein.Compared to the normal lung tissues,there was a stronger specific staining for both CXC16 and CXCR6 protein in the lung cancer tissues.Three kinds of lung cancer cell lines,including A549,95D and H292,all expressed CXCL16 and CXCR6 protein.Furthermore,human recombinant CXCL16 significantly promoted the viability and invasiveness of A549,95D and H292 cells.The stimulated action of CXCL16 on lung cancer cell lines could be effectively blocked by CXCL16 neutralizing antibody.Conclusion CXCL16 and CXCR6 protein are co-expressed in human native lung cancer.CXCL16 is able to promote the viability and invasiveness of lung cancer cell lines,which might be the molecular mechanisms on the metastasis of lung cancer.

Public relationship has an outstanding effect on virtue education. Public relationship can regulate behavior, culture noble ethics, coordinate interpersonal relations and improve the ability of society adaptation for medical students. Public relationship can also build up good image of medical students, and improve their comprehensive qualities.

Objective To investigate the relationship of serum cholinesterase(CHE) level with the severity and prognosis in patients with acute cerebral infarction. Methods A total of 325 patients with acute cerebral infarction were recruited as patients group,and another 101 healthy sub?jects were selected as control group. Velocity method was employed to detect the level of serum CHE. Patients with acute cerebral infarction were then divided into different groups according to the infarcts diameter and the modified Rankin scale(mRS)at 1 year post stroke. The collected data were analyzed statistically. Results The level of serum CHE in small and medium area infarction group was higher than control group(P<0.01);the level of serum CHE in large area infarction group was lower than control group(P<0.01);the level of serum CHE was negatively correlated with infarct size,NIHSS and the mRS score(r=-0.302,-0.232,-0.455,P<0.001). The level of CHE,age,NIHSS and infarcts diameter was identified as independent influence factors for prognosis of acute cerebral infarction. Conclusion Early phase of serum CHE level is closely related with the infarct size and illness severity index in patients with acute cerebral infarction,which could be an independent factor affecting the prognosis of cere?bral infarction.