Objective To observe the clinical effect of point-to-point acupuncture with electric stimulation of direct current induction for facial nerve paralysis. Methods A total of 65 patients with facial nerve paralysis were randomly divided into the observation group (n=33) and the control group (n=32). The control group received routine treatment, and observation group was received Dicang (ST4)-to-Jiache (ST6) and Yangbai (GB14)-to-Taiyang (EX-HN5) by acupuncture with electric stimulation of direct current induction combined with conventional western medicine. The treatment of both groups last 3 weeks. The House-Brackmann Scale and the BR indexe at baseline and after 3 weeks treatment were observed. Results After treatment, The clinical effect of observation group was 66.7%, which was significantly higher than control group 43.8% (U=2.175, P=0.013). After treatment, House-Brackmann facial nerve scale (Ⅰ level=15 cases, Ⅱ level=4 cases, Ⅲ level=3 cases) in the observation group was significantly better than that in the control group (Ⅰ level=5 cases, Ⅱ level=7 cases, Ⅲ level=2 cases; U=2.069, P=0.018). After treatment, R1 latency (12.28 ± 2.55 ms vs. 13.84 ± 3.07 ms, t=2.227) and R2 latency (32.28 ± 7.08 ms vs. 35.95 ± 5.11 ms, t=2.396) in the observation group were significantly shorter than those in the control group (P=0.030, P=0.020). Conclusions The point-to-point acupuncture with electric stimulation of direct current induction could reduce latency of R1 and R2 for facial nerve paralysis, and improve the clinical effect.

BACKGROUND:Numerous studies have demonstrated that mild hypothermia has a better protective effect on neurons after cerebral infarction.
OBJECTIVE:To investigate theeffect of mild hypothermia on nerve regeneration microenvironment of infarcted area in rat models of cerebral infarction and analyze its possible effects on neural functional recovery after cerebral infarction.
METHODS:Twenty out of 65 adult femaleSprague-Dawleyrats were randomly selected as the sham group. The remaining 45 rats were subjected to carotid artery ligation to establish rat models of cerebral infarction. Five rats were rejected because of modeling failureor death, the remaining 40 rats were randomly and evenly divided into cerebralinfarction and mild hypothermia groups. The head temperature of rats in the cerebral infarction group was downregulated to (37±1)℃ using a semiconductor refrigeration instrument. The rats were transferred to the room with the temperature of 25℃ after the operation. Brain hypothermia was also induced in rats from the mild hypothermia group. At 13.0-14.0 minutes after establishing rat models of cerebral ischemia, the head on the side of cerebral ischemia was tightly connected with the probe of the semiconductor refrigeration instrument. The refrigerator temperature was adjusted to 6-8℃, so as to make the temperature of brain tissue on the lesion side at 32.0-33.0℃ for 4 hours.
RESULTS AND CONCLUSION:Compared with the cerebral infarction group, the BBB scores of rats inthe mild hypothermia group were distinctly increased, and the volume of infarcted area decreased. At 1 day after modeling, the expression level of growth associated protein 43 mRNA in brain tissue of rats in the mild hypothermia group was close to that in the cerebral infarction group. At 2 weeks after modeling, the expression level of growthassociated protein 43 mRNAin brain tissue of rats in the mild hypothermia group was significantly increased compared with that in the cerebral infarction group. These results suggest that mild hypothermia therapy can protect nerve cels against injury caused by cerebral infarction and promote the recovery of neurological function. Its underlying mechanism may be related to the up-regulation of the expression of growth associated protein 43 in ischemic penumbra .

Objective To analyze the clinical and pathological features of Wegener granulomatosis (WG) in children in order to improve the understanding of this disease. Methods Nine cases of WG,including two cases from our hospital and seven cases throughout the country,were analyzed in aspects of their clinical characteristics,laboratory examinations,X-ray and treatments. Results Of the nine cases,six cases were male and three cases were female with average age of twelve years old. The average time from the initiation of clinical symptom to diagnosis was 8.3 months. Patients had multiple systems and organs involvements. Lung and kidney involvement were the most common. Six out of seven were positive in c-ANCA and anti-PR3 antibody. Biopsy was conducted in eight patients,and pathological manifestations involved parenchymal necrosis,granulomatosis,vasculitis and so on. Most patients improved significantly after being treated with glucocorticoids and cyclophosphamide. Conclusion WG is a syndrome which involves many organs without distinctive clinical manifestation. An ANCA test should be performed to make an early diagnosis.

OBJECTIVE: High mean platelet volume (MPV) values are a risk factor for cardiovascular diseases. Our aim was to investigate the association between nasal obstructive disease and MPV value. METHOD: This study included 40 patients with nasal obstructive disease and 30 age-and sex-matched healthy subjects as controls. The levels of the number of platelets, MPV, platelet distribution width (PDW) were evaluated and compared in the two groups. Then the MPV was compared in the patients before and after operation in the study group. RESULT: Platelet count is significantly lower in the study group than the control group [(215.0 ± 47.5) x 10(9)/L versus (237.8 ± 46.2) x 10(9)/L]; MPV and PDW is significantly higher in the study group [(10.7 ± 0.7) fL versus (10.3 ± 0.8) fL]; [(12.9 ± 2.0) % versus (12.0 ± 1.3) %]. Comparing to preoperation, MPV values of the study group is significantly decreased after nasal obstructive operations [(10.7 ± 0.7) fL versus (10.4 ± 0.6) fL]. CONCLUSION MPV levels are elevated in patients with nasal obstructive disease, and can be decreased by nasal obstructive operation.
Blood Platelets ; Cardiovascular Diseases ; etiology ; Case-Control Studies ; Female ; Humans ; Male ; Mean Platelet Volume ; Nasal Obstruction ; blood ; complications ; Platelet Count ; Risk Factors

nges in standard square field.

Our studies tried to demonstrate Eha (Et haemolysin activator) could regulate the resistance of the bacterium against acidification to survive in the macrophage and explain its underlying molecular mechanism.When the bacteria infected the macrophages at time intervals,intracellular survival rate in bafilomycin-treated macrophages was higher than that with untreated cells,and the rate of wild type ET 13 was higher than that of its eha mutant,respectively (P＜0.05).The survival rate of the wild type was higher than that of the mutant under acid treatment (P＜0.05).To determine the conditions that induced the highest eha expression,we constructed a pMP220-Peha LacZ plasmid and determined the lacZ expression under different conditions.After exposure of pH6.3 medium for 2 h time,we performed the whole transcriptomic profiles of the wild type and mutant by RNA-sequencing.We identified 147 differentially-expressed genes ([log2 ratio| ≥1),113 and 34 of which were significantly up-and down-regulated,respectively in the mutant,comparing with the wild type.These findings were validated by qRT-PCR.GO functional analysis revealed that these genes were divided into 25 categories,including the bacterial catalysis,cellular composition,combination,localization,metabolism,processing,and transportation.Based on the KEGG database,these genes were distributed in 55 pathways,such as two-component system,ABC transporters,and microbial metabolism in diverse environments.Overall,Eha is an important regulator to affect all kinds of target genes and pathways for E.tarda to adapt to an acid environment.These results could be helpful for further investigations of the mechanisms by which E.tarda survives in macrophages.

Objective To explore the effect of evidence-based medicine combined withcase based learning(CBL) in pediatric residency training.Methods Totally 52 residents were equally divided into two groups:experiment group and control group.Method of CBL combined with the evidencebased medicine (Taking two residents as one group,firstly teacher posed the questions and then residents searched for references when off duty and made evidence-based case presentation at fixed time when doing teaching ward around,after wards all personnel in the department made case discussion,finally teacher made the summary) was used in experimental group while traditional teaching method (teacher guided the residents to analyze the case by clinical experiences,residents took notes and sometimes asked questions,teacher directly gave the answers)was used in control group.The teaching effect is evaluated by questionnaire,theory test and clinical skills assessment.Statistical analysis was carried out on appraisal results with SPSS 16.0 software,test results and appraisal results were expressed as ((x-) ±s) and t test was performed,P ＜ 0.05 was taken as statistically significant.Results Residents in experimental group had more advantages in self-study ability,literature retrieval ability,physician teamwork spirit,clinical thinking,PowerPoint making and language expression after receiving CBL combined with evidence-based medicine.Theory examination showed that average score of experimental group was better than that of control group (75.46 ± 6.646) vs.(71.38 ±4.758),with statistically significantly differences (P =0.014),especially in subjective items.Clinical skills assessment showed that experimental group was better than control group in writing medical records and doing clinical thinking.Conclusions Teaching method of evidence-based medicine combined with CBL is significantly better than traditional indoctrination teaching in improving the abilities of self-study,cultivating clinical thinking,literature retrieval,language performance and other skills.This teaching method is more suitable for pediatric residency training.

OBJECTIVETo establish a perceived fatigue evaluating model during simulated load carriage that is based on objective variables through analyzing the characteristics and trends of shoulder force, shoulder pressure, waist pressure, back pressure, and perceived fatigue, and to provide an analytical technique for research on load carriage.

METHODSA 50-min simulated walking (at a speed of 5 km/h and a slope of 0%) experiment including 14 healthy male adults was conducted under four levels of backpack payloads (25, 29, 34, 37 kg). Shoulder force and trunk pressure were sampled simultaneously and analyzed with time- and frequency- domain methods. Multivariable linear regression was used to build a perceived fatigue evaluating model during load carriage.

RESULTSThe perceived fatigue evaluating model based on shoulder force, trunk pressure distribution ratio, load, and body mass index (BMI) was established. Its adjusted determination coefficient (aR2) was 0.709 and the absolute percentage error (APE) at the end of the experiment was less than 20%. The goodness of fit of the model based on frequency-domain independent variables was much higher compared with the model based on time-domain independent variables. The addition of BMI that represents the individual differences to the model obviously improved the goodness of fit.

CONCLUSIONThe perceived fatigue evaluating model established in this study does not rely on the physiological changes of individuals, and thus can be used to establish an evaluation system for human load carriage with dummy as a substitution for human in experiments and to provide a scientific basis for efficient human load carriage.

Objective The effect of Asperosaponin Ⅵ(ASAⅥ)on adipocyte differentiation and the involvement of Wnt signal pathway was investigated. Methods The murine bone marrow stromal cell line ST-2 were divided into 6 groups:control group, adipocyte differentiation group, and 4 different doses of ASAⅥgroups. Control group was exposed to the vehicle, adipocyte differentiation group was exposed to adipogenic reagent, and those 4 ASAⅥgroups were treated with different concentration(10-7, 10-6, 10-5, 10-4 mol/L)of ASAⅥafter adipocyte differentiation induction. 5 days later, oil red O staining was performed to calculate adipocyte rate. Then mRNA transcription levels of PPARγ, FABP4 genes andβ-catenin that were Wnt/β-catenin signaling pathway proteins were examined by FQ-PCR. Then Wnt pathway inhibitor DKK1 was supplemented into ST-2 cells treated with 10-4 mol/L ASAⅥfor 5 days. After that FQ-PCR was used to detect whether tran?scription levels of PPARγ, FABP4 andβ-catenin in ST-2 cells were changed. Results Compared with adipocyte differenti?ation group 10-5 mol/L and 10-4 mol/L ASAⅥtreatments greatly down-regulated the number of lipid droplets and markedly inhibited transcription levels of adipocyte characterization transcription factors included PPARγ, FABP4 while up-regulat?ed transcription level ofβ-catenin in ST-2 cells. DKK1 can reverse the inhibitory effect of ASAⅥon adipocyte differentia?tion in ST-2 adipocyte. The transcription levels of PPARγand FABP4 were up-regulated significantly while transcription level ofβ-catenin was inhibited. Conclusion ASAⅥblocks adipocyte differentiation in ST-2 cells which might be medi?ated through activating Wnt/β-catenin signaling pathway.

Objective To evaluate the effect of dexmedetomidine on the postoperative pulmonary function in patients undergoing laparoscopic operation.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-70 kg,undergoing laparoscopic radical resection of rectal cancer,were divided into 2 groups (n =40 each) using a random number table:control group (group C) and dexmedetomidine group (group Dex).General anesthesia combined with epidural anesthesia was used.In group Dex,dexmedetonidine was intravenously infused as a bolus of 0.3 μg/kg over 10 min after epidural catheterization and before induction of general anesthesia,followed by an infusion of O.4 μg · kg-1 · h-1 starting from the end of tracheal intubation until 30 min before the end of operation.The equal volume of normal saline was given instead in group C.After epidural catheterization and before infusion of dexmedetomidine (T0),immediately before termination of pneumoperitoneum (T1) and at 1,6 and 24 h after operation (T2-4),blood samples were taken from the peripheral vein for determination of concentrations of serum interleukin-6 (IL-6),IL-10,tumor necrosis factor-alpha and malondialdehyde,and arterial blood gas analysis was performed simultaneously.Respiratory index and oxygenation index (OI) were calculated,and the occurrence of OI ≤ 300 mmHg was recorded.Results Compared with group C,the serum IL-6 and tumor necrosis factor-alpha concentrations and respiratory index were significantly decreased,and IL-1O concentrations and OI were increased at T1-4,and malondialdehyde concentrations were decreased at T1-3,and the incidence of OI ≤ 300 mmHg was decreased in group Dex (P＜0.05).Conclusion Dexmedetomidine can inhibit inflammatory responses and improve the postoperative pulmonary function in patients undergoing laparoscopic operation.