As we known,serum creatinine(Scr),serum urea nitrogen(SUN) and creatinine clearance rate(Ccr),the most established marker of renal function,are affected by age,gender,muscle mass or nutritional status.Scr determines the glomerular filtration rate(GFR) improperly.Serum Cystatin C(sCys C) is freely filtered at the glomerulus and then resorbed and fully catabolised by proximal renal tubules,ma-king it an ideal marker of GFR.It is not affected by gender,muscle mass or malignancy,its production rate is usually constant and its plasma concentration therefore is dependent only on GFR.sCys C has been demonstrated to be more accurate and sensitive than Scr in the detection of early renal impairment and in specific populations may allow for early detection of renal disease.The aim is to discuss the advantages and limitations of sCys C and of established GFR methods.

OBJECTIVETo verify the clinical efficacy on chronic fatigue syndrome of qi deficiency syndrome treated with acupuncture at selective time and explore the effect mechanism.

METHODSEighty patients were randomized into a selective-time-acupuncture group and an acupuncture group, 40 cases in each one. Qihai (CV 6), Guanyuan (CV 4), Hegu (LI 4), Taichong (LR 3), Sanyinjiao (SP 6) and Zusanli (ST 36) were selected in the two groups. In the selective-time-acupuncture group, acupuncture was used at 9:00am to 11:00am. In the acupuncture group, acupuncture was used at any time except in the range from 9:00am to 11:00am. No any manipulation was applied after the arrival of needling sensation. The treatment was given once every day, 10 day treatment made one session and two sessions of treatment were required. The fatigue scale was adopted to evaluate the efficacy before and after treatment in the patients of the two groups. The ratios among CD3+, CD4+ and CD8+ T cells in the peripheral blood were detected before ad b a after treatment.

RESULTSIn the acupuncture group, the total score of fatigue and the score of physical fatigue were reduced after treatment as compared with those before treatment (all P<0.05). In the selective-time -acupuncture group, the total score of fatigue, the s core of physical fatigue and the score of mental fatigue after treatment were reduced obviously as compared with those hefore treatment (all P<0. 01). The improvements in the scores of the selective-time-acupuncture group were superior to the acupuncture group (all P<0. 05). The ratio of CD3+ and CD8+ T cells was increased obviously after treatment in the two groups (all P<0. 05) and the ratio of CD4+ and CD8+ T cells was reduced obviously in the selective-time-acupuncture group (P<0. 05), which was better than that in the acupuncture group (all P<0.05). The total effective rate was 95.0% (38/40) in the selective-time-acupuncture group, which was better than 80.0% (32/40) in the acupuncture group (P<0.05).

CONCLUSIONThe acupuncture therapy at selective time is effective in the treatment of chronic fatigue syndrome of qi deficiency syndrome, which is especially better at relieving mental fatigue. The effect of this therapy is achieved probably by improving the immune function via the regulation of the ratios among CD3+, CD4+ and CD8+ T cells.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Fatigue Syndrome, Chronic ; immunology ; therapy ; Female ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Qi ; T-Lymphocyte Subsets ; cytology ; immunology ; Treatment Outcome ; Young Adult

Objective To evaluate and eliminate the potential bias between data obtained from dry and liquid biochemical assays,making data obtained by different assays matchable.Methods Bias estimation was performed based on document EP9-A2.Simple data comparison and methodology validation were performed after the experiment methods were modified with the estimated correction factors and interception.All the collected data were analyzed by EXCEL2007 software.Results The predicted bias of 4 of the 10 compared items exceeded their corresponding acceptable bias.After being adjusted by the coefficient and interception obtained from linear regression analysis,the four bias was improved and was within the acceptable range.The results of simple data comparison further confirmed this comparability.Conclusion Based on EP9-A2,we have established a protocol to obtain a consistency of data from different biochemical analyzers,which makes it possible that the detection results of the same patient from different detection systems can be used directly.The protocol has been approved by the experts during the medicinal laboratory accreditation of ISO15189.

Objectives To study the effects of pU- vascular endothelial growth factor (VEGF)- short interfering RNA (siRNA) on the formation and apoptosis of malignant melanoma in models of nude mice and its mechanism. Methods The siRNA eukaryotic expression vector for VEGF was constructed, then transfected into A375 (a human malignant melanoma cell line) by electroporation. The nude mice models of malignant melanoma were constructed. The protein expression of VEGF and factor Ⅷ related antigen (FⅧRAg) specific for vascular endothelial cells was detected by immunohistochemical technique and morphological quantitative analysis. Microvessel density (MVD) was counted based on the endothelial cells positively stained with anti-FⅧRAg antibody. The apoptosis of the neoplasms in nude mice was quantitatively determined by TdT mediated dUTP nick end labeling (TUNEL). Results Both the number and the growth speed of the neoplasm formation were lower in the experimental group than those in the controls (both P

Objective To explore the safety of bedside bowel movement during the earlY phase of patients with acute myocardial infarction(AMI).Methods 55 patients were randomly divided into the experimental group(28 cases)and the control group(27 cases).The experimental group adopted bedside bowel movement while the control group used routine in-bed bowel movement.The heart rate,blood pressure and myocardial oxygen comsumption(D-P)were observed.Results The heart rate,systolic blood pressure,and diastolic blood pressure in the control group were higher than those in steady state(P＜0.05).While in the experimental group the above factors were not statistically different from those in steady state (P＞0.05).The D-P both increased in the two groups compared with that in steady state(P＜0.05).The incidence of uncomfortable complaint and complications were not different between the two groups but the rate of constipation and mean in-hospital days were lower than those in the control group(P＜0.05).Conclusion It proved safe and applicable for patients with AMI to adopt bedside bowel movement during 24 to 72hours after infarction under the electrocardiac and blood pressure monitoring if their vital signs were steady and did not have any serious complications.

Jin's three-needle technique is named after Professor JIN Rui. The connotation of Jin's three-needle technique is summarized by his followers through long-term teaching and clinical practice. His principle and method of point combination are based on syndrome differentiation of acupuncture. And his unique needling technique and treating principle of mental tranquilization also play an important role in his clinical practice.
Acupuncture Therapy ; instrumentation ; methods ; Humans ; Needles

Objective To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods From Feb.2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy,effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV( with 10 keV increment) in late arterial phase [(36±13)HU vs. (62±23)HU, (26 ±8)HU vs. (40±15)HU, and (19±6)HU vs. (27±10)HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [ (43 ± 14 )HU vs.(61 ±25)HU and (30 -10)HU vs. (40 ± 16)HU respectively], effective-Z (late arterial phase 7.80 ± 0. 16 vs. 8.05 ± 0. 21, and portal venous phase 7. 87 ± 0. 15 vs 8.02 ± 0. 22 ), concentration of calcium (water) [late arterial phase (5 ±3) g/L vs. (11 ±4) g/L, t= -3.836, P=0.001 and portal venous phase (7 ± 3 ) g/L vs. ( 10 ± 5 ) g/L, t = - 2.071, P = 0. 049 ] and iodine (water) [ late arterial phase (0.38 ±0.24) g/L vs. (0.78 ±0.32) g/L, t = -3.755, P=0.001 and portal venous phase (0.48 ± 0. 24) g/L vs. (0. 72 ± 0. 34 ) g/L, t = - 2. 161, P = 0. 041 ] were lower in serous oligocystic adenoma than those in mucinous cystic neoplasms. In discriminant analysis, multiple parameters [ age, symptom,tumor size, CT values on 40 keV to 50 keV, effective-Z, concentration of iodine (water) in late arterial phase and concentration of calcium (water) in portal venous phase] showed high accuracy (100%, 27/27 )of joint diagnosis between serous oligocystic adenoma (100%, 15/15 ) and mucinous cystic neoplasms (100%, 12/12). Conclusions The serous oligocystic adenoma and mucinous cystic neoplasms had distinct characteristic findings on CT spectral imaging. CT spectral imaging is highly accurate in the differential diagnosis between serous oligocystic adenoma and mucinous cystic neoplasms.

Objective:To investigate the correlation between lumbar bone mineral density (BMD), musculoskeletal perfusion andmuscle mass.Methods:From May 2019 to August 2020, totally 91 patients who applied for CT perfusion (CTP) examination of abdomen (the scan range included the vertebral body of L1－L3) in Shanghai Tenth People′s Hospital of Tongji University were retrospectively analyzed. The mean BMD of L1－L3 vertebral body was measured by quantitative CT (QCT) at the same time of CT plain scan. According to BMD, the subjects were divided into normal BMD group ( n=33), osteopenia group ( n=41) and osteoporosis (OP) group ( n=17). The L3 level perivertebral muscle mass index and fat fraction were calculated based on QCT examination. The lumbar vertebral and perivertebral muscle perfusion parameters were measured based on CTP images. The parameters of QCT and CTP among three groups were analyzed by Kruskal-Wallis H test or one-way ANOVA. The correlation analysis was conducted between these parameters using Pearson or Spearman analysis. Results:The differences of the perivertebral muscle mass index and fat fraction among three groups were statistically significant ( P<0.05). The differences of the lumbar vertebral perfusion parameters including blood flow (BF), blood volume (BV) and flow extraction product (FE) among three groups were statistically significant ( P<0.05), and BF, BV and FE were positively correlated with BMD ( r=0.444, 0.312 and 0.266 respectively, all P<0.05; adjusted for age and gender r=0.437, 0.340 and 0.337 respectively, all P<0.05). There was no statistically significant difference in perivertebral muscle perfusion parameters among three groups ( P>0.05). Perivertebral muscle mass index was negatively correlated with fat fraction ( r=-0.599, P<0.001; adjusted for age and gender r=-0.404, P<0.001), and there was no correlation between perivertebral muscle mass index and muscle perfusion parameters, as well as perivertebral muscle fat fraction and muscle perfusion parameters. Conclusions:With the changes of BMD, bone mass and perivertebral muscle mass at L3 level are synchronous. Decreased vertebral bone mass is accompanied with reduced perivertebral muscle mass, increased muscle fat and decreased bone perfusion. The changes of vertebral perfusion and perivertebral muscle perfusion at L3 level are asynchronous, which implies that reduced perfusion in OP patients may be confined to the bone.

An extremely thermoacidophilic isolate K4-1 was obtained from an acidic hot spring in Teng- chong Rehai, Yunnan province. Morphology, growth characteristics, utilization of carbon compounds, en- ergy sources and 16S rRNA gene sequence of K4-1 were studied. Cells of K4-1 are irregular cocci with monotrichous flagella. The strain grew aerobically in either a lithotrophic or a heterotrophic mode. Growth on elemental sulfur occurred through oxidation of sulfur. It grew optimally at 75?C and pH 3.5. On the basis of 16S rRNA gene sequence similarity, strain K4-1 was shown to belong to genus Sulfolobus, being related to the type strains of genus Sulfolobus (86.6%~94.3% similarity), and being most closely related to strain Sulfolobus tengchongensis RT8-4 (98.9% similarity). The GenBank accession number of strain K4-1 16S rRNA gene sequence is EU729124.

Objective To investigate a shorter and safer route for contralateral C_7 nerve root transfer. Methods Eight male patients were treated from Dec2005 to Nov.2006Their range of age was from 22 to 43 years with an average of 30 yearsFive cases had total brachial plexus avulsion.The operative delay was from 2 to 6 months(mean:4 months).The sealenus anterior muscle was transected before a prespinaJ & ret- ropharyngeal tunnel was madeThe contralateral C_7 nerve root was used to repair the upper trunk or the infra- clavicular lateral cord and posterior cord of injured side via this routeusing direct anastomosis or nerve graft- ing.Results The length of the harvested contralateral C_7 nerve root was(4.67?0.52em in the early 5 casesThe nerve graft was6.25?0.35)em long for repairing supraclavicular brachial plexus and(8.56?0.45cm long for repairing infraclavicular brachial plexusThe length of the harvested contralateral C_7 nerve root averaged 6.85cm in the other 3 cases2 of which had direct anastomosis to the residual nerve C_5 and C_6 nerve roots and the other used nerve graft of 3 cm in lengthTransient contralateral sensory symptoms were re- ported in most patientsAt 3 months followups6 patients had tingling sensation on the contralateral fingers with percussion on the injured cervical areaIpsilateral SSEP could be recorded by stimulating at 2 cm above sternoclavicular joint on the injured sideAt 7 months follow ups of 5 patientsCMAP could be recorded in bi- cepsdeltoids and infraspinatus or triceps with stimulation at Erb's pointHoweverno clinical movements was noticedAt 12 months follow ups of 3 patientswe could observe early motor and sensory function recovery of those patients to different extent.Conclusion Transection of anterior scalenus muscle shortens the length of the transfer route and allows more efficient neurotizationThe procedure is convenient and safeprovided certain precautions being usedThe principal of contralateral C_7 nerve transfer are reconstruct the anterior divi- sions of upper trunkposterior divisions of upper trunk and suprascapular nerve when repairing the supraclavic- ula brachial plexusReconstruct the lateral cord and posterior cord when repairing the infraclavicula brachial plexusPostsurgical fasting for 4 days included foods and liquids will benefit of healing of anastomosed nerves and regenerationaud avoid complications.