OBJECTIVETo compare the efficacy difference in the treatment of functional dyspepsia between acupuncture at the acupoints selected by pattern/syndrome differentiation and domperidone.

METHODSSeventy cases were randomized into an acupuncture group (35 cases) and a western medication group (35 cases). In the acupuncture group, Zusanli (ST 36) and Neiguan (PC 6) were selected. Taichong (LR 3) and Neiting (ST 44) were added for excess syndrome while Gongsun (SP 4) and Yinlingquan (SP 9) were added for deficiency syndrome. A pair of electrodes was attached to one acupoint and an assistant point (2 mm next to the acupoint centripetally) and stimulated with disperse-dense wave at 2 Hz/100 Hz, once a day. In the western medication group, domperidone was prescribed for oral administration, 10 mg each time, three times a day. In the two groups, the treatment of 5 days made one session and 4 sessions were required totally. Nepean dyspepsia index (NDI) was compared after treatment, 1, 2, 3, 4 and 5 months after treatment between the two groups respectively.

RESULTSThe score of symptom and score of life quality in NDI after treatment and at each follow-up time point were improved obviously in the acupuncture group as compared with those before treatment (all P < 0.01). In the western mediation group, the score of symptom and the score of life quality in NDI after treatment and in follow-up of 1, 2 and 3 months were improved obviously as compared with those before treatment (all P < 0.01), but the differences were not significant in follow-up of 4 and 5 months (both P > 0.05). Compared with the western medication group, the symptom score of NDI was reduced obviously after treatment and in each time point of follow-up in the acupuncture group (P < 0.05, P < 0.01), and the score of life quality was increased obviously (P < 0.05, P < 0.01).

CONCLUSIONAcupuncture at the acupoints selected by pattern/syndrome differentiation and domperidone are effective in the treatment of functional dyspepsia. Domperidone is unsatisfactory in the long-term effect, but acupuncture achieves the positive short-term and long-term effects on functional dyspepsia.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Dyspepsia ; diagnosis ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Time ; Treatment Outcome ; Young Adult

Therapeutic approaches to brain metastases from non-small cell lung cancer ( NSCLC ) include corticosteroids, anticonvulsants, surgery, radiotherapy and chemotherapy. In recent years, molecular targeted therapy such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) has become a new option. This article discussed the roles of surgery, brain radiation, chemotherapy, targeted therapy , and other new directions in the treatment of patients with brain metastases from NSCLC.

Objective To review the experience of colon interposition in the treatment of benign esophageal stricture.Methods 58 patients who had undergone colon interposition for esophageal replacements were studied retrospectively,including 53 patients with corrosive burn esophageal strictures,3 traumatic esophageal strictures and 2 congenital esophageal strictures.The interposition colon for all patients went through substemum paths.Results There was no postoperative death in the duration of hospital stay.14 cases developed postoperative complication including 2 total colon necrosis,7 anastomotic leak,2 anastomotic stricture and 3 recurrent laryngeal nerve injury.52 patients were followed-up(ranged 1 to 16 years),40 cases were extremely satisfied(1 grade),9 very satisfied(2 grade),2 satisfied(3 grade)and 1 unsatisfied(4 grade).Conclusion Colon interposition is an ideal procedure for esophageal benign stricture.

Objective To investigate the efficacy of endoscopic intranasal structure reconstruction surgery for rhinogenous headache. Methods 82 cases of rhinogenous headache were given endoscopic intranasal structure reconstruction. Compared VAS scores before and 6 months after treatment, counted the effective rate. Results Among the 82 patients, 69 patients(84. 1%) were cured, 8 cases (9. 8%) were of obvious effect, 5 cases (6. 1%) were invalid, and the total efficiency was 93. 9%. VAS scores of the mucosal contact headache group before treatment were greater than that of the sinus headache group (P<0. 05). Compared with VAS scores before treatment, both of the two groups had lower VAS scores after treatment (P<0. 05), but there was no significant difference between the two groups after treat-ment (P>0. 05). Conclusion Endoscopic surgical operation can remove the extrusion of the nasal cavity and paranasal sinuses and factors of nasal congestion, and then reconstruct normal anatomical structure of nasal cavity, thus restoring normal function of paranasal sinuses. It has good therapeutic effect on rhinogenic headache.

Objective To investigate the effect of insulin on D_5 dopamine receptor expression and function in renal proximal tubule (RPT).Methods Immortalized RPT cells and D_5 receptor transfected HEK293 (HEK-D_5) cells were used in the study to investigate the effect of insulin on D_5 receptor expression and function,and those effects were compared in RPT cells from Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). The function of D_5 receptor was determined by measurement of the Na~+-K~+-ATPase activity in HEK-D_5 cells. Results Insulin increased D_5 receptor protein expression in a concentration and time-dependent manner in WKY RPT cells,but not in SHR.The basal level of D_5 receptor expression was higher in WKY cells than that in SHR cells. Stimulation with fenoldopam(D_1-like dopamine receptor agonist) inhibited the Na~+-K~+-ATPase activity;pretreat- ment with insulin increased the inhibitory effect of fenoldopam on Na~+-K~+-ATPase activity in HEK-D_5 cells. Conclusion The abnormal regulation of insulin on D_5 receptor expression and function might be involved in the path- ogenesis of essential hypertension.

Objective To evaluate the roles of Toll-like receptor 2 (TLR2),TLR4 and myeloid differentiation factor 88 (MyD88) in immune recognition and immune mediation in sporotrichosis by detecting their expressions in skin lesions of sporotrichosis.Methods Biopsy specimens were obtained from the skin lesions of 19 patients with sporotrichosis and normal skin of 12 healthy human controls.Immunohistochemistry was performed to observe the expressions of TLR4 and MyD88,and real-time fluorescence-based quantitative PCR to quantify the expressions of TLR2 and MyD88 mRNAs.Data were expressed as mean ± standard error.Statistical analysis was done with the SPSS17.0 software.Independent samples t-test was conducted to compare the parameters between the lesional and control specimens.A p-value of less than 0.05 was considered to be statistically significant.Results TLR4 and MyD88 were mainly observed in the whole epidermis except the stratum corneum as well as plasma cells and lymphocytes in the dermis and subcutaneous tissue in lesional skin.However,TLR4 was nearly absent and MyD88 was weakly expressed in the dermis and subcutaneous tissue in normal skin.The expression levels of TLR4 and MyD88 were significantly higher in the lesional skin than in the control skin (TLR4,63.767 ± 3.829 vs.5.167 ± 3.246,t =4.82,P ＜ 0.05; MyD88,57.236 ± 4.744 vs.10.588 ± 1.640,t =3.30,P ＜ 0.05).Similarly,the lesional skin showed significantly stronger expressions of TLR2 and MyD88 mRNAs compared with the normal skin (TLR2,1.974 ± 1.452 vs.1.430 ± 1.073,P ＜ 0.05; MyD88,2.028 ± 2.061 vs.0.688 ± 0.422,P ＜ 0.05).Conclusion Sporothrix may induce the development of sporotrichosis by interacting with host immune system via TLR signaling pathways.

OBJECTIVE To investigate the surgical management and its result of the cervical esophageal cancer.METHODS Forty six patients with cervical esophageal carcinoma who received surgical treatment in our hospital were included in this retrospective study.The removed hypopharynx and cervical esophagus were repaired with laryngotracheal flap in 5 cases,free myocutaneous flap in 4 patients and free jejunum in 2 patients.The inversion stripping esophagectomy without thoracotomy were performed in 35 patients.RESULTS During the early postoperative period,complications included recurrent laryngeal nerve paralysis in 2 cases,anastomotic fistula in 3 cases,anastomotic stenosis in 5 cases,Long-term postoperative gastro-esophageal reflux occurred in 19 cases.The 5-year survival rate was 28.7%. CONCLUSION The surgical treatment for cervical esophageal carcinoma should be decided by the location of the tumor,the extent of the cancer involved and lymph node metastasis.

Objective To study the method of emergency blood collection during a long-distance voyage to ensure blood transfusion treatment.Methods Ten voluntary blood donors were recruited, a base unit of blood was collected and preserved.Reactions of the blood donors were observed, and the blood quality was tested.Results The success rate of blood collection was 90% and the qualification rate was 100%.Conclusion Emergency blood collection during a long-distance voyage is feasible,which can help ensure blood supply in peace time or war time.

Objective To investigate the impacts on inpatient costs of a hospital in Beijing as incurred by the reform of clinic-pharmacy-separation by means of DRGs. Methods As required by BJ-DRGs, we selected DRGs grouping information and medical record homepage information of the inpatients discharged from a tertiary hospital in Beijing from January to March in 2017 ( pre-reform group ) and that from May to July in 2017 ( the post-reform group ) . Then we compared the differences of inpatient costs before and after the reform, and the inpatient cost changes of the DRGs groups. Results The median of inpatient costs before the reform was 8751. 21 yuan, and that after the reform was 8522. 07 yuan, a difference without statistical significance (P>0. 05). Of the 104 DRGs studied, cost changes were found in 28 DRGs (P<0. 05), with increases in 19 DRGs and drops in 9 DRGs groups. Conclusions The reform, though without impact on the inpatient costs, changed the makeup of costs on the other hand, especially on HJ13 and BB25 DRGs groups, worthy of attention. A dynamic tuning mechanism is thus suggested for pricing of medical services, and a fine management suggested for the hospitals to curb unreasonable growth of costs.

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in the general adult population in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region where many minorities of north China live. Methods Sampling surveywas performed in the residents aged 20 years and older in the Hulunbeir Prefecture. All the investigated subjects were tested for urinary albumin to creatinine ratio (ACR); hematuria by microscopy of urinary sediment; and GFR estimated by modified MDRD equation for Chinese adults (eGFR). The related risk factors of CKD were also investigated. Results A total of 4522 subjects were enrolled in the study. The prevalence of albuminuria was 7.11％, hematuria was 2.64％ and reduced eGFR [60 ml-min-1·(1.73 m2)-1] was 2.75％. The prevalence of hypertension was 38.90％; hyperglycemia 6.61％; hyperlipidemia 2.72％; increased waist 24.79％ and metabolic syndrome 15.02％. After the subjects with combined microalbuminuria, hematuria and reduced eGFR were excluded, the prevalence of CKD was 12.95％. Logistic regression analysis and stratified analysis showed increased age, increased waist, elevated systolic pressure, hyperglycemia,hypertriglyceridemia and metabolic syndrome were independently associated with albuminuria;increased age, elevated systolic pressure and hyperglycemia were independently associated with reduced eGFR; increased age was independently associated with hematuria. Conclusions The prevalence of adult CKD is 12.95％ in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region. Independent risk factors of CKD include increased age, increased waist, hypertension,abnormal blood glucose or lipid, and metabolic syndrome.