Objective To investigate the medium-and long-term clinical efficacies of superficial needling therapy for lumbodorsal myofacial pain syndrome.Method Three thousand two hundred and fifty-one patients with lumbodorsal myofacial pain syndrome were randomly allocated to a superficial needling group of 1753 cases and an acupuncturegroupof 1498 cases.Seventy-threepatients in the superficial needling group and 105 patients in the acupuncture group did not complete the required courses of treatment and were lost to follow-up.The others in the two groups completed therequiredcourses of treatment and were followed up.After three courses of treatment, the clinical therapeutic effects were compared using the pain score at the end of treatment and at three and six months and one year after.Thereturn visit rates were also compared.Result There was a significant difference in the pain score (NRS score) between the two groupsat the end of treatment (P<0.01), which was significantly lower in the superficial needling group than in the acupuncturegroup, and a difference between the twogroupsat three months after.There was no significant difference in the pain score between the two groupsat six months after and no difference between the two groupsat one year after.There were no differences in clinical the rapeutic effect and the return visit rate between the two groupsat six months and one year after.Conclusion A clinical observation with a large sample shows that superficial needling has a good short-term therapeutic effect on lumbodorsal myofacial pain syndrome and is a safe and effective method, but its medium-and long-term the rapeutic effects are notgood enough.

Objective To study whether clinical variables could be used to predict the presence of esophageal varices(EV). Methods One hundred and twenty-six patients with decompensated liver cirrhosis were enrolled. Upper endoscopy was performed to identify the EV. The spleen vein (SV), portal vein(PV), spleen index(SI), ascites was determined by ultrasenography. Platelct count(Pt), prothrombin time(PT) and liver function was determined. Results Ninety-five patients with EV, and 42 patients with severe EV. Patients with EV had significant larger SI and lower Pt. Pt and SI were predictive factors for the presence of EV. When SI≥66.9 cm2 and Pt≤89.0×109/L, they had a positive predictive value of 97.4% and 96.5%, and a negative predictive value of 55.4% and 59.8%, respectively. SI was the only predictive factor for the presence of severe EV. When SI≥82.6 cm2, it had a positive and negative predictive value of 89.2% and 75.4%. Conclusions Pt and SI are predictive factors for the presence of EV. SI is the only predictive factor for the presence of severe EV. Non-invasive factors SI and Pt can be used to predict the EV in patients with decompensated liver cirrhosis.

ObjectiveTo investigate the changes of serum myocardial enzymes and high density lipoprotein cholesterol(HDL-C) in children with septic shock.MethodsFifty-two children with septic shock in our hospital from Jan 2006 to Mar 2011 were divided into severe septic shock group( n =27 ) and mild septic shock group ( n =25 ).The serum creatine kinase-MB ( CK-MB ),α-hydroxybutyrate dehydrogenase (α-HBDH),lactic dehydrogenase(LDH) and HDL-C were analysed in both two groups on 1,2,4,7,10,15 d,and compared with 32 normal children as control group.Meanwhile,the children's condition,death cases and cured time were recorded.ResultsThe levels of serum CK-MB [ ( 32.084 ± 4.595 ) U/L,( 61.481 ±5.639) U/L],α-HBDH/LDH(0.694 ±0.080,0.884 ±0.079) in mild and severe septic shock groups were higher than those of normal control group[ (21.675 ± 3.453) U/L ] and (0.443 ± 0.065 ) ( P ＜ 0.01 ) ;the levels of serum HDL-C[ (0.646 ±0.067) mmol/L,(0.310 ± 0.124) mmol/L ] in the two septic shock groups were decreased significantly than that of control group[ ( 1.012 ±0.156) mmol/L] (P ＜0.01 ).Five cases died in the severe septic shock group while no cases died in mild septic shock group.The times of CK-MB recovered[ (9.82 ±1.76) d vs (4.68 ± 1.22) d],α-HBDH/LDH recovered[ (7.23 ± 1.38) d vs (3.76 ± 0.83 ) d] and HDL recovered[ ( 12.14 ± 2.21 ) d vs ( 6.48 ± 1.33 ) d ] were more slowly in severe septic shock group than those of mild septic shock group( P ＜ 0.01 ).ConclusionThe higher of the serum CK-MB and α-HBDH/LDH,and the lower of HDL-C in septic shock children,the disease is more severe,the recovery time is longer and a worse prognosis may occur.

Aged ; Coronary Artery Bypass, Off-Pump ; methods ; Coronary Artery Disease ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

The relationship between M3 cholinergic receptor agonist (carbachol) hyperstimulation-induced pancreatic acinar cellular injury and trypsinogen activation or NF-kappaB activation in rats was studied in vitro. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, the active protease inhibitor (pefabloc), and NF-kappaB inhibitor (PDTC) in vitro. Intracellular trypsin activity was measured by using a fluorogenic substrate. The cellular injury was evaluated by measuring the leakage of LDH from pancreatic acinar cells. The results showed that as compared with control group, 10(-3) mol/L carbachol induced a significant increase of the intracellular trypsin activity and the leakage of LDH from pancreatic acinar cells. Pretreatment with 2 mmol/L pefabloc could significantly decrease the activity of trypsin and the leakage of LDH from pancreatic acinar cells (P < 0.01) following the treatment with a high concentration of carbachol (10(-3) mol/L) in vitro. The addition of 10(-2) mol/L PDTC didn't result in a significant decrease in the activity of trypsin and the leakage of LDH from pancreatic acinar cells treated with a high concentration of carbachol (10(-3) mol/L) in vitro (P > 0.05). It was concluded that intracellular trypsinogen activation is likely involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro. NF-kappaB activation may not be involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro.
Carbachol/*pharmacology ; Cholinergic Agonists/pharmacology ; NF-kappa B/*metabolism ; Pancreas/metabolism ; Pancreas/*pathology ; Rats, Wistar ; Receptor, Muscarinic M3/agonists ; Trypsinogen/*metabolism

BACKGROUND: The application of mesenchymal stem cells derived from umbilical cord cultured in serum-containing medium has some obstacles. OBJECTIVE: To establish serum free medium system for primary culture of umbilical cord-derived mesenchymal stem cells. METHODS: Wharton’s Jel y was isolated from umbilical cord, minced, 1-3 mm3, and subsequently incubated in either serum containing medium or serum free medium. Some cells were harvested on days 11, 14 and 17 for some detection. Based on the minimal criteria established by the International Society for Cel ular Therapy in 2006, mesenchymal stem cells were assayed with colony forming unit-fibroblast. RESULTS AND CONCLUSION: The mesenchymal stem cells grew rapidly in serum free medium condition compared with serum containing medium. On day 11, the number of colonies was larger in serum free medium condition than that in serum containing medium. Thus, serum free medium could maintain properties of mesenchymal stem cells and provide possibility a credible alternative to serum containing medium for primary culture of umbilical cord-derived mesenchymal stem cells.

Objective To evaluate the efficacy of different doses of glucocorticoid for prevention of postoperative complications in patients undergoing coronary artery bypass grafting (CABG).Methods We searched PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,Chinese Biomedical Database,and CNKI from 2000 to 2010 for randomized controlled trials involving the efficacy of different doses of glucocorticoid for prevention of postoperative complications in patients undergoing CABG.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included development of fibrillation,requirement for insulin treatment because of hyperglycosemia,infection,and death (during stay in hospital or within 30 days after discharge from hospital) after operation and mechanical ventilation time.Meta-analysis was conducted using the RevMan 5.1 software.Results Twenty-one randomized controlled trials involving 1737 patients were included in our meta-analysis.Different doses of glucocorticoid decreased the risk of fibrillation,and did not increase the risk of various causes-induced infection and death.Moderate and large doses of glucocorticoid increased the risk of requirement for insulin treatment because of hyperglucosemia.Large dose of glucocorticoid resulted in prolongation of ventilation time.Conclusion Different doses of glucocorticoid can decrease the development of postoperative fibrillation without increasing the risk of infection and death,moderate and large doses of glucocorticoid increase the risk of requirement for insulin treatment because of hyperglucosemia and large dose of glucocorticoid increases the risk of prolonged ventilation time in patients undergoing CABG.

Objective To investigate the CT characteristics of ectopic pheochromocytoma in the abdomen.Methods The CT characteristics of 31 cases of ectopic pheochromocytoma in abdomen proved by surgery and pathology were retrospectively analyzed.The relationship between the density,cystic change,calcification,boundary,the enhancement degree and pathological types and tumor tissue components were studied.Results The tumors location was:9 cases in mesentery,8 cases adjacent to abdominal aorta(7 on the left and1 right),3 cases above the adrenal gland(2 on the right and 1 left),3 cases outside the renal hilum(1 on the right and 2 left),3 cases behind the inferior venacava,3 cases in hepatic hilum,and 2 cases in duodenal ampulla.Tumor size ranged from 2.7 cm ×2.5 cm to 18.0 cm × 11.0 cm(average 6.8 cm ×5.6 cm).CT plain scan:the CT value was 32-58 Hu for the substantial part(average 45 Hu),18 to 25 Hu for the cystic necrosis part (average 21.5 Hu).28 cases had clear boundary and tumor boundary in 3 cases was not clear.24 cases had equal density of the substantial part,7 cases had high density of the substantial part.21 had irregular low-density areas of necrosis in the mass center.8 cases had punctiform,patchy or linear calcification in the mass.Enhanced CT:CT value in arterial phase was 47-105 Hu of the substantial part(average 76 Hu),among which tortuous expansion within the enhanced vascular shadow of the tumor was found in 8 cases.CT value in venous phase was 45 to 90 Hu of the substantial part(average 65Hu),among which 7 cases had obviously decreased density in parenchymal enhancement part,19 cases slightly decreased,and 5 cases strengthened constantly.CT value in delayed phase was 42 to 70 Hu of the substantial part(average 56 Hu),among which 26 cases had less enhancement degree of the substantial part compared to that in the arterial and venous phase,and 5 cases had constant enhancement.Conclusions Ectopic pheochromocytoma in the abdomen has certain characteristic in CT.CT characteristics are correlated with pathologic types and tissue components.CT findings combined with clinical manifestation may suggest diagnosis.

Objective To assess the inlfuence of depth on liver stiffness measurement with real-time shear wave elastography (SWE) and determine the optimal depth for SWE in liver. Methods SWE of liver was performed on 89 healthy volunteers between May 2012 and November 2012. The depths of each liver were varied from 0 cm to 7 cm (from the liver capsule) in 1 cm increment and there were 8 depth groups in total. Then the elastic modulus of liver in each depth group were measured three times by SWE. The body mass index (BMI) and the distance from body surface to liver capsule were documented. The success rates and the mean elastic modulus of each group were calculated. Results The success rates of 0-7 cm were 0, 98.9%(88/89), 98.9%(88/89), 98.9%(88/89), 71.9%(64/89), 24.7%(22/89), 3.4%(3/89) and 0, respectively. The success rates were highest in 1 cm, 2 cm and 3 cm groups but signiifcant decreased with the increasement of depths in 4 cm, 5 cm and 6 cm groups ( 3 cm vs 4 cm, χ2=25.94, P<0.001; 4 cm vs 5 cm, χ2=39.68, P<0.001;5 cm vs 6 cm,χ2=16.79, P<0.001). The mean elastic modulus of 1 cm, 2 cm, 3 cm, 4 cm and 5 cm groups were (4.77±0.99), (4.68±0.99), (4.76±0.95), (5.19±1.10) and (5.41±0.95) kPa, respectively. The mean elastic modulus of 4 cm and 5 cm groups were signiifcant higher than those of 1 cm, 2 cm, 3 cm groups (4 cm vs 1 cm, t=-2.85, P=0.005;4 cm vs 2 cm, t=-3.49, P=0.001;4 cm vs 3 cm, t=-2.76, P=0.006;5 cm vs 1 cm, t=-3.13, P=0.002;5 cm vs 2 cm, t=-3.66, P=0.000;5 cm vs 3 cm, t=-3.05, P=0.003). In the group of 4 cm, the BMI and the distance from body surface to liver capsule of the volunteers performed successfully and unsuccessfully were (20.70±2.87), (22.07±2.42) kg/m2 and (1.45±0.25 ), (1.60±0.29) cm, respectively. In the group of 5 cm, the BMI and the distance from body surface to liver capsule of the volunteers performed successfully and unsuccessfully were (19.82±2.76), (21.49±2.72) kg/m2 and (1.35±0.21), (1.54±0.26) cm respectively. The BMI had no signiifcant difference between the successful and unsuccessful groups (t=-2.83, P=0.108 for 4 cm;t=0.77, P=0.709 for 5 cm), but the distance from body surface to liver capsule was signiifcantly different (t=26.51, P=0.012 for 4 cm;t=79.57, P=0.004 for 5 cm). Conclusions The success rates and elastic modulus were different at different depths. SWE should be performed at the depths of 1-3 cm from the liver capsule.

OBJECTIVETo observe the dynamic expression changes of p38 mitogen-activated protein kinase (p38MAPK), nucler facter kappa B (NF-κB) and cyclooxygenase-2 (COX-2) in myocardial tissue after an exhausted exercise and study the impact of p38MAPK, NF-κB and COX-2 on its myocardial damage.

METHODSSixty Wister male rats were randomly divided into the control group (n = 10) and the exhausted exercise group (n = 50). Then the exhausted exercise group was further divided into 5 subgroups, namely 0 h, 3 h, 6 h, 12 h, 24 h after an exhausted exercise (n = 10). The myocardial injury animal model was set up by using an exhausted swimming exercise and the expression of p-p38MAPK, NF-κB and COX-2 were examined by Western blot.

RESULTSCompared with the control group, the expression of p-p38MAPK were increased significantly (P < 0.01) in all the groups and the 3 h group was the highest( P < 0.01); The expression of NF-κB were increased significantly (P < 0.05) in all the groups but 0 h P > 0.05) and the 6h group was increased significantly compared with the other groups( P < 0.05); The expression of COX-2 were increased significantly( P < 0.05) in all the groups but 0 h and the 24 h groups was increased significantly compared with the other groups(P < 0.05).

CONCLUSIONp38MAPK was activated in an acute exhausted exercise, p-p38MAPK may play an important role in modulating NF-κB and COX-2 expression and mediating the exhausted exercise induced myocardial damage.

Animals ; Blotting, Western ; Cyclooxygenase 2 ; metabolism ; Fatigue ; Male ; Myocardium ; pathology ; NF-kappa B ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Wistar ; Swimming ; p38 Mitogen-Activated Protein Kinases ; metabolism