BACKGROUND: Many basic researches and clinical observations prove that compound preparation of gingko extract and dipyridamole has an obvious effect on microcirculation. Methycobal is commonly used to repair nerve on clinic. Combination of compound preparation and methycobal has a great effect on treating diabetic peripheral neuropathy (DPN).OBJECTIVE: To observe the improved effect of combination of compound preparation and methycobal on conduction velocity of common peroneal nerve and hemorheology of DPN patients.DESIGN: Randomized controlled design and validated experiment on the basis of patients.SETTING: Department of Comprehensive Medicine, Tongji Hospital of Tongji Medic.al College, Huazhong University of Science and Technology.PARTICIPANTS: A total of 120 patients with type 2 diabetes mellitus (DM) combined with DPN were selected from the Department of Comprehensive Medicine in Tongji Hospital of Tongji Medical College affiliated to Huazhong University of Science and Technology between January 2002 and January 2005. Subjects were randomly divided into treatment group and control group with 60 in each group. All cases were consent.METHODS: Cases in the treatment group were venously dripped with 25 mL compound preparation and 250 mL saline (Guizhou Yibai Pharmacology Company Limited) once a day; meanwhile, 500 μg methycobal (Eisai Community, Japan) was intramuscularly injected into cases once a day for 4 successive weeks. Cases in the control group were intramuscularly injected with 500 μg methycobal once a day for 4 weeks.MAIN OUTCOME MEASURES: Conduction velocity of peroneal nerve and hemorheological indexes (blood viscosity, hematocrit and aggregative rate of platelet) of patients in the two groups at 1 day before treatment and at 4 weeks after treatment.RESULTS: A total of 120 patients were involved in the final analysis. ① Conduction velocity of motor nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.6±4.3), (38.5±3.8), (41.4±6.2) m/s, t=9.585, 4.312, P ＜ 0.01]; conduction velocity of sensory nerve was faster in treatment group after treatment than that before treatment and that in control group after treatment [(45.8±4.2), (36.7±4.8), (38.2±4.9) m/s, t=11.047, 9.120, P ＜ 0.01]. ② Values of high-shearing blood viscosity, low-shearing blood viscosity and plasma viscosity were lower in treatment group after treatment than those before treatment and those in control group after treatment (P ＜ 0.01). ③Value of hematocrit was lower in treatment group after treatment than those before treatment and those in control group after treatment [(41.32 ±3.56)%,(46.32±3.43)%, (44.32±4.49)%, t=7.834,4.05, P ＜ 0.01]. ④ Aggregative rate of platelet was lower in treatment group after treatment than those before treatment and those in control group after treatment [(31.35±2.11)%,(48.44±2.68)%, (45.91±3.54)%, t=38.810, 27.367, P ＜ 0.01].CONCLUSION: Combination ofcompound preparation and methycobal can increase nerve conduction velocity and decrease blood viscosity and aggregative rate of platelet, and it is also an effective method for treating DPN.

Objective:To establish a method which Nifedipine was used as an alternative control for determinating of three flavonoid glycosides in the tablets of Ginkgo biloba leaves by substitution method of reference substance.Methods:Make Nifedipine instead reference substance, the analysis was performed on a JADE-PAK C18 column (4.6 mm × 250 mm, 5 μm), with the mobile phase consisted of 0.5% phosphoric acid solution-methanol (adjusting pH value to 2.2) (50:50) at the flow rate of 1.0 ml/min, the column temperature was 35 ℃. The Nifedipine was selected as the reference substance of three flavonoid glycosides and the correction factor of Nifedipine. The content of total flavonoid glycosides was determined by relative correction factor f and substitute reference.Results:The linear ranges of Nifedipine, quercetin, kaempferide and isorhamnetin were 0.17-1.73 μg, 0.11-1.08 μg, 0.08-0.84 μg, 0.04-0.40 μg. The relative correction factor ( f) between Nifedipine and quercetin, kaempferide, isorhamnetin were 0.782 2, 0.768 5, 0.808 8, respectively. The average recovery ( n=6) were 98.48%, 98.03%, 94.55%. Conclusion:The results indicated that the HPLC method by substitute reference substance is economical, feasible and practical.

Objective To investigate the effect of recombinant human endostatin combined with chemotherapy on the expression of vascular endothelial growth factor (VEGF) in patients with advanced cancer.Methods250 patients with advanced malignant tumors were randomly selected from February 2012 to February 2016 the Third Hospital of Jiaxing, with unit control method experiment principle divided into two groups: experimental group (125 cases) and control group (125 cases).The experimental group treated by recombinant human endostatin combined chemotherapy, control group received routine chemotherapy for a week during the period of 21 days, after two cycles of treatment, clinical efficacy and adverse reactions of the two groups of patients were compared, and the expression of VEGF in tumor blood vessels weredetected.ResultsAfter two cycles of treatment, objective response rate, disease control rate in the experimental group patients was significantly higher than that in control group (P<0.05);after treatment, the expression level of VEGF in serum of the experimental group and the control groupwere decreased significantly, but the experimental group was lower than that of control group was more obvious (P<0.05).ConclusionRecombinant human endostatin combined with chemotherapy in the treatment of advanced malignant tumors can enhance the effect of chemotherapy, regulate the level of VEGF.

Breast cancer is one of the most common cancers.The clinical treatment of breast cancer has made great progress,but the inherent or acquired drug resistance,tumor migration and tumor infiltration,which lead to poor treatment efficiency and eventually death,are still the urgent problems to be solved.As with the occurrence and development of common tumors,the abnormal proliferation,migration and infiltration of breast tumor cells and muhidrug resistance (MDR) are closely related to the abnormal expression of specific genes in the cell.At present,many studies have found that the occurrence and development of tumor is closely related to the abnormal expression of microRNA.Therefore,in order to better understand the molecular mechanism of the occurrence and development of breast cancer,it is necessary to study the function of microRNA in breast tumor cells.In this paper,the application of microRNA in the treatment of breast cancer was reviewed,striving for providing effective ideas for the future selection of new strategies to control the development of tumors.

Objective To detect the gene expression difference between gastric cancer tissue and lymph node metastasis,screen different express genes,and study its mechanism of metastasis and the relationship with biological behavior.Methods Using U133plus 2.0 gene chip technology,we detected the gene expression difference between gastric cancer tissue and epithelial cells of lymph node metastasis in five patients,and screened out the differentially expressed gene Twist-l.In vitro,the cell proliferation and apoptosis level were measured by using gene over-expression and gene knockout.Metastasis ability of carcinoma cells was detected by cell scratch assay.The expression changes of epithelial-mesenchymal transition (EMT)-associated protein (E-cadherin,Vimentin) in Twist-1 overexpression and gene knockout cells were determined by Western blot.Finally,we detected the expression of Twist-1 in gastric cancer tissue,and its correlation with TNM stage was analyzed.Results The expression of Twist-1 was higher in epithelial cells than in gastric cancer tissue (12.12±3.21 vs.2.07±0.71,P＜0.01).There was no correlation of the expression of Twist-1 with cell proliferation(absorbance of cell proliferation:negtive control 0.84±0.16,null vector control 0.74 ±0.06 and Twist-1 expression cell 0.71 ± 0.07) and apoptosis [cell apoptosis rate:negtive control (2.05±0.08)％,null vector control (4.31±0.07)％ and Twist-1 expression (3.95±0.09)％],but cell migration ability enhanced.In Twist-1 over-expression group,the level of E-cadherin was decreased,while vimentin increased.Conclusions Twist-1 gene changes might be correlated with the metastasis of gastric cancer by the way of EMT.

Purpose To evaluate the diagnostic value of two-dimensional multiple-echo recalled gradient echo (2D MERGE) with flexural position in the hirayama disease. Materials and Methods Conventional MRI and axial MERGE images (7 cases) were analyzed and the anteroposterior diameter was measured at C6 vertebral body, and the structure of spinal, extramedullary and subdural space and extradural space were compared. Results The anteroposterior diameter was (5.7±0.6) cm and (4.7±0.5) cm in the neutral position and flexural position (t=-2.95, P<0.05). The“butterfly”shape of spinal grey matter could not be detected in the 4 cases on MERGE with flexural position, which could not demonstrated on the conventional MR images. 2D MERGE was not sensitive for the CSF flow artefacts and the contrast between spinal and surrounding structures was improved. However, the vascular images could not displayed on 2D MERGE images. Conclusion 2D MERGE sequence is better than T1WI and T2WI on sagittal view and T2WI on axial view in the pathological changes of hirayama disease except flow-empty vein sign, thus it has an important role in diagnosing hirayama disease.

Objective To identify the diffusion alterations of deep gray matter(GM) and white matter (WM) among Alzheimer's disease (AD), mild cognitive impairment (MCI) and healthy people by atlas?based analysis (ABA), and to investigate the respective relationship with cognitive function. Methods Twenty?one AD patients (AD group), 8 MCI patients (MCI group) and 15 normal controls (control group) were performed by conventional MRI and diffusion tensor imaging (DTI). The raw data of DTI was processed by using DTI studio software to generate the fractional anisotropy (FA) images. Then ABA was used to quantify the FA value in 58 deep GM and WM structures. The differences of FA value among three groups were compared by using one way ANOVA, with a post?hoc analysis. In AD and MCI groups, the partial correlation was further investigated between mini?mental state examination (MMSE) score and FA value in the brain regions that have significant differences between AD and MCI group or between MCI and control group. Results Compared with control group, AD patients showed wide?spread FA decrease in most deep GM and WM regions (corrected P<0.05). The FA values of the hypothalamus, the fornix, the superior longitudinal fasciculus (SLF) and the cingulum in AD group were significantly lower than those in MCI group (corrected P<0.05). The FA value of the right splenium of corpus callosum (SCC) in MCI group was significantly lower than that in control group (MCI:0.550±0.018 vs. Control:0.585±0.026, P<0.05). In AD and MCI group, the FA values of the left hypothalamus, the right hypothalamus, the left cingulum, the right cingulum, and the left SLF were positively correlated with MMSE scores(r=0.502, 0.515, 0.535, 0.527, 0.512; P<0.05). No significant correlation was found between the FA value of the right SCC, the right SLF, the right fornix/stria terminalis, the right fornix and MMSE scores(P>0.05). Conclusion Based on ABA, this study found the diffusion changes not only in the WM but also the deep GM in AD patients, but only WM diffusion disruptions in MCI group. The decreased FA value in the right SCC appeared early, but had no correlation with the cognitive impairment. The FA value in the hypothalamus, the fornix, the SLF and the cingulum decreased with the disease progression, and correlated positively with the cognition decline.

Objective To investigate the radiosensitiation effect of berberine on human nasopharyngeal carcinoma ( NPC) in hypoxia condition and explore the underlying mechanisms. Methods MTT assay, clonogenic assay and flow cytometry were performed to analyze cell proliferation, colony formation and apoptosis, respectively. Male nude mice inoculated subcutaneously with CNE-2 cells were used to examine the radiosensitization effect of berberine in vivo. The expressions of HIF-1α and VEGF were assessed by Western blot. Results Berberine efficiently inhibited the proliferation of CNE-2 cells in time-dependent and dose-dependent fashions with an IC50 of ( 14?9 ± 2?2 ) μmol/L. Clonogenic survival assay showed that berberine ( 5 μmol/L ) sensitized CNE-2 cells to ionizing radiation in hypoxia and its SERD0 was 1?27. Under hypoxic condition, berberine alone (5, 15 μmol/L) could induce apoptosis (t=5?01, 9?02,P<0?05) and it further promoted 8 Gy radiation-induced apoptosis (t =5?31, 9?91,P <0?05). Moreover, berberine significantly delayed the tumor growth in the combination group (berberine +irradiation) compared with the mice received irradiation alone or PBS (t =2?96, 14?52, P <0?05). Immunobloting assay showed that berberine inhibited the upregulation of HIF-1α and VEGF induced by hypoxia in CNE-2 cells. Conclusion Berberine confers radiosensitivity on hypoxic NPC in vitro and in vivo, which is probably associated with the downregulation of HIF-1α and VEGF expressions.

OBJECTIVETo compare the clinical efficacy differences between Zheng's gold hook, fishing acupuncture and electroacupuncture (EA) for lumbar disc herniation (LDH).

METHODSSixty patients of LDH were randomly allocated to a gold hook fishing acupuncture group and an EA group, 30 cases in each one. Lumbar Jiaji (EX-1 B 2), Yaoyangguan (GV 3), Shenshu (BL 23), Dachangshu (BL 25), Guanyuanshu (BL 26) and ashi points were selected in the gold hook fishing acupuncture group; after the needles were inserted, the manipulation of gold hook fishing acupuncture was applied at tendon junction points and ashi points. The identical acupoints were selected in the EA group and patients were treated with EA. The treatment was both given once a day; ten days of treatment were taken as one session, and totally 3 sessions were given. The clinical effective rate, visual analogue scale (VAS), low back pain score and Oswestry disability index (ODI) were used for efficacy evaluation.

RESULTSThe effective rate was 93.3% (28/30) in the gold hook fishing acupuncture group, which was superior to 86.7% (26/30) in the EA group (P < 0.05). The VAS, low back pain score and ODI were both significantly improved after treatment (all P < 0.05), which were more significant in the gold hook fishing acupuncture group (all P < 0.05).

CONCLUSIONZHENG's gold hook fishing acupuncture could effectively improve the symptoms and sings of LDH, reduce the disability index and improve the quality of life, which is superior to EA.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Low Back Pain ; therapy ; Male ; Middle Aged ; Quality of Life

Objective To discuss the clinical feature of chronic pain of aged people and strategies and effect of its self-management as well as their relationship.Methods Investigation with questionnaires wag carried out in 243 aged people who were above 65 years old to understand the clinical feature of chronic pain and strategies of its self-management.The results underwent analysis.Results Non-narcotic analgesics,physical exercise,cold and heat therapy and spiritual activity were used most frequently in selfmanagement of pain.No statistical difference existed in the use of self-management strategies between people in different age groups.Effect of self-management strategies was negatively correlated with degree of pain,interrupting with daily life and anxiety,but Wag positively correlated with self-efficacy score.Conclusions Aged people ale willing to attemp various strategies to cope with chronic pain.We should pain attention to the standardization of physical exercise,confrontation of anxiety and improvement of self-efficacy to improve the effect of self-management.