OBJECTIVETo compare the differences in the clinical efficacy between Guan's quadruple therapy for kidney disease and the conventional western medication in the treatment of chronic renal failure (CRF).

METHODSEighty patients were randomized into an observation group and a control group, 40 cases in each one. In the observation group, besides the physician instruction of low protein and low phosphorus diet in the two groups, Guan's quadruple therapy for kidney disease was applied, including (1) the isolated herbal moxibustion at Shenshu (BL 23) and Pishu (BL 21), or Ganshu (BL 18), Zusanli (ST 36) and Guanyuan (CV 4) alternatively; (2) acupuncture at the auricular points such as shen (CO10), jiaogan (AHR6), Shenshangxian (TG2), fei (CO14) and pizhixia (AT4); (3) injection of mixture of astragalus injection and lidocaine injection at Feishu (BL 13), Pishu (BL 21), Shenshu (BL 23) and the others; (4) modified Shenshuai Yihao decoction according to syndrome differentiation. In the control group, the conventional western medication was used. After 6 months of treatment, the differences were observed between the two groups in the clinical efficacy, serum creatinine (Scr), blood urea nitrogen (BUN), endogenous creatinine (Ccr) and 24 h urine protein quantitation (UPQ).

RESULTSIn the observation group, after treatment, the remarkably effective rate was 50.0% (20/40) and the total effective rate was 82.5% (33/40), which were superior to 25.0% (10/40) and 45.0% (18/40) in the control group (both P < 0.05). After treatment, the levels of Scr, BUN and 24 h UPQ were reduced apparently (all P < 0.05), and the level of Ccr was increased apparently in the two groups (both P < 0.05). After treatment, the levels of Scr, BUN and 24 h UPQ were reduced much more apparently in the observation group as compared with those in the control group (all P < 0.05).

CONCLUSIONGuan's quadruple therapy for kidney disease achieves a better efficacy on CRF compared with the conventional western medication. This therapy improves renal functions, relieves clinical symptoms and physical signs and benefits the life quality of patients.

Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Kidney Failure, Chronic ; drug therapy ; physiopathology ; therapy ; Kidney Function Tests ; Male ; Middle Aged ; Young Adult

OBJECTIVETo evaluate the expression of CD4+, CD8+ T cells and cell apoptosis in oral lichen planus (OLP) and investigate the role and the relationship of immunological reaction and cell apoptosis in the pathogenesis of OLP2.

METHODSImmunohistochemical technique was used to study the expression of CD4+, CD8+ T cells in 27 OLP cases. TUNEL was used for detecting the cell apoptotic index (AI) in 17 OLP2 cases.

RESULTSThe expression of CD4+, CD8+ T cells were obviously elevated in lamina propria of OLP group compared with control group (P<0.05). There was a strong significance when compared the ration of CD4/CD8 in both group. AI was remarkably increased in epithelia cells and significantly decreased in lymphocytes in lamina propria in OLP cases compared with its expression in the control group respectively.

CONCLUSIONThe increased amount of CD4+, CD8+ T cells in lamina propria of OLP and the change ration of CD4/CD8 suggest that immune response is involved in the pathogenesis of OLP. The abnormal cell apoptosis plays an important role in the pathogenesis of OLP.

Apoptosis ; Epithelial Cells ; Humans ; Lichen Planus, Oral

Objective To investigate the differences of X-ray findings of skeletal fluorosis between coal-burning type endemic fluo-rosis and industrial fluorosis.Methods The patients were randomly selected as research objects including 60 cases of coal-burning type endemic osteofluorosis and 60 cases of industrial osteofluorosis.The X-ray findings on the left forearm,crus and pelvic radio-graphs of these patients were analyzed retrospectively to find out the differences between skeletal fluorosis of coal-burning type endemic fluorosis and industrial fluorosis.Results X-ray features are no significant statistical differences between coal-burning type endemic fluorosis and industrial fluorosis,except these of interosseous membrane ossification of forearm and crus (forearmχ2=10.909,P<0.05;crusχ2=8.547,P<0.05),obturator membrane ossification of pelvis (χ2=36.554,P<0.05),periosteal proliferation outside bone of crus (χ2=4.937,P<0.05),and ossification of soleus (χ2=4.904,P<0.05).Conclusion The X-ray signs of endemic osteofluorosis and industrial skeletal fluorosis are almost similar,but there are some differences between them.

OBJECTIVETo examine the expression of TGF-beta1, Smad7 and cell apoptosis in oral lichen planus (OLP) and to evaluate the possible pathogenesis of oral lichen planus.

METHODSImmunohistochemical technique was used to study the expression of TGF-beta1 and Smad7 in the epithelia cells of 17 OLP cases and 7 normal oral mucosa (NOM). TUNEL was used for detecting the cell apoptosis in 17 OLP cases and 7 NOM.

RESULTSTGF-beta1 was moderately positive in the epithelia cells of OLP. All the epithelia cells in OLP showed strong cytoplasmic staining. The expression of TGF-beta1 and Smad7 were significantly increased in OLP compared with that in NOM (P < 0.05). Cell apoptotic index (AI) was remarkably increased in epithelia cells in OLP cases, and the cell apoptosis was localized in basal and suprabasal epithelial layers. There was a positive correlation between TGF-beta1 expression and cell apoptosis in the epithelia of OLP (r = 0.69, P <0.05).

CONCLUSIONSHigh expression of TGF-beta1 and Smad7 in the epithelia of OLP suggests that TGF-beta1-Smad7 signal pathway was disturbed in oral lichen planus. The imbalance of TGF-beta1-Smad7 pathway may contribute to the mechanisms of cell apoptosis of epithelial cells in OLP.

Apoptosis ; Case-Control Studies ; Epithelium ; metabolism ; pathology ; Female ; Humans ; Lichen Planus, Oral ; metabolism ; Male ; Mouth Mucosa ; metabolism ; pathology ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism

BACKGROUNDMany studies suggest that the gamma irradiation decreases allograft strength in a dose-dependent manner. However, no study has demonstrated that this decrease in strength translates into higher failure rate in meniscal allograft transplantation (MAT). The aim of this study was to investigate the effects of gamma irradiation on macroscopic and histological alterations of transplanted meniscal tissue and joint cartilage after MAT.

METHODSMedial total meniscectomies were performed on the right knees of 60 New Zealand white rabbits. All meniscal allografts were divided into three groups (20 in each group) and then sterilized with 0 Mrad, 1.5 Mrad, or 2.5 Mrad of gamma irradiation. For each group, 5 menisci were randomly chosen for scanning electron microscopic (SEM) analysis and the remaining 15 were prepared for MAT surgeries. Forty-five right knees received MAT surgeries (0 Mrad group, 1.5 Mrad group, 2.5 Mrad group, 15 in each group), whereas the remaining 15 only received medial meniscectomy (Meni group). The left knees of the Meni group were chosen as the Sham group (n = 15). All the rabbits were sacrificed at week 24 postoperatively. Cartilage of the medial compartment of each group was evaluated macroscopically using the International Cartilage Repair Society (ICRS) score and then histologically using the Mankin score based on the Masson Trichrome staining.

RESULTSThe SEM analysis confirmed that the meniscal collagen fibers would be significantly damaged as the dose of gamma irradiation increased. At week 24, the overall scores of macroscopic evaluations of the transplanted meniscal tissue showed no significant differences among the three groups receiving MAT surgeries, except for 2 in the 2.5 Mrad group presented partial radial tears at midbody. The ICRS scores and the Mankin scores showed the lowest in the Sham group and the highest in the Meni group (P < 0.05). For the three groups receiving MAT surgeries, the 2.5 Mrad group showed significant higher ICRS scores and Mankin scores than both the 0 Mrad group and the 1.5 Mrad group (P < 0.05). Whereas the 1.5 Mrad group presented similar results to the 0 Mrad group concerning both the ICRS scores and the Mankin scores.

CONCLUSIONSThe current in vivo animal study proved that although the meniscal collagen fibers were damaged after gamma irradiation, the failure rate of MAT surgeries might not significantly increase if the irradiation dose was <1.5 Mrad for New Zealand white rabbits.

Animals ; Female ; Gamma Rays ; Knee Joint ; surgery ; Menisci, Tibial ; surgery ; Rabbits ; Transplantation, Homologous ; methods

Adult ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; surgery ; Transplantation, Homologous ; methods

Objective To investigate the glucose metabolic pattern of brain functional loop in patients with refractory obsessive compulsive disorder (OCD) using 18 F-FDG PET.Methods Eight patients with refractory OCD and 8 age- and gender-matched healthy volunteers underwent 18F-FDG PET brain imaging.SPM software was used for image post-processing and quantitative analysis.Correlation analysis between 18F-FDG uptake and Yale-Brown obsessive compulsive scale(Y-BOCS) score was performed.Results Compared with the controls,the glucose metabolism of bilateral frontal cortices ( including the rectal gyrus,orbital gyrus and cingulate gyrus),left thalamus,right temporal lobe and bilateral cerebellum in refractory OCD patients increased significantly ( Zmax =3.45 - 5.80,all P ＜ 0.001 ).Bilateral motor cortices and bilateral parietal lobes (BA7),however,showed decreased glucose metabolism (Zmax =3.44 - 4.46,all P ＜0.001 ).Y-BOCS score was positively correlated with the glucose metabolism of the bilateral anterior cingulate cortex (Zmax =3.77,3.48 and 2.97,all P ＜ 0.01 ).Conclusions There is a characteristic metabolic pattern of increased glucose utilization in the fronto-striato-thalamic loop and decreased glucose utilization in bilateral motor cortices and parietal lobes in patients with OCD.The glucose metabolism in the anterior cingulate cortex might serve as a quantitative parameter for the assessment of the severity of OCD.

Objective To investigate the protective effects of diltiazem ( Dil) on damaged human umbilical vein endothelial cells induced by an-giotensin Ⅱ( Ang -Ⅱ).Methods Human umbilical vein endothelial cells( HUVECs) were cultured in vitro ,with 1 ×10 -6 mol· L-1 Ang-Ⅱas an injury factor simulating the injury model.The cell viability was as-sessed using MTT metabolism assay .The apoptosis rate of HUVECs was detected by flow cytometry , The production of lactate dehydrogenase ( LDH) activity in cell supernatant was detected by colorimetry.The pro-tective effect of diltiazemon damaged HUVECs induced by Ang -Ⅱ was investigated.Results Compared with control group,Ang -Ⅱ(1 ×10-7, 1 ×10-6 , 1 ×10-5 mol · L-1 ) concentration -and time -dependently decrease the cell vitality and the apoptosis rate of HUVECs.Pretreatment with dilconcentration-dependently improved the cell vitality and the apoptosis rate of HUVECs.In addition, compared with the damaged group , diltiazem reduced LDH activity in the cell supernatant.Conclusion Diltiazem has protective effect on the damaged HUVECs induced by Ang -Ⅱ.

Objective To develop the suitable for our country , high reliability and validity of cognitive questionnaire about blood pressure monitoring in critical care nurses ( CCNs ) in order to provide the help for understanding the status of blood pressure monitoring in CCNs in our country .Methods The original entry pool was preliminarily established according the international assessment scale of clinical outcome in patients through the structured decision-making including the McGhee-items, references from databases and experts ’ modification.70 CCNs and 120 undergraduate nursing students with one ICU at least were surveyed by the preliminary questionnaire .The entries were screened again through the investigation of entry distribution , dispersion, t test, resolution coefficient and the discussion in core group again , and the reliability and validity of internal consistency were evaluated .Results The original entry pool was 35 items, and the items of experts ’ modification was 3;5 items were deleted through the item selection combined with the discussion in core group . The items of the remaining entries in three dimensions including the physiology of blood pressure monitoring , technical aspects of monitoring , wave distinguish and data interpretation were respectively 12, 8, 10 items.The total Cronbach ’ s αcoefficient of questionnaire was 0.783, and the Cronbach ’ s αcoefficient of different dimensions were respectively 0.822, 0.793 and 0.734.Six extracting factors explained 82.57% of the total variance, and the loads of the corresponding dimensions were more than 0.55.Conclusions The initial questionnaire which is consisted of items after selection can comprehensively reflect the connotation of blood pressure monitoring , and can be used for investigating the cognitive level of blood pressure monitoring in CCNs in our country due to high validity and reliability .