Objective:To observe the clinical efficacy and safety of knee-balancing Tuina(Chinese therapeutic massage)manipulation for pes anserina bursitis(PAB). Methods:A total of 64 patients with PAB were enrolled and divided into a Tuina group and a medication group by the random number table method,with 32 cases in each group.The medication group was given votalin for external use,and the Tuina group was given knee-balancing Tuina manipulation based on treatment according to structure differentiation.Both groups were treated for 7 consecutive days.The visual analog scale(VAS)score,Lyshlom score,knee joint range of motion(ROM),and total effective rate were compared between the two groups.Adverse reactions were observed in both groups. Results:During the treatment,there was 1 dropout case in the medication group.The total effective rate was 93.8%in the Tuina group and 83.9%in the medication group.The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS score in both groups decreased significantly(P<0.05),and the Lyshlom score and knee joint ROM increased significantly(P<0.05).The differences in the VAS score,Lyshlom score,and knee joint ROM between the two groups were all statistically significant(P<0.05). Conclusion:The knee-balancing Tuina manipulation based on treatment according to structure differentiation can effectively relieve pain and improve knee function in PAB,and its efficacy is superior to that of external use of votalin.

Objective:To observe the clinical efficacy of Yin-Yang balancing acupuncture plus Tuina(Chinese therapeutic massage)for post-stroke depression(PSD). Methods:A total of 72 PSD patients were randomized into an acupuncture-Tuina group and a Western medicine group using the random number table method,with 36 cases in each group.The Western medicine group was treated with fluoxetine hydrochloride capsules.The acupuncture-Tuina group was treated with Yin-Yang balancing acupuncture plus Tuina therapy.Both groups were treated for 4 weeks.After treatment,the clinical efficacy was compared,and the changes in Hamilton depression scale(HAMD)score,National Institute of Health stroke scale(NIHSS)score,serum neurotransmitter levels,and electroencephalogram(EEG)were observed. Results:The total effective rate of the Western medicine group and the acupuncture-Tuina group was 83.3%and 94.4%,respectively.There was a significant difference in the total effective rate between the two groups(P<0.05).After treatment,the serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)were higher than those in the same group before treatment,and the intra-group differences were all statistically significant(P<0.05).The serum levels of 5-HT,NE,and DA in the acupuncture-Tuina group were higher than those in the Western medicine group,and the differences between the groups were statistically significant(P<0.05).After treatment,the scores of HAMD and NIHSS in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The scores in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were all statistically significant(P<0.05).After treatment,the EEG diffuse wave[(delta+theta)/(alpha+beta)]ratio(DTABR)and delta/beta ratio(DBR)in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The ratios in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were statistically significant(P<0.05). Conclusion:Yin-Yang balancing acupuncture plus Tuina therapy has a better efficacy than oral fluoxetine hydrochloride capsules in the treatment of PSD,which can increase the levels of serum 5-HT,DA,and NE,and regulate brain waves.

Long-term inflammation will develop into chronic inflammation and become inflammatory diseases.Antibiotics are commonly used in clinical practice to treat inflammatory diseases.But patients are prone to drug resistance.So we need to find new treatment.Chlorogenic acid is an organic compound extracted from honeysuckle and other plants.Its anti-inflammatory activity is strong,and it has a significant anti-inflammatory effect on inflammatory diseases in various systems.It has been shown that chlorogenic acid can regulate inflammation-related signaling pathways,such as nuclear factor κB(NF-κB)canonical signaling pathway,NF-κB atypical signaling pathway,nuclear factor-erythroid 2-related factor 2(Nrf2)canonical signaling pathway,and Nrf2 atypical signaling pathway,etc.It can up-regulate the expression of anti-inflammatory cytokines such as interleukin(IL)-4,IL-10,IL-13 and down-regulate the expression of pro-inflammatory cytokine such as IL-1β,IL-6,and IL-8.Although chlorogenic acid has a strong anti-inflammatory effect,but clinical trials and application still face many difficulties.In the future,the anti-inflammatory molecular mechanism of chlorogenic acid should be further studied to explore its clinical application value and improve new ideas for the treatment of inflammatory diseases.

Objective: To observe the clinical efficacy of warm needling moxibustion plus isokinetic muscle strength training for knee osteoarthritis (KOA).Methods: A total of 135 patients with KOA due to Yang deficiency and coagulated cold were randomized into a warm needling moxibustion group, an isokinetic muscle strength training group, and a combined group by the random number table method, with 45 cases in each group. The warm needling moxibustion group was treated with warm needling moxibustion. The isokinetic muscle strength training group was treated with isokinetic muscle strength training. The combined group was treated with warm needling moxibustion plus isokinetic muscle strength training. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS) were scored before and after treatment, and isokinetic indicators of peak torque (PT), total work (TW) and average power (AP) were evaluated. Results: The total effective rate of the combined group was 92.5％, which was significantly higher than 83.3％ in the warm needling moxibustion group (P<0.05) and 72.5％ in the isokinetic muscle strength training group (P<0.05). After treatment, the scores of WOMAC (total, pain, stiffness, and function) and VAS, and isokinetic indicators (PT, TW, and AP) were all improved compared with those before treatment (P<0.05) in all three groups. The differences among the three groups were statistically significant (P<0.05). The WOMAC total score and score of stiffness in the combined group were lower than those in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), and the scores in the warm needling moxibustion group were lower than those in the isokinetic muscle strength training group (P<0.05). The WOMAC score of pain and VAS score in the warm needling moxibustion group and the combined group were lower than those in the isokinetic muscle strength training group (P<0.05). The differences between the warm needling moxibustion group and the combined group were not statistically significant (P>0.05). The WOMAC function score in the combined group was lower than that in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), while there was no statistical difference between the warm needling moxibustion group and the isokinetic muscle strength training group (P>0.05). PT, TW, and AP in the combined group were higher than those in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), and they were higher in the isokinetic muscle strength training group than in the warm needling moxibustion group (P<0.05). Conclusion: Warm needling moxibustion plus isokinetic muscle strength training has a better effect in the treatment of KOA due to Yang deficiency and coagulated cold than either warm needling moxibustion or isokinetic muscle strength training alone.

Objective To compare the diagnostic value of X-ray film and MRI in the posterior ankle impingement syndrome (PAIS).Methods X-ray film and MRI data of 72 cases with posterior ankle pain were analyzed retrospectively.Passive plantar flexion test and diagnostic blocking were used as the diagnostic criteria.72 patients with posterior ankle pain were divided into PAIS group and non PAIS group.X-ray film and MRI findings in the PAIS group and non PAIS group were compared,and features which had differential diagnostic value were selected for calculating and comparing the efficacy of X-ray film and MRI in diagnosing or excluding PAIS.Results There was no significant difference for X-ray film findings such as os trigonum osteosclerosis(χ2 =2.947,P =0.086),os trigonum cystic changes(χ2 = 3.031,P =0.082)and posterior ankle soft tissue swelling(χ2 = 1.610,P =0.205 )between the PAIS group and the non PAIS group.There was significant difference for MRI features such as os trigonum or posterior talus bone marrow edema(χ2 =38.868,P =0.000 ),edema around os trigonum(χ2 =39.919,P =0.000 )and tenosynovitis of the flexor hallucis longus (χ2 =8.854,P =0.003)between the PAIS group and the non PAIS group.There was no significant difference for MRI features such as posterior ankle synovitis(χ2 =2.534,P =0.119)and posterior ankle ligament thickening(χ2 =1.515,P =0.218)between the PAIS group and the non PAIS group.Conclusion Using passive plantar flexion test and diagnostic blocking as the gold standard,the diagnostic efficacy of MRI on PAIS is obviously higher than that of X-ray film.MRI can significantly improve the diagnostic accuracy of PAIS,and avoid unnecessary diagnostic blocking.

Objective To study the influence of blood glucose, blood lipids and other cerebral infarction risk factors in the mean platelet volume (MPV). Methods A total of 562 patients with cerebral infarction and type 2 diabetes mellitus (DM) and 216 cerebral infarction patients without DM (non-DM) were included in this study. The platelet parameter of peripheral blood and other laboratory indexes were detected including platelet count (PLT), MPV, platelet distribution width (PDW), plateletcrit (PCT), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and very low density lipoprotein (VLDL-C), urea nitrogen (BUN), creatinine (Cr), uric acid (UA), high-sensitivity C-reactive protein (hs-CRP) and homocysteine (HCY). The patients were scored by the National Institute of Health stroke scale (NIHSS) after hospitalization. The MPV changes in patients with cerebral infarction were observed, and different influences of blood glucose, blood lipids to MPV were analysed. Results Values of FBG, HbA1c, TC, TG, LDL-C, BUN, UA, HCY, hs-CRP, and NIHSS were significantly higher in DM group than those of non-DM group. The score of NIHSS was significantly higher in DM group than that of non-DM group. The level of HDL-C was significantly lower in DM group than that of non-DM grou. The MPV was significantly higher in DM group than that of non-DM group [(9.60 ± 1.35) fL vs. (9.27 ± 1.01) fL, P<0.05). There was a positive correlation between MPV and FBG, HbA1c, hs-CRP, WBC, VLDL-C and NIHSS, r=0.438, 0.410, 0.336, 0.164, 0.321 and 0.249 (P<0.05). Multiple regression analysis showed that FBG, VLDL-C, HbA1c, hs-CRP and NIHSS were the independent influential factors of MPV (P<0.05). Conclusion The influencing factors of MPV should be controlled in patients with cerebral infarction combined with type 2 diabetes mellitus, reducing the activation of platelet, and delaying the progress of cerebral infarction.

Objective To study the clinical efficacy of percutaneous transluminal angioplasty (PTA) and vacuum sealing drainage technique on patients with diabetic foot and arteriosclerosis obliteration of the lower extremity.Methods Sixty-four patients were divided into two groups.Group A (32 patients) were treated by traditional methods,while 32 patients in Group B treated by vacuum sealing drainage technique in addition to percutaneous transluminal angioplasty.Results One week after surgery,ABI in group A was 0.53 ±0.17 vs 0.85 ±0.27 in group B,P =0.00.Ulcer healing rate increased from 31.25％ in group A to 81.25％ in group B,P ＜0.01.The amputation rate decreased from 56.25％ in group A to 18.75％ in group B,P =0.00.Claudication distance extended and ulcer recurrence rate in group A was 40％,while in group B it was 0,P =0.00.Conclusion The combination of PTA and vacuum sealing drainage significantly improves the prognosis of patients with diabetic foot and arteriosclerosis obliteration of the lower extremity.

Objective To study the expression of long non-coding RNA (lncRNA)-urothelial carcinoma associated 1 (UCA1) and miR-34b in bladder cancer and its correlation to the clinicopathologic features of bladder cancer.Methods Between January 2011 and October 2012,the expression of UCA1 and miR-34b in 5 bladder cancer cell lines (T24,BIU-87,EJ,T24-MMC,T24-ADM) and 1 normal bladder cell lines (SV-HUC-1) were measured by real-time reverse transcription-polymerase chain reaction (RTPCR).Meanwhile,the 56 bladder cancer specimens and paraneoplastic normal bladder tissues,which diagnosed by pathology were collected from bladder cancer patients undergoing radical resection of bladder.Among them,41 cases were male and 15 cases were female.The mean age was (68.4 ± 7.5)years old,range 52 to 78 years.43 cases were older than 65 years old,and 13 cases were less than 65 years old.The pathological classification included non muscle-invasive bladder cancer (NMIBC) 18 cases,muscle-invasive bladder cancer 38 cases;low grade papillary urothelial carcinoma 22 cases,high grade papillary urothelial carcinoma 34 cases;12 cases were primary lesion,the other 44 cases were diagnosed as tumor recurrence.Real-time RT-PCR was performed to analyze the expression of UCA1 and miR-34b.Results The relative expression levels of UCA1 in the normal bladder cell lines (SV-HUC-1) and 5 bladder cancer cell lines (T24,BIU-87,EJ,T24-MMC and T24-ADM) were (0.0675 ± 0.0133),(0.2934 ± 0.0531),(0.4246 ± 0.0650),(0.4206 ± 0.0826),(0.6472 ± 0.0875) and (0.7165 ± 0.1032),respectively (P ＜ 0.05).Moreover,the expression levels of UCA1 were up-regulated in 2 drug resistant bladder cancer cells lines T24-MMC (0.6472 ± 0.0875)and T24-ADM (0.7165 ± 0.1032),as compared with the T24 bladder cancer lines (0.2934 ± 0.0531),respectively (P ＜ 0.05).However,the expression levels of miR-34b in 5 bladder cancer cell lines [T24 (0.1600 ± 0.0455),BIU-87 (0.1720 ± 0.0658),EJ (0.1150 ± 0.0352),T24-MMC(0.0576 ± 0.0087),T24-ADM (0.0510 ± 0.0125)] were decreased (P ＜ 0.05),as compared with normal bladder cell lines SV-HUC-1 (0.6384 ± 0.1083).Moreover,the expression levels of miR-34b were down-regulated in 2 drug resistant bladder cancer cells lines T24-MMC (0.0576 ± 0.0087) and T24-ADM(0.0510 ± 0.0125),as compared with the T24 bladder cancer lines T24 (0.1600 ± 0.0455),respectively (P ＜ 0.05).The relative expression levels of UCA1 and miR-34b in bladder cancer tissues and paraneoplastic normal bladder tissues were (0.4225 ± 0.0714) vs.(0.0532 ± 0.0192) and (0.0340 ± 0.0134)vs.(0.5643 ±0.0616),respectively (P ＜0.05).Statistical correlation analysis showed that UCA1 to be significantly negative correlated with miR-34b in bladder cancer specimens(r =-0.54,P ＜ 0.05).The high level of UCA1 and low level of miR-34b were significantly correlated with tumor malignant grade,invasiveness and recurrence.The 3-year overall survival rate (OS) in UCA1 (+)/miR-34b(-) group (27.6％) were significantly worse compared with non UCA1 (+)/miR-34b (-) group (73.7％).Conclusion High expression of UCA1 and low expression of miR-34b were associated with the occurrence and development of bladder cancer.

Objective To compare the clinical efficacy of laparoscopic surgery and open surgery for intraperitoneal bladder rupture.Methods From January 2004 to August 2013,the clinical data and therapeutic methods of 50 patients with intraperitoneal bladder rupture were retrospectively reviewed,inclu-ding 26 cases of laparoscopic surgery and 24 cases of open surgery.The operative time,intraoperative blood loss,postoperative intestinal recovery,hospital stay,analgesic use rate and complication ratio were com-pared between the two groups.Results All surgeries were successfully performed.There were significant differences in intraoperative blood loss [(54.24 ±5.38)ml vs(89.35 ±12.17)ml],intestinal recovery time [(23.24 ±2.39)h vs(38.42 ±6.98)h],hospital stay [(4.64 ±1.42)d vs(7.04 ±1.29)d]and analgesic use rate [38.64%(10 /26)vs 75.00%(18 /24)]between laparoscopy group and open surgery group,respectively(P <0.05 ).No significant differences in operative time [(56.12 ±8.53 )min vs (64.48 ±13.21)min]and incidence of postoperative complication [7.69%(2 /26)vs 8.33%(2 /24)] were observed between laparoscopy group and open surgery group,respectively(P >0.05).Conclusion Laparoscopic treatment of intraperitoneal bladder rupture has the advantages of mini-invasion and rapid re-covery compared with traditional open surgery.

AIM:To investigate the activation and inactivation of nuclear factor kappa B(NF-κB)when tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)is applied to induce the apoptosis of androgen-independent prostate cancer cell line PC-3M.METHODS:After the treatment of TRAIL or LPS at different doses,we tested the nuclear translocation of NF-κB by cell immunohistochemical staining and electrophoretie mobility shift assay(EMSA),and evaluated the level of IκB by RT-PCR under pyrrolidine dithiocarbamate(PDTC)treatment.RESULTS:EMSA and cell immunohistochemical analysis showed that the translocation of NF-κB was significantly activated when PC-3M cells were treated with TRAIL or LPS(P＜0.05).The pretreatment of PDTC upregulated the expression of IκB and blocked the nuclear translocation of NF-κB.CONCLUSION:TRAIL remarkably stimulates the activation of nuclear NF-κB in androgen-independent prostate cancer cells.On the other hand,the translocation of NF-κB can be significantly and efficiently inhibited in PC-3M cells by pretreatment with PDTC.The increased expression of IκB might be a clue for this inhibition,which means the possible way to enhance the effect of TRAIL in the apoptosis of prostate cancer cells.