Objective To investigate the effect of acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture on the clinical efficacy and sleep quality of depressive patients. Methods A total of 64 patients who met the inclusion criteria were randomly divided into two groups, 32 in each group. The control group was treated with routine electro-acupuncture, while the observation group was treated with acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture. Both groups were treated for 8 weeks. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), and depression was assessed by Hamilton Depression Scale (HAMD) to evaluate the clinical efficacy. Results After treatment, the HAMD score (11.3 ± 2.4 vs. 14.5 ± 2.6, t=4.986) and PSQI index (9.6 ± 2.3 vs. 11.8 ± 2.5, t=3.307) in the observation group were significantly lower than those in the control group (P<0.01). The quality of life (12.9 ± 2.3 vs. 11.3 ± 2.5, t=2.598) and mental health score (13.5 ± 2.4 vs. 11.3 ± 2.6, t=3.413) of WHOQOL-BREF scale in the observation group were significantly higher than those in the control group (P<0.01). The total effective rate was 93.8％ (30/32) in the observation group and 75.0％ (24/32) in the control group. There were significant differences between the two groups (χ2=4.246, P=0.038). Conclusions Acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture can effectively improve depressive state, sleep quality and quality of life in patients with depression, and the curative effect is better than conventional electro- acupuncture treatment.

BACKGROUND:Apoptosis of islet cel s is closely related to the long-term hyperglycemia-and hyperlipemia-induced injuries. OBJECTIVE:To observe the effect of Shizidaiping formula on the apoptosis and insulin secretion in MIN6 cel s under the high glucose and lipid environment, and to explore the protective effect of Shizidaiping formula and the related apoptosis mechanism. METHODS:MIN6 cel s were divided into normal, model, melbine, low-, medium-and high-dose Shizidaiping formula groups. The cel activity was examined by cel counting kit-8, the insulin secretion was measured by ELISA, the rate of apoptosis was measured by Annexin V-FITC&PI and the expression levels of MEK1/2, ERK1/2 and p-ERK1/2 were examined by western blot assay. RESULTS AND CONCLUSION:Shizidaiping formula significantly improved MIN6 cel activity under high glucose and lipid condition (P<0.05), decreased early cel apoptosis, increased the level of insulin stimulated by low glucose in cel supernatant (P<0.05), and improved the expression levels of MEK1/2, ERK1/2 and p-ERK1/2 (P<0.05). These results suggest that Shizidaiping formula can protect islet cel s from hyperglycemia and hyperlipemia damage by improving the activity of MIN6 cel s, reducing the insulin secretion and inhibiting the apoptosis of pancreaticβcel s in MIN6 cel s.

Objective To evaluate the treatment outcomes and toxicities of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for children and adolescents with nasopharyngeal carcinoma.Methods Forty-three nasopharyngeal carcinoma patients less than 19 years old were recruited between April 2010 and April 2016.All patients were treated with IMRT (total dose 61.2-76 Gy) combined with cisplatin based chemotherapy.The Kaplan-Meier test was used to calculate overall survival (OS) and progression-free survival (PFS).The patient's clinical characteristics,side effects and longterm effects of treatment were retrospectively analyzed.Results Among 43 patients,there were 29 (67.4％) male and 14 (32.6％) female,and the median age was 14 years old (range,6-18 years).According to AJCC 7thstaging system,2 patients were in stage Ⅱ,26 in stage Ⅲ,7 in stage ⅣA and 8 in stage Ⅳ B.All patients were confirmed as non-keratinizing carcinoma.The positive rates of EB virus VCAIgA was 53.8％ (7/13),and Rta-IgG was 60.0％ (6/10) before treatment.The median radiation dose was 70 Gy (range,61.2-76 Gy) to the primary tumor.Thirty-three (76.7％) patients received neoadjuvant chemotherapy,with 20 (46.5％) and 36 (83.7％) patients treated by concurrent and adjuvant chemotherapy,respectively.With a median follow-up of 24 months (range,3-76 months),the 5-year OS and PFS ratios were 75.3％ and 64.7％,respectively.There were 5 patients (11.6％) occurred to bone metastasis within 2 years after treatment.Hypothyroidism was reported in 47.4％ (9/19) patients after IMRT.Conclusions Nasopharyngeal carcinoma in childhood and adolescence is mostly locally advanced diseases with poor differentiation.IMRT combined with chemotherapy produce a well treatment outcome with good tolerance in children and adolescents patients.The most common treatment failure bone metastasis.Radiation-induced hypothyroidism is common.

Objective To investigate the efficacy and adverse reactions of arsenicals in the treatment of refractory or relapsed multiple myeloma. Methods The data of 21 patients with refractory or relapsed multiple myeloma were retrospectively analyzed, including 10 patients with arsenicals (the arsenious acid group) and 11 cases treated with new regimens or treatments containing Bortezomib (the control group). The arsenious acid group comprised 5 males and 5 females, with the average age of (62±5) years old. The control group comprised 7 males and 4 females, with the average age of (59±9) years old. The total effective rate and overall survival (OS) in both groups were observed after 2 treatment courses. Results The median effective time and the total effective cases in the arsenious acid group and the control group was 8.00 mouths (6.00-9.00 mouths) and 3.50 mouths (1.00-24.00 mouths), 3 (3/10) and 6 (6/11) respectively. There was a statistically significant difference in the total effective rate (P= 0.245). There was no significant difference in the adverse reactions rate between the two groups (P> 0.05). The median OS time was 10.00 months (8.00-24.00 months) and 6.00 months (1.00-69.00 months) in the arsenious acid group and the control group respectively (P=0.900). Conclusion The arsenious acid in the treatment of refractory or relapsed multiple myeloma can not increase the incidence of adverse reactions with a favorable cost performance.

Objective To observe the effects of different modes treadmill training on cognitive func-tion and transforming growth factor β1 ( TGF-β1 ) expression in cerebral cortex of rats. Methods Two months old rats were divided into the control group,piecewise training group and intermittent training group ( n=10 in each group) . The training was performed five times a week for 6 weeks. Learning and memory a-bility of all rats was detected by water maze at 6 weeks after the training. TGF-β1 expression and localization in cerebral cortex was tested by QRT-PCR and immunofluorescence, respectively. Results The platform time in piecewise group ((30±28) s) and intermittent group ((25±23)s) was both significantly shorter than that in control group ((58±50)s). In the space exploration,the time around Ⅳ quadrant platform in piecewise group((23.6±3.9)s) and intermittent group ((24.3±8.9)s) was significantly higher than that in the control group((17.7±2.0)s). The expression of TGF-β1 mRNA in cerebral cortex in intermittent group (0.0067±0.0043)was obviously higher than that in piecewise group (0.0035±0.0006) and control group (0.0041±0.001). TGF-β1 was located in cell membrane and cytoplasm,and the relative optical density of intermittent group (0.0045±0.0017) was significantly higher than that of control group (0.0019±0.0004) and staging group (0.00175±0.00045). Conclusion (1)Learning and memory function both were im-proved after treadmill six weeks with piecewise and intermittent training models. ( 2) The level of TGF-β1 gene and protein was significantly increased after interval training in cortex of rats.

Objective To analyze the differences of biochemical and immunological indicators in gender or Lee′s classification of IgA nephropathy ( IgAN) to provide laboratory evidence for clinical diagnosis and treatment of IgAN.Methods Retrospective cohort study.The information of biochemical and immunological indicators of 213 in-hospital patients which were admitted in Chinese PLA General Hospital in June to December, 2012.The data were collected and analyzed with t-test, non-parameter analysis, Pearson correlation analysis, ROC curves analysis and Logistic regression analysis according to gender or Lee′s classification ( Lee′s≤3 group and Lee′s>3 group).Results In this study, the average age and sex ratio of patients with IgAN was ( 35.0 ±10.6 ) years old and 2.04∶1.00.T-test and non-parameter analysis indicated homocysteine(HCY), immunoglobulin E (IgE), immunoglobulin M (IgM), prealbumin (PA), ceruloplasmin ( CP) ,α1-acidoglycoprotein(α1-AGP) , albumin ( Alb) ,α2-globulin(α2-G) andγ-globulin (γ-G) had significant difference in gender (P<0.05).And cystantin-C (CYS-C), HCY, complement 4 (C4),β2-microglobulin(β2-MG), PA, α1-AGP, α1-globulin(α1-G), immunoglobulin G (IgG), IgM and transferrin ( TF ) had significantly different in Lee′s classification ( P<0.05 ).ROC curves analysis showed that the areas under curves of CYS-C andβ2-MG were 0.891 and 0.839 respectively;the sensitivity was 90.2%and specificity was 75.3% when cutoff value of CYS-C was 1.56 mg/L; the sensitivity was 80.3%and specificity was 78.8% when cutoff value of β2-MG was 0.275 mg/dl.Logistic regression analysis showed that CYS-C ( OR: 31.380, 95% CI: 10.808 -91.113, P=0.000 ) and HCY ( OR:1.035, 95%CI:1.002-1.069, P=0.040) were introduced into the model after twice variable selections.ROC curve of CYS-C combined with HCY for classifying Lee′s classification showed that the sensitivity, specificity, Jorden index and AUC were 0.843, 0.862, 0.705 and 0.894 ( P=0.000 ) , respectively.Conclusions CYS-C,β2-MG, PA and HCY were valuable indicators for Lee′s classification.CYS-C andβ2-MG had high correlation with Lee′s classification, which indicated that these two tests were related to the severity of IgAN.CYS-C combined with HCY could improve the diagnostic efficiency of IgAN Lee′s classification.Combination of biochemical and immunological indicators could improve the accuracy of Lee′s classification and provide effective laboratory evidence for clinical treatment of IgAN.

Objective To investigate the efficacy of prophylactic pancreatic stent placement and nonsteroidal antiinflammatory drugs( NSAIDs) for the prevention of post?endoscopic retrograde cholangiopan?creatography(ERCP) pancreatitis(PEP). Methods A total of 623 patients with high risk factors for PEP were treated with prophylactic pancreatic stent placement ( 145 patients, group A) or rectal NSAIDs( 478 pa?tients, group B) for PEP prevention by using the propensity score matching( PSM) analysis. Incidence of PEP, moderate and severe PEP were investigated. According to risk factors of PEP, indications of prophy?lactic pancreatic stent placement were analysed. Results Of 623 patients with high risk factors, 145 pairs were generated after PSM.Pancreatitis occurred in 32 patients,10 (6?9%) in group A and 22 (15?2%) in group B( P<0?05 ) . Moderate?to?severe pancreatitis developed in 5 ( 3?4%) patients in group A and 14 (9?7%) patients in group B(P<0?05).Risk factors of post?ERCP PEP were cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and history of ampullectomy. Conclusion Although the NSAIDs represent an easy, inexpensive treatment, prophylactic pancreatic stent placement is still a better prevention strategy for PEP.Prophylactic pancreatic stents should be recommended to those with risk factors including cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and ampullectomy.

Objective To observe the effect of combination of dexmedetomidine and sufentanil on postoperative analgesia for the highly nicotine dependent patients undergoing esophagectomy. Methods Ninety highly nicotine dependent patients undergoing esophagectomy were randomly allocated into three groups (n = 30 each): low-dose sufentanil group (Group S1), high-dose sufentanil (Group S2), dexmedetomidine and sufentanil group (Group DS). All patients of three groups received postoperative PCIA with following setting: 2 mL/h;bolus: 2 mL; lock time: 5 min; 4 hours limited: 40 mL. The scores of VAS and Ramsay, effective presses/total presses of PCIA, the consumption of sufentanil during 72 h after operation, side effects and the satisfaction degree of patients were recorded. Results Compared with those of group S2, the scores of VAS (both at rest and movement) decreased significantly in group DS from 1 h to 8 h (P<0.05). Compared with those of group S1, the scores of VAS (both at rest and movement) decreased significantly in group S2 and DS from 1 h to 72 h (P<0.05). Compared with that in group S1 and S2, the consumption of sufentanil during 72 h after operation decreased significantly in group DS (P < 0.05). Compared with those in group DS, The numbers of nausea and vomiting were significant decreased in group S1 and S2(P < 0.05). Compared with those in group S1, the remedial cases were significantly decreased in group S2 and group DS (P < 0.05). Conclusion The effect of combination of dexmedetomidine and sufentanil is superior to that of sufentanil in terms of postoperative analgesia in highly nicotine dependent male patients undergoing esophagectomy.

Objective To investigate the comprehensive prevention strategy in the prevention of oral mucositis (OM) during allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 721 patients who received HSCT from January 2010 to December 2011 at the Institute of Hematology, Peking University were enrolled. All the patients received the comprehensive prevention strategy of OM. Results A total of 315 patients (43.7 percents) suffered from OM during HSCT, the median time from HSCT to OM occurrence was 5 days. There were 173 (54.9 percents), 91(28.9 percents), 37(11.7 percents), and 14(4.4 percents) patients suffered from gradeⅠ,Ⅱ,Ⅲ, and IV OM, respectively. Tongue OM was most common. A total of 111 patients suffered from multiple OM (≥2 locations). Multiplicity showed that duration of agranulocytosis≥15 days was the only independent risk factor of OM in HSCT [ hazard ratio (HR) value 1.5, P<0.05 ]. Neutrophil engraftment time≥12 days was significantly associated with prolonged OM (≥8 days) (HR=2.1, P<0.05). Patient age ≥20 was independent risk factor for occurrance of grade Ⅲ-Ⅳ OM (HR=2.7, P<0.05). Conclusions Comprehensive prevention strategy can overcome the risk factors of OM and prevent the occurrence of OM during HSCT.

This study was aimed to investigate the effects of resveratrol on plasma glucose and the oxidative stress ability in gestational diabetic rats. A total of 100 SD rats with gestation for 5 days were intraperitoneally injected with streptozotocin (STZ, 35 mg?kg-1) to prepare gestational diabetic rat model. Rats were randomly divided into 6 groups, which were the normal gestation group, gestational diabetic model group, resveratrol (30, 60, 120 and 240 mg?kg-1) treatment groups, with 20 rats in each group. A total of 20 rats with gestation for 5 days were selected as the normal gestation control group and another 20 rats with no gestation were selected as the normal control group. The levels of plasma glucose and insulin were determined on 0, 7, 14 days after experiment. Two weeks later, the contents of malondialdehyde (MDA) and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) in serum were determined. The results showed that compared with the normal control group, there were no significant difference on the levels of plasma glucose and insulin, the content of MDA, and the activities of SOD, GSH-Px and CAT of the normal gestation control group (P > 0.05). Compared with the gestational diabetic model group, the content of MDA in serum of the resveratrol (30, 60, 120 and 240 mg?kg-1) treatment groups were significantly decreased (P < 0.05,P < 0.01); the level of plasma glucose were significantly decreased and the level of insulin was significantly increased of the resveratrol (120 and 240 mg?kg-1) treatment groups (P < 0.05,P < 0.01); the activities of SOD, GSH-Px and CAT were also significantly increased (P < 0.05, P < 0.01). It was concluded that resveratrol had dose-dependent effect on reducing plasma glucose and improving antioxidant ability in gestational diabetic rats, which perhaps related to its effects on raising the level of insulin and improving the activity of antioxidant enzymes.