BACKGROUND: Hemorrhoids are one of the most common conditions that lead to surgery, and until now surgical hemorrhoidectomy has been the major effective treatment. Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation. OBJECTIVE: This study evaluates the clinical efficacy of the pestle needle therapy, an acupoint stimulation method, for relief of post-hemorrhoidectomy pain. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This was a single-center, patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1. The treatment group received the pestle needle therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1), Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o'clock around the lesion); while the control group received a sham treatment with very light pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the surgery, and each lasted for 15 min. MAIN OUTCOME MEASURES: The primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the time and the VAS score of the patients' first defecation after surgery, as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge. RESULTS: The mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h after surgery. Compared with the control group, patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P = 0.002); and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group, patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no difference in their VAS scores at the first defecation (P = 0.092). CONCLUSION The pestle needle therapy was effective for relieving pain, reducing anxiety and improving bowel function after hemorrhoidectomy, and it is worthy of clinical application.

[Objective]To explore the relationship between peripheral arterial disease(PAD)and diabetic retinopathy(DR)in type 2 diabetes patients.[Methods]A total of 99 patients diagnosed with PAD were classified into grade 1-3 by their total scores of peripheral arterial stenosis assessed by color doppler ultrasound examinations,where the degree of stenosis 30% ~ 49% scored 0, 50%~99%scored 1,lumen occlusion(i.e. degree of stenosis 100%)scored 2,and therefore the total score 0-2 was categorized into Grade 1 ,3~4 into Grade 2 ,5~12 into Grade 3. The bilateral anterior tibial artery ,posterior tibial artery and dorsalis pedis artery of these patients were analyzed. The presence of diabetic retinopathy(DR)was graded from retinal photographs using a standard protocol.[Results]Among 99 cases of type 2 diabetic patients with peripheral arterial disease ,58.6%of them were male with average age of 67.3 ± 7.9 years old. Patients of Grade 1,Grade2,Grade 3 lesion accounted for 45.4%,30.3%,24.2%,respectively. Age, gender,smoking history,SBP,DBP,BMI,FBG,TC,TG,LDL-C,HDL-C,HbA1C among 3 groups were not statistically signifi-cant. The associations of DM duration and HbA1C value were significantly larger in DR than in PAD. The proportion of DR patients increased with the severity degree of PAD(p for trend=0.004). Degree of stenosis Grade 2 and Grade 3 could be predictive for DR.[Conclusions]DR is associated with the severity degree of PAD in type 2 diabetes patients as evaluated by duplex ultrasonography.Degree of stenosis Grade 2 and 3 could be used for screening or finding DR. Strategies for optimum treatment and early prevention are needed.

The aim of this study is to establish the method of loop-mediated indirect PCR assay for detection of Reproductive and Respiratory Syndrome Virus (PRRSV) infection and differentiation of highly pathogenic PRRSV (HP-PRRSV) and lowly pathogenic PRRSV (LP-PRRSV). Based on the alignments of ORF2 gene sequences and ORFla gene sequences of PRRSV Chinese isolates deposited in GenBank, two pairs of specific probes were designed and labeled to both ends of the soybean Lectin gene fragment by PCR, respectively. The probe-labeled soybean Lectin genes were used to be reporter genes for detection and differentiation of PRRSV. After one round strand displacement reaction, the reporter genes were amplified by reverse PCR. The specific PCR products were 193bp, 355bp for HP-PRRSV and 193bp, 442bp for LP-PRRSV, respectively. The method could detect 5. 6 TCID50/mL LP-PRRSV RNA and 18 TCIDs0/ mL HP-PRRSV RNA, and co-infection did not affect detection sensitivity. No amplification was observed with other porcine originated pathogens including CSFV, PPV, PRV, PCV2, ETEC and Haemophilus parasui. Twenty clinical samples were used for comparative testing with conventional PCR. Fourteen samples were found positive for PRRSV by the loop-mediated indirect PCR, of which 4 were LP-PRRSV, 9 HP-PRRSV and 1 LP/HP-PRRSV co-infection, consistent with the conventional PCR test results. In conclusion, the loop-mediated indirect PCR is a simple, rapid, sensitive and specific etiologic diagnosis tool, and suitable for the differential diagnosis of HP/LP-PRRSV, especially for identification of mixed infection of HP/LP-PRRSV.
Animals ; Coinfection ; veterinary ; DNA Primers ; genetics ; DNA, Complementary ; genetics ; Diagnosis, Differential ; Genes, Reporter ; Genetic Markers ; genetics ; Humans ; Porcine Reproductive and Respiratory Syndrome ; diagnosis ; virology ; Porcine respiratory and reproductive syndrome virus ; genetics ; isolation & purification ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; veterinary ; Sensitivity and Specificity ; Swine ; Time Factors ; Viral Proteins ; genetics

OBJECTIVETo screen long non-coding RNA which influences radiosensitivity of colorectal carcinoma cell lines and investigate the mechanism.

METHODSUnder different doses of radiation, colony formation assay and single-hit multi-target model were conducted to draw dose-survival curve and SF2 value of colorectal carcinoma cell lines(RKO, Lovo) was calculated. High-throughput lncRNA/mRNA chips were used to screen lncRNA genes and protein coding genes with expression differences more than 2 folds between RKO, Lovo cell lines and RKO cell line receiving 2Gy radiation. The main action pathway was computed by Gene Ontology analysis combined with Pathway analysis in order to explore the mechanism which induces the effect of lncRNA on radiosensitivity of colorectal carcinoma cell lines. Further experiment on P53, P21, cyclin D1 expression contents of RKO cell line was confirmed by real-time RT-PCR.

RESULTSLovo(SF2=0.47) was more sensitivity to radiation than RKO(SF2=0.53) according to the outcome of colony formation assay. High-throughput lncRNA/mRNA chips identified a total of 268 lncRNA genes and 270 protein coding genes. Gene Ontology analysis showed that the expression of genes associated with cell cycle process were significantly different (38.6%). There was a significant relationship between expression of several lncRNAs and CCND1 gene. Real-time RT-PCR showed no significant differences of P53 and P21 expression in RKO and Lovo cell lines(P>0.05), while cyclin D1 expression of RKO cell line was higher than that of Lovo cell lines(P<0.05). After exposed to 2 Gy doses of radiation, there was an obvious decrease of cyclin D1 expression in RKO cell lines(P<0.05), while P53 and P21 expressions were not different(P>0.05).

CONCLUSIONThe possible mechanism is that lncRNAs compose transcription compound to combine with CCND1 gene and influence radiosensitivity of colorectal carcinoma cell lines by regulating expression of cyclin D1, which is independent of P53-P21-cyclin D1 pathway.

Cell Line, Tumor ; Colorectal Neoplasms ; metabolism ; pathology ; Cyclin D1 ; genetics ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; RNA, Long Noncoding ; Radiation Tolerance

OBJECTIVETo investigate the effect of multidrug resistance-associated protein 4 (MRP4) expression on the radiosensitivity of colorectal carcinoma cell lines in vitro.

METHODSThe vector of shRNA for RNA interference was constructed and then transfected into HCT116 cell line to steadily down-regulate the expression of MRP4. HCT116 cells were divided into 3 groups including the CON group(non-transfected), NC group (negative control virus was added), and KD group (RNAi target was added for transfection). To test the effectiveness of RNA interference, real-time polymerase chain reaction and Western blot were used to measure the expression pattern of MRP4 at both mRNA and protein levels, respectively. For the examination of the effect of RNA interference of MRP4 on the radiosensitivity, flow cytometry was used to calculate the rate of apoptotic cells 24 h after 4 Gy radiation. Proliferation of the cells was measured via MTT assay at different time points.

RESULTSShRNA plasmid was successfully constructed. Transfection of this constructed vector into HCT116 cell line caused steady silencing of MRP4 expression (HCT116-KD). MRP4 mRNA and protein expression were significantly down-regulated following RNA interference(P<0.05). Twenty-four hours after radiation, the apoptosis rate of KD cell line was (71.7±0.8)%, significantly higher than that in the CON group [(56.1±0.9)%] and NC group[(59.8±0.8)%](P<0.05). Fourty-eight hours and 72 hours after radiation, the proliferation was significantly inhibited in KD cells compared to the control groups(P<0.05).

CONCLUSIONSExpression of MRP4 is closely related to radio-tolerance of colorectal carcinoma. Down-regulation of MRP4 expression by RNA interference enhances radiosensitivity of colorectal carcinoma cell lines in vitro. MRP4 may be an effective molecular marker for predicting the radiosensitivity of colorectal carcinoma.

Colorectal Neoplasms ; genetics ; metabolism ; Down-Regulation ; HCT116 Cells ; Humans ; Multidrug Resistance-Associated Proteins ; genetics ; RNA Interference ; Radiation Tolerance ; genetics

Objective To explore clinical value of intraoperative extra strong electrical stimulation in the treatment of birth brachial plexus palsy. MethodsFrom July 2008 to September 2011,intraoperative extra strong electrical stimulation was applied in 9 cases of incomplete birth brachial plexus palsy after neurolysis.The latency and amplitude of compound muscle action potentials before and after electrical stimulation were recorded and the extent of improvement was compare.ResultsThe latency was improved in 7 cases with 8.02％ in average,amplitude in 8 cases with 185.97％ in average.The related nerve recover partial motor function in 8 cases in 2 weeks after operation.ConclusionIntraoperative extra strong electrical stimulation is a effective assistant technique to promote motor functional recovery of birth brachial plexus palsy.

Objective To explore the role of neurotic in parental rearing patterns and interpersonal sensitive.Methods Using stratified sampling method to test 702 middle school students,symptom checklist 90 (SCL90),Egma minnen av bardndosnaupp forstran(EMBU) and Eycenck Personality Questionnaire(EPQ) were used to investigate and take one and a half years of follow-up observation on the sample of 245 students from first grade of junior and senior middle school.Correlated variables were made the correlation analysis,regression analysis,constructing the structure equation model and using tracking data to confirm.Results (1) Neuroticism,father's affective warmth and understanding,father's excessive protection,mother's rejection and deny had a direct effect,and the variation of total symptoms could be explained 40.8％ ; father's affective warmth and understanding,father's excessive protection,mother's over-interference and over-protection,mother's rejection and deny had a indirect effect on interpersonal sensitive,and explained 24.0％.(2) Effect analysis showed father's affective warmth and understanding,father's excessive protection,mother's rejection and deny impact on interpersonal sensitive by neuroticism,and father's excessive protection was the largest which accounted for 48.0％ of the total effect.The second was father's affective warmth and understanding,accounting for 47.3 ％.The last was mother's rejection and deny accounted for 42.7％,and its indirect effect increased with the age(69.1％).All of mother's over-interference and overprotection through the neurotic influence interpersonal sensitive,and the direct effect was 50.3％ between neurotic and interpersonal sensitivity.Conclusion Indirect effect of neurotic existed in relationships of parents rearing patterns and interpersonal sensitivity.

Objective To observe the clinical therapial value of functional reconstruction with Botulinum Toxin A (BTA) on spasitic cerebral palsy. Methods Thirty-two patients were treated by Achilles tendon lengthening and anterior transfer of posterior tibial tendon.According to the spasticity of triceps surae muscle,all cases were arranged by BTA injection 2 months later after operation.Results From Jan.2000 to Jan.2009,thirty-two cases with equinovarus foot of spasticitical cerebral palsy were collected,the muscle strength of ankle dorsal extensor increased from 0-2 grades to 4-5 grades,there was significant difference between preoperational muscle strength and postoperational one.There was also significant improvement to adjust yarus degrees of ankle joint.the musclar tension of triceps muscle of calf decreased from Ⅱ-Ⅳ grades to Ⅰ-Ⅱ grades. Conclusion Anterior transfer of posterior tibial tendon corresponding with Botulinum Toxin A injection not only release muscle spasticity but also improve dorsal extending strength of ankle joint.The clinical effect of these methods was reliable on cerebral palsy.

Objective To explore the clinical design and therapeutic effect of total root avulsion of brachial plexus by contralateral C_7 nerve transfer for directly repairing C_8T_1 via prespinal route combined with functioning gracilis transplantation. Methods Twelve cases of total roots avulsion of brachial plexus were operated at 1 month to 3 months after injury.The contralateral C_7 nerve was successfully transferred to directly repair avulsed C_8T_1 roots or lower trunk via prespinal route.At 2nd operation stage after 4 to 8 months,the functioning gracills transplantation was preformed to reconstruct the elbow flexion and fingers extension. Results Follow-ups were carried out in all 12 cases who had been discharged for 9 to 36 months after the first operation.The positive Tinel signs of ulnar or median nerves were located in the proximal arm at 3 months after 1st operation,in the elbow or proximal forarm at 6 months,and in the wrist or distal forarm at 9 months.At 12 months the positive Tinel signs were found in the plam or fingers in 9 cases.The contraction of sternocostal part of pectoralis major was found at 9 mooths in 7 cases.There were the restoration of the taction-pain sensation in the palm, finger, and medial side of forearm and the contraction of flexor carpi ulnaris and flexor digitorum(M_3)in 5 cases at 15 to 18 months after 1st operation.In 7 patients the flexion of elbow and extension of fingers and thumb restored at 9 to 12 months after the 2nd operation.Their elbow flexion was 90°-120°and M_3(Highet's method),and their finger and thumb extension M_3. Conclusion There is the possibility of the operative design and clinical application of total root avulsion of brachial plexus by contralateral C_7 nerve transfer for directly repairing C_8T_1 via prespinal route combined with functioning gracilis transplantation.There are not only the restoration of sensation and flexion of wrist and fingers,but also the restoration of elbow flexion and fingers extension.

Child, Preschool ; China ; Female ; Hepatitis A ; immunology ; prevention & control ; Hepatitis A Antibodies ; blood ; Hepatitis A Vaccines ; adverse effects ; immunology ; Humans ; Infant ; Male ; Safety ; Sampling Studies ; Vaccination ; Vaccines, Inactivated ; adverse effects ; immunology