OBJECTIVE: To observe the therapeutic effect of acupuncture on cancer-related fatigue (CRF) and to explore its possible mechanism. METHODS: A total of 80 patients with CRF were randomized into an observation group and a control group, and finally 67 patients completed the trial (36 patients in the observation group, 31 patients in the control group). Patients in the control group were treated with conventional chemoradiotherapy and symptomatic treatment, while no particular anti-fatigue intervention was adopted. On the basis of treatment in the control group, acupuncture was applied at Baihui (GV 20), Guanyuan (CV 4), Qihai (CV 6), Fengchi (GB 20), Zusanli (ST 36), Sanyinjiao (SP 6) in the observation group, once a day, 5 times as one course, with 2 days interval between each course, totally 4 courses were required. Before and after treatment, scores of functional assessment of cancer therapy-fatigue (FACT-F) in Chinese and McGill quality of life questionnaire (MQOL), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and soluble TNF receptor-1 (sTNF-R1) were observed in the two groups. RESULTS: ①Compared before treatment, the FACT-F score was decreased after treatment in the observation group (<0.05), while there was no significant difference in the control group (<0.05). The change of the FACT-F score in the observation group was larger than that in the control group (<0.05). ②In the observation group, scores of physiological and psychological dimension were decreased (<0.05), score of social support dimension was increased after the treatment (<0.05). The score changes of physiological, psychological and social support dimension in the observation group were larger than those in the control group (all <0.05). ③After treatment, the serum levels of IL-6, TNF-α and sTNF-R1 were decreased in the observation group (<0.05), while the serum levels of CPR and IL-6 were increased in the control group (<0.05). The serum levels of CPR, IL-6 and TNF-α in the observation were lower than those in the control group (<0.05). CONCLUSION ①Acupuncture can improve the related symptoms of depression, weakness and headache in patients with CRF, strengthen their cognition of the support from society and family, and boost the confidence in curing the disease. ②Acupuncture can effectively down-regulate serum levels of the relative inflammatory factors, which may be its possible mechanism on treating CRF.
Acupuncture Points ; Acupuncture Therapy ; Biomarkers ; blood ; C-Reactive Protein ; analysis ; Fatigue ; etiology ; therapy ; Humans ; Interleukin-6 ; blood ; Neoplasms ; complications ; therapy ; Quality of Life ; Receptors, Tumor Necrosis Factor, Type I ; blood ; Tumor Necrosis Factor-alpha ; blood

Objective To analyze the genetic diversity of Pomacea canaliculata based on the mitochondria DNA cytochrome c oxidase subunitⅠ(mtDNA COⅠ)gene as a molecular marker in Lincang City of Yunnan Province,so as to provide the scien-tific data for monitoring Angiostrongylus cantonensis in local areas. Methods The genotypes and polymorphisms of 38 speci-mens of P.canaliculata collected from Mengding Town of Lincang City were analyzed by sequencing COⅠgene.The phylogenet-ic tree and genetic distances were produced based on the haplotypes from GenBank and the present study by using the neighbour-joining method with the software MEGA version 6.06. Results Totally 31 sequences were acquired in the present study and they produced 3 unique haplotypes.Haplotype 1 showed a higher frequency compared to the others and it accounted for 83.9 % (26/31).The data showed that the least genetic distances ranged from 0 to 0.052 between P.canaliculata and 3 haplotypes,as well as the largest genetic distances ranged from 0.021 to 0.239 between Pila conica and 3 haplotypes.Otherwise,the analysis of the phylogenetic trees based on COⅠgene sequences of P.canaliculata indicated that all of 3 haplotypes clustered into one big clade with that from Japan(GenBank accession number: AB433769),China(GenBank accession number: KT313034)and USA(GenBank accession number:EU523129),which owned the closet relationship amongst them.Their genetic relationships were distantly related to the GenBank's reference sequences of P.insularum(GenBank accession number:EF514942),P.cam-ena(GenBank accession number: EF515059)and so on. Conclusion There is a P. canaliculata species in Lincang City of Yunnan Province as well as a high genetic diversity amongst the acquired 3 haplotypes in this study.

Objective To evaluate ketamine-induced cerebral protection in mice with traumatic brain injury (TBI) by magnetic resonance imaging (MRI).Methods Thirty-two pathogen-free healthy male C57BL/6 mice,aged 8 weeks,weighing 26-30 g,were divided into 4 groups using a random number table:control group (group C,n=7),ketanine group (group K,n=7),TBI group (n=9) and TBI plus ketamine group (group TBI+K,n =9).TBI was produced with a pneumatically driven controlled cortical impact device.Ketamine 150 mg/kg was intraperitoneally injected at l h after operation in TBI+K and K groups,while the equal volume of normal saline was given instead in TBI and C groups.Open field test was conducted at 24 h,72 h and 7 days after operation.The animals in TBI and TBI+K groups were scanned by T1-weighted MRI at 6,24 and 72 h after operation,the animals in C and K groups were scanned by MRI at 24 h after operation,and the development of cerebral edema was observed.Results MRI scan showed no cerebral edema in C and K groups,and different degrees of cerebral edema were found in TBI and TBI+K groups.Compared with group C,the locomotor distance was significantly shortened at 24 and 72 h after operation in group TBI (P＜0.05).Compared with group TBI,the size of cerebral edema was significantly decreased,and the locomotor distance was prolonged at 24 and 72 h after operation in group TBI+K (P＜0.05 or 0.01).Conclusion MRI method further clarifies that ketamine can produce cerebral protection to some extent in mice with TBI.

OBJECTIVETo compare the mid- to long-term outcomes of patients receiving isolated coronary artery bypass grafting (CABG) versus surgical ventricular restoration (SVR) plus CABG for left ventricular aneurysms.

METHODSThe clinical data were retrospectively analyzed in 205 patients with left ventricular aneurysms admitted to our hospital between January, 1997 and December, 2012, including 115 patients receiving SVR plus CABG and 90 undergoing isolated CABG. By matching preoperative echocardiographic parameters including aneurysm size, left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI) and EuroSCORE risk factors, 32 patients receiving SVR plus CABG and another 32 with isolated CABG were enrolled in this study. The patients were compared for survival rates, major adverse cardiac or cerebrovascular events (MACCEs), left ventricular geometry and function at 1, 3 and 5 years of follow-up.

RESULTSCompared with the patients receiving isolated CABG, those receiving SVR and CABG showed greater improvements in echocardiographic parameters and NYHA functional class. The differences in the echocardiographic parameters between the two groups gradually reduced with time and became comparable at 5 years after the operation (P>0.05). No significant difference was found in the mid- to long-term survival or the incidence of MACCEs between the two groups (P>0.05).

CONCLUSIONCompared with isolated CABG, SVR plus CABG does not reduce the incidence of MACCEs or improve the mid- to long-term survival rate of patients with left ventricular aneurysm with a LVESVI <60 mL/m(2).

Aneurysm ; surgery ; Coronary Artery Bypass ; Echocardiography ; Heart Ventricles ; surgery ; Humans ; Incidence ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Survival Rate ; Treatment Outcome ; Ventricular Function, Left

OBJECTIVETo establish a BALB/c nude mouse model with the huamanized chronic myeloid leukemia (CML) for the study of human CML.

METHODSThe BALB/c nude mice aged 4 weeks pretreated by splenectomy, the cyclophosphamide intraperitoneal injection and sublethal irradiation (SLI) were transplanted intravenously with bone marrow mononuclear cells from CML patients. The SLI-pretreated nude mice were divided into 2 groups: group A, in which the nude mice were injected with 0.3 ml PBS; group B, in which the nude mice were infused intravenously with 4.5×10mononuclear cells from CML patients. Then the changes of body weight and appetite were observed, the hemogram and cell morphology were determined, the expressions of human CD13 and CD45 were detected by flow cytometry, the pathologic analysis of bone, liver and intestine were performed by biopsy, and the BCR/ABL fusion gene was detected by RT-PCR.

RESULTSThe mice in group B displayed weakness, auantic, less foodintake and instabiligy of gait as time want on. The average survival time was 46.2±4.2 d (45-57 d). On the third week, the CD13CD45cells accounted for 0.56±0.05% and 2.56±0.36% respectively in group A and B. While on the sixth week, the CD13CD45cells accounted for 0.44±0.07% and 4.97±0.43% in A and B groups respectively, these results showed that cell count in B group was significantly higher than that in A group(P<0.05). Pathological examination showed that the leukemic cells were found in bone marrow of group B. The BCR/ABL fusion gene could be detected in bone marrow.

CONCLUSIONBALB/c nude mouse model with huamanized chronic myeloid leukemia(CML) model has been established by pretreating mice with SLI. The survival time of mice in this model has been long, and the cost to establish the model is low.

AlM: To observe clinical effect of vitrectomy with intravitreal ranibizumab for the treatment of diabetic retinopathy ( DR) .
METHODS:From February 2011 to February 2013, there were 90 cases in our hospital diabetic retinopathy patients withvitrectomy surgery. lt was randomly divided into observation group ( 45 cases ) and control group ( 45 cases ) . Two groups of patients were performed vitrectomy. Patients in observation group were injected intravitreal ranibizumab before surgery, then vitrectomy was underwent for diabetic retinopathy. Vitrectomy was only underwent in control group.
RESULTS:The patients in observation group with good effect accounting for 71% (32/45) and good rate was 89%(40/45 ), which were significantly higher than that in control group 51% ( 23/45 ) , 71% ( 32/45 ) . Differences were statistically significant ( P < 0. 05 ). Amount of bleeding was 9. 64 ± 2. 27mL, intraocular pressure was 13. 64 ± 3. 27mmHg. lt was significantly less than that in control group 10. 21 ± 3. 14mL, 16. 00 ± 3. 14mmHg. Differences were statistically significant (P<0. 05).
CONCLUSlON: The vitrectomy with intravitreal ranibizumab treatment of diabetic retinopathy can not only reduce blood loss, but also reduce edema and improve effectiveness and safety. lt's worth recommending for clinical practice.

OBJECTIVETo investigate the early and midterm postoperative outcomes and analyze risk factors of coronary artery bypass grafting (CABG) in octogenarians.

METHODSClinical data of 38 patients aged 80 years or greater receiving isolated coronary artery bypass grafting from September 2001 to November 2010 were reviewed. There were 33 male and 5 female patients, aging from 80 to 87 years with a mean of (82.6 ± 1.2) years. Twelve patients underwent conventional (on-pump) CABG and 26 patients underwent off-pump CABG. The number of bypass grafts was 1 to 5 (mean 2.5 ± 1.1). Left internal mammary artery was used in 37 (97.3%) patients.

RESULTSThe perioperative mortality was 2.6% (1/38). Postoperative complications included stroke (4 cases), respiratory infection (1 case). The atrial arrhythmias occurred in 25 patients. Intensive care unit and hospital length of stay lasted (3.8 ± 1.4) days and (15 ± 6) days, respectively. Totally 38 patients were followed up for 4 to 70 months. Six patients died during the follow-up period. The 92.6% patients recovered without any cardiac events.

CONCLUSIONSIsolated CABG can be performed safely with acceptable postoperative morbidity and mortality in octogenarians. Appropriate surgical strategy and intensive perioperative treatment must be enhanced in octogenarians who underwent CABG.

Aged, 80 and over ; Coronary Artery Bypass ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Risk Factors ; Treatment Outcome

OBJECTIVETo summarize the experience of ventricular septal myectomy (modified Morrow procedure) in patients with hypertrophic obstructive cardiomyopathy (HOCM).

METHODSFrom June 2003 to March 2011, 38 patients (26 male and 12 female) with HOCM underwent modified Morrow procedure. The mean age was 36.3 years (ranging from 18 to 64 years). The diagnosis was made by echocardiography and spiral CT. The mean systolic gradient between the left ventricle and the aorta from transthoracic echocardiography (TTE) was (89±31) mmHg (ranging from 50 to 184 mmHg, 1 mmHg=0.133 kPa) before operation. There was moderate or severe systolic anterior motion (SAM) in 38 cases and mitral regurgitation in 29 cases. Ventricular septal myectomy with modified Morrow procedure was performed in all 38 cases. TEE was used intraoperatively to evaluate the results of the surgical procedures. After 1 to 2 weeks of operation, TTE was performed to evaluate the effect of operation. All patients were followed up with TTE after operation.

RESULTSAll patients were discharged without complications. Intraoperative TEE showed that the mean systolic gradient between the left ventricle and the aorta was decreased from (95±36) mmHg before procedures to (14±11) mmHg after operation (t=13.265, P=0.000), and the thickness of ventricular septum was decreased from (28±8) mm to (12±3) mm (t=11.656, P=0.000). TTE showed that the mean systolic gradient between the left ventricle and the aorta was decreased from (89±31) mmHg preoperatively to (18±13) mmHg (t=12.729, P=0.000) in 1 to 2 weeks after operation. Mitral regurgitation and SAM were significantly improved or disappeared (t=7.930, t=5.213, both P=0.000). During the follow-up, all patients promptly became completely asymptomatic or complained of mild effort dyspnea only and syncope was abolished, and TTE showed that the pressure gradient was kept on the postoperative level or slightly decreased (P=0.494).

CONCLUSIONSVentricular septal myectomy with modified Morrow procedure is a mostly effective method for patients with HOCM. Good surgical exposure and the hypertrophied septum thoroughly excised are paramount for successful surgery.

Adolescent ; Adult ; Cardiomyopathy, Hypertrophic ; surgery ; Cardiomyoplasty ; methods ; Female ; Follow-Up Studies ; Heart Septum ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective To assess the efficacy of recoil of inflating syringe plunger in limiting laryngeal mask airway (LMA) cuff pressure.Methods Sixty ASA Ⅰ or Ⅱ patients aged 22-64 yr with body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were enrolled in this study.LMA Supreme (Laryngeal Mask Co.Singapore) size # 3 (for patients with body weight ≤50 kg) or # 4 (for patients with body weight ＞ 50 kg) was placed after induction of anesthesia.Correct position of LMA was confirmed by fiberoptic bronchoscopy.The LMA cuff was inflated to 60,80,100 and 120 cm H2O step by step using a 20 ml-syringe.The cuff pressure was measured with a monometer through a 3-way stopcock and maintained at each level for 10 seconds.The plunger was then allowed to recoil.The cuff pressure at the end of recoil (residual cuff pressure) was recorded.The patients were mechanically ventilated.The inspiratory pressure was limited to 30 cm H2 O.The airway pressure at which the air started to leak between LMA and larynx (leak pressure-Pleak) was recorded.Results The residual cuff pressure following the 4 inflating pressures was all ＜ 60 cm H2 O.The Pleak was ＞20 cm H2O.There was no significant difference in residual cuff pressure and Pleak between size # 3 and # 4.Conclusion Recoil of inflating syringe plunger can limit LMA pressure to safe level.

Objective To compare the effect of perineal cleansing with the potassium permanganate or sterile water on mid- stream urine culture. Methods Mid- stream specimens of urine were obtained from inpatients in our hospital between January 2002 and December 2006. All these patients may be diag-nosed as urinary tract infection. The urine specimens were divided into the potassium permanganate group (n=1572, the sterilization group) and the sterile water group (n=544). The change of positive and contami-nation rate of mid-stream urine culture from the specimens was observed. More than two kinds of germs in one urine specimen were defined as contamination. Results 830 patients with urinary tract infection had been enrolled. 2116 specimens were collected and 531 strains of causative organism were detected. The positive rate of the sterilization group and the sterile water group was 20.04% and 39.71%, respectively,and such difference was significant. The rate of identical causative organism from the same patient whose spec-imen was cultivated twice in the sterilization group was 0.012% and the rate was 0.105% in the sterile water group. The difference was significant. The rate of different or one kind of causative organism from the same patient whose specimen was cultivated twice in these two groups hadn't significant deviation. The contami-nation rate of the sterilization group (0.028%) was significantly higher than that of the sterile water group (0.007%). Conclusions Perineal cleansing with sterile water can reduce the false negative rate of mid-stream urine culture without increasing the contamination rate. Potassium permanganate sterilization is re-sponsible for the high false-negative in mid-stream urine culture.