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Recently, functional homotopy (FH) architecture, defined as robust functional connectivity (FC) between homotopic regions, has been frequently reported to be altered in MDD patients (MDDs) but with divergent locations.In this study, we obtained resting-state functional magnetic resonance imaging (R-fMRI) data from 1004 MDDs (mean age, 33.88 years; age range, 18-60 years) and 898 matched healthy controls (HCs) from an aggregated dataset from 20 centers in China. We focused on interhemispheric function integration in MDDs and its correlation with clinical characteristics using voxel-mirrored homotopic connectivity (VMHC) devised to inquire about FH patterns.As compared with HCs, MDDs showed decreased VMHC in visual, motor, somatosensory, limbic, angular gyrus, and cerebellum, particularly in posterior cingulate gyrus/precuneus (PCC/PCu) (false discovery rate [FDR] q 0.002, z = -7.07). Further analysis observed that the reduction in SMG and insula was more prominent with age, of which SMG reflected such age-related change in males instead of females. Besides, the reduction in MTG was found to be a male-special abnormal pattern in MDDs. VMHC alterations were markedly related to episode type and illness severity. The higher Hamilton Depression Rating Scale score, the more apparent VMHC reduction in the primary visual cortex. First-episode MDDs revealed stronger VMHC reduction in PCu relative to recurrent MDDs.We confirmed a significant VMHC reduction in MDDs in broad areas, especially in PCC/PCu. This reduction was affected by gender, age, episode type, and illness severity. These findings suggest that the depressive brain tends to disconnect information exchange across hemispheres.

Integrating artificial enzymes onto nanostructures target- and site-specifically is still a challenge. Here we show that target miRNAs trigger the formation of DNAzyme site-specifically at the tip of filamentous phage for detecting miRNA biomarkers. Through an antibody-modified oligonucleotide, the tip of the phage with magnetic nanoparticles on the sidewall captures a target miRNA, inducing the formation of DNAzyme that extends from the phage tip through a hybridization chain reaction. After magnetic separation, the resultant complex catalyzes a colorimetric reaction with the signal correlated to target concentrations, leading to the quantification of miRNAs with a detection limit of 5.0 fM, about 10

Background Ischaemic stroke has become the main cause of death and severe neurological disorders, for which effective restorative treatments are currently limited. While stem cell transplantation offers therapeutic potential through neural regeneration, this approach is associated with the challenges of limited applicable sources. Hair follicle stem cells (HFSCs) are multipotential cells that can differentiate into ectodermal and mesodermal lineages and proliferate for long periods. The therapeutic potentials of HFSCs have not been investigated in ischaemic stroke models, and therefore, in this study, we aimed to determine whether they could survive and migrate to ischaemic areas after a stroke attack. Methods A rat model of middle cerebral artery ischaemia/reperfusion was established and intravenously administered HFSCs. The potential of HFSCs to migrate and differentiate into neuron-like cells as well as their ability to reduce the infarct size was evaluated. Rat brain tissue samples were collected 2 weeks after cell transplantation and analysed via TTC staining, immunofluorescence and immunohistochemistry methods. The data were statistically analysed and presented as the means ± standard deviations. Results Intravenously administrated rat HFSCs were able to migrate to the penumbra where they expressed neuron-specific markers, reduced the infarct volume and promoted neurological recovery. Conclusion HFSC transplantation has therapeutic potential for ischaemic stroke and is, therefore, worthy of further investigation toward possible clinical development for treating stroke patients.

Aptamer-based biosensors have been widely constructed and applied to detect diverse targets. Metronidazole is a widely used broad-spectrum antibacterial drug, whose residue has multiple risks to human health. Herein, metronidazole-specific aptamers were selected from a random ssDNA library with the full length of 79 nucleotides (nt) based on DNA library-immobilized magnetic beads SELEX technology. After ten rounds of selection, four aptamers with highly similar secondary structures were selected, among which AP32, with the lowest dissociation constants, was chosen as the optimal aptamer for further optimization. Then a semi-rational post-SELEX truncation was carried out based on the secondary structure analysis and molecular docking, as well as affinity assessment. Redundant nucleotides in AP32 were stepwise removed without the decrease of affinity. Following such strategy, a truncated aptamer AP32-4 with the length of only 15 nt was eventually screened. The dissociation constant of 77.22 ± 11.27 nM is almost equivalent to the original AP32. Furthermore, an aptamer-based fluorescent biosensor for metronidazole was constructed based on AP32-4. With the help of exonuclease-assisted target-recycling amplification, the biosensor exhibits a linear detection range of 25-800 nM, and the detection limit of 10.50 nM. The biosensor was applied to detect metronidazole in honey samples. The results show that not only an efficient strategy for screening robust and practicable aptamers, but also an ultrahigh sensitive detection platform for metronidazole were established.

BACKGROUNDAdoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) has achieved remarkable clinical efficacy in metastatic cancers such as melanoma and cervical cancer (CC). Here, we explored the safety, feasibility, and preliminary tumor response and performed translational investigations of adjuvant immunotherapy using infusion of autogenous TILs (auto-TILs) following concurrent chemoradiotherapy (CCRT) in patients with CC who had locally advanced disease.METHODSTwenty-seven patients with CC with stage III-IV disease were recruited in this single-center, phase I study. TILs were isolated from lesions in the uterine cervix and generated under good manufacturing practice (GMP) conditions and then infused after CCRT plus i.m. IL-2 injections.RESULTSTILs from 20 of the 27 patients were successfully expanded, with a feasibility of 74.1%. Twelve patients received TILs following CCRT. Adverse events (AEs) were primarily attributable to CCRT. Only 1 (8.3%) patient experienced severe toxicity with a grade 3 hypersensitivity reaction after TIL infusion. No autoimmune AEs, such as pneumonitis, hepatitis, or myocarditis, occurred, and there were no treatment-related mortalities. Nine of 12 patients (75.0%) attained a complete response, with a disease control duration of 9-22 months. Translational investigation showed that the transcriptomic characteristics of the infused TIL products and some immune biomarkers in the tumor microenvironment and serum of patients with CC at baseline were correlated with the clinical response.CONCLUSIONTIL-based ACT following CCRT was safe in an academic center setting, with potentially effective responses in patients with locally advanced CC. "Hot" inflammatory immune environments were beneficial to the clinical efficacy of TIL-based ACT as adjuvant therapy.TRIAL REGISTRATIONClinicalTrials.gov NCT04443296.FUNDINGNational Key RD Program; Sci-Tech Key Program of the Guangzhou City Science Foundation; the Guangdong Province Sci-Tech International Key Program; the National Natural Science Foundation of China.

Objective To explore the influencing factors of age at onset of pain and severe pain in patients with Hartofilakidis type I developmental dysplasia of the hip (DDH). Methods A retrospective study of 83 patients with DDH treated at our hospital from January 2017 to June 2021 was conducted. The age at onset of pain, patients’ demographic data, and radiographic parameters were collected. Multiple linear regression was used to determine the influencing factors of age at onset of pain. Cox regression analysis was used to determine the influencing factors of severe pain attacks. Results According to the results of multiple linear regression analysis, when the distance between the medial femoral head and the ilioischial line increased by one millimetre, the age at onset of pain decreased by 1.7 years (β = − 1.738, 95% CI − 1.914–[− 1.561], p β = − 0.334, 95% CI − 0.496–[− 0.171], p β]: = 0.947, 95% CI 0.898–0.999, p = 0.044). For each additional millimetre in the distance between the medial femoral head and the ilioischial line, the likelihood of severe pain increased by 2.4 times (Exp [β]: 2.417, 95% CI 1.653–3.533, p Conclusion Larger distances between the medial femoral head and the ilioischial line and sharp angle can lead to an earlier age at onset of pain in patients with DDH. Small LCEA and excessive distance between the medial femoral head and the ilioischial line are risk factors for severe pain.

Hongjiannao groundwater exchange was the largest desert freshwater lake in China (57.25 km2 in 1986). However, it shrank sharply over the past 34a (1986–2019), with the smallest lake area 31.41 km2 in 2015. The objective of this study was to use the Landsat images, ASTER GDEM V2 data, and meteorology and statistics data, in combination with the water balance model to calculate the dynamics of water balance elements, quantify and characterize the interannual variations in lake-groundwater exchanges, and analyzed its influencing factors by using the geographical detector. The results showed that in the stable stage (1986–1997), the average rate of the lake area, water level, and lake volume change was − 0.26 km2/a, -0.0483 m/a, and − 0.0009 km3/a, respectively. Precipitation, river inflow, and groundwater were 0.0203 km3, 0.0485 km3, and 0.0098 km3, which accounts for the whole input were 25.83%, 61.70%, and 12.47%, respectively, evaporation was 0.0786 km3. In the reduction stage (1998–2015), the average rate of the lake area, water level, and lake volume change was − 1.21 km2/a, -0.2422 m/a, and − 0.0101 km3/a, respectively. Before 2006, precipitation, river inflow, and groundwater were 0.0154 km3, 0.0475 km3, and − 0.0025 km3, respectively; from 2006 to 2009, precipitation, river inflow, and groundwater were 0.0143 km3, 0.0334 km3, and 0.0058 km3, respectively; after 2009, precipitation, river inflow, and groundwater were 0.0139 km3, 0.0199 km3, and 0.0085 km3, respectively. Evaporation decreased from 0.0714 km3 to 0.0480 km3 from 1998 to 2015. In the growth stage (2016–2019), the average rate of the lake area, water level, and lake volume change were 1.38 km2/a, 0.27 m/a, and 0.0088 km3/a, respectively. Precipitation, river inflow, and groundwater were 0.0209 km3, 0.0005 km3, and 0.0373 km3, which accounts for the whole input were 46.63 %, 52.12 %, and 1.25 %, respectively, evaporation was 0.0187 km3. Compared with the stable stage, groundwater in the growth stage reduced from 12.47 % (0.0098 km3) to only 1.25 % (0.0005 km3). From 1998 to 2004, Hongjiannao Lake experienced continuous losing conditions (discharge from the lake to groundwater), with a variable exchange volume of up to -0.01582 km3 in 1999. Through geographical detector analysis, it was found that temperature was the dominant factor from 1988 to 1997, while human factors were the dominant factors from1998 to 2015.

In mature mammalian brains, the endocannabinoid system (ECS) plays an important role in the regulation of synaptic plasticity and the functioning of neural networks. Besides, the ECS also contributes to the neurodevelopment of the central nervous system. Due to the increase in the medical and recreational use of cannabis, it is inevitable and essential to elaborate the roles of the ECS on neurodevelopment. GABAergic interneurons represent a group of inhibitory neurons that are vital in controlling neural network activity. However, the role of the ECS in the neurodevelopment of GABAergic interneurons remains to be fully elucidated. In this review, we provide a brief introduction of the ECS and interneuron diversity. We focus on the process of interneuron development and the role of ECS in the modulation of interneuron development, from the expansion of the neural stem/progenitor cells to the migration, specification and maturation of interneurons. We further discuss the potential implications of the ECS and interneurons in the pathogenesis of neurological and psychiatric disorders, including epilepsy, schizophrenia, major depressive disorder and autism spectrum disorder.

To compare the clinical effect differences among different acupoint selection methods for primary insomnia.A total of 333 patients with primary insomnia were recruited from 3 study centers and randomly divided into a group A (111 cases, 7 cases dropped off), a group B (111 cases, 5 cases dropped off) and a group C (111 cases, 2 cases dropped off). The patients in the group A were treated with acupuncture at Shenmen (HT 7) and Baihui (GV 20), the patients in the group B were treated with acupuncture at Sanyinjiao (SP 6) and Baihui (GV 20), and the patients in the group C were treated with acupuncture at non-acupoint and Baihui (GV 20). All the treatment was given once a day, 30 min each time; 5 treatments were taken as a course and 5 courses of treatment were given. The Pittsburgh sleep quality index (PSQI) and Athens insomnia scale (AIS) scores were evaluated before and after treatment as well as 4 weeks after treatment. The encephalofluctuograph technology (ET) was observed before and after treatment.Compared before treatment, the PSQI scores after treatment and at follow-up were significantly decreased in three groups (The acupuncture at acupoints along the meridians could improve the sleep quality in patients with primary insomnia, and the therapeutic effect of acupoint along the meridians is better than that of non-acupoint.

Background This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD). Methods Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration’s risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. Results Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: − 1.53, 95% confidence interval − 2.95 to − 0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers. Conclusions NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.

Aims. The over-the-scope clip (OTSC) has recently emerged as a new endoscopic device for treating gastrointestinal bleeding, perforations, fistulas, and leaks. A modified OTSC device (full-thickness resection device, FTRD) has been widely used for endoscopic full-thickness resection. However, there is less experience regarding the indications and methods for OTSC removal. We aimed to summarize the existing methods and indications for OTSC removal. Methods. We searched PubMed, Cochrane Library, and ClinicalTrials.gov to identify relevant publications on OTSC removal. The details of OTSC removal, including the methods, indications, success rates, adverse events, and failure causes, were extracted and summarized. A meta-analysis of pooled success rates was conducted using STATA 15.0. Results. Eighteen articles were included. The reported methods for OTSC removal included (1) grasping forceps, (2) the Nd : YAG laser, (3) argon plasma coagulation, (4) the remOVE system, (5) endoscopic mucosal resection/endoscopic submucosal dissection, and (6) ice-cold saline solution. Indications for OTSC removal were (1) poor healing, (2) OTSC misplacement, (3) repeat biopsy/therapy or further treatment, (4) adverse events after OTSC implantation, (5) removal after recovery, and (6) patient wishes. The pooled success rate of OTSC removal was 89% in patients treated with the remOVE system. Minor bleeding, superficial thermal damage, and superficial mucosal tears were common adverse events. Mucosal overgrowth was the main cause of OTSC removal failure. Conclusions. The remOVE system is the best investigated method, with sufficient efficacy and safety for OTSC removal. This is the first systematic review of OTSC removal and provides significant guidance for clinical practice.

Objectives The pectoral nerves (Pecs) II block is a technique that places local anesthetic between the thoracic muscles to block the axillary and breast regions. This study aimed to compare the quality of perioperative analgesia and side effects of the Pecs II block under general anesthesia versus general anesthesia alone in immediate unilateral breast reconstruction with an implant and latissimus dorsi flap after modified radical mastectomy. Materials and methods Sixty-four patients scheduled for immediate breast reconstruction after modified radical mastectomy were randomly allocated into the Pecs II block under general anesthesia group (group P, n=32) or the general anesthesia alone group (group G, n=32). After anesthesia induction, patients in group P underwent a Pecs II block. The primary endpoint was postoperative morphine consumption in the first 24 hours in postoperative intensive care unit. Intraoperative fentanyl consumption, visual analog scale scores, shoulder range of motion, and postoperative nausea and vomiting were also assessed. Results Sixty patients completed the study. There was a significant reduction in postoperative morphine consumption (3.67 mg; 95% confidence interval, 2.91-4.51 mg) and intraoperative fentanyl consumption in group P patients compared with group G patients. Less postoperative nausea and vomiting (relative risk 0.22; 95% confidence interval, 0.05-0.94) and lower visual analog scale scores were also observed in group P. No block-related complications were recorded. Discussion When patients underwent immediate breast reconstruction with an implant and latissimus dorsi flap, the Pecs II block offers a comprehensive block of associated nerves in the surgical area, and therefore can provide superior analgesia and reduced perioperative opioids use without obvious block-related complications.

Summary Epstein–Barr virus (EBV) is a well-documented aetiological factor for multiple sclerosis (MS). EBV encodes at least 44 microRNAs (miRNAs) that are readily detectable in the circulation of human. Previous studies have demonstrated that EBV-encoded miRNAs regulate host immune response and may serve as biomarkers for EBV-associated diseases. However, the roles of EBV miRNAs in MS are still unknown. To fill the gap, we conducted a comprehensive profiling of 44 mature EBV miRNAs in 30 relapsing–remitting MS (RRMS) patients at relapse and 30 matched healthy controls. Expression levels of ebv-miR-BHRF1-2-5p and ebv-miR-BHRF1-3 were elevated significantly in the circulation and correlated positively with the expanded disability status scale (EDSS) scores of MS patients. Receiver operating characteristic (ROC) analyses confirmed that the expression of these two miRNAs distinguished MS patients clearly from healthy controls. Luciferase assays revealed that ebv-miR-BHRF1-2-5p may directly target MALT1 (mucosa-associated lymphoid tissue lymphoma transport protein 1), a key regulator of immune homeostasis. In conclusion, we described the expression of EBV miRNAs in MS and preliminarily validated the potential target genes of significantly altered EBV miRNAs. The findings may pave the way for prospective study about the pathogenesis of MS.

This study was to evaluate the upper airway changes in patients with skeletal Class Ⅲ maxillary retrognathia after rapid maxillary expansion and protraction.An electronic search in PubMed, Cochrane Library, Embase, CNKI, CBM, VIP and Wanfang was performed until March 1st, 2018. According to the inclusion and exclusion criteria, two investigators respectively reviewed the literature and selected eligible studies, then assessed the risks of bias and extracted the data of the included studies. The extracted data were quantitatively analyzed with Revman 5.3 software.A total of 12 studies were included for meta-analysis. The results showed that, after treatment the nasopharyngeal volum(P0.05) increased significantly. However, no statistically significant differences in oropharyngeal volume(P0.05) and hypopharyneal volume (P0.05) existed. The nasopharyngeal airway dimensions had increased significantly with the following measurements: PNS-ad1 (P0.05), PNS-ad2(P0.05). However, no statistically significant differences in lower pharynx dimension existed with the following measurements: MPS(P0.05), IPS(P0.05).Rapid maxillary expansion and protraction can increase nasopharyngeal volume and sagittal airway dimensions in skeletal Class Ⅲ subjects with maxillary retrusion. It may be suggested that rapid maxillary expansion and protraction have the potential to reduce the risk of obstructive sleep apnea syndrome in children with maxillary retrusion by enlarging airway space.

Multiple sclerosis is among the most serious inflammatory demyelinating diseases (IDD). Interleukin-23A (IL23A) regulates and coordinates the activities of immune cells by interacting with its receptor IL23R and plays key roles in the pathogenesis of immune inflammatory diseases. IDD, deemed to be a kind of autoimmune diseases, may involve IL23A in the pathogenesis. The aim of this work was to validate the hypothesized involvement of IL-23A and its receptor in IDD. We sequenced the IL-23A and IL-23R genes for 206 Chinese Han IDD patients and evaluated SNPs within or near those genes. The serum levels of IL23A in IDD participants were analyzed using ELISA. The statistical analyses were conducted using Chi-Square Tests as implemented in SPSS (version 19.0). The Hardy-Weinberg equilibrium test of the population was carried out using online software OEGE. Three variants rs2066808, rs2371494, rs11575248 in IL-23A gene and one variant rs1884444 in IL-23R gene were demonstrated to be associated with the risk of MS or other IDD diseases, and the expression level of serum IL-23A in the MS patients was also altered. We conclude that variants in IL-23A and IL-23R genes were associated with the risk of MS or other IDD diseases.

This meta-analysis compared clinical outcomes, including survival rate, marginal bone loss (MBL), and technical and biological complications of short implants (7 mm) and long implants (≥7 mm) placed in the posterior alveolar bone.Electronic (via PubMed, EMBASE, Cochrane Library) and manual searches were performed for articles published prior to November 29, 2019.The review protocol was registered with PROSPERO (CRD42019140718). Only randomized controlled trials (RCTs) comparing short implants and standard implants in the same study after an observation period of at least five years were included.Nine RCTs were included in this study. The survival rates of short implants (7 mm) ranged from 86.7 %-98.5 %, whereas the survival rates of longer implants (≥7 mm) were 95.1%-100% with follow-up ranging from 5 to 10 years. Dichotomous variables were compared using the Mantel-Haenszel (MH) method, and continuous variables were compared using the inverse variance (IV) method. The random effects model and the fixed effects model were used. Meta-analyses showed that short implants had a poorer survival rate than longer implants (P = 0.008). Short implants were associated with lower MBL than longer implants (P0.001). The biological complications of short implants were lower (P0.001) and the technical complications were higher, than those of long implants (P = 0.006).The results indicate that although the survival rate of short implants in the maxilla may be lower than that of long implants, the survival rate of short implants in the mandible is similar to that of long implants, and short implants can result in a lower rate of biological complications. The conclusions should be interpreted with caution due to the limited numbers of participants and implants.When selecting the length of implants, surgeons should consider survival rate, the location of implant placement, their own clinical experience, and the incidence of complications.

Antiangiogenesis is a promising approach to cancer therapy but is limited by the lack of tumor-homing capability of the current antiangiogenic agents. Angiogenin, a protein overexpressed and secreted by tumors to trigger angiogenesis for their growth, has never been explored as an antiangiogenic target in cancer therapy. Here it is shown that filamentous fd phage, as a biomolecular biocompatible nanofiber, can be engineered to become capable of first homing to orthotopic breast tumors and then capturing angiogenin to prevent tumor angiogenesis, resulting in targeted cancer therapy without side effects. The phage is genetically engineered to display many copies of an identified angiogenin-binding peptide on its side wall and multiple copies of a breast-tumor-homing peptide at its tip. Since the tumor-homing peptide can be discovered and customized virtually toward any specific cancer by phage display, the angiogenin-binding phages are thus universal "plug-and-play" tumor-homing cancer therapeutics.

Excessive forces may cause root resorption and insufficient forces would introduce no effect in orthodontics. The objective of this study was to investigate the optimal orthodontic forces on a maxillary canine, using hydrostatic stress and logarithmic strain of the periodontal ligament (PDL) as indicators. Finite element models of a maxillary canine and surrounding tissues were developed. Distal translation/tipping forces, labial translation/tipping forces, and extrusion forces ranging from 0 to 300 g (100 g=0.98 N) were applied to the canine, as well as the force moment around the canine long axis ranging from 0 to 300 g·mm. The stress/strain of the PDL was quantified by nonlinear finite element analysis, and an absolute stress range between 0.47 kPa (capillary pressure) and 12.8 kPa (80% of human systolic blood pressure) was considered to be optimal, whereas an absolute strain exceeding 0.24% (80% of peak strain during canine maximal moving velocity) was considered optimal strain. The stress/strain distributions within the PDL were acquired for various canine movements, and the optimal orthodontic forces were calculated. As a result the optimal tipping forces (40-44 g for distal-direction and 28-32 g for labial-direction) were smaller than the translation forces (130-137 g for distal-direction and 110-124 g for labial-direction). In addition, the optimal forces for labial-direction motion (110-124 g for translation and 28-32 g for tipping) were smaller than those for distal-direction motion (130-137 g for translation and 40-44 g for tipping). Compared with previous results, the force interval was smaller than before and was therefore more conducive to the guidance of clinical treatment. The finite element analysis results provide new insights into orthodontic biomechanics and could help to optimize orthodontic treatment plans.

Various types of mesenchymal stromal cells (MSCs) have been used in urological tissue engineering but to date the existence of MSCs has not been reported in the human bladder. The present study provided evidence that a small number of MSC-like cells exist in the human bladder and designated this class of cells ‘human bladder-derived MSC-like cells’ (hBSCs). It was demonstrated that hBSCs can be cultured to yield a large population. These hBSCs expressed the surface markers of MSCs and exhibited the capacity for osteogenic, adipogenic and chondrogenic differentiation. On induction with appropriate media in vitro, hBSCs could differentiate into bladder-associated cell types, including urothelial, endothelial and smooth muscle cell-like lineages. In addition, the average telomerase activity of adult hBSCs was higher compared with adult human bone marrow-derived MSCs, but lower than that of human umbilical cord Wharton's jelly-derived MSCs. These findings may inspire future studies on the role of hBSCs in urological tissue engineering applications and in other fields.

Olfactory dysfunction (ODF) has been reported in patients with neuromyelitis optica (NMO) and multiple sclerosis (MS). However, the comparison of olfactory function and olfactory-related gray matter (GM) between patients with NMO and MS needed to be further elucidated.Thirty-seven patients with NMO and 37 with MS were enrolled. Olfactory function was evaluated with a Japanese TT olfactometer test kit, and the neuroanatomical features of olfactory-related GM were assessed using voxel-based morphometry.Olfactory deficits were found in 51.4% of patients with NMO and 40.5% of patients with MS. Patients with NMO with ODF had significantly smaller olfactory bulbs than patients with MS with ODF (p = 0.031). Olfactory-related GM atrophy was found in patients with NMO in several regions of the right orbitofrontal cortex and right superior frontal gyrus; in patients with MS, reduced GM volume was found in the right parahippocampal gyrus and piriform cortex (p0.05, cluster size200 voxels).Olfactory deficits are common in both NMO and MS. However, the neuroanatomical features related to olfactory deficits differ greatly between the two diseases.

Background: Acupuncture and moxibustion has been widely applied to hyperlipidemia treatment in clinical practice in China, serving as an alternative treatment to statins. Warm-needling acupuncture and medicinal cake-separated moxibustion have been separately reported with potential therapeutic effects on hyperlipidemia treatment in several studies but with limitations in study methodology. Combining these two modalities may provide a more advantageous strategy in treating hyperlipidemia. Therefore, a strict evaluation through well-designed randomized controlled trials (RCT) is necessary to determine their efficacy and safety on hyperlipidemia. Methods The study a multicenter, open-label, randomized, stratified, active-controlled, noninferiority trial with two parallel groups. Subjects with hyperlipidemia will be stratified into different groups by risk levels of heart diseases. They then will be instructed to the Therapeutic Lifestyle Change (TLC) diet. Those who have not reached the target lipid level will be randomly assigned to the treatments of either acupuncture and moxibustion or simvastatin with a 1:1 allocation. One hundred and thirty subjects are aimed to be recruited. The duration of intervention for this study will be 12 weeks, followed by another 4 weeks for post-treatment assessment. The primary outcome is percentage change from baseline to the end of the study in low-density lipoprotein cholesterol (LDL-C). Other indicators in lipid change, safety and adherence will also be assessed secondarily. The repeated measures, linear mixed-effects model will be applied to the analysis. Discussion Acupuncture and moxibustion could be a potentially effective treatment alternative for hyperlipidemia. A study with careful design is developed to evaluate the efficacy and safety of combined acupuncture and moxibustion, by integrating the traditional Chinese Medicine (TCM) regimens with the standardized Western medicine appraisal approach. Trial registration ClinicalTrials.gov, NCT02269046 . Registered on 26 September 2014.

OBJECTIVE: To explore the clinical and pathological features and the diagnosis of childhood Alport syndrome (AS). METHODS: A retrospective analysis was performed on clinical data of 91 children with AS. RESULTS: Hematuria was observed in all 91 patients, of whom 86 were accompanied with proteinuria. Sixty-one children with X-Linked AS (XL-AS) had positive family history. Renal biopsy was performed on 82 children. Mild to moderate mesangial proliferation was observed in 74 cases. Small amounts of immune complexes deposits in the glomerular mesangial area were observed in 48 cases. Glomerular basement membrane (GBM) attenuation, thickening and layering were observed in 53 cases by electron microscopy (EM). In 63 cases receiving renal tissue type Ⅳ collagen α3 and α5 chain immunofluorescence detection, 58 were diagnosed with AS, including 53 cases of XL-AS and 5 cases of autosomal recessive AS. In 91 cases of AS, 58 were diagnosed as AS by renal tissue type Ⅳ collagen α3 and α5 chain immunofluorescence, 21 were diagnosed by EM, one was diagnosed by skin biopsy, and 12 were diagnosed by gene detection. Six novel mutations of COL4A5 gene were found. Forty-five cases were misdiagnosed before the diagnosis of AS. Forty-one of the 45 cases received steroids and/or immunosuppressant therapy. CONCLUSIONS: The clinical manifestations and pathological changes are not specific in children with AS, resulting in a higher rate of misdiagnosis. Typical lesions of GBM under EM are only observed in a part of patients. There is a high novel mutation rate of COL4A5 in the detected AS children.

Backgrounds Guillain-Barre syndrome (GBS) is a postinfectious immune-mediated peripheral neuropathy. Interleukin (IL)-27 and IL-35 have been recognized as novel members of IL-12 family. We evaluated the serum and cerebral spinal fluid (CFS) concentrations of IL-27 and IL-35 in GBS and analyze their correlations with clinical characteristics. Methods Serum samples from 50 patients with GBS including 9 acute inflammatory demyelinating polyradiculoneuropathy (AIDP), 33 acute motor axonal neuropathy (AMAN) and 8 unclassified and 35 age- and sex-matched healthy controls were collected. Thirty CSF samples from these patients and 25 patients with other noninflammatory neurological disorders (ONNDs) as disease controls were collected after lumbar puncture. Serum and CSF IL-27 and IL-35 concentrations were measured using human IL-27 or IL-35 ELISA. Results Serum IL-27 concentrations were elevated (p = 0.002) whereas serum IL-35 concentrations were decreased (p = 0.031) in patients with GBS comparing with healthy controls, particularly in patients exhibiting AMAN (p = 0.012). Additionally, serum IL-35 concentrations were negatively correlated with disease severity and outcomes in patients with AMAN (r = − 0.358, p = 0.041; r = − 0.416, p = 0.016). Conclusions IL-27 might be pathogenic, whereas IL-35 be protective in GBS. Additionally, serum IL-35 concentrations may be important biomarkers for the severity and outcomes of AMAN.

To evaluate the change in accommodative lag and accommodation convergence/accommodation (AC/A) after patients with myopia wear orthokeratology lenses. A total of 48 myopic subjects (a test group), who wore orthokeratology lenses regularly, and 48 myopic subjects (a control group), who wore spectacles regularly, were enrolled for this study from January 2011 to January 2013 in Optometric Center, the Forth Hospital of Changsha. Accommodative lag was measured by fused cross cylinder method, where the patients should gaze at the front optotypes 40 cm away. Gradient of the AC/A ratio was measured by Von Grafe method to check closer distance heterophoria. Accommodative lag and AC/A ratio were analyzed by statistics. After 1-year follow-up, accommodative lag and AC/A rate in patients with low or moderate myopia in the test group was decreased in 1, 3, 6 months or 1 year compared with that in the control group (P0.05). Compared with spectacles, orthokeratology lenses are able to decrease accommodative lag and high AC/A rate in patients with low or moderate myopia. The relationship between accommodation and convergence is improved by orthokeratology lenses. Orthokeratology is an effective way to control myopia.目的：研究近视患者配戴角膜塑形镜后调节滞后量及调节性集合与调节的比值(accommodative convergence/accomodation，AC/A)的改变。方法：收集2011年10月至2013年10月在长沙市第四医院视光中心规范验配、随诊的低、中度青少年近视患者96例，其中配戴角膜塑形镜者(试验组)和配戴框架眼镜者各48例(对照组)，使用融像性交叉柱镜法(FCC 法)测量其注视眼前40 cm处视标时的调节滞后量，采用Von Grafe 法检查视近处斜视度，梯度法测AC/A值。对两组的调节滞后量和AC/A值进行统计学分析。结果：与对照组比较，低、中度近视患者试验组在随访的1，3，6，12个月时AC/A值均减小，调节滞后量均减小(P0.05)。结论：低、中度近视患者配戴角膜塑形镜与框架眼镜相比调节滞后量减少，并且角膜塑形镜可以降低高AC/A值，改善调节与集合的关系。角膜塑形镜是控制近视的一种有效方法。.

The DEAD-box RNA helicase p68 plays a very important role in early organ development and maturation. However, the role of p68 in glioma is unclear. In this study, we showed that p68 protein levels were significantly elevated in high-grade gliomas compared to low-grade gliomas and normal adjacent brain tissues. Importantly, the expression of p68 was significantly associated with poorer overall survival and enhanced resistance to treatment with radiotherapy plus temozolomide for glioma patients. Ectopic expression of p68 enhanced glioma cell proliferation both in vitro and in vivo. In contrast, knockdown of endogenous p68 prevented glioma cell proliferation. Using a tandem affinity purification assay, we found a new p68-binding protein, nuclear factor (NF)–κB p50. We found that p68 bound with the N-terminal of NF-κB p50, and the mutant of p68 lacking the p50-interaction domain failed to stimulate glioma cell proliferation and tumor growth. Moreover, p68 induced NF-κB p50 accumulation in the nucleus through release of NF-κB p50 from IκBα and increased NF-κB p50 target luciferase transcription activity. Knockdown of NF-κB p50 rescued the phenotypes induced by p68 both in vitro and in vivo. We concluded that p68 induces glioma tumor growth through binding with NF-κB p50, regulating NF-κB p50 nucleus accumulation and transcription activity.

Heat stroke (HS) is a fatal illness characterized by an elevated core body temperature above 40°C and complicated with rhabdomyolysis and acute renal failure. We retrospectively analyzed the effect of continuous veno-venous hemofiltration (CVVH) in patients with HS.A total of 16 patients with HS were retrospectively analyzed. All patients were treated by CVVH for at least 96 hours, and CVVH was initiated with replacement fluid between 25°C and 30°C for 2 hours to 2.5 hours, and 36°C thereafter. The vital signs were monitored and blood samples were collected during CVVH to measure serum urea, creatinine, myoglobin, creatine kinase, and total bilirubin.All patients survived. The core temperature of the patients decreased from 41.3 ± 0.2°C to 38.7 ± 0.1°C after 2 hours and to 36.7 ± 0.1°C after 5 hours during CVVH (p0.05). Compared with values before starting CVVH, there were remarkable improvements in mean arterial blood pressure, heart rate, and oxygenation index (p0.05). The serum creatinine, urea, myoglobin, and creatine kinase decreased significantly (p0.05), while the bilirubinemia had no obvious decline (p0.05). The scores of APACHE II and arterial lactate had also obvious decline (p0.05). The hemodynamic variables were stabilized during CVVH, and no obvious side effects related to CVVH were found.CVVH is safe and feasible in the treatment of patients with HS by lowering core temperature, removal of myoglobin, support of multiorgan function, and modulating systemic inflammatory response syndrome (SIRS). The impact of CVVH on patient outcome, however, still needs proof by larger randomized controlled trials.

The current study was conducted to determine the prevalence of Helicobacter pylori in the oral cavity of a Chinese population. Nested polymerase chain reaction (PCR) was used to investigate whether individuals with oral H. pylori show more possibility of gastric infection and to examine the relationship between gastric H. pylori infection and the presence of the bacteria in the oral cavity. A total of 443 dyspeptic patients participated in the study. Gastric H. pylori infection was detected by the rapid urease test and histology with Giemsa staining, PCR, or smear examination, whereas the presence of the bacteria in the oral cavity was observed by nested PCR from dental plaque. Relevant periodontal and dental parameters were recorded in the process of oral examination. Of the 443 study patients, oral H. pylori was found in the dental plaque of 263 (59.4%) and the stomach of 273 (61.6%). Additionally, in all four age groups, the prevalence of gastric infection was significantly higher among the patients with positive tests for H. pylori in their dental plaque than in the patients with no H. pylori in their dental plaque (P < 0.05). The oral cavity may be a potential reservoir for H. pylori, and the prevalence of oral H. pylori approximated that of gastric H. pylori in the studied population. Furthermore, a close relationship may exist between H. pylori in the oral cavity and bacteria in the stomach or gastric infection, and dyspeptic patients with gastric infection are more likely to harbor H. pylori in their oral cavity.

Isoniazid is widely used to treat tuberculosis. In populations with a high prevalence rate of tuberculosis, acute ingestion of isoniazid has been reported as a potential cause of coma. In this study, we present the diagnosis and treatment of isoniazid poisoning in a case with acute coma as the major clinical presentation. A 32-year-old male who ingested 12 g isoniazid (2 hours prior to medical attention) was brought to the emergency department while in a coma and experiencing frequent seizures. Initial treatment with large doses of pyridoxine (for 6 hours) failed to awaken this patient. The patient was then given hemodialysis and pyridoxine; after 3 days he awoke from coma, with no further reported seizures. Isoniazid poisoning should be suspected in patients whose major symptoms are coma and seizure, especially those who have access to isoniazid. Monitoring the blood level of isoniazid will establish the diagnosis and help clinical management. A combination of hemodialysis and pyridoxine is effective in treating isoniazid poisoning.

The saturated free fatty acid (FFA), palmitate, could induce apoptosis in various cell types, but little is known about its effects on human umbilical cord-derived mesenchymal stem cells (hUC-MSCs). Here, we investigated whether palmitate induced apoptosis and endoplasmic reticulum (ER) stress in hUC-MSCs. hUC-MSCs were stained by labeled antibodies and identified by flow cytometry. After administration with palmitate, apoptotic cell was assessed by flow cytometry using the Annexin V-FITC/7-AAD apoptosis detection kit. Relative spliced XBP1 levels were analyzed using semi-quantitative RT-PCR. The mRNA of BiP, GRP94, ATF4 and CHOP were analyzed by real-time PCR. Relative BiP and CHOP protein were analyzed using Western blot analysis. The results showed that hUC-MSCs were homogeneously positive for MSC markers; palmitate increased apoptosis of hUC-MSCs and activated XBP1 splicing, BiP, GRP94, ATF4 and CHOP transcription. These findings suggest that palmitate induces apoptosis and ER stress in hUC-MSCs.

Objective: To investigate the effectiveness of the Shikani optical stylet (SOS) and GlideScope video laryngoscope (GVL) for tracheal intubation of thyroid tumor patients with a difficult airway. Subjects and Methods: One hundred and twenty thyroid tumor patients with a difficult airway, who were undergoing elective surgery requiring general anesthesia, were enrolled in the study. They were randomly allocated to 3 groups (n = 40 each) who underwent direct laryngoscopy (DL), SOS or GVL. The outcomes recorded were time to intubation, first-attempt success rate, mean artery pressure (MAP), heart rate (HR) and incidence of complications. Results: The mean time to intubation in the SOS group (group S; 42.4 ± 24.1 s) and the GLV group (group G; 29.8 ± 22.3 s) was significantly less than that in the DL group (group D) (68.8 ± 26.6 s). The first-attempt success rate in group S (90.0%) and group G (97.5%) was significantly higher than that in group D (75.0%; all p < 0.05). The HR and MAP at 1 min after intubation were lowest in group S (76.4 ± 9.2 beats/min and 12.9 ± 1.1 kPa), followed by group G (79.9 ± 9.3 beats/min and 13.0 ± 0.9 kPa) and then group D (90.4 ± 8.1 beats/min and 16.6 ± 1.2 kPa). The difference was statistically significant (all p < 0.05). The incidence of lip or mucosal trauma was lowest in group S, followed by group G and then group D. Conclusion: The SOS and the GLV had advantages over the DL in the management of thyroid tumor patients with a difficult airway in terms of a shorter time to intubation, a higher first-attempt success rate and a reduced incidence of complications. Thus, a rational choice of one of these techniques may be better for the perioperative safety of thyroid tumor patients with a difficult airway.

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease that is caused by an abnormal immune system that attacks the central nervous system. MicroRNAs (miRNAs) are known to play essential roles in the immune system. Most of the previous studies about miRNA dysregulation in MS have focused on European populations. In the present study, the miRNA expression profiles associated with Chinese MS patients are investigated. Here, human miRNA expression profiling experiments were performed on the peripheral blood mononuclear leukocytes from ten MS patients and ten healthy controls. Nine overexpressed and six underexpressed miRNAs were found. The 15 miRNAs were validated independently in a second cohort of 40 MS patients and 40 controls by real-time PCR; six miRNAs were significantly abnormally expressed, and principal component analysis of six miRNAs indicated that the MS patients could be clearly differentiated from the healthy controls based on the miRNA expression patterns. This study provided the indications of abnormal miRNA expression patterns in the peripheral blood mononuclear leukocytes of Chinese MS patients. The potential roles of these differentially expressed miRNAs as MS biomarker and in pathogenesis need to be investigated in future studies.

To observe the curative effect of different duration of mild moxibustion in superficial gastritis patients with deficiency cold pattern of spleen and stomach.A total of 84 superficial gastritis patients were randomly divided into moxibustion-20 min group, moxibustion-40 min group and medication (Ranitidine) group, with 28 cases in each group. Mild moxibustion was applied to bilateral Zusanli (ST 36) and Zhongwan (CV 12, odd days), Pishu (BL 20) and Weishu (BL 21, even-numbered days) for 20 min and 40 min respectively, once daily for 20 days. The symptom integrative score of superficial gastritis patients and the therapeutic effects were assessed according to "The Scoring Table for Symptoms and Signs of Gastrointestinal Disorders of Chinese Medicine", etc.Following 20 days' treatment, of the three 28 gastrititis patients in the medication, moxibustion-20 min and moxibustion-40 min groups, 0, 1, and 0 cases were cured, 5, 7 and 12 experienced marked improvement in their symptoms, 15, 16 and 12 had an improvement, and 8, 4 and 4 were invalid, with the effective rates being 71.4%, 85.7% and 85.7%, respectively. After one month's follow up, of the three 28 cases in the medication, moxibustion-20 min and moxibustion-40 min groups, 0, 4 and 0 cases were cured, 4, 8, and 13 experienced marked improvement, 15, 16 and 13 had an improvement, 9, 0 and 2 were ineffective, with the effective rates being 67.9%, 100% and 92.9%, respectively. Self-comparison of each group showed that the integrative scores of symptoms were all decreased significantly after the treatment and one-month's follow up in the three groups (P0.01). The effective rates of both moxibustion-20 min and -40 min were significantly higher than that of the medication group after one month's follow up (P0.01, P0.05). The therapeutic effect of moxibustion-20 min group was significantly superior to that of the medication group in lowering the integrative score of symptoms after one month's follow up (P0.01). No significant differences were found among the three groups in the therapeutic effects and in reducing integrative scores of symptoms after 20 days' treatment (P0.05).Mild moxibustion is significantly superior to medication in long-term therapeutic effects in the treatment of superficial gastritis patients with spleen-stomach deficiency-cold pattern.

To explore the change characteristics of regional cerebral blood flow (rCBF) and its correlation with curative efficacy in patients with obsessive-compulsive disorder (OCD).The images of rCBF and computed tomography (CT) were acquired from 30 OCD and 30 normal controls by single photon emission computed tomography (SPECT) and CT. The tomographic data of rCBF were normalized, smoothed and statistically processed with the statistical parametric mapping (SPM) software with two-sample Z-test. And the OCD grade was evaluated with the Y-BOCS at pre- and post-medication.The abnormal results of CT were not found. The SPM Z-test showed that the sections of higher rCBF in the OCD patients were predominantly located in basal ganglia and occipital lobe compared with the normal controls (P0.001). The scores of Y-BOCS in 30 patients were markedly lower at post-medication than those at pre-medication (24 ± 7 vs 11 ± 6, P0.001). At post-medication, the scores of Y-BOCS with higher rCBF in basal ganglia and occipital lobe were higher than those in basal ganglia or occipital lobe (P0.05).The OCD patients have higher rCBF in basal ganglia and occipital lobe. The curative efficacy of OCD with higher rCBF in basal ganglia and occipital lobe is worse than that in basal ganglia or occipital lobe.

To observe the effects of moxibustion on contents of epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha) and epidermal growth factor receptor (EGFR) expression in the gastric mucosa tissue in rats with gastric mucosal lesion.Thirty-six SD rats were randomly and equally divided into control, model and moxibustion groups. Gastric mucosal lesion model was duplicated by restraint and cool water immersion stress. Pre-moxibustion was applied to "Zusanli" (ST 36) and "Zhongwan" (CV 12), "Pishu" (BL 20) and "Weishu" (BL 21) alternately, once everyday for 8 days before modeling. The contents of EGF and TGF-alpha in gastric mucosa were detected by enzyme-linked immunosorbent assay (ELISA) and the expression of EGFR determined by immunohistochemistry.Compared with the control group, only TGF-alpha content in the gastric mucosa in the model group was increased significantly (P0.05). Compared with the model group, the EGF and TGF-alpha contents and EGFR immunoactivity in the gastric mucosa were increased significantly in the moxibustion group (P0.05, P0.01).Pre-moxibustion at ST 36, CV 12, BL 20 and BL 21 can up-regulate gastric mucosal EGF and TGF-alpha contents and EGFR protein expression in gastric mucosa lesion rats, which may contribute to its effect in relieving stress-induced gastric mucosal injury.

Background and purpose The exact place for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis and management of thyroid tumors is still under debate. We performed the study to analyze and compare the parameters generated from DCE-MRI for thyroid lesions. Materials and methods For each thyroid lesion, time intensity curves (TIC), time of peak enhancement ( T peak ), maximum enhancement ratio (ER max ) and maximum rise slope (Slope max ) were plotted and calculated. Receiver operator characteristics (ROC) analysis was conducted to assess the diagnostic ability and appropriate cut-off value. The area under the ROC curve (AUC) and the confidence intervals (CIs) were also assessed. Results Forty-two patients were consecutively included. All 21 lesions demonstrated the rapid inflow and washout pattern (type-I) were benign. The 12 cases with delayed inflow pattern (type-III) were all malignant. When compared with the benign lesions, the thyroid carcinoma showed significantly lower Slope max and higher T peak ( P max was found between malignant and benign ones ( P = 0.15). The AUC of ER max , Slope max and T peak in differentiating benign thyroid lesions from malignant ones were 0.63, 0.93and 1, respectively. The ER max cut-off value of 73.86 (sensitivity, 71.4%; specificity, 64.3%), Slope max cut-off value of 2.4126 (sensitivity, 92.9%; specificity, 82.1%) and T peak value of 28 (sensitivity, 100%; specificity, 100%) offered the best diagnostic performances. Conclusions DCE-MRI, especially the pattern of TIC and the value of Slope max and T peak , could be helpful in differentiating thyroid carcinoma from benign thyroid lesions.

To report the recently 7 cases of drug induced hepatitis patients in our department.From October 2008 to December 2008, 7 patients were enrolled in our department for drug induced hepatitis caused by Zhixue capsules administration. The Zhixue capsule is composed of cortex dictam and radices sophorae flavescentis. There were 4 female and 3 male patients. The patients were of age 31 to 52 years old. Of those, 6 patients belonged to the hepatocellular injury type and one to the mixed type. The time period Zhixue capsule was administered was from 6 to 18 days. When the patients enrolled into our department, they were treated for jaundice and protective liver function.When the patients were discharged the symptoms were all improved evidently and liver function became normal. One patient with mixed type was hospitalized for 63 days and he was treated with glucocorticoid to help his recovery.Zhixue capsule could induce acute hepatitis of various types, but mainly hepatocellular injury type. The patients of all types could be recovered with proper treatment. The combined type may need glucocorticoid administration to help recovery.

Needle-sticking method has essential differences from stuck needle induced by acupuncture accident. This manipulation refers to the needle-sticking manifestation induced by twirling the needle in one direction after arrival of qi so as to tangle muscle fibers, which can combined with some compound methods such as trembling, shaking, flying, lifting, plucking, dragging and so on. It is effective for excessive syndrome, pain syndrome, arthralgia syndrome, etc. and with functions of promoting flow of qi and inducing qi to carry out stimulating circulation of channel-qi, promoting the needling sensation propagating along the channel and accelerating qi reaching to the affected region. Its main adverse reactions are pain, tissue damage and so on. The selection of needling instruments, the needling depth, the twirling intensities and location of forbidden or careful application must be paid attention in concrete practice.

It is widely accepted that environmental degradation and poverty are linked and that conservation and poverty reduction should be tackled together. However, success with integrated strategies has been elusive. Here, we present the results of a study that illustrates how development that combines environmental and economic perspectives and that provides appropriate compensation to affected populations can improve both nature and society, thereby eradicating the “poverty trap.” The results show that if we cannot improve the livelihood of local residents, we will be unable to restore degraded environments when state-owned property is transferred to private ownership to encourage better management by residents. In contrast, measures to eliminate poverty, combined with the development of green enterprises that improve the livelihoods of private land owners in the long term, is the precondition for successful ecological restoration.

To compare the therapeutic effects of opposing needling and routine acupuncture for treatment of poststroke shoulder-hand syndrome.Sixty cases were randomly divided into an opposing needling group and a routine acupuncture group, 30 cases in each group. In the two groups, Jianyu (LI 15), Jianliao (TE 14), Quchi (LI 11), Hegu (LI 4), etc. were selected, with on the healthy side selected for the opposing needling group and on the affected side selected for the routine acupuncture group. The motor function of the affected limb was evaluated by Fugl-Meyer scale, activity of daily living by ADL scale, and pain by VAS, and the edema degree was investigated before and after treatment.There were significant differences before treatment and after 2 therapeutic courses in the scores of Fugl-Meyer for the upper limb motor function and the ADL score for activity of daily living (both P0.05), with the opposing needling group being significantly better than the routine acupuncture group (P0.05); after treatment, both the edema degree and the pain scores significantly decreased (both P0.05), with the opposing needling group in improvement of the edema degree being better the routine acupuncture group (P0.05), and with no significant difference between the two groups in improvement of pain (P0.05); the total effective rate was 93.3% in the opposing needling group and 90.0% in the routine acupuncture group with a significant difference between the two groups (P0.05).The clinical therapeutic effect of the opposing needling is better than that of routine acupuncture therapy for treatment of poststroke shoulder hand syndrome.

Carcinoid tumors of the duodenum are rare, and their natural history has not been defined. Duodenum carcinoid can present with various clinical symptoms. It is difficult to diagnose this disease. When duodenum carcinoid is smaller than 1.0 cm, it can be removed by endoscopy. When it is bigger than 1.0 cm, it should be surgically resected. We report a patient who presented with a duodenum carcinoid 1.2 cm in size. As the patient refused surgical resection, we gave him endoscopic mucosa resection. After one-year follow-up, the duodenum carcinoid was found to be completely resected, and the patient had no cancer metastasis.

To study the applicability of MultiCalc software to prenatal screening of Down's syndrome in Jiangsu province, China.The gestational age-specific median of maternal serum marker was calculated by means of regression method. Regression functions for adjustment of Multiple of the Median (MoM) by weight were established for our own population.Before the adjustment by weight, the average level of alpha fetal protein(AFP) was 16% higher and the free beta-human chorionic gonadotrophin (beta-hCG) was 14% higher than those of the Caucasian in MultiCalc software respectively. But when the AFP and free beta-hCG results were converted to weight-adjusted MoM levels, the values were 0.99 and 1.02 respectively. The median of MoM of AFP and the free beta-hCG were 1.00 through the regression model of gestational age and weight adjustment.There was no difference of average weight-adjusted MoM levels between the Jiangsu population and the Caucasian, and the MultiCalc software was applicable to maternal serum screening for Down's syndrome of Jiangsu.

To study the diagnostic value of double-balloon endoscopy (DBE) for small intestinal diseases.155 patients clinically suspicious of small intestinal diseases were studied. 110 of them were male and 45 female. Their age ranged from 6 to 75 and with an average of 41 years. They consisted of 92 cases of small intestinal hemorrhage, 39 abdominal pain, 7 diarrhoea, 13 abdominal distention, 3 malnutrition and one diarrhoea as well as refractory hypoalbuminemia. In the procedure, the operator manipulated and advanced the endoscope and the assistant helped to advance the over tube.Among the 155 cases lesions were found in 125 cases, with positive results accounting for 80.6%. These lesions mainly consisted of small intestinal ulcer (including Crohn's disease), chronic inflammation, Meckel's diverticulum, interstizialoma, vascular deformity and carcinoma of small intestine. In 84 of the 92 patients suspicious of intestinal hemorrhage the lesions were confirmed with a positive rate of 91.3%. In 24 of the 39 patients with abdomen pain the etiologies were confirmed with a positive rate of 61.5%. In 16 of the 23 patients with diarrhoea, abdominal distention and malnutrition the positive rate was 69.6%. The cause of the only one case with refractory hypoalbuminemia was confirmed. Among the 155 cases, 9 had lesions located in stomach and duodenum, 115 in small intestine and one in large bowel, no lesion was found in 30 cases. Among the patients, 43 were found to have small intestinal ulcer. In the 43 patients, 12 patients were with single intestinal ulcer and 31 with multiple. For cases of Meckel's diverticulum, interstizialoma, carcinoma, vascular deformity and intestinal adhesion of small intestine in this series, diagnoses made by DBE combined with morphology were completely consistent with those found in operation. However, for ulcer lesions (mainly Crohn's disease), there was diversity in the diagnoses between the two methods, the coincidence was 57.1%. Two patients had complication, one perforation of small intestine and the other acute intestinal stasis.DBE is efficient and safe for the diagnosis of small intestinal diseases, especially in confirming the lesions. However, for ulcer of small intestine, this method even combined with biopsy is sometimes unable to determine its nature, so surgery may be beneficial in this condition.

Background Diseases of the small intestine include, among others, ulceration, chronic inflammation, Meckel's diverticula, vascular deformities, and cancer. Objective To study the diagnostic value of double balloon enteroscopy (DBE) for small-intestinal disease in a Chinese patient cohort. Design DBE was performed via the mouth, anus, or both approaches to diagnose small-intestinal disease. Patients We studied 155 patients with clinically suspected small-intestinal disease: 110 men and 45 women. Their age ranged from 6 to 75 (mean 41). There were 92 cases with small-intestinal hemorrhage, 39 with abdominal pain, 7 with diarrhea, 13 with abdominal distention, 3 cases with malnutrition, and 1 with diarrhea and refractory hypoalbuminemia. Results Among the 155 patients, lesions were found in 126 (81.3%). These lesions found were small-intestinal ulcers (including Crohn's disease), chronic inflammation, Meckel's diverticulae, vascular deformities, and carcinoma. Eighty-five of the 92 patients with suspected intestinal hemorrhage were confirmed, with a positive rate of 92.4%. Also confirmed were 24 of the 39 patients with abdominal pain (positive rate of 61.5%); 16 of the 23 patients with diarrhea, abdominal distention, or malnutrition (positive rate of 69.6%); and 1 patient with refractory hypoalbuminemia. Among the 126 patients with positive findings, the lesions were located in the small intestine in 116 patients, in the stomach and duodenum in 9 patients, and in the colon in 1 patient. In the 45 patients with small-intestinal ulcer, 29 patients had recurrent hemorrhage, 9 had abdominal pain, 4 had abdominal distention, 2 had malnutrition, and 1 had diarrhea. Ulcers were located in the jejunum in 20 patients, in the ileum in 20 patients, and in both the jejunum and ileum in 5 patients. For 7 patients with small-intestinal ulceration diagnosed as Crohn's disease, the concordance rate of diagnosis between preoperative and postoperative diagnosis was 57.1%, lower than other diseases (P Conclusion DBE is effective and safe for the diagnosis of small-intestine disease in a Chinese patient cohort.

To investigate the effects of p57(kip2), cyclinE protein and proliferating cell nuclear antigen (PCNA) on occurrence and progression of human pancreatic cancer.The expression of p57(kip2), cyclinE protein and PCNA in tumor tissues and adjacent tissues from 32 patients with pancreatic cancer was detected by SP immunohistochemical technique.The positive expression rate of p57(kip2) protein in tumor tissues was 46.9%, which was lower than that in adjacent pancreatic tissues (chi(2) = 5.317, P0.05). p57(kip2) protein positive expression remarkably correlated with tumor cell differentiation (P0.05), but not with lymph node metastasis (P0.05). The positive expression rate of cyclinE protein in tumor tissues was 68.8%, which was higher than that in adjacent pancreatic tissues (chi(2) = 4.063, P0.05). CyclinE protein positive expression significantly correlated with tumor cell differentiation and lymph node metastasis (P0.05). The positive expression rate of PCNA in the tumor tissues was 71.9%, which was higher than that in adjacent pancreatic tissues (chi(2) = 5.189, P0.05). PCNA positive expression remarkably correlated with tumor cell differentiation and lymph node metastasis (P0.05).The decreased expression of p57(kip2) and/or overexpression of cyclinE protein and PCNA may contribute to the occurrence and progression of pancreatic cancer. p57(kip2), cyclinE protein, and PCNA play an important role in occurrence and progression of pancreatic cancer.

To investigate the relation of transfer growth factor (TGF-beta1) and beta-glucuronidase (beta-GCD) on the occurrence and progress of pancreatic cancer.The expression of TGF-beta1 and beta-GCD in the pancreatic cancer tissue and normal pancreatic tissue was determined synchronously using ABC method of immunohistochemistry.The percentage of TGF-beta1 positive cells was significantly higher in pancreatic cancer tissue (43.8%+/-5.2%) than in adjacent pancreatic tissue (28.7%+/-3.6%, P0.01). The worse the cancer cells differentiated and lymph nodes metastasis, the more over-expression of TGF-beta1. The percentage of beta-GCD positive cells was also significantly higher in the pancreatic cancer tissue (62.5%+/-4.1%) than in the adjacent pancreatic tissue (33.5%+/-2.8%, P0.01). The degree of over-expression of beta-GCD was related to the degree of cancer cells differentiation, but not to the lymph nodes metastasis. The expression of TGF-beta1 was significantly correlated with the expression of beta-GCD in pancreatic cancer tissue.The genesis of pancreatic cancer results from multi-factor, multi-step and multi-gene variation. The synchronous detection of TGF-beta1 and beta-GCD helps to determine the malignant degree of tumors and the prognosis of patients with such disease.

To investigate the effect of inhibiting factor of cell cycle regulation p27(kip1), retinoblastinoma protein (Rb protein), and proliferating cell nuclear antigen (PCNA) on the genesis and progression of human pancreatic cancer.The expression of p27(kip1), Rb protein and PCNA in the tumor tissue and adjacent tissue of 32 patients with pancreatic cancer was detected by SP immunohistochemical technique.The p27(kip1) protein positive-expression rate in the tumor tissue of pancreatic cancer was 56.25%, which was lower than that in the adjacent pancreatic tissue (P0.05). p27(kip1) protein positive-expression was correlated significantly with tumor cell differentiation and lymph node metastasis (P0.05). The Rb gene protein positive-expression rate in the tumor tissue was 50%, which was also lower than that in the adjacent pancreatic tissue (P0.05). The PCNA positive-expression rate was 71.87%, which was higher than that in the adjacent pancreatic tissue (P0.05). PCNA positive-expression was also correlated significantly with tumor cell differentiation and lymph node metastasis (P0.05).The decreased expression of p27(kip1), Rb protein and over-expression of PCNA may play an important role in the genesis and progression of pancreatic cancer.

The abnormality of mammalian cell cycle regulation is an important cause of cell over-proliferation and oncogenesis. There were few reports about the relationship between p57(kip2) protein as negative factor of cell cycle regulation and pancreatic cancer. This article aims to investigate the effects of p57(kip2), cyclin E and proliferating cell nuclear antigen (PCNA) protein on the occurrence and progression of pancreatic cancer.Expression of p57(kip2), cyclin E, and PCNA in tumor tissue and adjacent tissue from 32 patients with pancreatic cancer were detected using SP immunohistochemical technique.The positive-expression rate of p57(kip2) protein in tumor tissue of pancreatic cancer was 46.9%, which was lower than that in adjacent pancreatic tissue (75.0%) (Chi(2)=5.317, P0.05); p57(kip2) protein positive-expression was remarkably correlated with tumor cell differentiation (P0.05), but was not correlated with lymph node metastasis (P0.05). The positive-expression rate of cyclin E in tumor tissues was 68.8%, which was higher than that in adjacent pancreatic tissue (43.8%) (Chi(2)=4.063,P0.05); Cyclin E positive-expression was remarkably correlated with tumor cell differentiation and lymph node metastasis (P0.05). The positive-expression rate of PCNA protein in tumor tissues was 71.9%, which was higher than that in adjacent pancreatic tissue (43.8%) (Chi(2)=5.189,P0.05); PCNA positive- expression was remarkably correlated with tumor cell differentiation and lymph node metastasis(P0.05).The decreased expression of p57(kip2) protein and over-expression of cyclin E and PCNA proteins may significantly related to genesis and progress of pancreatic cancer.

To increase the knowledge of STDs control and prevention among young couples by intervention, and to improve their reproductive health.The intervention plan was made and carried out on the basis of the information from baseline interview and Focus Group Discussions. The activities of the intervention included lectures given by experts, counseling service, delivering knowledge foldouts and knowledge competition. The final survey was conducted. The data of baseline and final survey were analyzed with SAS software.Before intervention, young couples knowledge of STDs was similar between the experimental and the control group. After intervention, proportion of knowing numbers of STDs kinds in experiment group significantly was higher than that in control group(P0.01); The proportion of knowing harm of STDs and knowing to use consom to prevent STDs couples were significantly higher in experiment group than that in control group(P0.01).The intervention activities including lectures and counseling services were positive and great sociological affects on family planning and reproductive health improvement for young couples which has one child.