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Spinal dural arteriovenous fistula (SDAVF) is difficult to make early diagnosis for non-specific clinical manifestations and imaging features. A patient of SDAVF with lower limb paraplegia exacerbation after intravenous methylprednisolone was reported. The patient was mainly characterized by low back pain and numbness of bilateral lower limbs. He was misdiagnosed as lumbar disc herniation and acute myelitis. After intravenous methylprednisolone 1 000 mg for more than 10 hours, the patient's lower limb weakness aggravated significantly than before. Later spinal angiogram confirmed SDAVF. The author summarized the clinical and imaging characteristics of SDAVF,and analyzed the diagnosis and treatment of the disease with literature review.
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Objective@#To explore the relationships among social support, depression, anxiety and suicide ideation among middle school students in rural areas of south Sichuan Province so as to provide a scientific basis for promoting middle school students’ mental health and reducing suicide ideation.@*Methods@#A sum of 2 217 students of grade 7 and 10 from 2 township middle schools in mountainous areas of Zizhong County, Sichuan Province, were investigated by means of typical sampling and cluster random sampling. Social Support Rating Scale (SSRS), Self-rating Scale for Depression (SDS), Self-rating Anxiety Scale (SAS) and Self-compiled adolescent health questionnaire were used to measure suicidal ideation, and structural equation model was used for statistical analysis.@*Results@#The depression score of middle school students was (13.51±12.57), and the self-rating scale for Depression score of girls was (14.61±12.67), higher than that of boys (12.24±12.34). The SSRS score of Social Support Rating Scale of junior high school students was (35.49±5.88), which was higher than that of senior high school students (34.70±5.43), and the differences were of statistical significance(t=4.46, 2.67, P<0.05). The results of structural equation model showed that depression and anxiety directly affected suicidal ideation, and the standardized effects were respectively 0.11 (95%CI=0.06-0.16) and 0.09(95%CI=0.05-0.14). Depression and anxiety were the intermediate variables in the relationship between social support and suicidal ideation, and the mediating effects were respectively -0.46(95%CI=-0.51--0.41) and -0.21(95%CI=-0.27--0.16). Studying period could play a mediating role in the indirect effect made by social support on suicide ideation through anxiety.@*Conclusion@#Anxiety and depression have significant mediating effect on the relationship between social support and suicidal ideation among middle school students in rural areas of south Sichuan province. Anxiety and depression intervention are important measures to reduce suicide ideation among low social supporters.
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OBJECTIVE@#To explore the curative effect and origin of antrochoanal polyp (ACP) with various approaches.@*METHOD@#Fifty-seven patients with ACP were included in the study. All the ACP patients were examined by preoperative endoscopy and computer tomographic (CT) scans. The patients were treated by various endoscopic approaches including endoscopic middle meatus antrostomy, inferior meatus antrostomy combined with endoscopic middle meatus antrostomy or endoscopic medial maxillectomy combined with endoscopic middle meatus antrostomy respectively. The relationship between polyp location in middle meatus and lesions in the antrum was explored during the surgery. Pathological examination was carried out and patients were regularly followed up after operation.@*RESULT@#Fifty-seven ACP develops from antral cyst. In 22 cases of endoscopic middle meatus antrostomy, two patients relapsed. In 17 cases of inferior meatus antrostomy combined with endoscopic middle meatus antrostomy, one patients relapsed. In 18 cases of endoscopic medial maxillectomy combined with endoscopic middle meatus antrostomy, no one relapsed.@*CONCLUSION@#Our data indicated that the ACP mainly originates in antral cyst, and capsule wall herniates to middle meatus through the antral ostium. ACP are common in unilateral, rare in both sides. The endoscopic approaches of middle meatus antrostomy and inferior meatus antrostomy combined with endoscopic middle meatus antrostomy might guarantee good prognosis. If the cyst is on the anterior wall of maxillary sinus, the approach of endoscopic medial maxillectomy can obtain a better vision and completely remove the lesions.
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Humans , Cysts , General Surgery , Endoscopy , Maxillary Sinus , General Surgery , Nasal Polyps , General Surgery , Nasal Surgical Procedures , Methods , Tomography, X-Ray ComputedABSTRACT
Objective To analyze the data of Human Immunodeficiency Virus (HIV ) screening in Qinnan District of Qinzhou from 2013 to 2015 ,and to provide scientific evidences for the prevention and control of Acquired Immune Deficiency Syndrome (AIDS) .Methods HIV antibody data which was collected from the AIDS laboratory between 2013 and 2015 in Qinnan District of Qinzhou were analyzed .Results Of 3 955 cases of the HIV antibody detecting in the AIDS laboratory from 2013 to 2015 ,200 cases were HIV antibody positive ,and the positive rate was 5 .06% which was decreased compared with previously .The HIV antibody positive rate of man was 9 .26% ,which was higher than women .Among the HIV positive people ,the rate of the ages older than 50 was 25 .36% which was the highest compared to the other age groups .The positive rate of farmers was 30 .83% and the rate of di‐vorced or widowed was 30 .86% and the rate of the illiterate was 16 .08% .Conclusion Man ,farmers ,the age older than 50 years old ,the divorced or widowed and the low degree of education groups are the focus groups of health education and prevention of AIDS .If we can find HIV infectors earlier ,we can control the epidemic of AIDS and formulate the prevention and control strategies better .
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Objective: To categorize and summarize the clinical and mechanism studies of the past 30 years on the treatment of Hashimoto’s thyroiditis (HT) with moxibustion, moxibustion plus medication, and acupuncture plus medication, etc., and to analyze the current problems. Methods: The clinical and laboratory studies related to the treatment of HT with acupuncture-moxibustion therapies published before June 2015 were retrieved from MEDLINE, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP). Results:Moxibustion, moxibustion plus medication, and acupuncture plus medication can produce certain therapeutic effects in treating HT. Conclusion:The research on the treatment of HT with acupuncture-moxibustion therapies is rather limited in the amount and content. In the future, standardization should be fortified, specific moxibustion research needs deepening, and the action mechanism of moxibustion should be emphasized.
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BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on aleviating chronic visceral pain in irritable bowel syndrome patients. OBJECTIVE: To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion. METHODS: With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization. RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fuly understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controled trials employing advanced scientific techniques and equipments wil stil be needed in the future.
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BACKGROUND:With the development of science and technology and improvement in living quality, telemedicine has played an important role in daily life, in particular in disease diagnosis and treatment as wel as rescue process for elderly people. OBJECTIVE: Based on Web of Science and ClinicalTrials.gov databases, to analyze the international telemedicine and elderly disease development so as to provide referential basis for the related study in China. METHODS: An online retrieval of Web of Science and ClinicalTrials.gov databases was performed with the key words “telemedicine” and “geriatric diseases” for papers regarding telemedicine for geriatric diseases published from 2003 to 2013. RESULTS AND CONCLUSION: (1) 239 papers regarding telemedicine for geriatric diseases were retrieved in Web of Science from 2003 to 2013. As per distribution by country for publications, USA published the highest number of papers (n=93, 38.912%). As per distribution by institute for publications (2003-2013), University of Washington was most prolific, folowed by Columbia University, The University of Queensland and The University of Western Australia (Australia). Among the included journals,Journal of Telemedicine and Telecare published the greatest number of papers (n=20, 8.368%). The number of included papers gradualy increased over the 10-year study period. Among these 239 papers, only 4 of them were from China, indicating that Chinese scholars paid relatively little attention in this research field, and the number and quality of Chinese papers on telemedicine for geriatric diseases need to be improved. (2) 18 studies regarding telemedicine for geriatric diseases were registered in ClinicalTrials.gov database from 2003 to 2013. Interventional studies (n=15) accounted for the largest proportion, folowed by observational studies.
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Objective To investigate the therapeutic effect and the detailed mechanisms of intraarterially delivery of bone marrow mesenchymal stem cells ( BMSCs) for treatment of middle cerebral artery occlusion (MCAO) in rats.Methods BMSCs were isolated,purified and amplified with the adherence culture method.BMSCs were labeled with 5-bromo-2-deoxyuridine ( BrdU ) (10 μmol/L) for 48 h before transplation.Surface antigens of CD90,CD29,CD106,CD34,CD45,CD11b were identified by flow cytometry.The MCAO model was established with suture emboli method.In this study,3×106 BMSCs were injected into rats with MCAO through intraarterial route at day 7 after stroke.The effects on functional and physical recovery were assessed with the behavioral tests (mNSS test and adhesive test) and body weight.Bielshowsky-Luxol Fast Blue double staining was used to demonstrate the reconstruction of axon and myelin.The Brdu-labeled BMSCs in vitro and in vivo were detected with direct immunofluorescent staining.The expression of neuron specific enolase ( NSE),neurite outgrowth inhibitor-A ( Nogo-A),synaptophysin (SYN),ki-67 nuclear antigen (Ki-67),glial fibrillary acid protein( GFAP),vascular endothelial growth factor ( VEGF) in brain were analyzed with immunohistochemical staining.Results Flow cytometry indicated that the positive rates of high expression of CD90,CD29,CD106 in BMSCs were respectively 91.70%,88.40% and 52.20%.Meanwhile,the positive rates of low expression of CD34,CD45,CD11b in BMSCs were 2.70%,5.65% and 7.82%,respectively.There was a significant difference in behavioral tests ( mNSS test and adhesive test) between BMSCs group and PBS group at day 21,28,35 after MCAO (mNSS:4.89 ±1.36,7.00 ±1.67,3.78 ±1.30 and 6.33 ±1.21,2.44 ±1.13,5.67 ± 1.51;t =2.69,3.83,4.75;adhesive test:54.00 ± 10.48,68.17 ± 11.09,36.89 ±9.80 and 59.33 ± 12.40,23.44 ± 9.04,46.50 ±9.38;t =2.51,3.92,4.77;P <0.05).Meanwhile,a significant difference in body weight was discovered between them at day 28,35 after MCAO.In BMSCs group,the area of corpus callosum in the ipsilateral hemisphere was significantly enlarged,the positive number of Brdu,SYN,Ki-67,GFAP,VEGF in brain was significantly increased,the expression of Nogo-A in brain was significantly decreased,nevertheless,the number of NSE-positive cells in brain and the infarct volume were not significant different from PBS group at day 35 after MCAO.Conclusions These results suggest that intra-arterial transplantation of BMSCs is an efficient treatment protocol for stroke.Treatment with BMSCs increases endogenous cells proliferation,angiogenesis,synaptogenesis,enhances axonal regeneration and the protective function of astrocytes,all of which may contribute to neurological functional recovery.
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Objective To investigate the correlation between the glial fibrillary acidic protein(GFAP),neuron-specific enolase(NSE),synaptoghysin (SYN),neurite outgrowth inhibitor-A(Nogo-A)expression and neurological outcome in tissue surrounding the infarct during the recovery after cerebral ischemia-reperfusion injury in rats.Methods A 2-hour middle cerebral artery occlusion(MCAO)and reperfusion model in rats was induced by the intraluminal suture method.The modified neurological severity score(mNSS)was performed at day 28,35,42,and 49.Immunohistochemistry was used to detect the expressions of GFAP,NSE,SYN,and Noga-A in tissue surrounding the infarct.Results The mNSS score decreased gradually over time after cerdnal ischemia-reperfusion injury in rats.Except day 35(5.11±0.737)vs.day 42 (4.54±0.519),and day 42 vs.day 49(4.29±0.488),there were significant differences at all other time points(all P<0.05).The numbers of GFAP positive cells deergased gradually form day 28 to day 49,in which,the numbers of GFAP positive cells at day 42(51.00±13.59)vs.day 49(44.38±11.94) were significantly less than those at day 28(69.00±15.10)(P<0.05).There were no significant differences in the numbers of NSE positive cells at all time points,but their integrated optical density(IOD)increased gradually.There were significant differences between day 28(6 218.57±1 864.25)and day 42(9 414.00±2 491.12) or day 49(12 522.50±3 106.99),and between day 35(7 343.40±1 533.35)and day 49(all P< 0.05).There were no significant differences at all other time points.The SYN express (IOD)increased gradually.and it was significantly lower at day 49(66 503.00±12 834.61)than that at day 28(43 905.14±13 208.59)(P<0.05).The numbers of Nogo-A positive cells decreased gradually,and they were significantly less at day 49(42.13±14.45) than those at day 28(59.57±15.25)(P<0.05).The GFAP expression was positively correlated with the mNSS scores(r=0.993,P=0.007).The NSE(r=-0.954,P=0.044)and SYN(r=-0.992,P=0.008) expression was negatively correlated with the mNSS scores.Conclusion The neurological outcome was associated with the downregulation of GFAP expression and the upregalation of NSE and SYN expression during the recovery after cerebral ischemia-reperfusion injury in rats.
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Objective: To observe the effects of electroacupuncutre at Tianzhu point on the expressions of bcl-2 and bcl-XL in the degenerative cervical intervertebral disc of rats. Methods: Forty SD male rats were randomly divided into 4 groups, sham surgery group, model group, Western medicine group and electroacupuncture group, there were 10 rats in each group. Except for rats in the sham surgery group, rats in the other groups were made to be of cervical intervertebral disc degeneration by unbalanced dynamic and static forces. Rats in the electroacupunture group were treated with electroacupuncture at Tianzhu (BL 10) and Dazhu (BL 11) points, while rats in the Western medicine group with Fenbid, and rats in the model group were not treated. After 30-day treatments, the expressions of bcl-2 and bci-XL were observed with immunohisto-chemical method in the cervical intervertebral disc. Results: The expression of bcl-2 was higher in the electroacupuncture, sham surgery, and western medicine groups than that in the model group (P<0.01), whereas, there was no difference among these three groups. The expression of bcl-XL in the electroacupuncture group was lower than that in the sham surgery group (P<0.01), and higher than those in the Western medicine group and model group (P<0.01). Conclusion: Electroacupuncture treatment can enhance the expressions of bcl-2 and bcl-XL, which may be the mechanism of delaying the cell apoptosis in the intervertebral disc to treat diseases.
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To observe the effect of electro-acupuncture on matrix metalloproteinase in degenerated cervical intervertebral disc rats.Methods:The rat model of cervical intervertebral disc degeneration was induced by unbalanced dynamic and static forces,then the rats were randomly allocated to model group,electro-acupuncture groupⅠ(acupoints Dazhu(BL 11) and Tianzhu(BL 10) were electro-acupunctured),and electro-acupuncture group Ⅱ(acupoints Dazhu (BL 11),Tianzhu(BL 10)and Shenshu(BL 23) were electro-acupunctured),with the normal rats as control.then the HE staining method was adopted to observe the morphological change of cervical intervertebral disc and the immunohistochemical staining method was used to detect the marx metalloproteinases-1(MMP-1) and matrix metalloproteinases-3(MMP-3) in cervical intervertebral disc.Results:The morphological observation showed that after electro-acupuncture treatment,the degrees of cervical intervertebral disc degeneration in electro-acupuncture groupⅠand electro-acupuncture group Ⅱ were alleviated,and the electro-acupuncture group Ⅱ was superior to electro-acupuncture group Ⅰ.The expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were increased(P<0.01),and after electro-acupuncture treatment,the expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were decreased,especially the electro-acupuncture group Ⅱpresented the better effect as compared with electro-acupuncture group Ⅰ(P<0.05).Conclusions:Electro-acupuncture at acupoints Dazhu (BL 11) and Tianzhu (BL 10) had a certain therapeutic effect on cervical intervertebral disc degeneration,and in combination with acupoint Shenshu(BL 23),this therapeutic effect could be enhanced,its action mechanism might be that electro-acupuncture can reduce the expressions of MMP-l and MMP-3 in degenerated cervical intervertebral disc,inhibit the degradation of matrix in intervertebral disc.so as to relieve cervical intervertebral disc degeneration.
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Different from the traditional teaching method, PBL (Problem-Based Learning) teaching mode is emphasized to foster the students' skills in spontaneous study and problem solving and the analyzing and comprehensive thinking ability. The authors believe that in the application of the PBL teaching method, the teachers' functions should be stressed on how to select the initial moment, provide the topics, excite the interesting points, search information,make comments and evaluate the students' ability, i.e. to offer fish and teach how to catch fish as well.
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Objective To observe the therapeutic effects and action mechanism of moxibustion in the treatment of intestinal fibrosis in ulcerative colitis. Methods Tianshu (ST 25) and Qihai ( CV 6) were the main acupoint; other points were used according to syndrome differentiation. Sixty-five patients were randomized into two groups: Group A in which 32 cases were treated by herbpartitioned moxibustion and group B in which 33 cases were treated by bran-partitioned moxibustion. The therapeutic effects and TGF-β1, Ⅰ and Ⅲ collagen expressions were measured before and after treatment. Results In group A, 17 cases were cured, 12 cases improved and 3 failed; in group B, 1 1 cases were cured, 16 cases improved and 6 cases failed. Ⅰ , Ⅲ collagen expressions were obviously inhibited in the two groups, in group A in particular. Conclusion In the prevention and treatment of intestinal fibrosis, moxibustion may reduce the expression of TGF-β1, and hence to block or inhibit the synthesis of Ⅰ、Ⅲ collagens, and improve the structure and function.
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Objective To test and analyse the characteristics of double three field iono chamber developed by ourselves. Methods We tested the time characteristic, dose rate characteristic and X ray quality characteristic by using direct test method, and current characteristic, voltage characteristic and thickness characteristic of double three field iono chamber by using photograph test method with NERO 6000B test meter, RF 500 mA X ray equipment and so on. The results were analysed. Results The time characteristic and dose rate characteristic had satisfied linear scales(the return coefficients of linety scales were R =0.999 61 and R = 0.998 88 respectively). The X ray quality characteristic was steady (the maximum output variation was ? max ≤?5%). The good characteristics of current, voltage and thickness were found(the maximum variations of film density were ?D max ≤?0.01, ?D max ≤?0.15 and ?D max ≤?0.06 respectively). The excellent repeat was showed (repeating error of exposure time and dose were ?T max ≤?0.004 s and ?X max ≤0.01?10 -5 C/kg). Conclusion The performace of the new Iono chamber is excellent and steady, so it has practical value.
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Objective To design an automatic exposure control circuit for X ray equipment to improve the performance of equipment and the quality of film. Methods The device acted in series control. During exposuring process,the X ray reaching the film through patient body was measured by ray sensor. After it was treated with integration, amplification and contrast management,the signal of X ray quantity drived the device to cut off exposure circuit, so that the exposure time was automatic any controlled. Results The effect of the device has been proved by its application in several hospitals. Conclusion The device is simple and effective and has practical value.
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Objective To design a new X-ray sensor of iono-chamber type to achieve automatic exposure control(AEC) of the X-ray machine. Methods We designed the chamber acording to the ionization theory and the requirements of automatic exposure control. Results (1) The device had double-negative poles, so the distance between positive and negative poles was 1/2 shorter and its test-volume was equal to odd-negative pole. (2)It had good property of electromagnetism-resistance because of the double shielded design by double-negative poles and screen-rings.(3) Iono-chamber was made of low-density material, so it had low absorb-ratio of X-ray and could not form image on film. Conclusion The property of the device was steady and reliable. It had applying and spreading value.