Effect of Fang's scalp acupuncture on perceived stress and sleep structure in insomnia patients: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the efficacy on insomnia between Fang 's scalp acupuncture combined with conventional acupuncture and the simple conventional acupuncture.@*METHODS@#A total of 66 patients with insomnia were randomly divided into an observation group (33 cases, 1 case dropped off) and a control group (33 cases, 2 cases dropped off). In the control group, the routine acupuncture therapy was applied to Shenmen (HT 7), Baihui (GV 20), Zhaohai (KI 6) and Sanyinjiao (SP 6), etc. Based on the treatment as the control group, Fang's scalp acupuncture therapy was supplemented at fuxiang tou, fuzang shangjiao, fuzang zhongjiao, siwei, etc. At these scalp points, the needles were inserted perpendicularly with flying needling technique and manipulated with trembling one. In either group, the treatment was given once daily, continuously for 2 weeks. Before and after treatment, separately, the score of Pittsburgh sleep quality index (PSQI) and the score of Chinese perceived stress scale (CPSS) were observed, as well as the parameters monitored by polysomnography, i.g. total sleep time (TST), sleep onset latency (SOL), wakefulness after the sleep onset (WASO), sleep efficiency (SE), the percentages of the time of rapid eye movement sleep phase (REM) and non-rapid eye movement sleep phase 1, 2, 3 and 4 in TST (REM%, N1%, N2%, N3%). The efficacy was compared between two groups.@*RESULTS@#After treatment, the scores of each factor and the total scores of PSQI, as well as CPSS scores were all lower than those before treatment in the two groups (P<0.01, P<0.05); except the score for sleep quality, the score of each factor and the total score of PSQI, as well as CPSS score in the observation group were lower than those in the control group (P<0.01, P<0.05). After treatment, TST, SE%, REM% and N3% were increased and SOL, WASO, N1% were decreased as compared with before treatment in the two groups (P<0.01, P<0.05), and N2% in the observation group was decreased (P<0.01); SE%, REM% and N3% in the observation group were higher than the control group (P<0.05) and N1% and N2% were lower than the control group (P<0.05). The total effective rate was 93.8% (30/32) in the observation group, higher than 87.1% (27/31) in the control group (P<0.05).@*CONCLUSION@#Fang 's scalp acupuncture, on the base of routine acupuncture, obviously improves the sleep quality and perceived stress and adjusts the sleep structure in the patients with insomnia.

Autologous hematopoietic stem cell transplantation and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes: long term follow-up / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It has been indicated that autologous hematopoietic stem cell transplantation (AHST) is a promising treatment to adults with type 1 diabetes, however, the application of AHST therapy to children with type 1 diabetes still needs more data. The aim of this study was to assess the clinical effect of immune intervention combined with AHST and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes.</p><p><b>METHODS</b>This 1:2 matched case-control study was comprised of 42 children who were newly diagnosed with type 1 diabetes in the Department of Endocrinology, Beijing Children's Hospital from 2009-2010. The case group included 14 patients, who were treated with AHST within the first 3 months after being diagnosed with diabetes at request of their parents during 2009-2010. The control group included 28 patients with newly diagnosed type 1 diabetes at the same period of hospitalization. We compared the baseline and follow-up data of them, including ketoacidosis onset, clinical variables (glycosylated hemoglobin (HbA1c), insulin dosage and serum C-peptide).</p><p><b>RESULTS</b>The clinical characteristics of the patients was comparable between the case group and the control group. At 6-12 months ((10.7±4.2) months) after AHST treatment, we found 11 patients in the case group did not stop the insulin therapy, three cases stopped insulin treatment for 2, 3 and 11 months, respectively. No diabetic ketoacidosis (DKA) occurred after transplantation in all the patients in the case group. HbA1c in the control group was significant lower than that in the case group (P < 0.01), while the insulin dosage and serum C-peptide were not significant different between the two groups (P > 0.05). In order to eliminate the honeymoon effect, we performed final follow-up at the 3-5 years ((4.2±1.8) years) after AHST treatment, and found that HbA1c in the control group was still lower than that in the case group (P < 0.01); however, the insulin dosage and serum C-peptide were not significantly different between the two groups (P > 0.05). Moreover, the insulin dosage was not significant different from baseline to follow-up period in the case group.</p><p><b>CONCLUSION</b>AHST treatment showed no advantage in effectiveness in children with newly diagnosed type 1 diabetes, both in insulin dose and long term blood glucose control.</p>

Construction of let-7a expression plasmid and its inhibitory effect on k-Ras protein in A549 lung cancer cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To elucidate the role of let-7a-mediated gene regulation in the pathogenesis of lung cancer.</p><p><b>METHODS</b>Two template DNA sequences were designed based on hsa-let-7a sequence in miRBase database. The let-7a expression construct and a control plasmid, namely pGenesil-let-7a and pGenesil-control, respectively, were generated by cloning the annealed oligonucleotides into pGenesil-1 and then transfected into A549 cells, which were selected by G418 to establish the lung cancer cell lines stably expressing let-7a-GFP and control-GFP. The living cells were counted by MTT assay and cell growth curves were drawn to analyze the cell proliferation. The k-Ras mRNA level was assessed by semi-quantitative RT-PCR, and the expression of k-Ras protein was determined by Western blotting and immunocytochemistry.</p><p><b>RESULTS</b>The recombinant vectors were verified by sequencing. The cell growth curves indicated that the proliferation of the cells transfected with pGenesil- let-7a were inhibited significantly compared with that of cells transfected with pGenesil-control and A549 cells. Semi- quantitative RT-PCR analysis showed that the levels of k-Ras mRNA almost remained unchanged in cells with or without the treatments. Western blotting and immunocytochemistry demonstrated a significant decrease of k-Ras protein levels in cells transfected with pGenesil-let-7a, but not in cells transfected with pGenesil-control, when compared to A549 cells.</p><p><b>CONCLUSION</b>let-7a over-expression represses the expression of k-Ras protein and significantly inhibits the growth of lung cancer cells.</p>

Determination of the serum mannose binding lectin levels in 738 Han ethnic group children / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution of serum mannose binding lectin (MBL) levels in Han ethnic group children.</p><p><b>METHODS</b>The concentrations of MBL in serum were measured by ELISA in 268 umbilical cord blood specimens from Chongqing, Wuhan and Urumqi as well as in serum of 470 normal children aged from 0 to 6 years and 87 adults in Chongqing.</p><p><b>RESULTS</b>The distribution of serum MBL levels in children (28 days to 6 years) was abnormal but there was no significant difference in MBL serum levels in subjects of different ages and genders. The median concentration of MBL in serum was significantly lower in newborns (median: 1597 microg/L, range: 884 - 1825 microg/L), cord blood group (median: 1462 microg/L, range: 0 - 4604 microg/L) than in other groups (children group median: 2536 microg/L, range 0 - 7860 microg/L; adult group median: 2920 microg/L, range 98 - 6495 microg/L). While among the other sub-groups aged from 28 days-6 years (28 day group median 2299 microg/L, range 214 - 4195 microg/L; 6 months-group median 2622 microg/L, range 5 - 4637 microg/L; 2 years-6 years group 2585 microg/L, range 198 - 7860 microg/L), there was no statistically significant difference. The median serum MBL level in normal children aged from 28 days to 6 years was 2563 microg/L and the P(2.5)-P(97.5) was 171 - 5079 microg/L.</p><p><b>CONCLUSIONS</b>The distribution of serum MBL levels in children (28 days to 6 years) was abnormal type but there was no statistically significant difference among different age and sex groups. The reference value of P(2.5)-P(97.5) in children (28 days-6 years) was 171 - 5079 microg/L.</p>

PET/CT-based classification of delayed radiation encephalopathy following radiotherapy for nasopharyngeal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate positron-emission tomography-computed tomography (PET/CT) findings of radiation encephalopathy (RE) following radiotherapy for nasopharyngeal carcinoma (NPC), observe the metabolic changes of the compromised brain tissues, and postulate the clinical classification of RE to provide reference for its diagnosis.</p><p><b>METHODS</b>This study included 53 pathologically confirmed NPC patients who received previous radical radiotherapy, and the diagnosis of RE was established according to the clinical manifestations and CT/PET findings. All the patients underwent PET/CT whole-body and head scans, and the image data were evaluated along with the clinical data of the patients.</p><p><b>RESULTS</b>RE most frequently involved the lateral or bilateral inferior temporal lobes. PET identified hypometabolic changes in the bilateral temporal lobes of 35 patients (70 lobes) and in the lateral temporal lobe of 18 patients (18 lobes). According to the PET/CT findings, the lesions were classified into 3 types, namely the oedema type (56 temporal lobes), liquefactive necrosis type (10 temporal lobes), and atrophic calcification type (22 temporal lobes). One patient with oedema type lesion received neurotrophic treatment and recovered completely with normal brain tissue density and metabolism, but the oedema type lesions in 2 patients progressed into to atrophic calcification type; the liquefactive necrotic lesions in another 2 patients also progressed into atrophic calcification type.</p><p><b>CONCLUSION</b>RE patients exhibit significant hypometabolic changes in the inferior temporal lobe on PET. According to the findings by PET/CT, RE can be classified into the oedema type, liquefactive necrosis type, and atrophic calcification type, and lesions of the former two types may progress into the third type.</p>

Comparison of Clinical Pathology in Children with Immunoglobulin A Nephropathy and Henoch - Schonlein Purpura Nephritis / 实用儿科临床杂志

Objective To explore the relationship of immunoglobulin A(IgA) nephropathy (IgAN) and Henoch - Schonlein purpura nephritis(HSPN) in children by making comparison in the aspects of clinical symptoms, laboratory tests and renal pathology. Methods Process the data of 69 cases of HSPN and 33 cases of IgAN respectively in clinical symptoms' frequency, indices of urinalysis and blood cell count, protein quantity in urine of 24 hours, serum level of immunoglobulins, C3 and C4, as well as renal pathologic results. Results In IgAN group, the incidence of male was higher than that of female, respiratory tract infections usually occur as prodrome. Macroscopic hematuria was the most prominent clinical feature, while rash, joint pain, abdominal symptoms seldom happened. Level of hemoglobin in IgAN group was decreased significantly. There were no significant differences in edema, hypertension, proteinuria degree, level of plasm albumin, level of serum IgA, IgG, IgM, IgE, C3 and C4, as well as the features of renal pathologic changes between IgAN and HSPN.Conclusions IgAN and HSPN have similar features in clinical symptoms,level of immunoglobulins and complements and renal pathology. But it is still under discussion whether they are different stages of the same disease.

Radiofrequency catheter ablation of septum originated tachycardia in children / 中华儿科杂志

<p><b>OBJECTIVE</b>The study was undertaken to analyze retrospectively the results of radiofrequency catheter ablation (RFCA) on septum originated tachycardia in children with arrhythmia. The 98 children were all treated with RFCA on septum originated tachycardia in which the ablation sites were located near the bundle of His.</p><p><b>METHODS</b>Fifty female and forty-eight male cases were included in this analysis. They were at the age of 8.1 +/- 2.3 years and their body weight was (28 +/- 9) kg. The arrhythmia they suffered from consisted of atrioventricular nodal reentry tachycardia (AVNRT) (n = 62), atrioventricular reentry tachycardia (AVRT) on septum (n = 25), atria Itachycardia on Koch areas (n = 3) and left ventricular tachycardia (ILVT) on the septum (n = 8). Swartz SRO long sheath was used on the right site ablation. Titration of capacity and degreed time of increase were used in the ablation.</p><p><b>RESULTS</b>Radiofrequency ablation was successful in all cases. Eleven cases had relapse after the procedure. They accepted RFCA again and then the treatment succeeded. One case of AVRT at the posterior septum experienced complete atrioventricular block (AVB) during ablation. Two weeks later this case was implanted with permanent pacemaker.</p><p><b>CONCLUSIONS</b>The septal site is narrow and small in children. Atrioventricular node is tender. If the above facts were neglected, it was very likely to cause AVB, especially in children accepting the procedures of electrophysiologic study an RFCA on the septal site. Attention should be paid to the followings during such procedures: ablation in the sinus rhythm; ablation following the principle, titration of capacity and degreed time of increase; ablation at the right site long sheath; thermo-ablation catheter application and ablation on the two sides of septum in the posterior septum ablation procedure. The end-point of ablation in children should be the elimination of tachycardia and the delta wave, disassociation of VA or passing through bundle of His at pacing in the ventricle, disappearance of jumping conduction or no echo or one echo but without AVNRT after infusion of isoprenaline and stimulation procedure. Avoiding bundle of His injury is important during the procedure of ablation in children.</p>

Myocardial injury in the long-term follow-up after catheter radiofrequency ablation in children / 中国介入心脏病学杂志

AVNRT, (3)There was no evidence of new arrhythmia occurring for the late electrophysiologic sequelae of RFCA lesions. Conclusion The technique of RFCA is safe, it causes significant minor myocardial injury and takes 3 months to develop from initially resembling coagulation necrosis to fibrosis. There is no evidence of new arrhythmia occurring for late electrophysiologic sequelae of RFC lesions.

Treatment of perimenbranous ventricular septal defect-transcatheter occlution vs surgery / 中国介入心脏病学杂志

Objective To evaluate the therapeutic effect of transcatheter closure of perimenbranous ventricular septal defect (PMVSD) with membranous VSD occluder device and compare the effect of transcatheter closure of VSD with surgery. Methods The therapeutic effect of transcatheter occlusion in 48 children with VSD is compared with that of other 73 cases who had received surgical treatment. Age, height, weight, pulmmary artery pressure, size of the defect, time for hospitalization, success rate as well as complications after operations are compared between the 2 groups. All the data are proccessed either by means of t test or ? 2 test statistically. Results There are no statistical differences between the two groups in age, height, weight, pulmonary systolic pressure and the rate of success. But the size of VSD is smaller and the time for operation and hospitalization is shorter in the group of transcatheter occlusion. There are no significant differences between the two groups in the rate of complications including the second surgery, residual shunt, bleeding, nerve injury, hemolysis, Ⅲ atrioventricular block, pneumothorax, hydrothorax, hydropericardium, aortic valve insufficiency and infection. But left anterior bundle branch block and complete left bundle branch block occur more often in the group of the catheter interventions during or after the occlusion. Conclusion Transcatheter occlusion shows a promising therapeutic effect on VSD. To prevent complications, therapeutic rules and technical criterias should be obeyed and close monitoring after the closure should be carried out.

Transcatheter closure of congenital vascular malformations with cook coils and aGA amplatzer duct occluder in children / 中国介入心脏病学杂志

Objective To explore the method and therapeutic principle of transcatheter closure of coronary artery fistula, aortopulmonary collaterals and aortopulmonary window. Methods Interventional occlusion of 4 cases of coronary artery fistulas and 1 case of aortopulmonary collaterals with Cook coils, 1 case of coronary artery fistulas and 1 case of aortopulmonary window with AGA Amplatzer duct occluder. The mean age of 7 children were 8.5 years. Results Transcatheter closure of 7 cases of vascular malformations were successful. During the follow-up period of 1 month to 5 years, no residual shunt and other complications appeared. Conclusion The curative effect of transcatheter closure of vascular malformations was good. But for the occlusions′ success and prevention from complications occurrence, the indications of closure should be obeyed, the time of X-ray exposure should be less than 60 minutes.