Post-stroke shoulder-hand syndrome of phlegm-stasis obstruction treated with the combined therapy of eye acupuncture, Tengliao and rehabilitation training: a multi-central randomized controlled trial / 中国针灸

OBJECTIVE@#To assess the efficacy on relieving pain and improving the range of motion of shoulder joint in post-stroke shoulder-hand syndrome of phlegm-stasis obstruction in treatment of the combined therapy of eye acupuncture, Tengliao (Chinese herbal warm dressing technique) and rehabilitation training (eye acupuncture + Tengliao + rehabilitation) as compared with the combined treatment of Tengliao and rehabilitation training (Tengliao + rehabilitation) and the simple rehabilitation training (rehabilitation).@*METHODS@#A total of 356 patients with post-stroke shoulder-hand syndrome of phlegm-stasis obstruction were randomized into an eye acupuncture + Tengliao + rehabilitation group (group A, 122 cases, 2 cases dropped off), a Tengliao + rehabilitation group (group B, 120 cases, 3 cases dropped off) and a rehabilitation group (group C, 114 cases, 1 case dropped off). In the group C, the basic treatment was combined with routine rehabilitation training. In the group B, on the base of the treatment as the group C, Tengliao was exerted. A medical bag composed of over 20 Chinese herbal materials was heated and dressed at the affected area, 30 min each time, 5 times weekly. In the group A, besides the treatment as the group B, eye acupuncture was applied to heart region, kidney region, upper jiao region and lower jiao region, 30 min each time, 5 times weekly. The treatment lasted 28 days in all of three groups. Separately, before treatment, in 7, 14, 21 and 28 days of treatment, as well as in 14 days after treatment of follow-up, the score of visual analogue scale (VAS) for pain, the score of guides to evaluation of permanent impairment (GEPI) and the score of National Institutes of Health stroke scale (NIHSS) were observed in each group.@*RESULTS@#The scores of VAS, GEPI and NIHSS were all improved with the treatment lasting in the three groups (P<0.000 1). In 7, 14, 21 and 28 days of treatment and in follow-up as well, VAS scores in the group A were all lower than the group C (P<0.05). After 14 days of treatment, GEPI score showed increasing trend, while NIHSS score showed decreasing trend in the group A compared with the group B. Before treatment, GEPI score was lower and NIHSS score was higher in the group A compared with the group C (P<0.05). It was suggested that the illness was slightly serious in the group A. After propensity score matching, in 14, 21 and 28 days as well as in follow-up, GEPI scores in the group A were higher than the group C respectively (P<0.05). Regarding NIHSS score at each time point, the difference had no statistical significance between the group A and the group C (P>0.05).@*CONCLUSION@#The combined therapy of eye acupuncture, Tengliao and rehabilitation training obtains a better efficacy on post-stroke shoulder-hand syndrome of phlegm-stasis obstruction as compared with rehabilitation training.

16S rDNA-based molecular profiles of circulating bacteria in patients with severe acute pancreatitis / 肠外与肠内营养

Objective:This study aims to characterize the bacterial profile presenting in peripheral blood of severe acute pancreatitis (SAP) patients and investigate the potential role of circulating microorganisms in the development of systemic infection.Methods:A total of 30 patients with SAP were recruited in this study and divided into three groups:infected,sepsis and Septic shock (n =10 for each group).The peripheral blood was collected sterilely for extraction of DNA,which was subsequently amplified using the universe primers targeted the V6-V8 region of 16S ribosomal RNA genes.The amplicons were separated by denaturing gradient gel electrophoresis (DGGE),and then the gels were stained and photographed.The bands were cut out and sequenced to determine the closest bacterial relatives.Results:As shown in DGGE profile,multiple DNA bands (3 to 8 bands) were detected in peripheral blood from all (100％) of SAP patients complicated with septic shock.The microorganisms most frequently presenting in the blood of these cases included Escherichia coli,Bacillus coagulans,Pseudomonas putida,Pseudomonas aeruginosa,and Klebsiella pneumonia,with an incidence of 40 ％ or higher.In patients with sepsis,bacterial DNA consisting of 2 to 4 bands was observed in 90％ of the blood samples.The most common bacterial species was Pseudomonas putida (60％),followed by Shigella flexneri (40％),Staphylococcus aureus (30％) and Enterococcusfaecium (20％).By contrast,the positive rate of blood bacterial DNA was relatively lower in infected patients (70 ％).Of them,single bacterial species was commonly found in the blood samples.Conclusions:Our data showed that the bacterial profiles presenting in peripheral blood are distinct among SAP patients with different manifestations.Polymicrobial translocation could contribute to the development of systemic infection,offering novel insights into the pathogenesis of sepsis in SAE The findings are helpful for the prevention and treatment for bacterial infection and complications of SAP.

Assessment of left ventricular function in patients with aortic regurgitation using tow-dimensional speckle-tracking echocardiography / 中华医学超声杂志（电子版）

Objective Analyse the change of left ventricular (LV) longitudinal and radial strain in patients with aortic regurgitation (AR) and discuss the relationship between the 2D strain parameter and the filling and ejection of LV. Methods Thirty healthy controls and 45 patients with AR (24 patients with moderate AR and 21 with severe AR) were enrolled in this study, LV systolic global peak radial strain(GRS), systolic global peak longitudinal strain(GLS) and systolic peak longitudinal strain(S), systolic peak longitudinal strain rate(SRs), early diastolic peak longitudinal strain rate(SRe) of every segment were measured or calculated using 2D-STE, early and late diastolic transmitral flow velocity (E, A) were recorded by pulsed Doppler echocardiography and early diastolic mitral annular velocity (Ea) were assessed by tissue Doppler imaging,the E/A and E/Ea ratio were calculated. Discuss the relationship of GLS and LV ejection fraction (LVEF), GLS and E/Ea using the Pearson correlation analysis. Results The GLS were (-20.09±1.47)%, (-18.68±1.52)%, (-12.56±3.25)%and the GRS were (46.71±7.65)%, (43.01±5.95)%, (28.52±6.13)% in control group, patients with moderate and severe AR (MAR group and SAR group) respectively. There were significant differences among the groups (F =82.08,47.69, both P < 0.01) as following:SAR group with control group and MAR group [ q=17.56,13.60 (GLS), q=13.44, 10.20 (GRS), all P<0.01),MAR group and control group [ q=3.42 (GLS), P<0.01]. The SRs of the apical segment were (-1.24±0.22)s-1, (-1.19±0.25)s-1, (-1.04±0.28)s-1 in control group,MAR group and SAR group respectively. There were significant differences among the groups (F=4.47, P < 0.05) as following:SAR group with control group and MAR group ( q=4.02,3.28, both P<0.01). The S, SRe of apical segment and the S,SRs,SRe of basal and midventricular in MAR group were all lower than the control group ( q=4.42, 5.01, 3.48, 3.24, 4.78, 4.12, 3.61, 6.72, all P < 0.01). Pearson correlation analysis revealed the GLS had a relationship with LVEF and E/Ea ( r=-0.73, 0.64, both P<0.01). Conclusion The reduced longitudinal strain and strain rate could detect LV dysfunction in patients with AR in early stage and the GLS had the ability to reflect the diastolic filling and systolic ejecting of the LV.

Primitive research on the effect of FSH autoantibody on the spermatogenic capability of the rat testis / 中华男科学杂志

<p><b>OBJECTIVE</b>To establish rat models of FSH autoantibody and to investigate the effect of FSH autoantibody on the spermatogenic capability of rat testis.</p><p><b>METHODS</b>Thirsty 21-day old SD rats were randomly divided into an experimental and a control group of equal number. A specific polypeptide corresponding to the rat FSHbeta subunit was synthesized and coupled to (keyhole limpet hemocyanin) KLH. The rats in the experimental group were immunized with polypeptide-KLH and these in the control group with KLH. Further immunization was performed every 2 weeks for 7 times. On the 77th, 91st and 105th day of the immunization, 5 rats from the experimental group and another 5 from the control group were killed. Then the structures of the seminiferous tubule and epididymal sperm were observed by light and electron microscope, respectively. Meanwhile, the counts of sperms and the percentage of swelled sperm were calculated. And the level of serum testosterone was detected by enzyme-linked immunospecific assay (ELISA).</p><p><b>RESULTS</b>The titer of the anti-polypeptide antibody was 1:200 on the 49th day of the immunization, and reached 1:400 on the 63rd. Compared with the control group, the percentage of swelled sperm significantly decreased on the 91st day (60.4 +/- 6.23 vs 50.60 +/- 3.05, P < 0.05), and the number of spermatogenic cells and sperms in seminiferous tubules reduced on the 105th day in the experimental group, the counts of sperms (46.08 +/- 6.56 vs 32.53 +/- 3.41) and the percentage of swelled sperm (60.60 +/- 5.86 vs 48.60 +/- 3.85) significantly lower (P < 0.05), while the level of serum T significantly higher than that in the control group (P < 0.05).</p><p><b>CONCLUSION</b>FSH autoantibody might cause testis dyszoospermia.</p>

Combined monitoring of evoked potentials during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neurophysiologic monitoring during surgery is to prevent permanent neurological injury resulting from surgical manipulation. To improve the accuracy and sensitivity of intraoperative neuromonitoring, combined monitoring of transcranial electrical stimulation motor evoked potentials (TES-MEPs), somatosensory evoked potentials (SSEPs) and brainstem auditory evoked potentials (BAEPs) was attempted in microsurgery for lesions adjacent to the brainstem and intracranial aneurysms.</p><p><b>METHODS</b>Monitoring of combined TES-MEPs with SSEPs was attempted in 68 consecutive patients with lesions adjacent to the brainstem as well as intracranial aneurysms. Among them, 31 patients (31 operations, 28 of posterior cranial fossa tumors, 3 of posterior circulation aneurysms) were also subjected to monitoring of BAEPs. The correlation of monitoring results and clinical outcome was studied prospectively.</p><p><b>RESULTS</b>Combined monitoring of evoked potentials (EPs) was done in 64 (94.1%) of the 68 patients. MEPs monitoring was impossible for 4 patients (5.9%). No complication was observed during the combined monitoring in all the patients. In 45 (66.2%) of the 68 patients, EPs were stable, and they were neurologically intact. Motor dysfunction was detected by MEPs in 8 patients, SSEPs in 5, and BAEPs in 4, respectively.</p><p><b>CONCLUSIONS</b>A close relationship exists between postoperative motor function and the results of TES-MEPs monitoring. TES-MEPs are superior to SSEPs and BAEPs in detecting motor dysfunction, but combined EPs serve as a safe, effective and invasive method for intraoperative monitoring of the function of the motor nervous system. Monitoring of combined EPs during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms may detect potentially hazardous maneuvers and improve the safety of subsequent procedures.</p>

Study on the prevalence of depression and its risk factors among high school students in Nanjing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the prevalence of depression and its major risk factors among high school students in Nanjing, China.</p><p><b>METHODS</b>A population-based cross sectional study was conducted between October 2004 and December 2004. 168 classes from 56 schools were randomly selected in thirteen administrative districts/counties of Nanjing, China. Data from a total number of 7161 eligible students including 71.0% from junior high school and 29.0% from senior high school students with 49.4% boys and 50.6% girls. Among them 47.6% from urban and 52.4% from rural area. The response rate was 92.5%.</p><p><b>RESULTS</b>The overall prevalence of depression was 14.8% in this sample which was higher in boys (16.4%) than in girls (13.0%). There was no significant difference between junior and senior high school students (14.6% vs. 15.4%) or between age groups and urban rural residence. The identified major risk factors would include: lack of interest on learning, unmet academic achievements, lack of self-estimated capability of competence, too much burden on learning, lack of close friends, badving relation with friends/relatives, indifferent attitude towards friends/relatives, status of parents employment, and family structure.</p><p><b>CONCLUSION</b>The prevalence of depression was 14.8%, which was close to the figure in Asian-American high school students. More attention should be paid on the issue of mental health in high school students under the rapid transition of society, economy, life style and ideas in China.</p>