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Clinical expertise, patient preference, and the best evidence are the three elements of evidence-based medicine. Based on high-level and high-quality evidence, qualitative and quantitative analysis of the prescribing decisions of physicians is beneficial to improving clinical efficacy. A mature methodological system is available for the retrieval, analysis, summary, evaluation, and recommendation of the evidence, but there are still few studies on physicians' prescribing decisions. How to analyze the trend of physicians' prescribing decisions based on the priority ranking in addition and subtraction of prescriptions? Analytic hierarchy process(AHP) is a method for decision making, which arranges the elements of the decision problem into overall goal, criteria, and operational sub-criteria, and uses the matrix eigenvector method to solve the problem. This study aims to analyze the priority of physicians' prescribing decisions for diabetes mellitus with deficiency of both Qi and Yin based on AHP. To be specific, a database of diabetes mellitus cases with deficiency of both Qi and Yin was established and AHP was used to yield the priority ranking of Chinese patent medicine prescriptions in specific clinical scenarios. In the selected cases of diabetes mellitus with deficiency of both Qi and Yin, Xiaoke Pills was the best prescription for the treatment of type 2 diabetes mellitus(deficiency of both Qi and Yin)(normalized=0.388), followed by Liuwei Dihuang Pills(normalized=0.269), Qishen Capsules(normalized=0.230), and Shengmai Injection(normalized=0.113). According to the analysis the available data, for type 2 diabetes mellitus(deficiency of both Qi and Yin), Xiaoke Pills was the most effective prescription in specific scenarios. When the physicians' prescribing decisions are consistent with the evidence, quantitative analysis of physicians' cognition will boost the evidence-based medical decision-making. However, the research results are also affected by the quality of literature, evidence level and priority, which are thus have some limitations. It is recommended that further small data research based on individual cases be carried out to lay a evidence-based basis for the clinical decision-making of type 2 diabetes mellitus.
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Humans , Analytic Hierarchy Process , China , Diabetes Mellitus, Type 2/drug therapy , Drug Prescriptions , Medicine, Chinese Traditional , Nonprescription Drugs/therapeutic use , Qi , Syndrome , Yin Deficiency/drug therapyABSTRACT
The paper explains academician
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Humans , Acupuncture , Acupuncture Points , Acupuncture Therapy , Antihypertensive Agents , Hypertension/therapyABSTRACT
BACKGROUND@#Deep brain stimulation (DBS) has seizure-suppressing effects but the molecular mechanisms underlying its therapeutic action remain unclear. This study aimed to systematically elucidate the mechanisms underlying DBS-induced seizure suppression at a molecular level.@*METHODS@#We established a macaque model of mesial temporal lobe epilepsy (mTLE), and continuous high-frequency hippocampus DBS (hip-DBS) was applied for 3 months. The effects of hip-DBS on hippocampus gene expression were examined using high-throughput microarray analysis followed by bioinformatics analysis. Moreover, the microarray results were validated using quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analyses.@*RESULTS@#The results showed that chronic hip-DBS modulated the hippocampal gene expression. We identified 4119 differentially expressed genes and assigned these genes to 16 model profiles. Series test of cluster analysis showed that profiles 5, 3, and 2 were the predominant expression profiles. Moreover, profile 5 was mainly involved in focal adhesion and extracellular matrix-receptor interaction pathway. Nine dysregulated genes (Arhgap5, Col1a2, Itgb1, Pik3r1, Lama4, Fn1, Col3a1, Itga9, and Shc4) and three genes (Col1a2, Itgb1, and Flna) in these two pathways were further validated by qRT-PCR and Western blot analyses, respectively, which showed a concordance.@*CONCLUSION@#Our findings suggest that hip-DBS could markedly reverse mTLE-induced abnormal gene expression. Findings from this study establish the basis for further investigation of the underlying regulatory mechanisms of DBS for mTLE.
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Animals , Humans , Deep Brain Stimulation , Epilepsy, Temporal Lobe/therapy , Hippocampus , Macaca , SeizuresABSTRACT
BACKGROUND@#Lung cancer is one of the leading causes of cancer-related morbidity and mortality. Oncolytic virotherapy is an emerging therapeutic modality that utilizes replication-competent viruses to destroy cancers. As a powerful tool to kill tumor cells with excellent safety profile, attenuated measles virus of the Edmonston strain (MV-Edm) has been widely applied in the development of tumor therapy and preclinical trials. The aim of this study was to investigate the synergistic effect of nuclear factor kappa B (NF-κB) signaling pathway inhibitor and oncolytic measles virus vaccine against lung cancer and the involved mechanisms.@*METHODS@#Using Western blot to detect MV-Edm infection of A549 and H1299 were infected by MV-Edm alone or used the NF-κB pathway inhibitor PS1145/cell autophagy related siRNA, expression level of p-IκBα, IκBα, PARP and BAX were determined by western blot. Using flow cytometry to analysis the rate of apoptosis, and using MTT [3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide] method to detect the cell survival rate.@*RESULTS@#Inhibition of cell autophagy could obviously inhibit the MV-Edm infection induced the NF-κB pathway activation in A549 and H1299. In MV-Edm infected A549 and H1299, p-IκBα level increased and IκBα level decreased over infection time, compared with control group. Inhibition of the NF-κB pathway by PS1145 could promote the apoptosis of MV-Edm infected A549 and H1299 and amplify the tumor killing effect.@*CONCLUSIONS@#The combination of NF-κB signaling pathway inhibitor pS1145 and oncolytic measles virus vaccine strains can promote the apoptosis of human lung cancer cells A549 and H1299 and enhance their oncolytic effect.
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Objective@#To analyze the characteristics of levels related to the risk through self-evaluation system, among MSM users in Guangzhou, between 2015 and 2017.@*Methods@#Between 2015 and 2017, data was collected from the users of a self-evaluation system network related to HIV infection, based on the previous 'HIV health risk appraisal model’. Information on risk factors was collected to calculate the scores and levels of risks and to estimate the incidence of HIV. Taking the reference of R value on risks as (R=0.9-1.1) in general population. The ones with very low risk, with low risk, moderate risk, high risk and very high risk were set as R≤0.5, 0.5<R≤0.9, 0.9<R≤1.1, 1.1< R≤2.0 and R>2.0, respectively. The scores of modifiable risk factors were compared with different subgroups of MSM.@*Results@#A total of 4 601 MSM were involved in this study, with the following features presented as: aged 16-64 (28.38±7.11) years, proportions of residence from Guangzhou, Guangdong province or other provinces as 38.6%(1 776/4 601)、35.4%(1 629/4 601) and 26.0%(1 197/4 601), 59.6%(2 742/4 601) received bachelor or above degrees. 81.3%(3 741/4 601) of them claimed as having homosexual orientation. R values of risk level on very low risk, low risk level, moderate risk, high risk and very high risk appeared as 12.9%(594/4 601), 50.9%(2 342/4 601), 17.0%(783/4 601), 14.8%(682/4 601) and 4.3%(200/4 601), respectively. Scores of modifiable risk factors decreased year by year (P<0.05), among MSM in this study. In either of the groups that experiencing insertive or receptive sex, the ones with heterosexual orientation presented the highest scores of modifiable risk factors (P<0.05).@*Conclusions@#The risk levels on HIV infections called for special attention among the users of the self-evaluation network system. Among the MSM that carrying either insertive or receptive sex role, the ones with heterosexual orientation had the highest risk levels and scores of modifiable risk factors in Guangzhou. Further study should be explored to better understand the causes of related risks.
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<p><b>OBJECTIVE</b>The aim of this study was to evaluate the impact of the revised Chinese National Standard GB26878-2011 'Iodine Content in Edible Salt' on the iodine status among the Chinese population.</p><p><b>METHODS</b>In 2011 and 2014, the probability proportionate to size sampling (PPS) was used in each Chinese province to obtain the representative data. In each sampling unit, school children aged 8-10 years and pregnant women were selected. Key indicators included urinary iodine concentration (UIC), thyroid volume (TV), and the iodine content in edible household salt.</p><p><b>RESULTS</b>The median urinary iodine concentration (MUIC) decreased between 2011 and 2014 from 238.6 to 197.9 µg/L in school-age children. The number of provinces with iodine excess decreased to zero. The proportion of children whose UIC was > 300 µg/L was 18.8% and decreased to 11% compared with 29.8% in 2011. There was no significant difference in UIC < 50 µg/L between 2014 (4.3%) and 2011 (3.7%) (P > 0.05). The MUIC among pregnant women in 2014 was more concentrated between 110 and 230 µg/L. The goiter rate among children aged 8-10 years was unchanged, both the goiter rate of 2011 and 2014 remaining below 5%, in view of the sustainable elimination of iodine deficiency disorders.</p><p><b>CONCLUSION</b>The National Standard GB26878-2011 'Iodine Content in Edible Salt' that was introduced in March 2012 resulted in an overall improvement in iodine status, reducing the risk of excessive iodine intake in the Chinese population.</p>
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Purpose To investigate the expression and the clinical significances of SEL1L and BCL-2 in 123 cases of diffuse large B cell lymphoma (DLBCL) and cell line SUDHL-4, LY-10. Methods Immunohistochemistry staining for SEL1L was performed in 123 DLBCL and 60 reactive lymphoid hyperplasia (RLH), and also BCL-2 protein in 123 DLBCL. Immunocytochemistry staining and Western blot analysis for SEL1L protein were used in SUDHL-4 and LY-10. Results The high expression rate of SEL1L was 69.9％ in 123 DLBCL, which was significantly higher than that in 60 RLH (25.0％ ). The expression of SEL1L protein in DLBCL was not related to clinic pathological parameters. The positive rate of BCL-2 was 83.7％ in123 DLBCL. The expression of BCL-2 protein was correlated with immunophenotyping, primary location, and Ann Arbor stage. The expression of SEL1L protein was positively correlated with that of BCL-2 protein in DLBCL (r=0.227, P＜0.05). SEL1L protein was also detected in SUDHL-4 and LY-10 cell lines. Conclusion The SEL1L protein may play an important role in the carcinogenesis of DLBCL, and may be associated with BCL-2.
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OBJECTIVES@#To study the correlation between the movement distance of small intestinal contents and survival time in female SD rat models after one-time satiation, and to evaluate its application value for postmortem interval estimation.@*METHODS@#Adult female SD rats were randomly divided into postprandial groups （1, 2, 3, 4 and 5 h after feeding） and control group. The postprandial groups were fed for 1 h, meanwhile control group was kept fasting. All rats were sacrificed at the given time. The contents in stomach and small intestine were observed, described, compared and photographed, and the movement distance of small intestinal contents was measured. The data of postprandial groups were analysed by one-way analysis of variance.@*RESULTS@#The stomach and duodenum of control group were empty with a little thin and yellow small intestinal liquid. The gastral cavities of 1 h postprandial group were full of undigested food. The evolutionary changes of character, colour and content were observed in the gastric and small intestinal contents of other postprandial groups. The movement distance of intestinal contents increased while the empty part decreased gradually. The differences among the postprandial groups were statistically significant （P<0.05）.@*CONCLUSIONS@#After a 24 h fasting with free drinking and the following 1 h feeding, an ideal animal model can be established successfully on female SD rats, which can provide an experimental basis for postmortem interval estimation based on the changes of small intestinal contents in forensic practice.
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Animals , Female , Male , Rats , Body Fluids , Gastrointestinal Contents , Rats, Sprague-Dawley , StomachABSTRACT
Purpose To explore the clinicopathologic features of metastatic gastrointestinal stromal tumors (GIST) and the mechanism of lymph node metastasis.Methods 45 cases of surgical specimens with metastasis were selected as the research object and 50 cases of primary tumors in the same period were compared.All materials were stained with immunohistochemical method that marked Ki-67,CD31,D2-40,and then micro vessel density (MVD) and lymphatic microvessel density (LMVD) in each group were calculated.Results The total metastatic rate was 5.45％,the blood metastatic rate was 1.33％ and the lymph node metastatic rate was 1.09％.MVD of metastatic GIST was 398.39 ± 68.20/mm2and MVD of non-metastatic GIST was 192.07 ± 56.85/mm2,and the difference between them was statistically significant.There was no lymphatic vessels distribution in the essence of GIST regardless of metastasis.About metastatic GIST,LMVD of the edge area of the essence was 13.28 ±2.40/mm2 and LMVD of normal tissue around the essence was 25.36 ± 6.71/mm2.In regard to non-metastatic GIST,LMVD of the edge area of the essence was 12.21 ± 1.83/ mm2 and LMVD of normal tissue around the essence was 24.23 ± 8.64/mm2.No statistically significant existed between LMVD of the edge area of the essence and LMVD of normal tissue around the essence.All of the 9 cases of lymph node metastatic GIST and 12 from 86 cases of non-metastatic GIST showed invasive growth.Conclusion MVD of metastatic GIST is higher than that of non-metastatic GIST.There is no lymphatic vessel within the essence of GIST.The invasive growth way may be the cause of the lymph node metastasis.
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Purpose To investigate the relationship of HIF-1α,BCL-2 and clinicopathological features in salivary adenoid cystic carcinoma by detecting the levels of two proteins.Methods Immunohistochemical of SP staining assay was used to detect the level of HIF-1α and BCL-2 expression in fifty-six section from primary resection of salivary adenoid cystic carcinoma.Furthermore,the correlation between the expressions of two proteins with clinical data was evaluated through differently statistical analysis.Results Thirty-six samples (64.3％) were found to express HIF-1α.The level of HIF-1α was significantly correlated with TNM stage of tumors and the primary site of salivary adenoid cystic carcinoma (P ＜ 0.05).Positive BCL-2 expression was detected in fifty-five cases (98.2％).The level of HIF-1 α was positively correlated with that of BCL-2 (P ＜ 0.05)and the significant correlation between HIF-1α and TNM stage was dependent upon the strong expression of BCL-2 (P ＜ 0.05).Conclusion It is therefore indicated that the expression of HIF1α and BCL-2 may influence the clinical stage of salivary adenoid cystic carcinoma.
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<p><b>OBJECTIVE</b>To evaluate the usefulness of the thyroglobulin (Tg) level in adults as a nutritional biomarker of iodine status and to identify the factors related to the serum Tg level.</p><p><b>METHODS</b>A cross-sectional study was conducted in adult populations of areas differing in iodine nutrition from three provinces (Autonomous Region) in China. Serum levels of thyroid hormones and Tg as well as thyroid autoantibodies were measured. The thyroid volume and nodule were measured by ultrasound. A multivariate linear regression analysis was used to assess iodine intake and other indeterminate factors associated with the serum Tg level.</p><p><b>RESULTS</b>A total of 573 adults were recruited for this study. The serum Tg levels differed significantly among the three groups (22.27 μg/L, 9.73 μg/L and 15.77 μg/L in the excess, more-than-adequate, and deficient groups, respectively). The results of multivariate linear regression analysis indicate that excess and deficient iodine intake, goiter, thyroid nodule, hypothyroidism are significantly related with higher Tg level, and TgAb positivity is significantly related with lower serum Tg.</p><p><b>CONCLUSION</b>The serum Tg level reflects abnormal thyroid function and is a sensitive functional biomarker of iodine nutrition status.</p>
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Adult , Female , Humans , Male , Middle Aged , Biomarkers , Blood , China , Cross-Sectional Studies , Iodine , Thyroglobulin , Blood , Thyroid Diseases , Blood , Thyroid Gland , MetabolismABSTRACT
Purpose To investigate the expression of FABP5 in oligodendroglioma and its clinic pathological significance.Methods Immunostaining of FABP5 and Ki-67 were performed in 87 oligodendrogliomas and 23 paracancerous brain tissues.The relationships between FABP5 expression and Ki-67 expression or clinic pathological parameters were statistically analyzed.Patients were followed up after operation.Results (1) The expression of FABP5 was significantly higher in oligodendroglioma [63.2％ (55/87)] than that in normal control [34.8％ (8/23)].(2)The expression of FABP5 was positively correlated with the histological grade (P =0.018,rs =0.254) and the Ki-67 expression (P =0.003,rs =0.318) in oligodendroglioma.(3) Univariate analysis showed that the expression of FABP5 protein,Ki-67 protein,age and chemotherapy were significant prognostic factors for oligodendroglioma patients.Conclusion FABP5 may play an important role in the pathogenesis and progression of oligodendroglioma,and could be used as a novel biological indicator of disease progress as well as prognosis for oligodendroglioma patients.
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Purpose To investigate the clinicopathological characteristics and the survival outcomes of invasive lobular carcinoma. Methods A retrospective analysis of 98 patients with invasive lobular carcinoma and 530 invasive carcinoma of no special type was performed in order to observe the histological features and the clinical outcomes of invasive lobular carcinoma. Results Median follow-up was 68. 5 months for invasive lobular carcinoma and 67 months for invasive carcinoma of no special type. Invasive lobular carcinoma presented with a larger tumor size, more histopathological grade 2 tumors, increased rate of hormonal receptor positivity, human epider-mal growth factor 2 (HER-2) negativity, and had a lower proliferative index as compared to invasive carcinoma of no special type, more frequently presented with the luminal A subtype (P<0. 001). The classical invasive lobular carcinoma presented with a smaller tumor size, to have a lower histological grade and proliferative index compared to the non-classic type, and more frequently presented with the luminal A subtype, whereas the non-classic invasive lobular carcinoma patients more frequently presented with the luminal B, HER-2 overexpression, or triple negative subtype (P=0. 035). A statistically significant difference in the outcome was observed at un-ivariate analysis for patients with non-classic for disease-free survival (P=0. 043) and for overall survival (P=0. 048), as compared with patients with classical invasive lobular carcinoma. The disease-free survival difference between the invasive lobular carcinoma and the invasive carcinoma of no special type was not significant (P=0. 537), and the overall survival rates were not statistically different between the two groups (P=0. 397). A statistically significant difference of overall survival was observed at multivariate analysis for patients with HER-2 positive and triple negative subtypes versus patients with luminal A invasive lobular carcinoma (P=0. 015, P=0. 016) . Conclusions The outcome of invasive lobular carcinoma is significantly correlated with histological and immunohistochemi-cally defined molecular subtypes. New tailored strategies should be explored in these subgroups of patients with poor outcome.
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<p><b>BACKGROUND</b>Over past two decades, vagus nerve stimulation (VNS) has been widely used and reported to alleviate seizure frequency worldwide, however, so far, only hundreds of patients with pharmaco-resistant epilepsy (PRE) have been treated with VNS in mainland China. The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.</p><p><b>METHODS</b>We retrospectively assessed the clinical outcome of 94 patients with PRE, who were treated with VNS at Beijing Fengtai Hospital and Beijing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients. The clinical data analysis was retrospectively examined.</p><p><b>RESULTS</b>Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve. At last follow-up, we found McHugh classifications of Class I in 33 patients (35.1%), Class II in 27 patients (28.7%), Class III in 20 patients (21.3%), Class IV in 3 patients (3.2%), and Class V in 11 patients (11.7%). Notably, 8 (8.5%) patients were seizure-free while ≥50% seizure frequency reduction occurred in as many as 60 patients (63.8%). Furthermore, with regard to the modified Engel classification, 12 patients (12.8%) were classified as Class I, 11 patients (11.7%) were classified as Class II, 37 patients (39.4%) were classified as Class III, 34 patients (36.2%) were classified as Class IV. We also found that the factors of gender or age are not associated with clinical outcome.</p><p><b>CONCLUSIONS</b>This comparative study confirmed that VNS is a safe, well-tolerated, and effective treatment for Chinese PRE patients. VNS reduced the seizure frequency regardless of age or gender of studied patients.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Drug Resistance , Epilepsy , Therapeutics , Retrospective Studies , Treatment Outcome , Vagus Nerve Stimulation , MethodsABSTRACT
Purpose To investigate the expression of EZH2 and p53 protein in breast cancer and to analyze their relationship with the clinical pathologic characteristics and prognosis. Methods The expression of EZH2 and p53 protein were detected by immunohisto-chemical method in 50 cases of breast adenosis tissues, 92 cases of breast invasive lobular carcinoma ( ILC) and 200 cases of breast in-vasive ductal carcinoma ( IDC) , and their correlation was also analyzed. Results There was no statistical significance of EZH2 be-tween ILC and IDC (P>0. 016 7), while its expression in breast adenosis tissues was lower than that in ILC and IDC (P0. 016 7), while its expression in IDC was higher than that in ILC and breast adenosis tissues (P<0. 016 7). Its expression had no related to patient age, menopausal status, tumor size, lymph node metastasis in breast cancer, but related to histological types, pTNM stage, molecular subtype and sur-vival status (P<0. 05). The Kaplan-Meier survival analysis showed the expression of EZH2 and p53 had correlated with disease-free and overall survival rates of breast cancer (P<0. 05). Multivariate COX regression analysis showed that the expression of EZH2 and p53 were independent affecting factors to breast cancer patients. Conclusion The expression of EZH2 and p53 protein increase in the breast adenosis, ILC and IDC gradually, and they have positive correlation. The expression levels of EZH2 and p53 protein have im-portant value to evaluate the prognosis of breast cancer patients.
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Purpose To study the value of the ultrasonic imaging in the diagnosis and differential diagnosis of benign and malignant breast tumor. Methods Color doppler ultrasound examination were conducted in 262 cases of patients with breast tumor. The mor-phology of the tumor, edge, envelope, internal echo, microcalcification, length and breadth ratio, axillary lymph node and blood-flow signals of color doppler in breast tumors were observed and these results were compared with the pathological observation postoperation. Results There were 314 tumors in all cases, the coincidence rate in the diagnosis of benign breast diseases with ultrasonic imaging and pathological diagnosis was 97. 3%, the misdiagnosis rate was 2. 7%. The coincidence rate in the diagnosis of breast malignant tumors with ultrasound imaging and pathological diagnosis was 92. 9%, the misdiagnosis rate was 7. 1%. There were statistically signif-icant differences between benign tumors and malignant tumors in the tumor shape, edge, echo, microcalcification, length and breadth ratio, axillary lymph node imaging characteristics (P<0. 01). Conclusion Ultrasound imaging can be more accurate diagnosis and i-dentification of benign and malignant breast tumors.
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Purpose To measure the nuclear morphological parameters of breast cancer to study the relationship between nuclear mor-phological parameters and ER, PR, HER-2 expression, and clinicopathologic features of breast carcinoma. Methods 388 cases of breast cancer specimens were collected and molecular classification was made according to ER, PR and HER-2 expression. the nucleus parameters were measured by image analysis software after HE staining. The difference among groups was statistically analysed, and follow-up was done by phone or by hospitalization. Results Among the 4 groups of breast cancer case, the differences of circle diame-ter, area and perimeter edges of the nucleus were statistically significant (P<0.05). Nuclear morphometric quantitation between ER+/PR+ patients and ER-/PR- patients was statistically significantly differentice (P<0.05). The majority of patients with ER-/PR- were histological gradeⅢand poor survival rate (P<0.05). The disease-free survival in Luminal A type was higher than that of Basal-like type (P<0.05), and its overall survival was higher than HER-2 over-expression (P<0. 05) and Basal-like type (P<0.05) . Conclusion The nucleus morphological quantitation in breast cancer is of significant difference, which has certain reference value in its molecular typing. The result of ER, PR and HER-2 expression, combined with nuclear morphology measurement, are meaningful to the treatment and assessment of prognosis.
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Objective To identify the levels of exposure to second-hand smoking (SHS)among Chinese adults living in the urban areas and their knowledge on the risks of SHS,to support for the Smoke-free policy.Methods Data from the Global Adult Tobacco Survey (GATS) and the International Tobacco Control Policy Evaluation China Survey (ITC China Survey) was analyzed and SAS was used to calculate the rates and 95％ CI.Results In the two surveys,less than 40％ of the respondents reported that their workplaces had completely stopped smoking.Participants who reported that they had seen people smoking at various public places with different rates,also they could reflect the levels to SHS exposure.Restaurants were the venue with the heaviest overall exposure (83.4％-95.6％),followed by the workplace (53.3％-84.0％).Exposure was low in health facilities,schools and public transport venues.In the GATS survey,60.6％ smokers and 68.5％ non-smokers believed that SHS could cause lung cancer,but only one-third of the participants believed that SHS could cause heart diseases in adults.Participants in the ITC China survey reported a comparatively higher level of awareness on the harm of SHS,but only 58.2％ smokers believed that SHS could cause heart diseases in adults.Overall,data from the ITC China survey showed that participants' support for a comprehensive smoke-free policy in schools,health-related facilities,government buildings and in taxi were high (over 70％).However,the proportion of participants supporting comprehensive smoking-free policy at workplaces (50.9％-60.9％) was relatively low.Conclusion The proportion of indoor workplaces with complete smoking ban was low in urban areas but levels to SHS exposure were high.People's awareness of harms related to SHS and their attitude on setting up a comprehensive smoke-free workplace need to be improved.
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<p><b>OBJECTIVE</b>We review the targets of the deep brain and the responsive neurostimulation system (RNS) to identify the best optimal stimulation parameters and the best mode of stimulation, whether cyclical, continuous, or smarter.</p><p><b>DATA SOURCES</b>This review is based on data obtained from published articles from 1950 to 2013. To perform the PubMed literature search, the following keywords were input: deep brain stimulation (DBS), RNS, and refractory epilepsy.</p><p><b>STUDY SELECTION</b>Articles containing information related to brain stimulation or RNS for the treatment of refractory epilepsy were selected.</p><p><b>RESULTS</b>The currently available treatment options for those patients who resist multiple antiepileptic medications and surgical procedures include electric stimulation, both direct and indirect, of brain nuclei thought to be involved in epileptogenesis. The number of potential targets has increased over the years to include the anterior nucleus of the thalamus, the centromedian nucleus of the thalamus, the hippocampus, the subthalamic nucleus, the caudate nucleus, and the cerebellum, among others. The results of a randomized controlled trial and the RNS trial were published to reveal the effectiveness.</p><p><b>CONCLUSIONS</b>Although statistically significant reductions in seizures have been observed using several different stimulation techniques, including vagus nerve stimulation, DBS, and RNS, these effects are currently only palliative and do not approach the efficacy comparable with that seen in resection in appropriately selected patients. More research is needed to determine optimal stimulation targets and techniques as well as to determine which epilepsy patients will benefit most from this technology.</p>
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Female , Humans , Male , Deep Brain Stimulation , Methods , Epilepsy , Therapeutics , Vagus Nerve Stimulation , MethodsABSTRACT
<p><b>OBJECTIVE</b>To observe the effects of sacral canal injection in treating lumbar intervertebral disc herniation with different sections, types and courses, in order to provide selective basis for clinical indications.</p><p><b>METHODS</b>From March 2007 to May 2011, 329 patients with lumbar intervertebral disc herniation were treated with sacral canal injection and their data were retrospectively analyzed. There were 178 males and 151 females,ranging in age from 16 to 78 years old with an average of 45 years; ranging in course of disease from 2 days to 41 years with an average of 4.1 years. All the protrusions were simple segment, and L3,4 of 51 cases, L4,5 of 142 cases, L5S1 of 136 cases including central protrusion of 137 cases, posterolateral of 145 cases, extreme posterolateral of 47 cases. According to different sections, types, courses (more than or less than 6 months ) of lumbar intervertebral disc herniation, the patients were divided into several groups, clinical effects of the groups were compared and analyzed.</p><p><b>RESULTS</b>Clinical effect of protrusion in L5S1 group was better than that of L3,4, L4,5 group; the effect of patients with course less than 6 months was better than with course more than 6 months; effect of posterolateral protrution was better than that of central and extreme posterolateral protrusion. Clinical effect of corresponding the three conditions was better than that of others no corresponding the three conditions,the three conditions included the course less than 6 months, protrusion in L5S1 section, with type of posterolateral protrusion. No complications were found in all patients and cured patients were followed up for 1 year with the recurrence rate of 0.05%.</p><p><b>CONCLUSION</b>The patients with short course, lower protrusion, type of posterolateral protrusion can obtained better effects, while the patients who meets the three conditions is appropriate mostly to sacral canal injection therapy.</p>