ABSTRACT
Objective:To observe any effect of dry needling of myofascial trigger points on substance P and synaptophysin expression in the spinal dorsal horn.Methods:Sixty-four Sprague-Dawley rats were randomly divided into a control group ( n=16) and a model group ( n=48). Myofascial trigger points were induced in the model group by a blunt strike and eccentric running. That group was then randomly divided into a no-treatment group ( n=15), a massage group ( n=16), and a dry needling group (16 rats). The rats in the two treatment groups received 4 weeks of dry needling or Chinese massage. Pressure pain thresholds were recorded before the experiment and after the 4 weeks. The content of substance P and synaptophysin in the spinal dorsal horn were measured using immunoblotting and immunohistochemistry. Results:After the treatment 14 rats (93%) in the model group had trigger points, significantly higher than the 8 rats (50%) in the massage group and the 7 rats (44%) in the dry needling group. After treatment, the average pressure pain thresholds of the no-treatment and massage groups was significantly lower than the control group′s average, while the difference between the dry needling group and the control group was not significant. The average pressure pain threshold had improved significantly in the no-treatment group, the massage group and the dry needling group, and the averages of the massage group and the dry needling group were significantly higher than that of the no-treatment group. The level of substance P was significantly higher in the no-treatment group than in the other three groups and the ratio of substance P to Glyceraldehyde 3-phosphate dehydrogenase (GAPDH)was significantly higher. The substance P: GAPDH ratio of the massage group was significantly higher than that of the control group.Conclusions:Dry needling and massage are effective in relieving myofascial pain, at least in rats. Both can reduce the content of substance P in the spinal dorsal horn.
ABSTRACT
As the medical college students are scattered to each practice hospital, the status of the secondary clinical medical colleges' education management to interns is weakened, and the problems and contradictions are becoming increasingly prominent. In the process of internship education management, through the establishment of the secondary medical colleges' interconnection management working mecha-nism, we can effectively solve the outstanding problems in the current internship edu-cation management, to achieve mutual trust between the secondary clinical medical college and the training hospital, and en-hance the effectiveness of the management of interns.
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Objective To explore the MSCT manifestations of chromophobe renal cell carcinoma (CRCC)and to improve its accu-racy of preoperative diagnose.Methods Clinical and MSCT finding were retrospectively reviewed in 14 patients with CRCC,which were confirmed by surgical pathology or biopsy.Results (1)On plain scanning,most of the CRCC lesions showed round or oval (86.7%,13/1 5)and isodensity (73.3%,1 1/1 5)mass;and the border of 66.7% (10/1 5)lesions were clear.53.3% (8/1 5)of the lesions were heterogeneous with lamellar cystic low density (8 lesions)and coarse ringed and/or foliated calcifications (4 lesions). (2)On contrast-enhanced sacanning,the CRCC lesions showed mild to moderate (86.7%,13/1 5)and heterogeneous (60%,9/1 5) enhancement,and 73.3% (1 1/1 5)of the lesions were persistent enhanced.(3)According to the pathology,80% (12/1 5)of the le-sions was the typical type,20% (3/1 5)was the eosinophilic type,and 0 was the hybrid type.Conclusion CRCC demonstrates cer-tain characteristics signs at MSCT examination.Lesion mostly shows well-circumscribed round or oval mass in the renal parenchy-ma,mild to moderate,heterogeneous and continuous enhancement on the contrast scanning.The diagnosis of CRCC should be con-sidered especially when the lesion has cystic change and coarse ringed and/or foliated calcifications.
ABSTRACT
<p><b>OBJECTIVE</b>To identify pathogenic mutation in a boy affected with riboflavin responsive-multiple acyl-CoA dehydrogenase deficiency (RR-MADD).</p><p><b>METHODS</b>The patient was initially diagnosed as primary carnitine deficiency (PCD) and has been treated with carnitine supplementation for 7 years. Clinical manifestations and characteristics of fibula muscle specimen were analyzed. Potential mutation in electron transfer flavoprotein dehydrogenase (ETFDH) gene (for the patient and his parents) and carnitine transfer protein gene (SLC22A5) (for the patient) was screened.</p><p><b>RESULTS</b>Electronic microscopy of the muscle specimen has suggested lipid storage myopathy. Mutation analysis has found that the patient carried compound heterozygous mutations, c.250G>A and c.380T>C, in exon 3 of the ETFDH gene, whilst his father and mother were heterozygous for the c.380T>C and c.250G>A mutations, respectively. Screening of the SLC22A5 gene has yielded no clinically meaningful result. After the establishment of diagnosis of RR-MADD, the condition of the patient has improved greatly with supplementation of high doses of riboflavin along with continuous carnitine supplement.</p><p><b>CONCLUSION</b>The c.250G>A (p.Ala84Thr) mutation of exon 3 of the ETFDH gene has been a hot spot in Southern Chinese population, whilst the c.380T>C (p.Leu127Pro) is rarely reported. Our case has suggested that therapeutic diagnosis cannot substitute genetic testing. The mechanism for having stabilized the patient with only carnitine supplementation for 7 years needs further investigation.</p>