Serum LAPTM4B-35 protein as a novel diagnostic marker for hepatocellular carcinoma / 北京大学学报(医学版)

OBJECTIVE@#LAPTM4B-35 protein is one of the isoforms that are encoded by a cancer driver gene, LAPTM4B. This gene was primarily found and identified in our lab of Peking University School of Basic Medical Sciences. The LAPTM4B-35 protein and its encoded mRNA are significantly over-expressed in a variety of cancers, such as hepatocellular carcinoma (HCC), lung cancers (including non small-cell lung cancer and small-cell lung cancer), stomach cancer, colorectal carcinoma, pancreatic cancer, gallbladder cancer, cholangiocarcinoma, breast cancer, prostate cancer, ovarian cancer, cervical cancer, endometrial cancer, and so on. It has firmly demonstrated through lab experiments either in vivo or in vitro, as well as clinical studies that the over-expression of LAPTM4B-35 can promote cancer growth, metastasis, and multidrug resistance. Specially, the expressive level of LAPTM4B-35 is associa-ted with recurrence of HCC. The aim of this study is to identify the release of LAPTM4B-35 protein from hepatocellular carcinoma into blood of HCC patients and into the medium of cultured HCC cells, and to identify its possible form of LAPTM4B-35 protein existed in blood and cell culture medium, as well as to explore the possibility of LAPTM4B-35 protein as a novel HCC biomarker for diagnosis of HCC and prognosis of HCC patients.@*METHODS@#Immunobloting (Western blot) and enzyme-linked immunosorbent assay (ELISA) were used for identification of LAPTM4B-35 protein in the blood of HCC patients and normal individuals. Ultrafiltration and ultracentrifugation were used to isolate and purify exosomes from the culture medium of HCC cells.@*RESULTS@#LAPTM4B-35 protein existed in the blood from HCC patients and normal donors that were demonstrated through Western blot and ELISA. LAPTM4B-35 was also released into the culture medium of HCC cells in the form of exosomes. Preliminary experiments showed that the average and the median of LAPTM4B-35 protein level in the blood of HCC patients (n=43) were both significantly higher than that in the blood of normal donors (n=33) through sandwich ELISA.@*CONCLUSION@#It is promising that the LAPTM4B-35 protein which is released from HCC cells in the form of exosomes into their extraenvironment may be exploited as a novel cancer biomarker for HCC serological diagnosis.

Risk factors and treatment of intraoperative periprosthetic acetabular fracture during total hip arthroplasty / 中华骨科杂志

Objective To analyze the risk factors of periprosthetic acetabular fracture in total hip arthroplasty (THA) and to discuss the prevention and management.Methods A total of 1 023 patients (1 168 hips) undergoing THA were retrospectively analyzed between January 2012 and June 2015.There were 421 males (507 hips) and 602 females (661 hips),aged from 23 to 96 years with mean age of 64.2± 15.0 years.Primary total hip arthroplasty was conducted in 1 053 hips,while revision surgery was conducted in 115 hips.The reasons of periprosthetic acetabular fracture were summarized.Age,gender,BMI,primary disease,left or right sides,surgical approach,osteoporosis,prosthetic type,the coverage rate of acetabulum-bone,and the amount of surgical operation annually were compared between non-fracture and fracture.Risk factors associated with the fracture were analyzed using chi square test followed by a multivariate logistic regression.Furthermore,revision surgery was compared with primary THA using chi square test.Results The incidence of intraoperative periprosthetic acetabular fractures was 2.8％ (33/1 168).The incidence of fracture was higher in revision surgery than that in primary THA (6.1％ vs.2.5％).Multivariate logistic regression showed that primary disease (developmental dysplasia of the hip and rheumatoid arthritis),osteoporosis,uncemented acetabular cup,the high-er coverage rate of acetabulum-bone,and the less amount of surgical operation annually were prone to appear periprosthetic acetabular fracture in primary THA.Among the 33 patients with acetabular fractures,13 cases (39.4％,13/33) were found intraoperatively and 20 cases (60.6％,20/33) postoperatively.Acetabular wall fractures were in 26 (78.8％,26/33),column fractures in 2 (6.1％,2/33),transverse fractures in 2 (6.1％,2/33) and quadrilateral surface fractures with prosthetic central dislocation in 3 (9.1％,3/33).Seven cases of 26 stable fractures and 6 cases of 7 unstable fractures were found intraoperatively.Acetabular wall fractures were fixed by additional augmentation screws or accepted no special treatment,and column fractures were fixed with plate.One quadrilateral surface fracture was accepted revision surgery using Jumbo cup,2 quadrilateral surface fractures and 2 transverse fractures with reconstruction cage.The patients were followed up for 42.3±13.7 months (range 29-60 months).The Harris hip score was 83.3±6.6 (range 72-94) at last follow-up.No complication,such as hip dislocation,osteolysis,and prosthetic loosening was reported.Conclusion Most of periprosthetic acetabular fiactures are wall fractures which could not endanger the periprosthetic stability.The detection rate of acetabular stable fracture is lower than that of unstable fracture in operation.Primary disease (developmental dysplasia of the hip and rheumatoid arthritis),osteoporosis,uncemented acetabular cup,the higher coverage rate of aeetabulum-bone,the less amount of surgical operation annually are the intraoperative risk factors which closely related to acetabular fractures of primary THA.The risk of intraoperative periprosthetic acetabular fractures in revision THA is higher than that in primary THA.

Using modular fluted tapered stem for management of periprosthetic femoral fracture in revision hip arthroplasty / 中华骨科杂志

Objective To evaluate the technique and clinical results of the modular fluted tapered stems for treating periprosthetic femoral fractures in revision hip arthroplasty.Methods From August 2007 to February 2014,fourteen patients (14hips) with periprosthetic femoral fractures underwent revision hip arthroplasty with modular fluted tapered stem.A retrospective analysis was performed involving all patients who were followed-up more than 2 years.The subjects consisted of 4 males and 10 females with mean age of 73.4±6.6 years (range,62-82 years) at the time of revision.All patients were unilateral with 8 left hips and 6 right hips.The status of primary arthroplasty was bipolar hemiarthroplasty in 3 patients and total hip arthroplasty in 11 patients.Nine cases were with cemented stems,5 cases with uncemented stems.The interval from primary hip arthroplasty to revision surgery ranged from 40 to 163 months,with an average of 120.9±31.9 months.Eight cases with Vancouver type B3 periprosthetic femoral fracture were found preoperatively,6 cases with aseptic loosening and bone deficiency occurred periprosthetic femoral fracture during the operation.Based on the Paprosky classification system for femoral bone deficiency:type ⅢA in 8 hips,type ⅢB in 5 hips,type Ⅳ in 1 hip.Both the femoral and the acetabular components were revised in 9 patients.All femoral fractures were treated with cable fixation,and the cortical allograft struts were used to augment femoral bone stock in 7 patients.The patients were followed up at 6 weeks,3 months,6 months,9 months,12 months and annually thereafter.Harris Hip Score System and radiographic examination was used to evaluate the clinical results,including fracture union,implant stability,bone stock,hip joint function and postoperative complications.Results The mean duration of follow-up was 62.1 ±22.2 months (range,30-96 months).The mean times of fracture union were 6.2±2.5 months (range,3-12 months).The Harris Hip Score improved from 29.6± 10.3 preoperatively to 86.3±4.2 postoperatively (t=-21.6,P=0.00).Thirteen cases (93％,13/14) had the stem subsidence of 4.9±2.5 mm (range,0-9 mm).Thirteen cases (93％,13/14) were presented with femoral bony restoration.Two cases showed incorporation of the allograft in 7 patients.One patient developed deep venous thrombosis of lower limbs,and one suffered from subcutaneous hematomas after surgery.There was no infection,aseptic loosening,dislocation or periprosthetic fracture complications at the followup.Conclusion The short-medium term results of the modular fluted tapered prosthesis applied in periprosthetic femoral fractures are encouraging in revision hip arthroplasty.The present technology can provide reliable primary stability and can tolerate minimal subsidence postoperatively.

Investigation on the current situation of nursing specialty construction at department level in Shanghai tertiary hospitals / 中华护理杂志

Objective To investigate the current situation of nursing specialty construction at department level in Shanghai tertiary hospitals.Methods Totally 92 nursing specialties in 6 hospitals were investigated using a selfdesigned questionnaire of evaluation indicator system for nursing specialty construction at department level in tertiary hospitals.Results The score rate of 92 nursing specialties was between 27.75％～75.10％.There were 6 departments with a score of 70％ to 79.9％,accounting for 6.52％.There were 18 departments with a score of 60％ to 69.9％,accounting for 19.57％.There were 68 departments with a score less than 60％,accounting for 73.91％.For the first-level indicator,the score rate of "nursing practice" was the highest,followed by "teaching level""specialized training base construction""talent echelon construction" and "scientific research".Conclusion The overall level of nursing specialty construction at department level in Shanghai tertiary hospitals is relatively low.Hospitals should pay attention to "talent echelon construction","scientific research" and "training base construction" to increase the level of nursing specialist construction.

Effects of slow twisting needle insertion and tubing needle insertion at Neiguan (PC 6) on cardiovascular function: a comparative study / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects between slow twisting needle insertion and tubing needle insertion.</p><p><b>METHODS</b>With cross-over design, 100 healthy young subjects (half male and half female) aged from 19 to 23 years were randomly divided into two groups by random digital table, 50 cases in each one. At the first stage, subjects in the group A were treated with slow twisting needle insertion while, subjects in,the group B were treated with tubing needle insertion. One week later, the procedure of second stage was performed alternately. The needle was inserted into Neiguan (PC 6) with two methods by one acupuncturist. The needle was retained for 5 min before removal. Five min before needle insertion as well as needle withdrawal and 30 min after needle withdrawal, ZXG-E automatic cardiovascular diagnostic apparatus was used to test cardiovascular function.</p><p><b>RESULTS</b>At the tim of needle withdrawal, slow twisting needle insertion could improve effect work of kinetics (EWK), effective blood volume (BV) and reduce elastic expansion coefficient of blood vessel (FEK) and left ventricular spray blood impedance (VER), which was significantly different from tubing needle insertion (all P < 0.05). Thirty min after needle withdrawal, the differences of the indices of cardiovascular function between the two groups were not significant (all P > 0.05).</p><p><b>CONCLUSION</b>The slow twisting needle insertion is significantly superior to tubing needle insertion on lowering vascular tension and VER, improving EWK and BV.</p>

Effect of Acupuncture at Neiguan (PC 6) with Different Inserting Methods on Short-form McGill Pain Questionnaire and Cardiovascular Function / 上海针灸杂志

Objective To observe the changes of cardiovascular function after acupuncture at Neiguan (PC 6) respectively with slowly twirling needling and tube needling in healthy subjects, and to objectively evaluate the pain intensity of the two needling methods.Method A hundred healthy young subjects were randomized into group A and group B, 50 cases in each group. Neiguan (PC 6) point was selected for acupuncture in both groups. In the first stage, group A received acupuncture by slowly twirling needling, while group B received acupuncture with tube needling; in the second stage (a week later), group A received acupuncture with tube needling, while group B by slowly twirling needling. The Short-form McGill Pain Questionnaire (SF-MPQ) was observed after acupuncture for each subject, and ZXG-E automatic cardiovascular function detector was adopted to evaluate the cardiovascular function before puncturing, 5 min after puncturing, and 30 min after puncturing.Result The Sensory Pain Rating Index (S-PRI) and total SF-MPQ scores of slowly twirling needling were significantly different from that of tube needling (P<0.01). The Affective Pain Rating Index (A-PRI), Visual Analogue Scale (VAS), and Present Pain Intensity (PPI) of slowly twirling needling method were significantly different from that of tube needling (P<0.01). At 5 min after needle insertion, the FEK and VER values of twirling needling were significantly different from that of tube needling (P<0.01).Conclusion The pain produced by slowly twirling needling is more variant and stronger than that by tube needling, and this pain variation can produce a positive effect on cardiovascular function.

Clinical observation on Governor Vessel-regulating, liver-soothing and mind-calming needling for insomnia due to liver fire disturbing the heart / 针灸推拿医学（英文版）

Objective:To compare the therapeutic effects between the Governor Vessel-regulating, liver-soothing and mind-calming needling and the routine acupuncture therapy for insomnia due to liver fire disturbing the heart. Methods:A total of50 cases with insomnia were randomly divided by the random numberl table into the two groups, 25 cases in each group. The observation group was treated with the Governor Vessel-regulating, liver-soothing and mind-calming needling, while the control group was treated with the routine acupuncture therapy. The two groups were treated for five sessions per week, ten sessions as a course. After 3-course treatment, the therapeutic effects and the improvement of Pittsburgh sleep quality index (PSQI) were observed. Results:After treatment for three courses, the total effective rate was 100% in the treatment group and 92% in the control group. The difference in the therapeutic effect between the two groups was statistically significant (P0.05). Conclusion:Thetherapeutic effect of Governor Vessel-regulating, liver-soothing and mind-calming needling is better for insomnia due to liver fire disturbing the heart than the routine acupuncture therapy.

Clinical study of PEI combined with HIFU for treating unresectable middle and advanced stages of primary liver cancer / 重庆医学

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Current status and progress of fully covered self-expandable metal stents in the treatment of benign biliary and pancreatic ductal strictures / 中华消化外科杂志

Though the primary data on fully covered self-expandable metal stents (FCSEMS) in the treatment of benign biliary strictures caused by chronic pancreatitis and anastomotic stricture following orthotopic liver transplantation is encouraging,the risks including stent translocation,biliary infection,pancreatitis and inability to remove stents should be considered before replacing plastic stents with FCSEMS for the first-line treatment of benign biliary strictures in routine practice.FCSEMS is effective in treating benign pancreatic ductal strictures,but it is also associated with a high rate of stent translocation.To overcome this problem,FCSEMS with better conformability and flared ends need to be designed.There is a theorectial risk of pancreatic ductal infection caused by the blockage of side branches of the pancreas by covering membrane of the stents.However,no such complication was reported.Given the uncertain long-term efficacy and safety of FCSEMS for benign pancreatic ductal strictures,their use may be reserved for the management of retractory,symptomatic benign strictures only in selected groups of patients.

Observation of the effect of biliary stenting combined with ademetionine on malignant obstructive jaundice / 中国基层医药

Objective To explore the effect of biliary stenting combined with ademetionine on malignant obstructive jaundice.Methods According to the digital table,60 patients of malignant obstructive jaundice were randomly divided into the control group and the observation group.The patients in the control group were treated with biliary stenting individually,and the observation group received biliary stenting and combined treatment with ademeotionine.The variety of liver function and C-reactive protein were observed.Results The liver function and index of Creactive protein of patients in the observation group were significantly superior to those in the control group (all P ＜0.01).Conclusion The treatment of malignant obstructive jaundice by biliary stenting combined with ademetionine is effective.The mechanism may be related to the effect of ademetionine on promoting cytothesis,glutathione synthesis and eliminating free-radicals.

Application of case-based learning in clinical probation of anesthesiology / 中华医学教育探索杂志

Objective To investigate the effects of case-based learning (CBL) applied in the clinical probation of anesthesiology.Methods Totally 313 undergraduates from the department of anesthesiology were randomly divided into 2 groups:CBL group (n =157) and LBL group (n =156).CBL methods were used to teach students in CBL group while traditional teaching methods were used to teach students in LBL group.After the causes being finished,a combination of theoretical examination and questionnaire were used to evaluate the teaching effectiveness between the two groups and a questionnaire was used to evaluate the recognition of teachers on CBL method.Data were managed by SPSS 17.0 software package.Quantitative data between groups were compared by t-test,enumeration data between groups were compared by chi-square test.Results Students in CBL group acquired higher score (86.7 ± 5.4) than those in LBL group (75.8 ± 4.5).82％ students in CBL group considered that their overall quality was improved while 42％ students in the LBL group thought so (P ＜ 0.05).75％ of faculties preferred the CBL methods.Conclusions Effect of CBL methods is better than traditional teaching methods and it's preferred by faculty and students.

Intra-biliary tunnel electro-resection and aspiration approach during ERCP for severe biliary stricture / 中华消化内镜杂志

Objective To evaluate intra-biliary tunnel electro-resection and aspiration approach during ERCP for severe biliary stricture.MethodsA total of 14 patients with severe benign or malignant biliary stricture,which failed in previous ERCP,were recruited. First the guide wire was passed gently through the narrow segment under fluoroscopy,then the double-lumen needle knife was placed near the stricture and wire cutter was protruded.The tunnel electro-resection and aspiration was performed along the guide wire until the narrow segment could be passed through under fluoroscopy by the expanding balloon dilator for the following procedures.ResultsOf 14 patients with severe biliary strictnres,electro-resection and aspiration procedure were successful in 12 (85.7％).Metal stents were implanted in all 7 patients with malignant biliary strictures.Plastic stents were placed after balloon dilatation in 5 patients with benign stenosis.Three out of 5 patients received double plastic stents,while the two others only needed a single plastic stent.The procedure was failed in 2 patients ( 14.3％ ) with malignant biliary strictures as hilar cholangiocarcinoma invaded the left and right hepatic duct,forming a right angle in biliary stenosis,so that needle knife could not go through,and the following procedure was aborted.There were no severe complications like massive bleeding,perforation or death observed.ConclusionThe intra-biliary tunnel electro-resection and aspiration approach can significantly increase the success rate of ERCP in severe biliary strictures.

Diagnostic value of plasma D-dimer and fibrinogen in acute lower extremity deep vein thrombosis after artificial joint replacement / 中华骨科杂志

Objective To evaluate diagnostic value of plasma D-dimer (D-D),fibrinogen (Fg) and Ddimer/fibrinogen (D/F) ratio in acute lower extremity deep vein thrombosis (DVT) after artificial joint replacement.Methods From August 2009 to December 2011,273 patients who had undergone total hip arthroplasty (THA) or total knee arthroplasty (TKA) underwent venography of lower extremity deep vein at 35 days postoperatively.According to results of angiography,all patients were divided into DVT group including 66 patients (15 males and 51 females,median age 66 years) and non-DVT group including 207 patients (70 males and 137 females,median age 63 years).Plasma levels of D-D and Fg were measured by immunoturbidimetry and solidification methods respectively preoperatively and at 3-5 days postoperatively.The differences of plasma levels of D-D and Fg and D/F ratio between the two groups were analyzed with statistical method.Furthermore,diagnostic value of postoperative plasma D-D and D/F ratio in acute DVT was assessed using a receiver operating characteristic (ROC) curve.Results There was no statistical significance in preoperative plasma levels of D-D and Fg,and postoperative plasma levels of Fg between two groups.However,the postoperative plasma levels of D-D and D/F ratio were higher in the DVT group than those in the nonDVT group,and there was significant difference between two groups.In addition,the ROC curve analysis showed that the area under curve of postoperative plasma D-D and D/F ratio was 0.688 and 0.684,respectively,but this difference did not reach statistical significance.Conclusion Plasma Fg may be meaningless for the diagnosis of acute DVT after artificial joint replacement.Although plasma D-D and D/F ratio may be useful for diagnosing acute DVT,the diagnostic accuracy is low.

Inhibitory effect of resveratrol on ischemia reperfusion-induced cardiocyte apoptosis and its relationship with PI3K-Akt signaling pathway / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of resveratol on ischemia reperfusion-induced cardiocyte apoptosis and its relationship with PI3K-Akt signaling pathway.</p><p><b>METHOD</b>Fifty male SD rats were divided randomly into five groups: the control group (SH group), the ischemia reperfusion group (I/R group), the resveratol pretreatment group (Res group), the resveratol pretreatment + wortmannin group (Res +Wom group) and the ischemia reperfusion + wortmannin group (I/R + Wom group). The myocardial ischemia model was established by ligating left coronary artery for 45 min followed by 120 min reperfution, in order to observe the contents of NOS and NO. Cardiac myocyte apoptosis was determined by terminal deoxynueleotidyl transferase-mediated dUTP nick end labeling (TUNEL). Bcl-2 and Bax proteins were detected by immunohistochemistry. The t-Akt and p-Akt signaling protein expressions were determined by Western blotting analysis.</p><p><b>RESULT</b>Compared with the I/R groups and the Res + Wom group, the Res group showed significant increase in the expressions of NOS, NO, Bcl-2 protein and p-Akt and notable decrease in cardiocyte apoptosis and Bax/Bcl-2. The difference of above indicators showed a statistical significance (P<0.05). Furthermore, above changes can be blocked by wortmannin, a specific blocker of PI3K-Akt signaling pathway, indicating a statistical significance in their changes (P<0.05).</p><p><b>CONCLUSION</b>Resveratol can inhibit the ischemia reperfusion-induced cardiocyte apoptosis, in which PI3K-Akt signaling pathway gets involved.</p>

Role of cadiocyte connexin 43 in mito-KATp channel mediated cardioprotection against ischemia-reperfusion injury induced by sevoflurane preconditioning in isolated rat hearts / 中华麻醉学杂志

Objective To evaluate the role of cadiocyte connexin 43 (Cx43) in mito-KATP channel mediated cardioprotection against ischemia-reperfusion(I/R) injury induced by sevoflurane preconditioning in isolated rat hearts.Methods Forty hearts from male adult SD rats weghing 200-250 g were excised and perfused in a Langendorff apparatus with K-H solution with 95 ％ O2-5 ％ CO2 at 36.5-37.5 ℃.Their hearts were randomly divided into 5 groups (n =8 each): control group (group C),group I/R,sevoflurane preconditioning group (group S),sevoflurane preconditioning + 5-HD group (group SH) and 5-HD group (group H).Myocardial I/R was induced by occlusion of the anterior descending branch of left coronary artery (LAD) for 30 min followed by 120 min reperfusion.After 10 min of equilibration,group C received continuous perfusion and LAD was exposed but not occluded.Group I/R received continuous perfusion for 30 min and LAD was occluded.In group S,SH and H,3％ sevoflurane,3 ％ sevoflurane mixed with 100μmmol/L 5-HD and 100 tmmol/L 5-HD was added into K-H solution to perfuse for 15 min respectively.After that,the hearts were washed by K-H solution for 15 min.HR,left ventricular systolic pressure ( LVSP),left ventricular diastolic pressure (LVDP) and ± dp/dtmax were recorded before administration (T0),immediately after administration (T1),immediately before ischemia ( T2 ),at 30 min of ischemia (T3) and 120 min of reperfusion (T4).At the end of reperfusion,left ventricular tissue was removed for determination of myocardial infarct size and expression of Cx43 and phosphor Cx43 (p-Cx43) by immunohistochemistry and Western blot respectively.Results Compared with group C,HR,LVSP and ± dp/dtmax were significantly decreased,LVDP was increased and the expression of Cx43 and p-Cx43 were down-regulated in groups I/R,SH and H (P ＜ 0.05).Compared with group I/R,HR,LVSP and ± dp/dtmax were significantly increased,LVDP and myocardial infarct size decreased,and the expression of Cx43 and p-Cx43 up-regulated in group S ( P ＜ 0.05),no significant difference was found in groups S + H and H( P ＞ 0.05 ).Conclusion Sevoflurane preconditioning can open mito-KATP channel,promote cadiocyte Cx43 phosphorylation,attenuate I/R injury in isolated rat hearts.

Endoscopic metal stent implantation for hilar cholangiocarcinoma / 中华消化外科杂志

Objective To investigate the therapeutic effectiveness of endoscopic self-expandable metal stent implantation for hilar cholangiocarcinoma. Methods The clinical data of 73 patients with hilar cholangiocar-cinoma who had received endoscopic metal stent implantation at the General Hospital of PLA Chengdu Command from July 2004 to July 2009 were retrospectively analyzed. The success rate of stent implantation, effective rate of jaundice release, duration of patency of the stent, survival time and postoperative complications were analyzed. Results Among the patients, 70 were successfully implanted with the stents. Unilateral metal stents were implan-ted in 62 patients, bilateral metal stents in three patients, and metal + plastic stents in five patients. The effective rate of jaundice release was 87% (61/70), the median duration of patency of the stent was 190 days, and the median survival time was 246 hours. Seven patients had complications of cholangitis, three had pancreatitis and two had bleeding. Conclusions The advantages of endoscopic metal stent implantation include minimal trauma and good efficacy in alleviating jaundice. It is the option of choice for the treatment of malignant biliary obstruction in patients with inoperable hilar cholangiocarcinoma.

Effects of the Zusanli or Sanyinjiao point electroacupuncture of obese rats on fat metabolism / 中华医学美学美容杂志

Objective To study the electroacupuncture effects of the single point Zusanli or Sanyinjiao on simple obese rats and to observe the regulation of fat metabolism.M[ethods Before and after the treatment,the body weights and lengths of rats in each group were measured tO calculate the Lee's index;besides,total cholesteriol (TC) and triglycerides (TG) in the rat blood were also determined.Finally,the rats were treated and observed for tWO courses,and SPSS11.5 statistical software was employed to conduct statistical analysis of the experimental data.Results A significant difference was observed about the effects on the height,weight,Lee's index,TC and TG between treatment group and the model group or normal control group (P<0.05 or P<0.01),but no significant difference between treatment group and normal control group (P>0.05).Conclusion Electroacupuncture of Zusanli and Sanyinjiao points has effects on simple-obesity rats,which can make weight loss and decrease Lee's index,TC and TG levels.The underlying mechanism may relate to the improvements of fat metabolism.

Acupuncture therapy for apoplectic aphasia: a systematic review / 中国针灸

<p><b>OBJECTIVE</b>To assess the therapeutic effect of acupuncture for apoplectic aphasia.</p><p><b>METHODS</b>A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture for apoplectic aphasia was performed with Cochrance system assessment methods. The quality of researches was reviewed one by one, and data was extracted by two reviewers independently. Meta-analysis was conducted with the assistance of RevMan 5.0 software.</p><p><b>RESULTS</b>Eleven randomized controlled trials (RCTs) involving 756 patients were included. Meta-analysis indicated that there was statistical difference between acupuncture and language training groups on cured rate with [RR = 1.74, 95% CI (1.10, 2.74), P = 0.02] at the end of treatment. However, acupuncture combined language training group was statistically superior to language training group on cured rate with [RR = 3.01, 95% CI (1.81, 5.01), P < 0.000 1], language function score with [WMD =10.54, 95% CI (7.86, 13.21), P < 0.000 01], oral expression with [WMD = 8.86, 95% CI (7.38, 10.35), P < 0.000 01].</p><p><b>CONCLUSION</b>It is approved that acupuncture (or acupuncture combined language training) is effective for apoplectic aphasia. But the quality of inclusive literature is low. Therefore, more RCTs of high methodological quality is requested to be carried out.</p>

Effects of warm needle moxibustion on bone mass density and biochemical indexes of bone metabolism in patients of postmenopausal osteoporosis / 中国针灸

<p><b>OBJECTIVE</b>To compare therapeutic effects of warm needle moxibustion and medication on osteoporosis and to study the mechanism.</p><p><b>METHODS</b>Forty cases were randomly divided into an acupuncture group and a medication group, 20 cases in each group. The acupuncture group was treated by warm needle moxibustion at Dazhu (BL 11), Ganshu (BL 18), Shenshu (BL 23), Zusanli (ST 36), Yanglingquan (GB 34) etc. once other day, for 3 months; and the medication group was treated by oral administration of tablet Caltrate with Vit D2 for 3 months. The changes of bone mass density (BMD), estradiol (E2), osteocalcin (bone growth protein, BGP), urine calcium/creatinine (Ca/Cr) in the two groups before and after treatment and therapeutic effects were investigated.</p><p><b>RESULTS</b>After treatment, BMD significantly increased (P<0.05, P<0.01) in the acupuncture group and did not signifi cantly changed in the medication group (P>0.05) with a significant difference between the two groups (P<0.05). After treatment E2 level significantly increased as compared with before treatment in both of groups (P<0.01); after treatment BGP significantly decreased as compared with before treatment in both of groups (P<0.01); after treatment Ca/Cr significantly decreased as compared with before treatment in the acupuncture group (P<0.05) ; af ter treatment, there were significant differences in BGP and Ca/Cr between the two groups (P<0.05 or P<0.01). The clinically controlled rate in the acupuncture group and in the medication group were 35.0%, 5.0%, respectively, the therapeutic effect of the acupuncture group being better than that of the medication group (P<0.01).</p><p><b>CONCLUSION</b>The therapeutic effect of warm needle moxibustion on osteoporosis is better than that of oral administration of tablet Caltrate with Vit D2 and it can increase levels of hormones and delay bone loss. It is an effective method for preventing and treating postmenopausal osteoporosis.</p>

Clinical Study on Kidney-Nourishing and Governor Vessel-Regulating Acupuncture Therapy for Apoplexy Sequela / 针灸推拿医学（英文版）

To observe the clinical efficacy of kidney-nourishing and governor vessel-regulating therapy for apoplexy sequela.Methods:Sixty subjects were equally randomized into observation group and control group,and respectively treated for 35 days.The scores of survival quality,interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor (TNF) were measured,and the clinical efficacy were compared between two groups.Results and Conclusion:After treatment.all the observational items were improved,with better results in observation group than in control group.This therapy has better effects than regular method in the treatment of apoplexy sequela.