Effect of the staging comprehensive treatment with acupuncture-moxibustion on Bell's facial palsy in the acute stage / 中国针灸

OBJECTIVES@#To compare the clinical effect on Bell's facial palsy in the acute stage between the staging comprehensive treatment with acupuncture-moxibustion and western medication.@*METHODS@#Sixty patients with Bell's facial palsy in the acute stage were randomly divided into an observation group and a control group, with 30 cases in each one. The patients in the control group were administered orally with prednisone acetate tablets and methylcobalamin tablets until the 28th day of illness. In the observation group, the staging comprehensive treatment with acupuncture-moxibustion was adopted. On the affected side, Qianzheng (EX-HN 16), Yifeng (TE 17), Sibai (ST 2), Yangbai (GB 14), Jiache (ST 6), Dicang (ST 4) and Touwei (ST 8), etc. were stimulated. In the acute stage (Day 1 to 7 of illness), the routine acupuncture and the point-toward-point needle insertion were delivered, no any manipulation was exerted at acupoints, and the needles were retained for 30 min. In the subacute stage (Day 8 to 14 of illness), on the base of the treatment as the acute stage, the depth of needle insertion was adjusted at a part of acupoints and the even needling technique was operated by twisting needle. Besides, electroacupuncture (EA) was attached to Qianzheng (EX-HN 16) and Dicang (ST 4), with continuous wave of low intensity and high frequency, 100 Hz, for 20 min. In the recovery stage (Day 15 to 28 of illness), on the base of the treatment as the subacute stage, the heavy stimulation of acupuncture was given, in which, the sticking and lifting needle techniques were delivered after the needles were inserted from Sibai (ST 2) toward Dicang (ST 4), and from Dicang (ST 4) toward Jiache (ST 6), separately; warm needling was operated at Yifeng (TE 17), and EA changed to stimulate the acupoints with the intermittent wave of high intensity and low frequency, 2 Hz, for 30 min. Acupuncture-moxibustion was given once every other day until the end of the 28th day of illness. The level of House-Brackmann facial nerve function rating scale (H-B grade),the score of Sunnybrook facial nerve grading system (Sunnybrook), the score of facial disability index (FDI), the temperature difference in the infrared thermal imaging facial area and electromyogram (EMG) situation of the affected muscle group were observed before and after treatment in the two groups. Using musculoskeletal ultrasound,the facial nerve diameter was detected and the clinical effect was compared between the two groups.@*RESULTS@#After treatment, the level of H-B grade, Sunnybrook score, the scores of physical function and social life function in FDI were improved when compared with those before treatment in the patients of either group (P<0.01, P<0.05), and the results of these evaluations in the observation group were better than those of the control group (P<0.05). After treatment, the temperature difference of the frontal area, the eye area, the zygomatic area and the mouth corner was declined in comparison with that before treatment in the two groups (P<0.05), and the temperature difference in each area in the observation group was lower than that of the control group (P<0.05).The root mean square (RMS) of the frontal muscle group, the zygomatic muscle group and the orbicularis muscle group on the affected side increased in comparison with that before treatment in the two groups (P<0.01), and RMS of the observation group was higher than that of the control group (P<0.05) after treatment. Before treatment, the diameter of the facial nerve on the affected side was larger than that on the healthy side (P<0.01), and after treatment, the diameter on the affected side was reduced when compared with that before treatment in the two groups (P<0.01); the diameter of the facial nerve on the affected side in the observation group was smaller than that of the control group (P<0.05), while, the diameter on the affected side was larger when compared with the healthy side in the control group (P<0.05). The total effective rate of the observation group was 93.3% (28/30), higher than that of the control group (83.3% [25/30], P<0.05).@*CONCLUSIONS@#The staging comprehensive treatment with acupuncture-moxibustion is clearly effective on Bell's facial palsy in the acute stage, which affirms the effectiveness of acupuncture-moxibustion for the acute stage of Bell's facial palsy in comparison with conventional western medication.

Research progress of combined statins and clopidogrel on atherosclerotic plaques / 中国基层医药

Statins and antiplatelet drugs are the two cornerstones for the treatment of cerebrovascular disea －ses.This two drugs play a vital role in reducing platelet reactivity and inhibiting inflammation .Statins can effectively delay the progression of atherosclerosis ,reduce plaque volume and reduce the incidence of cerebrovascular diseases through multiple pathways .Clopidogrel is currently used primarily for anti －platelet aggregation .Some studies indicate that clopidogrel is also involved in the process of atherosclerosis ,but the mechanism is not clear .The anti－atheroscle－rosis effect of clopidogrel is often neglected , when statins are combined with clopidogrel .This article reviews the progress in the treatment of atherosclerotic plaque by statin combined with clopidogrel .

Clinical characteristics and influencing factors on prognosis of pregnancy complicated with intracerebral hemorrhage / 中华围产医学杂志

Objective To analyze the clinical features and factors affecting prognosis for intracerebral hemorrhage (ICH) during pregnancy and postpartum.Methods A study of ICH was performed on 61 women in Beijing Tiantan Hospital,Capital Medical University between January 1997 and December 2014,and all cases were diagnosed with cerebral hemorrhage or subarachnoid hemorrhage during pregnancy or six weeks after delivery with CT or MRI after exclusion of ICH due to craniocerebral trauma.The subjects were divided into surgery (n=26) and conservative treatment (n=35) groups according to different ways of treatment;pregnancy associated problems (n=11) and cerebrovascular diseases groups according to the aetiology of ICH;low (n=13) and high score group (n=48) according their Glasgow score at the first visit;and short clinical onset to diagnosis time (O-D time) group (≤ 24 h,n=33) and long O-D time (＞24 h) group (n=28).We compared the maternal clinical features and prognosis between different groups with t,Mann-Whitney U or Chi-square tests.A stratified logistic regression was used to assess the effect of factors affecting the prognosis.Results The average gestational age at the onset of ICH of the 61 cases was (28.8±8.3) weeks (6-40 weeks),the Glasgow score was (11.3±4.8),the median O-D time was 24.0 h,the modified Rankin scale (mRS) was 2.7,and 14 maternal deaths were reported (23.0％).Among the 61 women,three were terminated in early trimester,12 terminated in second trimester,and the rest 46 delivered in late term among which two fetal deaths,44 live births,and four neonatal deaths.Thus the perinatal infant death rate was 13.0％ (6/46).The difference of maternal clinical features and prognosis between the surgery and conservative treatment group was not significant (all P＞0.05).However,comparison between the cerebrovascular disease and pregnancy associated diseases group showed the latter had a lower Glasgow score and Apgar score [12.2(3.0) vs 7.5(12.0),(8.9±1.9) vs (7.2±2.6)],the higher mRS [2.4(2.0) vs 3.9(5.0)] and gestational age [(27.7±8.4) vs (34.9±4.1)],maternal mortality rate [14.0％ (7/50) vs 7/11] and perinatal death rate [5.4％ (2/37) vs 4/11] (t or x2=-3.09,-2.34,1.93,1.17,2.12 and 1.78,all P＜0.05).For women with low Glasgow score,the median O-D time was shorter than that of higer Glasgow score group (8.0 vs 48.0 h),the mRs and maternal mortality rate were higher 4.9(2.5) vs 3.1(2.0);9/13 vs 10.4％(5/48),t,U or x2=426.00,5.77 and 19.14,all P＜0.05].The short O-D time group showed lower Glasgow score and average Apgar score of the newborns than the long O-D time group [9.8(11.3) vs 13.2(2.0),(7.9±2.7) vs (9.2±0.9);t,U or x2=-2.91 and-2.23,both P＜0.05].The Glasgow scores was negatively associated with the mRs (OR=-0.26,95％CI:-0.16 to-0.05).In particular,O-D time (OR=0.03,95％CI:0.00-0.66) and pre-eclampsia (OR=0.33,95％CI:0.12-0.26) were both positively related to maternal mRs.However,the Glasgow scores,surgical treatment,O-D time and concomitant pre-eclampsia were irrelevant to the death ofperinatal infants (all P＞0.05).Conclusions The prognosis is poor in women with ICH during pregnancy or postnatal period whose Glasgow score was low or O-D time was long,or the ICH occurred due to pre-eclampsia.Antenatal care should be strengthened and early identification and diagnosis might improve the prognosis.

Effect of HPV E6 siRNA on the proliferation and chemotherapy sensitivity of cervical cancer HeLa cells / 基础医学与临床

Objective To elucidates the effects of HPV18 E6 siRNA targeting at human papillomavirus(HPV)18 E6 gene on the proliferative activity of HeLa cells and chemotherapy sensitivity.Methods HPV18 E6 expression of HeLa cells was inhibited by siRNA interference,the change of P53 and P21 proteins expression level was measured by Western blot.MTT assay was used to detected proliferative activity and sensitivity to paclitaxel liposome of HeLa cells.Results After inhibition of E6 expression,P53 and P21 proteins increased and the growth of HeLa cells was decreased(P ＜0.01).The inhibition rate of HeLa was markedly increased after transfection of HPV18 E6 siRNA and paclitaxel liposome.Conclusion HPV18 E6 siRNA can effectively silence gene expression of E6 and inhibit proliferation of HeLa cells.HeLa cells are more sensitive to combine HPV18 E6 siRNA with paclitaxel liposome than that of control groups.