Analysis of continuous polysomnography in children with recurrent vertigo / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the relationship between sleep status and the disease in children with recurrent vertigo（RVC） by analyzing the objective sleep condition of children with recurrent vertigo. Methods:According to the diagnostic criteria of RVC, 50 children with RVC and 20 normal controls without RVC were selected. According to the vertigo questionnaire score, the RVC group was divided into mild, moderate and severe groups according to severity. Continuous polysomnography（PSG） was performed for all participants, and SPSS 25.0 statistical software was used to analyze the monitoring results. Results:①There were significant differences in sleep time of each period, total sleep time and sleep efficiency between RVC group and control group（P<0.05）, but there was no significant difference in sleep latency（P>0.05）. The specific manifestations were that the proportion of sleep time in N1 and N2 phases increased, the proportion of sleep time in N3 and REM phases decreased, the total sleep time and sleep efficiency decreased in RVC group. ②The abnormal rate of sleep apnea hypopnea index, that is, the proportion of AHI≥5 times/h and the abnormal rate of lowest blood oxygen saturation in RVC group were higher than those in normal control group. There was significant difference between the two groups（P<0.05）. ③There were significant differences in the proportion of AHI≥5 times/h and lowest SpO2 among mild group, moderate group and severe group（P<0.05）. ④There was no significant correlation between the degree of vertigo and the abnormal rate of AHI in children with RVC, but there was a negative correlation between the degree of vertigo and the abnormal rate of lowest SpO2 in children with RVC. Conclusion:Children with RVC are often accompanied by sleep disorders, clinicians should pay attention to both the symptoms of vertigo and sleep condition in children. Polysomnography is non-invasive and operable, providing a new idea to the auxiliary examination of RVC in children. It is of certain clinical significance for the comprehensive treatment of children with RVC to actively improve vertigo symptoms and pay attention to improving sleep quality.

Clinical research of mild and moderate lumbar disc herniation of blood stagnation syndrome treated with-conducting needling technique at the governor vessel acupoints combined with electroacupuncture / 中国针灸

<p><b>OBJECTIVE</b>To compare the difference in the clinical therapeutic effects on mild and moderate lumbar disc herniation (LDH) of blood stagnation syndrome between-conducting needling technique at the governor vessel acupoints combined with electroacupuncture (EA) and conventional EA.</p><p><b>METHODS</b>Two hundred and one patients of LDH at the mild and moderate stage, differentiated as blood stagnation syndrome were randomized into an observation group (101 cases) and a control group (100 cases). In the observation group, the-conducting needling technique at the governor vessel acupoints and EA were used. The acupoints were Yaoyangguan (GV 3), Shiqizhui (EX-B 8), Huantiao (GB 30) and Yanglingquan (GB 34). Afterarrival, the-conducting needling technique was used at Yaoyangguan (GV 3) and Shiqizhui (EX-B 8); the EA was at Huantiao (GB 30) and Yanglingquan (GB 34). The treatment was given once every two days, 3 times a week. The treatment for 12 times was as one session. The observation lasted for 1 session. In the control group, the acupoints were the same as the observation group and stimulated with EA. The EA parameters, treatment frequency and duration were all the same as the observation group. The lumbar back pain score of Japanese Orthopedics Association (JOA) score before treatment, after treatment and in 3-month follow-up visit in the two groups, the infrared thermogram temperature in lumbar region and the relaxation area under curve (RAUC) before and after treatment as well as the short-term and the long-term therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>The total short-term effective rate was 89.11% (90/101) and the total long-term effective rate was 91.11% (82/90) in the observation group, and those were 86.00% (86/100) and 89.53% (77/86) in the control group respectively, without significant differences between the groups (both>0.05). The short-term clinical curative rate was 52.48% (53/101) and the long-term clinical curative rate was 55.56% (50/90) in the observation group, better than 36.00% (36/100) and 34.88% (30/86) in the control group (both<0.05). Compared with those before treatment, JOA scores were all improved after treatment and in follow-up visit in the two groups (all<0.01), without statistical significance at each time point between the two groups (all>0.05). The infrared thermogram temperature was improved after treatment in the two groups (both<0.01). The increasing amplitude in the observation group was higher than that in the control group (<0.01). The lumbar RAUC after treatment was increased apparently as compared with that before treatment in the observation group (<0.01) and larger than that in the control group (<0.01).</p><p><b>CONCLUSIONS</b>The-conducting needling technique at the governor vessel acupoints combined with EA achieve the better clinical therapeutic effects than regular EA in the treatment of mild and moderate LDH of blood stagnation sydrome.</p>

Clinical research of shoulder-arm pain of cervical spondylotic radiculopathy treated with acupunc- ture based on the axillary nerve distribution / 中国针灸

<p><b>OBJECTIVE</b>To compare the difference in the efficacy on cervical spondylotic radiculopathy (CSR) between acupuncture at the acupoints on the axillary nerve distribution and the regular selection of acupoints. Methods Eighty patients of cervical spondylotic radiculopathy were randomized into an observation group and a control group, 40 ca.ses in each one. In the observation group, Jianjing (GB 21), Jianzhen (SI 9), Jianliao (TE 14) , Jianyu (LI 15) , Quyuan (SI 13), Tianzong (SI 11) and the trigger points in the scalpular region were selected along the axillary nerve distribution. The Hegu needling was adopted at the trigger points and stimulated with electric apparatus, continuous wave, 1Hz. In the control group, Dazhui (GV 14), Tianzhu (BL 10), Houxi (SI 3), cervical Jiaji (EX-B 2) were selected and stimulated with the regular acupuncture. Electric stimulation was added at cervical Jiaii (EX-B 2), with continuous wave, 1Hz. The needles were retained for 30 min in the two groups, once every two days and 10 treatments made one session. The efficacy was assessed in one session of treatment. The 20-point scale of CSR developed by Japanese scholar, Tanaka Yasuhisa, and the visual analogue scale (VAS) were adopted to score the clinical symptoms and pain degree before and after treatment in the patients and assess the efficacy of the two groups.</p><p><b>RESULTS</b>The symptom scores and VAS scores after treatment were improved apparently as compared with those before treatment in the two groups (P<0. 05, P<0. 01), and the results in the observation group were better than those in the control group (both P<0. 05). The total effective rate in the observation group was 85. 0% (34/40), better than 71. 8% (28/39) in the control group (P<0. 05).</p><p><b>CONCLUSION</b>The acupuncture at the acupoints on the axillary nerve distribution achieves the definite efficacy on CSR, better I than the regular acupuncture at cervical Jiaji (EX-B 2).</p>

Efficacy differences between different position in patients treated with electroacupuncture for lumbar herniated disc / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy differences between modified lateral position and prone position in patients treated with electroacupuncture (EA) for lumbar herniated disc (LHD).</p><p><b>METHODS</b>Seventy-six patients with LHD were randomly divided into a lateral position group and a prone position group, 38 cases in each one. The acupoint selection and treatment method were identical in the two groups except the position. Mingmen (GV 4), Yaoyangguan (GV 3), Dachangshu (BL 25), Xiaochangshu (BL 27), Zhibian (BL 54) and Huantiao (GB 30) were selected. EA was given three times a week, ten times were taken as one course and totally 20 times were given. The visual analogue scale (VAS) and Japanese orthopaedic association (JOA) scale were taken as efficacy criteria, which were evaluated before and after treatment as well as one month after treatment.</p><p><b>RESULTS</b>After treatment, VAS and JOA were significantly improved in the two groups (lateral position group:JOA 10.60±2.60 vs 18.92±3.87, VAS 8.13±0.99 vs 2.34±0.81; prone position group:JOA 10.94±2.06 vs 17.02±3.96, VAS 8.02±1.05 vs 2.86±0.96, all<0.01); the VAS and JOA in the lateral position group were higher than those in the prone position group (both<0.05). One month after treatment, VAS and JOA were significantly improved in the two groups (all<0.01), which was more significant in the lateral position group (both<0.05).</p><p><b>CONCLUSIONS</b>The treatment position could influence the efficacy of EA for LHD, and lateral position pre-sents certain advantages to prone position group.</p>

Relationship between MRI sign and outcome of percutaneous kyphoplasty in acute phase of osteoporotic vertebral compression fracture / 中华创伤杂志

Objective To observe the correlation of MRI findings with treatment outcome of percutaneous kyphoplasty (PKP) in the acute phase of osteoporotic vertebral compression fracture (OVCF).Methods A total of 101 patients with single-segment OVCF undergone PKP in the acute phase were included in the study.There were 19 males and 82 females, at age range of 61 to 89 years (mean, 69.3 years).According to the T2WI signal intensity, the patients were divided into low signal group (Group A), low-medium signal group (Group B), medium signal group (Group C), and mediumhigh signal group (Group D).visual analogue scale (VAS) was used to evaluating the pain relief.Correlations of MRI signal with vertebral height, vertebral compression ratio, Cobb's angle change in each group were determined.Results All MRI images were shown as low signal in T1WI and high signal in FS-T2WI.On the T2WI images, the signal was medium-high in 14 vertebrae, medium in 18 vertebrae, low-medium in 31 vertebrae, and low in 38 vertebrae.Among four groups, the VAS score, vertebral body height, vertebral compression ratio and Cobb's angle changes before operation showed no statistical difference compared with those after operation (P ＜ 0.05).Conclusions MRI findings are primarily low or medium signal on T2WI images in the acute phase of OVCF, which shows insignificant correlation with effect of PKP.However, PKP is effective in the treatment of OVCF.

Electroacupuncture at Houxi (SI 3) for acute lumbar sprain：a meta-analysis of randomized controlled trials / 针灸推拿医学（英文版）

Objective:To assess the efficacy and safety of electroacupuncture (EA) at Houxi (SI 3) in treating acute lumbar sprain. Methods: Randomized controlled trials (RCTs) involving EA at Houxi (SI 3) for acute lumbar sprain were retrieved from PubMed (1966-2014), EMBASE (1980-2014), Cochrane Library (Issue 1, 2014), CQVIP Database (1989-2014), Wanfang Digital Journal (1998-2014), the Chinese Biological Medical Literature Database (CBM, 1978-2014), and China National Knowledge Internet (CNKI, 1979-2014). The collection of data also adopted hand-search of the relevant journals from the Library of Shanghai Jiao Tong University. All of the data were first evaluated and extracted by two reviewers independently with a specially designed form. Then, the available data were analyzed by the Cochrane Collaboration's RevMan 5.2.0 software. Results:A total of 6 trials involving 1 288 patients were eligible. Meta-analysis showed that the total effectiveness rate in the EA group was significantly different when compared with Nimesulide [RR=1.33; 95% CI (1.19 to 1.49)] and Mobic [RR=1.08; 95% CI (1.03 to 1.14)], but similar to that of acupuncture at Yaotongdian (EX-UE 7) [RR=71.09; 95% CI (1.00 to 1.19)] and Diclofenac Sodium [RR=1.08; (95% CI 0.96 to 1.21)]. The recovery rate in the EA group was significantly different when compared with Mobic [RR=1.67; (95% CI 1.45 to 1.92)] and Nimesulid [RR=1.37; (95% CI 1.15 to 1.62)], but similar to that of acupuncture at Yaotongdian [(RR=1.35; 95% CI 0.99 to 1.84)] and Diclofenac Sodium [(RR=1.19; 95% CI 0.88 to 1.61)]. Conclusion:Up to the search date, there are few high quality RCTs to evaluate the clinical efficacy of EA at Houxi (SI 3) for acute lumbar sprain, especially studies in English. Yet EA at Houxi (SI 3) still appeared to be an efficacious method for acute lumbar sprain, despite several inherent defects of the included studies. Further large scale trials are required to define the role of EA at Houxi (SI 3) in the treatment of this disease.

Therapeutic Observation of LU’s Heat-producing Needling (Shao Shan Huo) for Cervical Spondylotic Radiculopathy / 上海针灸杂志

Objective To evaluate the short-term and long-term therapeutic efficacies of LU’s heat-producing needling (Shao Shan Huo) in treating cervical spondylotic radiculopathy (CSR). MethodTwo hundred patients with CSR were randomized into a treatment group and a control group, 100 in each group. The treatment group was intervened by using heat-producing needling method, while the control group was by regular acupuncture technique with even reinforcing-reducing manipulations. For both groups, the treatment was given once a day, 10 sessions as a treatment course. The Pain Rating Index (PRI), Present Pain Intensity (PPI), and Visual Analogue Scale (VAS) were adopted for observation before intervention and after two treatment courses. The clinical efficacies were compared between the two groups.Result Right after the intervention and in the 3-month follow-up, the VAS, PPI, and PRI scores were significantly different from that before intervention in both groups (P<0.01). There were significant differences in comparing the VAS, PPI, and PRI scores between the two groups after intervention and in the 3-month follow-up (P<0.01). The VAS, PPI, and PRI scores in the treatment group right after intervention were markedly different from that in the 3-month follow-up (P<0.01). The total effective rate was 98.0% in the treatment group versus 79.0% in the control group, and the difference was statistically significant (P<0.01).Conclusion LU’s heat-producing needling is an effective way in treating CSR, as it can significantly reduce pain intensity, and improve other symptoms and body signs.

A Self-control Study of Acetic Acid Stain-guided Biopsies in Detection of Intestinal Metaplasia and Dysplasia in Barrett’s Esophagus / 胃肠病学

Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.

Therapeutic Efficacy Observation on‘Setting F ire on the Mountain’ Manipulation by Lu Shou-yan for Cervical Radiculopathy / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of‘setting fire on the mountain’ manipulation by Lu Shou-yan for cervical radiculopathy as well as the infrared thermographic changes of the cervical area before and after treatment. Methods:A total of 120 eligible cases with cervical radiculopathy were randomly allocated into an observation group and a control group, 60 in each group. Cases in the observation group were treated with Lu Shou-yan’s ‘setting fire on the mountain’ manipulation, whereas cases in the control group were treated with even reinforcing-reducing manipulation. After two courses of treatment, the infrared thermographic changes and overall therapeutic efficacies in the two groups were compared. Results: The recovery rate and total effective rate in the observation group were 68.3%and 98.3%respectively, versus 28.3%and 81.7%in the control group, showing statistical differences in recovery rate and total effective rate (both P Conclusion:‘Setting fire on the mountain’ manipulation by Lu Shou-yan is better than even reinforcing-reducing manipulation for cervical radiculopathy.

Qi-guiding Needling Based on Meridian Differentiation for Lumbar Disc Herniation:A Multi-centered, Randomized Controlled Trial / 针灸推拿医学（英文版）

Objective: To observe the efficacy of acupoint selection by meridian differentiation plus qi-guiding needling in treating lumbar disc herniation (LDH). Methods: By using the random number table, 549 patients with LDH were randomized into two groups. Two hundred and eighty participants in the observation group were intervened by selecting acupoints by meridian differentiation associated with qi-guiding needling method, and the other 269 participants in the control group were by selecting acupoints by meridian differentiation plus electroacupuncture. At the end of intervention, the changes of conduction velocities of the common peroneal nerve, superficial peroneal nerve, and tibial nerve were observed, and the therapeutic efficacies were compared. Results: The total effective rate was 87.5% in the observation group versus 86.6% in the control group, and the difference was statistically insignificant (P>0.05). The recovery rate was 51.8% in the observation group versus 37.2% in the control group, and the difference was statistically significant (P Conclusion: Selecting acupoints by meridian differentiation associated with qi-guiding needling can produce a similar total effective rate to selecting acupoints by meridian differentiation plus electroacupuncture, while its recovery rate is comparatively higher.

Clinical Study of Qi-guiding Acupuncture at Points Selected According to Meridian Differentiation for Treatment of Lumbar Intervertebral Disc Herniation / 上海针灸杂志

ObjectiveTo investigate the efficacy of meridian differentiation-based point selection plus qi-guiding acupuncture in treating lumbar intervertebral disc herniation.MethodFive hundred and forty-nine patients with lumbar intervertebral disc herniation were randomly allocated, using a random number table, to two groups. The treatment group of 280 patients received qi-guiding acupuncture at points selected according to meridian differentiation and the control group, electroacupuncture at points selected according to meridian differentiation.ResultThe total efficacy rate was 87.5% in the treatment group and 86.6% in the control group; there was no statistically significantdifference between the two groups (P>0.05). The cure rate was 51.8% in the treatment group and41.6% in the control group; there was a statistically significant difference between the two groups (P<0.05). ConclusionThe total efficacy rate of qi-guiding acupuncture at points selected according to meridian differentiation for lumbar intervertebral disc herniation is similar to that of electroacupuncture at points selected according to meridian differentiation, but the cure rate of the former is higher thanthat of the latter.

Clinical Study on Acupuncture plus Medication for Chronic Atrophic Gastritis Due to Spleen-stomach Deficiency / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of combining acupuncture and medication in treating chronic atrophic gastritis (CAG) due to spleen-stomach deficiency. Methods: Totally 176 patients with CAG were randomized into two groups by the random number table. The 91 subjects in the treatment group were intervened by acupuncture and oral Chinese patent medication; the other 85 subjects were by oral Chinese patent medication alone. The clinical efficacies were compared at the end of intervention. Results: After a treatment course, the total effective rate was 87.9% in the treatment group versus 75.3% in the control group; according to the gastroscopy and pathological biopsy examinations, the total effective rate was 85.7% in the treatment group versus 74.1% in the control group. There were significant differences in comparing the clinical efficacy, gastroscopy and pathological examinations between the two groups (P Conclusion: Combining acupuncture and medication can produce a better therapeutic efficacy than medication alone in treating CAG due to spleen-stomach deficiency.

Clinical analysis of 16 cases frontal, ethmoid sinus cyst with eye symptoms as initial amount / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis of frontal, ethmoid sinus cyst with eye symptoms as initial amount,and the curative effect of nasal endoscopic operation.@*METHOD@#To retrospectively analyze clinical data of sixteen patients with frontal, ethmoid sinus cyst from February 2006 to March 2008.@*RESULT@#Diagnostic accordance rate of paranasal sinus MRI and CT examination In 16 patients is 100%. Fourteen patients' ocular symptoms disappeared after nasal endoscope operation treatment, two of them improved. None of them recurrened after the fol low-up 3-6 years up to now, all the patients had satisfactory curative effect.@*CONCLUSION@#Paranasal sinuses and or bital cavity have close relationship , patients with sinus lesions always firstly visit Ophthalmology doctor. The results of MRI and CT examination are of great value for diagnosis. Patients with frontal, ethmoid sinus cyst with eye symptoms as initial amount should be early diagnosed. The treatment of nasal endoscope operation is safe, effective and is worth of firstly chosen.

The expression of Smac and survivin in sinonasal inverted papilloma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the expression of Smac(second mitochondria-derived activator of caspase)and survivin on the growth, development, recurrence and carcinogenesis of the sinonasal inverted papilloma(NIP).@*METHOD@#Immunohistochemical method was used to detective the expression of Smac and survivin in 10 cases of (nasal cavity mucosae, NM), 45 cases of NIP. The NIP group including 25 cases of NIP without dysplasia, 11 cases of NIP with dysplasia, and 9 cases of NIP with malignant transformation to squamous cell carcinoma(SCC).@*RESULT@#The intensity of the positive expression of Smac in NIP was lower than NM, the intensity of the positive expression decreased with the decreasing degree of histological differentiation. There was significantly difference between NIP without dysplasia and SCC. The expression of survivin was negative in the control group, the expression intensity of NIP was enhanced. The degree of histological differentiation was lower, the intensity of the positive expression was higher. The expression between NIP without dysplasia and SCC had significantly differences. Smac negatively correlated with survivin(rs = -0.403, P<0.01).@*CONCLUSION@#Smac and survivin were associated with the growth and carcinogenesis of NIP.

Correlation between CYP21A2 genotype and phenotype in patients with 21-hydroxylase deficiency / 临床儿科杂志

Objectives To study the mutation spectrum in CYP21A2 gene in patients with 21-hydroxylase deficiency (21-OHD), and to analyze the relationship between genotype and phenotype. Methods Eighteen patients with 21-OHD were identified by neonatal screening of 17α-OH progesterone (17α-OHP). The allele specific PCR-DNA sequencing com-bining with multiplex ligation-dependent probe amplification was applied to determine the genotype in the patients and their parents. Results Six mutations of CYP21A2 gene were identified. I2G (44.4%) and del (33.3%) were the most frequent mutations and also were the most common mutations in salt-wasting form. The detection rate of I172N mutation in simple virilizing form was 75%. Patients were classified into three groups according to the degree of 21-hydroxylase enzymatic compromise caused by the mutation. The serum 17α-OHP, ACTH and T levels which reflected the severity of disease were significantly different among three groups (P<0.05). Conclusions The genetic diagnosis of 21-OHD reveals the consistency between genotype and phenotype.

Effect and mechanism of acupuncture in the treatment of knee osteoarthritis / 中国组织工程研究

BACKGROUND: Studies have shown that acupuncture combined with Chinese medicine has a certain effect in the treatment of knee osteoarthritis. OBJECTIVE: To investigate the mechanism and effect of acupuncture combined with Chinese medicine for the treatment of knee osteoarthritis. METHODS: The animal models of knee osteoarthritis were established to detect the expression levels of related factors, including matrix metal oproteinase 3, transforming growth factor β, interleukin-1β and tumor necrosis factor-α. The knee osteoarthritis patients treated with acupuncture combined with Chinese medicine were fol owed-up, and the patients received acupuncture in the main points and the adjunct points, as wel as the Chinese medicine administration and the external application and fumigation. Then, the active function recovery of the knee joint was observed to identify the effect of acupuncture combined with Chinese medicine. RESUTLS AND CONCLUSION: Acupuncture can delay the destruction of knee joint articular cartilage and improve the knee function through decreasing the contents of matrix metal oproteinase 3, transforming growth factor β, interleukin-1β and tumor necrosis factor-α, thus playing the treatment effect on knee osteoarthritis. The knee osteoarthritis patients treated with acupuncture combined with Chinese medicine can obtain better effect, and the treatment efficiency is more than 90%. Compared with the single application of sodium hyaluronate or acupuncture treatment, acupuncture combined with Chinese medicine has higher treatment efficiency and better treatment effect.

The value of the gastroesophageal reflux disease questionnaire score for acid exposure prediction in gastroesophageal reflux disease patients / 中华消化杂志

Objective To evaluate whether the gastroesophageal reflux disease (GERD) questionnaire (GerdQ) symptom score could reflect the acid exposure indicated by 24-hour esophageal pH monitoring in patients with GERD, and to further validate the clinical application value of GerdQ.Methods From November 2008 to March 2010, 134 GERD patients from outpatient department with heartburn and acid reflux symptoms were enrolled.All the patients had undergone endoscopy examination, 24-hour esophageal pH monitoring and GerdQ scoring.According to 24-hour esophageal pH monitoring result, acid exposure group and none acid exposure group was divided by the percentage of time that pH was lower than 4 over 4.2% or DeMeester score over 14.72, the difference of GerdQ score was assessed.The receiver operating characteristic (ROC) curve of GerdQ score was drawn according to DeMeester score and the percentage of time that pH was lower than 4 as the gold standard.With SPSS 17.0 statistical software, the ratio was compared with the u test and Chi-square test, comparison between groups with t test.Results The BMI of acid exposure group was higher than that of none acid exposure group(t= 2.365, P= 0.019).The GerdQ score of acid exposure group (8.51± 2.34) was significantly higher than that of none acid exposure group (6.67 ± 2.79), the difference was statistically significant (t = 4.002, P = 0.000) .ROC curve was drawn according to DeMeester score over 14.72 as gold standard; the area under curve (AUC) was 0.70.When the critical value of GerdQ score was 7.5, Youden index was up to 0.3365, the sensitivity of diagnosis was 0.6909 and specificity was 0.6454.The percentage of time that PH was lower than 4 over 4.2% as the gold standard, the AUC of GerdQ score was 0.663.When the critical value of GerdQ score was 7.5, Youden index was up to 0.2790, the sensitivity of diagnosis was 0.6600 and specificity was 0.6190.Conclusions GerdQ score greater than 7.5 can better reflect acid exposure at the lower esophageal.There is stronger association between GerdQ score with the DeMeester acid exposure score over 14.72 than with the percentage of time that pH lower than 4 over 4.2% as the critical value for acid exposure.Obesity may aggravate the transient lower esophageal sphincter relaxation leading to occurrence of GERD symptoms.

Results of second-trimester prenatal screening using two serum markers for Down's syndrome in 60 931 pregnant women / 中华围产医学杂志

Objective To approach the efficiency of second-trimester prenatal screening using two serum markers for Down's syndrome (DS).Methods Retrospective analysis was conducted on the results of prenatal screening using two serum markers,alpha fetoprotein (AFP) and free beta subunit of human chorionic gonadotropin(free-β-hCG),in 50 cases of DS pregnancy identified among 60 931 pregnant women received prenatal screening from November 1997 to April 2008 in Nanjing Maternal and Child Health Hospital.Results Among the 50 DS cases,the detection rate of DS was 50% (25/50) when taking free-β-hCG≥2.5 MoM as the cut-off,with the positive rate of screening was 6.6%.And the detection rate of DS would be 18.0%(9/25) when taking AFP≤0.5 MoM as the cut-off,with the positive rate of screening was 4.6%.When the risk cut-off value of DS was set at 1/270,the detection rate changed to 52.0%,and the positive rate of screening was 4.7%;and the two figures changed to 62.0% and 5.5%,respectively,when the risk cut-off was set to 1/300.Thirteen DS cases showed the risk value between 1/1000 and 1/300,among which two were monomarker abnormality.Thirteen (26.0%) of the 50 DS fetus were found to have one or two abnormality markers by ultrasound scan,among which one was DS low risk,and the other 12 were DS high risk in serum screening.Conclusions The second-trimester prenatal screening using AFP or free β-hCG for Down's syndrome is effective in identifying DS pregnancy with limited specificity and sensitivity.But the detection rate can be elevated by the combination of these two markers.The second trimester systemic ultrasound scan is not ideal for DS identification,but it can increase the specificity and sensitivity of serum prenatal screening.

Regulatory effects of transforming growth factor beta in electro-acupuncture treatment of knee osteoarthris / 中国组织工程研究

BACKGROUND: Electro-acupuncture therapy shows good central and peripheral analgesic effects. Several studies have shown that transforming growth factor β (TGF-β) plays an important role in the pathogenesis of knee osteoarthritis. OBJECTIVE: To investigate the mechanism underlying electro-acupuncture treatment of knee osteoarthritis. METHODS: A total of 80 healthy male 3-month-old Sprague Dawley rats were randomly and evenly divided into normal, model, electro-acupuncture and drug groups. Rat models of knee osteoarthris were estbalished by ligating the femoral veins and forcing rats to do activies. At 1 month after knee osteoarthris induction, the electro-acupuncture group rats received electro-acupuncture therapy at two acupoints Neixiyan (EX-LE4) and Dubi (ST 35) with a depth of 0.1 cun (pulse 2 Hz, 20 minutes, once a day). The drug group rats were intraarticularly administerd sodium hyaluronate (0.1 mL/administration, once a week). After 2-week treatment, synovial tissue of the knee joint was harvested to determine the exprssion of TGF-β1, TGF-β1 receptor Ⅰand TGF-β1 receptor Ⅱ. RESULTS AND CONCLUSION: TGF-β1 expression in synovial tissue of the knee joint was significantly increased after knee osteoarthris (P < 0.05), but after electro-accupuncture therepy or sodium hyaluronate treatment, TGF-β1 expression was significantly decreased (P < 0.05), moreover, TGF-β1 receptor Ⅰ, Ⅱ expression was signficantly decreased (P < 0.05). These findings suggest that electro-acupuncture for treatment of knee osteoartheis improves the symptoms of osteoarthris by downregulating TGF-β1 expression, and reduction in TGF-β1 receptor Ⅰ, Ⅱ expression promotes the recovery of knee osteoarthris.