Effect of intraoperative low vs. conventional tidal volume on the incidence of postoperative acute kidney injury after noncardiac surgery: a two-center randomized clinical trial.

BACKGROUND: In adults undergoing noncardiac surgery, the correlation between intraoperative tidal volume and postoperative acute kidney injury (AKI) is unclear. This study aimed to investigate the effects of low tidal volume ventilation on the incidence of postoperative AKI compared with conventional tidal volume in adults undergoing noncardiac surgery. METHODS: This was a two-center prospective randomized controlled trial on adult patients who underwent noncardiac surgery and had a mechanical ventilation of >60 min. Patients were randomized to receive either a tidal volume of 6 mL/kg pre-predicted body weight (PBW, low tidal volume) or a tidal volume of 10 mL/kg pre-predicted body weight (conventional tidal volume). The primary outcome was the incidence of AKI after non-cardiac surgery. Appropriate statistical methods were used for this study. RESULTS: Among the 1982 randomized patients, 943 with low tidal volume and 958 with conventional tidal volume were evaluable for the primary outcome. Postoperative AKI occurred in 12 patients (1.3%) in the low tidal volume group and 11 patients (1.1%) in the conventional tidal volume group, with an odds ratio of 0.889 (95%CI, 0.391-2.03) and a relative risk of 0.999 ([95%CI, 0.989-1.01]; P=0.804). Postoperative serum creatinine levels increased in 284 (30.0%) patients with low tidal volume compared to 316 (32.0%) patients with conventional tidal volume (P=0.251). No difference in postoperative serum creatinine levels was found between the two groups (57.5 [49.0-68.2] µmol/L vs. 58.8[50.4-69.5] µmol/L, P=0.056). CONCLUSIONS: Among adults undergoing noncardiac surgery, low tidal volume mechanical ventilation did not significantly reduce the incidence of postoperative AKI compared with conventional tidal volume.

Evaluation of Coenzyme Q10 (CoQ10) Deficiency and Therapy in Mouse Models of Cardiomyopathy.

ABSTRACT: Mitochondrial dysfunction plays a key role in the development of heart failure, but targeted therapeutic interventions remain elusive. Previous studies have shown coenzyme Q10 (CoQ10) insufficiency in patients with heart disease with undefined mechanism and modest effectiveness of CoQ10 supplement therapy. Using 2 transgenic mouse models of cardiomyopathy owing to cardiac overexpression of Mst1 (Mst1-TG) or ß 2 -adrenoceptor (ß 2 AR-TG), we studied changes in cardiac CoQ10 content and alterations in CoQ10 biosynthesis genes. We also studied in Mst1-TG mice effects of CoQ10, delivered by oral or injection regimens, on both cardiac CoQ10 content and cardiomyopathy phenotypes. High performance liquid chromatography and RNA sequencing revealed in both models significant reduction in cardiac content of CoQ10 and downregulation of most genes encoding CoQ10 biosynthesis enzymes. Mst1-TG mice with 70% reduction in cardiac CoQ10 were treated with CoQ10 either by oral gavage or i.p. injection for 4-8 weeks. Oral regimens failed in increasing cardiac CoQ10 content, whereas injection regimen effectively restored the cardiac CoQ10 level in a time-dependent manner. However, CoQ10 restoration in Mst1-TG mice did not correct mitochondrial dysfunction measured by energy metabolism, downregulated expression of marker proteins, and oxidative stress nor to preserve cardiac contractile function. In conclusion, mouse models of cardiomyopathy exhibited myocardial CoQ10 deficiency likely due to suppressed endogenous synthesis of CoQ10. In contrast to ineffectiveness of oral administration, CoQ10 administration by injection regimen in cardiomyopathy mice restored cardiac CoQ10 content, which, however, failed in achieving detectable efficacy at molecular and global functional levels.

Ketamine administration ameliorates anesthesia and surgery-induced cognitive dysfunction via activation of TRPV4 channel opening.

Perioperative neurocognitive disorder (PND) is a common complication associated with anesthesia and surgery in the elderly. The dysfunction of transient receptor potential vanilloid 4 (TRPV4) has been associated with a number of diseases, including Alzheimer's disease. Given that ketamine can reportedly improve PNDs, the present study sought to determine whether ketamine-induced PND alleviation was mediated by activation of TRPV4 channel opening. A total of 120, 20-month-old male C57BL/6 mice were randomly divided into five groups: Vehicle, PND (tibial fracture surgery), PND + ketamine (Ket), PND + Ket + HC-067047 (HC), and PND + HC groups. Ketamine (0.5 mg/kg) was administered intraperitoneally once a day for 3 days after surgery and HC-067047 (1 µmol/2 µl), an antagonist of TRPV4, was administered via the left lateral ventricle 30 min before ketamine treatment. Superoxide dismutase (SOD), malondialdehyde (MDA), lipid peroxidation (LPO), IL-1ß, IL-6, adenosine monophosphate-activated protein kinase (AMPK), NF-κB, TNF-α and IFN-ß levels were determined 3 days after surgery. At 28 days after surgery, fear conditioning and novel object recognition were assessed, and Aß1-42 levels were measured and ionized calcium binding adaptor molecule 1 (Iba1) staining was conducted on day 31 after surgery. The results revealed that ketamine administration upregulated total SOD activity, downregulated MDA and LPO content, mitigated phosphorylated (p)-NF-κB, TNF-α mRNA and IFN-ß mRNA expression in the hippocampus, and promoted p-AMPK 3 days after surgery. Furthermore, it was found that ketamine increased both context- and tone-dependent fear conditioning, and the time spent exploring a novel object, and reduced Aß peptide levels and microglial activation 30 days after surgery. Notably, these changes could be reversed by HC-067047 to a certain extent. In conclusion, ketamine improved PND in aged mice after tibial fracture surgery and the potential mechanism may involve activation of the TRPV4/AMPK/NF-κB signaling pathway.

CXCL10 is a potential biomarker and associated with immune infiltration in human papillary thyroid cancer.

BACKGROUND: In recent years, the annual incidence of thyroid cancer (TC) has increased, with papillary thyroid cancer (PTC) identified as the most commonwinwordpathological type accounting for approximately 80% of all thyroid cancer cases. The tumor microenvironment is known to play a vital role in tumor information transmission and immune detection. METHODS: In the present study, we examined gene expression data from 518 patients with PTC. The ESTIMATE algorithm was used to calculate immune and stromal scores of PTC patients. Based on a protein-protein interaction (PPI) network, functional enrichment and overall survival analyses, C-X-C motif chemokine ligand 10 (CXCL10) was identified as a core gene. We further investigated the roles of core genes of PTC in the tumor immune microenvironment using LinkedOmics, GSEA, and TIMER tools. RESULTS: Immune, stromal and ESTIMATE scores were related to clinicopathological variables of patients with PTC, but not survival outcomes. Eight differentially expressed genes (DEGs) were associated with survival outcome. In addition, immunochemical staining experiments revealed lower expression of CXCL10 in PTC than paracancerous tissues. GSEA pathway enrichment analysis revealed downregulation of CXCL10 in multiple cancer pathways. CXCL10 and related genes were enriched in pathways related to adaptive immune response, cellular defense response and regulation of innate immune response. CONCLUSION: The tumor microenvironment plays a critical role in development of PTC and CXCL10 may serve as a novel target of precision therapy for this patient population.

Identification of key genes of papillary thyroid carcinoma by integrated bioinformatics analysis.

BACKGROUND: Papillary thyroid carcinoma (PTC) is one of the fastest-growing malignant tumor types of thyroid cancer. Therefore, identifying the interaction of genes in PTC is crucial for elucidating its pathogenesis and finding more specific molecular biomarkers. METHODS: Four pairs of PTC tissues and adjacent tissues were sequenced using RNA-Seq, and 3745 differentially expressed genes were screened (P<0.05, |logFC|>1). The enrichment analysis indicated that the vast majority of differentially expressed genes (DEGs) may play a positive role in the development of cancer. Then, the significant modules were analyzed using Cytoscape software in the protein-protein interaction network. Survival analysis, TNM analysis, and immune infiltration analysis of key genes were analyzed. And the expression of ADORA1, APOE, and LPAR5 genes were verified by qPCR in PTC compared with matching adjacent tissues. RESULTS: Twenty-five genes were identified as hub genes with nodes greater than 10. The expression of 25 genes were verified by the GEPIA database, and the overall survival and disease-free survival analyses were conducted with Kaplan-Meier plotter. We found only three genes were confirmed with our validation and were statistically significant in PTC, namely ADORA1, APOE, and LPAR5. Further analysis found that the mRNA levels and methylation degree of these three genes were significantly correlated with the TNM staging of PTC. And these three genes were related to PTC immune infiltration. Verification of the expression of these three genes by RT-qPCR and Western blot further confirmed the reliability of our results. CONCLUSION: Our study identified three genes that may play key regulatory roles in the development, metastasis, and immune infiltration of papillary thyroid carcinoma.

[Bilateral atlantoaxial lamina hook and atlantoaxial joint space screw for the treatment of acute type I transverse ligament injury in school-age children].

OBJECTIVE: To evaluate the effect of bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft on atlantoaxial dislocation caused by acute type I transverse ligament injury in school-age children. METHODS: From February 2006 to February 2019, 8 school-age children with atlantoaxial dislocation caused by acute type I transverse ligament injury were systematically reviewed, including 6 males and 2 females; aged 9 to 12 years old; 8 acute injuries included 4 high-level falls, 2 car accidents and 2 sports injuries; the atlantoaxial interval(ADI) was 5 to 8 mm. Eight cases presented with pain, stiffness, numbness and cervical spine dysfunction in different degrees. Two of them were accompanied by nerve compression and ASIA grade D. The preoperative C1,2 angle averaged 20.7° to 23.4°. All patients received cranial traction and surgical treatment after complete reduction or atlantoaxial reduction. The changes of Japanese Orthopaedic Association(JOA) score, space available for the cord(SAC), neck disability index(NDI), ADI, ASIA classification(ASIA) injury classification(1992) and C1,2 angle before and after treatment were observed. RESULTS: The average follow-up time was 8 to 156 months. Clinical and radiological follow-up showed that the atlantoaxial joint was completely relieved, the reduction was satisfactory and the arthrodesis was stable. Nerve and vascular injuries associated with this technique were not observed. JOA score, SAC, NDI, C1,2 angle of the last follow-up of the children were significantly improved. Two children of ASIA grade D recovered to grade E. CONCLUSIONS: Bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft is simple, less bleeding, strong stability and high fusion rate. It is an ideal surgical procedure for acute type I transverse ligament injury with atlantoaxial dislocation in school-age children.

Grip strength can be used to evaluate postoperative residual neuromuscular block recovery in patients undergoing general anesthesia.

BACKGROUND: Residual postoperative neuromuscular blockade is an important clinical issue. Neuromuscular monitoring is usually used to evaluate neuromuscular recovery in patients undergoing general anesthesia. However, this procedure is inconvenient and not widely adopted. We aimed to examine the correlation between grip strength and train-of-four ratio (TOFr) to examine whether assessing grip strength can be used clinically to monitor residual neuromuscular blockade. METHODS: One hundred twenty patients with ASA I or II scheduled for laparoscopic cholecystectomy under general anesthesia were enrolled in this study. All patients were randomly selected to receive standard anesthesia induction with either 0.6 mg·kg rocuronium or 0.2 mg·kg cisatracurium. Grip strength was tested in all patients using an electronic device before anesthesia and when TOFr values of 0.7, 0.8, and 0.9, and an hour later of TOFr value of 0.25. The time required for a change in TOFr values from 0.25 to 0.75 and 0.9 was evaluated. Spearman rank correlation analysis was performed to determine correlations between grip strength and TOFr. RESULTS: Spearman rank correlation analysis indicated that there was a significant correlation between grip strength and TOFr during patient recovery from general anesthesia (correlation coefficient for grip strength recovery [rs] = 0.886). Subgroup analysis revealed that there were no differences in mean maximum grip value recovery between patients treated with rocuronium and those treated with cisatracurium when TOFr was 0.7, 0.8, and 0.9 or when the TOFr was 0.25 after 60 minutes (all P >.05). Recovery of TOFr from 0.25 to 0.75 and from 0.25 to 0.9 was longer in patients treated with rocuronium than in those treated with cisatracurium (both P <.001). CONCLUSION: There was a strong correlation between grip strength and TOFr during recovery from general anesthesia. Evaluation of grip strength can be used as an additional strategy to evaluate postoperative residual neuromuscular blockade.

Bilateral atlantoaxial lamina hook and atlantoaxial joint space screw for the treatment of acute type I transverse ligament injury in school-age children / 中国骨伤

OBJECTIVE@#To evaluate the effect of bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft on atlantoaxial dislocation caused by acute type I transverse ligament injury in school-age children.@*METHODS@#From February 2006 to February 2019, 8 school-age children with atlantoaxial dislocation caused by acute type I transverse ligament injury were systematically reviewed, including 6 males and 2 females; aged 9 to 12 years old; 8 acute injuries included 4 high-level falls, 2 car accidents and 2 sports injuries; the atlantoaxial interval(ADI) was 5 to 8 mm. Eight cases presented with pain, stiffness, numbness and cervical spine dysfunction in different degrees. Two of them were accompanied by nerve compression and ASIA grade D. The preoperative C₁,₂ angle averaged 20.7° to 23.4°. All patients received cranial traction and surgical treatment after complete reduction or atlantoaxial reduction. The changes of Japanese Orthopaedic Association(JOA) score, space available for the cord(SAC), neck disability index(NDI), ADI, ASIA classification(ASIA) injury classification(1992) and C₁,₂ angle before and after treatment were observed.@*RESULTS@#The average follow-up time was 8 to 156 months. Clinical and radiological follow-up showed that the atlantoaxial joint was completely relieved, the reduction was satisfactory and the arthrodesis was stable. Nerve and vascular injuries associated with this technique were not observed. JOA score, SAC, NDI, C₁,₂ angle of the last follow-up of the children were significantly improved. Two children of ASIA grade D recovered to grade E.@*CONCLUSIONS@#Bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft is simple, less bleeding, strong stability and high fusion rate. It is an ideal surgical procedure for acute type I transverse ligament injury with atlantoaxial dislocation in school-age children.

Clinicopathological features and risk factors of neuroendocrine tumors in 256 patients / 天津医药

Objective To investigate the epidemiology, clinical manifestations, diagnosis, treatment and prognosis of neuroendocrine tumors (NETs). Methods Medical records of 265 patients with neuroendocrine tumors diagnosed and treated in our hospital from January 2006 to August 2015 were collected and retrospectively reviewed in this study. The clinicopathological data including gender, age of onset, initial symptoms, primary site, pathological conditions, diagnosis, treatment, prognosis and follow up were analyzed. Results The gender ratio M/F of the 265 cases was 160:105 (1.5:1), with mean age of (55.8±2.7) years, and the high incidence was in age of 55-65 years. The tumors were located in the colon and rectum (127 cases, 47.9％), lung (59 cases, 22.3％), stomach (21 cases, 7.8％), appendix (15 cases, 5.7％), small intestine (especially in the duodenum and pancreas, 10 cases, 3.8％), mammary gland (11 cases, 4.2％), neck (10 cases, 3.8％) and unknown primary site (12 cases, 4.5％). Patients with different tumor sites showed different symptoms. Patients with colorectal tumors mainly manifested as changes in bowel habits, such as diarrhea, constipation and blood in stool. The main manifestation of patients with primary pulmonary symptoms was cough or bloody sputum. The patients with tumors at stomach, appendix or small intestine showed many discomfort, such as abdominal pain and abdominal distention. Among the 265 cases, 186 patients were diagnosed as phase G1 (70.2％), 54 patients were diagnosed as phase G2 (20.4％) and 25 patients were diagnosed as phase G3 (9.4％). Immunohistochemistry showed that synaptophysin (Syn) was positive in 228 cases (86.4％), chromaffin A (CgA) was positive in 102 cases (38.5％), and C56 was positive in 74 cases (27.9％). A total of 232 patients were treated with surgery (87.5％), 28 patients received radiotherapy or chemotherapy treatment (10.6％) and 5 patients were not treated. One hundred and ninety-eight patients were followed up at least 1 time, and the follow-up rate was 74.7％. The median follow-up time was 38 months. No tumor related death was found in patients with phase G1 during the follow-up, 6 cases of tumor associated death were found in patients with phase G2 and 19 cases of cancer related death were found in patients with phase G3. Metastasis was found in all 23 patients with tumor related death. The survival rate of patients with neuroendocrine tumor (G1+G2) was significantly higher than that of patients with neuroendocrine carcinoma (G3, Log rankχ2=13.774,P<0.01). Conclusion The males have a higher incidence rate of NETs than females. Patients with different tumor sites showed different symptoms. The most common primary sites of NETs are the digestive tract, especially in patients with colorectal cancer. The more late the pathological stage, the worse the prognosis.

[Risk factors associated with stress ulcer bleeding in postoperative rectal cancer patients].

OBJECTIVE: To explore the influence factor of stress ulcer bleeding(SUB) in postoperative rectal cancer patients. METHODS: Clinical data of rectal cancer patients undergoing operation in our hospital were analyzed retrospectively. Patients were divided into case group and control group according to the postoperative occurrence of SUB. Univariate analysis combined with multivariate analysis were used to evaluate the influence factors. RESULTS: Chronic diseases incidence of case group was higher than that of control group. Except for renal failure, the incidence of postoperative complications of case group was higher than that of control group. Univariate analysis revealed that age, chronic disease, preoperative, and postoperative complications had statistical significant differences(P<0.05). Multivariate analysis identified that age(OR=2.893, 95%CI:1.118-5.543), drinking history(OR=3.839, 95%CI:1.012-6.654), preoperative chronic disease(OR=4.646, 95%CI:1.872-8.892), intraoperative bleeding volume(OR=5.129, 95%CI:2.829-9.328), occurrence of severe complications after surgery(OR=6.576, 95%CI:4.539-13.278), postoperative application of glucocorticoid(OR=2.978, 95%CI:1.013-4.512), preoperative application of non-steroidal anti-inflammatory drugs(OR=2.126, 95%CI:1.287-7.636) were risk factors for SUB in rectal cancer patients after operation. Postoperative prophylactic use antacids(OR=0.102, 95%CI:0.017-0.196) was protective factor for SUB patients. CONCLUSION: Effective measures should be taken for high-risk patients, in order to improve the prognosis of patients.

Risk factors associated with stress ulcer bleeding in postoperative rectal cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the influence factor of stress ulcer bleeding(SUB) in postoperative rectal cancer patients.</p><p><b>METHODS</b>Clinical data of rectal cancer patients undergoing operation in our hospital were analyzed retrospectively. Patients were divided into case group and control group according to the postoperative occurrence of SUB. Univariate analysis combined with multivariate analysis were used to evaluate the influence factors.</p><p><b>RESULTS</b>Chronic diseases incidence of case group was higher than that of control group. Except for renal failure, the incidence of postoperative complications of case group was higher than that of control group. Univariate analysis revealed that age, chronic disease, preoperative, and postoperative complications had statistical significant differences(P<0.05). Multivariate analysis identified that age(OR=2.893, 95%CI:1.118-5.543), drinking history(OR=3.839, 95%CI:1.012-6.654), preoperative chronic disease(OR=4.646, 95%CI:1.872-8.892), intraoperative bleeding volume(OR=5.129, 95%CI:2.829-9.328), occurrence of severe complications after surgery(OR=6.576, 95%CI:4.539-13.278), postoperative application of glucocorticoid(OR=2.978, 95%CI:1.013-4.512), preoperative application of non-steroidal anti-inflammatory drugs(OR=2.126, 95%CI:1.287-7.636) were risk factors for SUB in rectal cancer patients after operation. Postoperative prophylactic use antacids(OR=0.102, 95%CI:0.017-0.196) was protective factor for SUB patients.</p><p><b>CONCLUSION</b>Effective measures should be taken for high-risk patients, in order to improve the prognosis of patients.</p>

[Clinical observation on distinctive water-medicine cup therapy for treatment of cervical spondylopathy of cervical type].

OBJECTIVE: To use distinctive water-medicine cup therapy for treatment of cervical spondylopathy of cervical type as a sample to provide a more effective cupping method for clinic. METHODS: One hundred and forty cases were randomly divided into a medicine cup group (n = 47), a water cup group (n = 47) and a empty cup group (n = 46). The medicine cup group were treated by cupping therapy with a self-made medicine cup with 45 degrees C Chinese herb solution; the water cup group were treated with a cup with 45 degrees C water, and the empty cup group with a cup with nothing. Clinical symptoms and signs were observed for comparison of therapeutic effects. RESULTS: Clinically cured was 39 cases, and markedly effective was 8 cases in the medicine cup group; 20 cases were clinically cured, 22 cases were markedly effective and 5 cases were effective in the water cup group; 12 cases were clinically cured, 19 cases were markedly effective and 15 cases were effective in the empty cup group. There were significant differences in the ratio of cases of different therapeutic effects and the difference of pain score before and after treatment between the medicine cup group and the water cup group (P < 0.05), between the water cup group and the empty cup group (P < 0.05), and between the medicine cup group and the empty cup group (P < 0.01). CONCLUSION: The therapeutic effect of the distinctive medicine cup is better than the water cup group, and the water cup group is better than the empty cup group.

[Clinical control study of dialysates with different concentrations of calcium on blood pressure in patients under hemodialysis for prolonged period].

OBJECTIVE: To investigate the changes in blood pressure in hemodialysis patients treated with low calcium dialysate or high calcium dialysate for long time. METHODS: Fifteen patients undergoing hemodialysis were enrolled in this study. High calcium dialysate (1.75 mmol/L, Dca1.75) was first used for 6 months, then low calcium dialysate (1.25 mmol/L, Dca1.25) was used for 6 months. Serum calcium, phosphate, blood urea nitrogen, and creatinine were measured, blood pressure was recorded before and after hemodialysis at the beginning, and also at 1, 2, 3 and 4 hours after hemodialysis. RESULTS: Compared with that before the treatment, systolic and diastolic blood pressure lowered significantly after single low calcium hemodialysis for 4 hours (both P<0.05), while systolic and diastolic blood pressure rose significantly after single high calcium hemodialysis (both P<0.05). Systolic blood pressure changed more obviously after two hemodialyses (both P<0.05). Changes in systolic, diastolic and mean blood pressure were positively related to changes in serum total calcium (r(1)=0.326, P(1)=0.054; r(2)=0.383, P(2)=0.037; r(3)=0.391, P(3)=0.032). During 6 months of hemodialysis with low calcium dialysate, blood pressure lowered slightly with no significant difference in it (P>0.05), while systolic blood pressure rose during 6 months of hemodialysis with high calcium dialysate (P<0.05). Changes in systolic blood pressure were significantly different between two groups using dialysates with different calcium concentrations (P<0.05). CONCLUSION: Systolic blood pressure and incidence of hypertension decrease after single low calcium hemodialysis.

Clinical and molecular analysis of hereditary non-polyposis colorectal cancer in Chinese colorectal cancer patients.

AIM: To analyze the frequency of hereditary non-polyposis colorectal cancer (HNPCC) in Chinese colorectal cancer (CRC) patients, and to discuss the value of microsatellite instability (MSI) and/or immunohistochemistry (IHC) for MSH2/MLH1 protein analysis as pre-screening tests in China. METHODS: The Amsterdam criteria I and II (clinical diagnosis) and/or germline hMLH1/hMSH2 mutations (genetic diagnosis) were used to classify HNPCC families. Genetic tests, including microsatellite instability, immunohistochemistry for MSH2/MLH1 proteins and hMSH2/hMLH1 genes, were performed in each proband. RESULTS: From July 2000 to June 2004, 1988 patients with colorectal cancer were analysed and 114 CRC patients (5.7%) from 48 families were categorized as having HNPCC, including 76 from 26 families diagnosed clinically and 38 from the other 22 families diagnosed genetically. The sensitivity and specificity of high MSI and IHC for predicting mutations were 100% and 54%, and 79% and 77%, respectively. CONCLUSION: The frequency of HNPCC is approximately 10% among all Chinese CRC cases. The MSI and IHC detections for hMSH2/hMLH1 proteins are reliable pre-screening tests for hMLH1/hMSH2 germline mutations in families suspected of having HNPCC.

Clinical observation on distinctive water-medicine cup therapy for treatment of cervical spondylopathy of cervical type / 中国针灸

<p><b>OBJECTIVE</b>To use distinctive water-medicine cup therapy for treatment of cervical spondylopathy of cervical type as a sample to provide a more effective cupping method for clinic.</p><p><b>METHODS</b>One hundred and forty cases were randomly divided into a medicine cup group (n = 47), a water cup group (n = 47) and a empty cup group (n = 46). The medicine cup group were treated by cupping therapy with a self-made medicine cup with 45 degrees C Chinese herb solution; the water cup group were treated with a cup with 45 degrees C water, and the empty cup group with a cup with nothing. Clinical symptoms and signs were observed for comparison of therapeutic effects.</p><p><b>RESULTS</b>Clinically cured was 39 cases, and markedly effective was 8 cases in the medicine cup group; 20 cases were clinically cured, 22 cases were markedly effective and 5 cases were effective in the water cup group; 12 cases were clinically cured, 19 cases were markedly effective and 15 cases were effective in the empty cup group. There were significant differences in the ratio of cases of different therapeutic effects and the difference of pain score before and after treatment between the medicine cup group and the water cup group (P < 0.05), between the water cup group and the empty cup group (P < 0.05), and between the medicine cup group and the empty cup group (P < 0.01).</p><p><b>CONCLUSION</b>The therapeutic effect of the distinctive medicine cup is better than the water cup group, and the water cup group is better than the empty cup group.</p>

[Clinical study on moxibustion for treatment of abnormal blood lipids].

OBJECTIVE: To observe clinical therapeutic effect of moxibustion on abnormal blood lipids. METHODS: The patients who did not take the medicine for regulating blood lipids and had still abnormal blood lipids after diet therapy for 3 months, were divided into 4 groups according to different types of abnormal blood lipids. Forty cases selected in each group were again divided randomly into a treatment group and a control group. The treatment group were treated with moxibustion at Shousanli (LI 10), Zusanli (ST 36) and Shenque (CV 3) on the basis of diet therapy, and the control group only with the diet therapy. Their therapeutic effects were observed and compared after treatment of 90 days. RESULTS: There were significant differences between the treatment group and the control group in various groups of different types of abnormal blood lipids (P < 0.05). CONCLUSION: Moxibustion at Shousanli (LI 10), Zusanli (ST 36) and Shenque (CV 3) has a better therapeutic effect on abnormal blood lipids.

[The role of TGF-beta1/Smads in the development of peritoneal fibrosis induced by high glucose peritoneal dialysate and LPS].

OBJECTIVE: To investigate the expression and the potential role of TGF-beta/Smads in peritoneal fibrosis induced by high glucose dialysate and LPS in rats. METHODS: 24 male Sprague-Dawley rats were randomly allocated into four groups: control group, normal rats; LPS group: rats were treated with intraperitoneal injection of LPS (0.6 mg/kg body weight) on days 1, 3, 5, 7; dialysate Group: rats were treated with daily intraperitoneal injection of 4.25% peritoneal dialysate (100 ml/kg body weight) for 4 weeks; LPS + dialysate Group: daily intraperitoneal injection of 4.25% dialysate combined with four times injection of LPS (0.6 mg/kg body weight on days 1, 3, 5, 7) for 4 weeks. The parietal thickness was measured with masson stain. The expression of alpha-SMA, TGF-beta1, Smad 2/3, Smad 7 and ColI in peritoneal membrane was detected with confocal microscope by immuno-fluorescence, Western-blot and RT-PCR. RESULTS: Masson stain show the parietal thickness of the rats in all groups was significantly increased compared with control group and collagen deposition was evident in the thickened submesothelial compact zone. Parietal thickness of the rats in LPS + dialysate Group was most (vs LPS group: 41.5 +/- 3.3 microm vs 34.70 +/- 3.6 microm, P = 0.007, vs dialysate Group, 41.5 +/- 3.3 microm vs 20.2 +/- 3.6 microm, P = 0.000). The expression of alpha-SMA, Col I, TGF-beta1, Smad 3 was up-regulated in protein and mRNA level and the protein level of phosphorylated-Smad 2/3 was increased significantly. The most significant changes were found in LPS + dialysate Group. Compared with control group the mRNA and protein level of Smad7 was increased, but the protein ratio of phosphorylated Smad/Smad 7 in all groups was higher. Under electro-microscope, the mesothelial cells in LPS + dialysate Group had myofibroblast morphology with the presence of large bundles of actin microfilaments and dense bodies within the cytoplasm. CONCLUSIONS: High concentration glucose dialysate or LPS contributes to peritoneal fibrosis by stimulating TGF-beta/Smads signaling. 4.25% peritoneal dialysate can coordinate with LPS to activate TGF-beta/Smads signaling pathway and induce mesenchymal transdifferentiation and peritoneal fibrosis.

Clinical study on moxibustion for treatment of abnormal blood lipids / 中国针灸

<p><b>OBJECTIVE</b>To observe clinical therapeutic effect of moxibustion on abnormal blood lipids.</p><p><b>METHODS</b>The patients who did not take the medicine for regulating blood lipids and had still abnormal blood lipids after diet therapy for 3 months, were divided into 4 groups according to different types of abnormal blood lipids. Forty cases selected in each group were again divided randomly into a treatment group and a control group. The treatment group were treated with moxibustion at Shousanli (LI 10), Zusanli (ST 36) and Shenque (CV 3) on the basis of diet therapy, and the control group only with the diet therapy. Their therapeutic effects were observed and compared after treatment of 90 days.</p><p><b>RESULTS</b>There were significant differences between the treatment group and the control group in various groups of different types of abnormal blood lipids (P < 0.05).</p><p><b>CONCLUSION</b>Moxibustion at Shousanli (LI 10), Zusanli (ST 36) and Shenque (CV 3) has a better therapeutic effect on abnormal blood lipids.</p>

[Clearance effect of different blood purification techniques on parathyroid hormone in renal function failure patients on maintenance hemodialysis].

OBJECTIVE: To evaluate the effect of different blood purification techniques on serum parathyroid hormone (PTH) level in chronic hemodialysis (HD) patients with renal failure. METHODS: Ninety patients were randomly divided into three groups: absorption (AP) group, hemodiafiltration (HDF) group, and HD group. Patients in AP group received therapy with resin absorptive devices associated with HD, patients in HDF group received HDF, while patients in HD group received HD. Blood routine examination, serum albumin, globulin, blood urea nitrogen, creatinine and PTH were measured before and after these treatments, and vital signs and side effects were recorded during HD. Glomerular filtration rate (GFR) and the length of HD were compared among three group. RESULTS: (1)Serum PTH in AP group was decrease from (291.7+/-237.5)ng/L to (122.2+/-114.5)ng/L, the difference was statistically significant. The mean single clearance rate was 48.6%+/-55.2%, the rate of relief from skin discomfort was 83.3%e10/12 cases). (2)Serum PTH in HDF group was decreased from(325.9+/-423.1)ng/L to (90.9+/-93.7)ng/L, the difference was statistically significant. The mean single clearance rate was 59.5%+/-22.7%, and the rate of relief from skin discomfort was 50.0%(4/8 cases).(3)Serum PTH in HD group was decreased from (297.7+/-211.3)ng/L to (248.1+/-105.5)ng/L, which showed no statistically significant difference. The mean single clearance rate was 13.1%+/-30.2%, the rate of relief from skin discomfort was 14.3%(1/7 cases). CONCLUSION: Resin absorptive devices and HDF can safely and effectively clear PTH, relieve skin discomfort; while hemodialysis alone can not.