Table of Content

05 December 2016, Volume 31 Issue 12

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Pharmacotherapy of insomnia disorder

Peng Anyu， Pan Jiyang

2016, 31(12):  1277-1281.  doi:10.3969/j.issn.1004-583X.2016.12.001

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Insomnia disorder  within sleep disorder is the most common disease，whose diagnosis and treatment are challenges to clinical doctors. This assay introduces  the pharmacotherapy for insomnia disorder.

Exercise therapy in treatment of chronic insomnia

Zhao Kai，Tang Wenjie，He Jincai

2016, 31(12):  1282-1285,1290.  doi:10.3969/j.issn.1004-583X.2016.12.002

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Non medication treatment， especially cognitivebehavioral therapy has been widely used in the clinical management of insomnia. In recent year， exercise training has been proposed as a lowcost， easily accessible and nonpharmacologic treatment alternative. The review will discuss the potential mechanisms by which exercise could promote sleep in chronic insomnia， and identify studies on the effect of physical activity on chronic insomnia to provide evidences for the treatment of insomniac patients.

Easily confusing issues during diagnosis and treatment of insomnia

Yu Jinxia1， Chen Guihai2

2016, 31(12):  1286-1290.  doi:10.3969/j.issn.1004-583X.2016.12.003

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Insomnia disorder is popular， but it is difficult to cure the disease， especially in its chronic type. The reasons are partially attributable to insufficient knowledge of insomnia disorder during its diagnosis and treatment for the sufferers and clinicians. In order to enhance the ability to diagnose and treat the insomnia disorder， the paper will discuss nine common issues， which are easily confused during diagnosis and treatment of the disease.

Sleep disorder following stroke

Zhang Xuan， Xue Rong

2016, 31(12):  1291-1294.  doi:10.3969/j.issn.1004-583X.2016.12.004

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Sleep disorder is one of the common complications following stroke， which includes excessive daytime sleepiness， insomnia， parasomnia， narcolepsy， circadian rhythm disorder， sleep related movement disorders and sleepdisodered breathing.Various factors contribute to the poststroke sleep disorder， such as neurobiological and psychosocial factors. In this article， we briefly review the change of poststroke sleep structure as well as epidemiology and pathophysiological mechanism of poststroke sleep disorder.

Obesity hypoventilation syndrome

Li Jing， Wang Hanqiao，Xu Maoren，Liu Pengfei

2016, 31(12):  1295-1297.  doi:10.3969/j.issn.1004-583X.2016.12.005

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With the improvement of living standards， fat people tend to be more and more. Obesity is becoming increasingly important in causing a series of related diseases such as hyperlipidemia， diabetes， respiratory diseases and so on. But  obesity hypoventilation syndrome (OHS) which is easy to be ignored but has clinical significance  can seriously affect the patient respiratory， cardiovascular and endocrine system. If OHS not timely corrected，  the prognosis is poor， including respiratory failure， arrhythmia， heart failure and so on. This paper provides a review on OHS conception，pathogenesis， clinical manifestations and diagnostic criteria and treatment. OHS deserves more attention.

Risk factors of early progressive renal function decline in type 2 diabetes mellitus patients

Zhang Xinrong，Sun Mengdi，Yue Xiaodan，Gao Zhongai，Chang Baocheng，Yang Juhong

2016, 31(12):  1298-1301,1307.  doi:10.3969/j.issn.1004-583X.2016.12.006

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ObjectiveTo examine the risks of early progressive renal function decline in patients with type 2 diabetes mellitus(T2DM) with or without microalbuminuria and risk factors.MethodsA total of  170 T2DM patients were selected for prospective followup study. According to  24 h urinary microalbumin(UMA) levels， the patients were divided into two groups， nonalbuminuriagroup( 24 hUMA  030 mg/24 h)， and  UMA group(24 hUMA>30300  mg/24 h). At the end of the followup， the patients were subdivided into two groups by the glomerular filtration rate（GFR） fall per year: early progressive renal function decline subgroup(≥3.3% descent rate compared with initial estimated  GFR(eGFR)  and stable renal function subgroup(<3.3% descent rate per year compared with initial eGFR).The differences  between early progressive renal function decline subgroup and stable renal function subgroup were analyzed， including the general data:  T2DM duration， body mass index(BMI)， and the laboratory indexes: hemoglobin A1C(HbA1c)，liver function， renal function and others， respectively. ResultsThe proportion of early progressive renal function decline in microalbuminuria group was higher.In microalbuminuria group: early progressive renal function decline subgroup had higher systolic blood pressure(SBP)， pulse pressure(PP)， HbA1c and lower BMI compared with those of stable renal function subgroup. In nonalbuminuria group: early progressive renal function decline subgroup had lower HDLC  compared with that of stable renal function subgroup. ConclusionT2DM patients may present early progressive renal dysfunction. In T2DM patients without microalbuminuria，HDLC decline is a risk  for early progressive renal dysfunction.But， for  the patients with microalbuminuria， higher SBP， PP， HbA1c are the risks  of early progressive renal dysfunction.

Clinical efficacy for diabetic foot infection by topical antibiotics

Zhu Xiaoqinga， Ding Mina， Xu Juna，Sun Huia，Ma Yanana，Wang Penghuab

2016, 31(12):  1302-1307.  doi:10.3969/j.issn.1004-583X.2016.12.007

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ObjectiveTo observe the control of wound infection， drug resistance and wound healing in topical antibiotics combined with systemic antibiotics therapy for treating diabetic foot infection(DFI). MethodsOne hundred and ten hospitallized patients with DFI in our hospital were selected， then the patients were randomly divided into two subgroups， control group and observation group，each group 55 cases. According to anklebrachial index，each group was divided into two subgroups， nonischemic group and ischemia group.All patients accepted norms of diabetic foot infection therapy， patients in experimental group using moxifloxacin hydrochloride's absorbability gelatin sponge treatment. At days of 0，14，28， blood samples were collected to test infectionrelated indicators， bacterial culture and sensitivity test， measuring of wound area and calculate the total efficiency.ResultsAt 14 and 28 days， the infectionrelated indicators in observation group were decreased，wounds size reduction and total clinical efficiency were better than those of control group(P＜0.05). Antibiotic bacterial resistance were not increased(P>0.05); For ischemia group in observation group，the infectionrelated indicators were decreased， wounds size reduction and total clinical efficiency were better than those of control group (P＜0.05)，but in the nonischemic group， they showed no significant  difference(P>0.05).ConclusionTopical application seems safe，can control  infection and promote wound healing when combined with systemic antibiotics  therapy in DFI patients with ischemia.


Correlation study between serum uric acid and metabolic syndrome and risk factors in Dali Bai population in Yunnan

Chen Xiaoyun1a，Ma Shungao1b，Yang Chun1a，Gao Yujie1a，Sha Yanmei1a，Yao Xiuzhen2，Li Weijuan1a，Tang Zhengqiao1a，Wang Xiaofen1a，

2016, 31(12):  1308-1312,1317.  doi:10.3969/j.issn.1004-583X.2016.12.008

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ObjectiveIn order to investigate the correlation between serum uric acid and metabolic syndrome (MS) and their risk factors. MethodsA total of 5 444 cases from Bai population， including urban， rural， urban fringe living for more than five years， were analyzed by questionnaire， physical examination and biochemical parameters. Results①With the level of uric acid elevated， the systolic blood pressure， diastolic blood pressure， triglycerides， lowdensity lipoproteins cholesterol， body mass index， waisthip ratio increased gradually in both men and women， however， highdensity lipoprotein protein cholesterol  decreased (P<0.01);  though fasting blood glucose and glycated hemoglobin in men showed no significant change with serum uric acid elevated (P>0.05)，but，the indexes increased gradually in women (P<0.01); ②The prevalence of hyperuricemia (HUA) and metabolic syndrome in men were higher than in women; with increasing age， the prevalence increased gradually（P<0.01）; the prevalence in urban， rural， urban fringe population increased gradually （P<0.01）. The smoking history， drinking history and family history of metabolic disease: the proportion in men was significantly higher than in women（P<0.01）; the proportion in urban， rural， urban fringe population increased gradually (P<0.01); with increasing age， the proportion of smoking history， alcohol consumption history decreased gradually (P<0.01); ③With the level of uric acid elevated， the prevalence of MS and its components increased gradually in both men and women (P<0.01) . ④Logistic regression analysis showed that  the level of serum uric acid was positively correlated with the prevalence of MS in both men and women， especially in women from Dali Bai population.ConclusionThe prevalence of HUA was high in Yunnan Dali Bai population， the level of serum uric acid was positively correlated with MS， and increasing uric acid was an independent risk factor of MS.


Correlation analysis and clinical significance of serum omentin and adiponectin in patients with liver cirrhosis

Wei Xinliang， Wei Sichen， Tian Shuying， Kong Yu， Wang Weiwei， Jiang Hongyu

2016, 31(12):  1313-1317.  doi:10.3969/j.issn.1004-583X.2016.12.009

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ObjectiveTo investigate the the relationship between the serum omentin， adiponectin levels in liver cirrhosis patients and the insulin， ChildPugh  grade， liver biochemical indexes and serum lipids. MethodsNintyseven patients with liver cirrhosis (A33， B32 and C32) patients and 32 cases of healthy controls were enrolled. Serum omentin， serum adiponectin and related clinical and biochemical parameters were observed in two groups. ResultsThe serum omentin and serum adiponectin levels in patients with liver cirrhosis were higher than those of  healthy control group (P<0.05). The omentin and adiponectin level showed no significant difference in A， B and C grade of liver cirrhosis group (P>0.05). There were no obvious correlation between serum omentin， adiponectin levels and HOMAIR， insulin levels in liver cirrhosis patients（r=-0.135，P=0.277，r=-0.171，P=0.166；r=-0.194，P=0.115，r=-0.102，P=0.401）.The level of omentin was positively correlated with adiponectin and albumin（r=0.447，P=0.00；r=0.225，P=0.037）.And the level of adiponectin was positively correlated with highdensity  lipoprotein （r=0.264，P=0.036），but negtively correlated with prothrombin time（r=-0.306，P=0.014）.  The areas under the ROC curves of omentin and adiponectin were 0.761 and 0.918， rspectively and the cutoff values for liver cirrhosis prediction were 905.18  ng/L  and  763.85  μg/L. And the adiponectin had higher sensitivity for the diagnostic value. ConclusionThe omentin and adiponectin  can be used as prediction indexes of liver cirrhosis， but not be used to evaluate  the severity of liver function in liver cirrhosis.


Clinical and pedigree analysis of one child with autoimmune polyendocrinopathy  syndrome typeⅠ caused by rare gene mutation

Pi Yalei， Zhang Yanan， Han Xiao， Men Xinyi， Li Chaonan， Zhang Huifeng

2016, 31(12):  1318-1320.  doi:10.3969/j.issn.1004-583X.2016.12.010

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ObjectiveTo analyze the clinical and autoimmune regulator(AIRE) gene mutation characteristics of one case with autoimmune polyendocrinopathy syndrome typeⅠ(APSⅠ) and to further understand APSⅠ.MethodsOne case of 9year old male APSⅠ patient was analyzed. Clinical data of the patient was collected and 2 ml venous blood of the patient and his parents as well as his elder brother were extracted. All the exons and adjacent introns of 33 immunorelated genes were sequenced by next generation sequencing. AIRE gene mutation was detected and verified by sanger sequencing. Both his parents and elder brother's AIRE gene were analyzed. ResultsThe APSⅠ child patient had repeated oral candidiasis since soon after birth. Tetany and mucocutaneous hyperpigmentation successively appeared at 8 years old. His blood biochemistry and iPTH， ACTH， COR results along with his symptoms accorded with all the three aspects of the APSⅠdiagnostic criteria. AIRE gene test showed compound heterozygous mutation (IVS11+1G>A and AIRE gene heterozygous deletion) for the boy and a heterozygous mutation of IVS11+1G>A for his father respectively. Verification by realtime  quantitative polymerase chain reaction (QPCR) showed a heterozygous deletion of AIRE gene for his mother. There was no AIRE gene mutation detected for his elder brother. ConclusionGlands  involvement in APSⅠpatients always appeared successively leading to easy misdiagnosis and missed diagnosis. Therefore， more concerons put on new glands involvement during every followup. IVS11+1G>A mutation of AIRE gene is rare and its combination with heterozygous deletion of AIRE gene has not been reported.

Relationship between left ventricular hypertrophy and visceral adipose tissue  distribution

Zu Xiuguang1， Chen Liman2， Hao Yuming1， Liu Jinming1

2016, 31(12):  1321-1323,1327.  doi:10.3969/j.issn.1004-583X.2016.12.011

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ObjectiveTo investigate the relationship between left ventricular hypertrophy  (LVH) and visceral adipose tissue distribution in patients with essential hypertension (EH). MethodsAge， gender， blood pressure， heights， body mass， waist circumference and hip circumference were recorded in 80 patients with EH. Cardiac ultrasound examination and abdominal CT were performed， then V/S and LVMI were calculated. ResultsThere were no significant difference in age， systolic pressure， and diastolic pressure between LVH group and nonLVH group (P>0.05). The V/S， BMI， WHR and WHtR were significantly higher in LVH group than in nonLVH group (P<0.05). And there were linear regression between V/S， WHtR， WHR， BMI and LVMI. ConclusionObesity contributes to the LVH in EH patients， and visceral adipose tissue plays significant role in the pathogenesis of LVH．

Influence of polymorphisms of beta 1adrenergic receptor on cardiac hypertrophy in hypertensive patients

Zhang Yonglin1， Sheng Hongzhuan2

2016, 31(12):  1324-1327.  doi:10.3969/j.issn.1004-583X.2016.12.012

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ObjectiveTo investigate influence of polymorphisms of beta 1adrenergic receptor G1165C site and A145G site on the cardiac hypertrophy in hypertensive patients. MethodsThe study mcluded healthy subjects 115 cases from simultaneous body check，hypertension patients with cardiac hypertrophy 113 cases，and hypertension patients without cardiac hypertrophy 114 cases. The polymorphisms of G1165C site and A145G site of beta1adrenergic receptor were detected by means of polymerase chain reactionrestriction fragment length polymorphism(PCRRFLP). Results(1)There were significant  difference between the occurrence of 1165C beta1adrenergic receptor (78.5%) in hypertensive patients without cardiac hypertrophy and  in hypertensive patients with cardiac hypertrophy (89.8%). There was no significant difference between the occurrence of 145G beta1adrenergic receptor (16.7%) in hypertensive patients with no cardiac hypertrophyand in hypertensive patients with cardiac hypertrophy (16.8%). (2) There was significant difference between the left ventricular mass index of hypertensive patients with cardiac hypertrophy (123.78±5.12) g/m2 in 1165G beta1adrenergic receptor， and (154.16±47.82)  g/m2  in 1165C beta1adrenergic receptor (P<0.05). There was no statistical difference between the left ventricular mass index of hypertensive patients with cardiac hypertrophy. The left ventricular mass index of 145A beta1adrenergic receptor and 145G beta1adrenergic receptor were (150.85±46.88) g/m2 and (152.11±44.31)  g/m2，respectively.ConclusionPolymorphisms of G1165C beta1adrenergic receptor was involved in occurring cardiac hypertrophy and regulating degree of cardiac hypertrophy in hypertensive cardiac hypertrophy. There was no correlation between polymorphisms of A145G beta1adrenergic receptor and left ventricular hypertrophy in hypertensive patients.

Value of combining V1 and aVL or aVR lead in differential diagnosis of atrioventricular nodal reentrant tachycardia

Zhu Chunyu，Lin Chunyi， Weng Lan，Lin Shanying，Zheng Wenkai

2016, 31(12):  1328-1331.  doi:10.3969/j.issn.1004-583X.2016.12.013

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ObjectiveTo evaluate the diagnostic accuracy of the combining V1 and aVL or aVR lead in electrocardiographic(ECG) differentiation of atrioventricular nodal reentrant tachycardia (AVNRT) from atrioventricular reciprocating tachycardia (AVRT).MethodsA 12lead ECG was recorded in 143 consecutive patients with regular paroxysmal supraventricular tachycardia(PSVT) during both sinus rhythm and tachycardia. All ECGs were reviewed by two experienced electrophysiologists who had no knowledge of the tachycardia mechanism. The ECG recordings were evaluated for standard criteria including pseudor′wave in lead V1， notch in lead aVL， pseudor′ wave in lead aVR， RP  interval ≥100 ms， STsegment elevation ≥1.5 mm at the Jpoint lasting 80 ms in lead aVR during tachycardia， and so on. Mechanism of arrhythmia was confirmed by the electrophysiological study. ResultsPatients with AVNRT were older (P<0.01)， predominantly female (72.4% vs 50.0%，P<0.01). Among the ECG criteria of the AVRT diagnosis， visible Pwave with RP  interval ≥100 ms had the highest diagnostic accuracy (sensitivity 69.6%， specificity 87.4%， and positive predictive value 78.0%). The combination of  visible Pwave with RP  interval ≥100 ms and STsegment elevation≥1.5 mm at the Jpoint lasting 80 ms in lead aVR obviously improved the sensitivity of the AVRT diagnosis. For AVNRT diagnosis， notch in lead aVL had a higher sensitivity（60.9%）， specificity（89.3%）， and positive predictive value(89.8%) compared with the conventional criteria of the pseudor′ in V1 and pseudos in inferior leads (all P<0.05). The combination of V1 and aVL or aVR lead obviously improved the sensitivity of the AVNRT diagnosis to 78.2% and 74.7%， respectively.But the positive predictive value did not decrease obviously.ConclusionThe combination of V1 and aVL or aVR lead is helpful to improve the accuracy of AVNRT diagnosis in ECG.

Clinical observation in rare causes of GuillainBarré syndrome

Wang Li1， Xia Cheng1， Zhang Ying2，Wang Tingting1，Sun Xianhui1

2016, 31(12):  1332-1335.  doi:10.3969/j.issn.1004-583X.2016.12.014

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ObjectiveTo study the rare causes of GuillainBarré syndrome(GBS). MethodsA total of 9 rare cases of GBS were retrospectively analyzed. ResultsAll 9 cases ranged from 16 to 80 years old， included 8 males and 1 female， the causes of GBS were 1 case of eye trauma，1 case of hepatitis E virus infection，1 case of epidemic hemorrhagic fever， 2 cases of lumbar surgery， 2 cases of head trauma and 2 cases of diabetic ketoacidosis. ConclusionGBS was triggered by trauma， hepatitis E virus infection， epidemic hemorrhagic fever， diabetic ketoacidosis， and surgery after 5 to 14 days prior to symptom onset， the illness reached its peak after onset of 10 to 21 days. The prognosis was relatively good if given treatment of immunglobulin in the early stage of disease， but the pathogenesis of rare causes of GBS was unclear.

Clinical effect of  Danshen Chuanxiongqin combined with Nimodipine in treatment of transient ischemic attack

Wang Xiaojun1， Cao Xuebing2

2016, 31(12):  1336-1339.  doi:10.3969/j.issn.1004-583X.2016.12.015

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ObjectiveTo explore the clinical effect of Danshen Chuanxiongqin combined with Nimodipine in treatment of transient ischemic attack (TIA).MethodsA total of 100 cases of TIA were selected and randomly divided into control (B) and treatment(A) groups. The patients in group B received Danshen Chuanxiongqin with aspirin， and those in group A got Danshen Chuanxiongqin combined with Nimodipine， and aspirin. The levels of blood pressure， blood plasma homocysteine (Hcy)， platelet aggregation (PAG) and pulse index (PI) and resistant index (RI) of related arteries (such as common carotid artery， internal carotid artery， internal vertebra artery， external vertebra artery) were measured before and after treatment. And 50 healthy volunteers served as blank control group. All data were processed by SPSS 16.0. ResultsThe levels of blood pressure， PAG and PI and RI of related arteries were obviously different before and 3 weeks′ after treatment in group B and group A than in blank control group(P＜0.05).Compared with pretreatment， the level of Hcy was greatly decreased after treatment in group A（P＜0.05)，and there was no statistic significant difference before and after treatment in group B（P＞0.05). There were few side effects in two groups. ConclusionThe therapy of Danshen Chuanxiongqin combined with Nimodipine can significantly improve hemodynamics and hemorheology of related arteries， and reduce the levels of blood pressure and Hcy. Meanwhile， the therapy is safe and  may play an important role in preventing brain stroke.

Clinical research on injection of botulinum toxin type A by ultrasound combined with electrical stimulation guided for treatment of spasticity to early stroke  patients

Zhang Dawei， Chen Qingmei

2016, 31(12):  1340-1343.  doi:10.3969/j.issn.1004-583X.2016.12.016

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ObjectiveTo observe the effect of ultrasound combined with electrical stimulation guided injection of botulinum toxin type A（BTXA）for the treatment of spasticity in early cerebral vascular accident patients. MethodsFortysix early cerebral vascular accident patients with lower limb spasticity were divided randomly into two groups: treatment  group（23 patients）  and control group(23 patients).Patients in control group got routine rehabilitation training， and those in treatment group were given ultrasound combined with electrical stimulation guided injection of botulinum toxin type A additionally. The functions of two groups were evaluated by using the modified Ashworth scale(MAS)，FuglMeyer assessment（FMA），intergrated electromyography（iEMG），WHO Quality of LifeBREF（WHOQOLBREF）  before and six weeks after treatment. ResultsAfter six weeks of treatment， the treatment group improved much better than the control group. The average MAS，FMA，WHOQOLBREF，iEMG score in treatment group were significantly higher than those  of control group(P<0.05).ConclusionUltrasound combined with electrical stimulation guided injection of botulinum toxin type A for the treatment of spasticity in early cerebral vascular accident patients is effective， accurate and safe.

Misdiagnosis analysis of adverse reactions of compound paracetamol and amantadine hydrochloride  capsules in ten patients with dyskinesia and psychiatric symptoms

Shen Yuan，Shi Haicun，Zhang Xianxian

2016, 31(12):  1344-1346.  doi:10.3969/j.issn.1004-583X.2016.12.017

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ObjectiveTo analyze the neuropsychiatric symptoms of the patients poisoned with compound paracetamol and amantadine hydrochloride capsules. MethodsThe clinical data of ten patients poisoned with compound paracetamol and amantadine hydrochloride capsules were retrospectively analyzed. ResultsThe mean age of onset in ten patients was (73.8±9.0) years old， four cases of them had a history of uremia. The main symptoms included dyskinesia and psychiatric symptoms. Dyskinesia mainly presented  with postural tremor (100%) and unsteady walking (10.0%). Psychiatric symptoms mainly presented with insomnia (50.0%)， hallucinations (60.0%)， euphoric spirit (10.0%) and slow response (20.0%). The concomitant symptoms included vague words， headache， palpitations and sweating. Major misdiagnosed diseases included intracranial infection， uremic encephalopathy，cerebral infarction and low blood sugar. Most of the patients recovered after drug withdrawal and fluid replacement， a minority of them recovered after the blood perfusion combined with hemodialysis. ConclusionThe patients poisoned with compound paracetamol and amantadine hydrochloride capsules mainly presented with dyskinesia and psychiatric symptoms， who were prone to be found in the elderly and the patients with renal insufficiency.

Mechanism of miRNA455 delaying heart failure after longterm pressure load

Wu Chuntaoa， Ma Qianlia， Li Qiana， Li Yongjunb

2016, 31(12):  1347-1351.  doi:10.3969/j.issn.1004-583X.2016.12.018

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ObjectiveTo explore the mechanism of the miRNA455 delaying heart failure after longterm pressure load. MethodsFourweekold Kunming male mice were randomly divided into three groups， TAC mice with miR455(TAC.miR455) group， TAC mice with GFP(TAC.GFP) group， and sham operation mice with GFP(sham)group. TAC or sham operation was carried out. Hematoxylin and eosin(HE) and Masson staining were carried out on the myocardial tissue to observe the histopathological changes in mice after four weeks of operation. Western blot was applied to detect apoptosis protein. qRTPCR and Western blot were applied to detect miR455 target genes and proteins. ResultsSignificant increase of miR455 gene in the miR455treated hearts of TAC were observed（P<0.01）. Myocardial collagen fibers and cell apoptosis were significantly reduced in the miR455treated hearts of TAC(P<0.05). Western blot  showed that Calr was one of the target proteins in miR – 455. PCR results dedicated that Clar decreased with calr mRNA.ConclusionmiR455 attenuates the progressive deterioration of left ventricular function. The mechanism is that ventricular remodeling is improved by Calr falling through  miR455  making target mRNA degradation.

Study of PPS combined with interleukin15 enhanced killing activity of peripheral blood mononuclear cells to K562 cells

Ren Shipu1， Huang Jie1， Wang Xia2

2016, 31(12):  1352-1356.  doi:10.3969/j.issn.1004-583X.2016.12.019

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ObjectiveTo study the effects of polyporus polysaccharide(PPS) combined with interleukin15(IL15) on the proliferation of human peripheral blood mononuclear cells (PBMC)， and to further clarify the effect on its killing activity and mechanism to chronic myeloid leukemia K562 cells.MethodsDensity gradient method was used to separate PBMC， then IL2， IL15， PPS， PPS combined with IL2 and PPS combined with IL15 were used to stimulate PBMC to proliferate PBMC respectively， so as to acquire the effecter cells. Finally， FCM was used to detect the immunophenotype of T cells， NK cells activated in PBMC; double antibody sandwich ELISA method was performed to detect the levels of IFNγ and TNFα in cell culture supernatant; MTT colorimetry method was performed to detect the cytotoxic effect of effector cells to target cells. ResultsThe combination of PPS and IL15 could synergistically stimulate T cells and NK cells’ proliferation in PBMC; it could raise the levels of cytokines IFNγ and TNFα in effector cell culture supernatant; Also it could enhance the cytotoxic effect of effector cells to target cells in a timedependent manner. ConclusionThe combination of PPS and IL15 can improve the cytotoxicity effect of PBMC on cell strain K562 which presented at the increase of IR of the tumor cells’ proliferation. The killing mechanism may be caused by the proliferation of T cells and NK cells stimulated by the combination of PPS and IL15 and the improved levels of IFNγ and TNFα in cell culture supernatant.

Effectiveness of aromatherapy for somatopathy comorbided insomnia: a metaanalysis of randomized controlled trials

Dong Ci1a， Ma Li2， Liu Shaona1a， Zhang Xin1a， Sun Ai1a， Chen Haiying2， Wang Wei1b， Gu Ping1

2016, 31(12):  1357-1361.  doi:10.3969/j.issn.1004-583X.2016.12.020

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ObjectiveTo evaluate the effectiveness of aromatherapy for somatopathy comorbided insomnia in patients. MethodsElectronic database Pubmed， CBM， ScienceDirect， FMRS， CNKI， Wanfang and Vip digital database were searched to collect randomized controlled trials(RCTs) on aromatherapy for comorbid insomnia in patients. Studies were selected and data were extracted by two investigators independently. Metaanalysis was conducted by RevMan 5.3. ResultsSeven studies met the inclusion criteria， involving 508 patients.  The results of metaanalysis favoured aromatherapy more than the control (P<0.01). ConclusionAromatherapy can improve somatopathy comorbided insomnia in patients significantly. Therefore， aromatherapy is recommended as a complementary therapy to improve insomnia in patients with somatopathy.

Magnesium sulfate for chronic obstructive pulmonary disease: a metaanalysis

Ma Kang1， Nie Zhipin2

2016, 31(12):  1362-1369.  doi:10.3969/j.issn.1004-583X.2016.12.021

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ObjectiveTo systemically review the efficacy and safety of magnesium sulfate for chronic obstructive pulmonary disease (CODP). MethodsThe randomized controlled trials (RCT) concerning magnesium sulfate for CODP from databases as Pubmed， Cochrane Library， Embase， CBM， CNKI， VIP， Chinese Medical Journal Digital and ISI Web of Knowledge published between inception to February 2015 were retrieved. Meta analysis on the selected literature was conducted by means of RevMan 5.0 software. Two reviewers screened literature according to the inclusion and exclusion criteria， extract data and assessed methodological quality of included studies. ResultsA total of 14 RCTs involving 955 patients were included.  Compared with control group， Magnesium sulfate had higher remission rate of clinical signs (OR=3.22， 95%CI=1.87 to 5.55，P<0.01)，higher FEV1%（MD=10.17， 95%CI=9.07 to 11.18，P<0.01）. However， compared with control group， magnesium sulfate had no significant differences in FEV1 (MD=0.05，95%CI=0.00 to 0.10，P=0.03)， FEV1/FVC (MD=1.43，95%CI=0.00 to 2.85，P=0.05)， pH of arterial blood gas (MD=-0.01， 95%CI=-0.03 to 0.01， P=0.43)， PO2 of arterial blood gas (MD=-3.97， 95%CI=-7.41 to 15.35，P=0.49)， PCO2 of arterial blood gas (MD=0.94，95%CI=-2.69，4.57，P=0.61)，(MD=-0.94，95%CI=-0.23 to 0.04，P=0.19). Funnel plot of the remission rate of clinical signs and incidence of adverse reactions were asymmetric，which indicated publication bias. ConclusionMagnesium sulfate of intravenous infusion could significantly improve the FEV1% of lung function of COPD patients. Furthermore， it could improve the remission rate of clinical signs and have a lower incidence of adverse reaction. But there is no significant difference with other indicators. Due to limited quantity and quality of the included studies， the conclusion above should be further verified by conducting more high quality， large scale， multicentre RCTs.

Interpretation of consensus guidelines for investigation and management  of encephalitis in adults and children in Australia and New Zealand

Zhao Sena， Zhang Songb， Song Ninga， Jia Weihuaa， Yuan Shengfanga， Guo Xianlia

2016, 31(12):  1370-1376.  doi:10.3969/j.issn.1004-583X.2016.12.022

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Encephalitis is a complex neurological syndrome caused by inflammation of the brain parenchyma. Due to the variety of causes， broad differential diagnosis， rapid progression of the disease， frequent need of intensive supportive management， and the lack of effective therapeutic means of a variety of primary causes， the diagnosis and treatment of encephalitis are still huge challenges. In 2015， Australian Society of Infectious Diseases(ASID)， Australasian College of Emergency Medicine (ACEM)， Australian and New Zealand Association of Neurologists (ANZAN) and Public Health Association of Australia (PHAA) jointly formulated consensus guidelines for the investigation and management of encephalitis in adults and children in Australia and New Zealand， this is by far the latest regional expert consensus on the diagnosis and treatment of encephalitis. This guideline was established based on the previous European and American guidelines of encephalitis and integrated the latest progresses of encephalitis in recent years， the epidemiology， etiology， diagnosis， differential diagnosis， treatment and comprehensive management of encephalitis were illustrated systematically. We are here to interpret the guidelines， in order to provide references to Chinese doctors for management of encephalitis more better.