Objective To observe the effect of acupuncture at Tianzhu (BL10) on Blood Stasis Type lumbar disc herniation (LDH). Methods From October, 2013 to October, 2015, 108 LDH cases were randomized into observation group (n=53) and control group (n=55) in accordance with the order of visiting. The observation group received Tuina and acupuncture mainly at Tianzhu, while the control group only received Tuina, for four weeks. The clinical efficacy and improvement of Japanese Orthopaedic Association (JOA) scores were record-ed, and the Visual Analogue Scale (VAS) and serum levels of interleukin-6 (IL-6) were measured before and after treatment. Results The VAS score and IL-6 content decreased in both groups after treatment (t>4.220, P<0.001), and decreased more in the observation group than in the control group (t>3.745, P<0.001). The total effective rate was 94.34% in the observation group, more than 81.82% in the control group (χ2=3.997, P=0.046). The incidence of impromvement of JOA scores was 90.57%in the observation group, more than 76.36%in the control group (χ2=3.920, P=0.048). Conclusion Acupuncture at Tianzhu based on Tuina is more effective on Blood Stasis Type lumbar disc herniation, in term of pain and function, which may relate with decrease of the level of IL-6.

The aim of this study is to determine whether seeded Dacron with autologous venous tissue fragments shows significant 6-keto-prostglandin F 1? (6 K PGF 1? )production after in vivo implantation.The Dacron grafts seeded with autologous venous fragments were implanted into the inferior vene cava(IVC)of the 13 canines as seeded group;and the control group (8 canines),in which grafts were only preclotted with fresh blood. Plasma 6 K PGF 1? and TXB 2 were assessed at different time.All of the specimens explanted at exsanguination were observed with light microscopy and sanning electron microscopy and the amounts of 6 K PGF 1? from the luminal surface were assessed using ridioimmunoassay. The results showed that the total patency rate of the explanted vessels was higher in seeded group (61.5%) than that in control group ( 25% ),and that endothelial cells lined the whole luminal surface of Dacron at the 14th day after operation in seeded group,but thrombus covered the surface of Dacron at the 14th day in control ones. The level of 6 K PGF 1? from plasma and the luminal surface of Dacron grafts in seeded group was higher,but the level of plasma TXB 2 was lower than that in control group. It can be concluded that seeding Dacron with autologous venous fragments makes a new endothelial lining possible at two weeks,and can release more 6 K PGF 1? and thus lead to an improved patency rate of canine IVC reconstructions,so the graft patency might be determined according to the changes of plasma 6 K PGF 1? and TXB 2 level.

Objective To investigate the clinical significance of red blood cell distribution width in the early diagnosis of patients with chronic heart failure.Methods Seventy eight cases of chronic heart failure patients from November 2011 to November 2013 in our hospital were recruited in this study,and were divided into three different heart failure groups (Ⅱ,Ⅲ,and Ⅳ) according to the degree of heart failure; 40 healthy cases were used as control group.The red blood cell distribution width was measured among four groups.The relationship of the red blood cell distribution width and chronic heart failure was analyzed.According to the red blood cell distribution width data,patients were grouped into ＜ 13.1％,13.1％ ～ 14.5％,and ＞ 14.5％ groups.The eventual fatality rates were compared among three groups with different red blood cell distribution width.Results (1) The red blood cell distribution width was (11.63 ±0.71)％,(13.11 ±1.08)％,(14.31 ±1.52)％,and (16.83 ±0.71)％ in the healthy group,andⅡ,Ⅲ,and Ⅳ heart failure groups,respectively.The red blood cell distribution width was gradually increased with the degree of heart failure,with a statistically significant difference among four groups (P ＜ 0.05).(2) The mortality was 0 (0/32),14.8％ (4/29),and 41.2％ (7/ 17) in different red blood cell distribution width groups (＜ 13.1％,13.1％ ～ 14.5％,and ＞ 14.5％),respectively.The mortality was gradually increased with the increased red blood cell distribution width,with a statistically significant difference among three groups (P ＜ 0.05).Conclusions Red blood cell distribution width is of great importance to detect disease degree of chronic heart failure and can guide one to effectively evaluate disease processes and therapeutic effect.

Objective To study the diagnosis, therapy and prevention of bile duct carcinomas in choledochal cysts. Methods We retrospectively analysed clinico pathologic data, the ways of operation and living time of 11 patients with bile duct carcinomas in choledochal cysts in two hospitals from 1986 to 1997. Results There were complete excision of the choledochal cysts associated with choledochojejunostomy in 4 patients, exploration of bile duct and drainage with T shape tube in 3 patients. And there were also the excision of the wall of bile duct cysts and the tumor and cholangioplasty, choledochocystoduodenostomy, biopsy, pancreaticoduodenectomy and cholangiojejunostomy at the porta hepatis, resection of original rhynchostoma of choledochojejunostomy in one patient, respectively. One patient has lived for 3.6 years after radical resection. Others lived for 13.6 months after operation. Conclusions It is the key of improving and lengthening lives to find this disease in the early stage and to resect radically as early as possible.

Objective To investigate the therapeutic efficacy of acupuncture plus Bobath therapy in treating motor dysfunction of the core muscles in patients with hemiplegia after cerebral stroke.Method Totally 144 patients with post-stroke hemiplegia were divided into a control group, treatment group 1 and treatment group 2. The treatment group 1 was intervened by Bobath therapy, while the treatment group 2 was by abdominal acupuncture and scalp acupuncture in association with Bobath therapy. The recruited patients were examined for the manual muscle strength rating of the abdominal core muscles, Berg Balance Scale (BBS) score, and Barthel Index (BI) score on the day of admission, the 30th day and 60th day after admission.Result There were no significant inter-group differences in comparing the core muscle strength, BBS, and the Activities of Daily Living (ADL) on the day of admission (P>0.05). The core muscle strength, BBS, and ADL were significantly increased on the 30th and 60th day after admission in the three groups (P<0.05), and the scores in treatment group 2 were significantly higher than that in the control group and treatment group 1 (P<0.05).Conclusion Acupuncture plus Bobath therapy can significantly improve the motor dysfunction of the core muscles in patients with hemiplegia after cerebral stroke.

Objective To study the clinical value of serum N-terminal pro-brain natriuretic peptide (NT-ProBNP) and cardiac troponin I (cTnI) levels in children with severe pneumonia. Methods A total of 72 children with severe pneumonia in pediatric intensive care unit were divided into heart failure (HF) group and non-HF group according to the occurrence of heart failure, and 30 healthy children were selected as control group. Serum NT-ProBNP and cTnI levels were detected and analyzed. Results Compared with control group, NT-ProBNP and cTnI levels were signiifcantly higher (P<0.01) in HF and non-HF group. The levels of NT-ProBNP and cTnI in HFgroup were both signiifcantly higher (P<0.01) than that in non-HFgroup. Serum NT-ProBNP level was positively related to the level of cTnI(P=0.000) in children with severe pneumonia. The abnormal rate of cTnI in HF group was significantly higher (P=0.037) than that in non-HFgroup. The difference of the abnormal rate of NT-ProBNP between the two groups was not signiifcant (P=0.375), however, the abnormal rate of NT-ProBNP was signiifcantly higher (P=0.036) than that of cTnI in non-HF group. Conclusions There was obvious myocardial damage in children with severe pneumonia. NT-ProBNP and cTnI could be important serological markers to assist diagnosis of myocardial damage and its severity.

Objective To explore the surgical treatment and perioperative management of carotid body tumors.Methods Fifteen patients with carotid body tumor were operated upon after appropriate perioperative management.Results Among the 15 cases,6 underwent simple tumor excision,7 had co-resection of carotid body tumor and carotid artery,and 2 cases had arterial anastomosis of common carotid artery and internal carotid artery after co-resection of carotid body tumor.There was no mortality after operation in this series.All patients were followed up from 1 year to 3 years (average,15.3months).Operative incisions healed by primary intention.The pressure symptoms of carotid body tumor disappeared after operation,but two patients had temporary headache for 3months,and one patient died of cerebral infarction.Injury of hypoglossal nerve occurred in one patient but it recovered after treatment.There were no recurrences of carotid body tumor after operation.Conclusions Adequate perioperative management can improve the effect and safety of operation,and decrease operative complications of patients with carotid body tumor.

Objective To study the changes and clinical value of platelet(PLT)parameters and coagulation indicators in children with severe pneumonia.Methods 97 children were divided into severe pneumonia groupⅠand severe pneumonia groupⅡ according to whether children were associated with other diseases besides severe pneumonia,and 30 healthy chil-dren were in control group.The levels of PLT count,mean platelet volume(MPV),prothrombin time(PT),activated par-tial thromboplastin time(APTT),fibrinogen(FIB),antithrombin-Ⅲ(AT-Ⅲ),and D-dimer(DD)among three groups were compared.Results The differences of PLT,MPV,DD and AT-Ⅲ activities were all significant among three groups (all P < 0.05).PLT,MPV and DD levels in group Ⅰ were all significantly higher than those of control group ([454.00±157.00]×109/L vs [300.00±63.00]×109/L ;[9.66±1.24]fL vs [8.90±0.37]fL;[0.47±0.37] mg/L vs [0.27±0.06]mg/L,respectively);AT-Ⅲ activity in groupⅠ was lower than control group([79.91 ± 20.34]% vs[107.03±8.11]%)(both P <0.05).AT-Ⅲ activity and PLT level in group Ⅱwas (66.11±11.12)%and (279.00±185.00)×109/L respectively,which were both significantly lower than group Ⅰ,MPV and DD level was (10.37± 1.51)fL and (0.70±0.46)mg/L respectively,which were both higher than groupⅠ (both P <0.05).Conclusion There is obvious coagulation dysfunction in children with severe pneumonia.The changes in PLT,MPV,AT-Ⅲ and DD levels are associated with the severity of pneumonia.

Objective To carry out the urban community residents satisfaction investigation and analyze the present situation of public service of medical institutions,to discuss under the new situation,the development of medi-cal and health innovation mechanism,thus to meet the multi -level and diverse people health services demand. Methods Random stratified sampling of Qingdao city community residents,1 430 people,adopted the method of the questionnaire about the present situation of public hospital and community health service center and the satisfaction was investigated.Results Of Qingdao city community residents,1 430 people chose to large public hospital patients (65.8%),community health service centers (37.3%).In a large public hospital from visits to the end,took at least half a day to account for 69.5%,more than a day (18.7%);Unreasonable process part (45.2%),such as hospital formalities complex,paper take inconvenient,medical guide was too little,expert outpatient service limit number,to see the doctor for a long time,adjust time was shorter,the doctor for the patient and the lack of patience,etc.The process was reasonable and convenient accounted for 40.0%.Think of large public hospital service attitude,subject to further improvement accounted for 58.2%;Think good service attitude,the very satisfied accounted for 30.7%.Think that community health service center service attitude good,very satisfied accounted for 43.2%;Think the service attitude in general,efficiency was 37.9%.96.1% of the respondents believed that society should form a public -private joint diversified do medical pattern,provided residents with various preferential policies.98.4% of the respondents expected countries to optimize the medical service resources allocation,promoted resources with high quality and the countryside in poor areas.Conclusion At present,most of the patients choose to large public hospital,process and service attitude is the key of the need to improve.Large public hospitals and community health service center should strengthen the cooperation and formation mechanism of innovation and development,and make the patients more options,so as to get better medical service quality.

BACKGROUND: The studies concerning rehabilitation robot step later in China, many of which are assisted rehabilitation robot rather than rehabilitation training robot. Currently, the rehabilitation instruments in China can not satisfy the intelligentification and man-machine engineered requirement of robots.OBJECTIVE: Considering the predicament of supply and demand relationship of medical service for rehabilitation, to propose a combined robot system for assisted tele-rehabilitation based on remote operation technology and medical device. METHODS: Considering the safety, magneto-theological damper and direct current machine was adopted to design a combined manipulator, which utilizing tale-robot technology in training limb disability patients. According to the remote setting of rehabilitation therapist, patients could perform rehabilitation exercise, which can realize real-time and precision of stiffness display.RESULTS AND CONCLUSION: The clients are patients who have upper limbs movement disorders. Through disassembly and combination of the mechanical arms, it can provide different training modes and therapeutic schemes. The adoption of computer network technology allows the patients to accomplish rehabilitation according to the settings of the physicians via internet; the applications of virtual reality technology greatly raise the enthusiasm in patients and improve the rehabilitation effect remarkably.The experimental results show that the system has good applicability and safety.