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.

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.

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.

10.3969/j.issn.1000-3606.2013.06.009

Objective To investigate the clinical efficacy of a novel path of lymph node dissection combined with peripheral vascular occlusion for the treatment of gastric cancer in stage ⅢC.Methods The clinical data of 142 patients with gastric cancer in stage Ⅲ C who were admitted to the 175th Hospital of PLA from January 2006 to December 2009 were retrospectively analyzed.Seventy patients received novel path of lymph node dissection combined with peripheral vascular occlusion (combined group) and 72 patients received simple lymph node dissection via the novel path (simple group).The positive rate of mRNA expression of carcinoembryonic antigen (CEA) and the distal metastatic rate of tumor cells between the 2 groups were compared.Patients were followed up via outpatient examination,phone call and in-patient examination till January 2013.The measurement data and the enumeration data were analyzed using the t test and the chi-square test,respectively.Results The operation time,volume of blood loss and number of lymph nodes dissected were (184 ± 26) minutes,(282 ± 80) mL and 28 ± 5 in the combined group,(180 ± 28)minutes,(355 ± 85)mL and 27 ± 5 in the simple group,with no significant difference between the 2 groups (t =0.882,5.267,0.496,P ＞ 0.05).The positive rates of mRNA expression of CEA of the combined group and the simple group were 10.0％ (7/70) and 9.7％ (7/72),with no significant difference between the 2 groups (x2 =0.003,P ＞ 0.05).The positive rates of mRNA expression of CEA after lymph node dissection of the combined group and the simple group were 2.9％ (2/70) and 16.7％ (12/72),with significant difference between the 2 groups (x2 =8.240,P ＜ 0.05).The positive rates of mRNA expression of CEA after total gastrectomy of the combined group and the simple group were 4.3％ (3/70) and 4.2％ (3/72),with no significant difference between the 2 groups (x2=0.001,P ＞ 0.05).All patients were followed up at postoperative year 1,and 139 patients were followed up at postoperative year 3.The median time of follow-up was 33.5 month (range,12.0-42.0 month).The 1-year distal metastatic rate of the combined group and the simple group were 7.1％ (5/70) and 8.3％ (6/72),with no significant difference between the 2 groups (x2=0.070,P ＞0.05).The 3-year distal metastatic rate of the combined group and the simple group were 33.3％ (23/69) and 51.4％ (36/70),with significant difference between the 2 groups (x2=4.660,P ＜0.05).The distal metastatic rates of distal parenchymatous organs of the combined group and the simple group were 10.1％ (7/69) and 44.3％ (31/70),with significant difference between the 2 groups (x2=20.390,P ＜ 0.05).Conclusions Novel path of lymph node dissection combined with peripheral vascular occlusion can block the lymph node and blood backflow,and thus effectively reduces the distal metastatic rate of gastric cancer in stage ⅢC after operation.

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 study the change and clinical significance of coagulation and fibrinolytic function in neonatal sepsis. Methods 86 neonates inpatients in the neonatology department of our hospital were selected and divided into the ordinary infection group(30 cases)and the sepsis group(56 cases),and 30 healthy neonates were selected as the normal control group.Plasma AT-Ⅲactivity,DD level and PLT count were detected immediately after admission and the detection results were analyzed.Results Com-pared with the control group and the ordinary infection group,the AT-Ⅲ activity and the PLT count in the sepsis group were sig-nificantly decreased,while the DD level was significantly increase,the difference had statistical significance(P <0.01).The differ-ences of the three indexes had no statistical significance between the normal control group and the ordinary infection group(P >0.05);however,the AT-Ⅲ activity and the PLT count in the DIC group were significantly decreased and the DD level was signifi-cantly increased(P <0.01),the occurrence rate of abnormal three indexes was 83.33%(15/18)in the DIC group,which was signifi-cantly higher than that in the non-DIC group(χ2 =17.75,P =0.00).Conclusion The obvious dysfunction of coagulation and fibri-nolysis exists in neonatal sepsis,which is related with the severity degree of disease.The joint detection of AT-Ⅲ activity,DD level and PLT count is helpful for the early diagnosis of DIC in neonatal sepsis.

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.