Objective To analyze the differences of clinical results between CAS and routine NCAS localization in TKA and to evaluate the safety and reliability of CAS in TKA in order to take advantages and avoid disadvantages of this new technology.Methods From October of 2004 to October of 2005,18 cases(20 joints)of TKA in Group Ⅰ which were perform utilizing computer assisted imaging guidance system(CAS)and there were 7 males and 11 females with an average age of 67 years.From October of 2003 to October of 2004,17 cases(22 joints)of TKA in Group Ⅱ which were performed with conventional method previously(NCAS)and there were 5 males and 12 females with an average age of 65 years(56-78).The differences between two groups in clinical results,mechanical axes,soft-tissues balance,coincidence,blood loss,and operating time were statistically analyzed.Results All cases were followed for an average of 10 months(3-12).The mechanical axes error was 2-3 degrees in CAS group and 3-6 degrees in NCAS group.Soft-tissues balance angle was within 2 degree in CAS group and 2-4 degrees in NCAS group.The distance variable was 2-4 mm in CAS group and 5-7 mm in NCAS group.The blood loss was 550-700 ml in CAS group and 700-900 ml in NCAS group.The surgery time was 75-100 min in CAS group and 45-60 min in NCAS group.There were statistically significant differences between two groups.There were no major complications such as fat embolism occurred in both groups.Conclusion Utilizing computer assisted imaging guidance in TKA can obtain reliable and sound clinical results with better mechanical axes and soft-tissues balance.It is a safe and reliable procedure in TKA.

Objective To observe the therapeutic efficacy of acupuncture at myofascial trigger points (MTrPs) in treating cervical spondylosis of vertebral artery type. Methods Ninety-eight patients with cervical spondylosis of vertebral artery type were randomized into a treatment group of 51 cases and a control group of 47 cases. The treatment group was intervened by acupuncture at the MTrPs, while the control group was by injection of medical solution for anti-inflammation and analgesia. The positive rate of rotate-cervix test, dizziness score, and visual analogue scale (VAS) of the head and neck pain were compared before and after intervention. Results After intervention, the positive rate, dizziness score, and VAS score were significantly changed in both groups (P＜0.05). There were significant differences in comparing the positive rate, dizziness score, and VAS score between the two groups after intervention (P＜0.05). The total effective rate was 96.1%in the treatment group versus 76.6%in the control group, and the difference was statistically significant (P＜0.05). Conclusion Acupuncture at the MTrPs can improve the dizziness and head-neck pain in patients with cervical spondylosis of vertebral artery type.

OBJECTIVETo verify the clinical therapeutic effects on shoulder joint pain of rotator cuff injury treated with electroacupuncture (EA) and Mulligan's mobilization.

METHODSA total of 120 patients of shoulder joint pain of rotator cuff injury were randomized into an EA group, a rehabilitation group and a combined therapy group, 40 cases in each one. In the EA group, EA was applied to Jianzhen (SI 9), Jianliao (TE 14), Jianyu (LI 15), Tianzong (SI 11), Jianqian (extra) and Binao (LI 14) in the affected side. Of these acupoints, Jianliao (TE 14) and Jianyu (LI 15), Jianzhen (SI 9) and Tianzong (SI 11) were stimulated with's electric apparatus. In the rehabilitation group, Mulligan's mobilization was used, including scapular mobilization, static joint mobilization and dynamic joint mobilization. In the combined therapy group, EA was used in combination with Mulligan mobilization. The treatment was given once a day in each group, 5 sessions a week, totally for 6 weeks. The pain intensity of shoulder joint (VAS), the University of California at Los Angeles shoulder rating scale (UCLA) and the range of motion (ROM) of shoulder joint were evaluated before and 6 weeks after treatment separately. The adverse reactions were recorded in each group.

RESULTSVAS scores were all reduced, UCLA scores increased and ROM improved after treatment as compared with those before treatment in the patients of the three groups (all<0.05). After treatment, VAS score, UCLA score and ROM in the combined therapy group were remarkably improved as compared with those in the EA group and the rehabilitation group (all<0.05). Regarding the improvements of VAS and UCLA scores, the results in the EA group were better than those in the rehabilitation group (both<0.05). Regarding ROM improvement, the results in the rehabilitation group were superior to those in the EA group (all<0.05). There was no adverse reaction in the two groups.

CONCLUSIONThe combined therapy of EA and Mulligan's mobilization relieves shoulder joint pain of rotator cuff injury, better than the simple application of either EA or Mulligan's mobilization.

Diabetic peripheral neuropathy （DPN） is one of the common complications of diabetes. The disease has a long course with nerve pain and other symptoms， seriously affecting the quality of life of patients. DPN is related to high glucose in vivo， inflammation， oxidative stress， apoptosis， and autophagy， involving phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， nuclear factor-κB （NF-κB）， mitogen-activated protein kinase （MAPK）， and other signaling pathways. At present， the treatment of DPN mainly focuses on symptomatic treatments such as blood glucose control and neurotrophic therapy， but the effect is not ideal. Therefore， it is particularly important to select a reasonable and effective drug to prevent and treat DPN. In recent years， Chinese medicine has played an important role in the treatment of DPN. Many studies have explored the mechanism of Chinese medicine in the treatment of DPN， and it has been found that some Chinese medicine monomers and compounds can regulate signaling pathways to prevent and treat DPN. This paper reviewed the research results of signaling pathways involved in DPN and the regulation of related pathways by Chinese medicine， aiming to provide references for the clinical treatment of DPN.

This case report presents the diagnosis and treatment of a case of cystic echinococcosis misdiagnosed as hepatic cyst. The case had anaphylactic shock caused by extravasation of cyst fluid during extraction of hepatic cyst and suffered from postoperative recurrence of echinococcosis. This case report may provide insights into diagnosis and treatment of cystic echinococcosis among healthcare workers in non-endemic areas.