ObjectiveTo evaluate the long-term therapeutic efficacy of muscle-region alignment needling plus dermalneedle therapy in treating post-stroke upper-limb spasticity.MethodTotally 488 patients with post-stroke upper-limb spasticity were randomized into a treatment group and a control group, 244 in each group. Besides theessentialrehabilitation treatment, the treatment group was intervened by muscle-region alignment needling plus dermal needle therapy, while the control group was given regular Western medication.Thetwo groups were intervened for 3 weeks and were followed up for 6 months. The neurologic function, Functional Comprehensive Assessment (FCA), and Stroke Speciality-Quality of Life (SS-QOL) were observed for the follow-up study.ResultThe total effective rate was 93.4% in the treatment group versus 61.5% in the control group, and the difference was statistically significant (P<0.05); the neurologic function, FCA score, and SS-QOL score in the treatment group were significantly superior to that in the control group at the end of the follow-up study (P<0.05).ConclusionMuscle-region alignment needling plus dermal needle therapycan produce a content long-term therapeutic efficacy in treating post-stroke upper-limb spasticity.

Objective To investigate the effect of ultrasound debridement combined with vacuum sealing drainage on the treatment of diabetic foot ulcer and the potential mechanism. Methods Eighty-one patients with diabetic ulcer were randomly divided into two groups:ultrasound debridement combined with vacuum sealing drain-age as the experimental group,routine debridement combined with vacuum sealing drainage as the control group. The clinical curative effect,the reduction rate of the wound,the rate of blastocyst and the rate of bacterial clear-ance and blood flow were detected.Results The clinical curative effect in the experimental group was significantly better than that in the control group(P < 0.05). The rates of wound reduction and granulation were significantly higher than those in the control group(P<0.05).After 14-day treatment,the blood perfusion in the experimental group was significantly higher than that in the control group(P<0.05),and the expression of HIF-1α and VEGF in the ulcer tissue was significantly higher than that in the control group(P<0.05).Conclusions Ultrasound de-bridement combined with vacuum sealing drainage can improve the clinical efficacy,wound reduction rate,granu-lation coverage rate and bacterial clearance rate,and increase ulcer tissue blood flow. The potential mechanism is related with the increases of HIF-1α and VEGF in ulcer tissue.

Objective:To investigate the clinical application of cervix-uterine internal target volume (ITV) in volume-modulated arc therapy (VMAT) for cervical cancer under different bladder filling conditions, aiming to obtain more accurate planning target volume (PTV).Methods:Sixty-two patients with cervical cancer receiving radiotherapy rather than surgery were selected and randomly divided into the study ( n=31) and control groups ( n=31). In the study group, individualized ITV, PTV and PTV margin were obtained under three bladder filling status by localization CT scan to compare the VMAT. The target area and organs at risk (OARs) within the target area were statistically compared between two groups. The target missing rate in CBCT, adverse events and short-term efficacy of radiotherapy were analyzed in two groups. Results:There was no significant difference in the volume of target area and OARs in the target area between two groups (both P>0.05). In the study group, the target missing rate and target missing volume were significantly lower compared with those in the control group (both P<0.05). There was no significant difference in the incidence of acute radiation-induced adverse events between two groups ( P>0.05). The 1-, 2-year overall survival and progress-free survival did not significantly differ between two groups (all P>0.05). One patient in the study group had uterine recurrence and 2 cases in the control group. Conclusion:Application of individualized cervix-uterine ITV and PTV in definitive VMAT under different bladder filling conditions can improve the accuracy of target area contouring and improve the local control rate in cervical cancer patients.

Objective To explore the interventional effect of repetitive transcranial magnetic stimulation(rTMS)on tardive dyskinesia(TD)in schizophrenic patients.Methods A total of 105 schizophrenic patients were selected as subjects and randomly divided into 1 Hz treatment group,10 Hz treatment group and control group,with 35 patients in each group.All three groups received rTMS treatment for 12 weeks.The Abnormal Involuntary Movement Scale(AIMS),Scale for the As-sessment of Negative Symptoms(SANS),Positive and Negative Syndrome Scale(PANSS)and Treat-ment Emergent Symptom Scale(TESS)scores were compared among the three groups.Physiological indicators such as electrocardiogram,blood routine,blood biochemistry and hormone levels were mo-nitored.Results After treatment,the total AIMS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment,and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group(P＜0.05).The reduction rates of AIMS scores in the 1 Hz and 10 Hz treatment groups were 68.6％and 65.7％,respectively,which were significantly higher than the 22.9％in the control group(P＜0.05).After treatment,the total SANS and PANSS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment,and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group(P＜0.05).There was no statistically significant difference in the total AIMS score,efficacy and total PANSS score between the 1 Hz and 10 Hz treatment groups(P＞0.05).There were no significant differences in the total TESS scores and physiological indicators among the three groups before and after treatment(P＞0.05).Conclusion Both 1 Hz and 10 Hz rTMS can effectively improve TD in schizophrenic patients with good safety and have no significant side effects or physiological damage.

Objective To explore the interventional effect of repetitive transcranial magnetic stimulation(rTMS)on tardive dyskinesia(TD)in schizophrenic patients.Methods A total of 105 schizophrenic patients were selected as subjects and randomly divided into 1 Hz treatment group,10 Hz treatment group and control group,with 35 patients in each group.All three groups received rTMS treatment for 12 weeks.The Abnormal Involuntary Movement Scale(AIMS),Scale for the As-sessment of Negative Symptoms(SANS),Positive and Negative Syndrome Scale(PANSS)and Treat-ment Emergent Symptom Scale(TESS)scores were compared among the three groups.Physiological indicators such as electrocardiogram,blood routine,blood biochemistry and hormone levels were mo-nitored.Results After treatment,the total AIMS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment,and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group(P＜0.05).The reduction rates of AIMS scores in the 1 Hz and 10 Hz treatment groups were 68.6％and 65.7％,respectively,which were significantly higher than the 22.9％in the control group(P＜0.05).After treatment,the total SANS and PANSS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment,and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group(P＜0.05).There was no statistically significant difference in the total AIMS score,efficacy and total PANSS score between the 1 Hz and 10 Hz treatment groups(P＞0.05).There were no significant differences in the total TESS scores and physiological indicators among the three groups before and after treatment(P＞0.05).Conclusion Both 1 Hz and 10 Hz rTMS can effectively improve TD in schizophrenic patients with good safety and have no significant side effects or physiological damage.

Well designed and fabricated custom tray is the precondition to acquire qualified edentulous impression and key to successful complete denture.It has shown that primary impression without custom trays is hard to meet clinical requirements for successful restoration of complete denture.According to the fabrication techniques,edentulous custom tray can be classified into several types such as:compound trimming technique,handcrafted technique with polymerizing acrylic resin based on the study cast,and computer aided design and three dimensional printing(CAD & 3DP) technique based on the primary impression or study cast,etc.With regard to some special edentulous jaws,the custom tray and impression techniques such as open-window,frame cut,closed-mouth custom trays,and so on can be applied to acquire accurate impressions.All above technologies have their own characteristics and emphases.In clinic,appropriate custom trays should be selected according to residual ridge condition,oral status,and other clinical requirements of each edentulous patient.

OBJECTIVE： To provide reference for strengthening clinical application of key monitoring drugs and promoting rational drug use in clinic. METHODS： Based on evidence-based medicine， taking key monitoring drugs Shuxuetong injection as example， clinical evidence of domestic and foreign clinical studies were collected. The included literatures were graded according to the quality of GRADE evidence and recommended strength system. Evidence-based medicine evidence for the indications of Shuxuetong injection were evaluated， and criterion for clinical use of Shuxuetong injection was formulated in Huaihua First People’s Hospital （our hospital）. RESULTS： The main content of criterion for clinical application of Shuxuetong injection formulated by our hospital was that there was A-level evidence support for acute ischemic cerebral infarction， but it was weakly recommended and only used for adjuvant therapy； there was B-level evidence support for anticoagulation （for preventing DVT）， diabetic peripheral nerve lesion， but it was weakly recommended； there was only C-level or D-level evidence support for other indications， it was strongly recommendation against use. CONCLUSIONS： Clinical pharmacists formulate the criterion for clinical application of Shuxuetong injection by evidence quality evaluation method， provide reference for clinical application management of key monitoring drug and play an important effect on rational drug use in clinic.