OBJECTIVE:To survey utilization of traditional Chinese medicine(TCM)combined with western medicine for TCM outpatients in our hospital and to probe into pharmaceutical care in order to decrease and prevent druginduced diseases because of irrational use of drug and provide reference for safe use of TCM combined with western medicine in the clinic. METHODS:100 cases were collected from TCM department from Jan. 1 to Dec. 31 of 2009 and their prescriptions were recorded. General information in prescriptions were recorded and analyzed. RESULTS:1 200 cases of patients there were 909 patients(75.75%) using the combination therapy,136 patients(11.33%)while use of proprietary Chinese medicines,Chinese herbal medicine and western medicine. There are 655 cases of combination therapy patients(72.06%)for rational use of medicines,while 254 patients (27.94%)are not. CONCLUSION:TCM outpatients in our hospital are treated with TCM combined western medicine in general (Chinese patent medicine combined with western medicine). There is some inappropriate use of drugs so that pharmaceutical care is necessary. Drug combination is the key to pharmaceutical care.

OBJECTIVE:To identify the influence of twisting or untwisting Taixi(K13) on the brain function by observing functional mag-netic resonance imaging.METHODS:Twelve healthy young cases were enrolled in this research.A block design including three blocks which baseline and stimulation appear alternately was adapted.In stimulation phase,the needle was twisted manually,or not twisted.Scanned images were analyzed using SPM2.RESULTS:The right superior temporal gyrus(BA22),left medial frontal gyrus(BA46),followed by right and left postcentral gyrus of parietal lobe(BA2,BA3),left inferior frontal gyrus(BA45) and left inferior parietal lobule(BA40) were evoked by acu-puncture at Taixi,but there was no activeation area after untwisting acupoint.CONCLUSION:The different areas evoked by twisting or untwisting Taixi acupoint are closely related with the internal organs as well as the course of the channels and collaterals.

Objective:To observe the influence of SBAR communication mode on the condition of patients undergoing thoracolaparoscopic combined with esophageal cancer resection.Methods:A total of 200 patients who were admitted to the Department of Gastroenterology and Oncology from October 2017 to October 2019 in Affiliated Hospital of Southwest Medical University were selected for elective thoracolaparoscopic combined with esophageal cancer resection. According to the random number method, they were divided into 100 cases in the control group and the SBAR group. The control group used conventional preoperative communication visit mode, and the SBAR group used SBAR communication mode and preoperative visit based on the control group. The following items such as the preoperative negative mentality scores, quality of life score, postoperative complications and nursing satisfaction rate of the two groups before and after nursing interventionwere compared.Results:Before the intervention, the difference of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of the two groups was not statistically significant ( P>0.05). After the intervention, the SAS and SDS scores of the two groups were 49.32±4.96, 55.95±5.32, 50.93±4.74, and 56.33±5.89, respectively, which were significantly reduced. The SDS and SAS scores of the SBAR group were lower than those of the control group ( t values were -9.115 and -7.142, P<0.001). The difference of the World Health Organization Brief Table on Quality of Life (WHOQOL-BREF) scores of the two groups before the intervention was not statistically significant ( P>0.05). After the intervention, the WHOQOL-BREF scores of the two groups were 12.27±1.39 vs. 9.18±1.24, 16.13±1.51 vs. 12.48±1.22, 16.13±1.95 vs. 12.71±1.28, 15.09±1.81 vs. 13.08±1.48, 18.11±1.82 vs. 13.51±1.47, 14.09±1.61 vs. 12.98±1.28. The scores of the SBAR group were higher than those of the control group ( t values were 5.397-19.662, P<0.001). The postoperative complications rate of the SBAR group was 3.00% (3/100), which was less than 18.00% (18/100) of the control group ( χ 2 value was 11.971, P<0.001). The overall satisfaction rate of patients in the SBAR group with care was 100.00% (100/100), which was higher than the 84.00% (100/100) in the control group ( χ 2 value was 17.391, P<0.001). Conclusions:In patients with esophageal cancer undergoing thoracic laparoscopy combined with esophageal cancer resection, the use of SBAR communication mode for the patient′s preoperative visit can significantly reduce the patient′s preoperative anxiety and depression negative scores and improve the patient′s quality of life, reduce the occurrence of postoperative complications, improve patient satisfaction with nursing with ideal effect.

OBJECTIVETo introduce the clinical application of venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot.

METHODSBased on the anastomoses between the medial plantar artery of the hallux and the nutritional vein, the flap was designed with the perforator of medial plantar artery adjacent to the first metatarsal bone as the rotation point. The flap axis was along the vein at the medial aspect of the foot between rotation point and medial malleolus.

RESULTS5 cases were treated with primary healing and complete survival flaps. The patients were followed up for 1-12 months with good match of texture and color.

CONCLUSIONSThe venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot can be transpositioned to repair the defect at forefoot.

Arteries ; Forefoot, Human ; Hallux ; blood supply ; Humans ; Metatarsal Bones ; Surgical Flaps ; blood supply ; Veins ; Wound Healing

ObjectiveTo evaluate the efficacy of mini-incisional double-tsuge suture method with 0-0 absorbable polydioxanone-cord (PDS-Ⅱ)in repair of acute achilles tendon rupture.MethodsA total of 34 patients were subjected to acute closed achilles tendon ruptures,including 25 males and 9 females at a mean age of 32 years ( range,20-45 years).Injury causes included sports injuries in 27 patients,falling injuries in six and heavy object impingement injury in one.The time from injury to operation was average 3 days (range,1-6 days).All patients underwent minimally invasive repair with double-tsuge suture method by using PDS-Ⅱ.The ankle joint was fixed with short leg plaster cast at 30° plantar flexion position and the cast was removed six weeks later to take functional exercise.The patients could walk with full weight-bearing 8-10 weeks later and could gradually return to activity 3-4 months later.Results There was one patient with poor incision healing and one patient with reflex sympathetic dystrophy postoperatively.The rest patients had stage Ⅰ incision healing without skin adhesions.No complications such as infection,lower extremity deep venous thrombosis or sural nerve injury occurred postoperatively.All the patients received follow-up of 12-24 months (average 15 months),which showed no complications like tendon rerupture occurred.According to clinical evaluation criterion of Termann,the average score was 92 points (range,76-96 points).The result was excellent in 28 patients,good in five and fair in one,with excellence rate of 97％.ConclusionsSmall incisional double-tsuge suture method achieves low rate of complications and good outcomes for repairing acute achilles tendon rupture and is an ideal tendon surgery approach.

Objective To explore different clinical and pathological features of thymomas with and without myasthenia gravis(MG),and accumulate the experience of perioperative managements.Methods Patients with thymoma admitted by our department between June 2010 and June 2016,were retrospectively reviewed.Results Of the 273 patieuts,150 were males and 143 were fenales(median age:48 years).115 of all patients(42.1％) were combined with paraneoplastic diseases.There was no mortality during perioperative period.Video-assisted Thoracoscopic surgery was successfully performed for 246 cases(90.1％).The female thymoma patients with with MG(TMG) were more than those without MG and thymic hyperplasia (53.0％ VS 39.5％,P =0.036).Compared to the thymoma patients without MG and thymic hyperplasia,the TMG was associated with younger age of onset [(46.6 ± 12.9) years VS.(50.6 ± 14.32) years,P =0.026],longer hospital stay [(18.3 ± 9.4)days VS.(14.6 ±5.7) days,P =0.000],higher postoperative complications morbidity(22.0％ VS.11.6％,P =0.027).Although the TMG has a lower recurrence rate,there was no significant difference between the two groups for recurrence rate(0 VS.2％,P =0.274).Conclusion Extended thymectomy should be recommended for thymoma and thymic hyperplasia whether combined with or without paraneoplastic diseases.

Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P ＞ 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P ＞ 0.05).There were no complications in the experiment group while there were 14 complications (31.1％) in the control group,showing a significant difference (P ＜ 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.

Objective To explore the effect of functional electrical stimulation combined with treadmill training and botulinum toxin type A injection on foot-drop and strephenopodia among stroke survivors.Methods Sixty-seven stroke survivors with foot-drop and strephenopodia were randomly divided into an electrical stimulation group (n=23),a conventional treatment group (n =22) and a combined treatment group (n =22).All 3 groups received a 400 U injection of BTX-A and electrical stimulation.After 24 hours,the patients in the conventional treatment group received conventional treatment including a brain protection agent,limb function exercises,gait training,balance training and training in the activities of daily living.The patients in the combined treatment group received that conventional treatment,plus functional electrical stimulation and weight loss training on a treadmill.The patients in the electrical stimulation group received functional electrical stimulation treatment supplementing the conventional treatment.Therapeutic effects were evaluated before and after six weeks of treatment using integral electromyography (iEMS) of the anterior tibial muscle and the lateral head of the gastrocnemius muscle,the co-contraction ratio (CR) during ankle dorsiflexion,the modified Ashworth Scale (MAS),the Berg balance scale (BBS),a functional walking score (FAC),and the active range of motion (AROM) of the ankle in dorsiflexion and eversion.Results After the treatment,significant improvement was observed in all three groups in the average iEMS value of the anterior tibial muscle and the lateral head of the gastrocnemius muscle,the CR in ankle dorsiflexion,and in their MAS,BBS,FAC and AROM results.There was no significant difference among the three groups after treatment in their average iEMS values at the lateral head of the gastrocnemius.The average values of the other indicators were,however,significantly better in the combined treatment group than in the other 2 groups.Conclusion Functional electrical stimulation combined with treadmill training and botulinum toxin type A injection can significantly improve foot-drop,strephenopodia and the walking function of stroke survivors.This combined treatment deserves popularization and application in clinical practice.

Objective To investigate the diagnostic value of urinary light chain detection in essential hypertension renal injury. Methods According to "National Prevention and Treatment Guide of Hypertension" (2005 Edition) and the diagnostic criteria of essential hypertension renal injury, patients'medical history and damage of target organs, we selected 60 patients with essential hypertension and divided them into two groups: 28 patients without renal injury and 32 patients with renal injury. Meanwhile, Thirty healthy individuals were included in a control group. Urinary proteins and light chains were detected by immuonephelometry and the activity of NAG was determined by liquid kinetic rate assay with MNP as substrate. The urinary light chains concentration of each group were compared and analyzed with those of Alb and α1-MG. Results The results of lamU in renal injury group [8. 89(3.84-33. 30) mg] were higher than those of non renal injury group [3. 84(3. 84-10. 4) mg] and control group [3.84(0. 00-3.84) mg]. There was statistically significant difference ( H = 37.97, P ＜ 0. 01 ). The levels of kapU in renal injury group [26. 65 (6. 97-62. 5 ) mg] were higher than those of non renal injury group [6. 97 (6. 97-23.7 )mg] and control group [6. 97(6. 97-7. 20) mg], which also had statistical significance (H =40. 09,P ＜0. 01 ). All the other results in renal injury group ( Alb, α1-MG, IgG, TRF and NAG) were higher than those of non renal injury group and control group ( H =21.02, 32. 65, 25.50, 30. 45 and 30. 57, P ＜0. 01 ). Correlation analysis showed that Alb levels were highly correlated with urinary IgG and TRF levels [Correlation coefficient (r) =0. 911, 0. 965, P ＜ 0. 01]. The levels of urinary light chain lamU and kapU were also highly correlated with α1-MG ( r = 0. 804, 0. 827, P ＜ 0. 01 ). However, There was no correlationship between NAG and α1MG levels (r=0. 398,P＞0. 05). Conclusion The urinary light chain lamU and kapU can be used as indicators for evaluation of renal injury in essential hypertension, especially renal tubular injury.

Objective To study the relationship between behavioral problems and family environment in preschool-age children. Methods Children between 4-6 years of age in the kindergartens of Zhongshan city were randomly selected. Child Behavior Checklist (CBCL) was used to assess the behavioral problems in children, and self-designed general situation question-naire and Family Environment Scale-Chinese Version (FES-CV) were applied to evaluate the family environment. Results A total of 3445 children were enrolled and 29.87%children showed behavioral problems. There were signiifcant differences in the scores of feeling expression, family conlfict, intelligence, recreation, organization and control between children with and without behavior problems (P<0.001). The scores of feeling expression, intelligence, recreation, organization and control were signiif-cantly higher and the score of family conlfict was lower in healthy children in comparison with children with behavior problems. Through multivariate logistic regression, it was suggested that female (OR=2.04), non-urban population (township OR=1.45, rural OR=1.51), non-local Zhongshan resident (OR=1.39), father’s low educational level (technical secondary school OR=1.77, junior high school OR=2.17, primary school and below OR=3.24), discipline styles (indulgent OR=1.47, mixed OR=1.37), family conlfict (OR=1.13) were independent risk factors for behavioral problems (P<0.05). Mother’s age over 30 (OR=0.74) or over 40 (OR=0.46), feeling expression (OR=0.94) and intelligence (OR=0.87) were independent protective factors for behavioral prob-lems (P<0.05). Conclusions Behavioral problems in preschool-age children are closely related to family environment, which needs to be paid more attention.