Objective To observe the real-time efficacy of balance acupuncture in treating primary hypertension. Method Totally 160 patients with primary hypertension were randomized into a treatment group and a control group, 80 in each group. The treatment group was intervened by balance acupuncture, while the control group was by oral administration of Captopril. The blood pressure and symptom score were observed before and after intervention. Result There were no significant differences in comparing the total effective rate at different time points between the two groups (P>0.05). There was a significant difference in comparing the headache score in male patients at 30 min after treatment between the two groups (P<0.05). Conclusion Balance acupuncture is an effective method in treating primary hypertension, and can release headache of the patients.

Objective To discuss the value of percutaneous dilatational tracheotomy(PDT) for cardiosurgery in intensive care unit by comparing its outcomes with that of open tracheotomy(OT).MethodsA prospective study was conducted on 40 severe patients undergoing cardiosurgery.The patients were divided into PDT(treated from January 2002 to July 2003) and OT groups(treated from August 2003 to February 2008) with 20 cases in each.The operation time,length and heal time of the incision,blood loss,vital signs,and postoperative complications were compared between the two groups.ResultsThe operation time,length and heal time of the incision in the PDT group were significantly different from that in the OT group [(8.8?2.2) min vs(21.5?5.3) min,t=-9.897;(1.3?0.2) cm vs(3.4?0.5) cm,t=-17.440;and(3.9?0.9) d vs(5.9?1.2) d,t=-5.963;P=0.000].One patient in the PDT group(5%) had Ⅱ degree blood loss during the operation that was significantly less than those in the OT group(13 patients,65%,?2=15.824,P=0.000).The level of the vital signs change in the PDT group was significantly milder than those in the OT group [MAP: 1-5 mm Hg(median 2) vs 1-20 mm Hg(median 3.5),Z=-2.959,P=0.003;heart rate: 3-12 beats/min(median 5.5) vs 7-70 beats/min(median 10),Z=-3.956,P=0.000;SpO2: 0-4%(median 2%) vs 0-31%(median 3.5%),Z=-3.548,P=0.000].Furthermore,the rate of incisional leakage of sputum and overall rate of complications in the PDT group were significantly lower than those in the OT group.[1(5%) vs 8(40%),?2=5.161,P=0.023;and 1(5%) vs 12(60%),?2=13.789,P=0.000].ConclusionsPDT is a safe and minimally invasive technique with a high rate of success and low rate of complications.The method is easy to operate,and thus could be a good choice for severe patients after cardiovascular surgeries.

Objective To explore the characteristics of family functioning between parents and adolescent and the association of adolescents' self-esteem,and depression.Methods Data were collected from reports of 257 middle school students and their parents in Shanghai,and by self-evaluation questionnaires including the depression scale,the self-esteem scale,and the family adaptability and cohesion scale.Results ①Adolescent perceived more negative than parents in the family adaptability (69.02 ± 11.49),(70.60± 9.60) and cohesion (43.84 ± 9.25),(46.56±7.86),and the difference in family adaptability were significant (t=4.064,P＜0.01).② Adolescents' self-esteem positively related to their family cohesion(r=0.525) and adaptability (r=0.427,P＜0.01),while depression negatively related to family cohesion(r=-0.565) and adaptability (r=-0.475,P＜0.01).③Students in families with high adolescent-parent perceptual differences in family functioning showed more depressive symptom,lower level of self-esteem than those in low adolescent-parent perceptual differences,and the difference were significant (P＜0.05).Conclusion Adolescents' self-esteem,depression symptoms are significantly related to their familyadaptability and cohesion,the adolescent-parent perceptual differences in family functioning may also affect adolescents' psychological well being.

Objective To evaluate the MR manifestation to provide guidance for the clinical diagnosis of adenomyosis.Methods The MR images of 43 cases of adenomyosis which were proved by operation and pathology were reviewed.Results Among the 43 cases of adenomyosis,26 cases were of diffuse adenomyosis and 17 of focal adenomyosis.Leiomyoma(21 cases),intra-pelvic cavity chocolate cyst (17 cases)and ovarian cyst(15 cases)were concurrently found in this group of patients.The MRI of diffuse adenomyosis demonstrated an enlarged uterus and widened uterine junction zone with ill-defined margin between junction zone and myometrium.The adenomyosis lesions showed iso-signal intensity on T_1 weighted images and iso-signal or slight low signal intensity on T_2 weighted images with scattered hyper- intense foci.The uterine cavities were irregularly narrowed due to compression of thickening junction zone.The lesions showed mild con- trast enhancement on contrast-enhanced MR images.The MRI of focal adenomyosis displayed localized myometrial masses with ill-defined margin with widening of junction zone.The lesions were round or oval in shape with iso-signal intensity on T_1 weighted images and inho- mogeneous slightly low signal on T_2 weighted images.Multiple scattered hyperintense foci could be found in the mass on the T_2 weighted images.The lesions had mild contrast enhancement on contrast-enhanced MR images.The concurrent leiomyoma,intra-pelvic cavity choc- olate cyst and ovarian cyst were also displayed by MR imaging.Conclusion The widened junction zone is the characteristic change of ade- nomyosis.MRI can demonstrate the types,size and concurrent changes in adenomyosis,and is a useful noninvasive imaging method for the diagnosis of adenomyosis.

Objective To study renal involvement in hepatic glycogen storage disease(GSD) in childhood. Methods One hundred and eight patients aged less than 21 years old with type Ⅰa GSD (54 cases), type Ⅲ (29 cases) and uncertain type hepatic GSD (25 cases). Urine analysis, urine albumin, urine protein of 24 h, urine ?_2-MG, BUN, creatinine, Ccr were evaluated. Results Of 108 patients with hepatic GSD, 16 patients (20.8%) had proteinuria proven by urine albumin or urine protein of 24 h, their ages first found proteinuria were 8～15 years. Two 15-year-old patients had proteinuria over 1.0g/24h. Among 72 patients, urine ?_2-MG of 51 cases (70.8%) increased (175～10 623mg/L), and the mean urine ?_2-MG of type Ⅰ a GSD was much higher than that of type Ⅲ GSD, 4138.2 and 1790.1mg/L respectively. Of 91 patients, 10 had renal insufficiency, 1/10 (15-year-old girl) had heavy proteinuria (3.5g/24h), elevated BUN (9.3mmol/L) and Scr(1061 ?mol/L). Five elder patients (11～21 years old) had hematuria with renal colic caused by renal calculus. Conclusions Persistent protenuria, increased urine ?_2-MG, decreased Ccr, and renal stones are common complications of hepatic GSD in childhood. Renal function should be thoroughly evaluated during follow-up.

Objectives:To study the impact of nutritional support in non operative management of severe acute pancreatitis. Methods:Sixteen patients with severe acute pancreatitis were provided with stage nutritional support. Results:Fourteen cases fully recovered and 2 cases died. Stage of maintenance equilibration was (57.0?12.5)hours,TPN was (12.1?4.2)days and PN+EN was (12.2?3.5)days. Conclusions:Stage nutritional support might be favourable in improving prognosis and survival rate of severe acute pancreatitis.

Objective To investigate the clinical pathologic features and treatment scheme of primary bronchial carcinoid tumor.Methods Twenty-one cases with primary bronchial carcinoid tumors were selected as our subjects.Clinical information was recorded.Of 21 patients,17 cases were undergone surgery including 12 cases for lobectomy,2 cases for pneumonectomyin,1 case for pulmonary wedge resection and 1 case for egmental resection;Three cases were received adjuvant chemotherapy,1 case for adjuvant and radiation therapy and chemotherapy and 1 case for chemotherapy only.Results Histological classification showed that 7 cases were typical carcinoid,and other 14 cases were atypical carcinoid.Nine cases were TNM stage I,8 cases at stage Ⅱ,1 case at stage Ⅲ,3 cases at stage Ⅳ.All cases were performed follow-up for 5 years.Nineteen cases survived at 1st year and 10 cases survived at 3rd years survival.5 years survival rate was 23.8％ (5/21).Conclusion Surgical operation is proved to be the main method for treating bronchopulmonary carcinoid tumors,and surgical radical operation was recommended.

Objective To study the correlation between quantitative parameters of contrast-enhanced ultrasonography(CEUS)and microvessel density(MVD)in hepatocellular carcinoma(HCC),and to investigate the value of CEUS in noninvasively assessing HCC angiogenesis.Methods The patients with 28 HCCs confirmed by pathology were examined by CEUS.A new type quantification software SW-UCS was used to delineate time-intensity curve(TIC)and to obtain quantitative parameters of HCC and hepatic parenchyma in region of interest.The quantitative parameters were compared with MVD,which was counted by immunohistochemistry method using CD34 antibody,and the correlation between them was studied.Results The TICs of HCC showed typical contrast-enhancement pattern of"fast-in and fast-out"comparing with normal hepatic parenchyma.There were significant differences between HCC and hepatic parenchyma in slope of rise time(a3),time to initial peak(TTP),peak intensity(PI),increased signal intensity(ISI)and acceleration time(ACT)(P＜0.05).MVD in HCC(49.36±12.57)was higher than that in hepatic parenchyma(32.46±11.78,P=0.000).For HCC,the PI,ISI and area under curve were positively correlated with MVD,while the slope of decrease to half of peak(a2)was negatively correlated with MVD (P＜0.05).Conclusions The quantitative parameters of CEUS in HCC were correlated with MVD,CEUS can evaluate the angiogenesis of HCC in vivo noninvasively.

Objective To explore the clinical efficacy and safety of continuous sequential hormone replacement therapy of femoston for menopausal syndrome .Methods 121 cases of menopausal syndrome at expert outpatient service in our hospital from January 2014 to October 2015 received hormone replacement therapy of femoston for 24 weeks .Before and after treat-ment ,Kupperman score ,blood follicle stimulating hormone (FSH) ,estradiol (E2 ) ,luteinizing hormone (LH) and endometri-al thickness were determined .Results With the prolonging of treatment time ,patient's menopausal symptoms gradually re-lieved .Kupperman scores were declining .After 6 courses of treatment ,patient's menopausal symptoms completely eased . Kupperman scores decreased by 95 .0% (P<0 .01) ,serum FSH and LH decreased significantly (P<0.05 and P<0 .01) and serum E2 increased notably (P<0 .01) without endometrial thickness changes (P>0.05) .Conclusion Continuous sequential therapy of femoston can effectively relieve menopausal syndrome and control the menstrual cycle and the endocrine level without stimulating the endometrium excessively .

The paper described the presence and characteristics of " substitution " in health examinations, and analyzed the consequences and hazards of such a phenomenon. It is held that substitution will incur conflicting results of those receiving such examination, constituting medical risk and legal risk exposure as well. Due preventions should be taken in the rules and regulation of medical practice, with enhanced personnel management and ensured quality of health examination.