Objective: To observe the clinical efficacy of warm needling moxibustion plus Tuina (Chinese therapeutic massage) for knee osteoarthritis (KOA).Methods: A total of 60 patients with KOA were randomized into an observation group and a control group by the random number table, with 30 cases in each group. The control group was treated with warm needling moxibustion, and the observation group was treated with additional Tuina treatment. The treatments were performed once every other day, for a total of 10 times. The visual analog scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) were scored before and after treatment, and the surface electromyography (sEMG) signals of quadriceps femoris were collected. Results: The total effective rate of the control group was 76.7％, and that of the observation group was 90.0％. The difference between the two groups was statistically significant (P<0.05). The WOMAC and VAS scores in both groups after treatment were improved, and the integrated electromyography (iEMG) and median frequency (MF) of quadriceps femoris were increased. The intra-group differences were statistically significant (P<0.05). After treatment, the WOMAC and VAS scores in the observation group were lower than those in the control group, and the differences between the two groups were statistically significant (P<0.05). The improvement of quadriceps femoris function in the observation group was more notable than that in the control group, and the iEMG value and MF were significantly higher than those in the control group (P<0.05). Conclusion: Warming needling moxibustion plus Tuina can effectively relieve the pain in patients with KOA, improve their daily activity function, and increase the sEMG signals of the quadriceps femoris.

Objective To investigate the expression of aquaporin-4 (AQP4) in contused brain and contralateral side and correlation of AQP4 level with brain edema.Methods A total of 70 health adult SD rats were divided into sham operation group (n =10) and brain contusion group (n =60) according to the random number table.Except for no impact in sham operation group,the remaining operations were the same in both groups.Ten rats in brain contusion group were separately sacrificed at 1,6,24,48 and 72 hours,and 7 days.Pathological changes in brain tissues of rats were detected and immunohistochemistry staining and Western-blot were used to measure AQP-4 expression.Results There were no abnormalities of brain tissue structure in sham operation group with AQP4 expressed mainly in glial cells and vascular endothelial cells.With respect to the injured side in brain contusion group,mixed brain edema that consisted of angioedema and cellular edema occurred along with tissue necrosis,massive inflammatory cell infiltration,and microgial proliferation.AQP4 was apparently expressed in gliocytes and vascular endothelial cells,which showed a fall at 1 hour,the lowest at 6 hours,the peak at 24 hours,slow fall at 48 hours,a second peak at 72 hours,and then a fall until 7 days.Level of AQP4 other than that at 1 hour had significant difference compared with sham operation group (P ＜ 0.01).Whereas the contralateral side in brain contusion group showed no pathological abnormalities at 1 hour,but cellular edema emerged at 6 hours followed by mixed brain edema mainly characterized as cellular edema at 24 hours,continued cellular edema but alleviated angioedema at 48 and 72 hours,and alleviated cellular edema at day 7.AQP4 was up-regulated in gliocytes and vascular endothelial cells,which decreased at 1 hour (1.313 ± 0.01),minimized at 6 hours (0.922 ± 0.03),peaked at 24 hours (2.848 ± 0.020),fell at 48 hours,peaked again at 72 hours (2.662 ± 0.02) and fell to almost normal level at day 7.By contrast with sham operation group,level of AQP4 had significant difference other than that at 1 hour and 7 days (P ＜ 0.01).Conclusions After brain contusion,angioedema and subsequent cellular edema emerge in the contused side.Pathological changes are delayed in non-contused side with cellular edema ahead of angioedema.Level of AQP4 is closely related with traumatic brain edema.

Objective To explore clinical indications and curative effects of microwave coagulation combined with submucous 5-fluorouracil (5-FU) injection in the management of early-stage lower rectal cancer. Methods Nine patients with early-stage lower rectal cancer underwent microwave coagulation with submucous 5-FU injection from January 1996 to December 2002. After the microwave treatment, a retention enteroclysis with 100~200 ml normal saline containing 1.0 g 5-FU was performed once daily for 3 days. Results In 3 patients, levels of carcinoembryonic antigen (CEA), which were preoperatively increased, were reduced below normal limits after microwave treatment. No hemorrhage or other intra- or post-operative complications was observed. Follow-up observations to January 2006 showed that all the 9 patients survived. One patient survived for 3 years and 5 months, 1 patient survived for 3 years and 8 months, and 1 patient experienced a tumor relapse at 1 year and 4 months and survived for 2 years and 9 months after a Miles procedure. Among 6 patients who survived longer than 5 years, 1 survived for 5 years and 1 month, 1 for 6 years and 3 months, 1 for 6 years and 8 months, 1 for 7 years and 6 months, and 2 for 9 years. Conclusions Surgical indications for microwave coagulation combined with submucous 5-FU injection for rectal cancer included early-stage cancer, lesions located within 7 cm away from the anus, the mass type cancer, tumor diameter at 0.5~3.0 cm or less than one third of the rectum’s circumference, well differentiated tumor, and patient’s strong anus-sparing demand. This method is minimally invasive, safe, reliable, and cost-effective.

Ablation Techniques ; adverse effects ; Animals ; Bone and Bones ; pathology ; Disease Models, Animal ; Extremities ; Swine

ObjectiveTo analyze the short-term efficacy of mastoscopic axillary lymph node dissection for the patients with early breast cancer who undergo breast-conserving surgery.MethodsThirty patients who met the standard of breast-conserving surgery were divided into two groups by random digits table with 15 cases each.All of these patients underwent breast-conserving surgery,then study group underwent mastoscopic axillary lymph node dissection while control group underwent open technique.The short-term efficacy was observed and compared between two groups.ResultsThe operation time in study group [(88.0 ± 18.0) min] was longer than those in control group [(68.0 ± 12.5) min] with significant difference (P =0.001 ).The incidence of upper extremity edema [ 6.7％ ( 1/15 ) ] and intercostobrachial nerve injury (0) in study group was lower than those in control group[60.0％(9/15),40.0％(6/15) ] with significant difference(P =0.002,0.022).There was no significant difference in blood loss,nodes harvest,total drainage volume and residual cancer cells between two groups [ ( 18.0 ± 12.2) ml vs.(21.3 ± 9.0) ml; 14.6 ±5.0 vs.16.4 ±3.6; (87.9 ±25.1) ml vs.(86.3 ±13.8) ml;6.7％(1/15) vs.13.3％(2/15)] (P ＞0.05).ConclusionsMastoscopic axillary lymph node dissection has the similar nodes harvest with open technique.The incidence of adverse reaction is lower,and the short-term effect is better.

OBJECTIVE: To observe the effects of matrine on proliferation and apoptosis of human renal cell carcinoma cell line GRC-1 in vitro, and to explore its mechanism. METHODS: The human renal cell carcinoma cell line GRC-1 was treated with matrine of different concentrations for 24, 48, 72 and 96 h respectively. The MTT assay was used to evaluate the cytotoxic effects of matrine on GRC-1 cells. The transmission electron microscope and flow cytometry were utilized to observe and detect the apoptosis of GRC-1 cells induced by matrine. The expression levels of Bcl-2 and Bax proteins were evaluated by streptavidin-biotin-peroxidase method. RESULTS: The matrine of different concentrations all have cytotoxic effects on GRC-1 cells, with obvious dose- and time-dependent effects. The apoptosis induced by matrine was confirmed in GRC-1 cells. With intervention of matrine (1.5 g/L) for 12 h, the expression level of Bcl-2 in GRC-1 cells was decreased while the expression level of Bax was increased as compared with those in the untreated group. CONCLUSION: The proliferation-inhibiting effects of matrine on human renal cell carcinoma cell line GRC-1 may be related to down-regulating the ratio of Bcl-2/Bax protein expression and promoting the apoptosis.

BACKGROUND: Improper practice during military training is likely to cause various training wounds, among which patellar tendinosis is the common one.OBJECTIVE: To explore the onset characteristics of patellar tendinosis caused by military training and incidence changes after the implementation of interventions.DESIGN:Sampling investigation.SETTING: Department of Orthopedics, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA; Department of Surgery, Hospital of Chinese PLA Garrison in Hong Kong PARTICIPANTS: Male army soldiers aged 18-24 years were recruited from a full-time training army in August 2000 (non-intervention group) and August 2001 (intervention group). The same training program was carried out among the 2,783 soldiers in non-intervention group and 5,824 soldiers in the intervention group.METHODS: The investigation group was composed of medical workers with senior and intermediate professional titles. Uniform diagnostic standard was made before the investigation, and questionnaire survey wascombined with on-the-spot inspection on soldiers who complained about knee joint pain following training. Those who conformed to the diagnosis were inquired of their training state in detail and possible causes; meanwhile knee X-ray examination was also conducted. Soldiers in the non- intervention group were subjected to the investigation of the incidence and cause of patellar tendinosis due to fulltime training without given any preventive intervention. By contrast, soldiers in the intervention group were given preventive and therapeutic interventions and then subjected to the investigation into the interventional outcomes one year later.MAIN OUTCOME MEASURES: The incidence of patellar tendinosis in soldiers of the two groups.RESULTS: The first and second investigations were conducted on the 2 783 soldiers and 5 824 soldiers, respectively. All of them entered the rediers of the non-intervention group (the incidence of 0.61%) as compared to 15 soldiers in the intervention group (the incidence of 0.26%) (P＜0.01).tenderness. Patel1ar bone X-ray inspection on 12 of them displayed patellar ciated with run-jump training projects; 23 cases were caused by 400 mbarrier training and 7 cases by 5 km cross-country training.CONCLUSION: Patellar tendinosis during military training is mostly caused by run-jump training and can be remarkably prevented by preventive interventions.

Objective To investigate the effect of point Zusanli acupuncture on serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) in high-intensity military training soldiers and explore its possible antifatigue mechanism.Methods Sixty healthy soldiers were randomly allocated to groups A and B, 30 each. Group A received acupuncture at point Zusanli and group B, no treatment. After two weeks of treatment, two groups of soldiers separately did 5 km high-intensity running training and fulfilled the requirement of army examination. CK and CK-MB were measured in two groups before and after training and five days after training.Results In the two groups, there were statistically significant differences in serum CK and CK-MB contents between before training and after or five days after training (P<0.05). After or five days after training, there were statistically significant differences in serum CK and CK-MB contents between groups A and B (P<0.05).ConclusionsAcupuncture at point Zusanli can effectively improve bodily antifatigue ability and reduce myocardial and skeletal muscle injury caused by high-intensity exercise in military training soldiers.

Objective To observe the effect of edaravone combined with Plantula Ixeridis Sonchifoliae(PIS) on relieving neurologic impairment symptoms of patients with acute cerebral infarction(ACI).Methods Ninety-two ACI patients were equally randomized into the treatment group and the control group.The two groups were given routine western medical treatment such as use of aspirin and neurotrophic drugs,and decreasing intracranial pressure and symptomatic treatment for large-size cerebral ischemia.Additionally,the treatment group received intravenous injection of edaravone injection plus PIS injection,and the control group received PIS injection.Fourteen days constituted one treatment course,and the treatment lasted 2 courses.The score of neurologic impairment was evaluated with European Stroke Scale(ESS),and the score of activities of daily life(ADL) was observed before treatment,and after one and two treatment course(s).The adverse reaction was recorded during the treatment.Results At the end of the first treatment course,the scores of ESS and ADL were improved in both groups(P0.05).At the end of the second treatment course,the scores of ESS and ADL were markedly improved in both groups(P

Objective To observe destruction of tibias created in ablating of the swine limbs in vivo with radiofrequency,the influence on the surrounding organization structure,and the repair process of lesions for treating bony tumor.Methods There were eight pigs included in the first part of the experiment.RFA was performed under DSA guidance at the same position of the diaphysis and the upper end of their right tibias in hind leg during anesthesia,then X-ray and CT examinations were performed at different time points after RFA,and subsequently the pigs were executed by depth anesthesia.Control specimens,specimens of the immediate time,the third day,the tenth day,the twenty-fourth day,the fifth week,the eighth week,the twelfth week after RFA were obtained at the diaphysis and the upper end of their tibias.X-ray and CT examinations of these specimens were performed.These specimens were observed both by naked eye and under microscope.The observation included the general state of the laboratory animals after RFA,the configuration of RFA lesions in the gross specimen and the corresponding histologic changes,the boundary of necrosis in RFA lesions and the corresponding boundary of the gross specimen.There were sixteen pigs in the second part of the experiment.RFA was performed at the same position of the diaphysis and the upper end of their right and left tibias in hind leg during anesthesia,and the pigs were immediately executed by depth anesthesia after RFA to get thirty-two capitulum specimens and thirty-two diaphysis specimens.The scope of necrotic tissue in RFA lesions was observed and measured.The border and scope of necrotic tissue in RFA lesions were observed.Major axis,minor axis,and necrosis volume were measured.The independent sample t test was employed to compare the volume of necrotic tissues between capitulum and diaphysis.The one sample t test was employed to analyze volume of necrotic tissue among capitulum,diaphysis and the standard data.Results No accidental death of the animals occured in the first experimental.The loss of neurological function of the hind leg did not happen.Coagulation necrosis in cancellous bone of capitulum and marrow of diaphysis lesions created in ablating was observed.On 3th to 10th day after RFA,inflammatory cells infiltrated in hemorrhage tape and then granulation tissues formed.Granulation tissues replaced necrotic bone gradually from outside to inside.Low density band was showed on images of X-ray and CT examination in the specimen of 10th day,and it extended inward.The immature bone was observed in fibrous tissue sited at the edge of lesions,which appeared as sclerosis on X-ray and CT examination.The scope of necrotic tissue in RFA lesions included coagulation necrosis and hemorrhagic zone of its periphery.The dead bone and secondary pathological fracture appeared in two of eight pigs.RFA hardly damaged compact bone in the diaphysis,but the damage of soft tissue was observed outside the compact bone.In the second experiment,the shape of lesions in cancellous bone of capitulum was ellipsoid,with long axis of(2.59±0.21) cm,minor axis of(2.15±0.10) cm,and volume of(6.34±0.27) cm3.The shape of lesions in the diaphysis of tibias was ellipsoid,with long axis of(4.53±0.20) cm,minor axis of(1.71 ±0.22) cm,and volume of(7.14±0.36) cm3.There was significantly difference of necrosis volume between the capitulum and diaphysis lesions,(t=2.011,P＜0.05).The virtual necrosis volume of the capitulum and diaphysis lesions was significantly different from the presumed volume with RFA instrument(t=-613.371,-295.878,P＜0.01).Conclusion Cancellous bone of the capitulum can be damaged by RFA,but the compact bone of the diaphysis can hardly be damaged.The intact compact bone can be helpful to protect the surrounding soft tissues.X-ray and CT examination can be used in the evaluation of curative effect of RFA for treating bone tumors.Pathological fracture of the diaphysis may appear after RFA.