ObjectiveTo investigate the clinical efficacy of points injection of mouse nerve growth factor in treating sciatic nerve injury.MethodAcupuncture point injection of injectable mouse nerve growth factorwas performed in 60 patients with sciatic nerve injury. Points Huantiao(GB30)and Zusanli(ST36)were selected. Treatment was given once daily, for a total of 30 times. Sensory and motor functions were assessed (MS and SS) and electromyography (EMG) was performed before and after treatment to compare motor nerve conduction velocities (MCV) and sensory nerve conduction velocities (SCV) in the injured nerves and EMG changes in the musclescontrolled by the injured nerves.ResultAfter treatment, nerve function was restored to more than S3M3, with an efficacy rate of 81.7%, in 49 patients. Neuro-electrophysiological study showed that regenerative potentials occurred, accounting for 71.7%,in43patients. Denervated potentials were fewer after treatment than before; there was a significant difference (P<0.05). The mean MCV value increased after treatment compared with before; there was a significant difference (P<0.05). ConclusionAcupuncture point injection of mouse nerve growth factor can markedly improve sensory and motor functions in the regions controlled by the injured sciatic nerve. It provides an effective way to promote the repair of sciatic nerves and the reconstruction of limb function after the nerves are injured.

Objective:To compare the changing trends and differences of bed numbers,doctor numbers and medical service utilization in the US.and China so as to provide polity implication for the health care reform in China from the supply side.Methods:The data of beds,doctors,hospitalization and outpatient service utilization from the website of OECD and CDC of the United States as well as Chinese Statistical Yearbook of Health and Family Planning were used to describe the trends.Results:The beds per 1000 people in China had exceeded that of the US,while the doctors per 1 000 people in China was less than the US.Both the two countries had yearly increasing trend of outpatient visits.However,the hospitalization was decreasing in the US,while the growth rate of hospitalization was even higher than the outpatient visits in China.Conclusion:The decrease of bed amount and the increase of outpatient amount were the main changing trend of medical resources and service utilization in the US.The imbalanced structure of medical resource supply in China resulted the overuse of hospitalization services.In the supply side reform of medical reform in China,it suggested to promote the cooperation of medical insurance,drug and health care,adjusted the reform thought from resource amount into the promotion of service quality,changed the health management system from disease centered into health centered.

Summarized in the paper are the practices and experiences of hospitals across China,in their optimization of medical resources under the Healthcare Improvement Initiative to meet medical needs.Namely rationally allocating medical resources to strengthen emergency rescue,introducing new technologies to improve procedures and efficiency,introducing day surgery and day-care units,and innovating resource sharing among others.The author also recommended on further optimization of medical resources.

Objective To investigate the clinical efficacy of Jin’s three-needle acupuncture plus intelligence training in treating mental retardation in children under 6 years old. Methods Three hundred mental retardation patients aged 0 to 6 were randomly allocated, according to their parents’ willingness, to treatment and control groups, 150 cases each. The treatment group received Jin’s three-needle acupuncture plus intelligence training and the control group, intelligence training alone. An assessment was made using Chinese revised version of the Gesell Developmental Schedules in both groups before and after treatment.Results The total efficacy rate was 84.7% in the treatment group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05). The total efficacy rates in liver-kidney deficiency, heart-spleen deficiency, phlegm and blood stasis, and qi deficiency and blood stasis types were 86.8%, 86.8%, 76.5% and 75.0%, respectively, in the treatment group and 76.2%, 76.8%, 62.5% and 60.0%, respectively, in the control group. There were statistically significant differences in the total efficacy rates in different syndrome types between the two groups (P<0.05). The total efficacy rates in the patients with mild, moderate, severe and very severe diseases were 96.9%, 94.7%, 66.7% and 44.4%, respectively, in the treatment group and 90.0%, 82.5%, 47.8% and 35.3%, respectively, in the control group. There was a statistically significant difference in the total efficacy rate between the two groups of patients with moderate, severe or very severe disease (P<0.05).Conclusion Jin’s three-needle acupuncture plus intelligence training is an effective way to treat mental retardation in children.

Migration of coils during endovascular procedures is a rare, but well-known complication. We are reporting two cases of successfully retrieving migrated coil using detachable intracranial stent. In both of our cases there was distal migration of coil during the intracranial aneurysm coiling procedure. The Solitaire® AB stent (Covidien, Irvine, CA, USA) was used to retrieve those coils. The stent was passed distal to the migrated coil using standard technique. It was then partially deployed and gradually withdrawn along with the entangled coil. Coil retrieval using the fully retrievable intracranial stent is a very simple, safe and easily available alternative for retrieval of distally migrated coil.
Embolization, Therapeutic* ; Endovascular Procedures ; Intracranial Aneurysm* ; Stents*

In China's new healthcare reform, the pilot local governments explore the practice of establishing a new model of hierarchical diagnosis and treatment system.Zhejiang Province has adopted a special policy of effectively allocating hospital resources and human resources, and efficiently improving primary healthcare institution capability and patient satisfaction(hereinafter referred to as double allocation, double improvement), focusing on the implementation of the 'Healthcare Talents Project', in order to fill a vacancy of human resources in primary healthcare institutions.This paper uses system dynamics modeling and the WISN method of WHO to estimate the gap in physician supply in primary healthcare institutions.After building the system dynamics model of 'Healthcare Talents Project', this paper simulates the influence of the policy on the vacancy of doctors in primary healthcare institutions and analyzes the sensitivity of regulatory factors.The simulation results show that, there are a big gap in physician supply of about 14,000 to build the hierarchical diagnosis and treatment system.The project can gradually increase the number of primary doctors, and the policy may fill the vacancy by 2021.However, if the efficiency of the hospital doctors who give assistance to primary institutions is increased by 10%, the targeted training and recruitment 100% achieve the policy plans and objectives, the project goal may be achieved by 2020.Therefore, this project can effectively adjust the human resources structure quickly and reasonably, and it can be used as reference for the reform of hierarchical diagnosis and treatment system.

OBJECTIVETo study the surgical timing, strategy and outcome of intracranial giant aneurysms.

METHODSThe clinical and surgical data of 15 cases of intracranial giant aneurysms treated between January, 2001 and January, 2010 were analyzed. Aneurysm clipping was performed in 8 cases, aneurysm trapping with extracranial-intracranial (EC-IC) bypass in 1 case, parent artery occlusion with EC-IC bypass using great saphenous vein graft in 3 cases, aneurysm resection with aneurysm wall suture in 1 case, and exclusive aneurysm trapping in 2 cases.

RESULTSDeaths occurred in 2 (13%) of the cases. Good surgical outcomes were achieved in 12 cases (80%), and poor outcome was found in 1 case (7%) after the surgery.

CONCLUSIONIndividualized surgical planning is suggested for microsurgical management of intracranial giant aneurysms, and the operation should be performed by surgeons having sufficient microsurgical experience and capable of vessel reconstruction.

Adult ; Aged ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Microsurgery ; Middle Aged ; Neurosurgical Procedures ; Retrospective Studies ; Treatment Outcome

Objective To explore the acupoint selection law for acupoint stimulation to improve gastrointestinal function after colorectal cancer surgery based on data mining technology.Methods Literature about acupoint stimulation to improve gastrointestinal function was retrieved from CNKI,VIP,Wanfang Data,SinoMed,PubMed,Web of Science and Cochrane Library from the establishment of databases to July 1,2023.Data extraction and analysis were performed using Excel 2021.Association rule analysis and clustering analysis were conducted using R language.Results Totally 197 articles were collected,with 242 combinations of acupoints involving 69 acupoints and the total use frequency of acupoints was 878 times.The top 3 acupoints used in frequency were Zusanli(ST36),Shangjuxu(ST37),and Neiguan(PC6).The top 3 involved meridians were the stomach meridian,Conception Vessel,and spleen meridian.The acupoints were mainly distributed in the lower limbs,and the most commonly used intervention method was needle punching.The association analysis discovered a combination of acupoints centered around Zusanli(ST36),which included Shangjuxu(ST37),Neiguan(PC6),and Sanyinjiao(SP6).Clustering analysis identified 4 effective cluster combinations.Conclusion Acupoint stimulation improves gastrointestinal function after colorectal cancer surgery.Multiple acupoint selection ideas are used,and the summarized acupoint selection and compatibility law in this study can provide reference for clinical research and application.

Objective To explore the curative effect of embolism of cavernous sinus with Onyx and coils on cavernous sinus dural arteriovenous fistulas (csDAVFs) and to sum up the experiences.Methods Retrospective analysis of clinical data and radiographic records of 25 patients with csDAVFs who had received embolisation of cavernous sinus using Onyx or in combination with coils through inferior petrosal sinus between August 2008 and February 2013 was performed;all patients were diagnosed by conventional cerebral angiography and received ophthalmological examination before operation.Twenty-two patients used coils and Onyx,three patients used Onyx only.Results Twenty-five embolization sessions were conducted.The mean number of coils was 2.55±0.91 and the mean volume was 32.15±16.03 mm3per patient;the mean volume of Onyx was 2.57±0.86 mL per patient.Three patients (12.0％) who used only Onyx achieved subtotal occlusion and other 22 patients (88.0％) were completely occluded in the immediate angiography.All patients (100％) achieved complete occlusion in the follow-up angiography.Seven patients (28.0％) demonstrated no symptoms at discharge time and 18 patients (72.0％) demonstrated symptoms improvement.All patients remained asymptomatic in the subsequent follow-up periods.Six patients (24.0％) occurred complications and all the complications were cured after proper treatment.Conclusion Effective use of Onyx and coils is the key to cure cavernous sinus dural arteriovenous fistulas and reduce the complications.

Objective To systemically evaluate the efficacy of all kinds of therapies of cerebral venous sinus thrombosis (CVST) associated with intracranial hematoma (ICH) and provide reference for making treatment scheme.Methods We searched English databases (Pubmed,ISI Web of science and Cochrane library databases) for publications on CVST associated with ICH and the relevant references of those articles.Retrieval time deadline was up to January 2015,and the language was set to English.All publications were searched without restrictions of publication type or published fields.Documents were screened to extract data and to analyze systemically.Results In total,17 articles fulfilled the inclusion criteria and included 31 patients.Because of the severities of reported cases were greatly different and treatments were varied,these patients were divided into 3 levels to get a better understanding of the efficacy.In 6 patients of stage Ⅰ,3 accepted anticoagulation,1 operative treatment,1 endovascular intervention and the left one used more than one methods;the prognosis was good and modified Rankin scale (mRS) score was 0 no matter which kind of therapy was performed.In 11 patients of stage Ⅱ,2 accepted anticoagulation enjoyed mRS scores of 0 and 6,3 operative treatment enjoyed mRS scores of 0,1 and 6,1 endovascular intervention enjoyed mRS scores of 0,and the left 5 used more than one method enjoyed mRS scores of 0,1,1,2 and 2.In 8 patients of stage Ⅲ,1 accepted anticoagulation enjoyed mRS scores of 2,3 operative treatment enjoyed mRS scores of 1,2 and 4,and 4 endovascular intervention enjoyed mRS scores of 0,1,1 and 1.Conclusion It seems that anticoagulation therapy alone may not be effectively enough for those patients that with severe clinical or imaging features;individualized therapy strategies with different types would be more effective.