Chronologicaol order of acupuncture,as one of the in uential factors of acupuncture therapeutic e ect,has been commonly ignored at present.This article is to explain the rationality and necessity of chronologicaol order of acupuncture through following aspects.One is based on TCM theory,such as the'branch'and the'root',gentleness and urgency,qi and blood,reinforcing de ciency and reducing excess.The other is ndings of modern clinical and experimental researches.

Objective　In order to explore the prevalence of hypophosphatemia in postoperative patients of general surgery,as well as the time and dosage of phosphate replacement and its effects.Methods　To serum phosphate levels of 45 patients with phosphate replacement begun on the second postoperative day and 45 without replacement were monitored at the preoperative day,and the first,third,fifth and seventh postoperative day.Results　The incidence of hypophosphatemia was 91.1%(41/45) in cases without phosphate replacement.While it was 57.8%(26/45) in those with replacement.The serum phosphate concentrations in cases with phosphate replacement were higher than those without replacement on the third(P<0.001),fifth(P<0.05) and seventh(P<0.01) postoperative day.The Apache Ⅱ scores in cases with phosphate replacement decreased on the third postoperative days compared with those on the first day(P<0.001).Conclusion　The postoperative replacement of phosplates can avert the occurrence of hypophosphatemia and improve the Apache Ⅱ score.

With well understanding of the ethical problems in ophthalmic clinical treatment, strategies were developed to help establish a credible relationship with children and then to avoid causing psychological harm to them. The informed consent given prior to treatment can effectively minimize potential medical risks.

Objective To discuss the value of essential hypertension arteriosclerosis as a predictor of early renal damage.Methods 90 cases of essential hypertension with early renal damage were selected and statistical analysis to result of AASI,Scr,ACR and eGFR with SPSS17.0、Excel statistical analysis software were carried out.Group A was defined as AASI≥0.55 and group B was defined as AASI＜0.55.Compared the two groups with relevant analysis,and then built multivariate linear regression equation.Results ① The group A showed higher age(P＜0.01),24 h DBP(P＜0.05),ACR(P＜0.01),ACR(+) rate(P＜0.01)and lower eGFR (P＜ 0.01),compared with the group B.②AASI showed a positive correlation with age (r＝ 0.483,P＝ 0.000),24 h SBP (r＝ 0.350,P ＝0.001),ACR (r＝0.474,P＝ 0.000),and a negative correlation with eGFR (r＝-0.383,P＝ 0.000).Two multiple linear regressions showed that AASI was associate with eGFR (B ＝-0.001,P＝ 0.038) and ACR(B ＝ 0.025,P ＝ 0.000) independent of other factors.Conclusion ①Arteriosclerosis is closely related with age and blood pressure mutation rate day and night.②Arteriosclerosis has a closely relationship with essential hypertension early renal damage,and can predict early renal damage in hypertension patients.

AIM: To investigate therapeutic effects of recombinant human growth hormone(rhGH) on rat sepsis and its possible mechanisms. METHODS: Mean arterial pressure (MAP), levels of plasma TNF?,IL-1? and endotoxin,leukocyte count and survival rate within 1 week were determined after E. coli injection among control group,sepsis group and sepsis+rhGH group. RESULTS: (1)rhGH diminished the decrease of MAP, reduced plasma endotoxin and TNF? levels and increased neutrophil ratio in total leukocytes in sepsis rat. rhGH increased survival rate within 1 week on sepsis rat. (2)No changes were found in IL-1? level among the three groups. CONCLUSION: rhGH showed desirable beneficial effects on rat sepsis, which may attribute to: improving circulatory function; maintaining intestinal mucosa barrier, attenuating bacteria/endotoxin translocation and inhibiting the production and release of TNF?.

ObjectiveTo value fluorescent quantified PCR (polymerase chain reaction) technique to detect the DNA of Mycobacterium tuberculosis from clinical patients.MethodsDetect the DNA of TB from the sputum of 80 active tuberculosis and hydrothorax of 40 tuberculous pleuritis.At equal pace,make a comparison to proceed microscopic examination and cultivation.ResultsWith fluorescent quantified PCR,56.2％ (45/80),27.5％ (11/40)positive detection from active tuberculosis and tuberculous pleuritis respectively.16.2％ ( 13/80 ),0.0％ positive specimen were detected with microscopic examination in two group of patients.Cultivation got 37.5％ (30/80),2.5％(1/40) positive detection respectively.ConclusionFluorescent quantified PCR was more sensitive and specific than traditional methods,and valuable in the microscopic examination and cultivation negative patients especially.

Child ; Humans ; Pneumonia ; diagnosis ; etiology ; Recurrence

Objective To investigate the value of C-reactive protein (CRP),serum amyloid A (SAA) and CD64 in early diagnosis of sepsis in very low birth weight infants (VLBWI).Methods Fifty-four VLBWI suspected to sepsis and 20 VLBWI without infection in neonatal intensive care unit of the Second Hospital of Wenzhou Medical College from May 2010 to May 2012 were enrolled in this study.CRP,SAA and CD64 of sepsis group were measured at 0 and 24 hour after suspected bacterial infection; and those of control group were measured at corresponding age.CRP and SAA were detected by enzyme-linked immunosorbent assay,and CD64 was detected by flow cytometry.The difference between groups was compared by Mann-Whitney U test.Receiver operating characteristic curve was used to predict the sensitivity and specificity of the three biomarkers on sepsis.Results Fifty-four VLBWI were suspected with sepsis,and 37 patients were finally diagnosed.The levels of the three biomarkers in sepsis group were higher than those of control group not only at 0 h [CRP:13.3 mg/L(4.6-67.2 mg/L) vs 4.4 mg/L(1.6-11.2 mg/L),Z=-2.308; SAA:95.7 mg/L(4.5-265.9 mg/L) vs 7.3 mg/L(2.5-16.9 mg/L),Z=-2.425; CD64:7306 fluorescent antibody molecules/cell (2667-10 853 fluorescent antibody molecules/cell) vs 2502 fluorescent antibody molecules/cell (1839-3017 fluorescent antibody molecules/cell),Z=-3.704],but also at 24 h[CRP:35.4 mg/L (7.7 106.5 mg/L) vs 3.2 mg/L (1.1-7.8 mg/L),Z-5.501; SAA:359.3 mg/L (3.8-503.2 mg/L) vs 6.6 mg/L (3.0-12.7 mg/L),Z =-2.818; CD64:8304 fluorescent antibody molecules/cell (2819-11 758 fluorescent antibody molecules/cell) vs 2563 fluorescent antibody molecules/cell (1760-3154 fluorescent antibody molecules/cell),Z =-7.670],P＜0.05 respectively.The best cutoff value of CD64 was 2934 fluorescent antibody molecules/cell,with the sensitivity of 81.1％ at 0 h and 91.9％ at 24 h; and the specificity of 90.0％ at 0 h and 80.0％ at 24 h.Although SAA had similar sensitivity (0 h:83.8％; 24 h:86.5％) as CD64,its specificity was relatively low(0 h:65.0％; 24 h:55.0％).Both the sensitivity (0 h:62.2％; 24 h:70.3％) and specificity (0 h:70.0％; 24 h:70.0％) of CRP were low.Combination of the three infection biomarkers could increase the sensitivity (0 h:91.9％; 24 h:97.2％) and specificity (0 h:95.0 ％ ; 24 h:90.0％).Conclusions Combination of CRP,SAA and CD64 might improve the diagnostic accuracy of sepsis in VLBWI.

ObjectiveTo explore the clinical presentation, diagnosis, treatment, and outcome of the Barth syndrome (BTHS).MethodsClinical data were collected and analyzed from 3 patients with conifrmed genetic diagnosis of BTHS from June 2013 to October 2014.ResultsAll of the 3 patients were males and two of them were twins. The main clinical manifes-tations of the 3 patients were cardiomyopathy and heart failure, accompanied by different degrees of trabeculations of the left ventricle. Two of them were diagnosed of left ventricular noncompaction (LVNC). All of the 3 patients presented with motor retardation, muscle weakness, growth delay and signiifcantly increased urinary excretion of 3-methylglutaconic acid (3-MGC). One patient was found to have neutropenia. All 3 patients hadTAZ gene mutations which included a novel missense mutation (c.527A>G, p.H176R) detected in the twins and a known nonsense mutation (c.367C>T, p.R123X) identiifed in the other patient. All of the mutations were inherited from their mothers. During the follow-up, the twins died at 7 months old and 7.5 months old respectively. The other patient was still alive.ConclusionBTHS is one of the causes of cardiomyopathy in children. In the male patients who presented with muscle weakness, neutropenia, and increased urinary excretion of 3-MGC, especially in those com-bined with LVNC, BTHS should be screened.

Objective To investigate the fall-related knowledge and behaviors and ways after injury by chief caregivers of inpatients with neurological disease.Method We designed a questionnaire of fall-related knowledge,behaviors and ways after injury and used it among 208 chief caregivers of inpatients with neurological disease.Results On fall-related knowledge,the three items with the lowest scores about fall-related knowledge included fall-related medicine,postural hypotension and abnormal excretion.Of fall-prevented behaviour score,the lowest 3 items were three steps for getting up,placing things correctly and using wheelchair protection derive.Of the inquiry and fall measures score,the lowest 3 item were helping the patient up,observation and prevention after fall.There were significant differences in the total scores on education,time for taking care of the patients,history of fall and health education on fall (P＜0.05).The scores of those with education of senior middle school,college or above were significantly higher than those with education of junior middle school or lower (P＜0.001).The following time for taking care of the patients were compared with statistics significant:＜1month and 3～6 month,＜1month and ＞6 months,1～3 months and 3～6 months (P＜0.001).Conclusion The caregivers of the patients with neurological disease are short of knowledge in fall-related knowledge,normal behaviors and should carry out individualized health education to them.