Acupuncture is widely used as an alternative therapy with few side effects because of its simple manipulation and low cost. However, accidents may occur if the practitioner uses it improperly. Early in the Qin dynasty, the Canon of Medicine mentioned that improper use of acupuncture could cause injury to the body and even death, and it systematically described the occurrence and prevention of acupuncture accidents. Physicians in the successive dynasties frequently reported it, and realized that the manipulation skills were significantly important in preventing the occurrence of acupuncture accidents. Since the 1950s, acupuncture accidents had been effectively prevented because of the improving of acupuncture instruments, enhancing of the quality of the practitioners, popularizing of sterilization and disseminating of anatomic knowledge. Nevertheless, with the renovating of acupuncture techniques, new accidents may occur constantly. The prevention of acupuncture accidents still should be an arduous task for acupuncturists. Nowadays, acupuncture therapy is being used in more than 140 countries, and acupuncture accidents due to improper application are increasing. Prevention of acupuncture accidents has become a global issue deserving of great attention.

Moxibustion is an important invention of the Chinese nation, which originated as early as in the clan commune period of the primitive society. The literature records on moxibustion can be traced back to the Warring States Period (475 B.C. to 221 B.C.). Doctors through the ages made considerable progress and published a great number of books on moxibustion. Moxibustion has been applied in treating a great range of diseases. Since the 1950s, the treatment scope of moxibustion has been expanded, and the therapeutic methods of moxibustion are becoming increasingly rich and varied, and great progress in research on the mechanism of moxibustion has been made. Moxibustion was once popular in Europe after its dissemination to the West in the seventeenth century, and the practitioners invented some new methods of moxibustion. Japan is the country in the West where fruitful efforts have been made in research on moxibustion. In modern times, moxibustion has been used for health protection, and the scientists are paying great attention to the experimental research on moxibustion.

Acupuncture Therapy ; adverse effects ; Adolescent ; Adult ; Eye ; blood supply ; Eye Diseases ; therapy ; Hemorrhage ; etiology ; Humans ; Male

BACKGROUND : Chitosan, derived from chitin, has a poor solubility which limits its application greatly. For improving its dissolubility, according to the feature that intramolecular hydroxy and amino group in chitosan are easy to be chemically modified, and functional groups are introduced to improve its solubility and functionality to widen the range of its application, which has become one of the new trend of development for investigating the application of chitosan. OBJECTIVE: To sum up the research advancements in the application and modification of chitosan in carboxylation,acylation, alkylation, etherification, etc.RETRTEVE STRATEGY: The relevant articles published in English between 1998 and 2007 were searched for in Pubmed database with the key words of "chitosan, modification", and the relevant articles published between 1998 and 2007 were searched for in Elsevier Science database with the key words "chitosan, modification" and search "derivate" within search results in English. Articles closely related to the structural modification and application of chitosan were involved, and repetitive and old studies were excluded.LTTERATURE EVALUATION: Totally 154 articles were selected, and 30 of them are accorded with the inclusive criteria,including 5 are reviews, and the others are clinical or experimental studies.DATA SYNTHESTS: The intramolecular hydroxy and amino groups in chitosan are mostly modified because they are easy to be chemically modified. Recently, reports lay particular emphasis on the modification in carboxylation, acylation,alkylation, etherification, etc. Functional groups are introduced to improve its solubility and functionality to widen the range of its application.CONCLUSTON: The water-solubility of chitosan can be improved through structural modification and introducing multifunctional group, which can also bring about much more special efficacies.

Sepsis is the leading cause of acute kidney injury (AKI) in pediatric intensive care unit.Development of AKI during sepsis increased patient morbidity,predicts higher mortality and days of stay in the intensive care unit.The mechanisms behind AKI in sepsis remain controversial but were believed to be complex and multi-factorial.The pathophysiology of AKI in sepsis involved intrarenal hemodynamic changes,endothelial dysfunction,infiltration of inflammatory cytokines.The new markers of neutrophil gelatinase-associated lipocalin as the representative is helpful for early diagnosis of AKI.Renal replacement therapy (RRT)is the main treatment of sepsis related AKI.At present,the model,dose and exact timing of RRT is not well defined.A widely accepted viewpoint is that the injury stage of RIFLE diagnostic criteria and fluid overload up to 10％ ～ 20％ is the beginning of the most appropriate chance of RRT.

Objective To investigate the subjective well-being and its influencing factors of the advanced elderly in the community. Methods Totally 409 cases aged 80 years and over in five communities of Hang zhou city were surveyed using Memorial University of Newfoundland Subjective Well-bing Scale. Results The subjective well-being of the advanced age people was at a high level.The cases with good hearing,well eyesight,income from own source,monthly income between 1000-3000 yuan,health satisfaction and frequently or occasionally regular interest in the activities had higher subjective well-being(all P＜0.05).Subjective well-being was not significantly affected by age,sex,level of education (P＞ 0.05). Conclusions Subjective well-being of aged people is mainly affected by state of health and economic resources.

Sorafenib is a novel oral multikinase inhibitor that inhibits Raf kinase because of its anti-proliferative property. Sorafenib also inhibits receptor tyrosine kinases of multiple proangiogenic factors, such as VEGFR-1/2/3 and PDGFR-β. The combina-tion of both its anti-proliferative and anti-angiogenic properties makes sorafenib an attractive agent in cancer treatment. To date, sorafenib is the only approved systemic treatment for patients with hepatocellular carcinoma. The most common adverse events of this inhibitor included hand-foot skin reactions, nausea, diarrhea, weight loss, and hypertension. These adverse events can severely affect patient compliance, which may negate the effect of therapy. Correct understanding and treatment of these adverse events can improve clinical outcome. This paper discusses the clinical aspect of sorafenib-induced adverse events and the molecular basis behind their toxic-ity. Recommendations for the management of the adverse effects are also provided.

Recent findings indicate that metastasis-associated gene in colon cancer 1 ( MACC1 ) has an abnormal high expression in most malignant tumors.As a key regulator of HGF-MET signal pathway,MACC1 could obviously up-regulate the expression of MET and promote cancer cell's movement,invasion and metastasis.Further studies will shed light on elucidating the mechanisms of metastasis and may provide a new method for targeted therapy.

Objective To evaluate the incidence and the causes of the intra-and postoperative cerebrospinal fluid(CSF)leakage during transsphenoidal surgical removal of pituitary adenomas,and discuss the sella closure methods.Method During the period from January 1998 to May 2008,118 patients underwent 134 transsphenoidal operations for pituitary adenomas.Two different methods to close the sella were used.The first one consisted packing the sella turcica and sphenoidal sinus with autologous fat and restoring the defect of sella turcica with autologous bone.In the second method,tht regenerated oxidized cellulose and collagen sponge with human fibrin were used to cover the seUa membrane defect and the dural defect,followed by packing the seHa with autologous fat.Proportions of each type of pituitary adenomas were analyzed.The frequency of the intra-and postoperative CSF leakage were evaluated in different type tumors and different operations.Data had been studied by statistical analysis.Results The incidence rate of intraoperative CSF leakage(26.5%,9/34)Was obviously increased in patients with growth homone adenoma compared with other type of adenoma(13.0%,13/100).Patients with invasive adenoma had an increased incidence rate of intraoperative CSF leakage(21.1%,8/38)compared with noninvasive adenoma(14.6%,14/96)(P＜0.05).When the descent of the sella turcica membrane Was visualized with tumor being totally removed,the incidence rate of intraoperative CSF leakage increased(18.7%,20/107)compared with when membrane descent was not seen with tumor remaining(7.4%,2/27)(P＜0.05).There were 3 cases postoperative CSF leakage happened in all 12 cases which adopted the first method. By the second method,there was no postoperative CSF leakage,and the number of postoperative complications was significantly smaller than the first method (10.0% and 33.3%,respectively). Conclusions The technique of covering the sella membrane and dural defects with oxidized cellulose and collagen sponge with human fibrin in the presence of intraoperative CSF leakage appears to be the most reliable,as no postoperative CSF leakage after applying this technique has been observed.

Objective　To probe the relationship of differentiation degree with spread or survival prognosis in retinoblastoma　(RB).　Methods　Clinical data, follow up status and eyeball specimens in 156 RB cases were investigated retrospectively. The tumors were divided into differentiated and undifferentiated groups.Conditions of the tumor invasion of ocular or surrounding tissues were reviewed. The fatality rate was obtained from the follow-up materials of 82 cases of RB. The fatality rate and the invasion rate between the two types were compared statistically by Chi-square test. In addition, the relation between the tumor invasion and death ,and the average survival time for dead people after surgery were explored.　Results　Local invasion of tumor cell was found in 8　eyes among 17 eyes with differentiated RB (47.06%),and in 66 eyes among 139 eyes with undifferentiated RB　(47.48%).There was no significant difference with regards to the local invasion between the two types (P>0．05). The fatality rate of cases of differentiated RB was 27.27%,and 22.54% in undifferentiated RB, and there was no statistical difference between the two types .The fatality rate for patients with orbital and scleral extension was 100%,optic nerve invasion (grade Ⅳ) was 62.50%,and uveal invasion was 22.22%.The survival time for the dead victims were from 5 months to 41 months and averaged to 21.92 months.　Conclusion　There was no significant difference both in survival prognosis and local invasion between the two types. The survival prognosis of metastatic RB was dependent on the degree of spread and the efforts of treatment and regardless of the types of differentiation of RB cells.