'Ten Acupuncture Skills' refers to ten types of needling techniques for difficult and intractable neurological diseases. It has been summarized by Prof. Gao Wei-bin, a famous traditional Chinese medicine expert in China, based upon his clinical experience for years, including neck acupuncture for bulbar palsy, neck acupuncture for laryngeal muscular paralysis, stuck needling technique for ocular muscular paralysis, electric field therapy at Jiaji (EX-B 2) points for incomplete spinal paraplegia, electroacupuncture (EA) for urination disorder, electric neck acupuncture for waking up and treating various cerebral and nuchal diseases, EA at Jiaji (EX-B 2) points for intractable hiccup, EA at Jiaji (EX-B 2) points for cervical and lumbar spondylopathy, antagonistic EA for post-apoplectic hemiplegia, and EA for facial paralysis. The ten acupuncture skills are summarized in order to guide the clinical application.

The main content of the 2019 Myasthenia Gravis Foundation of America Scientific Session is summarized, and the main conclusions are presented as follows: Muscle-specific receptor tyrosine kinases antibody positive myasthenia gravis (MuSK-MG) is still the research hot spot in MG research fields, including the clinical researches, the clinical pharmaceutical researches and the fundamental experiment researches. Thymectomy shows safety and effectiveness for acetycholine receptor antibody positive MG (AChR-MG). However, thymectomy needs further discussion about the safety and effectiveness for other types of MG. AChR-MG patients with or without thymoma can benefit from thymectomy. Now there are still no special effective drugs to cure MG, and monoclonal antibody drugs are the hopes for MG patients. With the emergence of different kinds of monoclonal antibodies, MG will be more likely to be conquered. More attention has been paid to the role of B cells′ origin and apoptosis abnormality in the pathogenesis of MG in MG researches.

Objective To study the clinical characteristics of spinal hydatid disease and help to diagnozy and treat the disease. Methods 14 cases with spinal hydatid disease, admitted in our hospital between July 1994 and October 2003, were studied retrospectively. Besides routine examinations, plain X-ray films were performed in all 14 cases, CT in 8 cases and MRI in 13 cases, respectively. 8 cases sufferred serodiagnostic tests for human hydatidosis. All cases underwent operation and the histopathological examination. There were 5 males and 9 females with an average age of 25.8 years(range, 5-53 years) in this series. All 14 cases had the living history in endemic area and the average duration of symptom was 26.7 months(range, 4-120 months). The lesions most frequently involved the thoracic segments, accounting for 35.8%, and then 21.4% in the lumbar, and 28.6% in the lumbosacral segments, cervical segments were the least commonly involved. According to Dew'classification, spinal hydatid cysts located primarily at intradural extramedullary area in 1 case, extradural intraspinal in 2 cases, vertebral in 7 cases, paravertebral in 1 case and combination of various extradural tissues involved in other 3 cases. Results The clinical manifestations were localized back pain or radiating pain, mass and gradually progressive neurological dysfunction. Eight of 14 cases displayed abnormality in X-ray films which showed local, well-defined and irregular erosions with or without surrounding sclerosis or calcifications. CT scans presented multiloculated low density lesions. The MRI characteristics of the lesions were multiloculated cysts, signal intensities of the cyst content were similar to that of CSF. On T1W images the cyst wall appeared iso- or slightly more hypo-intense than the cyst content, T2W images demonstrated a low intensity rim and the hyper-intense cyst content resembling a bunch of grapes. Seven of 8 cases performed the 3-tests serodiagnosis were positive, and 3 cases with positive 3-tests serodiagnosis accepted 8-tests were positive. All the specimens were shown to be Echinococcus Granulosus. Conclusion MRI was the most sensitive diagnostic method and the best method to determinate the site and extent of the cystic lesions. CT and serological examination are useful for diagnosis. The key of avoiding misdiagnosis is to enhance understanding of the disease.

An intensive practice scheme,integrating clinical practicing education with continuing medieal education after graduation was introduced to Provide a new mode of teaching activities and management of clinical practice.

Objective To analyze the typing and clinical characteristics of neurosyphilis and provide evidences to improve early diagnostic.Methods Retrospective study of 18 cases of neurosyphilis was performed.Results Acute or subacute onset was observed in most cases; The interstitial neurosyphilis was the commonest, of which the clinical features varied widely and arose primarily from corresponding vascular infarctions; CSF examination revealed increase in pressure, protein and cells.TPHA and RPR were of the highest specificity among the serologic indexes;CT/MRI findings of brain revealed multiple, asymmetrical lesions which were different from those of infarctions caused by hypertension or arteriosclerosis.Conclusion Misdiagnosis rate is high at the initial reception.The clinical manifestations of neurosyphilis are closely related to pathological types. The lab tests and radiological findings are important clues to early diagnosis.

Objective To investigate the relationship between cerebrospinal fluid (CSF) changes and prognosis in patients with neurosyphilis.Methods The CSF and the clinical data of 55 syphilis patients were analysed retrospectively,including 30 neurosyphilis cases and 25 syphilis cases during incubation period.The CSF leukocyte, protein and pressure of the two groups were measured,meanwhile, rapid plasma regain circle card(RPR) and treponema pallidum particle assay (TPPA) were simultaneous determination. All cases were treated with penicillin G normally during the whole range.Two groups of patients were followed-up by telephones or outpatient department in two year and the prognosis were evaluated. Function Independent Measure (FIM) were scored at the same time.Results The seum RPR and TPPR in two group patients were all positivity CSF leukocyte and protein were higher in neurosyphilis than that of in syphilis incubation period, There was significant difference between the two groups (all P

Objective To observe the effect of intensive insulin therapy (ⅡT) on prognosis of severe chest trauma (SCT) pateints.Methods 42 consecutive patients were randomly assigned to 2 groups:ⅡT group (n =21) and the conventional insulin therapy group (CIT group,n =21).Blood glucose was maintained at the level of 4.4 -6.1mmol/L in ⅡT group,and 10.0 -11.1mmol/L in CIT group.The 2 groups were observed in terms of fatality rate during hospital stay,infection rate,the duration of mechanical ventilation,ICU stay length,pleural drainage day and count of neutrophils.Results No death or hypoglycemic reaction happened during hospitalization.Compared to CIT group,infenction rate,mechanical ventilation time,ICU stay length,and the time required for white blood cell to resume normal in ⅡT group were decreased significantly ( P ＜ 0.05 ).The difference had no statistical significance between the 2 groups in duration of pleural drainage and incidence of hypoglycemia (P ＞ 0.05).Conclusion ⅡT improves the short-term prognosis of SCT patients.

Objective:To investigate the feasibility and accuracy of osmometer in the osmolarity measurement of pirenoxinun sodi-um eye drops. Methods:An osmometer was used to measure the osmolarity of pirenoxinun sodium eye drops, and the stability of the osmolality was studied. Results:The osmolarity of pirenoxinun sodium eye drops with different formula conformed to the requirement of ophthalmic preparations. The osmolality showed no significant change at the ambient temperature, indicating the stability of the prepa-ration. Conclusion:The method is simple, rapid and practical, which can be used as the osmolarity measurement method for pirenoxi-nun sodium eye drops.

Objective To investigate the expression of macrophage migration inhibition factor (MIF) in pulmonary tissues of the smokers with and without chronic obstructive pulmonary disease (COPD).Methods The subjects were assigned into three groups:non-smokers without COPD (control group,n =12),smokers without COPD (smoker group,n =13) and smokers with COPD (COPD group,n =16).The specimens were obtained from lung tissues as far away from cancer focus as possible (＞ 5cm).Real-time quantitative PCR and immunohistochemistry were used to investigate the expression and distribution of MIF in pulmonary tissues.The relationship between the severity of airflow obstruction and the differential expressions of MIF in lung tissues of the smokers with or without COPD was analyzed.Results (1) MIF mRNA expression in COPD group (4.87 ± 1.79) was higher than that in the smoker group (2.16 ±0.72;P＜0.01),which was higher than that in the control group (1.09 ±0.48;P ＜0.01).(2)Immunohistochemistry analysis showed that MIF protein expression in lung tissues of the COPD group (0.277±0.025) was higher than that in the smokers group (0.199 ±0.034;P ＜0.01),which was significantly higher than that in control group (0.130 ±0.021 ;P ＜0.01).(3) Correlation analysis of MIF mRNA expression in the lung tissues and pulmonary function parameters of forced expired volume in one second (FEV1) percentage of predicted (FEV1 pred) and ratio of FEV1 to forced vital capacity (FEV1/FVC) suggested that MIF mRNA expression in the lung tissues was negatively related with FEV1 pred (r=-0.578,P ＜ 0.01) and FEV1/FVC (r =-0.607,P ＜ 0.01).Conclusions MIF expression significantly increases in the smokers with COPD,and MIF level in the lung is positively correlated with airflow limitation.The results suggest that MIF may play an important role in the pathogenesis of smokinginduced COPD.