This article discusses the functions of massage in acupuncture treatment and argues that massage acts to diagnose diseases, locate acupoints, activate meridian qi before acupuncture treatment,protect healthy qi, dispel pathogenic factors, promote qi arrival and movement during acupuncture treatment, warm and nourish the body, and further promote qi movement and eliminate pathogenic factors after acupuncture treatment. Therefore, massage complements with acupuncture and becomes an essential method in acupuncture treatment.

Objective To analyze the diagnostic value of diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT) in viral encephalitis at 3.0T magneton. Methods 25 patients with viral encephalitis confirmed by clinic and 25 age-match healthy patients were examined by conventional MRI and DTI. The average diffusion coefficient (ADC) map, fractional anisotropy (FA) map and diffusion tensor tractography (DTT) was acquired through image post processing technique. The ADC value, FA value of lesions and normal tissues were measured by region of interest (ROI) with the same standard and the results were statistically analyzed.Results In the acute stage of viral encephalitis: The ADC values were significantly lower than that in normal tissues of control group (P<0.01), FA values of lesions were higher than that of control group and had no statistical significance (P＞0.05). In the subacute and chronic stage of viral encephalitis: The ADC values were higher than that of control group and had statistical significance(P＜0.01), FA values of lesions were significantly lower than that of control group(P<0.05). DTT imaging showed infiltrative changes of white matter fibers in the lesion areas.Conclusion DTI and DTT technique may provide some complementally informations and clinical diagnostic value for viral encephalitis.

Objective To analyze and compare the independent and combined diagnostic values of high frequency ultrasonography (HFU) and molybdenum target imaging (MTI) for early breast tumor in a prospective study.Methods 258 patients with breast mass which were suspected as breast tumors by physical examination received HFU,MTI,their combined applications and operative treatments.Comparative studies were made between the surgical pathology and imaging evaluations.Results Totally 258 cases were enrolled in this study.Surgical pathology confirmed 135 cases of early breast cancer and 123 cases of benign breast tumor.For the diagnosis of early breast cancer,combined application was more effective than HFU or MTI alone in sensitivity (P<0.05),and more superior than MTI alone in accuracy.While the specificity,positive predictive value,negative predictive value, false positive rate, false negative rate had no difference among HFU, MTI and combined applications (P>0.05).In the patients of early breast cancer, compared with HFU,MTI found less nodules of calcification(18.3% vs 36.5%,P<0.01),but revealed more axillary lymph metastasis (69.0% vs 33.3%,P<0.01).Conclusion HFU and MTI alone or their combined application are reliable imaging methods for the diagnosis of early breast cancer.For the sensitivity and accuracy of diagnosis, combined applications has more superior advantages.

Objective To investigate the clinical features of patients with systemic lupus erythematosus (SLE) complicating with hepatitis B virus (HBV) infection.Methods The medical records of 40 inpatients with SLE complicating with HBV infection and 60 SLE inpatients without HBV infection were analyzed retrospectively.Chi-square test and t test were used for statistical analysis.Results Forty patients with SLE complicating with HBV infection were included,including 4 men and 36 women,with the mean age of (32±13) yr.Twenty-three patients suffered from chronic HBV hepatitis,5 patients were serological HBsAg carriers,12 patients with HBV occult infection.Twenty-one patients had mild liver dysfunction,presented mainly as increased ALT,2 patients presented with severe liver function abnormality.The main types of lupus rlephritis were Class Ⅳ and Class Ⅴ,2 patients complicating with HBV-associated glomerulonephritis.Compared with the control group,patients with SLE complicating with HBV infection had a significantly higher prevalence of fever,liver involvement,renal lesion,thrombocytopenia and cytomegalovirus infection respectively.One patient with severe liver abnormality had poor prognosis.Conclusion More attention should be paid to the clinical features of SLE complicating with HBV infection.Patients with SLE complicating with HBV infection have a significantly higher prevalence of fever,liver involvement,renal lesion,thrombocytopenia and cytomegalovirus infection respectively.Patients with SLE complicating with HBV infection may suffer from HBV-associated glomerulonephritis.Severe liver abnormality predicts poor prognosis.Anti-HBV drugs should be prescribed for SLE patients with serological positive HBsAg while immunosuppressive agents are used.

The incidence rate of liver cancer tends to increase in recent years, and the molecular and pathogenic mechanisms of liver cancer should be further investigated to guarantee health. As an important model organism, zebrafish have highly conserved genes and grow fast. The early embryo of zebrafish is transparent, which helps with the real-time observation of the development process. Zebrafish are similar to humans in the composition, function, and signaling pathways of hepatocytes, as well as response to injury. In modern biological studies, zebrafish have been wildly used as the model of liver diseases. This article summarizes the research advances in the application of zebrafish as the model of liver cancer, and points out that the techniques for establishing the zebrafish model of liver cancer have become mature. With the constant development of experimental techniques, great achievements will be achieved in the field of liver cancer.

Objective:To survey the awareness of common primary care clinical guidelines among primary care providers in Qingdao city.Methods:A questionnaire survey on the awareness of common clinical guidelines in primary care was conducted in August 2020 among 659 providers (293 males and 366 females) from 81 primary medical institutions in Qingdao city. The contents of the questionnaire included the general information of primary physicians, the frequency of using the guidelines, the level of understanding of the guidelines, the effect of guidelines in clinical work, the attitudes towards promoting the guidelines, and the interest in learning the guidelines and the way of learning.Results:A total of 659 valid questionnaires were recovered with a recovery rate of 100.0%. The results showed that 14.7% (97/659) practitioners applied the guidelines in most cases, and 31.6% (208/659) frequently used. There were significant differences in use frequency among providers with different practice types, professional titles, education background, practice locations and institutions ( P<0.01). Among participants, 15.2% (100/659) did not know about primary care guidelines, 63.3% (417/659) knew but did not learned guidelines, 21.5% (142/659) knew and studied guidelines carefully. The top five of the learned guidelines (114, 80.3%) were bronchial asthma (113, 79.6%), type 2 diabetes (108, 76.1%), chronic obstructive pulmonary disease (101, 71.1%), and chronic cor pulmonale (83, 58.5%). Most participants who learnt the guidelines viewed the guidelines as quite helpful or very helpful, the score of usefulness for professional knowledge was the highest (4.44±0.60). Most of participants (94.2%, 621/659) thought it was necessary to develop primary care guidelines; and the major factors affecting the promotion were lack of training (79.8%, 526/659), difficulties in access (46.7%, 308/659) and ignorance or neglect (23.2%, 153/659).Most practitioners (93.8%, 618/659) were interested in learning primary care clinical guidelines, and the expected ways of training were online teaching (70.0%, 420/618), training courses(58.3%, 360/618) and special lectures (55.2%, 341/618). Conclusion:The current situation of learning clinical guidelines among primary care providers in Qingdao is not satisfactory, but they are willing to learn the guidelines for improving clinical practice. We should strengthen the training and promotion of primary care guidelines among primary care providers in the future.

Objective:To explore the health seeking behavior, utilization of health services and the economic burden of the elderly patients with diabetic foot ulcer ( DF) , with aim to provide policy evidence for improving their DF prevention and treatment outcomes. Methods: The purposive sampling method was applied to recruit 15 elderly DF patients treated in the 454 th Hospital of Chinese PLA from December 2013 to January 2014. After informed con-sent, they were in-depth interviewed. Results: The elderly with DF had a higher demand for the health services. They emphasized on treatment and neglected prevention. The utilization and efficiency of health services were affected by patients' economic level, medical insurance, capacity of community services, and so on. Conclusion:In order to improve the treatment outcome and quality of life for the elderly DF patients, it's necessary to strengthen patients' health education, to build a community-based and integrated health care system on DF prevention, treatment and management, and to develop the policies for reducing DF related economic burden.

AIM: To investigate the effects of sodium hydrosulfide ( NaHS ) , a donor of hydrogen sulfide ( H2 S) , on the membrane permeability , intracellular Ca 2+concentration ( [ Ca2+] i ) and the release of IL-1βinduced by a-denosine triphosphate (ATP) in rat microglia, and to explore the effect of H2S on ATP-P2X purinergic signaling pathway and the molecular mechanism of its neuroprotective effect .METHODS: Rat microglia in logarithmic growth phase were used in the study.The [Ca2+]i was detected by Fura-2/AM staining.Fluorescent dye YO-PRO-1 was used to observe the membrane permeability.Interleukin-1β(IL-1β) was measured by rat IL-1βELISA kits.RESULTS:The YO-PRO-1 flu-orescence intensity was obviously elevated by ATP induction in a dose -dependent manner in the rat microglia , but this effect was counteracted by NaHS pretreatment (P<0.05).[Ca2+]i rapidly increased and then decreased slowly , forming a sta-ble platform for a long time when rat microglia were treated with ATP .Ca2+spike activity induced by ATP had no change , but the platform disappeared (P<0.05) after NaHS pretreatment.The ATP and LPS together facilitated the release of IL-1β, but the phenomenon was inhibited by NaHS (P<0.05).CONCLUSION:Hydrogen sulfide may decrease the mem-brane permeability , calcium inflow and IL-1βrelease in rat microglia activated by high dose of ATP .The cytoprotection of hydrogen sulfide may be mediated by purinergic signaling pathway .

[Summary] Neuroischemic diabetic foot ulcer ( NDFU) is characterized by infection, ulceration of deep tissues, neurological abnormalities, and various degrees of peripheral vascular disease in the lower limbs. The patients often have multiple risk factors such as older, longer duration, cardiovascular disease. The treatment is very difficult. The prognosis depends on the severity of complications, tissue range of infections, and the peripheral vascular disease. In this article, the treatment process of an old inpatient with NDFU and severe complications was reviewed and to propose a standard pathway for its management.

Objective To summarize the placement, maintenance, and safety of a high-pressure resistant peripherally inserted central catheter. Methods Ten patients were peripherally placed with this catheter (included 4Fr-single lumen, 5Fr-dual lumen, and 6Fr-three lumen) using ultrasound-guided Seldinger technique in Peking Union Medical College Hospital in August 2010. The therapeutic effectiveness and safety were evaluated. Result Ten catheters were inserted successfully into the upper arms, with few complications noted during routine maintenance. Conclusions This peripherally inserted central catheter can be used for high-pressure injection, central venous pressure monitoring, and fast flow-speed transfusion. Therefore, it can be successfully applied for contrast-enhanced CT angiography and massive fluid infusion.