Objective To observe the incidence of residual gallbladder in patients undergone cholecystectomy through laparotomy (OC),mini-incision laparotomy cholecystectomy (MC) or laparoscopic cholecystectomy (LC),and to explore the causes,diagnosis,prevention and treatment of residual gallbladder.Methods The clinical data of 241 patients undergone laparotomy cholecystectomy (OC group),231 patients undergone mini-incision laparotomy cholecystectomy (MC group) and 290 patients undergone laparoscopic cholecystectomy (LC group) were retrospectively analyzed,and the incidence of residual gallbladder was compared among the three groups.Results Residual gallbladder was found in 32 patients after the surgical procedures,with 4 in OC group (1.7%),13 in MC group (5.6%) and 15 in LC group (5.2%),respectively.Statistical analysis showed that the incidence of residual gallbladder was lower in OC group than in MC and LC group (P0.05).Multivariate analysis showed that severity of inflammation before the operation,operative methods and operator's experience were correlated with the incidence of residual gallbladder.All the 32 cases were diagnosed by ultrasonography,computed tomography (CT),magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP).24 patients were cured with surgical procedure,and the symptoms disappeared during a follow-up period of 6 months to 9 years;other 8 cases were treated with conservative management and the results were unsatisfactory.The pathological examination showed no tumor or malignant change in the excised specimen.Conclusions Residual gallbladder is not a negligible complication of cholecystectomy.Effective control of inflammation of the gallbladder,selection of a proper time and procedure of operation,and the operation done by an experienced surgeon can reduce the incidence of residual gallbladder,and reoperation is the effective treatment for it.

Objective To compare the clinical efficacy of locking plate (LCP),dynamic hip screw (DHS)and proximal femo-ral nail (PFNA)internal fixation in the treatment of elderly stable femoral intertrochanteric fracture.Methods A total of 60 pa-tients with stable stable intertrochanteric fractures in elderly patients were randomly divided randomly into proximal femoral LCP fixation group (group A),the DHS fixation group (group B)and PFNA fixation group (group C).The operative time,blood loss, postoperative complications and postoperative weight-bearing time were analyzed among three different groups.Results There were significant difference in blood loss,postoperative weight-bearing time,operative time among three different groups (P < 0.05 ). Group C was significantly better than the group A(P <0.05).Two cases of hip varus deformity,one case of crew loosening and su-perficial infection were appeared among group A.One case of hip varus deformity occurred in group B.One case of suffered refrac-ture occurred in group C.Conclusion LCD fixation,fixation with DHS and PFNA fixation are effective treatment for stable femoral intertrochanteric fracture in the elderly patients.

Objective To explore the change of plasma D-dimer (DD),lactate dehydrogenase isoenzyme 3 (LDH3),tissue plasminogen activator (t-PA) in the early stage of acute pulmonary embolism and their clinical significance.Methods Forty-six patients with acute pulmonary embolism of early stage (pulmonary embolism group) and 50 cases of normal person (control group) were enrolled in this study.The patients in pulmonary embolism group were divided into low-risk(18 patients),middle-risk(15 patients) and higher-risk (13 patients).The levels of DD,LDH3 and t-PA were detected and compared.Results The levels of DD,LDH3 and t-PA in pulmonary embolism group were (2.95 ± 0.73) mg/L,(421.42 ± 63.29)U/L and (0.85 ±0.02) U/L,and significantly higher than those in control group [(0.03 ±0.01) mg/L,(198.17 ± 23.37) U/L and (0.59 ± 0.02) U/L] (P ＜ 0.05).The levels of DD,LDH3 and t-PA in low-risk patients [(1.49 ± 0.04) mg/L,(315.47 ± 38.24) U/L and (0.63 ± 0.01) U/L] were significantly lower than those in middle-risk patients [(2.22 ±0.27) mg/L,(382.41 ±54.36) U/L and (0.79 ±0.02) U/L] and higher-risk patients [(3.38 ± 0.98) mg/L,(583.93 ± 117.21) U/L and (0.92 ± 0.03) U/L] (P ＜ 0.05).The levels of LDH3 and t-PA in middle-risk patients were significantly lower than those in higher-risk patients (P ＜ 0.05).After treatment,the levels of DD,LDH3 and t-PA were significantly decreased [(2.95 ± 0.73)mg/L vs.(1.03 ±0.11) mg/L,(421.42 ±63.29) U/L vs.(223.24 ±25.04) U/L,(0.85 ±0.02) U/L vs.(0.62 ± 0.02) U/L] (P ＜ 0.05).Conclusions The levels of DD,LDH3 and t-PA in the early stage of acute pulmonary embolism are increased significantly,and with the remission of the patient's condition,the levels of DD,LDH3 and t-PA are decreased.United detection conduces to the diagnosis of acute pulmonary embolism.

Objective:To observe the analgesia effect and of low-level combined- and single-laser irradiation on Zusanli (ST 36) in rats and the relationship between mast cell degranulation and laser acupuncture analgesia.Methods: A total of 66 Sprague Dawley (SD) rats were randomly assigned into normal control,model control,sham irradiation,10.6 μm laser (220 mW,40 Hz) 650nm laser(36mW,continuous),combined laser (10.6 μm+ 650 nm) groups.Arthritis mode 1 was established by injection of Complete Freund's Adjuvant (0.05 mL) into the left ankle joint.The paw withdrawal latency (PWL) was detected with a radiant heat algesimeter.Zusanli (ST 36) was irradiated with sham,single or combined laser for 30 min.After sacrifice under anesthesia (1% embutal),tissues of Zusanli (ST 36) area were sampled,sliced (5 μm) and stained with Toluidine Blue for skin for observing the mast cell degranulation.Results:Compared with model control and sham group,the pain threshold increased significantly in 650nm and combined laser groups (P＜0.01),while remained no significant difference in 10.6 μm group.Compared with model and sham group,the degranulation ratios of mast cells in 650nm and combined laser group were significantly higher (P＜0.001),while remained no significant difference in 10.6 μm group.The linear correlation coefficient between degranulation ratios of mast cells and PWL after laser acupuncture is 0.737 (P＜0.001).Conclusion:Both 650 nm and combined laser stimulation of Zusanli (ST 36) can effectively raise pain threshold,and enhance degranulation ratio of mast cells at the stimulated acupoint.The result also suggested a linear correlation between degranulation ratio of mast cell and analgesia effect.

OBJECTIVE: To observe the effect of infrared laser stimulation on Neiguan (PC 6) for bradycardia of rabbits induced by injection of pituitrin. METHODS: 10.6 microm CO(2) infrared laser, 650 nm semiconductor red laser and the compound laser of their aggregation were sent out by a compound laser sanatory instrument to stimulate Neiguan (PC 6) respectively for the purpose of analyzing the differences of the effects exerted by infrared laser and red laser as well as the changes of the effects after their aggregation. RESULTS: After 30 min and 40 min of the injection of pituitrin, the heart rate showed no significant difference between 10.6 microm CO(2) infrared laser group and the normal control group (P>0.05). However, the heart rate showed significant difference between the 650 nm semiconductor red laser group and the normal control group (P<0.05). After 30 min of the injection of pituitrin, the heart rate of the compound laser group were significantly different to that of the untreated group (P<0.05), and it was not significantly different to that of the normal control group (P>0.05). However, the heart rate of non-acupoint stimulated by the compound laser group showed no significant difference to that of the untreated group (P>0.05), and it was significantly different to that of the normal control group (P<0.05). CONCLUSION: Stimulation on Neiguan with 10.6 microm CO(2) infrared laser can evidently improve the bradycardia induced by injection of pituitrin, while the 650 nm semiconductor red laser has no such function, but they have coordinating effect. The thermal effect produced by CO(2) infrared laser stimulating acupoint is probably beneficial for semiconductor laser penetrating skin as well as the biochemical reactions it carries. The improvement of heart rate produced by the laser stimulation on Neiguan (PC 6) has relative specificity.

Objective: To evaluate the effects of 650 nm-10.6 μm combined laser in patients with knee Osteoarthritis (OA) and to determine whether the combined laser provides greater pain relief and improved function compared with red light. Methods: Forty-eight patients with knee OA were randomly allocated to two groups (24 per group), receiving 20 rain irradiation with 650 nm -10.6 μm combined laser or red light emitting diode respectively on point Dubi (ST 35) 3 times a week for the first course (2 weeks) and twice a week for the second one (4 weeks). The main outcome measures were WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores. In addition, patients' global assessment, adverse effects and validation of patient blinding were analyzed. Results: All the patients completed the first course, but 12 were lost during the second one. Due to the high dropout rate by the second course, only the data acquired from the first course could be analyzed. No differences of general data of patients and WOMAC scores were found in between-group comparison before treatment (P>0.05). The WOMAC scores of patients in both combined laser group and red light group reduced significantly compared to baseline by the end of the first course (P<0.01). There were no significant differences on the reduction rate of WOMAC scores between two groups (P>0.05). Neither the patients' global assessment nor the dropout rate showed statistical differences between two groups (P>0.05). There was no difference between two groups in patients correctly guessing the treatment assignment (P>0.05). There was no significant difference in the reduction rate of WOMAC scores and the patients' global assessment between patients who guessed their assignment (P>0.05). Conclusion: Both combined laser and red light irradiation are beneficial to patients with knee OA. But as the statistical indifferences between two groups, the authors can't conclude from this study whether the combined laser is more effective.

Objective To study whether ferulic acid can promote healing on chronic ischemic wounds and its possible mechanisms.Methods 40 male New Zealand white rabbits were randomly divided into 4 groups:vaseline group,ischemic control group,5％ ferulic acid group and recombinant bovine basic fibroblast growth factor for external use (rb-bFGF) group.Gross wounds were carefully observed and HE staining was used to observe the wound healing and immumohistochemical staining to observe the expression of the VEGF and CD31.The RNA was extracted to detect the expression of VEGF and HIF-1a by real-time PCR.Results The general observation and the HE staining of each specimen 11 days after operation all indicated that the duration of wound healing of the 5 ％ ferulic acid group was similar to that of the rb-bFGF group and markedly shorter than the ischemic control group and the vaseline smear group.The result of the immunohistochemical staining indicated that the content of the VEGF and CD31 expression of the 5 ％ ferulic acid groups and the rb-bFGF group made lit tle difference,but there was markedly less VEGF and CD31 in ischemic control group and the vaseline smear group.The result of the PCR showed that expression level of VEGF and HIF-1α in the 5 ％ fer ulic acid group was similar to that in the rb bFGF group and the vaseline smear group,but was obviously more than that of the ischemic control group and the vaseline smear group (P ＜ 0.05).Conclusions Ferulic acid can promote angiogenesis by increasing VEGF and HIF-1α which are closely related to angiogenesis and then promote the healing of chronic wounds.

Manipulations are essential to the acupuncture curative effect. With the technique limited, the researches on acupuncture manipulations can only be carried out with respect to the senses and experience of doctors and patients, thus seriously impeding the modernization and internationalization of acupuncture. Both the modern integration technology of transducer and the biomechanical principles are applied to develop a detection system that can measure the interaction force between the manipulator and the manipulated patient on the needle at each kind of manipulation. Through clinical practice, the force waveforms acting on needle with the manipulations of symmetrical twirling-rotating and symmetrical lifting-inserting were recorded so as to realize the quantitative, objective and real-time detection of the force during the acupuncture process, which provided a new experimentation means and analysis method for the improvement of clinical curative effect and quantitative research of acupuncture and meridians.
Acupuncture ; instrumentation ; Biosensing Techniques ; instrumentation ; Equipment Design ; Humans ; Mechanics ; Medicine, Chinese Traditional ; Needles ; Software ; Software Design

As the transportation of O2 and CO2 inside human body is an integrated aspect of Qi-blood transportation, a hemodynamic model is established based on the analysis of the respiratory and circulation system. The results of such model show that the abnormality of the circulatory and respiratory parameters always lead to a reduction of Po2 (O2 pressure) in tissue fluid, and then a Lung Qi-Deficiency Syndrome (QDS). This model can be used to quantitatively explain, to some extent, the physiological phenomena of Lung QDS, and could combine all the discoveries of in clinical researches, on Lung QDS. The measurement of Po2 in tissue fluid as an index to analyze Lung QDS is in accordance with TCM and TMM (the theory of modern medicine). This model may provide a new approach in clinical research of Lung QDS.
Hemodynamics ; Lung Diseases ; physiopathology ; Medicine, Chinese Traditional ; Models, Biological ; Qi ; Respiratory Mechanics

Based on the morphology and function of lymphatic vessel, and on the achievements of researches in the regulatory mechanism of lymphatic circulation, we fully considered the dynamic interaction of blood, interstitial fluid and lymph fluid; then we imitated and used Sungawa's method of analyzing the heart output, and finally set up a dynamic model for describing lymphatic circulation. Comparison of our calculating results with the data from Ikomi's experiment showed that they were identical, thus indicating that our model is of value in explaining the dynamic mechanism of lymphatic circulation. In this paper is especially calculated the relationship between lymph flow and massage frequency, which is useful for analyzing the effect of massage on the lymph flow rate with respect to this model.
Animals ; Computer Simulation ; Endothelium, Lymphatic ; cytology ; physiology ; Humans ; Lymph ; physiology ; Lymphatic Vessels ; physiology ; Models, Biological ; Nonlinear Dynamics ; Pressure ; Rabbits ; Rheology