Objective To explore the clinical efficacy of Wenshen Juanbi Deco ction combined with warm acupuncture in the treatment of cold and dampness lumbar disc herniation. Methods Retrospective analysis of our hospital in April 2015 to February 2017 treatment of 60 cases of cold and humid lumbar disc herniation in patients with clinical data, according to different treatment methods were divided into control group and the study group,with 30 cases in each group.The control group underwent routine single Pelvic traction treatment, the study group underwent Wenshen Juanbi decoction combined with warm acupuncture treatment, The symptom improvement after treatment in two groups was compared. Results The total effective rate was 86.67% (26/30) in the study group and 58.06% (18/30) in the control group. The difference between the two groups was statistically significant (P<0.05). Compared with before treatment, the index of lower and lower extremity radiating pain, straight leg raising test, lower limb skin sensation, tendon reflex, spinous process tenderness and limited waist activity after treatment in the two groups were significantly improved (P<0.05). And the improvement effect of the study group was better than that of the control group (P<0.05). Conclusion Wenshen Juanbi Decoction combined with warm acupuncture is effective in the treatment of cold and dampness lumbar disc herniation, which can effectively improve the clinical curative effect and improve the clinical symptoms of patients with high clinical application and popularization value.

Objective To investigate the diagnostic value of MSCT with multi-planar reconstruction(MPR)and maximum intensity projection(MIP)in diagnosis of spinal burst fracture.Methods 45 patients(53 vertebras)with vertebral burst fracture were examined by MSCT and processed with MPR and MIP.The imaging features were analyzed comparatively.Results The axial images clearly demonstrated the vertebral body vertically or transversely burst crack in 49 vertebras(92.5%),bony fragment inserted into the spinal canal and stenosis of spinal canal in 34 vertebras(64.2%).The sagittal images showed kyphosis in 28 vertebras(62.2%).The sagittal and coronal images showed decreased height of the vertebral body in 37 vertebras(69.8%)and depressed fracture of vertebral end plate in 19 vertebras(35.8%).Total 44 fractures were located at spinal appendix,39 were showed by axial images,35 by sagittal images and 33 by coronal images.MIP displayed the space changes of bone structures in all cases and rotary dislocation fracture in 6 cases(11.3%).Conclusion MPR and MIP are of significant values in diagnosis and clinical treatment of spinal burst fracture.

Objective To investigate the effect of percutaneous transluminal angioplasty(PTA) by minor-caliber and long balloon on diabetic patients with below-knee artery. Methods 16 consecutive DM patients(21 limbs)were treated with PTA by minor-caliber and long balloon and followed 7 months(1 ～22 months). The success rate,complication,clinical effects and the changes of ABI were investigated and analyzed. Results The technical success rate is 90.5% (19/21) ,no serious complication occurred. The clinical symptoms of all patients improved after successful PTA. The median ABI marginally increased from the baseline value of (0.31 ±0. 15) to (0.57 ±0.23) after intervention,the difference is significant (P ＜ 0.05). Post-operative pain in patients with rest pain disappeared 9 (60.0%), relieved 4 (26.7%), reduce 2 (13.3 %). Ulcer healing in patients with foot gangrene 4 (66.7 %), Ulcer area was significantly reduced 1 (16.7%), high amputation 1 (16.7%). Postoperative follow-up, two limbs reoperation because of increased symptoms. Conclusion The treatment of percutaneous transluminal angioplasty by minorcaliber and long balloon was effective on diabetic patients with below-knee arterial disease.

【Objective】 To establish a blood transfusion outcome prediction model for comprehensivel evaluation of coagulation function of patients with upper gastrointestinal bleeding by thrombelastogram (TEG) and blood coagulation indicators. 【Methods】 The data of 101 patients with upper gastrointestinal hemorrhage, admitted to the Department of Gastroenterology of Zhejiang Provincial People′s Hospital and its Chun′an Branch from June 2018 to June 2021, were collected through Tongshuo blood transfusion management system and His system. Those patients were divided into blood transfusion group (n=56) and non-transfusion group (n=45), and into cirrhosis group (n=74) and non-cirrhosis group (n=27), and 40 patients, with non-upper gastrointestinal bleeding, were enrolled as the control. The results of TEG indicators (R, K, α, MA), coagulation function (PT, INR, APTT, TT, Fib), blood routine (Hb, Plt, WBC, NEUT%) and biochemical detection(Alb, SCr, ALT, AST, GGT) before transfusion were compared between groups and the correlation between TEG indicators and traditional coagulation parameters was analyzed. Single-factor and multi-factor analysis were used to screen blood transfusion-related factors to establish a predictive model. 【Results】 The comparisons of paremeters between transfusion and non-transfusion group were as follows, K (min), α (°), and MA (mm) was 3.86±3.12 vs 2.50±1.47, 54.00±14.08 vs 61.05±10.88, and 51.12±13.37 vs 58.26±11.08, respectively (P<0.01); PT (s) and Fib (g) was 16.36±7.45 vs 13.44±1.50 and 1.59±0.87 vs 2.35±1.09 (P<0.01); NEUT% and Hb (g/L) was 0.75 ±0.13 vs 0.66±0.15 and 68.04±14.49 vs 100.73±22.92 (P<0.01); Alb (g/L) and SCr (nmol/L) was 29.73±6.08 vs 33.73±7.19 and 99.50±53.55 vs 76.25±19.28 (P<0.01). Correlation analysis showed that APTT was positively correlated with R and K values, and negatively correlated with α and MA. Fib was negatively correlated with K values, and positively correlated with α and MA. Plt was negatively correlated with K values, and positively correlated with α and MA (P<0.01). Eight pre-transfusion indicators as K, MA, PT, Fib, NEUT%, Hb, Alb, and SCr were subjected to Logistic regression to establish a blood transfusion prediction model. The optimal ROC curve of blood transfusion threshold (blood transfusion predictive value of patients), sensitivity, specificity and AUC were 0.448, 92.9%, 88.9%, and 0.969, respectively. 【Conclusion】 The establishment of Logistic regression model by integrating detection indicators of TEG, coagulation function, blood routine and biochemistry in patients with upper gastrointestinal bleeding have showed significant correlation with blood transfusion prediction, and good clinical practicability.