[Objective] To analyze the stress distribution in facet joint of lumbar spine on normal and degenerative models with biomechanical method during the manipulation. [Methods] The finite element model of lumbar facet joint of L4-5 were reconstructed with finite element method and imaging method. Different movements such as anteflexion, retroflexion, lateral flexion, rotation and compression were loaded on the models and then stress distribution during the mimetic spinal manipulation was analyzed and compared. [Results] The facet joint of lumbar spine has an important role in resisting load, especially in resisting rotation. [ Conclusion ] The strong flexion-rotation manipulation should be avoided for seriously degenerative subject.

Objective:To improve the accuracy of the rotary manipulations of the neck in the treatment of neck pain, according to subjective and objective clinical findings. Methods: Two groups of 60 outpatients diagnosed with neck pain were suited to the manipulation and each group was 30 cases. The diagnosis of neck pain was made with conventional clinical evaluation, including history, palpation examinations, CT scan and X-ray. Group A received a manipulation of obliquely pulling the neck. While group B received manipulation of pulling the rotated and located neck. Subjects received a maximum of 10 treatments over a 3-week treatment period. Both treatment groups were assessed with subjective (cervicodynia, neck discomfort, upper limb numbness, vertigo and tinnitus) and objective (cracking sounds). The cracking sounds during two of the manipu1ations were recorded by a microphone positioned at both sides of the neck. The sounds were compared in patients of two groups. Statistical analysis was conducted with a one-factor within-subjects analysis of variance tests and descriptive statistic. Results: Analysis of the subjective indicated that the cases with upper limb numbness were reduced from 12 to 6 in group 2, while the cases with vertigo and tinnitus were reduced from 13 to 4 in group 1. Analysis of the objective indicated two kinds of neck rotary manipulations act not only on the rotary-side facet joints, but on the opposite to the rotary side on1y in a few cases. The results showed that manipulation of pulling the rotated and located neck has a small action range and centralized action points, while manipulation of obliquely pulling the neck has many action segments and discentra1ized action points. Conclusion: It was concluded that the rotary manipu1ations act mainly on the rotary side, not on the opposite, and that manipulation of obliquely pulling the neck has a wider action range and a better therapeutic effect on cervical upper-segment lesions, while manipulation of pulling the rotated and located neck has a limited action range and is suitable for cervical lower-segment lesions. There were some relations between the joint sounds during the manipulation and clinical curative effect.

Objective To investigate the effects of Xinshang Xuduan Decoction(XXD, mainly composed of Rhizoma Drynariae, Radix Dipsaci, and Eupolyphaga seu Steleophaga) on the proliferation and differentiation of rat osteoblasts and bone morphogenetic protein 2(BMP-2)expression in the osteoblasts . Methods The animal serum containing XXD was prepared by serum pharmacological method and then was mixed together with α-MEM for the cell culture. Osteoblasts were isolated from the skull bone of SD neonatal rats by collagenase digestion and were identified by alkaline phosphatase(ALP) staining and alizarin red staining. The third and fourth generations of osteoblasts were treated with XXD at the volume fraction of 5%, 10%, 20% for 24, 48 , 72 hours respectively, and then the proliferation of the cells was evaluated by Cell Counting Kit-8(CCK-8). In the other test, osteoblasts were cultured with blank control serum, and 10% serum containing XXD, Radix Dipsaci, and Rhizoma Drynariae, respectively, and then the ALP activity was examined by using ALP assay kit and the expression of BMP-2 was investigated by enzyme-linked immunosorbent assay(ELISA). Results XXD had a dose- and time-dependent effect on the proliferation of rat osteoblasts in a suitable volume fraction range from 5% to 20%, and the effect of XXD at 10% was the best. Compared with the blank control serum group, ALP activity was increased in the cells treated with 10% serum containing XXD, Radix Dipsaci, and Rhizoma Drynariae(P<0.01). On culturing day 7, the expression of BMP-2 was increased in 10% XXD group and Rhizoma Drynariae group(P<0.05). Conclusion XXD can increase the ALP activity and BMP-2 expression in the osteoblasts in vitro, so does the single herb of Rhizoma Drynariae. And their therapeutic mechanism in promoting the healing of fractures may be related with the enhancement of osteogenesis of osteoblasts.

Objective To explore clinical significance of C-reactive protein( CRP) and procalcitonin ( PCT) in chronic obstructive pulmonary disease( COPD) with acute exacerbation.Methods Included 120 COPD patients with acute exacerbations,and at the same time,according to the random number table method,120 COPD patients with stable were extracted, all respondents were given corresponding symptomatic support treatment, observation before treatment,after treatment,the 1d,7d,14d patients serum levels of CRP was associated with change PCT level. Results Compared with before treatment, after treatment, the serum levels of CRP of COPD patients with acute exacerbation of at 1d,7d,14d was associated with a decline in PCT level, different time points more statistically significant difference( all P<0.05);Compared with patients with stable,before treatment,after treatment,the 1d,7d serum levels of CRP[(12.32 ±6.59)mg/L,(9.05 ±3.31)mg/L,(7.31 ±2.31)mg/L,(4.45 ±1.54)mg/L]was associated with a high level of PCT[(0.34 ±0.05)μg/L,(0.26 ±0.04)μg/L,(0.18 ±0.04)μg/L,(0.10 ± 0.03)μg/L]were obvious,more statistically significant difference(all P<0.05);But after treatment,serum CRP was associated with differences in the level was no statistical comparison PCT significance ( P >0.05 ) .Conclusion COPD patients with acute exacerbation of serum CRP and early PCT significantly higher level,its level after treatment dropped significantly,joint observation CRP and serum PCT level can reflect COPD acute exacerbation issue of the inflammatory reaction.

General practitioner represents the core competency of community health care center and also the key for sustainable discipline development.Talent developing is regard as critical issue for both discipline construction and community health service development.Community health care center,as a platform for internship,practice and continue medical education of medical professionals,plays an important role in career development of general practitioner.We clearly defined the role and responsibility of community health care center in general practicing talent development,and built an excellent career development platform.We integrated project-talent-discipline three-in-one to promote clinical research and talent development;applied two-factor theory to set up effective talent plan and incentive mechanism.This article summarized our approach and experience in talent development as a reference for colleagues in other community centers.

A novel molecularly imprinted polymer with adequate attractability for Schistosoma japonicum miracidia was prepared.When adulterated with polyvinyl alcohol(PVA),the fabricated film with good swelling property was formed which can suspend on water and slowly release XF(a chemical to be published).This reusable film can well attract Sch-istosoma japonicum miracidia,and hopefully be used in the prevention of schistosome infection.

BACKGROUND: Although the fixed-point cervical vertebra rotating reduction has a notable treatment effect, yet it has not been deeply studied in the medical field. Some clinical surgeons feel difficult to make an accurate control on the power and rotatory joint position while operating, even results in iatrogenic injury. OBJECTIVE: To discuss the action mechanism of rotatory technique based on the central rotatory point of cervical vertebra fixed-point rotatory technique. METHODS: Samples were scanned through a 64-row spiral CT working platform at 1-mm layer distance. The picture's profilogram data were extracted from the image processing functional module in PHILIPS MEDICAL SYSTEMS, and then the three-dimensional structure of the upper cervical vertebra was reconstructed and displayed. Taking the axis spinous process peak (point A), odontoid process vertical axes (point B), and the midpoint (point C) of their link as the rotating axes (the rotating central point in simulation), spherical system on each point was set up. The intersection angle of the links between the axis' spinous process peak and the lower jaw, and between the odontoid process vertical axes and the lower jaw before and after rotation were all measured. RESULTS AND CONCLUSION: While applying fixed-point rotation of the cervical spine, the rotatory centre is the vertical axle center of the odontoid process, rather than the handy axis spinous process peak. The rotatory angle of the axle centre is larger than the observation angle. A new concept of fixed-axis rotation should be accepted and its principle should be comprehended in order to appropriately apply the cervical rotatory technique.

BACKGROUND:It is generaly recognized that cervical rotation manipulation can increase the risk of detachment of unstable plaques in carotid atherosclerosis, but few studies are reported on the influence of cervical rotation manipulation on the stable plaque in early carotid atherosclerosis. OBJECTIVE:To explore the influence of the cervical rotation manipulation on the lipid contents in carotid atherosclerotic plaque in a rabbit model of early carotid atherosclerosis. METHODS:After being fed for 15 days with normal diet, 30 male New Zealand White rabbits were further fed for 18 weeks with normal diet (n = 10; control group) or a high-fat diet containing 2% cholesterol, 10% lard and 88% normal granules to build rabbit models of early carotid atherosclerosis with stable carotid plaque (n = 20). At 14 weeks of feeding with high-fat diet, the experimental rabbits fed with high-fat diet were randomly divided into a cervical rotation manipulation group (n = 10) and a model group (n = 10). The rabbits in the cervical rotation manipulation group underwent cervical rotation manipulation to the left and right sides, once each side, with the maximal range of rotation. Total five cervical rotation manipulations, once every 3 days, were performed. RESULETS AND CONCLUSION:The 1 450 cm-1 and 1 660 cm-1 peaks of the Raman spectrum of lipid in the carotid atherosclerotic plaque of rabbit models were not distinctly present in the control group, however, they were obviously observed in the cervical rotation manipulation group and model group. Nevertheless, the relative intensity differences at spectrum characteristic peaks were not significant between cervical rotation manipulation group and model group (P > 0.05). The environmental findings indicate that the lipid content in carotid atherosclerotic plaque of rabbit models of early carotid atherosclerosis cannot be increased after short-term administration of cervical rotation manipulation.

Objective To explore the bronchoscopic features of endobronchial tuberculosis induced by lymphatic fistula and the efficacy of interventional treatment. Methods The data on 31 patients with endobronchial tuberculosis induced by lymphatic fistula who had received bronchoscopic diagnosis and treatment in our hospital during the period of January 2010 to June 2013 were reviewed. The bronchoscopic features , along with the frequency of interventional therapies and duration of the therapies , were retrospectively analyzed; and the efficacy of the therapies and the related complications were assessed. Rusults The endoscopic appearance showed: granuloma (19.4%), necrosis (51.6%), granuloma with necrosis (25.8%), and fistulous opening (3.2%). Dark gray matter or carbon deposition inside the lesions was the characteristics of endobronchial tuberculosis induced by lymphatic fistula. There were 76 orificium fistulae in 31 patients , mostly in the right side. The median frequency of treatment was five in patients with single orificium fistulae and the median treatment duration was 65 days; whereas the median frequency of treatment was nine in patients with multiple fistulae and the median treatment duration was 108 days. There were significant differences between the two groups (P < 0.05 for both comparisons). The effectiveness rate of treatment was 98.7%. The therapy-related complication was of a small amount of bleeding, with a rate of 2.1%. Conlusions Endobronchial tuberculosis induced by lymphatic fistula shows certain characteristics under bronchoscopic examination. Bronchoscopic clamping combined with infusions with antituberculosis agents is a safe, simple, effective therapeutic method.

Clinical data of 129 young pafienm with lung cancer were analyzed retrospectively.Adenocarcinoma was the main pathologic type of lung cancer(n=62,48.1%),followed by undifferentiated small cell carcinoma(n=35,27.1%),squamous carcinoma(n=20,15.5%).Forty four cases were misdiagnosed at first consultation with a misdiagnosis rate of 34.1%.To avoid misdiagnosis seems to be the key issue for improvement of prognosis in young patients with lung cancer.