Objective To investigate the clinical application and effect of repair infectious bone defect in femur with free vascularized fibular graft.Methods From April,2008 to April,2013,9 patients that had infectious bone defect in femur underwent repaired with free vascularized fibular graft.The bacterier cultivation of sinus tract excretion in preoperation and focal zone in operation had proved the infection.The length of bone defect were7.5 cm on average.The bone defect was repaired with free vascularized fibular graft on one stage in 6 cases and two stages in 3 cases after the cure of infection.Six patients underwent folded and 3 patients underwent single vascularised fibula graft transfer.The skin island flaps were used as a postoperative predictor of vascularized fibula graft viability in 6 cases.The transfer fibulars were fixed with plate in 6 cases,external fixor in 3 cases.Time to union was recorded through evaluation of plain radiographs.The Enneking score system was applied to evaluate the lower extremity function.Results The vascularized fibular survived and bony fusion was achieved in all patients.All cases were followed up 24.5 months(12-39 months).The average length of the transfer fibula was 14.5 ± 3.2 cm.The average time for bone union at allograft-host junction was 5.5 ± 1.2 months.Of the 9 cases,the mean scores was 24 (their scores ranged from 20 to 27) at final follow-up.The functions of supplied regions were not found malfunctional,no recurrence of infection occurred.There were no stress fracture in inlay fibula.Conclusion Free vascularized fibular graft will benefit to control the infection in femur,have high bone union rate,and is an optimal choice.

On the basis of understanding acupuncture method of inducing resuscitation (xing nao kai qiao) and training methods of modern rehabilitation medicine, new training methods were developed and could be used at different stages of stroke patients with upper-limb motor dysfunction, including acupuncture method of Jiquan acupoint (HT01) and rehabilitation training.

Professor ZHENG Kuishan has been engaged in the education and clinical practice of acupuncture and moxibustion for over 60 years. Professor ZHENG is strict in scholarly research and exquisite in medical techniques and he is good at treatment of bi syndrome induced by invasion of wind, cold and damp with warming and, promoting therapy. He emphasizes on syndrome differentiation and acupoint combination and selects the accurate manipulations. Not only are the symptoms relieved apparently, but also the body state is improved. As a result, the primary and secondary are treated simultaneously. In the paper, professor ZHENG's experience is introduced in the treatment of bi syndrome in the aspects of theory, method, formula, acupoint and technique. And his clinical therapeutic approaches have been deeply analyzed.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans ; Male ; Moxibustion ; history ; methods

OBJECTIVE: To investigated influence of co-stimulatory signal produced by CD40/CD40 ligand (CD40L) on proliferation and differentiation of leukemic stem cells and B cells as well as the role of CD40L anti-leukemia.DATA SOURCES: We searched Pubmed database and Springer database for the related literatures on CD40/40L, leukemic stem cell and leukemia published from January 1995 to December 2005, using the keyword "CD40, 40L, leukemic stem cell, leukemia" in English.STUDY SELECTION: We focused on published data that included the literatures of experimental groups and control groups, excluded obviously no random experiments, no random clinical studies and repeated researches.DATA EXTRACTION: We collected 30 experimental articles on influence of co-stimulatory signal produced by CD40/CD40L on proliferation and differentiation of leukemic stem cells and B cells as well as the role of CD40L anti-leukemia. Twenty-three articles that met inclusion criteria, excluded 7 articles were the same research ones.DATA SYNTHESIS: Twenty-three trials included influence of co-stimulatory signal produced by CD40/CD40L on proliferation and differentiation of leukemic stem cells, B cells and prognosis of leukemia, and the treatment of leukemic patients by CD40L. We analyzed the influence and role of co-stimulatory signal produced by CD40/CD40L on proliferation and differentiation of leukemic stem cells, B cells and leukemia.CONCLUSION: The evidence conformed that co-stimulatory signal produced by CD40/CD40L promoted proliferation and differentiation of leukemic stem cells , B cells, and it is important for the occurrence,progress and prognosis of leukemia. CD40/CD40L plays a crucial part in immune response, and proves wide application in the immune therapy of leukemia.

The big-data era has arrived, which involves all professions and trades. Its impact on the medical field has gradually revealed. With the characteristics of big data "4V" (volume, velocity, variety, value) and its theory generality with TCM (holistic thinking, correlativity) as well as regularity of disease development, combined with present status of acupuncture clinical research, the influences of big-data era on trial design, data collection, analysis and sharing of acupuncture clinical research are discussed in this paper, aiming to provide references for solving the difficulties of study design and determining the future research direction of acupuncture clinical research.
Acupuncture Therapy ; Biomedical Research ; Clinical Trials as Topic ; Database Management Systems ; Humans ; Medicine, Chinese Traditional

Based on traditional acupuncture theory and modern researches, the factors that cause the difference of acupoints synergy effect are summarized and analyzed. It is found that the factors include the specificity of acupoint, the interaction of acupoints, the pathway of acupuncture signal, the body condition level, acupuncture manipulation, etc. It is believed that the specificity of acupoint is the key factor to determine the difference of acupoints synergy effect. Interaction of acupoints may be related to the pathway of selected acupuncture signal, which is an important factor in difference of acupoints synergy effect. The body condition level and acupuncture manipulation are internal and external factor to influence acupoints synergy effect, respectively.
Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Humans ; Meridians ; Signal Transduction ; Treatment Outcome

Objective To introduce the research progress of the modern methods in evaluating de qi sensation in acupuncture and moxibustion, and to analyze the current research situation and major problems. Method The objective evaluation methods majorly used to estimate qi sensation were summarized. Result The currently used evaluation methods basically include scales and cerebral function imaging, while the rest methods are still in the beginning stage. Conclusion As a subjective feeling, de qi sensation is difficult to determine and quantify objectively, and there lacks an objective standard. The study on the mechanism of de qi sensation is relatively insufficient and superficial.

According to foreign and domestic standards of clinical quality and the author team’ experience summary of long-term clinical study, it has been found that quality control in clinical acupuncture operators is closely related to operator’s ability, good communication between doctors and patients, signature for informed consent, implementation of inclusion and exclusion criteria, practice of blind method and random concealment, patient’s compliance, standardized writing and keeping of CRF, management of instruments and consumables, and coordination and association between researchers. The implementation method of quality control in clinical acupuncture operators is explored by the clinical practice of the author team in “973” project, and analysis and discussion of the above key points.

Objective To observe the clinical efficacy of Qianyang Mixture for the treatment of perimenopause hypertension. Methods Eighty cases of perimenopause hypertension patients were randomly divided into treatment group and control group, with 40 cases in each group. The two groups were given Amlodipine Besylate Tablets for oral taking, one tablet each time, once a day. The treatment group was treated with Qianyang Mixture, 35 mL for each time, twice a day, 1 h after meal. Course of treatment was 12 weeks. The changes of blood pressure, heart rate and sex hormone level of patients in both groups were observed, and efficacy of TCM syndrome were evaluated. Results After treatment, the heart rate, average daily blood pressure and morning blood pressure of the treatment group were lower than those of the control group, with statistical significance (P<0.05);After the treatment, the levels of estradiol in the treatment group were higher than those in the control group, with statistical significance (P<0.05). The total effective rate was 92.5% (37/40) in the treatment group and 80.0% (32/40) in the control group, with statistical significance (P<0.05). Conclusion Qianyang Mixture can obviously reduce blood pressure and heart rate of patients with perimenopause hypertension, and can regulate hormone levels, improve TCM symptoms.