OBJECTIVETo explore a new method for body surface orientation of the puncture site, determination of the direction of the needling and puncture depth for caudal block.

METHODSThree-dimensional reconstruction of the pelvis was performed in 8 cases for measuring the distances between the sacral hiatus and the planned site of anesthetic delivery and the size of the sacral hiatus. After image processing with the technique of shaded surface display (SSD), the shapes of sacral hiatus and sacral tube were evaluated.

RESULTSThree-dimensional reconstruction of the pelvis in the 8 cases allowed clear view from any directions of the sacral hiatus and sacral tube and accurate measurement of the size of the sacral hiatus. After simulated cutting of half of the rumpbone, the distances between the sacral hiatus and the drug injection site were accurately measured. With these measurements, accurate preoperative localization of the puncture site on the skin was achieved and the anesthesia was successful in all the cases.

CONCLUSIONSThis technique can provide accurate data for localization of the puncture site on the skin and determination of the direction of the needling and the puncture depth for caudal block to increase the successful rate of anesthesia, lower the operative risks and allow simulated operative training.

Adolescent ; Adult ; Aged ; Anesthesia, Caudal ; methods ; Anthropometry ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Reproducibility of Results ; Sacrum ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVETo observe the therapeutic effect of traditional Chinese medicine (TCM) and Western medicine (WM) treatments on mycoplasmal pneumonia in children and the changes in the serum cytokines.

METHODSNinety children with mycoplasmal pneumonia were randomly divided into the treatment group and the control group. TCM was given orally and azithromycin at the daily dose of 10 mg/kg was administered intravenously in the treatment group. In the control group, only intravenous azithromycin was given. After a 7-day treatment, the response rate, time of symptom disappearance, and serum levels of IL-6, IL-8 and TNF-alpha were observed.

RESULTSThe total response rate was 93.33% in the treatment group and 73.33% in the control group, showing a significantly better therapeutic effect in the treatment group (P<0.05). The combined treatments also showed better effects in alleviating fever, coughing and rales (P<0.05), and resulted in more obvious reduction in the serum levels of cytokines (P<0.05).

CONCLUSIONCombined treatment with TCM and WM produce good therapeutic effects in children with mycoplasmal pneumonia.

Azithromycin ; therapeutic use ; Child ; Child, Preschool ; Cytokines ; blood ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infant ; Male ; Phytotherapy ; Pneumonia, Mycoplasma ; blood ; drug therapy ; Treatment Outcome

Acupuncture anesthesia (AA) is an anesthetic method created by medical workers and researchers in China during medical practice in 1950s. As a paragon of integrated traditional Chinese and Western medicine, AA clinical practice and basic theoretic research have gained continuous improvement and progress, and obtained a series of outstanding achievements in the past 60 years. Consequently, the theory of traditional Chinese medicine was enriched, and the acupuncture therapy was pushed forward to the world. The present paper reviews the course of formation and development of clinical application of AA from the late years of 1950s up to now, including the initial stage (1958-1966), rapid propulsion stage (1967-1979), consolidation period (1980-2004) and newly developing period (2005-now). The AA has experienced flexural pathway from simple acupuncture analgesia, to acupuncture-drug compound anesthesia (or acupuncture-assisted anesthesia), and to the application of whole perioperative period. Nowadays, it keeps unceasing development and innovation from simple analgesia and sedation to organ protection during perioperative period and reduction of post-operative complications. The AA possesses unique prosperous vitality, and also has a plenty room for improvement, being worthy of further popularization and research.

To obtain higher potency and specificity, a series of 7-alkoxy analogues of illudalic acid was synthesized on the base of structure-activity relationship (SAR). All of these compounds exhibited submicromolar inhibition of the enzyme when tested against human leukocyte common antigen-related phosphatase (LAR) (for example, for 15e, IC50 = 180 nmol x L(-1)). They represent the most potent small-molecule inhibitors of LAR so far. These analogues also display excellent selectivity for LAR over other protein tyrosine phosphatases (PTPs) except for the highly homologous PTPsigma. The compound 15f is of 120-fold selectivity for LAR versus PTP-1B inhibition. The development of potent enzyme-specific inhibitors is so important that they may serve both as tools to study the role of LAR and as therapeutic agents for treatment of type II diabetes.

OBJECTIVETo observe the clinical efficacy on senile female bladder neck obstruction treated with acupoint application, therapy and western medication.

METHODSFifty cases of senile female bladder neck observation were randomized into an obstrvation group and a control group, 25 cases in each one. Tamsulosin hydrochloride capsules were taken orally in the two groups, 0.2 mg every night, continuously for 100 days. In the observation group, with radix aconiti lateralis preparata, semen brassicae and fructus ligustri lucidi contained, bushentongyu plaster was used at Shenque (CV 8), Sanyinjiao (SP 6), Pangguangshu (BL 28), Zhongji (CV 3) and Sanjiaoshu (BL 22), once every two days. Eight treatments made one session and 6 sessions were required totally. The international prostate symptom score (IPSS), the bother score (BS), the residual volume (RV) and the maximal urinary flow rate (MFR) were observed before and after treatment in the two groups. The clinical efficacy was compared between the two groups.

RESULTSEvery score in IPSS after treatment was reduced apparently as compared with that before treatment in the two groups (all P < 0.01). The improvements in feeling of incomplete, bladder emptying, intermittency < 2 h, urgency, interupted urination and nocturia in the observation group were more advantageous than those in the control group (all P < 0.05). The total effective rate was 95.65% (22/23) in the observation group, higher than 85.71% (18/21) in the control group (P < 0.05). After treatment, RV, MFR and BS were significantly different as compared with those before treatment (all P < 0.05).

CONCLUSIONThe combined therapy of acupoint application of bushentongyu plaster and oral administration of tamsulosin hydrochloride capsules achieves the significant efficacy on senile female bladder neck obstruction as compared with the simple administration of tamsulosin hydrochloride capsules.

Acupuncture Points ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Middle Aged ; Treatment Outcome ; Urinary Bladder Neck Obstruction ; drug therapy ; physiopathology ; Urination

OBJECTIVETo explore the polymorphism of low density lipoprotein receptor (LDL-R) genes Pvu II and Ava II in a population with phlegm-dampness constitution (PDC).

METHODSPolymorphism of LDL-R genes at Pvu II and Ava II of 48 persons with gentle constitution (GC) and 61 with PDC were analyzed with PCR-RELP technique, and their serum contents of lipids and glucose were determined and compared as well.

RESULTSThe A+ allelic and P-allelic frequency were higher and the P+ allelic frequency was lower in subjects with PDC than those in subjects with GC, which were 0.3083 vs 0.1771, 0.9098 vs 0.7708 and 0.0902 vs 0.2292, respectively, all showing significant difference between the two groups (P<0.05). Comparison of the two groups in serum levels of triglyceride (TG), fasting blood glucose, 2 h postprandial blood glucose, and 2 h postprandial insulin showed that all the parameters were higher in subjects with PDC than in subjects with GC respectively, showing significant difference (P<0.05).

CONCLUSIONPDC is related with the P- and A+ allelic frequency of higher LDL-R genes at Pvu II and Ava II, therefore, the polymorphism of LDL-R genes could be taken as one of the genetic markers for PDC, and humans with PDC are more liable to suffer from blood lipids and glucose disorder than those with GC.

Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; C-Peptide ; DNA-Cytosine Methylases ; metabolism ; Deoxyribonucleases, Type II Site-Specific ; metabolism ; Female ; Genetic Predisposition to Disease ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Receptors, LDL ; genetics ; Tongue Diseases ; genetics

ObjectiveTo observe the clinical efficacy of Qushi Huayu granules in treating non-alcoholic fatty liver disease （NAFLD） with dampness-heat accumulation. MethodSixty NAFLD patients with the syndrome of dampness-heat accumulation treated in the outpatient and inpatient departments of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from July 2018 to May 2020 were selected according to the diagnostic criteria and inclusion criteria of both traditional Chinese medicine （TCM） and Western medicine. The patients were assigned into a control group and an observation group by a random， controlled， double-blind， and double simulated method. The observation group was treated with Qushi Huayu granules combined with the mimetic agent of Dangfei Liganning capsules， and the control group was treated with Dangfei Liganning capsules combined with the mimetic agent of Qushi Huayu granules. The treatment course of both groups was 24 weeks. The TCM symptom scores， liver imaging parameters ［controlled attenuation parameter （CAP） in Fibroscan and liver-to-spleen ratio in upper abdominal computerized tomography （CT）］， serum levels of alanine aminotransferase （ALT） and γ-glutamyl transpeptidase （γ-GT）， and safety indicators of the two groups were measured. Result① The total response rate in terms of TCM symptoms in the observation group was 89.29% （25/28）， which was higher than that （48.15%， 13/27） in the control group （Z=-3.582，P<0.01）. The total score of the primary and secondary symptoms in both groups of patients declined after treatment （P<0.05）， and the observation group outperformed the control group in decreasing the total score of the main and secondary symptoms as well as the scores of right rib swelling pain， abdominal fullness and distension or pain， sticky stool， and yellow urine （P<0.05）. ② The response rate in terms of Fibroscan CAP of the liver in the observation group was 75.00% （21/28）， which was higher than that （48.15%， 13/27） in the control group （Z=-1.968，P<0.05）. ③ The response rate in terms of the serum enzyme levels in the observation group was 75.00% （21/28）， which was higher than that （44.44%， 12/27） in the control group （Z=-2.018，P<0.05）. The serum levels of ALT and γ-GT in the two groups declined after treatment （P<0.05， P<0.01） and were lower in the observation group than in the control group （P<0.05， P<0.01）. ④ The response rate in terms of liver CT in the observation group was 67.86% （19/28）， which was higher than that （30.77%，8/26） in the control group （Z=-2.507，P<0.05）. ConclusionQushi Huayu granules were safe and effective in the clinical treatment of NAFLD patients with the syndrome of dampness-heat accumulation， which improved the evidence in TCM treatment of NAFLD and was worthy of in-depth clinical research and promotion. Qushi Huayu granules outperformed Dangfei Liganning capsules in terms of TCM symptoms， serum levels of ALT and γ-GT， and liver imaging parameters.

OBJECTIVETo observe the clinical efficacy differences between different needling methods for dry eye syndrome.

METHODSSixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding-acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups.

RESULTSCompared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all<0.001); the improvements of eye symptom score and SⅠT in the observation group were superior to those in the control group (both<0.05). The differences of BUT and VSA score between the two groups were not significant (both>0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group (<0.05). .

CONCLUSIONThe conventional EA and guiding-acupuncture combined with EA are both effective for dry eye syndrome, and the efficacy of guiding-acupuncture combined with EA is superior to that of conventional EA.

OBJECTIVE: To observe the analgesic effect of manipulation loading on chronic low back pain (CLBP) model rats and the expression of inflammatory factors in psoas major muscle tissue, and to explore the improvement of manipulation on local inflammatory microenvironment. METHODS: Thirty two SPF male SD rats weighing 340-360g were randomly divided into blank group, sham operation group, chronic low back pain model group and treatment group, with 8 rats in each group. In the model group, L RESULTS: There was no significant difference in PWT and PWL between the blank group and the sham operation group after modeling ( CONCLUSION Local massage loading has analgesic effect on CLBP rats, at the same time, it can inhibit the content of CGRP and NGF in psoas muscle tissue of CLBP rats, and improve the local inflammatory microenvironment.
Animals ; Calcitonin ; Calcitonin Gene-Related Peptide ; Low Back Pain/therapy* ; Male ; Nerve Growth Factor/genetics* ; Rats ; Rats, Sprague-Dawley

Objective To investigate the effect of muscle function on structural stress in patient with lumbar disc herniation (LDH), by observing the stress changes in LDH lumbar-pelvis finite element model loaded with muscle force. Methods One normal healthy volunteer and one LDH patient were selected. Their CT data were collected to establish two corresponding normal and LDH lumbar-pelvis finite element models, and their gait data were also simultaneously collected to drive the AnyBody musculoskeletal model. The muscle force around the lumbar and pelvis as well as the hip-joint force were obtained as the loading condition. Self-loading of the normal and LDH model as well as the normal model loaded with LDH muscle forces were conducted seperately. Then the stress changes in L4 and L5 intervertebral discs and sacroiliac joints under two above loading conditions were compared. Results The stress curve of normal model loaded with LDH muscle force showed a unimodal stress curve, instead of a bimodal curve, and such trend of stress-time curve was as same as the trend of the LDH model during self-loading. But the stress difference in L4 and L5 intervertebral discs and sacroiliac joint of the normal model loaded with LDH muscle force was smaller than that in the LDH model during self-loading. Conclusions Abnormal muscle function of LDH could lead to abnormal joint stress of the intervertebral discs and sacroiliac joint. Structural imbalance itself could lead to stress imbalance, and muscle as a driving factor was an important cause of anomaly structural dynamic stress, thus leading to abnormal joint motion patterns. Therefore, attention should be paid to assessment of the imbalance of peripheral muscle function in clinical treatment of LDH.