Objective:To observe the clinical efficacy and action mechanism of Jin’s three-needle acupuncture plus Long’s chiropractic tuina manipulations in treating cervical vertigo. Methods:By adopting a randomized controlled method, 80 eligible patients were randomized into an observation group of 41 cases and a control group of 39 cases. The control group was intervened by Jin’s cervical three-needle acupuncture plus acupuncture at the vertigo-pain points and Fengchi (GB 20); the observation group was by Long’s chiropractic tuina manipulations in addition to the treatment given to the control. For both groups, the intervention was given once a day, 7 sessions as a treatment course, with a 1-day interval after a course, for 2 courses in total. The therapeutic efficacy was evaluated after the first session and the second treatment course, at the 3-month and 6-month follow-ups. Results:After the first session, the recovery plus markedly effective rate of the observation group was significantly higher than that of the control group (P<0.01); the rate was markedly higher in the observation group than that in the control group after 2 treatment courses (P<0.01); at the 3-month follow-up, the relapse rate was 2.5% in the observation group versus 13.5% in the control, and the between-group difference was statistically insignificant (P>0.05); the 6-month follow-up study showed that the relapse rate was 5.0% in the observation group versus 21.6% in the control group, and the between-group difference was statistically significant (P<0.05); at the 6-month follow-up, the total relapse rate was 7.5% in the observation group versus 35.1% in the control group, and the inter-group difference was statistically significant (P<0.01). Conclusion:The two treatment protocols are both effective in treating cervical vertigo. However, due to its more significant efficacy, more efficient action and lower relapse rate compared to acupuncture alone, acupuncture plus tuina can be regarded as a verified protocol for cervical vertigo.

The medical disputes in the primary hospitals increase year by year , and the practical experience at the grass-roots level during 1999 and 2013 showed the medical disputes had various reasons .For primary hospi-tals, the reasons included incomplete reform and management , unsuitable technical level of medical staff , inappropri-ate physician -patient communication and medical service , disunity within the hospital , lack of self -protection awareness;For patients, the reasons included the high expectations of medical service , non-compliance with medi-cal workers, poor economic conditions , week legal awareness;and some reasons from the society , media, etc.To ef-fectively alleviate the tension of physician -patient relationship and build a harmonious medical environment , the pri-mary hospitals need to strengthen the internal management , improve the comprehensive quality of medical staff , en-hance the physician -patient communication , improve self-protection awareness , and establish a good image of pri-mary hospitals.

Objective To examine the clinical characteristics,treatment,and prognosis of patients with synchronous head and neck and esophageal cancer (SHNEC).Methods The clinical data of 30 SHNEC patients treated in the Department of Radiotherapy of the First Affiliated Hospital of China Medical University from 2010 to 2014 were retrospectively reviewed.The patients were followed up and survival was calculated using the Kaplan-Meier method.Differences between survival curves were analyzed by the log-rank test,and prognostic analysis was performed using the Cox regression model.At the same and different time,the comprehensive diagnosis were 24 cases and 6 cases.21 patients were treated with radiochemotherapy, 9 patients were treated by surgery and radiotherapy±chemotherapy.Results SHNEC was frequently found in elderly men with heavy drinking and smoking habits.Hypopharyngeal cancer with middle esophageal cancer was most common among the patients;of the 30 patients,23(77%) had hypopharyngeal cancer,and 12(40%) had hypopharyngeal cancer with middle esophageal cancer.The median survival time of the patients was 20 months,and the 1-and 2-year overall survival (OS) rates were 83% and 37%,respectively.Univariate analysis showed that the stage of esophageal cancer,heavy smoking and drinking habits,and a family history of cancer were significantly associated with patient prognosis (P=0.009,0.044,0.012).In addition,the Cox analysis also demonstrated that the stage of esophageal cancer (HR=3.53,P=0.008),heavy smoking and drinking habits (HR=2.33,P=0.049),and a family history of cancer (HR=2.78,P=0.026) were independent prognostic factors.Conclusions Hypopharyngeal and middle esophageal cancer is the most common type of SHNEC,and the stage of esophageal cancer and heavy smoking and drinking habits are significantly associated with the prognosis of SHNEC patients.In addition,patients with stage Ⅰ and Ⅱ esophageal cancer can also achieve acceptable survival after receiving radiotherapy-based comprehensive treatment.

Objective To study the exposure-response relationship between particulate pollution level and hospital outpatient visits. Method From 2001 to 2005,daily outpatient visits data were from a municipal hospital in Taiyuan,meteorological data and air pollution data were from Taiyuan Meteorological Bureau and Taiyuan Environmental Monitoring Station respectively. Poisson Generalized Additive Model(GAM)) extended Poisson regression was used to examine the relationship between particulate pollution level and hospital outpatient visits,controlling with time trends,weather and the day of week. According to the shape of exposure-response relationship curve,piecewise linear regression was used for risk analysis. Results From 2001 to 2005,the average concentration of PM10 was 190.41 ?g/m3,the average number of daily hospital outpatient visits was 18.31 to the respiratory department,and 23.99 to the cardiovascular department. Exposure-response relationship analysis suggested a nonlinear positive correlation between PM10 and daily hospital outpatient visits. A larger increase in daily hospital outpatient visits was observed at lower concentration of PM10 than that at higher concentration. When PM10 increased 10 ?g/m3,respiratory outpatient visits increased 0.260 1%-0.917 8% and respiratory outpatient visits increased 0.208 3%-0.402 7%. The estimated effects of 2 or 3 days moving average of PM10 concentration were greater than that of concurrent day. The stronger effect of PM10 was found on respiratory outpatient visits,which was statistically significant. Conclusion PM10 may produce effect on respiratory outpatient visits.

The electromyography of the superior and inferior heads of lateral pterygoid muscle of 15 human subjects were recorded. It has been observed that marked active potential occurred in the superior head of the ipsilateral pterygoid muscle and the inferior head of the contralateral muscle during a one-side molar bite. Marked active Potential appeared in the superior head of the lateral pterygoid muscle during the closing movement of the jaw, whereas it appeared in the inferior head during the opening movement.It has not been confirmed that the lateral pterygoid muscle is an important protractor of the mandible, as only relatively weak active potential was recorded in the two heads of the muscles on both sides during the protraction of the jaw. Very marked active potential has been observed in the ipsilateral prenygoid muscle during the lateral movement of the mandible, while in the contralatenal superior head it occurred only slightly. The. above finding does not correspond to the descriptions found in current text-books.The two heads of the lateral pterygoid can therefonose considered as two functionally and structurally distinct muscles.

Objective To discuss the clinical application of rotational DSA and its advantages. Methods 35 cases undergoing cerebral angiography and hepatic arteriography were performed with standard DSA, of which, 24 ones were performed with rotational DSA. Results Standard DSA could only display partial lesion at lateral side, while rotational DSA could display the pathological structure and surrounding structure. Conclusion Rotational DSA is valuable for the diagnosis and treatment of encephalic angioma and liver tumor.

Objective To investigate the effect of asphyxia on newborn's gastric myoelectrical activity by electrogastrography (EGG). Methods Twenty four asphyxia newborns (mild and severe type) and 15 normal newborns were enrolled. Electrogastric activity were recorded by a Portable EGG. The recording were performed 30 minutes before and after feeding respectively Results Compared with normal control,bradygastria (4 cpm) increased significantly ( P 0.01). Conclusions (1)By the help of EGG, we can get information about gastric myoelectrical activity in neonatal asphyxia.(2)Bradygastria is more prominent before feeding in mild asphyxia group; Slow wave is decreased in severe asphyxia group than that of control and mild asphyxia, but tachygastria increases significantly. This kind of abnormal electrogastric rhythm may contribute to feeding difficulty, abdominal distension and vomiting in asphyxia newborns.

Objective To investigate the pharmacokinetic difference between the combination of cyclophosphamide and cisplatin and single medication.Methods High performance liquid chromatography (HPLC) was used to detect the pharmacokinetic parameters and distribution parameters in tissue of cisplatin and cyclophosphamide.Results The pharmacokinetic curve of the CP regimen showed two-compartment model,and there was no significant difference between the absorption half life of the combination of the two drugs (0.56±0.02,0.72±0.02) and that of single medication (0.92±0.02,1.16±0.12) (t =2.091,t =2.379,both P ＞ 0.05).While the elimination half life of the combination (0.56±0.02,0.72±0.02) was significantly longer compared with that of single medication (0.92±0.02,1.16±0.12) and there were significant differences (t =5.796,t =6.213,both P ＜ 0.05).There was no significant difference of MRT in heart between the disturbution of the combination of the two drugs and that of single medication (t =2.231,t =2.096,both P ＞ 0.05).While there was significantly longer compared with that of single medication and there were significant differences in lung and liver (t =5.976,t =6.270,both P ＜ 0.05).Conclusion When used in combination,the elimination of the drugs is slower,which suggests that the interval and dosage of the drugs should be adjusted to their pharmacokinetic parameters in clinical use to improve effects and lower side effects.

Complex clinical situation requires healthcare providers to be able to perceive, un-derstand and predict the situation changes correctly, namely they need situation awareness. Good clin-ical situational awareness can help clinical decision-making and cooperation, which is critical to im-proving the quality of healthcare. Therefore this review aims to summarize the meaning, applications, status and influence factors, measurements and training of clinical situation awareness, to provide evidence for training and improving clinical situation awareness.

According to their polypeptide length and number of d is ulphide bonds, disintegrins are divided into five groups, including short-sized disintegrins, medium-sized disintegrins, long-sized disintegrins, dimeric dis integrins and disintegrin-like molecules released from the disintegrin-like do mains of P-III snake venom metalloproteinases. The integrin-inhibitory activit y of disintegrins, to inhibit platelet aggregating, cell attaching and angiogene sis, depends on the active tripeptide RGD, the appropriate pairing of cysteine r esidues, the amino acids adjacent to the RGD motif within the integrin-binding loop and the C-terminus of the disintegrin polypeptidesl as well.