Objective: To provide anatomic data for management of pterygopalatine fossa lesions via endoscopic transnasal approach. Methods: Fifteen (30 sides) formalin-preserved human skulls were subjected to microsurgical dissection to evaluate the exposure scopes of 3 different endoscopic surgery approaches: endonasal middle meatal transpalatine approach, endonasal middle meatal transantral approach, and endonasal inferior turbinectomy transantral approach. Meanwhile, 20 (40 sides) dry skulls were dissected and the related measurements were obtained. Results: The 3 approaches allowed for different exposure of the pterygopalatine fossa structure. The mean distances from foramen rotundum to anterior nasal spur, superior orbital fissure, and optic canal were (61.86±3.67)mm,(3.56±0.75) mm, and (11.23±1.24) mm, respectively. Conclusion: The 3 endoscopic approaches are safe and effective for resection of different pterygopalatine fossa lesions and foramen rotundum serves as a landmark for safe management of the pterygopalatine fossa.

Adult ; Aged ; Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Hemorrhage ; etiology ; Tracheotomy ; adverse effects ; Young Adult

OBJECTIVETo compare the difference in clinical efficacy on chronic obstructive pulmonary disease (COPD) at stable stage in the patients among the combined therapy of cutting method and western medication (combined therapy), simple cutting method and simple western medication.

METHODSOne hundred and twenty cases of COPD were randomized into three groups, 40 cases in each one. In the cutting method group, for excessive phlegm pattern/syndrome, Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1) and Yuji (LU 10) were selected as the main acupoints, and Lieque (LU 7) and Pianli (LI 6) were as the supplementary acupoints. For the pattern/syndrome of failure to consolidate kidney primary, Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4) and Yuji (LU 10) were selected as main acupoints, and Jueyinshu (BL 14) and Zusanli (ST 36) were as the supplementary acupoint. Three acupoints were selected alternatively in each treatment and the cutting method was applied once every 10 days. Three treatments made one session. Two sessions of treatment were required. In the western medication group, salbutamol sulfate aerosol, one press (200 μg/press) was used each night, as well as salmeterol xinafoate and fluticasone propionate powder for inhalation, one inhalation each night. The treatment of 1 month made one session. Two sessions were required. In the combined therapy group, the cutting method and western medication were applied in combination. The results of clinical symptom score, lung function test, arterial blood gas analysis, degree of inflation as well as clinical efficacy were observed before and after treatment in each group.

RESULTSExcept the degree of lung inflation, the clinical symptom score, indices of lung function test, partial pressure of arterial blood gas (PaO2) and partial pressure of carbon dioxide (PaCO2) were all obviously improved after treatment as compared with those before treatment in each group (all P<0.05). They were apparently improved after treatment in the combined therapy group and the cutting method group as compared with those in the western medication group (all P<0.05). The total effective rate was 77.5% (31/40) in the combined therapy group and was 75.0% (30/40) in the cutting method group, both better than 60.0% (24/40) in the western medication group (both P<0.05).

CONCLUSIONThe simple cutting method based on syndrome differentiation and the combined therapy with western medication achieve the superior efficacy on COPD at stable stage as compared with the simple western medication. The effect mechanism is possibly related to the improvement of bronchial airway function through constant acupoint stimulation.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Albuterol ; administration & dosage ; analogs & derivatives ; Androstadienes ; administration & dosage ; Combined Modality Therapy ; Female ; Fluticasone ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; physiopathology ; therapy ; Salmeterol Xinafoate ; Treatment Outcome

OBJECTIVETo observe the clinical effect of acupuncture on acute heart failure (AHF) patients.

METHODSTotally 60 patients who were diagnosed as AHF were assigned to the acupuncture group and the control group, 30 in each group. Those in the control group received inotropic agents, preload and afterload reducing therapy, anti-infection and so on. Besides, those in the acupuncture group received needling at relative points, once daily for 5 consecutive days. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SI), left ventricle working index (LCWI) were monitored by thermodilution pulse-indicated continuous cardiac output (PiCCO) technique. Changes of the aforesaid data were compared between before and after treatment. The ICU length of stay, readmission rate,and the 28-day mortality were also compared between the two groups.

RESULTSAfter 5 days of the treatment, CI, SI, and LCWI increased more obviously (P < 0.01), HR and MAP decreased significantly (P < 0.05). Of them, CI, SI, and LCWI increased more obviously in the acupuncture group (P < 0.05).There was no obvious difference in HR or MAP between the two groups (P > 0.05). Compared with the first day of admission in the same group, CI, SI, and LCWI obviously increased in the acupuncture group from the second day (P < 0.05). HR started to decrease since the fourth day (P < 0.05), and MAP began to decrease until the fifth day (P < 0.05). CI, SI, and LCWI started to increase in the control group from the third day (P < 0.05); HR and MAP both began to decrease since the fifth day (P < 0.05). Compared with the control group, the ICU length of stay was obviously shortened in the acupuncture group (P < 0.05). The readmission rate and the 28-day mortality rate were lower than those of the control group (P < 0.05).

CONCLUSIONThe combination of acupuncture and Western medical therapy might strengthen acute heart failure patients' heart functions, elevate the therapeutic effect, and improve the prognosis.

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Heart Failure ; physiopathology ; therapy ; Heart Rate ; Humans ; Male ; Middle Aged ; Stroke Volume

Objective To evaluate the clinical efficacy and safety of amiodarone in the treatment of acute myocardial infarction combined with atrial fibrillation.Methods A total of 51 patients with acute myocardial infarction and atrial fibrillation were recruited from January 2012 to October 2014 in our hospital.And they were randomly divided into treat-ment group ( n=26 ) and control group ( n=25 ) .Patients in the treat-ment group were treated with amiodarone 100 mg +0.9%NaCl solution 20 mL by intravenous injection within 6 min and followed by amiodarone 0.5 -1.0 mg? min-1 by intravenous drip until back to sinus rhythm. Patients in the control group were treated with cedilanid 0.4 mg +5%glucose 20 mL by intravenous injection within 5 min.The data of atrial fibrillation control rate in the first 24 hours, the sinus rhythm sustain rate in the first month and adverse drug reactions were compared between the two groups.Results The artial fibrillation control rate was 53.8%and 24.0% in the treatment and control group respectively , indicating treatment group was significantly higher than control group ( P<0.05 ) . The sinus rhythm sustain rate in treatment group was significant higher than that in control group ( 88.5% vs 48.0%, P <0.05 ) .And the incidence of adverse drug reactions in the treatment group were much lower than that in the control group (7.6%vs 40.0%, P<0.05).Conclusion Amiodarone is superior to cedilanid in the treatment of patients with acute myocardial infarction combined with atrial fibrillation for the aspect of clinical efficacy and safety.

BACKGROUND: Precision medicine pays attention to the depth characteristics of the disease and the high precision of the treatment, and is a precise and accurate personalized approach of the diagnosis and treatment of the disease. In recent years, it has gradually become the hotspot of the medical field. As a new concept of medicine and medical model, its value in clinical treatment of orthopedics has been gradually highlighted. OBJECTIVE: To summarize the current status and progress of precision medicine in the field of orthopedics.METHODS: A computer-based search of PubMed and CNKI databases was performed for literatures about application and prospect of precision medicine in the field of orthopedics in and outside China published within the past 10 years using the keywords of "precision medicine, Orthopedics, bone, 3D printing, computer assisted navigation, minimal invasive, gene". RESULTS AND CONCLUSION: (1) In the study on the prevention and treatment of the disease of orthopedics, 3D printing technology, computer assisted navigation technology, precision minimally invasive orthopedic technology, and gene research are four effective way to achieve precise and personalized healthcare. (2) The appearance of precision medicine, a novel medicinal model, enriches the treatment of the disease in the field of orthopedics and enhances the curative efficacy of the disease. Precision medicine brings the new dawn to the patient and provides some new clues for medical workers and researchers engaged in the clinical and basic research of the disease in the field of orthopedics.

Osteonecrosis of the femoral head (ONFH) is a common refractory disease in orthopedics, and the rate of disability is very high, and its pathogenesis is unknown. TCM has unique advantages in the prevention and treatment of ONFH, and it has gradually received attention. This article reviewed the clinical application status of TCM for prevention and treatment of ONFH in recent years from ONFH's TCM name, etiology, pathogenesis, syndrome differentiation, and clinical treatment, with a purpose to provide a reference for the clinical treatment of ONFH.

Objective To investigate the mechanism and suppression effect of human cytomegalovirus (HCMV) on proliferation of megakaryocyte progenitors(CFU-Mk)in vitro.Methods Colony forming unit-assay was applied to observe the effect of HCMV-AD 169 strain on CFU-Mk of cord blood. The technique of PCR was used to demonstrate the existence of HCMV-AD 169 DNA in the colony cells of cultured CFU-Mk.Results 1.The number of CFU-Mk colonies in HCMV-infected groups decreased significantly compared with that of control group. The CFU-Mk formation was inhibited significantly after HCMV-AD 169 strain infection.The suppression effect showed a dose-dependent fashion: 46.7 % inhibition with 10 -1of HCMV, 29.7 % with 10 -2 and 14.5 % with 10 -3 in the CFU-Mix assay. The peak of CFU-Mk colonies (d16-18) was not significantly different between control group and experimental groups, but the duration of the CFU-Mk colonies in infected groups was significantly shorter than that in control group.2. HCMV-DNA was positively detected in the colony cells of viral infected group by PCR, while negative in control group.Conclusions HCMV-AD 169 strain may inhibit the differentiation and proliferation of CFU-Mk by infecting the hematopoietic progenitors. HCMV may cause the suppression of hematopoiesis by direct infection, which may be the main reason for HCMV infection associated with thrombocytopenia.

ObjectiveTo observe female university students' differences of cognitive mechanism in processing different types of sexual picture from International Affective Picture System (IAPS).MethodsUsing event related potential (ERP),the differences of the amplitudes of N2,P3 and PSW were examined induced by the neutral pictures and different types of erotic pictures.ResultsThe amplitudes of N2 ( (0.99 ±1.69 ) μV) and P3 ( ( 17.27 ± 1.45 ) μV) elicited by heterosexual couple erotic pictures were highest,followed by the male erotic pictures( ( -0.02 ± 1.83 ) μV,( 15.92 ± 1.26 ) μV),and then were the female erotic pictures ( ( -0.22 ± 1.56)μV,( 15.49 ±1.34) μV).There was statistical significance in N2 and P3 between heterosexual couple erotic pictures and female erotic pictures ( P ＜0.05 ).There was no significant difference in PSW component between heterosexual couple erotic pictures( ( 15.22 ± 1.98 ) μV) and female erotic pictures ( ( 14.53 ± 1.75 ) μV ),but the PSW induced by male erotic pictures (( 10.93 ± 2.60 )μV) was significantly smaller than the other sexual pictures (P＜0.05).ConclusionThe level of sexual arousal elicited by explicit heterosexual couple erotic pictures is highest and also the attention maintains longest.

OBJECTIVETo assess the impact of Paidu Baoshen Pill (PBP, modified Dahuang Zhechong Pill), in retarding the procession of chronic renal failure (CRF) of stage II-III.

METHODSThe 283 patients of CRF stage II-III were randomly assigned to two groups, 151 patients in the treatment group treated with oral administration of PBP 3 g twice a day, and 132 patients in the control group with oxidative amylase aldehyde enveloped capsule 5-10 capsules thrice a day after meal. The course for both groups was 2 months, and the changes after 1 or 2 courses treatment in scoring of quality of life (QOL) and clinical symptoms, also in laboratory indexes including serum levels of creatinine (Cr), urea nitrogen (UN), and intrinsic creatinine clearance rate were observed.

RESULTSThe total effective rate was 70. 86% (107/151 cases) in the treatment group and 44.70% (59/132 cases) in the control group, showing significant difference between them (X2 = 18.69, P < 0.01). Significant differences between groups were also shown in comparisons of scores of QOL and clinical symptoms after treatment. Inter-group comparison showed no difference in all the three indexes detected before treatment, but they did show statistical significance respectively after 1 and 2 courses of treatment (P < 0.05 and P < 0.01).

CONCLUSIONPBP could effectively retard the progression of chronic renal failure and significantly improve the QOL of patients.

Adult ; Aged ; Creatinine ; blood ; Disease Progression ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Kidney Failure, Chronic ; blood ; drug therapy ; pathology ; Male ; Middle Aged ; Quality of Life ; Young Adult