Objective To investigate the analysis of collateral circulation in patients with acute symptomatic internal carotid artery occlusion (ICAO)and its clinical significance. Methods Seventy-two consecutive patients with symptomatic ICAO diagnosed by digital subtraction angiography (DSA)were enrolled retrospectively. The American Society of Intervention and Treatment Neuroradiology / Society of Interventional Radiology (ASITN/ SIR)scores were used to evaluate the collateral circulation in the region of ICAO,and the collateral circulation of the patients with different causes,different clinical manifestations, and different types of infarcts were compared. Results Of the 72 patients with ICAO,61(84. 7%)had atherosclerotic occlusion,8(11. 1%)had cervical dissection,and 3 (4. 2%)had cardioembolism;55 patients (76. 4%)had cerebral infarction and 17(23. 6%)had transient ischemic attack. There were no significant differences in the ASITN/ SIR scores among the different causes (P > 0. 05). The ASITN/ SIR scores in patients with cerebral infarction and transient ischemic attack were 2. 64 ± 0. 80 and 3. 29 ± 0. 69 respectively. There was significant difference (P < 0. 05). In patients with cerebral infarction,the ASITN/SIR scores in patients with internal watershed infarction and regional cerebral infarction only were 2. 43 ± 0. 68 and 2. 36 ±0. 51 respectively,they were lower than the patients with only external watershed infarction only and/ or cerebral infarction in cortical territory (3. 42 ±0. 90,P <0. 05). Conclusion Atherosclerotic occlusion is the most common cause of ICAO. ASITN / SIR scores may reflect the conditions of collateral circulation in patients with ICAO. The occurrence of internal watershed infarction and regional infarction indicates the collateral circulation is poor,and need for further therapeutic intervention.

Treatment based on syndrome differentiation is an essential feature of traditional Chinese medical diagnosis. The interventions based on changes of syndrome types in randomized controlled trials are complicated, leading to the difficulty of blind method enforcement. This article described a double-blind method. It could be used in randomized controlled trials under the condition of different syndrome types and different medications. It numbered drugs in two stages, and in two phases to achieve double-blind. This method not only guaranteed investigators and subjects to be in blinded conditions, but also achieved using different medications for patients of different syndromes. It also caused no drug waste. It was scientific and feasible.
Double-Blind Method ; Humans ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic ; Single-Blind Method

OBJECTIVE: To analyze the causes of misdiagnosis in patients with familial nasal bleeding and to improve the level of diagnosis and treatment. METHOD: The clinical characteristics of 7 families with nose blood were analyzed retrospectively and 2 typical cases were reported, including their treatment and misdiagnosis in consulting, out-patient and in-patient. RESULT: Typical case 1 was misdiagnosed and mistreated for 42 years, misdiagnosed as blood disease so that the patient was biopsied in bone marrow, misdiagnosed as endometriosis so that the patient was performed uterus resection. Typical case 2 was misdiagnosed and mistreated for 17 years, misdiagnosed as upper digestive tract hemorrhage so that the patient was performed endoscopic sleeve ligation, misdiagnosed as inferior turbinate hemangioma so that the patient was performed nasal endoscopic surgery. CONCLUSION Neglect of family history and the typical signs are the causes of misdiagnosis. So asking about the family history and checking for the typical signs in patients with nose blood can avoid misdiagnosis.
Diagnostic Errors ; Endoscopy ; Epistaxis ; diagnosis ; Female ; Humans ; Nasal Surgical Procedures ; Retrospective Studies ; Turbinates

OBJECTIVETo investigate the influences of bicortical anchorage on values of natural frequencies of dental implants utilizing the 3-dimensional finite element analysis.

METHODSUsing the commercial code of Solidworks, 3-D models of a screw-shaped dental implant and a mandibular bone segment were generated. After the 3-D implant-bone complex was meshed by ABAQUS software, effects of bicortical anchorage on the buccolingual and axial first-order natural frequencies of the implant were computed.

RESULTSBicortical anchorage increased both the buccolingual and axial natural frequencies remarkably. As the bicortical anchorage got deeper, the frequencies correspondingly got higher.

CONCLUSIONBicortical anchorage can increase the buccolingual and axial primary stability of dental implants.

Dental Implantation, Endosseous ; Dental Implants ; Dental Stress Analysis ; Finite Element Analysis ; Humans ; Mandible

Objective To summarize the epidemiological characteristics of ankle fractures and clinical outcome of open reduction and fixation for the treatment of posterior Pilon fracture with supporting plate. Methods From January 1st,2013 to December 31st,2016,the data of three hundred and twelve patients with ankle fracture in Jinshan Hospital of Fudan University were collected, and 21 cases of posterior Pilon fracture were treated with open reduction and fixation using supporting plate and were followed up,the ankle function was assessed by American Orthopaedic Foot and Ankle Society ankle hindfoot scale. Results There were 312 patients with ankle fractures,180 males,132 females. The age distribution of patients was as follows:1. 28%,12. 82%,14. 42%,24. 04%,28. 53%,11. 54%,6. 09% and 1. 28% in the following age group:≥18 and≤20 years of age,>20 and ≤30 years of age,>30 and ≤40 years of age,40> and ≤50 years of age,>50 and≤60 years of age,>60 and ≤70 years of age,>70 and ≤80 years of age and >80years of age. Traffic accidents (49%),sprains(31%),falling injury (11%),heavy pound(6%) were the main causes of ankle fractures. In terms of fracture types,238 (76. 2%) cases with lateral malleolus,235 (75. 3%) cases with medial malleolus fractures,161 (51. 6%) cases with posterior malleolus,and 105 (33. 7%) cases with trimalleolar fracture,21 (6. 8%)cases with posterior Pilon fracture. 21 patients with posterior Pilon fracture were followed up for 13. 0 to 56. 0 months,with an average of (31. 7±12. 6) months. Postoperative incision infection occurred in 3 patients,of which 1 cases had mild external leakage,and all wounds healed after dressing change. No fracture and screw prolapse occurred in all follow-up patients. The average score of AOFAS was (87. 2± 7. 1) points,of which 9 cases were excellent,10 cases were good,and 2 cases were fair. Conclusion Patients with ankle fractures were more common in males aged 60 and below,while in patients above 60 years old,the majority patients were females. In addition,patients aged 40 to 60 years old accounts for more than half of the population and the most common age group were between 50 and 60 years old. Traffic accidents and sprains are the common causes. The incidence of different fracture types in descending order were as follows: lateral malleolus fractures, medial malleolus fractures,posterior malleolus fractures and trimalleolar fractures. Pilon fracture was a common type of ankle fracture. Clinical outcome of open reduction and fixation for the treatment of posterior Pilon fracture with supporting plate was satisfied.

OBJECTIVETo investigate the clinical effect of atlantoaxial pedicle screw internal fixation for treatment of atlantoaxial dislocation.

METHODSSixteen patients with atlantoaxial dislocation were treated from Dec. 2005 to June 2007, included 10 males and 6 females, aged from 38 to 45 years old (means 40.5 years). Among them 12 patients combined with nerve injury, according to ASIA grade: there were 3 cases in grade B, 5 cases in grade C, 4 cases in grade D. All patients received preoperative CT, radiograph and skull traction. Intraoperative posterior approach general spine pedicle screw-rod orthopaedics fixation system used and iliac bone block were implanted in space of posterior atlantal arch and axial vertebral plate. The outcome and complications were observed in the near future.

RESULTSThere was no vascular or neural injury found. The patients were followed up for 12 to 24 months (means 18 months). All head pain, acid storm symptoms were improved after operation. According to the Odom's clinical efficacy evaluation standard, 12 cases were excellent, 4 were good. Eleven cases of 12 with nerve injury recovered significantly. By ASIA classification: 1 cases was in grade B, 2 cases were in grade C, 5 cases were in grade D, 4 cases were in grade E. No looseness or breakage of screw occurred. Bony fusion was achieved in all cases.

CONCLUSIONPosterior approach atlantoaxial pedicle screw internal fixation have the advantages of direct screw placement, short-segment fusion, intraoperative reduction, fixation reliable, high fusion rate, and it can restablish the upper cervical vertebrae stability and help to recover the spinal cord and nerve function.

Adult ; Atlanto-Axial Joint ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Joint Dislocations ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

This paper introduces the old nine-needle including its name, shape, function, manipulation and origination, as well as systematically introduces the new nine-needle as a new product which has been developed under the guidance of modern science and technology based on the old nine-needle since 1949. As a new tool, the new nine-needle provide much more choice for acupuncture treatment and obtained satisfied clinical effect. During the development of research and clinical practice on the new nine-needle, its theory has been consummated successively. Combining various kinds of needles for treatment is not only paying attention to the specificity of one kind of needles, but also emphasizing the whole function of all kinds of needles, which makes the new nine-needle formed the characteristic and distinct theory of its own.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Needles

Mechanisms of acupuncture and moxibustion for treatment of hypertension have been studied extensively from poly-aspects, poly-levels and poly-links. The present paper reviews the studies on nervous regulation, humoral regulation and regulation of peripheral vessel resistance and other pathways and their relationships in recent ten years, and indicates further perfecting these studies from the following aspects: studies on the mechanism of section and combination of blood pressure-decreasing points, relationship of time-effect and dose-effect of acupuncture and moxibustion, and studies on mechanisms of functions of nerve-endocrine-immune system.
Acupuncture Therapy ; Brain ; physiology ; Endothelins ; physiology ; Humans ; Hypertension ; physiopathology ; therapy ; Moxibustion ; Neurotransmitter Agents ; physiology ; Peripheral Nerves ; physiology ; Renin-Angiotensin System ; physiology ; Vascular Resistance

With the unique structure and manipulation techniques of blood-letting and cutting, hook needle serves as a role in dredging meridians, removing blood stasis, purging heat for resuscitation and relaxing synechial tissues. There are three needling techniques of hook needle: swift pricking, bleeding and pricking. Six manipulations are commonly used as lifting-thrusting, plucking, pulling, pushing-scraping, vibration and massage. The mechanism and manipulations of hook needling are summarized systematically in the present paper. In this way, its manipulations, indications and contraindications are expounded in detail.
Acupuncture Therapy ; instrumentation ; methods ; Humans ; Needles

Paracetamol was used as a model drug in this study to investigate the synergetic effects of lipid coating and beta-cyclodextrin (beta-CD) inclusion for masking the bitter taste of poorly soluble drugs. To control the concentration as low as possible of the free drug which produced a bitter taste, a kinetic model was established to calculate the drug distribution theoretically among the free drug in medium, lipid coated particles and molecular inclusion on the basis of the preparation and characterization of the lipid microspheres, so as to select the proper amount of beta-CD. Finally, the synergetic drug delivery systems were prepared and characterized by 1H nuclear magnetic resonance (1H NMR), molecular simulation and the electronic tongue. As a result, the drug release rate constant (k) of the lipid microspheres coated with octadecanol was determined as 0.001 270 s(-1). Then, the synergetic drug delivery systems were prepared with the ratio of 6.74 : 1 (w/w) for beta-CD and paracetamol. The chemical shift values for the fingerprint peaks of paracetamol all increased and hydrogen bonds were formed between the oxygen on the phenolic hydroxyl group, the nitrogen on the imino in paracetamol and the hydrogens on the hydroxyl groups in beta-CD. The results tested by the electronic tongue indicated that the paracetamol, lipid microspheres, beta-CD inclusion and their mixture showed different taste characteristics, with the bitterness order of the synergetic drug delivery systems approximately lipid microspheres < beta-CD inclusion < paracetamol, which confirmed the synergetic taste masking effects of lipid coating and beta-CD molecular inclusion. In summary, the synergetic taste masking was jointly achieved through the retard of the drug release by the lipid coating and the inclusion of the free paracetamol by beta-CD through hydrogen bonds.
Acetaminophen ; administration & dosage ; chemistry ; Administration, Oral ; Drug Delivery Systems ; Electrical Equipment and Supplies ; Electrochemical Techniques ; instrumentation ; methods ; Hydrogen Bonding ; Kinetics ; Lipids ; chemistry ; Microspheres ; Solubility ; Taste ; drug effects ; beta-Cyclodextrins ; chemistry