As an important acupoints beyond meridians, Huatuo spine points are used extensively. Its localization generally is considered on the back waist where is under the both sides of the spinous processes (0.5 inch) from the first thoracic vertebral to the fifth lumbar. Furthermore, Huatuo spine points include 17 points on the right side and 17 points on the left. Through a large number of clinical observations and literature’s searching, the writer considers that the Huatuo spine points are an integrated, independent region that is combined pass through the Bladder meridian and the Du meridian. Therefore, acupuncture the region may depend on the specific conditions.

Acupuncture has a definite curative in treating pain.Pain is a subjective feeling,which is not easy to be measured because of lack of quantifiable index.Besides,because evaluation measures for acupuncture analgesia are not unanimous,it is lack of comparability among the different clinical researches.The author summarized the clinical evaluation measures of acupuncture analgesia which are used in clinical commonly,and considered that the clinical study on acupuncture analgesia should be globally evaluated from the extent of pain,complication symptoms and life quality on the basis of determining the nature and xing quantity of the subjective index.

To improve the comprehension on the alcoholic liver cirrhosis at high altitude area, 91 cases of high altitude native Tibetans(HANT) with alcoholic liver cirrhosis were analyzed retrospectively. The results showed that among all kinds of liver cirrhosis, the incidence of alcoholic liver cirrhosis in HANT was about 42 3%. The mean quantity of wine drunk by them was 4601 7g qingke wine and beer, together with 607 8g white wine. The time between first drinking wine to first hospital ization was 21 1 years. All the patients had anorexia, dyspepsia and vague pain at right hypochondrium, but no spider angioma and spleen enlargement appeared. The incidence of hepatic encephalopathy was 30 8%. Clinical recovery was achieved in 96 7% the patients. The results suggested that the incidence of alcoholic liver cirrhosis in HANT is significantly higher than that of plain area people. The mean quantity of wine consumed by HANT is significantly larger than that by plain area people, btut their onset time of liver cirrhosis is much longer than that of plain area people. The incidences of some symptoms are higher than reported, and no spider angioma and spleen enlargement could be found. The incidence of hepatic encephalopathy in HANT is high, but its clinical recovery rate is also high.

BACKGROUND:Theex-vivo expanded autologous adipose-derived stem cels have the capability of multipotential differentiation and have a broad application prospect in the field of tissue engineering and regenerative medicine. OBJECTIVE:To observe the nasal mucosal structural repair and functional reconstruction usingex-vivo expanded autologous adipose-derived stem cels. METHODS:Ten patients with mucosal damage due to the physical or chemical factors were enroled, including six cases of mucosal scar and four cases of mucosal ulceration. Autologous adipose tissue was extracted forin vitro isolation, culture and expansion of adipose-derived stem cels. Before transplantation, quality safety testing was done. Al the patients were injected adipose-derived stem cels (1×107/cm2 0.1 cm mucosal tissue sample at 30 days before and after transplantation for hematoxylin-eosin staining, Masson ) at an interval of 15 days, totaly for three times. Nasal volume, minimum cross-sectional area, and mucociliary clearance function were determined at 30, 90, 150 days after the final injection. Three of 10 patients were selected to take a 0.1 cm× trichrome staining, and AB-PAS staining. RESULTS AND CONCLUSION:Clinical symptoms were aleviated in al patients undergoing transplantation of adipose-derived stem cels. Compared with the baseline data, the nasal volume and minimum cross-sectional area were both decreased at 30, 90, 150 days after transplantation (P < 0.05), and the mucociliary clearance function was improved but not significantly (P > 0.05). Compared with the baseline data, the inflammation of the nasal mucosa was significantly reduced, colagen fibers arranged neatly, the deposition was decreased, and mucin secreted from goblet cels was increased in the selected three patients at 30 days after cel transplantation. These findings indicate thatex-vivo expanded autologous adipose-derived stem cels can be used to reconstruct the nasal mucosal structure and its function.

Objective Our goal was to summarize the clinical data of the combined anteversion of both stem and cup measured by CT method after total hip arthroplasty and to evaluate the accuracy of conventional freehand technique for positioning the combined anteversion by comparing the results to the Dorr′s “safe zone” .Methods We prospectively studied 206 primary total hip arthro-plasties .For all the arthroplasties ,we used posterior lateral approach and conventional freehand technique without any alignment guides .12 surgeons performed all the 206 arthroplasties .Postoperatively all the patients were examined by CT scan within one week .We measured radiographic anteversion of acetabular components using a 3D CT method and measured femoral components anteversion using CT scans .Acetabular anteversion ,femotal component anteversion and combined anteversion were statistically ana-lyzed .Results In all the 206 hips ,the mean acetabular components anteversion was 16 .23° ± 8 .27° ,76 .21% of cases was in Lewin-neck′s safe range of 5°-25° .The mean femoral components anteversion was 23 .79° ± 10 .70° .The mean combined anteversion was 40 .02°± 13 .50° ,65 .05% was in safe range of 25°-50°recommended by Dorr .The acetabular components anteversion ,femoral com-ponents anteversion and combined anteversion placed by senior surgeons was no significantly different from those placed by junior orthopedic surgeons(P>0 .05 ,0 .726 ,0 .143 ,0 .061 ,respectively) .Conclusion The conventional freehand technique is an inaccurate method for positioning the cup anteversion or the combined anteversion .The experience of surgeons can not significantly improve this accuracy .

Objective To investigate the predictors of systemic inflammatory response syndrome (SIRS) in patients with acute ischemic stroke. Methods The patients with acute ischemic stroke admitted to hospital from January 2010 to April 2014 were enroled. The demographics, vascular risk factors, baseline clinical data, and laboratory tests in both groups were colected. Flow cytometry was used to analyze the peripheral blood T helper cel (Th) subgroup. Double antibody sandwich enzyme-linked immunosorbent assay was used to detect the levels of peripheral blood interferon-γ (IFN-γ) and interleukin-4 (IL-4). Results A total of 143 patients with acute ischemic stroke were enroled, including 56 in a SIRS group and 87 in a non-SIRS group. Univariate analysis showed that there were significant differences in the history of hypertension, history of stroke, baseline systolic blood pressure, low-density lipoprotein cholesterol level, National Institutes of Health Stroke Scale (NIHSS) score, percentage of Th1 cels, and IFN-γ concentration in patients of both groups (al P < 0. 05). Multivariate logistic regression analysis showed that the NIHSS score ≥6 (odds ratio [ OR] 2. 40, 95% confidence interval [ CI] 1. 24 - 5. 15, P = 0. 008), decreased percentage of Th1 cels (OR 2. 81, 95% CI 1. 51 - 6. 83, P = 0. 013), and decreased IFN-γ concentration (OR 4. 63, 95% CI 1. 01 - 9. 72, P = 0. 004) were the independent predictive factors for occurring SIRS in patients with acute ischemic stroke. Conclusions Severe neurological deficit, decreased percentage of Th1 cels or decreased IFN-γ level may increase the risk of acute ischemic stroke patients with SIRS.

Objective: To evaluate the induced membrane technique combined with microsurgery for repair of open leg fractures of Gustilo types ⅢB-C. Methods: This retrospective study reviewed 15 patients who had been treated for open leg fractures of Gustilo types ⅢB and ⅢC by the induced membrane technique and microsurgery between January 2015 and January 2017 at Institute of Orthopedics, 920 Hospital, The Joint Logistic Service of The People’s Liberation Army. They were 10 men and 5 women, aged from 18 to 41 years(average 32 years). There were 9 cases of Gustilo type IIIB and 6 ones of Gustilo type IIIC. After thorough debridement, the fractures were reduced and fixated temporarily using external frames. The bone defects were filled with antibiotic bone cement to induce biofilm formation. After necessary reconstruction of limb structures, including neurovascular repair and transposition of tendon and nerve, crucial soft-tissue wounds were covered with surgical flaps. In the secondary surgery 6 to 8 weeks later, with the external frames replaced by internal fixation or not, the bone cement was removed without damaging the biofilm before graft reconstruction with autogenous cancellous bone. Results: The 15 legs were all salvaged successfully. The in-hospital time ranged from 21 to 39 days (mean, 29 days). Crucial wounds were repaired primarily without any severe or persistent infection. Follow-ups ranged from 12 to 24 months (average, 15 months). Bone union time ranged from 10 to 17 months (average, 11.2 months) with satisfactory aesthetic and functional recovery of the leg. Conclusion Reconstruction of open leg fractures of Gustilo types Ⅲ B-C with induced membrane technique and microsurgery can result in decreased therapeutic duration, reduced complications and positive outcomes.

Objective:To report our experience of treating open comminuted limb fractures caused by gunshots using the Masquelet technique.Methods:Between January 2016 and July 2018, 3 patients were admitted to Institute of Orthopedics, 920 Hospital of Joint Logistic Service of People's Liberation Army for open comminuted limb fractures caused by gunshots.They were all male, aged from 18 to 41 years (average, 30.7 years).Their fractures were complicated with perforating wounds and belonged to Gustilo type ⅢB for open fractures.The bone defects were 5 to 9 cm in length (average, 6.7 cm), located at the proximal femur in 2 cases and at the upper middle humerus in one.They were treated by standard Masquelet technique at 2 stages.The postoperative functions of the hip, knee and shoulder were evaluated according to the Harris hip score, Lowa knee score and Constant-Murley shoulder function score.Results:The 3 patients obtained an average follow-up of 17.3 months.The bone defects were all repaired in the 3 patients without any signs of infection.The 2 patients with femoral defects were rated as both excellent by the Harris hip score, as excellent in one and as good in the other by the Lowa knee score; the patient with humeral defects was rated as excellent by the Constant-Murley shoulder function score.Conclusion:Masquelet technique is a desirable treat-ment of segmental long bone defects caused by gunshots.