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.

Objective To identify the COL7A1 gene mutation in a family with dy strophic epidermolysis bullosa pruriginosa. Methods PCR and direct DNA sequencin g were employed to determine the mutation sites and mutation types. RT-PCR and cloning sequencing were performed to further identify the pathogeny of this dise ase. Results A splicing mutation was found in 87 exon of COL7A1 gene which resul ted in an in-frame deletion of exon 87. Synthesis of ?1(VII) collagen polypept ides was internally shortened by 23 amino acids. The mutation was not found in n ormal controls. Conclusions The splicing mutation of COL7A1 gene is the underlyi ng cause of and specific rather than common polymorphism for the family with dys trophic epidermolysis bullosa pruriginosa subtype.

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 To investigate the application value of Calot triangle hollowing-out maneuver in laparoscopic cholecystectomy (LC) for preventing bile duct injury.Methods The retrospective cross-sectional study was conducted.The clinical data of 537 patients who underwent LC in the Dexing People's Hospital between January 2011 and December 2015 were collected.The tissues in Calot triangle were hollowed out,and cystic ducts were cut off and then gall bladders were resected.Observation indicators:(1) operation situations:anatomy of the Calot triangle and operation time;(2) postoperative recovery situations:postoperative complications and bile duct injury;(3) follow-up situation.The follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and occurrence of cholangitis up to May 2016.Results (1) Operation situations:of 537 patients with LC,anatomical relation among cystic duct,common hepatic duct and common bile duct (three-duct relation for short) could be seen in 165 patients without dissection,and three-duct relation cannot be seen in other 372 patients.Of 372 patients,16 were operated on with the gallbladder open due to the difficult dissection of Calot triangle,7 were converted to open surgery due to local severe adhesion and unclear structure,1 was converted to open surgery due to intraoperative varices induced bleeding in Calot triangle,and other 348 patients underwent successful LC using Calot triangle hollowing-out maneuver.Operation time was 15-190 minutes,with an average time of 28 minutes.(2) Postoperative situations:2 patients were complicated with biliary colic pain,showing stones in the distal common bile duct via magnetic resonance imaging scans,and then received endoscopic sphincterotomy (EST);3 had subxyphoid puncture hole infection,1 had a small amount of postoperative bleeding due to hepatocirrhosis,3 had pulmonary infection,and they were improved by symptomatic treatment;1 had chylous fistula and were improved through drainage and low fat diet intake for 1 week;2 with mild bile leakage was improved through peritoneal drainage.No bile duct injury was detected.(3) Follow-up situation:348 patients were followed up for 12-18 months,with a median time of 16 months.During the followup,348 patients with follow-up had survival without manifestation of cholangitis.Conclusion Calot triangle hollowing-out maneuver could effectively prevent bile duct injury in LC.

Objective To evaluate the value of CT virtual endoscopy(CTVE)for microsurgery of pituitary microadenomas via transsphenoidal approach.Methods In 18 patients with pituitary micmadenomas underwent microsurgery via transsphenoidal approach,the presurgical CT data was transfered to work station,the anatomies of the sphenoid sinus were then reconstructed by CTVE.The CTVE images were used to make the preoperative planning and indentify sphenoid sinus, sellar floor,and the position of the tumor during surgery.The CTVE images and the views from intraoperative microscope were compared. Results CTVE could display the anotomoties of sphenoid sinus in a three-dimentional mode.The display rates of superfical antomies such as sphenoid septa,sellar floor,carotid prominence,optic prominence and opticocarotid recess were 344.4%,100%,41.7%,36.1%and 58.3%respectively and the visual fields of these anatomic landmarks were larger than the views from the intraoperative microscope. CTVE could depcit the anatomies of the enhanced carotid ateries and pituitary tissue and some optic canals underlying the sellae by transparent function or heighten the threshold.The sites of the tumor could be marked correctly on CTVE images.CTVE could simulate the operative approach and some operating procedures properatively. Conclusion CTVE can display the anatomies of sphenoid sinus in a three-dimensional mode. In transsphenoidal treatment of pituitary microadenoma,CTVE can help to make preoperative planning,locate the intraoperative structures and make a precise bone window during surgery.

Objective To report effects of microsurgical treatment for tumors in cervical spinal canal. Methods A total of 32 cases of tumors in cervical spinal canal had received microneurosurgery through a posternmedial approach. 22 cases had received reconstruction of cervical spinal canal stability. Results A total tumor resection was performed in 26 cases (81.25%),a subtotal tumor resection was conducted in 6 cases(18.75%). A cemplete recovery was achieved in 23 cases(71.88%), an improvement of symptoms was achieved in 6 cases(18.75%), and no improvement in 3 cases(9.38%), no death was encountered. Follow up observations were carded out in 30 cases for 3 months to 3 years. MRI examinatious 3 months after operation in 26 cases found no residual or recurrent tumor,recurrence was seen in 3cases of astrocytoma, 1 case was invariable. X-ray radiography in 26 cases showed good vertebral stability ,spinal deformation was found in 4 eases. Conclusion Microsurgery in early period play a key role in treatment of cervical spinal tumors. Reconstruction of spinal canal stability is important to patients.

AIM: To observe the effects of vascular endothelial growth factor(VEGF) on the proliferation and differentiation of neural stem cells(NSCs) of rats in vitro.METHODS: NSCs isolated from the hippocampal gyrus of SD rats were primary cultured and subcultured,and then divided into two groups:(1) the cells in VEGF group were treated with 150 ?g/L VEGF in the culture system,and VEGF was removed at the 7 th day;(2) control group(without VEGF treatment).The cellular morphology of two groups was observed by contrast phase microscope.Nestin and NF-200 expressing cells were detected via immunofluorescence method.The percentages of the immunostaining positive cells in each group at the 7 th day and at the 11 th day were determined.RESULTS: At the 7 th day,the percentage of nestin positive cells in VEGF group was 52.19%?7.95%,vs 29.26%?4.12% in control group(P

Purpose: Through meta-analysis, we aimed to assess the efficacy and safety of drug-coated balloons (DCB), compared with drugeluting stents (DES) or uncoated devices, in the treatment of de novo coronary lesions. Materials and Methods: Only randomized controlled trials were included. The primary outcomes were late lumen loss (LLL), target lesion revascularization (TLR), and major adverse cardiac events (MACEs). Subgroup analyses were conducted based on clinical indications, whether DCBs were used with a systematic or bailout stent, and types of DESs. Results: The present meta-analysis demonstrated that DCBs elicit significantly lower incidences of TLR, MACE, and LLL, compared with uncoated devices, and similar incidences, compared with DESs, in the treatment of de novo coronary lesions. Subgroup analysis indicated that DCBs used with a bailout stent achieved lower incidences of binary restenosis and myocardial infarction, compared with uncoated devices, and provided less LLL than DESs. DCBs showed similar rates of TLR and MACE, with significantly less LLL, than DESs in treating de novo small-vessel diseases. The clinical efficacy of DCBs was similar to that of secondgeneration DES. Conclusion Overall, DCB is favored over bare metal stent alone in treating de novo coronary lesions. DCBs appear to be a promising alternative to DESs in the treatment of de novo coronary lesions.