In order to optimize acupuncture protocol for stephenipodia after stroke, related papers of the recent 20 years are retrieved. Interrelated factors which may influence the therapeutic effect of acupuncture are analyzed through the aspects such as acupoints, needling methods and opportunities of acupuncture. It is held that importance should be attached on relation between acupoints and anatomy during acupoint selection. Different acupuncture protocol can be adopted in different phases of stephenipodia according to its time of occurrence. And it is found that the combination of acupuncture and rehabilitation can reinforce the therapeutic effect. Relationship between effect of acupuncture and patient's condition, acupoint selection and prescription, acupuncture manipulations (including directions, angles, reinforcing and reducing, quantity of stimulus) are worth to be further studied. On the base of the above all mentioned studies, optimization can be carried out on selection of acupoints and acupuncture manipulations. And therapeutic effect can be enhanced when the optimized acupuncture protocol is combined with rehabilitation therapies.
Acupuncture Points ; Acupuncture Therapy ; Foot Diseases ; etiology ; therapy ; Humans ; Stroke ; complications

Angiogenesis Inhibitors ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Precancerous Conditions ; drug therapy ; Stomach Neoplasms ; blood supply ; drug therapy

Objective To explore risk factors,prevention and treatment of common complications of benign esophageal stenosis treated with the retrievable covered stents in children.Methods Fifteen cases,diagnosed as benign esophageal stenosis by barium esophagogram were treated with retrievable covered stents under fluoroscopy,Then the stents were removed after 2-3 weeks.The cases were followed-up and complications were observed.Results The stents were successful implanted in all cases.The diet was improved obviously after operation,and gradually transformed from liquid,semiliquid to normal feeding.At the same time,narrow section gradually expanded from 0.1-0.6 cm to 0.6-1.5 cm.Postoperative follow-up was in 1,2,3 weeks and 3 months.Main complications were stents shift in 5 cases,esophageal restenosis in 2 cases,esophageal-tracheal fistula in 1 case,postoperative dull pain behind sternum and foreign body sensation in 6 cases.Relevant preventions and treatments were performed based on different complications.Conclusion It should not be ignored that complications after covered stent placement are more in children than in adults,preventions and treatments should be taken positively.

The pancreatic enzyme-II type collagenase digestion method was adopted for primary culture of osteoblasts, inoculation and passage. They were identified by alkaline phosphatase dye-liquor. N-butanol extract fractions from different processed products of Cibotium barometz were prepared. The above osteoblasts were jointly cultured with protocatechuic acid, protocatechuic aldehyde, kojic acid and the mixed control liquid of the above three substances, and their proliferation was detected by CCK-8. Various n-butanol extract fractions from different processed products of C. barometz showed a significant proliferative effect on osteoblasts in the order of the wined > the heated > the salted > the sand-heated and wined system > the alcohol-processed > the steamed > the crude. The q test showed no significant difference among sand-heated, alcohol-processed and steamed C. barometz, no significant difference between heated and salted C. barometz. Various control substances also showed a certain proliferative effect on osteoblasts in the order of the mixed control > protocatechuic aldehyde > protocatechuic acid > kojic acid. The q test showed no significant difference between protocatechuic aldehyde and protocatechuic acid. All of n-butanol extract fractions from different processed products of C. barometz showed a significant effect on osteoblast proliferation, of which wined C. barometz showed the best effect. All of phenolic compounds such as protocatechuic aldehyde, protocatechuic acid and kojic acid showed a significant proliferative effect on osteoblasts.
Animals ; Cell Proliferation ; drug effects ; Drug Compounding ; methods ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Osteoblasts ; cytology ; drug effects ; Pteridophyta ; chemistry ; Rats ; Rats, Sprague-Dawley

Objective To preliminarily optimize the acupuncture protocol in treating migraine in acute stage. Method Ninety patients with migraine in acute stage were observed, with Visual Analogue Scale (VAS) as the evaluation index and an orthogonal design. Acupoints groups [Taiyang (EX-HN5), Fengchi (GB20), Taiyang (EX-HN5) and Fengchi (GB20)], insertion directions (perpendicular, downward penetration, and backward penetration), stimulation dosage (1 needle, 3 needles, and 5 needles) and acupuncture duration (30 min, 1 h, and 2 h), altogether 4 factors and 3 levels, formed up different acupuncture protocols to observe the analgesic efficacy in treating migraine in acute stage, so as to determine the role of the four factors (Chi-square test), advantage of the 3 levels (multiple comparisons) and the optimal grouping of the 4 factors and 3 levels. Result Acupoints group, insertion direction and stimulation dosage were the major factors in acupuncture analgesia, and the acupuncture duration was the secondary factor (P<0.05). The analgesic effect of Taiyang (EX-HN5) and Fengchi (GB20) was more significant than either Taiyang (EX-HN5) or Fengchi (GB20) (P<0.05). Penetration puncture from Naokong (GB19) towards Fengchi (GB20) (downward penetration) produced a more significant analgesic effect than from Fengchi (GB20) towards Wangu (GB12) and from Tianyou (TE16) towards Fengchi (GB20) (both backward penetration) (P<0.05). Acupuncture with Five needles and 3 needles (parallel horizontal insertion) were superior to that with 1 needle (P<0.05); acupuncture with 5 needles was better than that with 3 needles but without a statistical significance (P>0.05). Needle retaining for 2 h produced a better analgesic effect than retaining for 30 min and 1 h, but without statistical significances (P>0.05). Conclusion Taiyang (EX-HN5) plus Fengchi (GB20), downward penetration acupuncture, 5-needle parallel horizontal acupuncture, and 2-h needle retaining combine an optimal acupuncture protocol in treating migraine in acute stage. Nevertheless, 3-needle parallel acupuncture with 30-60-min needle retaining can also be chosen according to the condition of the patients.

Objective To explore the feasibility and short-term efficacy of laparoscopic and thoracoscopic Ivor Lewis esophagectomy using a circular-stapled anastomosis with trans-oral anvil in treating esophageal carcinoma.Methods 30 consecutive patients with esophageal cancer received minimally invasive Ivor Lewis esophagectomy from January 2011 to December 2011.Operations of all the cases comprised of both abdominal and thoracic procedures which were performed with Iaparoscopic and thoracoscopic techniques respectively.The intrathoracic esophago-gastric anastomosis was created using a circular-stapled anastomosis with trans-oral anvil technique.Results There were 24 males and 6 female with median age of 62.5-year-old (from 47 to 82).The lesions located in middle and/or lower portion of the esophagus.25 patients with esophageal squamous cell cancer (n =25) and 5 patients with adenocarcinoma (n =5) underwent an Ivor Lewis esophagectomy.All the operations were successfully performed without intra-operative technical failures of the anastomosis or deaths.The mean operation time was 95 minutes in abdomen and 177 minutes in thorax.The mean blood loss was 310 ml.The mean number of harvested lymph nodes was 10.6 from thorax and 4.9 from abdomen.Postoperalively,there were thoracic wound infections in 4 patients.One patient had a left diaphragmatic hernia and was successfully treated by re-operation 6 days after first operation.One patient had chylothorax and recovered without surgery.There was no anastomotic leak and the patients were able to have spoon meat at 5.6 postoperative days.Conclusion Laparoscopic and thoracoscopic Ivor Lewis esophagectomy can be accomplished smoothly with acceptable occurrence of complications.The circular-stapled anastomosis with the trans-oral anvil is an efficient,safe and reproducible technique for intrathoracic esophago-gastric anastomosis.

Objective To analyze the clinical features and prognosis of patients with infective endocarditis(IE) and acute kidney injury(AKI),and to evaluate the effect of timely operation on prognosis of renal function.MethodsClinical data of 45 IE and AKI cases in Peking Union Medical College Hospital from January 2010 to May 2016 were retrospectively reviewed;among them 8 cases underwent renal biopsy and the pathologies were analyzed.Patients were divided into Operation group(22 cases) and Non-operation group(23 cases),the clinical data and prognosis were compared.Results The ratio of male to female was 2.46:1 and the average age was 48.3±16.6.35.6% of cases were found with basic valve diseases,the congenital valve diseases were the most common type.The most frequently infected valves were mitral valve(46.7%),aortic valve(28.9%) and prosthetic valve(8.9%) ordinally.The most common pathogenic bacteria were streptococcus(46.7%) and staphylococcus(35.6%).Some rare and special pathogen could also be found in these cases.In 8 cases underwent renal biopsy,3 cases were diagnosed as crescentic nephritis,2 cases were diagnosed as focal proliferative glomerulone-phritis and mesangial prolif-erative glomerulonephritis respectively,1 case was diagnosed as acute interstitial nephritis.C3 sedimentation was the most common phenomenon found in immunofluorescence.There was no significant difference between the baseline data of Operation and Non-operation groups,and neither was the survival rate.However,renal function recovered better in Operation group(P<0.05): the serum creatinine declined remarkably in 7 days(P<0.05) and 30 days(P<0.01)post operation,compared with the peak valve before operation.Conclusions The underline valve diseases and pathogen have been changed in IE as compared with traditional description.Crescentic nephritis is common in renal pathologic manifestation when parenchymal lesion is developed after the onset of IE.Timely operation can improve the renal prognosis in patients with IE and AKI.

OBJECTIVETo evaluate the midterm follow-up results of extended release of posterior clearance in total knee arthroplasty.

METHODSA total of 120 patients with knee osteoarthritis were equally randomly assigned to the experimental group and control group, and underwent unilateral TKA from March 2010 to March 2012. In experimental group, there were 21 males and 39 females with an average age of (62.2±10.9) years old. In the control group, there were 25 males and 35 females with an average age of (64.9±11.4) years old. All the patients were performed using the anterior knee approach. During operation, after osteotomy of the tibia and the femoral condyle, extended release of the posterior knee clearance were taken in experimental group, while only the clearance of osteophyte in the posterior condyle were performed in the control group. The KSS scores including knee functional score and knee clinical score,as well as the range of motion (ROM) of patients, were compared between the two groups at midterm follow-up.

RESULTSTotally 49 patients in the experimental group and 54 patients in the control group were followed up, and the median follow-up time was 46 months. The knee functional score of patients in the experimental group was 91.3±3.4, which was better than 86.4±3.9 of patients in the control group; initiative ROM of flexion of patients in the experimental group was (133.2±5.9)°, which was better than (126.9±7.4)° of patients in the control group. There were no significant difference of knee clinical score between 86.9±4.6 of patients in the experimental group and 85.7±5.1 of patients in the control group, and the initiative ROM of extension between (0.5±1.1)° and (0.3±1.2)°.

CONCLUSIONExtended release of the posterior knee clearance contributes to the knee function and initiative flexion ROM during a midterm follow-up and patients benefit.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Case-Control Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular

OBJECTIVETo investigate the effect of Dachengqi Decoction (DCQD) on the key signaling molecules in lung and large intestine of mice with endotoxemia for exploring the exterior-interior relation between Fei and Dachang.

METHODSA total of 32 BALB/c mice were randomly and equally allocated into four groups: mice in Group C and D were made into endotoxemia model by intraperitoneal injection of 10 mg/kg lipopolysaccharide (LPS); while those in Group A and B were not modeled but given intraperitoneal injection of saline instead. Thirty min after then, saline to Group A and C, and DCQD to Group B and D were given by gastric infusion, and mice were sacrificed 6 h later. Their tissues of lung and large intestine were taken for observing pathological changes by inverted microscopy with HE staining; detecting expressions of tumor necrosis factor-alpha (TNF-alpha) by LiquiChip system; determining gene transcription and protein expression of toll-like receptor 4 (TLR4) using reverse transcription-polymerase chain reaction (RT-PCR) and Western blot, and the correlation of TNF-alpha and TLR4 levels in the lung and the large intestine tissue was analyzed. RESULTED: Compared with Group C, hemorrhage, pathologic toxemic features, including pulmonary edema and inflammatory cell infiltration as well as intestinal wall congestion and neutrophil infiltration, were significantly alleviated in Group D. Levels of TNF-alpha expression, TLR4 protein expression and gene transcription raised significantly in the modeled mice (P < 0.01), but comparison between the two modeled groups showed that the three parameters were lower in Group D than in Group C (P < 0. 01 or P < 0.05) respectively. Correlation analysis showed that the levels of TNF-alpha expression, TLR4 protein expression and gene transcription in pulmonary tissues were positively correlated with those in large intestinal tissues respectively (r = 0.973, P < 0.01, r = 0.906, P < 0.01, and r = 0.880, P < 0.01).

CONCLUSIONSThe effects of DCQD in alleviating pulmonary and large intestinal inflammation induced by endotoxemia might be correlated to its reduction on levels of TNF-alpha expression, TLR4 protein expression and gene transcription. Levels of the three parameters in the lung are correlated with the corresponding levels in the large intestine, which suggested the existence of exterior-interior relation between Fei and Dachang.

Animals ; Endotoxemia ; metabolism ; pathology ; Intestine, Large ; drug effects ; metabolism ; Lung ; drug effects ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Plant Extracts ; pharmacology ; Toll-Like Receptor 4 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Through the collection of the literatures published in recent years on the opportunity of acupuncture therapy for post-stroke dysphagia, the therapy of acupuncture-moxibustion combined with the rehabilitation training is regardes as the optimal program in the paper. In this program, the timing of acupuncture intervention is a key factor to impact the efficacy on post-stroke dysphagia. It is vitally significant to grasp the intervention timing of acupuncture-moxibustion in the recovery of swallowing function as well as articulation function with dysphagia involved.
Acupuncture Therapy ; Animals ; Deglutition Disorders ; etiology ; therapy ; Humans ; Moxibustion ; Stroke ; complications