Objective To observe the effect of penetrating needling with thick needle at Shenzhu (GB 12) on the Unified Parkinson’s Disease Rating Scale (UPDRS) score in patients with Parkinson’s Disease (PD). Methods Sixty-one PD patients were randomized into a treatment group of 31 cases and a control group of 30 cases. The treatment group was intervened by penetrating needling with thick needle at Shenzhu (GV 12) in addition to oral administration of Levodopa and Benserazide Hydrochloride;while the control group was by oral administration of Levodopa and Benserazide Hydrochloride alone. The UPDRS was evaluated before and after intervention in both groups. Results Respectively after 30-day treatment, 90-day treatment, and 90 d after the intervention, the UPDRS scores were significantly changed compared to that before intervention in both groups (P<0.01, P<0.05);there were also significant differences in comparing the UPDRS score between the two groups at each time point (P<0.01, P<0.05). Conclusions Penetrating needling with thick needle at Shenzhu (GV 12) can improve the UPDRS score in PD patients, and it’s an effective method in treating PD.

Objective To investigate the relationship between metabolism syndrome (MS) and fatty liver. Methods Plasma lipids, plasma glucose, liver function, blood pressure, body height and body weight were determined in 666 leaders receiving physical examination. Their livers were also examined by ultrasound. Whit analysis of variance and chi-square test, the effect of plasma lipids, plasma glucose, blood pressure, and weight index on fatty liver, and the relation between MS and fatty liver were analyzed. Results The weight index, systolic pressure, diastolic pressure, and the levels of total cholesterol, triglyceride, apolipoprotein B and plasma glucose in the patients with fatty liver were higher than those in healthy subjects. The levels of high-density lipoprotein and apolipoprotein A were lower in patients with fatty liver than those in healthy subjects. The morbidity of fatty liver in the patients with MS was higher than that in healthy subjects. Conclusion There was a close relation between MS and fatty liver. It was necessary to early treat MS.

目的观察神经阻滞治疗颈源性头痛的效果。方法对颈源性头痛患者30例行星状神经节阻滞,伴颈椎旁神经或耳颞神经阻滞治疗,观察治疗前后疼痛视觉模拟评分(VAS)、每周头痛发作次数、服用止痛药物与睡眠改善例数。结果治疗前后VAS评分改善(P<0.05),治疗后头痛完全缓解15例,好转9例,有效4例,无效2例;治疗后头痛发作次数及持续时间均缩短(P<0.05);治疗前服用止痛药物28例,治疗后2周12例,4周4例(P<0.05);睡眠不佳治疗前29例,治疗后2周13例,4周为4例(P<0.05)。结论神经阻滞是治疗颈源性头痛是一种良好的治疗方法。

[Objective]To inrestigate the clinical outcomes of using bilateral tibial flap of the second toe nail flap combined with the fibulal flap of the big toe to repair the multi-finger degloving injury.[Method]A variety of different methods were used to repair the multi-finger degloving injury,six fingers in 3 cases were repaired by partial bilateral wrap-around flaps combined with the tibial flap of the second toe.Sixteen fingers in 8 cases were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe.Six fingers in 2 cases were repaired by bilateral second toenail flap,the fibulal flap of the big toe and the digital arterial island flap.Three fingers in l case were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe and the the lateral flap of dorsum of foot.Six fingers in 3 cases were repaired by bilateral second toe nail flap and the fibulal flap of the big toe and bilateral dorsum flap of foot.Four fingers in 1 case were repaired by partial bilateral wrap-around flaps and the tibial flap of the second toe and the anterolateral thigh flap.Six fingers in 3 cases were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe,and bilateral dorsum flap of foot and bilateral anterolateral thigh flap.[Result]Ninety-seven flaps of 98 flaps of 47 fingers in 21 cases were suvived well,with 1 flap developed necrosis.The follow-up duration ranged from 6 months to 9 years in 17 cases (37 fingers).In addition to the activities of DIP limited,the other interphalangeal joint activities were nearly normal.All of the fingernail grew well.Two point discrimination of the fingers was between 5mm and 11 mm.The donor site was hardly affected.[Conclusion]It is a better method using the big toe flap combined with the second toe flap to repair the the multi-finger degloving injury at one stage.

Objective To evaluate the electrophysiological mechanism of early recurrence of atrial tachyarrhythmias(ATa) after initial ablation for paroxysmal atrial fibrillation(AF)and the feasibility of early re-ablation.Methods Forteen cases(8 males,average age of 61.8?8.4 years) presented with early recurrent ATa within 1 month after initial ablation were included.Early recurrence was observed after a mean of 4.9?3.7 days post-ablation.During re-ablation,all pulmonary vein(PV) reconnection was re-isolated,and AF induction was applied to map and ablate non-PV triggers.ECG and Holter monitor was applied to evaluate the effect.Results Re-ablation was performed after a mean follow-up of 24.7?5.5 days after the first ablation.PV re-connection was identified in 13 cases(92.9%) and was re-isolated by closing conduction gaps along initial lesion lines.By AF induction,superior vena cava(SVC) originated AF was detected in 3 cases and was terminated by SVC isolation.Upper crista terminalis(CT) foci was found in 1 case which was eliminated by focal ablation.Typical atrial flutter(AFL) in 3 cases and left atrial AFL in 1 case were terminated by linear ablation.At the end of follow-up of 5.8?1.4 months,13 cases were free from ATa recurrence and anti-arrhythmic drugs.Paroxymal ATa was observed in 1 case which could be suppressed by verapamil.Conclusion PV re-connection is the main influencing factor of early recurrence of ATa after initial ablation for paroxysmal AF.Other factors include foci located in SVC and CT.Early re-ablation is feasible and effective.

Objective To analyze the prevalence of complications following catheter ablation for atrial fibrillation and to describe the characteristics of transition of complications.Methods From October 2004 to December 2008,2 260 cases(1 265 males)with atrial fibrillation(AF)were admitted for catheter ablation.AF was paroxysmal in 1 449 cases and chronic in 811 cases.Circumferential pulmonary vein isolation(CPVI)was carried out alone for paroxysmal AF and in combination with fractionated electrograms ablation for chronic AF.Complications were summarized and analyzed by dividing the whole duration into three sections:Year 2004-2006,Year 2007 and Year 2008.Results Complications occurred in 61 cases(2.70%).Cardiac tamponade developed in 11 cases,embolism in 18 cases,pulmonary vein stenosis in 14 cases,and vessel access related complications in 18 cases.In Year 2004-2006,cardiac tamponade occurred in 5 cases,cerebral embolism in 3 cases,mesenteric artery embolism in 1 case,pulmonary vein stenosis in 6 cases,and vessel access related complications in 6 cases.In Year 2007,cardiac tamponade occurred in 4 cases,cerebral embolism in 3 cases,Mesenteric artery embolism in 1 case,pulmonary vein stenosis in 4 cases,and vessel access related complications in 5 cases.In Year 2008,cardiac tamponade occurred in 2 cases,cerebral embolism in 7 cases,mesenteric artery embolism in 3 cases,pulmonary vein stenosis in 4 cases,and vessel access related complications in 7 cases.There was no significant difference in the prevalence of complications among three sections.The prevalence of cardiac tamponade was lower in Year 2008 compared with that in the other two sections,P=0.5.However,the prevalence of embolism was higher in Year 2008 compared with that in the other two the sections,P=0.2.Conclusion It is safe to perform catheter ablation for the treatment of AF.Despite the improvement of technical skills,the prevalence of severe complications such as cardial tamponade,pulmonary vein stenosis or stroke did not decrease.

Objective To investigate hemodynamie change in uremia complicating heart failure of elderly patients. Methods Totally 241 cases with uremia complicating heart failure received measurement of circulation dynamic detection(CD).The volume load,myocardial contractility and blood pressure were analyzed in the elderly group aged(71±6)years (n=116) and young and middleaged group aged(38± 10)years(n =125). Results The central venous pressure(CVP)[(26.7±11.3)cmH2O vs.(23.6 ± 10.7) cm H2O,t=2.410,P =0.010],effective circulation volume (ECV)[(4362± 1340)ml vs.(3085 ± 1001 ) ml,t =7.674,P =0.000],stroke volume(SV) [(185 ± 52) ml vs.(114±41)ml,t=7.803,P=0.000],cardiac output (CO)[( 13.9±4.3)L/min vs.(11.2±3.6)L/min,t=4.802,P=0.000],left ventricular end diastolic volume (LVD)[(388± 145)ml vs.(258±98)ml,t =7.673,P =0.000],left ventricular end systolic volume ( LSV ) [( 223 ± 95 ) ml vs.( 135 ± 59) ml,t =7.186,P=0.000] were significantly higher group than in young and middle-aged group.The ejection pressure (EP)[(178±29)mm Hg vs.(183±24)mm Hg,t=2.323,P=0.012],myocardium negative inotropic(MNC) [(0.609±0.149)vs.(0.683±0.188),t=3.113,P=0.002],ejection fraction (EF) [(0.433± 0.034) vs.(0.445 ± 0.031 ),t =2.451,P =0.010],diastolic blood pressure (DBP) [( 87 ±14)mm Hg vs.(1.08±22)mm Hg,t=8.141,P=0.000],systematic vascular resistance(SSR)[(952±207)gcm-4 s-2 vs.(1217± 308) gcm-4 s-2,t =7.143,P=0.000],ejection resistence(ER) [( 178± 29)vs.( 183 ± 24),t =2.323,P =0.012] were lower in elderly group than in young and middle-aged group.DBP(x2 =16.474,P=0.000,OR=0.752,95％CI:0.714-0.790),SBP(x2 =11.913,P=0.000,OR=1.148,95％CI:1.091-1.205),ER(x2 =17.892,P=0.000,OR=0.906,95％CI:0.861-0.951),CVP(x2 =14.672,P=0.000,OR=0.698,95％CI:0.663-0.733) and LDV(x2 =21.080,P=0.000,OR=0.942.95％ CI:0.895-0.989) were dangerous factors of uremia complicating heart failure.Conclnsions The increased volume load,decreased myocardial contractility and cardiac afterload may appear in the elderly patients with uremia complicating heart failure.

Objective To compare the clinical outcomes of 2 different catheter ablation strategies for patients with chronic atrial fibrillation(CAF).Methods One hundred and thirty four consecutive patients(77 males,mean age 56.8?12.3 yrs)were randomized into 2 groups of different catheter ablation strategies.All the patients suffered from frequent attacks(more than 3 times per month),drug refractory and symptomatic CAF.One group received circumferential pulmonary rein ablation(CPVA group,n=68)and the other group received complex fractionated electrogram ablation additional to CPVA(CPVA+CFEA group,n=66).All ablation was guided by 3 dimensional mapping system(CARTO).Follow-up ECG,Holter and clinical outcomes of the 2 groups within 6 months after the procedures were analyzed.Results The baseline characteristics were comparable between the 2 groups.The mean procedure time in the CPVA+CFEA group was longer than that in the CPVA group but the mean fluoroscopy time between two groups had no significant difference.After the first procedure,60%of patients in the CPVA group and 77% of patients in the CPVA +CFEA group were free from symptomatic atrial tachycardia without any use of antiarrhythmic drugs for at least 3 months(P

Objective To evaluate the safety and effectiveness of catheter ablation for atrial fibrillation(AF)therapy guided by 3-D mapping systems.Methods Eight hundred cases(482 male,mean age 62.1?15.6 years)were enrolled.AF was paroxysmal in 611 cases,and persistent in 189 cases.The mean left atrium diameter was 38.4 9.2 mm.Ablation was guided by EnSite-NavX in 260 cases and by CARTO in 540 cases.Circumferential pulmonary vein isolation(CPVI)was performed for paroxysmal AF,and CPVI combined with complex fractionated atrial electrograms(CFAEs)and mitral isthmus ablation was applied for persistent AF.Every case received oral anticoagulation with warfarin and class IC and class III antiarrhythmic drugs for 1 to 3 months.ECG and Holter were applied every month during follow-up.Results Seven hundred and ninty-five cases underwent the procedure successfully,with the mean procedural time 161 33 min and fluoroscopic time 17 13 min.PV isolation was achieved in 96.5% of cases for left-sided PVs,and in 98.6% of cases for right-sided PVs.Radiofrequency application terminated paroxysmal AF in 90 out of 98 cases.AF recurred in 137 cases within 2 weeks post-ablation,and subsided in 103 cases during subsequent follow-up.Fifty-seven cases underwent re-ablation and 6 cases required third ablation.Persistent AF was terminated in 30 cases(16.1%)and was converted to atrial tachycardia in 15 cases(8.1%)by CPVI.For patients receiving CFAEs ablation,persistent AF was terminated in 20 cases(10.8%)and was converted to atrial tachycardia in 23 cases(12.4%).AF recurred in 78 cases(41.9%)early after ablation and 65 cases underwent re-ablation(10 cases received third ablation).Atrial tachycardia/flutter developed in 104 cases(13.1%)after ablation,and remitted in 68 cases.Atrial tachycardia/flutter was mapped and ablated in 30 cases,and was eliminated in 23 cases.Complications:Cardiac tamponade developed in 5 cases,requiring pericardiocentesis in 3 cases and surgical repair in 2 cases.PV stenosis was present in 6(0.7%)cases,TIA in 1 case,cerebral embolism in 2 cases,mesentery artery embolism in 1 case,hemothorax in 1 case and pneumothorax in 1 case.There were femoral artery pseudo-aneurysm in 3 cases and femoral artery-vein fistula in 1 case.All the patients were cured by conservative therapy.During a mean follow-up of 16.2?5.7 months,550 cases(9.4% of them received re-ablation and 11.5% received antiarrhythmic drugs)with paroxysmal AF and 159 cases(34.9% of them received re-ablation and 28.5% received antiarrhythmic drugs)with persistent AF were free of atrial tachyarrhythmias recurrence.Conclusion Catheter ablation guided by 3-D mapping systems were safe and effective for AF therapy.CPVI alone was enough for paroxysmal AF treatment,while CPVI combined with CFAEs and isthmus ablation were preferable for persistent AF treatment,and re-ablation were needed in 40% of the patients to improve effectiveness.