Objective To explore an effective treatment for knee osteoarthritis.Methods All patients were randomly recruited into an observation group(n=41)and a control group(n=37).The observation group was treated by warming needling.while the control group was treated by common acupuncture combined with TDP. Results The effective rate of the observation group and the control group was 90.24%and 70.27%respectively,showing significant difference(P<0.05).Conclusion The warming needling was effective in treating knee osteoarthritis.

Gastroesophageal varices hemorrhage is a common complication of portal hypertension. Drug and endoscopic therapy have become the basic treatments for varices. Transjugular intrahepatic portal venous shunt is recommended for the management of refractory or recurrent variceal hemorrhage. Liver transplantation will be considered when variceal hemorrhage becomes fatal and traditional therapies are with high risk, contraindicated, or have unsatisfactory results. Patients who received traditional treatments can achieve short-term efficacy and even stabilize the disease for a long time. However, if these treatments lead to complications such as portal vein thrombosis and hepatorenal syndrome, it may increase the risk of liver transplantation complications and affect the patient’s prognosis. Elevated portal venous pressure has a variety of adverse effects on systemic circulation, which can cause hepatopulmonary syndrome, portal pulmonary hypertension, refractory ascites, etc. In these cases, liver transplantation should be performed as early as possible. Conventional treatments are unsatisfactory. In addition, frailty may be worsened after traditional treatment, which will significantly increase the risk of liver transplantation. With the increase of model for end-stage liver disease, the requirement for donor liver volume will also has been increased, which will also affect the implementation of living donor liver transplantation. Some patients with portal hypertension may have poor quality of life and it may also become a clinical indication for liver transplantation. These liver transplant-related issues should be evaluated when administering traditional therapies. Traditional therapies aimed at improving the patient's condition, delaying or controlling complications should not interfere with the consequent implementation of liver transplantation. Improving the long-term overall survival rate and quality of life of patients with portal hypertension is the ultimate standard of all treatments.

The testing conditions and devices in the standards of China and foreign countries were summarized. The testing method was analyzed for the electromagnetic field induced by electrical potential therapy equipment. The safety range was proposed for the electromagnetic field of the tester, and then the risk was reduced greatly to the patient.

Cholecystolithiasis combined with choledocholithiasis is a common disease.The typical open surgery is challenged by the minimally invasive surgery recently.The minimally invasive surgery combined with laparoscopy and choledochoscopy or duodenoscopy has been accepted widely through analyzing and summarizing comprehensively the current situation of the minimally invasive surgery for cholecystolithiasis combined with choledocholithiasis.Laparoscopic cholecystectomy (LC) +endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation (EPBD) should be chosen primarily for the patients with cholecystolithiasis combined with choledocholithiasis and without common bile duct dilatation (common bile duct diameter ＜0.8 cm),and LC + laparoscopic transcystic common bile duct exploration and lithotomy are used under favorable conditions.LC + choledocholithotomy or T tube drainage should be chosen primarily for the patients with cholecystolithiasis combined with choledocholithiasis and common bile duct dilatation (common bile duct diameter ＞ 0.8 cm).Primary suture of common bile duct should be used with removal of the common bile duct stones,patency of distal common bile duct and recovery function of sphincter of Oddi.The minimally invasive surgery combined with laparoscopy and choledochoscopy or duodenoscopy which is selected reasonably could improve the treatment of cholecystolithiasis combined with choledocholithiasis and reduce the complications,with a significant clinical efficacy.

To analyze the polyps in the aspects of distribution, helicobacter pylori ( HP) infection and the use of proton pump inhibitors ( PPI) in different histological types of gastric polyps;to observe the morphosis under endos-copy histopathology and the surveillance situation in colonic polyps. The infection rates of HP in gastric hyperplasic polyps, inflammatory polyps and adenomatous polyps were 31.11%, 45.31% and 58.33%;the using rate of PPI among inflammatory polyps patients was higher. The main histopathological type of colonic polyps was adenomatous polyps;20 cases of colorectal polypectomy surveillance of 2 years had recurrence. The occurrence of gastric adeno-matous polyps may be related to HP infection;PPI had no obvious correlation with the pathological type of the gas-tric polyps. Colorectal adenoma should strengthen the surveillance colonoscopy of postpolypectomy.

Objective To compare the outcomes of arthroscopic coracoacromial ligament augmentation and clavicular hook plating in treatment of acromioclavicular joint dislocation.Methods From March 2008 to March 2012,47 patients with acute closed type Ⅲ-Ⅴ acromioclavicular joint dislocations underwent an arthroscopic repair with coracoacromial ligament augmentation and suture (ligament augmentation group,23 patients) and with AO clavicular hook plate (hook plate group,24 cases).Mean age of the patients (32 males and 15 females) was 34.8 years (range,17-45 years).There were 32 left and 15 right injuries.Postoperative outcome was assessed through radiographic examination,American Shoulder and Elbow Surgeon (ASES) score and Karlsson scoring method.Results Mean period of follow-up was 18 months (range,12-24 months).In ligament augmentation group ASES score improved from (28.7 ± 7.3) points preoperatively to (96.3 ± 6.9) points postoperatively (t =51.34,P ＜ 0.05).In hook plate group ASES score improved from (29.3 ± 7.6) points preoperatively to (83.6 ± 8.5) points postoperatively (t =43.78,P ＜ 0.05).Postoperative radiographic examination showed well joint reduction of all patients.Good and excellent results with the Karlsson score accounted for 96％ (22/23) in ligament augmentation group and 71％ (17/24) in hook plate group (x2 =9.05,P ＜0.05).Conclusions Efficacy of coracoacromial ligament augmentation and suture for the treatment of acromioclavicular joint dislocation is better than clavicular hook plate.Coracoacromial ligament augmentation and suture are associated with lower incidence of shoulder pain and shoulder activity limitation,shorter recovery time,fewer complications and early activities.

AIM To establish an RP-HPLC method for the simultaneous content determination of five nucleosides in Houtoujun Tablets (mycelia of Hericium erinaceum).METHODS The analysis of aqueous extract of this drug was performed on a 26 ℃ thermostatic Zorbax SB-Aq C18 column (250 mm ×4.6 mm,5 μm),with the mobile phase comprising of methanol-0.1％ phosphoric acid flowing at 0.5 mL/min in a gradient elution manner,and the detection wavelength was set at 260 nm.RESULTS Cytidine,adenine,uridine,adenosine and guanosine showed good linear relationships within the ranges of 0.007-0.169,0.005-0.115,0.032-0.797,0.032-0.792 and 0.004-0.103 μg,whose average recoveries (n =6) were 99.4％ (RSD =2.0％),98.3％ (RSD =1.8％),98.0％ (RSD =2.8％),101.4％ (RSD =1.9％) and 101.7％ (RSD =1.2％),respectively.CONCLUSION The contents of five nucleosides in Houtoujun Tablets from different manufacturers exhibit obvious differences,to which we should pay attention.

ObjectiveTo summarize long-term effects of different op eration methods to cure congenital blepharophimosis syndrome in the past twenty years. MethodsIn the past twenty years, according to the clini cal features of 74 cases of congenital blepharophimosis syndrome,we adopted one -stage or two-stage technique to do the medial and lateral canthoplasty and/or to correct blepharoptosis. 24 patients accepted post-operative follow-up as l ong as 9 years. ResultsGenerally, Mustrarde technique was adop ted to correct inverse epicanthus for 54 cases, but for 20 patients with mild ep icanthus we adopted other methods. When enlarging the medial canthus, we selecti vely shortened the medial canthal ligament for 36 patients. When transverse tens ion on the upper eyelids was not increased, 33 cases selected one-stage techniq ue to correct this syndrome and obtained the same effects as two-stage techniqu e did for the other 41 cases. Other combined deformations of the patients should be treated in adolescence according to the patients' requirements. ConclusionBy adopting one-stage or two-stage technique to perform the medial and lateral canthoplasty and/or to correct blepharophimosis for con genital blepharophimosis syndrome can reach the satisfactory results if a correc t indication is selected.

Objective To establish a learning evaluation indexes systen of flipped teaching method,and provide the basis for evaluating academic performance of each student who majors in nursing.Methods The indexes were determined by Delphi method of two rounds of consultation involving 15 experts,and the weight of every index was set up by analytic hierarchy process.Results The response rates of questionnaire investigation for the two rounds of consultation were 13/15 and 12/13 respectively.The authority value of experts was 0.847.The Kendall concordance coefficients for the indexes of first-level,second-level and third-level were 0.373,0.258 and 0.595 respectively,P＜0.05.Finally,the evaluation indexes system including 3 first-level indexes,5 second-level indexes,and 6 third-level indexes was set up.Conclusions The results of the two rounds of expert consultation are reliable.The consistency of expert opinions is good.The study provides a scientific and systematic evaluation tool for evaluating nursing undergraduates' performance under flipped teaching.

Objective To investigate the role of interferon regulatory factor-1 (IRF-1) in liver ischemia/reperfusion (IR) injury and its underlying mechanism,and identify effective managements in alleviating liver IR injury.Methods Three groups of mice models with liver IR injury were well established,including control group (S),warm liver IR injury group (IR) and recombinant IRF-1 group (IRF-1).The levels of mRNA and protein,liver function and pathological changes of liver tissue were detected in group S and group IR.Additionally,the marker of IRF-1,p-Stat1,p-P38,PARP1 and Caspase-3 were measured and PCNA expression was determined in group IR and group IRF-1 mice with 6-hour liver IR injury.Results IRF-1 mRNA and protein and the levels expression of proteins were significantly elevated with peak occurred after 6-hour IR injury,which was statistic difference compare to the group S (t2h =-3.512,t6h =-4.247,t12h =-4.088,t24h =-3.851;P ＜ 0.05).Serum ALT and AST of mice detected in group IR were higher than group S at all endpoints (tALT =4.931,4.592,4.277,4.809;tAST =4.980,4.617,4.336,4.915;P ＜ 0.05).Furthermore,pathological damage change was more distinct compared with group S.The elevated levels of IRF-1,p-Statl,p-P38,PARP1 and Caspase-3 and decreased PCNA expression were determined in mice models with recombinant IRF-1 intervention.Conclusion IRF-1 expression could be closely correlated with liver IR injury,and its underlying mechanism may be attributed to activation of JNK MAPK protein and inhibition of PCNA expression.