Objective To study effects of fluid resuscitation on thoracoabdominal injury combined with hemorrhagic traumatic shock.Method A total of 98 patients,who were treated in Affiliated Zhongshan Hospital of Dalian University from November 2004 to December 2006,were retrospectively analyzed.The patients were diagnozed according to Surgery(fifth edition).Patients were divided into delayed fluid resuscitation group(n= 51)and immediate fluid resuscitation group(n=47).Patients in delayed fluid resuscitation group were given with balanced salt solution for the body to maintain basic requirements.Patients in immediate fluid resuscitation group were rapidly administered with a lot of isotonic crystaUoid and(or)colloid solution after admission. Hemoglobin,platelet count,hematocrit,blood lactic acid,basedeficit,preoperative resuscitation time and mortality were compared between the two groups.Paired t test and variance analysis or x~2 test were used.Results The transfusion fluid volume of delayed group and immediate group was(1586?346)ml,(3520?575)ml, respectively,with P value

OBJECTIVETo systematically review the clinical efficacy of acupuncture on the patients with low back pain (LBP).

METHODSRandomized controlled trials (RCTs) about pure acupuncture therapy versus other treatments in treating LBP were electronically searched in PubMed, CBM, EMbase, The Cochrane Library, CNKI, VIP and Wanfang Data from January 2004 to May 2014. The observed index on the results were the changed scores of VAS, ODI, JOA and RMDQ. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as the extracted data, and assessed the methodological quality. The results of Meta-analysis was conducted by RevMan 5.2 software.

RESULTSTen RCTs involved 751 patients were finally included. The results of Meta-analysis indicated that the role of pure acupuncture group in improving the VAS score was better than that of the control group, and the combined effect size was RR = -.32, 95% CI (-1.41, -1.22); Z=27.28, P<0.00001; the role of pure acupuncture group in improving the ODI score was better than that of the control group, and the combined effect size was RR = -5.07, 95% CI (-7.50, -2.65); Z=4.10, P<0.0001; the role of pure acupuncture group on improved JOA score was better than that of the control group and the combined effect size was RR=2.83, 95% CI (2.02, 3.63), Z=6.90, P<0.00001. The role of pure acupuncture group in improving the RMDQ score was better than that of the control group, and the combined effect size was RR = -2.80, 95% CI (-3.49, -2.11), Z=7.95, P<0.00001.

CONCLUSIONThe result of meta-analysis demonstrates that pure acupuncture may have a favorable effect on self-reported pain and functional limitations in LBP patients.

Acupuncture Therapy ; Humans ; Low Back Pain ; therapy ; Randomized Controlled Trials as Topic ; Treatment Outcome

Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients' psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient's anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.

OBJECTIVETo observe the clinical efficacy of acupuncture at Hegu (LI 4) on central facial nerve paralysis after ischemic stroke, and explore dose-effect relationship among different stimulation intensities of acupuncture at Hegu (LI 4) as well as its optimal treatment plan.

METHODSAccording to different acupuncture stimulation intensities which were based on treatment time and needle insertion direction, fifty patients were randomly divided into a Hegu 1 group, a Hegu 2 group, a Hegu 3 group, a Hegu 4 group and a control group, ten cases in each one. Different stimulation intensities of acupuncture at Hegu (LI 4) combined with facial paralysis acupoints, including Yingxiang (LI 20), Dicang (ST 4), Jiache (ST 6) and Quanliao (SI 18), were applied in Hegu 1 to 4 groups; meanwhile acupuncture at stroke acupoints, including Neiguan (PC 6), Shuigou (GV 26) and Sanyinjiao (SP 6), and medication treatment were adopted. Except acupuncture at Hegu (LI 4), the treatment of the control group was identical as Hegu groups. The treatment duration lasted for 14 days. The House-Brackmann facial never grading systems (H-B), Toronto facial grading system (TFGS), degrees of facial never paralysis (DFNP), facial disability index (FDI) and clinical efficacy were compared among groups.

RESULTS(1) Compared before the treatment, H-B, TFGS, DFNP and physical function score in FDI were all improved significantly in the Hegu 1 to 4 groups (all P < 0.05), but social function score in FDI was not obviously improved (all P > 0.05); all the scores in the control group were not evidently changed (all P > 0.05). (2) Compared with the control group, differences of H-B before and after treatment in the Hegu 1 to 4 groups, differences of TFGS in the Hegu 2 group and differences of DFNP in the Hegu 1 and Hegu 2 group were significantly improved (all P < 0.05). The differences of any scale among Hegu 1 to 4 groups were not significant (all P > 0.05), in which the most evident change was found in Hegu 2 group. (3) The total effective rate was 90.0% (9/10), 100.0% (10/10), 90.0% (9/10) and 80.0% (8/10) in Hegu 1 to 4 groups, which were significantly higher than 60.0% (6/10) in the control group (all P < 0.05).

CONCLUSIONAcupuncture at Hegu (LI 4) has affirmative clinical efficacy on central facial nerve paralysis after ischemic stroke, in which oblique insertion along the opposite direction of meridian for 5 s of twirling manipulation has the best clinical effect.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Facial Paralysis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications

OBJECTIVETo observe the analgesic effects of single-and combined-laser irradiation with low-intensity applied at "Zusanli" (ST 36) in rats, and their relation to degranulation of mast cells.

METHODSSixty-six SD rats were randomly divided into 6 groups: normal control group (Group NC), model control group (Group MC), sham irradiation group (Group SI), 10.6 microm laser irradiation group (Group 10.6 microm LI), 650 nm laser irradiation group (Group 650 nm LI) and combined (10.6 microm + 650 nm) laser irradiation group (Group CLI). Complete Freund's Adjuvant (0.05 mL) was injected into the left ankle joints of all the rats except those in Group NC to cause acute adjuvant-induced arthritis. In treatment, laser irradiation was applied at "Zusanli" (ST 36) for 30 minutes in all the rats except those in Group NC and Group MC. The paw withdrawal latency (PWL) to radian heat was used to compare analgesic effects among the groups. By means of toluidine blue, dyed slices of local tissues of "Zusanli" (ST 36) were used to observe changes of mast cell degranulation before and after laser irradiation.

RESULTSThe pain thresholds to irradiation of the rats in Group 650 nm LI and Group CLI were significantly higher than those in Group MC and Group SI (P < 0.01), and the mast cell degranulation rate in Group 650 nm LI and Group CLI were also significantly higher than that in Group MC and Group SI (P < 0.001). The pain threshold and mast cell degranulation rate in Group 10. 6 microm LI were not significantly different from those in Group MC and Group SI. There was a linear correlation between mast cell degranulation rate and PWL with 0. 737 in coefficient (P < 0.001).

CONCLUSIONSingle 650 nm laser and combined 650 nm + 10.6 microm laser with low intensity irradiated at "Zusanli" (ST 36) in acute adjuvant rats can provide remarkable analgesic effects, and there was a positive correlation between mast cell degranulation rate and analgesic effects, which plays an important part in laser irradiation-induced analgesia.

Acupuncture Analgesia ; methods ; Acute Disease ; Animals ; Arthritis, Experimental ; chemically induced ; physiopathology ; therapy ; Cell Degranulation ; radiation effects ; Combined Modality Therapy ; Freund's Adjuvant ; Low-Level Light Therapy ; methods ; Male ; Mast Cells ; cytology ; physiology ; Pain Measurement ; Pain Threshold ; radiation effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley

The theory of branch atheromatous disease (BAD) has been commonly underused in clinical practice and research since it was proposed in 1989.In this study,we sought to explore clinical characteristics of its substypes and biomarkers for prognosis of BAD.A total of 176 consecutive patients with BAD were classified into two groups:paramedianpontine artery group (PPA group,n=70) and lenticulostriate artery group (LSA group,n=106).Bivariate analyses were used to explore the relationship between white matter hyperintensities (WMHs),National Institutes of Health Stroke Scale (NIHSS) scores and prognosis evaluated by the modified Rank Scale (mRS) at 6th month after stroke.The differences in prevalence of diabetes mellitus and a history of ischemic heart disease were statistically significant between PPA group and LSA group (x2=8.255,P=0.004;x2=13.402,P＜0.001).The bivariate analyses demonstrated a positive correlation between NIHSS and poor prognosis in patents with BAD and in the two subtype groups,and a positive correlation between WMHs and poor prognosis in the PPA group.It is concluded that a significantly higher prevalence of diabetes mellitus and a history of ischemic heart disease exist in the PPA group than in the LSA group.In addition,high grades of NIHSS scores imply poor prognosis in patients with BAD and in the two subtype groups.Moreover,WMHs are a positive predictor for poor prognosis in patients in the PPA group.

OBJECTIVETo understand the self-discrimination experience of MSM and its relationship with sexual behavior and psychological factors.

METHODSBy respondent-driven sampling (RDS) method, a call-for action and anonymous self-administration questionnaire investigation was carried out in Mianyang city on experience of self-discriminations, sexual partners and behaviors and depression symptom, etc. The first 12 qualified people were designated as the "root" in the whole investigation from different MSM subgroups. Every "root" would get 3 recruit cards after their own investigation, then cards could be promoted to another 3 qualified people who were willing to accept questionnaires. And this process would go on till the sample size was accomplished. χ(2) test, rank correlation and contingency coefficient would be applied for the statistical analysis.

RESULTSIn total, 201 persons were investigated. Within the past 6 months, 59.2% (119/201) persons felt they did harm to their family or made the family down as gays, 79.6% (160/201) had to disguise their real sexual orientation in avoidance of being discriminated, 39.3% (79/201) were humiliated for having gay sex. It showed correlation between humiliation or harm to family and frequency to disco balls/night clubs (r = 0.196, χ(2) = 7.95, P < 0.05), concerts or theaters (r = 0.201, χ(2) = 8.423, P < 0.05) with MSM friends, HIV health consultancy (r = 0.231, χ(2) = 11.329, P < 0.05), experiences of one night stands (r(s) = 0.183, µ = 2.588, P < 0.05), detection of depression (r(s) = 0.241, µ = 15.717, P < 0.05) and stress-related perception (r(s) = -0.310, µ = 23.112, P < 0.05), the corresponding behavior report rates of who experienced 3-4 times were 66.7% (11/33), 52.9% (18/34), 41.2% (14/34), 17.6% (6/34), 44.1% (15/34), 44.7% (10/24). Statistical significance was found between the relations of humiliation for gay sex and frequency into concerts or theaters (r = 0.195, χ(2) = 7.933, P < 0.05) with MSM friends, experiences of one night stands (r(s) = 0.145, µ = 2.051, P < 0.05), man-man anal sex (r = 0.165, χ(2) = 10.823, P < 0.05), numbers of female sexual partners (r = 0.265, χ(2) = 11.422, P < 0.05), protectiveness of female sexual behavior in the past 6 months (r = 0.513, χ(2) = 7.442, P < 0.05), detection of depression (r(s) = 0.152, µ = 13.034, P < 0.05) and stress-related perception (r(s) = -0.259, µ = 21.190, P < 0.05), the corresponding behavior report rates of who experienced 3-4 times were 22.7% (5/22), 9.1% (2/22), 13.6% (3/22), 91.6% (2/22), 66.7% (2/3), 57.1% (4/7), 33.3% (19/57). It has statistical significance between the relations of disguising their real sexual orientation in avoidance of being discriminated and the frequency of show up in the cybercafé (r = 0.272, χ(2) = 15.932, P < 0.05), involvement of HIV test (r = 0.232, χ(2) = 11.446, P < 0.05), and stress-related perception (r(s) = -0.373, µ = 28.868, P < 0.05). It was found that increasing of discrimination was connected to entrance into gay-welcome places, acceptance of HIV consultancy and tests, posting gay information among MSM friends and hold of many sexual partners. Meanwhile, the pressure was rising when depression was checked out.

CONCLUSIONSelf-discrimination was prevalent among MSM, which had brought critical influence on the individual behavior, MSM psychological health and prevalence of AIDS.

Adolescent ; Adult ; Homosexuality, Male ; psychology ; Humans ; Male ; Middle Aged ; Prejudice ; Self Concept ; Sexual Behavior ; Social Control, Informal ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo observe a turning performance in the rats excited by using a proper electrical stimuli of the barrel cortex region (BC), and the expression of choline acetyltransferase (ChAT) in the BC regions after electoral stimulation.

METHODSSD rats were divided into three groups. The stimulation electrodes were surgically implanted into the bilateral BC regions in the control group and the experimental group rats. The experiment group post surgery for seven days was given the electrical impulses via connection with the electrodes for three times each day through consecutive three days. Three groups of the rats were killed and the brains were quickly removed for frozen sections and then performed with conventional HE and immunohistochemistry staining. And protein samples were prepared from brain and the hippocampus tissues of the three groups to detect the level of the ChAT protein by Western blot.

RESULTSThe experimental rats turn left or right when continuously stimulation in the bilateral BC regions with electric pulse. HE staining showed no significant damage around electrodes in the cerebral cortex. Compared with the control and blank groups, the ChAT positive rate in the brain section in the experimental rats was significantly high by immunohistochemistry assay; the level of the ChAT protein in the rats given the electrical stimulation increased.

CONCLUSIONTurnings performance of the rat could be initiated hy electrical stimuli in the BC region. Expression of ChAT is significantly higher in the BC regions of rat under electrical stimulation, suggesting that acetylcholine might be associated with signal transmission between senses and movement behavior in the nervous central system.

Acetylcholine ; metabolism ; Animals ; Cerebral Cortex ; metabolism ; Choline O-Acetyltransferase ; metabolism ; Electric Stimulation ; Rats ; Rats, Sprague-Dawley

The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy.
Adult ; Female ; Fibula ; pathology ; transplantation ; Fractures, Stress ; pathology ; Humans ; Hypertrophy ; Male ; Middle Aged ; Tibia ; surgery ; Tibial Fractures ; surgery

OBJECTIVETo review the diagnosis and treatment of interstitial pregnancy.

METHODSFour cases with complicated interstitial pregnancy were diagnosed and treated from January, 2004 to June, 2007 at the Affiliated Obstetrics and Gynecology Hospital, College of Medicine, Zhejiang University. The clinical data and follow-up records were analyzed retrospectively.

RESULTSAll 4 nulliparous patients were misdiagnosed before operation. The median age was 30 years (25-34 years), and the median duration of amenorrhea was 48 days (37-58 days). The median concentrations of serum beta-hCG were 3245.5 IU/L (282-30729 IU/L). Two patients with interstitial pregnancy had high levels of beta-hCG, and were diagnosed and treated under laparoscopy. Among them one patient was underwent transcervical curettage under laparoscopic guidance,and another underwent laparoscopic salpingotomy. The remained two patients had low levels of beta-hCG, and were diagnosed and treated under hysteroscopy, 50 mg methorexate(MTX)was injected into the implanted sites under hysteroscopic guidance. The levels of serum beta-hCG in 4 patients dropped down quickly, reaching undetected levels at a mean duration of 13 days after operation. Three months postoperatively, ultrasonic examination revealed the normal contour of uterus.

CONCLUSIONSEndoscopic examination is helpful to make a correct diagnosis, and transcervical curettage (or transcatheter chemotherapy) under laparoscopic guidance (or under hysteroscopic guidance) may be a promising approach for young or nulliparous women with interstitial pregnancy who want to maintain future fertility.

Adult ; Chorionic Gonadotropin, beta Subunit, Human ; blood ; Female ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Tubal ; diagnosis ; surgery ; Retrospective Studies