Fifteen morphologically and structurally complete sacrum specimens of normotrophic adult females were choosen. Distances between posterior sacral foramina and median sacral crest,and between the cores of adjacent posterior sacral foramina were measured. Then statistical analysis was done so as to provide objective anatomical evidence for the surface localization of Baliao points. The average distance between Shangliao (BL 31) and median sacral crest was (2.08 ± 0.19) cm; and the average distance between Ciliao (BL 32) and median sacral crest was (1.75 ± 0.12) cm; Zhongliao (BL 33), (1.59 ± 0.15) cm; Xialiao (BL 34), (1.56 ± 0.15) cm. And the distance of S₁-S₂ was (2.36 ± 0.31) cm averagely; S₂-S₃, (1.98 ± 0.23) cm; S₃-S₄, (1.71 ± 0.18) cm. It is considered that to locate Baliao points, Ciliao (BL 32) needs to be ascertained firstly.
Acupuncture Points ; Adult ; Female ; Humans ; Meridians ; Sacrum ; anatomy & histology

Objective To explore the rule of etiopathogenisis disposition and tendency.Methods Bronchoscopic test was performed in these 899 patients.The differences among different periods,age groups and smoking status groups were compared.Results In recent 15 years,the ratio of old patients raised obviously.The causes were unspecialized inflammation(76.6%),tumor(12.9%),and tuberculosis(8.2%).Unspecialized inflammation cause was significantly more in young group than middle age group and old age group(P400 cigarette-years group than non-smoker group(P400 cigarette-years,should be alert for tumor,and take bronchoscopic test timely.Young patients should pay more attention to tuberculosis cause.

Objective To study the effects of decoy strategy targeted to NF-?B on IL-6 in rat's liver after traumatic inflammatin. Methods Ninty six Wistar rats were randomly divided into 4 groups: control group,traumatic inflammation group, decoy ODN group, and mutant decoy ODN group. Rats were killed on 3 , 6, 12, 24, 48 , and 72 h respectively, for the determination of plasma ALT. Hepatocytes were isolated and nuclear protein was extracted, DNA binding activity of NF-?B was measured by EMSA. Decoy ODN's competition inhibition effect was assayed by EMSA. IL-6 gene expression in liver tissue was assessed by RT-PCR and IL-6 protein level was determined by ELISA. Results After traumatic inflammation, DNA binding activity of NF-?B in the liver increased. IL-6 mRNA and protein level also significantly increased and was in positive correlation with the activity of NF-?B. Decoy ODN effectively inhibited the activity of NF-?B ex vivo. After using decoy ODN, IL-6 mRNA and protein levels of liver tissue significantly decreased, plasma ALT levels were also significantly decreased. Conclusions Decoy strategy targeted to NF-?B could effectively inhibit rat's liver IL-6 release by inhibiting specifically the activity of NF-?B.

Objective To explore the risk factors of multiple organ dysfunction syndrome (MODS) in severe trauma patients, put forward a new warning scoring system of MODS, and to provide a more accurate scoring method for doctors to judge the clinical condition and prognosis of patients. Methods Clinical data of 342 patients with severe trauma admitted to intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical College and Daping Hospital of the Third Military Medical University from January 1st, 2015 to December 31st, 2016 were retrospectively analyzed. The patients were divided into MODS groups (n = 251) and non-MODS group (n = 91) according to clinical outcomes. The clinical data of patients, including gender, age, heart rate (HR) and blood pressure within 24 hours after admission to the hospital, indicators of blood routine and blood biochemistry, severity of disease, severity of trauma, whether received the emergency intubation or surgery within 24 hours or not, whether developed sepsis or acute respiratory distress syndrome (ARDS) during hospitalization, were recorded, and univariate analysis was conducted. The indicators with statistical significance found by univariate analysis were enrolled in multivariate Logistic regression analysis, and the risk factors for MODS in patients with severe trauma were screened and assigned, and the final total score was MODS warning score. Receiver operating characteristic (ROC) curve was plotted to evaluate MODS warning score for predicting the occurrence of MODS in patients with severe trauma. Results Compared with non-MODS group, HR, Na+, serum creatinine (SCr), activated partial thromboplastin time (APTT), injury severity score (ISS), new injury severity score (NISS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and sequential organ failure assessment (SOFA) score in MODS group were significantly increased, pH value, red blood cell (RBC), platelet (PLT), albumin (Alb) and Glasgow coma score (GCS) were remarkably decreased, and multiple injury, the patients with shock at admission, blood transfusion, central venous catheter, emergency intubation and infection were also increased, and more patients suffered from sepsis and ARDS. Multivariate Logistic regression analysis showed that the number of injured places equal or more than 2, shock at admission, APACHEⅡ score ≥ 15, SOFA score ≥ 4 and APTT > 40 s were risk factors for MODS in patients with severe trauma, with total MODS warning score of 7.5. ROC curve analysis showed that the area under ROC curve (AUC) of MODS warning score for predicting MODS in patients with severe trauma was 0.822, which was significantly higher than that of APACHEⅡ score (AUC = 0.698, P < 0.001), APTT (AUC = 0.693, P < 0.001) and SOFA score (AUC = 0.770, P = 0.025). When the cut-off value of MODS warning score was 2.5, the sensitivity was 61.35%, the specificity was 90.11%, and Youden index was 0.515. Conclusions MODS warning score is composed of five factors, including the number of injured places, shock at admission, APACHEⅡ score, SOFA score and APTT, which could be regarded as early warning score system for predicting MODS in patients with severe trauma. MODS warning score can be more comprehensive and timely to assess the possibility of MODS and prognosis of patients with severe trauma, and the prediction result is better than the single use of APTT, APACHEⅡ or SOFA score.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

OBJECTIVETo evaluate the feasibility, reliability and accuracy of the automated magnetic resonance spectroscopy ((1)H-MRS) guided frameless brain biopsy with intraoperative magnetic resonance imaging (iMRI).

METHODSBetween July 2011 and July 2013, a consecutive series of 93 patients were prospectively enrolled. All the patients had intracranial lesions which need biopsy to confirm the diagnosis. Among them, 48 patients were male, 45 patients were female. Their age range from 7 years to 76 years, the median age was 47 years. All patients underwent MRS examination. With MRS automatic fusion technique, the metabolic images were integrated into a standard navigation system (Vario Guide) to guide frameless biopsy. High-field iMRI (1.5 T) was used for target inspection, brain shift correction, and intra-operative exclusion of intra-cerebral hemorrhage and other complications.

RESULTSFor all the 93 patients, (1)H-MRS based metabolic images could be automatically integrated into a standard navigation system and average fusion procedure could be taken 5 minutes 6 seconds. For (1)H-MRS guided stereotactic biopsy of intracranial lesions, the diagnosis yield rate was 94.6% (88/93). Four cases did not get a clear pathological diagnosis, while 1 case did not match the pathological diagnosis result which obtained by following craniotomy. Technical related complication rate was 2.2% (2 cases, intra-cerebral hemorrhage), which were intra-operatively depicted with iMRI, and managed properly. Among them, 1 case with small volume (5 ml) intracerebral hematoma fully recovered 10 days after surgery without second surgical intervention. One case with large volume intracerebral hematoma (32 ml) was depicted with iMRI, followed by craniotomy and hematoma evacuation in the same session. This case had no new or worsened neurologic deficit post-operatively.

CONCLUSIONS(1)H-MRS based metabolic imaging can be automatically integrated into a standard navigation system and used for frameless brain biopsy. The target can be selected according to the metabolic status of the lesion. Hence, the target can be more accurate. And the pathological diagnosis yield rate is higher. With iMRI, the method is safe, and has high clinical efficacy.

Adolescent ; Adult ; Aged ; Biopsy ; methods ; Brain ; pathology ; Brain Neoplasms ; pathology ; Child ; Female ; Humans ; Male ; Middle Aged ; Neuronavigation ; methods ; Prospective Studies ; Proton Magnetic Resonance Spectroscopy ; Stereotaxic Techniques ; Young Adult