BACKGROUND: Xingnao kaiqiao acupuncture is a series of systematic acupuncture methods with yin channels in domination, assisted by specified standards of quantity manipulation, which was founded according to the pathogenesis of stroke, and it is effective in treating stroke.OBJECTIVE: To observe the effects of xingnao kaiqiao acupuncture on blood lipids and blood viscosity in stroke patients of different syndrome types.DESIGN: A comparative observation.SETTINGS: Institute of Acupuncture and Moxibustion, and Special Care Ward of Acupuncture, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine.PARTICIPANTS: Totally 750 stroke inpatients (466 males and 284 females) were selected from the Special Care Ward of Acupuncture, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine between January and December in 2001, the average age was (64±12) years,the disease course ranged from 2 hours to 3 years. All the patients were informed and agree with the therapeutic program.METHODS: ① The traditional Chinese medicine (TCM) syndrome differentiations of stroke were in reference to the fifth edition of Traditional Chinese Medicine and Internal Medicine. There were 688 cases of stroke of meridian and collateral type and 47 cases of stroke attacking zang-fu organs type. ② Huatuo filiform needles produced by Suzhou [1.0-1.5 cun in length, 0.32-0.38 mm in diameter (No. 30-28)] were used in the xingnao kaiqiao acupuncture. Firstly, the acupoints of bilateral Neiguan were acupunctured perpendicularly for about 0.5-1.0 cun, the reducing manipulation by twirling as well as lifting and thrusting the needle was performed for 1 minute; Secondly, the needle was inserted at Renzhong towards nasal septum for about 0.3-0.5 cun, the manipulation of heavy bird-peck needling was used till the eyeballs were wet or tears fell down; Then Sanyinjiao was acupunctured, the needle was inserted along the medial border of tibia at an angle of 45° with skin for about 1.0-1.5 cun, the reinforcing manipulation by lifting and thrusting the needle was performed till the ipsilateral lower limb had three tics; The acupoint of Weizhong was selected by lying and lifting the leg, the needle was inserted perpendicularly for 0.5-1.0 cun, and the reducing manipulation by lifting and thrusting was applied till the ipsilateral lower limb had three tics; The acupoint of Jiquan was acupunctured at 1 cun below the source point along the channel in avoidance of axillary hairs, the needle was inserted perpendicularly for 1.0-1.5 cun, and the reducing manipulation by lifting and thrusting was applied till the ipsilateral upper limb had three tics; The elbow was flexed to 120° for acupuncture at Chize, the needle was inserted perpendicularly for 1.0 cun, the reducing manipulation by lifting and thrusting was applied till the ipsilateral upper limb had three tics. Twice a day for 7 days as a course. ③ After four courses averagely, the whole blood viscosities were detected with the hemorrheologic detector, and the normal ranges for lowshear, middle-shear and high-shear of whole blood viscosities were 6.50-9.25, 4.35-5.45 and 3.65-4.40 mpa ·s respectively. The levels of total cholesterol and triglyceride were detected with blood lipid detector, and the normal ranges were 3.38-6.5 mmol/L and 0.56-0.147 mmol/L.MAIN OUTCOME MEASURES: The effects of xingnao kaiqiao acupuncture on the blood lipids and blood viscosity in stroke patients of different syndrome types were observed.RESULTS: Totally 690 and 721 cases finished the detections of whole blood viscosities and blood lipids respectively. There were obviously fewer cases with normal whole blood viscosities in the patients with stroke of meridian and collateral than in those with stroke attacking zang-fu organs (10.3%, 15.4%, P ＜ 0.01), but markedly more cases with higher total cholesterol and triglyceride than in those with stroke attacking zang-fu organs (80.5%, 91.5%; 64.1%, 71.3%; P ＜ 0.01).CONCLUSION: The levels of blood lipids in the patients with stroke of meridian and collateral are more abnormal than in those with stroke attacking zang-fu organs, but their blood viscosities are better than in those with stroke attacking zang-fu organs.

Objective To investigate the effect of irrigation with hypothermic artificial cerebral-spinal fluid (aCSF)on expression of aquaporin-4(AQP-4) in the spinal cord following spinal ischemia-reperfusion (I/R) in rabbits.Methods Fifty-four adult male New Zealand white rabbits weighing 2.0-2.5 kg were randomly divided into 3 groups (n=18 each):group sham operation(S group); group I/R and group irrigation with hypothermic aCSF (FI group). Spinal I/R was induced by clamping the abdominal aorta below renal artery for 60 min. Hypothermic aCSF(25 X.)was infused at L4,5 interspace at a rate of 30 ml/h and drained from L7,8 interspace during spinal ischemia.Neurological function was evaluated at 4, 24, 48 and 72 h of reperfusion and scored (0=no hind limb activity, 4=hind limb function completely recovered) in 6 animals in each group. Six animals were sacrificed at 4, 24 and 72 h respectively in each group.The lumbar segment (L5-8) was removed for measurement of water content and AQP-4 protein expression (by immuno-histochemistry).Results Neurological function scores were significantly lower,water content was higher and AQP-4 expression smaller in group I/R than in group S. I/R-induced effects were significantly attenuated by irrigation of hypothermic aCSF. Conclusion Irrigation with hypothermic aCSF can ameliorate the spinal cord I/R injuries by up-regulation of AQP-4 expression.

Objective To explore the therapeutic effect and application value of the self-made spinal positioning equipment and percutaneous pedicle screw fixation system in the treatment of thoracic and lumbar fracture. Methods To determine the fractured vertebra and pedicle screws entrance point with spinal positioning equipment, 67 patients with thoracic and lumbar fractures were performed percutaneous pedicle screw fixation by using self-made percutaneous pedicle screw fixation system. By contrasting the perioperative indicators, and imaging indicators, to evaluate the therapeutic effect and application value of the system. Results For the spinal positioning equipment, the location time were (15.85±2.45) min and the location accuracy were 95.03%±3.27%. But for the open reduction internal fixation, the location time were (35.46±5.39) min and the location accuracy were 94.02%±2.95%. There was no significant difference in location accuracy, but were significant differences in location time (P＜0.05). Percutaneous pedicle screw fixation had the same effect on three sides with open reduction internal fixation in vertebral height restore,kyphosis deformity and correction and lumbar spinal stenosis's correction. The perioperative indicators of the preoperative and postoperative grope had significant difference (P＜0.05). There were significant differences in all perioperative indicators between the percutaneous pedicle screw fixation and the open reduction internal fixation (P＜0.05). Conclusion The spinal positioning equipment is helpful to determine the fractured vertebra and pedicle screws entrance point accurately and reduce the radiation. The percutaneous pedicle screw fixation system has the advantage of convenient manipulation and accurate implantation. The system can not only reduce surgical damage and post-operation reaction but also make patients recover quickly and face less complications.

Objective To optimize the parameters for the diffusion tensor imaging (DTI)of the ulnar nerve in elbow.Methods 5 groups of DTI sequences with different b values and numbers of diffusion gradient directions (NDGDs)were used to collect ulnar nerve images from 13 volunteers,and then the diffusion tensor tractography (DTT)was established.The fractional anisotropy (FA),apparent diffusion coefficient (ADC),length of ulnar nerve fiber and DTI image quality were compared under different imaging parameters. Results DTI results for 18 normal ulnar nerves were included in the study.Under different imaging conditions,FAs showed no significant differences.With constant NDGDs,increasing b value decreased both image quality and ADCs of the ulnar nerve.NDGDs had no significant effects on ADCs or image quality.When b=1 000 s/mm2 and NDGDs=20,the length of the ulnar nerve fiber was the longest and DTT had the best subjective scoring in image quality.Conclusion b=1 000 s/mm2 and NDGDs=20 is recommended for DTI of elbow ulnar nerve,so as to obtain high image quality and stable observing targets.

OBJECTIVE:To explore the effect of prophylactic use of vitamin B6 with chlorpheniramine on the adverse reactions in fundus fluorescein angiography (FFA). METHODS:326 patients with FFA were randomly divided into observation group and control group. Observation group was orally given Vitamin B6 tablet 10 mg 30 min before angiography+Chlorpheniramine maleate tablet 4 mg;control group was orally given Metoclopramide tablet 10 mg+Chlorpheniramine maleate tablet 4 mg. The occurrence time and incidence of adverse reactions in 2 groups were observed and correlation analysis was conducted. RESULTS:There was no significant difference in the occurrence time of adverse reactions between 2 groups(P>0.05);the incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). The correlation analysis of adverse reactions in control group showed the occurrence of adverse reactions had no correlation with age and gender of patients(P>0.05). CONCLUSIONS:Prophylactic use of vitamin B6 with chlorphenir arnine can reduce the occurrence of adverse reactions in FFA.

Objective To study the influence of mill speed on extract of ultra- fine powder of Bulbus Fritillariae Cirrhosae. Methods The extraction rate of ultra- fine powder of Bulbus Fritillariae Cirrhosae, which passed a 400- mesh screen, was detected and compared with that passed a 100- mesh screen under different mill speeds. At the same time, mathematical models for extraction established with applied hyperbolic function and Weibuer function were compared. Result The extraction rate of the ultra- fine powder was higher than that of the fine powder when the mill speed was over 70 r/min (P 0.05). Applied hyperbolic function was superior to Weibuer function for the simulation of extraction. Conclusion The mill speed has an influence on the extraction of to ultra- fine powder of Bulbus Fritillariae Cirrhosae, indicating that the effect of divergent function on the extraction should be considered.

Objective To establish the quality standard of Fengshi Bitong Capsule.Methods Notopterygh Rhizoma,Angelicae Pubescentis,and Saposhnikoviae Radix were identified by thin layer chromatography(TLC).Aconitine limit test in this drug also carried out by TLC.The contents of Isoimperatorin in the Notopterygh Rhizoma were determined by high performance liquid chromatography(HPLC).Results The spots in the TLC were fairly clear and no interference was shown in the blank samples.The aconitine limited in conformity with the 《Chinese Pharmacopoeia》 2010.Isoimperatorin showed a good linear relationship within a range of 3.668 96-183.448 00 μg· mL-1(r=1).The average of recovery was 96.42%,RSD=2.64%,respectively.Conclusion The established methods are highly specific,stable and reproducible,which can be used as quality control of fengshi bitong capsule.

Objective:To investigate the correlation between body composition and cardiovascular disease (CVD) in patients with chronic kidney disease (CKD).Methods:CKD patients who were hospitalized in the Department of Nephrology of Chongqing General Hospital from January 2017 to December 2019 and had complete clinical biochemical data were divided into CKD patients with CVD and CKD patients without CVD according to their medical history and corresponding auxiliary examinations. Clinical data were collected and anthropometric measurements were conducted. Skeletal muscle index (SMI), appendage lean mass/height 2, total body fat (TBF), visceral adipose tissue (VAT), bone mineral capacity, bone mineral density and et al, were measured by dual-energy X-ray absorptiometry. T test, U test and Chi-square test were used for statistical analysis. Logistic regression was used to analyze the relationship between body composition and CVD. Results:A total of 604 CKD patients were included in this study, including 560 patients (92.7%) with CKD stage 3, 44 patients (7.3%) with CKD stage 4, and 180 CKD patients with CVD (29.8%), 424 CKD patients without CVD (70.2%). Compared with CKD patients without CVD, the proportion of men, the proportion of hypertension, the proportion of diabetes, age, duration of CKD, systolic blood pressure, blood uric acid, waist to hip ratio and waist circumference were higher (all P<0.05), while low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and estimated glomerular filtration rate (eGFR) were lower in CKD patients with CVD (all P<0.05). In terms of body composition, SMI ( t=-11.964, P<0.001) and body mass index ( t=-4.462, P<0.001) in CKD patients with CVD were significantly lower than those in CKD patients without CVD, but VAT ( t=3.089, P=0.002) and TBF ( t=5.177, P<0.001) in CKD patients with CVD were significantly higher. After adjusting for confounders such as age, CKD duration, hypertension history, diabetes history, LDL-C, body mass index, eGFR, TBF, etc. by multivariate logistic regression analysis, the risk of CKD patients suffering from CVD increased significantly with the decrease of SMI [with SMI high tertile (36.37%-50.80%) as reference, SMI middle tertile (28.23%-36.31%): OR=1.49, 95% CI 1.24-1.71, P=0.003; SMI low tertile (15.28%-28.19%): OR=2.17, 95% CI 1.79-2.62, P<0.001], and VAT was not found to be associated with the risk of CVD in CKD patients ( P>0.05). Conclusion:Reduction of SMI is independently associated with CVD in CKD patients.

Objective To investigate the removal effect of immunoadsorption (IA) on associated antibodies and the efficacy in late-onset myasthenia gravis (MG). Methods A total of 25 late-onset MG patients were randomly selected to enroll in this study. IA therapy was given to 10 patients (IA group), while immunoglobin (0.4 g·kg-1·d-1) was administrated to the other 15 patients for 5 days(Ig group). The titers of Titin antibody (Titin-ab), acetylcholine receptor antibody (AchR-ab) and presynaptic membrane antibody (PrsmR-ab) were detected before and after the treatment. Quantitive MG (QMG) score was assessed before and immediately after the entire course of treatment. The clinical efficacy, the duration of respiratory support and in-hospital were compared between two groups. The correlation between three antibodies and QMG score was also analyzed. Results Compared with that before treatment, the Titin-ab PIN values, the AchR-ab PIN values, and the PrsmR-ab P/N values of IA group were all decreased significantly after treatment (P<0.05, respectively). The P/N value of Titin-ab in IA group was decreased by 54.7%～3.5%, which was significantly higher than that in Ig group(19.9%±3.1%) (P<0.01). QMG score reduced by 42.4%± 4.2% and 23.8%±3.7% in IA group and Ig group respectively (P<0.01, respectively). Symptoms were effectively ameliorated by both treatments, but the effective power of IA group was higher than that of Ig group (70% vs 40%, P<0.05). Remission time of IA group was significantly shorter than that of Ig group [(5.38±0.42) d vs (8.4±1.54) d, P=0.008), so was the duration of in-hospital [(13.50±0.50) d vs (16.50±0.50) d, P<0.05). The number of respiratory support in IA group was less than that in Ig group (1/10 vs 6/15, P<0.05). By the Pearson correlation analysis, the decrease of Titin-ab showed a better longitudinal correlation with the decrease of QMG score than the other two antibodies (r=0.6315, P<0.01). Conclusion IA can rapidly and effectively clear the pathogenic antibodies of late-onset MG patients and its short-term clinical efficacy is better than immunoglobin.

Objective To explore the clinical application and follow-up results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating proximal humeral fractures. Methods From December 2006 to September 2008, MIPPO using locking plate was employed to treat 36 patients (23 males and 13 females) with proximal humeral fracture. According to AO classification, there were four patients with type A2 fractures, 10 with type A3 fractures, five with type B1 fractures, 11 with type B2 fractures, three with type C1 fractures and three with type C2 fractures. Longitudinal or transverse incision was made through anterolateral acromial approach to separate the deltoid muscle and expose the fracture fragments. The direct and indirect reduction of the fractures were performed under direct vision. The locking plate was inserted distally beneath the deltoid muscle and a longitudinal incision was made at the lateral end of the plate. Locking screws were inserted to the proximal and distal plates. Postoperative follow-up was done to provide guidance to functional exercise and evaluate the clinical results. Results The operation lasted for (50.1±11.3) minutes, with intra-operative blood loss of(76±18.7) ml and average operative incision of (4.5±0.8) cm. All the patients were followed up for 12-17 months (average 14 months), which showed that the time of bone healing was (10. 1 ±1.2) weeks. Neer scoring standards showed the total excellence rate of 86%. Conclusion MIPPO is an ideal method for treatment of proximal humeral fractures, for it has the advantages such as safety, minor trauma, short bone healing time, alleviation of pain and good X-ray reduction.