The authors investigated and discussed therapeutic mechanism of small knife needle in treating closed myofascitis on the basis of pathomechanism of modern medicine and acupuncture theory of TCM among numbers of clinical cases and experimental data. Therapeutic mechanism lies in 6 aspects: (1) Relieve the energy crisis of tenderness point on muscular fasciae; (2) Affect nervous system and reduce induction of harmful stimulating signal; (3) Inhibit aseptic inflammatory reaction on muscular fasciae; (4) Regulate dynamic equilibrium of soft tissue by cutting scar and releasing the conglutination; (5) Increase patients' regional threshold of feeling; (6) Reduce tension and pressure of soft tissue of tenderness point so as to relieve extrusion of nervus cutaneous.
Acupuncture Therapy ; instrumentation ; Fasciitis ; therapy ; Humans ; Needles

Objective To prepare the recombinant epitopes of HSV-gB and HSV-gD protein and provides a new antigen protein for the development of herpes simplex virus(HSV)vaccine.Methods The epitopes of HSV-gB and HSV-gD protein were analyzed by epitope prediction software.A novel gene named X which encoded 9 predicted epitopes of HSV-Gb and HSV-gD protein was designed and synthesized using chemical method.X gene was cloned into vector PET-28a(+),expressed in Escherichia cob' BL21(DE3),and analyzed by Western blot.Results X gene was successfully designed and expressed in Escherichia coli BL21(DE3).Western blot analysis showed that recombinant X protein,which was with His marker,can be detected by anti-His antibody.Conclusion In this study we establish a newmethod to express recombinant epitope protein,which may be a new protein for developing vaccine against HSV infection.

Objective To investigate the effect and mechanism of FTY720 in protecting the motor nerve function in rats with acute spinal cord injury (ASCI).Methods A model of ASCI in the rat was established using Allen' s method.The rats were divided into five groups according to random number table:Group A (normal control group,n =6),Group B (sham group,n =27),Group C (ASCI group,n =27),Group D (FTY720 systemic treatment group,n =27) and Group E (FTY720 topical treatment group,n =27).After treatment,each group was observed for the changes of lymphocytes in peripheral blood and topical spinal cord tissue,BBB score,pathological changes of spinal cord tissue and expression intensity of glial fibrillary acidic protein (GFAP).Results After ASCI in rats,the infiltration of local T lymphocyte subpopulations CD3,CD4 and CD8 was promoted,but the number of peripheral blood T lymphocyte subpopulations CD3,CD4 and CD8 was decreased.After FTY720 therapy,both local and peripheral blood lymphocytes were reduced in number and the decrease of peripheral blood lymphocytes in Group E was between Groups C and D.BBB score,pathologic observation and GFAP staining showed a neuroprotective effect of FTY720 and better motor nerve function recovery in Group E than in Groups C and D.Conclusions FTY720 therapy facilitates motor nerve function recovery.Local FTY720 application reduces peripheral blood lymphocytes and lowers the incidence of infection.

We investigated the development of an injectable, biodegradable hydrogel composite of poly(trimethylene carbonate)-F127-poly(trimethylene carbonate)(PTMC11-F127-PTMC11 )loaded with bone morphogenetic protein-2 (BMP-2) derived peptide P24 for ectopic bone formation in vivo and evaluated its release kinetics in vitro. Then we evaluated P24 peptide release kinetics from different concentration of PTMC11-F127-PTMC11 hydrogel in vitro using bicinchoninic acid (BCA)assay. P24/ PTMC11-F127-PTMC11 hydrogel was implanted into each rat's erector muscle of spine and ectopic bone formation of the implanted gel in vivo was detected by hematoxylin and eosin stain (HE). PTMC11-F127-PTMC11 hydrogel with concentration more than 20 percent showed sustained slow release for one month after the initial burst release. Bone trabeculae surround the P24/ PTMC11-F127-PTMC11 hydrogel was shown at the end of six weeks by hematoxylin and eosin stain. These results indicated that encapsulated bone morphogenetic protein (BMP-2) derived peptide P24 remained viable in vivo, thus suggesting the potential of PTMC11-F127-PT- MC11 composite hydrogels as part of a novel strategy for localized delivery of bioactive molecules.
Animals ; Biocompatible Materials ; chemistry ; Bone Morphogenetic Proteins ; pharmacology ; Bone and Bones ; drug effects ; Dioxanes ; chemistry ; Drug Delivery Systems ; Hydrogels ; chemistry ; Osteogenesis ; drug effects ; Peptides ; Prostheses and Implants ; Rats

Objective To evaluate the effect of three diamension-digital subtraction angiography (3D-DSA) or computed tomography angiography (CTA) on the patients with ruptured multiple intmcranial aneurysm (MIA). Methods A retrospective study on 21 patients with MIA was performed.After scanning with 3D-DSA or 3D-CTA, three-dimensional reconstruction of MIA was carried out by 3D workstation,then the diagnosis was decided and the treatment plan (endovascular treatment or microsurgery) was selected according to stereoscopic image of MIA. Results (1) 3D-DSA or CTA was performed in 21 patients with subarachnoid hemorrhage (SAH),it was revealed these patients carried with 48 aneurysms,including 35 small aneurysms (25 mm).Not only miero-aneurysms and small aneurysms could be precisely showed,also the size of aneurysmal neck,the relationship of the aneurysm and the parent vessel and contiguous branches by stereoscopic image.(2) According to the standard of classification,9 patients with MIA for gradeⅠ(42.9%),10 for gradeⅡ(47.6%),2 for gradeⅢ(9.5%),0 for gradeⅣ.Endovascular treatment was selected prior to microsargery for those high grade patients.In this group,17 patients with 40 aneurysms underwent endovascular embolotherapy with GDC coils.Twenty four anemysms were completely occlusioned,12 beyond 90%,4 were left without treatment because of their small size.In microsurgery group,3 aneurysrus were totally clipped,1 could not be found during operation.No any treatment was accepted in 2 patients with 4 aneurysms. Conclusions 3D-DSA or CTA,which is very useful for the diagnosis and treatment of MIA,could improve the accuracy of diagnosis of MIA and clearly show the stereoscopic image of MIA,also the relation of sac and parent artery.For those patients with high grade MIA,endovascular treatment was selected prior to microsurgery,pro re nata,used to combine with mierosurgery.

Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural adhesion.Methods Fifty-three cases of thoracic OLF from January 2003 to December 2009 were reviewed retrospectively.All patients were treated by the methods of en bloc resection of semi-facet and lamina.All patients were followed up for more than half an year,including 32 males and 21 females,aged from 43 to 73 years(average 54.7 years).The lesions located in upper thoracic for 18 patients,and in thoracolumbar for 35 patients.For multi-level or jumping OLF patients,the responsible levels were determined by combination of images and clinical symptoms.For multi-level OLF with ossification of posterior longitudinal ligament(OPLL)or thoracic kyphosis(＞50°),multi-level pedicle screw fixation and correction of kyphosis were performed.For dural adhesion patients,part of cerebrospinal fluid was released with a caudal incision of dural sac resulting in collapse and epidural arachnoid separation.Ossific and adhesion dura mater were removed with integrity of arachnoid.The surgical outcomes were evaluated with preoperative and postoperative thoracic Japanese Orthopaedic Association(JOA)score,Nurick grade and neurologic functional recovery ratio.Results Fifty-three cases were followed up for 6 months to 6 years,with an average of 18 months.The average preoperative JOA score was 4.3±2.3,which significantly increased to 8.3±1.8 after operation.Postoperative neurologic functional recovery rates were 11% to 80%(average 65.8%),including excellent in 18 cases,good in 20,fair in 10,and poor in 5.The excellent or good rate was 71.7%.The mean preoperative Nurick grade was 3.7(2-5 grade)and decreased to 2.3 grade after operation.Conclusion En bloc resection of semi-facet and lamina is a safe and effective method for treatment of thoracic OLF.For the patients with OPLL or kyphosis,pedicle screws fixation and kyphosis correction was beneficial for recovery of neurologic function of thoracic OLF patients.

Objective To analyze the feasibility of Ilizarov apparatus for ankle joint distraction to treat post-traumatic ankle osteoarthritis(OA).Methods From March 2012 to May 2014,15 patients with moderate post-traumatic ankle OA treated with foot and ankle deformities,and combined with ankle distraction surgery simultaneously by Ilizarov apparatus.The average age of patients was (35.6±6.5) years (10 Males and 5 females).Selected cases were involved in unilateral ankle disease,including 9 cases with ankle fractures medical history and 6 cases with ankle sprain medical history.Distraction was carried out for 3 months during which full weight bearing was allowed.Results Joint mobility and radiographic joint space were preserved in all 15 cases.No patients had undergone either ankle arthrodesis or total ankle arthroplasty.Ankle osteoarthritis scale (AOS) score was (33.8 ± 7.95) points before operation,(55.4 ± 5.46) points in the first year follow-up,and increased to (71.4 ± 10.19) points in the second year after operation,medical outcomes study 36-item short-form health survey (SF-36) score was (37.2 ± 4.32) points before operation,and increased to (52.8 ± 3.42) and (59.2 ± 2.95) points at 1 year and 2 years after operation,respectively,the difference between the two groups was statistically significant.The results of ankle range of motion (ROM) indicated function improved which was similar at both 1 year and 2 year's follow-up.Radiology joint space width (JSW) assessment indicated that ankle gap was improved significantly in 11 patients (73.3％,11/15) in the first year and maintain successfully in the second year.For the rest 4 patients (26.7％,4/15),ankle joint gap did not improved significantly,AOS and SF-36 showed clinical symptoms improved.Conclusion Ilizarov apparatus for ankle joint distraction is a promising treatment for moderate post-traumatic ankle OA at early stage of treatment,at least delaying the need for a joint fusion or total ankle arthroplasty.

Objective To prepare P24/PTMC11-F127-PTMC11 hydrogel,to study the in vitro release profile and to observe ectopic bone formation in p24 peptide incorporated PTMC11-F127-PTMC11 hydrogel.Methods Corresponding weight powder of p24 peptide was infunded into tubes of PTMC11-F127-PTMC11 solution with concentrations of 16％,20％ and 25％.Release profiles of P24 peptide in different concentration PTMC11-F127-PTMC11 hydrogel were measured in vitro by BCA assay.P24/PTMC11-F127-PTMC11 hydrogel was implanted into each rat's erector muscle of spine,and the implanted gel was detected by hematoxylin and eosin stain (HE).Results PTMC11-F127-PTMC11 hydrogel showed sustained slow release for the whole process after the initial burst release.With the increase of concentration in PTMC11-F127-PTMC.hydrogel,the initial burst release was reduced significantly.Ectopic bone formation was observed by computed tomography in p24 peptide incorporated PTMC11-F127-PTMC11 hydrogel after four weeks.Bone trabeculae surround the P24/PTMC11-F127-PTMC11 hydrogel was observed at forth week by hematoxylin and eosin stain.The bone trabeculae became thicker from sixth week.Conclusion Delayed release of peptide from the hydrogel was mainly controlled by disintegration of hydrogel and a satisfactory release profile was observed.These results suggest that the p24-loaded PTMC11-F127-PTMC11 hydrogel remmns active of p24 at the implanted site,continuously induce differentiation of osteoblast precursor cells into osteoblasts,and activate osteoblasts to promote ectopic calcification.

Objective To discuss the applicability and application skills of lag screw in condylar intracapsular sagittal fracture and also to observe its therapeutic effect .Methods We conducted surgical reduction and rigid internal fixation to 21 patients with 27 sides of condylar intracapsular sagittal fracture in department of oral and maxillofacial surgery of the first affiliated hospital of chongqing medical university .Fixation of 24 sides were carried out with lag screw and and the rest sides had condylar bone fragment removal surgeries .Imaging data and clinical symptoms of each side were analyzed before and after the treatment .Results After postoperative follow‐ups in average 17 .4 months ,there were no facial paralysis ,salivary fistula and loose screws in 21 patients .Al‐so ,the recoveries of mouth opening degree and occlusal relationship were satisfactory .There were different degrees of temporoman‐dibular joint disturbances syndrome for the 3 patients with just 1 side done with condylar bone fragment removal surgeries and screw internal fixation before .Seven sides of patients had malocclusion and slight bone absorption in image inspection after surgery . However ,the functions were basically normal .Conclusion Lag screw could be used in condylar intracapsular sagittal fracture and the effect in recovery of the height of ramus and the function of joints is exact .

Objective To study the sedative and analgesic effects of different drugs on patients under-going endoscopic variceal ligation( EVL). Methods Sixty patients undergoing selective EVL were randomly assigned to three groups:pethidine group( A),propofol-fentanyl group( B)and dexmedetomidine-fentanyl group(C). Data concerning blood pressure,heart rate,peripheral oxygen saturation,Ramsay score,endo-scopic operation and anesthesia time,surgeons' satisfaction and adverse reactions were recorded. Follow-up was done 24 hours later to confirm the patients' satisfaction and incidence of intraoperative awareness. Results The Ramsay scores of group B(5. 2 ± 0. 3)and C(3. 5 ± 0. 4)were significantly higher than group A (1. 6 ± 0. 4)(P<0. 05). There was no cough,body movement and high blood pressure during the EVL in group B or C,while the incidences of these symptoms in group A(40%,40% and 30%)were obviously higher (P<0. 05). The surgeons'satisfaction of group B(9. 2 ± 0. 3)and C(9. 6 ± 0. 4)were significantly higher than that of group A(5. 0 ± 0. 4)(P<0. 05). The patients' satisfaction scores of group B(9. 6 ± 0. 3)and C (9. 6 ± 0. 4)were also markedly higher than that of group A(5. 4 ± 0. 3)(P<0. 05). There was no difference of operation time among the three groups. The anesthesia time of group A(44 ± 6)was obviously longer than those of group B(35 ± 4)and C(36 ± 5)(P<0. 05). There was no difference in patients'or surgeons'satis-faction,or anesthesia time between group B and C. But the incidences of bradycardia( 40%),hypotension(30%)and hyoxemia(30%)in group B were obviously higher than those of group C(5%,0,0)(P<0. 05). There was no intraoperative awareness in group B or C. Conclusion Both dexmedetomidine and propofol com-bined with fentanyl are superior to pethidine for patients undergoing EVL,while dexmedetomidine provides bet-ter hemodynamics and respiratory conditions compared with propofol.