[Objective]To improve the teaching quality ofMeridians and Acupoints. [Methods]Based on the ten-year experience of teaching the course ofMeridians and Acupoints, the authors suggest three issues on how to study well with this subject. [Results] The first, using the comparing method to remember meridians and acupoints, always do analysis and summary are all important ways to learn the basic knowledge.The second, understanding the property of acupoints, make prescription of acupoints like the way of making Chinese herbal formula according to syndrome differentiation, can cultivate students' dialectical thinking and improve the ability of diagnosis and treatment in acupuncture clinic.The third, introducing the origin,history and development of each meridian and some special acupoints. [Conclusion]The above three suggestions can help students to learn better about the science of acupuncture,and improve their professional thinking, and mine the potential ability of innovation.

Objective To compare the different ways of alkaline mouthwash slobber use in preventing the oral infection in patients with fever. Methods The patients who satisfied the requirements were involved and randomly divided into A, B and C group. A group did not use alkaline mouthwash; B group prescribed alkaline mouthwash slobber following the doctor's advice; C group received propaganda and demonstration of intensive use of the alkaline mouthwash, and then used the slobber in right way under the surveillance of nurses. The infection rates of oral ulcer and oral leukoplakia were compared and analyzed among the three groups. Results The incidence rates of oral ulcer and oral leukoplakia gradually decreased among the three groups and the differences had statistical significance (χ2=9.243,P=0.010;χ2=6.495,P=0.033).Compared with A group, there was no significant differences in the rates of oral ulcers and oral leukoplakia between Group A and B(OR=0.486, 95%CI:0.113-2.087;OR=0.557, 95%CI: 0.120-2.583), but the incidence rates of oral ulcers and oral leukoplakia gradually decreased(OR=0.024, 95%CI:0.002-0.293;OR=0.036, 95%CI:0.003-0.448)in C group. Conclusions Strengthening use of alkaline mouthwash slobber is more effective in preventing oral infection in patients with fever compared with the routine way of mouthwash use.

Objective To investigate the potential factors which have impact on the working space for surgeons in gasless laparoscopic cholecystectomy and to probe into the specifications of gasless surgeries.Methods Clinical data of 49 cases of gasless laparoscopic cholecystectomy between March 2007 and July 2010 were summarized.The impacts of body mass index,bowel preparation and means of anesthesia on operation time and conversion to laparotomy were analyzed.Results For patients with body mass index ≤25and ＞ 25,operation times were (43.0 ± 5.4) min,and (52.8 ± 7.4 ) min,respectively,and rates of conversion to laparotomy were 0/34 and 4/15,respectively.Both indices in the first group were higher.For patients with and without bowel preparation,operation times were (44.5 ± 5.4) min and (46.1 ± 8.0)min,respectively,and rates of conversion to laparotomy were 2/26 and 2/23,respectively.For patients with epidural anesthesia and lumbar/epidural anesthesia,operation times were (46.5 ± 7.9) min and (44.1 ±6.8) min,respectively,and rates of conversion to laparotomy were 2/24 and 2/25,respectively.Conclusions The operation time of gasless laparoscopic cholecystectomy could be affected by many factors,such as body mass index.Gasless operations can be improved by evaluating the conditions of patients correctly and by selecting suitable operation methods,anesthesia means and bowel preparation.

To investigate the effects of particle size, mPEG molecular weight, coating density and zeta potential of monomethoxyl poly(ethylene glycol)-poly(lactic-co-glycolic acid) (mPEG-PLGA) nanoparticles on their transportation across the rat nasal mucosa, mPEG-PLGA-NPs with different mPEG molecular weights (M(r) 1 000, 2 000) and coating density (0, 5%, 10%, 15%) and chitosan coated PLGA-NP, which loaded coumarin-6 as fluorescent marker, were prepared with the nanoprecipitation method and emulsion-solvent evaporation method, and determine their particle size, zeta potential, the efficiency of fluorescent labeling, in vitro leakage rate and the stability with the lysozyme were determined. The effects of physical and chemical properties on the transmucosal transport of the fluorescent nanoparticles were investigated by confocal laser scanning microscopy (CLSM). The result showed that the size of nanoparticles prepared with nanoprecipitation method varied between 120 and 200 nm; the size of nanoparticles prepared with emulsion-solvent evaporation method varied between 420 and 450 nm. Nanoparticles dispersed uniformly; the zeta potential of PLGA-NPs was negative; mPEG-PLGA-NPs was close to neutral; chitosan coated PLGA-NPs was positive; and the efficiency of fluorescent labeling were higher than 80%. In vitro leak was less than 5% within 4 h and nanoparticles were basically stable with lysozyme. The CLSM results show that the transportation efficiency of mPEG-PLGA-NPs with a high PEG coating density and high mPEG molecular weight was significantly higher than that of uncoated PLGA nanoparticles and also that of chitosan coated PLGA-NPs (P < 0.05). The hydrophilcity, zeta potential and particle size of nanoparticles play important roles on the efficiency of mPEG-PLGA nanoparticles to transport across the rat nasal mucosa.

Objective To evaluate the value of PLR-△SVV for the septic shock patients with autonomous breathing. Methods 60 patients were included in the study. Hemodynamic data of PICCO were collected before and after treatment. After rehydration, the group (△SV≥10%) was defined volume responder group, and then the predictive value of PLR-△SVV was analyzed. Results Compared with the nonresponders group, PLR-△SVV was increased significantly in response group[(10 ± 4)mL vs (14 ± 6)mL,P<0.05]. The ROC curve for PLR-△SVV were 0.881, and the sensitivity was 85.7%, the specificity was 92.0%. Conclusion PLR-△SVV can be used to predict fluid responsiveness for septic shock patients with spontaneously breathing.

Objective To evaluate the clinical efficacy and safety of a fractional bipolar radiofrequency device for the treatment of wrinkles of the face and neck.Methods This study enrolled 39 volunteers (including 37 females and 2 males aged 35-60 years) with Fitzpatrick skin type Ⅳ-Ⅴ and Fitzpatrick wrinkle scale score of 4-6.All the subjects received three sessions of treatment with a fractional bipolar radiofrequency device at intervals of 4-6 weeks.Follow-up visits were scheduled at one month after each treatment session for evaluation of efficacy (using standardized photography),subjective satisfaction and adverse effects.Results After three sessions of treatment,all the subjects experienced a significant decrease in Fitzpatrick wrinkle scale compared with baseline values,and wrinkle improvement score increased with the increase in treatment sessions.The Fitzpatrick wrinkle scale score for forehead wrinkles,glabella wrinkles,fishtail lines and neck wrinkles in these subjects after three sessions of treatment significandy differed from that before treatment (all P ＜ 0.01).Significant differences were also observed in the wrinkle improvement score for forehead wrinkles between these subjects after two sessions and one session of treatment (P ＜ 0.01),and observed in that for glabella wrinkles,fishtail lines and neck wrinkles between these subjects after three sessions and one session of treatment (P ＜ 0.05 or 0.01).Side effects were mild with no significant downtime.Conclusion Fractional bipolar radiofrequency may be a safe and effective option for the treatment of wrinkles of the face and neck in individuals with Fitzpatrick skin type Ⅳ-Ⅴ.

Objective To observe the clinical efficacy of abdominal acupuncture in treating perimenopausal insomnia.Method Sixty patients with perimenopausal insomnia were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by abdominal acupuncture, while the control group was by regular body acupuncture. The FSH, LH, and E2 contents, and Pittsburgh Sleeping Quality Indext (PSQI) were observed before and after intervention, and the clinical efficacies were compared.Result The total effective rate was 90.0% in the treatment group versus 86.7% in the control group, and the difference was statistically insignificant (P>0.05). The PSQI score was changed significantly in both groups after intervention (P<0.01). After intervention, there was no significant difference in comparing PSQI score between the two groups (P>0.05). The FSH, LH, and E2 contents were significantly changed after intervention in both groups (P<0.01). After intervention, there were no significant differences in comparing FSH, LH, and E2 contents between the two groups (P>0.05).Conclusion Abdominal acupuncture in an effective method in treating perimenopausal insomnia.

Objective To explore the clinical features and gene mutations of blepharophimosis-ptosis-intellectual-disability syndrome (BPID). Methods The clinical data, diagnosis and treatment of a child with BPID in neonatal intensive care unit (NICU) were reviewed. Based on the literature retrieved from PubMed database, the common classification, clinical features, diagnosis and genetic counseling of BPID and its affiliated blepharophimosis-mental retardation syndromes (BMR) were reviewed. Results This male infant was 39 weeks of gestational age with birth weight of 1920 g, and was admitted to NICU 15 min after birth due to dyspnea. The main clinical manifestations were facial deformity such as biepharophimosis, ptosis and micromandible, inspiratory dyspnea with laryngeal cartilage softening, malformations of the thorax and feeding difficulties. A heterozygous mutation in UBE3B gene was identified by complete exon sequencing and he was diagnosed of BPID, a rare genetic disorder. Reviewing the literature, there was no relevant report in domestic. While one foreign literature was found to report 5 patients from 4 families having a subtype of BMR, a kind of autosomal recessive diseases caused by mutations in the UBE3B gene. Conclusion BPID is a rare clinical entity of BMR. Complete exon sequencing can be used to diagnose the disease.

The purpose of this study is to evaluate the interaction effects of In-Chen-How (Artemisia capillaries Thunb.) on the pharmacokinetics of acetaminophen and on liver microsomal cytochrome P450 enzyme activity in rats. The rats were divided into control group (n=8) without In-Chen-How and the pretreated group (n=8) administered with In-Chen-How (approximately 1.0 mL·kg-1, according to weight) for 5 consecutive days. Rats in the control group received water simultaneously. Each rat was then given acetaminophen. The pharmacokinetic parameters of acetaminophen of the two groups were significantly different. In the In-Chen-How pretreated group, the maximum concentration of acetaminophen and the area under the plasma concentration-time curve were reduced about 58.4%, 56.7% and 55.4%. To further explain the results, liver microsomal suspensions were obtained from rats that were randomly divided into control and In-Chen-How pretreated group. The levels of CYP1A2 and CYP2E1 in hepatic microsomal protein from pretreated group were increased as compared to that from the control group. It indicated that In-Chen-How can stimulate the activity of CYP isozymes. The changes in the pharmacokinetics of acetaminophen resulting from the administration of In-Chen-How are related to an increase in metabolic activity of CYP1A2 and CYP2E1.

Objective To explore the effect of PDCA circulation on the effective utilization of the disposable articles in the operating room.Methods 9,362 aseptic articles for 446 operations in the departments of general surgery and hepatobiliary surgery during January to May 2012 were put in the pre-experiment group,in which PDCA circulation was not used.Another 11,973 articles for 501 operations in the same departments during June to November 2012 were set as the post-experiment group,in which PDCA circulation was used.The two groups were compared in terms of the effective utilization rate and the degree of doctor’s satisfaction with the nurses in the operation room.Result After the implementation of PDCA circulation,the effective utilization rate and the degree of doctor’s satisfaction were both significantly higher than before the implementation(both P<0.05).Conclusion PDCA circulation for the management of sterile disposable articles in the operation room may effectively improve the utilization rate of disposable articles, reduce wasting of articles and safe resources.