Objective To observe the intervention efficacy of Tiao Ren Tong Du (regulating the Conception Vessel and unblocking the Governor Vessel) needling in treating perimenopausal insomnia and its effect in improving the symptoms, for providing theoretical evidence for the treatment of perimenopausal insomnia. Method A total of 72 female perimenopausal insomnia patients were randomized into a treatment group (36 cases) and a control group (36 cases). The treatment group was intervened by Tiao Ren Tong Du needling at Baihui (GV20), Shenting (GV24), Yintang (EX-HN3), Zhongwan (CV12), Qihai (CV6), Guanyuan (CV4), Neiguan (PC6), Shenmen (HT7), Sanyinjiao (SP6), and Zusanli (ST36) after standard sterilization, with lifting and thrusting manipulations until needling sensation was obtained. The treatment was given three times a week, successively for 4 weeks. The control group was intervened by conventional public education, without treatment. The Pittsburgh Sleep Quality Index (PSQI) and Kupperman Menopausal Index (MI) were scored before and after the treatment to evaluate the therapeutic efficacy. Result Thirty-three cases in the treatment group finished the treatment and 3 dropped out; while 32 cases in the control group finished the treatment and 4 cases dropped out, and the drop-out rate was 9.7%. The total effective rate was 87.9% in the treatment group versus 40.6% in the control group, and there was a significant difference in comparing the clinical efficacy between the two groups (P<0.01). After the treatment, PSQI and MI sores were significantly changed in thetreatment group (P<0.01,P<0.05). There were no significant changes in PSQI and MI scores in the control group after the treatment (P>0.05). There were significant differences in PSQI and MI scores between the two groups after the treatment (P<0.01,P<0.05). Conclusion Tiao Ren Tong Du needling is effective in treating perimenopausal insomnia, and it can improve perimenopausal syndrome and significantly enhance the patients' quality of life.

Competition in the medical market in future will be the competition of core competence. Confronted with the increasing integration of the domestic and foreign medical markets, hospitals in our country will have no other strategic alternative but to devote major efforts to enhancing their core competence. After defining the concept of core competence of hospitals, the authors make an analysis of the features and elements of core competence of hospitals and put forward measures for enhancing the core competence of hospitals.

Objective To explore the effect of rehabilitation on pneumonia in children with cerebral palsy (CP).Methods60 CP children with pneumonia were randomly divided into the control group and rehabilitation group with 30 cases in each group. All children in two groups received active support therapy but those in the rehabilitation group were added with rehabilitation treatment.ResultsThe time of body temperature decline, alleviation of cough and expectoration, role disappear of the rehabilitation group were shortened compared with that of the control group ( P<0.05).ConclusionRehabilitation treatment is helpful for treatment of pneumonia in CP children.

Objective To compare the reproducibility and reliability of facial soft tissue landmarks using a direct and an indirect placement methods in facial three-dimensional (3D) soft tissue assessment.Methods 3D coordinates of 37 soft tissue landmarks were obtained respectively in 35 normal healthy volunteers from 3D optical capture system and Materialise's interactive medical image control system (Mimics).Landmarks were affixed on the cutaneous surface (direct method) and marked on the 3D reconstructed craniofacial model (indirect method).Intra-class correlation coefficients (ICCs) and paired t-tests were used to compare the reliability and reproducibility of facial landmarks between two placement methods.Results For the direct placement method,86.5 ％ landmarks had an ICC higher than 0.75.For the indirect placement method,75.7％ landmarks had an ICC higher than 0.75.The inter-observer variability using the direct placement method was (1.259±0.566) mm,which was significantly smaller (P＜0.05) than (1.420±0.638) mm obtained by the indirect placement method.Conclusions Compared with indirect method,direct method has higher reliability and reproducibility in evaluating facial soft tissue.

Objective:To study the effect of continuous blood purification on inflammatory state and immune response in patients with multiple injury and sepsis.Methods:88 patients with multiple injury and sepsis who were treated in our hospital from January 2015 to May 2016 were selected as the research object,they were divided into the control group (n=44) and observation group (n=44) according to random number table method.The control group was given conventional treatment,and the observation group was given continuous blood purification treatment.The acute physiology and chronic health conditions Ⅱ (APACHE Ⅱ)score was observed in two groups Ⅱ at 3 d after treatment.The serum content of Interleukin-2(IL-2),Interleukin-4(IL-4),Interleukin-10(IL-10) and interferon-γ (IFN-γ) were detected by ELISA method.The levels of CD3 +,CD4 +,CD8 + and NK cell were analyzed by flow cytometry.The urea nitrogen (BUN),serum creatinine (Scr),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time (APTT) were tested by automatic biochemical analyzer.Results:The APACHE Ⅱ score,BUN and Scr levels in observation group were lower than the control group (P＜0.05).The content ofIL-2,IL-4,IL-10 and IFN-γ in observation group were lower than the control group (P＜0.05).The levels of CD3+,CD4+,CD8+ and NK in observation group were higher than the control group (P＜0.05).The levels ofPT,TT and APTT in observation group were lower than the control group (P＜0.05).Conclusion:Continuous blood purification in patients with multiple injury and sepsis had better clinical curative effect,can reduce inflammation,improve immune function and the function of blood coagulation.

Objective To evaluate the feasibility and safety of endoscopic thyroidectomy via anterior chest and breast for the treatment of patients with papillary thyroid carcinoma ( PTC ).Methods Endoscopic thyroidectomy was performed in 85 PTC patients between March 2006 and March 2010. Diagnosis was based on intraoprative frozen section. There were 83 females and 2 males, age averaged at 36. 3 years. Sixty three of 85 cases were diagnosed preoperatively as thyroid carcinoma and US revealed ipsilateral cervical lymph node enlargement suspective of metastasis in 12 cases. Endoscopic thyroidectomy plus selective neck dissection was performed. Results This procedure was carried out successfully in 84patients. There were 51 cases of papillary thyroid microcarcinomas(<1. 0 cm) , 28 cases between 1. 0 cm and<2. 0 cm, and 5 cases with the diameter between 2. 0 cm and 3. 0 cm. Total thyroidectomy, ispilateral lebectomy and ispilateral lebectomy plus contralateral subtotal lobetomy were performed in 4, 6, 74 cases,respectively. Central compartment dissection was performed in all of the 84 cases and ipsilateral neck dissection was also performed in 12 cases that were suspected metastatic lateral neck lymph nodes. The mean operative time was (113. 3 ±46. 5) minutes. No significant blood loss occurred. The mean number of lymph nodes yield in the central compartment and lateral compartment were 6. 5 (range 2 to 14) and 19. 2 (range 9 to 26 ), respectively. Forty-four cases ( 44/84, 52. 4% ) had metastatic lymph nodes in central compartment, while 11 cases (11/12,91.1% ) in lateral compartment. Six patients (6/84,7.14%) had transient vocal cord palsy and recovered after 1-2 months. Postoperative transient hypocalcaemia occurred in 4 cases (4. 8% ) , and there were no other major complications. The average postoperative hospital stay was 3. 7 days (range 3 to 6). No evidence of residual or recurrent disease was found at follow-up. The cosmetic results of this procedure were excellent. Conclusions The anterior chest and breast approach of endoscopic thyroidectomy is feasible and safe and cosmetic worthwhile for selected cases of PTC.

Dental Implantation, Endosseous ; methods ; Dental Implants ; Dental Restoration Failure ; Denture, Complete, Immediate ; Humans ; Jaw, Edentulous ; surgery

Objective:The abstraction of characteristics in CT perfusion image is crucial in the clinical diagnosis of brain infarction and cerebral tumor.Methods:After describing the relevant parameters of CT cerebral perfusion imaging,such as cerebral blood flow (CBF),cerebral blood volume (CBV),the mean transition time (MTT) and the permeability surface (PS).With using Visual C ++ programming and CT scan images sequence obtained,the time-density curves of the brain tumor region were visualized.The more accurate hemodynamic parameters were calculated through an improved algorithm basing on the deconvolution and measuring method of the length,angle,area and other parameters.Conclusion:The quantitative analysis of feature parameter is of great benefit to clinical doctor in making timely diagnosis and treatment of brain tumor.

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