Taking the basic theory of Chinese medicine as the instruction, through the bidirectional features of clinical manifestations, the relative etiology and pathology, acupoints and treatments, the bifunctional law in acupuncture theory is discussed. And it is held that after the confirmation of bidirectional symptoms of some diseases or syndromes, acupoints which have special functions in the bifunctional theory of acupuncture with a narrow meaning can be taken as major acupoints. And at the same time, other proper acupoints and flexible treating methods can be selected under the instruction of the bifunctional law of the broad meaning, so as to get the best therapeutic effect.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Medicine in Literature ; Meridians

OBJECTIVE:To observe therapeutic efficacy and safety of tripterygium glycosides combined with valsartan in the treatment of idiopathic membranous nephropathy(IMN). METHODS:A total of 85 patients with IMN were enrolled and randomly divided into observation group(42 cases)and control group(43 cases). Based on routine treatment(reducing lipid,anti-platelet ag-gregation,protein dietary restriction),control group was additionally given oral valsartan,with initial dose of 80 mg/d,and gradu-ally adding the amount to 160 mg/d if there was no obvious ADR;based on control group,observation group was additionally giv-en Tripterygium glycosides tablet 40 mg,tid,and reducing the amount to 20 mg,tid after complete remission. 2 groups were treat-ed for 12 months. RESULTS:Total effective rate of observation group was 92.86%,which was significantly higher than that of con-trol group(74.42%),with statistical significance(P<0.05). Compared with before treatment,the levels of 24 h urine protein,TC and TG of 2 groups were decreased after treatment,and serum albumin(ALB)of observation group increased;24 h urine protein and TG of observation group was lower than control group,while the serum level of ALB was higher than control group,with sta-tistical significance(P<0.05 or P<0.01). No obvious ADR was found in 2 groups. CONCLUSIONS:Tripterygium glycosides com-bined with valsartan can improve the kidney function and blood lipid level of IMN patients with high safety.

Objective To investigate the clinical value of bone scintigraphy for the diagnosis of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Methods The characteristics of SAPHO syndrome on 99Tcm-MDP imaging of 8 cases were retrospectively analyzed. Results The 99TcmMDP bone scan was positive for all patients. Seven cases were found lesions in the costoclavicular region, 3cases involved with unilateral sacroiliac joint, 2 cases involved with spine and 1 patient with extremity. Four lesions were found without relevant clinical symptoms. Conclusion Bone scintigraphy is useful for the diagnosis of SAPHO syndrome, especially for those lesions with no clinical symptoms.

AIM: The aim of the present study is to investigate changes of five biochemical markers of bone turnover during the formation of ovariectomized rat model. METHODS: Three-month-old female SD rats were divided randomly into ovariectomized (OVX) group, sham-operated (sham) group and control group. Five biochemical markers of bone turnover levels, including serum osteocalcin (OC), total alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), tartrate-resistant acid phosphatase (TRAP) and hydroxyproline (HYP) were measured before and at 1, 1.5, 2, 2.5, 3 and 4 months after surgery. The right proximal tibias of rats were excised at the same time point for histopathological observation. RESULTS: Serum OC, ALP, BALP, TRAP and HYP levels in OVX group were significantly higher than that in sham group. As regard to the time of peak level arrived, the sequence of changes was as follows: TRAP/HYP→OC→ALP/BALP. There was a significant positive correlation between five markers. The pathological changes of trabecular bone in OVX group were only observed 3 months after surgery. CONCLUSION: The results suggest that postmenopausal osteoporosis has a high bone turnover rate. During the formation of ovariectomized rat model, changes of bone resorption markers precede changes of bone formation markers. Serum OC, ALP, BALP, TRAP and HYP are sensitive to evaluate the bone loss in the earlier stage of postmenopausal osteoporosis.

Objective To investigate the clinical value of 99Tcm-MIBI gated G-MPI in detecting the myocardial damage in sarcoglycanopathy.Methods 99 Tcm - MIBI G - MPI was performed in 8 patients (3 males,5 females,age ranged from 10 to 30 y) with sarcoglycanopathy confirmed by clinical results and molecular pathology and 4 healthy persons as control group.Quantitative gated SPECT (QGS) software was used for processing and interpretation.Myocardium of left ventricle was divided into 7 segments and 20 subsegments.A five-point scoring system was used to evaluate the myocardial damage.Results Seven patients showed positive results in G-MPI (7/8).Fifty-nine sub-segments of injured myocardium were detected in the 140 sub-segments of 7 abnormal patients.One abnormal segment was observed in 1 patient,two abnormal segments were detected in 2 patients,and ≥3 abnormal segments were observed in 4 patients.Enlarged left ventricles were detected in 5 patients (5/8),and the LVEF of 3 patients among them decreased to (43.1 ±2.8)％.Conclusion 99Tcm-MIBI G-MPI can detect myocardial damage in sarcoglycanopathy as a direct and non-invasive method,and can be used in the early diagnosis and long-term follow-up in sarcoglycanopathy.

Objective To estimate the clinical effect and application value of percutaneous transluminal angioplasty and stenting (PTAS) on patients with lower extremity atherosclerotic occlusive disease (LEAOD). Methods Percutaneous transluminal angioplasty (PAT) and PATS were performed on 127 patients with diabetic lower limb arteriosclerosis. Results Total achievement ratio was 97.64% (124/127). PTAS was failed in 3 patients, clinical symptoms disappeared or improved in 124 patients. The average ankle brachial index (ABI) before and after operation was 0.35 (0.11-0.58) and 0.87 (0.67-1.06), respectively. The difference in ABI before and after operation was significant (P<0.05). During 3-60 months following-up, arteria iliaca remained open in 53 patients, and no recurrence of clinical symptom was found. At 6, 12, 36 and 60 months after operation, the encumbered superficial femoral artery kept smooth bloodstream with a proportion of 97.78%, 91.11%, 84.44%, 75.56% in 45 patients in upper 2/3 segment and 89.66%, 79.31%, 72.41%, 65.52% in 29 patients in infer 1/3 segment, respectively. Conclusion Long-term vessel recanalization can be obtained effectively and haemodynamics index be remarkably improved with PTA and PTAS in LEAOD patients.

OBJECTIVE: To study a surgical and repairing method for defects after the resection of basal cell carcinoma of external nose. METHOD: There are 26 cases of basal cell carcinoma that tumors have been resected completely after operation. For defect repairing in those 26 cases, 2 cases adopt direct suture method; 2 cases use skin graft repairing methods; 18 cases employ naselabial skin flap repairing method; 4 cases choose forehead pedicle skin flap repairing methods. RESULT: the wound of all the 26 cases was primary healed. Additionally, skin flap and skin graft were all survived. Follow-up studied in patients 1 to 3 years after the surgery showed that the local scar was not obvious and no tumor recurred or transferred. CONCLUSION Different surgical and repairing methods are performed to obtain a satisfactory results based on the area of defect and its location in nose. Naselabial skin flap is especially an ideal method to repair defects.
Carcinoma, Basal Cell ; surgery ; Cicatrix ; Forehead ; Humans ; Neoplasm Recurrence, Local ; Nose ; Nose Neoplasms ; surgery ; Reconstructive Surgical Procedures ; Skin ; Skin Neoplasms ; surgery ; Skin Transplantation ; Surgical Flaps ; Wound Healing

Objective To investigate the control status of iodine deficiency disorders (IDD) in the highrisk areas of Gansu province,and to provide a scientific basis for development of effective preventive measures.Methods Twelve counties with high-risk areas of IDD in Gansu province were selected into the survey in 2007 -2009.All patients with suspected cretinism born after the first of January,1997 were enrolled in the study from the 12 counties.Meanwhile,three townships were chosen in each of the 12 counties,two villages were taken in each township,40 children aged 8 to 10 in each village primary school were selected to carry out thyroid examination by B-ultrasonography and palpation,urinary iodine(UI) test,and intelligence quotient(IQ) test; 30 women of childbearing age were selected in each village to fill in the questionnaire,and to test their urinary and salt iodine,and the local salt-related situation was investigated.Results In the 12 high-risk counties,7 were diagnosed as new cretinism cases from a total of 120 suspected cases of cretinism.The goiter rate of children aged 8 - 10 by Bultrasound was 6.8％(290/4281 ),5 counties had goiter rates higher than 5％,of which 3 counties had goiter rates higher than 10％.The average IQ of children was 82.38.The median urinary iodine(MUI) of children was 180.34 μg/L,the ratio of UI ＜ 50 μg/L was 11.0％(482/4383).The MUI of women of childbearing age was 175.91 μg/L,the ratio of UI ＜ 50 μg/L was 16.5％(126/762).MUI of women of childbearing age was less than 100.0 μg/L in Xiahe and Dongxiang counties,which were 95.24 μg/L and 66.30 μg/L,respectively.The coverage rate of iodized salt in 8 of the 12 counties was more than 95％,and that of the remaining four counties was ＜ 85％,of which the coverage rates of iodized salt were only 39.2％ (47/120)and 66.7％ (120/180),respectively,in Guanghe and Dongxiang counties.Fourteen point nine percent (206/1380) of the residents complained that iodized salt was not convenient to buy and 87.7％ (1210/1380) complained that the current price of these salts exceeded the accepted range.Only 29.9％(413/1380)of the housewives knew how to prevent IDD.Conclusions Impact factors of IDD in high-risk areas are widespread.The monitoring of IDD in high-risk areas should be strengthened.Effective measures should be taken to ensure adequate iodine nutrition of people at risk.At the same time,iodized salt-based comprehensive prevention measures should be strengthen and a long-term effective control strategy of IDD should be established.

Objective To evaluate the accuracy of renal scintigraphy for the estimation of glomerular filtration rates (dGFR) in patients with diabetic nephropathy as compared to the conventional dual-plasma sample clearance method (pscGFR). Methods Forty-six patients with diabetic nephropathy underwent both dynamic renal scintigraphy and dual-plasma sample measurement after 99Tcm-DTPA injection. Paired student t-test and correlation analysis were performed to compare dGFR and pscGFR (normalized to body surface area,1.73 m-2). Results The mean dGFR was higher than mean pscGFR ((51.08±26.78)ml·min-1vs (44.06±29.43)ml·min-1,t=4.209,P=0.000). The dGFR correlated with pscGFR ( r=0.923,P=0.000) linearly (regression equation:pscGFR=1.015×dGFR-7.773,F=254. 656,P=0.000).Conclusions dGFR correlated well with pscGFR. Although it could not absolutely replace the latter in patients with diabetic nephropathy,dGFR could reasonably evaluate the filtration function for these patients.

Objective To evaluate the effect of iodine supplementation on improvement of developmental quotient (DQ) at the critical period of infant brain development.Methods Pregnant,lactating women and infants less than 3 years old were supplemented with iodized oil in Linxia Hui Autonomous Prefecture(Linxia Prefecture) Gansu Province in 2006-2010.Before and after the intervention(2006,2007-2010),five townships were randomly selected in the north,the south,the east,the west and the center of eight counties(cities) of Linxia.One village was chosen from each of those townships and 20 infants,20 pregnant women and 20 lactating women were randomly selected in each village(insufficient was made up from the neighboring villages).Urinary iodine(UI) level of the infants,pregnant and lactating women were determined by arsenic cerium catalytic spectrophotometry.DQ value of infants was measured before and after supplementation of iodized oil in 2006 and 2010.UI value of pregnant,lactating women and infants was monitored every year after iodine supplementation.Results Before iodine supplementation(2006),the median UI level of pregnant,lactating women and infants was 89.28,84.85,107.3 μg/L,respectively.After iodine supplementation,the medians UI level in 2007,2008,2009 and 2010 were,respectively,pregnant women:136.0,187.8,118.2,175.8 μg/L; lactating women:135.2,159.8,187.5,163.5 μ g/L; infants:139.6,174.7,190.7,168.4 μg/L.Before iodine supplementation,the DQ value of infants was 92.8 ± 16.3,and the average score of gross motor,fine motor,adaptive capacity,language and social behavior was 93.7 ± 20.0,91.4 ± 20.0,92.4 ± 19.0,90.3 ± 20.0,96.4 ± 22.1,respectively.After iodine supplementation,the DQ value of infants was 104.3 ± 13.8,and the average score of gross motor,fine motor,adaptive capacity,language and social behavior was 104.8 ± 21.5,104.1 ± 17.2,104.8 ± 16.1,99.9 ± 19.1,108.0 ± 22.7,respectively,which were higher than that before iodine supplementation (t =-10.43,-10.77,-13.78,-14.28,-9.96,-15.33,all P ＜ 0.01).Conclusions Iodine deficiency at the critical period of brain development can affect the intellectual development of infants and young children at all functional areas of intelligence.Iodine supplementation at the critical period of brain development can prevent mental retardation caused by iodine deficiency disorders.