OBJECTIVETo evaluate the short effect and safety of the acupoint application of dog days for allergic rhinitis.

METHODSTwo hundred and forty-nine patients were randomly divided into an application group (166 cases) and a placebo group (83 cases). On the first day of the first dog days, the first day of the second of the three ten-day periods of the hot season and the first day of the last of the three ten-day periods of the hot season, acupoint application was adopted mainly at Dazhui (GV 14), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) in the application group. The plaster was made of Chinese herbs, including Baijiezi (semen brassicae), Xixin (asarum), Yanhusuo (corydalis tuber) and Gansui (euphorbia kansui). Buckwheat plaster without medical ingredient was used in the placebo group. The application was pasted for 2-6 h every time. On the first three days of all the three periods of dog days, treatment was used continuously. The whole period of dog days was made into one course. The changes of symptom and syndrome scores, visual analogue scale (VAS) for symptom before and after treatment and the adverse reaction with the condition disposed were observed in the two groups.

RESULTSAfter treatment, the symptom and syndrome scores and VAS for symptom were improved compared with those before treatment in the two groups (all P < 0.05), and the improvements of the application group were more obvious than those of the placebo group (all P < 0.05). The short effective rate of the application group was 68.1% (113/166), which was better than 48.2% (40/83) of the placebo group (P < 0.05). The adverse reaction rates were 4.2% (7/166), 2.4% (2/83) respectively, with no statistical significance between the two groups (P > 0.05).

CONCLUSIONThe dog days plaster achieves obvious effect with good safety for allergic rhinitis.

Acupuncture Points ; Adolescent ; Adult ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; Treatment Outcome ; Young Adult

Objective:To observe the mechanism and effect of Modified Simiao Powder on experimental polymyositis with damp-heat syndrome.Methods:The immunization combined with damp-heat syndrome modeling method was used to set up damp-heat model of polymyositis in guinea pigs.Methods of pathology,electron microscopy,electromyography,serum muscle enzymes were used to observe and compare the effects of Modified Simiao Powder and prednisone.Results:After treatment,the average time and improved degree of volatility of EMG in high dose herbal group were more superior to the prednisone group;the serum CPK,LDH,AST in all treatment groups decreased at different degree.The serum muscle enzymes in Chinese combined Western medicine group were significantly lower than other groups.In the changes of muscle,liver tissue pathology and ultra-structure,high-dose of Chinese herb showed more significant improvement than prednisone group,and the most significant improvement of interstitial pneumonia was observed in Chinese combined Western medicine group.Conclusion:Modified Simiao Powder has good effect on experimental polymyositis with damp-heat syndrome,it can inhibit cellular immune response and control the inflammatory cell infiltration,which may be involved in regulating the whole immune system.

Objective To investigate the clinical efficacy of dog days' acupoint application in treating allergic rhinitis and assess its safety.Methods Two hundred and forty-nine patients were randomly allocated to a dog days' acupoint application group of 166 cases and a placebo group of 83 cases. The two groups were received treatment at the first day of the first, second and last periods of the hot season The dog days' acupoint application group received acupoint application of Chinese herbal medicine and the placebo group, acupoint application of non-medicinal placebo. In the two groups, the symptoms and signs were scored and the VAS score was recorded before and after treatment and during the follow-up period, and adverse reactions and relapses were observed and the clinical therapeutic effect of acupoint application and its safety were assessed after treatment and during the follow-up period.Results The total efficacy rate was 69.8% in the dog days' acupoint application group and 44.4% in the placebo group. The therapeutic effect was significantly better in the dog days' acupoint application group than in the placebo group (P<0.01). The totalefficacy rate was 89.4% at the 6-month follow-up and 90.7% at the 12-month follow-up in the dog days' acupoint application group and 4.9% and 1.2% in the placebo group. The long-term therapeutic effect was significantly better in the dog days' acupoint application group than in the placebo group (P<0.01). In the dog days' acupoint application group, the symptom score, the sign score and the VAS score were significantly lower after treatment and during the follow-up period than before treatment (bothP<0.01). In the placebo group, those scores only had significant pre-/post-treatment differences (P<0.01). There were statistically significant differences in the symptom score, the sign score and the VAS score between the two groups at different times. The adverse reaction rate was 4.3% in the dog days' acupoint application group and 2.5% in the placebo group; there was no statistically significant difference between the two groups (P>0.05). The relapse rate was 46,6% at the 6-month follow-up and 62.1% at the 12-month follow-up in the dog days' acupoint application group and 85.2% and 95.1% in the placebo group; there were statistically significant differences between the two groups (P<0.01).Conclusions Dog days' acupoint application has better short-term and long-term therapeutic effect on allergic rhinitis with a low relapse rate and high safety.

Objective To commission a Mobetron intra-operative mobile accelerator and analyze the characteristics of its electron beams. Methods The dosimetrie characteristics of the electron beams genera-ted by Mobetron accelerator were measured and compared with those generated by conventional accelerator (Primus, Siemens). M oberton accelerator can generate electron beams of nominal energies of 4,6,9 and 12 MeV. The measurement items were as followings : percentage depth dose perpendicular to water phantom sur-face and beam profiles parallel to water phantom surface, output factors, applicator leakage, electron beam at-tenuation made by lead blocks,and machine output calibration. The measurement devices included a three-dimensional ( 3 D) water scanning phantom, an electrometer, a 0.6 cm3 Farmer ionization chamber, a parallel-plate ionization chamber and solid water slabs. During measurement, all applicators of different tilt angles and diameters were attached to the machine head,and their ends were adjusted to be tangent to the phantom surface. Results Except for the 12 MeV,skin dose for all energies was no more than 90%. The skin dose was higher for Mobetron accelerator electron beams than for regular electron beams. The Dmax depth in water for a 10 cm flat applicator were 0.7,1.3,2.0 and 2.2 cm for the 4 energies,respectively. The depths of 90% dose were 1.0,1.8,2.7 and 3.6 cm, respectively. The selected flat applicator was just 1 cm larger than the tumor bed. But for the beveled applicators,the field flatness and symmetry became worse,and con-sequently,the applicator size had to be selected based on the isodose distribution. The leakage dose at 1 cm outside the applicator was 1.2% ,5.1%, 10.0% and 9.1%, respectively. The lead thickness for full block was 1.5,3.0,4.5 and 6.0 mm,respectively. Conclusions Through the commissioning of Mobetron accel-erator, the machine characteristics are understood, and the data for clinical implementation and routine quality assurance are acquired.

Objective To evaluate a new self-designed device to assist closed reduction of femoral shaft fracture.Methods From January 2012 to June 2014,18 cases of femoral shaft fracture received closed reduction and internal fixation with anterograde intramedullary nails on a popular fluoroscopic orthopedic table.The new self-designed distraction reduction device was used during the operation.The patients contained 14 males and 4 females,aged from 21 to 48 years (mean,33.6 years).Fracture AO classification was type 32A2 in 8 cases,32A3 in 5 cases,32B1 in 3 cases and 32B2 in 2 cases.Mean pre-operation time was 5.5 days (range,3-10 days).Results Operation time ranged from 85 to 130 minutes (mean,96 minutes).Intraoperative bleeding ranged from 120 to 180 ml (mean,150 ml).X-ray fluoroscopy time ranged from 20 to 40 seconds (mean,25 seconds).Frequency of nailing into the distal fracture end was 1 to 3 times (mean,1.5 times).One case had additional small incision for open reduction.Fourteen cases experienced external rotational deformity of the femur from 2° to 6° (mean,3.6°) after surgery,and four cases were free of rotational deformity.All patients were followed up for 6 to 20 months (mean,12.8 months).All patients had fracture healing in a period of 4.5 to 8.5 months (mean,5.5 months).No iatrogenic fracture,infections,nail breakage or other complications occurred.At the final follow-up,knee score according to the system of hospital for special surgery (HSS) was found to be excellent in 12 cases,good in 4,and fair in 2,giving an excellent-togood rate of 89％.Conclusion The new self-designed distraction device is an easy-to-operate instrument that is useful in assisting distraction and reduction of the femoral shaft fracture diffictlt to be fixed with routine methods as well as intramedullary nailing just on a popular fluoroscopic orthopedic table.

Objective To investigate and compare the clinical feature and natural course of polycythemia vera(PV)between Uygur and Han nationalities in Xinjiang Uygur Autonomous Region.Methods Clinical symptoms,signs,laboratory tests and prognosis of 37(20 Han,13 Uygur,4 other nationalities)patients with PV were analyzed.Results There were 22 males and 15 female.The mean age of all patients was 59.41±11.31(31-85)years old.The mean hemoglobulin level was(191.11±21.41)g/L.Erythremia combined with leukocytosis or thromboeytosis were observed in 23(62.2%)or 19(51.4%)patients respectively.Splenomegaly was found in 27(73.0%)patients and hepatomegaly in 9(24.3%).Serum LDH was elevated in 28(75.7%)patients.Twenty two patients(59.5%)had vascular thrombotic events.Two patients developed MF.N0 secondary neoplasm was identified.Two patients died of thrombosis.Over 60 years old,leukocytosis and thrombocytosis were the high risk factors associated with thrombosis.No significant differences of clinical manifestations and thrombotic events have been found between Uygur and Han patients in Xinjiang.Conclusion Over 60 years old,leukocytosis and thromboeytosis were probably the high risk factors of thrombosis in PV patients.There was no significant differenee in clinical feature and natural course of PV between Uygur and Han nationalities in Xinjiang Uygur Autonomous Region.

Objective To evaluate the efficacy of parecoxib sodium for preemptive analgesia.Methods PubMed,EMBASE,Cochrane Library,and CNKI database were searched for randomized placebo-controlled trials involving the efficacy of parecoxib sodium for preemptive analgesia.The modified Jadad scale was used for quality assessment.Evaluation indexes included VAS scores at 1,6,12 and 24 h after operation,consumption of morphine within 24 h after operation,and incidences of nausea and vomiting after operation.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.2 software.Results Fourteen randomized placebo-controlled trials involving 1086 patients were included in our meta-analysis.The modified Jadad scale scores for the 14 studies were ≥ 4.The patients were divided into 2 groups:placebo group and parecoxib sodium 40 mg injected before operation group.The results of meta-analysis showed that VAS scores at 1,6,12 and 24 h after operation were significantly decreased,the consumption of morphine within 24 h after operation was reduced,and the incidences of nausea and vomiting after operation were decreased in parecoxib sodium 40 mg injected before operation group as compared with placebo group (P ＜ 0.05).Conclusion Intravenous injection of parecoxib sodium 40 mg before operation can produce significant preemptive analgesic efficacy and is helpful in decreasing the adverse effect of postoperative analgesia.

Objective This study analyzes the effect of the shrinkage of thermoplastic mask on patient positioning. Methods Design of the two test. Test 1:thermoplastic film shrinkage test. Get some thermoplastic film by the size of 10 cm×5 cm, extrude it at a certain rate after heated. Measure the length of thermoplastic film on different time, and calculate the contraction. Test 2:phantom test. Take advantage of head and neck phantom, and simulate the procedure that from making mask for patients to radiation therapy. Measure the off set of isocenter which caused by the contraction of thermoplastic mask. Results The largest shrinkage of thermoplastic had happened in 20 minutes. Different tensile ratio had little effect on the shrinkage. The offset of isocenter which caused by the shrinkage of thermoplastic mask were:LR ( -0?? 1± 0?? 3) mm,SI (-0?? 2±0?? 2) mm, AP (0.6±0?? 4) mm,respectively. There was little change in the course of six weeks ( P= 0.185?0?? 961). Conclusions The cooling time should be more than 20 minutes, when making a mask for the patient. The setup errors which caused by the shrinkage of thermoplastic mask is at an acceptable level on this premise.

Objective To observe the effectiveness of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.Methods Seventy patients (17 males,53 females,aged 20-65 years,ASA grade Ⅰ or Ⅱ) undergoing laparoscopic cholecystectomy were randomized to receive either dexmedetomidine (group R,n=35) or dexamethasone (group D,n=35).The patients in the group R received 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine before intubation.The patients in the group D received 8 mg dexamethasone before intubation.The BP and HR were recorded at the following points: on arrival in the operating room (T1),before intubation (T2),5 minutes after intubation (T3),5 minutes after the beginning of the operation (T4),30 minutes after the beginning of the operation (T5),at the end of operation (T6) and 5 minutes after extubation (T7).The inhaling concentration of sevoflurane,extubation time,operation time and anesthesia time were recorded.The incidence of nausea and vomiting were recorded at 8,24,48 hours after operation.Results The incidence of nausea and vomiting at each point were similar between two groups.The HR at T2-T7 in group D was significantly lower.But MAP was similar between two groups.Conclusion 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy,similar to dexamethasone.

Objective To assess community health service ability of general practitioners (GPs) with the Standardized General Practitioner Training(SGPT) in Shanghai.Methods One hundred and four GPs receiving SGPT and matched 102 GPs without SGPT were enrolled in this retrospective cohort study from September to November in 2014.Community health service ability,including abilities in basic medical service and public health service were assessed and compared between two groups.Written examination was applied in the public health services ability assessment.Objective structured clinical examination (OSCE) was applied for evaluation of basic medical service abilities.Results The scores of written examination in GPs with SGPT were higher than those without SGPT[(66 ±4) vs.(62 ±7),P ＜0.01].The OSCE scores in GP with SGPT were higher than those without SGPT [(494 ± 78) vs.(448 ± 80),P ＜ 0.01].GPs with SGPT also abtained the higher scores in consultation competence and clinical skills assessment [(245 ± 44) vs.(225 ±40),P＜0.01;(252 ±59) vs.(225 ±61),P ＜0.01].In OSCE,GPs with SGPT got higher score than those without SGPT in 5 stations (medical history collection,doctor-patient communication,basic operation,ECG interpretation,and CPR) (all P ＜ 0.01);however,no significant differences were observed in 3 stations (physical examination,case analysis and X-ray interpretation) between two groups (all P ＞ 0.05).Conclusions GPs with SGPT have better basic medical service and public health service ability.But some aspects of basic medical service ability need to be strengthened in the training and practice.