OBJECTIVETo explore the effect and mechanism of electroacupuncture (EA) for Z syndrome without organic lesion (metabolic syndrome combined with obstructive sleep apnea hypopnea syndrome).

METHODSFifty-eight patients with Z syndrome were divided into three groups according to mild,moderate and severe degree. Acupuncture and EA were used at Daimai (GB 26), Zhongwan (CV 12), Xiawan (CV 10), Zusanli ST 36), Qihai (CV 6) and Huaroumen (ST 24), etc., once a day and five times a week. The treatment of ten times was a course, and two courses were acquired continuously. Sleep respiration monitoring (PSG) was done before EA and in one week after treatment respectively. Triacylglycerol (TG) fasting blood glucose (FBG) fasting insulin (INS) and serum leptin (Lep) were tested before and after treatment in the three groups.

RESULTSAfter treatment apnea hypopnea index (AHI) and the percentage of the time of arterial oxygen saturation (SaO₂) less than 90% taken in the total sleep time (SLT 90%) were improved apparently than those before treatment in the three groups (all P < 0.05). The levels of TG, FPG, INS and Lep were decreased after treatment in all groups (all P < 0.05).

CONCLUSIONEA can improve AHI and nocturnal hypoxia of Z syndrome, and the mechanism may be related to decreasing the indices of metabolism syndrome and leptin.

Acupuncture Therapy ; Adult ; Female ; Humans ; Insulin ; blood ; Leptin ; blood ; Male ; Metabolic Syndrome ; blood ; physiopathology ; therapy ; Middle Aged ; Sleep ; Sleep Apnea, Obstructive ; blood ; physiopathology ; therapy ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

Objective To investigate the clinical efficacy and safety of high-frequency electric snare for the treatment of main airway neoplasm through bronchoscopy. Methods The clinical datas of 18 patients from July 2013 to April 2016, who had main airway neoplasm and were treated with high-frequency electric snare through bronchoscopy, were retrospectively analyzed. Meanwhile, the interventional bronchoscopic techniques partly included argon plasma coagulation and cryoablation. After operarion, the relief of symptoms and complications were observed. Results After operarion, the clinical symptoms, shortness of breath, dyspnea index score and the degree of airway stenosis were improved significantly. No serious complications such as massive hemoptysis occurred in all patients. Conclusion High-frequency electric snare is an effective and safe approach for the treatment of main airway neoplasm.

Objective To explore the methods and effects of nursing care in lumbar discogenic pain after coblation annuloplasty surgery. Methods A total of 58 patients with lumbar discogenic pain after coblation annuloplasty in Xuanwu Hospital Capital Medical University from January to June 2016 were prospectively recruited. The research objects were randomly divided into surgery group (control group) and surgery combined with rehabilitation nursing group (observation group) by random number table method. Excluding the lost visits and patients who underwent other surgical treatment, 26 cases were included in control group and 28 in observation group. The patients in control group received routine nursing care after coblation annuloplasty, while patients in observation group received rehabilitation nursing care. All the patients were evaluated for pain and nerve function recovery by Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI) respectively on admission and 3 months after discharge. Results Before the surgery, the NRS score of control group and observation group was (7.120±1.231) and (6.881±1.437) respectively, and there was no statistical difference (P=0.516). Three months after the surgery, the NRS score of each group was (4.180±1.396) and (3.060±1.417) respectively, and the difference was statistically significant (P=0.005). The ODI score of control group and observation group before surgery was (71.2±9.7) and (68.9±13.2), and there was no statistical difference (P=0.472). After the surgery, the ODI score of each group was (28.7±6.7) and (18.9±5.4), and the difference was statistically significant (P< 0.001). There were 2 cases of subcutaneous ecchymosis in control group and 4 in observation group, and there was no statistical significance in the difference (P=0.670). There were 5 patients reporting local pain at the puncture point in control group and 9 in observation group, and there was no statistical significance in the difference as well (χ2=1.170,P=0.279). All of these symptoms disappeared after 2 weeks. Conclusions Providing high quality rehabilitation nursing care may improve patients' neurological deficits and relieve pain in patients with lumbar discogenic pain after coblation annuloplasty surgery.

Objective To investigate the clinical features of patients with bacterial liver abscess.Methods The clinical data of patients with liver abscess during January 2014 to December 2016 were retrospectively analyzed.Results There were 93 cases enrolled,26.88％ were accompanied by diabetes mellitus (DM),60.22％ were accompanied liver,gall bladder,pancreas diseases or had history of liver,bile duct or gastrointestinal surgery.The most common symptoms were fever (94.62％) and gastrointestinal symptoms (50.54％),while 15.05％ for shock;91.40％ were single abscess,and 73.12％ were in the right lobe.The white blood cell count (WBC),neutrophil (N),hypersensitive C-reactive protein (hsCRP),procalcitonin (PCT),alanine aminotransferase (ALT),and aspartate aminotransferase (AST) were elevated in 60.22％,65.59％,97.85％,82.93％ (34/41),47.31％,and 46.24％ of patients,respectively.12/62 (19.35％) were positive by blood culture and 32/54 (59.26％) were positive by pyogenic fluids or bile culture,the top two pathogenic bacteria were Klebsiella pneumonia (52.27％) and Escherichia coli (27.27％).Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores were between 0-25 points,72.04％ cases were (0-10) points,26.88％ case were (11-20) points and one patient was more than 20 points.Among the 93 cases,82.79％ were underwent antibacterial by carbapenem,penicillin enzyme compound preparation or combined with levofloxacin,and 45.16％ were underwent liver puncture of drainage treatment.A percentage (96.77％) of patients was cured or recovered.Conclusions Biliary retrograde infection is the main cause of hepatic abscess.In the early experiential antibacterial therapy,the first-line choices of antibiotics are those effective to extended spectrum 3-lactamase (ESBL) positive enterobacteriaceae bacteria.Liver puncture of drainage treatment may be effective and safety.APACHE Ⅱ score may be useful to assess the prognosis of live abscess.

Objective To explore the clinical curative effect of pre cut type perforated patellar needle combined with tension band steel wire internal fixation minimally invasive in the treatment of patellar transverse fracture. Methods A total of 67 cases of patients with patellar transverse fracture were treated with pre cut with holes patellar needles com-bined with tension band wire fixation of minimally invasive, the fracture degree,joint activity,knee functional score and incidence of complications were observed and analysised. Results Postoperative knee function score, the excellent and good rate was 92.5%was significantly higher than the preoperative 9.0%,postoperative knee activity, excellent rate was 90.0% significantly higher than the preoperative 6.0%,postoperative X piece shows the alignment score the excellent rate of 100%was significantly higher than the preoperative 11.0%fractures ,the differences were statistically significant (P<0.05),the incidence of complications of patients was 9.0%. Conclusion Pre cut type perforated patellar needle combined with tension band steel wire internal fixation minimally invasive in the treatment of patellar transverse frac-ture is be conducive to the fracture and recover the function of knee joint,the incidence of complications of patients is low, witch is the practical operation in treatment of patella fracture.

Objective To investigate the clinical distribution and drug resistance of carbapenemsresistant Klebsiella pneumoniae (CRKP).Methods A total of 134 clinical strains of CRKP were collected from inpatients in our hospital from January 2014 to December 2016.VITEK-2 compact automatic microbiological analyzer was used to identify the bacteria and the supporting gram-negative bacterial drug susceptibility card was used for susceptibility testing.The sensitivity of other clinical commonly used antimicrobial agents was measured by K-B method.And the clinical distribution of CRKP and its resistance to antimicrobial agents were investigated and analyzed.Results The clinical strains of CRKP were isolated mainly from urine (n=70,52.2％) and sputum (n=38,28.4％).Klebsiella pneumoniae was identified in samples from the department of neurosurgery,including neurosurgery ICU (47.8％,64/134),ICU (23.9％,32/134),department of hepatobiliary surgery (8.2％,11/134) and department of urology (6.0％,8/134).Among all 22 antimicrobial agents tested,the resistant rates of CRKP to 16 antimicrobial agents were ＞90％,especially for ampicillin it was 100％,and those to 19 antibiotics were ＞80％,only for tigecycline it was 23.1％.There were 16 strains of CRKP with positive extended spectrum β-lactamases (ESBLs) (11.9％).All the CRKP strains were resistant to more than three kinds of antimicrobial agents,except one strain that was resistant to two kinds.Conclusion There is a wide range of clinical distribution of CRKP,which is resistant to most of antimicrobial agents,while tigecycline still has a strong antibacterial activity to CRKP.