BACKGROUND: The osteoarthritis (OA) is attributed to Gubi of TCM,which is mainly caused by liver and kidney deficiency, deficiency and damage of both qi and blood and wind-cold-damp pathogen. Kidney-deficiency with coagulating-coldness syndrome is very common.OBJECTIVE: To explore the clinical effect of the treatment of OA by invigorating the kidney, dispelling the cold and activating collaterals.DESIGN: Randomized controlled clinical study.SETTING: Department of Traditional Chinese Medicine, Dongguan Shilong People's Hospital of Guangdong Province.PARTICIPANTS: Eighty-eight inpatients and outpatients who were most possible to benefit from the experiment were selected as the subjects from the Department of Rheumatism and the Clinic of Orthopedics from June 2005 to July 2006. All subjects were randomized into the experimental group (n=44) including 21 males and 23 females, whose ages ranged 42-70 years, and their average age was (62±8) years and the average course of diseases was (34±18) months, and the control group (n=44), including 24 males and 20 females, whose ages ranged 40-69 years, and their average age was (61±7) years and the average course of diseases was (34±16)months.METHODS: Patients in the experimental group were treated with Bushen Quhan Tongluo herbs by orally taken or externally washing. The prescription of Bushen Quhan Tongluo: Hutaorou (12 g), Buguzhi (12 g), Chaoduzhong (12 g), Shudi (15 g), Dahuixiang (9 g), Luoshiteng (15 g),Zhichuanwu (9 g), Sanqi (6 g), Wugong (3 g), Jixieteng (15 g). The prescription for external washing: Tuogucao (40 g), Danggui (15 g), Sumu (15 g),Shengdahuang (15 g), Shengnanxing (10 g), Ruxiang (10 g), Meyao (10 g),Bingpian (3 g). (Orally taken: The medicine shall be taken with water of 37 ℃ one dose a day. External washing: The medicine that dissolved in 500 mL of 100 ℃ boiled water was adopted to wash both knees while the temperature down to 35 ℃ one dose upon a time and twice a day). Patients in the control group were given sulfated glucosamine (Weiguli Capsule.Each capsule contains 314 mg of sulfated glucosamine crystal, which is equal to 250 mg of sulfated glucosamine) two capsules a time and 3 times a day as well as piroxicam (Yantong Xikang Pill) once a day and 20 mg each time. Patients in both groups were administrated for 12 weeks. Referring to the Western Ontario and McMaster Universities (WOMAC) OA index and the clinical effect criterion of OA, the curative effect was compared between the two groups.MAIN OUTCOME MEASURES: WOMAC pain score, stiffness score,physiological function score, total score and the clinical effect.RESULTS: A total of 88 patients were involved in the analysis of results.joint stiffness index, physiological function index and the total index after the treatment in both the experimental group and the control group than those before the treatment (The experimental group: 4.95±2.46,11.39±4. 10;0.70±0.88,1.57± 1.42; 13.16±5.71,31.16± 10.08; 18.82±7.96,44.11 ± 13.29;Control group: 6.64±1.81,11.59±3.07 ;0.68±0.86,1.52±1.34; 14.25±3.99,pain index in the experimental group after the treatment was lower than that in thecontrol group, and the difference was remarkable (P ＜ 0.05),The total effective rate was 95.5% in the control group and it was 93.2% in the experimental group, and there was no marked difference between the epigastric discomfort in the control group, while there was no haematemesis, hemafecia or aggregation due to continuous administration. No adverse effect was found in the experimental group.CONCLUSION: Satisfying effect can be achieved in the treatment of OA of cold coagulation due to kidney deficiency by invigorating the kidney,dispelling the cold and activating the collaterals, moreover, the effect of relieving pain is especially excellent.

BACKGROUND: Total glucosides of paeony, effective component extracted from peony, has good inflammatory and analgesic effect. OBJECTIVE: To investigate the curative effect and side effect of total glucosides of paeony combined with methotrexate and sulfasalazine in the treatment of ankylosing spondylitis. DESIGN: Randomized and controlled observation SETTING: Department of Rheumatology , Guangdong Hospital of Traditional Chinese Medicine PARTICIPANTS: Totally 80 inpatients with ankylosing spondylitis hospitalized in the Clinic of Department of Rheumatology, Guangdong Hospital of Traditional Chinese Medicine from June 2003 to April 2004 were involved. The patients were randomly divided into 2 groups with 40 patients in each group. Informed consent was obtained. METHODS: Experimental group: 2 capsules of total glucosides of peony was taken orally, three times per day; methotrexate 10 mg/time, once per week; sulfasalazine 0.5 g/time, three times per day. Control group:methotrexate and sulfasalazine were taken orally and the dosage and method were the same as those in the experimental group. Two groups all used the same NSAID (Nimesulide) , 0.1 g/time, twice per day. The period of the treatment was 3 months. Evaluation of spinal column function and laboratory examination was performed before treatment and 4, 8 and 12 weeks after treatment. MAIN OUTCOME MEASURES: Primary outcomes: Bath ankylosing spondylitis activity index, Bath ankylosing spondylitis function index [1-2],duration of morning stiffness, systemic pain and spinal pain on a four point Likert scale, overall assessment of patient and physician on a four point scale. Secondary outcomes: ①erythrocyte sedimentation, C-reaction protein,Schober test, chest expansion, Occiput to wall distance and finger to floor distance.② Adverse events and side effects. RESULTS: The observation of 38 patients in the experiemtnal group and 37 patients in the control group was completed. ①Result of Bath ankylosing spondylitis activity index, Bath ankylosing spondylitis function index,duration of morning stiffness, pain and spinal pain on a four point Likert scale, overall assessment of patient and physician on a four point scale:The indices at week 4, 8 and 12 werevmore significantly decreased than those before treatment in each group (P ＜ 0.05); the Bath ankylosing spondylitis activity index, pain and spinal pain on a four point Likert scale,overall assessment of patient and physician on a four point scale at week 4and all the indices at week 8 and 12 were more significantly decreased than those in the control group (P ＜ 0.05). ② Evaluation result of Erythrocyte sedimentation rate (ESR) and C reaction protein, Schober test, chest expansion , occiput to wall distance and finger to floor distance: Each index at week 4, 8 and 12 in the experimental group were significantly decreased than those before treatment (P ＜ 0.05), those at week 8 and 12 in the control group were more significantly decreased than those before treatment (P ＜ 0.05). ESR , C reactive protein (CRP) , chest expansion and finger to floor distance at week 12 in the control group were more significantly decreased . ③ Adverse events and side effects: All adverse reactions occurred transiently during the course of disease in the two groups. Undisposed or after having taken live-protective medicine, all patients recovered.Drug was not withdrawn in any case.The incidence of adverse reaction in the experimental group was lower than that in the control group [10％ (3/30),57％(17/30) ,P ＜ 0.05]. CONCLUSION: Combination of total glucosides of paeony, methotrexate and sulfasalazine has an enhanced effect and better safety without special adverse reaction in the treatment of ankylosing spondylitis.

Objective To investigate the effect of health education on enhanced curative effect of motor imagination therapy of patients with hyperbaric oxygen(HBO). Methods Thirty patients undergoing HBO combined with motor imagination therapy were given health education including contents of motor imagination,time for motor imagination,intervention of bad emotions and time for motor imagination after leaving the treatment cabin.The understanding of motor imagination-associated knowledge after education was compared to that before education. Results The understanding of motor imagination-associated knowledge after education was significantly better than before education(χ2=9.017,P=0.003). Conclusion Health education may help improve the curative effect of hypterbaric oxygen treatment(HBO)by way of improving the understanding of motor imagination-related knowledge.

Objective: To explore a method for macrostomia repairment, in order to to achieve better physiological and aesthetic outcomes. Methods: 23 patients with macrostomia were treated by standard procedure: including orbicularis oris reconstruction, perioral expression muscles fixation, modiolus reconstruction, commissure point shift, and " w" shape incision. Results: 22 cases obtained both static and dynamic symmetrical outcomes. One case developed asymmetrically. Conclusions The macrostomia repairment following present standard procedure, is likely to achieve both static and dynamic satisfactory outcomes, due to balanced perioral muscles.