OBJECTIVETo compare the difference among the combined method of oral administration of forlaxand acupoint embedding therapy, the simple acupoint embedding therapy and the simple oral administration of for-lax in the clinical efficacy on diabetic constipation.

METHODSOne hundred and fifty patients were randomized intoa comprehensive group, an acupoint embedding group and a forlax group, 50 cases in each one. In the acupointembedding group, the embedding therapy was applied to bilateral Tianshu (ST 25), Daheng (SP 15), Shangjuxu(ST 37) and Dachangshu (BL 25), once a week. In the forlax group, forlax (polyethylene glycol) was prescribedfor oral administration, once a day, 10 g each time. In the comprehensive group, the acupoint embedding therapyand forlax were combined and the methods were the same as the first two groups. The treatment for 4 weeks wasas one session, and 2 sessions were required in the three groups. Separately, in 4 weeks, 8 weeks of treatment and2 months after treatment, the constipation symptom scores were compared among the three groups. At the end of2 sessions of treatment, the clinical efficacy and adverse reactions were compared among the three groups. In2 months after treatment, the recurrence rate was compared among the three groups.

RESULTSThe total effectiverate was 98. 0% (49/50) in the comprehensive group, better than 86. 0% (43/50) in the acupoint embeddinggroup and 78. 0% (11/50) in the forlax group (both P<0. 01). In the 4 weeks and 8 weeks of treatment, the con-stipation symptom scores were reduced significantly as compared with those before treatment in the three groups(all P<0. 05). The results in the comprehensive group were lower than those in the other two groups (all P<0. 05). In the 4 weeks of treatment, the scores were not different significantly between the acupoint embedding group and the forlax group (P>0.05). In 8 weeks of treatment and 2 months after treatment, the scores in the acupoint embedding group were better tan those in the forlax group (all p<0.05). There were 2 cases of drug adverse reaction in the comprehensive group, 6 cases in the forlax group and 0 case in the acupoint embedding group. The recurrence rate was 8.1% (4/49) in the comprehensive group, lower than 32.6% (14/43) in the acupoint embedding group and 59.0% (23/39) in the forlax group (both P<0.01).

CONCLUSIONthe combined therapy of acupoint embedding and forlax achieves the better clinical efficacy on diabetic constipation and constipation symptom scores as compared with the simple acupoint embedding therapy and the oral administration of forlax the short-term efficacy of the simple acupoint embedding therapy is not different significantly from the simple forlax medication, but the long-term efficacy and safety are better than those of simple forlax medicaiton.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Constipation ; drug therapy ; etiology ; physiopathology ; therapy ; Defecation ; Diabetes Complications ; complications ; physiopathology ; Female ; Humans ; Laxatives ; administration & dosage ; Male ; Middle Aged ; Polyethylene Glycols ; administration & dosage ; Treatment Outcome

Hepatitis B virus ( HBV) threatens human's health seriously, immune disorder is the main pathogenesis.HBV cannot naturally infect mouse liver, thus the researchers tried to established HBV mouse models to imitate the immunological pathogenesis of HBV infection.This review summarize various methods to establish HBV mouse models, including HBV transgenic technics, HBV in vivo liver-target transfection technics and HBV naturally infected humanized mouse technics etc.Their advantages, disadvantages and contributions to immunological studies were also analyzed, and the development of this area was also prospected.

Objective To explore the diameter change of the extrahepatic bile duct before and after laparoscopic cholecystectomy (LC). Methods From Jan. 2006 to Dec. 2007, 113 patients including chronic gallstone cholecystitis (n=55), inactive cholecystolithiasis (n=46) and gallbladder polyps (n=12) were collected and treated by LC. The diameters of their extrahepatic bile ducts were measured by B ultrasonography before operation, 3 months and 6 months after operation. These data were collected and analyzed retrospectively. Results The diameters of the extrahepatic bile ducts of all patients before LC, 3 months and 6 months after LC were (5?2) mm, (8?2) mm and (6?2) mm respectively. And in chronic gallstone cholecystitis patients they were (5?2) mm, (9?2) mm and (6?2) mm respectively, in inactive gallstone cholelithiasis patients they were (5?2) mm, (8?2) mm and (6?2) mm respectively, and in gallbladder polyps ones they were (5?2) mm, (7?2) mm and (5?2) mm respectively. Conclusion The change of the extrahepatic bile duct diameter after LC is a dynamic process. It is enlarged on the third month after operation than before operation. In the sixth month after operation marked retraction occurs, and compared with before operation, it shows no obvious statistic significance.

Objective To investigate the clinical symptoms and imaging features of Budd-Chiari syndrome with hepatic vein obstruction (HVBCS) and the reasons of mistreatment. Methods Thirteen patients with HVBCS were misdiagnosed and mistreated as inferior vena cava (IVC) obstruction,including 8 patients treated with stent implantation in IVC once and 5 patients with balloon dilatation. After analysis of the clinical symptoms,signs and imaging features; hepatic vein obstruction was further confirmed by digital subtraction angiography (DSA)in all patients. Results All patients had variable degrees of portal hypertension and no apparent symptoms of IVC obstruction. CT or / and MRI showed obvious caudate lobe enlargement and DSA showed IVC narrowing with external compression. All patients were undertaken hepatic vein angiography including 4 with PTV and 9 with hepatic vein stent implantation. All patients' clinical symptoms and signs completely disappeared or markedly improved after the procedure. Conclusion The stenosis of IVC in HVBCS,caused by compression compensatory hypertrophy of hepatic caudate lobe can be cured by hepatic vein angioplasty which is the most correct and effective method.

OBJECTIVE: To observe the short and long-term efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in different age groups. METHOD: The clinical data of 113 adult patients with single PC-BPPV who underwent quick repositioning maneuver from July 2009 to February 2015 were retrospectively analyzed. The quick repositioning maneuver was to roll the patient from involved side to healthy side in the coronal plane for 180° as quickly as possible. The patients were divided into 3 groups according to different ages: young group (< 45 years), middle-age group (45 ≤ age < 60 years) and old group (≥ 60 years). The short and long term outcomes of the three groups were observed. RESULT: The left ear was involved in 58 cases (51.3%) and the right ear in 55 cases (48.7%). The short term improvement rates of the young, middle-age and the old groups were 92.5%, 93.6% and 92.3% respectively, and the long term improvement rate was 90.0%, 85.1% and 73.1% respectively. There was no significant difference among the three groups in short and long term outcomes (P > 0.05). The recurrence rate of the three groups was 5.0%, 6.4% and 15.4% respectively, also no significant difference (P > 0.05). CONCLUSION The quick repositioning maneuver along the coronal plane for PC-BPPV has a definite effect for every age groups. The method is simple, rapid and easy to master, and the patients are tolerated the maneuver well without evident side effect.
Adult ; Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Middle Aged ; Patient Positioning ; Retrospective Studies ; Semicircular Canals ; physiopathology

Foundations of Oriental Medicine (FOM) is one of the mandatory examinations for the Diplomate of Oriental Medicine (Dipl.OM.), Chinese Herbology (Dipl.CH.), or Acupuncture (Dipl. Ac.) by American National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). In the light of NCCAOM Certification Handbook, Foundations of Oriental Medicine Expanded Content Outline,and Foundations of Oriental Medicine Study Guide, the authors introduced the examination pattern and examination-related contents including: Clinical diagnostic methods; assessment, analysis, and pattern-differentiation based upon Oriental Medicine theory and treatment principle and strategy.

OBJECTIVE To investigate the choise of operation approach for chronic otitis media surgery. METHODS Auditory and high resolution computed tomography (HRCT) assessment were carried out prior to the operation in 160 ears with otitis media. Tympanoplasty or mastoidectomy and tympanoplasty were performed. RESULTS Thirty-one patients received tympanoplasty and 129 patients received mastoidectomy and tympanoplasty. Closed and opened surgery were performed in 49 and 80 cases respectively. The ear-drying time ranged from 7 to 51days with an average of 23 days. Mean hearing increased by 15dB. CONCLUSION Assessing the HRCT scan prior to the surgery can help us choose a reasonable approach in chronic otitis media surgery.

Objective To discuss the feasibility of laparoscopic renal surgery following kidney rupture.Methods Two patients with left kidney rupture were treated laparoscopiclly at our institution in the last 4 years. 1 operated 7 days after hemorrhage and another operated immediately. Both of them performed retroperitoneal laparoscopic nephrectomy. Results The operations succeeded, the operating time being 100～120 min, the blood loss 200～300 mL. There were no postoperative complications in all cases. Conclusion Laparuscopic exploration and extirpation offer a viable measure to treat kidney rupture.

Objective:CD4+CD25+regulatory T cells (Treg) may contribute to tumor progression by suppressing antitumor im-munity. The function of Treg in antitumor immunity regulation in the peritoneal microenvironment of ovarian cancer (OC) was investi-gated and compared with the circulating Treg to elucidate OC immune escape. Methods: Flow cytometry was used to determine the proportion of CD4+CD25+T cells in CD4+T cells in ascites of 27 patients with OC and in peripheral blood lymphocytes of 28 patients with OC. The samples were analyzed and classified in three stages:primary disease (PD), after chemotherapy (AC), and recurrence dis-ease (RD), according to the clinical conditions of the OC patients upon donating the samples. The percentage of Treg in the three groups was determined in ascites and blood. CD4+CD25+T cells were isolated from ascites and peripheral blood of patients with OC us-ing magnetic sorting (MACS) system. The cells were then tested for regulatory function through coculture with carboxyfluorescein diac-etate succinimidyl ester-labeled autologous CD4+ CD25- responder cells. Results:The proportion of CD4+ CD25+T cells in CD4+T cells significantly increased in ascites (28.25%± 14.06%) compared with that in blood (14.6%± 4.74%;P<0.0001). The Treg in ascites and blood in AC showed higher proportion (P<0.0001) than those in the PD and RD;the proportion in RD was higher than that in PD (P<0.0001). Moreover, the Treg in ascites mediated a significantly higher suppression compared with the Treg in peripheral blood (P<0.001). Conclusion:The frequency and suppressor function of Treg were significantly higher in ascites than in peripheral blood. This finding suggests more possibility for escape immune surveillance in the peritoneal microenvironment. Moreover, the proportion of Treg in AC was higher than that in PD or RD;the proportion in RD was higher than that in the PD. Chemotherapy may favor the expansion of Treg, which may promote the recurrence of cancer.

Objective To investigate the risk factors for postoperative nausea and vomiting (PONV) in spinal anesthesia patients.Methods A total of 841 patients received spinal anesthesia were visited after operation.Data were analyzed using univariate analysis and multivariate Logistic regression to identify risk factors related to PONV.Results PONV occurred in 94 patients (11.2％,94/841).Univariate analysis showed that PONV was unrelated with gender,age,ASA classification,anesthesia mode (P ＞ 0.05),related with operation department (P =0.026),body mass index (P =0.020),education level (P =0.000),history of previous surgery anesthesia (P =0.005),history of PONV (P =0.000),history of kinesia (P =0.002),smoke (P =0.019),intraoperative using of tramadol (P =0.018).Multivariate analysis showed that operation department (OR =4.039,95％ CI 1.331-12.259,P=0.048),education level (OR =3.504,95％ CI 1486-8.260,P=0.015),history of PONV (OR =5.113,95％ CI 1.790-14.606,P =0.002),intraoperative using of tramadol (OR =5.316,95％ CI 1.091-25.908,P =0.039) were identified as independent risk factors for PONV.Conclusions The independent factors associated with PONV following spinal anesthesia include operation department,education level,history of PONV,intraoperative using of tramadol.Identifying patients who are at high risk for PONV will enable the formation of more timely management project.