OBJECTIVE: To explore the effectiveness and safety of the combined treatment with acupuncture and venlafaxine hydrochloride on depression in terms of the microstructure change of white matter fiber tracts of brain based on diffusion tensor imaging technology (DTI). METHODS: The prospective study design was adopted. All of 60 patients with depression were randomized into an acupuncture-medication group and a medication group, 30 cases in each one. In the medication group, venlafaxine hydrochloride was used, 75 mg per day in the 1st week, 150 mg per day in the 2nd week and 225 mg per day from the 3rd to 6th week. In the acupuncture-medication group, on the base of the treatment in the medication group, acupuncture was combined. Baihui (GV 20) and Yintang (GV 29) were the main acupoints. The supplementary acupoints were selected according to the clinical symptoms of individuals. The needles were retained for 30 min. Acupuncture was provided once every 2 days, 3 times a week. The consecutive 12 weeks of treatment were required in the two groups. Additionally, a normal group was prepared with 30 healthy volunteers. Separately, before treatment, in 2, 8 and 12 weeks of treatment, Hamilton's depression scale (HAMD-17), Beck depression inventory scale (BDI) and the antidepressant side effect scale (SERS) were adopted to evaluate the effectiveness and safety of the two groups. Moreover, before and after 12 weeks of treatment, DTI was adopted to detect the fractional anisotropy score (FA) of each brain region in the patients. RESULTS: After treatment, the scores of HAMD-17 and BDI were all reduced in the two groups (<0.05). In 8 and 12 weeks of treatment, the scores of HAMD-17 and BDI in the acupuncture-medication group were less than those in the medication group (<0.05). The difference in SERS score was not significant statistically between the two groups (>0.05). Compared with the healthy volunteers, FA scores in 6 brain regions changed obviously in the patients with depression, including the white matter of bilateral frontal lobes, splenium of corpus callosum, left cingulated gyrus, white matter of bilateral inferior temporal gyrus, white matter of bilateral inferior parietal lobe and white matter of bilateral deep temporal occipital region separately. Before treatment, the differences in FA scores of these 6 brain regions were not significant statistically between the two groups (>0.05). After treatment, FA scores in the white matter of bilateral frontal lobes, white matter of bilateral inferior temporal gyrus and white matter of bilateral deep temporal occipital region in the acupuncture-medication group were all higher than those in the medication group (<0.05). CONCLUSION Acupuncture repairs the brain white matter fiber tracts in some brain regions to certain extent and the therapeutic effects are enhanced with the adjuvant medication of venlafaxine hydrochloride.
Acupuncture Therapy ; Brain ; Depression ; therapy ; Diffusion Tensor Imaging ; Humans ; Prospective Studies ; Venlafaxine Hydrochloride

Objective To prepare biomimetic bone material by reconstructing type Ⅰ collagen combined with polyaspartic acid. Methods By acid hydrolysis,rat tail type Ⅰ collagen was decomposed into collagen fibers,which were then placed in the calcium phosphate mineralization solution. Under the cross-linking of glutaraldehyde,the collagen fibers were reconstructed and assembled into collagen fibers,and the calcium phosphate crystals were wrapped in the inner side of the collagen fibers for biomineralizationin. After poly aspartate acid was added,calcium hydroxyapatite calcium precursor was added into the collagen fibers to simulate thebiomimetic biomineralizationin the human body. After mineralization for 3-9 days,the bone mineralization process was observed by transmission electron microscopy and electron diffraction. Results Transmission electron microscopy and electron diffraction displayed that,after 3 days of mineralization,calcium hydroxyapatite precursor was wrapped in the collagen fiber gap,and the collagen fiber was partially mineralized. After 9 days of mineralization,calcium hydroxyapatite precursor completely infiltrated into the collagen fiber,and the amorphous calcium phosphate was transformed into hydroxyapatite calcium crystal. Thus,the simulation of bone mineralization was completed,and collagen type Ⅰ collagen/hydroxyapatite calcium biomimetic bone material was formed. Conclusion Reconstruction of type Ⅰ collagen combined with polyaspartic acid can prepare biomimetic bone material that has close chemical composition and molecular structure to the human bone tissue.

OBJECTIVE: To compare clinical effects of artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with profitated plate. METHODS: From April 2015 to April 2019, 60 patients with complex calcaneal fractures were treated with open reduction and heteromorphic plate internal fixation, and were divided into experiment group and control group by implant bone substitutes, and 30 patients in each group. In experiment group, there were 21 males and 9 females aged from 18 to 71 years old with an average of (36.85±7.42) years old;19 patients were classified to type Ⅲ and 11 patients were type Ⅳ according to Sanders classification;implanted with artificial bone. While in control group, there were 23 males and 7 females aged from 20 to69 years old with an average of (37.26±7.38) years old;18 patients were classified to type Ⅲ and 12 patients were type Ⅳ according to Sanders classification; implanted with autogenous bone. Operation time, intraoperative blood loss, drying time of incision, fracture healing time and complications were compared between two groups, changes of preoperative and postoperative Böhler angle and Gissane angle were also compared, and Maryland scoring was applied to evaluate recovery of affected foot. RESULTS: Both of two groups were followed up from 3 to 15 months with an average of (10.15±2.67) months. Operation time and intraoperative blood loss in experiment group were (89.32±12.43) min, (101.64±5.13) ml, respectively;while in control group were (112.45±13.82) min, (119.01±5.26) ml, respectively;and there were statistical difference between two groups ( CONCLUSION Artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with irregular plate have similar function in promoting fracture healing, drying time of incision, fracture healing time and complications, while artificial bone has better effects in reducing intraoperative blood loss, shorten operation time.
Adolescent ; Adult ; Aged ; Bone Plates ; Calcaneus/surgery* ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Fractures, Bone/surgery* ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo introduce and report the preliminary results of 7 old patients with fractures and dislocations of the elbow.

METHODSFrom July 2011 to August 2015, 7 old patients suffered from fractures and dislocations of the elbow(5 of which were terrible triad). One patient had type Iradial head fracture, 3 type IIand 1 type III according to the Mason classification, and 1 type I, 5 type IIand 1 type III according to the Regan-Morrey classification. All the 7 patients received operation and then were treated with external fixation. Fractures of the radial head were fixed with Herbert screws or locking plates and screws. Fractures of ulnar coronoid were reduced and fixed with lag screws or K-wires or PDS sutures or locking screws according to the types. The lateral and medial collateral ligaments were also repaired. Plaster external fixation was applied for 3 weeks after operation, in the position with elbow flexion in 90 degrees and forearm rotation in neutral. External fixation braces were used for each patient after the plasters were removed, and at the same time rehabilitation programs were carried out.

RESULTSAll the 7 patients were followed up, and the during ranged from 13 to 48 months(averaged, 20 months), with healed fractures, stable elbow and no pain movement. The functional outcome was excellent in 3 patients, good in 3 and fair in 1 according to the Mayo Elbow Performance Score(MEPS).

CONCLUSIONSIt is not easy to get stable fixation for fractures and dislocations of the elbow in old patients with osteoporosis and low density of bone, but the operation can achieve satisfied clinical outcomes after external fixation.

OBJECTIVETo evaluate the middle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty(PKP) for vertebral fragility fracture in the elderly.

METHODSThe clinical data in elderly patients with vertebral fragility fracture treated by unilateral and bilateral PKP between January 2008 and January 2010 was retrospective analyzed. According to a unified criteria to divided into two groups for 104 patients(44 males and 60 females), of them, 50 cases were divided in unilateral group using unilateral pedicle surgical approach for PKP and 54 cases were in bilateral group using bilateral pedicle approach. VAS score, Cobb angle, and the height of anterior and posterior vertebral body were respectively analyzed peroperatively and at 3 d, 3 months, 1 year, 3 years postoperatively and final follow-up. Clinical effects and safety were assessed in two groups.

RESULTSAll the operations were successful. Operative time and bone cement injection volume in unilateral group were less than those of bilateral group(<0.05). Postoperative VAS scores, Cobb angle, and the height of anterior and posterior vertebral body were obviously improved in two groups(<0.05), and there was no significant difference between two groups(>0.05). Bone cement leakage occurred in 12 cases(11.5%), recurrent fracture of vertebral body occurred in 5 cases(4.8%), cerebrospinal leak occurred in 2 cases(1.9%), and nerve root irritation occurred in 3 cases(2.9%). The above complications were transient and released after symptomatic treament.

CONCLUSIONSMiddle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty for vertebral fragility fracture are safe and satisfactory, and may be extended as a minimally invasive method. Unilateral approach for PKP has advantages of short operation time, relative less trauma, thus is a more ideal method.

OBJECTIVE: To study and compare the clinical effects of Rehmannia Decoction and alendronate sodium for the treatment of primary osteoporosis. METHODS: From January 2016 to December 2017, 72 patients with primary osteoporosis who took Dihuang Decoction(DHD) orally and alendronate regularly for more than one year were randomly divided into 2 groups:experimental group and control group. The experimental group consisted of 14 males and 22 females, with an average age of(63.97±3.70) years old. The patients in the experimental group took Chinese medicine DHD, one dose each time, one time in the morning and one time in the evening, twice a week. The control group consisted of 16 males and 20 females with an average age of(63.36±3.07) years old. Patients in the control group were given alendronate 70 mg orally once a week. The basic treatment for osteoporosis remained unchanged in both groups(600 mg of calcium carbonate D3 and 0.5 μg of calcitriol capsules were taken daily). Bone mineral density (BMD) of femoral neck and lumbar vertebrae was measured by dual energy X-ray absorptiometry before and after treatment for one year. The levels of serum collagen type I C-terminal peptide (beta-CTX) and serum osteoclast (SOST) were measured before and after treatment for two groups. RESULTS: The age, bone mineral density, SOST and beta-CTX baseline values between the two groups before and after anti-osteoporosis treatment were compared. The difference was not statistically significant(>0.05). Compared with the two groups, the BMD of femoral neck and lumbar vertebrae were increased after 1 year of anti-osteoporosis treatment. The differences were statistically significant (<0.001). The value of serum beta-CTX was significantly lower than before. The values were 52.002 and 50.071 respectively. The value of serum SOST was increased than that before treatment. The values were -29.242 and -30.807 respectively. The differences were statistically significant (<0.001). BMD of the femoral neck and lumbar spine was compared between the two groups after treatment. The P values were 0.294 and 0.478 respectively. The difference was not statistically significant (>0.05). The serum beta-CTX values were compared between the two groups after treatment. The value was 0.908. The serum SOST values were compared between the two groups after treatment. The value was 0.888. The difference was not statistically significant (>0.05). CONCLUSIONS In this study, traditional Chinese medicine DHD is used to treat osteoporosis. It is found that DHD and alendronate have a good effect. The DHD can be used as a choice of Chinese medicine in the treatment of primary osteoporosis.
Absorptiometry, Photon ; Aged ; Alendronate ; therapeutic use ; Bone Density ; Bone Density Conservation Agents ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis ; drug therapy

OBJECTIVETo evaluate the short and long term results of discectomy for lumbar intervertebral disc herniation.

METHODSFrom 2000 to 2007, 400 patients (male 220 and female 180, the age was from 16 to 73 years old with an average of 42.3 years) with lumbar intervertebral disc herniation underwent discectomy by posterior mini-incision less than 5 cm and vertebrae plate was ectomized in 2 cm x 2 cm winder,and nerve root was compressied. The short and long term clinical result were analyzed with SPSS 10.0 software.

RESULTSThree hundred and eighty patients were followed up in the short term (less than 2 years after operation), 308 cases obtained excellent result, 48 good, fair 24, the excellent and good rate was 93.7%. Three hundred and forty-eight patients were followed up in the long term (more than 3 years after operation), 244 cases obtained excellent result, 48 good, fair 56,the excellent and good rate was 83.9%. There was significant difference in follow-up between the short and long term (P < 0.05).

CONCLUSIONThe clinical effect of discectomy for lumbar intervertebral disc herniation decreased with time lapse.

Adolescent ; Adult ; Aged ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; therapy ; Lumbar Vertebrae ; pathology ; Male ; Middle Aged ; Time Factors ; Treatment Outcome

Adult ; Female ; Fractures, Open ; pathology ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Treatment Outcome ; Young Adult

Objective To observe the effect of Huoxue-Yixin decoction combined with atorvastatin on NT-pro and QTd in patients with chronic heart failure (CHF). Methods A total of 120 patients with chronic heart failure in our hospital from December 2016 to June 2017 were enrolled in this study. The subjects were randomly divided into the control group (n=60) and the treatment group (n=60). The control group were treated with conventional treatment,and the treatment group were treated with Huoxue-Yixin decoction combined with atorvastatin. The two groups were treated for 30 days. The NT-ProBNP, QTd, QTcd and LVESD, LVEDD, LVEF of the two groups before and after treatment were compared.Results The QTd at 2 d(45.6 ± 8.9 ms vs.64.0 ± 18.2 ms,t=-7.029),14 d(44.3 ± 6.8 ms vs.55.7 ± 12.8 ms,t=-6.092)in the experiment group were significantly lower than those of control group(P<0.01).The level of QTcd at 2 d(50.8 ± 10.1 ms vs.71.2 ± 19.8 ms,t=7.109), 14 d(48.1 ± 9.7 ms vs.63.1 ± 13.1 ms,t=7.128)of the experiment group were significantly lower than those of control group(P<0.01).After treatment,the NT-ProBNP(494.58 ± 331.61 ng/L vs.594.71 ± 382.65 ng/L,t=-1.532), LVESD(40.23 ± 3.13 mm vs.49.72 ± 3.99 mm,t=-14.495)and LVEDD(58.22 ± 3.30 mm vs.65.11 ± 3.95 mm, t=-10.720)of the treatment group were significantly lower than those of the control group(P<0.01).The LVEF (69.82% ± 4.72% vs. 50.34% ± 4.02%, t=-10.720) of the treatment group was significantly higher than the control group(P<0.01).Conclusions The Huoxue-Yixin decoction combined with atorvastatin can reduce the level of NT-ProBNP, QTd and QTcd in patients with CHF, can significantly improve cardiac function.

Objective: To summarize and explore the clinical effect and application of L-shaped flap pedicled with peroneal artery perforator in the treatment of unhealed lateral L-shaped incision after calcaneal fractures. Methods: From October 2013 to March 2015, 17 patients with unhealed L-shaped incision after calcaneal fractures were treated with one-stage thorough debridement, artificial bone filling with antibiotics-laden calcium sulphate and L-shaped flap pedicled with peroneal artery. Flap areas ranged from 8 cm × 2 cm to 11 cm × 3 cm. Donor sites are primarily sutured. Results: All 17 patients were followed up for 6 to 18 months with an average of 11.5 months. All patients with infection were cured effectively, demonstrating well survived flaps with normal elasticity and pigmentation, no scar contracture, satisfactory appearance and normal ankle joint motility. Conclusions L-shaped flap pedicled with peroneal artery perforator was an effective method in the treatment of unhealed lateral L-shaped incision after calcaneal fractures. It was suitable for coverage of the unhealed wound and worthy of being popularized.