Taking the basic theory of Chinese medicine as the instruction, through the bidirectional features of clinical manifestations, the relative etiology and pathology, acupoints and treatments, the bifunctional law in acupuncture theory is discussed. And it is held that after the confirmation of bidirectional symptoms of some diseases or syndromes, acupoints which have special functions in the bifunctional theory of acupuncture with a narrow meaning can be taken as major acupoints. And at the same time, other proper acupoints and flexible treating methods can be selected under the instruction of the bifunctional law of the broad meaning, so as to get the best therapeutic effect.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Medicine in Literature ; Meridians

Objective To increase curative rate of nonoperation treatment for adult blunt splenic trauma.Methods Data of 141 patients with blunt splenic trauma treated in our hospital from March 2010 to October 2014 were retrospectively analyzed in accordance with the spleen injury degree classification issued by the Spleen Surgery Group of Chinese Society of Surgery in 2000.According to the treatment within 6 hours of injury,these patients were divided into operative and nonoperative management groups.Results The proportion of non operation was 69.5％ (98/141) and the success rate was 89.8％ (88/98).43 cases were in operation group:34 cases in grade Ⅲ,9 cases with grade Ⅳ,3 cases died; 98 cases were in non operation group:including 32 cases of grade Ⅰ,50 cases of grade Ⅱ,15 cases of grade llⅢ,1 case with grade Ⅳ.10 cases failed non operation treatment including 1 case with grade Ⅰ complicated by pancreatic and intestinal injury causing peritonitis during the period of observation,1 case of grade Ⅱ complicated by contusion of the liver and secondary bleeding on day 3 after the trauma,7 cases of grade Ⅲ,were converted to surgery because of multiple organ injury and rebleeding secondary to pulmonary complications,and 1 case of grade Ⅳ with multiple organ injury and shock being immediately converted to surgery.In overall there were 2 deaths in nonsurgery group,1 case with grade Ⅲ and 1 case with grade Ⅳ.Condusions Nonoperative treatment of blunt splenic trauma is safe and feasible in grade up to]Ⅱ blund splenic trauma patients.

Objective To explore the variation of serum galectin-3 and its correlation with ventricular remodeling in children with chronic cardiac failure (CHF). Methods Forty-ifve children with CHF were included and divided into cardiac function II group (n=10 ), III group (n=18 ), and IV group (n=17 ) according to the severity of CHF. The subjects were also divided into endocardial fibroelastosis (EFE) group (n=21 ) and dilated cardiomyopathy (DCM) group (n=24 ) according to primary disease. Thirty health children were included as control group. The level of serum galectin-3 was detected by ELISA. The level of serum NT-pro BNP was measured by radio immunoassay. The index of ventricular remodeling was detected by ultrasonic cardiogram. The correlation of the level of serum galectin-3 with ventricular remodeling and the level of serum NT-pro BNP were analyzed. Results In 45 children ( 19 males and 26 females) with CHF, the mean age was 3 . 42 ± 1 . 89 years. The levels of serum galectin-3 and NT-pro BNP were higher in cardiac function II group, III group, and IV group than those in control group (all P?0 . 05 ). Spearman rank correlation analysis showed that the level of serum galectin-3 was positively correlated with the left ventricular end diastolic diameter, the left ventricular mass, the left ventricular mass fraction, and the level of serum NT-pro BNP (all P?

Objective To compare the antineoplastic immunological effects of nanoemulsion-encapsulated MAGE1-HSP70 and SEA(the ratio of MAGE1-HSP70 fusion protein to SEA superantigen was 100∶1)as NE(MHS)vaccine as given in different routes,and try to look for a novel and effective immune route.Methods NE(MHS)was prepared using magnetic ultrasound methods,and the size,the encapsulation rate and the stability of the nanoemulsion vaccine were evaluated.C57BL/6 mice were immunized via p.o.,subcut.,i.v.,or i.p.route.The cellular immunocompetence was detected by ELISpot assay and LDH release assay.The therapeutic and tumor challenge assay were examined too.Results When the vaccine was given orally,the tumor masses formed 28 days after B16-MAGE1 inoculation in mice were markedly bigger than that formed in the mice of the other groups(P

Objective To summarize the perioperative outcomes of patients undergoing endovascular repair,and to screen out related preoperative risk factors in order to provide reference for the promotion of postoperative rehabilitation of patients.Methods The clinical data of 2 896 patients undergoing elective endovascular repair in the Department of Vascular Surgery,Zhongshan Hospital,Fudan University from Jan.2013 to Dec.2014 were analyzed to screen out related preoperative risk factors of postoperative complications retrospectively.Results A total of 148 patients had postoperative complications,including 2 cases of death during hospitalization.The incidence of complications in the patients older than 75 years old,with hypertension,diabetic mellitus,renal dysfunction,chronic obstructive pulmonary disease (COPD) or ASA physical status more than grade Ⅱ is 9.7％,8.1 ％,14.3 ％,8.0 ％,29.7 ％,6.3 ％,respectively.The multivariate Logistic regression analysis identified that patients older than 75 years old (P =0.000,OR =43.29,95％CI:22.51-83.28),with hypertension (P=0.000,OR=3.822,95 ％CI:2.37-6.16),diabetic mellitus (P=0.025,OR=1.714,95％CI:1.07 -2.75),renal dysfunction (P =0.017,OR =2.692,95 ％ CI:1.19-6.07) or COPD (P =0.000,OR =7.158,95％CI:3.83-13.37) and ASA physical status more than grade Ⅱ (P =0.000,OR =27.77,95％CI:13.79-55.93) were the independent risk factors with postoperative complications of endovascular repair surgery.Conclusions The patients older than 75 years old,with hypertension,diabetic mellitus,renal dysfunction or COPD and ASA physical status more than grade Ⅱ were the independent risk factors for endovascular repair surgery.

Objective To determine the detection rate of duodenal papilla and the diagnostic rate of small bowel diseases by capsule endoscopy(CE)and its possible influencing factors.Methods A total of 369 cases with suspected small bowel disease who had undergone CE were retrospectively reviewed. The de- tection rate of duodenal papilla and that of small bowel disease were calculated respectively. The detection rate of duodenal papilla in another 369 patients having received gastroscopy was also counted in order to findout the miss detection rate of forward-viewing endoscopy. The CE findings were reviewed at the rate of 1 im-age and 15 images per second by hand-motion respectively. The detection rate of duodenal papilla was calcu-lated,and the number of frames showing duodenal papilla was counted. Differences of detection rate of duo-denal papilla were also analyzed by different age and gender groups. In addition,the potential difference in detection rate of duodenal papilla between different bowel preparations before CE of two different reviewing approaches was also investigated respectively. Results The miss detection rate of duodenal papilla with for-ward-viewing gastroscopy was 22. 0%. The detection rate of duodenal papilla reviewed at the rate of 1 image by hand-motion,where less frames were needed to visualize duodenal papilla(3. 7vs7. 0),was significantly higher than that at the rate of 15 images per second(32. 2%vs13. 6%,P=0. 001). The diagnostic rate of small bowel diseases was also significantly higher than that of duodenal papilla by CE(67. 2%vs32. 2%,P=0. 000). Age and gender were not significantly correlated with the detection rate of duodenal papilla. No significant correlation was found between various kinds of bowel preparation before CE at different viewing rate and the detection rate of duodenal papilla. Conclusion It iS relatively difficult to identify duodenal pa- pilla by CE,as they are peculiarly positioned in anatomy,so the detection of duodenal papilla does not nec- essarily represent the detection rate of small bowel diseases. The major factors that influencing the detection of duodenal papilla by CE include local anatomy,viewing rate and technical limitations of CE.

Objective To determine the role of extracellular signal-regulated kinases (ERK1/2) in aldosterone-induced rat mesangial cells (RMCs) proliferation. Methods RMCs were obtained from intact glomeruli of 4- to 6-week-old Sprague-Dawley rats and characterized according to published methods. RMCs between passages 5 and passages 10 were used. Protein levels of mineralocorticoid receptor (MR) in RMCs were analyzed by Western blotting. The cells were divided into the following groups: control group, PD98059 (10 (μmol/L) group, eplerenone (1 μmol/L) group, aldosterone (100 nmol/L) group, aldosterone (100 nmol/L) +PD98059 (10 μmol/L) group, aldosterone (100 nmol/L)+eplerenone (1 μmol/L) group. ERK1/2 activity was measured by Western blotting. Cell proliferation of RMCs was evaluated by [3H]-thymidine uptake measurements.Results MR protein expression in RMCs was confirmed by Western blotting. Aldosterone activated ERK1/2, and the maximal ERK1/2 activation induced by aldosterone was at a concentration of 100 nmol/L. Aldosterone (100 nmol/L)-induced activation of ERK1/2 peaked at 10 minutes (P＜0.05).Pretreatment with a selective MR antagonist eplerenone (1 μmol/L) significantly attenuated aldosterone-induced ERK1/2 phosphorylation. Aldosterone (100 nmol/L) treatment for 30 hours increased [3H]-thymidine incorporation of RMCs (135% ±8% of controls, P ＜0.05). Cellular proliferation induced by aldosterone could be prevented by pretreatment with eplerenone or an ERK (MEK) inhibitor PD988059. Conclusion Aldosterone induces RMCs proliferation through MR and ERK1/2 activation, which may contribute to the pathogenesis of glomerular mesangial injury.

Objective To probe into the medical practicing of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in Shanghai, discovering measures and suggestions for improvement Methods Such methods as onsite inspection and questionnaires were called into play to study the practice of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in 68 secondary and tertiary hospitals. Results Such three disciplines in the 68 hospitals have in total 3288 beds, 1142 medical practitioners, 19 assistant medical practitioners, and 1983 nurses. In 10 of the 68 hospitals, the medical space for these disciplines is non-standard; In 3 hospitals, personnel use is non-standard in general; 8% of the medical records are incompliant in generals 15% of the prescriptions are incompliant in general. Conclusion Medical practicing of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in Shanghai is found to be legally compliant in general. However, there exist defects in medical space, personnel use, as well as medical records and prescriptions. In this regard, enhanced management and inspection are recommended.

OBJECTIVE:To observe therapeutic efficacy and safety of tripterygium glycosides combined with valsartan in the treatment of idiopathic membranous nephropathy(IMN). METHODS:A total of 85 patients with IMN were enrolled and randomly divided into observation group(42 cases)and control group(43 cases). Based on routine treatment(reducing lipid,anti-platelet ag-gregation,protein dietary restriction),control group was additionally given oral valsartan,with initial dose of 80 mg/d,and gradu-ally adding the amount to 160 mg/d if there was no obvious ADR;based on control group,observation group was additionally giv-en Tripterygium glycosides tablet 40 mg,tid,and reducing the amount to 20 mg,tid after complete remission. 2 groups were treat-ed for 12 months. RESULTS:Total effective rate of observation group was 92.86%,which was significantly higher than that of con-trol group(74.42%),with statistical significance(P<0.05). Compared with before treatment,the levels of 24 h urine protein,TC and TG of 2 groups were decreased after treatment,and serum albumin(ALB)of observation group increased;24 h urine protein and TG of observation group was lower than control group,while the serum level of ALB was higher than control group,with sta-tistical significance(P<0.05 or P<0.01). No obvious ADR was found in 2 groups. CONCLUSIONS:Tripterygium glycosides com-bined with valsartan can improve the kidney function and blood lipid level of IMN patients with high safety.

Objective To investigate the clinical and laboratory characteristics of anticentromere antibody (ACA)and anti-SSA antibody expressions in patients with Primary Sj(o)gren's Syndrome (PSS). Methods Twelve PSS patients with ACA positive but SSA negative(ACA PSS)and 19 PSS patients with SSA positive but ACA negative(SSA PSS)were enrolled into the study and classified into two groups. We compared the age,laboratory data,occurrence of Raynaud's phenomenon(RP),and histological changes in minor labial salivary glands biopsies of the patients from two group. Results The mean age of the ACA PSS group(68.4 ± 7.9)years was significantly higher than that of the SSA PSS(54. 6 ± 16. 2)years group(P ＜ 0. 05). Serum IgG level of ACA PSS group(17. 89 ±4. 08)g/L was close to the normal range,which was significantly lower than that of SSA PSS(27.90 ±6. 72)(P ＜0. 01). Leukocytopenia was less frequently observed in ACA PSS than in SSA PSS(P ＜ 0. 05),the difference between two groups was statistically significant. We also found more frequent RP in the ACA PSS group than SSA PSS group(P ＜ 0. 05). Conclusions Our data confirm that ACA positive PSS differs from SSA positive PSS at several clinical respects and laboratorial examinations.