The painless needle insertion technique, summarized by Professor WU Lian-zhong during his decades of acupuncture clinical practice is introduced in this article, which is characterized as soft, flexible, fast, plucking and activating antipathogenic qi. The Sancai (three layers) lifting and thrusting manipulation technique is adopted by Professor WU for getting the qi sensation. And features of 10 kinds of needling sensation such as soreness, numbness, heaviness, distension, pain, cold, hot, radiation, jumping and contracture are summarized. Finger force, amplitude, speed and time length are also taken as the basis of reinforcing and reducing manipulations. Moreover, examples are also given to explain the needling technique on some specific points which further embodies Professor WU's unique experiences and understandings on acupuncture.
Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans ; Needles

ObjectiveThis paper aims to probe into the effect of working and studying combined teaching reform of chnical medicine major.MethodsTwo classes containing 46 students respectively were selected at random as observation group and control group,from the six classes of Grade Two majoring in clinical medicine.The two groups of students were trained by adopting working and studying combined teaching model and traditional teaching model respectively,after which they were evaluated in terms of clinical theory,practical skills and operations,and exercitation achievement.ResultsThe observation group does better in practical skills and exercitation achievement than the control group,while they have no difference in clinical theory.ConclusionWorking and studying combined teaching model can improve students' clinical analytical ability,strengthen their awareness of medical morals,and help them achieve more in exercitation.

Adult ; Diabetes Mellitus ; etiology ; Humans ; Male ; Nose Diseases ; etiology ; surgery ; Pancreatitis ; complications ; Reconstructive Surgical Procedures ; Ulcer

Objective To evaluate surgical treatment of infected femoral artery pseudoaneurysm.Methods The data on surgical treatment of 45 patients with infected femoral artery pseudoaneurysm admitted from January 2003 to June 2008 were analyzed retrospectively.Fourty-three patients underwent operative treatment including excision of infected femoral artery pseudoaneurysm,exhaustive debridement and bypass graft with vascular prosthesis.Two patients were unavoidable to undergo removing of infected femoral artery pseudoaneurysm and ligating the proximal and distal artery of pseudoaneurysm because of severe infection and large volume.Results The patients were followed up from 3 to 12 months(mean 7.82 months).The limbs of all the patients underwent bypass graft with vascular prosthesis were salvaged successfully,patients of which had secondary wound healing and had not intermittent lameness.One of two patients performed ligation of artery was salvaged successfully but had severe intermittent lameness,another patient underwent high amputation above knee because of ischemic gangrene.ConclusionFor infected femoral artery pseudoaneurysm,the operative treatment including excision of infected femoral artery pseudoaneurysm,exhaustive debridement and bypass graft with vascular prosthesis is effective and safe.

Objective　To study the value of B type ultrasonography guiding percutaneous radiofrequency ablation (PRFA) for hepatic cancer (HC). Methods　70 patients with primary or metastatic hepatic malignancies were treated by PRFA under ultrasound guidance through LeVeen multipolar array needle electrode and RF 2000. All patients were followed up by turnor marker, B type sounography and MRI monthly. Results　PRFA were performed in 53 patients with hepatocellular carcinoma (HCC) and 17 cases with metastatic liver cancer. Liver function classfication was 53 cases in Child class A, 15 in class B and 2 in class C. In 21 patients with non-operated small HCC (≤5 cm), 12 of 17 patients with AFP positive were decreased to normal (70.6%) and decreased markedly in 4 (23.5%), and MRI showed the treated tumors were completely necrosis in 16 patients (76.2%). The 3, 6 month survival rates were 90.5%, 100% respectively in small HC groups, and 66.7% to 72.7% and 27.6% to 72.7% in large HC groups.Conclusions　PRFA as a local thermal therapy is becoming a kind of new palliative treatment for hepatic malignancies, which not only is safe, minimally invasive, and effective for small ones; but also can be used with combination of TACE for larger ones.

Objective To study the effects of sodium bicarbonate (SB) on resuscitation in swine model of asphyxiation cardiac arrest (CA).Methods Thirty-two healthy miniature pigs were randomized (ramdom number) into two groups,the SB group (n =16) and the control group (n =16).Animals in both groups underwent endotracheal tube clamping to induce CA.Once induced,CA left untreated for a period of 8 minutes.At the beginning of initiation of cardiopulmonary resuscitation (CPR),SB (1.0 mEq/kg,diluted to 40 mL) was injected in central venous in SB group and isopyknic normal saline solution was injected in control group.Two minutes following initiation of CPR,defibrillation was attempted until return of spontaneous circulation (ROSC) was achieved or animals died.To assess the SB effects on myocardial metabolism,positron emission tomography (PET) was performed at baseline and 6 after ROSC.To analyze 18F-FDG myocardial uptake identified in PET,the maximum standardized uptake value (SUV) was measured.Results ROSC was 10/16 successful in SB group and only 8/16 successful in control group.The average survival time of SB group was (3.63 ± 0.76) h and that of control group was (2.45 0.70) h.Myocardial metabolism imaging using PET demonstrated that myocardial metabolism injuries in control group were more severe than in SB group at 6 h after ROSC and SUVmax was more higher in SB group than in control group (6 hrs after ROSC:1.32 ± 0.20 vs.1.10 ± 0.14,P =0.035).Conclusions In swine model of asphyxiation CA,SB improve the myocardial metabolism and might raise the possibility of ROSC and have no hypernatronemia.

ObjectiveTo evaluate the clinical efficacy and safety of astragalus injection on the immune function in patients with senile sepsis.Methods Sixty patients with old age sepsis in Critical Care Medicine Department of Guangdong Provincial Traditional Chinese Medicine Hospital were enrolled and randomly assigned into control and treatment groups according to the table of random numbers, 30 cases in each group. According to 2012 sepsis guidelines for treatment, including antibacterial drug, mechanical ventilation, visceral function support, etc., the therapy was given to the control group; besides the treatment in the control group, intravenous drip of 60 mL astragalus injection(10 mL per ampoule) in 250 mL 0.9% normal saline was additionally given in the treatment group, once a day for 7 days. Before and after treatment, the immunological indexes, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment(SOFA) score, duration of mechanical ventilation and time of stay in intensive care unit(ICU), 28-day mortality and adverse drug reactions were compared between the two groups.Results Before treatment, there were no statistically significant differences in CD3+, CD3+CD4+, CD3+CD8+ and T helper cells /T suppressor cells(Th/Ts)levels between the two groups(allP>0.05), while CD3-NK+ of the control group was significantly higher than that in the treatment group〔(10.47±6.22)% vs. (6.26±4.13)%,P<0.05〕. After treatment in treatment group, CD3+, CD3+CD4+ and CD3-NK+ were increased, CD3+CD8+,Th/Ts were decreased compared with those before treatment; in the control group after treatment, CD3+,CD3+CD8+ and CD3-NK+ were decreased and CD3+CD4+ and Th/Ts increased compared with those before treatment. In the comparisons between the treatment group and control group after treatment, the differences in CD3+, CD3+CD4+ and CD3+CD8+ had statistical significance〔CD3+:(30.30±17.17)% vs.(41.91±22.29)%, CD3+CD4+:(31.54±13.24)% vs.(40.08±15.28)%, CD3+CD8+:(14.25±8.10)% vs.(9.52±9.33)%,allP<0.05〕; while the differences in Th/Ts and CD3-NK+ had no statistical significance(bothP>0.05). After treatment in the treatment group, IgG was increased compared with that in the control group〔IgG(g/L): 13.07±5.43 vs. 10.10±3.96,P<
0.05〕. The differences in IgA, IgM, complement(C3,C4) and total serum complement activity(CH50) in the comparisons between the two groups had no statistical significance after treatment(allP>0.05). The differences in APACHEⅡ score(13.83±6.18 vs. 15.90±7.48), SOFA score(7.38±4.66 vs. 6.89±4.19), time of stay in ICU(day: 11.63±5.13 vs. 13.62±8.08), invasive ventilation time(hour: 155.44±119.68 vs. 224.08±174.15) and noninvasive ventilation time(hour: 55.55±42.24 vs. 98.57±43.17) had no statistical significance in comparisons between the treatment group and control group after treatment(allP>0.05). The difference in 28-day mortality had no statistical significance in comparison between the treatment group and control group〔16.7%(5/30) vs. 20.0%(6/30),P>0.05〕. In 60 cases, there were 2 patients with adverse drug reaction, one diarrhea and another little rashes, the rest of the patients did not appear any drug side effect.ConclusionAstragalus injection combined with conventional western medicine therapy possibly has certain effect on adjustment of disturbance of immunologic functions in old patients with sepsis, and its therapeutic safety is well.

Objective To study the effect of Neuregulin-1 (NRG) on rat heart failure(HF) after myocardial infarction,and to investigate the underlying mechanism involving in NRG-mediated cardioprotection.Methods 60 adult Wister rats underwent sham operation (n=12) or coronary ligation (n=48) to induce HF.Four weeks after ligation,28 animals with HF were randomly divided into NRG group (rats received rhNRG-1 10 μg · kg-1 · d-1 intravenously for 10 days) or HF group (rats received an equal volume of water intravenously for 10 days).Left ventricular function was detected by echocardiography.Mitochondrial ultrastructure in non-infarcted myocardium was observed by transmission electronic microscopy.Cell apoptosis was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) assay.Mitochondrial membrane potential was measured by immunofluorescence method.Caspase-3 activity was determined by commercial kit.The expression of cytochrome C protein in cytoplasm was detected by Western blot.Results Compared with HF group,the left ventricular end-systolic diameter was decreased,and left ventricular ejection fraction and fractional shortening were increased in NRG group (P＜0.05 or 0.01).Apoptosis index was reduced inNRG group as compared with HFgroup [(18.1±3.0)％ vs.(11.9±1.4)％,P＜0.01].Mitochondrial membrane potential was increased and the release of cytochrome c in cytoplasm was reduced in NRG group as compared with HF group [(249.8±7.4) mV vs.(222.2±7.5) mV,(0.356±0.024) vs.(0.664±0.085),both P＜0.01].Caspase-3 activity was decreased in NRG group as compared with HF group (P＜0.01).Conclusions NRG attenuats mitochondrial stress and inhibits myocardial cells apoptosis in heart failure rats after myocardial infarction,which may play an important role in the cardioprotection by NRG.

Objective To determine the renal function compromised in patients after ST-segment elevation myocardial infarction (STEMI) with left ventricular aneurysms (LVA) by measurement of serum cystatin C (Cy-C) concentrations and Cy-C-based eGFR.Methods A total of 355 patients admitted from January 2011 to December 2012 could be categorized into group A (STEMI without LVA,n =183) and group B (STEMI with LVA,n =172) confirmed by echocardiography in 24 hour after admission.Of them,273 patients were treated with primary percutaneous coronary intervention (PCI) after admission and included in the analysis.Cy-C-based estimated glomerular filtration rate (eGFR) and creatinine (Cr)-based eGFR were calculated for evaluating cardiac function in tern to assess the magnitude of compromised renal function.The correlation between magnitude of compromised renal function and in-hospital mortality was analyzed.Distributions of categorical variables were compared using the chi-square test.Continuous variables were compared by one-way ANOVA with the Bonferroni test.Results The in-hospital mortality rate of whole patient cohort was 14.0％.Mortality in the group B was 18.6％ and in the group A was 9.8％ (P ＜ 0.01).With multivariable regression analysis,the compromised renal function was found when the Cr-based eGFR was ＜60 mL/ (min · 1.73 m2) or Cy-C-based eGFR was ＜ 60 mL/min/1.73m2 which were independently associated with in-hospital mortality (OR 0.13,95％ CI 0.02-0.7,P =0.02 ; OR 0.01,95％CI 0.003-0.05,P ＜ 0.01).Compared with the acute myocardium infarction (AMI) patients with chronic kidney disease (CKD) stage 2,the Cy-C based eGFR was greater in the AMI patients with LVA group (P ＜ 0.05),and compared with AMI with CKD stages 3 or CKD 3-5,this difference was also significant (P ＜ 0.01).Conclusions Renal dysfunction was an independent predictor of in-hospital mortality in patients with STEMI,especially in patients with LVA.Cy-C and Cy-C based eGFR were more sensitive to judge renal dysfunction in STEMI patients with LVA.

Purpose:To investigate the value of susceptibility-weighted imaging(SWI)in evaluating the histopathologic grade of cerebral astrocytomas.Materials and Methods: 18 patients with histologically proven cerebral astrocytomas,including 7 diffuse astrocytomas,3 ana-plastic astrocytomas and 8 glioblastomas before treatment were involved in this study.The features on SWI were analyzed in 18 cerebral astrocytomas.Results: The veins in the tumors were not detected in 7 diffuse astrocytomas.Slight edema round tumors appeared in all the diffuse astrocytomas.Plenty veins in the tumors and severe edema round the tumors appeared in 3 anaplastic astrocytomas and 8 glioblastomas.The hemorrhagic foci were detected in 1 anaplastic astrocytomas and 6 glioblastomas.The edema round the tumors were moderate or severe in all the anaplastic astrocytomas or glioblastomas.Conclusions: Susceptibility-weighted imaging can provide the informations about blood supply,hemorrhagic focus and edema round the tumors.SWI is very useful for preoperative evaluation of the histopathologic grade of cerebral astrocytomas,especially for evaluation of high or low grade astrocytomas.