OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

In order to summarize and perfect the basic skill practicing method in acupuncture teaching and form a characteristic teaching, the research on skill training and technique improving of acupuncture and tuina major was carried out. The undergraduate students in acupuncture and tuina major from College of Acupuncture-Moxibustion and Tuina were randomly divided into an experimental group and a control group. Students from both groups received the basic courses of acupuncture-moxibustion and tuina as requested in the syllabus and the special teaching was added to the experimental group, namely "three practice" (strength practice, coordination practice, targeted practice of acupuncture basic skills) and "three enlightenment" (technique enlightenment, mind and qi enlightenment, efficacy enlightenment). During and after the courses, the teaching effectiveness was evaluated on the basis of needling manipulation. The peacetime score in the experimental group was superior to that in the control group (38.03 +/- 1.14 vs 33.25 +/- 1.31, P < 0.05), the total score in the experimental group was superior to that in the control group (84.03 +/- 6.30 vs 78.05 +/- 6.55, P < 0.05). The special teaching method of "three practice" and "three enlightenment" can improve the effect of skill training teaching method. It highlights the unique feature of central plains by integrating the essence of Shaolin internal qigong and Chen-style Taiji, it can also provide new ideas for the practical teaching of TCM professional courses and the construction of characteristic professionals.
Acupuncture ; education ; manpower ; Acupuncture Therapy ; methods ; Humans ; Students ; Teaching

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Drug-Eluting Stents ; adverse effects ; Humans ; Male ; Plaque, Atherosclerotic ; complications ; Rupture ; Thrombosis ; complications

Study the serum level of HGF, Cys C and TGF-beta1 in type 2 diabetic nephropathy (DN), the infect of Pingshen decoction on those index. Selected 69 cases of 2 type DN and randomly divided into therapy group (36 cases) and control group (33 cases). The therapy group were treated with Pingshen decoction 1 dose/d, bid po. The control group were treated with NephritisShu tablet, 6 tablet, tid po. 8 weeks was a course. Before and after treatment, we examine the serum level of HGF, Cys C and TGF-beta1 by ELISA and immunonephelometry, and compare with 30 cases of healthy control group. The study demonstrates that before treatment, the serum level of HGF in both groups were significantly lower than healthy control group (P < 0.01), but Cys C, TGF-beta1 were significantly higher (P < 0.01). After treatment, the serum level of HGF of both groups were increased. The serum level of HGF of therapy group were significantly higher than of control group (P < 0.01), but the serum level of Cys C and TGF-beta1 were significantly lower than control group (P < 0.01). The serum level of HGF was correlated negatively with Cys C,TGF-beta1. In control group, the UAER, urine beta2-MG and quantity of 24-hour urine protein were significantly decreased after treatment (P < 0.01). The index of urine of therapy group were significantly lower than control group (P < 0.01). Results indicate that test of serum level of HGF and Cys C,TGF-beta1 of diabetic nephropathy have important clinical significance. Pingshen decoction can effectively intervene in the serum level of HGF and Cys C, TGF-beta1 and index of urine.
Aged ; Aged, 80 and over ; Case-Control Studies ; Cystatin C ; blood ; Diabetic Nephropathies ; blood ; drug therapy ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Hepatocyte Growth Factor ; blood ; Humans ; Male ; Middle Aged ; Transforming Growth Factor beta1 ; blood

Objective To preliminarily investigate the clinical features and efficacy of surgical treatment of moyamoya syndrome in patients w ith hyperthyroidism. Methods From December 2002 to April 2013, 41 patients w ith moyamoya syndrome based on the disease of hyperthyroidism admitted to the Department of Neurosurgery, the 307th Hospital of PLA w ere analyzed retrospectively. The clinical data w ere colected, including sex, age of onset, initial symptoms, progress symptoms, imaging features, Suzuki staging, and surgical efficacy, and they w ere compared w ith the clinical data of the patients w ith moyamoya disease treated at the same time. Results The ratio of male to female w as about 1∶4 in moyamoya syndrome patients w ith hyperthyroidism. The peak age of onset w as 25 to 34 years old. Compared w ith the patients w ith moyamoya disease at the same period, the proportion of patients w ith cerebral infarction as initial symptom w as higher in the moyamoya syndrome group ( 39.0% vs.24.2%; χ2 = 4.796, P =0.029), more patients had symptomatic progression (46.3% vs.25.4%; χ2 =9.207, P =0.002), and the proportion of of patients w ith cerebral hemorrhage as initial symptom w as low er ( 2.4% vs.14.6%; χ2 = 4.829, P =0.028). Thirty-seven patients w ho received encephalo -duro-arterio-synangiosis (EDAS) w ere folow ed up for 43 ± 19 months. The results show ed that the clinical symptoms of 31 patients had different degrees of improvement. Conclusions Moyamoya syndrome of hyperthyroidism is more common in w omen. The risk of cerebral infarction is higher and more prone to have disease progression. The efficacy of EDAS is better for controling the progression of moyamoya syndrome in patients w ith hyperthyroidism.

Objective To summarize the safety and efficacy of Sunitinib in the treatment of metastatic renal clear cell carcinoma. Methods Fifteen patients with clear cell metastatic RCC were treated with Sunitinib,with 11 males and 4 females,aged from 26 to 74 years with median age of 55 years.Thirteen cases of 15 were T3 to T4 stage,and 8 cases underwent radical nephrectomy,while 5 other cases underwent renal biopsy with the pathological diagnosis of renal cancer.The other two cases (one man and one woman)with the solitary kidney renal cell carcinoma ( stage T1a) and renal insufficiency,were diagnosed as metastatic renal cell carcinoma by biopsy.Sunitinib monotherapy was administered by the regimen of 6 weeks per cycle with daily oral Sunitinib 4 weeks,followed by 2 weeks off ( from 1 - 10 cycles).Response was evaluated by RECIST.Renal tumor was 9.52 ± 3.3 cm in diameter at baseline,and the assessment of metastases included retroperitoneal lymph nodes (6 cases),mediastinal lymph nodes (3 cases),brain (2 cases),lung (6 cases),bone (2 cases) and liver (2 cases).Karnofsky score,tumor changes,adverse events and the survival of each patient was assessed and recorded. Results The follow-up duration was from 1.5 - 15months,with median follow-up of 6 months,and tumor response was evaluated by RECIST.Seven of 15 patients (46.7％) treated with Sunitinib achieved partial responses (PR),7 patients (46.7％) demonstrated stable disease (SD),and 1 patient (6.7％) developed progressive disease (PD) during the follow-up.Objective Response Rate (ORR) was 46.7％,PR + SD was 93.3％,6 months PFS was 93.3％,and median PFS was 12 months,respectively.Renal tumor was 8.7 ± 4.0 cm in diameter after therapy.Two PR patients with the obvious effectiveness had experienced progressed hypertension,and one cases with hypertension that could be controlled below 140/90 mm Hg ( 1 mm Hg =0.133 kPa) by a single drug before treatment,showed increased blood pressure ( ＞ 160/105 mm Hg) following the second cycles treatment,who were administered increased dosage and combination therapy.The other case without history of hypertension,showed high blood pressure ( ＞ 150/100 mm Hg) in the third cycle,and could be controlled well by antihypertensive drugs.Fortunately,the tumor of these two cases reduced obviously by more than 50％. 1/2 adverse reactions of 12 cases:yellowing of the skin and yellow sweat ( 12 cases,80％ ),fatigue ( 12 cases,80％ ),4 cases of hypothyroidism (26.7％),bilirubin and triglyceride levels elevated in 7case (46.7％); Four cases showed 3/4 degree adverse events with the emergence of gastrointestinal bleeding in one case secondary to platelets reduction (6.7％).Three cases (20％) showed serious fatigue,nausea,vomiting and severe hand-foot skin reaction. Conclusions Sunitinib is recommended for the treatment of metastatic renal clear cell carcinoma with good efficacy and safety.

The government of the Song Dynasty paid high attention to develop the science of acupuncture and moxibustion, improved the position of acupuncture and moxibustion, specially made collation and systematization on ancient books of acupuncture and moxibustion, compiled monograph of acupuncture and moxibustion, set up acupuncture and moxibustion program and founded acupuncture bronze statue, launched experiment teaching and so on, which made acupuncture and moxibustion spread and be populated, accelerating the development and advancement of acupuncture and moxibustion sciences.
Acupuncture ; history ; China ; History, Medieval ; Moxibustion ; history

Study the transition factors of valuing acupuncture above moxibustion in Song, Jin and Yuan dynasties. The transition factors of valuing acupuncture above moxibustion in Song, Jin and Yuan dynasties are the breakthrough in pathogenesis theory and syndrome differentiation theory, the improvement of meridian theory, the flexible prescriptions, the widely practices of Chinese medicine in clinical settings, changes of diseases spectrum, the prevalence of heat diseases, the increase in trauma and fracture, and the limitations and disadvantages of moxibustion.
Acupuncture Therapy ; history ; China ; Drug Therapy ; history ; Drugs, Chinese Herbal ; therapeutic use ; History, Ancient ; Humans ; Medicine, Chinese Traditional ; history ; Moxibustion ; history

OBJECTIVETo observe the differences of therapeutic effects on common cold of wind-cold type at early stage treated by different cupping duration.

METHODSSixty cases of common cold of wind-cold type were randomly divided into an observation group and a control group by fifty-fifty. Flash cupping was applied at Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Xinshu (BL 15) and Geshu (BL 16), etc., and the cupping was retained for 25-30 min in the observation group and 15 min in the control group. The therapeutic effects were compared after twice treatments.

RESULTSThe total effect rate was 93.3% (28/30) in observation group, superior to that 66.7% (20/30) in control group (P < 0.01).

CONCLUSIONThe therapeutic effect of common cold of wind-cold type at early stage treated with cupping for 25-30 min is obvious, superior to that for 15 min.

Acupuncture Points ; Adolescent ; Adult ; Common Cold ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Treatment Outcome ; Young Adult

To investigate the changes in bcl-2, bax expression and neuron apoptosis in the hippocampus after the blockade of cervical lymphatics, the model of lymphostatic encephalopathy was established by occluding and removing both the superficial and deep cervical lymph nodes in rats. The animals were sacrificed at 1, 2, 3, 5, 7 and 14 d after operation. H and E staining was used to observe the structure of brain tissues and TUNEL staining was used to detect in situ cell apoptosis in the hippocampus. The expression of bcl-2 and bax in the hippocampus were examined by RT-PCR. The results showed that cerebroedema appeared at day 2 and was most serious at day 5 after the blockade of cervical lymphatics. The number of TUNEL positive cells began to increase at day 2 and reached the maximum at day 5. The expression of bax began to increase at day 1 and reached the maximum at day 2. The expression of bcl-2 began to decrease at day 1 and dropped to the minimum at day 5. The items mentioned above recovered to control level at day 14. These results suggest that lymphostatic encephalopathy following the blockade of cervical lymphatics result in changes in bcl-2 and bax expression in the hippocampus and that apoptosis is the main form of neuron death.
Animals ; Apoptosis ; physiology ; Female ; Hippocampus ; metabolism ; pathology ; Lymph Node Excision ; Lymphatic System ; physiology ; Male ; Neck ; Neurons ; cytology ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; bcl-2-Associated X Protein ; genetics ; metabolism