Objective:To explore therapeutic effect of pharyngeal treatment machine (PTM) combined resuscitating acupuncture (RA) on patients with dysphagia after stroke.Methods: A total of 98 stroke patients with dysphagia were selected.According to random number table, they were randomly and equally divided into pure pharyngeal treatment group (received pure PTM therapy based on routine treatment) and combined treatment group (received RA based on pure pharyngeal treatment group).Video fluorography (VFG) score and swallow-quality of life (SWAL-QOL) score before and after treatment, and total effective rate were evaluated and compared between two groups.Results: Compared with before treatment, there was significant rise in VFG score, and significant reduction in SWAL-QOL score in both groups after treatment, P<0.01 all;compared with pure pharyngeal treatment group after treatment, there was significant rise in VFG score [(5.46±2.04) scores vs.(6.54±2.75) scores], and significant reduction in SWAL-QOL score [(741.33±25.92) scores vs.(632.54±26.77) scores] in combined treatment group, P=0.032, 0.001 respectively.Total effective rate of combined treatment group was significantly higher than that of pure pharyngeal treatment group (93.88% vs.75.51%), P=0.014.Conclusion: Compared with pure pharyngeal treatment machine, pharyngeal treatment machine combined resuscitating acupuncture possesses better therapeutic effect for recovery of swallowing function, which is worth extending.

Objective To observe the therapeutic efficacy of low-frequency electrical stimulation (LFES) plus acupuncture in treating deglutition disorders after cerebral stroke. Method Seventy-six patients were randomized into two groups. The treatment group (38 cases) was intervened by LFES plus acupuncture;the control group (38 cases) was by LFES. Result The water drinking test scores were significantly changed after the treatment in both groups (P<0.05); after the intervention, there were significant differences in comparing the water drinking test score, improvement score, and therapeutic efficacy grading between the two groups (P<0.05). Conclusion LFES and acupuncture are both effective in treating deglutition disorders after cerebral stroke, and the combination of the two methods can enhance the clinical efficacy.

Objective To discuss the X-knife radiosurgery (XKS) in the treatment of brain metastasis of lung carcinoma. Methods A total of 100 patients with similar prognostic factors were divided into two groups with 50 patients in each group, receiving either whole-brain radiotherapy alone (30~40 Gy/3~4 weeks) (Radiotherapy Group) or XKS combined with radiotherapy (Combination Group). In the Combination Group, 27 patients received XKS with single fraction of radiation, with a median prescription dose of 14.2 Gy, and the other 23 patients received multiple fractions of radiation (5~10 Gy/f, 3 times weekly), with a total dose of 15~30 Gy. Results In the Combination Group and the Radiotherapy Group, the median survival time was 16.4 and 10 months, respectively (P=0.0064), the 2-year local tumor control rate was 88% (44/50) and 44% (22/50), respectively (?2=21.569,P=0.000), and the effective rate under CT or MRI scanning at 1~3 months after treatment was 87.5% (35/40) and 52.2% (24/46), respectively (?2=16.497,P=0.001). An analysis on the cause of death showed that 11.9% of patients (5/42) in the Combination Group died from brain metastasis, which was significantly lower than that in the Radiotherapy Group (55.6%, 25/45) (?2=25.908,P=0.000). The incidence of complications was not significantly different between the Combination Group (8%, 4/50) and the Radiotherapy Group (4%, 2/50) (?2=0.709,P=0.400). Conclusions Combined use of X-knife radiosurgery and routine radiotherapy has better therapeutic effects than radiotherapy alone for treating brain metastatic tumor.

Objective To investigate the effect of different doses of ketamine on inflammatory cytokines in rabbits with severe burn at early stage and preliminarily approach its regulatory action on early stage of inflammatory reaction due to stress of trauma.Methods Forty healthy male New Zealand rabbits were randomly divided into four groups in accord with the random number table method: normal control group, scald model group, ketamine analgesia group and ketamine anesthesia group. Before scald, pentobarbital sodium was used for anesthesia, afterwards catheters were inserted into internal jugular vein and internal carotid artery respectively ready for use, and 24 hours later, Ⅲ degree scald at the animal back and buttocks occupying 30% total body surface area (TBSA) was performed as the scald model for all the rabbits except those in normal control group. In ketamine analgesia group, after scald for 0.5 hour, 0.5 mg/kg ketamine intravenous injection was given to the rabbits as the loading dosage and then persistent intravenous pump infusion of 9μg·kg-1·min-1 ketamine was applied for all together 24 hours. In ketamine anesthesia group, after scald for 0.5 hour, 1.5 mg/kg ketamine intravenous injection was given to the rabbits, and then persistent intravenous pump infusion of 45μg·kg-1·min-1 ketamine was applied for 4 hours to maintain systemic anesthesia. In normal control and scald model groups, only intravenous infusion of equal amount of normal saline was given to the rabbits. The amount of intravenous transfusion in each group and the total dosages of ketamine used in ketamine analgesia group and ketamine anesthesia group were recorded. Before scald and 0.5, 6, 12, 24 hours after scald, arterial blood gas analyses were made, and the levels of serum interleukins (IL-1, IL-6) and tumor necrosis factor-α (TNF-α) were determined.Results Although the indexes of blood gas analysis were changed in the four groups, they were all in the normal range, showing that the respiratory function was in the normal range and indirectly reflecting that the circulatory function was also in the normal range, thus the effects on cytokines by factors of respiratory and circulatory functions were ruled out. The levels of IL-1, IL-6 and TNF-α before scald showed no statistically significant differencesamong the four groups (allP > 0.05). From 0.5 hour after scald, the levels of IL-1, IL-6 and TNF-α were markedly higher in model group than those of normal control group [IL-1 (ng/L): 30.27±0.93 vs. 13.79±1.11, IL-6 (ng/L): 47.22±1.49 vs. 46.31±4.12, TNF-α (ng/L): 243.39±20.85 vs. 190.95±14.97, allP < 0.05], and the situation continued until 24 hours after scald; the levels of IL-1, IL-6 and TNF-α from 6 hours after scald were significantly decreased in ketamine analgesia and ketamine anesthesia groups compared with those in the model group, and from 12 hours after scald, the degrees of descent in levels of the above indexes in ketamine analgesia group were more obvious than those in ketamine anesthesia group [IL-1 (ng/L): 19.28±2.51 vs. 40.12±10.31, IL-6 (ng/L): 52.10±4.23 vs. 72.20±10.11, TNF-α (ng/L): 246.03±20.74 vs. 313.71±27.34, allP < 0.05].Conclusion The low-dose ketamine analgesia and ketamine anesthesia have certain degree of inhibitory effect on the expression and release of inflammatory cytokines at the early stage in rabbits with severe burn, the effect of long-term low-dose ketamine analgesia being more significant.

In this study, the psbA-trnH sequence was used as DNA barcoding to evaluate the accuracy and stability for identification of Bamboo shavings, Concretio Silicea Bambusae and their closely related species. 56 samples were collected and conducted the DNA extraction. Obtained sequences were assembled using the CodonCode Aligner V4.2, the genetic distances and NJ tree were computed and constructed using MEGA 5.0. The results shows that the maximum intra-specific K2P distances were less than the minimum inter-specific K2P distances. The NJ tree indicated that Bamboo shavings, Concretio Silicea Bambusae and their closely related species can be distinguished from each other clearly, except for Bambusa tuldoides Munro and Bambusa textilis, which perhaps attributed to their closely genetic relationship.

Objective:To observe the clinical effect of mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus for deglutition disorder of stroke patients in convalescence stage.Methods:A total of 136 patients conforming to the inclusion criteria were randomized into three groups by the random number table,including group A of 46 cases,group B of 44 cases and group C of 46 cases.Patients in group A received swallowing disorder therapeutic apparatus treatment,patients in group B received mind-refreshing and orifice-opening needling method treatment,and patients in group C received mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus treatment.The treatment was given once a day for 10 d as a course,the whole treatment lasted for 4 courses.Therapeutic evaluation items including water-swallowing test (WST),standardized swallowing assessment (SSA) and modified Barthel index (MBI) were measured before treatment,after treatment and at follow-up visit (2 months after treatment).Results:After treatment,scores of WST and MBI in all three groups increased significantly (all P＜0.05),while the SSA score dropped significantly (all P＜0.05).After treatment and during follow-up visit period,score of WST in group C was significantly higher than that in group A and group B (both P＜0.05),while the difference between group A and group B showed no statistical significance (P＞0.05);the SSA score in group C was substantially lower than that in group A and group B (all P＜0.05),the difference between group A and group B showed no statistical significance (P＞0.05);the MBI scores in group B and group C were substantially higher than that in group A (all P＜0.05),the difference between group B and group C showed no statistical significance (P＞0.05).After treatment and during follow-up visit period,the differences in overall therapeutic effect between group A and group B showed no statistical significance (P＞0.05),while the overall therapeutic effect in group C was substantially better than that in group A and group B (all P＜0.05).Conclusion:Both mind-refreshing and orifice-opening needling method and swallowing disorder therapeutic apparatus can alleviate symptoms of deglutition disorder of stroke patients respectively,and the combination of two methods can improve the therapeutic effect.

OBJECTIVETo observe the impacts on the muscle strength in the patients of stroke-induced acroparalysis treated with Xunjingcuiqi needling technique.

METHODSOne hundred patients were randomized into a Xunjingcuiqi group and a routine acupuncture group, 50 cases in each group. In the routine acupuncture group, the routine acupuncture technique was adopted at the main acupoints, such as Shangxing (GV 23), Baihui (GV 20), Dicang (ST 4), Quchi (LI 11), Huantiao (GB 30) and Zusanli (ST 36), etc. In Xunjingcuiqi group, on the basis of the routine acupuncture technique, Xunjingcuiqi needling technique (pricking technique was quickly applied with the filiform needle along the running course of meridian to promote the conduction of meridian qi) was added. For the patients being hard to feel the needling sensation and with the muscle strength of 0 to 1 degree, Dongzhencuiqi technique was supplemented at shu-stream points of yang meridians (after qi arrival, the needling manipulation with limb movement was given to promote the conduction of meridian qi). The treatment was given once every day in the two groups. Ten treatments made one session. Three sessions of treatment were required. At the end of each session treatment, the muscle strength and clinical efficacy were assessed.

RESULTSIn the 1st, 2nd and 3rd sessions of treatment, 20, 24 and 36 cases achieved the 3 to 5 degrees muscle strength in Xunjingcuiqi group, respectively; and 6, 10 and 15 cases achieved the 3 to 5 degrees muscle strength in the routine acupuncture group. The differences were significant statistically in comparison of the two groups (P < 0.01, P < 0.05). The markably effective rates were 60.0% (30/50), 64.0% (32/50) and 70.0% (35/50) after the 1st, 2nd and 3rd sessions of treatment in Xunjingcuiqi group, respectively; and those were 38.0% (19/50), 44.0% (22/50) and 46.0% (23/50) in the routine acupuncture group, respectively. The differences were significant in the 1st and 3rd sessions of treatment between the two groups (both P < 0.05).

CONCLUSIONXunjingcuiqi needling technique combined with routine acupuncture achieves the apparent superior efficacy on acroparalysis induced by ischemic stroke as compared with the simple routine acupuncture. Xunjingcuiqi needling technique obviously improves muscle strength and shortens the duration of sickness.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Aged ; Female ; Humans ; Male ; Middle Aged ; Paralysis ; etiology ; therapy ; Qi ; Stroke ; complications ; Treatment Outcome

Objective To investigate the age distribution and types of human papillomavirus (HPV) cervical infection in patients in Wuhan region, so as to provide scientific basis for the prevention and treatment of HPV infection and cervical cancer.Methods 9 915 exfoliated cervical cell specimens from patients in Wuhan Medical and Health Center for Women and Children between January 2015 and March 2016 were performed HPV genotyping (21 subtypes), clinical data of 1 732 HPV positive cases were statistically analyzed.Results HPV-positive rates in ≤25, 26~, 36~, 46~, and ≥56 age groups were 22.15%, 15.90%, 17.04%, 19.97%, and 17.57%,respectively (χ2=36.587,P<0.01),HPV-positive rates in ≤25 and 46~ age groups were both higher than other age groups.There were significant differences in single infection and multiple infection rates among different age groups respectively(χ2=14.39, 36.51,respectively, both P<0.05),single infection rate was highest in 46~ and ≤25 age groups (15.41% and 15.24% respectively);multiple infection rates was highest in ≤25 and ≥56 age groups (6.90% and 5.86% respectively).The percentage of single infection and multiple infection were 75.58% and 24.42% respectively, the major single infection type was HPV high-risk subtype (84.34%),the major multiple infection types were high-risk and high-risk compound subtype as well as high-risk and low-risk compound subtype, accounting for 60.52% and 38.77% respectively.The main single infection types were HPV high-risk subtypes 33, 68, 31 and 16, as well as and low-risk subtype 11, the ratios of single infection to multiple infection were 3.13, 2.03, 1.71, 1.67 and 2.00 respectively.Conclusion Cervical infection rates in women in Wuhan region is high in ≤25 and 46~ age groups, there are differences in the distribution of different HPV subtypes of single infection and multiple infection.

Objective To investigate the role of polymorphisms of scavenger receptor class B gene CD36 in affecting the progress of subclinical atherosclerosis (AS) and the associated factors affecting the expression of CD36 on the surface of peripheral blood monouclear cells (PBMC) and the association between CD36 expression and progress of subclinical AS in type 2 diabetic patients.Methods CD36 polymorphisms (CD36-rs1984112, CD36-T620C) were typed by PCR-RFLP in 470 cases of type 2 diabetes mellitus and 220 non-diabetic controls of Hans in Hunan area.The genotypes and allele frequencies were compared between cases and controls.Fluorescence intensity of CD36 on the surface of PBMC was analyzed in 102 cases of type 2 diabetes mellitus by flow cytometry and was compared between the patients without AS and the patients with subclinical AS.Multiple linear regression was applied to evaluate the relevant factors contributing to CD36 expression.Results The genotypes and allele frequencies of CD36-rs1984112 in type 2 diabetes mellitus were not significantly different between cases and controls (P＞0.05), either did CD36-T620C (P＞0.05).The mean florescence intensity (MFI) of CD36 in type 2 diabetics with subclinical AS was higher than that without AS (1 382±659 vs 1 173±340, P＜0.05).Factors affecting the CD36 expression were: age (P=0.005), gender (P=0.021), systolic blood pressure (SBP) (P=0.027), standardized coefficients Beta was 0.28, 0.31 and -0.21, respectively.Age contributed to the CD36 expression level in males (P=0.002) and diastolic blood pressure in females (P=0.001) respectively.Conclusion CD36-rs1984112 and T620C seem not to be a functional polymorphism sites in Hans of Hunan, southern China.CD36 expression level is higher in type 2 diabetics with subclinical AS in contrast with those without AS.CD36 expression on PBMC surface is higher in aged males with lower SBP.

ObjectiveTo evaluate the various methods of choledochoplasty in the repair of major bile duct defects in Mirizzi syndrome.MethodsThis is a retrospective study on 3 patient with Mirizzi syndrome with a large bile duct defect.These defects were repaired by using a vascular gastric pedicle patch in our department from July 2008 to November 2011.The authors searched the domestic medical literature on surgical repair for Mirizzi syndrome in the past ten years.The patients were treated by various surgical methods,and they were analyzed according to the Csendes Classification.ResultsThere were no surgical complications in our three patients.There was one patient with a Csendes type Ⅲ,while the remaining 2 patients were with Csendes type Ⅳ.At a median follow- up of 2.5 years,no patient developed signs of chronic cholangitis.In the medical literature,there were 93 patients who were with Csendes type Ⅰ ; and 58 patients were treated by cholecystectomy only,while 35 patients were treated by partial cholecystectomy plus mucosal ablation.Of the 40 patients with type Ⅱ,29 patients were treated by direct fistula repair,9 patients by pedicle gallbladder flap and 2 patients by pedicle round ligament.Of the 20 patients with type Ⅲ,9 patients were treated by pedicle gallbladder flap.1 patient by pedicle round ligament,3 patients by pedicle gastric flap and 7 patients by Rouxen- Y hepaticojejunostomy.For the 5 patients with type Ⅳ,they were treated by Roux-en- Y hepaticojejunostomy.Of these 159 patients,postoperative complications included biliary fistula (n=1 ),upper gastrointestinal bleeding (n=1),and biliary stricture (n=1).All the remaining patients were cured.ConclusionIn patients with Mirizzi Syndrome,the choice of treatment depends on the size of the fistula.For patient with a major tissue defect in the common hepatic duct,a pedicle vascular gastric flap is a good treatment.