Objective To search for an effective acupuncture-moxibustion therapy for high fever in common cold. Methods According to the randomized and multi-central trial principle, 276 cases enrolled were randomly assigned to observation group of 138 cases and control group of 138 cases. The observation group were treated by electroacupuncture at Dazhui and the control group were treated by Antondinie injection coordinating pathogeny therapy to observe the prompt effects in 24 hours. Results After treatment, the temperature of every time point of the observation group was lower than that of the control group (P 0.05). Conclusion The method of electroacupuncturing at Dazhui has a definite therapeutic effect on high fever in common cold.

Objective To probe into the clinical effect of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ on patients with constipation of phlegm-heat and bowel-repletion type in acute cerebral infarction.Methods The enrolled cases were randomly assigned to an observation group of 35 cases and a control grouD of 35 cases.Besides both groups were treated with routine neurological treatment and acupuncture with the flinchon of brain activating,the observation group was treated by acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ and the control group was treated with Dilute Glycerol.Such indexes of patients in both groups were observed 7 days and 21 days before and after the treatment as clinical effect of constipation,scores of related symptoms,and scores of traditional Chinese medical category and clinical effect.Results The effective rates of eonstipation 7 davs and 21 days after treatment were 93.7% and96.9% in the observation group,and 61.8% and79.4% in the control group,with significant differences between the two groups(P＜0.01).After the treatment for 7 days and 21 days,the symptoms of constipation.dark tongue,yellow and greasy fur were improved significantly in the observation group than those in the control group(P＜0.05);The observation group also showed a definite therapeutic effect than the control group on treating the svmptoms of upset minded,constipation,red or dark tongue,yellow and greasy fur(P＜0.01).The scores of traditional Chinese medical category of the observation group were lower than that of the control group(P＜0.01)after treatment for21 days.The total improvement rate was 97.0% in the observation group comparing 55.8%in the control group,showing significant difference(P＜0.01).Conclusion The method of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ has a definite therapeutic effect on treating constipation of phlegm-heat and bowel-repletion in acute cerebral infarction.It can also improve clinical effects of these patients,which is worth generalizing in the clinical practice.

Objective　To study the value of comprehensive examination of visual electrophysiology in prognosis of visual function after cataract operation.Methods　315 patients with cataract(408 eyes) underwent preoperative routine examination with pattern reversal visual evoked potential(PVEP), red and blue flicker electroretinogram(ERG) and oscillatory potential (OPs). Normal control group included 162 cases (266 eyes). All of the ocular fundi were examined postoperatively and corrected visual acuities were obtained 3 months after operation. Results　Postoperative corrected visions ≥0.5(Ⅰ) and ＜0.5(Ⅱ) in case group compared with that in control group, amplitudes of PVEP P100-wave decreased significantly and PVEP P100-wave latency times prolonged significantly in group Ⅰ and Ⅱ. There was much more prominent changes in P100-wave of group Ⅱ due to other factors influencing visual function. There wasn't significant difference of the amplitudes and the latency times of a-wave and b-wave of Red-Blue ERG in group Ⅰ and the control group preoperatively. The amplitudes of a-wave and b-wave of Red ERG decreased, the latency times of a-wave and b-wave of Red ERG prolonged, the amplitudes of a-wave and b-wave of Blue ERG decreased but latency times didn' t prolong in group Ⅱ. The value of OPs decreased in groupⅡ compared with that of the control group, which was related to the retinopathy due to blood circulation obstruction.Conclusion　Combined examination of visual electrophysiology can estimate visual function thoroughly. The prognosis will be good if various examinations are normal before operation, but will not be good if PVEP P100 latency time prolong, the amplitudes of a-wave and b-wave of Red ERG decrease and the latency time prolong, the amplitudes of a-wave and b-wave of Blue ERG decrease and the value of OPs decrease.

Objective To investigate the clinical characteristics and mutations of guanosine triphosphate eyclohydrolase (GCH) Ⅰ gene in patients with dopa-responsive dystonia (DRD). Methods Five families with 18 affected family members and 17 patients with sporadic DRD were examined. Patients were allocated into 3 groups according to onset time, either in childhood, or in adolescence or adult. Interview, physical examination, psychologic testings and CT/MR scan were performed. Mutation screening was performed on 26 patients and 1 normal family nember. Thirty-five healthy control subjects were matched for age and sex. Statistical analysis were conducted with the use of SPSS 13.0 computer software. Results(1)Most of patients started with dystonia. The main clinical manifestation was dystonia too. There was no difference among 3 groups.(2) There were significant differences in diurnal fluctuation among 3 groups(15/15,6/6,7/14, χ2=13.125,P=0.001). Diurnal fluctuation negatively correlated with age (r=-0.720, P<0.01).(3)The differences in postural tremor were also found among 3 groups (7/15,5/6,1/14, χ2=8.073, P=0.018). Postural tremor positively correlated with age (r=0.399, P=0.018).(4)There were differences in exaggeration of tendon among three groups(11/15,1/6,4/14, χ2=8.309, P=0.016). Exaggeration of tendon reflexes negatively correlated with age (r=-0.429, P=0.010).(5)The scores of Hamilton Depression Scale and Hamilton Anxiety Scale in patients were higher than those in controls.(6)DNA sequencing revealed a heterozygous A224G missense mutation(Tyr75Cys)located within exon 1 in one autosomal dominant inheritance family. Conclusions The manifestations of DRD varies. The clinical course is closely correlated with age. A missense mutation(A224G)in coding region of the GCH 1 gene probablyleads to the occurrence of DRD.

Internationality ; Medicine, Chinese Traditional

Objective To evaluate the value of prenatal ultrasound in the interrupted aortic arch (IAA), and analyze the reasons of misdiagnosis and improve diagnostic ratio of this kind of defects. Methods Ultrasonic characteristics were analyzed in 16 fetuses with aortic arch anomalies, which were compared with ultrasound image and autopsy results of the normal fetus. The relativity of fetal IAA and abnormal chromosome was also analyzed. Results Among the 16 cases, 15 cases were confirmed by anatomy and the accuracy of ultrasound diagnosis was 94% (15/16), of which one case was serious constriction of aortic arch, one case was error type, three cases were obtained explicit type due to unsatisfactory results of prenatal ultrasound. The coincidence rate of ultrasonic type was 73% (11/15). All of the corrected diagnosed cases were detected with ventricular septal, of which 5 cases were detected with complete endocardial cushion defect, 9 cases were found extra cardiac malformations. Among the 7 karyotype check cases, 3 cases were diagnosed with Trisomy 18, 1 case Trisomy 13, while the rest 3 cases normal. The incidence rate of Trisomy 18 was 43 % (3/7). Conclusions Prenatal ultrasound shows a high accuracy in diagnosing fetal interrupted aortic arch (IAA ), but there’s a need to be improved in explicit typing. It is difficult to identify fetal interrupted aortic arch (IAA) and serious constriction of aortic arch (COA). The incidence rate of Trisomy 18 in the abnormal chromosome of fetal IAA is high.

Objective To evaluate the application of percutaneous nephroscopy in the treatment of upper urinary tract transitional cell carcinoma, particularly renal pelvic carcinoma. Methods From June 2006 to June 2010, eight cases (with 10 sides) of renal pelvic carcinoma received percutaneous nephroscopy tumor resection. There were six males (with 7 sides) and two females (with 3 sides) in the study group. There were six cases with solitary kidney and two cases with bilateral renal pelvic tumors. There were four cases with high-grade tumors and six cases with low-grade tumors. The age of patients ranged from 52 to 72 yrs (average 61.2 yrs). Tumor sizes ranged from 0.5 to 3.5 cm (average 2.6 cm). Patients were treated with laser or electrocautery through percutaneous nephroscopy. A ureteral stent was placed in the patients after the procedure. Chemotherapy was administered postoperatively through the nephrostomy tube. Results All the operations were successfully completed uneventfully. The operative time was 45-95 min (average 73 min), estimated blood loss was 20-300 ml (average 50 ml). No remarkable differences were found in serum creatinine levels before and after operation. After 10 to 36 mon. follow-up by CT, MRI, and ureteroscopy, one patient died of tumor metastasis and two patients had local tumor recurrence. The remaining patients had no local recurrence. Conclusions Percutaneous nephroscopy in treating renal pelvic tumor is safe and feasible. This is a better choice for the renal pelvic carcinoma patients who are unsuitable for ureteronephrectomy.

Objective To investigate the relationship between the ultrasonography diagnosis in prenatal and the postnatal placental vascular casts of the twins reversed arterial perfusion(TRAP) sequence. Methods Six cases of TRAP sequence underwent the two-dimensional and color Doppler ultrasonography, and performed placental vascular casts after termination of pregnance. Results According to the anatomical features and ultrasonography, there were 3 cases of acardius acephalus( IV) ,2 cases of acardius anceps( II ) , and 1 case of acardius acormus( I ). In all 6 cases,there were arterio-arterial and veno-venous anastomoses at the level of the chorionic plate between the normal co-twin and the acardiac twin,these anastmosis vessels were superficial and large calibre, and the distances of the placental insertions of the umbilical cords were different,4 cases <0. 5 cm, 2 cases were 4-5 cm. In 4 cases, the vessels entered and went out of the acardiac twin were just one large umbilical artery and one large umbilical vein. In 2 cases, the umbilical artery and umbilical vein had many vascular branches in the placenta. Out of 6 cases of the pump twin, 4 cases died,and 2 cases survived. Conclusions Ultrasonography was consistent with the placental vascular casts,the contrast observing gives us new information for the further research of the special type of the vascular anastmosis and prognosis of the TRAP sequence.

AlM:To observe the changes of corneal endothelium after phacoemulsification cataract surgery in different types of cataract patients.
METHODS: Randomly selected age-related cataract, diabetic cataract and cataract of high myopia 30 eyes of 30 cases, respectively, in our hospital. All patients underwent phacoemulsification combined with intraocular lens implantation, corneal endothelial density and the percentage of hexagonal cells were measured by corneal endothelial cell instrument without touching before surgery and one week after surgery.
RESULTS: The difference of the preoperative corneal endothelial cell density and the percentage of hexagonal cells among three groups were not statistically significant (P>0. 05). One week after surgery, the cell density in three groups were respectively 2 496. 86 ± 298. 96/mm2 , 2 379. 51 ± 375. 13/mm2 , 2 425. 38 ± 312. 68/mm2 , the percentage of hexagonal cells were respectively ( 46. 20 ± 12. 03)%, (43. 44±13. 99)%, (44. 35±8. 13)%. Both the cell density and the percentage of hexagonal cells one week after surgery were lower than those before operation. There were significant difference in three groups ( P <0. 05). Both the measurements in diabetic cataract group and cataract of high myopia group after surgery were lower than those in age-related cataract group, the cell density and the percentage of hexagonal cells in diabetic cataract group were lower obviously compared with those in age- related cataract group and the difference was significant (P<0. 05).
CONCLUSlON:The tolerance of corneal endothelial cell to phacoemulsification cataract surgery is lower in cataract with diabetes and high myopia. Corneal endothelium should be assessed preoperatively and protected intraoperatively.

Objective To discuss the technique of laparoscopie radical cystectomy with Studer orthotopic ileal neobladder. Methods Eight men with bladder cancer who were indicated for radical surgery underwent laparoscopic cysteetomy with Studer orthotopic ileal neobladder. The ages were be-tween 51 and 69 with the mean age was 57 years. Seven cases were transitional cell carcinoma and 1 case was adenocarcinoma. A 5-port approach was employed. The first step was the bilateral pevic lymphadenectomiy including obturator lymph nodes, internal and external iliac lymph nodes. Then ventral surface of the bladder was mobilized and the bilateral endopelvic fascia was incised. Next step included the stich of dorsal vein complex and dissection of both the vas deferens and seminal vesicles. Denonvillier's fascia was incised to develop the plane between the rectum and the prostate. The urethra located in the prostatic apex was divided and transected thereby completely separating the specimen. Then the specimen was placed in a packet. Finally, a 6-8 cm lower median abdominal incision was performed, through which the specimen was extracted. Construction of the Studer pouch. A portion of terminal ileum about 45cm long was isolated approximately 20cm proximal to the ileocecal valve. The ends of the isolated ileal segment were closed to restore the bowel continuity. The distal 40 cm segment of ileum was placed in a U shape and opened along the antimesenteric border. The two medial borders were then oversewn and the bottom was folded over to form a neobladder. The ureters were anastomosed to the nonineised 5 cm portion of ileum. Finally, the neobladder was put into the abdomi-nal cavity and the anastomosis between the neck of the neobladder and the end of the remaining ure-theral was performed with interrupted suture. Results All the procedures were successful. The time of the operation was 6-8 h with the mean estimated blood loss 420(200-800)ml. Complication included 1 case of right ureteral indigitation in neobladder. The postoperative histopathology revealed 7 cases of pT2 and 1 cases of pT3. No positive margin was found. The follow-up (3 - 12 months) showed no recurrence. Conclusions The technique of laparoseopic radical cystectomy is feasible with the advantages of smaller incision and less blood loss. Studer orthotopic ileal neobladder has the ad-vantages of simple skill, antireflux, better postoperative urination.