OBJECTIVETo observe the clinical effects of acupuncture method of "Huoxue Sanfeng, Shugan Jianpi" (activating blood and eliminating wind, soothing liver and strengthening spleen) on morning blood pressure in patients with cerebral infraction combined with essential hypertension.

METHODSSixty-eight patients were randomly divided into an observation group and a control group, 34 cases in each one. The patients in the two groups were treated with acupuncture method of "Xingnao Kaiqiao" (consciousness-restoring resuscitation) and oral administration of nifedipine. In addition, patients in the observation group were treated with acupuncture method of "Huoxue Sanfeng, Shugan Jianpi" that met the criteria of standard manipulation, in which bilateral Renying (ST 9), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3) were selected. The treatment was given once a day, five times a week, for totally six weeks. The improvement and control rate of morning blood pressure in the two groups were observed.

RESULTS(1) After treatment, the morning blood pressures were decreased significantly in the two groups (all P < 0.05); after 15 treatments, the reduction of systolic pressure and diastolic pressure in the observation group was superior to that in the control group, but the difference was not significant (both P > 0.05); after 30 treatments, the reduction of systolic pressure and diastolic pressure in the observation group was significantly superior to that in the control group (both P < 0.05). (2) After 30 treatments, the control rate of morning blood pressure in the observation group was significantly higher than that in the control group [82.4% (28/34) vs 58.8% (20/34), P < 0.05].

CONCLUSIONAcupuncture method of "Huoxue Sanfeng, Shugan Jianpi", characterized with standard manipulation criteria, can effectively control morning blood pressure in patients with cerebral infraction combined with essential hypertension.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Cerebral Infarction ; physiopathology ; therapy ; Essential Hypertension ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Liver ; physiopathology ; Male ; Middle Aged ; Spleen ; physiopathology ; Treatment Outcome

The low-risk mild hypertension constitutes a considerable proportion in hypertension. Through searching CNKI, Wanfang database, VIP database and PubMed database, literature during the last 10 years was collected and reviewed. It was indicated that excessive diagnosis, insufficient evidence of drug treatment, and poor drug adherence existed in low-risk mild hypertension, however, acupuncture at Renying (ST 9) and other therapies had remarkable effects. This paper mainly expounded the diagnosis and treatment status of low-risk mild hypertension as well as the research summary of acupuncture for low-risk mild hypertension.
Acupuncture Points ; Acupuncture Therapy ; trends ; Humans ; Hypertension ; therapy ; PubMed ; statistics & numerical data

Objective To investigate the effects of short term insulin pump intensive therapy on flow-mediated dilation (FMD) in type 2 diabetes mellitus (T2DM) patients with and without vascular complications. Methods Seventy-six patients with T2DM (T2DM group) were divided into 2 subgroups: T2DM1 subgroup (28 patients with vascular complications) and T2DM2 subgroup (48 patients without vascular complications). Meanwhile, 30 healthy cases were selected as NC group. All research subjects accepted high-frequency ultrasound detection on brachial artery for FMD. After insulin pump intensive therapy,FMD in T2DM group was reexamined, fasting insulin was detected and HOMA-IR was calculated. Results Compared with that in NC group, FMD in T2DM group was significantly lower(P＜ 0.01). However, glycosylated hemoglobin (HbA1c ), fasting plasma glucose (FPG ),H0MA-IR and blood fat were significantly higher (P＜0.01 or ＜0.05). Correlation analysis showed that FMD had negative correlation with HbA1c, FPG, HOMA-IR, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C)(P＜0.01),and had positive correlation with high-density lipoprotein cholesterol (HDL-C). After 2 weeks of insulin pump therapy, the improvement of FMD between the two groups was different. FMD in T2DM1 subgroup increased from (4.25 ± 1.96)% to (4.96 ± 1.36)%(P＞0.05), and FMD in T2DM2 subgroup increased from (4.02 ± 2.35)% to (7.56 ± 2.34)%(P＜ 0.01). Conclusion Insulin pump intensive therapy can evidently improve FMD in T2DM patients without vascular complications.

Achalasia of cardia caused by neuromuscular dysfunction at esophagus-stomach junction is a functional disease of esophageal dynamic dysfunction. It is characterized by absence of peristalsis of esophageal body and failure of the lower esophageal sphincter to relax. The methods of therapy include botulinum toxin injection, stent placement, laparoscopic Heller myotomy and balloon dilatation. However,these methods have some shortages,such as easy to recur, causing larger trauma,etc. . With the development of technology of endoscopy,a new method peroral endoscopic myotomy ( POEM)is widely used in clinical practice,and it can used in some special patients such asⅢ type achalasia,pediatric and elderly patients,as well as sigmoid-type achalasia. This article reviewed the current status and progress of POEM in treatment of achalasia of cardia.

Gitelman's syndrome (GS) is an autosomal recessive hereditary tubulopathy.It is caused by sodium reabsorption in the distal convoluted tubule of the renal unit,which is not yet fully cured.It is characterized by great heterogeneity with clinical manifestations.Some patients with no symptoms,were confirmed by hypokalemia with physical examination.The others can be manifested as fatigue,nocturia,polydipsia and hypotension.Less literature is reported about GS combined with osteoarthrosis.In this report,the author reported a patient of GS with osteoarthrosis characterized by hypokalemia,hypomagnesemia,metabolic alkalosis,lower blood pressure,and swelling and pain in left knee joint.The symptoms were improved after treatment with potassium and magnesium supplementation

Bacterial biofilms are considered to be the hindrance in the treatment of chronic wound, because of their tolerance toward antibiotics and other antimicrobial agents. They also have strong ability to escape from the host immune attack. Acetic acid, as a kind of organic weak acid, can disturb the biofilms by freely diffusing through the bacterial biofilms and bacterial cell membrane structure. Then the acid dissociates to release the hydrogen ions, leading to the disorder of the acid-base imbalance, change of protein conformation, and the degradation of the DNA within the membranes. This paper reviews the literature on the characteristics and treatment strategies of the bacterial biofilms and the acetic acid intervention on them, so as to demonstrate the roles acetic acid may play in the treatment of chronic wound, and thus provide a convincing treatment strategy for this kind of disease.
Acetic Acid ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Biofilms ; drug effects ; Humans ; Wound Healing

Objective: To investigate effects of clinical strategy on repair of pressure injury on ischial tuberosity based on the histopathological type. Methods: From January 2014 to January 2018, 33 patients with 33 pressure injuries on ischial tuberosity were admitted to our department. There were 25 males and 8 females aged 35 to 87 years. Pressure injuries on ischial tuberosity were repaired with different methods according to pathological types of denatured tissue on basal parts of wounds and tissue defect volumes. Areas of wounds after thorough debridement ranged from 2.0 cm×1.0 cm to 14.0 cm×12.0 cm. Pressure injuries of necrosis type with tissue defect volumes of 6.5-9.5 cm³ were sutured directly after debridement at the first stage. Tissue defect volumes of 3 patients with pressure injuries of granulation type ranged from 56.0 to 102.5 cm³. According to situation around wounds, the above mentioned 3 patients were respectively repaired with posterior femoral Z-shaped reconstruction, posterior femoral advanced V-Y flap, and posterior femoral propeller flap. Tissue defect volumes of 5 patients with pressure injuries of infection type ranged from 67.5 to 111.0 cm³. Among the patients, 2 patients were repaired with posterior femoral propeller flaps, 2 patients were repaired with posterior femoral advanced V-Y flaps, and 1 patient was repaired with posterior femoral Z-shaped reconstruction. Among patients with pressure injuries of synovium type, wounds of 14 patients with tissue defect volumes 6.4-9.5 cm³ were sutured directly after debridement, and tissue defect volumes of another 8 patients were 97.0-862.5 cm³. Among the 8 patients, 7 patients were repaired with gluteus maximus myocutaneous flaps and continued vacuum sealing drainage was performed for 7 to 14 days according to volume of drainage, and 1 patient was repaired with posterior femoral propeller flap. Areas of flaps or myocutaneous flaps ranged from 3.5 cm× 2.5 cm to 14.0 cm×12.0 cm. The donor sites of flaps were sutured directly. Operative areas after operation and healing of wounds during follow-up were observed. Results: The sutured sites of 33 patients connected tightly, with normal skin temperature, color, and reflux. During follow-up of 12 months, wounds of 25 patients healed well with no local ulceration, and 8 patients were admitted to our department again due to recurrence of pressure injuries on or near the primary sites. Pathological types of pressure injuries of the 8 patients were synovium types. After complete debridement, the tissue defect volumes were 336.8-969.5 cm^3, wounds with areas ranged from 8.0 cm×7.0 cm to 14.0 cm×12.0 cm were repaired with gluteus maximus myocutaneous flaps or posterior femoral propeller flaps which ranged from 8.0 cm×7.0 cm to 14.0 cm×12.0 cm. Eight patients were discharged after wound healing completely. During follow-up of 12 months, operative sites of the patients healed well, with no recurrence. Conclusions Appropriate and targeted methods should be chosen to repair pressure injuries on ischial tuberosity based on the pathological types. Direct suture after debridement is the first choice to repair pressure injury of necrosis type. Pressure injuries of granulation type and infection type can be repaired with posterior femoral propeller flap, Z-shaped reconstruction, or advanced V-Y flap according to situation around wounds. Gluteus maximus myocutaneous flap is the first choice to repair pressure injury of synovium type. In addition, recurrence-prone characteristics of pressure injury of synovium type should be taken into consideration, plan should be made previously, and resources should be reserved.

Objective To observe the protection of human lens epithelial cells(HLEC) by different polar alkaloids extracted from Herba Dendrobii(HD).Methods We extacted the Herba Dendrobii powder with ethanol,and then treated the extract with falling-film concentration,acidification,salting out,chloroform extraction,and washing with water.Different polar alkaloids were extracted from HD after the above treatment.The protective effect of HD alkaloids was observed on HLEC,which were cultured with DMEM medium containing 10% fetal calf serum.Ten groups were set up for the experiment: normal control group,model group,high-and low-dose water-soluble alkaloids groups,high-and low-dose fat-soluble alkaloids groups,high-and low-dose low-polar alkaloids group,and high-and low-dose weak-polar alkaloids groups.The high-dose dosage of the alkaloids was 25.0 ?g/L and low-dose dosage was 12.5 ?g/L.Methyl thiazolyl tetrazolium(MTT) assay was used to evaluate the proliferation of HLEC under the different conditions of interventions.Results The single-factor experiments showed that the highest extracting rate of HD alkaloids was obtained under the conditions of extracting the powder with 80% ethanol for 3 times and for 3 hours.The results of protective experiment showed that the proliferation of HLEC in the model group was inhibited by hydrogen peroxide(H2O2),and the inhibitive rate was lower in low-dose fat-soluble alkaloids group than that in the model group(P

[Objective] Molecular distillation technique was applied for the separation and purification of Atractylodes Lancea oil (ALO) to increase the yield of atractylodin. [Methods] Atractylodes Lancea oil prepared with supercritical extraction was refined by molecular distillation technique. The optimum refining conditions were selected by uniform design containing two factors of temperature and vacuum and five levels. The content of atractylodin from refined Atractylodes Lancea oil was measured and the remainder after isolation was detected by high performance liquid chromatography (HPLC). [Results] A yield rate of atraotylodin from Atractylodes Lancea oil was 52.17% at the temperature of 105℃ and under the vacuum of 100 Pa. [Conclusion] The application of molecular distillation technique makes it easy to collect the volatile atractylodin from Atractylodes Lancea oil at lower temperature and under higher vacuum; this method ensures the yield rate of atractylodin over 50% and has no problem of environmental pollution.

Objective: To summarize the characteristics of arrhythmia with the relevant factors affecting its prognosis in patients of apical hypertrophic cardiomyopathy (AHCM). Methods: A total 283 AHCM patients with echocardiography or cardiac magnetic resonance (CMR) conifrmed diagnosis in our hospital from 2005-01 to 2012-08 were summarized. The patients were divided into 2 groups: With arrhythmia group, n=103 and Without arrhythmia group,n=180. The endpoint event was followed-up by clinical and telephone visits in both groups and the relevant risk factors affecting AHCM prognosis were investigated by Cox regression analysis. Results: There were 269 patients ifnished the follow-up investigation, 98 in With arrhythmia group, 171 in Without arrhythmia group, and the death rate was 4.08% vs 1.17%, the occurrence of endpoint event was 18.37% vs 5.58%respectively. Cox regression analysis indicated that age (HR=23.051, 95% CI 1.08-1.068,P<0.005), left atrial diameter (HR=4.113, 95%CI 1.002-1.119,P=0.043) and NT-proBNP (HR= 18.653, 95% CI 3.433-26.650,P<0.005) were the independent risk factors affecting prognosis in AHCM patients. Conclusion: Arrhythmia is one of the common presentations of AHCM, it does not have much impact on survival, while it may cause ventricular ifbrillation and increase the occurrence of cardiovascular events.