The origin and development of "five elements motion and six kinds of qi" acupuncture technique are reviewed, and acupuncture for treatment and prevention of disorders of "five elements motion and six kinds of qi" is summarized. Also its principle is analyzed. Problems such as the inconformity of acupoint selection, lack of systematic theory are discussed. It is pointed out that, instead of indiscriminate copy, treatment should be based on the observation of the transportation and transformation of qi; it is suggested that the classics should be inherited and innovated, combining the tradition with contemporary, and according to a sixty-year cycle, the acupuncture technique of "five elements motion and six kinds of qi" can be improved systematically for promotion and application.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians ; Qi ; history

Objective To compare the postoperative analgesic effect between serratus plane block and thoracic paravertebral block in patients undergoing thoracoscopic surgery.Methods Sixty patients undergoing thoracoscopic surgery, 38 males and 22 females, aged 18-65, BMI 18-25 kg/m2, falling into ASA physical status I or II.They were divided into groups S and T by random number table, 30 cases in each group.Two groups of patients were treated with general anesthesia with endobronchial intubation and PCIA after operation.Group S performed Ultrasound-guided serratus plane block and group T performed thoracic paravertebral block, 0.4％ropivacaine 30 ml were used in the two groups.The two groups of patients were observed 30 min after block, and the sensory block plane was measured with acupuncture and recorded.Recording operation time, onset time and duration of the block.Resting and cough VAS score were recorded at 2, 4, 8, 12, 24, and 48 hafter surgery.The first pressing time of the analgesic pump and times of press analgesic pump, the amount of sufentanil used and times the number of cases of useing piperidine were recorded within 48 hafter operation.Block related complications and analgesic related adverse reactions were recorded.Results Compared with group T, the operation time of the block obviously shortening but the duration obviously lengthening (P<0.01).Resting and cough VAS score at 12 hafter surgery significantly was lower (P<0.01).The first pressing time of the analgesic pump obviously lengthening, the number of press analgesic pump and the amount of sufentanil used significantly were reduced (P<0.01) in group S.Conclusion Ultrasound guided SP block and TPVB block can provide good postoperative analgesia for patients undergoing thoracoscopic surgery, but SP block is more durable, with less operation time and complications than TPVB block, and can effectively reduce the opioid demand and incidence of nausea and vomiting after operation.

Objective:To develop a grading system for necrosis of pedicled flaps in reconstruction of foot and ankle, and to verify its effectiveness and repeatability.Methods:A retrospective observational study was conducted. A total of 40 necroses of foot and ankle pedicled flaps were selected by 2 senior surgeons based on the flap surgery performed by the same surgical group in Department of Orthopaedic Surgery, the 920 Hospital of Joint Logistic Support Force of PLA from January 2010 to January 2022. A grading system for pedicled flap necrosis was proposed by a working group and the 40 necrotic flaps were graded. The coincidence rate was calculated to evaluate the effectiveness of the grading system through correlation studies between grading and clinical treatment. One photo of a typical postoperative necrotic flap was collected from each of the 40 flaps. Then 5 extramural surgeons were asked to grade the necroses shown on the photos according to the proposed grading system. Moreover, weighted Kappa analysis was performed on the results of proposed grading system and also on the standard grading currently in use, to evaluate the repeatability of the proposed grading system. Evaluated data were expressed by Mean±SD, and the coincidence rate was expressed by percentage. The reproducibility was studied by weighted Kappa analysis.Results:Of the 40 necrotic flaps, 7 flaps were classified in Grade I, 16 in Grade Ⅱ, 12 in Grade Ⅲ and 5 in Grade IV. In comparison with the actual treatment methods, the overall coincidence rate of the grading system was 92.5%. It indicated that the proposed grading system could effectively guide the selection of a treatment procedure. The average weighted Kappa coefficient of surgeons was at 0.628 with a 95% confidence interval (95%CI) between 0.460-0.796, which was strongly consistent with the standard of the grading system currently in use.Conclusion:The grading system for necrosis of pedicled flap in reconstruction of foot and ankle proposed in this study is simple and clear. It is able to effectively guide the treatment of flap necrosis. The preliminary validation shows that the classification system has good repeatability.