Objective To investigate the effect of spleen-supplementing and lung-strengthening therapy on patients with chronic obstructive pulmonary disease(COPD)treated by mechanical ventilation and enteral-parenteral nutritional support.Methods Acute exacerbation COPD patients complicated with respiratory failure treated by mechanical ventilation were randomized into group A(n=32)and group B(n=30).The two groups received invasive or non-invasive mechanical ventilation,routine western medicine and enteral-parenteral nutritional support.Group A received oral use of Jianpi Yifei Granules(mainly composed of Radix Ginseng Destillata,Rhizoma Atractylodis Macrocephalae,Poria,Radix Ophiopogonis,Cortex Mori,Radix Astragali)and electroacupuncture(EA)on bilateral acupoints of Zusanli additionally.The treatment lasted 2 weeks.The changes of leg circumference and arm circumference,and serum levels of total protein(TP),albumin(Alb),prealbumin(PAlb)and hemoglobin(Hb)were observed.The outcomes of mortality rate during hospitalization,success rate of removing respiratory machine,time for parenteral nutritional support,time for invasive or non-invasive mechanical ventilation,fee for nutritional support and hospitalization fee in intensive care unit(ICU)were compared in the two groups.The incidences of complications of pneumonia,fungal infection,and upper gastrointestinal hemorrhage were also observed during mechanical ventilation.Results After treatment,serum levels of TP and PAlb were higher in group A than those in group B(P0.05);leg circumference and arm circumference in the two groups increased(P0.05).Time for parenteral nutritional support,time for invasive or non-invasive mechanical ventilation,and fee for nutritional support and hospitalization fee in ICU were lower in group A than those in group B(P

Objective To identify the feasibility and the anatomical parameters of posterior transarticular pedicle screw fixation in the thoracic spine, provide a reference for clinical applications. Methods Twenty human cadaveric thoracic spine segments were dissected posteriorly and anteriorly, with care taken to expose the laminas and pedicles. The entrance point of transarticular pedicle screws was located in the 7 mm away from the above at the inferior margin of the lamina and the inside at the exterior margin, respectively. Posterior transarticular pedicle screws implantation was performed under direct visualization into T1,2,T5,6 and T9,10 Under direct abservation, the feasibility of posterior transarticular pedicle screw fixation was assessed. Then a CT was done. On the morphologic CT scan, the angle and length of the transarticular pedicle crew trajectory were measured. Results The thoracic transarticular pedicle screw trajectory were caudal tilting in the sagittal plane and lateral tilting in the axial plane with successful placement. Screws were placed across the facet joint, and from the inferior articular process of upper thoracic vertebra into the pedicle of lower thoracic vertebra. There was little difference between different number of thoracic vertebrae of the angle, but without significance. The average angles of the screws were 41.4°+3.2°caudal tilting in the sagittal plane and 2.1°±0.7° lateral tilting in the axial plane. The average trajectory lengths were (40.6±4.9)mm, and the lengths increased gradually from upper thoracic vertebra to middle and lower. There were significant differences statistically among T1,2, T5,6 and T9.10 (F=74.09, P＜0.01 ). Conclusion Posterior transarticular pedicle screw fixation is feasible, and there are some directions for implantating the screws. Transarticular pedicle fixation in the thoracic spine affords an alternative to standard pedicle screw placement for thoracic stabilization.

Objective To study the effect of urodynamic factors on the urinary retention of the patients with cervical cancer received radical hysterectomy. Methods Seventy-two patients with cervical cancer Ininternational Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ bl to Ⅱ a hospitalized in Fujian Provincial Maternity and Child Health Hospital between June 2006 and August 2009, who were not found any abnormal representation of urodynamics before the operation, were divided into the group with urinary retention and the group without urinary retention based on whether urinary retention after the operation. All patients were detected by urodynamic examination following radical hysterectomy. Data obtained from urodynamic examination were analysed by logistic regression to evaluate the influence of urodynamic factors on the urinary retention postoperation. Results Twenty-one patients out of all were found with urinary retention after the operation , the incidence rate of urinary retention was 29%. The first sensation after operation in both groups were increased significantly than those before operation[ ( 171 ±61 )ml vs.(126 ±28)ml, (134±39)ml vs. (119 ± 17)ml,all P＜0.05], while the maximum volume[ (337 ±66) and (300 ±66)ml, respectively], the compliance[ (31 ±25) and (29 ± 18) ml/cm H2O (1 cm H2O =0. 098 kPa), respectively], the maximum flow rate[ (10 ±4) and (12 ±5) ml/s, respectively] and the pressure at the maximum flow rate [ (27 ±9) and (32 ±8) cm H2O, respectively] were decreased obviously after radical hysterectomy in both the group with urinary retention and the group without urinary retention ( all P ＜0.05), compared with the corresponding value before the operation. The urodynamic changes in urinary retention group was much more severe than those in group without urinary retention ( P ＜ 0. 05 ). The single factor analysis results showed that bladder destusor dysfunction ( OR = 8. 20, 95% CI: 2.62 - 25. 66, P ＜0. 01 ) and lack of sensation ( OR = 6. 90, 95% CI: 1.95 - 24. 43, P ＜ 0. 01 ) were relevant to the urinary retention post-operation. While there were not relationship was found between low compliance bladder( OR =1.99, 95% CI:0. 70 - 5.63, P = 0. 195 ), detrusor overactivity ( OR = 2. 51, 95% CI: 0. 73 - 8.67, P =0. 144), bladder outlet obstruction ( OR = 3.77, 95% CI: 0. 76 - 18. 57, P = 0. 104 ) or dyssynergia of urethral external sphincter( OR =2. 67, 95% CI:0. 49- 14. 45, P =0. 255 ) and urinary retention following the operation. There were an antagonistic effects ( OR = 7.60, 95% CI: 1.43 - 40. 39, P = 0. 017 ) of detrusor overactivity and bladder destrusor dysfunction on urinary retention. The multiple factors analysis results revealed that bladder destusor dysfunction( OR = 7.01, P ＜ 0. 01 ) and lack of sensation( OR = 5.45, P =0. 018)were the independent risk factors influening on the urinary retention post-operation. Conclusions There are obvious urodynamic change in cervical cancer patients following radical hysterectomy. Bladder destrusor dysfunction and lack of sensation are the independent urodynamic risk factors influencing on urinary retention following radical hysterectomy, while detrusor over activity may be a protective effect on bladder destrusor dysfunction post-operation in some degree. Urodynamic test is important for analysis and treatment of urinary retention following radical hysterectomy.

Through the expert questionnaire (Delphi Indagate) to form Traditional Chinese Medicine (TCM) Healthy Lifestyle Guiding Principles.We conducted two rounds of surveys of TCM experts in the field of preventive health care on the basis of previous literature research.This study was aimed to form the framework in order to entry to the TCM Healthy Life-style Guiding Principles.The results showed that the positive coefficient of experts in two rounds of investigation were 84.31％ and 100％,respectively.The authoritative decree were both more than 0.7.The expert opinion score mean median was 9.21 and 9.085.Median mean values were 7.965 and 7.925.The median scores of full marks were higher than 65.12％ and 66.67％.The minimum coefficients of variation were 0.11 and 0.10.It was concluded that in the investigation and study,the enthusiasm of the experts,professional standards and credibility were high.Expert opinion is more concentrated.Expert opinion is well coordinated and gradually converges through two rounds of surveys.Through the Delphi indagate,the basic framework and items of TCM guiding principles of healthy lifestyle were established,which laid the foundation for further standardizing the guiding principles of TCM in healthy lifestyle.

ObjectiveTo observe the therapeutic effect of Chaishao Longmu decoction on insomnia in the patients with the syndrome of live depression and spleen deficiency and explore the correlation between infrared thermal imaging and insomnia with liver depression and spleen deficiency. MethodA total of 72 insomnia patients treated in the outpatient department of Shenzhen Hospital of Guangzhou University of Chinese Medicine （Futian） from May to December in 2022 were selected and randomized into a treatment group and a control group， with 36 patients in each group. The patients in the treatment group were treated with Chaishao Longmu decoction and those in the control group with eszopiclone for 4 weeks. The clinical efficacy， Pittsburgh sleep quality index （PSQI） score， TCM syndrome score and infrared thermal imaging characteristics ［temperature and temperature changes of frontal sleep line， frontal region， anterior trunk， Zhongwan （CV12）， conception vessel （CV）， left hypochondrium， right hypochondrium， dorsal trunk， and governor vessel （GV）］ of two groups were determined before and after treatment. ResultAfter treatment， the clinical response rate in treatment group was 91.67% （33/36）， which was higher than that （66.67%， 24/36） in the control group （Z=-2.617， P<0.01）. The treatment in both groups decreased the PSQI score and TCM syndrome score （P<0.01）， and the decreases were more significant in treatment group than in the control group （P<0.01）. After treatment， the total response rate of sleep line improvement in the treatment group was 86.11% （31/36）， which was higher than that （66.67%， 24/36） in the control group （Z=-2.591， P<0.05）. The frontal temperature of the two groups decreased （P<0.01） after treatment. Compared with those before treatment， the temperatures of anterior trunk， CV12， CV， left hypochondrium， right hypochondrium， dorsal trunk， and GV rose after treatment （P<0.01）. After treatment， the treatment group had lower frontal temperature and higher temperatures of anterior trunk， CV12， CV， left hypochondrium， right hypochondrium， dorsal trunk， and GV than the control group （P<0.01）. The treatment in the treatment group reduced the ∆T values of GV （P<0.01） and increased that of the CV12， CV， left hypochondrium， and right hypochondrium （P<0.05，P<0.01）. The treatment in the control group increased the ∆T value of CV12 （P<0.01）. After treatment， the treatment group had lower ∆T values of GV （P<0.01） and higher ∆T value of CV12， CV， left hypochondrium， and right hypochondrium （P<0.05， P<0.01） than the control group. Compared with that before treatment， the temperature difference between GV and CV in the two groups increased after treatment （P<0.01）. According to the infrared thermal image characteristics， the normal temperature difference between GV and CV was within the range of 0.5-1. The median value after treatment in the treatment group was 0.69 （0.52， 0.88）， which was within the normal range， indicating that the treatment group outperformed the control group. ConclusionChaishao Longmu decoction can alleviate short-term insomnia by soothing liver， invigorating spleen， harmonizing the middle energizer， and regulating GV and CV. With definite clinical effect， this decoction deserves promotion. Furthermore， the frontal temperature， sleep line， CV12， CV ∆T， and temperature difference between GV and CV revealed by the infrared thermal images could be used for the diagnosis and of insomnia with liver depression and spleen deficiency.