The evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion are based on extesiv evidene of literature an compiled by eperience of experts, so the recommended acupoints present special thoughts and laws of compatibility. It is found the traditional acupoint combination methods predominate, such as distal-local acupoint combination, syndrome differentiation-based acupoints combination and symptom-based acupoints combination, etc., and are combined with research achievements of modern medical science;
Acupuncture Points ; Acupuncture Therapy ; methods ; standards ; Evidence-Based Medicine ; methods ; standards ; Humans ; Practice Guidelines as Topic

This article summarized the characteristics and rules of acupoints grouping recorded in Huang Di Nei Jing (Yellow Emperor’s Canon of Internal Medicine), holding that it had passed important concept of acupoints grouping, formed the embryonic form, and brought up basic grouping types including distant and proximal grouping, and interior-exterior grouping, despite the small number of involved acupoints. Besides, it also paid much attention to other factors that may influence the therapeutic efficacy of acupoints grouping. Therefore, Huang Di Nei Jing has played a crucial role in guiding the development of acupoints grouping theories.

Objective To identify the role of survivin and VEGF in angiogenesis of colorectal tumor by investigating tissue expression of survivin, VEGF and CD34 in human colorectal tumors. Methods Immunohistochemical staining for the paraffin sections by using the polyclonal antibodies of survivin, monoclonal antibodies of VEGF and CD34, was performed by the standard avidin-biotin-peroxidase technique. The percentage of positive cell and quantitative analysis were made by image analysis system, which also helped to calculate the amount of MVD. Results The immunoreactivity of survivin significantly increased in the transition from adenoma with low dysplasia to adenoma with high dysplasia (P <0.01). Similar changes in protein expression were observed for VEGF and MVD. The expression of survivin was closely related with that of VEGF. Both were positively correlated with MVD. Conclusion Survivin promotes angiogenesis of colorectal tumor together with VEGF. VEGF may be the potential causes of reexpression of survivin during colorectal tumorigenesis.

Objective To discuss the clinical manifestation and pathology of papillary renal cell carcinoma (PRCC).Methods From January 2007 to January 2012,the clinical and pathologic data of 25 patients (17 males and 8 females with average age of 54 years ranging from 24-76 years) with PRCC were retrospectively analyzed in combination with review of literature.The clinical stages of the tumor were as follows,Ⅰ in 16 cases,Ⅱ in 5 cases,Ⅲ in 4 cases.And the radiographic inspections of PRCC were compared with that of 100 randomly selected clear renal cell carcinoma (CRCC).Results All the PRCC cases had different imaging presentations compared with CRCC.CT attenuation of CRCC was higher than that of PRCC in corticomedullary,nephrographic and excretory phase (P＜0.05).Heterogeneous enhancement was most commonly seen in CRCC than PRCC (P＜0.05).There were 21 patients underwent radical nephrectomy,and 4 patients underwent laparoscopic nephron sparing surgery.The pTNM stages of the tumor were as follows,pT1N0M0 in 16 cases,pT2N0M0 in 5 cases,pT3aN0M0 in 2 cases,pT1N1M0 in 1 case,,pT2N1M0 in 1 case.Of these 25 patients,8 (32％) and 17 (68％) were diagnosed as type Ⅰ and type Ⅱ PRCC,respectively.All the 25 cases of patients were followed up from 6 to 60 months.One case died of metastasis,1 case died of cerebrovascular disease and the other 23 patients survived with tumor-free.Conclusions PRCC is a special type of RCC with low morbidity.Radiological examination can be used in the differential diagnosis of CRCC and PRCC before surgery.The prognosis after surgical treatment is good,but the adjuvant systemic treatment is to be study.

OBJECTIVETo study the clinical effects of Müller method for reconstruction of posterolateral corner (PLS) of knee joint.

METHODSFrom June 2005 to June 2007, 13 patients with PLS injured were treated with Müller method. Four patients complicated with injuries in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), 7 patients complicated with injuries in PCL, 4 patient also had injuries in ACL, 1 patient complicated with ACL injury, and 1 patient complicated with avulsions fractures of the tibial ACL insertion. Among the patients, 5 patients had chronic injuries with a duration of 2 to 7 months. After the cruciate ligament was reconstructed, the popliteus tendon was reconstructed with iliotibial band and lateral collateral ligament (LCL) reconstructed with biceps femoris tendon. All the ligaments were fixed with interface screws. The patients were encouraged to do strength and motion exercise on bed immediately after operation and permit toe-touch weight-bearing till two months after operation. The brace was used till six months after operation.

RESULTSThe average follow-up period was 13 months (ranged from 6 to 27 months). There was no restriction of range of motion. External rotation range were good compared to the normal side. One year after operation, one-grade varus instability at 30 degrees flexion was found only in 2 patients. The postoperative Lysholm scores were from 77 to 94 (average 86).

CONCLUSIONThe method is easier to perform, easier to get the materiar for reconstruction and promised satisfactory clinical results.

Adult ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo study therapeutic effects of lateral ankle ligaments reconstruction for the treatment of chronic lateral instability of the ankle joint.

METHODSFrom July 2005 to January 2008, among 13 patients with chronic lateral instability of the ankle joint, 10 patients were male and 3 patients were female, ranging in age from 24 to 45 years,with an average of 33 years. Anterior talo-fibular ligament (ATFL) and calcanea-fibular ligament (CFL) were anatomy reconstructed with a split peroneus brevis tendon graft for all patients. The ankle scoring system was used to evaluate ankle joint function before and after operation, which including stability, pain, locomotor activity and X-ray films.

RESULTSAll the patients were followed up ranged from 6 to 32 months, averaged 16.4 months. The postoperative scores of the ankles increased in respect to stability, pain and locomotor activity. The total average score increased from preoperative (43.54+/-7.04) to postoperative (73.38+/-4.17). There was significant difference between preoperative scores and postoperative scores (P<0.01). All the patients were satisfied with the results.

CONCLUSIONAnatomy reconstruct of the ATFL and CFL with a split peroneus brevis tendon graft (Sammarco method) is a practical method for lateral ankle instability and promise good results especially for patients complained of instability.

Adult ; Ankle Joint ; anatomy & histology ; pathology ; surgery ; Female ; Humans ; Joint Instability ; pathology ; surgery ; Lateral Ligament, Ankle ; anatomy & histology ; pathology ; surgery ; Male ; Middle Aged ; Models, Biological ; Reconstructive Surgical Procedures ; methods ; Young Adult

BACKGROUND: Numerous evidence has demonstrated that the magnesium aloy with excelent mechanical properties can degradein vivo, and can be used as vascular stent materials, bone fixation materials, porous materials for bone repair. But it is not reported in the biliary stent. OBJECTIVE:To observe the degradation procedures and evaluate the changes of mechanical characteristics of biliary stents made of magnesium aloy (AZ 31B) in human bilein vitro. METHODS:The baloon-expandable biliary stents were made of magnesium aloy with laser sculpture. Then, 15 stents treated with micro-arc oxidation on the surface served as experimental group and another 15 stents without micro-arc oxidation as control group. A dynamic numerical simulation system was establishedin vitro to simulate the internal environment of human biliary tract. Al of the biliary stents were placed into this system. Their shapes were observed, and their qualities and radical forces were measured every 20 days. At the same time, their surfaces were scanned by scanning electron microscope. RESULTS AND CONCLUSION:(1) The degradation speeds of the stents in the experimental group were obviously slower than those in the control group. The fracture of the connecting rods in control group and experimental group appeared 20 days and 40 days later, respectively. The peak time of degradation in the control group and experimental group were 30 days and 50 days, respectively. The stents were fuly biodegraded within 70 days in the control group while within 90 days in the experimental group. With time, the stent surface became more rough, and the density, area and depth of etch pits were al increased in the two groups. At the same stage, the degradation speed of the control group was more rapid than that in the experimental group. (2) The qualities and radical forces of the stents were gradualy reduced with time in both groups. However, the degradation speed of stents in the experimental group was much slower than that in the control group. In summary, the degradation speed of the biliary stents made of magnesium aloy treated with micro-arc oxidation is appropriate and can meet the clinical requirement for the degradation time of biliary stents. This novel material could potentialy be used for the preparation of biliary stents.

Objective To explore the clinical value of intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver transplantation. Methods Routine color doppler imaging (CDI) was used to detect hepatic artery thrombosis (HAT) after liver transplantation in 160 cases. Suspected patients were further confirmed by immediate angiography. Four cases of HAT were diagnosed and treated by intra-arterial thrombolysis. Two cases received repeatable transcatheter hepatic arterial thrombolysis with a low dose of urokinase. Results Hepatic artery recanalization was achieved in 3 cases. Among the 3 cases, multiple HAT occurred in 1 case, intra-arterial thrombolysis was successfully completed in the end. Two cases had intra-abdominal hemorrhage, which was cured by conservative treatment. One case received retransplantation because of interventional thrombolysis failure and intra-abdominal hemorrhage. Conclusion Intra-arterial thrombolytic therapy may be a promising method in the treatment of HAT. Transcatheter hepatic arterial thrombolysis shows a significant result.

ObjectiveTo study the impact of EZH2 silence on the sensitivity of human hepatic multidrug-resistant cancer cells Bel/Fu to 5-Fu.MethodsBel/Fu cells were cultured in vitro; EZH2 siRNA was used to interfere EZH2 expression; RT-PCR and Western blot was used to detect the efficiency of interference.MTT assay was used to detect the cellular growth inhibitory rate; Annexin V-FITC/PI double staining was used to detect the apoptosis rate of cells ; Flow cytometry was to analyze cell cycle ; Western blot analysis was used to detect the expression of multidrug resistance-associated protein MDR1 after silencing EZH2.The experiment set up four groups:control group,5-Fu treatment group,EZH2 siRNA treatment group,5-Fu combined with EZH2 siRNA treatment group. ResultsThe expression of EZH2 was greatly decreased after 24 h in the combined group,the apoptotic inhibitory rate by MTT was 43.17％ ± 3.81％,higher than other three groups; the apoptotic rate in the combined group by Flow cytometry was 30.4％ ± 1.77％,markedly higher than other three groups.The cell cycle of the combined group detected by Flow cytometry was 69.16％ ±2.31％ of cells in the combined group at G1 phase,the percentage was higher than other three group,30.76％ ± 1.29％ at S,G2 and M phases,lower than other three groups,indicating the cell cycle was blocked at G1 phase.MDR1 protein level in the combined group was lower than other groups.ConclusionsSilencing EZH2 strengths the sensitivity of Bel/Fu cells to 5-Fu,probably by a mechanism decreasing the expression of MDR1.

Objective To investigate the risk factors associated with early mortality (within 30 days) of patients with spontaneously ruptured hepatocellular carcinoma (SRHCC) and assess the efficacies of different treatment regimens. Methods The clinical data of 28 patients with SRHCC who had been admitted to our hospital from January 1999 to January 2006 were retrospectively analyzed. Multiple factors that might cause early mortality were determined, and the efficacies of different treatment regimens were assessed. Results Eleven patients died within 30 days. with the mortality rate of 39%. Univariate analysis showed that shock, Child C status, hemoglobin. ALT, and volume of blood transfusion were associated with early mortality (X2=3.020, 13.741, Z=-2.059, -2.210, -4.153, P<0.05). Child C status and volume of blood transfusion were the independent risk factors. All the patients were divided into hepatectomy group (8 cases), surgical hemostasis group (7 cases), transarterial embolization group (7 cases) and conservative group (6 cases). Patients in hepatectomy group had a better 30-day and median time survival rate compared with those in the other 3 groups (X2=8.098, 8.098, 15.025, Z=-3.127, -2.840, -3.004, P<0.05). Conclusions Poor hepatic functional reserve and severe hemorrhage are closely associated with early mortality of patients with SRHCC. Hepatectomy is a better choice for SRHCC.