Objective:To observe the clinical effect of regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina for cerebral infarction. Methods:A total of 61 eligible cases with cerebral infarction were treated with regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina, once a day, 12 d for a course. There was a 3-day interval between two courses. These cases were treated for 3 courses. Before treatment, the infarction severity was graded using neurological deficit score. The score changes and correlation between infarction severity and therapeutic efficacy were evaluated after 1, 2 and 3 courses of treatment. Results:Before treatment, the neurological deficit score was (18.65±3.28), versus (13.63±3.91), (9.53±3.22) and (5.57±3.97) respectively after 1, 2 and 3 courses of treatment. When the third course was completed, 4 cases obtained almost full recovery, 33 cases obtained marked effect, 18 cases obtained improvement and 6 cases had no effect. The total effective rate was 90.2%. Conclusion:Regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina can substantially improve limb function in patients with hemiplegia due to cerebral infarction.

Objective To investigate the effects of surgical trauma on synaptic structure in hippocampal CA3 area in aged rats.Methods Fifty-six healthy SD rats aged 18 months were randomly divided into 3 groups: control group (group C, n = 8) , anesthesia group (group A, n = 24) , and operation group (group O, n - 24) . Anesthesia was performed with intraperitoneal ketamine 40 mg/kg but no operation was carried out in group A. Anesthesia was also performed with intraperitoneal ketamine 40 mg/kg, and splenectomy was performed after loss of righting reflex in group O. Eight animals from group A and O selected on 1, 3, and 7 d after anesthesia or operation respectively underwent Morris water maze test for assessment of the cognitive function. The animals were . then decapitated. Hippocampal CA3 area was isolated for examination with electron microscope and the synaptic structure in the polymorphic layer of hippocampal CA3 area was measured. Results Compared to group C and A, the times of passing through the original platform and number of synapses were significantly reduced, the width of synaptic cleft was significantly increased, the thickness of the postsynaptic density was significantly decreased, the length of the active zones was significantly shortened, and the curvature of the synaptic interface and percentage of perforated synapses were significantly decreased at T_(1,2), ( P < 0.05 or 0.01) , but no significant change was found in the indices mentioned above at T_3 in group O(P > 0.05). Compared to group C, the latency and swimming distance were significantly prolonged at T_1 in group A and at T_(1,2) in group O ( P < 0.01) . Compared to group A, the latency at T_(1,2) and the swimming distance at T_2 were significantly prolonged in group O ( P < 0.05) . Conclusion Surgical trauma can induce early postoperative cognitive impairment through changing synaptic structure in hippocampal CA3 area in aged rats.

Objective To observe the clinical efficacy of Tiao Ren Tong Du (regulating the Conception Vessel and unblocking the Governor Vessel) needling method plus bloodletting at the Jing-well points in treating post-stroke spastic state. Method Sixty-seven eligible patients were randomized into a group to receive Tiao Ren Tong Du needling plus bloodletting at the Jing-well points (treatment group) and a rehabilitation group (control group). For the two groups, the treatment was given once a day, 6 times as a treatment course, for 4 courses in total. The Modified Ashworth Scale was used to evaluate the spasticity intensity, and the Patient Reported Outcome (PRO) for post-stroke spastic hemiplegia was used to measure the patients from the following four aspects:subjective symptoms, objective symptoms, mental state, and social function. Result After intervention, the scores of spasticity, and physiological, mental, social, and environmental factors were significantly improved in both groups (P<0.01,P<0.05). Compared to rehabilitation, Tiao Ren Tong Du needling plus bloodletting at Jing-well points can more significantly release the muscular spasticity and reduce the PRO score (P<0.01). The recovery plus markedly-effective rate was 70.6% in the treatment group versus 42.4% in the control group. Conclusion Tiao Ren Tong Du needling plus bloodletting at Jing-well points can effectively improve post-stroke spastic state and the quality of life.

Objective To evaluate clinical effect of expandable intramedullary nail in unreamed treatment of tibia fracture.Methods 31 patients with proximate tibia fracture were treated with expandable intramedullary nail and unreamed.Among those patients,4 cases were compound fracture,27 cases were closed fracture;16 cases were AO/ASIF type A,4 cases were type B and 11 cases were type C.The following-up of 9 months to 5 years(average 2 years) performed after operation.Results The fractures of 30 patients healed up and patients' functions recovered.1 case with comminuted and multiple fracture got delayed union.Conclusion Expandable intramedullary nail is an utility and satisfactory method to treat proximate tibia fracture.

Objective:To explore the clinical features of acute pancreatitis in pregnancy (APIP) and the risk factors for fetal death.Methods:The clinical data of 90 patients with APIP in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed from January 2013 to June 2020. Based on the severity, the patients were classified into MAP groups ( n=41), MSAP groups ( n=33), SAP group ( n=16). According to the presence of fetal deaths, the patients were divided into fetal death group ( n=13) and fetal survival group ( n=77). The clinical characteristics and indicators of patients in each group were compared. Binary logistic regression analysis was performed on the variables with differences between groups to explore independent risk factors for fetal death. The receiver operating characteristic curves of laboratory indicators were drawn to evaluate their diagnostic efficacy. Results:Hyperlipidemia was the main cause in 90 APIP cases (42/90, 46.7%). The levels of LDH, CRP, blood glucose, D2 polymer, albumin and ApoA1, the 1-min and 5-min Apgar scores of neonates were statistically significant among MAP group, MSAP group and SAP group (all P<0.05). There were no maternal deaths in 90 cases and 13 fetal deaths (14.4%). Fetal mortality increased with the severity of APIP. APIP combined with hypertension ( OR=14.742, 95% CI 1.157-187.890, P=0.038), ketoacidosis ( OR=19.587, 95% CI 1.789-214.469, P=0.015) and CRP level ( OR=1.013, 95% CI 1.001-1.025, P=0.031) were risk factors for fetal death. ApoA1 level ( OR=0.118, 95% CI 0.021-0.664, P=0.015) was a protective factor for fetal death. The sensitivity and specificity of ApoA1 for predicting fetal death were 84.6% and 79.2%, the sensitivity and specificity of CRP for predicting fetal death were 76.9% and 84.4%, and the sensitivity and specificity of the combination of the two indicators for predicting fetal death were 100% and 67.5%. Conclusions:The severity of APIP was closely related to fetal death. Hypertension, ketoacidosis and blood level CRP were independent risk factors for fetal death, which should be paid special attention.

Objective: To evaluate the intestinal trophic effects and adverse reactions of nasojejunal and jejunostomy tube im-plants on patients with total gastrectomy. Methods:A total of 86 patients with advanced gastric cancer were randomly and equally di-vided into two groups. Groups A and B received enteral nutrition therapies through nasojejunal and jejunostomy feeding tube implants, respectively. The therapeutic efficacy of the two methods of enteral nutrition therapy and the corresponding adverse reactions observed in the two groups were compared. Results:Group B patients demonstrated shorter anal evacuation and defecation times than group A patients, the difference is statistically significant (P<0.05). Moreover, the bodyweight, total protein, and albumin levels of the patients significantly decreased in both groups after enteral nutrition therapy was administered (P<0.05). Postoperative nutritive indexes were higher in group B than in group A;however, no significant difference was obtained between the two groups (P>0.05). Nonetheless, the patients in group B tolerated the treatment well compared with those in group A (P<0.05). The complication rates of groups A and B were 18.6%and 23.3%, respectively, but this difference was not significant (P>0.05). Conclusion:Patients subjected to total gastrecto-my showed higher tolerance to jejunal tube implants for enteral nutrition than to nasojejunal tube implants, indicating that jejunal tube implants can be used to improve the nutritional status of patients.

Objective To know the efficacy and safety of the blood sugar control by double-pump a-mong severe patients with duodenectomy. Methods Divided 60 severe patients with doudenectomy into the experimental group and the,control group randomly, there were 30 cases in each group. In the control group, pa-tients received intravenous infusion with the liquid containing glucose and neutral insulin (4g: 1 U), intravenous injection of 50U neutral insulin added into 50ml normal saline by micro-pump, the pump speed was In the ex-perimental group, sugar-containing liquid without insulin was infused within 24 hours by infusion pump with u-niform speed, a neutral insulin 50U mixed with 5Oral normal saline were injected by micro-pump according to the ratio fo glucose 4g: 1U neutral insulin through the same vein. Which also adjusted the pump speed according to maintaining blood sugar in the range of 4.4～8.3mmol/L. Compared the level of blood sugar control, treatment safety, efficacy and the workload of nurses between the two groups. Results The highperglycemic index and the time to achieve target values of blood sugar in the experimental group was shorter than in the control group respectively, while the time of keep blood sugar in idea level in the experimental group was longer than in the control group. There were no significant difference about incidence rale of hypoglycemia and workload of nurses between the two groups. Conclusions Double-pump can effective control blood sugar for severe patients with duodenectomy without burden nurses' workload, which is more reasonable than the traditional method.

Objective To investigate the clinical efficacy of Jin’s Three Needles plus twelve Jing-Well points in treating post-stroke shoulder-hand syndrome. Methods Sixty patients meeting the inclusion criteria of post-stroke shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture with Jin’s Three Needles plus twelve Jing-Well points and the control group, conventional acupuncture. The Clinical Neurological Disfunction Scale (CNDS) score, the Fugl-Meyer Assessment (FMA) score, the Visual Analogue Scale (VAS) score and the Functiional Comprehensive Assessment (FCA) score were observed in the two groups before and after two weeks of treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the CNDS, FMA, VAS and FCA scores in the two groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 96.7%and 55.7%in the combination group, respectively, in the treatment group and 83.3%and 26.7%, respectively, in the control group;there were statistically significant differences between the two groups (P<0.05). Conclusion Acupuncture with Jin’s Three Needles plus twelve Jing-Well points is an effective way to treat post-stroke shoulder-hand syndrome.

Objective:To collect the imaging data and related materials of the patients with in-stent restenosis (ISR)after coronary artery stent operation with intravascular ultrasound (IVUS),and to analyze the risk factors of ISR,and to propose the reasonable intervention strategies.Methods:Fifty patients with ISR were divided into ISR ≤ 50% drug group (n = 14 )and ISR > 50% drug group (n = 36),including drug-coated balloon therapy group (n=16)and stent treatment group (n=20);IVUS virtual organization technology was used to compare the plaque area,location,tissue composition,thrombus and other factors of the patients in various groups after treatment;the data changes after 6 months of follow-up were analyzed.Results:The IVUS results showed the plaque areas and plaque loads of the ISR patients treated with intervention were significantly reduced compared with before operation (P <0.05);the plaque compression degree of the patients in drug-coated balloon therapy group was lower than that in stent treatment group (P <0.05),but the differences were not found between drug-coated balloon therapy group and stent treatment group in fibrous tissue components and calcified tissue proportion (P >0.05).Conclusion:The ISR rate is higher in the patients with high degree of fiber components,plaque composition heterogeneity and distribution of diffuse tortuous and calcified lesions.ISR has no significant correlation with the plaque wall thickness and lipid content and plaque instability and necrotic tissue proportion.

Objective To observe the clinical efficacy of acupuncture plus moxibustion at Baihui (GV 20) in treating post-stroke insomnia.Method Sixty-five patients with post-stroke insomnia were randomized into a treatment group of 33 cases and a control group of 32 cases. The treatment group was intervened by acupuncture plus moxibustion at Baihui (GV 20), while the control group was by conventional acupuncture. The SPIEGEL scale and Stroke-specific Quality of Life (SS-QOL) were evaluated before and after intervention, and the clinical efficacies were compared between the two groups.Result The SPIEGEL and SS-QOL scores were significantly changed after intervention in both groups (P<0.05). After intervention, the SPIEGEL and SS-QOL scores of the treatment group were significantly different from that of the control group (P<0.05). The total effective rate was 93.9% in the treatment group, versus 68.8% in the control group, and the difference was statistically significant (P<0.05).Conclusion Acupuncture plus moxibustion at Baihui (GV 20) is an effective method in treating post-stroke insomnia.