Objective To explore the method and result of endoscopic thyroidectomy. Methods Thyroidectomy was performed endoscopically in 4 cases of thyroidoma. Results 4 patients underwent endoscopic thyroidectomy, whose operation time was 52,63,70,75 minutes respectively. An average blood loss during operation was 35ml and no complication occurred. They were discharged 4 days～5 days after operation. Conclusions The endoscopic thyroidectomy has the advantages of minimal invasion, less bleeding, less complication and quicker recovery.

Objective To explore hypoxemia on transportation in elderly patients who underwent laparoscopic cholecystectomy(LC) under general anesthesia. Methods SPO 2 was monitered continuously during peridecannulation period, especially within the first 5 minutes in case of incidence of hypoxemia. Results 15 out of 100 cases were found to undergo hypoxemia with SPO 2≤92%. The incidence rate of hypoxemia was 15%(15/100). Conclusions It is important to monitor SPO 2 and administer oxygen inhalation continuously on transfer from operation room back to ward to prevent hypoxemia in elderly patients.

Objective] To evaluate the acupuncture treatment of type 2 diabetes peripheral neuropathy clinical curative effect and safety. [Methods] Com-puter retrieval of the CENTRAL, Cochrane, Web Of Science, CBM, CNKI, VIP database, find al about acupuncture and moxibustion treatment of type 2 diabetic gastroparesis of randomized control ed trial(RCT), build library retrieval time until March 19, 2014.At the same time ShouJian into literature references.According to inclusion and exclusion criteria, independently by two researchers after RCT extraction and filtering, data quality evaluation, using Revman5.2 Meta analysis software, use the GRADE system for quality evaluation of evidence. [Results] Seven studies involving 364 patients were includ-ed.Meta analysis showed:(1) effective rate:the acupuncture compared with drugs, the results between the two groups were statistical y significant (RR=3.35, 95% CI=(2.05, 5.48)], suggesting that acupuncture treatment can improve efficiency for the treatment of type 2 diabetes peripheral neuropathy. (2) MNCV:the median nerve, and results showed that the statistical significance was found between the two groups[MD=2.29, 95%CI=(0.61, 3.98)].Includ-ing philalways nervous, the result showed that between the two groups had statistical significance[MD=2.16, 95% CI=(0.16, 4.16)].(3)SNCV:includ-ing median nerve, the results showed that the statistical significance was found between the two groups[MD=1.79, 95% CI=(0.57, 3.02)].Including phi-lalways nervous, the result showed that the two groups had statistical significance[MD=3.59, 95%CI=(2.28, 4.91)].Based on GRADE system ,al the evidence was at low level and weak recommendation. [Conclusion] Acupuncture-moxibustion for the type 2 diabetes peripheral neuropathy is better than the conven-tional medicine treatment.Limited by the guality of the inclusive literalures, it needs more high quality, large sample of RCT further argument.

OBJECTIVETo compare the differences of clinical effects in female patients with obesity and hyperlipidemia of yang deficiency of spleen and kidney syndrome between warm acupuncture combined with auricular acupuncture and simple warm acupuncture.

METHODSOne hundred and thirty patients were randomly divided into an observation group and a control group, 65 cases in each one. In the control group, acupuncture was used at Pishu (BL 20), Zhongwan(CV 12), Shenshu(BL 23), Zhongji(CV 3), Guanyuan(CV 4), Mingmen(GV 4), Taibai(SP 3), Fenglong(ST 40), etc.; warm acupuncture was applied at Pishu(BL 20), Zhongwan(CV 12), Shenshu(BL 23) and Zhongji(CV 3); the treatment was required once every two days and for 3 months continuously. In the observation group, based on the treatment in the control group, thumbtack intradermal needles were embedded at auricular points, including pi(CO13), shen(CO10), pangguang(CO9), sanjiao(CO17), neifenmi(CO18), neishengzhiqi(TF2), etc. Obesity indices [body mass(W), obesity degree(A), body mass index(BMI), body fat percentage(F%)] blood lipid indices [serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C)] and clinical efficacy were observed before and after treatment in the two groups. Results After treatment in the two groups, the obesity indices of W, A, BMI, F% and the blood lipid levels of TC, TG, LDL-C were obviously decreased compared with those before treatment (all P<0. 01) and the HDL-C levels were apparently increased than those before treatment (both P<0. 01). After treatment, the improvement of TC and HDL-C in the observation group was superior to that in the control group (both P<0. 01). The difference was not statistically significant in the aspect of improving every obesity index between two groups (all P>. 05). The comprehensive total effective rate of the observation group was 95.4% (62/65), which was better than 84. 6% (55/65) of the control group (P<0. 001).

CONCLUSIONWarm acupuncture combined with auricular acupuncture and simple warm acupuncture can both benignly adjust abnormal lipid metabolism of obesity patients with hyperlipidemia, and warm acupuncture combined with auricular acupuncture are superior to simple warm acupuncture treatment on antiobesity action and improving the TC and HDL-C levels.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adult ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Kidney ; physiopathology ; Middle Aged ; Obesity ; metabolism ; physiopathology ; therapy ; Spleen ; physiopathology ; Triglycerides ; metabolism ; Yang Deficiency ; metabolism ; physiopathology ; therapy ; Young Adult

OBJECTIVETo explore the efficacy on obesity of spleen deficiency and damp blockage pattern and hyperlipemia treated with warm needling therapy and auricular acupuncture and the effect mechanism of the combined treatment.

METHODSOne hundred and ten patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia were randomized into an observation group and a control group, 55 cases in each one. Additionally, a healthy group (52 cases) was set up as the control. In the control group, the warm needling therapy was applied to Taibai (SP 3), Chongyang (ST 42), Yinlingquan (SP 9), Zusanli (ST 36), etc., once every two days. In the observation group, on the basic treatment as the control group, the auricular acupuncture was applied to Pi (CO₁₃), Wei (CO₄), Fei (CO₁₄), Shen (CO₁₀), etc., once every 2 to 3 days. The efficacy was evaluated after 3-month, treatment in the two groups. The observation was conducted on the obesity outcomes [body mass, obesity degree (A), body mass index (BMI), body fat percentage (F%)], blood-lipoids indicators [such as serum total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], fat-islet endocrine axis outcomes [such as fasting plasma glucose (FPG) , fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR) and insulin β cell function index (Homa-β)], as well as autonomic nerve function index (Y) before and after treatment in the patients of the two groups. The efficacy was assessed in the two groups.

RESULTSThe total effective rate was 96.4% (53/55) in the observation group, better than 87.3% (48/55, P < 0.01) in the control group. For the improvements of the obesity indices, the differences were not significant between the two groups (all P > 0.05). Before treatment, the levels of TC, TG, LDL-C, FLP, FPG, FINS and Homa-IR in the two groups were all significantly higher than those in the healthy group (all P < 0.01), and the levels of HDL, ISI, Homa-β and Y were significantly lower than those in the healthy group (all P < 0.01). After treatment, except Homa-β, the other indices were all improved significantly (all P < 0.01). The results in the observation group were better than those in the control group (all P < 0.01).

CONCLUSIONThe patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia have the disturbances of lipid metabolism, "fat-islet endocrinal axis" function and automatic nerve function. The combined treatment of warm needling therapy and auricular acupuncture or simple warm needling therapy present the effects of weight reducing and lipid reducing. The effect of the combined treatment is better than simple warm needling therapy. The efficacy mechanism is probably relevant to the positive regulation of blood glucose, lipid metabolism, fat-islet endocrinal axis and automatic nerve function.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adolescent ; Adult ; Blood Glucose ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Lipids ; blood ; Male ; Middle Aged ; Obesity ; metabolism ; therapy ; Spleen ; physiopathology ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

This study was aimed to observe the effect of electro-acupuncture (EA) treatment on Zhong-Xiao (ZX, T2MD) with obesity. A total of 203 patients with ZX accompanied with obesity accepted EA treatment. Before and after 3-month treatment, observations were made on patients' fasting blood glucose (FBS), fasting insulin (FINS), in-sulin sensitivity index (ISI), insulin resistance index (Homa-IR), insulin secretion index (Homa-β), degree of obesity (A), body mass (Kg), body mass index (BMI) and body fat percentage (F%) changes. The results showed that com-pared with pretreatment, the posttreatment FINS, Homa-IR, FBS had a significant decrease among 203 patients (P<0.01); the ISI and Homa-β had a significant increase (P < 0.01). There was a significant statistical difference on islet β-cell function before and after treatment. The A, body mass, BMI, and F% were significantly decreased (P<0.01). It was concluded that EA can significantly correct ZX with obesity patients' glucose consumption, protect the islet β-cell function, and reduce the body mass of patients.

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This study was aimed to observe effect of combined therapy of acupuncture, tapping and auricular needling on fatty-insulin endocrine axis in obesity complicated with hyperlipidaemia patients withyin-deficiency and blood-stasis pattern. A total of 108 patients with obesity complicated with hyperlipidaemia ofyin-deficiency and blood-stasis pattern were randomly divided into the treatment group of combined therapy of acupuncture, tapping and auricular needling, and the acupuncture and tapping group, with 54 cases in each group. The comparison was made to 52 patients in the normal group. Observations were made on changes of fatty-insulin endocrine axis index, lipid index, obesity index, vegetative nerve function index (Y value) and clinical weight-reducing and lipid-reducing effect. The results showed that the pretreatment obesity index, fasting insulin (FINS), fasting plasma glucose (FPG), insulin resistance index (Homa-IR), fasting leptin (FLP), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL-C) and Y value of patients in both groups were significantly higher than those of the normal group (P < 0.01). However, the high density lipoprotein (HDL-C) and insulin sensitivity index (ISI) were significantly lower than those of the normal group (P < 0.01). After treatment, both groups received satisfied effects on weight-reducing and lipid-reducing. The fatty-insulin endocrine axis indexes (FINS, FPG, Homa-IR and FLP) were significantly reduced (P < 0.05); and ISI was significantly increased (P < 0.05). The combined therapy of acupuncture, tapping and auricular needling had better regulation effects on the fatty-insulin endocrine axis level, lipid level and vegetative nerve function level compared with the acupuncture and tapping group (P < 0.05). It was concluded that patients with obesity complicated with hyperlipidaemia ofyin-deficiency and blood-stasis pattern had dysfunction of the fatty-insulin endocrine axis. The combined therapy of acupuncture, tapping and auricular needling, or the therapy of acupuncture and tapping had good regulation effect. However, the combined therapy of acupuncture, tapping and auricular needling had more significant therapeutic effect.

Objective To investigate the kinds of isolates and the causes of bloodsream infection.Methods A total of 4 459 blood samples were cultured by BacT/Alert 3D240. The isolates were identified by API system.Results 247 strains were isolated from 246 patients. The isolates included Gram-negative bacteria (66.0%), Gram-positive bacteria (30.4%) and fungi(3.6%). E. coli, Salmonella paratyphi A , Salmonella typhi and Staphylococcus sp. not-Staphy. aureus were the main pathogen. The causes of bloodstream infection resulted from non-surgical disease, surgical disease, and others were 82.5%, 4.1% and 13.4%, respectively. The major symptom of blood infection was fever, which was presented in 41.5% of positive blood culture cases. 77.6% of Salmonella sp. was isolated from the patients of the department of respiratory and the department of emergency. E. coli was mainly isolated from the patients of the department of nephrolgy, haemotology and surgical department. Staphycoccus sp.not-Staphy. aureus was mainly isolated from the patients of the department of respiratory and pediatrics. The positive blood culture rate in 12,24,36,48,72,96 h were 24.4%,74.0%,87.4%,93.1%,97.2%, and 99.2% respectively.The coincidence rate of positive blood culture detected under microscope and identified by API system was ~99.6%. Conclusion Automated blood culture systems were important apparatus for diagnosis of bloodstream infection.

This study was aimed to observe the clinical effect of acupuncture together with warm acupuncture on fe-male type 2 diabetes mellitus (T2DM) patients of dual deficiency of yin and yang syndrome. A total of 92 female T2DM patients of dual deficiency of yin and yang syndrome were divided into two groups, which were priority of yin deficiency in the type of dual deficiency of yin and yang (group 1) and priority of yang deficiency in the type of dual deficiency of yin and yang (group 2). There were 46 cases in each group. The treatment of acupuncture together with warm acupuncture was given for three month. The observation was made on the fasting plasma glucose (FPG), fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR), insulin secre-tion index (Homa-β), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high den-sity lipoprotein cholesterol (HDL-C), body mass, body mass index (BMI) and body fat percentage (F%) before and af-ter treatment. The results showed that the total effective rate of group 1 was 69.57%, while the total effective rate of group 2 was 84.78%. There was no significant statistical difference between two groups. Compared with pretreatment, there were significant decrease on FLP, FPG, FINS, Homa-IR, TC, TG, LDL-C, body mass, BMI, and F% of both groups after treatment (P < 0.01). There was obvious increase on ISI, Homa-β, and HDL-C (P < 0.01). After treat-ment, the FPG, Homa-β and BMI of group 2 were better than group 1 (P< 0.05). After treatment, the level of LDC-C and HDC-L of both groups reached normal level. And the FPG of group 2 also reached normal level. It was con-cluded that acupuncture together with warm acupuncture can significantly adjust the level of fat-pancreatic islet shaft of T2DM patients of dual deficiency of yin and yang syndrome, reduce the leptin resistance and insulin resistance, enhance the sensibility of insulin and the function of pancreatic β cell, and correct the endocrine disorder, gly-cometabolism disorder and lipometabolism disorder. Acupuncture together with warm acupuncture did much better in lowering blood sugar and improving the function of pancreatic β cells of T2DM patients whose priority of yang defi-ciency in the type of dual deficiency of yin and yang than those whose priority of yin deficiency in the type of dual deficiency of yin and yang.