Objective To observe the clinical efficacy of needle knife, Governor-Vessel moxibustion plus medication in treating ankylosing spondylitis (AS).Method Forty AS patients were randomized into a treatment group and a control group, 20 cases in each group. The control group was intervened by intravenous administration of Ossotide injection, while the treatment group was by needle knife and Governor-Vessel moxibustion in addition to Ossotide injection. Before and after the intervention, the symptoms and body signs, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Functional Index (BASFI) were observed in the two groups, and the clinical efficacies were compared between the two groups.Result The total effective rate was 90.0% in the treatment group versus 75.0% in the control group, and the between-group difference was statistically significant (P<0.05). After the intervention, the symptoms and body signs (spinal pain score, Schober test, morning stiffness duration, chest expansion degree, and occiput-wall distance) were changed significantly in both groups (P<0.05). The BASDAI and BASFI scores were significantly changed after the intervention in both groups (P<0.05). The BASDAI and BASFI scores in the treatment group were significantly different from those in the control group after the intervention (P<0.05).Conclusion Needle knife plus Governor-Vessel moxibustion and medication is an effective approach in treating AS.

Objective To explore the feasibility of low-dose multi-slice computed tomography(MSCT) scan on pulmonary artery three-dimensional angiography, and the relationship between pulmonary VR image quality and the SD value of plain scan. Methods Pulmonary artery CT examination was performed in 87 patients. 63 volunteers were administered with low dose as a low-dose group, and the other 24 were scanned with conventional dose as a routine group. Both plain scans were use conventional dose of pulmonary scan with 150 mAs, and the low-dose pulmonary enhanced scans were used with 60 mAs. The images were post-processed with volume rendering(VR) and classified into three grades A, B and C, and VR image quality levels of both groups compared. The receiver operating characteristic curve( ROC) was used to analyze the relationship between VR image quality level and SD value of plain scan image SD value. Results The VR image level of A-class was 100% in the conventional dose group, and 85. 7% was in the low dose group . According to the correlation analysis between the standard deviation(SD) value of plain scan image and pulmonary artery VR image quality, the area under curve in receiver-operated characteristic analysis was 0. 906. Conclusions The low-dose scan of pulmonary artery three-dimensional angiography is feasible. Using 60 mAs low-dose in pulmonary artery enhanced scan could ensure better image quality. With the SD value of the plain scan decreased, the pulmonary artery VR image quality is improved.

This study was aimed to observe the protective effect of astragalus on bones of vitamin D deficiency rat model. A total of 30 male SD rats were randomly divided into 3 groups, which were the control group, model group, and the astragalus group. The experimental period was 8 weeks. After the experiment, enzyme immunoassay was used for the detection of serum 25 hydroxy vitamin D3 [25 (OH)VD3], fibroblast growth factor-23 [FGF-23], Klotho, and HE staining of femur. The results showed that compared with the normal control group, the vitamin D deficiency rat model group had a decrease in both serum 25 (OH)VD3 and Klotho, and a increase in FGF-23, which meant the ex-istence of osteoporosis. Compared with the model group, the astragalus group had a decrease in both the serum 25 (OH)VD3 and FGF-23, and a increase in Klotho, which meant the osteoporosis of the astragalus group had been im-proved significantly. It was concluded that astragalus can regulate FGF-23 and Klotho in vitamin D deficiency rats in order to have a protective effect for bones.

Acupuncture Therapy ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Gastritis, Atrophic ; therapy ; Humans ; Male ; Middle Aged

Objective To evaluate the clinical effect of the reversed saphenous fasciocutaneous island flap combined with the VSD therapy in plate exposure of the distal tibia.Methods From January 2008 to July 2010,seven patients with hardware exposure following internal fixation of the distal tibia fracture were treated by VSD therapy and reversed saphenous fasciocutaneous island flap reconstruction.The VSD therapy was performed from 7 to 26 days after hardware exposure,and the flap transfer was performed 7 to 14 days after the VSD therapy.The size of the soft-tissue defect ranged from 4 cm × 2 cm to 13 cm × 4 cm.The mean follow-up was 10.6 months after the fracture (range,8-14 months).Results The average times of the VSD therapy was 1.3.After VSD was removed,the exposed hardware was covered by healthy granulation tissue in all cases.All flaps were successfully transplanted,and the size of flap ranged from 6 cm × 3 cm to 15 cm × 6 cm.Six of 7 flaps survived completely without further procedures.The necrosis of the distal margin of the flap occurred in 1 patient.A solid bony union was confirmed by the X-ray in all patients after 4-6 months postoperatively.No skin defects or fistulae were observed.Conclusion The combination of the reversed saphenous fasciocutaneous island flap and VSD therapy could save the exposed hardware and cover the soft tissue defects in the distal tibia.

Objective:To investigate the effects of experimental periodontitis on serum C reactive protein(CRP) and insulin resistance in obese rats.Methods:4 week old SD rats (n=35)were fed with high fat diet for 16 weeks to establish the model of obesity.According to the obesity criteria,5 rats were screened out.According to the proportion of 1:2,10 rats were randomly selected as obese control group,20 obese rats were used for the establishment of the obesity with periodontitis model(combination group) by periodontal ligation using silk thread.4 rats died after ligation.Before periodontal ligation,1 and 4 weeks after periodontal ligation,orbital venous blood were collected for the detection of fasting blood glucose and fasting insulin.Homeostasis model assessments of insulin resistance index(HOMA-IR) and beta cell function index(HOMA-β) were calculated.The level of serum CRP was examined by ELISA.Results:The level of CRP in the combination group was increased 1 week after periodontal ligation,and then gradually decreased in the following 4 weeks(F=7.773,P=0.004).HOMA-IR in the combination group were higher than that in the obese group(F=-4.691,P=0.000),and beta cell function index was significantly lower(F=3.672,P=0.002) than that in the control group 4 weeks after periodontal ligation.Conclusion:The experimental periodontitis may affect the serum level of CRP in obese rats,aggravate insulin resistance and decrease the function of beta cells in obese rats.

Objective To investigate the effects of three laparoscopic bariatric operations on relieving type 2 diabetes in morbid obese patients. Methods From 2005 to 2009, 15 morbid obese patients with type 2 diabetes received bariatric operations in Shengjing Hospital including lapband operation (7 cases) , sleeve gastrectomy (7 cases) and gastric bypass(4 cases). All patients were followed up for more than 1 year. Results All patients recovered without major complications. Body weight decreased and BMI was respectively (27. 6 ± 2. 0) kg/m2, ( 26. 9 ± 1. 4) kg/m2 and (27. 5 ± 3. 0) kg/m21 year after operation. The excess BMI loss in three groups were (76. 4% ± 6. 8% ) , (83. 7% ± 4. 6% ), (85. 7% ±9. 5% ) 1 year after operation. On the other side, the fasting glucose levels and glycohemoglobin in gastric bypass group were much lower than that in other two groups. Conclusion All these operations were effective in controling the weights and fasting glucose levels, while the gastric bypass method is better than other two methods in weight and serum glucose control. Sleeve gastrectomy was better in weight and glucose control than lap band operation.

Asthma is a common chronic respiratory disease in Singapore and it is the primary cause of chronic respiratory disease burden in childhood and early adulthood. Despite having one of the best healthcare systems in the world, our asthma mortality rates are several folds higher than other first world countries. Most asthma deaths are preventable. We illustrate a case of fatal asthma and highlight some learning points from this case.

Objective To investigate the outcomes of lateral approach combined with anteromedial approach for the treatment of terrible triad of the elbow injuries.Methods Data of 23 patients with terrible triad of the elbow injuries treated at our hospital using this modified surgical technique from July 2008 to January 2011 were retrospectively analyzed.Two patients lost to follow-up leaving 21 patients (21 elbows) for evaluation.There were 17 males and 4 females with a mean age of 38.4 years (range,17-63 years).The 21 elbows were treated surgically after a mean of 4 days from the injury.According to O'Driscoll classification of coronoid fractures,there were 5 cases of type A1,12 of A2,and 4 of B2.According to Mason classification of radial head fracture,there were 2 cases of type Ⅰ,12 of Ⅱ,and 7 of Ⅲ.According to Zhong Biao classification of soft tissue injury in terrible triad of the elbow,there were 6 cases of type Ⅰ,12 of Ⅱ,and 3 of Ⅲ.Our surgical procedure included fixation or replacement of the radial head and repair of the ruptured lateral collateral ligament (LCL) through a lateral approach.Simultaneous fixation of the coronoid process and repair of the common flexor muscle and medial collateral ligament (MCL) injury were performed through an anteromedial approach.Mayo elbow performance score (MEPS) was determined for each patient at the latest clinic visit.The Broberg and Morrey classification was used for evaluating traumatic arthritis.Results The mean follow-up period was 32 months.At the latest follow-up the mean flexion-extension arc of the elbow was 126° (range,115°-135°) and the mean forearm rotation was 139°(range,125°-145°).The mean MEPS was 95 points (range,85-100 points),with 19 excellent results and 2 good results.Concentric stability was restored in all cases.Early post-operative complication occurred in one patient as a wound infection,which healed uneventfully after surgical debridement and antibiotic therapy.Late post-operative complication occurred in four patients including two cases of heterotopic ossification,1 case of radial head nonunion,and one case of ulnar nerve neuropathy,but none of them required additional surgery.Conclusion Lateral approach combined with anteromedial approach for terrible triad of the elbow provided both bony and soft-tissue stability,thereby allowing early active motion as well as functional recovery of the elbow.

Objective To investigate the effective therapic methods of the perioperative vasovagal reflex(RV)in patients with atrial arrhythmias(AAs)underwent by catheter ablation .Methods The clinical data in the patients with atrial arrhythmias(AAs) complicated by vasovagal reflex(RV)were retrospectively analyzed during the perioperative procedure of catheter ablation guided by three dimensional mapping system CARTO ;the clinical data were compared between patients with RV and without RV .Results A total of 535 patients with AAs underwent catheter ablation guided by three dimensional mapping system were collected from Janu‐ary 2010 to December 2012 ,and 35 cases of intraoperative RV were found .Compared by patients without RV ,the patients with RV had more elderly cases and the cases of hypertension ,coronary heart disease and diabetes .The RV occurrence was also associated with the fasting ,painful stimuli ,operation time and skill .Conclusion The perioperative RV often is occurred in the cases of high risk and have the precipitating factors ,and the good prognosis could be obtained by the detect and treatment as early as possible .