Objective To study effects of fluid resuscitation on thoracoabdominal injury combined with hemorrhagic traumatic shock.Method A total of 98 patients,who were treated in Affiliated Zhongshan Hospital of Dalian University from November 2004 to December 2006,were retrospectively analyzed.The patients were diagnozed according to Surgery(fifth edition).Patients were divided into delayed fluid resuscitation group(n= 51)and immediate fluid resuscitation group(n=47).Patients in delayed fluid resuscitation group were given with balanced salt solution for the body to maintain basic requirements.Patients in immediate fluid resuscitation group were rapidly administered with a lot of isotonic crystaUoid and(or)colloid solution after admission. Hemoglobin,platelet count,hematocrit,blood lactic acid,basedeficit,preoperative resuscitation time and mortality were compared between the two groups.Paired t test and variance analysis or x~2 test were used.Results The transfusion fluid volume of delayed group and immediate group was(1586?346)ml,(3520?575)ml, respectively,with P value

OBJECTIVETo systematically review the clinical efficacy of acupuncture on the patients with low back pain (LBP).

METHODSRandomized controlled trials (RCTs) about pure acupuncture therapy versus other treatments in treating LBP were electronically searched in PubMed, CBM, EMbase, The Cochrane Library, CNKI, VIP and Wanfang Data from January 2004 to May 2014. The observed index on the results were the changed scores of VAS, ODI, JOA and RMDQ. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as the extracted data, and assessed the methodological quality. The results of Meta-analysis was conducted by RevMan 5.2 software.

RESULTSTen RCTs involved 751 patients were finally included. The results of Meta-analysis indicated that the role of pure acupuncture group in improving the VAS score was better than that of the control group, and the combined effect size was RR = -.32, 95% CI (-1.41, -1.22); Z=27.28, P<0.00001; the role of pure acupuncture group in improving the ODI score was better than that of the control group, and the combined effect size was RR = -5.07, 95% CI (-7.50, -2.65); Z=4.10, P<0.0001; the role of pure acupuncture group on improved JOA score was better than that of the control group and the combined effect size was RR=2.83, 95% CI (2.02, 3.63), Z=6.90, P<0.00001. The role of pure acupuncture group in improving the RMDQ score was better than that of the control group, and the combined effect size was RR = -2.80, 95% CI (-3.49, -2.11), Z=7.95, P<0.00001.

CONCLUSIONThe result of meta-analysis demonstrates that pure acupuncture may have a favorable effect on self-reported pain and functional limitations in LBP patients.

Acupuncture Therapy ; Humans ; Low Back Pain ; therapy ; Randomized Controlled Trials as Topic ; Treatment Outcome

Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients' psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient's anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.

OBJECTIVETo observe the clinical efficacy of acupuncture at Hegu (LI 4) on central facial nerve paralysis after ischemic stroke, and explore dose-effect relationship among different stimulation intensities of acupuncture at Hegu (LI 4) as well as its optimal treatment plan.

METHODSAccording to different acupuncture stimulation intensities which were based on treatment time and needle insertion direction, fifty patients were randomly divided into a Hegu 1 group, a Hegu 2 group, a Hegu 3 group, a Hegu 4 group and a control group, ten cases in each one. Different stimulation intensities of acupuncture at Hegu (LI 4) combined with facial paralysis acupoints, including Yingxiang (LI 20), Dicang (ST 4), Jiache (ST 6) and Quanliao (SI 18), were applied in Hegu 1 to 4 groups; meanwhile acupuncture at stroke acupoints, including Neiguan (PC 6), Shuigou (GV 26) and Sanyinjiao (SP 6), and medication treatment were adopted. Except acupuncture at Hegu (LI 4), the treatment of the control group was identical as Hegu groups. The treatment duration lasted for 14 days. The House-Brackmann facial never grading systems (H-B), Toronto facial grading system (TFGS), degrees of facial never paralysis (DFNP), facial disability index (FDI) and clinical efficacy were compared among groups.

RESULTS(1) Compared before the treatment, H-B, TFGS, DFNP and physical function score in FDI were all improved significantly in the Hegu 1 to 4 groups (all P < 0.05), but social function score in FDI was not obviously improved (all P > 0.05); all the scores in the control group were not evidently changed (all P > 0.05). (2) Compared with the control group, differences of H-B before and after treatment in the Hegu 1 to 4 groups, differences of TFGS in the Hegu 2 group and differences of DFNP in the Hegu 1 and Hegu 2 group were significantly improved (all P < 0.05). The differences of any scale among Hegu 1 to 4 groups were not significant (all P > 0.05), in which the most evident change was found in Hegu 2 group. (3) The total effective rate was 90.0% (9/10), 100.0% (10/10), 90.0% (9/10) and 80.0% (8/10) in Hegu 1 to 4 groups, which were significantly higher than 60.0% (6/10) in the control group (all P < 0.05).

CONCLUSIONAcupuncture at Hegu (LI 4) has affirmative clinical efficacy on central facial nerve paralysis after ischemic stroke, in which oblique insertion along the opposite direction of meridian for 5 s of twirling manipulation has the best clinical effect.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Facial Paralysis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications

OBJECTIVETo observe the analgesic effects of single-and combined-laser irradiation with low-intensity applied at "Zusanli" (ST 36) in rats, and their relation to degranulation of mast cells.

METHODSSixty-six SD rats were randomly divided into 6 groups: normal control group (Group NC), model control group (Group MC), sham irradiation group (Group SI), 10.6 microm laser irradiation group (Group 10.6 microm LI), 650 nm laser irradiation group (Group 650 nm LI) and combined (10.6 microm + 650 nm) laser irradiation group (Group CLI). Complete Freund's Adjuvant (0.05 mL) was injected into the left ankle joints of all the rats except those in Group NC to cause acute adjuvant-induced arthritis. In treatment, laser irradiation was applied at "Zusanli" (ST 36) for 30 minutes in all the rats except those in Group NC and Group MC. The paw withdrawal latency (PWL) to radian heat was used to compare analgesic effects among the groups. By means of toluidine blue, dyed slices of local tissues of "Zusanli" (ST 36) were used to observe changes of mast cell degranulation before and after laser irradiation.

RESULTSThe pain thresholds to irradiation of the rats in Group 650 nm LI and Group CLI were significantly higher than those in Group MC and Group SI (P < 0.01), and the mast cell degranulation rate in Group 650 nm LI and Group CLI were also significantly higher than that in Group MC and Group SI (P < 0.001). The pain threshold and mast cell degranulation rate in Group 10. 6 microm LI were not significantly different from those in Group MC and Group SI. There was a linear correlation between mast cell degranulation rate and PWL with 0. 737 in coefficient (P < 0.001).

CONCLUSIONSingle 650 nm laser and combined 650 nm + 10.6 microm laser with low intensity irradiated at "Zusanli" (ST 36) in acute adjuvant rats can provide remarkable analgesic effects, and there was a positive correlation between mast cell degranulation rate and analgesic effects, which plays an important part in laser irradiation-induced analgesia.

Acupuncture Analgesia ; methods ; Acute Disease ; Animals ; Arthritis, Experimental ; chemically induced ; physiopathology ; therapy ; Cell Degranulation ; radiation effects ; Combined Modality Therapy ; Freund's Adjuvant ; Low-Level Light Therapy ; methods ; Male ; Mast Cells ; cytology ; physiology ; Pain Measurement ; Pain Threshold ; radiation effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley

The theory of branch atheromatous disease (BAD) has been commonly underused in clinical practice and research since it was proposed in 1989.In this study,we sought to explore clinical characteristics of its substypes and biomarkers for prognosis of BAD.A total of 176 consecutive patients with BAD were classified into two groups:paramedianpontine artery group (PPA group,n=70) and lenticulostriate artery group (LSA group,n=106).Bivariate analyses were used to explore the relationship between white matter hyperintensities (WMHs),National Institutes of Health Stroke Scale (NIHSS) scores and prognosis evaluated by the modified Rank Scale (mRS) at 6th month after stroke.The differences in prevalence of diabetes mellitus and a history of ischemic heart disease were statistically significant between PPA group and LSA group (x2=8.255,P=0.004;x2=13.402,P＜0.001).The bivariate analyses demonstrated a positive correlation between NIHSS and poor prognosis in patents with BAD and in the two subtype groups,and a positive correlation between WMHs and poor prognosis in the PPA group.It is concluded that a significantly higher prevalence of diabetes mellitus and a history of ischemic heart disease exist in the PPA group than in the LSA group.In addition,high grades of NIHSS scores imply poor prognosis in patients with BAD and in the two subtype groups.Moreover,WMHs are a positive predictor for poor prognosis in patients in the PPA group.

OBJECTIVETo understand the self-discrimination experience of MSM and its relationship with sexual behavior and psychological factors.

METHODSBy respondent-driven sampling (RDS) method, a call-for action and anonymous self-administration questionnaire investigation was carried out in Mianyang city on experience of self-discriminations, sexual partners and behaviors and depression symptom, etc. The first 12 qualified people were designated as the "root" in the whole investigation from different MSM subgroups. Every "root" would get 3 recruit cards after their own investigation, then cards could be promoted to another 3 qualified people who were willing to accept questionnaires. And this process would go on till the sample size was accomplished. χ(2) test, rank correlation and contingency coefficient would be applied for the statistical analysis.

RESULTSIn total, 201 persons were investigated. Within the past 6 months, 59.2% (119/201) persons felt they did harm to their family or made the family down as gays, 79.6% (160/201) had to disguise their real sexual orientation in avoidance of being discriminated, 39.3% (79/201) were humiliated for having gay sex. It showed correlation between humiliation or harm to family and frequency to disco balls/night clubs (r = 0.196, χ(2) = 7.95, P < 0.05), concerts or theaters (r = 0.201, χ(2) = 8.423, P < 0.05) with MSM friends, HIV health consultancy (r = 0.231, χ(2) = 11.329, P < 0.05), experiences of one night stands (r(s) = 0.183, µ = 2.588, P < 0.05), detection of depression (r(s) = 0.241, µ = 15.717, P < 0.05) and stress-related perception (r(s) = -0.310, µ = 23.112, P < 0.05), the corresponding behavior report rates of who experienced 3-4 times were 66.7% (11/33), 52.9% (18/34), 41.2% (14/34), 17.6% (6/34), 44.1% (15/34), 44.7% (10/24). Statistical significance was found between the relations of humiliation for gay sex and frequency into concerts or theaters (r = 0.195, χ(2) = 7.933, P < 0.05) with MSM friends, experiences of one night stands (r(s) = 0.145, µ = 2.051, P < 0.05), man-man anal sex (r = 0.165, χ(2) = 10.823, P < 0.05), numbers of female sexual partners (r = 0.265, χ(2) = 11.422, P < 0.05), protectiveness of female sexual behavior in the past 6 months (r = 0.513, χ(2) = 7.442, P < 0.05), detection of depression (r(s) = 0.152, µ = 13.034, P < 0.05) and stress-related perception (r(s) = -0.259, µ = 21.190, P < 0.05), the corresponding behavior report rates of who experienced 3-4 times were 22.7% (5/22), 9.1% (2/22), 13.6% (3/22), 91.6% (2/22), 66.7% (2/3), 57.1% (4/7), 33.3% (19/57). It has statistical significance between the relations of disguising their real sexual orientation in avoidance of being discriminated and the frequency of show up in the cybercafé (r = 0.272, χ(2) = 15.932, P < 0.05), involvement of HIV test (r = 0.232, χ(2) = 11.446, P < 0.05), and stress-related perception (r(s) = -0.373, µ = 28.868, P < 0.05). It was found that increasing of discrimination was connected to entrance into gay-welcome places, acceptance of HIV consultancy and tests, posting gay information among MSM friends and hold of many sexual partners. Meanwhile, the pressure was rising when depression was checked out.

CONCLUSIONSelf-discrimination was prevalent among MSM, which had brought critical influence on the individual behavior, MSM psychological health and prevalence of AIDS.

Adolescent ; Adult ; Homosexuality, Male ; psychology ; Humans ; Male ; Middle Aged ; Prejudice ; Self Concept ; Sexual Behavior ; Social Control, Informal ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo evaluate the effectiveness of three-dimensional computed tomography (3D-CT) guided radiofrequency trigeminal rhizotomy (RF-TR) in treatment of idiopathic trigeminal neuralgia (ITN).

METHODSFrom 1999 to 2001, 18 patients with ITN were treated with percutaneous controlled RF-TR. Intraoperative 3D-CT scanning was performed to guide the trajectory of the puncture. After correction of the needle tip according to the CT scans and stimulation effects, 2 to 5 lesions were made for a duration of 60-90 seconds at a temperature of 60 degrees C to 75 degrees C depending on the pain distribution and the age of patient.

RESULTSThe needles located in foramen ovale. Pain alleviated immediately with no serious complication in all patients. The patients were followed up for an average of 31.5 months (range 24-41 months). Acute pain relief was experienced by 17 patients after the procedure, reaching an initial success rate of 94.4%. Early (< 6 months) pain recurrence was observed in 2 patients (11.1%), whereas late (> 6 months) recurrence was reported in 3 patients (16.7%). Thirteen patients had complete pain control, with no need for medication thereafter. Five cases experienced partial pain relief, but required medication at a lower dose than in the preoperative period.

CONCLUSION3D-CT foramen ovale locations can raise the successful rate of puncture, enhance the safety, and reduce the incidence rate of complication.

Adult ; Aged ; Catheter Ablation ; Female ; Follow-Up Studies ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Recurrence ; Rhizotomy ; methods ; Tomography, X-Ray Computed ; methods ; Treatment Outcome ; Trigeminal Neuralgia ; diagnostic imaging ; surgery

OBJECTIVETo study the effects of L.F04, the active fraction of Lycopus lucidus, on erythrocytes rheological property so as to investigate its mechanism in promoting blood circulation and removing blood stasis.

METHODThe effects of L.F04 (used for treatment for 10 days in different dosages) on deformability, aggregation and membrane liquidity of erythrocytes (MLE) as well as whole blood apparent viscosity (eta(b)) were examined on the basis of rat model of blood-stasis syndrome induced by venous injection of high molecular weight dextran.

RESULTAs compared with the normal control group, the model group's RBC deformability and MLE were lower, and the aggregation of erythrocytes and eta(b) were higher. Compared with the model group, both L.F04 0.612 g/kg and 0.306 g/kg showed significant effect in improving deformability and inhibiting aggregation of red blood cells (RBC) and reducing blood viscosity. The trend of improving MLE was also shown.

CONCLUSIONL.F04 could significantly improve the abnormal rheological property of erythrocytes.

Animals ; Blood Viscosity ; drug effects ; Dextrans ; pharmacology ; Drugs, Chinese Herbal ; administration & dosage ; Erythrocyte Aggregation ; drug effects ; Erythrocyte Deformability ; drug effects ; Hemorheology ; Hemostasis ; drug effects ; Lycopus ; Male ; Rats ; Rats, Wistar ; Space Flight

OBJECTIVETo explore the dosimetric variance in forward intensity modulated radiotherapy (IMRT) based on 4D CT and 3D CT after breast conserving surgery.

METHODSSeventeen patients after breast conserving surgery underwent 3D CT simulation scans followed by respiration-synchronized 4D CT simulation scans at free breathing state. The treatment plan constructed using the end inspiration (EI) scan was then copied and applied to the end expiration (EE), and 3D scans and dose distribution were calculated separately. Dose-volume histograms (DVHs) parameters for the CTV, PTV, ipsilateral lung and heart were evaluated and compared.

RESULTSThe CTV volume difference was biggest between T0 and 3D CT, and the volume difference was 4.10 cm(3). Mean dose of PTV at EE was lower than that at EI (P = 0.019), but there were no statistically significant difference between 3D and EI, EE (all P > 0.05). The homogeneity index (HI) at EI, EE, 3D plans were 0.149, 0.159 and 0.164, respectively, and a significant difference was only between EI and EE (P = 0.039). The highest conformal index (CI) was at EI phase (P < 0.05), and there was no significant difference between EE and 3D (P = 0.758). The V(40) and V(50) of ipsilateral lung at EE phase were lower than that at EI (P < 0.05). There were no significant differences in all the indexes for heart (P > 0.05).

CONCLUSIONSThe breast deformation during respiration may be disregarded in whole breast IMRT. PTV dose distribution is significantly changed between EI and EE phases, and the differentiation of the lung high dose area between EI and EE phases may be induced by thorax expansion. 3D treatment planning is sufficient for whole breast forward IMRT, but 4D CT scans assisted by respiratory gating ensures more precise delivery of radiation dose.

Adenocarcinoma, Mucinous ; diagnostic imaging ; radiotherapy ; surgery ; Adult ; Breast Neoplasms ; diagnostic imaging ; radiotherapy ; surgery ; Carcinoma, Ductal, Breast ; diagnostic imaging ; radiotherapy ; surgery ; Dose Fractionation ; Female ; Four-Dimensional Computed Tomography ; methods ; Humans ; Imaging, Three-Dimensional ; methods ; Mastectomy, Segmental ; Middle Aged ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; Respiration