Objective To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of lumbar disc herniation(LDH)of qistagnation and blood stasis type.Methods A total of 62 cases of patients with LDH of qistagnation and blood stasis type were randomly divided into observation group and control group,with 31 cases in each group.The control group was given conventional western medicine for treatment,and the observation group was treated by acupuncture on the basis of the control group,the course of treatment covered three consecutive weeks.After three weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Japanese Orthopedic Association(JOA)scores and Oswestry Disability Index(ODI)scores,as well as the Visual Analogue Scale(VAS)scores of pain,were observed before and after the treatment of the patients in the two groups.The changes in muscle tension,muscle hardness,and muscle elasticity of the multifidus muscle(MM)and lumbar multifidus muscle(LMM)before and after treatment were compared between the two groups.And the safety and the occurrence of adverse reactions in the two groups were evaluated.Results(1)The total effective rate was 96.77%(30/31)in the observation group and 74.19%(23/31)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the VAS,JOA,and ODI scores of the patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with a statistically significant difference(P<0.01).(3)After treatment,the muscle tension,muscle hardness,and muscle elasticity of LMM and MM of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)The incidence rate of adverse reactions was 9.68%(3/31)in the observation group and 9.68%(3/31)in the control group;the intergroup comparison showed that there being no statistically significant difference(P>0.05).Conclusion Acupuncture combined with western medicine in the treatment of LDH of qistagnation and blood stasis type can significantly improve the lumbar function and clinical symptoms of the patients,and improve the muscular performance of the patients'LMM and MM,so as to enhance their quality of life.

Objective To explore the distribution of the plantar pressure in patients with knee osteoarthritis after knee joint replacement surgery.Methods The plantar pressure of 33 patients with double knee osteoarthritis and single knee replacement was measured using the Belgian footscan plantar pressure test system.The peak pressure,the impulse,the peak time of the peak pressure and the parameters of the foot support period were observed.Results The average peak pressure and average impulse of the 2nd,3rd and 4th foot metatarsal,together with the medial and lateral heel,midfoot and full plantar of the knee replacement side were higher than the other side but without significant differences (P＜0.001,P＜0.05).The duration of the maximum pressure peak of the lst,2nd,3rd,4th and 5th metatarsal area and midfoot of the knee replacement side was significantly longer than the other side (P＜ 0.001,P＜0.05).The time of initial contact phase,the duration of foot flat phase and the duration of all single foot support of knee replacement side were significantly longer than the other side(P＜0.05).Conclusions It shows that the plantar pressure parameters and the knee joint's movement ability have improved significantly after the replacement.The foot pressure analysis can be used to evaluate the function of knee joint,to better understand the biomechanical changes of knee joint,so as to explore the best treatment and rehabilitation after the knee arthroplasty.

Objective To investigate the predictive value of serum glycated hemoglobin A1c (HbA1c)level and early neurological deterioration (END)in patients with acute cerebral infarction. Methods From June 2014 to January 2016,the consecutive patients with acute ischemic stroke (interval time from onset to admission < 3 days)admitted to the Department of Neurology,Suqian People′s Hospital were enrolled retrospectively. The neurological deficits of all patients were evaluated on the day of admission with the National Institutes of Health Stroke Scale (NIHSS). The symptoms of neurological deficits in patients were evaluated repeatedly for all patients within 7 days after admission. Any score increased ≥2 compared with before admission was defined as END. The 226 patients met the inclusion and exclusion criteria were enrolled,and they were divided into either an END group (n = 50,22. 1%)or a non-END group (n = 176,77. 9%)according to whether END occurred after acute cerebral infarction. Univariate analysis was used to analyze the differences between the 2 groups. Multivariable Logistic regression analysis was used to analyze the correlation between the HbA1c level and END. Results Compared with the non-END group,there were significant differences in the age,prevalence of diabetes,NIHSS score,hypersensitive C-reactive protein level,rate of ASPECT score 0-7,and serum HbAlc level in the patients of the END group (all P < 0. 05). The results of logistic regression analysis showed that the elevated hypersensitive C-reaction protein and serum HbA1c levels were the independent risk factors for END of acute cerebral infarction (OR,1. 048 and 1. 809 respectively,95% CI 1. 008 -1. 089 and 1. 429 -2. 292 respectively;P = 0. 018 and 0. 002 respectively). Conclusion The increased serum HbA1c level is an independent risk factor for END of acute cerebral infarction. It has certain predictive value for END.

Objective:The changes both within lesions and normal-appearing white matter load on T2-weighted MRI in patients with ischemic leukoaraiosis(ILA) was investigated by diffusion tensor MRI(DTI) and the relation between the changes of DTI parameters and cognitive dysfunction was assessed.Methods: Thirty-four patiens with ischemic leukoaraiosis and 19 healthy volunteers underwent DTI,conventional MRI,and neuropsychological assessment. Results: In ILA group,on DTI,diffusity was increased within lesions and in normal-appearing white matter compared with the control group,FA was reduced.The changes of MD in the NAWM correlates with full scale intelligence quotient(IQ) and executive dysfunction,the changes of FA in the NAWM correlates with global cognitive impairment assessed by the MMSE. Conclusion: DTI can reveal pathological changes in normal-appearing white matter load on T2-weighted MRI in patients with ischemic leukoaraiosis,which correlates with cognitive dysfunctions.