Objective To evaluate the clinical efficacy of Gushang External Wash Granules combined with extracorporeal shockwave therapy(ESWT)in treating early-to-middle-stage knee osteoarthritis(KOA)with cold-damp obstruction syndrome.Methods A total of 84 patients diagnosed as early-to-middle-stage KOA(cold-damp obstruction syndrome)at the Orthopedic Outpatient Clinic of Dongguan Hospital of Guangzhou University of Chinese Medicine(Dongguan Traditional Chinese Medicine Hospital)from July 2022 to July 2023 were enrolled.Patients were randomly assigned to either the observation group or control group using a random number table,with 42 cases in each group.Both groups received ESWT,while the observation group additionally underwent topical washing with Gushang External Wash Granules.The treatment course lasted 4 weeks for both groups.The changes in traditional Chinese medicine(TCM)syndrome scores,Visual Analogue Scale(VAS)scores for pain,and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores in the two groups were measured before and after treatment,and the clinical efficacy was evaluated after treatment.Results(1)After 4 weeks of treatment,the total effective rate was 95.24%(40/42)in the observation group versus 76.19%(32/42)in the control group.Intergroup comparison(tested by chi-square test)showed significantly superior efficacy in the observation group(P＜0.05).(2)After treatment,both groups demonstrated significant reductions in VAS pain scores compared to those before treatment(P＜0.01),while no statistically significant difference was found between groups(P＞0.05).(3)WOMAC scores were decreased significantly in both groups after treatment(P＜0.01),and the observation group showed significantly greater reduction than the control group(P＜0.01),with statistically significance.(4)After treatment,the scores for the TCM symptoms of intolerance of cold and limb chilling,restricted flexion-extension,and stiffness and numbness in the extremities were significantly reduced in both groups(P＜0.01),and the observation group demonstrated significantly greater improvements in all TCM syndrome scores than the control group(P＜0.01).Conclusion The combination of Gushang External Wash Granules and ESWT demonstrates significant efficacy for the patients with early-to-middle-stage KOA of cold-damp obstruction type,and is effective on alleviating clinical symptoms and improving knee function and quality of life of the patients.

Objective:To evaluate the effect and safety of adjustable closed loop(ACL) in the treatment of short bowel syndrome (SBS).Methods:From January 2017 to December 2017, the clinical data of 2 cases with ostomy in continuity after surgery in Children's Hospital Affiliated to Xi'an Jiaotong University were analyzed.The age was 1 and 3 months, both were females, and preservation of intestinal tube length were 65 cm and 60 cm respectively.They were all diagnosed SBS with a lot of stool like water.Self-made ACL was installed to maintain SBS.The blood circulation of stoma, weight, BMI, defecating, abdomen, nutrition status changes, nursing convenience, intestinal infection susceptibility were observed.Results:There was no necrosis in stoma, and the overall condition was improved, and no significant increase in abdominal distension.ACL used in babies with ostomy in continuity could improve the anus stool, weight, nursing convenience.Conclusion:ACL installed in baby with SBS could contribute to intestinal management, and is easy to install.

Objective DSA and/or surgery was used as a control to evaluate the image quality, radiation dose and diagnostic efficacy of 70 kV combined with low contrast agent dose and 80 kV dual-source CT scanning of coronary artery. Methods Between Apr, 2012 and Apr, 2017, a total of 150 consecutive pediatrics with suspected or confirmed coronary arterial diseases underwent DSCTCA, and the patients were randomly divided into 3 groups by different scanning protocols. Group A (n=50): 80 kV with 1.5 ml/kg contrast agent;Group B (n=50): 70 kV with 1.5 ml/kg contrast agent;Group C (n=50): 70 kV with 1.0 ml/kg contrast agent. ANOVA was used to compare the differences of subjective coronary arteries image quality between the three groups; The t-test was used to compare the difference in effective radiation dose between the 70 kV group and the 80 kV group; The surgery and/or angiography results were used as gold standard to evaluate the diagnostic efficacy of the three groups. Results All patients underwent DSCTCA successfully and satisfactory diagnostic images were gained . The mean scores of subjective image quality of coronary artery were 3.5±0.7, 3.4±0.6, 3.7±0.8, respectively. There was no significant difference between the 3 groups (F=2.042, P=0.133). The diagnostic accuracy of the three groups for coronary artery disease was 100%, as the surgical and/or angiographic results were used as gold standard. The effective radiation doses in 80 kV group (A group) and the 70 kV group (B+C group) were (0.49 ± 0.04) and (0.30 ± 0.03) mSv, respectively, with a statistically significant difference (t=4.037, P=0.001). Conclusions DSCTCA can better display and diagnose pediatric coronary artery lesions with 70 kV tube voltage combined with low contrast agent, and has a high diagnostic accuracy. It is a reliable method for diagnosing pediatric coronary artery disease.

Objective To explore the clinical usefulness of low-dose dual-source CT (DSCT) angiography in detecting coronary artery anomaly (CAA) in patients with complex congenital heart disease (CHD). Methods A total of 615 consecutive patients with complex CHD who underwent DSCT angiography between 2008 and 2012 were retrospectively reviewed. According to the ultrasonic results, a total of 312 patients with tetralogy of Fallot (n=176 cases) or double outlet right ventricle (n=72 cases) or pulmonary artery atresia (n=64 cases) were included. Scans were divided into 3 groups: retrospective electrocardiogram (ECG)-triggered spiral scanning in 75 cases, prospective ECG?triggered spiral scanning in 158 cases, and prospective ECG?triggered high?pitch spiral scanning in 79 cases. The subjective image quality was evaluated with a four?point scale by two radiologists. Radiation dose values were calculated. Interobserver agreement in subjective image quality grading was assessed by using Kappa statistics. The scanning groups were compared with the Kruskal?Wallis test. Results The incidence of CAA was 8.0 %(25/312). CAA was detected in 7.9%(14/176)patients with tetralogy of Fallot, 8.3%(6/72)patients with double outlet right ventricle, 7.8%(5/64)patients with pulmonary artery atresia. In 76%(19/25)of the patients, the anomalous vessels were crossing the right ventricular outflow tract (RVOT). Thirty of 312 CT examinations were nondiagnostic (9.6%). Two radiologists acquired good agreement (Kappa=0.72,P<0.01). The median subjective image quality score of three scan groups was 3 (range 1—4). The score in high?pitch spiral scanning group was significantly lower than those in other two groups (H=29.1,P<0.01). Retrospective ECG?triggered scans had a median dose of 1.19 mSv(range 0.52—3.29 mSv), prospectively ECG?triggered scans had a median dose of 0.51 mSv(range 0.27—2.13 mSv), and prospectively ECG?triggered high?pitch spiral scans had a median effective dose of 0.30 mSv(range 0.18—0.62 mSv). The difference between groups was statistically significant (H=160.0, P<0.01). Conclusions DSCT angiography is a reliable diagnostic method for the assessment of CAA with complex CHD and low?dose prospectively ECG?triggered DSCT scan is the best choice.

Objective: To compare the efficacy of paroxetine and amitriptyline in the treatment of primary fibromyalgia syndrome.Methods:46 out- and in-patients with primary fibromyalgia syndrome were randomized to two groups and treated respectively with amitriptyline 25mg~50mg per day and paroxetine 10mg~20mg per day. The Visual analogue scales(VAS) was used to evaluate the efficacy and adverse effects were recorded at baseline, month 1 and month 3.Results:In both groups pain was alleviated with statistical significance after 1 month of treatment. However the efficacy of amitriptyline and paroxetine was not statistically significant at different time points. The occurrence of adverse effects in paroxetine group was less than in amitriptyline group and the difference was statistically significant, especially dry mouth and palpitation.Conclusion:Paroxetine is as effective as amitriptyline in the treatment of primary fibromyalgia syndrome but with a better safety profile.

In this paper,the candida carrier rate of 1996 healthy infants and juveniles of the Han,Dai and Zang nationalities was reported.The specimens were taken from the tongue,cheek mucosa,stool,urine,finger web and vagina.The carrier rate of C.albicans in the mouth was significantly higher than that in the other regions. C.albicans at the tongue of the Han,Dai and Zang people was 4.5%,5.3%, 1.07% respectively.Therefore,C.albicans' residence in the mouth was probably an important source of the internal infection of candidiasis.Of the 1996 healthy individuals none had C.albicans isolated from the urine.The carrier rate of C. albicans isolated from the vagina was only 0.15% in the Han and zero in the Dai and Zang.The carrier rate of candida was least in the newborn.Our data also suggested that the carrier rate of candida at the tongue was much higher than that at the cheek mucosa.Regard must be paid when isolating fungi from the mouth.