Objective:To observe the clinical efficacy of Yin-Yang balancing acupuncture plus Tuina(Chinese therapeutic massage)for post-stroke depression(PSD). Methods:A total of 72 PSD patients were randomized into an acupuncture-Tuina group and a Western medicine group using the random number table method,with 36 cases in each group.The Western medicine group was treated with fluoxetine hydrochloride capsules.The acupuncture-Tuina group was treated with Yin-Yang balancing acupuncture plus Tuina therapy.Both groups were treated for 4 weeks.After treatment,the clinical efficacy was compared,and the changes in Hamilton depression scale(HAMD)score,National Institute of Health stroke scale(NIHSS)score,serum neurotransmitter levels,and electroencephalogram(EEG)were observed. Results:The total effective rate of the Western medicine group and the acupuncture-Tuina group was 83.3%and 94.4%,respectively.There was a significant difference in the total effective rate between the two groups(P<0.05).After treatment,the serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)were higher than those in the same group before treatment,and the intra-group differences were all statistically significant(P<0.05).The serum levels of 5-HT,NE,and DA in the acupuncture-Tuina group were higher than those in the Western medicine group,and the differences between the groups were statistically significant(P<0.05).After treatment,the scores of HAMD and NIHSS in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The scores in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were all statistically significant(P<0.05).After treatment,the EEG diffuse wave[(delta+theta)/(alpha+beta)]ratio(DTABR)and delta/beta ratio(DBR)in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The ratios in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were statistically significant(P<0.05). Conclusion:Yin-Yang balancing acupuncture plus Tuina therapy has a better efficacy than oral fluoxetine hydrochloride capsules in the treatment of PSD,which can increase the levels of serum 5-HT,DA,and NE,and regulate brain waves.

Objective:To investigate the factors affecting postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after severe traumatic brain injury (sTBI).Methods:A case-control study was conducted to analyze the clinical data of 55 patients with prolonged disorders of consciousness after sTBI admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University and Seventh Medical Center of PLA General Hospital from September 2021 to September 2022. There were 33 males and 22 females, with the age range of 13-68 years [(43.0±15.5)years]. All patients were assessed for the consciousness level using the coma recovery scale-revision (CRS-R) preoperatively and within 48 hours postoperatively. A total of 33 patients were observed in vegetative state and 22 in minimally conscious state preoperatively. The consciousness level was found to be improved in 26 patients (consciousness- improved group), but not improved in the remaining 29 patients (consciousness-unimproved group). Indicators were documented including gender, age, cause of injury, Glasgow coma score (GCS) on admission, course of injury, preoperative consciousness level, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade, analgesic regimen and sedation maintenance drugs. A univariate analysis was conducted first to assess those indicators′ correlation with postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI. Multivariate Logistic regression analysis was then used to determine the independent risk factors for their postoperative short-term improvement of consciousness level.Results:Univariate analysis showed that GCS on admission, course of injury, preoperative consciousness level and analgesic regimen were correlated with short-term improvement of postoperative consciousness level in patients with prolonged disorders of consciousness after sTBI (all P<0.05), whereas gender, age, cause of injury, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade and sedation maintenance drugs showed no relation to the improvement of postoperative consciousness level (all P>0.05). Multivariate Logistic regression analysis showed that the GCS &ge;7 points on admission ( OR=0.06, 95% CI 0.01, 0.36, P<0.01), preoperative minimally conscious state ( OR=0.09, 95% CI 0.02, 0.40, P<0.01) and intraoperative use of Sufentanil combined with Remifentanil ( OR=0.07, 95% CI 0.01, 0.43, P<0.01) were significantly correlated with postoperative improvement of consciousness level. Conclusion:The GCS on admission (&ge;7 points), preoperative minimally conscious state and intraoperative use of Sufentanil combined with Remifentanil are independent risk factors affecting short-term postoperative improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI.

Percutaneous vertebroplasty (PVP) is a minimally-invasive technique,which has been widely employed in the treatment of hemangiomas,vertebral compression fractures,spinal metastases,myeloma and other diseases.Clinically,it is generally believed that the curative effect of PVP is closely related to the injected amount of bone cement.However,there is still great controversy over the optimal injection volume of bone cement.Based on the current researches both at home and abroad,this article aims to make a brief introduction about the relevant vertebral biomechanical factors that might affect the injection volume of bone cement,the influence of the injected volume of bone cement on the vertebral strength,rigidity and adjacent vertebral bodies.The main current disputes are pointed out so as to lay the foundation for further study.

Objective To investigate the relationship between the cystic fluid characteristics of symptomatic sacral canal cyst and the interventional therapeutic prognosis.Methods A total of 114 patients with symptomatic sacral canal cyst were enrolled in this study.Clinically,all patients complained of discomfort at lumbosacral area.Among the 114 patients,86 were primary sacral canal cyst and 28 were recurrent sacral canal cyst.Under DSA guidance,percutaneous puncturing of the cyst was performed,2-5 ml cerebrospinal fluid (CSF) was aspirated and sent for laboratory tests.Then a small amount of nonionic contrast agent was injected into the cyst to determine whether the cyst was communicated with the subarachnoid space or not.Finally,double-needle method was used to aspirate the cyst fluid.Results Radiography showed that communication between the cyst and subarachnoid space was detected in 66 patients (group A),while no communication between the cyst and subarachnoid space was observed in 48 patients (group B).In patients with primary symptomatic sacral canal cyst,the differences in the sugar and chloride levels of CSF between group A and group B were statistically significant.In patients with recurrent symptomatic sacral canal cyst,the differences in the sugar,protein and chloride levels of CSF between group A and group B were also statistically significant.Statistically significant correlation existed between the single or multiple CSF changes and the interventional therapeutic prognosis.Conclusion Sacral canal cysts can be classified into two types:cyst-subarachnoid space communicating type and cyst-subarachnoid space non-communicating type.The characteristics of CSF in patients with primary symptomatic sacral canal cyst are different from those in patients with recurrent symptomatic sacral canal cyst.Multiple CSF changes,the increased sugar level and decreased chloride level in CSF are well correlated with the interventional therapeutic prognosis.

Along with the aging of population in China,more and more people suffer from osteoporosis.As a consequence,osteoporotic vertebral compression fracture has become one of the major clinical issues.More and more patients like to take percutaneous vertebroplasty (PVP) as the preferred treatment,thus,the number of patients who develop recurrent vertebral fracture after PVP is also increased.In recent years,more and more attention has been paid to the recurrent fractures after PVP for vertebral compression fractures by clinicians.In order to reduce the incidence of recurrent vertebral fracture after PVP,it is necessary to make the further and deep studies on the risk factors that cause recurrent vertebral fractures.This paper aims to make a comprehensive review about the risk factors that may cause recurrent vertebral fractures after PVP for osteoporotic vertebral compression fracture.

OBJECTIVETo establish the ultrasonographic criteria for normal size of infrarenal aorta (IRA) and common iliac arteries (CIA) of young males in a Chinese school and to determine the associations between IRA diameter (IRAD) and CIA diameter (CIAD) and body habitus as well as traditional cardiovascular risk factors.

METHODSCross-sectional study was done of 203 Chinese young males enrolled from a technical school in Beijing Changping district from May to June 2013. The IRA and CIA scans were carried out using ultrasonography. Longitudinal scans were used to assess aortic morphology and tortuosity. The maximum internal anteroposterior IRAD and CIAD in any area of the arteries were measured during the cardiac cycle. Participants information on demographic, medical history, smoking history and alcohol consumption was obtained through unified questionnaire. Univariate and multivariate linear regression was used to determine the associations between arterial diameter and body habitus as well as other risk factors.

RESULTSThe median participants age was 21.5 (ranging from 18 to 28) years. The IRAD was (13.4±1.9) mm, and the CIAD was (9.4±1.6) mm. There was no significant difference between the left and right CIAD. Waist circumference was significantly associated with increasing IRAD (P=0.03), while alcohol had an inverse correlation (P=0.04). Age, hip circumference were significantly associated with increasing CIAD (P=0.00, 0.04), while the systolic pressure and alcohol had inverse correlations (P=0.01, 0.00). By dividing the entire group into equal four groups using quartile values for both age and waist/hip circumference, the older group and the larger waist/hip circumference had greater arterial diameter.

CONCLUSIONSThe enrolled Chinese young males have smaller IRAD and CIAD compared with foreign older population. Age, waist circumference, hip circumference, alcohol and systolic pressure have statistically significance but small effects on arterial diameter.

Adolescent ; Adult ; Age Factors ; Aorta, Abdominal ; diagnostic imaging ; Beijing ; epidemiology ; Blood Pressure ; Cardiovascular Diseases ; epidemiology ; Cross-Sectional Studies ; Humans ; Iliac Artery ; diagnostic imaging ; Male ; Risk Factors ; Ultrasonography ; Waist Circumference ; Young Adult

OBJECTIVETo investigate the therapeutic effect of reconstruction of facial defects with frontal expanded flaps bipedicled by superficial temple vessels and supraorbital/supratrochlear neurovascular bundles.

METHODSFrom June 2006 to Mar. 2013, the patients with mostly unilateral facial defects which affected temple area and crossed the facial midline, were treated with frontal expanded flaps. The expanders were implanted at first stage and the expanded frontal flaps were transferred at second stage. At third stage, pedicle division was performed and the pedicle skin tissue was used to repair the residue defect.

RESULTAll the 18 flaps survived completely with satisfactory color and texture. Good results were achieved during the follow-up period of one year.

CONCLUSIONThe bipedicled frontal expanded flap has a reliable blood supply which is very suitable for large facial defect.

Adolescent ; Adult ; Child ; Face ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Treatment Outcome ; Young Adult

10.3969/j.issn.2095-4344.2013.25.025

Objective To evaluate the expression of epidermal growth factor-like domain 7 (Egfl7) in atherosclerotic plaques and effects of its small interference RNA (siRNA) on angiogenesis gene expression in human endothelial cell line (HUVEC). MethodsEgfl7 expression in atheroscleroticplaquesweredetectedinhumaniliacarteryandmousearteriaeusing immunohistochemistry and immunofluorescence stainings.The siRNA targeting Egfl7 was transfected into HUVEC by lipofectamine with non-transfected cells and unconcerned siRNA as controls.At 0 h,12 h,24 h and 48 h after intervention,the levels of mRNA and protein of Egf17,vascular endothelial growth factor(VEGF),platelet derived growth factor-A (PDGF-A),platelet derived growth factor-B (PDGF-B),vascular cell adhesion molecule(VCAM) and intercellular adhesion molecule (ICAM)were measured by RT-PCR and Western blotting,respectively. ResultsThe expressions of Egfl7 in human iliac artery and mouse arteriae were increased.The expressions of Egfl7 in HUVEC at the levels of mRNA were[(0.14±0.02),(0.09±0.01),(0.02±0.01)]and the levels of protein[(0.71±0.11),(0.39±0.09),(0.07±0.01)]at 12 h,24 h and 48 h after siRNA intervention,respectively,which were decreased as compared with 0 h intervention [(0.31 ±0.05) and (0.93±0.08) ].Other genes such as VEGF,PDGF-A and PDGF-B were reduced or silenced at the levels of protein and mRNA in HUVEC with siRNA longer interventions(all P＜0.05).ConclusionsThe expression of Egfl7 in atherosclerotic plaques is increased.The siRNA inhibiting Egfl7 gene expression results in silence of other factors involved in angiogenesis.

ObjectiveTo observe the clinical efficacy of hyperbaric oxygen (HBO) in treatment of diabetes complicated with acute cerebral infarction (ACI) and its effect on insulin resistance (IR).Methods One hundred and twenty-eight patients with diabetes complicated with ACI were divided into control group and treatment group with 64 cases each by table of random digit.The control group was treated with routine medication,while the treatment group was treated with HBO besides routine medication.The two groups were treated for 14 days.The neural function defect degree score,fasting blood glucose(FPG),fasting insulin (FINS) and insulin action index(IAI) were assessed before and after treatment in each group.Correlation between the difference value of IAI and neural function defect degree score was analyzed with Pearson correlation analysis.ResultsThe total effective rates in treatment group and control group were 87.50％ (56/64) and 70.31％(45/64) respectively,with a significant difference between two groups (P＜ 0.05).IAI after treatment in control group and treatment group showed significant difference compared with that before treatment(P＜ 0.05 or ＜ 0.01 ),but IAI after treatment in treatment group and control group had significant difference (-4.03 ± 0.51 vs.-4.22 ± 0.55,P ＜ 0.05).There was negative correlation between the difference value ofIAI and neural function defect degree score(r =-0.696,P ＜ 0.01 ).ConclusionHBO may increase the clinical efficacy in treatment of diabetes complicated with ACI,and also it improves IR significantly.