Objective:To summarize medication law of prescription and clinical experience on the treatment of chronic cough through data mining technology. Method:The formula information of 650 cases of chronic cough cases diagnosed and treated by professor HAN Ming-xiang was processed with data mining technology, and system cluster analysis and factor analysis were conducted by SPSS Statistics 22.0. Result:High-frequency medicines of professor HAN Ming-xiang for treating chronic cough were Stemonae Radix, Citri Reticulatae Pericarpium, Asteris Radix et Rhizoma and other 37 herbs, their frequency of occurrence accounted for 80.52%. According to the efficacy, the medicines could be classified into 10 categories, such as expectorant cough antiasthmatic drugs, tonifying deficiency drugs, and diaphoretic drugs. Cluster analysis showed 5 combinations of drugs. Factor analysis yielded 13 common factors, such as Stemonae Radix-Asteris Radix et Rhizoma-Farfarae Flos-Cynanchi Stauntonii Rhizoma et Radix, Asari Radix et Rhizoma-Schisandrae Chinensis Fructus-Zingiberis Rhizoma-Fritillariae Thunbergii Bulbus. Conclusion:Combined with clinical experience, it can be concluded that clinical treatment of professor HAN Ming-xiang for chronic cough attaches great importance to the pathogenesis of wind-evil, Yang deficiency and cold phlegm underlying lung, phlegm and blood stasis and Qi stagnation. The treatment mainly starts from the lung and spleen, with the method of warm and moist, or with some traditional Chinese medicines with the function of removing phlegm by warming the lung, dispersing cold by thinning the surface, strengthening the spleen and resolving phlegm, strengthening the lung and fixing the surface, and relieving spasmolysis by wind.

OBJECTIVE: To retrospectively compare the effect of alternate levels miniplate and anchor fixation with the effect of all levels miniplate fixation in expansive open-door cervical laminoplasty (EOLP). METHODS: Patients with cervical spondylosis underwent EOLP between July 2015 and June 2016 were included in the study. There were 33 patients in the alternate group (alternate levels miniplate and anchor fixation group) and 34 patients in the miniplate group (all levels miniplate fixation group). Neurological function was evaluated with the Japanese Orthopedic Association (JOA) score and degree of pain was assessed with the visual analogue scale (VAS) score. Basic clinical and surgical data, complication rates and medical costs of the two groups were compared. In addition, radiological examinations were performed pre- and post-operatively and at the final follow-up. Relative imaging data such as anteroposterior diameter (APD), cervical curvature index (CCI) and open angle were collected and compared. RESULTS: (1) The mean follow-up time was 18.6 months in the alternate group and 18.9 months in the miniplate group. There were no significant differences in operation time, intraoperative blood loss, perioperative complication rates, post-operative hospital stays, VAS scores and neurological recovery rates preoperatively and at the final follow-up between the two groups. (2) Additionally, no obvious differences were observed about CCIs and APDs at the three follow-up time points between the two groups. Post-operative open angles at C4 and C6 in the alternate group were significantly smaller than those in the miniplate group. However, there were no significant differences in C3, C5 and C7 open angles between the two groups post-operatively. Notably, no significant differences were detected about the open angles at all levels between the two groups at the final follow-up. (3) When comparing radiologic data at different time points in each group, CCIs and open angles at each level had no significant differences, but APDs after surgery and at the final follow-up were significantly larger than pre-operative APDs. (4) Total costs in the alternate group were significantly lower than those in the miniplate group. CONCLUSION The two surgical methods showed almost the same neurological recovery rates and complication rates. However, use of alternate levels miniplate and anchor fixation in EOLP can reduce medical expenses.
Bone Plates ; Cervical Vertebrae ; Humans ; Laminectomy ; Laminoplasty ; Retrospective Studies ; Treatment Outcome

BACKGROUND: With the continuous development of finite element method in biomechanics of orthopedics, the study of spine-related diseases by finite element method has become the main research direction nowadays. Especially, the stress analysis of internal fixation of the spine, the mechanical effect of different internal fixation and the development of new internal fixation are the current hot spot. Spondylolysis is a common disease of the spine. Especially when anatomical bone defects occur, the pathological model and biomechanics of the spine after surgery have corresponding mechanical changes. OBJECTIVE: To review the method of establishing spondylolysis models, the verification of the models and the pplication of finite element models of spondylolysis in various fields, and to summarize the application prospect and value of finite element modeling in lumbar spondylolysis. METHODS: The first author used computer to search the PubMed database and China Journal Full-text Database from January 1998 to December 2016 for related articles. Key words were "finite element, lumbar spine, isthmus, model". A total of 123 related articles were retrieved and 53 articles met the inclusion criteria. RESULTS AND CONCLUSION: (1) At present, finite element analysis of spondylolysis can well reflect the mechanical condition of internal bone. The finite element model of spondylolysis can be used to evaluate the structure and shape of lumbar spine (such as the defect isthmus), the material properties of different anatomical sites (lamina terminalis, cancellated bone and cortical bone) as well as the load of the spine under different exercise states. In particular, stress analysis of the internal structure of the vertebral body and the ancillary structures of the spine (such as disc and articular process) has obvious advantages. (2) In addition, the reconstruction data of the finite element model are derived from the original CT of the patient,and the simulation is high.Compared with the in vitro experiments,the finite element simulation of spondylolysis is reliable and can reduce the damage to the experimental subjects caused by external forces and radiation, and can effectively avoid medical ethics problem.

Background:The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma;therefore,the use of morcellation is limited in the USA.A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy.Methods:A national multicenter study was performed in China.From 2002 to 2014,33,723 cases were retrospectively selected.We calculated the prevalence and recorded the clinical characteristics of the patients with malignancy after morcellation application.A total of 62 cases were finally pathologically confirmed as malignant postoperatively.Additionally,the medical records of the 62 patients were analyzed in details.Results:The proportion of postoperative malignancy after morcellation application was 0.18％ (62/33,723) for patients who underwent laparoscopic myomectomy.Nearly 62.9％ (39/62) of patients had demonstrated blood flow signals in the uterine fibroids before surgery.And,23 (37.1％) patients showed rapid growth at the final preoperative ultrasound.With respect to the pathological types,38 (61.3％) patients had detectable endometrial stromal sarcoma,13 (21.0％) had detectable uterine leiomyosarcoma,only 3 (3.2％) had detectable carcinosarcoma,and 5 (8.1％) patients with leiomyoma had an undetermined malignant potential.Conclusions:The proportion of malignancy is low after using morcellation in patients who undergo laparoscopic myomectomy.Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential,and morcellation should be avoided.

OBJECTIVETo compare the differences in the clinical function and lumbar and abdominal myodynamia in patiants of lumbar disc herniation treated with moxibustion at Dazhui (GV 14) and Guanyuan (CV 4) and acupuncture.

METHODSForty cases were randomized into a moxibustion group and an acupuncture group, 20 cases in each group. In the moxibustion group, the warm moxibustion was applied alternatively at Dazhui (GV 14) and Guanyuan (CV 4) once every other day, 1 h each time, once every day. In the acupuncture group, acupuncture was applied to the corresponding acupoints based on the affected lumbar vertebras, such as Jiaji (EX-B 2), Shens-hu (BL 23), Dachangshu (BL 25) and Huantiao (GB 30), etc. , once evey day 30 min each time. The treatment for 3 weeks was taken as one session in each group. Totally, one session treatment was required. Surface electromyography (SEMG) of bilateral paraspinal muscle and rectus muscle, and JOA score of low back pain were observed in the two groups.

RESULTS(1) JOA score: the score of subjective symptoms, score of activity of daily living (ADL) and total score were improved obviously as compared with those before treatment in the two groups (P<0.01, P<0.05). The results of subjective symptoms score, score of ADL and total score in the acupuncture group were superior to those in the moxibustion group after treatment (6.95+/-0.94 vs 5.50 +/-0.89,10. 90+/-1.86 vs 8.90+/- 1. 92,22.50 +/- 2.82 vs 19.35 +/- 2. 70, all P<0. 05). (2) SEMG comparison: root-mean-square value (RMS) was all reduced in SEMG of the anteflexion, rear protraction, orthostatism, bilateral bending and neck and leg rear flexion for strengthening lumbar muscle as compared with those before treatment in the two groups (P< 0.05, P<0. 01). RMS of the anteflexion and bilateral bending in the acupunture group were reduced much obviously as compared with the moxibustion group. In terms of sitting position anteflexion, rear protraction, orthostatism, bilateral bending and neck and leg rear flexion for strengthening lumbar muscle, median frequency (MF) after treatment was all improved as compared with that before treatment in the two groups (P<0. 05, P<0. 01). In terms of anteflexion, the electrode MF after treatment was improved much obviously in the acupuncture group(P<0. 05).

CONCLUSIONMoxibustion at Dazhui (GV 14) and Guanyuan (CV 4) and conventional acupuncture all improve muscle function, relieve muscle fatigue, increase the ability of anti-muscle fatigue, strengthen lumbar vertebral stability, release subjective symptoms and improve ADL. But, the effects of moxibustion are slightly lower than those of acupuncture.

Acupuncture Therapy ; Adult ; Aged ; Electromyography ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; therapy ; Lumbar Vertebrae ; physiopathology ; Male ; Middle Aged ; Moxibustion ; Young Adult

Objective To study the optimal waist circumference (WC) cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China.
Methods A total of 2 873 men and 5 559 women were included in this cross-sectional study. Metabolic syndrome (MetS) was diagnosed according to the definition of Chinese Diabetes Society in 2004. The relation between WC and MetS was analyzed by multivariate logistic regression analysis. The optimal WC cut-off values were identified using the area under the ROC curve and the different diagnostic criteria for central obesity were compared.
Results The WC was the risk factor for MetS independent of BMI, blood glucose, blood lipid, and blood pressure. The optimal WC cut-off value was 83.8 cm and 91.1 cm for identifying MetS in women and men, respectively. Compared with 80 cm and 85 cm for women and men, 85 cm and 90 cm had a higher Youden index for identifying all metabolic risk factors and MetS in women and men.
Conclusion The appropriate WC cut-off value is 85 cm and 90 cm for identifying central obesity and MetS in women and men in Shandong Province of China.