The E3 ubiquitin ligase NEDD4-1 protects against acetaminophen-induced liver injury by targeting VDAC1 for degradation

Acetaminophen (APAP) overdose is a major cause of liver injury. Neural precursor cell expressed developmentally downregulated 4-1 (NEDD4-1) is an E3 ubiquitin ligase that has been implicated in the pathogenesis of numerous liver diseases; however, its role in APAP-induced liver injury (AILI) is unclear. Thus, this study aimed to investigate the role of NEDD4-1 in the pathogenesis of AILI. We found that NEDD4-1 was dramatically downregulated in response to APAP treatment in mouse livers and isolated mouse hepatocytes. Hepatocyte-specific NEDD4-1 knockout exacerbated APAP-induced mitochondrial damage and the resultant hepatocyte necrosis and liver injury, while hepatocyte-specific NEDD4-1 overexpression mitigated these pathological events both in vivo and in vitro. Additionally, hepatocyte NEDD4-1 deficiency led to marked accumulation of voltage-dependent anion channel 1 (VDAC1) and increased VDAC1 oligomerization. Furthermore, VDAC1 knockdown alleviated AILI and weakened the exacerbation of AILI caused by hepatocyte NEDD4-1 deficiency. Mechanistically, NEDD4-1 was found to interact with the PPTY motif of VDAC1 through its WW domain and regulate K48-linked ubiquitination and degradation of VDAC1. Our present study indicates that NEDD4-1 is a suppressor of AILI and functions by regulating the degradation of VDAC1.

Efficacy of internal fixation with common intramedullary nail versus bone cement reinforced antirotation intramedullary nail in the treatment of femoral intertrochanteric fracture / 中国基层医药

Objective:To investigate the efficacy of internal fixation with common intramedullary nail versus bone cement reinforced antirotation intramedullary nail in the treatment of femoral intertrochanteric fracture. Methods:A total of 106 patients with femoral trochanteric fractures who were surgically treated in Weihaiwei People's Hospital from January 2018 to January 2019 were selected and divided into a control group and an observation group with 53 patients in each group. The control group received internal fixation with common intramedullary nails. The observation group was fixed with bone cement reinforced anti-rotation intramedullary nails. The therapeutic effects were compared between the two groups.Results:There were no significant differences in the amount of blood loss, postoperative Visual Analogue Scale score, amount of fluid drainage, postoperative time to get out of bed, and postoperative hospital stay between the two groups ( t = 1.33, 0.19, 0.34, 0.58, 0.37, all P > 0.05). Operative time in the observation group was significantly longer than that in the control group [(80.21 ± 6.52) minutes vs. (75.92 ± 8.15) minutes, t = 2.99, P < 0.05]. Time to fracture healing in the observation group was significantly shorter than that in the control group [(9.25 ± 1.12) weeks vs. (10.05 ± 1.31) weeks, t = 3.37, P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [3.77% (2/53) vs. 16.98% (9/53), χ2 = 4.97, P = 0.025]. At 6 and 12 months after surgery, Harris hip scores in the observation group were (82.84 ± 6.58) points and (85.55 ± 7.91) points, respectively, which were significantly higher than (78.35 ± 7.54) points and (79.92 ± 9.94) points in the control group ( t = 3.26, 3.22, both P < 0.05). Conclusion:Internal fixation with bone cement-reinforced anti-rotation intramedullary nails for treatment of femoral trochanteric fractures can shorten the time to fracture healing, reduce complications, and improve hip joint function.

Auxiliary role of Python-based handover database in online teaching activities for medical clerks / 中华医学教育探索杂志

Objective:To evaluate the auxiliary role of the Python-based handover database in online teaching activities for medical clerks and to complete the teaching tasks during the COVID-19 epidemic.Method:Sixteen teachers were randomized into two groups, experimental group and control group, with 8 ones in each group. The experimental group used the self-built handover database, while the control group used the hospital's HIS system. To make multimedia courseware for medical students, suitable cases were screened. The time to acquire cases and picture data, and the index like numbers were statistically analyzed, and the quality of multimedia courseware was scored. All the data were analyzed by SPSS 25.0 statistical software.Results:The time for the two groups of teachers to acquire target cases during making multimedia coursewares were (8.88±3.48) min and (43.50±5.26) min respectively; the time to obtain the pictures were (5.62±1.92) min and (30.25±5.39) min; the numbers of obtained pictures were (11.12±2.17) and (6.12±2.80); and the scores of coursewares were (92.62 ± 4.93) points and (84.75 ± 6.20) points respectively, all with significant differences.Conclusion:The application of the self-made handover database can significantly improve the speed of teachers' access to related teaching data, and also can improve the quality of multimedia courseware.

Gait Analysis of Hip Disarticulation Amputees Based on Kinematic Parameters and Plantar Pressure Measurement / 医用生物力学

Objective To analyze the gait characteristics of hip disarticulation amputees, and analyze the reasons for their differences from normal gait, so as to assist clinical diagnosis and evaluation. Methods Through the portable human motion capture device and plantar pressure analysis system, the kinematics and plantar pressure information of 5 hip amputees were collected and compared with 15 healthy volunteers in control group. Gait differences between the amputees and normal subjects and between the affected leg side and the healthy leg side of the amputees were compared. Results The proportion of double-support period for hip amuptees was higher than that of normal gait. Step length, step time, loading response period, mid support period, pre-swing period, proportion of the swing period for the affected leg side and healthy leg side of hip amputees showed significant differences with those of control group. The relative symmetry index of the gait for hip amputees was 0.60±0.05. Compared with the affected leg side, the support period of the healthy leg side was extended, the step length was shortened, the ground reaction force was greater than that of the affected leg side, and the center of pressure trajectory shifted to the affected leg side. Conclusions The gait of hip amputees is significantly different from that of normal people. Hip amputees have weak walking ability, poor gait symmetry, and they lack of continuity in the body’s center of gravity. The results provide experimental basis and theoretical analysis for the design of mechanical structure and control system of novel hip prosthesis.

Nuciferine protects against high-fat diet-induced hepatic steatosis and insulin resistance via activating TFEB-mediated autophagy-lysosomal pathway

Nonalcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis and insulin resistance and there are currently no approved drugs for its treatment. Hyperactivation of mTOR complex 1 (mTORC1) and subsequent impairment of the transcription factor EB (TFEB)-mediated autophagy-lysosomal pathway (ALP) are implicated in the development of NAFLD. Accordingly, agents that augment hepatic TFEB transcriptional activity may have therapeutic potential against NAFLD. The objective of this study was to investigate the effects of nuciferine, a major active component from lotus leaf, on NAFLD and its underlying mechanism of action. Here we show that nuciferine activated ALP and alleviated steatosis, insulin resistance in the livers of NAFLD mice and palmitic acid-challenged hepatocytes in a TFEB-dependent manner. Mechanistic investigation revealed that nuciferine interacts with the Ragulator subunit hepatitis B X-interacting protein and impairs the interaction of the Ragulator complex with Rag GTPases, thereby suppressing lysosomal localization and activity of mTORC1, which activates TFEB-mediated ALP and further ameliorates hepatic steatosis and insulin resistance. Our present results indicate that nuciferine may be a potential agent for treating NAFLD and that regulation of the mTORC1-TFEB-ALP axis could represent a novel pharmacological strategy to combat NAFLD.

A pelvic support weight rehabilitation system tracing the human center of mass height / 生物医学工程学杂志

The body weight support rehabilitation training system has now become an important treatment method for the rehabilitation of lower limb motor dysfunction. In this paper, a pelvic brace body weight support rehabilitation system is proposed, which follows the center of mass height (CoMH) of the human body. It aims to address the problems that the existing pelvic brace body weight support rehabilitation system with constant impedance provides a fixed motion trajectory for the pelvic mechanism during the rehabilitation training and that the patients have low participation in rehabilitation training. The system collectes human lower limb motion information through inertial measurement unit and predicts CoMH through artificial neural network to realize the tracking control of pelvic brace height. The proposed CoMH model was tested through rehabilitation training of hemiplegic patients. The results showed that the range of motion of the hip and knee joints on the affected side of the patient was improved by 25.0% and 31.4%, respectively, and the ratio of swing phase to support phase on the affected side was closer to that of the gait phase on the healthy side, as opposed to the traditional body weight support rehabilitation training model with fixed motion trajectory of pelvic brace. The motion trajectory of the pelvic brace in CoMH mode depends on the current state of the trainer so as to realize the walking training guided by active movement on the healthy side of hemiplegia patients. The strategy of dynamically adjustment of body weight support is more helpful to improve the efficiency of walking rehabilitation training.

Design and simulation of dynamic hip prosthesis based on remote motion center mechanism / 生物医学工程学杂志

The rotation center of traditional hip disarticulation prosthesis is often placed in the front and lower part of the socket, which is asymmetric with the rotation center of the healthy hip joint, resulting in poor symmetry between the prosthesis movement and the healthy lower limb movement. Besides, most of the prosthesis are passive joints, which need to rely on the amputee's compensatory hip lifting movement to realize the prosthesis movement, and the same walking movement needs to consume 2-3 times of energy compared with normal people. This paper presents a dynamic hip disarticulation prosthesis (HDPs) based on remote center of mechanism (RCM). Using the double parallelogram design method, taking the minimum size of the mechanism as the objective, the genetic algorithm was used to optimize the size, and the rotation center of the prosthesis was symmetrical with the rotation center of the healthy lower limb. By analyzing the relationship between the torque and angle of hip joint in the process of human walking, the control system mirrored the motion parameters of the lower on the healthy side, and used the parallel drive system to provide assistance for the prosthesis. Based on the established virtual prototype simulation platform of solid works and Adams, the motion simulation of hip disarticulation prosthesis was carried out and the change curve was obtained. Through quantitative comparison with healthy lower limb and traditional prosthesis, the scientificity of the design scheme was analyzed. The results show that the design can achieve the desired effect, and the design scheme is feasible.

Correlation between pre-delivery glycated hemoglobin Alc level and pregnancy outcome in patients with gestational diabetes mellitus / 中国基层医药

Objective:To investigate the relationship between pre-delivery glycated hemoglobin A1c (HbA1c) level and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:A total of 200 GDM patients who received treatment in Zhuji Maternal and Child Health Hospital, China between April 2018 and April 2020 were included in this study. All patients were subjected to health education, medical nutrition therapy, exercise intervention and necessary drug treatment. These patients were divided into GDM-1 (HbA1c > 7.0%, n = 30), GDM-2 (HbA1c 5.5%-7.0%, n = 30) and GDM-3 (HbA1c < 5.5%, n = 106) groups according to HbA1c levels within pre-delivery 1-3 days. An additional 400 healthy pregnant women who concurrently received health examination were included in the healthy control group (NC group). HbA1c level was compared between GDM patients and healthy controls. Pregnancy outcome was compared among patients with different HbA1c levels. Results:The incidences of pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery were significantly higher than those in the NC group ( χ2 = 4.59, 8.11, 9.19, 7.42, 10.05, 11.52, 35.75, 21.12, all P < 0.05). The incidences of pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery in the GDM-1 group were 10.00% (3/30), 30.00% (9/30), 33.33% (10/30), 26.67% (8/30), 30.00% (9/30), 36.67% (11/30), 50.00% (15/30), 30.00% (9/30), respectively, and they were 4.69% (3/64), 14.06% (9/64), 28.13% (18/64), 14.06% (9/64), 18.75% (12/64), 18.75% (12/64), 39.06% (25/64), 15.63% (10/64), respectively in the GDM-2 group, and 0.94% (1/106), 6.60% (7/106), 14.15% (15/106), 9.43% (10/106), 4.72% (5/106), 4.72% (5/106), 18.87% (20/106), 9.43% (10/106), respectively in the GDM-3 group. There were significant differences in these indexes among the three groups ( χ2= 6.07, 11.91, 7.56, 5.97, 15.97, 21.59, 14.47, 8.07, all P < 0.05). Conclusion:Pre-delivery HbA1c level in GDM patients is related to pregnancy outcomes such as pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery. Strict control of blood glucose is of great significance to improve the outcomes of pregnant patients with GDM and their newborns.

Static Finite Element Analysis on Hip Disarticulation Prosthesis Socket-Residual Limb in Stance Phase / 医用生物力学

Objective To study mechanical properties of the interface between hip residual limb and hip socket during the stance phase by using the finite element analysis (FEA) method, so as to provide the theoretical basis for structure optimization and design of hip socket, as well as the research basis for comfort evaluation of hip socket. Methods According to CT scan images of the patient’s residual limb, the model of bone, soft tissues and socket was reconstructed by reverse modeling. The distribution of normal stress and shear stress on the interface between hip residual limb and hip socket was analyzed and a pressure acquisition module system was designed to verify the stress distribution condition. Results The interfacial stress between hip residual limb and hip socket was mainly distributed in the waist and the bottom of the residual limb, and the interfacial stress was more evenly distributed in the rest of the residual limb. The results of finite element calculation were in good agreement with the system measurement results of pressure acquisition module. Conclusions In order to improve force transfer and safety and comfort of the hip socket, it is necessary to fully consider stress condition of the waist and bottom of the residual limb, as well as the coordination degree between residual limb and hip socket.

Detection of white blood cells in microscopic leucorrhea images based on deep active learning / 生物医学工程学杂志

The number of white blood cells in the leucorrhea microscopic image can indicate the severity of vaginal inflammation. At present, the detection of white blood cells in leucorrhea mainly relies on manual microscopy by medical experts, which is time-consuming, expensive and error-prone. In recent years, some studies have proposed to implement intelligent detection of leucorrhea white blood cells based on deep learning technology. However, such methods usually require manual labeling of a large number of samples as training sets, and the labeling cost is high. Therefore, this study proposes the use of deep active learning algorithms to achieve intelligent detection of white blood cells in leucorrhea microscopic images. In the active learning framework, a small number of labeled samples were firstly used as the basic training set, and a faster region convolutional neural network (Faster R-CNN) training detection model was performed. Then the most valuable samples were automatically selected for manual annotation, and the training set and the corresponding detection model were iteratively updated, which made the performance of the model continue to increase. The experimental results show that the deep active learning technology can obtain higher detection accuracy under less manual labeling samples, and the average precision of white blood cell detection could reach 90.6%, which meets the requirements of clinical routine examination.

Analysis of 221 Chinese Patent Medicine Instructions Based on the Patient's Concern Survey of Oral Medication / 中国药房

OBJECTIVE:To provide reference for the improvement of Chinese patent medicine instruction.METHODS:The outpatients were selected randomly from a Third Grade Class A hospital.A questionnaire survey was conducted on the attention degree of the outpatients to Chinese patent medicine instructions when taking medicine orally.The concern content label of patients in 221 Chinese patent medicine instructions were counted,analyzed and graded according to survey results.RESULTS:A total of 515 questionnaires were distributed,and 498 effective questionnaires were collected with effective recovery rate of 96.7％.The results of questionnaire survey showed that the highest concern from the patients was usage and dosage (92.4％),followed by attentions and taboos (88.0％,70.3％).The following items were drug interaction,pregnant and lactating women medication,children medication and the elderly medication (56.2％,46.4％,45.2％,42.4％).Among the description of medication methods (usage and dosage) in 221 Chinese patent medicine instructions,203 prescriptions clearly marked medication times (91.9％),160 clearly marked drug dosage (72.4％) and 36 clearly marked medication course (16.3％).In matters of taboos (attentions,taboos,pregnant and lactating women medication,children medication and the elderly medication),124 prescriptions clearly marked population taboos (56.1％),82 clearly marked symptom taboos (37.1％) and 71 clearly marked diet taboos (32.1％).According to the scoring statistics of 221 Chinese patent medicine instructions,there were 52 instructions with score of 6,followed by 47 instructions with score of 8;there were only 4 instructions with full score (12).CONCLUSIONS:At present,related contents of medication methods highly concerned by the patients are well marked in Chinese patent medicine instructions,especially its guidance is basically able to meet the requirements in respect of medication times.The related contents of medication taboos,which is next only to attention degree of medication methods by patients,is poorly marked.Its guidance remains to be improved.

Comparison of the effects of total hip arthroplasty via direct anterior approach and posterolateral piriformis-sparing approach / 北京大学学报(医学版)

Objective:To compare the clinical effects of direct anterior approach (DAA) and posterolateral piriformis-sparing approach (Mis-PLA) for minimally invasive surgery of total hip arthroplasty.Methods: The patients who had total hip arthroplasty from March 2015 to February 2016 were randomly divided into 2 groups: DAA group and Mis-PLA group.In the study,43 patients (45 hips) were performed with total hip replacement via the direct anterior approach (DAA group).As comparison,39 patients (42 hips) were performed with total hip replacement via the posterolateral piriformis-sparing approach (Mis-PLAgroup) at the same period.DAA group:27 male patients (27 hips),and 16 female patients (18 hips),with an average age of (57.4±7.3) years,preoperative Harris score (41.4±8.7),body mass index(BMI)(24.3±2.2) kg/m2;Mis-PLA group: 25 male patients (26 hips),14 female patients (16 hips),with an average age of (59.2±7.3) years,preoperative Harris score (39.6±8.4),BMI (24.7±2.5) kg/m2.The length of incision,operation time,blood loss,postoperative Harris score were observed and specially the hip functional recovery was fully assessed.Results: (1) All the incisions healed by first intention.No complications were found in both groups.The length of incision:DAA group:(9.2±0.7) cm and Mis-PLA group:(9.5±0.6) cm.No statistical significant differences were found (P=0.053).The operation time:DAA group (74.3±10.1) min and Mis-PLA group(37.5±4.3) min,which showed statistically significant differences(P<0.01).Blood loss:DAA group(229.6±79.2) mL and Mis-PLA group (215.7±56.0) mL.Nostatistical significant differences were found (P=0.366).(2) The patients in both groups were followed up for 6-12 months.The Harris hip scores for 6 weeks' follow-up:(85.5±4.1) in DAA group and (79.0±4.4) in Mis-PLA group,which indicated statistically significant differences (P<0.01).The Harris scores for the 6-month follow-up:(94.3±2.7) in DAA group and (95.2±1.9) in Mis-PLA group.No statistically significant differences were found (P=0.125).The basic daily hip function analysis for the 6-week follow-up:walking speed: no statistically significant differences were found between the two groups(P=0.298);Climbing stairs: Mis-PLA group' outcome was better than DAA group's with statistical differences (P=0.047);Circling,sitting and wearing shoes and socks: outcomes in DAA group exceeded Mis-PLA group's with statistically significant differences (P<0.01,P=0.016,P<0.01).Conclusion: Total hip arthroplasty through either DAA or Mis-PLA approaches could result in very satisfactory clinical effect.Comparing with DAA,Mis-PLA requires less operation time,shorter learning curve,which indicates that it is a re-latively safer approach.The advantages of total hip arthroplasty through direct anterior approach lie in less positional limitation in the early stage of postoperative period,as well as a faster recovery of hip function.

One-stage posterior approach surgical treatment for congenital scoliosis caused by lumbosacral spine deformity in children / 中华实用儿科临床杂志

Objective To explore the treatment method and clinical effect of congenital scoliosis caused by lumbosacral spine deformity in children.Methods From October 2000 to October 2015,a consecutive series of 21 congenital scoliosis due to lumbosacral spine deformity were treated in Department of Pediatric Orthopedics,the Third Affiliated Hospital of Zhengzhou University,including 12 male and 9 female,and the age was (63.1±47.3) months(3-144 months).The hemivertebrae,bone bridge,and the mixed type were found in 18 cases,2 cases,and 1 case,respectively.Hemivertebraes were on the left in 10 cases,on the right in 9 cases;involved L5 in 8 cases,S1 in 6 cases,multiple vertebrae malformation in 4 cases,wedged-shaped vertebrae involved L5 associated with contralateral bar in 1 case,unilateral unsegmented bar from L4 to S1 in 1 case,from L2 to L5 in 1 case.There were 4 cases combining with thoracic hemivertebrae,3 cases with ribs fusion and contralateral bar,16 cases(76%) with spinal cord malformations,3 cases(17%) with urinary system malformations,no congenital heart malformation.All the 21 patients were operated with one-stage posterior approach.Compared the scoliosis Cobb angle,trunk shift,operative time,blood loss volume,and complications among preoperation,post-operation and final follow-up.Results In this study,operative time was (278.9±83.1) min,blood loss volume was (355.3±249.0) mL,follow-up was (5.1±2.7) years.There were 18 cases operated with pedicle screw fixation,aged (72.9±44.1) months(16-144 months),operative time was (296.2±74.2) min,blood loss volume was(422.1±238.2) mL;the mean coronal Cobb angle of malformation area at preoperation,post operation and the final follow-up were(27.3±10.2)°,(11.0±5.9)°,(9.8±4.2)°,while the correction rate of post-operation and the final follow-up were 59.7%,64.1%.There were 3 cases operated by hemivenebra resection without pedicle screw fixation,aged 7.7 months(3-15 months),operative time was 168.3 min,blood loss volume was 103.3 mL.The mean coronal Cobb angle of malformation area at preoperation,post-operation and the final follow-up were 26.0°,13.6°,12.5°,while the correction rate of post-operation and the final follow-up were 47.7%,51.9%.The follow-up period was (5.1±2.7) years.The coronal Cobb angle of lumbosacral curve at preo-peration,post-operation and the final follow-up were (27.7±10.0)°,(11.3±5.4)°,(10.0±5.0)°,compared with preoperation,the differences of post-operation and the final follow-up were statistically significant (t=6.600,7.230,all P<0.05),with the correction rate of 59.2%,63.9%;the compensatory head side Cobb angle were(25.0±12.8)°,(11.9±8.2)°,(10.3±6.9)°,compared with preoperation,the differences of post-operation and the final follow-up were statistically significant (t=3.934,4.626,all P<0.05),with the correction rate of 52.4%,58.8%.Trunk shift was significantly improved.One case appeared fracture fixation rods breakage after 9 years,1 case appeared iliac screw breakage after 2 years but no complication such as infection,nerve injury.Conclusions The formation of obstacles and vertebral segmentation defects will lead to lumbosacral spine deformity,and scoliosis.Early one-stage posterior hemivertebra resection,breakage the bone bridge combined with pedicle screw fixation can obtain satisfactory clinical outcome.

Therapeutic observation of Fu's subcutaneous needling for scapulohumeral periarthritis / 针灸推拿医学（英文版）

Objective: To observe the therapeutic efficacy of Fu's subcutaneous needling (FSN) in treating scapulohumeral periarthritis (SP). Methods: Eighty patients with SP were randomly divided into an observation group and a control group, 40 cases in each group. Patients in the observation group received FSN treatment while those in the control group received conventional acupuncture treatment. Visual analogue scale (VAS) and range of motion (ROM) were observed before and after the treatment, and the therapeutic efficacy was also evaluated. Results: After the treatment, the VAS scores decreased significantly in the two groups, and the VAS score in the observation group was significantly lower than that in the control group (P<0.01). After the treatment, the ROM increased significantly in both groups (both P<0.01), and the ROM in the observation group was significantly higher than that in the control group (P<0.01). The recovery rate and the total effective rate in the observation group were respectively 40.0% and 95.0%, significantly higher than 12.5% and 77.5% in the control group (P<0.01, P<0.05). Conclusion: FSN can effectively relieve pain and improve the joint motion in treating SP, thus offering a novel option to the treatment of this kind of musculoskeletal disorder.

Chromosomal microarray analysis of 2000 pediatric cases / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the feasibility of chromosomal microarray analysis(CMA) for studying the correlation between birth defects and chromosomal aberrations.</p><p><b>METHODS</b>A total of 2000 patients with birth defects were recruited for the CMA testing.</p><p><b>RESULTS</b>Five hundred twenty two patients (26.1%) were found to have chromosomal abnormalities. These included 24 cases with numerical abnormalities, 11 with mosaicisms, and 11 with uniparental disomies. The remaining 476 cases were of well-known microdeletion or microduplication syndromes. The advantage of CMA over conventional karyotyping was demonstrated in many cases.</p><p><b>CONCLUSION</b>As a powerful tool for patients with birth defects, CMA can produce a higher diagnostic yield compared with conventional karyotyping.</p>

Assessment of the Clinical Efficacy of Superficial Needling Therapy for Nape Myofascitis / 上海针灸杂志

Objective To investigate the clinical efficacy of superficial needling therapy for nape myofascitis. Method Seventy patients were randomly allocated to superficial needling and Western medicine groups, 35 cases each. The superficial needling group received superficial needling therapy once every other day, three times a week, two weeks as a course. The Western medicine group took celecoxib (Celebrex) 200 mg twice daily, two weeks as a course. The Pain Visual Analogue Scale (VAS) score, the tenderness score and the Neck Disability Index (NDI) score were recorded in the two groups of patients before and after treatment. Result The VAS score, the tenderness score and the NDI score decreased in the two groups of patients after treatment compared with before (P<0.05, P<0.01) and decreased more in the superficial needling group than in the Western medicine group (P<0.05). The cure and marked efficacy rate and the total efficacy rate were 57.1%and 94.3%, respectively, in the superficial needling group, which were higher than 31.4%and 77.1%in the Western medicine group (P<0.05). Conclusion Superficial needling therapy can better relieve the symptoms and is more effective than oral celecoxib in treating nape myofascitis.

Therapeutic Observation of Thread Embedding plus Chinese Medication for Primary Dysmenorrhea Due to Blood Stagnation Caused by Cold Accumulation / 上海针灸杂志

Objective To observe the clinical efficacy of thread embedding plus Chinese medication in treating primary dysmenorrhea due to blood stagnation caused by cold accumulation. Methods Totally 136 patients with primary dysmenorrhea due to blood stagnation caused by cold accumulation were randomized into a treatment group and a control group, 68 in each group. The treatment group was intervened by thread embedding at Shiqizhui (EX-B 8) and bilateral Ciliao (BL 32) plus Chinese medication;while the control group was by Chinese medication alone. The dysmenorrhea symptom score and Visual Analogue Scale (VAS) were observed before and after intervention, and the clinical efficacies were compared. Results The total effective rate and recovery-markedly effective rate were respectively 93.8%and 78.1%in the treatment group, versus 85.2%and 50.0%in the control group, and there was a significant difference in comparing the recovery-markedly effective rate (P<0.05). After intervention, the dysmenorrhea symptom score and VAS score were significantly changed in both groups (P<0.01);there were significant differences in comparing the symptom score and VAS score between the two groups (P<0.05). The half-a-year follow-up study showed that the total effective rate and recovery-markedly effective rate were respectively 90.6%and 68.8%in the treatment group, versus 70.6%and 38.2% in the control group, and the differences were statistically significant (P<0.05, P<0.01). Conclusions Thread embedding plus Chinese medication is an effective approach in treating dysmenorrhea due to blood stagnation caused by cold accumulation, and it’s easy-to-operate and causes less pain.

Observation on clinical effect of acupuncture plus Z i Shen T iao Gan Decoction for perimenopausal insomnia / 针灸推拿医学（英文版）

Objective:To explore the therapeutic effect of acupuncture plus Zi Shen Tiao Gan (Kidney-reinforcing and Liver-regulating) Decoction for perimenopausal women with insomnia. Methods:A total of 126 eligible cases were randomly divided into two groups, 63 cases in each group. Patients in the observation group were given acupuncture plus Zi Shen Tiao Gan (Kidney-reinforcing and Liver-regulating) Decoction. Those in the control group were treated with the same acupuncture treatment as the observation group. The therapeutic effects were assessed after continuous treatment for four weeks. Results:The total effective rate was 96.8%in the observation group and 74.6%in the control group. The comparison of the total clinical effects between the two groups was statistically significant (P Conclusion: Acupuncture plus Zi Shen Tiao Gan (Kidney-reinforcing and Liver-regulating) Decoction for perimenopausal insomnia is affirmative in the therapeutic effect, and the therapeutic effect is better than simple acupuncture treatment.

Warm Needling Moxibustion for Knee Osteoarthritis:A Randomized Controlled Trial / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of warm needling moxibustion for knee osteoarthritis (KOA) by a randomized controlled trial. Methods: Sixty cases with KOA were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated by warm needling moxibustion. The control group was treated by simple acupuncture. Ten sessions made one course and the two groups were treated for two courses. The scores of knee joint pain, stiffness and knee functions before and after the treatment were observed. Results: The scores of Western Ontario and McMaster Universities osteoarthritis index (WOMAC) on pain, stiffness and joint functions before and after treatment in both groups were statistically different (all P Conclusion: Warm needling moxibustion can improve the clinical symptoms and functions of the patients with KOA, and is better than ordinary acupuncture in the therapeutic effect.

Analysis on the turnover intention of the health technicians of county-level public hospitals in three cities of Shandong province / 中华医院管理杂志

Objective The turnover intention and the work states of the health technicians were investigated to analyze the influencing factors of turnover and the relationship between turnover intention and work state,to guide the health technicians who want to dimission to make a correct decision,and to make some suggestions to improve their work states.Methods Multistage stratified cluster random sampling method was adopted to survey 2903 health workers on the job of all the county-level public hospitals in Shandong Province by the questionnaire of the Fourth National Health Services Survey.Analysis methods included Two Logistic classification regression and three evaluation methods based on two weights.Results 32.4 percent health technicians had turnover intention.The risk factors of the turnover intention were as follows:medical department,bad assessments of the practice environment,low degree of the diversity of job skills,small level of improving the individual's capacity,low degree of job satisfaction,high degree of job autonomy,high requirement for the expression of individual emotions,high working pressure,high job burnout.The higher turnover intentions were,the lower synthetical evaluation scores of the work states were.Conclusion The county hospitals ought to pay more attention to the health technicians with high tumover intention,and to guide the health technicians who want to dimission to make a correct decision,and to make some suggestions to improve their work states through having a heart-to-heart talk,training,and career planning,etc.