Application of scheduling model based on linear programming model in human resource allocation of surgical nursing staff / 中国实用护理杂志

Objective:Use linear programming model to predict the allocation of surgical nursing human resources, and optimize the allocation of nursing staff.Methods:This study was a controlled clinical trial. A total of 91 nurses from 5 surgical departments in Affiliated Hospital of Qingdao University were selected by convenience sampling method. The nurses who participated in the scheduling in August and September 2020 were the routine scheduling groups, and in March and April 2021 were the linear scheduling groups. The linear programming model of surgical nursing human resources was established. The LINGO 11.0 software was used to calculate the minimum number of nurses required for the next day operation. According to the predicted results and the requirements of the operation specialty and rank level, the surgical staff was arranged for the next day. The overtime hours of nurses in the routine scheduling groups and the linear scheduling groups were compared and analyzed.Results:The number of on-duty nurses was the same in 4 groups, the overtime hours of the conventional scheduling groups in August and September 2020 and the linear scheduling groups in March and April 2021 were 865 (505, 1 435), 780 (475, 1 355), 650 (460, 910) and 720 (350, 915) min, the difference of overtime hours was statistically significant ( H=13.66, P<0.05). The overtime hours of the routine scheduling group in August 2020 were significantly different from those of the linear scheduling group in March 2021 and April 2021 respectively ( Z=-2.69, -2.55, both P<0.05). The overtime hours of the routine scheduling group in September 2020 were significantly different from those of the linear scheduling group in March 2021 and April 2021 respectively ( Z=-2.62, -2.58, both P<0.05). Conclusions:The linear programming model was used to predict the human resource allocation of surgical nursing staff, optimized the allocation of operating room human resources. It reduced the overtime hours of surgical nursing staff effectively. Indirectly, it accelerated operations, improved operation efficiency and ensured the safety of patients.

Evidence summary of early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation / 中华危重病急救医学

Objective:To evaluate and summarize the best evidence for early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation (VV-ECMO).Methods:Evidence on early rehabilitation of adult VV-ECMO patients was searched by computer from 7 English literature databases [PubMed database, cumulative index to nursing and allied health literature (CINAHL), Embase database, Cochrane library database, UpToDate clinical consultant, BMJ best clinical practice, JBI database], 5 Chinese literature databases (China biomedical literature database, China Yimai Tong, China national knowledge infrastructure, Wanfang data, VIP database), 5 guideline networks [National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), China Guide Network] and 2 professional association websites [Extracorporeal Life Support Organization (ELSO), Chinese Association of Rehabilitation Medicine]. The search period is from January 2011 to December 2021. The appraisal of guidelines for research and evaluation Ⅱ (AGREE ) and JBI 2014 quality assessment tools were used to evaluate the quality of inclusion guidelines, systematic reviews, expert consensus and original studies, respectively, and to extract and summarize the best evidence for early rehabilitation of adults with VV-ECMO.Results:A total of 2 guidelines, 2 expert consensuses, 2 systematic reviews and 8 original studies [including 1 randomized controlled trial (RCT), 1 non-randomized controlled study, 3 cohort studies and 3 case reports] were included. The evidence was summarized from 9 aspects including the necessity of early rehabilitation, rehabilitation initiation time, rehabilitation location, pre-rehabilitation preparation, pre-rehabilitation assessment, rehabilitation method, rehabilitation frequency and duration, rehabilitation process monitoring and effect evaluation,and finally 24 pieces of the best evidence were summarized.Conclusion:Early rehabilitation of adults with VV-ECMO is safe and feasible. The summary of the best evidence can provide evidence-based guidance for clinical medical staff to reasonably carry out early rehabilitation.

Sedentary behavior and the risk of gestational diabetes mellitus: a systematic review / 中华健康管理学杂志

Objective:To systematically evaluate the relationship between sedentary behavior (SB) and the risk of developing gestational diabetes mellitus (GDM).Methods:PubMed, Medline, EMBASE, CINAHL, the Cochrane Library, the Rehabilitation & Sports Medicine Source, the Sedentary Behavior Research Database (SBRD), Wanfang Database, the China Journal full-text database, and the China Biomedical Literature Database were searched for cohort studies, case-control studies, and cross-sectional studies concerning the risk of SB and GDM from the establishment of the database to January 2021. Two researchers screened the literature, extracted data, evaluated the quality of the data according to the inclusion and exclusion criteria, and, finally, produced a descriptive analysis of the results.Results:A total of 11 studies were included, including eight cohort studies, two cross-sectional studies, and one case-control study. The overall quality of the studies was moderate. The prevalence of GDM was 5.04%-26.81%, and the prevalence of SB before and during pregnancy was 39.47%-40.21% and 28.86%-93.50%, respectively. In terms of the prevalence of SB before pregnancy, four moderate-quality studies reported no association with GDM risk. In terms of SB during pregnancy, four moderate-quality studies reported no association with GDM risks, and four studies (one of high quality and three of moderate quality) reported an association with GDM risks, two of which focused on the second trimester. There was considerable heterogeneity between studies on the diagnosis of GDM and SB.Conclusion:SB before pregnancy is not associated with the risk of GDM, while the relationship between SB and the risk of GDM is unclear, but the level of SB in the second trimester of pregnancy may be positively associated with the risk of GDM.

Evidence summary on prediabetes management in high risk population with gestational diabetes mellitus / 中华健康管理学杂志

Objective:To search, evaluate and summarize the evidence on prediabetes management in high-risk population with gestational diabetes mellitus (GDM).Methods:Two researchers independently screened the evidence according to the inclusion criteria and exclusion criteria. The quality of the included evidence was evaluated by the clinical guideline research and evaluation system (AGREE Ⅱ). The quality of the evidence and the strength of recommendation were graded by the GRADE system. According to the clinical nursing practice guidelines for gestational diabetes mellitus, the recommendations for GDM high-risk groups were extracted.Results:A total of 14 pieces of evidence were included, including 4 guidelines, 2 consensus, 5 practice guidelines and 3 diagnosis and treatment standards. 29 pieces of recommendations for prediabetes management of high-risk population with gestational diabetes mellitus were summarized from five aspects, including disease risk assessment, prenatal examination guidance, management objectives of gestational weight and blood glucose, diet guidance and exercise guidance.Conclusion:The evidence of prediabetes management of high-risk population with gestational diabetes mellitus is scientific and reliable.

Factors affecting the efficacy of repetitive transcranial magnetic stimulation for patients with Alzheimer's disease / 浙江大学学报·医学版

Repetitive transcranial magnetic stimulation (rTMS) is a safe and non-invasive technique. In recent years, many studies have demonstrated that rTMS can improve cognitive function in Alzheimer's disease (AD) patients and has potential as a therapeutic method for AD. However, the efficacy varies greatly with different rTMS treatment regimens, which is related to the frequency, type, location, duration, intensity and focusing power of stimulation. Recent studies have shown that high-frequency stimulation is superior to low-frequency stimulation; efficacy of intermittent theta burst stimulation (iTBS) is similar to that of conventional rTMS, but iTBS treatment session is shorter and might be more acceptable for AD patients; rTMS stimulation sites targeting AD-damaged brain regions or associated networks would be more effective; short-term intensive treatment combined with long-term maintenance treatment can gain long-term efficacy; dynamic adjustment of stimulus intensity combined with the degree of cognitive impairment can enhance the efficacy; functional connection based on functional magnetic resonance imaging may improve the focusing power of rTMS. In this article, we review the factors related to the efficacy of rTMS, to provide reference for feasible rTMS therapeutic regimens of AD.

Ultrasound-guided placement of midline catheter reduces the incidence rate of catheter-related bloodstream infection / 中华急诊医学杂志

Objective:To investigate the effect of ultrasound-guided midline catheter placement on the incidence of catheter-related bloodstream infection (CRBSI) in severe emergency patients.Methods:Five hundred and twenty-nine patients were chosen as the research objects from March 2018 to December 2019 at Emergency Intensive Care Unit, which was divided into the experimental group ( n=278) and the control group ( n=251). In the experimental group, ultrasound-guided midline catheter was used as central venous catheter (CVC) removal method of sequential, and in the control group, peripheral venous indwelling needle was used as sequential method after removal of CVC. CVC, midline catheter and the indwelling time of indwelling needle were counted. The utilization rate of CVC was compared between the two groups. Kaplan-Meier survival curve was plotted to describe the CVC indwelling time of the two groups and log-rank test was performed. Cox regression analysis was performed to analyze the influencing factors of CVC indwelling time and compare the incidence of CRBSI and other catheter-related complications. Results:The CVC indwelling time of the experimental group was significantly shorter than that of the control group (8 d vs. 13 d, P=0.000). The CVC utilization rate of the experimental group was significantly lower than that of the control group (49.83% vs. 80.45%, P=0.000). Multivariate Cox regression analysis showed that difficult intravenous access, length of ICU stay, the site of catheter placement, and midline catheter implantation without ultrasound-guidance were independent risk factors for prolonged CVC indwelling time ( P=0.000). The CRBSI rate of the experimental group was significantly lower than that of the control group (0.571‰ vs. 3.802‰, P=0.038). There was no significant difference in the incidence of other catheter-related complications between the two groups ( P=0.403). Conclusions:Ultrasound-guided midline catheter implantation can shorten the indwelling time of CVC, reduce the utilization rate of CVC, and reduce the incidence of CRBSI, which is worthy of clinical promotion.

Development of a perioperative nursing quality evaluation indicator system for lobectomy patients with Da Vinci robotic under enhanced recovery after surgery / 中国实用护理杂志

Objective:To develop nursing quality evaluation indicator system for perioperative patients with Da Vinci robotic under enhanced recovery after surgery(ERAS), in order to provide references for clinical evaluation of nursing quality for lobectomy patients.Methods:Based on the theory of structure-process-outcome quality model and ERAS, literature review, semi-structured interviews were adopted to determine nursing quality indicator system for perioperative patients. Delphi method was used in two rounds of consultation among 21 experts.Results:The positive coefficient was 100%, authority coefficient was 0.839,0.901, and the coefficients of concordance were 0.317,0.335. The final indicator system consisted of 3 first-level indicators, 14 second-level indicators, and 52 third-level indicators.Conclusion:The nursing quality evaluation indicator system for lobectomy patients with Da Vinci robotic was scientific and reliable, which can provide scientific references for evaluating nursing quality for perioperative patients with Da Vinci robotic under ERAS.

Correlation between suicidal ideation and polysomnography parameters in late-life depression patients / 浙江大学学报·医学版

OBJECTIVE@#To investigate the relationship between sleep parameters and suicidal ideation in patients with late-life depression (LLD).@*METHODS@#Seventy-seven LLD patients over 60 years old from Sir Run Run Shaw Hospital of Zhejiang University during July 2017 and July 2018 were included in the study. All patients were assessed with Hamilton Depression Rating Scale (HAMD) and polysomnography (PSG) overnight. The suicidal score of item 3 in HAMD (HAM-D3)was used to define whether there was a suicidal ideation. Participants were subsequently grouped according to endorsement of presence (HAM-D3 score ≥1, =46) versus absence (HAM-D3 score=0, =31) of suicidal ideation symptoms. The sleep efficiency, total sleep time, wakefulness after sleep onset, rapid eye movement percent/latency, and non-rapid eye movement sleep stages 1-3 (N1-N3) were assessed. ANOVA analyses were conducted to explore the correlation of sleep parameters with suicidal ideation between the groups with and without suicidal ideation. In model 1, the HAM-D3 constituted the independent variable in separate ANOVA tests; in model 2 the impact of depressive symptoms were assessed as a covariate with sleep parameters.@*RESULTS@#There was less stage N3 [(55±41)min, =-4.731, <0.05] and the reduced percentage of N3 [(15±11)%, =-4.194, <0.05] in LLD patients with suicidal ideation, compared with the LLD patients without suicidal ideation [(104±49) min, (26±11)%]. Correlation analyses revealed that there was a significant correlation between the suicidal ideation and the percentage of stage N3 and sleep time of stage N3 (both <0.05).@*CONCLUSIONS@#Suicidal ideation is associated with less N3 sleep in LLD patients.

Study on the relationship between screen time and prediabetes in adolescents / 中国实用护理杂志

Objective@#To explore the relationship between screen time and prediabetes in adolescents.@*Methods@#A cross-section study. A total of 532 adolescents aged 12~18 years in Shandong Zibo Vocational Institute were selected by stratified sampling method. The screen time was investigated by questionnaire survey. Measuring fasting fingertip blood glucose, screening for who with potentially abnormal blood glucose, and measuring their fasting venous blood glucose, which is to determine whether it is prediabetes.@*Results@#With the increase of screen time, the risk of prediabetes increased continuously. Compared with adolescents with those who spend 0~119 minute per day screen time, the risk of prediabetes of adolescents with an average daily screen time of 120~239, 240~317, ≥318 minute increased by 0.37%, 2.63%, and 3.57%, respectively. After multi-factor adjustment, the risk of prediabetes with who take 240~317, ≥318 minute per day screen time is still higher than who with the average daily screen time of 0~119 minute, the adjusted OR was 2.502 (95% CI 1.279-4.897), 2.337(95% CI=1.189-4.594).@*Conclusion@#The results of this study show that the longer the screen time, the higher the risk of prediabetes in adolescents, and adolescents should be encouraged to reduce screen time.

Management of cytokine release syndrome related to CAR-T cell therapy / 医学前沿

Chimeric antigen receptor T (CAR-T) cell therapy is a novel cellular immunotherapy that is widely used to treat hematological malignancies, including acute leukemia, lymphoma, and multiple myeloma. Despite its remarkable clinical effects, this therapy has side effects that cannot be underestimated. Cytokine release syndrome (CRS) is one of the most clinically important and potentially life-threatening toxicities. This syndrome is a systemic immune storm that involves the mass cytokines releasing by activated immune cells. This phenomenon causes multisystem damages and sometimes even death. In this study, we reported the management of a patient with recurrent and refractory multiple myeloma and three patients with acute lymphocytic leukemia who suffered CRS during CAR-T treatment. The early application of tocilizumab, an anti-IL-6 receptor antibody, according to toxicity grading and clinical manifestation is recommended especially for patients who suffer continuous hyperpyrexia, hypotensive shock, acute respiratory failure, and whose CRS toxicities deteriorated rapidly. Moreover, low doses of dexamethasone (5-10 mg/day) were used for refractory CRS not responding to tocilizumab. The effective management of the toxicities associated with CRS will bring additional survival opportunities and improve the quality of life for patients with cancer.

Study on the relationship between screen time and prediabetes in adolescents / 中国实用护理杂志

Objective To explore the relationship between screen time and prediabetes in adolescents. Methods A cross-section study. A total of 532 adolescents aged 12～18 years in Shandong Zibo Vocational Institute were selected by stratified sampling method. The screen time was investigated by questionnaire survey. Measuring fasting fingertip blood glucose, screening for who with potentially abnormal blood glucose, and measuring their fasting venous blood glucose, which is to determine whether it is prediabetes. Results With the increase of screen time, the risk of prediabetes increased continuously. Compared with adolescents with those who spend 0～119 minute per day screen time, the risk of prediabetes of adolescents with an average daily screen time of 120～239, 240～317,≥318 minute increased by 0.37% , 2.63% , and 3.57% , respectively. After multi-factor adjustment, the risk of prediabetes with who take 240～317,≥318 minute per day screen time is still higher than who with the average daily screen time of 0～119 minute, the adjusted OR was 2.502 (95% CI 1.279-4.897), 2.337 (95% CI=1.189-4.594). Conclusion The results of this study show that the longer the screen time, the higher the risk of prediabetes in adolescents, and adolescents should be encouraged to reduce screen time.

Metformin inhibits proliferation and functions of regulatory T cells in acidic environment / 南方医科大学学报

OBJECTIVE@#To investigate the regulatory effect of metformin on regulatory T cells (Treg) in acidic environment.@*METHODS@#CD4 CD25 Treg cells were obtained by magnetic bead sorting. Treg and conventional T cells (Tcon) cells were cultured for 24-72 h in pH 7.4 or pH 6.7 medium, and the cell proliferation, apoptosis and Foxp3 expression were detected by flow cytometry. Real-time PCR was used to detect the expression levels of the genes related with glucose metabolism. Thirty-two C57BL/6 male mouse models bearing subcutaneous prostate cancer xenograft derived from RM-1 cells were randomized into 4 equal groups for treatment with PBS, metformin, tumor vaccine, or both metformin and the vaccine. The treatment started on the 4th day following tumor cell injection, and metformin (100 mg/kg) or PBS was administered by intraperitoneal injection on a daily basis; the vaccine was intramuscularly injected every 4 days. The tumor size was continuously monitored, and the mice were euthanized on day 25 after tumor implantation to obtain tumor and blood samples. Flow cytometry was used to detect the changes in CD4, CD8, CD4Foxp3 cell subsets in the tumor tissue and peripheral blood.@*RESULTS@#Treg cells showed significantly enhanced proliferation ( < 0.05) while the proliferation of Tcon cells was suppressed in acidic medium ( < 0.001). Treg cells cultured in acidic medium showed significantly increased expressions of OXPHOS-related genes pgc1a ( < 0.001) and cox5b ( < 0.01), which did not vary significantly in Tcon cells in acidic medium. Treg cells exhibited significantly decreased apoptosis in acidic medium ( < 0.01) with increased Foxp3 cells ( < 0.001) and intracellular alkaline levels ( < 0.01). Metformin obviously reversed the acid tolerance of Treg cells without producing significant effect on Tcon cells. In the animal experiment, both metformin ( < 0.05) and vaccine ( < 0.01) alone reduced the tumor volume, but their combined treatment more potently reduced the tumor volume ( < 0.001). Metformin alone did not obviously affect CD4 cells or CD8 cells but significantly decreased the percentage of CD4Foxp3 ( < 0.05); the vaccine alone significantly increased CD4 cells and CD8 cells ( < 0.001) and also the percentage of CD4Foxp3 cells ( < 0.05). The combined treatment, while reducing the percentage of CD4Foxp3cells to a level lower than that in the vaccine group ( < 0.01), produced the strongest effect to increase CD4 cells and CD8 cells ( < 0.01).@*CONCLUSIONS@#Metformin can inhibit the proliferation and function of regulatory T cells in an acidic environment and enhance the effect of tumor vaccine by reducing the proportion of Treg cells to achieve the anti-tumor effect.

New progress in prevention of pressure ulcers for patients undergoing prone ventilation patients / 中国实用护理杂志

As an important means of lung protective strategy, prone position ventilation (PPV) which can effectively shorten the time of mechanical ventilation, significantly reduce the mortality of patients with acute respiratory distress syndrome (ARDS), and is suitable for popularization and application in the ICU. However, some studies show that prolonged prone position can significantly increase the incidence of Stress injury, making it difficult to implement PPV in the practical level. In order to achieve the goal of safe and effective prevention of skin Stress injury, and to promote the correct implementation of PPV, this paper review the methods of preventing Stress injury in patients with PPV.

Validity and reliability of the knowledge-attitude-practice scale for prevention catheter associated urinary tract infection measurement / 中国实用护理杂志

Objective To develop a scale of catheter-associated urinary tract infection (CAUTI) knowledge-attitude-practice (KAP) and to test its psychometric properties, and to provide effective assessment tools for clinical evaluation of knowledge, attitude and practice of CAUTI prevention. Methods Based on KAP theory and CAUTI preventive current guideline,the scale was developed by using literature review,Delphi expert inquiry.A questionnaire survey was conducted among 300 medical workers in a third grade A hospital in Qingdao.Exploratory factor analysis and confirmatory factor analysis were both conducted to screen the items further.The psychometric properties of scale was tested. Results The finalized scale included 4 subscales and 45 items,amount to 63.21% of the variance contribution rate. The total Cronbach's alpha was 0.914,and the split half reliability was 0.812.The content validity of the scale was 0.895,while it ranged from 0.846-1.000 for each subscale.The correlation of item-to total was 0.711-0.862,and the correlation coefficient of item-to-item ranged from 0.425-0.564. Conclusions The scale of CAUTI KAP has good reliability and validity. It can be used to evaluate CAUTI related knowledge,attitude and practice level of medical workers.

Effectiveness research on network informatization postoperative pain management / 中国实用护理杂志

Objective Through the network informatization management, postoperative pain assessment, nursing records, process the results into the network electronic medical records, more standardized postoperative pain management, improve the effectiveness of postoperative analgesia. Methods A total of 3 680 patients after the operation from November to December in 2015 were selected and divided into control group and observation group according to the operation time. In November for the traditional postoperative pain management in control group (1 850 cases), in December as observation group (1 830 cases), with Hospital Information System and Anesthesia Information System, all of the records in the postoperative pain management content network electronic information management, according to the degree of pain and analgesia method to select a different form, data sharing, wrong alarm to remind, handle in time. To establish a network of WeChat public platform to perform health education and information communication. The analgesia effect and patient′s satisfaction were compared between two groups. Results The incidence of incomplete pain was 12.5%(231/1 850) in control group and 4.2%(77/1 830) in observation group, and there was significant difference between two groups(c2= 82.22, P<0.01). The satisfaction score was (5.9 ± 3.7) points in observation group and (4.4 ± 2.6) points in control group, and there was significant difference between two groups(t = 2.10, P<0.05). Conclusions Postoperative pain management network informatization can effectively improve the effect of postoperative analgesia, improve work efficiency.

A Multicenter Randomized Controlled Trial of Fire-needle Therapy for Scapulohumeral Periarthritis / 上海针灸杂志

Objective To observe the clinical efficacy of fire-needle therapy in treating scapulohumeral periarthritis, and to observe the changes of pain score and the motor function of shoulder joint. Method Totally 180 patients were randomized into a fire-needle therapy group of 90 cases and a filiform needle group of 90 cases by randomized single-blinded method. Result There were significant differences between the two groups in comparing the recovery rate, motor function of shoulder joint, and the relapse rate 30 d after the whole intervention (P0.05). Conclusion Compared to filiform needle therapy, fire-needle therapy can produce a better recovery rate and motor function of shoulder joint in treating scapulohumeral periarthritis.

Correlation between meta cognitive ability and clinical practice ability of college nursing students / 中国实用护理杂志

Objective To survey the status of the clinical competence and meta-cognitive ability of college nursing students, to explore the correlation between the two factors, and analyze the influencing factors of baccalaureate nursing students′ clinical skills, then explore the approach of improving the clinical competence of nursing students. Methods Totally 184 nursing students from Taishan Medical University were investigated by General Information Questionnaire, Clinical Competence Test Scale, University Students Meta Cognitive Ability Scale. Results Nursing students′ average score of meta cognition was 80.48 ± 11.97, the average score of clinical competence was 121.22 ± 22.74. The meta cognitive ability and clinical competence of nursing undergraduate students both maintained at the middle level. Meta cognitive ability was positively correlated with clinical competence. To some extent, enhancing the meta cognitive ability could help students improve the clinical competence. Conclusions To understand the status and correlation between meta cognitive ability and clinical competence can guide students to learn effectively, can help teachers play a good role in teaching effectively.

Difference expression of Cx37 and Cx40 of arteries in spontaneously hypertensive rats / 重庆医学

Objective To investigate the change of connexin (Cx) in mesenteric artery (MA) and aorta of spontaneously hyper‐tensive rats (SHR) and normotensive rats .Methods Quantitative RT‐PCR and Werstern blot technique were used to compare the difference in the expression of Cx37 and Cx40 mRNA and protein in MA and aorta of SHR and normotensive rats .Results The level of Cx37 mRNA expression in MA from SHR was decreased compared with that of the normotensive rats (P0 .05) .The expression of Cx37 protein in MA from SHR was decreased compared with that of the normotensive rats (P0 .05) . Conclusion Hypertension may could decrease gap junctional communication in cells of MA and aorta from SHR by the downregu‐lation of the expression of Cx37 and/or Cx40 .

Expression and significance of gene Rad52 in nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and clinical significance of Rad52, a homologous recombination repair gene, in tissues of nasopharyngeal carcinoma (NPC).@*METHOD@#The expression of Rad52 was detected with three-step immunohistochemistry technique in tissues of 38 NPC patients and which have the corresponding paracancerous tissues. All of the Rad52 expression and clinical data (gender, age, clinical stage ) were compared and analyzed to conclude the relationship between them.@*RESULT@#The Rad52 expressions were significantly different from NPC tissues to peri-NPC tissues (P 0.05). The expression of Rad52 influenced the survival time of NPC patients significantly (P < 0.05).@*CONCLUSION@#The Rad52 expression can be a useful prognostic and treatment factor for NPC patients.

Effects of Vertebral Basilar Artery Bloodstream about CSA Treated by Small Needle Knife Combining with Massage Manipulation in Clinical Practice / 世界科学技术-中医药现代化

This study was aimed to explore the action mechanism of massage treatment in combination with small needle knife to cervical spondylotic vertebral arteriopathy (CSA). A total of 400 CSA patients were randomly divided into four groups, which included group A (medicine treatment group), group B (small needle knife therapy group), group C(massage treatment group) and group D (small needle knife combined with massage treatment group). The observation was given on the average blood flow velocity (Vm), pulsatility index (PI) and treatment efficiency of ver-tebral artery(VA) and basilar artery (BA) before and after treatment among 400 cases using transcranial doppler (TCD). The results showed that TCD detection of Vm of VA and BA in group B, C and D were obviously improved after treatment; and the PI of them was close to normal. The total effective rate of group A was 66.0%, 78.6% in group B, 80.2% in group C, and 96.0% in group D. It was concluded that the treatment by massage in combination with small needle knife therapy of vertebral artery type of cervical spondylosis had a clear effect. Its mechanism may be related to the improvement of Vm and PI of vertebral basilar artery.