Application of "Sancai principle" for needle-knife treatment of bi syndrome of neck region / 中国针灸

Under the guidance of the "Sancai principle", based on the understanding of the etiology and pathogenesis of the imbalance of muscles and bones in bi syndrome of neck region, holistic treatment should be used. The needle-knife release therapy is applied at corresponding acupoints in the three parts i.e. head, neck and back including Tiancai points (Naohu [GV 17] and Naokong [GB 19]), Rencai points (neck Jiaji [EX-B 2]), and Dicai points (Dazhui [GV 14], Quyuan [SI 13] and Tianzong [SI 11]). According to the layers of the lesion's meridians and muscles, the needle-knife is inserted into skin, muscle and bone to relax the tendons and treat bone disorders, and restore the normal mechanical balance of neck.

Effect of Serum from Kidney Yang Deficiency Rats on Expression of β-catenin/OPG/RANKL in OB-OC Co-culture System and Regulatory of Icariin / 中国实验方剂学杂志

Objective:To observe the effect of serum of kidney Yang deficiency rats on the expression of β-catenin，osteoprotegerin(OPG) and nuclear transcription factor-κB receptor activator ligand (RANKL) in the co-culture system and regulatory of icariin on it， and to explore the possible mechanism of inducing osteoporosis.Method:The 16 male SD rats were randomly divided into blank group and model group， 8 rats in each group. 10 mL·kg-1 adenine was administrated to stomach to establish kidney yang deficiency model. Serum was separated and extracted after the model was established successfully. Isolation and culture of osteoblast（OB） and osteoclast（OC） in vitro， OB was observed and identified by alkaline phosphatase（ALP），alizarin red and Giemsa staining， OC was identified by tartrate resistant acid phosphatase（TRAP） staining， OB-OC co-culture system was established in transwell cell， icariin group（100 μmol·L-1）， blank group， icariin（100 μmol·L-1） + serum group， serum group and Dickkopf1（DKK-1） drug（100 μg·L-1） were set up in group ， 2 days after intervention of co-culture system， OC was counted， ALP and TRAP in supernatant were detected by microplate enzyme labeling， and the expression of OPG，β-catenin and RANKL in each group was detected by Western blot.Result:Compared with blank group， the ALP activity，β-catenin and OPG protein expression in serum group were significant reduction （P<0.05）， while the OC quantity， TRAP activity and RANKL protein expression were marked increase （P<0.05）. Compared with serum group， ALP activity of icariin group decreased significantly （P<0.01）， Compared with icariin group， ALP activity and OPG protein expression decreased （P<0.05）， trap activity and RANKL expression increased （P <0.05） in icariin + serum group.Conclusion:The serum of kidney Yang deficiency rats can induce the occurrence of osteoporosis， and the mechanism of action may be through inhibition of ALP activity， down regulating the expression of β-catenin and OPG protein， increasing the activity of TRAP and the expression of RANKL protein.

Depressant effect of Lithium on apoptosis of nerve cells of adult rats after spinal cord injury / 中国骨伤

<p><b>OBJECTIVE</b>To study whether lithium agent produces neuroprotective effect by inhibiting the nerve cell apoptosis of rats after spinal cord injury.</p><p><b>METHODS</b>Forty-two male SD rats weighing 200 to 250 g were randomly divided into 3 groups: blank control group(=6) without surgery, normal saline(NS) group(=18) with intraperitoneal injection of NS (40 mg/kg); and Lithium chloride (Licl) group (=18) with intraperitoneal injection of Licl (40 mg/kg). After Allen method modeling, Licl group started intraperitoneal injection of Licl solution (40 mg·kg⁻¹·d⁻¹) within 15 min after operation to the second week. NS group, during the same interval, was injected with a same amount of NS. Postoperative 3, 7, 14 d, BBB scores in each group were measured;the expression of Bcl-2 and Bax protein were observed by immunohistochemisty staining;TUNEL staining was used to observe the nerve cell apoptosis.</p><p><b>RESULTS</b>The BBB scores in blank control group were 21. Postoperative 7, 14 d, BBB scores of Licl group were higher than that of NS group(<0.05). As for the Bcl-2 protein expression, black control group has a level of 0.081±0.003;7 d and 14 d postoperatively, the level in Licl group was 0.151±0.003, 0.163±0.003 and in NS group, 0.143±0.003, 0.154±0.002, respectively. Licl group showed significantly increased Bcl-2 protein expression(<0.05). As for the Bax protein expression, black control group showed a level of 0.071±0.003; 7 d and 14 d postoperatively, the level in Licl group was 0.121±0.002, 0.106±0.002 and in NS group was 0.126±0.001, 0.120±0.002, respectively. The Bax protein expression is significantly inhibited in the Licl group(<0.05). In nerve cell apoptosis by TUNEL staining, the positive cells were fewer in the black control group with apoptosis index (AI) of 1.98±0.19;while 7d and 14d postoperatively, the AI of Licl group was 13.12±0.69, 4.29±1.00 and of NS group, 18.26±0.87, 5.48±0.70, respectively. Licl group showed significant inhibition of the cell apoptosis(<0.05).</p><p><b>CONCLUSIONS</b>Licl can promote the Bcl-2 protein expression and inhibit the Bax proteins expression in nerve cells of rat after SCI, thereby playing a role in the inhibition of nerve cell apoptosis. This may be one of the mechanisms that Licl can promote the recovery of motor function of rats after SCI.</p>

Effects of Jieduan Niwan Prescription on IL-6 and TNF-α in Serum and Hepatic Tissue of Acute-on-Chronic Liver Failure Rats / 中国中医药信息杂志

Objective To observe the effects of Jieduan Niwan Prescription on IL-6 and TNF-α in serum and hepatic tissue in acute-on-chronic liver failure rats (ACLF); To study the partial mechanism of the treatment for ACLF. Methods The ACLF rat model was established by using human serum albumin immuno-induced hepatic fibrosis followed with D-galactosamine and lipopolysaccharide joint acute attack. The SPF Wistar male rats were randomly divided into normal group, model group and Jieduan Niwan Prescription group, respectively. The Jieduan Niwan Prescription group was treated by Jieduan Niwan Prescription after the acute attack for 24 h, and the rats were sacrificed respectively at 5, 10 and 15 days after gavage administration. Transmission electron microscope was employed to observe the ultrastructural changes in liver cells and ELISA was used to detect the contents of IL-6 and TNF-α in serum and liver tissue, respectively. Results Compared with the normal group, the contents of serum and liver tissue IL-6 and TNF-α in model group increased at each time point. Compared with the model group, the contents of serum and liver tissue IL-6 and TNF-α decreased in Jieduan Niwan Prescription group, especially in 15 days. Under the transmission electron microscope, the changes of ultrastructure of liver tissue were observed. With the passage of time, the degree of hepatocyte injury in model group gradually increased, but decreased significantly in Jieduan Niwan Prescription group at each time point. Conclusion Jieduan Niwan Prescription can effectively reduce the levels of IL-6 and TNF-α in serum and liver tissue, reduce the degree of liver damage, and has a certain protective effect on the liver.

Meta analysis of clinical effects between intramedullary nail and volar plate internal fixation for distal radius fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate curative effects of intramedullary nail and volar plate internal fixation for distal radius fractures.</p><p><b>METHODS</b>The studies concerning about randomized controlled trial of intramedullary nail and volar plate internal fixation for distal radius fractures from create database to May, 2016 were searched from PubMed, Cochrane Library, Web of Science, CNKI, Wan Fang data and VIP. Information was screen and taken out according to inclusion and exclusion criteria, quality of literature was evaluated according to Cochrane Handbook evaluating system. Meta analysis was performed by RevMan 5.2 software. Postoperative grip strength, clinical effects(results of flexion and extension, pronation, supination, deflection of ulnar and radialis) , imaging evaluation (ulnar variance, radial height, volar tilting angle and radial inclination) and the incidence of postoperative complications were analyzed.</p><p><b>RESULTS</b>Totally 6 RCT including 370 patients were chosen. According to the Meta analysis, there were no statistical differences in extension[MD=5.63, 95%CI(-7.01, 18.27),=0.38], flexion[MD=3.10, 95%CI(-0.67, 6.86),=0.11], pronation[MD=2.58, 95%CI(-0.49, 5.65),=0.10], supination[MD=0.82, 95%CI(-1.89, 3.54),=0.55], radial deviation[MD=-5.16, 95%CI(-14.42, 4.11),=0.28], ulnar deviation[MD=0.19, 95%CI(-2.39, 2.77),=0.88], ulnar variance[MD=-0.01, 95%CI(-0.43, 0.42),=0.97], ulnar inclination[MD=-0.31, 95%CI(-1.37, 0.73),=0.56], radial height[MD=-0.27, 95%CI(-0.98, 0.44),=0.45], radial inclination[MD=0.29, 95%CI(-0.41, 0.99),=0.42] and the incidence of postoperative complications[RR=0.71, 95%CI(0.46, 1.09),=0.12] between intramedullary nail and volar plate internal fixation.</p><p><b>CONCLUSIONS</b>Compared with volar plate internal fixation, intramedullary nail has the same effect in grip strength, clinical effect, but could not reduce the occurrence of postoperative complications. However, a large number of prospective randomized controlled study should be carried out to prove clinical effect of intramedullary nail for distal radius fractures.</p>

Intermittent porta hepatis occlusion is a risk factor of postoperative intra-hepatic recurrence of hepatocellular carcinoma / 中华肝胆外科杂志

Objective To investigate the impact of intermittent porta hepatis occlusion on postoperative intra-hepatic recurrence of hepatocellular carcinoma.Methods We retrospectively reviewed the records of 335 patients who underwent partial hepatectomy.The patients were classified into 2 groups:(1) the study group (n=97):porta hepatis was occluded with intermittent Pringle maneuver with 2-3 cycles of clamp/unclamp time of 15 min/5 min,repeated 2-3cycles; (2) the control group (n=238):including using Pringle maneuver,preconditioning occlusion of porta hepatis and selective occlusion of portal blood inflow.Patients were followed-up in the Outpatient Department once every 2-3 weeks in the 1st year,and once every 3-6 weeks in the 2nd year with US/CT/MRI and serum AFP test.The mean duration of follow-up was 26.5 months.Results The perioperative mortality was 1.8％ (6/335).Tumour recurrence in the study group was 31.6％ and 48.4％ in the 1st and 2nd year,respectively.The recurrence rates were significantly higher,than the 21.4％ and 38.0％ in the control group (P＜0.05).To exclude the miscellaneous factors which were involved in intra-hepatic recurrence of HCC,we set up 3 criteria to include patients for subgroup analysis:tumor ≥5 cm; serum AFP decreased to normal level within 4 weeks; negative intra-operative US scan.The number of patients included were 79 and 155 in the study and the control groups,respectively.There were significant differences in recurrence rate between the study and the control groups in the 1st and 2nd year (29.1％ vs 18.7％,46.8％ vs 35.5％,P＜0.05).There were no significant differences in overall survival rate between the two groups.Conclusions Intermittent porta hepatis occlusion is a risk factor of postoperative intra hepatic recurrence of hepatocellular carcinoma.

Repair of soft tissue defects on the lower limbs with the facial pedicled flap with vascular perforating branch of leg / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the operative techniques and clinical results of the facial pedicled flap with vascular perforating branch of leg.</p><p><b>METHODS</b>From May 1998 to January 2009,62 patients with soft tissue defects on the lower limbs were treated by four kinds of flap pedicled with the medial, posterior,anterolateral and posterolateral vascular perforating branches in the leg, included 50 males and 12 females, aged from 7 to 78 years old. There were 23 cases of the facial pedicled flap based on the perforating branch of the tibialis posterior artery, 9 cases of the facial pedicled flap based on the distal perforating branch of peroneal artery, 22 cases of the facial pedicled flap based on the peroneal artery perforator, 8 cases of the facial pedicled flap based on the lateral popliteal cutaneous artery.</p><p><b>RESULTS</b>The remaining flaps were completely survived except for 2 cases with epidermal necrosis and scab of distal flap, and 1 case with skin necrosis and skingrafting later. The patients were followed-up for from 1 month to 3 years, the appearance of the flaps were satisfied and the function were good.</p><p><b>CONCLUSION</b>The blood supply area of single perforator vascular of the leg is insufficient, so the presence facial pedicled flap of arterial chains will expend obviously the area of perforator flap that be good to blood supply and venous return.</p>

Repair of wound defect with exposed tibia with facial flap pedicled with vascular perforating branch of leg / 中华创伤杂志

Objective To explore the method of repairing wound defects with exposed tibia. Methods 32 patients with soft tissue defects with exposed tibia were treated with three kinds of flaps pedicled with interior,lateral and posterior vascular perforating branches in the leg,respectively.Re- suits One flap with distal part necrotic was treated with change of dressings and got one-stage healing. One case had delayed union for muscular infection under the flap.Other flaps all were successful and sur- vived.No ostemyelitis was found.Conclusion The flap pedicled with vascular perforating branches of leg has abundant blood supply and is a good method for repairing small or middle wound defect with ex- posed tibia.