Acupoint puncture combined with Ilizarov technique for the treatment of elderly paitents with knee osteoarthritis / 中国骨伤

OBJECTIVE@#To explore the clinical effect of acupoint puncture combined with Ilizarov technique in the treatment of knee osteoarthritis in the elderly.@*METHODS@#From March 2015 to February 2016, 76 patients with primary knee osteoarthritis were treated with tibial osteotomy acupoint puncture grouop and Ilizarov technique anatomical puncture group, including 24 males and 52 females, aged 56 to 75 years old with an average of 61.4 years old, and a course of 3 to 17 years with an average of 5.2 years. Among them, 38 cases were treated with external fixation of acupoint puncture needle and 38 cases were treated with external fixation of anatomical puncture needle. Preoperative full-length X-ray of both lower limbs showed tibial varus deformity, narrowing of medial knee joint space and enlargement of lateral knee joint space. The force line of the affected knee and lower limb was moved inward by body surface measurement, and the KSS knee function score was decreased. Symptoms included medial knee pain, flexion and extension, and conservative treatment for more than 2 years.@*RESULTS@#The lower limb force lines of both groups were corrected and the osteotomy ends healed well. No nonunion of osteotomy, inadequate correction of lower limbs or recurrence of deformity were found. Seventy-five patients were followed up for 3, 6, 12 and 24 months after operation. There was no significant difference in knee joint mobility between the two groups before operation and on 6, 12, 24 months after operation(=1.346, >0.05). There were significant difference in KSS pain and total score between the two groups at 3 months after operation, acupoint puncture group was better than anatomical puncture group(0.05).@*CONCLUSIONS@#The acupoint puncture group formed a potential acupuncture effect in the acupoint area by continuously tightening the steel needle on Ilizarov ring external fixator during the post-operative adjustment. Within three months after wearing external fixator, the knee pain symptoms of knee osteoarthritis were relieved rapidly, continuously and effectively, which was significantly better than that of the anatomical puncture group.

Case-control study on Pi needle for the treatment of the cutaneous nerve entrapment low back pain / 中国骨伤

<p><b>OBJECTIVE</b>To explore a safe and effective method for the treatment of low back pain in the cutaneous nerve, and to clarify the indication of Pi needle to treat it.</p><p><b>METHODS</b>From January 2003 to December 2004, 278 patients with cutaneous nerve entrapment low back pain were divided into two groups: Pi needle group and electrical stimulation group. In the Pi needle group, there were 68 males and 70 females, ranging in age from 20 to 60 years old, with an average of(41.92±10.88)years old. In the electrical stimulation group, there were 68 males and 72 females, ranging in age from 18 to 60 years old, with an average of(41.44±10.47) years old. The pain, tenderness and soft tissue tension of the two groups were measured and compared before and after treatment.</p><p><b>RESULTS</b>All of the selected cases were qualified. No suspension, culling and shedding cases occurred in either group. In Pi needle group, visual analog scale(VAS) of pain decreased from 8.78±1.52 before treatment to 1.33±1.33 after treatment;and in electrical stimulation group, VASof pain decreased from 8.59±1.76 before treatment to 5.20±2.64 after treatment;and the VAS of pain of the Pi needle group was lower than that of the electrical stimulation group. In Pi needle group, VAS of tenderness decreased from 9.12±1.24 before treatment to 1.60±1.36 after treatment;and in electrical stimulation group, VAS of pain decreased from 8.79±1.60 before treatment to 5.34±2.60 after treatment;and the VAS of pain of the Pi needle group was lower than that of the electrical stimulation group.</p><p><b>CONCLUSIONS</b>Once tissue texture changes to pain point, cord, nodules, Pi needle is the first line treatment for the cutaneous nerve entrapment low back pain.</p>

Therapeutic Effects of Ultrasound-Guided Injection of Botulinum Toxin Type A into the Cricopharyngeus Muscle for Cricopharyngeal Dysfunction / 中山大学学报(医学科学版)

[Objective] To investigate the feasibility and effectiveness of using ultrasound-guided cricopharyngeal (CP) botulinum toxin (BTX) injection to treat cricopharyngeal dysfunction after brainstem infarction.[Method] A patient with dysphagia caused by subacute lacunar infarction in the right pontobulbar junction was diagnosed with incomplete opening of cricopharyngeal muscle by videofluoroscopic swallowing study (VFSS).After precisely locating the CP muscle with catheter balloon and ultrasound,we injected BTX (25 U/0.8 mL) into the left CP muscle using the out-of-plane approach technique.[Result] After the injection,the patient made great progress in swallowing.He was able to eat porridge independently without bucking on the 5th day,while soft rice on the 8th day and sip water.Two weeks after the injection,VFSS showed that the bolus progressed into the esophagus fluently without the route getting narrow or broken off,and hardly found residue in pharynx,which suggested that the CP muscle could open properly.[Conclusion] Cricopharyngeal injection of BTX guided by ultrasound is a safe and effective way to treat cricopharyngeal dysfunction after brainstem infarction,which is also convenient to operate and deserves to be disseminated after the further studies proves its effectiveness.

Expression of circadian gene NPAS2 in colorectal cancer and its prognostic significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the expression of NPAS2 in colorectal cancer (CRC) and analyze its relationship with the clinicopathological parameters and prognosis of the patients.</p><p><b>METHODS</b>Real-time q-PCR was used to detect the expression of NPAS2 mRNA in 40 fresh CRC tissues and paired adjacent tissues; immunohistochemistry was used to detect the expression of NPAS2 protein in 120 paraffin-embedded tumor and adjacent tissues. The relationship between NPAS2 expression level and the 5-year survival rate of 78 CRC patients with follow-up data were analyzed with Kaplan-Meier survival analysis.</p><p><b>RESULTS</b>Compared with the adjacent tissues, fresh CRC tissue expressed significantly lower NPAS2 mRNA levels (P<0.01). Among the paraffin-embedded CRC tissues, 19.2% were positive for NPAS2 expression, as compared to a much higher rate of 62.5% in the adjacent tissues (P<0.05). The expression of NPAS2 was correlated with the tumor size, lymph node metastasis and TNM stages (P<0.05) but not with the patients' gender, age, distant tumor metastasis, differentiation, or invasion. Patients with high NPAS2 expression levels had a significantly higher 5-year survival rate than those with low NPAS2 expressions (P=0.0001).</p><p><b>CONCLUSION</b>NPAS2 is down-regulated in CRC and closely correlated with the malignant biological behavior of the tumor and 5-year survival of the patients, suggesting its value in predicting the prognosis of the CRC patients.</p>

Advances in biomechanical studies on functional training for the treatment of fractures / 中国骨伤

Functional training is put a very high position in the treatment of fractures by Western Medicine and Traditional Chinese Medicine. The influences of functional training during fracture healing are very important. Functional training will begin after reduction and fixation and it represents the principle of the combination of functional training and fixation in the fracture treatment by TCM. Functional training makes kinds of favourable stress, which can accelerate the healing of fracture, but the incorrect functional training makes shear strength or torsion and so on, which may make interfere fracture healing. So, the biomechanical studies on functional training of the fracture are becoming a focus of fracture treatment.

Consistency between histopathological results of routine endoscopy and biopsy in observing gastric mucosa of patients with non-malignant gastroduodenal diseases / 第二军医大学学报

Objective: To analyze the consistency between the histopathological results of routine endoscopy and biopsy in observing the gastric mucosa of patients with non-malignant gastroduodenal diseases, and to evaluate the necessity of biopsy following gastric endoscopy. Methods: From Jan. 2005 to Dec. 2005, 320 patients who received upper gastrointestinal endoscopy and biopsy because of upper abdominal symptoms were included in this study. The patients were selected consecutively according to their disorders diagnosed by macroscopic endoscopy and were divided into 64 groups. The 5 patients in each group had reflux esophagitis, non-atrophic gastritis, atrophic gastritis, gastric ulcer and duodenal ulcer, respectively. Patients in the same group were matched with each other in gender, age and their history of diseases. The results of endoscopy, including the exudation, congestion, erosion, roughness, bile reflux, etc., were read by 2 experienced endoscopists. The biopsy was performed by an experienced pathologist and pathological variables included active inflammation, chronic inflammation, atrophy, intestinal metaplasia and atypical hyperplasia. The status of Helicobacter pylori (H. pylori) infection was evaluated by rapid urea test, silver staining and histological methods; the result was deemed positive when the results of either 2 tests were positive. Results: Erosion, exudation, roughness, and H. pylori infection were related with active inflammation; erosion and H. pylori infection were related with chronic inflammation; roughness of mucosa was related with atrophy; roughness and H. pylori infection were related with intestinal metaplasia; and obsolete hemorrhage; H. pylori infection, roughness mucosa, and bile reflux were related with atypical hyperplasia. Macroscopic diagnosis rate of atrophic gastritis was 71.9% (46/64) with a false positive rate of 28.2% (18/64) and a false negative rate of 34.38% (22/64). Conclusion: Macroscopic diagnosis is indicative to path ological changes of gastric mucosa, but the predictive value is relatively poor, making biopsy and pathological examination necessary in the diagnosis of gastric mucosa disorders during routine endoscopic examination.