Comparison of isometric and anatomical graft placement in synthetic ACL reconstructions: A pilot study

Correct graft placement is critical to the success of anterior cruciate ligament reconstructions (ACLR). Whilst current trend is to insert the graft in an anatomical location, synthetic grafts have shown to better perform when they are located in an isometric position. Placement, however, is largely dependent on the surgeon and no consensus has been reached for synthetic grafts.Kinematic flexion-extension data of four separate cadaveric knees was obtained using an optical tracking system. Knees were CT-scanned and computer models were developed for each specimen. Three different graft insertion techniques were simulated in each of the computer models. Kinematic data obtained from the optical tracking was applied to the 3D computer models to simulate knee flexion-extension, and virtual change in ACL graft length was measured over the cycle for each insertion technique. Length changes were plotted onto the Radiological-Quadrant.The isometric region on the femur was found to be a band spreading from the mid to deep end of the Blumensaat's line down to the shallow-inferior end of the femoral condyle. The JP Laboureau isometric point technique was consistently located in the isometric zone, with the following coordinates on the Radiographic-Quadrant: t=0.375 (SD 0.0066), h=0.227 (SD 0.0266). The Bernard–Hertel and Charlie Brown anatomical placement methods were located (13%, ?6%) and (8%, ?15%) away, from the JP Laboureau isometric point, respectively, based on t- and h- coordinates of the Radiographic-Quadrant.This study has determined the isometric region using three-dimensional analysis relative to the Radiographic-Quadrant. The JP Laboureau method best finds the isometric point. This information is useful for synthetic graft placement.     

针刺夹脊穴结合温针灸治疗原发性面肌痉挛临床疗效观察

目的:比较针刺夹脊穴结合温针灸与常规针刺治疗原发性面肌痉挛的疗效差异。方法:选择60例符合纳入标准的原发性面肌痉挛病人随机分成两组,每组各30例。对照组用常规针刺治疗,治疗组在对照组的针刺选穴基础上取颈部夹脊穴(C3-C6棘突下旁开0.5寸,左右各4穴)和温针灸养老穴。结果:两组患者的面肌痉挛强度和频率均降低(P<0.05)。总有效率比较,治疗组(90%)>对照组(63.3%),(Z=-2.815,P=0.005<0.01)。结论:针刺夹脊穴结合温针灸与常规针刺均可改善患者面肌痉挛症状,且夹脊穴结合温针灸治疗疗效更佳。     

电针深刺夹脊穴治疗腰椎间盘突出症163例疗效观察及对血浆β-内啡肽的影响

目的观察电针深刺夹脊穴治疗腰椎间盘突出症的疗效及血浆β-内啡肽的影响。方法将163例腰椎间盘突出症患者随机分为治疗组85例和对照组78例,2组均采用电针并配合牵引治疗,其中治疗组选取深刺腰部夹脊穴,对照组常规取穴,分别于治疗前、后测定患者血浆β-内啡肽的含量,采用模糊视觉疼痛量表(VAS)及JOA腰痛评分标准对疼痛进行评定。结果治疗后2组模糊视觉疼痛(VAS)评分及JOA腰痛评分均明显改善,与治疗前比较差异均有统计学意义(P0.01),与对照组相应时间点比较,差异有统计学意义(P0.01)。治疗后2组β-内啡肽含量均明显增高,与治疗前比较,差异有统计学意义(P0.01);其中治疗组β-内啡肽含量增高更为明显,与对照组相应时间点比较,差异有统计学意义(P0.01)。结论电针深刺夹脊穴治疗腰椎间盘突出症具有显著的临床疗效,并可提高患者血浆β-内啡肽活性,这可能是电针镇痛作用机制之一。     

Characteristics and Impact of Life Turning Points for Older Adults

This research examines the characteristics of turning points, events considered as being significant in one’s life. One hundred and forty-nine turning points, as reported by 53 older adults were investigated. They were characterized according to: age at occurrence of turning point, domain, specific or thematic nature, and areas of functioning on which the turning point had an impact. Compared to men, women reported significantly more turning points related to the health domain. Turning points were distributed through the life span, with some concentration at midlife. Family was the sphere most influenced by turning points. The different domains of turning points corresponded to the specific spheres of impact. Turning points were more often related to discrete events than to a series of events clustered under a theme. Identity and social role processes appear most influential in leading older adults to identify particular life circumstances as turning points in their lives.

The cut-off value of impaired fasting glucose should be lower: Based on the associations of fasting blood glucose with blood lipids

ObjectiveThe previous study served impaired fasting glucose (IFG), a pre-diabetic state which was much greater than that of diabetic patients, have reached no consensus on its cut-off value. In this study, we aimed to explore the cut-off value of IFG via the associations of blood lipids with fasting plasma glucose (FPG).DesignA cross-sectional study in Jilin province, China, 2012.Sample13,093 participants aged 18–79 years in Jilin province were involved in the study. The Lamba-Mu-Sigma (LMS) method and generalized additive model (GAM) were used to explore the associations of different levels of FPG and blood lipids.ResultsThe distributions of FPG, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) were significantly different by gender (p < 0.01). In general, both LMS and GAM results showed that the TG and HDL-c curves had a steeper tendency when the FPG was greater than 6.0 mmol/L.ConclusionFPG was positively associated with TG while negatively associated with HDL-c, and the associations were stronger in females. The cut-off value of IFG was suggested to be 6.0 mmol/L.     

《御纂医宗金鉴》伤科内治原则及方药应用特色探研

[目的]探求《御纂医宗金鉴》伤科内治原则及方药应用特色。[方法]运用文献法对《御纂医宗金鉴》伤科内治法相关内容进行研究,从辨治原则和方药应用两个角度进行归纳和分析,并举医案一则探讨该治法对临床的指导作用。[结果]《御纂医宗金鉴》伤科内治法以辨瘀血出血、辨病位为辨证要点;伤科的治疗原则包括瘀血从肝论治、分阶段论治、调畅情志、兼症施治;书中用方经典,多在用方时加用引药,并提出了"假其热以行其寒"的用药思想。所举验案诊为骨折脾虚肝郁、瘀血阻滞证,基于该理论,从肝论治伤科疼痛,治以疏肝健脾、活血通络,注重情志调节与兼症施治,故见收效。[结论]《御纂医宗金鉴》系统总结了伤科内治的辨治原则和方药应用,伤科内治注重辨瘀血出血及辨病位,治疗原则包括瘀血从肝论治、分阶段论治、调畅情志、兼症施治,用方时多加用引药,对于指导临床治疗伤科病症具有重要的参考价值。     

针刺加红外线照射五脏调神穴联合药物治疗不寐40例

目的:观察针刺加红外线照射五脏调神穴联合药物治疗不寐的临床疗效。方法:纳入80例不寐患者,按照随机数字表法分为观察组与对照组各40例,对照组采取地西泮和谷维素口服治疗,观察组在对照组基础上加用针刺合红外线照射五脏调神穴治疗,10 d为1个疗程。3个疗程后,对比两组患者匹兹堡睡眠质量指数(PSQI)得分、临床疗效及脑电图主要睡眠参数变化。结果:两组治疗后PSQI得分得到优化,观察组得分优于对照组(P<0.05);两组治疗后睡眠参数得到优化,观察组优于对照组(P<0.05);观察组痊愈率高于对照组(P<0.05);两组皆无明显不良反应。结论:针刺加红外线照射五脏调神穴联合药物疗法治疗不寐具有较好效果,能够改善患者睡眠质量、脑电图参数,且不良反应较少。     

仰卧旋转扳法联合电针治疗腰椎间盘突出症的临床效果观察

目的 研究仰卧旋转扳法联合电针治疗腰椎间盘突出症的临床效果。方法 选取2017 年11 月～2019 年11 月浙江中医药大学附属第三医院收治的腰椎间盘突出症患者为研究对象,采用随机分组法将纳入标准的腰椎间盘突出症患者104 例分为观察组与对照组,每组各52 例,对照组采用仰卧旋转扳法,观察组在对照组的治疗基础上加用电针治疗。比较两组治疗后的总有效率、SF-McGill 疼痛评分、ODI 评分、SOD 与α1-AGP 指标。结果 治疗后观察组治疗总有效率为96.2%,高于对照组的75.0%;观察组PRI、VAS、PPI 的评分较对照组显著下降,SOD 指标较对照组显著升高,α1-AGP 较对照组显著下降,差异均有统计学意义（P＜0.05）。结论 仰卧旋转扳法联合电针治疗腰椎间盘突出症能提高临床效果,值得推广。     

子午流注针法对结肠癌术后腹腔热灌注化疗患者胃肠反应影响

【目的】观察子午流注纳子法指导下的辰时电针胃肠下合穴治疗脾胃虚弱型结肠癌术后腹腔热灌注化疗(HIPEC)患者胃肠反应的临床疗效。【方法】将60例符合纳入标准的患者随机分为观察组和对照组,每组各30例。对照组患者术后给予常规治疗和HIPEC治疗,观察组在对照组基础上给予辰时电针胃肠下合穴(足三里、上巨虚、下巨虚)治疗,疗程为5 d。观察2组患者治疗前后Karnofsky功能状态评分(KPS)的变化情况及治疗后患者消化道指标[总胆红素(TB)、丙氨酸氨基转氨酶(ALT)、碱性磷酸酶(ALP)]和食欲恢复情况,评价2组患者的胃肠反应和KPS评分的改善疗效。【结果】(1)治疗后,观察组改善恶心呕吐、腹胀腹痛、腹泻等胃肠反应的总有效率分别为83.33%、76.67%、86.67%,对照组分别为50.00%、53.33%、86.67%,观察组改善恶心呕吐、腹胀腹痛的总有效率及总体疗效均明显优于对照组(P<0.05)。(2)治疗后,观察组患者的食欲恢复情况明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,观察组患者的KPS评分较治疗前明显改善(P<0.05),而对照组改善不明显(P>0.05),观察组对KPS评分的改善作用明显优于对照组(P<0.05)。(4)治疗后,观察组患者的KPS评分改善率为56.67%,对照组为23.33%,观察组对KPS评分的改善疗效明显优于对照组(P<0.05)。(5)治疗后,2组患者血清TB、ALT、ALP水平比较,差异均无统计学意义(P>0.05)。【结论】子午流注纳子法指导下的辰时电针胃肠下合穴治疗脾胃虚弱型结肠癌术后HIPEC患者胃肠反应,疗效确切,可明显减轻恶心呕吐、腹胀腹痛发生程度,提高食欲恢复程度,改善KPS评分,从而有利于术后HIPEC患者胃肠功能恢复。