Friedrich Trendelenburg: Historical background and significant medical contributions

Friedrich Trendelenburg's name is widely known today because it is associated with the Trendelenburg position. However, Trendelenburg made many other valuable contributions to the field of medicine, including a test, a gait, and a sign. A historical review of his life helps to elucidate the factors that contributed to his innovative approaches and techniques. Both Trendelenburg's mentors in his early years and the influences upon him throughout his professional career contributed to his development as a pioneer of surgery, anesthesia, and clinical diagnostics. Clin. Anat. 27:815–820, 2014. © 2014 Wiley Periodicals, Inc.     

Ebstein anomaly review: what’s now,what’s next?

Ebstein anomaly accounts for 1% of all congenital heart disease. It is a right ventricular myopathy with failure of tricuspid valve delamination and highly variable tricuspid valve morphology that usually results in severe regurgitation. It is the only congenital heart lesion that has a range of clinical presentations, from the severely symptomatic neonate to an asymptomatic adult. Neonatal operation has high operative mortality, whereas operation performed beyond infancy and into adulthood has low operative mortality. Late survival and quality of life for hospital survivors are excellent for the majority of patients in all age brackets. Atrial tachyarrhythmias are the most common late complication. There have been more techniques of tricuspid repair reported in the literature than any other congenital or acquired cardiac lesion. This is largely due to the infinite anatomic variability encountered with this anomaly. The cone reconstruction of Ebstein anomaly can achieve near anatomic restoration of the tricuspid valve anatomy. Early and intermediate results with these repairs are promising. Reduced right ventricular function continues to be a challenge for some patients, as is the need for reoperation for recurrent tricuspid regurgitation. The purpose of this article is to outline the current standard of care for diagnosis and treatment of Ebstein anomaly and describe innovative strategies to address poor right ventricular function and associated right-sided heart failure.     

The effect of scan parameters on cone beam CT trabecular bone microstructural measurements of the human mandible

The objective of this study was to investigate the effect of different cone beam CT scan parameters on trabecular bone microstructure measurements. A human mandibular cadaver was scanned using a cone beam CT (3D Accuitomo 170; J.Morita, Kyota, Japan). 20 cone beam CT images were obtained using 5 different fields of view (4×4 cm, 6×6 cm, 8×8 cm, 10×10 cm and 10×5 cm), 2 types of rotation steps (180° and 360°) and 2 scanning resolutions (standard and high). Image analysis software was used to assess the trabecular bone microstructural parameters (number, thickness and spacing). All parameters were measured twice by one trained observer. Intraclass correlation coefficients showed high intraobserver repeatability (intraclass correlation coefficient, 0.95–0.97) in all parameters across all tested scan parameters. Trabecular bone microstructural measurements varied significantly, especially in smaller fields of view (p = 0.001). There was no significant difference in the trabecular parameters when using different resolutions (number, p = 0.988; thickness, p = 0.960; spacing, p = 0.831) and rotation steps (number, p = 1.000; thickness, p = 0.954; spacing, p = 0.759). The scan field of view significantly influences the trabecular bone microstructure measurements. Rotation steps (180° or 360°) and resolution (standard or high) selections are not relevant.     

Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma: a Meta-analysis of randomized control trials

ObjectiveTo systematically evaluate the effectiveness and safety of heat-sensitive moxibustion (HSM) on asthma.MethodsLarge databases in China and overseas were searched by electronic and manual means to collect information on randomized controlled trials (RCTs). Two evaluators independently extracted data and evaluated the quality of RCTs according to Cochrane Review Handbook v5.0. RevMan v5.0.20 was used for statistical analyses.ResultsFourteen RCTs involving 637 patients were collected. Thirteen RCTs compared the effects of HSM and Western Medicine. After 3-month treatment and after 6-month follow-up, there was no significant difference in effective rate [relative risk (RR) =1.01, 95% CI (0.92, 1.12), and 1.12, (0.93, 1.36), respectively], in the asthma control test score of asthma symptoms [weighted mean difference (WMD) = − 1.54, 95% CI (− 3.54, 0.47), and 1.41, (− 0.48, 3.29), respectively] and in the forced expiratory volume in 1 second (FEV₁) and peak expiratory flow (PEF). One RCT compared the effect of HSM with warm-suspended moxibustion. After 6-month follow-up, there was a significant difference in FEV₁ and PEF [WMD=0.51, 95% CI (0.10, 0.92), and 1.78, (1.06, 2.50), respectively]. After 3-month treatment, there was no significant difference between the two groups. One RCT compared the effect of HSM with acupoint application. After 3-month treatment, there was no significant difference in the effective rate [RR=0.68, 95% CI (0.42, 1.12)].ConclusionsHSM did not show superiority to conventional Western Medicine and acupoint application in terms of curative effects, and may be superior to warm-suspended moxibustion with regard to long-term curative effects. Because of low quality of the included RCTs, this conclusion must be bolstered with higher-quality RCTs.     

口腔COPT与CBCT对受检者的体表辐射剂量对比

目的：研究口腔COPT和CBCT受检者的体表辐射特征,做好全口腔影像检查的辐射防护。方法应用长杆电离室和X射线多功能检测仪,采用非介入式方法测试COPT和CBCT影像接收器处的辐射剂量,计算受检者入射体表空气比释动能和空气比释动能率。结果在最小技术条件下,CBCT和COPT受检者入射体表空气比释动能分别为0.21、0.13 mGy,空气比释动能率分别为20.10、8.65μGy/mAs。在最大技术条件下,CBCT和COPT受检者入射体表空气比释动能分别为20.05、4.49 mGy,空气比释动能率分别为178.2、21.02μGy/mAs。在临床常用技术条件下, CBCT（84~90）kV和COPT（62~70）kV受检者入射体表空气比释动能分别为（16.61~18.62）和（0.87~3.12）mGy,空气比释动能率分别为（105.3~138.2）和（11.42~14.42）μGy/mAs。结论口腔CBCT受检者入射体表辐射剂量高于COPT。口腔临床和放射医生要遵守辐射防护三原则,合理应用COPT与CBCT。     

改良式单孔锥颅置管引流术治疗慢性硬膜下血肿疗效分析

目的：探讨改良式单孔锥颅置管引流术治疗慢性硬膜下血肿的临床疗效。方法选取2011年1月至2013年1月于我院就诊的慢性硬膜下血肿患者共100例,按照入院编号,将患者随机分为两组,观察组和对照组各50例。对照组患者给予常规的钻孔手术治疗,观察组给予患者改良式单孔锥颅置管引流术治疗,观察患者接受治疗后的临床效果。结果观察组50例患者在接受具有针对性和科学性护理之后,其中痊愈患者30例（60.0%）,好转20例（40.0%）,总有效率为100%;对照组患者中痊愈患者26例（52.0%）,好转18（36.0%）,无效6例（12.0%）,总有效率为88.0%。观察组患者治疗总有效率和痊愈率要明显高于对照组患者,组间治疗效果差异有统计学意义（P＜0.05）。结论临床上在治疗慢性硬膜下血肿症时,可以采用改良式单孔锥颅置管引流术治疗方法,能有效改善患者治疗效果,提高预后质量,获得非常理想的治疗效果。     

隔药灸脐联合补中益气汤治疗肛肠术后并发症的临床观察

目地探讨隔药灸脐联合补中益气汤治疗肛肠术后并发症的疗效。方法选取2013年9月1日至2014年11月1日来安徽省针灸医院肛肠科的患者120例,随机分为三组,每组40例,即灸脐组（隔药灸脐组）、药物组（补中益气汤组）、灸药联合组（隔药灸脐＋补中益气汤）,观察三组的术后情况,并作数据统计。结果灸脐组治愈10例,好转18例,无效12例,总有效率70％;药物组治愈13例,好转16例,无效11例,总有效率72．5％;灸药联合组治愈20例,好转15例,无效5例,总有效率87．5％。结论隔药灸脐联合补中益气汤在治疗肛肠术后并发症方面疗效显著,有统计学意义（P ＜0．05）,值得临床推广。     

艾灸神阙穴辅助宫缩药治疗宫缩乏力性产后出血的临床观察

目的：观察艾灸神阙穴辅助宫缩药治疗宫缩乏力性产后出血的临床疗效。方法将纳入研究的137例患者随机分为观察组（74例）和对照组（63例）,对照组给予西医常规宫缩药物,观察组在常规西医治疗的基础上给予隔盐灸神阙。1 d之后统计观察两组患者2 h和24 h出血量,以及分娩前后血细胞分析。结果两组孕妇治疗后,观察组24 h出血量少于对照组24 h,两组24 h出血量比较差异有显著性（P＜0．05）,且治疗后持续出血观察组少于对照组,比较差异有显著性意义（P＜0．05）;治疗后,观察组与对照组比较红细胞计数（RBC）、血红蛋白（Hb）、红细胞压积（HCT）差异均有显著性（P均＜0．05）。结论艾灸神阙穴辅助宫缩药治疗宫缩乏力性产后出血疗效确切,值得推广。     

The efficacy of moxibustion and acupuncture therapy for ankylosing spondylitis: A protocol for an overview of systematic reviews and meta-analysis

Background:Ankylosing spondylitis is a complex and progressive autoimmune inflammatory disease with a worldwide prevalence ranging up to 0.9%. Several systematic reviews and meta-analyses of traditional Chinese medicine alternative therapies, such as acupuncture or moxibustion, have demonstrated the effectiveness of moxibustion and acupuncture in the treatment of ankylosing spondylitis. However, there is no relevant literature to comprehensively evaluate the evidence. The purpose of this overview is to synthesize and evaluate the reliability of evidence generated in the systematic review (SR) and meta-analysis of moxibustion and acupuncture as a primary or complementary therapy for patients with ankylosing spondylitis.Methods:PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database were searched for systematic reviews and meta-analysis that review the efficacy of acupuncture or moxibustion as the primary treatment for patients with Ankylosing Spondylitis. The literature published before August 2020 will be selected. Additionally, the relevant SRs and meta-analyses that unpublished or ongoing will be searched in PROSPERO and INPLASY. The methodological guidelines for overviews will be used to review and extract data by 2 reviewers, and their will do it independently. Methodology quality will be analyzed by the assessment of multiple systematic reviews-2and the risk of bias by POBIS. For the included studies, we will adopt the following results as primary evaluation indicators: effective rate, visual analogue scale and bath AS disease activity index. Reviewers will assess the certainty of evidence by Grading of Recommendations Assessment, Development and Evaluation.Results:The results will be published in a peer-reviewed journal.Conclusion:This overview will provide comprehensive evidence of moxibustion and acupuncture for patients with Ankylosing Spondylitis.     

Efficacy of warming needle moxibustion in the treatment of ankylosing spondylitis: A protocol of a randomized controlled trial

Background:Ankylosing spondylitis is a recurrent autoimmune disease, which has a high disability rate and seriously affects patients’ daily life. Conventional treatment cannot effectively solve the clinical problems of patients, and long-term medication is accompanied by adverse reactions. The evidence shows that warming needle moxibustion has advantages in the treatment of ankylosing spondylitis, but there is still a lack of clinical studies on warm acupuncture alone and long-term follow-up.Methods:This is a prospective randomized controlled trial to study the efficacy and safety of needle warming through moxibustion in the treatment of ankylosing spondylitis. It was approved by the Ethics Committee of Clinical Research of our hospital. Patients were randomly assigned to an observation group or a control group. The patients were followed up for 6 months after 30 days of treatment. Observation indicators include; activity index, functional ability, Bath Ankylosing Spondylitis Metrology Index, inflammatory indicators, adverse reactions, and so on. Finally, SPASS 22.0 software is used for statistical analysis of the data.Discussion:This study will evaluate the clinical efficacy of warming needle moxibustion in the treatment of ankylosing spondylitis. The results of this study will provide a reference basis for the clinical use of warm needle moxibustion in the treatment of ankylosing spondylitis.Trial registration:OSF Registration number: DOI 10.17605/OSF.IO/GWPX3