Reflections on problems facing western medicine doctors in developing TCM services in Shanghai / 上海预防医学

By integration of traditional and Western medicine under particular historical conditions in China, some doctors of Western medicine are learning traditional Chinese medicine (TCM)and try to interconnect the two theories.To promote medical progress, they provide TCM services in clinic, such as acupuncture, herbal medicine, etc.But as we know that the laws are lacking for the doctors of Western medicine who want to carry out traditional Chinese medicine service.For the reason, the paper holds that at present there are three fundamental problems that should be solved.First of all, it must be clear that doctors should have qualifications and conditions to provide TCM service.Secondly, it must be clear that the doctors should have practicing scope to guarantee medical security and medical quality.Thirdly, it is imperative to strengthen TCM education and training for doctors.Now it is necessary to further strengthen the standardization of health supervision and law enforcement.

Reflections on problems facing western medicine doctors in developing TCM services in Shanghai / 上海预防医学

By integration of traditional and Western medicine under particular historical conditions in China, some doctors of Western medicine are learning traditional Chinese medicine (TCM)and try to interconnect the two theories.To promote medical progress, they provide TCM services in clinic, such as acupuncture, herbal medicine, etc.But as we know that the laws are lacking for the doctors of Western medicine who want to carry out traditional Chinese medicine service.For the reason, the paper holds that at present there are three fundamental problems that should be solved.First of all, it must be clear that doctors should have qualifications and conditions to provide TCM service.Secondly, it must be clear that the doctors should have practicing scope to guarantee medical security and medical quality.Thirdly, it is imperative to strengthen TCM education and training for doctors.Now it is necessary to further strengthen the standardization of health supervision and law enforcement.

Percutaneous transforaminal endoscopic TESSYS technique for the treatment of bilateral lumbar disc herniation in single segment / 中国骨伤

OBJECTIVE@#To investigate the early clinical effects of transforaminal endoscopic spine system (TESSYS) for the treatment of bilateral lumbar disc herniation in single segment.@*METHODS@#The clinical data of 38 patients with single-segment bilateral lumbar disc herniation treated by TESSYS technique from February 2016 to February 2018 were retrospectively analyzed. There were 26 males and 12 females, aged from 30 to 55 years old with an average of(35.2±6.4) years, 6 cases of L₃,₄, 22 cases of L₄,₅, and 10 cases of L₅S₁1. Using the intervertebral foramen endoscope produced by Joimax GmbH, Germany, under local anesthesia, bilateral puncture to the outside of the intervertebral foramen of the diseased segment, four-stage dilatation catheter to complete the progressive enlargement of the intervertebral foramen, and the ring saw progressively enlarge the intervertebral foramen. The bilateral foramen was placed and the herniated nucleus was removed until the nerve root was completely released. Postoperatively, the patients were reviewed on regular outpatient visits and telephone follow-ups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were compared before operation and after operation at 1, 3, 6, 12 months respectively. At the final follow-up, according to modified MacNab criteria to evaluate the clinical effect.@*RESULTS@#Thirty-six patients underwent successful surgery and were followed up for more than 12 months. The ODI score and VAS score of the lower extremities pain at 1, 3, 6, 12 months after operation were obviously improved (0.05). At the final follow-up, according to MacNab criteria, 14 cases got excellent results, 16 good, 4 fair, 2 poor.@*CONCLUSIONS@#Using TESSYS technique to remove the bilateral herniated nucleus from single segment can fully decompress for the nerve root, and can be effectively applied to patients with single-segment bilateral lumbar disc herniation.

Detection of respiratory viruses in children with acute lower respiratory tract infection: an analysis of 5,150 children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution of respiratory viruses on throat swabs in hospitalized children with acute lower respiratory tract infection (ALRTI).</p><p><b>METHODS</b>A total of 5,150 children with ALRTI who were admitted to Hebei Children's Hospital between March 2014 and February 2015 were enrolled to investigate the distribution of respiratory viruses in children with ALRTI. Direct immunofluorescence assay was performed for throat swabs from these children to detect influenza virus A (FA), influenza virus B (FB), adenovirus (ADV), respiratory syncytial virus (RSV), and parainfluenza virus types 1, 2, and 3 (PIV-1, PIV-2, and PIV-3).</p><p><b>RESULTS</b>Of all the 5,150 throat swabs from hospitalized children, 2,155 (41.84%) had positive virus detection results. RSV had the highest detection rate (1,338 cases/25.98%), followed by PIV-3 (439 cases/8.52%) and FA (166 cases/3.22%), and 29 patients had mixed infection with 2 viruses. With the increasing age, the detection rates of viruses tended to decrease (χ2=279.623; P<0.01). The positive rate of RSV increased gradually from September, and reached the peak value (60.09%) in November; the lowest positive rate occurred in June (1.51%). The positive rate of PIV-3 was the highest in May (21.38%) and the lowest in November (1.77%).</p><p><b>CONCLUSIONS</b>The distribution of viruses in children with ALRTI varies with age and season, with RSV prevalence in autumn and winter and PIV-3 prevalence in spring and summer. RSV is the most common viral pathogen that causes ALRTI in hospitalized children.</p>

Comparative analysis of conventional pulmonary function test results in children with asthma or cough variant asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the conventional pulmonary function test results of children with asthma or cough variant asthma (CVA).</p><p><b>METHODS</b>A total of 140 children, who were diagnosed with asthma or CVA from May 2010 to May 2011, were divided into acute asthma attack (n=50), asthma remission (n=50) and CVA groups (n=40); 30 healthy children were included as a control group. The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow after 25% of vital capacity has been expelled (FEF25), forced expiratory flow after 50% of vital capacity has been expelled (FEF50), forced expiratory flow after 75% of vital capacity has been expelled (FEF75) and maximal midexpiratory flow (MMEF75/25) were measured.</p><p><b>RESULTS</b>The mean percent predicted values of all the above indices were lower than 80% in the acute asthma attack group, with FEF50, FEF75 and MMEF75/25 declining markedly; the mean percent predicted values of FEF75 and MMEF75/25 were lower than 80% in the CVA group. All the pulmonary function indices in the acute asthma attack group were lower than those in the control group. The mean percent predicted values of FVC, FEV1, FEF25 and MMEF75/25 in the asthma remission and CVA groups were lower than in the control group. All the pulmonary function indices in the acute asthma attack group were lower than in the asthma remission and CVA groups, but there were no significant differences between the asthma remission and CVA groups.</p><p><b>CONCLUSIONS</b>There is small and large airway dysfunction, particularly small airway dysfunction, in children with acute asthma attack. Children with CVA present mainly with mild small airway dysfunction, as do those with asthma in remission.</p>

Epidemiological effects of the A(H1N1)influenza vaccine immunization program on students / 中华流行病学杂志

Objective To evaluate the epidemiological effects of vaccine immunization program related to A(H1N1)influenza in the middle school students.Methods Non-randomized clinical trial was designed to assess the A(H1N1)influenza vaccine on its efficacy.14883 students from 8 middle schools in Zhejiang province were recruited and classified into vaccinated or control groups,based on the status of immunization with A(H1N1)influenza vaccine.All subjects were followed up through one epidemic period(6 months)and the incidence rates of influenza-like illnesses,A(H1N1)influenza,and seasonal influenza in these two groups were compared to evaluate the efficacy of the vaccine.Results There were 6334 subjects in the vaccinated group and 8549 in the control group.7441.75 person-years were followed from these two groups.The incidence rate of A (H1N1)influenza in vaccinated group was 1.64‰ per person-year,lower than that of the control group.The rate difference(RD)was-1.64‰ per person-year(95% confidence interval value from-3.04‰ to-0.23‰ per person-year),and the difference was significant(P=0.010).The incidence rate of influenza-like illnesses in vaccinated group was 21.47‰ per person-year,lower than that of the control group(22.69‰ per person-year)and the diffefence was not significant(P>0.05).The incidence rate of B influenza in vaccinated group was 6.63‰ per person-year,higher than that of control group(7.02‰ per person-year)but the difference was not significant(P>0.05).Conclusion This vaccine demonstrated a good epidemiological effect against the A(H1N1)influenza virus infection,observed through a student-immunization program.The cross-protection effect against the influenza-like illnesses and other seasonal influenzas was not noticed in this study.