The major papilla of Vater is usually located in the second portion of the duodenum, to the posterior medial wall. Sometimes the mouth of the biliary duct is located in other areas. Drainage of the common bile duct in...The major papilla of Vater is usually located in the second portion of the duodenum, to the posterior medial wall. Sometimes the mouth of the biliary duct is located in other areas. Drainage of the common bile duct into the pylorus is extremely rare. A 73-year old man, with a history of duodenal ulcer, was admitted to hospital with the diagnosis of cholangitis. Dilatation of the extrahepatic biliary duct was observed by abdominal ultrasonography, and endoscopic retrograde cholangiopancreatography （ERCP） was performed. No area suggesting the presence of the papilla of Vater was found within the second duodenal portion. Finally the major papilla was located in the theoretical pyloric duct. Cholangiography was performed and choledocholithiasis was found in the biliary tree. The patient underwent dilatation of the papilla with a balloon tyre and removal of a 7 mm stone using a Dormia basket, which solved the problem without further complications. This anomaly increased the difficulty of performing therapeutic interventions during ERCR This alteration in anatomy may increase the risk of complications during papillotomy, with a theoretically higher risk of perforation. Dilatation using a balloon was the chosen therapeutic technique both in our case and in the literature, due to its low rate of complications.展开更多
One of the key challenges in largescale network simulation is the huge computation demand in fine-grained traffic simulation.Apart from using high-performance computing facilities and parallelism techniques,an alterna...One of the key challenges in largescale network simulation is the huge computation demand in fine-grained traffic simulation.Apart from using high-performance computing facilities and parallelism techniques,an alternative is to replace the background traffic by simplified abstract models such as fluid flows.This paper suggests a hybrid modeling approach for background traffic,which combines ON/OFF model with TCP activities.The ON/OFF model is to characterize the application activities,and the ordinary differential equations(ODEs) based on fluid flows is to describe the TCP congestion avoidance functionality.The apparent merits of this approach are(1) to accurately capture the traffic self-similarity at source level,(2) properly reflect the network dynamics,and(3) efficiently decrease the computational complexity.The experimental results show that the approach perfectly makes a proper trade-off between accuracy and complexity in background traffic simulation.展开更多
Objective： To observe the effect of needling different points on functional reconstruction of wrist following cerebral apoplexy. Methods： Forty apoplexy cases were randomly allocated into four groups, 10 in each. Ca...Objective： To observe the effect of needling different points on functional reconstruction of wrist following cerebral apoplexy. Methods： Forty apoplexy cases were randomly allocated into four groups, 10 in each. Cases in group A were treated by needling the extensor muscle motor points. Cases in group B were treated by needling alternating extensor-flexor muscle motor points. Cases in group C were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10） and Waiguan （TE 5）. Cases in group D were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10）, Waiguan （TE 5）, Chize （LU 5） and Neiguan （PC 6）. The motor functions of affected upper limbs were evaluated on the surface electromyography （SEMG）, Fugl-Meyer function scale and Barthel ADL （Activities of Daily Living） indexes. Results： Needling alternating extensor-flexor muscle motor points can significantly increase the peak value （MAX） of the upper limb SEMQ integrated electromyogram （IEMG）, Fugl-Meyer motor function value and Barthel ADL indexes. Conclusion： Needling different points may produce different effects on wrist function following cerebral apoplexy. Needling alternating extensor-flexor muscle motor points can obtain an exact treatment effect.展开更多
Objective： To observe the clinical effect of Governor Vessel-regulating and brain-unblocking acupuncture on post-stroke depression. Methods： A total of 70 eligible cases were randomly allocated into an observation g...Objective： To observe the clinical effect of Governor Vessel-regulating and brain-unblocking acupuncture on post-stroke depression. Methods： A total of 70 eligible cases were randomly allocated into an observation group and a control group according to the random number table. Patients in the observation group were treated with Governor Vessel-regulating and brain-unblocking acupuncture, whereas patients in the control group were treated with oral Escitalopram Oxalate tablet. The treatment lasted for 8 weeks. The Hamilton depression scale （HAMD）, Montgomery Asberg depression rating scale （MADRS）, and Barthel index （BI） were used to evaluate the patients＇ condition before, 4 weeks and 8 weeks after treatment respectively. In addition, adverse reactions were also recorded. Results： After 4 weeks of treatment, the HAMD and MADRS scores were significantly decreased in both groups （P〈0.05）; and the BI scores were significantly increased in both groups （P〈0.05）. There was no between-group statistical difference in HAMD score （P〉0.05）; the MADRS score in the observation group was significantly lower than that in the control group （P〈0.05） and the BI score in the observation group was significantly higher than that in the control group （P〈0.05）. After 8 weeks of treatment, there were no between-group statistical differences in all aspects （P〉0.05）; however, the adverse reactions in the observation group were significantly less than those in the control group. Conclusion： The Governor Vessel-regulating and brain-unblocking acupuncture is safe and effective for post-stroke depression and can obtain similar efficacy as Escitalopram Oxalate tablet. In addition, it can fast alleviate core symptoms of depression and improve the activities of daily living （ADL） and has fewer adverse reactions.展开更多
Objective： To observe the clinical effect of combining acupuncture, Chinese medicine and rehabilitation training for subacute stroke. Methods： A total of 120 subacute stroke cases were randomly allocated into a trea...Objective： To observe the clinical effect of combining acupuncture, Chinese medicine and rehabilitation training for subacute stroke. Methods： A total of 120 subacute stroke cases were randomly allocated into a treatment group （n=60） and a control group （n=60）. Patients in the control group received standard rehabilitation therapy alone, whereas patients in the observation group received additional acupuncture and Chinese medicine. Before treatment, after 30-day and 60-day treatments, and 3 months after treatment, the neurologic deficit severity was evaluated using the National Institute of Health stroke scale （NIHSS）; the motor function was evaluated using the FugI-Meyer assessment scale （FMA）; the activities of daily living {ADL） was evaluated using the Barthel index （BI）; and the changes of traditional Chinese medicine （TCM） symptoms were evaluated according to TCM symptom scores. Results： After 30-day, 60-day treatments, and 3 months after treatment, the NIHSS, FMA, BI and TCM symptoms scores were statistically different from those before treatment in both groups （all P〈0.05）; and there were between-group statistical differences at same time points （all P〈0.05）. Conclusion： Combining acupuncture, Chinese medicine and rehabilitation training can improve neurologic deficit, motor function and ADL in subacute stroke patients and its efficacy is better than rehabilitation therapy alone.展开更多
Objective： To observe the clinical effect of Fu’s subcutaneous needling plus electroacupuncture on post-stroke spastic hemiplegia. Methods： A hundred and twenty patients with post-stroke spastic hemiplegia were div...Objective： To observe the clinical effect of Fu’s subcutaneous needling plus electroacupuncture on post-stroke spastic hemiplegia. Methods： A hundred and twenty patients with post-stroke spastic hemiplegia were divided into the treatment group and the control group randomly, 60 individuals in each group. Patients in the treatment group received Fu’s subcutaneous needling plus electroacupuncture treatments, while only elecroacupuncture treatment for those in the control group. Limbs spasticity, extremity motor function and activity of daily living （ADL） was respectively evaluated with Ashworth scale, simplified Fugl-Meyer motor function score and modified Barthel index （BI） before treatment and after 30-day treatment. Results： After treatment, Ashworth scale score, Fugl-Meyer motor function score and BI score in the treatment group were much higher than those in the control group （P0.05）. Fu’s subcutaneous needling plus electroacupuncture can release spastic hemiplegia, and it is better than the control group. Conclusion： Fu’s subcutaneous needling plus electroacupuncture can release post-stroke spastic hemiplegia effectively.展开更多
文摘The major papilla of Vater is usually located in the second portion of the duodenum, to the posterior medial wall. Sometimes the mouth of the biliary duct is located in other areas. Drainage of the common bile duct into the pylorus is extremely rare. A 73-year old man, with a history of duodenal ulcer, was admitted to hospital with the diagnosis of cholangitis. Dilatation of the extrahepatic biliary duct was observed by abdominal ultrasonography, and endoscopic retrograde cholangiopancreatography （ERCP） was performed. No area suggesting the presence of the papilla of Vater was found within the second duodenal portion. Finally the major papilla was located in the theoretical pyloric duct. Cholangiography was performed and choledocholithiasis was found in the biliary tree. The patient underwent dilatation of the papilla with a balloon tyre and removal of a 7 mm stone using a Dormia basket, which solved the problem without further complications. This anomaly increased the difficulty of performing therapeutic interventions during ERCR This alteration in anatomy may increase the risk of complications during papillotomy, with a theoretically higher risk of perforation. Dilatation using a balloon was the chosen therapeutic technique both in our case and in the literature, due to its low rate of complications.
基金supported by the Science and Technology Project of Zhejiang Province(No. 2014C01051)the National High Technology Development 863 Program of China( No.2015AA011901)
文摘One of the key challenges in largescale network simulation is the huge computation demand in fine-grained traffic simulation.Apart from using high-performance computing facilities and parallelism techniques,an alternative is to replace the background traffic by simplified abstract models such as fluid flows.This paper suggests a hybrid modeling approach for background traffic,which combines ON/OFF model with TCP activities.The ON/OFF model is to characterize the application activities,and the ordinary differential equations(ODEs) based on fluid flows is to describe the TCP congestion avoidance functionality.The apparent merits of this approach are(1) to accurately capture the traffic self-similarity at source level,(2) properly reflect the network dynamics,and(3) efficiently decrease the computational complexity.The experimental results show that the approach perfectly makes a proper trade-off between accuracy and complexity in background traffic simulation.
文摘Objective： To observe the effect of needling different points on functional reconstruction of wrist following cerebral apoplexy. Methods： Forty apoplexy cases were randomly allocated into four groups, 10 in each. Cases in group A were treated by needling the extensor muscle motor points. Cases in group B were treated by needling alternating extensor-flexor muscle motor points. Cases in group C were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10） and Waiguan （TE 5）. Cases in group D were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10）, Waiguan （TE 5）, Chize （LU 5） and Neiguan （PC 6）. The motor functions of affected upper limbs were evaluated on the surface electromyography （SEMG）, Fugl-Meyer function scale and Barthel ADL （Activities of Daily Living） indexes. Results： Needling alternating extensor-flexor muscle motor points can significantly increase the peak value （MAX） of the upper limb SEMQ integrated electromyogram （IEMG）, Fugl-Meyer motor function value and Barthel ADL indexes. Conclusion： Needling different points may produce different effects on wrist function following cerebral apoplexy. Needling alternating extensor-flexor muscle motor points can obtain an exact treatment effect.
基金supported by Project of Hebei Provincial Science and Technology Department(No.14277706D)~~
文摘Objective： To observe the clinical effect of Governor Vessel-regulating and brain-unblocking acupuncture on post-stroke depression. Methods： A total of 70 eligible cases were randomly allocated into an observation group and a control group according to the random number table. Patients in the observation group were treated with Governor Vessel-regulating and brain-unblocking acupuncture, whereas patients in the control group were treated with oral Escitalopram Oxalate tablet. The treatment lasted for 8 weeks. The Hamilton depression scale （HAMD）, Montgomery Asberg depression rating scale （MADRS）, and Barthel index （BI） were used to evaluate the patients＇ condition before, 4 weeks and 8 weeks after treatment respectively. In addition, adverse reactions were also recorded. Results： After 4 weeks of treatment, the HAMD and MADRS scores were significantly decreased in both groups （P〈0.05）; and the BI scores were significantly increased in both groups （P〈0.05）. There was no between-group statistical difference in HAMD score （P〉0.05）; the MADRS score in the observation group was significantly lower than that in the control group （P〈0.05） and the BI score in the observation group was significantly higher than that in the control group （P〈0.05）. After 8 weeks of treatment, there were no between-group statistical differences in all aspects （P〉0.05）; however, the adverse reactions in the observation group were significantly less than those in the control group. Conclusion： The Governor Vessel-regulating and brain-unblocking acupuncture is safe and effective for post-stroke depression and can obtain similar efficacy as Escitalopram Oxalate tablet. In addition, it can fast alleviate core symptoms of depression and improve the activities of daily living （ADL） and has fewer adverse reactions.
基金supported by Zhejiang Key Research Program of Traditional Chinese Medicine for Prevention and Treatment of Major Diseases~~
文摘Objective： To observe the clinical effect of combining acupuncture, Chinese medicine and rehabilitation training for subacute stroke. Methods： A total of 120 subacute stroke cases were randomly allocated into a treatment group （n=60） and a control group （n=60）. Patients in the control group received standard rehabilitation therapy alone, whereas patients in the observation group received additional acupuncture and Chinese medicine. Before treatment, after 30-day and 60-day treatments, and 3 months after treatment, the neurologic deficit severity was evaluated using the National Institute of Health stroke scale （NIHSS）; the motor function was evaluated using the FugI-Meyer assessment scale （FMA）; the activities of daily living {ADL） was evaluated using the Barthel index （BI）; and the changes of traditional Chinese medicine （TCM） symptoms were evaluated according to TCM symptom scores. Results： After 30-day, 60-day treatments, and 3 months after treatment, the NIHSS, FMA, BI and TCM symptoms scores were statistically different from those before treatment in both groups （all P〈0.05）; and there were between-group statistical differences at same time points （all P〈0.05）. Conclusion： Combining acupuncture, Chinese medicine and rehabilitation training can improve neurologic deficit, motor function and ADL in subacute stroke patients and its efficacy is better than rehabilitation therapy alone.
文摘Objective： To observe the clinical effect of Fu’s subcutaneous needling plus electroacupuncture on post-stroke spastic hemiplegia. Methods： A hundred and twenty patients with post-stroke spastic hemiplegia were divided into the treatment group and the control group randomly, 60 individuals in each group. Patients in the treatment group received Fu’s subcutaneous needling plus electroacupuncture treatments, while only elecroacupuncture treatment for those in the control group. Limbs spasticity, extremity motor function and activity of daily living （ADL） was respectively evaluated with Ashworth scale, simplified Fugl-Meyer motor function score and modified Barthel index （BI） before treatment and after 30-day treatment. Results： After treatment, Ashworth scale score, Fugl-Meyer motor function score and BI score in the treatment group were much higher than those in the control group （P0.05）. Fu’s subcutaneous needling plus electroacupuncture can release spastic hemiplegia, and it is better than the control group. Conclusion： Fu’s subcutaneous needling plus electroacupuncture can release post-stroke spastic hemiplegia effectively.
