2012年1月24日星期二

China's Cancer Drug - China

Many of our patients travel to Guangzhou from all over the world for medical treatment and tourism. China medical tourism can help with becoming a patient, travel arrangements and language assistance. If you want to know more about our services, please browse the web:h http://www.medicaltourism.hk/
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Philomina Moniz was given six months to live by Australian doctors. Her bladder cancer had spread into her abdomen, and there seemed no chance of controlling further spread. She heard of the Gendicine treatment in an article on the internet, and traveled to China where she was given an 80% chance of survival. Professor John Rasko admits that, "In cancer medicine it's always important to allow for hope", but he worries that there is still "no compelling evidence" that Gendicine is the miracle cure it is billed as.
The treatment does not come cheap with a full course costing as much as 0,000, and while for some the price of life can never be too high, Rasko worries that not only are people wasting their time, they are also subjecting themselves to "considerable extra suffering" and "unexpected side-effects". Philomena's cancer ultimately proved not to respond to the Gendicine therapy. But she does not regret her trip, "at least I've tried everything in the book" she says. For her, like the hundreds of other patients in the clinic, "seeing people walk out of the clinic cancer free" provided the hope needed to go on fighting this deadly disease.

The famous China Medical tourism website www.medicaltourism.hk

Is Medical Tourism the Future of Healthcare?

Many of our patients travel to Guangzhou from all over the world for medical treatment and tourism. China medical tourism can help with becoming a patient, travel arrangements and language assistance. If you want to know more about our services, please browse the web:h http://www.medicaltourism.hk/
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How far would you go for affordable dentistry work, a hip replacement, or plastic surgery? The high cost of healthcare throughout the world has caused millions of patients to cross international borders to receive healthcare in a growing trend called medical tourism.

China Japan Thailand India Mexico
Even though it's just catching on, medical tourism isn't new. In fact, it's been around hundreds of years. In the past, many patients looking for better quality care would travel to the U.S. or other Western nations for treatment. However today, researchers are finding a reverse trend in medical tourism, where Westerners, particularly Americans, are going oversees to countries like India and Korea for more affordable care.


According to Treatment Abroad, most of the surgeries done overseas are non-emergency or elective procedures. Popular treatments include dentistry work (crowns, veneers), plastic surgery (breast augmentation, liposuction, facelift), and elective surgeries, such as laser eye surgery and hip or knee replacement.


Medical tourists in most cases aren't sacrificing quality for value. For example, Sun Yat-sen University Cancer Center (SYSUCC) in China is a World Health Organization (WHO) Collaborating Center for cancer research. Since 2003, SYSUCC became a sister institution of the University of Texas MD Anderson Cancer Center, SYSUCC gives the hospitals access to cutting edge research. Many hospitals abroad are also certified by the U.S.-based Joint Commission and staff doctors trained in the U.S. or UK.


Deloitte Consulting estimates that 1.6 million Americans will travel abroad to receive medical treatment in 2012. According to KGI Securities, 33 percent of medical tourists are from America, followed by China (29 percent), and Japan (18 percent). Most American patients travel either just across the border to Mexico or fly across the globe to Asian hubs, such as India. Of those American patients, 86 percent said they would travel overseas again for healthcare in a 2009 Medical Tourism Association survey.

There's no denying the value in traveling internationally for a procedure. In the United States an average hip replacement would cost about $43,000. This same procedure in Singapore or Thailand would cost as little as $12,000 and $9,000 in China.

There are, however, risks associated with traveling abroad for medical care. After returning home, patients won't be able to have the same contact with their surgeon, in case of complications or infections. The U.S. government also warns potential medical tourists of the different malpractice laws in each country.

Medical tourism isn't just good business for overseas hospitals, but also for countries' overall tourism industry. The Medical Tourism Association found that in 2009, almost 83 percent of patients traveled with a companion and that 90 percent of patients or companions engaged it tourism-related activities.

The famous China Medical tourism website www.medicaltourism.hk

Concerns Grow Over Medical Tourism in Asia

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One of the fastest growing businesses around the world, particularly in Asia, is medical Tourism.

How fast is medical tourism growing? Dr David Vequist, who heads the Center for Medical Tourism Research in San Antonio, Texas says one medical research organization predicts explosive growth.

“According to Fox and Sullivan, by 2012, it’s expected to be worldwide about a $100-billion business, and it’s growing worldwide from 20 to 30 percent. There was a recent estimate that in Asia alone, it was growing as much as 17 percent," he said.

And Vequist says many of the medical facilities around the world are giving the best medical facilities in the United States a run for their money.

“The Johns Hopkins, the Mayo Clinic, the Texas Medical Center, MD Anderson, Cedar Sinai, these really great facilities in the United States that arguably are among the best in the world are receiving more and more competition from best in class facilities in places like Turkey at Parkway Hospital or Bumrungrad in Thailand or Severance in Korea. These locations around the world are getting very good," he said.

But then there is the down side. Glen Cohen, Co-Director of the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at the Harvard Law School says there is evidence that profitable medical tourism is taking away medical services from the poor in some host countries

“In India, for example, there have been a number of anecdotal claims that the existence of the medical tourism industry has siphoned doctors away from treating poor Indian patients and has basically resulted in a net loss for India’s poor. There are others who say no, it’s quite the opposite, that there is an infusion of technology, there is trickledown economics. Again, it’s a contested empirical claim. But beyond that, there is an ethical claim about whether you’ve done something wrong," he said.

Much of China’s medical tourism industry has focused on organ transplants, reportedly about 10,000 of them a year, mostly kidney and organ transplants. The Chinese government has admitted that some of the organs for transplantation have come from executed prisoners.

Nancy Scheper-Hughes, a professor of medical anthropology at the University of California at Berkley and a co-founder and director of the medical rights organization Organs Watch says many of those have lead to very bad results.

“I am in touch [with] a number of families who have had disastrous transplants in China because it was so unregulated. A family named the McGalkers, in Israel, they were of Indian background, went to China in 2009. It was just a horror show. The father had a botched transplant with a 15 year old village girl. Mr. McGalker died and as a result had to be air shipped out, the young donor died. This is serious business. Not just using executed prisoners but setting up living liver transplants and no regulation," she said.

That has recently changed as China has enacted new regulations surrounding transplants. One proposed law would give the death penalty to anyone found guilty of illegal organ trafficking. However Scheper-Hughes says the entire process brings up troubling consequences.

“It does turn doctors and ministries of health into brokers because you still have to find people and it’s not going to be your children or my children. It’s going to be ethnic minorities, the poor, the desperate, the imprisoned people, the people who are looking for visas, the displaced populations of the world, the refugees," she said.

China is also moving forward on plans to set up and market treatment using stem cell therapy that, for the most part, is unavailable in the United States.

Professor Glenn Cohen of the Harvard law school said, “Many scientists think in the next 50 years or so, many of the breakthroughs in medicine may be related to stem cell therapies. So obviously this is promising and obviously with terminally ill patients who have exhausted all approved therapies or clinical therapies in the U.S., the calculus is quite different in terms of the safety and efficacy. But there are significant risks when you engage in any experimental therapy and stem cells are no different. And I’m not really aware of too many success stories in this regard.”

If you are considering availing yourself of the ever growing medical tourism offerings, Cohen said in addition to ethical concerns, there are at least three concerns that must be addressed.

“One is the quality of service that’s being provided to you abroad. The second concern is that if something does go wrong, what is your ability to recover a medical malpractice by suing the doctors abroad, and the third maybe is the willingness to get a doctor in your home country to engage in follow up care, the availability of health records and what the quality of care will be back home," he said.

Even with all of these concerns, medical tourism continues to expand. Reasons why and some services that are likely to become available, are the subject of the next report.

The famous China Medical tourism website www.medicaltourism.hk

China will be the world leader in stem cell research

Many of our patients travel to Guangzhou from all over the world for medical treatment and tourism. China medical tourism can help with becoming a patient, travel arrangements and language assistance. If you want to know more about our services, please browse the web:h http://www.medicaltourism.hk/
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Stephen Minger is director of the biology laboratory of stem cells of the Wolfson Centre for Age-Related Diseases of King’s College London. He has been pioneer in embryonic stem cell research in the United Kingdom. In 2001 he obtained one of the two first licences that the British Human Fertilisation and Embryology Authority (HFSA) conceded for the derivation of embryonic stem cells. The following year, his group generated the first line of these cells in the United Kingdom, one of the first in the world.

Cristina Jiménez | 24 September 2009

The United Kingdom is one of the most prolific countries in stem cell research.
In the last years there has been a lot of public investment in this field, for both lines of adult and embryonic stem cells. Moreover, the British public generally welcomes this kind of research. The strong collaboration between the different British universities is also important. In London, for example, there is the London Network of Regenerative Medicine and at national level, the UK Stem Cell Network. The United Kingdom has to maintain these investment levels if it wants to remain competitive. China and the United States are investing astronomic quantities and the UK could be left behind.


Does the recent move of Barack Obama to lift the veto on embryonic stem cells influence it?
The decision of Obama is important, but symbolic at large. I am not very optimistic because in the United State there isn´t a coherent scenario in the federal field for the research on embryonic stem cells. Even if a scientist receives federal money from the National Health Institutes, the state can decide if it can be used or not. Therefore many scientists don’t feel too comfortable working with these cells: if the state goes from having liberal politicians to conservative, the researcher can see how his researchers fall flat on their face. Whilst the States have the last word, things will not change too much. And the problem is not due to lack of money, but to the regulation imposed by Bush; they are four to five years behind other more advanced countries. China will soon be the world’s leader in stem cell research.

China?
The quantity of money invested in China is enormous. They have laboratories equipped with the latest technologies and their scientists are very prepared. The laws that regulate the research with embryonic stem cells are similar to those from the United Kingdom, very strict, but generally accepted. From the Buddhist-Confucian perspective, the embryo is not considered a human being until one day after it is born. At King’s College we collaborate with scientists from the University of Zhejiang [Hangzhou], Fudan and Jiao Tong [both in Shanghai] and from the Institute of Biomedicine and Health of Canton.

With the current techniques of cell reprogramming, there are scientists that believe that therapeutic cloning is redundant.
The technology of cell reprogramming is a big step, but it cannot meet all expectations. For this motive it is necessary to research in parallel with conventional embryonic stem cells. The technique is so new that the iPS cells [induced pluripotent stem cells] are not properly characterized. Parallel research consists in cloning the same individual with two types of cells and compare properties and differences. But therapeutic cloning requires a large quantity of ova in order to be able to carry it out. Therefore, Lyle Armstrong, from the University of Newcastle, Justin St John, from Warwick University, and me encouraged a change in legislation at the end of last year; it allows the creation and use of human-animal hybrid embryos.

Something which at the beginning was very critical for British legislation…
It is the test where scientific rationality can omit often religious pressures. The United Kingdom is one of the most advances and progressive countries in the world regarding its legislations on cell therapy, but it is extremely strict.
In order to carry out studies on hybrid embryos one has to ask for its approval, as well as justify why such research cannot be carried out in another way. Also, hybrids cannot be kept alive for more than 14 days, when the embryo starts to develop. In any case, even though the legislation allows it, the team and necessary reagents for this type of research are extremely expensive, and the majority of the projects presented have not managed to get government funding.

Will this situation prolong itself in the future?
Regenerative medicine has a hopeful future, and therapies will be developed with both types of stem cells. Some will consist of injecting stem cells to substitute dead tissue; others will stimulate them from damaged tissue. Methods will be invented to repair tissues, especially those of the brain and heart, and work will be carried out with them to study new drugs, especially to measure their toxicity.

What has your group focused on?
We are interested in Parkinson’s disease and type 1 diabetes. Introducing cells to patients with these disease works; the problem is that there are not sufficient stem cells available for transplant. Our objective is to mange to change defective cells for others that produce dopamine or insulin.

PROGRESS IN TRADITIONAL MEDICINEMinger´s team has recently initiated a very special collaboration with China. With the use of stem cell biology, the scientists from King´s College aim to understand better the chemistry if traditional Chinese medicine to try and convert traditional remedies in future pharmacological products. The objective is to study the active principles in different stem cell types and see how these act.

The investment dedicated to this type of research is necessary not only to unblock the enormous potential of traditional medicine to treat common western disease.

It is also important to protect the public from insecure natural remedies. The complex differences between the western pharmacological products and the natural oriental products present a significant challenge for the development of conventional drugs based on traditional Chinese medicine.

The famous China Medical tourism website www.medicaltourism.hk

2012年1月18日星期三

Sofastin injection needle-knife with the treatment of knee osteoarthritis clinical

Many of our patients travel to Guangzhou from all over the world for medical treatment and tourism. China medical tourism can help with becoming a patient, travel arrangements and language assistance. If you want to know more about our services, please browse the  web: http://www.medicaltourism.hk/
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Knee osteoarthritis (Osteoarthritis, OA) is a chronic joint disease, mainly characterized by degeneration of articular cartilage and inflammatory bone hyperplasia. Common in the elderly, the disease mechanism is currently unknown, most scholars believe that with aging, inflammation and metabolism. With the accelerated aging of our population, the incidence rate increased subsequently, in the middle-aged Chinese are now up to 7.8%, seriously affecting the quality of life of older persons. Although the treatment of OA more, but the effects are not ideal, can not prevent or delay the occurrence of disease and development. To study Sofastin injection needle-knife with the clinical efficacy of OA, the author will be from March 2003 to March 2007 were treated 230 cases of OA were randomly divided into two groups, its effects were compared. Reported as follows.
A clinical data
1.1 General information on the observation group 120 cases, male 42 cases, female 78 cases; aged 43 to 86 years of age; course of disease 7 months to 6 years. Danxi 56 cases, 64 cases of both knees, a total of 184 knee. Kellgren X ray classification: Ⅰ grade 31 knees, Ⅱ grade 86 knees, Ⅲ grade 43 knees, Ⅳ grade 24 knees. Control group, 110 cases, male 35 cases, female 75 cases; aged 45 to 87 years of age; course of 8 months to 6 years. Danxi 43 cases, 62 cases of both knees, a total of 167 knees. Kellgren X ray classification: Ⅰ grade 25 knees, Ⅱ grade 83 knees, Ⅲ grade 39 knees, Ⅳ grade 20 knees. Patients had varying degrees of knee pain, manifested as morning stiffness, pain started moving, after the event reduced, then increased walking activity and rest can be characterized by partial remission. Assessed by VAS pain score of 56 cases of mild, moderate 93 cases, 81 cases of moderate and severe. By knee function score method evaluation, 60 patients with mild activities, barriers, obstacles to the activities of 120 cases of moderate and severe obstacles to the activities of 50 cases.

1.2 diagnostic criteria adopted in 1995 revised American Rheumatism Association diagnostic criteria for OA, ≥ 3 of which would be consistent with these conditions, X-ray confirmed OA performers. OA X-ray film changes according to Kellgren classification method.
1.3 Treatment (1) General treatment:
① acute phase: joint effusion clear who puncture fluid, elastic bandage fixed. General puncture 1 ~ 3 times, and gradually ambulation.
 ② traditional Chinese medicine fumigation: fumigation using self-prepared Chinese medicine, the application of Chinese medicine products Dalian bed fumigation fumigation treatment, 2 times / d, 4 weeks for a course of treatment.
③ Oral: Nuosong tablets 0.4,1 times / d, Kangguzhengsheng films, 4 / time, 3 times / d, 4 weeks for a course of treatment.

(1) needle-knife therapy: patient supine knees, knees pads, pillows, regular elections point after disinfection, the application needle-knife around the right knee patella, suprapatellar bursa, infrapatellar pouch, infrapatellar fat pad, cruciate ligament, intercondylar eminence and , the lateral collateral ligament and biceps femoris, semitendinosus, semimembranosus, iliotibial tract, etc. attached to the point of tenderness and bone hyperplasia Department degeneration, scarring, adhesions and contracture of the soft tissue release and shovels to cut grinding, leveling, etc. The treatment facilities within the surgery. Needle-knife treatment options depending on the specific point of knee localized disease may be more of a one election 8:00, less of a one 3:00, the election mostly 5 to 6 o'clock.

[2] needle-knife treatment of postoperative external means, ie prior to flat direction of the patellofemoral joint surface pushed by the upper and lower left patella, do not push to the rear, loosen patellofemoral adhesions, and then the passive knee flexion and extension, loosen tibial-femoral joint adhesion.

(3) intra-articular injection: The Sofastin (sodium hyaluronate injection) 2ml intra-articular injection, 1 times / week, were injected four times.
(4) treatment options: observation group were treated with the general treatment, needle-knife therapy combined with intra-articular injections of Sofastin the control group using the general treatment, both after treatment effects were evaluated after 3 months.
1.4 Efficacy in VAS pain score assessed pain intensity before and after treatment changes: O into painless, 1 ~ 3 were divided into mild, 4 to 6 is divided into moderate, 7 to 9 pm was severe, 10 were divided into severe pain. More down the stairs, squatting activities, assessment of knee joint function; O sub-normal, a sub-mild, 2 points moderate, 3 severe, 4 points loss of function.
1.5 Statistical analysis measurement data in order to (x ± s), said the use of statistical data analysis and processing SPSS10.0 statistical software.
2 Results
Treatment of a course of treatment in both groups, at the end of treatment within a specified time after the follow-up, according to the VAS pain score assessed before and after treatment efficacy, the results shown in Table 1,2, the two groups after treatment in patients with joint pain were alleviated knee joint function of the observation group improved significantly better than the control group. The two groups were not related complications occurred. Table 1 the two groups before and after treatment VAS pain score comparison table two groups before and after treatment of knee joint function score comparison (Note: △ before and after treatment P <0.01, ▲ after treatment the two groups P <0.01.

3 Discussion
 Knee osteoarthritis (OA) is due to degeneration of articular cartilage and joint synovitis characterized by the transformation of intra-articular lesions. Knee osteoarthritis is a cartilage degeneration, destruction, joint surface, the edge of reactive hyperplasia, osteophytes arising from the formation of secondary inflammatory synovium, joint capsule and soft tissue pathologic changes to joint pain and dysfunction of The main clinical manifestations. With the onset hiding, slow progress, while the prevalence rate increased with age characterized by the elderly of the common and frequently-occurring disease.

Clinically, with joint swelling, pain, stiffness, limited mobility, muscle atrophy, joint distortion characterized. Late medial joint space narrowing, often a result of extensive cartilage destruction flexion deformity. Synovial membrane and joint support structure surrounding proliferative changes were accompanied by chronic damage to the tissues around joints, in tissue repair occurs when the ligaments, muscle and bone between the adhesion.
The formation of local scarring, adhesions, muscle disuse atrophy. There authors found that there is arthritis, the muscles around the trigger point (TrP), the point EMG testing (EMG) activity, especially the inner thigh muscle tension Office. TrP through treatment can effectively eliminate EMG changes.
Needle-knife therapy can be used directly on the patella and the joint space to conduct cutting-week, sneak lysis patellar weeks tendons, ligaments, bursa and other soft tissue scar adhesions, contracture, destruction TrP, improve blood circulation, and soft tissue adhesion, the elimination of nerve endings to stimulate to improve blood circulation and the lifting of reflex muscle spasm, soft tissue to restore knee movement coordination, effectively regulate the balance between structural mechanics around the knee to enhance knee stability, while the needle through the needle-knife effect, and clear the meridians, to reconcile qi and blood, to "General does not hurt," the purpose [2]. YU Jie et al [3] that the needle-knife therapy can gradually restore joint kinetics of dynamic balance, mitigate and alleviate the friction knee injury, relieve pain, swelling, promote the function of the knee to recover. Combination of intra-articular injection of polymers, high-viscosity elastic Sofastin (glass sodium injection), can effectively improve the unit - tibial and femoral - patellar articular and synovial tissues between the coefficient of friction joints to reduce wear and eliminate inflammation.

The famous China Medical tourism website http://www.medicaltourism.hk/

'Catfish effect' theory in the needle-knife treatment of frozen shoulder

Many of our patients travel to Guangzhou from all over the world for medical treatment and tourism. China medical tourism can help with becoming a patient, travel arrangements and language assistance. If you want to know more about our services, please browse the  web: http://www.medicaltourism.hk/
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will 'catfish effect' philosophy applied to needle-knife therapy for frozen shoulder. Protest lysis beak ligament is a needle-knife treatment of frozen shoulder brachial important part.
[Keywords:] scapulohumeral periarthritis; needle-knife therapy; Catfish Effect
Frozen shoulder frozen shoulder is a common type, commonly referred to as frozen shoulder, more likely than referring to the frozen shoulder. Frozen shoulder with rapid onset, severe pain, shoulder muscle protective spasm, caused by the activities of limited shoulder. The acute phase generally lasted 2 to 3 weeks after the chronic phase to enter.

1 'catfish effect' theory in the use of frozen shoulder treatment
Needle-knife therapy is currently in the efficacy of conservative treatment of frozen shoulder sure that a shorter course of treatment, patients more acceptable method of treatment. Treatment typically begins with the needle-knife to find the most obvious point of tenderness, but a lot of history longer or more severe in patients with adhesions are often not very clear, tender points, the chief complaint often only 'pain in the shoulder and upper arm are not out of pain, but the inside pain, hard to explain specifically what point, shoulder limited activity '. At this time we will be based on clinical experience, for the first time prior to the brachial beak ligament, coracoid Department, supraspinatus arrived only side gang under the teres minor muscle and the arrival only for the treatment of end-point, the general election 2 to 3 points, rostral brachial ligament which must be selected for the point, because it is the author use the word 'catfish effect' of the catfish.

2 treatment
 Patient sitting or lateral position, the skin has fully exposed the ipsilateral shoulder, gentian violet points, or experience pain in the sensitive treatment of fixed points, local disinfection, shop-hole towel, mixed imitation Stejneger's solution (2% lidocaine 5ml, vitamin B122mg, indeed triamcinolone acetonide 20mg, normal saline 10ml), half of mixture into the shoulder joint cavity, and the other half of mixture were injected into each treatment point, the medical Shi pressurized piercing needle-knife technique, needle-knife to reach lesions after incision with dissection or vertical line to clear the stripping method, peel 3 ~ 5-pin, when the needle under the pine needles out of dynamism, when the last band-aid deposited cover.

7d treatment every 1, 3 ~ 5 times for a course of treatment, most patients can be fundamental cure for a course of treatment. The vast majority of patients after the first needle-knife therapy after consciously ipsilateral Jianbi pain better, suffering from shoulder and activity improved. The most important is that the patient was separated 7d hospital for the second treatment can be very clearly pointed out that often the most obvious point of tenderness, pain points, these points with needle-knife as a treatment for lysis, supported by appropriate means traction pull stretch rotation in order to restore the activity of the shoulder joint. Are often subject to a second needle knife, after lysis, the patient will be significant improvement in symptoms, suffering from shoulder activity also improved significantly. Later according to the severity of illness, need a ~ 3 times a needle knife loosen, leak fill a vacancy, the consolidation of efficacy, a course of treatment usually no more than 5 times.
3 experience
Author in clinical profoundly aware that lysis beak ligament is a needle-knife treatment of frozen shoulder brachial important part. Brachial beak ligament is a tough fiber bundles, affixed to the top of the shoulder joint capsule, starting at the outer edge of the Ministry of coracoid process level, down through the supraspinatus and the subscapularis muscle between its fibers to the joint capsule and with the large, small nodules between the transverse humeral ligament connects the proximal fiber spin out when the tension, there are bound shoulder external rotation role. Humeral adduction internal rotation when the beak ligament and joint capsule of brachial beak squeezed in between the gap, resulting in varying degrees of compression shocks and friction, combined with multi-axis position of the shoulder joint activities so that the organization of chronic wear and tear of rotator cuff, shoulder bag degeneration, leading to shoulder around the muscles, ligaments adhesion, particularly adhesion rostral brachial ligament shortening, in varying degrees, the activities of limited shoulder.

Therefore, treatment of frozen shoulder contracture should first be denatured lysis beak to beak brachial brachial ligament gap increases. Needle-knife operation in the coracoid process to clear the lateral longitudinal spin-off, if the beak ligament degeneration of brachial sclerosis, needle under which there is a clear sense of resistance, this time knife-edge lines can be turned 90 degrees, so that the blade with the beak ligament fibers perpendicular to the brachial, top-down followed by cutting, rampant shovel stripping, needle under the loose change is better. Reason refractory frozen shoulder, in fact, because the disease more than the Department of bursa lesions, lesions involving the glenohumeral joint articular capsule, subacromial, or deltoid, the long head biceps tendon bursa, etc.. Early lesions of bursa hyperemia, edema and exudation synovial cavity adhesions post-lockout, fiber-like change. Shoulder pain affected the early events involved in the above inter-organizational development of fibrosis and scar further restrict the activities of the shoulder.
This vicious cycle, causing an objective to extend the course of the disease, adding to the suffering of patients, while the extension of course, exercise pain, short-term cure in patients with remote has led to subjective doctors were unwilling to cooperate actively in functional training, thus greatly reducing the In the hospital physical therapy and oral anti-inflammatory analgesic efficacy, a further blow to the confidence of patients, leading to further vicious circle. Lysis beak as if the entire brachial ligament treatment of frozen shoulder into a 'catfish', after this 'catfish' stimulus, making up the entire treatment interaction, treatment improved the symptoms, functional exercises makes it possible through functional exercises make deep surface of the lesion and the surface adhesion points, giving the direction of the medical treatment, by further treatment, but also to further improve the symptoms and activity.

The famous China Medical tourism website http://www.medicaltourism.hk/

Traditional Chinese Medicine Treatment of osteoarthritis of the knee Overview

Many of our patients travel to Guangzhou from all over the world for medical treatment and tourism. China medical tourism can help with becoming a patient, travel arrangements and language assistance. If you want to know more about our services, please browse the  web: http://www.medicaltourism.hk/
or mail to us: giels-x@medicaltourism.hk,firstcare-china@hotmail.com

osteoArthritis of the knee is a common disease of the elderly, and frequently-occurring disease has seriously affected the daily lives of the elderly and work with high morbidity and disability. Articular cArtilage in the early stages of a primary or secondary degenerative changes, and accompanied by subchondral bone destruction and bone hyperplasia, so that the gradual destruction of joints and produce deformities. The disease affects not only the whole process of Articular cArtilage, but also meniscus, subchondral bone, ligament, joint capsule, synovial membrane around the muscles and joints. Traditional Chinese Medicine in the treatment of osteoarthritis of the knee has its unique clinical efficacy, treatment methods, including Traditional Chinese Medicine taken orally, for external use, acupuncture, massage and so on.
[Keywords:] Knee Osteoarthritis Knee osteoarthritis of Chinese Medicine
Osteoarthritis (Osteoarthritis, OA) also known as bone and joint disease, degenerative joint disease, hypertrophic arthritis, age-related arthritis is a common to joint pain, swelling, stiffness and deformity characterized by bone and joint disease. Joints osteoarthritis can occur, especially the knee, it has been reported in the literature about the incidence rate of 41% of patients with osteoarthritis. Our country is entering an aging society, and thus the incidence of elderly OA also showed a rising trend year by year, joint pain and disability in the elderly the main reasons [1].
A Traditional Chinese Medicine Oral Therapy
Chinese medicine, osteoarthritis of the knee is Arthralgia, bone Bi category, multi-due to liver and kidney deficiency, bones and muscles lose support, and blood shortage, easy to damage caused by the body and feel the wind cold dampness evil and disease, is a false standard of the virtual card , the treatment can be roughly divided into replenishing liver and kidney, gluten Zhuanggu, promoting blood circulation Qufengchushi, temperature by-pass network, such as governance is nourishing Qi. Yao Shu-Yuen et al [2] The Biqi Capsule (Darren Tang Pharmaceutical Factory, Tianjin Development) in treatment of 94 patients with knee osteoarthritis, efficiency of 98.87%. Zhao Lin et al [3] The Mustard Seed Powder (White Mustard Seed, Eupolyphaga insects, pangolins, safflower, etc.) in the treatment of knee osteoarthritis in 90 cases, with a total effective rate was 86.7%. Lu Jian Guo et al [4] with Bu Shen Huo Xue Prescription (health Astragalus, puerarin, epimedium, Ligustrum lucidum, Dodder, Clematis, Bupleurum, Forsythia, Cyathula, red sage root, Eucommia, Dipsacus, etc.) in the treatment 165 cases of knee osteoarthritis, with a total effective rate 93%. CHENG Yu-to, etc. [5] with the compound Tongbi capsules (Angelica sinensis, ephedra, the herb, Radix Paeoniae Alba, Cortex Moutan, Cyathula, red sage root, Cyperus rotundus, turmeric, Poria, Plantago, papaya, money nosed pit viper, Eupolyphaga insects, Strychnos, Scorpio, Eucommia ulmoides, Phellodendron, Chuanwu, epimedium, Loranthaceae, Atractylodes, Clematis, Rehmannia glutinosa, etc.) in the treatment of 300 cases of knee osteoarthritis, with a total effective rate 92%. Wang Chunqiu, etc. [6] with the self-made Gubi Tung Wan (Rehmannia glutinosa, white peony root, Cistanche, Drynaria, deer rank grass, epimedium, Clematis, Gentiana, Eucommia, Millettia, Radish Seed, Gui branches, Lindera aggregata, licorice, etc.) treatment of 92 patients with knee osteoarthritis, with a total effective rate 94.5%, one-year follow-up cases were cured without recurrence. Bear across the sea, etc. [7] using self-made knee-Bi Shu Tong drink (Epimedium, Rehmannia glutinosa, Chinese wolfberry, Eucommia, Cyathula, Drynaria, astragalus, Chinese angelica, Millettia, Agkistrodon, system gall Southern Star, white peony root , licorice, etc.) Syndrome addition and subtraction and in line with Angelica injection point injection (get ipsilateral Yanglingquan, hanging bell, Ashi points, etc.) treatment of 30 patients with knee osteoarthritis, with a total effective rate 96.7%. Yuan-Lin Chen et al [8] using self-made Bu Shen Huo Xue Fang (Rehmannia glutinosa, Chinese angelica, Chuanxiong, Achyranthes bidentata, Millettia, psoralen, Epimedium, Eucommia, Dipsacus, red peony, Chinese angelica, Gentiana, etc.) in the treatment 49 patients with knee osteoarthritis, with a total effective rate was 93.9%. Gu Qian et al [9] used DUHUOJISHENG soup (independent living, Loranthaceae, Eucommia, Cyathula, Asarum, Gentiana, Poria, cinnamon, wind, Chuanxiong, Codonopsis, Chinese angelica, peony root, Rehmannia glutinosa, licorice, etc.) in the treatment 60 patients with knee osteoarthritis, with a total effective rate was 93.3%, obviously superior to western medicine control group.

2 Chinese Herbs Therapy
External include Traditional Chinese Medicine Fumigation heat or outside the front and Chinese medicine treatments such as iontophoresis. Feng Guojun et al [10] using self-made blood circulation Shujin lotion (raw rhubarb, Speranskia tuberculata, Lycopodium clavatum, Millettia, Sanleng, Drynaria, Cyathula, turmeric, pangolins, Clematis, Chinese angelica, Gui, salt, etc.) after the first heat or fumigation treatment of 150 cases of knee osteoarthritis, excellent rate of 91.9%. Xu two equal [11] The Gubi paste (Pleurotus eryngii, kaempferol, clove, cinnamon, borneol, etc., plus EE into the plaster) Sticking the lesion, treatment, 78 patients with knee osteoarthritis, with a total effective rate 97.44%.

3 Acupuncture Massage Therapy
Zhang Xianwen, etc. [12] the use of small needle-knife aspect of pain points dredge, shovel cut, cutting, in order to loosen adhesion, and clear the meridians, results were satisfactory. Deng et al [13] using manual massage [including acupuncture (take too River, Xie River, foot three years, wind city, ring jump, red door, bearing mountain, Venezuela, Cheng Fu, etc. Point), loose tendons, shaking knees, reduction and other methods] treated 60 patients with knee osteoarthritis, with a total effective rate was 90.00%.

4 Comprehensive Therapy
Zhangxian Yong et al [14] herbal infusion (raw Chuanwu, the health and Aconitum, raw Pinellia, downtown flower sheep, raw gall Southern Star, the health and Strychnos, snow-capped mountains an Artemisia, safflower, Menispermaceae, turmeric, Sanleng, Zedoary, soil Fuling, etc.) and add wet compress to cut out infrared radiation, soft tissue techniques to relax the knee, point by point and pain flexion and extension, ring shake knee (flexion and extension without severe swelling, ring shake knee), and knee with Danshen injection Point (knee eyes, Venezuela, Albania is a hole) injection and knee functional training methods such as treatment of 350 cases of knee osteoarthritis, with a total effective rate 96.6%, cured patients were followed up for more than one year without recurrence. YANG Meng-Lin et al [15] with Chinese Herbs (single live, Loranthaceae, Cyathula, angelica, peony root, Gentiana, papaya Zaocys, frankincense, myrrh, cinnamon, licorice, etc.) and the dregs for external knee and acupuncture (extracted from inside and outside the knee eye, knee-Yang Guan, Yang Ling-chuen, Hong Leong, sea of blood, Zusanli, etc.) in the treatment of knee osteoarthritis 164 cases, with a total effective rate 98.8%. Water Qi Cai et al [16] with the joint puncture (those with joint effusion) and Traditional Chinese Medicine Fumigation (Cyathula officinalis, single live, Gentiana, Pittosporum skin, Lycopodium clavatum, Speranskia tuberculata, turmeric, frankincense, myrrh, safflower, Artemsia argyi, cassia twig, etc.), combined with manual massage and non-weight-bearing knee flexion and extension functions such as training on their own (Tong Shen Mei Luo Xikang of oral capsules, 7.5 mg, day 1) in the treatment of knee osteoarthritis in 126 cases (157 knees ), the total effective rate was 98.7%. Husheng Ping et al [17] to health knee Decoction (Millettia, deer rank grass, Lycopodium clavatum, Speranskia tuberculata, Clematis, Geranium, Cyathula, papaya, Drynaria, Passepartout, etc. ) and the outer wash (the remaining dregs into the daily bag, the release pot add water 1500 mL, heat 20 min boiling, add a small amount of rice wine, while hot Fumigation knee until the temperature when it is appropriate for drug bags placed in hot-iron knee) and with the local massage and functional exercise (including strength training exercises and joint activities) in the treatment of knee osteoarthritis in 53 cases, with a total effective rate was 92.5%.

5 Conclusion
Primary osteoarthritis of the knee lesion was degeneration of articular cartilage and secondary osteoarthritis [18]. Chinese medicine, the incidence of this disease with liver and kidney deficiency, bones and muscles lose support, and blood and injury and feelings of lack of wind cold dampness and other related evil. Chinese medicine treatment can be adjusted from the overall function, replenishing liver and kidney, gluten Zhuanggu, promoting blood circulation, from the outside for the local symptoms Shujin Tongluo, temperature after cold-dispelling dehumidification, rousing played a total of tackling the problem of the Gong embodies the traditional Chinese medicine 'Jane, then, inexpensive and inspection' principle. But there are TCM, such as lack of uniform standards for diagnosis and treatment of evaluation criteria and other issues.


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Report of 15 cases of axillary nerve injury

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To explore the axillary nerve injury and efficacy of conservative treatment. Methods: 15 cases of axillary nerve injury were treated with drugs, acupuncture, enhance muscle strength and psychological rehabilitation methods such as treatment and diagnostic use of TCM Syndrome Clinical assessment of efficacy evaluation criteria. Results: The cure in 13 cases, improved in 2 cases. Conclusion: The use of acupuncture, physiotherapy, rehabilitation and comprehensive treatment methods such as the precise effect of axillary nerve injury.
[Keywords:] acupuncture and physiotherapy rehabilitation of axillary nerve injury inflammation of water neural activation
June 2008 ~ September, the author to physical therapy, acupuncture, small needle-knife and psychological treatment of axillary nerve injury in 15 cases, satisfactory effect, the report is as follows.
A clinical data
1.1 General information on this group, 15 cases were male, aged 30 to 55 years. Multi-pairs of upper limbs due to a sudden force on the move, or prolonged compression, tension pulled muscle contraction emerged axillary nerve injury in shoulder pain, loss of shoulder abduction, followed by shoulder muscle atrophy.

1.2 The main symptoms of upper limb outreach difficulties, external rotation weakness, deltoid muscle atrophy, loss of shoulder plump shape, deltoid area skin and sensory disturbances. Anterior and lateral shoulder pain, but pain location positioning is not clear; limb abduction, external rotation places the maintenance of 1 min, can induce pain and symptoms; electromyography see the axillary nerve injury, MRI examination can be found teres minor atrophy .
Two treatment
 2.1 reduce the local inflammation edema, promote nerve regeneration using microwave, infrared, low-IF electrotherapy and other physical therapy; neurotrophic factor, vitamin microcirculation and other drug treatment.

2.2 analgesic painkillers treatment of blood circulation, or to take quadrilateral hole closed treatment.
 2.3 to activate nerve Acupoint: Shoulder three needles, A is the point; distribution points: Qu Chi, Hegu. Electroacupuncture.
2.4 to enhance muscle strength in the 3 below can be used neuromuscular electrical stimulation treatment of paralysis of the muscles, passive movement, active movement help slow muscle atrophy and increase muscle strength. Strength up to three more, resistance exercises should be carried out. In order to prevent the bottom of humeral head dislocation, shoulder harnesses are available.
 2.5 Prevention of soft tissue contracture and joint stiffness of limb muscle massage, passive movement of joints; ultrasound, thermal therapy, intermediate frequency electrotherapy and other physical therapy can be anti-inflammatory swelling, loosen adhesion; if contracture has occurred, should be carried out joint mobilization, passive traction, physiotherapy and other treatment.
2.6 Treatment of swelling of the muscles after nerve injury lost motor function, but also lost the role of upper limb venous compression return, especially if the limbs are drooping position, flexion contracture, when the axillary scar contracture, prone to swelling. Treatment can be used shoulder straps, bandage hanging limbs, active and passive activities, massage, pay attention to suspension time can not be too long, otherwise the lack of activity due to increased upper extremity edema, remove the sling several times a day should be exercise.
2.7 psychological treatment for axillary nerve injury, the loss of most of the side of the limb function, affect people's work and life, coupled with slow recovery, course length, so that patients have anxiety, therefore, should prepare the patient's ideological work; to encourage patients to establish disease-fighting confidence.
2.8 small needle-knife therapy on the treatment effect is not obvious in the use of small needle-knife-line four sides Conson solution technique.
3 Clinical Standards and the results of Healing: shoulder joint function recovery, muscle strength returned to normal; improved: shoulder joint function recovery, partial restoration of muscle strength; healed: Symptoms not improved. Results: 15 patients were cured in 13 cases, improved in 2 cases.

4 Summary
After axillary brachial plexus nerve bundle from the bottom, mainly composed by the C5 nerve root. Axillary nerve injury, such as four-sided hole in the extrusion more prolonged, intense muscle contraction pulling axillary nerve injury. Treatment in order to restore nerve function Xiaozhongzhitong principles, use of physiotherapy, electric acupuncture, needle knife loosen as the main way to increase muscle strength with exercise therapy, rehabilitation shoulder motor function, the effect is satisfactory. There is also a result of cervical plexus neuritis that is caused by viral infection axillary nerve injury, the acute phase should first anti-inflammatory anti-viral therapy. Acute axillary nerve injury recovery, according to 'Clinical Pain' records, the required 15 d ~ 3 months, the individual cases require 6 months, therefore, should adhere to treatment [1  3].


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Needle-knife and traction with the orthopedic treatment of cervicogenic

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To explore the needle-knife and traction with the orthopedic treatment of cervicogenic headache clinical efficacy and mechanism. Methods 36 cases of cervicogenic headache patients after the use of needle knife loosen the soft tissue and then with the occipital bone-setting governance practices and cervical spinal traction to relieve the oppression and cervical nerve stimulation. Results of 36 cases of cervicogenic headache patients cured 32 cases (88.89%), improved in 3 cases (8.33%), ineffective in 1 (2.78%), the total effective rate 97.22%. Conclusion needle-knife and traction with the orthopedic treatment of cervicogenic headache effect is significant.
Keywords: needle-knife; orthopedic; traction; cervicogenic headache
The cause of many headaches for clinical multiple common diseases. Most patients have neck tenderness, this with the cervical nerve irritation related to their headaches for a long time the high incidence, clinical manifestations complex, more difficult to treat. Most scholars believe that the majority of degenerative changes with cervical spine and cervical dislocation, and muscle spasms related to named cervicogenic headache, I used needle knife after lysis pillow soft tissue tenderness point, and with the bone-setting rule and cervical traction to treat cervical spinal source headache, 36 cases of significant effect.
1 Data and methods
1.1 General Information of this group of 36 patients, male 12 cases, female 24 cases; age of 12 to 63 years, mean 37.2 years old; duration of the longest 23 years and the shortest half a month, an average of 6 years.
1.2 Clinical manifestations and diagnosis of
 1.2.1 In early clinical manifestations of occipital, suboccipital Department, ears back, the lower part there is ear discomfort. After the gradual expansion into nausea and acid pain, pain location can be expanded to the neck, top of the forehead, temporal region. Some can be accompanied by ipsilateral shoulder, back, upper limb pain. Pain can have remission. As the illness progresses, and slowly increase the persistence, remission shortened episodes increased. Fatigue, agitation, coughing, drinking, cold and weather changes can trigger the pain increased.

1.2.2 Diagnostic criteria based on pain location and performance, eliminate swelling
Tumor, traumatic brain injury sequelae, tuberculosis, chronic subdural hematoma, paranasal sinuses and periodontal diseases such as organic, and meet the following four characteristics:
(1) from head and neck movements or posture problems, headache, excitation;
(2) push aggravate or cause headache and neck with "comfortable pain";
(3) headache radiation to the neck and the ipsilateral shoulder and upper extremity.
(4), headache, occipital, suboccipital discomfort, as well as the performance of cervical spondylosis.

1.3 Treatment
1.3.1 Needle-knife lysis in the treatment of patients treated with prone position in bed, in patients with chest pad a thin pillow, and placed in the treatment of bed, bedside treatment of patients with head out, so that the head forward 45 ° ~ 60 ° or so. In the upper and lower entry line, C2 spinous process and transverse ligament items to find tender points, marking with gentian violet, sterile surgical field prepared skin under local anesthesia, shop towel, after hole No. 4 with the Han Zhang needle-knife, the knife-edge lines and points vertical axis parallel to the spine, straight into the direct bone surface, slightly raised needle-knife, longitudinal cutting, there is no breakthrough feel-stop, to pine for the degrees, so you can cut Mito can be vertical and horizontal swing. After swinging shovels should be affixed to bone surface transverse cut, left and right click, and then press out the pin. 3 ~ 6 points each so a week, an times, three times for a course of treatment.

1.3.2 Bone-setting rule whether there is cervical spinal dislocation according to the patients and, if misplaced persons, OK needle knife to loosen after cervical spinal orthopedic reset rule.
Based methods in patients with cervical dislocation for the corresponding ridge of bone-setting rule tactics. Such as the occipital ring, atlantoaxial joint dislocation who make upward, and shaking Dhamma: The patient supine, low pillow, a Satisfy their lower jaw, another Satisfy occipital, will be on his head Yang, tilt, slowly shaking a ~ 2, the relaxation in patients with head, it will first go to the most significant time, with limited wrist quick moment "flash power" to the cephalic Dayton pull.
 If the level of side tilting left cervical dislocation were for cervical lateral pull by the entire complex method: The patient supine, operator stand bedside, one hand Hold hold his neck and to the thumb side elevated risk of vertebral transverse Department, Another Satisfy his jaw and affixed his cheek with a forearm, both hands cooperation will be the first traction in patients with head and evolute to the contralateral to the affected side after the bend, when to impose the maximum angle of the affected side, the thumb "sentinel" not to relax, with the "fixed point "At the same time to make a move one hand by a slight joint" flash power ", the thumb can touch the whole sense of re-bounce, and multi-joint joint shells could be heard the sound. Such as the rotary cervical dislocation, the entire complex is being pushed for cervical spine: The patient supine, low pillow, to the left cervical correction, for example, the operator squat in patients with cephalic left-rear, two-handed thumb-index finger open, respectively, in patients placed on both sides of cheek, the index finger and the face parallel to the fixed index finger after the thumb, and the other three fingers to hold back the skull and facial Wang Youce patients to the appropriate angle so that patients in a non-neck muscle stiffness as a degree, this time, right below the left In the left hand thumb between the first 1,2 withhold suffering from intervertebral joints of the articular process, his right hand to his head on the patient care to the moderate point of view, and the hand-over, start with within the band way to move forward, upward 45 ° c. the implementation of the entire complex correction.
1.3.3 line needle knife loosen after cervical traction, no cervical dislocation, that is to make continuous supine cervical traction therapy; a cervical dislocation, he shall rule the way orthopedic spinal reset, before making the continuous supine cervical traction therapy, traction supine forward position angle of about 20 ° ~ 40 °, pulling the weight of the individual patient weight and the patient feels comfortable as the basis, ranging from 5 ~ 15kg force day one times, each 30min.
2 Results
2.1 The efficacy of the standard is not valid: patients with symptoms and signs with no change in pre-treatment; valid: to alleviate symptoms, there are clear incentives pillow when you still have pain and tenderness; healing: patient symptoms and signs disappeared completely.

 2.2 The results of 36 patients treated by 1 ~ 3 times after treatment, recovered 32 cases, accounting for 88.89%, effective in 3 cases, accounting for 8.33%; ineffective one cases, accounting for 2.78%. The total effective rate 97.22%. Recovered after 6 months follow-up cases, in addition to three cases of patients with occasional discomfort, the rest had no recurrence.
3 Discussion
1995 BOGDUK that cervicogenic headache is the direct cause of cervical degenerative changes, and muscle spasms. He believes that cervicogenic headache can be called cervical dorsal rami-derived pain. Its pathogenesis [1] may be involved according to the different parts of nerve root is divided into neuropathic pain and muscle-derived pain.

Sensory nerve root irritation caused by the root fibers of neuropathic pain, while the ventral motor nerve root irritation is caused when the muscle-derived pain. C1 ~ 3, after most of the nerves leaving the spinal canal through the soft muscle tissue. Degeneration in the cervical spine and cervical dislocation, based on the dynamic equilibrium of cervical disorders, foraminal stenosis and intervertebral disc space narrowing. If the pillow back of the soft tissue inflammation, ischemia, spasm and chronic injuries and so on, can be stimulating and (or) pressure caused cervical dorsal rami of cervical pain.
Needle knife loosen the upper and lower entry line, spinous process, transverse process, nuchal ligament attached to the soft tissue, etc., while to peel adhesion, scar curettage, loosen muscles, lifting spasm, blocking clear, the role of blood flow . Pillow soft tissue to restore the dynamic balance after the effective lifting of soft tissue spasm, ischemia and inflammation, can be lifted after cervical nerve branch stimulation and oppression, and ultimately achieving the purpose of lifting of cervical pain.
It should be noted in the needle-knife operation, familiar with the local anatomical structure, the operation should be careful, gentle, in the upper and lower lines between the items into the needle, needle-knife and the skull surface perpendicular to knife-edge parallel with the blood vessels and nerves.
Transverse process and spinous process in the Ministry of therapy, a knife could not leave the bone surface, carefully moving blade to prevent injury in the spinal cord, blood vessels and nerves. Governance practices with the correction of spinal bone-setting because of dislocation and bone mechanical Citation nerve pain, bone-setting reset mode when you need to distinguish between cervical dislocation, targeted the main ridge of the different methods, is the key to effective operation, aiming at steady, accurate, Qiao, way to avoid iatrogenic injury caused by improper. Needle-knife release and orthopedic Across The main purpose of cervical traction tension of skeletal muscle tension or spasm, and play a role in braking, and can increase the intervertebral space and expanded the role of the intervertebral foramen to relieve mechanical oppression, to restore cervical homeostasis.

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Tendon sheath was injected with a small knife treatment of flexor tendon

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To observe the flexor tendon sheath of flexor tendon sheath was injected with a small knife inside the injection plus tenosynovitis of flexor tendon therapy clinical therapy. Methods 83 patients with flexor tendon tenosynovitis clinic patients were randomly divided into two groups, A groups: control group 41 cases, the use of tendon sheath injection therapy. B group: 42 patients observed within the tendon sheath injection plus with a small knife therapy. The results A, B Observation of two groups: 15 patients were cured (36.59%) and 35 (83.33% ), effective for the 32 cases, respectively (78.05%) and 41 cases (97.62%), cure rate and efficiency of B group was significantly higher than that of A group (P <0.05); ineffective were 9 cases (21.95%) and 1 cases (2.38%), recurrence rates of 14 patients (34.15%) and 2 cases (4.76%), relapse rate and inefficiency of group B was significantly lower than A (P <0.05). Conclusion injection plus small knife sheath Treatment of tendon sheath injection therapy than clinical grading of more than grade ?? tenosynovitis of flexor tendon high efficacy, and less recurrence.
[Keywords:] tenosynovitis; tendon sheath injection; small knife
Finger flexor tendon tenosynovitis (Tenosynovitis of hand fLexor tendons), also known as "trigger finger" or "snapping means," to the metacarpophalangeal joints pain and snapping the main symptoms. The disease can occur at different ages, more common in housewives and manual workers. Any finger may occur, but more common in the thumb, middle finger and ring finger, is the impact of common clinical pain in the fingers of disease activity. tendon sheath injection usually non-surgical treatment, non-surgical treatment failure if surgery is required to narrow fibrous tendon sheath tendon sheath incision line partial resection of cartilage rings. I subjects with tendon sheath injection needle-knife therapy plus high efficacy tenosynovitis of flexor tendon, and less recurrence, are as follows.
1 Clinical data
1.1 General information on this group were selected from October 2004 to December 2006 during treatment for the disease and the degree of clinical grade ?? [1] (metacarpal bone risk refers to the local pain, tenderness and mild swelling, tenderness palpable induration, friction sensitivity occurs, occasionally snapping) or more of the 83 patients. male 23, female 56 cases, aged 18 to 83 years, mean 50 years of age, duration of two weeks to 3 years, an average of 5 months. which means a single thumb incidence of 71 cases, mean incidence of 2 cases of a single index finger, ring finger means the incidence of 1 case of single, double thumb while incidence of 9 cases. The patients were randomly divided into two groups, A groups: control group 41 cases, the use of tendon sheath injection therapy. B Group: Observation 42 patients with tendon sheath injection plus small knife therapy. two groups in gender, age, disease duration, disease severity (clinical classification) terms were no significant differences.
degree of clinical classification: risk refers to the palm of local bone pain, tenderness and mild swelling.
 degree: In addition to grade
symptoms, tender points can be touched sclerosis, friction sensitivity occurs, occasionally snapping.
degree: frequent snapping , occasionally interlocking symptoms.
degree: frequent symptoms of locking.

1.2 after treatment in patients with burglary, natural stretch palm up fingers, flat on the treatment table. Routine disinfection shop towels, to risk his hand palm side of the hard nodules at the bone for the needle position, the anti-inflammatory analgesic solution (dexamethasone palmitate 4mg + Vitamin B650mg + Vitamin B120.5mg +2% lidocaine 3mL dubbed 6mL) 2mL into the tendon sheath, the injection means the patient feels pain and to suffer from finger radiation, while distal pulp swelling, skin gray, proved drugs are injected into flexor tendon sheath. posted at the injection site after injection of benzalkonium chloride paste. 1 week, 1 to 2 times as a course of treatment, risk refers to the brake as much as possible, rest for 1 week.
Add a small knife inside the tendon sheath injection therapy such as injection of the tendon sheath tendon sheath injection therapy first, the last remaining anti-inflammatory analgesic solution 0.5mL side back side of injection needles, to the subcutaneous finished. Be patient injection site pain was gone, with 4 small the skin at the injection point of the vertical knife needle, knife-edge parallel to the vertical line and the cut strip of flexor tendon, lateral goes, if it should be cut release sclerosis, back knife to skin, instruct patient suffering from active flexion and extension means. If still a snapping and locking, repeat the above operation until the risk refers to the flexion and extension freely, without snapping and locking. refers to excessive dorsiflexion risk of surgery to stop bleeding, knife mouth in the benzalkonium chloride paste. instruct patient on the tiger's mouth to stop bleeding 5min, the next day began to suffer from that often do flexion and extension exercises. 1 week, 1 to 2 times as a course of treatment.
1.3 to assess the clinical efficacy is divided into three:
cure: risk refers to the pain, tenderness disappeared, so easily, without snapping and locking;
 improvement: risk refers to the pain, tenderness, reduced activity was normal fingers, snapping and locking minor ;
invalid: risk refers to the pain, tenderness, snapping and locking as before or increased.

1.4 Statistical Methods The statistical software SPSS 11.5 for statistical analysis, line ??2 test, P <0.05 was considered statistically significant.
Links to Research Papers Download http://www.hi138.com
2 Results
All patients were in the treatment of a course of 2 weeks after the statistical treatment, followed up for six months. In the follow-up period, the cured or improved in symptoms and functional levels back to pre-treatment than before treatment, or no obvious improvement in symptoms and function for the recurrence; collectively referred to as an effective cure and improvement. A, B Observation of clinical treatment groups shown in Table 1. which is not found to be infected B group of cases, complications such as bowstring sign. Table 1 Comparative clinical efficacy
3 Discussion
Tenosynovitis of finger flexor tendon in the metacarpal bone disease sites corresponding to the song refers to the beginning of the tendon sheath fiber department. Here by a thick fibrous sheath with the ring metacarpal bone fibrous form a relatively narrow tube. Refers to the song through this tendon by mechanical stimulation at leaving when the friction increase, coupled with the uplift of parts of the palm bones, hands holding things, the tendon sheath by a hard object with the palm squeeze both bone damage, and gradually form a narrow ring [2]. pathogenesis of early as the flexor tube through the fibrous tendon strain arising from the friction of aseptic inflammation, congestion and edema.
 in possession of advanced fibrous thickening gradually harden to form a narrow ring, flexor tendon is also deformed, or gourd-shaped spindle-shaped swelling, causing the tendon through the difficulties, suffering from disorders that range of motion, pain, snapping and locking symptoms. early patient sheath corticosteroid injection drugs, can reduce local inflammation and edema, to prevent progression to reach the purpose of healing. But in the late within the tendon sheath in patients with simple injections of glucocorticoid anti-inflammatory drugs can reduce swelling, relieve symptoms and can not lift the flexor tendon sheath stenosis and enlargement of the root causes of proliferation, poor efficacy, not multiple injections, further treatment will need surgery. conventional surgery treatment is to narrow sheath incision, partial resection of fibrous tubes [3], but the trauma and postoperative prone to tendon adhesions, affecting long-term effect.
and add a small knife sheath injection therapy to avoid the shortcomings of both , in line with minimally invasive, high efficacy of the principle of a small knife can be narrow and deformation of the swollen tendon sheath longitudinal incision decompression, lysis of adhesions, reduction of the tendon sheath on the oppression and friction, in order to address its root causes Therefore, the higher efficacy. Therefore, the cure rate and efficiency of B group was significantly higher than that of A group (P <0.05), which is consistent with the conclusions of other scholars. [4] note the following treatment to improve efficacy and reduce complications:
tendon sheath injection treatment, the drugs should be accurately injected into the tendon sheath;
small knife cut the release of tendon sheath should be appropriate to snapping and locking symptoms disappear prevail, to avoid bad effect or cause symptoms bowstring;
 times after treatment risk refers to the functional exercise date.


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Needle-knife technique with 68 patients with lumbar disc herniation

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Referred to as lumbar disc herniation herniation is common disease. I clinic from July 2008 ~ June 2009, using a small knife Zhu gap in the lumbar spine lesions, the lateral recess, intertransverse ligament at the release, and with manual therapy to relieve nerve compression, improve microcirculation and eliminate aseptic inflammation of the nerve stimulation. The clinical observation of 68 cases, results were satisfactory, are as follows.
Materials and Methods
1. General Information of this group 36 males and 32 females, aged 23 to 76 years; which L4 ~ L530 cases, L5 ~ S124 patients, L3 ~ L42 cases, L4 ~ L5 and L5 ~ S18 cases, L3 ~ L4 and L4 ~ L52 cases. side of a square of 50 cases, 18 cases of central type; course of 30 days to 21 years.

2. Diagnosis and exclusion criteria used <<cure disease diagnosis based on improved standards>> [1] based on the diagnosis of lumbar disc herniation: ?? often history of trauma or back pain;
 low back pain to one side or both sides of radiation to the leg or lower limb lateral dorsal, activity increase, reduce bed; straight leg raising test was positive, weak thumb dorsiflexion;

 imaging: CT or MRI examination revealed the site of lumbar disc herniation (segments) and the degree of image in all cases data of consistent diagnostic criteria for lumbar herniation. and exclude the following cases:
spondylolisthesis, fractures, tuberculosis, tumors were;
non-those great prominence;
prominent nucleus were no severe calcification and ossification;
those without cauda equina injury ;
not associated with severe spinal canal stenosis.

3. Treatment
(1) needle knife surgery: Patients were prone position, the abdomen below the belly button pad for a small pillow height of about 20 cm. Skin routine disinfection, the skin entry point to 1% lidocaine for local anesthesia, four-step by knife Practice into the knife. In the ipsilateral side of the square for treatment, the treatments on both sides of the central type.
release interspinous ligament: Knife in the lesions of the middle segment of interspinous through the skin, ligaments ridge between direct spinal ligament , exploration, and a spinous process on the edge of the bone surface, close to the bone surface between the ridges 3 to 4 blade ligament release.
release the lateral recess: Knife in the lesion segment near the midline between the spinous process to open 0.5 1 cm at, through the skin, subcutaneous, erector spinae direct lamina, close to the bone for the medial lamina deep knife blade cut 3 to 4.
release intertransverse ligament: in the lesions on a segment midline spinous process tip is to open at 2.5 ~ 3.5 cm, the needle-knife puncture of transverse bone surface, bone surface in the transverse incision of the lower edge of peel intertransverse ligament.
knife surgery, pinhole 1 acupressure 3 minutes, when the pins without bleeding to Band-Aid covering pins.
(2) manual therapy: needle knife of surgery, according to the following methods to do manual therapy to patients.
led by the shaking means: take the patient prone position, two hands, head of the bed. Surgery patient who grabbed the two legs, forced the patient back led by the shaking, repeatedly shaking led by 3 to 5 times.
 lift by means: the patient prone, ipsilateral knee flexion 90 angle (central side bending). intraoperative overlapping of hands, right hand on the patient lumbar hypothenar interstitial lesions on the lower spinous process, a helper stand on the bed, grasp the patient ipsilateral leg (two legs grasping central), patients affected side (central to both sides) from the anterior superior iliac spine to mention 1 bed 3 cm, the surgeon suddenly Press firmly with both hands, anterior superior iliac spine when the patient reaches the bed, the assistant to the patient on the bed legs. After the repeat 15 to 20 times above the action.
oblique wrench method: Patient side, the affected side in the last, for the surgeon, contralateral limb extension, hip flexion knee lower limb. surgery for patients who single-handedly push the shoulders back elbow, and the other elbow, pull the Ministry of hip forward, both hands At the same time a sudden force, only once.

4. Evaluation standard recovery: low back pain disappeared, straight leg raising 80 ?? above the waist back to normal activities, to participate in the work. Markedly: significantly reduced low back pain, straight leg raising and lumbar function improved working and living without effects. Effective: low back pain reduced, straight leg raising, lumbar functional activities improved. invalid: no change or worsening symptoms and signs.
5. Treatment Results After six months follow-up, cured 57 patients (83.8%) were cured, 8 cases (11.8%), improved in 2 cases (2.9%), 1 patient (1.5%), the total effective rate was 98.5%.
Discussion
Principles of treatment of lumbar herniation is not the highlight of the disc tissue degeneration and recovery in situ, but to change the disc tissue and the relative position of the nerve root compression, to reduce or lift the nerve root, nerve root adhesions loosen and eliminate the nerve root inflammation, and thus relieve the symptoms [2]. Xieke Gong et al [3] treatment of lumbar intervertebral disc extrusion with spinal stenosis, surgery is only part of the yellow ligament and the vertebral bone, does not deal with herniated disc nucleus, as can low back pain or disappearance of symptoms, also confirmed that this treatment of lumbar herniation principle.

Scalpel lysis closed the gap by cutting off part of lumbar spine disease, the lateral recess at the yellow ligament, intertransverse ligament, nerve root transfer for the creation of loose traction conditions, the lifting of the nerve root compression, remove the cause disease factors, re-balance of biological forces, and the surgical removal of herniated disc nucleus [4] compared to a similar effect, but the knife closed release the cost of much lower risk than surgical removal. knife surgery , with slight shaking, carried by, oblique wrench method, so that the residual lesion can be further loosen adhesions, lift the nerve root compression. after the lesion proper rest help organizations speed up the absorption of aseptic inflammation, elimination of the chemical nature of nerve root irritation. The method for lumbar herniation, with good efficacy, low cost, adaptability and superiority, is the ideal treatment of lumbar herniation therapies.

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2012年1月12日星期四

Needle knife of cervical vertigo patients of vertebral artery blood flow velocity

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More by cervical vertigo cervical vertebral Artery (Cervical Spondylosis of Vertebral Artery type, CSA) caused greater pain to the sufferers, and many clinical drug therapy can not cure, and often long-term adverse drug reactions. In recent years, I applied needle knife Treatment CSA 40 cases, while the use of Doppler ultrasound before and after treatment of vertebral Artery blood flow velocity changes, provide a scientific basis for clinical. are reported below.
1 Clinical data
1.1 General information
CSA were observed in 80 cases for the June 2006 -2009 on June physiotherapy treatment at our hospital were randomly divided into 2 groups of 40 cases. Acupuncture control group, 11 males and 29 females, age 20 65 years, mean 51 years, the shortest duration of 3 d, up to 10 years, with an average of 1.2 years. knife treatment group 13 males and 27 females, aged 18 to 64 years, mean 50 years, the shortest duration of 2 d, most 9 years longer on average 1.3 years .2 group sex, age, duration and other general information on the difference was not statistically significant (P> 0.05), comparable.

1.2 Diagnostic criteria
Reference 1992 National Symposium of cervical spondylosis of vertebral Artery type of cervical proposed diagnostic criteria for disease [1]:
① dizziness, visual rotation as the main performance,
② neck rotation test was positive,
③ X-ray showed intervertebral joint instability or proliferation of Luschka joints,
④ symptoms associated with sympathetic,
⑤ exclude endogenous eye, ear vertigo.

1.3 Inclusion criteria
① age of 18 to 65 years,
② the number of vertigo in more than 2,
③ vertigo attack lasted more than 7 d, or medication can not relieve itself ineffective.

1.4 Exclusion criteria
①Pregnancy or breast-feeding women
② combined cardiovascular, liver, kidney, hematopoietic system in patients with severe primary disease and mental illness,
③ eye origin, patients with otogenic vertigo,
④ who occasionally occur 1 vertigo,
⑤ do not meet the inclusion standards, not follow regulations for examination or treatment, or incomplete information.

2 Methods
2.1 Treatment
2.1.1 knife treatment group
Patients were sitting or prone position. Palpation according to the image and the positive point of the body surface with precise positioning, routine disinfection, local anesthesia, drape after the treatments. Uses a type IV needle knife, knife-edge line along the longitudinal axis of the body at the point piercing pressure. in the lesions to the joint capsule segment joints probe cross cut line, and then put knife to muscle, fascia release the number of longitudinal cutting knife, the knife turned the knife rampage release number. fascia, such as ring pillow hypertrophy in the pillow off the assembly line tenderness point vertical and horizontal release several knives.

These are the next release to the knife when the knife was no significant resistance, hemostasis, the wound with a Band-Aid paste. knife after the end of treatment, the patient supine position, the first doctor to sit in the patients before single-handedly put back of the neck, the thumb to withstand the transverse tilt skew the other hand placed on the side of cheek and jaw in patients with head turned to the contralateral, his hands after a few seconds of cervical traction , push the thumb to exert suppress the transverse process transverse process, you can feel the "clicks" Reset sound, that the wrong skew reduction of cervical spine joint segments, the role of the stretch, the lesion segment and further to release adhesions. 3 d treatment of 1, 3 times for a course of treatment efficacy after 2 courses of Statistics.
2.1.2 acupuncture group
Acupoints: the wind pool (both sides), neck Jiaji (both sides). Patients prone sitting position, each hole through the wind pool, the tip facing the opposite direction of the wind pool of acupuncture, according to the patients body, can penetrate 50 75 mm, acupuncture Jiaji, the tip slightly obliquely to the direction of the spine, piercing the 20 ~ 40 mm, applied twisting reducing method. all point the needle 30 min, 1 day acupuncture, continuous treatment of 10 to 1 a course of treatment efficacy after 2 courses of Statistics.

2.2 Observation Method
Doppler ultrasonography of carotid-type instrument for the HP 21000, HP 25500 type, transducer frequency 7.5 MHz. By the ultrasound physicians, the patients were fasting quiet supine position or left lateral position, the vertebral artery imaging in a clear, place the probe treatment of vertebral artery blood flow parameters before and after the detection of vertebral artery. Measurement of vertebral artery blood flow velocity, diameter, vertebral artery observed the shape, size, whether there is a narrow, walk the line is bent, twisted, and whether the wall thickening, echo is enhanced intima have plaque formation.

2.3 Clinical Standards
Reference to the State Pharmaceutical Administration promulgated in 1994 <<TCM Syndrome Diagnostic efficacy of the standard>> [2], by healing, effective, better and invalid assessed.

2.4 Statistical Methods
All data were statistically treated by .2 SPSS11.5 software group compared with the χ2 test efficacy differences, compared with a t test measurement data.

3 results (see Table 1, Table 2)
Table 1, group 2 patients with cervical vertigo treatment of vertebral artery blood flow parameters before and after comparison, Table 2, group 2 patients with cervical vertigo Clinical Comparison of (slightly.

4 Discussion
Cervical vertebral artery is the main mechanism: the vertebral soft tissue injury caused by acute or chronic aseptic inflammation, tissue between the scar and adhesions and contracture, stimulation, compression through them the blood vessels, nerves and caused the other hand, adhesions, contracture of the vertebral soft tissue can be attached to the vertebral traction force of the imbalance, leading to a total or partial cervical vertebrae resulting from the displacement of small bone and joint displacement, the stress on various parts of vertebral body corresponding changes occur in the human body under the action of self-compensatory mechanisms lead to the occurrence of bone hyperplasia, hyperplasia of bone around the neck pressure will stimulate the nerves, blood vessels, produce a series of cervical spinal cord and the clinical symptoms.

knife treatment of lesions in the accurate positioning, based on the chronic injury The soft tissue release, and clear and peel, and tips for X-ray anatomy of the small bone and joint pathology, with a unique way Acupotomology be corrected. We believe that it is this imbalance of cervical stress improvement eliminate or reduce the vertebral artery oppression, pull, twist and other stimuli, so that the vertebral artery hemodynamics improved. coupled with our use of supine positioning rotating Pulling pulling so wrong joints Luschka joints, facet joints easily reset and restore the normal sequence of cervical vertebral artery pressure to lift the brain to smooth the natural blood supply, thereby reducing or eliminating the dizziness, headache, neck discomfort symptoms.
Doppler ultrasonography revealed blood flow in patients with needle knife treatment parameters significantly improved significantly faster vertebral artery, vertebral artery diameter increased cross-section. Tip needle knife therapy can relieve spasm state, increasing lesions of the blood supply, promote local congestion, edema subsided, eliminating aseptic inflammation, so as to achieve a good therapeutic effect.

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