In spite of the fact that the Hippocrates method hardly has been evaluated in a scientific manner and numerous associated iatrogenic complications have been reported, this method remains to be one of the most common t...In spite of the fact that the Hippocrates method hardly has been evaluated in a scientific manner and numerous associated iatrogenic complications have been reported, this method remains to be one of the most common techniques for reducing anterior shoulder dislocations. We report the case of a 69-year-old farmer under coumarin anticoagulant therapy who sustained acute first time anterior dislocation of his dominant right shoulder. By using the Hippocrates method with the patient under general anaesthesia, the brachial vein was injured and an increasing hematoma subsequently caused brachial plexus paresis by pressure. After surgery for decompression and vascular suturing, symptoms declined rapidly, but brachial plexus paresis still was not fully reversible after 3 mo of follow-up. The hazardousness of using the Hippocrates method can be explained by traction on the outstretched arm with force of the operator's body weight, direct trauma to the axillary region by the physician's heel, and the topographic relations of neurovascular structures and the dislocated humeral head. As there is a variety of alternative reduction techniques which have been evalu-ated scientifically and proofed to be safe, we strongly caution against the use of the Hippocrates method as a first line technique for reducing anterior shoulder dislocations, especially in elder patients with fragile vessels or under anticoagulant therapy, and recommend the scapular manipulation technique or the Milch technique, for example, as a first choice.展开更多
Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining...Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining 46 patients were treated with hot fomentation and bed rest only （control group）. After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng＇s Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root.展开更多
One of the main obstacles limiting the performance of protonic ceramic fuel cells(PCFCs) is the sluggish kinetics of the oxygen reduction reaction(ORR) at reduced temperatures.Here,the surface manipulation of a triple...One of the main obstacles limiting the performance of protonic ceramic fuel cells(PCFCs) is the sluggish kinetics of the oxygen reduction reaction(ORR) at reduced temperatures.Here,the surface manipulation of a triple-conducting cathode BaCe_(0.5)Pr_(0.3)Y_(0.2)O_(3-δ)(BCPY) by an efficient catalyst coating PrNi_(0.5)Co_(0.5)O_(3-δ)(PNC) to enhance the ORR activity and CO_(2) tolerance is reported.The developed PNC-coated BCPY cathode achieves the polarization resistance of 0.25 and 1.00 Ω cm^(2) at 600 and 500 ℃,respectively,approximately 1/5 of that for the pristine BCPY cathode(0.99 and 4.79 Ω cm^(2)),while maintaining an excellent CO_(2) tolerance.The single cell on a BaZr_(0.8)Yb_(0.2)O_(3-δ) electrolyte also exhibits a high peak power density of 0.79 W cm^(-2)at 700 ℃ and a stable operation for 200 h at 600 ℃.Such high ORR activity is mainly attributed to the synergistic effect of BCPY support and PNC nanoparticles.Namely,BCPY provides a tripleconducting path(mainly protons),and PNC nanoparticles facilitates surface oxygen exchange and steam adsorption/desorption processes due to the enriched surface oxygen vacancies.This study will provide a new design strategy for developing high-performance PCFCs cathode.展开更多
文摘In spite of the fact that the Hippocrates method hardly has been evaluated in a scientific manner and numerous associated iatrogenic complications have been reported, this method remains to be one of the most common techniques for reducing anterior shoulder dislocations. We report the case of a 69-year-old farmer under coumarin anticoagulant therapy who sustained acute first time anterior dislocation of his dominant right shoulder. By using the Hippocrates method with the patient under general anaesthesia, the brachial vein was injured and an increasing hematoma subsequently caused brachial plexus paresis by pressure. After surgery for decompression and vascular suturing, symptoms declined rapidly, but brachial plexus paresis still was not fully reversible after 3 mo of follow-up. The hazardousness of using the Hippocrates method can be explained by traction on the outstretched arm with force of the operator's body weight, direct trauma to the axillary region by the physician's heel, and the topographic relations of neurovascular structures and the dislocated humeral head. As there is a variety of alternative reduction techniques which have been evalu-ated scientifically and proofed to be safe, we strongly caution against the use of the Hippocrates method as a first line technique for reducing anterior shoulder dislocations, especially in elder patients with fragile vessels or under anticoagulant therapy, and recommend the scapular manipulation technique or the Milch technique, for example, as a first choice.
基金supported by grants from the Key Topics of China Traditional Chinese Medicine Scientific Research Project,General Logistics Department of Chinese PLA,No.10ZYZ125the Army Medical Science and Technology the125Scientific Research Projects,Chinese PLA,No.AKJ11J004
文摘Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining 46 patients were treated with hot fomentation and bed rest only （control group）. After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng＇s Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root.
基金partially based on results obtained from projects, Development of Ultra-High Efficiency Protonic Ceramic Fuel Cell Devices, WP1 Development of Innovative High-Performance Electrodes, JPNP20003, commissioned by the New Energy and Industrial Technology Development Organization (NEDO)supported by Grant-in-Aid for Japan Society for the Promotion of Science (JSPS) Postdoctoral Fellowships for Research in Japan (JP21F20736)。
文摘One of the main obstacles limiting the performance of protonic ceramic fuel cells(PCFCs) is the sluggish kinetics of the oxygen reduction reaction(ORR) at reduced temperatures.Here,the surface manipulation of a triple-conducting cathode BaCe_(0.5)Pr_(0.3)Y_(0.2)O_(3-δ)(BCPY) by an efficient catalyst coating PrNi_(0.5)Co_(0.5)O_(3-δ)(PNC) to enhance the ORR activity and CO_(2) tolerance is reported.The developed PNC-coated BCPY cathode achieves the polarization resistance of 0.25 and 1.00 Ω cm^(2) at 600 and 500 ℃,respectively,approximately 1/5 of that for the pristine BCPY cathode(0.99 and 4.79 Ω cm^(2)),while maintaining an excellent CO_(2) tolerance.The single cell on a BaZr_(0.8)Yb_(0.2)O_(3-δ) electrolyte also exhibits a high peak power density of 0.79 W cm^(-2)at 700 ℃ and a stable operation for 200 h at 600 ℃.Such high ORR activity is mainly attributed to the synergistic effect of BCPY support and PNC nanoparticles.Namely,BCPY provides a tripleconducting path(mainly protons),and PNC nanoparticles facilitates surface oxygen exchange and steam adsorption/desorption processes due to the enriched surface oxygen vacancies.This study will provide a new design strategy for developing high-performance PCFCs cathode.
