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Objective:To summarize literature of risk prediction models for catheter-related thrombosis in PICC at home and abroad, in order to provide reference for the development and improvement of risk prediction models for PICC catheter-related thrombosis (PICC-CRT) and the selection and use of medical staff.Methods:All studies on the risk prediction model of PICC-CRT were systematically searched in the Chinese and English literature database from June 2012 to June 2022. Two researchers independently screened the literature and extracted the data. The prediction model risk of bias assessment tool was used to evaluate the bias risk and applicability of the included literature.Results:A total of 13 articles were included, including 1 multicenter study and 12 single-center studies. Eight literatures were retrospective studies and five were prospective studies. Bias risk assessment showed that there was a bias risk in all the 6 studies. In terms of applicability evaluation, the 13 studies had good applicability in all fields and overall.Conclusions:There were various types of PICC catheter-related thrombosis risk assessment models, which had good predictive efficiency, but there was also a high risk of bias in these studies. The important contents of PICC catheter-related thrombosis risk prediction model are patient factors and treatment factors. In the future, the existing models need to be validated and improved, or a prediction model with low risk of bias should be constructed to effectively prevent PICC-CRT.
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Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is an extremely rare, indolent skin malignancy that can be difficult to distinguish from autoimmune disease-associated panniculitides. Here, we describe a 12-year-old boy who was diagnosed at age 7 years with dermatomyositis with classical manifestations, including poikiloderma, Gottron’s sign, and symmetric muscle weakness. Recently, the boy presented multiple subcutaneous nodules and fever. Histopathological examination and immunohistochemical staining revealed coexistence of SPTL. To our knowledge, this is the first case of dermatomyositis accompanied with SPTL. This case alert clinical physicians of the possibility of SPTL should be considered when a patient with dermatomyositis has new lesions presenting as nodules and unknown fever.
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Objective By observing the effect of deeply needling Lianquan (CV23) plus acupuncture at the ten nape points on the deglutition function in post-stroke pseudobulbar palsy, to objectively evaluate the efficacy of deeply needling Lianquanplus acupuncture at the ten nape points in treating post-stroke pseudobulbar palsy.Method A total of 141 patients diagnosed with post-stroke pseudobulbar palsy were divided into a treatment group (71 cases) and a control group (70 cases) by following asimple-randomized design (random number table). The treatment group was intervened by deeply needling Lianquan plus acupuncture at the ten nape points, while the control group was intervened by conventional acupuncture. A month later, the general therapeutic efficacy, Kubota's water drinking test, Toshima Ichiro's swallowing assessment, and Standardized Swallowing Assessment (SSA) were evaluated, and the therapeutic efficacies of the two groups were compared.Result The general therapeutic efficacy, waterdrinking test result, Toshima Ichiro's swallowing assessment, and SSA score were significantly improved in both groups after the treatment (P<0.05). After the treatment, the general therapeutic efficacy, water drinking test result, Toshima Ichiro's swallowing assessment, and SSA score in the treatment group were significantly different from those in the control group (P<0.05), and the treatmentwas superior to the control group. The total effective rate was 91.5% in the treatment group, versus 70.0% in the control group, and the between-group difference was statistically significant (P<0.05).Conclusion Deeply needling Lianquan plus acupunctureat the ten nape points is effective in treating post-stroke pseudobulbar palsy, superior to the conventional needling method.
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Objective To investigate the effects of nephroblastoma over-expressed protein (CCN3) on the formation of extracellular matrix (ECM) induced by transforming growth factor-β1 (TGF-β1) in human mesangial cells (HMCs) and its underlying signal transduction mechanism related with microRNA-29(miRNA-29).Methods HMCs were pretreated with different doses of exogenous CCN3 (5 μg/L,50 μg/L and 500 μg/L) or transfected with pcDNA3.1(+)-CCN3 before exposed to TGF-β1(2 μg/L),to observe the expression of fibronectin (FN),type I collagen (COL I) and miRNA-29a,b and c.The mimics or inhibitor of the miRNA-29a were transfected into HMCs to analyze whether miRNA-29a affect CCN3.The expressions of FN mRNA,COL I mRNA and miRNA-29 family were detected by real time PCR.The protein expressions of FN and COL I were detected by Western blotting and cell immunofluorescence.Results (1) Compared with the normal control group,the expressions of FN and COL I were up-regulated in TGF-β1 group,while the expressions of miRNA-29a,b,c were down-regulated in TGF-β1 group (all P ＜ 0.05).(2) Compared with the TGF-β1 group,the expressions of FN and COL I were decreased when pretreated with the different doses of exogenous of CCN3 or transfected with pcDNA3.1(+)-CCN3 (all P ＜ 0.05).Meanwhile,the expression of miRNA-29a was significantly increased when pretreated with 50 μg/L and 500 μg/L CCN3 or transfected with pcDNA3.1(+)-CCN3 (all P ＜ 0.05);whereas miRNA-29b and c had no statistical difference (all P ＞ 0.05).(3) Compared with TGF-β1+CCN3 group,the expressions of FN and COL I were decreased in CCN3+TGF-β1+miRNA-29a mimics group (all P ＜ 0.05),whereas the expressions of FN and COL I in CCN3+TGF-β1+miRNA-29a inhibitors group were increased (all P ＜ 0.05).Conclusions CCN3 reduces the TGF-β1-induced production of ECM by the up-regulation of miRNA-29a.
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Objective:To observe the effect of acupuncture on gastric motility, plasma motilin and serum gastrin in patients with diabetic gastroparesis (DGP) and evaluate its clinical efficacy. Methods:A total of 100 eligible cases were randomly allocated into an acupuncture group (n=50) and a control group (n=50). Patients in the acupuncture group were treated by needling Zhongwan (CV 12), Zusanli (ST 36) and Neiguan (PC 6), whereas patients in the control group were treated with oral administration of Domperidone. The clinical efficacies of the two groups were compared; and changes in gastric motility, plasma motilin and serum gastrin in both groups were observed before and after treatment. Results:After treatment, the symptom scores, gastric motility and contents of plasma motilin and serum gastrin were significantly improved in both groups (P Conclusion:Acupuncture is effective for DGP and can reduce the levels of plasma motilin and serum gastrin.
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Objective To observe the therapeutic efficacy and action mechanism of muscle-region alignment electroacupuncture in treating post-stroke shoulder pain. Method Eighty patients were randomized into a muscle-region alignment needling group and a conventional acupuncture group. The Short-form McGill Pain Questionnaire (SF-MPQ), and serum levels of IL-6, TNF-?, and NO were majorly observed before and after the treatment. Result The muscle-region alignment electroacupuncture and conventional acupuncture both obviously reduced the SF-MPQ score and down-regulated the serum levels of IL-6, TNF-?, and NO, and the decreases by the muscle-region alignment electroacupuncture were more significant than that by the conventional acupuncture. Conclusion The action of muscle-region alignment electroacupuncture in treating post-stroke shoulder pain is plausibly by down-regulating serum levels of IL-6, TNF-?, and NO, reducing or inhibiting the production of inflammatory factors and restraining inflammation.
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ObjectiveTo investigate the clinical efficacy of electrothermic acupuncture in treating knee osteoarthritis.Method One hundred and twenty patients were randomly allocated to treatment and control groups, 60 cases each. The treatment group received electrothermic acupuncture and the control group took Xianlinggubao capsules orally. The clinical therapeutic effects and changes in the WOMAC score were observed in the two groups after four weeks of treatment.ResultThe total efficacy rate was 95% in the treatment group and 85% in the control group. There was a statistically significant difference in clinical therapeutic effect between the two groups (P<0.05). There was a statistically significant difference in pre-/post-treatment WOMAC score difference value between the two groups (P<0.05).ConclusionThe clinical efficacy of electrothermic acupuncture is better than that of Xianlinggubao capsules in treating knee osteoarthritis with yang deficiency and cold congealment.
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Objective To investigate the efficacy of wrist three-needle acupuncture in treating pre-adhesive stage scapulohumeral periarthritis. Method Seventy-eight patients with pre-adhesive stage scapulohumeral periarthritis were randomly allocated to two groups. The treatment group of 39 patients received wrist three-needle acupuncture and the control group of 39 patients, conventional acupuncture. Result After one course of treatment, the cure rate and the total efficacy rate were significantly higher in the treatment group than in the control group and there was a statistically significant difference (P<0.05). There was a statistically significant pre-/post-treatment difference in the VAS score in the treatment group (P<0.05). There was a statistically significant difference in the pre-/post-treatment difference value between the treatment and control groups (P<0.05). Post-treatment pain relief rate was significantly higher in the treatment group than in the control group (P<0.05). Conclusion Wrist three-needle acupuncture is even more effective than conventional acupuncture in treating pre-adhesive stage scapulohumeral periarthritis.
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BACKGROUND:Articular cartilage injury is often complicated by subchondral bone damage to form osteochondral defects, and its treatment remains a pressing problem in orthopedics. Osteochondral composite grafts fabricated by tissue engineering technology provide a new way to repair osteochondral defects. OBJECTIVE:To explore the feasibility of fabricating osteochondral composite grafts in an independently designed double-chamber stirring bioreactor. METHODS: Goat bone marrow mesenchymal stem cels were seeded into β-tricalcium phosphate scaffolds. The cel/scaffold constructs were subjected to chondrogenic and osteogenic induction simultaneously in the double-chamber stirring bioreactor. According to the applied shear stress, they were divided into dynamic and static culture groups. The proliferation of bone marrow mesenchymal stem cels was detected by MTT test and scanning electron microscope examination. Osteogenesis and chondrogenesis related genes were detected by RT-PCR for the evaluation of chondrogenic and osteogenic differentiation. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cels in both dynamic and static culturegroups demonstrated satisfactory proliferation and differentiation. Better proliferation and differentiation ability were found in the dynamic culture group. Fabrication of osteochondral composite grafts in the independently.designed double-chamber stirring bioreactor is feasible, which is better under the mechanical stimulus environment than the static environment.
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Objective 1) To verify the the potential of the adenoassociated viral vector as a strategy for intradiscal gene transfer in degenerative rabbit intervertebral discs. 2) To investigate the gene transduction efficacy and to quantify the biologic effects on the matrix synthesis after single gene transfer and combined gene transfer. Methods Rabbit models of disc degeneration were established by injecting the N-terminal 30×103 fibronectin fragment (Fn-f), 4 weeks later, saline with or without virus was injected directly into 144 lumbar discs of 36 skeletally mature New Zealand white rabbits. Group A (n =8) received the rAAV2-hTGFβ1; Group B (n=6) received rAAV2-hTGFβ3;Group C (n=6) recived rAAV2-hTGFβ1 and rAAV2-hTGFβ3; Group D (n=8) recived rAAV2-EGFP as the experimental control. Group E (n=8) recived PBS as the blank control. Two rabbits of the group A and group E were sacrefied 1 week after injection, immunohistochemical staining for hTGF-β1 was performed on the slices of nucleus pulposus (NP) tissues. On 4,8 and 12 weeks after gene transferring, NP tissues were cultured or decomposed to quantify the biochemical changes of the matrix using 35S-sulfate incorporation assay and western blot detection. The expression of EGFP was observed 12 weeks after injection. Results Discs in group A exhibited extensive and intense positive immunostaining for hTGF-β1 than the control discs in group E 1 week after gene transferring. The nucleus pulposus tissues in group A, B and C exhibited a 1.28-2.06 fold increase in proteoglycan synthesis and a 1.25-1.73 fold increase in collagen type Ⅱ production over those in group E (P＜0.05 or P＜0.01).Combination of two gene transfer in group C makes a significantly increased level of proteoglycan (1.195-1.290 fold)and collagen type Ⅱ (1.152-1.219 fold) than single gene transfer in group A and B(P＜0.05 or P＜0.01).No statistic differences shows between A group and B group. The difference of the matrix synthesis between group D and group E was also not statistically significant (P＞0.05). Extensive and intensive green fluorescence was observed on the slice of nucleus pulposus tissues received rAAV2-EGFP 12 weeks after gene delivery. The expression of EGFP kept for more than 12 weeks. Conclusion Findings showed that the disc tissue injected with rAAV2 mediated genes highly expressed the therapeutic proteins from 1 week to more than 12 weeks after delivery. It is suggested that adenoassociated virus be an valid vector for the transfer of the exogenous genes in the degenerative disc. The therapeutic factors hTGF-β1 and hTGF-β3 could efficiently increase the synthesis of proteoglycan and collagen type Ⅱ in the degenerative NP cells and combined transfer of two genes was more effective than single gene transfer. The two factors have an positive synergistic effects.