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Objective:To explore the clinical application of time of flight-magnetic resonance angiography (TOF-MRA), silent magnetic resonance angiography (SilenZ-MRA) and high-resolution vessel wall imaging (HR-VWI) in non-invasive evaluation of intracranial aneurysm after embolization.Methods:From February 2021 to February 2022, 39 patients, including 8 males and 31 females, who were 29-86 (54.50±11.80) years old and had received intracranial aneurysm embolization were collected in the Second Affiliated Hospital of Nanchang University. Kruskal-Wallis test was used to compare the image quality score and the evaluation results of lumen stenosis rate in the stent segments by TOF-MRA, SilenZ-MRA and HR-VWI. The diagnostic value of TOF-MRA, SilenZ-MRA and HR-VWI was analyzed by receiver operating characteristic (ROC) curve with DSA as the reference standard.Results:The image quality scores of TOF-MRA, SilenZ-MRA and HR-VWI were 2(1, 3), 4(3, 4) and 4(4, 4), respectively, with statistically significant difference ( H=80.78, P<0.05). The pairwise comparison results were as follows: TOF-MRA vs SilenZ-MRA, P<0.017; TOF-MRA vs HR-VWI, P<0.017; SilenZ-MRA vs HR-VWI, P>0.017. The lumen stenosis rates of stent segments measured by TOF-MRA, SilenZ-MRA, HR-VWI and DSA were 45.00% (29.60%, 61.05%), 17.60% (10.80%, 26.80%), 13.35% (8.90%, 15.95%) and 7.95% (4.80%, 11.25%), respectively, with statistically significant difference ( H=67.96, P<0.05). The results of comparison between TOF-MRA, SilenZ-MRA, HR-VWI and DSA were respectively as follows: TOF-MRA vs DSA, P<0.017; SilenZ-MRA vs DSA, P<0.017; HR-VWI vs DSA, P>0.017. DSA review showed that 12 (27.91%,12/43) aneurysms were not completely embolized, and 31 (72.09%, 31/43) aneurysms were completely embolized. The area under the curve of TOF-MRA, SilenZ-MRA and HR-VWI for evaluating the postoperative complete embolization of aneurysm was 0.75, 1.00 and 0.94, respectively, with statistically significant differences between TOF-MRA and HR-VWI ( Z=2.53, P<0.05) as well as between TOF-MRA and SilenZ-MRA ( Z=3.32, P<0.05). Conclusions:HR-VWI can clearly display the stent-segment lumen of the parent artery, and evaluate the stent-segment arterial wall and whether the stent-segment lumen is unobstructed or not. SilenZ-MRA is significantly superior to TOF-MRA in the evaluation of postoperative embolization status of aneurysms, and slightly superior to HR-VWI in tumor neck display. Combined application of HR-VWI and SilenZ-MRA has certain clinical significance for non-invasive evaluation of intracranial aneurysm after embolization.
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Objective: To observe the efficacy of acupuncture combined with sitting-position knee-adjustment manipulations in treating patellofemoral osteoarthritis. Methods: Ninety-two patients with patellofemoral osteoarthritis were randomized into an observation group and a medication group, with 46 cases in each group. The observation group received acupuncture and sitting-position knee-adjustment manipulations, and the medication group received oral celecoxib capsules. After 8-week treatment, changes in the short-form McGill pain questionnaire (SF-MPQ) and Lysholm knee scoring scale (LKSS) scores were observed, and the clinical efficacy was compared.Results: The total effective rate was 87.0％ in the observation group and 63.0％ in the control group; the between- group difference was statistically significant. Before treatment, there were no significant differences in the SF-MPQ score or LKSS score (P>0.05). After 8-week treatment, the SF-MPQ [including pain rating index (PRI), visual analog scale (VAS), and present pain intensity (PPI)] and LKSS scores showed notable changes in both groups (P<0.05); the SF-MPQ and LKSS scores in the observation group were significantly different from those in the control group (P<0.05).Conclusion: Combining acupuncture and sitting-position knee-adjustment manipulations can reduce pain and ameliorate joint function in patients with patellofemoral osteoarthritis, producing more significant efficacy than oral celecoxib capsules.
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Objective:To explore the technical feasibility of CT feature tracking (CT-FT) technique in evaluating left ventricular myocardial strain and evaluate the change of myocardial strain in patients with coronary heart disease.Methods:Eighty-one patients with coronary heart disease (lesion group) and 33 patients with normal coronary artery (control group) matched with age and sex were collected retrospectively from the Second Affiliated Hospital of Nanchang University from April 2019 to October 2020. The lesion group was first divided into single vessel stenosis group (42 cases) and multi vessel stenosis group (39 cases) according to the number of coronary artery stenosis branches, and the global myocardial strains of the left ventricle between the groups were analyzed. Lesion site included the left anterior descending branch (LAD), right coronary artery (RCA) and left circumflex branch (LCX), respectively. According to the degree of vascular stenosis, the lesion groups were divided into normal group, mild stenosis group, moderate stenosis group and severe stenosis group. The segmental myocardial strains of the branch segment of LAD, RCA or LCX were analyzed between groups. All CCTA examinations were performed with retrospective electrocardiogram gating. CVI 42 cardiac postprocessing software was used to obtain myocardial strain parameters, including global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS), and the segmental myocardial strains of the branch segment of LAD, RCA or LCX. The segmental myocardial strains included the peak longitudinal strain (PLS), peak circumferential strain (PCS) and peak radial strain (PRS). One way ANOVA or Kruskal Wallis H test were used for multi group analysis. Results:With the increased number of coronary artery stenosis branches, the absolute value of GPLS gradually decreased. The GPLS of the control group, single vessel stenosis group and multi vessel stenosis group were -14.1%±2.7%, -11.5%±2.3% and -8.8%±2.0%, respectively. The difference of GPLS between the 3 groups or any 2 groups was statistically significant (all P<0.001). The absolute values of GPRS and GPRS in multi vessel stenosis group were significantly lower than those in control group and single vessel stenosis group (all P<0.001). There was no significant difference in GPRS or GPRS between single vessel stenosis group and control group ( P=0.083, 0.118). And there were significant differences in the segmental myocardial strains of the branch segment of LAD, RCA or LCX among 3 groups ( P<0.001). In severe stenosis group, the absolute values of PRS, PCS and PLS in LAD, RCA or LCX were significantly lower than those in moderate stenosis group, mild stenosis group and normal group (all P<0.05). In the moderate stenosis group, the absolute value of PLS in each branch segment was lower than that of the mild stenosis and normal group (all P<0.05), and there was no significant difference in any 2 other myocardial strain parameters of each branch (all P>0.05). Conclusions:CT-FT technique was feasible to evaluate left ventricular myocardial function. With the increased number or degree of coronary artery stenosis, the global and segmental myocardial strain parameters of left ventricle gradually decreased, and the longitudinal strain was more sensitive.
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Objective To establish a long-term survival model of deep hypothermic circulatory arrest (DHCA) in rats,which could contribute to the research of organ damage mechanism and clinical treatments related to DHCA.Methods Twenty Sprague-Dawley rats were randomly (random number) divided into the sham group (n=10) and DHCA group (n=10).After anesthesia,a 20 G catheter was cannulated in the tail artery for arterial inflow,a multiorificed catheter in the right jugular vein for venous drainage,and a 24G catheter in the branch of left femoral artery for artery blood pressure monitoring.Rats in the DHCA group underwent DHCA procedure for 40 min after brain temperature cooled to 18℃,then rewarmed for 40 min,till the brain temperature were above 34℃.Rats in the sham group were cannulated but did not undergo cardiopulmonary bypass (CPB).Hemodynamic parameters and blood gas analysis were measured for 5 times (pre-CPB,15 min after CPB,10 min after rewarming,40 min after rewarming,and 30 min after CPB).Results One rat in the DHCA group died,and the rest rats survived.The lactate level in the DHCA group after rewarming during operation was significantly higher than that in the sham group (7.84 mmol/L vs 1.93 mmol/L,P＜0.05).Conclusions In this study,40-min DHCA model in rats is characterized by safe and long-term survival.
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Objective: To summarize and critically assess the evidence from randomized controlled trials (RCTs) of acupuncture in treating dry eye syndrome (DES) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Cochrane Collaboration recommendations. Methods: A search of PubMed, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Embase was made from their inception to August 2016, as well as Chinese, Japanese, and Korean databases. Two reviewers independently selected RCTs and assessed the methodological quality. Meta-analysis and the level of evidence were processed by RevMan 5.3 and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: After selection, 8 trials were subjected to our systematic review. The methodological quality was low generally. The 3-10 weeks follow-up showed that acupuncture improved the tear film break-up time (BUT) (MD=1.33, 95%CI=1.01-1.66, 619 participants). The mean difference of Schirmer's test was 1.73 mm (95%CI=1.28-2.18, 618 participants) between the acupuncture group and the control group. The subjective variables exhibited no significant differences. Conclusion: The low methodological quality of the trials does not suggest drawing firm conclusions on the value of acupuncture therapy for DES. Acupuncture treatment may have some effects on the tear film BUT and Schirmer's test, but not on the subjective symptoms. Well-planned large-scale high-quality RCTs are needed to make it clear whether acupuncture is effective in treating DES.
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Objective:To observe the therapeutic effect of warm needling moxibustion for erectile dysfunction (ED). Methods:A total of 46 eligible ED patients were randomized into a treatment group (n=24) and a control group (n=22). The treatment group was intervened by warm needling moxibustion while the control group by conventional acupuncture treatment, for a total of 4 courses. The therapeutic effect was evaluated by the international index of erectile function 5 (IIEF-5). Results:After 4 courses of treatment, the overall effective rate was 91.3% in the treatment group (23 completed), versus 75.0% in the control group (20 completed), with a significant difference (P Conclusion:Warm needling moxibustion can produce a more significant efficacy than conventional acupuncture in the treatment of ED.
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Objective To investigate whether inhibiting the expression of typeⅠ collagen gene is one of the mechanisms of action of electroacupuncture in improving knee osteoarthritis.Methods Forty male adult SD rats were randomized into normal, model, medication and electroacupuncture group, 10 rats each. A rat model of MIA-induced knee osteoarthritis was made by injecting monomer sodium iodoacetate (MIA) and driving rat movement. After model making, the medication group received an oral gavage of celecoxib dissolved in 10% DMSO and the electroacupuncture group, electroacupuncture at points Zusanli and Yanglingquan. Pain thresholds and the levels of cartilage expression of typeⅠ collagen mRNA were compared between various groups of rats before and after treatment.Results There was a statistically significant difference in pain threshold between the model, medication or electroacupuncture group of rats and the normal group after model making (P0.05). There was a statistically significant difference in the expression of typeⅠ collagen mRNA between the model, medication or electroacupuncture group of rats and the normal group (P0.05).Conclusion The mechanisms of actions of electroacupuncture and medication in treating knee osteoarthritis may be related to inhibiting the expression of typeⅠ collagen mRNA.
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Objective:To observe the clinical efficacy of warm needling moxibustion plus functional exercises in treating knee osteoarthritis (KOA).Methods:Totally 108 eligible KOA patients were intervened by warm needling moxibustionplus functional exercises. The warm needling moxibustion was given 3 times a week, successively for 4 weeks. The visual analogue scale (VAS) was adopted to evaluate the pain intensity of the knee joint. After 4-week treatment, the change of VAS score, range of motion (ROM) of knee, and Lysholm score were observed, and the clinical efficacy was also estimated. Results:After treatment, the VAS score dropped obviously, and the ROM and Lysholm score increased markedly; the total effective rate was 83.3%. Conclusion:Warm needling moxibustionplus functional exercises is effective in treating KOA, as it can relieve the knee joint pain and improve the joint motion.
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To summarize the clinical experience of Prof. Yan Jun-bai in treating rheumatic arthritis (RA) with suppurative moxibustion and aim to guide acupuncture treatment for RA. Prof. Yan believes that contributing factors of RA include external contraction of pathogenic factors, obstructed flow of qi and blood, internal phlegm-turbidity (due to deficiency of healthy qi or improper diet), and obstruction or malnourishment of meridians. As a result, the treatment strategies are to warm yang, remove pathogenic factors, and tonify the liver, spleen and kidney. Suppurative moxibustion is a reliable therapy for RA.
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Objective: To observe the efficacy of tuina manipulations for fibromyalgia syndrome (FMS). ＜br> Methods:Sixty eligible FMS patients were randomized into two groups, 30 in each group. Patients in the observation group were intervened by tuina manipulations to the corresponding segment of the spine based on the detection of disorders of the spine-related bones and tendons;patients in the control group were directed to practice functional exercises. Before and after intervention, the fibromyalgia impact questionnaire (FIQ) and visual analogue scale (VAS) were adopted for evaluation. ＜br> Results:After intervention, the FIQ and VAS scores dropped significantly in both groups (all P＜0.05), and there were significant differences between the two groups (both P＜0.05). The total effective rate was 86.7%in the observation group versus 63.3% in the control group, and the difference was statistically significant (P＜0.05). ＜br> Conclusion:Spinal tuina manipulations are effective and safe in treating FMS, for significantly promoting the quality of life of the FMS patients.
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Objective To observe the effects of extracorporeal shock wave therapy (ESWT) on spasticity of biceps brachii after stroke. Methods 12 patients with spasticity of biceps brachii after stroke were divided into control group (n=6) and ESWT group (n=6). The ESWT group received a session of ESWT and the control group received placebo treatment. All patients were assessed before and immediately after treatment, including integrated electromyogram (iEMG) and co-contraction ratio during maximum isometric voluntary contraction (MIVC) of elbow extension with surface electromyography, the modified Ashworth Scale (MAS) and content of shoulder and elbow of Fugl-Meyer Assessment (FMA). Results The scores of MAS and FMA, the iEMG and the cocontraction ratio of biceps brachii improved in the ESWT group after the treatment (P<0.05), and improved more than those in the control group (P<0.05). Conclusion ESWT can immediately re-lieve the spasticity of biceps brachii, inhibit the cocontraction of biceps brachii during elbow extension and improve the motor function of upper limb in patients post stroke.
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Objective: To investigate the therapeutic effect of Back-Shu acupoint in treating asthma. Methods: Sixty-one patients were randomly divided into a Back-Shu acupoint group, a acupuncture-moxibustion group and a acupuncture group. All the three groups were treated twice a week, 10 times made up a treatment course. The therapeutic effect was evaluated after three courses of treatment. Results and conclusion: The control and marked effective rate were significantly higher in the Back-Shu acupoint group and acupuncture-moxibustion groups than in the acupuncture group (P<0.05). They were slightly higher in the acupuncture-moxibustion group than in the Back-Shu acupoint group, but there was no statistically significant difference. The results indicated that the Back-Shu acupoints have a good therapeutic effect in treating asthma.
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This experiment was designed to investigate the effects of different chitosan on preventing peritoneal adhesion in rats. 240 SD rats were divided into 2 jumbogroups: jumbogroup A (144 rats) treated with chitosan gel and jumbogroup B (96 rats) with chitosan/gelatin mixed film. In jumbogroup A, 144 rats were randomly divided into 3 groups further, and different methods were used to induce peritoneal adhesions in each group while in the experiment group the wounded processus vermiformis was coated with chitosan gel before it was put back into the abdominal cavity. In jumpbogroup B, 96 rats were randomly divided into 4 groups (24 each) after surgical induction of perioneal adhesions; group B1 served as control group while in groups B2, B3 and B4, pure chitosan film and the chitosan film containing gelatin were respectively spread over the surface of the wounded. 2 and 4 weeks after surgical induction, exploratory laparatomy was performed on the rats to evaluate peritoneal adhesion, and the adhesive tissues were examined histopathologically. The results show that chitosan gel has perfect protective efficacy against traumatic or ischemic peritoneal adhesion, but pure chitosan film and the film chitosan containing gelatin could exacerbate peritoneal adhesion further.
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Animals , Female , Male , Rats , Chitosan , Chemistry , Pharmacology , Gelatin , Pharmacology , Gels , Pharmacology , Peritoneal Diseases , Random Allocation , Rats, Sprague-Dawley , Tissue AdhesionsABSTRACT
Purpose: To investigate the effect of Tuina plus acupuncture on treatment of cervical migraine and make a comparison. Method: Eighty outpatients with cervical migraine were divided into three groups and treated by Tuina, acupuncture and Tuina plus acupuncture, respectively. Results: All three groups of patients obtained a good effect. The cure rate was significantly higher in the Tuina plus acupuncture group than in the other two groups. Conclusion: The treatment of cervical migraine by Tuina plus acupuncture is worthy to be clinically popularized.
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In order to assess the transvalvular gradient of a Chinese-made Jiuling solid pyrolytic carbon bileaflet heart valve prosthesis, we determined its hydrodynamics in the laboratory and then measured the hemodynamic performance in the animals and patiens. The Jiuling prosthesis was tested in a pulsatile flow simulator in the aortic position. Six sheep subjected to mitral replacement with 21 mm Jiuling prosthesis were measured by open cardiac catheterization intraoperatively. Doppler echocardiography and open cardiac catheterization under dobutamine stress were performed in two sheep 60 months after implantation. Clinically, 14 cases of aortic valve and 10 cases of mitral valve in the patients who underwent valve replacement with Jiuling heart valve prosthesis were measured by open cardiac catheterization and Doppler echocardiopgraphy. The results showed that Juiling heart valve prosthesis had lower mean transvalvular gradient (below 10 mmHg) at any given tissue annulus diameter. In animal experiments, the transvalvular gradients of 6 sheep were 5.2 +/- 1.7 mmHg intraoperatively, and of 2 sheep 60 months after implantation were 6.1 +/- 0.3 mmHg by catheterization. In patients, the mean transvalvular gradients in the aortic position measured by means of catheterization and echocardiography were 6.26-4.10 mmHg and 9.42-7.48 mmHg; the gradients in the mitral position were 2.10-1.9 mmHg and 5.281-4.10 mmHg respectively. The above results demonstrate that Jiuling valve prosthesis has excellent hemodynamic performance.
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Adult , Animals , Female , Humans , Male , Aortic Valve , General Surgery , Biocompatible Materials , Carbon , Chemistry , Echocardiography , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation , Hemodynamics , Physiology , Mitral Valve , General Surgery , Prosthesis Design , Sheep , Ventricular Function, LeftABSTRACT
To observe the erythrocyte fragility and morphological changes of erythrocytes caused by roller pump. Ten tests were divided into two groups, Polystan pediatric pump group A (n = 5) and COBE pump group B (n = 5). Ten whole blood samples (each 400 ml) were circulated in the roller pump for 16 h. Erythrocyte fragility and free hemoglobin were measured before pumping and at every 2 hours during pumping. The possible morphological changes of erythrocytes caused by roller pump were observed by scanning electron microscope. The electron microscopic observation was made before pumping and at every 4 hours throughout pumping. Results showed that the erythrocyte fragility of two groups was not increased during a long period of pumping. The number of acanthocytes of two groups was 1.77/1.81% in the samples before pumping and 6.12/7.13, 9.18/8.73, 13.21/12.89, 16.53/17.21% at 4 h, 8 h, 12 h, and 16 h respectively. The free hemoglobin level of two groups was increased linearly during a long duration of pumping and the index of hemolysis of two groups was 0.296 mg/L/h and 0.3993 mg/L/h respectively. The result shows: 1. the erythrocyte fragility was not increased during a long period of pumping; 2. the erythrocyte membrane was injured or broken by roller pump directly; 3. the morphological changes of erythrocytes would be the basis of post operative hemolysis.
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Humans , Erythrocyte Deformability , Heart-Lung Machine , Hemoglobins , Hemolysis , In Vitro Techniques , Osmotic Fragility , Time FactorsABSTRACT
This study was directed at estimating the value of platelet count in the course of in-vitro hemolytic tests by roller pump. Five paired in-vitro tests were conducted using the POLYSTAN pump(group A) and COBE pump(group B). The pumps ran 16 hours. The samples for platelet count and plasma-free hemoglobin were taken before pumping, and every 2 hours after 4 hours of pumping. The 2 groups' platelet count and plasma-free hemoglobin levels were found to be linearly increasing with the hours of pumping and linear regression analysis showed the platelet count and plasma-free hemoglobin were positively correlated. These data suggested that platelet count could be used as an index in evaluating the in-vitro hemolytic properties of blood pumps.