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Rheumatoid arthritis (RA) is an autoimmune disease. It is the focus of current treatment to improve the immune disorders of RA patients and reduce the inflammatory damage. Acupuncture and moxibustion show the advantages of simple operation and safety. It has remarkable curative effect in the treatment of RA, and has a variety of intervention methods, including conventional acupuncture, moxibustion, combination of acupuncture and moxibustion, as well as innovative acupuncture and moxibustion therapies such as electroacupuncture and spinal moxibustion. The immune regulation of acupuncture and moxibustion on RA has the characteristics of bidirectional and multi-target. It can regulate Th17/Treg cell balance, Th1/Th2 cell balance, specific protein and NF-κB and other signaling pathways to regulate inflammatory immune response.
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Objective:To evaluate the effect of deep learning based on DWI and fluid attenuated inversion recovery (FLAIR) to construct a prediction model of the onset time in acute stroke.Methods:A total of 324 cases of acute stroke with clear onset time, from January 2017 to May 2020 in Nanjing First Hospital, were retrospectively enrolled and analyzed. The patients were divided into a training set of 226 patients and a test set of 98 patients according to the complete randomization method using a 7∶3 ratio, and the patients were divided into ≤ 4.5 h and >4.5 h according to symptom onset time in each group. The acute infarction areas on DWI and the corresponding high signal area on FLAIR were manually outlined by physician. Using the InceptionV3 model as the basic model for image features extraction, the deep learning prediction model based on single sequence (DWI, FLAIR) and multi sequences (DWI+FLAIR) were established and verified. Then the area under curve (AUC), accuracy of human readings, single sequence model and multi sequence model in predicting the acute stroke onset time from imaging were compared.Results:DWI-FLAIR mismatch was found in 94 cases (94/207) of patients with symptom onset time from imaging ≤ 4.5 h, while in 28 cases (28/117) of patients with symptom onset time from imaging >4.5 h. ROC analysis showed that the AUC of DWI-FLAIR mismatch in predicting acute stroke onset time from imaging was 0.607, and the accuracy was 60.2%. The prediction model of deep learning based on single sequence showed that the AUC of FLAIR was 0.761 and the accuracy was 71.4%; the AUC of DWI was 0.836 and the accuracy was 81.6%. The AUC of predicting stroke onset time based on the multi-sequence (DWI+FLAIR) deep learning model was 0.852, which was significantly better than that of manual identification ( Z = 0.617, P = 0.002), FLAIR sequence deep learning model ( Z = 2.133, P = 0.006) and DWI sequence deep learning model ( Z = 1.846, P = 0.012). Conclusion:The deep learning model based on DWI and FLAIR is superior to human readings in predicting acute stroke onset time from imaging, which could provide guidance for intravenous thrombolytic therapy for acute stroke patients with unknown onset time.
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Objective:To undemtand the direction and synergic relationship of the reform policy of Hierarchical Medical Treatment from perspective of urban public hospital of Guangdong.Methods:Policy analysis and the rainbow model of integrated care.Results:58 pohcy documents were included in analysis.A policy package was established based on the rainbow model of integrated care.The direction of the reform policy was clear but the synergic relationship among some policy measures was still not precise.Conclusion:The policy package was on conceptual phase.It was necessary to supplement some reform policies and measures to build synergic relationship productively.
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Objective To explore the correlation between the level of serum homocysteine (Hcy) and the thickness of retinal ganglion cell layer (GCL) on optical coherence tomography (OCT) in patients with type 2 diabetes.Methods Totally 60 diabetic patients were collected from October 2016 to October 2017 in the Shengjing Hospital of China Medical University,and they were divided into two groups:diabetic patients without retinopathy (NDR group,n =30) and non-proliferative diabetic retinopathy group (NPDR group,n =30) according to the ETDRS classification,and meanwhile additional 30 healthy subjects were enrolled as control group.The level of serum Hcy was detected,and the retinal GCL thickness was measure using OCT in all patients for the analysis of the correlation of serum Hcy level with the thickness of GCL.Results The serum Hcy level was (11.87 ± 2.19) nmol · L-1 in the control group,(14.87 ± 0.42)nmol · L-1 in the NDR group and (20.77 ± 2.40) nmol · L-1 in the NPDR group,which was significantly increased gradually,and the difference was statistically significant (P =0.000),but the thickness of GCL was (88.33 ± 6.36) μm,(81.73 ± 1.41) μm and (64.00 ± 12.73) μm in the three groups,accordingly,which was decreased significantly gradually,with statistically significant difference (P =0.000).Along with the progress of fundus lesions,the level of serum Hcy increased,but the thickness of GCL decreased,and there was a significant negative correlation of the serum Hcy level with the thickness of GCL in the retina by Pearson (r =-0.908,P =0.000).Conclusion The increase of serum Hcy level in diabetic patients is associated with the decrease of retinal GCL thickness,and Hcy is involved in neurodegenerative changes in patients with diabetic retinopathy.
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Objective To study the effects of ribosomal protein L41 (RPL41) on the proliferation and apoptosis of human retinoblastoma Y79 cells and its underlying mechanisms.Methods Y79 cells were seeded in RPMI 1640 medium containing 10％ fetal bovine serum for passage culture.Then the cells were divided into control group,with cells left untreatment,(40 μmol · L-1,80 μmol · L 1 and 120 μmol · L-1) RPL41 treatment group according to the concentration.Next CellTiter-Glo fluorescence cell viability testing system was used to observe the viability of Y79 cells in all groups,and flow cytometry was applied to measure the cell apoptotic rate in 100 μmol · L 1 RPL41 treatment group,with Hoechst staining for the observation of nuclear morphometry of apoptotic cells,and finally,Western blot was used to determine the expression of activating transcription factor 4 (ATF4) of each group.Results Compared with the control group,the viability of Y79 cells in the 40 μmol · L-1 RPL41 treatment group was (97.9 ± 1.5) ％,with no significant difference (P =0.055);and the viability in the 80 μmol · L-1 and 120 μmol · L-1 RPL41 treatment group was (87.6 ± 1.8)％ and (63.9 ± 2.0) ％,respectively,both of which were significantly different from the control group (both P ＜ 0.05),so RPL41 inhibited the viability of Y79 cells,and 100 μmol · L-1 RPL41 promoted the apoptosis of Y79 cells,with the apoptotic rate of (17.33 ± 2.47)％.Compared with normal cells,the apoptotic cells in the 100 μmol · L 1 RPL41 treatment group showed bright color and smaller cell volume by Hoechst staining.Western blot showed that PRL41 significantly decreased the expression of ATF4 protein and the expression of ATF4 protein in the 40 μmol · L 1,80 μmol · L-1 and 120 μmol · L 1 treatment group were 0.76 ± 0.04,0.29 ± 0.04,0.29 ± 0.05,respectively,all of which were significantly different from the control group (all P ＜ 0.01).Conclusion RPL41 can inhibit the proliferation and promote the apoptosis of human retinoblastoma Y79 cell,and its mechanism may be related to the expression of ATF4.
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Objective To investigate the relationship between vascular remodeling patterns of atherosclerotic middle cerebral artery (MCA) stenosis and plaque enhancement.Methods From August 2015 to June 2016,patients with unilateral symptomatic atherosclerotic MCA stenosis underwent routine MRI and black blood magnetic resonance inaging examinations.The vessel area and lumen area of MCA at the site of atherosclerotic MCA stenosis were measured,and the degree of MCA stenosis and the remodeling index were calculated.Results A total of 33 patients were included.Eleven had obvious plaque enhancement,including 9 positive remodeling and 2 negative remodeling;22 did not have plaque enhancement,including 5 positive remodeling,5 no remodeling,and 12 negative remodeling.The obvious plaque enhancement group was mainly positive remodeling (81.8％ vs.22.7％),and the no obvious enhancement group was mainly negative remodeling (54.5％ vs.18.2％).The difference was statistically significant (P=0.018).Conclusion Plaque enhancement at the site of atherosclerotic MCA stenosis is mainly positive remodeling,which reflects plaque instability.
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Empathy, a basic prosocial behavior, is referred to as an ability to understand and share others' emotional state. Generally, empathy is also a social-behavioral basis of altruism. In contrast, impairment of empathy development may be associated with autism, narcissism, alexithymia, personality disorder, schizophrenia and depression. Thus, study of the brain mechanisms of empathy has great importance to not only scientific and clinical advances but also social harmony. However, research on empathy has long been avoided due to the fact that it has been considered as a distinct feature of human beings from animals, leading to paucity of knowledge in the field. In 2006, a Canadian group from McGill University found that a mouse in pain could be shared by its paired cagemate, but not a paired stranger, showing decreased pain threshold and increased pain responses through emotional contagion while they were socially interacting. In 2014, we further found that a rat in pain could also be shared by its paired cagemate 30 min after social interaction, showing long-term decreased pain threshold and increased pain responses, suggesting persistence of empathy for pain (empathic memory). We also mapped out that the medial prefrontal cortex, including the anterior cingulate cortex, prelimbic cortex and infralimbic cortex, is involved in empathy for pain in rats, suggesting that a neural network may be associated with development of pain empathy in the CNS. In the present brief review, we give a brief outline of the advances and challenges in study of empathy for pain in humans and animals, and try to provide a novel bio-psychosocial-behavioral model for study of pain and its emotional comorbidity using laboratory animals.
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Animals , Humans , Mice , Rats , Cerebral Cortex , Physiology , Emotions , Empathy , Gyrus Cinguli , Physiology , Models, Animal , Pain , Pain Threshold , Prefrontal Cortex , PhysiologyABSTRACT
Objective: This study was designed to evaluate the effect of age on local recurrence after BCT (breast-conserving therapy) in patients with breast cancer. Methods: The clinical records of 548 female patients with breast cancer undergoing BCT between January 2000 and December 2007 were analyzed retrospectively, and the follow-up of these patients was performed. The univariable and multivariabe analyses were conducted to evaluate the potiential factors related to local recuurence after BCT. Results: For 548 patients, the recurrence rate within 5 years after BCT accounted for 4.01% (22/548). There were statistical differences in local recurrence rate among different ages (< 45 years vs ≥ 45 years, P = 0.041), tumor sizes (T1 vs T 2 vs T3, P = 0.014) and histologic grades (grades I-II vs grade III, P = 0.003). The multivariable analysis displayed that the factors of younger age (< 45 years, P = 0.013) and higher histologic grade (grade III, P = 0.046) were independent factors in prediction of poor prognosis of breast cancer after BCT. Conclusion: Younger age (< 45 years) is a reasonable justification to consider more aggressive treatment to prevent local recurrence in patients with breast cancer after BCT. Copyright © 2012 by TUMOR.
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<p><b>OBJECTIVE</b>To observe the effects on function rehabilitation of vocal cord after vocal cord polyps surgery treated with acupuncture at Sheng's Four Points of Throat.</p><p><b>METHODS</b>Sixty cases were randomly divided into a combined therapy group of Four Points of Throat and medication (group 1, 30 cases) and a medication group (group 2, 30 cases). In group 1 Four Points of Throat were punctured and routine medication was applied; in group 2, only routine medication was applied. The scores of symptom-sign and status of voice were observed and analyzed before and after treatment in two groups.</p><p><b>RESULTS</b>At 4th day after the surgery, the improvement of the symptom-sign scores in group 1 was more significant than that in group 2 (P < 0.05); and the voice analysis status in group 1 was superior to that in group 2 (all P < 0.05). The total effective rate was 83.3% (25/30) in group 1, which was superior to that of 60.0% (18/30) in group 2 (P < 0.05).</p><p><b>CONCLUSION</b>The effect on function rehabilitation of vocal cord after vocal cord polyps surgery treated with the combined therapy group of Four Points of Throat and routine medication is favorable, superior to that with routine medication therapy.</p>