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Acupuncture has been proved to be safe and effective by large-scale and authoritative clinical observation at home and abroad. However, in recent years, the results of some randomized controlled trials of acupuncture in JAMA showed no significant difference between acupuncture effect and sham acupuncture effect. Acupuncture and moxibustion in clinical practice is a summary of academic and clinical rules. Different from chemical drugs, the amount of stimulation, methods of operation and techniques vary. At present, sham acupuncture in clinical trials at home and abroad has been questioned by many scholars, who believe that sham acupuncture is not fake, and call for "fake targeted research" to be stopped. In order to improve the sham acupuncture control design, 5G + VR technology and the principle elements of sham acupuncture should be combined. We also discussed and analyzed advantages and prospects of modern intelligent medical technology of 5G + VR technology in the sham acupuncture RCT. We hope to promote standardization of acupuncture clinical trials, and the development, innovation and application of acupuncture research at home and abroad.
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ObjectiveTo explore the effect and possible mechanism of electroacupuncture （EA） at Fenglong （ST40） on liver lipid synthesis and insulin resistance （IR） in hyperlipidemic （HLP） rats. MethodEighteen rats were randomly divided into three groups， blank group， model group， and EA group， each consisting of six rats. The blank group rats were with fed a basic diet， while those in the model group and EA group were fed high-fat diet for 8 weeks. After modeling， the rats in the EA group received bilateral EA treatment at “Fenglong” （ST 40）. The rats in the model group underwent daily binding treatment， once a day， continuously 5 days a week， for a total of 4 weeks. Following the intervention， the levels of triglycerides （TG） and free fatty acids （FFA） in liver tissue was determined using ELISA. Serum TG， FFA， fasting insulin （FINS）， alanine transaminase （ALT）， aspartate Transaminase （AST）， tumor necrosis factor-ɑ （TNF-ɑ）and interleukin 6 （IL-6） were also measured. The fasting plasma glucose （FBG） assessed using a glucose meter and the homeostatic model assessment of insulin resistance （HOMA-IR） was calculated. Liver pathology was examined through HE staining and oil red O staining. The expression of hepatic sterol regulator binding protein 1c （SREBP1c）， recombinant fatty acid synthase （FASN） and stearoyl-CoA desaturase 1 （SCD1） were detected through immunofluorescence. The protein expression levels of liver insulin receptor substrate 1 （IRS1） and tyrosine-phosphorylated insulin receptor substrate 1 （p-IRS1-Tyr） were determined via Western blot. ResultsWhen compared to the blank group， the model group of rats exhibited elevated serum and liver tissue levels of TG and FFA， as well as increased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining revealed disordered arrangements of liver cells， indicating widespread fatty degeneration. Oil red O staining showed abundant bright red lipid droplets within liver cell cytoplasm， indicating severe lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly increased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly decreased （P＜0.05）. In comparison to the model group， the EA group of rats showed significantly reduced serum and liver tissue levels of TG and FFA， along with decreased serum levels of AST， ALT， TNF-α， IL-6， FBG， FINS， and HOMA-IR （P＜0.05）. HE staining indicated more regular arrangements of liver cells， and oil red O staining revealed a significant reduction in liver cell lipid droplets， indicating a less severe degree of lipid accumulation. The average fluorescence intensity of SREBP1c， FASN， and SCD1 in liver tissue significantly decreased （P＜0.05）， while p-IRS1-Tyr protein expression levels significantly increased （P＜0.05）， with no significant difference in IRS1 protein expression （P＞0.05）. ConclusionEA at “Fenglong” （ST 40） can significantly decrease serum lipid in HLP rats， improves liver fat accumulation， and also ameliorate insulin resistance. The mechanism may be related to the inhibition of hepatic lipid synthesis molecule expression， reduced serum inflammatory factors， and an increase in insulin substrate receptor phosphorylation levels.
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Sacral cyst usually occurs around the nerve root, which is the accumulation of cerebrospinal fluid between the intima and the perineurium at the junction of the posterior spinal nerve root and the dorsal root ganglion. Its typical clinical manifestations include low back pain, lower limb radiation pain, rectal/bladder dysfunction and so on. Complications of acute subdural hematoma with cerebral hernia after posterior midline cystectomy of sacral cyst are rare. A middle-aged female patient with sacral cyst was admitted to Gansu Provincial Hospital. After the operation, acute subdural hematoma occurred in the right frontoparietal temporal occipital region, and cerebral herniation was formed. After the operation, the patient was given rehabilitation exercise and discharged well. No neurological deficits were observed during follow-up.
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Objective:To explore any effect of electroacupuncture (EA) at the Zusanli point on the scorch death of duodenal cells in rats with functional dyspepsia (FD) and possible mechanisms.Methods:Twenty-four 7-day-old Sprague-Dawley rats were randomly divided into a blank group, a model group and an EA group, each of 8. FD was induced in both the model and EA group rats using iodoacetamide gavage with tail-clip stimulation. After successful modeling the EA group was given acupuncture at the Zusanli point and then connected with a Korean acupuncture point nerve stimulator for 2 weeks. The other 2 groups were not given any intervention. The rats′ body weight was recorded before and after the modeling, as well as 7 and 14 days later. The gastric emptying rate and the small intestine propulsion rate of the three groups were detected right after the EA intervention, and the serum expression levels of interleukin-1β (IL-1β) and interleukin-6 (IL-6) were measured using enzyme-linked immunoassays. Real-time fluorescence quantitative polymerase chain reactions were used to detect the transcription levels of IL-1β and IL-6 in the rats′ duodenums, while western blotting was employed to assess the expression of caspase-1 P20 and dermatin D (GSDMD) in their duodenums.Results:After successful modeling, the average body weight of the rats in the model and EA groups was significantly different from that in blank group, and after 7 and 14 days the average body weight of the former groups was significantly different from that of the blank group, with significant differences between the two groups as well. After the EA intervention significant differences were observed in gastric reside and small intestine propulsion rate between the EA group and the model group, as well as between the model and the blank group. After the intervention, there were significant differences between the blank group and the other two groups in the average expression of IL-1β and IL-6 in serum, IL-1β and IL-6 mRNA in the duodenum, as well as the GSDMD and caspase-1 p20 proteins in the duodenum. There were significant differences between the model and EA groups in all of the above measurements.Conclusions:EA at the Zusanli point can significantly reduce the level of scorch death in the duodenum of FD rats, as well as relieve low-grade duodenal inflammation and the clinical symptoms of FD. Its mechanism may be related to the down-regulation of the expression of caspase-1 P20 and GSDMD-N protein, and of inflammatory factors such as IL-1β and IL-6, relieving low-grade duodenal inflammation.
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Objective:To explore the abnormalities of efficiency in resting state functional brain network in patients with paranoid schizophrenia and the correlations between efficiencies and clinical symptoms.Methods:A total of 73 patients with schizophrenia (SZ group) met with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) criteria for schizophrenia and 70 healthy controls (HC group) were included .All subjects were checked by using functional magnetic resonance imaging (fMRI), and positive and negative syndrome scale(PANSS) were used to assess the symptoms.Abnormalities of global and local efficiency of brain regions in brain functional network were analyzed by graph theory.Pearson correlation was used to analyze the correlation between the abnormal global efficiency and local efficiency of brain regions of SZ group and PANSS.SPSS 20.0 software was used for dependent-sample t-test, ANOVA test and Pearson correlation analysis. Results:Compared with the HC group, SZ group showed increased global efficiency in bilateral thalamus(left: 0.26±0.06, 0.28±0.04, t=2.03, P=0.044.right: 0.26±0.06, 0.28±0.05, t=2.08, P=0.040), right orbital part of middle frontal gyrus(0.21±0.04, 0.23±0.05, t=2.25, P=0.026), cerebellar lobule Ⅸ(0.19±0.06, 0.21±0.05, t=2.56, P=0.011) and vermis Ⅲ(0.15±0.08, 0.19±0.07, t=3.27, P=0.001), while decreased global efficiency in bilateral parahippocampal gyrus(left: 0.25±0.05, 0.22±0.05, t=-3.34, P=0.001.right: 0.27±0.04, 0.23±0.05, t=-4.96, P=0.000), superior occipital gyrus(left: 0.27±0.03, 0.26±0.03, t=-2.70, P=0.008.right: 0.27±0.02, 0.26±0.03, t=-2.73, P=0.007), superior parietal gyrus(left: 0.27±0.03, 0.26±0.05, t=-2.63, P=0.010.right: 0.27±0.03, 0.25±0.05, t=-2.76, P=0.007), paracentral lobule(left: 0.28±0.03, 0.26±0.07, t=-2.47, P=0.015.right: 0.28±0.04, 0.25±0.07, t=-3.06, P=0.003), left precental gyrus(0.28±0.04, 0.27±0.04, t=-1.98, P=0.049), left cuneus(0.26±0.04, 0.25±0.04, t=-2.08, P=0.039), left lingual gyrus(0.29±0.03, 0.28±0.03, t=-2.28, P=0.024), left middle occipital gyrus(0.29±0.03, 0.28±0.03; t=-2.74, P=0.007), left middle temporal gyrus(0.28±0.03, 0.26±0.03, t=-2.73, P=0.007), temporal pole in left middle temporal gyrus(0.20±0.06, 0.18±0.06, t=-2.59, P=0.011) and right hippocampus(0.27±0.04, 0.26±0.06, t=-2.05, P=0.042).Compared with the HC group, SZ group showed increased local efficiency in bilateral caudate nucleus(left: 0.33±0.06, 0.35±0.05, t=2.54, P=0.012.right: 0.33±0.07, 0.35±0.04, t=2.77, P=0.007) and left superior occipital gyrus(0.39±0.03, 0.40±0.02, t=2.17, P=0.031), while decreased local efficiency in bilateral parahippocampal gyrus(left: 0.35±0.04, 0.32±0.07, t=-3.16, P=0.002.right: 0.34±0.04, 0.32±0.07, t=-2.91, P=0.004), left supplementary motor area(0.36±0.02, 0.35±0.05, t=-2.01, P=0.047), left inferior parietal but supramarginal and angular gyrus(0.35±0.03, 0.34±0.05, t=-2.65, P=0.009), left cerebellar crus Ⅱ(0.37±0.03, 0.36±0.04, t=-2.01, P=0.046), lobule ⅦB(0.37±0.03, 0.35±0.07, t=-1.98, P=0.049), right posterior cingulate gyrus(0.36±0.04, 0.34±0.07, t=-2.07, P=0.041), right superior parietal gyrus(0.37±0.03, 0.36±0.05, t=-2.19, P=0.031), right precuneus(0.36±0.02, 0.35±0.04, t=-2.36, P=0.020), right paracentral lobule(0.37±0.02, 0.36±0.06, t=-2.07, P=0.041) and right temporal pole in middle temporal gyrus(0.33±0.08, 0.30±0.09, t=-2.09, P=0.038).The global efficiency of bilateral paracentral lobule and left temporal pole in middle temporal gyrus in SZ group were negatively correlated with the negative scale scores( r=-0.25, -0.25, -0.26, all P<0.05).The global efficiency of right hippocampus in SZ group was positively correlated with total scores of PANSS( r=0.23, P=0.049).The global efficiency of left middle temporal gyrus in SZ group was negatively correlated with total scores of PANSS( r=-0.23, P=0.049).The local efficiency of right paracentral lobule in SZ group was negatively correlated with the positive scale scores( r=-0.24, P=0.038). Conclusion:The brain networks of patients with first-episode paranoid schizophrenia may have regional dysfunction in the transmission efficiency and fault-tolerant ability of resting state brain functional network, and the abnormalities of efficiency may be associated with the severity of psychiatric symptoms in several brain regions.
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Objective:To explore the functional connections of the whole brain and the two hemispheres in patients with obsessive-compulsive disorder (OCD).Methods:Twenty-six patients with obsessive-compulsive disorder(patients group) and thirty-seven healthy controls matched in gender, age and education(control group) were enrolled.All the participants accepted the resting-state functional magnetic resonance (rs-fMRI) scan.Based on DPABI and REST software, degree centrality (DC) and voxel - mirrored homotopic connectivity (VMHC) approaches were used to explore the pattern of functional connection in OCD.Results:Compared with the control group, the DC values in the right posterior cerebellar lobe(MNI: x, y, z=45, -87, -12), left precentral gyrus(MNI: x, y, z=-54, 9, 39), left inferior parietal lobule(MNI: x, y, z=-48, -51, 42), right anterior cingulate cortex(MNI: x, y, z=3, 18, 48) were significantly higher( t values were 5.75, 5.26, 5.28 and 5.16, respectively), and the DC values in the left inferior frontal gyrus(MNI: x, y, z=-36, 9, 30) were significantly lower( t value was -6.65) in patients group.The VMHC values in bilateral posterior cerebellar lobe(MNI: x, y, z=±51, -69, -33), bilateral inferior parietal lobule(MNI: x, y, z=±48, -51, 54), bilateral anterior cingulate cortex(MNI: x, y, z=±3, 21, 45)in patients group were significantly higher that those in control group( t values were 5.19, 5.19, 5.02, 5.02, 5.15 and 5.15, respectively). The DC and VMHC values in patients group were not significantly correlated with clinical symptoms(-0.23< r<0.19, P>0.05). Conclusion:OCD patients have abnormal connections between key brain network nodes and relevant brain regions, and functional connections have increased among multiple cerebral hemispheres.
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Objective@#To evaluate the tolerability and short-term efficacy of chemo-radiotherapy in 125 patients with stage ⅡB-ⅣA esophageal carcinoma after radical resection.@*Methods@#We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo-radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model.@*Results@#122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo-radiotherapy (41.6%), while 73 patients underwent only 1-4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up (6.4%). The 1-year and 3-year overall survival rate were 91.6% and 57.0%, respectively, with a median survival time of 64.4 months. The 1-year and 3-year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo-radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1-2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (P=0.006). But receiving more than 5 weeks was not the prognostic factor compared to 1 to 4 weeks chemotherapy (P=0.231). Multivariate analysis showed that only the numbers of concurrent chemotherapy was an independent prognostic factor (P=0.010).@*Conclusions@#Postoperative radiotherapy concurrent with weekly chemotherapy could improve the overall survival and decrease the recurrence for stage ⅡB-ⅣA esophageal carcinoma after radical resection. However, the completion rate of chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective randomized controlled trial.
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Objective To investigate the spontaneous activity of brain neurons in patients with obsessive－compulsive disorder (OCD) under resting state. Methods Forty－eight OCD patients and 50 age－, gender－ and year of education－matched normal controls were enrolled. All the subjects underwent 3.0 T fMRI to acquire resting state brain image. The brain regions with significant differences in amplitude of low－frequency fluctuation (ALFF) between patients and controls were analyzed. Whole－brain functional connectivity (FC) were analyzed using the brain regions with significant differences as seed points, and the correlation between brain regions with significant differences in ALFF and FC analysis and obsessive－compulsive symptoms was analyzed. Results Compared to the control group, the ALFF of left dorsolateral prefrontal cortex increased in patients with OCD (t=4.305, P＜0.001). Compared to the controls, the analysis of whole－brain FC (based on MNI template) with the left dorsolateral prefrontal cortex as the regions of interest showed that the FC strength between the left dorsolateral prefrontal cortex and right orbital inferior frontal cortex (t=3.897, P＜0.001), left anterior cingulate cortex (t=3.370, P＜0.001), right anterior cingulate cortex (t=4.299, P＜0.001), left middle cingulate cortex (t=3.220, P＜0.001), right middle cingulate cortex (t=4.607, P＜0.001) enhanced; the FC strength between the left dorsolateral prefrontal cortex and the left opercular part of inferior frontal gyrus (t=－4.630, P＜0.001) weakened in patients with OCD. The FC between the left dorsolateral prefrontal cortex and the left opercular part of inferior frontal gyrus was negatively correlated with obsessions score(r=－0.369, P=0.014), compulsions score (r=－0.392, P=0.009) and total score (r=－0.393, P=0.008) of the Yale－Brown obsessive compulsive scale (Y－BOCS). Conclusion In patients with OCD, spontaneous neural activity of the left dorsolateral prefrontal cortex is enhanced in resting state, and the FC with multiple brain regions is abnormal. The FC strength between the left dorsolateral prefrontal cortex and the left opercular part of inferior frontal gyrus is associated with obsessive－compulsive symptoms.
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Objective Regional homogeneity (ReHo) and functional connectivity (FC) were used to study obsessive-compulsive disorder(OCD),and to explore the mechanism of OCD in resting state.Method Resting-state functional magnetic resonance imaging (RS-fMRI) was performed in 55 patients with OCD (OCD group) and 50 normal controls (control group) matched by sex,age,nationality and education.The data and screening abnormal brain areas were analyzed and compared by DPARSFA2.3 and Rest software in OCD group.Whole brain FC analysis was performed with abnormal brain areas as seed points.Result Compared with the control group,ReHo in right thalamus (MNI:x=9,y=-24,z=6,t=4.3217) and left superior marginal gyrus (MNI:x =-45,y =-30,z =27,t =3.6320) increased and ReHo in right caudate nucleus (MNI:x=3,y=15,z=9,t=-3.1687) decreased in obsessive-compulsive disorder group,and the difference was statistically significant(P＜0.05).Using left superior marginal gyrus,fight thalamus and right caudate nucleus as seed voxels,the whole brain FC analysis showed that there were abnormal functional connections between bilateral cerebellar foot 1/2 area and left supramarginal gyrus,right thalamus and right caudate nucleus (P＜0.05) and the left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1,2-right caudate nucleus-right thalamic circuit existed in 0CD group.Conclusion The left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1,2-right caudate nucleus-right thalamic circuit may play an important role in the mechanism of OCD.
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Objective To investigate how electroacupuncture activates the AMPKαpathway in the treatment of functional dyspepsia ( FD) . Methods Tail clipping stimulation was combined with an irregular diet to induce FD in 20 Sprague-Dawley rats. They were randomly divided into a model group and an electroacupuncture group, each of 10. Ten others had no FD induced and formed a normal group. The rats in the electroacupuncture group were given 10 days of electroacupuncture treatment, while those in the normal and model groups were restrained and fixed like those in the electroacupuncture group, but not given electroacupuncture. The expression of phosphorylated adenosine mono-phosphate-activated protein kinase alpha (p-AMPKα), phosphorylated tuberin (p-TSC2) and Rheb protein in the stomachs and small intestines of each group were detected using the western blotting. Levels of mTOR mRNA were quantified using the reverse-transcription polymerase chain reaction ( RT-PCR) . Results The western blotting re-sults showed that compared with the normal group, the expression levels of p-AMPKα and p-TSC2 in the stomachs and small intestines of the model group decreased significantly, while that of Rheb protein increased significantly. Compared with the model group, the expression of p-AMPKαand p-TSC2 increased significantly after the electroacu-puncture treatment, while that of Rheb protein decreased significantly. According to the RT-PCR results, the expres-sion of mTOR mRNA in the stomachs and small intestines of the model group was up-regulated significantly compared with the normal group. Compared with the model group, expression of mTOR mRNA in the electroacupuncture group was significantly down-regulated. Conclusion Electroacupuncture can activate the AMPKα pathway, up-regulate the expression of the related protein p-TSC2, and decrease the expression of Rheb protein, thereby down-regulating the transcription of the mTOR gene. That would serve to treat FD.
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Objective To investigate the characteristics of amygdala neural circuitry in comorbidity of late-life depression (LLD) and cognitive impairment. Methods Twenty-four LLD,eighteen amnestic mild cognitive impairments (aMCI),thirteen aMCI with depression (dMCI) and thirty cognitive normal (CN) subjects completed resting-state functional magnetic resonance imaging scan. Main effects of depression and MCI and their interactions on the intrinsic amygdala functional connectivity network ( AFCN) connectivity were examined. Behavioral significance of AFCN that voxel-wised amygdala connectivity correlating with de-pression severity and memory scores were also tested after controlling the effects of covariates,including age, gender,education, gray matter atrophy, and group. Results The immediate memory and delayed memory function in the aMCI group (-0. 75 ± 0. 77 and -1. 13 ± 0. 56) and the dMCI group (-1. 07 ± 0. 79 and-1. 00±0. 52) were significantly lower than those of the CN group (0. 46±0. 73 and 0. 60±0. 61),and the difference was statistically significant (P<0. 01). Depression and anxiety in the LLD group (1. 00±0. 53 and 0. 93±0. 98) and the dMCI group (0. 86±0. 80 and 0. 78±0. 82) were significantly higher than those of the CN group (-0. 92±0. 25 and -0. 74±0. 22),and the difference was statistically significant (P<0. 01). Brain network analysis showed that separated neural circuits were implicated in the depression and cognitive im-pairment. Importantly,interactive effects of depression and MCI on the AFCN were also identified,especially in the bilateral somatomotor area,inferior parietal cortex/precuneus,posterior cingulate cortex,right medial prefrontal cortex/dorsolateral prefrontal cortex and hippocampus. Behavioral significance of AFCN also re-vealed the distinctive neural circuits involved in the depression severity and memory deficits,respectively. Conjunction analysis further identified the overlapped neural circuits associated with depression and memory deficits were primarily in the left DLPFC,insula,hippocampus,right inferior prefrontal cortex and dorsomedi-al prefrontal cortex. Conclusions Depression and cognitive impairment synergistically facilitate functional decoupling of AFCN and thus compromise the integrity of amygdala networks. Distinct depression-related or MCI-related neural constructs represent the characteristics of clinical phenotype of depression or MCI alone, while overlapped circuits probably reveal the neural basis of comorbidity of LLD and MCI.
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Objective To explore the association between the structural patterns of orbitofrontal sulcogyral pattern (OSP)and the susceptibility to schizophrenia in children and adolescents patients with schizophrenia. Methods Seventy-two childhood and adolescence schizophrenia aged 6~18 years were enrolled as the case group and 78 sex-, age-, education-matched healthy children served as the control group. MR images were acquired with a 3.0 T Magnetom Symphony MRI system. Positive and Negative Syndrome Scale (PANSS) was used to evaluate the symptom severity of patients.The pattern type of OFC was classified based on continuity among medial (MOS),lateral (LOS)and transverse (TOS) orbital sulci according to the method of Chiavaras and Petrides'. The orbitofrontal cortex (OFC) sulcogyral pattern was classified into three types(TypeⅠ,TypeⅡ,TypeⅢ)in each hemisphere. Results There were significant differences in the distribution of OFC patterns between the control and the case group (Left hemisphere: Χ2=6.668,P=0.036; Right hemisphere: Χ2=7.501,P=0.024). The linear regression analysis showed that Type Ⅲ in either hemisphere was associated with more severe symptoms in schizophrenia patients (B=7.214, P=0.008). Conclusions Type Ⅲ sulcogyral pattern may be a morphological risk marker for schizophrenia. Compared to the other two types, the Type Ⅲ expression is associated with more severe clinical symptoms.
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Objective To explore the possible mechanism of repetitive transcranial magnetic stimulation (rTMS) in learning and memory ability of Alzheimer's disease (AD) rats. Methods 90 SD rats with no differ-ence in learning and memory were selected and 30 rats were randomly selected as control group. The rest 60 were used for establishment of AD model by injecting A beta 1-42 into bilateral hippocampus of rats ,which was verified by Morris water maze test and immunohistochemistry. The successfully prepared model rats were randomly divided into AD group and (rTMS+AD) group,30 rats in each group. The (rTMS+AD) group was treated with rTMS,and the control group and AD group with pseudo stimulation. After intervention,Water maze test,EEG acquisition and analysis,immunohistochemistry and statistical analysis were done. Results (1)Compared with control group, the escape latency of AD group was longer and the average distance from the platform was farther away. Compared with AD group,the escape latency of (rTMS+AD) group was significantly longer and the average distance from the platform was significantly farther away (P<0.05).(2)Compared with control group,the LZ complexity of EEG signals in AD group was decreased. Compared with the AD group,the LZ complexity of EEG signals in (rTMS+AD) group was significantly increased statistically(P< 0.05).(3)The results of immunohistochemistry showed that there was no plaque in the brain tissues of control rats. The morphology of the cells was clear ,and the cells arranged neatly. Myelin staining was deeper and the distribution was long andconnected. There was plaque in the brain tissues of AD rats. Brain tissue cells became atrophy ,the morphology of the cells was not clear ,and the cells arranged randomly. Myelin staining was lighter and the distribution was short and disconnected. Compared with AD group,the cell atrophy of (rTMS+AD) group was reduced,and Myelin staining became deeper. Conclusions rTMS can increase the distribution of myelin in brain tissue ,raise the LZ complexity of EEG signals in AD model rats , and improve the learning and memory ability of them.
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Objective To observe the effect of two reverse pedicle flap repaired soft tissue defect of the finger.Methods From April,2011 to March,2015,46 patients were randomly divided into two groups.Twenty-eight cases were performed by dorsal metacarpal artery flaps with cutaneous branches as pedicle and the 18 cases were performed by reverse the proper palmar digital artery dorsal branches island flap.The complication,survival rate,hand function and appearance were analyzed.Results The dorsal metacarpal artery flaps with cutaneous branches as pedicle and reverse the proper palmar digital artery dorsal branches island flap were an average follow-up of 18 and 15 months,all flaps survived.For fingertip defects,8 cases were repaired with as pedicle as the dorsal metacarpal artery flaps with cutaneous branches as pedicle while 16 cases were repaired with reverse the proper palmar digital artery dorsal branches island flap.Among them,complication included 2 cases of early venous congestion and 2 cases of superficial skin necrosis.One case of reverse the digital artery dorsal branches island flap blistered;the flap sensibility was good recovery.The two-point discrimination testing of dorsal metacarpal artery flaps with cutaneous branches as pedicle was from 6.0 to 9.0 mm (average of 7.1 ± 0.5 mm);the two-point discrimination testing of dorsal metacarpal artery flaps with cutaneous branches as pedicle was from 4.0 to 7.0 mm (average of 5.2 ± 0.4 mm),but there were differences in two-point discrimination and there was statistically significant (P ＜ 0.05).There was no significant difference between the two groups each finger interphalangeal joint activity compared with the healthy side.The study found that 10 cases of dorsal metacarpal artery flaps appearance was 5 mm higher than normal skin and 1 patient of reverse the digital artery dorsal branches island flap appearance was 5 mm higher than normal skin,the difference was statistically significant (P ＜ 0.05),the latter was better than the former,especially repaired fingertip defect.Conclusion Dorsal metacarpal artery flaps with cutaneous branches as pedicle and reverse the proper palmar digital artery dorsal branches island flap were safe and reliable,it is the ideal flap finger defects.For finger fingertip defect repaired reverse the proper palmar digital artery dorsal branches island flap is superior dorsal metacarpal artery flaps with cutaneous branches as pedicle.
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<p><b>OBJECTIVE</b>To compare the clinical therapeutic effects and safety on menopausal symptoms between manual acupuncture (MA) and electroacupuncture (EA).</p><p><b>METHODS</b>Fifty patients were randomized into an MA group (25 cases) and an EA group (25 cases). In the MA group, the regular needling technique and pseudo-EA were used at Guanyuan (CV 4), Zigong (EX-CA 1), Tianshu (ST 25) and Sanyinjiao (SP 6). In the EA group, the acupoints were the same as the MA group and stimulated with EA and pseudo-MA (no manipulation applied in treatment), with disperse-dense wave, 10 Hz/50 Hz, 0.5 to 1.0 mA. In the two groups, the needles were retained for 30 min. The treatment was given once every two days, three times a week, totally for 8 consecutive weeks. The results of the menopause rating scale (MRS), the menopause-specific quality of life (MENQOL), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E) as well as adverse reactions were evaluated before treatment, in 4 and 8 weeks of treatment separately.</p><p><b>RESULTS</b>Compared with those before treatment, the scores of MRS, MENQOL, SAS and SDS were all reduced in the 4 and 8 weeks of treatment in the two groups (all<0.05). The results in 8 weeks of treatment were lower than those in 4 weeks of treatment in the two groups (all<0.05). The differen-ces were not significant statistically between the two groups (all>0.05). Compared with those before treatment, the levels of FSH and LH reduced and Eincreased after treatment in the two groups, without significant differences (all>0.05). The differences were not significant statistically between the two groups (all>0.05). The severe adverse reactions were not found in the treatment of the two groups.</p><p><b>CONCLUSIONS</b>Both manual acupuncture and electroacupuncture relieve the symptoms of depression and anxiety in menopausal syndrome,improve the living quality and do not induce apparent changes in serological sex hormones in the patients.</p>
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ObjectiveTo observe the clinical efficacies of electroacupuncture and Prucalopride succinate tablets in treating functional constipation.MethodForty patients were randomized into two groups, 20 cases in each group. The treatment group was intervened by electroacupuncture, and the control group was byoral administration of Prucalopride succinate tablets. The major symptoms scores, stool shape score, serum substance P (SP), and somotostatin (SS) were observed.ResultAfter treatment, there were no significant inter-group differences in comparing the changes of defecation frequency and difficulty scores (P>0.05), while there were significant inter-group differences in comparing the changes of incomplete bowel evacuation sensation, abdominal pain, and stool shape scores (P0.05).ConclusionElectroacupuncture and Prucalopride succinate tablets can produce equivalent efficacies in treating functional constipation, and have their own advantages in improving the relevant symptoms. Therefore, treatment should be chosen according to the disease condition.
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[ Abstract] Objective To investigate the clinical efficacy of preoperative three-dimensional radiotherapy (3DRT) with or without concurrent chemotherapy for esophageal carcinoma.Methods We retrospectively analyzed 103 esophageal carcinoma patients who received preoperative 3DRT with or without concurrent chemotherapy from 2004 to 2014 in Cancer Hospital CAMS.The median radiation dose was 40 Gy, and the TP or PF regimen was adopted for concurrent chemotherapy if needed.The overall survival (OS) and disease-free survival ( DFS) were calculated by the Kaplan-Meier method, and the survival difference and univariate prognostic analyses were performed by the log-rank test.The Cox proportional hazards model was used for multivariate prognostic analysis.Results The number of patients followed at 3-years was 54.The 3-year OS and DFS rates were 61.1% and 54.9%, respectively, for all patients.There were no significant differences between the 3DRT and concurrent chemoradiotherapy (CCRT) groups as to OS (P=0.876) and DFS (P=0.521).The rates of complete, partial, and minimal pathologic responses of the primary tumor were 48.0%, 40.2%, and 11.8%, respectively.There were significant differences in OS and DFS between the complete, partial, and minimal pathologic response groups (P=0.037 and 0.003). No significant difference in pathologic response rate was found between the 3DRT and CCRT groups (P=0.953).The lymph node metastasis rate was 26.5%, and this rate for the complete, partial, and minimal pathologic response groups was 14%, 30%, and 67%, respectively, with a significant difference between the three groups (P=0.001).The OS and DFS were significantly higher in patients without lymph node metastasis than in those with lymph node metastasis (P=0.034 and 0.020).The surgery-related mortality was 7.8% in all patients.Compared with the 3DRT group, the CCRT group had significantly higher incidence rates of leukopenia (P=0.002), neutropenia (P=0.023), radiation esophagitis (P=0.008), and radiation esophagitis ( P=0.023).Pathologic response of the primary tumor and weight loss before treatment were independent prognostic factors for OS and DFS (P=0.030,0.024 and P=0.003,0.042). Conclusions Preoperative 3DRT alone or with concurrent chemotherapy can result in a relatively high complete pathologic response rate, hence increasing the survival rate.Further randomized clinical trials are needed to confirm whether preoperative CCRT is better than 3DRT in improving survival without increasing the incidence of adverse reactions.
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BACKGROUND:Currently, conventional treatment methods for heart failure are al ineffective. OBJECTIVE:To explore the combined effects of human umbilical cord stem cel s and CD133+cel s in mice with heart failure, providing a new insight into the treatment of heart failure. METHODS:Ful-term newborn umbilical cord from vaginal delivery was col ected to isolate CD133+cel s and human umbilical cord stem cel s using lymphocyte separation medium method. Twenty Balb/C nude mice were randomly subjected to mononuclear cel injection (mononuclear cel group) or injection of CD133+cel s combined with human umbilical cord stem cel s (combined group) via the tail vein after establishing heart failure models. RESULTS AND CONCLUSION:Fourteen days after injection, the body weight and liver, heart and lung mass of mice were significantly larger in the combined group than the mononuclear cel group (P<0.05). After 30 days, myocardial cel s arranged regularly in the combined group, but disorderly in the mononuclear cel group;compared with the mononuclear cel group, the average area of myocardial col agen fibers was significantly decreased in the combined group (P<0.05), and the level of serum matrix metal oproteinase-9 was also significantly lower in the combined group (P<0.05). Masson staining showed that blue-stained col agen fibers in the combined group were less but arranged neatly;however, in the mononuclear cel group, the number of col agen fibers that arranged irregularly was increased to different extents. To conclude, the combined use of CD133+cel s and human umbilical cord stem cel s has desired outcomes in the treatment of heart failure in mice, indicating a higher clinical value.
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Objective To explore the cool execution function (CEF)and its influence factors before and after treatment in drug-na?ve, first-episode schizophrenics. Methods Twenty-one drug-naive, first-episode schizophrenics (patients group) and 25 healthy persons (control group) were interviewed by using the SCID. The severity of clinical symptoms was respectively assessed in patient group before treatment and after 8 weeks using the Positive and Negative Syndrome Scale (PANSS). The Trail-Marking Test A-B (TMT A-B) and Hanoi Tower Test (HTT) were conducted to assess cool executive function. Reaction time and the number of errors of TMT A-B’s and HTT’s reaction time and operative steps were recorded. Results Before treatment, the patient group’s reaction time was longer in HTT and TMT A-B than that in the control group's (P = 0.013;P = 0.000;P =0.001), respectively. Error number of TMT-B in the patient group was more than that in the control group (P =0.015); The operative steps of HTT and error number of TMT A were no statistical difference than those in the control group. After treatment, reaction time of TMT A reduced significantly than before treatment (P = 0.002);Before and after treatment , patients ’ reaction time of HTT and TMT B , operative steps of HTT and the error number of TMT A-B were all no statistical difference. Running multiple linear regression , reaction times of TMT-B was positively correlated with negative symptoms (β = 7.198,P = 0.012), and the error number of it was positively correlated with positive symptoms (β = 0.382,P = 0.024). Conclusions CEF in patients with drug-naive, first-episode schizophrenia is affected in a certain degree, especially the flexibility and attention transfer. Symptoms is the most serious influence factors. Treatment in sympotoms earlier is the important way to protect cool cognition.
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Objective To analyze the clinical value of postoperative radiotherapy for node-positive middle thoracic esophageal squamous cell carcinoma ( TESCC ) and to modify the target volume .Methods A total of 286 patients with node-positive middle TESCC underwent radical surgery in Cancer Hospital, Chinese Academy of Medical Sciences, from 2004 to 2009.In addition, 90 of these patients received postoperative intensity-modulated radiotherapy.The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis.The Cox model was used for multivariate prognostic analysis.The chi-square test was used for comparing the recurrence between patients receiving different treatment modalities.Results The 5-year overall survival ( OS) rates of the surgery alone ( S) group and surgery plus postoperative radiotherapy ( S+R) group were 22.9%and 37.8%, respectively, and the median OS times were 23.2 and 34.7 months, respectively ( P=0.003) .For patients with 1 or 2 lymph node metastases (LNMs), the 5-year OS rates of the S group and S+R group were 27.3%and 44.8%, respectively ( P=0.017);for patients with more than 2 LNMs, the 5-year OS rates of the S group and S+R group were 16.7%and 25.0%, respectively (P=0.043).The peritoneal lymph node metastasis rates of N1 , N2 , and N3 patients in the S group were 2.9%, 10.9%, and 20.0%, respectively ( P=0.024) .The S+R group had a significantly lower mediastinal lymph node metastasis rate than the S group ( for patients with 1 or 2 LMNs:8.0%vs.35.3%, P=0.003;for patients with more than 2 LNMs, 10.0%vs.42.3%, P=0.001) , and had a prolonged recurrence time compared with the S group ( 25.1 vs.10.7 months, P=0.000) .However, for patients with more than 2 LNMs, the S+R group had a significantly higher hematogenous metastasis rate than the S group (46.7%vs.26.1%, P=0.039).Conclusions Patients with node-positive middle TESCC could benefit from postoperative radiotherapy.The target volume can be reduced for patients with 1 or 2 LNMs.Prospective studies are needed to examine whether it is more appropriate to reduce the radiotherapy dose than to reduce the target volume for patients with more than 2 LNMs.A high hematogenous metastasis rate warrants chemotherapy as an additional regimen.