Effect of Acupuncture on Endometrial Blood Flow in Women Undergoing in vitro Fertilization Embryo Transfer: A Single Blind, Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the effect of manual acupuncture on endometrial blood flow parameters by three-dimensional (3D) power Doppler ultrasound in women undergoing in vitro fertilization embryo transfer (IVF-ET).@*METHODS@#Seventy patients undergoing IVF-ET were equally randomized into traditional or sham acupuncture treatment group for totally 4 days (from the day of oocyte aspiration to the day of embryo transfer) of treatment by random envelope method at the Reproductive Medicine Center and Outpatient Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology from January 2013 to December 2015. Patients in the traditional acupuncture group accepted traditional acupuncture methods with manual acupuncture, and Zhongji (CV3), Qihai (CV 6), Sanyinjiao (SP6), Taichong (LR 3), Tianshu (ST 25), Guilai (ST 29) and Zusanli (ST 36) were chosen. Patients at the sham acupuncture group accepted shallow acupuncture methods at 4 non-meridian points at each shoulder and upper arm. Outcome measures included endometrial ultrasonic indices such as vascularization index (VI), flow index (FI) and vascularization flow index (VFI), endometrial thickness and volume, subendometrial VI (sVI), subendometrial FI (sFI), subendometrial VFI (sVFI), implantation rate, clinical pregnancy rate, abortion rate, live birth rate and number of live births.@*RESULTS@#Finally, 34 patients in the traditional acupuncture group and 35 in the sham acupuncture group completed this trial. VI, FI and VFI of the traditional acupuncture group were significantly higher than those in the sham acupuncture group (P<0.05). No significant differences were found in endometrial thickness, endometrial volume, sVI, sFI, sVFI, implantation rate, clinical pregnancy rate, abortion rate, live birth rate and number of live births (P>0.05).@*CONCLUSIONS@#Manual acupuncture performed after oocyte aspiration and before transplantation improved the endometrial blood flow parameters VI, RI and VFI in women who underwent IVF-ET, instead of sVI, sFI and sVFI. Therefore, acupuncture might be beneficial in women undergoing IVF-ET by increasing endometrial blood flow and endometrial receptivity. (Registration No. ChiCTR2100053354).

Analysis of three-dimensional visualization imaging of severe portal vein stenosis after liver transplantation and clinical efficacy of portal vein stent implantation / 器官移植

Objective To analyze three-dimensional imaging characteristics and advantages for severe portal vein stenosis after liver transplantation, and to evaluate clinical efficacy of portal vein stent implantation. Methods Clinical data of 10 patients who received portal vein stent implantation for severe portal vein stenosis after liver transplantation were retrospectively analyzed. Imaging characteristics of severe portal vein stenosis, and advantages of three-dimensional reconstruction imaging and interventional treatment efficacy for severe portal vein stenosis were analyzed. Results Among 10 patients, 3 cases were diagnosed with centripetal stenosis, tortuosity angulation-induced stenosis in 2 cases, compression-induced stenosis in 2 cases, long-segment stenosis and/or vascular occlusion in 3 cases. Three-dimensional reconstruction images possessed advantages in accurate identification of stenosis, identification of stenosis types and measurement of stenosis length. All patients were successfully implanted with portal vein stents. After stent implantation, the diameter of the minimum diameter of portal vein was increased [(6.2±0.9) mm vs. (2.6±1.7) mm, P<0.05], the flow velocity at anastomotic site was decreased [(57±19) cm/s vs. (128±27) cm/s, P<0.05], and the flow velocity at the portal vein adjacent to the liver was increased [(41±6) cm/s vs. (18±6) cm/s, P<0.05]. One patient suffered from intrahepatic hematoma caused by interventional puncture, which was mitigated after conservative observation and treatment. The remaining patients did not experience relevant complications. Conclusions Three-dimensional visualization technique may visually display the location, characteristics and severity of stenosis, which is beneficial for clinicians to make treatment decisions and assist interventional procedures. Timely implantation of portal vein stent may effectively reverse pathological process and improve portal vein blood flow.

Effects of low concentration atropine on macular microcirculation in children with different degrees of myopia / 中国临床药理学与治疗学

AIM: To investigate the effects of 0.01% atropine eye drops on macular blood flow density and retinal thickness in children with different degrees of myopia. METHODS: This was a prospective case-control study. Sixty-four patients (112 eyes) diagnosed with myopia for the first time with 0.01% atropine eye drops before and 6 months after medication were investigated with the uncorrected distance visual acuity (UCVA), axial length (AL), spherical equivalent (SE), macular ganglion cell-inner plexiform layer thicknes (mGCIPL) using slit lamp examination and optical coherence tomography (OCT), vascular density in the macular area and the area of the avascular in the fovea using optical coherence tomography angiography (OCTA) . Changes in various indicators before and after medication were compared. RESULTS: Compared with before medication, the AL of the three groups of myopia patients increased significantly (P0.05). The difference was statistically significant between the moderate myopia group and the high myopia group (P0.05). After 6 months of medication, the central circle macular vessel density (cCVD) increased in the low myopia group and moderate myopia group (P0.05). Before and after medication, there was no significant difference in outer circle macular vessel density (oCVD), inner circle macular vessel density (iCVD), and whole circle macular vessel density (wCVD) among the three myopia groups (P>0.05). The increase in mGCIPL was statistically significant in the low myopia group (P0.05). There was no significant difference in foveal avascular zone (FAZ) among the three myopia groups before and after medication (P>0.05). There was no correlation between CVD, AL, and SE in the three myopia groups (P>0.01). There was a low correlation between CVD and mGCIPL in the low myopia group (r=0.442, P0.01). CONCLUSION: 0.01% atropine can significantly reduce the rate of axial and refractive growth in children with low to moderate myopia, increase the density of central macular vessels, and increase the thickness of mGCIPL in children with low to moderate myopia.

Quantitative analysis of differences in blood flow parameters in the macular area of healthy people of different ethnic groups in Xinjiang by OCTA / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To measure the superficial capillary plexus(SCP)vessel density(VD), deep capillary plexus(DCP)VD, and the area, circumference, and roundness index of the foveal avascular zone(FAZ)in healthy individuals of four ethnic groups, namely, Uyghur, Han, Kazakh, and Hui by optical coherence tomography angiography(OCTA), and to investigate the differences of blood flow parameters in macular area of healthy individuals among different ethnic groups in China.METHODS: A total of 80 cases(80 eyes)of healthy subjects if each of the four ethnic groups who went to the Eye Center of the Friendship Hospital of Ili Kazak autonomous Prefecture from December 2022 to March 2023 and met the criteria were selected for the study, with 320 eyes totally. The patients were grouped and numbered according to their ethnicity, and the spherical equivalent and axial length were obtained by using an autorefractor and IOL Master. The blood flow images of the macular area in the range of 3 mm×3 mm were obtained by using a DRI Triton OCT detector, and the images were analyzed by using the built-in IMAGENET6 software to obtain the blood flow parameters. Furthermore, the differences in the blood flow parameters between different ethnic groups as well as the effects of gender, age, and axial length on macular blood flow parameters of different ethnic groups were compared.RESULTS:There were no statistically significant differences in gender, age, axial length, diopter, and image quality(IQ)among the four groups of subjects(all P&#x003E;0.05). Ethnic differences: in SCP, Uyghur inferior VD is higher than Kazakh, Hui inferior VD is higher than Han and Kazakh, Han and Hui nasal VD is higher than Uyghur, Kazakh foveal VD is higher than Han and Hui, Kazakh FAZ area is smaller than the other 3 ethnic groups, Han and Hui FAZ perimeter is larger than Kazakh, and Hui FAZ circularity index is lower than the other 3 ethnic groups; in DCP, Uyghur foveal VD is higher than Han and Hui, Kazakh foveal VD is higher than Han and Hui, Kazakh FAZ area and perimeter are smaller than the other 3 ethnic groups and Kazakh FAZ circularity index is higher than the other 3 ethnic groups(all P&#x003C;0.05). Sex differences: in SCP, FAZ area and perimeter of Han females were larger than those of males, and FAZ circularity index of Hui females was higher than that of males(all P&#x003C;0.05); in DCP, parafoveal VD and whole VD in females of all four ethnic groups were higher than those of males(all P&#x003C;0.05). Age correlation: in SCP, age was negatively correlated with the FAZ circularity index of Kazakh; in DCP, age was negatively correlated with the parafoveal and the whole VD of Han, Kazakh, and Hui(all P&#x003C;0.05). Axial length correlation: in SCP, the axial length was negatively correlated with Kazakh and Hui foveal VD, Hui parafoveal VD, Uyghur, Kazakh and Hui whole VD, and positively correlated with Kazakh FAZ area and perimeter; in DCP, the axial length was negatively correlated with Uyghur, Kazakh, Hui foveal VD, Hui whole VD, and positively correlated with Kazakh and Hui FAZ area and perimeter(all P&#x003C;0.05).CONCLUSION:There were differences in macular blood flow parameters among the Uyghur, Han, Kazakh, and Hui populations, with the area and perimeter of the FAZ of the Kazakh significantly smaller than those of the other three ethnic groups. Gender, age, and axial length are also related to macular blood flow parameters.

Restricción parcial de flujo sanguíneo con resistencia, fundamento fisiológico y metodología de entrenamiento

El entrenamiento con restricción del flujo sanguíneo ha resultado ser una alternativa que logra resultados similares a los conseguidos por el entrenamiento de alta intensidad. El presente artículo ofrece el resultado de una investigación, en la que se realizó una revisión bibliográfica para indagar sobre la efectividad en el aumento de fuerza muscular, así como analizar los mecanismos de acción y metodología de aplicación práctica, mediante el método de restricción parcial de flujo sanguíneo con resistencia a bajas cargas. La literatura revisada respalda los efectos positivos de este método para generar hipertrofia y aumento de fuerza muscular, tanto en población sana como en periodo de rehabilitación. Los principales mecanismos propuestos como mediadores de esta adaptación son la elevación en la secreción de hormona del crecimiento, la señalización intracelular vía anabólica y catabólica y la contribución de procesos inflamatorios o edematosos. Se recomendó trabajar con cargas entre el 20 al 40 % de una repetición máxima y con un volumen de 75 repeticiones por sesión con entrenamiento entre 2 a 4 veces por semana, durante un tiempo mínimo de tres semanas. Se discutió sobre los efectos en la adaptación neurológica, sin existir evidencia que lo respalde. Se concluyó que el método de restricción parcial del flujo sanguíneo genera aumento de fuerza e hipertrofia y se recomienda como método complementario y alternativo al ejercicio de alta intensidad, en poblaciones que necesariamente se ven imposibilitadas de entrenar a altas intensidades.

SÍNTESE O treinamento com restrição do fluxo sanguíneo provou ser uma alternativa que alcança resultados similares aos alcançados pelo treinamento de alta intensidade. Este artigo oferece o resultado de uma pesquisa, na qual foi realizada uma revisão de literatura para investigar a eficácia no aumento da força muscular, bem como para analisar os mecanismos de ação e metodologia de aplicação prática, utilizando o método de restrição parcial do fluxo sanguíneo com resistência a cargas baixas. A literatura revisada apóia os efeitos positivos deste método para gerar hipertrofia e aumentar a força muscular, tanto na população saudável quanto no período de reabilitação. Os principais mecanismos propostos como mediadores desta adaptação são a elevada secreção hormonal de crescimento, a sinalização intracelular através de vias anabólicas e catabólicas e a contribuição de processos inflamatórios ou edematosos. Foi recomendado trabalhar com cargas entre 20 a 40% de uma repetição máxima e com um volume de 75 repetições por sessão com treinamento entre 2 a 4 vezes por semana, por um tempo mínimo de três semanas. Os efeitos sobre a adaptação neurológica foram discutidos, mas não há evidências que sustentem isto. Concluiu-se que o método de restrição parcial do fluxo sanguíneo gera maior força e hipertrofia e é recomendado como um método complementar e alternativo ao exercício de alta intensidade, em populações que são necessariamente incapazes de treinar em altas intensidades.

Blood flow restriction training has turned out to be an alternative that achieves results similar to those achieved by high intensity training. The present article offers the result of a research where, a bibliographical review was carried out to inquire about the effectiveness in increasing muscle strength, as well as to analyze the mechanisms of action and methodology of practical application, through the method of partial restriction of blood flow with endurance to low loads. The reviewed literature supports the positive effects of this method to generate hypertrophy and increase muscle strength, both in the healthy population and in the rehabilitation period. The main mechanisms proposed as mediators of this adaptation are increased secretion of growth hormone, intracellular signaling via anabolic and catabolic pathways, and the contribution of inflammatory or edematous processes. It was recommended to work with loads between 20 and 40 % of a maximum repetition and with a volume of 75 repetitions per session with training between 2 and 4 times a week, for a minimum of three weeks. The effects on neurological adaptation were discussed, without supporting evidence. It was concluded that the method of partial restriction of blood flow generates an increase in strength and hypertrophy and is recommended as a complementary and alternative method to high intensity exercise, in populations that are necessarily unable to train at high intensities.

Effect of Kangaroo Mother Care on Cerebral Hemodynamics in Preterm Neonates Assessed by Transcranial Doppler Sonography in Middle Cerebral Artery

Objective: To study the effect of KMC in premature newborns on cerebral hemodynamics in the middle cerebral artery (MCA) using transcranial doppler sonography. Methods: In this descriptive study, 40 clinically stable preterm neonates admitted to the neonatal intensive care unit of our institute and undergoing Kangaroo mother care (KMC) were enrolled. Physiological and cerebral blood flow parameters of MCA were obtained by using transcranial doppler sonography at baseline, at 60 minutes of KMC, and after 60 minutes of stopping KMC. Results: Of the 40 enrolled neonates (24 males), the mean (SD) birth weight, gestation age, and postnatal age were 1698.25 (495.44) g, 33.00 (1.67) wk, and 6.80 (4.51) days, respectively. The mean (SD) cerebral blood flow velocities increased (peak systolic velocity (PSV), P=0.03; end diastolic velocity, P<0.001; mean velocity, P<0.001) and doppler indices decreased (resistive index, P=0.001; pulsatility index, P<0.001) significantly; whereas, heart rate (P<0.001) decreased but SpO2 (P=0.001) and mean blood pressure (P=0.003) increased significantly at 60 minutes of KMC as compared to baseline. Sixty minutes after stopping KMC, all parameters (except PSV) were higher than baseline, indicating post KMC effect. Conclusion: KMC improves cerebral hemodynamics in clinically stable preterm neonates.

Superficial retinal blood flow density analysis and related factors in adolescents with different classification of high myopia / 中华眼底病杂志

Objective:To observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. Results:There were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group ( P<0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions ( P<0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side ( P>0.05). There was no significant difference in PERIM ( P>0.05). There were significant differences in FAZ area and AI ( P<0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions ( P <0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area ( P<0.05). AL was negatively correlated with retinal thickness in the outer ring region ( P<0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region ( P<0.05). AL was negatively correlated with FAZ area and AI ( P<0.05). SE was positively correlated with FAZ area and PERIM ( P<0.05). Retinal thickness was positively correlated with SRVD and SBPD ( P<0.05). Conclusions:The SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.

The macular structure and blood flow in familial exudative vitreoretinopathy with inner retinal layer persistence / 中华眼底病杂志

Objective:To compared the changes of macular microvascular architecture in early stage familial exudative vitreoretinopathy (FEVR) patients with inner retinal layer (IRL) persistence and without IRL persistence.Methods:A retrospective clinical study. From 2017 to 2022, 94 patients with stage 1 FEVR with or without IRL residue and 45 age- and sex-matched healthy volunteers with 45 eyes (normal control group) who were confirmed by ophthalmology examination in Hangzhou Hospital of Optometry Affiliated to Wenzhou Medical University and Zhejiang Provincial People's Hospital were included in the study. According to whether there was IRL residue, the patients were divided into IRL group and non-IRL group, with 22 patients (22 eyes) and 72 patients (72 eyes), respectively. Best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) were performed in all eyes. Superficial vessel density (SCP) and deep vessel density (DCP) of whole image, fovea and parafovea, the area and perimeter of fovea avascular area (FAZ), A-circularity index (AI, perimeter/standard circle perimeter with equal area) and vessel density around the 300 μm width of the FAZ (FD), central macular thickness (CMT) on macular 3 mm × 3 mm scan on OCTA were measured.Results:SCP and DCP of whole image ( F=10.774, 4.583) and parafovea ( F=10.433, 3.912), CMT ( F=171.940) in IRL group and non-IRL group on macular 3 mm × 3 mm scan on OCTA were significantly lower than that in normal persons ( P<0.05). There were significant differences among three groups of the area of FAZ ( F=4.315), AI ( F=3.413), FD-300 ( F=13.592) ( P<0.05). BCVA were worst in IRL group ( P<0.05). Conclusions:Blood flow density decreased in macular area of FEVR patients. CMT is significantly thicker than normal population. The FAZ area of the foveal IRL residual eyes is small and irregular, with worse BCVA and lower macular blood density.

The effects of blood flow restriction on the quadriceps femoris and knee stability after anterior cruciate ligament reconstruction / 中华物理医学与康复杂志

Objective:To explore the effect of blood flow restriction training on the quadriceps femoris and on knee stability after anterior cruciate ligament reconstruction.Methods:Forty patients recovering from anterior cruciate ligament reconstruction were randomly divided into an experimental group and a control group, each of 20. In addition to routine rehabilitation training, the control group was given routine knee flexion and extension strength training, while the experimental group trained for an additional 20 minutes doing knee flexion and extension resistance training with the blood pressure in their groins at 70% of their individual arterial occlusive pressure. (The mean pressure was (123±11.23)mmHg). The training lasted 8 weeks, three times a week. Knee function and hamstring and quadriceps peak torque were assessed before and after the intervention using a Lysholm scale and Humac Norm isokinetic muscle strength tests.Results:There were no significant differences between the two groups in any of the measurements before the training. After the intervention, all of the measurements had improved significantly in both groups, with the average Lysholm score, H/Q% and peak torque of the experimental group significantly better than the control group′s averages.Conclusions:Blood flow restriction training can improve the effectiveness of quadriceps femoris strength, knee stability and knee function training after anterior cruciate ligament reconstruction.

Blood flow restriction can improve knee proprioception and motor coordination after anterior cruciate ligament reconstruction / 中华物理医学与康复杂志

Objective:To explore any effect of blood flow restriction during exercise on knee proprioception and motor coordination after anterior cruciate ligament (ACL) reconstruction.Methods:Thirty patients recovering from ACL reconstruction were randomly divided into an experimental group and a control group, each of 15. Both groups were given routine rehabilitation training, while the experimental group was additionally provided with 45 minutes of training with blood flow restriction, 3 times a week for 8 weeks. The blood flow restriction training involved constant pressure in the groin while the patient performed knee flexion and extension resistance training, squats, alternate knee flexion and extension and ergometer cycling. Before and after the intervention, both groups′ knee function, proprioception and lower limb motor coordination were evaluated using the Lysholm knee scale, the Humac isokinetic measurement system and surface electromyography.Results:Before the experiment there were no significant differences between the two groups in any of the measurements. After the intervention, both groups′ average Lysholm score had improved significantly, and errors in reproducing a knee angle had decreased significantly. Significantly better improvement was observed in the observation group than in the control group. That group′s average coordinated contraction rate on the affected side in extension and flexion was also significantly better than the control group′s ave-rage. Indeed, there were no significant differences in the contraction rates between the healthy and affected sides.Conclusions:Training with restricted blood flow can significantly improve knee function, proprioception and motor coordination after anterior cruciate ligament reconstruction.

Advances in the study of small-for-size syndrome / 中华肝胆外科杂志

Small-for-size syndrome is one of the most common and dangerous complications of partial liver transplantation. With the accumulation of clinical experiences and basic researches developed in recent years, new knowledge about the pathogenesis, pathophysiological process, prevention and treatment of small-for-size syndrome has been established. This article summarizes the progress of research on the small-for-size syndrome in recent years to help better diagnosis, prevention and treatment, thus improving the prognosis and long-term survival of patients.

Effects of intravenous thrombolysis combined with Xingnaojing injection on intracranial arterial hemodynamic indexes and neurological function in patients with cerebral infarction / 中国基层医药

Objective:To investigate the effects of intravenous thrombolysis combined with Xingnaojing injection on hemodynamic indexes and neurological function in patients with cerebral infarction. Methods:A total of 142 patients with cerebral infarction who were treated in Xing An Meng Hospital from April 2020 to May 2021 were included in this study. They were randomly divided into a control group ( n = 71, intravenous thrombolysis) and a Xingnaojing injection group ( n = 71, intravenous thrombolysis + Xingnaojing injection). Intracranial arterial hemodynamic indexes, National Institutes of Health Stroke Scale score, Fugl-Meyer Assessment Scale score, serum inflammatory factors, oxidative stress indexes, brain injury markers, and the incidence of adverse reactions were compared between the two groups. Results:After treatment, serum levels of interleukin-1β, interleukin-6, and tumor necrosis factor-α were significantly lower in the Xingnaojing injection group than the control group [interleukin-1β: (4.05 ± 0.83) ng/L vs. (6.85 ± 1.02) ng/L, interleukin-6: (43.61 ± 5.14) ng/L vs. (60.31 ± 7.04) ng/L, tumor necrosis factor-α: (35.93 ± 4.25) ng/L vs. (20.93 ± 3.11) ng/L, t = 17.94, 16.14, 15.37, all P < 0.001]. After treatment, the mean blood flow velocities of the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery in the Xingnaojing injection group were significantly higher than those in the control group [anterior cerebral artery: (49.36 ± 5.28) cm/s vs. (41.15 ± 5.12) cm/s, middle cerebral artery: (61.27 ± 7.02) cm/s vs. (50.19 ± 6.08) cm/s, posterior cerebral artery: (44.92 ± 5.63) cm/s vs. (37.26 ± 4.93) cm/s, t = 9.40, 10.05, 8.62, all P < 0.001]. After treatment, the National Institutes of Health Stroke Scale score and Fugl-Meyer Assessment Scale score in the Xingnaojing injection group were superior to those in the control group [National Institutes of Health Stroke Scale score: (10.36 ± 1.52) points vs. (14.62 ± 2.05) points, Fugl-Meyer Assessment Scale score: (76.19 ± 8.08) points vs. (65.28 ± 7.14) points, t = 14.06, 8.52, both P < 0.05]. After treatment, the serum level of malondialdehyde in the Xingnaojing injection group was significantly higher than that in the control group [(6.35 ± 1.02) μmol/L vs. (10.05 ± 1.63) μmol/L), t = 16.21, P < 0.001]. The serum level of superoxide dismutase in the Xingnaojing injection group was significantly lower than that in the control group [(114.31 ± 13.69) U/L vs. (92.25 ± 10.16) U/L), t = 10.90, P < 0.001]. Serum levels of neuron-specific enolase and S100β in the Xingnaojing injection group were significantly lower than those in the control group [neuron-specific enolase: (24.01 ± 3.24) IU/L vs. (30.31 ± 4.02) IU/L, S100β: (0.73 ± 0.17) ng/L vs. (1.13 ± 0.22) ng/L, t = 10.28, 12.12, both P < 0.001). There was a significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Intravenous thrombolysis combined with Xingnaojing injection for the treatment of cerebral infarction can improve intracranial hemodynamics, reduce the inflammatory response and oxidative stress, and alleviate brain tissue injury. The combined therapy is beneficial to protect the neurological function of patients with cerebral infarction and is highly safe.

Determination of endometrial receptivity by three-dimensional power ultrasound for evaluation of pregnancy outcome after in vitro fertilization and embryo transfer / 中国基层医药

Objective:To investigate the clinical value of endometrial receptivity determination by transvaginal three-dimensional power ultrasound in the prediction of pregnancy outcome after in vitro fertilization and embryo transfer. Methods:A total of 220 infertile patients who underwent in vitro fertilization and embryo transfer in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2018 to July 2021 were included in this study. Before in vitro fertilization and embryo transfer, all patients were tested for endometrial receptivity by transvaginal two-dimensional and three-dimensional power ultrasound. Pregnancy outcomes were followed up. Anatomical indexes (endometrial thickness, endometrial volume, and endometrial morphology) and endometrial blood flow indexes [endometrial blood flow type, pulsation index, resistance index (RI), ratio of peak systolic velocity to end-diastolic velocity (S/D), vascularization index (Vl), blood flow index (FI) and vascular blood flow index (VFI)] were compared between different pregnancy outcomes. Results:There were no significant differences in endometrial thickness, endometrial volume, and endometrial morphology between successful pregnancy and failed pregnancy groups ( t or χ2 = 0.23-0.54, P = 0.523-0.890). There was no significant difference in endometrial blood flow typing between successful pregnancy and failed pregnancy groups ( χ2 = 0.217, P = 0.897). PI, RI, and S/D in the successful pregnancy group were (2.46 ± 0.29), (1.07 ± 0.21), and (0.57 ± 0.10), respectively, which were significantly lower than (2.71 ± 0.34), (1.35 ± 0.24), and (0.66 ± 0.11) in the failed pregnancy group ( t = 4.51, 5.27, 3.43, all P < 0.001). VI, FI, and VFI values in the successful pregnancy group were (23.04 ± 2.95), (32.26 ± 3.17), and (6.59 ± 0.94) respectively, which were significantly higher than (16.85 ± 2.17), (28.42 ± 3.04), and (4.88 ± 0.86) in the failed pregnancy group ( t = 10.94, 6.25, 8.37; all P < 0.001). Conclusion:Endometrial blood flow parameters such as PI, RI, S/D, VI, FI, and VFI determined by transvaginal three-dimensional power ultrasound have a certain predictive value for pregnancy outcomes after in vitro fertilization and embryo transfer. They can be used as sensitive indexes for evaluating endometrial receptivity.

Correlation analysis of serum anti-Mullerian hormone level and ovarian interstitial blood flow in patients with polycystic ovary syndrome / 中国医师进修杂志

Objective:To investigate the correlation between the level of anti Mullerian hormone (AMH) in serum and ovarian interstitial blood flow in patients with polycystic ovary syndrome (PCOS).Methods:The clinical data of 88 patients with PCOS (PCOS group) admitted to Jiangshan Hospital of Traditional Chinese Medicine from June 2019 to June 2022 and 50 women of the same age who underwent physical examination during the same period (normal control group) were collected retrospectively. The patients in the PCOS group were divided into two subgroups according to the homeostatic model assessment for insulin resistance index (HOMA-IR) evaluated by the steady-state model. Among them, patients with HOMA-IR ≥ 2.69 were divided into the insulin resistance subgroup (PCOS-IR subgroup, 50 cases), and patients with HOMA-IR<2.69 were divided into the non-insulin resistance subgroup (PCOS-NIR subgroup, 38 cases). The level of AMH were measured by electrochemiluminescence, and ovarian interstitial blood flow indicators, including peak blood flow velocity (PSV), pulsation index (PI), and resistance index (RI) were monitored. Pearson correlation test was used to analyze the correlation between serum AMH and insulin resistance and ovarian interstitial blood flow. Meanwhile, Logistic linear regression model was used to analyze the influencing factors of ovarian interstitial blood flow in patients with PCOS.Results:The levels of AMH, HOMA-IR and PSV in the PCOS group were higher than those in the normal control group: (2.13 ± 0.84) μg/L vs. (0.84 ± 0.29) μg/L, 4.6(2.0, 8.4) vs. 1.8(0.5, 3.9), (10.05 ± 1.52) cm/s vs.(6.78 ± 0.89) cm/s; the PI and RI in the PCOS group were lower than those in the control group: (1.14 ± 0.26)% vs. (2.01 ± 0.53)%, (0.37 ± 0.18)% vs. (0.85 ± 0.33)%, there were statistical differences ( P<0.05). The levels of AMH, HOMA-IR and PSV in the PCOS-IR subgroup were higher than those in the PCOS-NIR subgroup: (2.68 ± 0.81) μg/L vs. (1.59 ± 0.43) μg/L, (10.74 ± 2.32) cm/s vs. (7.93 ± 1.90) cm/s, 7.2(3.1, 15.8) vs. 2.1(0.6, 5.3); the PI and RI in the PCOS-IR subgroup were lower than those in the PCOS-NIR subgroup: (0.88 ± 0.35)% vs. (1.52 ± 0.50)%, (0.29 ± 0.04)% vs. (0.51 ± 0.05)%, there were statistical differences ( P<0.05). Pearson correlation analysis showed that the level of AMH were positively correlated with PSV and HOMA-IR ( r = 0.694 and 0.540, P<0.05), but negatively correlated with PI and RI( r = - 0.687 and - 0.692, P<0.05). Logistic linear regression model analysis showed that AMH and HOMA-IR were risk factors for ovarian interstitial blood flow in patients with PCOS( P<0.05). Conclusions:The serum AMH level in patients with PCOS is abnormally high and increases with insulin resistance. At the same time, the imbalance of AMH expression plays an important role in the increase of abnormal ovarian interstitial blood flow.

Cerebral blood flow autoregulation and cerebrovascular reactivity in patients with cerebral small vessel disease and depression / 中国医师进修杂志

Objective:To investigate the cerebral blood flow autoregulation and cerebrovascular reactivity in patients with cerebral small vessel disease (SVD) and depression.Methods:Eighty patients who were treated in Dalian Municipal Central Hospital Affiliated with Dalian University of Technology from May 2020 to may 2021 were selected and divided into observation group and control group according to the existence of depression. Transcranial Doppler sonography combined with standing and lying position test, breath holding test and breath exchange test were used to observe the "w" wave slope, the "w" wave slope, the "w" wave velocity and the "w" wave velocity cerebral blood flow velocity difference, breath holding index, pulsation index (PI) change rate before and after breath holding, resistance index (RI) change rate before and after breath holding, mean velocity (Vm), PI, RI change rate before and after breath exchange. The correlation between depression score and blood flow index was analyzed.Results:There were 38 and 29 patients occurred "w" wave in the control group and observation group respectively, and the rate were 95.0% (38/40) and 72.5% (29/40) respectively ( χ2 = 7.44, P = 0.006). The slope of "w" descending branch of Vm and the slope of "w" ascending branch of Vm in the observation group were smaller than those of the control group respectively: (1.26 ± 0.23) cm/s vs. (2.45 ± 1.00) cm/s, (1.38 ± 0.71) cm/s vs. (2.56 ± 0.77) cm/s, the difference of which had statistical meanings ( P<0.05). The difference of cerebral blood flow velocity of Vm after different positions in the observation group was higher than that in the control group significantly: (7.20 ± 3.07) cm/s vs. (2.93 ± 1.46) cm/s ( P<0.05). The breath holding index PI change rate, RI change rate before and after breath holding test in the observation group were lower than those in the control group statistically: (0.88 ± 0.33)% vs. (1.49 ± 0.27)%, (14.42 ± 9.31)% vs. (21.51 ± 8.79)%, (11.07 ± 1.70)% vs. (15.31 ± 6.73)% ( P<0.05). The change rates of Vm, PI and RI in the observation group before and after ventilation were lower than those in the control group ( P<0.05). There was a negative correlation between depression score and "w" wave slope (Vm), breath holding index, Vm change rate before and after ventilation, and a positive correlation between depression score and cerebral blood flow velocity difference (Vm) in supine and upright position with statistical meanings ( P<0.05). Conclusions:Depression could lead to the decline of cerebral blood flow autoregulation and cerebrovascular reactivity in patients with SVD. And with the aggravation of depression, the decline of cerebral blood flow autoregulation and cerebrovascular reactivity in patients with SVD is more serious.

Effects of recombinant human erythropoietin on cerebral blood flow in preterm infants: arterial spin labeling magnetic resonance imaging evaluation / 中国新生儿科杂志

Objective:To study the effects of recombinant human erythropoietin (rhEPO) on cerebral blood flow (CBF) in preterm infants using arterial spin labeling (ASL) magnetic resonance imaging (MRI).Methods:From September 2021 to June 2022, preterm infants (gestational age ≤32 weeks, birth weight ≤1 500 g) admitted to NICU of our hospital within 24 h after birth were randomly assigned into rhEPO group and control group for this prospective study. The rhEPO group was given rhEPO (500 IU/kg iv, once every other day for 2 weeks) within 72 h after birth plus symptomatic supportive treatment. The control group received same amount of normal saline injection. Both groups received brain MRI, diffusion-weighted imaging and ASL at adjusted gestational age of 35~37 weeks and CBF values of interested areas were measured.Results:A total of 85 infants were enrolled, including 40 in the rhEPO group and 45 in the control group. No significant differences existed in the incidences of periventricular-intraventricular hemorrhage, periventricular leukomalacia, focal white matter injury and extensive white matter injury between the two groups ( P>0.05). The CBF values [ml/(100 g·min)] of frontal cortex [left 15.1±3.9 vs. 17.9±3.1, right 15.9 (12.5, 17.8) vs. 18.1(16.1,20.2)], temporal cortex [left 15.8±4.3 vs. 18.6±3.8, right 16.3(13.2,19.4) vs. 18.1(15.7,19.7)], occipital cortex (left 15.8±6.1 vs. 18.8±3.3, right 16.8±5.5 vs. 19.3±4.8), basal ganglia (left 24.7±7.2 vs. 28.7±6.2, right 26.0±7.9 vs. 29.3±6.4) and thalamus (left 32.7±11.8 vs. 37.9±8.6, right 32.1±11.6 vs. 37.6±10.2) in the rhEPO group were significantly lower than the control group ( P<0.05). No significant differences existed of CBF value at the parietal cortex between the two groups ( P>0.05). Conclusions:Early application of rhEPO can reduce CBF in premature infants, which may be related to the neuro-protective effects of EPO.

Diagnostic value of vaginal color Doppler flow parameters in different FIGO stages of epithelial ovarian cancer / 中华内分泌外科杂志

Objective:To investigate the diagnostic value of vaginal color Doppler flow parameters in patients with epithelial ovarian cancer in different FIGO staging.Methods:178 patients with ovarian tumors who were treated by surgery in Dingzhou People’s Hospital from Jul. 2016 to Jul. 2022 were selected, and they were divided into ovarian cancer group (65 cases) and ovarian cyst group (113 cases) according to the results of postoperative pathological diagnosis. According to FIGO staging standards, ovarian cancer was divided into FIGO stage I (18 cases) , FIGO stage II (16 cases) , FIGO stage III (16 cases) and FIGO stage IV (15 cases) . The blood flow parameters of vaginal color Doppler ultrasound were measured, including arterial pulsatility index (PI) , end diastolic flow velocity (EDV) , resistance index (RI) , peak flow velocity (PSV) , serum vascular endothelial growth factor (VEGF) and human epididymal epithelial secretory protein 4 (HE4) . The levels of PI, EDV, RI, PSV, VEGF and HE4 were compared between the two groups and patients with different FIGO stages, and the value of ROC analysis of vaginal color Doppler flow parameters in predicting the occurrence of ovarian cancer was analyzed. The correlation between FIGO stage and vaginal color Doppler flow parameters and serum VEGF and HE4 levels was analyzed by person coefficient.Results:PI and RI levels in ovarian cancer group were (0.79 ± 0.15) , and (0.39 ± 0.12) , lower than those in ovarian cyst group (1.51 ± 0.17) , (0.72 ± 0.16) ; EDV, PSV, HE4, VEGF levels were (13.88 ± 4.18) cm/s, (25.61 ± 4.53) cm/s, (283.92 ± 28.97) pmol/L, and (372.55 ± 38.96) ng/mL, higher than those in ovarian cyst group ( P<0.05) . According to ROC analysis, the best cutoff values of transvaginal color Doppler blood flow parameters for predicting the occurrence of ovarian cancer were PI<1.235, EDV≥10.985 cm/s, RI<0.580, PSV≥22.975cm/s, all P<0.05. The levels of PI and RI in patients with different FIGO stages showed a decreasing trend with the increase of the severity of the disease, while the levels of EDV, HE4 and VEGF showed an increasing trend ( P<0.05) . There was no significant difference in PSV levels between patients with different FIGO stages ( P>0.05) . The correlation analysis showed that FIGO stage was positively correlated with the blood flow parameters EDV and the levels of serum HE4 and VEGF. FIGO stage was negatively correlated with PI and RI ( P<0.05) . Conclusions:There were significant differences in the levels of PI, RI and EDV in patients with ovarian cysts and ovarian cancer at different FIGO stages. The levels of PI, RI and EDV are closely related to the malignant degree of ovarian cancer.

The Clinical Effect of Pretreatment with Heat-sensitive Moxibustion on Primary Dysmenorrhea and Its Influence on Uterine Artery Blood Flow： A Randomized， Blinded Controlled Trial / 中医杂志

ObjectiveTo compare the clinical effect of heat-sensitive moxibustion before menstruation and since the first day of menstruation on primary dysmenorrhoea （PD）， thereby optimizing the clinical treatment plan. MethodsSixty patients with PD were randomly divided into pretreatment group （treated before menstruation） and conventional treatment group （treated since the first day of menstruation） of 30 cases each. For all patients， the area surrounded by bilateral Zigong （EX-CA1） and bilateral Guilai （ST 29） in the supine position， and that formed by bilateral Shenshu （BL 23） and Ciliao （BL 32） in the prone position were selected for circling moxibustion （2 min）， sparrow-pecking moxibustion （1 min）， and then moxibustion along the channels to stimulate the moxibustion sensation and obtain two heat-sensitive points with the best sensation for treatment. In the pretreatment group， moxibustion was applied 3-7 days before the onset of menstruation， and in the conventional treatment group， moxibustion was applied on the day of menstruation. Both groups were treated once daily for 7 days per menstrual cycle for 3 consecutive cycles. The clinical outcomes of the two groups were measured before and after treatment in terms of the COX menstrual pain symptom scale （CMSS） scores， visual analogue scale for pain （VAS） scores， and uterine artery hemodynamic indicators including blood pulsation index （PI） and resistance index （RI）， and the clinical effect was compared. ResultsAfter treatment， the CMSS scores， VAS scores， PI and RI in the two groups decreased， and lower scores were found in the pretreatment group （P＜0.05 or P＜0.01）. The total effective rate after treatment was 93.3% （28/30） in the pretreatment group， which was better than 73.3% （22/30） in the conventional treatment group （P＜0.05）. ConclusionThe clinical effect of heat-sensitive moxibustion before the menstruation for PD was better than that implemented since the first day of menstruation， by significantly improving the patients' dysmenorrhoea symptoms and uterine artery blood flow index.

Medical Therapy of Hearing Impairment and Tinnitus with Chinese Medicine: An Overview / 中国结合医学杂志

The current review gives a comprehensive overview of the recent development in Chinese medicine (CM) for treating several kinds of acquired nerve deafness and tinnitus, as well as links the traditional principle to well-established pharmacological mechanisms for future research. To date, about 24 herbal species and 40 related ingredients used in CM to treat hearing loss and tinnitus are reported for the treatment of endocochlear potential, endolymph growth, lowering toxic and provocative substance aggregation, inhibiting sensory cell death, and retaining sensory transfer. However, there are a few herbal species that can be used for medicinal purposes. Nevertheless, clinical studies have been hampered by a limited population sample, a deficiency of a suitable control research group, or contradictory results. Enhanced cochlear blood flow, antiinflammatory antioxidant, neuroprotective effects, and anti-apoptotic, as well as multi-target approach on different auditory sections of the inner ear, are all possible benefits of CM medications. There are numerous unknown natural products for aural ailment and tinnitus identified in CM that are expected to be examined in the future utilizing various aural ailment models and processes.

Effect of mild moxibustion with moxa stick and infrared mild moxibustion on skin blood perfusion at Waiguan (TE 5) / 中国针灸

OBJECTIVES@#To observe the changes of skin blood flow perfusion at Waiguan (TE 5) caused by mild moxibustion with moxa stick and infrared mild moxibustion using laser speckle contrast imaging technology, and to compare the microcirculatory effect during and after both moxibustion methods and explore the dose-response relationship of moxibustion.@*METHODS@#Twenty-four healthy participants were treated with mild moxibustion with moxa stick and infrared mild moxibustion at left Waiguan (TE 5). The record started when the skin temperature reached (44±1) °C, and both moxibustion methods were provided within this temperature range. The 20-minute moxibustion process was divided into four stages (5, 10, 15, and 20 min) using interpolation method, and each participant completed eight interventions with a minimum 24-hour interval between different interventions. The skin surface temperature of the left Waiguan (TE 5) was monitored when both moxibustion interventions were given for 10 min using a TES1306 thermocouple thermometer. The skin microcirculatory blood perfusion units (MBPU) of left Waiguan (TE 5) was measured using a PSIN-01087 laser speckle blood flow imager 1 min before moxibustion, at 5, 10, 15, 20 min during moxibustion and continuously for 20 min after moxibustion in each intervention.@*RESULTS@#The skin surface temperature of the left Waiguan (TE 5) remained within the range of (44±1) °C during both moxibustion methods, with no statistically significant difference (P>0.05). Compared with that before moxibustion, the MBPU of the left Waiguan (TE 5) was increased significantly at 5, 10, 15, and 20 min of both moxibustion methods (P<0.05, P<0.01). Compared with moxibustion for 10, 15 and 20 min, the MBPU of the left Waiguan (TE 5) of moxibustion for 5 min was lower in both moxibustion methods (P<0.01). For both moxibustion methods with the same moxibustion course, the MBPU of the left Waiguan (TE 5) 20 min after intervention was significantly higher than that at 1 min before moxibustion (P<0.001), and there was no significant difference in MBPU between 1 min before moxibustion and 20 min after moxibustion among different groups (P>0.05). Within the same moxibustion method, the MBPU of the left Waiguan (TE 5) 20 min after moxibustion with the intervention of 5 min was lower compared to that of 10, 15, and 20 min of moxibustion (P<0.001), with no significant differences between 10, 15, and 20 min of moxibustion (P>0.05).@*CONCLUSIONS@#When controlling the skin temperature at Waiguan (TE 5) within (44±1) °C, infrared mild moxibustion has similar effects on skin microcirculatory blood perfusion as traditional mild moxibustion with moxa sticks. From a dose-response perspective, microcirculation reached a stable state after 10 min of moxibustion, and moxibustion interventions lasting for more than 10 min shows better therapeutic effects.