Etiology composition and prognosis of pediatric chronic critical illness in a pediatric intensive care unit / 中国当代儿科杂志

OBJECTIVES@#To explore the etiology composition and outcomes of pediatric chronic critical illness (PCCI) in the pediatric intensive care unit (PICU).@*METHODS@#The children who were hospitalized in the PICU of Dongguan Children's Hospital Affiliated to Guangdong Medical University and met the diagnostic criteria for PCCI from January 2017 to December 2022 were included in the study. The etiology of the children was classified based on their medical records and discharge diagnoses. Relevant clinical data during hospitalization were collected and analyzed.@*RESULTS@#Among the 3 955 hospitalized children in the PICU from January 2017 to December 2022, 321 cases (8.12%) met the diagnostic criteria for PCCI. Among the 321 cases, the most common etiology was infection (71.3%, 229 cases), followed by unintentional injury (12.8%, 41 cases), postoperation (5.9%, 19 cases), tumors/immune system diseases (5.0%, 16 cases), and genetic and chromosomal diseases (5.0%, 16 cases). Among the 321 cases, 249 cases (77.6%) were discharged after improvement, 37 cases (11.5%) were discharged at the request of the family, and 35 cases (10.9%) died in the hospital. Among the deaths, infection accounted for 74% (26/35), unintentional injury accounted for 17% (6/35), tumors/immune system diseases accounted for 6% (2/35), and genetic and chromosomal diseases accounted for 3% (1/35). From 2017 to 2022, the proportion of PCCI in PICU diseases showed an increasing trend year by year (P<0.05). Among the 321 children with PCCI, there were 148 infants and young children (46.1%), 57 preschool children (17.8%), 54 school-aged children (16.8%), and 62 adolescents (19.3%), with the highest proportion in the infant and young children group (P<0.05). The in-hospital mortality rates of the four age groups were 14.9% (22/148), 8.8% (5/57), 5.6% (3/54), and 8.1% (5/62), respectively. The infant and young children group had the highest mortality rate, but there was no statistically significant difference among the four groups (P>0.05).@*CONCLUSIONS@#The proportion of PCCI in PICU diseases is increasing, and the main causes are infection and unintentional injury. The most common cause of death in children with PCCI is infection. The PCCI patient population is mainly infants and young children, and the in-hospital mortality rate of infant and young children with PCCI is relatively high.

Metabonomics Analysis of Brain Stem Tissue in Rats with Primary Brain Stem Injury Caused Death / 法医学杂志

OBJECTIVES@#To explore the potential biomarkers for the diagnosis of primary brain stem injury (PBSI) by using metabonomics method to observe the changes of metabolites in rats with PBSI caused death.@*METHODS@#PBSI, non-brain stem brain injury and decapitation rat models were established, and metabolic maps of brain stem were obtained by LC-MS metabonomics method and annotated to the HMDB database. Partial least square-discriminant analysis (PLS-DA) and random forest methods were used to screen potential biomarkers associated with PBSI diagnosis.@*RESULTS@#Eighty-six potential metabolic markers associated with PBSI were screened by PLS-DA. They were modeled and predicted by random forest algorithm with an accuracy rate of 83.3%. The 818 metabolic markers annotated to HMDB database were used for random forest modeling and prediction, and the accuracy rate was 88.9%. According to the importance in the identification of cause of death, the most important metabolic markers that were significantly up-regulated in PBSI group were HMDB0038126 (genipinic acid, GA), HMDB0013272 (N-lauroylglycine), HMDB0005199 [(R)-salsolinol] and HMDB0013645 (N,N-dimethylsphingosine).@*CONCLUSIONS@#GA, N-lauroylglycine, (R)-salsolinol and N,N-dimethylsphingosine are expected to be important metabolite indicators in the diagnosis of PBSI caused death, thus providing clues for forensic medicine practice.

Clinical Effect of Chaishao Longmu Decoction on Insomnia in Patients with Liver Depression and Spleen Deficiency Based on Infrared Thermal Images / 中国实验方剂学杂志

ObjectiveTo observe the therapeutic effect of Chaishao Longmu decoction on insomnia in the patients with the syndrome of live depression and spleen deficiency and explore the correlation between infrared thermal imaging and insomnia with liver depression and spleen deficiency. MethodA total of 72 insomnia patients treated in the outpatient department of Shenzhen Hospital of Guangzhou University of Chinese Medicine （Futian） from May to December in 2022 were selected and randomized into a treatment group and a control group， with 36 patients in each group. The patients in the treatment group were treated with Chaishao Longmu decoction and those in the control group with eszopiclone for 4 weeks. The clinical efficacy， Pittsburgh sleep quality index （PSQI） score， TCM syndrome score and infrared thermal imaging characteristics ［temperature and temperature changes of frontal sleep line， frontal region， anterior trunk， Zhongwan （CV12）， conception vessel （CV）， left hypochondrium， right hypochondrium， dorsal trunk， and governor vessel （GV）］ of two groups were determined before and after treatment. ResultAfter treatment， the clinical response rate in treatment group was 91.67% （33/36）， which was higher than that （66.67%， 24/36） in the control group （Z=-2.617， P<0.01）. The treatment in both groups decreased the PSQI score and TCM syndrome score （P<0.01）， and the decreases were more significant in treatment group than in the control group （P<0.01）. After treatment， the total response rate of sleep line improvement in the treatment group was 86.11% （31/36）， which was higher than that （66.67%， 24/36） in the control group （Z=-2.591， P<0.05）. The frontal temperature of the two groups decreased （P<0.01） after treatment. Compared with those before treatment， the temperatures of anterior trunk， CV12， CV， left hypochondrium， right hypochondrium， dorsal trunk， and GV rose after treatment （P<0.01）. After treatment， the treatment group had lower frontal temperature and higher temperatures of anterior trunk， CV12， CV， left hypochondrium， right hypochondrium， dorsal trunk， and GV than the control group （P<0.01）. The treatment in the treatment group reduced the ∆T values of GV （P<0.01） and increased that of the CV12， CV， left hypochondrium， and right hypochondrium （P<0.05，P<0.01）. The treatment in the control group increased the ∆T value of CV12 （P<0.01）. After treatment， the treatment group had lower ∆T values of GV （P<0.01） and higher ∆T value of CV12， CV， left hypochondrium， and right hypochondrium （P<0.05， P<0.01） than the control group. Compared with that before treatment， the temperature difference between GV and CV in the two groups increased after treatment （P<0.01）. According to the infrared thermal image characteristics， the normal temperature difference between GV and CV was within the range of 0.5-1. The median value after treatment in the treatment group was 0.69 （0.52， 0.88）， which was within the normal range， indicating that the treatment group outperformed the control group. ConclusionChaishao Longmu decoction can alleviate short-term insomnia by soothing liver， invigorating spleen， harmonizing the middle energizer， and regulating GV and CV. With definite clinical effect， this decoction deserves promotion. Furthermore， the frontal temperature， sleep line， CV12， CV ∆T， and temperature difference between GV and CV revealed by the infrared thermal images could be used for the diagnosis and of insomnia with liver depression and spleen deficiency.

GAO Wei-bin's clinical experience in treatment of neurogenic bladder with acupuncture / 中国针灸

The paper introduces GAO Wei-bin's clinical experience in acupuncture treatment for neurogenic bladder. In association with the etiology, the location and types of neurogenic bladder and in accordance with nerve anatomy and meridian differentiation, the acupoints are selected accurately in treatment. Four acupoint prescriptions are allocated. For frequent urination and urinary incontinence, the foot-motor-sensory area of scalp acupuncture, Shenshu (BL 23) and Huiyang (BL 35) are used. For all kinds of urine retention, especially the patients who are not suitable for acupuncture at the lumbar region, Zhongji (CV 3), Qugu (CV 2), Henggu (KI 11) and Dahe (KI 12) are selected. For all kinds of urine retention, Zhongliao (BL 33) and Ciliao (BL 32) are applicable. For the patients with both dysuria and urinary incontinence, Zhongliao (BL 33), Ciliao (BL 32) and Huiyang (BL 35) are chosen. In treatment of neurogenic bladder, both biao (root causes) and ben (primary symptoms) are considered, as well as the accompanying symptoms; and electroacupuncture is combined accordingly. During the delivery of acupuncture, the sites where the acupoints located are detected and palpated so as to rationally control the depth of needle insertion and the operation of reinforcing and reducing needling techniques.

Professor GAO Wei-bin's clinical experience of using electroacupuncture for dry eye / 中国针灸

The academic thoughts of professor GAO Wei-bin regarding the use of electroacupuncture in the treatment of dry eye are introduced. Professor GAO believes that the occurrence of dry eye is mainly related to the stagnation of qi and blood in the eye meridians, leading to inadequate nourishment of the eyes. The acupuncture treatment principle focuses on promoting blood circulation, clearing and benefiting the eye orifices. By integrating traditional acupuncture theory with modern neuroanatomy, the treatment approach centers on stimulating the lacrimal gland, emphasizing the importance of promoting, addressing symptoms as a priority, and considering both the root cause and symptoms.The precise acupoint selection is emphasized. Acupoints of periocular region, such as Taiyang (EX-HN 5) and Leixian point are selected along with Fengchi (GB 20) and Gongxue point to treat dry eye. Attention is also given to the use of electroacupuncture and the selection of its frequencies, emphasizing specific needling techniques based on the severity and classification of the disease.

Diagnostic value of contrast-enhanced ultrasound in hepatic epithelioid hemangioendothelioma / 中华肝脏病杂志

Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.

Surgical treatment methods and classification of proximal clavicle fracture / 中国骨伤

OBJECTIVE@#To summarize the surgical treatment of different proximal clavicle fractures, and discuss the classification of proximal clavicle fractures.@*METHODS@#Total of 24 patients with displaced proximal clavicle fractures were treated from January 2017 to December 2020 including 16 males and 8 females, aged 28 to 66 years old. Among them, 20 cases were fresh fractures and 4 cases were old fractures. According to the Edinburgh classification, 14 cases were type 1B1 fractures and 10 cases were type 1B2 fractures. The different internal fixation methods were selected for internal fixation treatment according to different fracture types.The operation time, blood loss, preoperative and postoperative displacement difference, fracture healing time and Rockwood scoring system were recorded.@*RESULTS@#All patients were followed up for 12 to 24 months. There were no patients with infection or loss of reduction after the operation. Three patients had internal fixation failure after operation, and the internal fixation device was removed. Results The operation time was 30 to 65 min, and the blood loss was 15 to 40 ml. No important nerves, blood vessels, or organs were damaged. The imaging healing time was 3 to 6 months. According to the Rockwood functional score, the total score was (13.50±1.86), pain (2.57±0.50), range of motion (2.78±0.41), muscle strength (2.93±0.28), restricted daily activity (2.85±0.35), subjective results (2.63±0.61);the results were excellent in 20 cases, good in 3 cases, fair in 1 case.@*CONCLUSION@#Proximal clavicular fracture is a type of fracture with low incidence. According to different fracture types, different internal fixation methods and treatment methods can be selected, and satisfactory surgical results can be achieved.

Cardiomyocyte Energy Metabolism in Mammalian Cardiac Regeneration / 中山大学学报(医学科学版)

Cardiovascular disease， such as coronary heart disease and acute myocardial infarction， is a leading cause of death globally. Due to the limited proliferative and regenerative capacity of adult mammalian cardiomyocytes （CMs）， any of the current therapies cannot reverse the massive loss of CMs and subsequent fibrosis resulting from cardiac injury. Mammals mainly rely on glycolysis in the embryonic stage and fatty acid oxidation after birth for energy production. Recent reports have indicated that this metabolic pattern switch is closely related to the loss of CM proliferation. In this review， we summarize the biological characteristics of CMs and advances in heart regeneration， meanwhile shed light on the important role of CMs energy metabolism in cardiac regeneration.

Finite element analysis of PMMA bone cement reinforced screw plate fixation for osteoporotic proximal humeral fracture / 中国骨伤

OBJECTIVE@#With the help of finite element analysis, to explore the effect of proximal humeral bone cement enhanced screw plate fixation on the stability of internal fixation of osteoporotic proximal humeral fracture.@*METHODS@#The digital model of unstable proximal humeral fracture with metaphyseal bone defect was made, and the finite element models of proximal humeral fracture bone cement enhanced screw plate fixation and common screw plate fixation were established respectively. The stress of cancellous bone around the screw, the overall stiffness, the maximum stress of the plate and the maximum stress of the screw were analyzed.@*RESULTS@#The maximum stresses of cancellous bone around 6 screws at the head of proximal humeral with bone cement enhanced screw plate fixation were 1.07 MPa for No.1 nail, 0.43 MPa for No.2 nail, 1.16 MPa for No.3 nail, 0.34 MPa for No.4 nail, 1.99 MPa for No.5 nail and 1.57 MPa for No.6 nail. These with common screw plate fixation were:2.68 MPa for No.1 nail, 0.67 MPa for No.2 nail, 4.37 MPa for No.3 nail, 0.75 MPa for No.4 nail, 3.30 MPa for No.5 nail and 2.47 MPa for No.6 nail. Overall stiffness of the two models is 448 N/mm for bone cement structure and 434 N/mm for common structure. The maximum stress of plate appears in the joint hole:701MPa for bone cement structure and 42 0MPa for common structure. The maximum stress of screws appeared at the tail end of No.4 nail:284 MPa for bone cement structure and 240.8 MPa for common structure.@*CONCLUSION@#Through finite element analysis, it is proved that the proximal humerus bone cement enhanced screw plate fixation of osteoporotic proximal humeral fracture can effectively reduce the stress of cancellous bone around the screw and enhance the initial stability after fracture operation, thus preventing from penetrating out and humeral head collapsing.

Clinical outcomes of reverse shoulder arthroplasty for the treatment of failed fixation of proximal humeral fracrtures in the elderly patients / 中国骨伤

OBJECTIVE@#To evaluate the clinical outcomes of reverse total shoulder arthroplasty as a revision procedure for the failed fixation of proximal humeral fractures in the elderly patients.@*METHODS@#A retrospective analysis was performed on 8 patients with failed internal fixation of proximal humeral fractures from May 2014 to March 2020, including 3 males and 5 females, aged from 65 to 75 years old. All 8 patients underwent reverse total shoulder arthroplasty, and the mean time between initial fixation and reverse total shoulder arthroplasty ranged from 8 to 16 months. Range of motion(ROM), University of California at Los Angeles(UCLA) shoulder score, visual analogue scale (VAS), self-rating anxiety scale(SAS), and Constant-Murley score of shoulder function were assessed pre-operatively and at the last follow-up. Complications relating to the surgery were recorded.@*RESULTS@#All 8 patients successfully followed up. The mean follow-up after reverse total shoulder arhroplasty ranged from 16 to 28 months. The range of motion (forward flexion, external rotation, abduction and internal rotation) of the affected shoulder was significantly improved after surgery, and the post-operative VAS, SAS and UCLA scores were also significantly improved. For the Constant-Murley score of shoulder joint function, the total scores and the subscores of pain, daily activities, range of motion and strength test at the last follow-up were all significantly improved. Scapular glenoid notch was observed in patient, which was evaluated as grade 1 on imaging. All the other patients did not develop specific or non-specific complications.@*CONCLUSION@#Reverse total shoulder arhroplasty is an appropriate treatment as a revision surgery for failed fixation of proximal humeral fractures. It has shown satisfactory clinical outcomes, accelerating the rehabilitation of shoulder function and improving the quality of life.

Application analysis of a modified retroauricular hairline incision in the resection of a benign parotid gland tumor / 华西口腔医学杂志

OBJECTIVES@#This study aimed to evaluate the application value of a modified retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle in the resection of benign parotid gland tumors.@*METHODS@#Forty-eight patients with benign parotid gland tumors were retrospectively analyzed: 19 cases were included in the experimental group with an improved retroauricular hairline incision and a sternocleidomastoid flap with an inferior pedicle, and 29 cases were assigned in the control group with a modified facelift incision. Operation time, postoperative drainage, postoperative esthetic degree, and incidence of facial nerve paralysis, salivary fistula, and Frey's syndrome were compared.@*RESULTS@#After the esthetic procedure, the average score of the experimental group was higher than that of the control group, and the esthetic effect of the former was better than that of the latter (@*CONCLUSIONS@#The modified retroauricular hairline incision and sternocleidomastoid flap with an inferior pedicle can be applied to resect benign parotid gland tumors safely. It shows a better cosmetic effect and does not cause obvious postoperative complications. Therefore, it should be promoted for tumor treatments.

Effect of acupuncture on pattern visual evoked potential of cerebral visual impairment in children aged 3-10 years / 中国针灸

OBJECTIVE@#To observe clinical effect of acupuncture combined with conventional visual stimulation on cerebral visual impairment (CVI) in children aged 3-10 years and influence on the pattern visual evoked potential (P-VEP).@*METHODS@#A total of 60 cases of children aged 3-10 years with CVI were randomly divided into an observation group and a control group, 30 cases in each group. The children in the control group received conventional visual stimulation therapy, 1 month as a course of treatment. On the basis of the control group, the children in the observation group was treated with acupuncture at Baihui (GV 20), Jingming (BL 1), Taiyang (EX-HN 5), Sibai (ST 2), etc. 3 times a week, and the treatment was given 4 weeks continuously as a course. Both groups received 3 courses of treatment. The visual acuity and P-VEP improvement were compared between the two groups before and after treatment.@*RESULTS@#After treatment, the incubation period (P100-L) of the two groups was shorter than before treatment, and the amplitude (P100-A) was higher than before treatment (@*CONCLUSION@#Acupuncture combined with conventional visual stimulation can improve the incubation period (P100-L) and amplitude (P100-A) of P-VEP in children with CVI, and improve the best corrected visual acuity in children, the clinical effect is better than the conventional visual stimulation alone.

Magnetic Resonance Imaging for Diagnosis of Idiopathic Pediatric Meningiomas / 中国医学科学院学报

Objective To analyze the radiological features of idiopathic pediatric meningiomas and explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery.Methods We retrospectively reviewed 29 cases of pathologically confirmed pediatric meningiomas with pre-operative magnetic resonance imaging in Beijing Tiantan Hospital from November 2014 to July 2018.We assessed the imaging features to explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery. Results Among the 29 cases,7 intraparenchymal meningiomas,5 extraparenchymal meningiomas,4 ventricular meningiomas,and 1 transcranial meningioma were misdiagnosed.Tumor location was significantly associated with possibility of misdiagnoses(

Whole exome sequencing in a pedigree with ankylosing spondylitis / 中国骨伤

OBJECTIVE@#To choose the disease-causing gene in a Chinese pedigree with ankylosing spondylitis (AS) by whole-exome sequencing (WES), and provide theory basis for mechanism of disease.@*METHODS@#Clinical data of AS pedigree were collected, including 2 males, the age were 48 and 18 years old, the course of disease were 23 and 4 years. Whole blood genomic DNA of AS was extracted to perform whole exome sequencing, the results were compared with human databases, common variations which had been reported were wiped out, then non synonymous single nucleotide variants(SNVs) from the family members were combined, and candidate genes was selected initially.@*RESULTS@#Totally 80 G data was obtained from AS family with high quality.By comparing results between patient and normal subject, and filtering with number of biological database, the result showed heterozygous mutation of JAK2 gene 12 exon c.1709 A>G (p.Tyr570Cys) may be the potential disease-causing gene. The variant c.1151T>C of MUC3A gene may be one of the causes of intestinal symptoms in the family members.@*CONCLUSION@#It is feasible to find t candidate gene mutations of AS by Exon sequencing. The mutation c.1709 A>G in gene JAK2 identified by whole exome sequencing might be the pathogenic mutation in this AS pedigree.

Preliminary development of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach due to three dimentional soft tissue print technique / 中国骨伤

OBJECTIVE@#To investigate the feasibility of a drill template for the placement of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach on digital design and 3D printing technology.@*METHODS@#The preoperative CT images of 20 patients with thoracic fracture were collected retrospectively. With the 3D soft tissue printing technology, the data was reconstructed by 3D imaging reconstruction software to produce 1∶1 three dimensional soft tissue model. The pedicle screw channel and the digital template were designed by the 3-matic module of Mimics15.0 software. After guide template was printed by 3D printer and three dimensional template was fixed on the model, 2.0 mm Kirschner was placed and the accuracy of a drill template was observed by CT scans, bone cement was injected through the puncture tube and verified with images. The time of nail guide design, guide template production and cost were recorded.@*RESULTS@#The effectiveness of three dimensional thoracic model and digital guided template of middle and upper thoracic percutaneous vertebroplasty of thoracic fractures in thoracic pedicle approach was confirmed. Kirschner was placed and the accuracy of screw placement was confirmed with CT scanning. Template and the corresponding anatomical landmark fitted well, bone cement had showed good filling. The average printing time of upper thoracic spine model with soft tissue, the mean time of nail guide design, guide template production and cost were (719.00±3.03) min, (12.30±1.01) min, (55.50±10.30) min and RMB 3 150 yuan on average respectively.@*CONCLUSION@#By means of individual design and 3D soft tissue printingtechnology, accurate placement of guided template of middle and upper thoracic percutaneous vertebroplasty could be realized.

Research on Medication Rules of Depression Syndrome Based on Ancient Medical Records / 中国实验方剂学杂志

Objective::To analyze and excavate the medication rules of ancient physicians in the treatment of depression syndrome, so as to provide reference for clinical treatment of depression syndrome. Method::The ancient medical records of depression syndrome sorted out in Yian Leiju were retrieved and collated, the data of traditional Chinese medicine (TCM) prescriptions in medical records were extracted, the obtained data of TCMs in prescriptions were standardized, and the data mining function of the ancient and modern medical records cloud platform V1.5 was adopted to carry out frequency statistics, cluster analysis, association analysis and complex network analysis of TCM data, the common drugs used by ancient physicians for treatment of depression syndrome, properties and classifications of commonly used medicines, pairs of commonly used medicines and core prescriptions were obtained. Result::After screening, a total of 364 medical cases, 461 visits and 439 prescription data of TCM were included, involving 67 ancient books. A total of 607 Chinese medicines were involved, and the total frequency of medication was 4 127.High frequency medicines included Poria (186 times), Citri Reticulatae Pericarpium (115 times), Glycyrrhizae Radix et Rhizoma (113 times), Ginseng Radix et Rhizoma (101 times), Angelicae Sinensis Radix (98 times), Atractylodis Macrocephalae Rhizoma (94 times), etc. The main properties and flavors of commonly used Chinese medicines were warm, flat, bitter and acrid, which were mainly attributed to the four meridians of spleen, lung, heart and liver. Commonly used couplet medicines were Atractylodis Macrocephalae Rhizoma-Poria, Poria-Glycyrrhizae Radix et Rhizoma, Poria-Angelicae Sinensis Radix, Atractylodis Macrocephalae Rhizoma-Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma-Poria, etc. The core prescription was based on the addition and subtraction of Danzhi Xiaoyaosan. Conclusion::In the treatment of depression syndrome, ancient physicians adopt the principles of invigorating the spleen, nourishing Qi and blood, soothing the liver and regulating Qi, nourishing the heart and tranquilizing the mind, giving consideration to both Qi and blood, and harmonizing the liver, spleen and heart.

Effect of Method of Relieving Depression and Resolving Phlegm on Expression of IRS-1 and IRS-2 in Liver Tissues of Rats with Polycystic Ovary Syndrome / 中国实验方剂学杂志

Objective::To observe the effect of Erchentang, Chaihu Shugansan, Erchentang+ Chaihu Shugansan and metformin on insulin receptor substrate-1(IRS-1)and insulin receptor substrate-2(IRS-2)mRNA and protein expression in liver tissues of model rats with polycystic ovary syndrome(PCOS), and to explore the biological mechanism of relieving depression and resolving phlegm to improve insulin resistance of polycystic ovary syndrome. Method::A model of polycystic ovary syndrome was replicated in rats by subcutaneous injection of dehydroepiandrosterone(DHEA) under the neck and back.The control group was the normal group, The model rats were divided into model group, Erchentang group(9.135 g·kg-1), Chaihu Shugansan group(6.615 g·kg-1), Erchentang+ Chaihu Shugansan group (Hefang group, 9.135 g·kg-1+ 6.615 g·kg-1), and metformin group(0.158 mg·kg-1). The corresponding drugs were given by intragastric administration once a day for 4 weeks. The ovarian and liver tissues of rats were isolated, and serum testosterone(T)and estradiol(E2)hormone levels in each group were detected by enzyme-linked immunosorbent assay(ELISA), the histopathological changes of ovary in each group were detected by hematoxylin-eosin (HE) staining, IRS-1 and IRS-2 mRNA and protein expression levels in rat liver tissues were detected by quantitative real-time fluorescence PCR(Real-time PCR)and Western blot. Result::Compared with normal group, the serum T and E2 level of model group were significantly decreased (P<0.01), the histology of ovary showed a large number of saccate dilated follicles, thin granular cell layer and rare corpus luteum, IRS-1, IRS-2 mRNA and protein levels in liver tissues decreased significantly (P<0.01). Compared with model group, the serum T and E2 level of each group significantly decreased (P<0.01), histopathology of ovarian tissue showed that the number of saccular dilated follicles decreased, and the granulosa cell layer thickened, showing follicles of all levels, IRS-1, IRS-2 mRNA and protein expression were significantly increased in Erchentang group(P<0.05, P<0.01), IRS-1 mRNA and protein expression were significantly increased in Chaihu Shugansan group(P<0.01), IRS-2 mRNA and protein expression were on the rise, IRS-1 mRNA and protein expression and IRS-2 mRNA expression were significantly increased in the Hefang group (P<0.05), while IRS-2 mRNA was on the rise, IRS-1 protein and IRS-2 mRNA and protein expression were significantly increased in metformin group (P<0.01), while IRS-1 mRNA showed an upward trend. Conclusion::Erchentang improved the insulin resistance of PCOS model rats more significantly than Chaihu Shugansan, and its mechanism may be related to IRS-1, IRS-2 mRNA and protein expression levels of key signaling molecules regulating insulin signal transduction pathway.

Overexpression of long noncoding RNA PTPRG-AS1 is associated with poor prognosis in epithelial ovarian cancer

SUMMARY OBJECTIVE Long noncoding RNAs (lncRNAs) have been shown to play a critical role in tumor progression. Abnormal expression of LncRNA PTPRG antisense RNA 1 (PTPRG-AS1) has been reported in several tumors. Hence, we aimed to determine the expression and clinical significance of PTPRG-AS1 in epithelial ovarian cancer (EOC) patients. METHODS The expressions of PTPRG-AS1 were assessed in 184 pairs of EOC tumor specimens and adjacent normal tissues. The levels of target lncRNAs and GAPDH were examined using standard SYBR-Green methods. The relationships between the expressions of PTPRG-AS1 and the clinicopathological features were analyzed using the chi-square test. Multivariate analysis using the Cox proportional hazards model was performed to assess the prognostic value of PTPRG-AS1 in EOC patients. RESULTS We confirmed that the expressions of PTPRG-AS1 were distinctly higher in the EOC tissue compared with the adjacent non-tumor specimens (p < 0.01). Higher levels of PTPRG-AS1 in EOC patients were associated with advanced FIGO stage (p = 0.005), grade (p = 0.006), and distant metastasis (p = 0.005). Survival analyses revealed that patients with high expressions of PTPRG-AS1 had a distinctly decreased overall survival (p = 0.0029) and disease-free survival (p = 0.0009) compared with those with low expressions of PTPRG-AS1. Multivariate assays indicated that PTPRG-AS1 expression was an independent prognostic factor for both overall survival and disease-free survival in EOC (Both p < 0.05). CONCLUSIONS Our study suggests that PTPRG-AS1 may serve as a novel prognostic biomarker for EOC patients.

RESUMO OBJETIVO Sabe-se que RNAs longos não codificantes (lncRNAs) desempenham um papel crítico na progressão tumoral. A expressão anormal do RNA 1 anti-senso LncRNA PTPRG (PTPRG-AS1) já foi relatada em diversos tumores. Assim, buscamos determinar a expressão e significância clínica do PTPRG-AS1 em pacientes com câncer de ovário epitelial (COE). METODOLOGIA As expressões do PTPRG-AS1 foram avaliadas em 184 pares de amostras tumorais de COE e tecidos normais adjacentes. Os níveis de lncRNAs e GAPDH alvo foram examinados usando o método padrão de SYBR Green. As relações entre as expressões do PTPRG-AS1 e as características clínico-patológicas foram analisadas através do teste qui-quadrado. Uma análise multivariada utilizando o modelo de riscos proporcionais de Cox foi realizada para avaliar o valor prognóstico do PTPRG-AS1 em pacientes com COE. RESULTADOS Constatou-se que as expressões do PTPRG-AS1 foram nitidamente maiores nos tecidos de COE em relação aos espécimes adjacentes não tumorosos (p<0,01). Níveis mais elevados do PTPRG-AS1 em pacientes com COE foram associados a um estágio avançado de FIGO (p = 0,005), grau (p = 0,006) e metástases à distância (p = 0,005). As análises de sobrevida revelaram que pacientes com expressões elevadas do PTPRG-AS1 tiveram uma diminuição significativa da sobrevida global (p = 0,0029) e da sobrevida livre de doença (p = 0,0009) em relação àqueles com baixas expressões do PTPRG-AS1. As análises multivariadas indicaram que a expressão do PTPRG-AS1 foi um fator de prognóstico independente tanto para a sobrevida global quanto para a sobrevida livre de doença em pacientes com EOC (p < 0,05). CONCLUSÃO Nosso estudo sugere que o PTPRG-AS1 pode ser um novo biomarcador prognóstico para pacientes com COE.

Clinical observation of the effects of moxibustion with seed-sized moxa cone plus opioid drugs on cancer pain and immune function / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy of moxibustion with seed-sized moxa cone plus opioid drugs for moderate-to-severe cancer pain, and the effect on immune function in patients with cancer pain. Methods: A total of 80 patients with moderate-to-severe cancer pain were randomized into an observation group and a control group by the random number table method, with 40 cases in each group. Both groups were treated with opioid drugs for analgesia according to the standardized management principles for cancer pain. In addition, the observation group was given moxibustion with seed-sized moxa cone. The treatment was performed once a day, continuous 5-day treatment with a 2-day interval constituted a treatment course, and a total of 2 courses were performed. The score of numerical rating scale (NRS) and 24 h equivalent morphine consumption was compared between the two groups before treatment, after 1 treatment course and after 2 courses of treatment. The immune functions were compared between the two groups before and after 2 courses of treatment. Results: During the treatment, there were 3 dropouts in the control group, and 2 dropouts in the observation group. Before the treatment, there were no significant differences in the NRS score and 24 h equivalent morphine consumption between the two groups (both P＞0.05). The NRS scores of both two groups were quite stable during the whole treatment period, and there was no significant difference in the intra-group comparison after treatment (both P＞0.05), and there was no significant difference between the two groups at the same time point (both P＞0.05). In the control group, the 24 h equivalent morphine consumption showed an increasing trend. The dosage after 1 treatment course and 2 courses of treatment was statistically different from that before treatment in the control group (both P＜0.01). There was no significant change in the mean 24 h equivalent morphine consumption in the observation group compared with that before treatment (both P＞0.05). After 2 courses of treatment, the 24 h equivalent morphine consumption in the observation group was significantly lower than that in the control group at the same time point (P＜0.05). Before treatment, there was no significant difference in the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) between the two groups (all P＞0.05). After treatment, the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) in the control group were lower than those before treatment (all P＜0.05), while the levels in the observation group were higher than those before treatment, and the levels of CD3+ and CD4+ were significantly different from those before treatment (both P＜0.05). After treatment, the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) of the observation group were significantly higher than those of the control group at the same time point (all P＜0.05). Conclusion: Moxibustion with seed-sized moxa cone can reduce the dosage of opioid drugs used in patients with moderate-to-severe cancer pain and improve their immune functions.

Impact of childhood sexual abuse on risky sexual behaviors among men who have sex with men in Guangzhou / 中华疾病控制杂志

Objective To explore the experience of childhood sexual abuse (CSA) among men who have sex with men (MSM) in Guangzhou, and to evaluate its impact on risky sexual behaviors in adulthood. Methods A non-probability sampling method was used to recruit MSM aged 18 years and over in Guangzhou. Sociodemographic characteristics, experience of CSA and risky sexual behaviors during the past 6 months were collected using an electronic questionnaire. 2 tests were used to compare the prevalence of CSA and risky sexual behaviors during the past 6 months among different sociodemographic characteristics. Logistic regressions were performed to assess the impact of CSA on risky sexual behaviors. Results Overall, 976 MSM were included with an average age of (28.35±6.83) years old. Nearly one-third (26.95%, 263/976) of MSM experienced CSA. Participants having multiple sexual partners (MSP) and unprotected anal intercourse (UAI) during the past 6 months accounted for 61.68% (602/976) and 47.95% (468/976), respectively. After adjusting age, ethnicity, household registration, local residence time, marital status, education, employment status, monthly income and sexual orientation, the results of multivariate Logistic regression showed that MSM who experienced CSA were likely to have MSP during the past 6 months (aOR=1.62; 95%CI: 1.19-2.22) than those did not experience CSA. But the association between UAI and CSA was not statistically significant. Conclusions The prevalence of CSA among MSM in Guangzhou is high. CSA can substantially increase the risk of risky sexual behaviors in adulthood. Intervention to reduce the risk of sexual risk behaviors may need to be tailored for MSM who experienced CSA.