Pregnancy Benefit of Acupuncture on in vitro Fertilization: A Systematic Review and Meta-Analysis / 中国结合医学杂志

BACKGROUND@#Currently, more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization (IVF). However, evidence from acupuncture for improving IVF pregnancy outcomes remains a matter of debate.@*OBJECTIVE@#To quantitatively summarized the evidence of the efficacy of acupuncture among women undergoing IVF by means of systematic review and meta-analysis.@*METHODS@#Four English (PubMed, Web of Science, EMBASE, and Cochrane Register of Controlled Clinical Trials) and Four Chinese databases (Wanfang Databases, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and SinoMed) were searched from database inception until July 2, 2023. Randomized controlled trials (RCTs) that evaluated the acupuncture's effects for women undergoing IVF were included. The subgroup analysis was conducted with respect to the age of participants, different acupuncture types, type of control, acupuncture timing, geographical origin of the study, whether or not repeated IVF failure, and acupuncture sessions. Sensitivity analyses were predefifined to explore the robustness of results. The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR), and the secondary outcomes were ongoing pregnancy rate and miscarriage rate. Random effects model with I2 statistics were used to quantify heterogeneity. Publication bias was estimated by funnel plots and Egger's tests.@*RESULTS@#A total of 58 eligible RCTs representing 10,968 women undergoing IVF for pregnant success were identifified. Pooled CPR and LBR showed a signifificant difference between acupuncture and control groups [69 comparisons, relative risk (RR) 1.19, 95% confifidence intervals (CI) 1.12 to 1.25, I2=0], extremely low evidence; 23 comparisons, RR 1.11, 95%CI 1.02 to 1.21, I2=14.6, low evidence, respectively). Only transcutaneous electrical acupoint stimulation showed a positive effect on both CPR (16 comparisons, RR 1.17, 95%CI 1.06 to 1.29; I2=0, moderate evidence) and LBR (9 comparisons, RR 1.20, 95%CI 1.04 to 1.37; I2=8.5, extremely low evidence). Heterogeneity across studies was found and no studies were graded as high-quality evidence.@*CONCLUSION@#Results showed that the convincing evidence levels on the associations between acupuncture and IVF pregnant outcomes were relatively low, and the varied methodological design and heterogeneity might inflfluence the fifindings. (Registration No. PROSPERO CRD42021232430).

Research Status and Hot Trends in Atherosclerosis Genomics between 2010 and 2019 / 中国医学科学院学报

Objective To analyze the research status,hotspots,and frontiers of atherosclerosis genomics from 2010 to 2019.Methods CiteSpace software was used to conduct data statistics and visual analysis on countries,institutions,authors,journals,co-cited papers,and keywords of the related papers published in the Web of Science from 2010 to 2019.Results A total of 1021 papers in English were included,and the annual number of publications generally showed an upward trend.The knowledge base in the research of atherosclerosis mostly focused on the genetic risk sites and biomarkers for coronary artery diseases such as coronary heart disease,myocardial infarction,and dyslipidemia.The related journals mainly involved the fields of molecular biology,biology,genetics,immunology,medicine,pharmacy,and clinical medicine.The latest research in atherosclerosis concentrated on genome-wide association study,DNA methylation,microRNA,messenger RNA and so on.The research frontiers involved long noncoding RNA,DNA methylation,and immune metabolism.Conclusion The studies in atherosclerotic genomics have gradually increased.

Dopamine D1 receptor in ventrolateral periaqueductal gray modulates propofol anesthesia in rats / 医学研究生学报

ObjectiveVentrolateral periaqueductal gray (vlPAG) locates in ascending reticular activating system, which plays a key role in the sleep-wake circle. However, the role of vlPAG in general anesthesia has not been identified. To investigate the effect of the dopamine receptor in vlPAG neurons on propofol anesthesia, we used real-time in vivo fiber photometry, microinjection and EEG.MethodsTo observe the alteration of neuronal activity in the vlPAG throughout propofol anesthesia, 10 Sprague-Dawley rats were used for calcium fiber photometry recording. 50 vlPAG bilateral microinjection models were established and assigned into five groups randomly, including D1R agonist group, D1R antagonist group, D2R agonist group, D2R antagonist group, and control group (n=10). Under propofol anesthesia, 1 μL of D1R agonist, D1R antagonist, D2R agonist, D2R antagonist, and isotonic saline were microinjected into the vlPAG of animals in the corresponding groups, respectively. The induction time, recovery time and the changes in electroencephalogram (EEG) before and after microinjection were recorded and analyzed.ResultsThe neuronal activity in the vlPAG was significantly inhibited during the induction period and markedly recovered during the recovery period from propofol anesthesia (P<0.05). Subsequently, the microinjection of D1R agonist into the vlPAG notably prolonged the induction time and reduced the emergence time of propofol anesthesia with a decrease of δ-band ratio. While the microinjection of D1R antagonist accelerated the induction time and prolonged the emergence time of propofol anesthesia with an increase of δ-band ratio and a decrease in β-band ratio in cortical EEG (P<0.05). The induction and recovery time of D2R agonist /antagonist group did not differ with those of control group. As well, EEG before and after microinjection in D2R agonist /antagonist group did not different.ConclusionThese results indicate that vlPAG modulates the process of propofol anesthesia via D1R.

Correlation analysis on the timing of enteral nutrition support and the prognosis in patients with septic shock / 中国综合临床

Objective To explore the correlation of the timing of enteral nutrition (EN) and the prognosis of the patients with septic shock.Methods From December 2016 to August 2017,fifty-five patients with septic shock who received treatment in the ICU of Tongji University School of Medicine were selected in the study and randomly divided into two groups,28 cases in the early enteral nutrition (EEN) group and 27 cases in the delayed enteral nutrition (DEN) group.All the patients was treated with EN before and after 48 h at admission respectively.After 1 week of treatment,the nutrition indicators,clinical efficacy,complications and prognosis of the two groups were compared.Results The levels of ALB,PA and HB in EEN group after treatment were significantly increased,compared with those before treatment,and were superior to those in DEN group ((38.4±4.5) g/L vs.(34.6±3.8) g/L,(207.8±41.4) mg/Lvs.(180.6±47.6) mg/L,(119.2 ±18.3) g/Lvs.(110.7±14.2) g/L;t =3.39,2.26,1.99,P＜0.05).Compared with DEN group,the length of ICU stay,CRRT time,mechanical ventilation time of EEN group were significantly shortened ((6.4± 1.7) d vs.(9.8±2.4)d,(4.7±1.2) d vs.(7.9±2.5)d,(3.6±1.2)d vs.(6.4±1.8) d;t=6.16,6.32,7.09,P＜0.05).After treatment,the SOFA score,APACHE Ⅱ score and qSOFA score were significantly improved in both groups,and the improvement in EEN group was significantly better than that in DEN group((3.8±0.9)points vs.(5.1 ± 1.2) points,(12.2 ± 2.4) points vs.(15.1 ± 3.7) points,(87.4 ± 14.7) points vs.(77.4 ± 13.2) points),(t=4.53,3.46,4.31,P＜0.05).Conclusion The implementation of EEN in patients with septic shock can improve the nutritional status of the patients,alleviate the severity of the disease,reduce the incidence of complications and improve the prognosis.

Relationship between effect of GP regimen prognostic significance and Nanog expression in advanced lung cancer / 肿瘤研究与临床

Objective To evaluate the correlation between the expression level of Nanog gene and clinical outcomes of GP regimen in the advanced non-small cell lung cancer (NSCLC).Methods 62 patients of NSCLC were treated by GP method,and the outcomes were investiged between Nanog positive and nagetive patients.The expression level of Nanong was evaluated by RT-PCR and immunohistology.Results 30 out of 62 patients (48.4 ％) were Nanog positive,9 patients (28.1％) were Nanog positive,and 23 out of 32 patients were Nanog negative (71.9 ％) who have the positive effect (CR+PR).However,among 32 treatment nagetive cases,there were 21 cases (70.0 ％) who were Nanog positive and 9 cases (30.0 ％) were Nanog negatve.Survival analysis showed that 5-years lifetime of Nanog positive patients was shorter than Nanong nagetive patients.Conclusion Nanog overexpression decreases the sensitivity of GP regimen and lifetime of NSCLC patient.Nanog expression level may provide a useful factor for clinical treatment and prognosis of NSCLC patient.

The clinical efficacy of treatment on the cases of severe hallux valgus by the first metatarsal basal osteotomy combined with Chevron-Gerbert operation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of treatment on the cases of severe hallux valgus by the first metatarsal basal osteotomy combined with Chevron-Gerbert operation.</p><p><b>METHODS</b>From June 2004 to August 2008, 37 cases of severe hallux valgus (66 feet) underwent first metatarsal basal osteotomy combined with Chevron-Gerbert operation. There were 5 males (10 feet) and 21 females (38 feet), aged 21 - 76 years (mean 58 years). For all patients with follow-up, radiographic measurements of frontal and lateral position of foot were taken to measure the hallux valgus angle (HVA), the IMA (intermetatarsal angle) and the proximal articular set angle (PASA) preoperatively, postoperatively and in follow-up respectively. The measuring results were compared among the preoperative, the 6-week postoperative and the final follow-up. At the same time the patients were evaluated with the AOFAS Maryland score.</p><p><b>RESULTS</b>Of the original 37 patients, 26 patients (48 feet) were followed up. The mean durations of follow-up was 2.3 years (range from 1 to 4 years). At final follow-up, HVA corrected 25.6° ± 3.8°, IMA corrected 8.6° ± 2.4°, and PASA corrected 4.7° ± 4.2°. According to AOFAS rating system, 91.7% patients were rated as excellent or good with excellent in 15 patients (28 feet), good in 8 patients (16 feet), and fair in 3 patients (4 feet).</p><p><b>CONCLUSIONS</b>First metatarsal basal osteotomy combined with Chevron-Gerbert operation has good efficacy to the patients with severe hallux valgus. However there are disadvantages such as complexity relatively for multi-stage osteotomy and internal fixation.</p>