Effect of electroacupuncture on expression of p-ERK and p-CREB in the spinal dorsal horn of diabetic neuropathic pain rats / 中华物理医学与康复杂志

Objective:To observe any effect of electroacupuncture (EA) on the expression of phosphorylated extracellular signal-regulated protein kinase (p-ERK1/2) and phosphorylated cyclic adenosine monophosphate response element binding protein (p-CREB) in the spinal dorsal horns of diabetics experiencing neuropathic pain.Methods:Eight rats were randomly selected from 30 healthy male Sprague-Dawley rats as the normal group (N), and the remaining twenty-two rats were treated with a single high-dose intraperitoneal injection of streptozotocin (STZ) to establish a neuropathic pain model. The rats modeled successfully were randomly divided into a model group (M, n=8) and an EA group ( n=8). In the EA group, electroacupuncture was applied at the bilateral Hou san li and Kunlun acupoints starting on the 15th day after the STZ injection. The daily sessions lasted 30 minutes for 1 week. Body weight (BW), fasting blood glucose (FBG) and paw withdrawal latency (PWL) were observed before the STZ injection and on the 7th, 14th, and 21st days afterward. The expression of p-ERK1/2 and p-CREB in the dorsal horns of the rats′ spinal cords was detected using western blotting. The count of p-CREB-positive cells in the dorsal horns and their co-localization with neurons was detected using immunofluorescence. Results:In comparison with the N group, the average BW of the M group on the 7th, 14th and 21st days after the STZ injection was significantly lower, while the average FBG was significantly higher. There was no significant difference between the M and N groups in the average PWL on the 7th day after the STZ injection, but it had decreased significantly in the M group on the 14th and 21st days. Compared with the M group, the average PWL of the EA group was significantly longer on the 21st day after the injection. The expression of p-ERK1/2 and p-CREB protein in the spines of the M group was significantly higher than in the N group. p-CREB positive cells were more numerous in the M group compared with the N group, while in the EA group they were fewer. P-CREB was co-located with neurons in the spinal dorsal horn.Conclusion:EA can alleviate neuropathic pain effectively, perhaps by inhibiting the expression of p-ERK1/2 and p-CREB in the dorsal horns of the spinal cord.

Establishment of fingerprint ，chemical pattern recognition and content determination for Qingshen tiaozhi xiaoke tablets / 中国药房

OBJECTIVE To e stablish the fingerprint of Qings hen tiaozhi xiaoke tablets （QTXT）and carry out the analysis of chemical pattern recognition ，and determine the contents of seven active components simultaneously. METHODS Using coptisine hydrochloride as reference ，the Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition）was utilized to establish the HPLC fingerprints of 13 batches of QTXT and analyze their similarity. The common peaks were confirmed by comparing with the chromatogram of the mixed control ；the attribution of the common peak was determined by comparing the chromatograms of the sample solutions of single decoction pieces and negative sample solutions ；using SPSS 22.0 and SIMCA 14.1 software，cluster analysis （CA），principal component analysis （PCA）and orthogonal partial least squares-discriminant analysis （OPLS-DA）were carried out ，and the markers affecting the quality of QTXT were screened ，using the variable importance in projection（VIP）value greater than 1 as the standard. Using coptisine hydrochloride as internal reference ，the contents of naringin ， hesperidin，neohesperidin，berberine hydrochloride ，palmatine hydrochloride and lovastatin were determined by quantitative analysis of multicomponents by single marker （QAMS），and then compared wi th the result s（except for coptisine hydrochloride ） of external standard method. RESULTS There were 17 Δ 基金项目：江苏省“双创团队”项目[No.（2018）2024号] ＊硕士研究生。研究方向：中药新药药学。E-mail：2769544062@ common peaks in 13 batches of QTXT ，and the similarity was qq.com 0.987-0.999. Seven chromatographic peaks were identified ， # 通信作者：副研究员，硕士生导师，博士。研究方向：中药药剂 namely naringin （peak 4）， hesperidin （peak 5）， 学。E-mail：tsliur411@sina.com neohesperidin（peak 6），coptisine hydrochloride （peak 8）， ·1204· China Pharmacy 2022Vol. 33 No. 10 中国药房 2022年第33卷第10期 palmatine hydrochloride （peak 9），berberine hydrochlo ride（peak 10），lovastatin（peak 14）. Peaks 7-10 were the exclusive peaks of Coptis chinensis ；peaks 3-6 and 11-13 were the exclusive peaks of bran-fried Fructus aurantii ；peak 14 was the exclusive peak of Monascus purpureus ；peak 1 was the common peak of C. chinensis and M. purpureus . Peak 2 and 15 were the common peak of bran-fried F. aurantii and M. purpureus ；peaks 16 and 17 were the common peaks of 6 traditional Chinese medicines. The results of CA showed that 13 batches of QTXT could be divided into three categories ，S2 was clustered into one category ，S1，S9，S10 were clustered into one category ，S3-S8 and S 11-S13 were clustered into one category. The results of PCA showed that accumulative variance contribution of the first three principal components was 85.120％. Compared with CA ，S1 was further distinguished from S9 and S 10 by PCA. OPLS-DA showed that 7 common peaks with VIP value greater than 1（from large to small ）were peak 10 （berberine hydrochloride ），peak 9（palmatine hydrochloride ），peak 5（hesperidin），peak 11 and peak 8（coptisine hydrochloride ）， peak 12 and peak 6（neohesperidin）. The contents of naringin ，hesperidin，neohesperidin，berberine hydrochloride ，palmatine hydrochloride and lovastatin measured by QAMS were 40.198-77.552，6.138-13.413，71.823-125.868，11.274-49.951，3.303- 5.367，1.821-3.185 mg/g，respectively. The contents of naringin ，hesperidin，neohesperidin，berberine hydrochloride ，coptisine hydrochloride，palmatine hydrochloride and lovastatin measured by external reference method were 41.454-79.976，6.404-13.993， 74.068-129.081，11.627-51.512，5.922-12.020，3.158-5.131 and 1.901-3.325 mg/g，respectively. The deviations of the two methods （except for coptisine hydrochloride ）were all less than 3.00％. CONCLUSIONS The established HPLC fingerprint and the method of QAMS are simple ，accurate and reproducible. Combined with chemical pattern recognition analysis ，it can be used for the quality evaluation of QTXT. Berberine hydrochloride ，palmatine hydrochloride and other components may be the markers affecting the quality of the drug.

Observation of the theutic effect of dual-channel thrombolytic urokinase method on acute thrombosis of internal fistula / 中国实用护理杂志

Objective:To explore the observation of the short-term recanalization rate and safety of acute thrombosis of arteriovenous fistula by dual-channel urokinase thrombolysis.Methods:A total of 52 dialysis patients with acute thrombosis of arteriovenous fistula in the Department of Nephrology, Shenzhen Hospital of Southern Medical University from January 2017 to January 2020 were selected. They were divided into control group and observation group by random number table. Twenty-seven cases in the test group used inflow arterial puncture and venous thrombosis, hereinafter referred to as dual channel, and bolus injection of urokinase for thrombolysis. Twenty-five cases in the control group were treated with tradi) ional peripheral intravenous bolus injection of urokinase for thrombolysis, and the recanalization time of internal fistula, adverse reactions and safety of thrombolysis were compared between the two groupsResults::The early (2 hours) reopening rate of the test group was 92.6% (25/27), which was higher than that of the control group by 44.0% (11/25) ( χ2 value was 14.389, P<0.05), which was statistically significant. The embolization site of the two groups of patients ( χ2 value was 2.989, P>0.05), the access situation of the two groups of patients ( χ2 value was 0.277, P>0.05), no statistical significance. There was no statistical significance in subcutaneous ecchymosis ( χ2 value was 0.088, P>0.05), bleeding at the puncture point ( χ2 value was 0.003, P>0.05), and puncture injury ( χ2 value was 0.944, P>0.05) in both groups. Conclusions:The double-channel urokinase thrombolysis method has the characteristics of high (2 hours) early recanalization rate, safe and effective in the treatment of acute arteriovenous fistula thrombosis.

Age-related differences in the management and outcome of acute coronary syndrome under the chest pain center model: a multicenter retrospective study / 中华危重病急救医学

Objective:To assess the age-related differences in the management strategies and outcomes of patients with acute coronary syndrome (ACS) under the chest pain center model.Methods:Clinical data of 2 833 patients with ACS were enrolled in the retrospective observational registry between January 2017 and June 2019 at 11 hospitals with chest pain centers in Chengdu. The patients were divided into four groups according to their ages: < 55 years old group ( n = 569), 55-64 years old group ( n = 556), 65-74 years old group ( n = 804), ≥ 75 years old group ( n = 904). The collected data included the patients' demographic characteristics, cardiovascular risk factors, medical history, symptoms and signs of onset, experimental examination, types of ACS and the time from the symptom to the hospital (S-to-D), etc., and the clinical characteristics, management strategies, all-cause mortality in the hospital, and the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) within 1 year after discharge were compared. The primary end point was the clinical outcome of ACS patients in different age groups, including all-cause deaths in the hospital and the incidence of MACCE within 1 year after discharge. The secondary end point was the proportion of ACS patients underwent percutaneous coronary intervention (PCI) in different age groups. Multivariate Logistic regression was used to analyze the risk factors of all-cause deaths in ACS patients. Kaplan-Meier curve was used to express the incidence of MACCE within 1 year after discharge in different age groups. Multivariate Cox regression was used to analyze the factors affecting the incidence of MACCE within 1 year after discharge of ACS patients. Results:As age increased, the proportion of male patients gradually decreased, and the percentages of male patients aged < 55 years old, 55-64 years old, 65-74 years old, and ≥ 75 years old were 87.2% (496/569), 77.0% (428/556), 66.4% (534/804), and 60.1% (543/904), respectively; and ACS patients combined with hypertension, diabetes, coronary heart disease, and stroke history were more common [the percentages of patients with hypertension aged < 55 years old, 55-64 years old, 65-74 years old, ≥ 75 years old were 41.3% (235/569), 52.2% (290/556), 59.7% (480/804), and 66.9% (605/904); the percentages of diabetes were 18.6% (106/569), 25.5% (142/556), 27.0% (217/804), and 28.2% (255/904); the percentages of coronary heart disease were 10.1% (57/564), 13.9% (77/555), 17.6% (141/803), and 23.7% (213/899); the percentages of stroke were 0.7% (4/564), 4.0% (22/552), 4.5% (36/801), and 8.6% (77/894)]. But the percentages of patients with a history of active smoking, typical chest pain/chest tightness and dyslipidemia were significantly reduced [the percentages of smoking history were 60.2% (340/565), 48.0% (266/554), 33.7% (270/801), and 21.7% (195/899), typical chest pain/chest tightness were 96.9% (536/553), 96.4% (516/535), 91.8% (716/780), 90.2% (776/860); the percentages of dyslipidemia were 11.2% (63/565), 9.2% (51/553), 5.7% (46/802), and 4.9% (44/896)], the time of S-to-D was significantly prolonged [minutes: 176.0 (73.5, 557.0), 194.5 (89.3, 682.3), 221.0 (98.8, 940.5), and 270.0 (115.0, 867.0)], hemoglobin (Hb) level was significantly reduced(g/L: 145.44±17.43, 135.95±19.25, 129.75±19.03, 122.19±20.55), and the incidence of non-ST-segment elevation myocardial infarction (NSTEMI) increased significantly [18.6% (106/569), 20.5% (114/556), 26.6% (214/804), 26.5% (240/904)], and the differences were statistically significant (all P < 0.05). The proportion of Killip grade Ⅲ -Ⅳ were the highest in patients aged ≥ 75 years old, 9.0% and 12.6%, respectively. Compared with the groups aged < 55 years old, 55-64 years old, and 65-74 years old, the proportion of patients aged ≥ 75 years old who underwent PCI was the lowest, and the all-cause mortality in the hospital and the incidence of 1-year MACCE of patients underwent PCI were significantly lower than those of patients underwent conservative treatment [6.0% (28/463) vs. 10.4% (45/434), 14.6% (43/294) vs. 24.3 % (55/226), both P < 0.05]. As age increased, the hospital all-cause mortality and the 1-year MACCE incidence increased (all-cause mortality rates in < 55 years old, 55-64 years old, 65-74 years old, ≥ 75 years old groups were 0.9%, 2.2%, 5.5%, 8.3%, and the 1-year MACCE incidences were 5.0%, 6.7%, 13.9%, 18.7%, both P < 0.01). The multivariate Logistic regression analysis showed that age, cardiogenic shock, ST-segment elevation myocardial infarction (STEMI), the number of vascular disease and underwent PCI were the independent risk factors of all-cause mortality [the odds ratio ( OR) and 95% confidence interval (95% CI) were 1.644 (1.356-1.993), 11.794 (7.469-18.621), 2.449 (1.419-4.227), 1.334 (1.096-1.624), 0.391 (0.247-0.619), all P < 0.001]. Cox regression analysis showed that age, STEMI, the number of vascular disease and underwent PCI were independent risk factors of the occurrence of MACCE within 1 year after discharge [hazard ratio ( HR) and 95% CI were 1.354 (1.205-1.521), 1.387 (1.003-1.916), 1.314 (1.155-1.495), 0.547 (0.402-0.745), all P < 0.05]. Conclusions:In the chest pain center model, compared with other age of ACS patients, the proportion of NSTEMI in elderly patients group aged ≥ 75 years old was higher, the proportion of PCI was lower, and the clinical outcome was worse. However, the prognosis of elderly patients receiving PCI treatment was better than the patients receiving conservative treatment.

Cerebral regional and network characteristics in asthma patients: a resting-state fMRI study / 医学前沿

Asthma is a serious health problem that involves not only the respiratory system but also the central nervous system. Previous studies identified either regional or network alterations in patients with asthma, but inconsistent results were obtained. A key question remains unclear: are the regional and neural network deficits related or are they two independent characteristics in asthma? Answering this question is the aim of this study. By collecting resting-state functional magnetic resonance imaging from 39 patients with asthma and 40 matched health controls, brain functional measures including regional activity (amplitude of low-frequency fluctuations) and neural network function (degree centrality (DC) and functional connectivity) were calculated to systematically characterize the functional alterations. Patients exhibited regional abnormities in the left angular gyrus, right precuneus, and inferior temporal gyrus within the default mode network. Network abnormalities involved both the sensorimotor network and visual network with key regions including the superior frontal gyrus and occipital lobes. Altered DC in the lingual gyrus was correlated with the degree of airway obstruction. This study elucidated different patterns of regional and network changes, thereby suggesting that the two parameters reflect different brain characteristics of asthma. These findings provide evidence for further understanding the potential cerebral alterations in the pathophysiology of asthma.

Decoronation management of the replacement resorption after delayed replantation of avulsed teeth-case report with 4-year follow-up / 华西口腔医学杂志

Replacement resorption is the most frequent complication after delayed replantation of avulsed teeth. The resorption can interfere with the development of the alveolar ridge and lead to tilt of the adjacent teeth in growing patients. However, there is no means of arresting or reversing the process. Recently decoronation is recommended by International Assocaition of Dental Traumatology as the optimal choice to manage it. This paper demonstrates the procedure and effectiveness of the decoronation by literature review and a case report with 4-year follow-up.

Investigation and analysis of clinical application of TCM nursing therapies in TCM hospitals in China / 中国实用护理杂志

Objective To evaluate the clinical application of TCM nursing therapies and identify the problems during the therapy implementation, in order to explore the countermeasures to promote its clinical improvement. Methods A descriptive cross-sectional study was conducted,and a self-designed questionnaire was employed to investigate 218 nurses from 148 grade A class three TCM hospitals in China. Results 25 TCM nursing therapies were implemented in these hospitals. Ear acupressure therapy was the most frequently implemented,accounting for 83.5%(182/218);while wax therapy was the least implemented, accounting for 7.8%(17/218). The implementation frequency of these technologies varied significantly, 0~860 times a week. The top three of them were acupoint application therapy, hot compression of Chinese medicine and ear acupoints therapy.TCM nursing therapies were considered to be the most frequently used in insomnia, headache, edema, arthralgia, cold, epigastric pain, hypochondriac pain and fever.Storage of TCM nurses,lacking of TCM knowledge and inapposite therapy implementation were the main problems in the application. Conclusions Scientific and rational allocation of human resources, cultivation of the TCM-specific nursing professional, enhancement of nurses'awareness of Chinese medicine, establishment of a reasonable charging standard, and strengthening the risk management in implementation will promote its clinical development.

The effects ofShenkang bolt on the IL-10 and IL-6 of the patients with continous ambulatory peritoneal dialysis / 国际中医中药杂志

Objective To observe the effects ofShenkang bolt on the IL-10 and IL-6 of patients with continous ambulatory peritoneal dialysis (CAPD).MethodsA total of 60 patients with CAPD were divided into the control group (n=30) andShenkang bolt observation group (n=30). The control group was treated with convertional treatment of CAPD, low salt, low fat, low phosphorus and high quality diet. The observation group was treated withShenkang bolt based on control group treatment. The clinic effect was detected after treatment for 8 weeks. The serum creatinine was determinated by basic picric acid method, and blood urea nitrogen was determinated by urease test. The clinic and biochemical indicator of Scr, BUN, 24h urine volume, Kt/Vurea, RRF, and ultrafiltration volume were compared between the two groups. The IL-10 and IL-6 were detected by ELISA analysis.Results After treatment, IL-10 (19.56 ± 4.38μg/mlvs. 8.98 ± 2.05μg/ml,t=4.392,P<0.01) was significantly higher in observation group than that in control group, and IL-6 (21.82 ± 3.57μg/mlvs. 49.66 ± 5.26μg/ml,t=5.264,P<0.01) was significantly lower in observation group than that in control group. The RRF (7.86 ± 2.12vs. 5.31 ± 1.62;t=2.436, P=0.046) and ultrafiltration volume (421.37 ± 81.61 ml/dvs. 321.23 ± 71.94 ml/d;t=2.617, P=0.038) was significantly higher in observation group than those in control group. ConclusionShenkang bolt could help patients with CAPD balancethe immune, suppress inflammation and improve the RRF and ultrafiltration volume.

Clinical significance of determination of serum neutrophil gelatinase associated lipocalin in the diagnosis of contrast induced nephropathy / 重庆医学

Objective To discuss the clinical significance of serum neutrophil gelatinase associated lipocalin(NGAL)detection in the diagnosis of contrast induced nephropathy .Methods A total of 299 inpatients with contrast medium in department of inten‐sive care unit(ICU) ,department of cardiovascular disease ,department of urology from Guangdong Province Hospital of Traditional Chinese Medicine were enrolled ,and the fasting blood glucose and lipids were detected .Sera were collected before examination of contrast medium and 1 ,2 and 6 d after examination of contrast medium respectively .Serum creatinine(SCr)and cystatin C(CysC) were detected ,the concentration of NGAL was determined .CIN was defined as of increased by 44 μmol/L or 25% from baseline in SCr within 24-48 h .The NGAL detection variation tendency was analyzed in different time point .Results In 299 cases ,CIN oc‐curred in 28 patients ,the incidence rate was 9 .36% .The diabetes patients in the incidence of CIN was 16 .21% (12/74) ,no inci‐dence of diabetic patients was 7 .11% (16/225) .When compared with that of before contrast ,CIN in serum of patients with Cr and CysC coronary angiography in 2 d significantly increased after contrast medium ,returned to the level before angiography on 6 d .But the serum NGAL in angiography 1 d after it was significantly increased (P<0 .05) ,statistically significant differences compared with pre contrast ,and was still at a high level on sixth day .Conclusion Prediction of CIN level of serum NGAL in contrast after 1 d could be a good predictor for CIN ,and the prediction time is earlier than the serum levels of Cr and CysC .The level of serum NGAL can be used for early diagnosis of CIN .

Study on neck management for tongue squamous cell carcinoma of cN0 stage / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This retrospective study is to analyze the outcomes of cN0 stage tongue squamous cell carcinoma and to discuss a reasonable neck management for these cases.</p><p><b>METHODS</b>Totally 132 cases of cN0 stage tongue squamous cell carcinomas were included. Seventy-one cases were performed neck dissection(group ND), 61 cases were under wait-and-see (group WS). The clinical, pathological and follow up data of two groups were analyzed.</p><p><b>RESULTS</b>The cumulative three-year-survival between group ND and group WS were 87.3% and 83.4% respectively. In group ND, the survival of T1 and T2 cases were 89.3% and 83.3% respectively, while 89.6% and 58.3% in WS. For T2b cases which the size was larger than 3.0 cm, the survival of group WS was greatly lower than that of group ND. Both in ND and WS groups. The pathologically poor differentiation cases got poor survival than middle and well cases.</p><p><b>CONCLUSION</b>The wait-and-see policy is recommanded for T1 stage cN0 tongue squamous cell carcinoma. For T2 cases that the tumor size is smaller than 3.0 cm, the wait-and-see is also reasonable, while the neck dissection should be considered in cases of poor differentiation. For large T2 cases, the selective neck dissection should be performed.</p>