The Clinical Outcomes and Perioperative Care of Neurofibromatosis Type 1 Thoracolumbar Kyphoscoliosis / 罕见病研究

  Objective  To evaluate the clinical outcomes and complications of posterior spinal fusion surgery in the treatment of neurofibromatosis type 1(NF1)thoracolumbar kyphoscoliosis, and to explore the mode of perioperative care for nurses provided to the patients.  Methods  We used the retrospective analysis on the 134 patients with NF1 thoracolumbar kyphoscoliosis admitted to our department from March 2012 to April 2022 and analyzed the clinical outcomes and perioperative complications by using the related statistics. We evaluated the Perioperative care by the nurses in the treatment of NF1 to explore the mode of nursing to the patients with the NF1, by using specific observation points and evaluation indicators.  Results  NF1 kyphoscoliosis patients had poor preoperative nutritional status and lung function. NF1 kyphoscoliosis underwent longer operation time, lost more blood in operation, had higher osteotomy grade and more postoperative complications. All the patients successfully completed the operation in our group. The correction rate of scoliosis was (52.8±22.7)%, and the correction rate of kyphosis was (57.3±34.6)%. 25 patients had complications but no such serious complications as nerve damage.  Conclusions  The practice of the perioperative nursing to NF1 type scoliosis patients facilitates the shortening of the recovery period, the prevention or timely detection of complications, and improvement of the therapeutic effect.

Diagnostic value of magnetic resonance spectroscopy for intracranial space-occupying lesions / 中国辐射卫生

Objective To evaluate the value of magnetic resonance spectroscopy (MRS) in the diagnosis of intracranial space-occupying lesions. Methods A total of 126 patients with intracranial space-occupying lesions in the First Affiliated Hospital of Xinjiang Medical University from 2019 to 2022 were enrolled and subjected to brain magnetic resonance imaging (MRI) and MRS examinations. The performance of MRI alone and in combination with MRS was evaluated and compared for diagnosis of intracranial space-occupying lesions. Results Tuberculoma (19.05%) and high-grade glioma (15.87%) were the intracranial space-occupying lesions most commonly diagnosed by MRI in combination with MRS. Radiologists confirmed the diagnosis of intracranial space-occupying lesions in 23.81% patients depending on MRI alone, and in 75.40% patients depending on MRI combined with MRS, with a 2.17-fold improvement (χ2 = 67.07, P<0.01). The combination of MRI and MRS improved the accuracy of imaging diagnosis of intracranial space-occupying lesions in 70 (55.67%) patients compared with MRI alone. In addition, MRI in combination with MRS significantly improved the accuracy of differential diagnosis of high-grade glioma, low-grade glioma, cerebral infarct, tuberculoma, recurrent tumor, and radiation necrosis compared with MRI alone (P<0.01). Conclusion The efficacy of imaging diagnosis of intracranial space-occupying lesions can be improved by MRI in combination with MRS relative to MRI alone. The combined use of MRI and MRS may serve as a non-invasive tool for diagnosis of intracranial space-occupying lesions. In addition, the combination facilitates the differentiation between low- and high-grade gliomas, between high-grade glioma and tuberculoma, and between recurrent tumor and radiation necrosis.

Liraglutide ameliorates high glucose-induced oxidative stress injury in rat H9c2 cells through modulation of SIRT1 / 中华内分泌代谢杂志

Objective:To investigate the effect of liraglutide(LRG) on high glucose-induced oxidative stress injury in(H9c2) cardiomyocytes and its underlying mechanisms.Methods:A high glucose treatment was applied to H9c2 cells for 24 hours to establish an in vitro model of myocardial cell injury. Different concentrations of liraglutide(10, 100, 1000 nmol/L) were administered for intervention. Cell viability was evaluated using the CCK-8 assay, and changes in cell morphology were observed under an inverted microscope. After 24 hours of liraglutide(100 nmol/L) intervention following high glucose treatment, the levels of lactate dehydrogenase(LDH), superoxide dismutase(SOD), and malondialdehyde(MDA) in the cell supernatant were measured. RT-PCR and Western blotting were used to detect the mRNA and protein levels of silent information regulator factor 1(SIRT1) and forkhead box protein O1(FOXO1). Western blotting was also used to assess the acetylation level of FOXO1 protein. Small interfering RNA(siRNA) technology was employed to silence SIRT1 in H9c2 cells to confirm its role in the study. Results:Compared to the control group, the high glucose group showed decreased cell viability, cell structure damage, increased levels of LDH and MDA in the cell supernatant, decreased SOD levels, aggravated oxidative stress, decreased SIRT1 expression, and increased acetylation level of FOXO1(all P<0.05). Compared to the high glucose group, liraglutide intervention resulted in increased cell viability, improved cardiac cell morphology, reduced oxidative stress levels, increased SIRT1 expression, and decreased acetylation level of FOXO1(all P<0.05). When SIRT1 was downregulated, the protective effects of liraglutide were weakened(all P<0.05). Conclusions:Liraglutide has a protective effect against high glucose-induced oxidative stress injury in H9c2 cells, which may be associated with the upregulation of SIRT1 expression.

Study of radiotherapy dose effect of neoadjuvant chemotherapy versus concurrent chemoradiotherapy in cervical cancer / 中华放射肿瘤学杂志

Objective:To compare the effect of neoadjuvant chemotherapy vs. concurrent chemoradiotherapy on the target volume and organs at risk for locally advanced bulky (>4 cm) cervical cancer. Methods:From March 1, 2019 to June 30, 2021, 146 patients pathologically diagnosed with cervical cancer were selected and randomly divided into two groups using random number table method: the neoadjuvant chemotherapy (NACT) + concurrent chemoradiotherapy (CCRT) group ( n=73) and CCRT group ( n=73). Patients in the NACT+CCRT group received 2 cycles of paclitaxel combined with cisplatin NACT, followed by CCRT, the chemotherapy regimen was the same as NACT. In the CCRT group, CCRT was given. Statistical description of categorical data was expressed by rate. The measurement data between two groups were compared by Wilcoxon rank-sum test for comparison of two independent samples, and the rate or composition ratio of two groups was compared by χ2 test. Results:Before radiotherapy, GTV in the NACT+CCRT group was (31.95±25.96) cm 3, significantly lower than (71.54±33.59) cm 3 in the CCRT group ( P<0.01). Besides, CTV and PTV in the NACT+CCRT group were also significantly lower compared with those in the CCRT group (both P<0.05). In terms of target volume dosimetry, D 100GTV, D 95CTV, V 100GTV, V 100CTV and V 95PTV in the NACT+CCRT group were significantly higher than those in the CCRT group (all P<0.05). The complete remision (CR) rates in the NACT+CCRT and CCRT groups were 86.3% and 67.6%, with statistical significance between two groups ( P<0.01) . Regarding organs at risk, NACT+CCRT group significantly reduced the dose to the bladder, rectum, small intestine and urethra compared with CCRT group (all P<0.05). Conclusions:NACT can reduce the volume of tumors in patients with large cervical masses, increase the radiation dose to tumors, reduce the dose to organs at risk, and make the three-dimensional brachytherapy easier. Therefore, NACT combined with CCRT may be a new choice for patients with locally advanced cervical cancer with large masses.

Extracellular vesicles in the blood components and their roles in transfusion-related immunomodulation / 中国输血杂志

Extracellular vesicles (EVs) with a variety of bioactive molecules can be continuously secreted during the storage of blood components, which can promote cell-cell interaction and mediate cell-to-cell signal transmission. EVs are widely involved in inflammation, metabolism and immunization. In recent years, studies have reported that EVs in the blood components can not only cause transfusion-related lung injury through activating neutrophils, but also act on monocytes to stimulate inflammatory response. EVs can play different regulatory effects on the immune system of patients. In this review, the role and mechanism in transfusion-related immunomodulation (TRIM) of EVs in different blood components have been summarized.

Liraglutide ameliorates palmitic acid-induced insulin resistance in L6 skeletal muscle cells by regulating Sestrin2 / 中华内分泌代谢杂志

Objective:To investigate the role of stress-inducible protein Sestrin2 (Sesn2) in the improvement of insulin resistance in rat L6 skeletal muscle cells treated with liraglutide.Methods:The establishment of insulin resistance model of rat L6 skeletal muscle cells was induced by palmitate. The experimental cells were divided into control group(Con group), palmitate 0.6 mmol/L treatment group(PA group), palmitate 0.6 mmol/L+ liraglutide 10 nmol/L treatment group(PA+ Lir10 group), palmitate 0.6 mmol/L+ liraglutide 100 nmol/L treatment group(PA+ Lir100 group), and palmitate 0.6 mmol/L+ liraglutide 1 000 nmol/L treatment group(PA+ Lir1000 group). The cell counting kit 8(CCK8) method was used to detect the cell activity in each group. Western blotting was used to detect the expression levels of glucose transporter 4(GLUT4), protein kinase B(Akt), phosphorylated protein kinase B(p-Akt), and Sesn2 protein in L6 cells. L6 cells were transfected with siRNA to inhibit the expression of Sesn2. The cells were treated with palmitate and liraglutide. Western blotting was used to detect the expression levels of Sesn2, Akt, p-Akt, and GLUT4 protein in L6 cells.Results:Compared with Con group, the cell survival rate, p-Akt/Akt ratio, Sesn2, and GLUT4 protein expression in PA group decreased significantly( P<0.05). After liraglutide intervention, the cell activity, p-Akt/Akt ratio, Sesn2, and GLUT4 protein expression of PA+ Lir100 and PA+ Lir1000 groups was increased( P<0.05). After inhibiting the expression of Sesn2, p-Akt/Akt ratio and GLUT4 protein in transfected si-Sesn2 and treated with 0.6 mmol/L palmitate group(PA+ si-Sesn2 group) and transfected si-Sesn2 and treated with 0.6 mmol/L palmitate+ liraglutide 100 nmol/L group (Lir100+ PA+ si-Sesn2 group) were significantly lower than those in transfection negative group (si-Con group; P<0.05). Even after liraglutide intervention, compared with PA+ si-Sesn2 group, p-Akt/Akt ratio and GLUT4 protein expression level were not significantly increased in Lir100+ PA+ si-Sesn2 group ( P>0.05). Conclusions:Palmitate could induce the decrease of p-Akt/Akt ratio and GLUT4 protein expression in L6 cells. Liraglutide upregulates the expression of Sesn2, which leads to the increase of p-Akt/Akt ratio and GLUT4 protein expression and contributes to the improvement of insulin resistance.

Epidemiological characteristics and macrolide-resistance of children hospitalized with Mycoplasma pneumo-niae infection in Beijing from 2016 to 2019 / 中华实用儿科临床杂志

Objective:To investigate epidemiological characteristics and macrolide-resistance of hospitalized children with Mycoplasma pneumoniae (MP) infections in Beijing from 2016 to 2019, so as to provide basis for the prevention and treatment of pediatric Mycoplasma pneumoniae pneumonia (MPP).Methods:The clinical data were analyzed retrospectively from 8 691 children hospitalized with community acquired pneumonia in Beijing Children′s Hospital between January 2016 and September 2019.MP RNA was detected by simultaneous amplification and testing (SAT), and macrolide resistance of MP was examined by MP and macrolide-resistant isolate diagnostic kit (PCR with fluorescence probes). Chi- square test was used for categorical analysis. Results:Among 8 691 cases detected by SAT, the overall detection rate of MP was 28.10% (2 442/8 691 cases). The detection rates of MP from 2016 to 2019 were 26.23%, 31.36%, 27.84 % and 26.57%, respectively.The detection rate of MP in 2017 was significantly higher than that in other years ( χ2=16.11, P<0.05). The detection rate of MP in females was 29.65%(1 107/3 733 cases), which was evidently higher than that in males 26.93%(1 335/4 958 cases) ( χ2=7.85, P<0.05). The positive rates of MP in summer[32.21% (726/2 254 cases)] and autumn[39.76%(852/2 143 cases)] were significantly higher than those in spring[17.00% (327/1 924 cases)] and winter[22.66%(537/2 370 cases)] ( χ2=315.15, P<0.001). The percentages of MP were 35.06%(732/2 088 cases) in preschoolers and 37.71%(1 160/3 076 cases) in school-age children, which were significantly higher than 11.20%(232/2 072 cases) in infants and 22.01% (318/1 445 cases) in toddlers ( χ2=509.89, P<0.001). Macrolide resistance detection was conducted in 1 524 patients by fluorescent PCR.Among them, 1 386 patients were positive for drug resistance, and the positive rate was 90.94%.The prevalence of macrolide-resistant MP from 2016 to 2019 were 88.19%, 90.93%, 90.56% and 92.90%, respectively.Macrolide-resistant rates were not related with gender, age and season. Conclusions:MP can be detected in all seasons, but most prevalently in summer and autumn.Girls are more prone to MP infections than boys.The detection rate of MP increases with age, and the positive rate is higher in preschoolers and school-age children.During the 4-year study period, the drug resistant rate of MP remain high.

Effects of different bladder filling volumes on target area and organs at risk during three-dimensional brachytherapy of postoperative early cervical cancer / 中华放射医学与防护杂志

Objective:To investigate the optimal bladder filling volume in the 3D brachytherapy of postoperative cervical cancer.Methods:Totally 111 early cervical cancer patients with positive incisal margins or insufficient safety boundaries were included. The normal saline 50, 60, 70, 80, 90, and 100 ml were filled into their bladders, and accordingly six groups were determined, and 66, 69, 66, 69, 72, 56 person-times in each group, respectively. The CT-based simulation positioning was performed. According to the ICRU 89 report, high-risk clinical target volume and organs at risk such as bladder and rectum were delineated. The Oncentra planning system was used to prepare the treatment program. The high-risk clinical target volume (HR-CTV), D90, and the D2 cm 3 and D1 cm 3 of organs at risk under different volumes were recorded. Results:Compared to the 60 ml group, the volume and dosage of HR-CTV in the groups of 50, 70, 80, 90, and 100 ml had no significant difference ( P>0.05). The D2 cm 3 and D1 cm 3 of the bladder and rectum of patients in these groups significantly decreased, and the difference was statistically significant ( tbladder = 3.21, 5.83, 2.89, 12.95, 7.96, Pbladder = 0.031, 0.010, 0.041, 0.000, 0.001; trectum = 2.94, 4.66, 2.53, 5.89, 4.13, Prectum = 0.037, 0.024, 0.049, 0.005, 0.028). The pairwise comparison among these groups except for the 60 ml group showed that the volume and dosage of HR-CTV and the D2 cm 3 and D1 cm 3 of bladder and rectum had no significant difference ( P > 0.05). Moreover, the D2 cm 3 and D1 cm 3 of sigmoid colon and small intestine of these groups had no significant difference ( P > 0.05). Conclusions:In the 3D brachytherapy of postoperative early cervical cancer, a bladder filling volume of 60 ml can ensure the volume and dose of HR-CTV and can protect the bladder and rectum compared with other filling volumes.

Predictive Value of CD44v6 and EGFR Expression in Neoadjuvant Chemotherapy Sensitivity of Stage Ⅱ-Ⅲ Cervical Cancer / 肿瘤防治研究

Objective To explore the predictive value of the expression of CD44v6 and EGFR on the efficacy of neoadjuvant chemotherapy (NACT) in stageⅡ-Ⅲ cervical cancer. Methods A total of 53 patients with stageⅡ-Ⅲ cervical cancer diagnosed by pathology were selected. All patients received two cycles of paclitaxel+platinum NACT. The pathological tissue samples of cervical tumors before NACT treatment were collected. The expression of CD44v6 and EGFR were detected by the immunohistochemical SP method, and we analyzed their predictive value of NACT in stageⅡ-Ⅲ cervical cancer. Results Among the 53 patients, 38 were in the NACT effective group (CR+PR), and 15 were in the NACT ineffective group (SD+PD). The expression of CD44v6 in the ineffective group was significantly higher than that in the effective group (P < 0.05). The expression of CD44v6 was significantly different in patients with CR, PR, and SD (P < 0.05). The AUC of CD44v6 to NACT effect on stage Ⅱ-Ⅲ cervical cancer was 0.74 (P < 0.05). The patients in the high expression group of CD44v6 had worse efficacy in NACT than those in the low expression group of CD44v6 (P < 0.05). Pearson test showed that CD44v6 and EGFR expression were correlated (R=0.34, P < 0.05). Conclusion High expression of CD44v6 may reduce the efficacy of NACT in stageⅡ-Ⅲ cervical cancer, suggesting that the expression of CD44v6 has a certain predictive value and clinical significance in the efficacy of paclitaxel+platinum NACT on cervical cancer. Moreover, CD44v6 is positively correlated with EGFR expression.

Etiology, diagnosis and treatment of infraoccluded primary second molars / 中华口腔医学杂志

Infraocclusion is a phenomenon that the relative occlusal growth of a tooth stops after the period of active eruption and then the tooth becomes depressed below the occlusal plane. Infraocclusion occurred more commonly in children and the mostly affected teeth were the primary mandibular second molars. The occlusal problem caused by infraocclusion may progressively worsen with age. This review summarizes the etiology, diagnosis and treatment of infraoccluded second primary molars, so as to provide reference for the dental clinicians.

Epidemiologic Features, Radiological Findings andClinical Outcomes of 19 Patients with COVID-19in a Single Center in Beijing, China / 中国医学科学杂志(英文版)

ObjectiveTo describe the epidemiologic, clinical, laboratory, and radiological characteristics and prognoses of COVID-19 confirmed patients in a single center in Beijing, China. Methods The study retrospectively included 19 patients with nucleic acid-confirmed SARS-CoV-2 infection at our hospital from January 20 to March 5, 2020. The final follow-up date was March 14, 2020. The epidemiologic and clinical information was obtained through direct communication with the patients or their family members. Laboratory results retrieved from medical records and radiological images were analyzed both qualitatively by two senior chest radiologists as well as quantitatively via an artificial intelligence software. Results We identified 5 family clusters (13/19, 68.4%) from the study cohort. All cases had good clinical prognoses and were either mild (3/19) or moderate (16/19) clinical types. Fever (15/19, 78.9%) and dry cough (11/19, 57.9%) were common symptoms. Two patients received negative results for more than three consecutive viral nucleic acid tests. The longest interval between an initial CT abnormal finding and a confirmed diagnosis was 30 days. One patient's nucleic acid test turned positive on the follow-up examination after discharge. The presence of radiological abnormalities was non-specific for the diagnosis of COVID-19. Conclusions COVID-19 patients with mild or no clinical symptoms are common in Beijing, China. Radiological abnormalities are mostly non-specific and massive CT examinations for COVID-19 screening should be avoided. Analyses of the contact histories of diagnosed cases in combination with clinical, radiological and laboratory findings are crucial for the early detection of COVID-19. Close monitoring after discharge is also recommended.

Relationship between choline acetyltransferase positive neurons in parabrachial nucleus and development of fear memory in mice / 中华麻醉学杂志

Objective:To evaluate the relationship between choline acetyltransferase (ChAT) positive neurons in parabrachial nucleus and development of fear memory in mice.Methods:Eighteen healthy male ChAT-ires-cre mice, aged 8-9 weeks, weighing 22-25 g, were divided into 3 groups ( n=6 each) using a random number table method: Cre-dependent AAV-DIO-hM 3Dq-mcherry (Gq) virus/clozapine-N-oxide (CNO) group (group Gq/CNO), Gq/normal saline (NS) group (group Gq/NS) and Cre-dependent AAV-DIO-mcherry (mc) virus/CNO group (group mc/CNO). Gq virus was injected into parabrachial nucleus, and CNO 2 mg/kg was injected intraperitoneally 3 weeks later in group Gq/CNO.Gq virus was injected into parabrachial nucleus, and the equal volume of normal saline was injected intraperitoneally 3 weeks later in group Gq/NS.In group mc/CNO, mc virus was injected into parabrachial nucleus, and CNO 2 mg/kg was injected intraperitoneally 3 weeks later.The fear conditioning test was performed at 30 min after intraperitoneal injection in all the 3 groups.The brains were then removed and sliced.The virus expression and areas of the brain projected by ChAT positive neurons were observed. Results:Compared with group Gq/CNO, the percentage of freezing time was significantly increased during testing phase in Gq/NS and mc/CNO groups ( P<0.05). Gq/mc virus carrying fluorescent protein mcherry was expressed in parabrachial nucleus and was co-expressed with mcherry-ChAT.The fibers of ChAT positive neurons projected to the red nucleus, substantia nigra, central amygdala, anterodorsal thalamic nucleus and bed nucleus of stria terminalis. Conclusion:The ChAT positive neurons in parabrachial nucleus are involved in the regulation of the development of fear memory in mice, which can impair fear memory, and the regulation is carried out probably through central amygdala.

Study on the relationship between the level of D-dimer and re-admission of patients with chronic obstructive pulmonary disease / 中国医师进修杂志

Objective@#To explore the role of D-dimer level in patients with acute exacerbation of chronic obstructive disease (AECOPD) in predicting the re-admission of patients.@*Methods@#One hundred and twenty chronic obstructive pulmonary disease (COPD) patients in the Shanghai General Hospital of Shanghai Jiao Tong University form January 2016 to December 2018 were divided into AECOPD group (62 cases) and stable COPD group (58 cases).The level of serum D-dimer was analyzed and Pearson correlation analysis was performed with the patient′s blood gas analysis and COPD assessment test (CAT) score. The area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum D-dimer level for readmission.@*Results@#Serum D-dimer level was significantly higher in AECOPD group than that in stable group: (1.24 ± 0.56) mg/L vs. (0.39 ± 0.22) mg/L, and there was statistical difference (P<0.01). Serum D-dimer level was negatively correlated with PaO2 in COPD patients (r = 0.712, P = 0.000), but positively correlated with PaCO2 (r = 0.683, P = 0.000) and CAT score (r = 0.652, P = 0.000). The area under the ROC curve of D-dimer level to re-admission of COPD patients within one year was 0.848. The cutoff value was 1.015 mg/L.@*Conclusions@#The level of D-dimer in COPD patients is of great value in predicting the re-admission of patients, which can be used as an independent indicator of disease progression.

Determination of ECs0 of ropivacaine for postoperative analgesia under general anesthesia combined with single interscalene brachial plexus block / 临床麻醉学杂志

Objective To determine the 50％ minimum effective concentration (EC50) of ropivacaine for postoperative analgesia after shoulder arthroscopy under general anesthesia combined with interscalene brachial plexus block.Methods Patients undergoing selective shoulder arthroscopy were included in this study.There were 9 males and 13 females,BMI 18-28 kg/m2,falling into ASA physical status Ⅰ or Ⅱ.The interscalene brachial plexus block was achieved under the guidance of ultrasound and nerve stimulator at the level of C6.The upper trunk of interscalene brachial plexus was blocked with 5 ml ropivacaine.The concentration of ropivacaine intially was 0.5 ％ and then depended on the response of the previous patient's postoperative NRS scale.The target ropivacaine concentration was determined by up and down sequential method.The ratio of two consecutive ropiva caine was 1.2.Two termination conditions were,firstly,to achieve seven negative-positive up-anddown deflections required to calculate EC50,and secondly,to deriminate if 7 were positive outcomes using 5 ml of 0.1 ％ ropivacaine or 7 were negative outcomes using 5 ml of 1 ％ ropivaciane.EC50 and 95％CI of ropivacaine was calculated using the formula of Dixon-Massey sequential method.The incidence of hemidiaphragmatic paresis was evaluated.Pre-and post-operative pulmonary function was compared using paired t test.Results The EC50 of ropivacaine was 0.21％ (95 ％CI 0.18％-0.25 ％).The incidence of hemidiaphragmatic paresis was 9 cases(40.90％).Postoperative FVC and FEV1/FVC was significantly decreased than preoperative,but FEV1 (P =0.116) was not.Conclusion For patients undergoing shoulder arthroscopy under general anesthesia and interscalene brachial plexus block,the minimum effective concentration of ropivacaine for analgesia of EC50 is 0.21％,95％ CI 0.18％-0.25％.

Effects of Acupuncture on the Level of Inflammatory Cytokines and Toll-like Receptor 4 in Hypothalamic Paraventricular Nucleus of Spontaneously Hypertensive Rats / 中国中医药信息杂志

Objective To observe the effects of acupuncture on the level of inflammatory cytokines and toll-like receptor 4 in hypothalamic paraventricular nucleus (PVN) of SHR; To investigate the mechanisms of acupuncture in reduction of mean arterial blood pressure (MAP) in SHR. Methods Thirty 10-week old SHR were randomly divided into SHR group, acupuncture group and non-acupoint group, with 10 rats in each group. 10 WKY rats were set as control group. Acupuncture group received bilateral acupuncture in "Taichong" acupoint, and twisting and diarrhea method was used to stimulate; non-acupoint group received acupuncture at the back of feet, and soothing and diarrhea with twisting method was used to stimulate. Materials were taken two weeks later. The mean arterial pressure of rats was detected every day; the expression of TLR4 mRNA in PVN was detected by RT-PCR; The expression of TLR4 protein in PVN was detected by Western blot; The levels of TNF-αa nd IL-6 were detected. Results Compared with control group, the mean arterial pressure of SHR group increased; TLR4 mRNA and protein expression in PVN increased significantly; the level of TNF-α and IL-6 increased significantly (P<0.05). Compared with SHR group, the mean arterial pressure of acupuncture group decreased significantly;TLR4 mRNA and protein expression in PVN decreased significantly; the level of TNF-α and IL-6 decreased significantly (P<0.05). There was no significant change in non-acupoint group. Conclusion Acupuncture in"Taichong" acupoint can attenuate blood pressure of SHR by inhibiting expression of TLR4 in PVN and reducing the levels of TNF-α and IL-6.

The mediating effect of resilience between family support and benefit finding in diabetic patients / 中华行为医学与脑科学杂志

ObjectiveTo investigate the status of benefit finding in diabetic patients,and mediating effect of resilience between family support and benefit finding in diabetic patients.MethodsFive hundred and thirteen diabetic patients from a hospital of Harbin were recruited as investigative subjects from September 2015 to June 2016.The resilience scale,family adaptability,cohesion scale and benefit finding scale were used in the study.ResultsThe scores of benefit finding,resilience and family adaptability and cohesion were 55.67±12.87,70.65±10.39 and 104.25±15.38,separately.The total score of family adaptability and cohesion was positively related to the total score of benefit finding(r=0.389,P<0.05).The total score of resilience was positively related to the total score of benefit finding(r=0.155,P<0.05).The total score of family adaptability and cohesion was positively related to the total score of resilience(r=0.112,P<0.05).Benefit finding as the dependent variable,the results of hierarchical regression analysis indicated that family adaptability and cohesion (β=0.382,P<0.01),resilience(β=0.098,P<0.01)entered the regression equation.There was a partial mediating effect of resilience between family support and benefit finding in diabetic patients.The mediating effect was 0.011,accounted for 2.8% of the total effect.The resilience was the important protective factor for benefit finding.ConclusionFamily support has a direct influence on benefit finding and an indirect effect mediated by resilience on benefit finding.

Qualitative study on experience of spouse caregivers of elderly and disable patients with stroke / 现代临床护理

Objective To explore the experience and feelings of spouse caregivers of elderly and disable patients with stroke in the process of care. Method Totally 8 spouse caregivers of elderly and disable patients with stroke were selected and investigated by semi structural in-depth interviews. Result Five major themes were found, e.g. responsibility and obligation of husband and wife, mental stress and physical stress, economic pressure, lack of effective information, positive feelings and countermeasures in the predicament. Conclusions The spouse caregivers suffer from psychological, physiological, economical and less information, but they are engaged with responsibility, obligation, positive feelings and coping. It is suggested that health care workers should take full attention to the elderly spouse caregivers and help them to reduce the pressure in the process of care, strive to tap their positive feelings and promote personal growth.

Clinical Observation of Scalp Acupuncture Combined with Swallowing and Speech Therapeutic Instrument for Treatment of Post-stroke Dysphagia / 广州中医药大学学报

Objective To observe the c linical effect of scalp acupuncture combined with swallowing and speech therapeutic instrument for the treatment of post-stroke dysphagia. Methods Sixty-eight patients with post-stroke dysphagia were randomly divided into treatment group (N = 34)and control group (N = 34). Both groups were given the internal medicine treatment for lowering blood lipids,stabilizing plaque,and nourishing nerves,and took rehabilitation training. And additionally,the treatment group was given scalp acupuncture therapy and the treatment with swallowing and speech therapeutic instrument,and the control group was given the treatment with s wallowing speech therapeutic instrument alone. Two weeks constituted one treatment course, and the two groups were treated for 4 weeks. The scores of Standardized Swallowing Assessment(SSA) and Swallowing Quality of Life Instrument (SWAL-QOL) of the two groups were observed before and after treatment, and then the curative effects were evaluated by Saito 7-grade dysphagia assessment method. Results (1)Till the end of the trial,7 cases of the 68 patients were excluded for transferring to other departments or loss to follow-up. Of the 7 excluded cases, 3 cases were from the treatment group and 4 were from the control group. (2) The total effective rate of the treatment group was 90.32%and that of the control group was 66.67%,the difference being significant(P < 0.05).(3)After treatment,SSA scores of the 2 groups were decreased(P < 0.01)and SWAL-QOL scores were increased (P < 0.01),and the effect on improving SSA scores and SWAL-QOL scores in the treatment group was superior to that in the control group (P < 0.01). Conclusion Both groups can relieve dysphagia and improve the quality of life of post-stroke dysphagia patients,and the scalp acupuncture combined with swallowing and speech therapeutic instrument is more effective for the treatment of post-stroke dysphagia.

Chemical constituents, biological activities and quality control of plants from genus Pyrola / 中国中药杂志

Plants from the genus Pyrola are widely distributed in North Temperate zone. The quinones, phenol glycosides, terpenoids, flavonoids and volatile oil compounds have been identified from these plants. The in vivo and in vitro studies have shown that the genus Pyrola plants exhibit a wide range of pharmacological properties, including antioxidant, antitumor, antibacterial, anti-ischemia and anti-inflammatory activities. Based on analysis of the literature of the genus Pyrola plant, this review summarized the research on chemical constituents, pharmacology and quality control in recent years which can provide evidences for further investigation on the genus Pyrola plants.

A randomized controlled trial on additional efficacy of local anesthetic injection on multimodal analgesia in total knee arthroplasty / 中华骨科杂志

Objective To evaluate the additional efficacy of local anesthetic injection (LAI) as a part of multimodal anal?gesia in patients undergoing total knee arthroplasty (TKA) with respect to pain, narcotic use, knee function and complications. Methods A multicenter randomized, controlled, double blind study was performed. A total of 101 patients undergoing unilateral TKA in two centers were randomly divided into injection group and control group. Injection group (50 cases) received local anes?thetic injection of ropivacaine (200 mg), fentanyl (1μg) and epinephrine (1∶1 000, 0.25 mg) in operation and control group (51 cas?es) did not. All patients received standardized general anesthesia and postoperative intravenous patient controlled analgesia (PCA). Preoperative baseline data, surgery?related conditions, postoperative pain (on a 0 to 10 scale), knee function, time of open?ing PCA, narcotic dosage in PCA and complications were compared respectively. Results The time of opening PCA in injection group (4-10 h, M=8 h) was longer than that in control group (2-5 h, M=4 h) (P0.05). Conclusion LIA in TKA can relieve pain early after TKA, prolong the time of opening PCA and reduce narcotic use compared with patients without it. It is simple and safe to use.