Caring for Patients Requiring Venous Arterial Extracorporeal Membrane Oxygenation: Can Upstream Palliative Care Make a Difference?

OBJECTIVE: Palliative care consultation is relevant for patients requiring Venous-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO); however, evidence is limited to support its value. For this population, we compared length of stay (LOS) (primary outcome), operational metrics and goals of care (GOC) frequency before and after a collaboration between cardiothoracic (CT) surgery and Geriatrics and Palliative Medicine (GaP). METHODS: Retrospective chart review of patients (18+) admitted to a quaternary center that required VA-ECMO between 2019-2021 and received GaP consultation. Demographics, LOS, times to consult, illness severity, GOC, and outcomes were analyzed. RESULTS: 120 patients met inclusion criteria and 64 (53.3%) had GaP consultation. No differences were observed regarding demographics and insertion status (emergent vs elective). Median (IQR) days to GaP consult for 2019, 2020 and 2021 were 6.5 (4.0-14.5), 5.0 (2.0-11.0) and 3.0 (2.0-5.0), respectively (P = .006). Median days from insertion to consult for 2019, 2020 and 2021 were 6.0 (4.0-20.0), 3.0 (1.0-6.0) and 2.0 (1.0-4.0) (P = .003). Among survivors, over the 3-year course, median LOS was not statistically different. Between expired patients, median (IQR) LOS for 2019, 2020, and 2021 was 28.5 (23.0-40.0), 12.0 (8.0-14.0), 11.0 (5.0-17.0) days (P = .013). For patients not seen by GaP, 8 (14.3%) GOC notes were documented, compared with 42 (65.6%) for patients seen. Mortality was similar (53.6% vs 53.1% [GaP]). CONCLUSION: For patient on VA-ECMO, early GaP consultation may improve hospital LOS and GOC rates. We suggest organizations consider early palliative integration when instituting mechanical circulatory support.

Analysis of drug therapy in a patient with pulmonary infection secondary to suppurative thrombophlebitis / 药学实践杂志

Objective To explore the role of pharmaceutical care in the treatment of patients with pulmonary infection secondary to suppurative thrombophlebitis. Methods The treatment of a patient diagnosed with pulmonary metastatic infection secondary to suppurative thrombophlebitis and the whole process of clinical pharmacists participating in the monitoring were analyzed retrospectively. The use of antibiotics was evaluated, and the experience of coagulation management in suppurative thrombophlebitis was explored. Results Based on the infection site, characteristics of septic thrombus, monitoring of vancomycin blood concentration, pharmacokinetics and pharmacodynamics characteristics of antibiotics, clinical pharmacists provided comprehensive pharmaceutical services for clinicians and patients in terms of anti-infection scheme adjustment, optimization of vancomycin individualized treatment, anticoagulant timing. Patient’s systemic infection and septic thrombus can be effectively controlled and which promotes the treatment of patients with suppurative thrombophlebitis. Conclusion Clinical pharmacists can play an important role in the treatment team of severe patients to improve the rational use of antibiotics.

IL-33 amplifies airways inflammation in a murine surrogate of asthma putatively via activation of dendritic cells.

Although contributions of IL-33 to pulmonary diseases, including asthma, have been well documented, the complexity of such regulation warrants additional exploration. To better understand the involvement of IL-33, we used a murine asthma surrogate based on sensitisation and challenge with dust mite extract in the presence/absence of IL-33. Murine models were established with Dermatophagoides farinae (Der f) to establish (1) the effect of co-administered rmIL-33; (2) the effect of prior glucocorticoid intervention; (3) the effect of IL-33 on challenge with sub-threshold dosage Der f. The effects of rmIL-33 on bone marrow-derived dendritic cells were explored in vitro. Mice challenged with Der f combined with IL-33 compared with diluent control evinced significantly more airways inflammation and local cytokine production which was less sensitive to inhibition by dexamethasone. IL-33 also induced airways hyperresponsiveness, eosinophilic inflammation and cytokine production in lung tissues of animals exposed to sub-threshold dosage of Der f. In vitro, IL-33-stimulated DCs showed a significantly elevated capacity to stimulate CD4+ T cell proliferation and cytokine production and were also significantly more resistant to dexamethasone-induced apoptosis. Our data suggest that IL-33 reduces the threshold for allergen-induced inflammation of the airways in acorticosteroid-resistant fashion possibly in part through acting on DCs, a phenomenon which may be relevant to the development of severe, corticosteroid-resistant airways obstruction in human asthmatic patients.

Effect of electroacupuncture on postpartum uterine contraction pain and uterine involution: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture on postpartum uterine contraction pain and uterine involution.@*METHODS@#A total of 80 patients with postpartum uterine contraction pain were randomly divided into an observation group and a control group, 40 cases in each group. The observation group was treated with electroacupuncture at Dahe (KI 12), Zhongzhu (KI 15), Hegu (LI 4), Xuehai (SP 10), etc. for 30 min, once a day, 3 days were as one course, and 2 courses with 1-day interval were required. The control group was treated with oral @*RESULTS@#Compared before treatment, the VAS scores of 24, 48, 72 h into treatment and after treatment were decreased in both groups (@*CONCLUSION@#Electroacupuncture can effectively relieve postpartum uterine contraction pain, accelerate the discharge of residual uterine hemorrhage in the uterine cavity, and promote uterine involution.

Effect of fecal microbiota transplantation on intestinal flora in mice with acute-on-chronic liver failure / 临床肝胆病杂志

ObjectiveTo investigate the protective effect of fecal microbiota transplantation (FMT) on mice with acute-on-chronic liver failure (ACLF) and its effect on intestinal flora. MethodsA total of 40 mice were randomly divided into control group (CON group), model group (MOD group), FMT group (feces of the mice in the CON group were used as fecal microbiota donor), and FMT model group (ANFMT group, with feces of the mice in the MOD group as fecal microbiota donor), with 10 mice in each group. All mice were observed in terms of body weight, death, liver histopathology, and changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and intestinal flora. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the SNK-q test was used for further comparison between two groups. ResultsCompared with the CON group, the MOD group had a significant reduction in body weight and significant increases in AST and ALT (all P＜0.05), as well as large patchy necrosis of hepatocytes, significant increases in Verrucomicrobia, Akkermansia, and Erysipelatoclostridium, and significant reductions in Dubosiella and Duncaniella (all P＜0.05). Compared with the CON group, the ANFMT group had a significant increase in AST (P＜0.05), hepatocyte swelling and mild ballooning degeneration, significant increases in Unclassified and Faecalibaculum, and significant reductions in Patescibacteria, Deferribacteres, Muribaculum, Candidatus_Saccharimonas, Rikenella, Odoribacter, Mucispirillum, and Lachnospiraceae_unclassified (all P＜0.05). Compared with the MOD group, the FMT group had significant reductions in AST and ALT (both P＜0.05), mild hepatocellular necrosis and marked ballooning degeneration, significant increases in Paramuribaculum and Bilophila, and significant reductions in Firmicutes, Rikenella, and Absiella (all P＜0.05). ConclusionIntestinal flora disturbance is observed in ACLF mice, and dysbacteriosis may lead to liver injury. FMT can alleviate liver inflammation in ACLF mice and thus exert a protective effect.

Effect of electroacupuncture at / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect of the combination of electroacupuncture (EA) at @*METHODS@#A total of 58 patients after uterine curettage of incomplete abortion were randomized into an EA group and a western medication group, 29 cases in each one. In the western medication group, mifepristone tablets were administered orally, 2 tablets each time, once daily. In the EA group, on the base of the treatment as the western medication group, EA was applied to @*RESULTS@#After treatment, the intrauterine residue area and CDFI blood flow signal positive rate were all reduced as compared with the values before treatment in patients of the two groups (@*CONCLUSION@#The combined treatment of electroacupuncture at

Similarities and differences in the effects of sensitisation and challenge with Dermatophagoides farinae and Dermatophagoides pteronyssinus extracts in a murine asthma surrogate.

Patients with atopic asthma may become sensitised to the grain storage mite Dermatophagoides farinae (Der f), the house dust mite Dermatophagoides pteronyssinus (Der p) or both, but thus far little attention has been paid to date to possible variation in their pathophysiological effects. Here we present a side by side comparison of the effects of extracts of these two dust mites in a murine surrogate of atopic asthma. Compared with the Der p-challenged mice, however, the mice-challenged with Der f had favour changes in lung tissue elasticity and expression in matrix metalloproteinases in lung tissue, while the mice challenged with Der p showed more neutrophils infiltrating around the airway and stronger expression of steroid-resistant related cytokines in the lung tissue. Our data suggest that different dust mite crude extracts might lead different pathological characteristics, at least in murine models of asthma.

Combined blockade of IL-25, IL-33 and TSLP mediates amplified inhibition of airway inflammation and remodelling in a murine model of asthma.

BACKGROUND AND OBJECTIVE: Isolated blockade of IL-25, IL-33 and thymic stromal lymphopoietin (TSLP) has been shown to reduce airways inflammation and hyperresponsiveness in murine asthma model. The hypothesis that combined blockade of all three cytokines can accomplish this more effectively has never been addressed. METHODS: We studied a murine asthma model employing sensitization and challenge with ovalbumin (OVA) or saline control. To discern the effects of IL-33 blockade, we compared outcomes in strain identical, wild-type and IL-33 receptor (St2 -/- ) gene-deleted mice. We then examined, in the St2 -/- animals, the effects of additional, single or combined blockade of IL-25 and TSLP with blocking antibodies. Outcomes included airways reactivity, inflammatory cellular infiltration, epithelial cell metaplasia, deposition of fibrosis-related proteins, local Th2-type cytokine expression and total and specific serum IgE concentrations measured by ELISA and quantitative immunohistochemistry. RESULTS: St2 -/- gene deletion significantly reduced airways reactivity, inflammatory cellular infiltration, lung tissue expression of Th2 cytokines and fibrosis related proteins and serum total IgE in response to OVA sensitization and challenge. Additional administration of anti-IL-25 and anti-TSLP blocking antibodies to the St2 -/- mice further significantly reduced inflammation, Th2 cytokine expression, airways fibrosis and IgE production, while anti-TSLP alone reduced eosinophil infiltration and local IL-4 expression. The airways inflammatory cellular infiltrate and lung tissue expression of Th2 cytokine, but not fibrosis-related proteins were also reduced in the presence of isotype identical, control antibodies. CONCLUSION: Combined blockade of these three cytokines may better ameliorate airways pathological changes in this murine asthma model, with implications for human asthma.

Effect of electroacupuncture at Shaoze (SI 1) on breast milk volume and composition in postpartum hypogalactia / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture at Shaoze (SI 1) on breast milk volume and nutrient composition in postpartum hypogalactia.@*METHODS@#A total of 62 women with postpartum hypogalactia were randomized into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 3 cases dropped off). Electroacupuncture was exerted at Shaoze (SI 1) in the observation group and at Shangyang (LI 1) in the control group, 10 Hz in frequency, 30 min each time, once a day. The treatment for 5 times as one course and 3 courses of treatment were required totally. Separately, before treatment and at the end of 1 course and 3 courses of treatment, the breast milk volume was measured and the composition was analyzed. The breast milk volume, nutrient composition (lactose, fat and protein), breast milk energy and density were observed in the two groups. After treatment, the clinical effect was compared between the two groups.@*RESULTS@#In the observation group, after 1 course of treatment, the breast milk volume and the values of lactose and protein in the breast milk were increased as compared with those before treatment, the breast milk energy and density were increased as compared with those before treatment (all <0.05). After 3 courses of treatment, the breast milk volume and the values of nutrient composition (lactose, fat and protein) were improved as compared with those before treatment, and the breast milk energy and density were increased obviously as compared with those before treatment in the observation group (all <0.05). In the control group, after 1 course and 3 courses of treatment, only breast milk volume was increased obviously as compared with that before treatment (both <0.05). After 1 course of treatment, the nutrient composition (lactose and protein), breast milk energy and density in the observation group were higher than those in the control group (all <0.05). After 3 courses of treatment, the levels of breast milk volume, nutrient composition (lactose, fat and protein), breast milk energy and density in the observation group were all higher than those in the control group (all <0.05). The effective rate was 92.9% (26/28) in the observation group, which was higher than 17.9% (5/28) in the control group (<0.05).@*CONCLUSION@#Electroacupuncture at Shaozhe (SI 1) increases breast milk volume in patients with postpartum hypogalactia and promotes the production of the nutrient composition in breast milk, as well as the breast milk energy and density.

Effect of warming acupuncture on uterine blood perfusion in patients with failed high-quality freeze-thawed embryo transfer / 中国针灸

OBJECTIVE@#To observe the effect of warming acupuncture on uterine blood perfusion in the patients with failed high-quality freeze-thawed embryo transfer (FET) and explore its effect mechanism on the improvement of clinical pregnancy rate after re-tranfer.@*METHODS@#A total of 72 patients of failed high-quality FET were randomized into an observation group and a control group, 36 cases in each one. In the observation group, after the menstrual period ended, warming acupuncture started at the acupoints located on the abdomen, e.g. Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3) and Qugu (CV 2) and those on the lumbar sacral region, e.g. Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3), 50 min in each treatment, once daily, at the interval of 1 day after 4-day treatment. The treatment was discontinued till the patients were at the ovulatory stage. In the control group, capsules were taken orally and continuously after the end of menstrual period, 3 capsules each time, three times a day and stopped at the ovulatory stage. The treatment of one menstrual cycle was taken as one course and the treatment for 3 menstrual cycles was required. Before and after treatment, the uterine artery pulsation index (PI), endometrial thickness, endometrial type, uterine blood perfusion, the recovery time of sufficient uterine blood flow, the endomentrial receptivity (ER) during the implantation window period and the clinical pregnancy rate were observed in the two groups.@*RESULTS@#After treatment, the endometrial thickness was increased and PI decreased obviously in the two groups (<0.05) and PI in the observation group was lower than that in the control group (<0.05). After treatment, the proportion of type a and type A of endometrium was increased markedly in the two groups (<0.05) and the proportion in the observation group was higher than the control group (<0.05). After treatment, the case proportion of sufficient uterine blood flow was increased obviously in the two groups (<0.05) and the value in the observation group was higher than the control group [83.3% (30/36) vs 69.4% (25/36), <0.05]. After treatment, the proportion of ER during the implantation window period was increased remarkably in the two groups (<0.05) and the value in the observation group was higher than the control group [72.2% (26/36) vs 50.0% (18/36), <0.05]. The recovery time of sufficient uterine blood flow in the observation group was shorter than the control group (<0.05) and the clinical pregnancy rate was higher than the control group [47.2% (17/36) vs 33.3% (12/36), <0.05].@*CONCLUSION@#Warming acupuncture enhances uterine blood perfusion and improves uterine endometrial receptivity so that the clinical pregnancy rate is increased after re-transfer in the patients with failed high-quality freeze-thawed embryo transfer.

Types and advantages of spinal implants in percutaneous kyphoplasty / 中国组织工程研究

BACKGROUND: Percutaneous kyphoplasty is of breakthrough significance in minimally invasive treatment of vertebral compression fractures, but it also has shortcomings, such as bone cement leakage, limited height recovery of the vertebral body, and increased risk of fracture of adjacent vertebral bodies. In recent years, a variety of spinal implants have been developed, and the application of these implants in the treatment of vertebral compression fractures in percutaneous kyphoplasty has achieved good clinical efficacy, and is beneficial to reduce the complications of traditional percutaneous kyphoplasty. OBJECTIVE: To describe the types and characteristics of various spinal implants and explore their clinical applications in percutaneous kyphoplasty. METHODS: CNKI, PubMed and Elsevier were retrieved for relevant literature. The key words were "percutaneous kyphoplasty, spinal implants, vertebral stents, vertebral compression fractures". Relevant articles published from January 2000 to June 2019 were reviewed, including review, basic research and clinical research. Preliminary screening was conducted by reading the article title and abstract, and the literatures with low relevance to the article topic were excluded. According to the inclusion and exclusion criteria, 62 articles were finally included for analysis. RESULTS AND CONCLUSION: (1) Spinal implants used in percutaneous kyphoplasty include VBS stent, Jack vertebra expander, SKY bone expander system, Osseofix system, SpineJack, KIVA system and memory alloy vertebral stent. (2) They are modified and developed on the basis of classic percutaneous kyphoplasty to achieve the same clinical efficacy while minimizing complications such as cement leakage, loss of vertebral height, and increased risk of adjacent vertebral body fracture.

Effect of wheat-grain moxibustion at Yinbai (SP 1) on the menstrual period prolongation after IVF-ET down-regulation treatment / 中国针灸

OBJECTIVE@#To compare the clinical effect between wheat-grain moxibustion at Yinbai (SP 1) and oral administration of dydrogesterone tablet for menstrual period prolongation after down-regulation treatment of in vitro fertilization embryo transfer (IVF-ET).@*METHODS@#A total of 54 patients with prolonged menstrual period after down-regulation treatment of IVF-ET were randomly divided into an observation group and a control group, 27 cases in each one. In the observation group, when the menstrual period delayed more than 7 days, the wheat-grain moxibustion at Yinbai (SP 1) was performed, once a day, with an interval of 1 day between two 3-day treatments; when the menstrual blood was cleaned, the ovulation was continued and the eggs were taken. In the control group, when the menstrual period delayed more than 7 days, the oral administration of dydrogesterone tablet was provided, 10 mg each time, twice a day; when the menstrual blood was cleaned, the ovulation was continued and the eggs were taken. The number of days for menstrual blood to be cleaned, the area change of uterine cavity hemorrhage, the morphology of endometrium, the blood supply of endometrium, the number of oocytes obtained, the grade of frozen embryo and the clinical effect were observed between the two groups after treatment.@*RESULTS@#Compared with the control group, the number of days for menstrual blood to be cleaned was shorter in the observation group after treatment (0.05). The cured rate in the observation group was 100.0% (27/27), higher than 33.3% (9/27) in the control group (<0.05).@*CONCLUSION@#The wheat-grain moxibustion at Yinbai (SP 1) could more effectively treat prolonged menstrual period after IVF-ET down-regulation treatment, which is beneficial to the preparation of the endometrium, and has no effect on the oocyte collection and embryo culture.

Effects of dioscin on T helper 17 and regulatory T-cell subsets in chicken collagen type II-induced arthritis mice.

BACKGROUND: This study was conducted to investigate the treatment efficacies and immunological mechanisms of action of dioscin in mice with chicken collagen type II-induced arthritis (CIA). METHODS: The CIA mice was randomly divided into the model group (M), dioscin group (D), and tripterygium group (T); a normal control group (C) was also included. Each group was orally administered with related drugs or an equal volume of solvent (group C) starting on the 21st day of primary immunity, after which the levels of T helper 17 cells (Th17), regulatory T cells (Tregs), and their related factors were detected on the 35th day. RESULTS: Compared to group C, group M exhibited significantly increased levels of interleukin 17 (IL-17) and IL-6 and decreased IL-27 (p < 0.05). Group D exhibited significantly decreased levels of IL-17 and IL-6 compared with group M (p < 0.05). Group M showed a significantly increased ratio of Th17 cells (p < 0.05), while dioscin significantly reduced this ratio (p < 0.05). Groups M and C showed no significant difference in the ratio of Tregs (p > 0.05) but dioscin significantly increased this ratio (p < 0.05). Group M significantly increased signal transducer and activator of transcription 3 (STAT3) and STAT5 compared with that in group C (p < 0.05), while the T and D groups showed significantly reduced levels of STAT3 and STAT5 (p < 0.05). CONCLUSION: Dioscin may affect the differentiation of Th17 and Tregs and secretion of related factors by regulating CD4 T cell subset-related signal transduction and the expression of transcription-activating factor STAT3 and STAT5, thus exerting useful immunoregulatory roles in CIA mice.

IL-33 induces production of autoantibody against autologous respiratory epithelial cells: a potential mechanism for the pathogenesis of COPD.

The mechanisms underlying the chronic, progressive airways inflammation, remodelling and alveolar structural damage characteristic of human chronic obstructive pulmonary disease (COPD) remain unclear. In the present study, we address the hypothesis that these changes are at least in part mediated by respiratory epithelial alarmin (IL-33)-induced production of autoantibodies against airways epithelial cells. Mice immunized with homologous, syngeneic lung tissue lysate along with IL-33 administered directly to the respiratory tract or systemically produced IgG autoantibodies binding predominantly to their own alveolar type II epithelial cells, along with increased percentages of Tfh cells and B2 B-cells in their local, mediastinal lymph nodes. Consistent with its specificity for respiratory epithelial cells, this autoimmune inflammation was confined principally to the lung and not other organs such as the liver and kidney. Furthermore, the serum autoantibodies produced by the mice bound not only to murine, but also to human alveolar type II epithelial cells, suggesting specificity for common, cross-species determinants. Finally, concentrations of antibodies against both human and murine alveolar epithelial cells were significantly elevated in the serum of patients with COPD compared with those of control subjects. These data are consistent with the hypothesis that IL-33 contributes to the chronic, progressive airways obstruction, inflammation and alveolar destruction characteristic of phenotypes of COPD/emphysema through induction of autoantibodies against lung tissue, and particularly alveolar type II epithelial cells.

Long-term efficacy of prostatic arterial embolization for benign prostatic hyperplasia / 中国介入影像与治疗学

Objective: To evaluate the long-term clinical efficacy of prostatic arterial embolization (PAE) for treatment of benign prostatic hyperplasia (BPH). Methods: A total of 38 patients with BPH underwent PTA were followed up for more than 36 months. Relative indicators, including International Prostate Symptom Score (IPSS), quality of life (QOL) score, maximum flow rate (Qmax), residual urine (RU), prostate-specific antigen (PSA) and International Index of Erectile Function (IIEF) were compared pre- and postoperation during follow-up. Transrectal CDFI was used to observe pre- and postoperative changes of maximal velocity (Vmax) during systole, minimum velocity (Vmin) during diastole and resistance index (RI) of the prostatic arteries. MRI was used to measure the pre- and postoperative changes of the prostate volume (PV). Results: The technical success rate of PAE for treatment of BPH was 100% (38/38), and the clinical success rate was 84.21% (32/38). The overall differences of IPSS, QOL score, Qmax, RU, PSA, PV, Vmax, Vmin and RI before and after PAE were all statistically significant (all P0.05). During the follow-up period, PV of 3 patients increased by 3.44% at the 48th month, while the symptoms of urinary tract obstruction were aggravated in 4 patients, with RU, times of nocturia and the blood flow signal of prostate increased, and the second PAE treatment was performed. Conclusion: Long-term efficacy of PAE for treatment of BPH is stable and reliable.

Clinical observation on the therapeutic effect of warm acupuncture on endometrial cavity fluid from in vitro fertilization-embryo transfer / 中国针灸

OBJECTIVE@#To observe the clinical effect of warm acupuncture on endometrial cavity fluid (ECF) from in vitro fertilization-embryo transfer (IVF-ET), and to explore the mechanism of warm acupuncture on ECF.@*METHODS@#Twenty-nine patients who were prepared for IVF-ET from 2016 to 2019 and whose transplantation was cancelled due to ECF found by vaginal B-ultrasound examination were divided into an observation group (14 cases) and a control group (15 cases) according to random number table method. The warm acupuncture was applied at Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3), Guilai (ST 29), Zigong (EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6) after the end of menstruation in the observation group, the treatment lasted for 60 min, once a day, 5 times as a course, with 2 days interval between the courses and 3 consecutive courses of treatment were given, until the embryo transfer was performed in the IVF assisted pregnancy cycle. After the end of menstruation, fresh leonurus japonicus capsule was given in the control group, 3 times a day, 0.8 g each time, 7 days as a course, and 3 courses of continuous treatment were received, until the embryo transfer was performed in the IVF assisted pregnancy cycle. The changes of ECF before and after treatment, the time required to prepare for embryo transfer during IVF assisted pregnancy cycle, and the clinical outcome of embryo transfer were observed in the two groups.@*RESULTS@#The decrease of ECF in the observation group was more significant than that in the control group (<0.05). The time required for the embryo transfer in the IVF assisted pregnancy cycle in the observation group was shorter than that in the control group (<0.05). The clinical pregnancy rate in the observation group was 42.9% (6/14), which was significantly higher than 26.7% (4/15) in the control group (<0.05).@*CONCLUSION@#Warm acupuncture may improve the clinical pregnancy rate by raising the local temperature of the lower abdomen, accelerating the blood circulation around the uterus and appendages, promoting the absorption of ECF, improving the uterine environment and endometrial receptivity.

The effects of interleukin-33 on airways collagen deposition and matrix metalloproteinase expression in a murine surrogate of asthma.

It has been suggested that interleukin-33 (IL-33) plays an important role in the pathogenesis of asthma through a variety of pathways, but its role in airways fibrosis in asthma has not been fully elucidated. In the present study we evaluated changes in the expression of extracellular matrix proteins (ECMs) as well as matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) in an IL-33-induced, antigen-independent murine surrogate of asthma as well as a conventional surrogate employing per-nasal challenge of mice previously sensitized to produce an IgE response to ovalbumin (OVA). In addition, in in vitro experiments we explored the direct effects of IL-33 on the proliferation and function of murine fibroblasts. Per-nasal administration of IL-33 alone was sufficient to induce airways deposition of ECMs, including collagens I, III, V and fibronectin, to a degree comparable with that observed in the OVA-sensitized and challenged mice. These changes were associated with a local imbalance between the expression of extracellular MMPs and TIMPs. Per-nasal challenge of mice with IL-33 also induced elevated airways expression of connective tissue growth factor and fibroblast growth factor receptor 4, two key facilitators of local fibrosis, again to a degree compatible with that observed in OVA-sensitized and challenged mice. Deletion of the ST2 gene, which encodes the IL-33 receptor, abrogated these fibrotic changes in the airways in the OVA surrogate. In vitro, IL-33 significantly increased the proliferation and expression of collagen III by murine lung fibroblasts. These data suggest that direct exposure of murine airways to IL-33 is able to induce local fibrotic changes, at least partially through effects of signalling through the IL-33/ST2 axis on fibroblast function and local expression of MMPs and their inhibitors, and other fibrosis-related proteins.

Accuracy and efficiency of computer-aided anatomical analysis using 3D visualization software based on semi-automated and automated segmentations.

OBJECTIVE: We investigated and compared the functionality of two 3D visualization software provided by a CT vendor and a third-party vendor, respectively. Using surgical anatomical measurement as baseline, we evaluated the accuracy of 3D visualization and verified their utility in computer-aided anatomical analysis. METHODS: The study cohort consisted of 50 adult cadavers fixed with the classical formaldehyde method. The computer-aided anatomical analysis was based on CT images (in DICOM format) acquired by helical scan with contrast enhancement, using a CT vendor provided 3D visualization workstation (Syngo) and a third-party 3D visualization software (Mimics) that was installed on a PC. Automated and semi-automated segmentations were utilized in the 3D visualization workstation and software, respectively. The functionality and efficiency of automated and semi-automated segmentation methods were compared. Using surgical anatomical measurement as a baseline, the accuracy of 3D visualization based on automated and semi-automated segmentations was quantitatively compared. RESULTS: In semi-automated segmentation, the Mimics 3D visualization software outperformed the Syngo 3D visualization workstation. No significant difference was observed in anatomical data measurement by the Syngo 3D visualization workstation and the Mimics 3D visualization software (P>0.05). CONCLUSIONS: Both the Syngo 3D visualization workstation provided by a CT vendor and the Mimics 3D visualization software by a third-party vendor possessed the needed functionality, efficiency and accuracy for computer-aided anatomical analysis.

Therapeutic effect of dioscin on collagen-induced arthritis through reduction of Th1/Th2.

The aim of this study was to detect the therapeutic effect of dioscin on collagen-induced arthritis (CIA). Mice model of CIA was induced by chicken collagen II and arthritis index was assessed. After suspension of dioscin (100mg/kg/d) or triptolide was intragastrically administered, the left paw swelling and body weight of each mouse were measured. Then tissue samples were assayed by histopathological analysis. The levels of Th1 and Th2 were detected by flow cytometry. The expression of p-STAT1, p-STAT4 and p-STAT6 was demonstrated by western blot analysis, and T-bet and GATA-3 expression was detected by RT-PCR. The paw swelling and arthritis index were decreased and body weight was increased in the high dose of dioscin group compared to the model group (P<0.05). Histopathological analysis revealed that the damage of synovium tissue in dioscin and triptolide group alleviated. The ratio of Th1/Th2 in the dioscin group (0.82±0.24) and triptolide group (0.99±0.44) was lower than that in the model group (1.84±0.70, P<0.05). Additionally, p-STAT4 expression was decreased, and both p-STAT6 and GATA3 expression was increased in the dioscin group than that in the model group (P<0.05). Dioscin might have some therapeutic effects on CIA through regulating the proportion of Th1/Th2 cells, which could reduce the expression of p-STAT4, increase the expression of p-STAT6 and GATA3 in the synovial tissue.

Epidemiological investigation of host animals infected with zoonotic parasitic worms in Nanbai Town of Zunyi County, Guizhou Province / 中华地方病学杂志

Objective A field investigation of worm eggs in dog feces,classification of crabs and metacercaria infection were carried out in Nanbai Town of Zunyi County,Guizhou Province.Methods One or two villages were selected as the survey sites in Nanbai Town of Zunyi County and the local dogs and crabs were chosen as survey objects.Worm eggs in dog feces were detected using natural precipitation method.On the base of holotype,the classification of crabs was identified.Then,crabs were mashed and metacercaria were detected.Results From November 2014 to September 2015,through this survey in Xiejia Village and Longquan Administration Village,fifty-three fresh feces of dogs were collected and three worm eggs were detected,such as Dipylidium caninum egg,Toxocara canis egg and Spirometra mansoni egg.Forty-two crabs were caught,including fourteen female adults (two larvaes) and twenty-eight male adults (nine larvaes).All these crabs were identified as Sinopotamonzunyiense by morphological method and metacercaria was not detected.Conclusion Nanbai Town of Zunyi County only has Sinopotamonzunyiense;metacercaria is not detected,which means that this local area is not a Paragonimus epidemiological region;only three worm eggs are detected in dog feces.