Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection: A randomized controlled trial.

BACKGROUND: Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery. The effects of transcutaneous electrical acupoint stimulation (TEAS) remain unclear. AIM: To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection. METHODS: Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive: (1) TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery, plus two 30-min daily sessions for 3 consecutive days after surgery (perioperative TEAS group); (2) Preoperative and intraoperative TEAS only; (3) Preoperative and postoperative TEAS only; or (4) Sham stimulation. The primary outcome was the time from the end of surgery to the first bowel sound. RESULTS: In total, 441 patients were randomized; 405 patients (58.4 ± 10.2 years of age; 247 males) received the planned surgery. The time to the first bowel sounds did not differ among the four groups (P = 0.90; log-rank test). On postoperative day 1, the rest pain scores differed significantly among the four groups (P = 0.04; Kruskal-Wallis test). Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group (1.4 ± 1.2) than in the sham stimulation group (1.7 ± 1.1; P = 0.04). Surgical complications did not differ among the four groups. CONCLUSION: TEAS provided analgesic effects in adult patients undergoing major abdominal surgery, and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

Efficacy of lenvatinib combined with sequential transarterial chemoembolization for primary hepatocellular carcinoma and the effects on serum basic fibroblast growth factor and vascular endothelial growth factor.

Objective: The aim of this research was to investigate the therapeutic efficacy of lenvatinib combined with sequential transarterial chemoembolization (TACE) on primary hepatocellular carcinoma (HCC) and the effects on serum basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF). Method: A total of 104 patients with primary HCC, admitted to People's Hospital of Leshan from April 2018 to January 2021, were selected as the study subjects and were divided into the TACE-LEN group (n = 53) who were treated with lenvatinib combined with sequential TACE and the TACE group (n = 51) who were treated with TACE alone, according to the appropriate treatment modalities. The clinical efficacy 8 weeks after treatment; the serum levels of total bilirubin, conjugated bilirubin, and alanine aminotransferase (ALT); the prothrombin time (PT); the indocyanine green retention rate at 15 min (ICGR15); and the serum bFGF and VEGF levels before treatment and at 8 weeks after treatment were compared between the two groups. The incidence of adverse events and the survival rates at 18 months were also recorded for both groups. COX regression analysis was used to analyze the risk factors affecting the survival of patients. Results: Eight weeks after treatment, the objective response rate was higher in the TACE-LEN group than in the TACE group (77.36% vs. 56.36%, p < 0.05), but there were no statistically significant differences in the bilirubin and ALT levels, the PT, and the ICGR15 between the two groups (p > 0.05). The serum bFGF and VEGF levels post-therapeutic were lower in the TACE-LEN group than in the TACE group (p < 0.05). The differences in the incidence of postoperative adverse events and the survival rate within 6 months were not statistically significant between the two groups (p > 0.05). In addition, the survival rates within 12 and 18 months after treatment were higher in the TACE-LEN group than in the TACE group than in the TACE group (81.1% vs. 64.7%, 69.8% vs. 49.1%, p < 0.05). ICG-R15 and treatment regimen are risk factors for survival. Conclusion: The worse the liver reserve is, the worse the prognosis is. The combination of TACE and lenvatinib showed better efficacy and longer survival than TACE monotherapy for HCC patients and reduced the levels of bFGF and VEGF.

[Effect of Yes-associated protein in regulation of electroacupuncture pretreatment on cerebral ischemia reperfusion injury rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) pretreatment on inflammatory reaction, apoptosis and expression of Yes-associated protein (YAP) of ischemic penumbra of cerebral cortex in cerebral ischemia reperfusion injury rats, and to explore the possible mechanism of its neuroprotection effect. METHODS: A total of 84 SD rats were randomized into a sham operation group (12 rats), a model group (18 rats), an EA group (18 rats), an EA+YAP virus transfection group (18 rats) and an EA+virus control group (18 rats). Except for the sham operation group, thread embolization method was adopted to establish the middle cerebral artery occlusion (MCAO) model in rats of the other groups. EA was applied at "Baihui" (GV 20) and "Dazhui" (GV 14) for 30 min in the 3 EA intervention groups 2 h before model establishment, disperse-dense wave, 2 Hz/15 Hz in frequency and 1 mA in intensity. Adenovirus transfection technique was used to induce gene silencing of YAP in the EA+YAP virus transfection group, and adenovirus vectors was injected as negative control in the EA+virus control group 4 d before model establishment. Twenty-four hours after model establishment, neurological function score was evaluated, the relative cerebral infarction area was observed by TTC staining, the apoptosis in the ischemic penumbra of cerebral cortex was detected by TUNEL staining, the levels of inflammatory factors IL-1ß, IL-6 and TNF-α in the ischemic penumbra of cerebral cortex was detected by ELISA method, the expression of YAP was detected by Western blot and immunofluorescence. RESULTS: Compared with the sham operation group, the expression of YAP was increased in the model group (P<0.05); compared with the model group, the expression of YAP in the ischemic penumbra of cerebral cortex was increased in the EA group (P<0.05). Compared with the sham operation group, the neurological function score, the percentage of TUNEL positive cells and the levels of IL-1ß, IL-6 and TNF-α in the ischemic penumbra of cerebral cortex were increased in the model group (P<0.001, P<0.01); compared with the model group, the neurological function score, the relative cerebral infarction area, the percentage of TUNEL positive cells and the levels of IL-1ß, IL-6 and TNF-α in the ischemic penumbra of cerebral cortex were decreased in the EA group (P<0.05, P<0.01); compared with the EA group, the neurological function score, the relative cerebral infarction area, the percentage of TUNEL positive cells and the levels of IL-1ß, IL-6 and TNF-α in the ischemic penumbra of cerebral cortex were increased in the EA+YAP virus transfection group (P<0.01, P<0.05); compared with the EA+YAP virus transfection group, the neurological function score, the relative cerebral infarction area, the percentage of TUNEL positive cells and the levels of IL-1ß, IL-6 and TNF-α in the ischemic penumbra of cerebral cortex were decreased in the EA+virus control group (P<0.01, P<0.05). CONCLUSION: Electroacupuncture pretreatment can effectively improve the ischemia reperfusion injury, its mechanism may be related to up-regulating the expression of YAP in the ischemic penumbra of cerebral cortex and relieving the apoptosis and inflammatory reaction.

Effect of thermal treatments on the structural change and the hemostatic property of hair extracted proteins.

Human hair is a readily available source for hair protein-based biomaterial and is increasingly explored as an alternative to existing hemostatic materials. The hair protein is a complex mixture of multiple proteins, which are preferably extracted at relatively high temperatures (50-90 °C) for increasing protein yields. However, the effect of processing temperature on the hemostatic property of the hair derived proteins are not yet well-understood. The objective of the current study was to characterize the influence of thermal treatments (37 °C, 50 °C, 75 °C, 80 °C, and 90 °C) on the (i) secondary structure of different fractions of hair proteins including keratin (40-65 kDa) and keratin-associated proteins (KAPs, 6-30 kDa), and (ii) their capability to precipitate the soluble fibrinogen in an in vitro fibrin clotting assay. Our results indicated that the thermal treatments induced changes to the helical contents of hair-derived protein extracts and also increased the precipitation amount and rate of soluble fibrinogen. While further studies are required to better understand the exact role of hair protein fractions on the coagulation process, the current research suggests that the hair proteins extracted under relatively high temperatures is a prerequisite approach for improving the hemostatic property of human hair-derived proteins.

Role of spinal adenosine A1 receptors in the analgesic effect of electroacupuncture in a rat model of neuropathic pain.

OBJECTIVE: The aim of this study was to determine the role of spinal adenosine A1 receptors (A1Rs) in the analgesic effects of electroacupuncture (EA) for neuropathic pain. METHODS: We performed EA for 30 minutes at the zusanli acupoint in the legs of rats with previously induced chronic constriction injuries and observed the mechanical and thermal pain thresholds 1 hour later. We also examined adenosine levels by high-performance liquid chromatography and A1R expression in the L4-6 spinal cord by western blot analysis. We then injected A1R short interfering RNA (AV-shA1RNA) into the L4-6 spinal cord to downregulate A1R expression and re-examined the mechanical and thermal pain thresholds. RESULTS: Adenosine levels and A1R expression in the L4-6 spinal cord were increased at 1 hour after EA. In addition, EA exhibited an analgesic effect that was reversed by AV-shA1RNA. CONCLUSIONS: Our results suggest that EA at the zusanli acupoint elicits an analgesic effect against neuropathic pain, mediated by A1Rs in the spinal cord.

Identifying the Genes Regulated by AtWRKY6 Using Comparative Transcript and Proteomic Analysis under Phosphorus Deficiency.

Phosphorus (P) is an important mineral nutrient for plant growth and development. Overexpressing AtWRKY6 (35S:WRKY6-9) was more sensitive and wrky6 (wrky6-1) was more resistant under low Pi conditions. To better understand the function of AtWRKY6 under low phosphate stress conditions, we applied two-dimensional gel electrophoresis (2-DE) to analyse differentially expressed proteins in the shoots and roots between wild type, 35S:WRKY6-9 and wrky6-1 after phosphorus deficiency treatment for three days. The results showed 88 differentially abundant protein spots, which were identified between the shoots and roots of 35S:WRKY6-9 and wrky6-1 plants. In addition, 59 differentially expressed proteins were identified in the leaves and roots of 35S:WRKY6-9 plants. After analysis, 9 genes with W-box elements in their promoter sequences were identified in the leaves, while 6 genes with W-box elements in their promoter sequences were identified in the roots. A total of 8 genes were identified as potential target genes according to the quantitative PCR (QPCR) and two dimension difference gel electrophoresis, (2D-DIGE) results, including ATP synthase, gln synthetase, nitrilase, 14-3-3 protein, carbonic anhydrases 2, and tryptophan synthase. These results provide important information concerning the AtWRKY6 regulation network and reveal potential vital target genes of AtWRKY6 under low phosphorus stress. two dimension difference gel electrophoresis, 2D-DIGE.

Pseudomonas aeruginosa mannose-sensitive hemagglutinin inhibits proliferation and invasion via the PTEN/AKT pathway in HeLa cells.

We investigated the effects of Pseudomonas aeruginosa mannose-sensitive hemagglutinin (PA-MSHA) on the proliferation and invasion of human cervical cancer cell lines, as well as the molecular pathways underlying these effects. MTT cell proliferation assays revealed a time- and concentration-dependent cytotoxic effect of PA-MSHA on HeLa cells but not H8 cells. Flow cytometry with propidium iodide and annexin-V-fluorescein isothiocyanate labeling (FITC) indicated that various concentrations of PA-MSHA could induce apoptosis and G2-M cell cycle arrest in HeLa cells. PA-MSHA also impaired the migration and invasion abilities of HeLa cells in Wound healing and Transwell invasion assays. Western blot results demonstrated that PA-MSHA reduced the expression of p-AKT, p-GSK3ß, BCL-2, Vimentin and ß-catenin, but increased the levels of PTEN, BAD, BAX and E-cadherin in HeLa cells. Importantly, PTEN siRNA induced the activity of p-AKT, while PA-MSHA partly inhibited this induction, indicating that PA-MSHA may reduce the cell proliferation and invasion potential by activating PTEN and thus inhibiting the AKT pathway in vitro. These data suggest the potential application of PA-MSHA to the treatment of human cervical cancer.

[Effect of transcutaneous acupoint electrical stimulation on stress in brain surgery with propofol target controlled infusion general anesthesia].

OBJECTIVE: To study the effect of transcutaneous acupoint electrical stimulation (TAES) on stress who received propofol target controlled infusion (TCI) general anesthesia in brain surgery. METHODS: Totally 40 neurosurgical patients of I-II grade (ASA grading) in our hospital were randomly divided into the TAES group (T group) and the control group (C group), 20 in each group. All patients received intravenous anesthesia by propofol TCI. The TAES intervention was adopted in those of C group. Electrodes were only applied to corresponding acupoints without electric stimulation. The arterial blood was withdrawn before TAES (T0), before anesthesia (T1), before cutting (T2), at 60 min after encephalic incision (T3), immediately after incisions suture (T4), at about 10 min after removing tracheal catheters (T5) to detect beta-endorphin (beta-EP), cortisol (COR), adrenalin (E), blood sugar (Glu). The heart rate (HR) and mean arterial pressure (MAP) were recorded. The total time of surgery, anesthesia, total infusion amount, blood lost amount, and urine amount were recorded. RESULTS: In both groups, HR, MAP, COR, and E at T2 were lower than at T0 significantly (P < 0.05). beta-EP in group C at T2 was lower than at T0 significantly (P < 0.05). HR, MAP, COR in group C at T3 were higher than at T0 significantly (P < 0.05). HR, MAP, E, and Glu in group C at T4 and T5 were higher than at T0 significantly (P < 0.05). beta-EP in group T at T1 and T3 were higher than at T0 significantly (P < 0.05). HR, COR, E, Glu, and beta-EP in group T at T4 and T5 were higher than at T0 significantly (P < 0.05). Between groups, comparing with the time point T0, the amplitude of variation of MAP, COR, and E at T2 in group C were significantly less (P < 0.05); the amplitude of variation of HR, MAP, and COR at T3 in group C were less significantly, when compared with the time point T0 (P < 0.05); the amplitude of variation of HR, MAP, COR, E, and Glu at T4 and T5 in group C were less significantly, when compared with the time point T0 (P < 0.05). When comparing the two groups, the amplitude of variation of beta-EP at time points of T1, T3, T4, and T5 in group T were larger than at T0 in group C (P < 0.05). CONCLUSION: TAES could reduce stress and stabilize the internal environment when used in brain surgery with propofol TCI general anesthesia.

[Laser treatment of port wine stains].

OBJECTIVE: To assess the efficiency of the PDL in the treatment of PWS in Chinese patients with skin type III-IV. METHODS: 252 patients with PWS at different anatomical sites were retrospectively studied. A flashlamp-pumped pulsed dye laser was used. The differences in therapeutic effect of laser were analyzed in the following ways: (1) by dermatomal distribution of face and neck; (2) by anatomical subdivision of face; (3) by the size of the lesion. The therapeutic effect was graded as 0 < or = poor < 25%, 25% < or = fair < 50%, 50% < or = good < 75%, 75% < or = excellent < or = 100%. RESULTS: It revealed that the lesions at neck had the best response. The dermatome II zone showed the least response to PDL. Among the anatomical subdivision of face, the frontal area had the highest clearance, while the zygoma and cheek had the lowest clearance. Patients with PWS on the extremities respond less favorably with the fair lightening effect. Furthermore, the mean lightening was decreased as the size of PWS was increased. CONCLUSIONS: The response difference of PWS to PDL was not only related to the anatomical region, but also related to the lesion size. It is imperative to give the patients rational treatment suggestion and normal expectation.

[Cephalometry of Li people through 3-dimensional CT].

OBJECTIVE: To investigate the skull characteristics of the Li people in Hainan through 3-D CT. METHODS: CT scan and 3-D reconstruction are very helpful for the cephalometry including the distance and angle measurement. The image can also be enlarged to make the measurement more precisely. 80 Li volunteers underwent the cephalometry through 3-D CT. The data were analyzed and compared with those an people. RESULTS: The results showed difference between the genders of Li people. Compared with Han people, Li people has their own facial characteristics, such as wider face and wider orbital distance. CONCLUSIONS: Cephalometry through 3-D CT can show the skull characteristics precisely. The data in this study has great significance in craniomaxillofacial surgery and ethnology.

[Experiment of using distraction osteogenesis to repair skull defect].

OBJECTIVE: To explore the possibility of using distraction osteogenesis to repair skull defect. METHODS: 17 goats with one year age were chosen randomly. The animals were divided to 3 groups. Group A includes 7 goats, a 3.0 cm x 2.2 cm rectangle skull defect is created on both sides of parietal area. Group B includes 5 goats, a 2.2 cm x 2.2 cm square skull defect was created on right side of parietal area. Group C includes 5 goats, a 3 cm x 1 cm rectangle skull defect was created on both sides of parietal area. Accordingly, different size of transport discs were created on right side of skull and the distraction apparatus is implanted. 3-D CT was done to measure the skull defect on group A. Biomechanical test was done on group B. Process of bone formation illustrated by histological stain, scan and transparent electric microscope was observed on group C. RESULTS: Group A measured by 3-D CT showed that skull defect of experimental side have been repaired by distraction osteogenesis. There was definitely difference between experimental and control side (P < 0.01). Group B measured by biomechanical test showed no definitely difference between experimental and normal side (maximum load P = 0.235 > 0.05, rigidity P = 0.213 > 0.05). Group C showed that the process of bone formation was typical intramembranous. CONCLUSIONS: The evidence showed that skull defect of goat can be repaired by distraction osteogenesis.

[The surgical management of unilateral Craniofacial Atrophy and Hypoplasia].

OBJECTIVE: To study the surgical reconstruction of unilateral Craniofacial Atrophy and Hypoplasia. METHODS: According to the etiological factors and severity of the facial deformities, different methods are employed, including bone framework reconstruction, soft tissue transplantation, orthognathic surgery. RESULTS: From September 1998 to August 2004, 42 cases were treated, Include: Hemifacial Microsomia 22 cases, Hemifacial Atrophy 16 cases, unilateral facial hypoplasia due to radiation 4 cases. Miniplate and transplants extrusion occurred on 2 post radiation patients due to poor soft tissue coverage, infection occurred on 1 patient after mandibular ramus reconstruction using autogenous rib and contralateral mandibular outer cortex. The leaving patients recovered well and the facial asymmetry were improved greatly. CONCLUSIONS: Facial asymmetry due to unilateral Craniofacial Atrophy or Hypoplasia is a common and complex condition for surgical management, The surgical plan should be delicated made individually according to the severity of the soft tissue and the underlying bone framework.

[Treatment of the asymmetric prominent mandibular angle].

OBJECTIVE: To investigate the causes and treatment of the asymmetric prominent mandibular angle. METHODS: From 1996 to 2001, mandibular angle osteotomy, mandibular outer cortex osteotomy, mandible, genioplasty and buccal pad excision were selected to treat 70 patients. RESULTS: All the patients had satisfactory results with complications of bleeding, infection and labial scar in three patients. CONCLUSION: Asymmetric prominent mandibular angle should be treated according to the characteristics of the deformity. Mandibular angle osteotomy, osteotomy of outer cortex of the mandible, genioplasty and bucal pad excision can provide satisfactory result.

[Secondary reconstruction of post-fracture deformities in the nasal-orbital ethmoid region].

OBJECTIVE: To study the surgical reconstruction of secondary fracture deformities of the nasal-orbital ethmoid area. METHODS: Typical bicoronal and subciliary incisions or the adjacent scar incision were employed to expose the fractured area. The flattened nasal bone was narrowed by curved osteotomy along the medial orbital rims and trimed with a bur. 2-3 pieces of cranial outer table were used to reconstruct the nasal framework, which were fixed to the frontal bone with mini-plates. After the medial orbital wall and orbital floor were exposed, the herniated orbital contents were released and reduced to the orbital cavity. The fractured orbital walls were repaired precisely with autogenous cranial outer table or Medpor. The medial canthal tendons were anchored superior-posteriorly to the lacrimal fossa with transnasal wires. RESULTS: From December 1996 to December 2001, 34 cases of severe nasal-orbital ethmoid fracture deformities were repaired with this technique. Of them, 12 cases had combined orbital-zygomatic fracture, 4 cases had fontal sinus fracture, 1 case had Le Fort II and 1 case had Le Fort III fracture. All the patients recovered well and their facial appearance improved greatly. CONCLUSIONS: The key points for surgical reconstruction of the periorbital post-fracture deformities are narrowing the flattened nasal root by curved osteotomy, the nasal framework reconstruction with autogenous bone graft, the orbital wall repair to correct enophthalmos, and most importantly, the medial canthal tendon reduction and canthal plasty.

[Intro-extro cranial approach treat serious post fronto-orbital fracture deformities].

OBJECTIVE: To explore the method of treating serious secondary fronto-orbital fracture deformities through intro-extra cranial approach. METHODS: The fronto-orbital fracture was divided into two types according to whether there were any large scale fronto-orbital bone defects: type I: Large scale fronto-orbital bone defect; type II: Concave fronto-orbital fracture deformity without large scale bone defect. Both types were treated through intro-extra cranial approach to expose the fracture site. For type I deformity, the bone defects were repaired and reconstructed with outer table of cranial bone and artificial bone. For type II, the deformity was repaired by osteotomy, bone reposition and internal rigid fixation. RESULTS: 18 cases were treated from June 1998 to October 2000, include type I, 12 cases, and type II, 6 cases. All the patients recovered well and the post-operative appearance were greatly improved. CONCLUSIONS: Intro-extra cranial approach can expose the fractured site better than the simple extrocranio approach, and make the operation more easily done. Combined with the technique of cranio maxillo facial surgery, the treatment can be more complete and the results can be more satisfactory.

[Analysis of the complications following correction of mandibular angle prominence].

OBJECTIVE: To investigate the causes and the prophylactic measures for the complications following correction of mandibular angle prominence. METHODS: From 1996 to 2001, a total of 203 patients with mandibular angle prominence underwent mandibular angle osteotomy. RESULTS: Of them, 9 patients had postoperative complications, which included bleeding, hematoma, infection, mental nerve injury, labia scar, asymmetry, and steep mandibular angle. CONCLUSION: The correction of mandibular angle prominence should be designed and performed precisely. Care must be taken to avoid severe complications like condyle fracture.