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Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.
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ObjectiveTo explore the possible mechanism of Tongdu Xingshen needling method （通督醒神针刺法） on post-stroke cognitive impairment. MethodsSD rats were randomly divided into a normal group （n=12）， a sham surgery group （n=12）， a model group （n=12）， and a electroacupuncture group （n=13）. The rats in the model group and electroacupuncture group were subjected to the wire bolus method to establish the rats model with learning memory impairment after cerebral ischaemia-reperfusion. After successful modelling， the rats in the electroacupuncture group were given electroacupuncture interventions at “Shenting （GV 24）” and “Baihui （GV 20）” once a day for 30 minutes for 14 days. The other three groups did not receive other interventions but grasp. A 5-day localisation navigation experiment was conducted on the 9th day of intervention， and a spatial exploration experiment was conducted on the 14th day of intervention to evaluate the learning and memory abilities of the rats. After the spatial exploration experiment， hippocampal tissues were taken from each group of rats， and the changes in the volume of cerebral infarction were observed by TTC staining； the changes in the morphology of pyramidal neurons and the density of dendritic spines in the CA1 area of the hippocampus were observed by Golgi staining； protein immunoblotting was used to detect the relative protein expression of the subunits of the α-amino-3-carboxy-5-methylisoxazole-4-propionic acid （AMPA） receptor including glutamate receptor 1 （GluR1）， glutamate receptor 2 （GluR2）， glutamate receptor 3 （GluR3） and auxiliary proteins TARPγ2， TARPγ8 in hippocampal tissues of rats in each group； the real-time fluorescence quantitative PCR was used to detect GluR1， GluR2， GluR3 mRNA levels in the hippocampal tissues of rats. ResultsIn the localisation navigation experiment， compared with the normal group and sham surgery group， the escape latency and total distance of rats in the model group were significantly extended （P＜0.05） at day 1， 2， 3， 4， and 5； and the escape latency and total distance of rats in the electroacupuncture group tended to be significantly shorter than those in the model group （P＜0.05）. In the spatial exploration experiment， compared with the normal group and the sham surgery group， the number of rats crossing the platform in the model group was significantly reduced （P＜0.05）， and the number of crossings of the platform in the electroacupuncture group increased significantly （P＜0.05）. The results of TTC staining showed that the volume of cerebral infarction increased clearly in the model group compared with the sham surgery group （P＜0.05）， and apparently decreased in the electroacupuncture group compared with the model group （P＜0.05）. Golgi staining showed that the number of dendritic branches of pyramidal neurons and dendritic spines in hippocampal CA1 region significantly decreased in the model group compared with the normal group and the sham surgery group （P＜0.05）. The number of dendritic branches of pyramidal neurons and the density of dendritic spines in hippocampal CA1 region significantly increased in the electroacupuncture group compared with the model group （P＜0.05）. The protein relative expression levels of GluR1， GluR2， GluR3， TARPγ2 and TARPγ8， and the mRNA levels of GluR1， GluR2 and GluR3 in hippocampus decreased in the model group compared with the normal group and the sham surgery group （P＜0.05）. The protein relative expression levels of GluR1， GluR2， GluR3， TARPγ2 and TARPγ8， and the mRNA levels of GluR1， GluR2 and GluR3 in hippocampus increased in the electroacupuncture group compared with model group （P＜0.05）. ConclusionThe Tongdu Xingshen needling method can improve learning memory impairment after cerebral ischaemia-reperfusion， which may be related to up-regulation of the expression of AMPA receptor and their auxiliary protein TARP， and promoting the synaptic plasticity of hippocampal tissues.
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Post-stroke cognitive impairment （PSCI） refers to a series of syndromes from mild cognitive impairment to dementia caused by stroke. The mitogen-activated protein kinases （MAPK）signaling pathway is a key pathway for transmitting cellular signals in mammals ，and p 38 is a classic branch of it. p 38 MAPK signaling pathway is involved in various pathophysiological processes such as cell growth ，differentiation，apoptosis and inflammatory response in central nervous system diseases. At present ，great progress has been made in clinical and basic experimental studies on prevention and treatment of PSCI by traditional Chinese medicine （TCM），but there is a lack of relevant systematic summary. Therefore ，this article summarizes the role of p 38 MAPK signaling pathway in PSCI and the pharmacological research progress of TCM in prevention and treatment of PSCI through p 38 MAPK signaling pathway.
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Objective:To observe the clinical efficacy of combining neuromuscular joint facilitation (NJF) with floating needle treatment in treating stroke survivors with painful shoulder subluxation.Methods:Thirty-nine stroke survivors with painful shoulder subluxation were randomly divided into an NJF group, a floating needle group and a combination group, each of 13. In addition to the basic treatment for shoulder subluxation and pain (including positioning, physiotherapy, active and passive motor function training, progressive training of the upper limbs, and using shoulder pads to protect the affected shoulders when standing or walking), the 3 groups were also given NJF, floating needle therapy or both as their group names imply six days per week for 4 weeks. Shoulder subluxation was evaluated using ultrasonography to measure the acromion-greater tuberosity distance (AGT). Pain was self-reported using a visual analogue scale. And the Fugl-Meyer assessment (FMA) was applied to quantify the treatments′ efficacy.Results:Before the treatment, no significant differences were found among the 3 groups in terms of their average AGTs, pain ratings or FMA scores. Afterward, significant improvement was observed in all of the measurements in all 3 groups, with the combination group′s average results significantly better than those of the other two. The combination group′s overall effectiveness was 85%, significantly better than that of NJF group (54%) and the floating needle group (62%).Conclusions:Floating needle treatment combined with NJF and routine rehabilitation can significantly improve motor functioning and relieve the pain of shoulder subluxation after a stroke.
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Objective To explore the effect of modified meridian breathing training on the lung function of acute stroke patients. Methods Sixty acute stroke patients were randomly divided into an intervention group and a control group, each of 30. In addition to the conventional neurological treatment, the control group received routine breathing training, while the intervention group was given modified meridian breathing training by professional reha-bilitation therapists once a day for 4 weeks. Forced vital capacity ( FVC) and forced expiratory volume in one second ( FEV1) , as well as the rate of pulmonary infection were assessed before and after the treatment. Results After 4 weeks of treatment, a significant increase was observed in the average FEV1 and FVC of both groups, but the im-provement in the intervention group was significantly greater than in the control group. There were 3 lung infections ( 10％) in the intervention group, which was significantly lower than the 7 cases ( 23. 3％) in the control group. Conclusion Modified meridian breathing training can improve the lung function of acute stroke patients and reduce the incidence of lung infection.
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Objective To investigate the expression of PAX-5 in anaplastic large cell lymphoma, discuss the value and pitfalls of PAX-5 in the diagnosis and differential diagnosis of lymphomas. Methods A total of 269 T lymphomas were studied retrospectively.PAX-5 positive anaplastic large cell lymphoma was confirmed by immo-munohistochemistry and gene rearrangement analysis. Literature review was performed and the clinicopathological features were discussed.Results Two cases of anaplastic large cell lymphoma were found with aberrant expression of PAX-5. Conclusions As a relatively specific B cell marker, PAX-5 can also express in anaplastic large cell lymphoma. In the diagnosis of lymphomas, especially the differential diagnosis between classical Hodgkin lympho-ma and Anaplastic large-cell lymphoma, diagnosis errors should be avoided by interpreting PAX-5 immunohisto-chemistry in the context of clinical features, morphology, a panel of B- and T-lineage-associated antibodies, and gene rearrangement analysis.
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@#Objective To explore the effect of Jianpi-bushen-huoxue Decoction combining with kinesiotherapy on blood perfusion in the ischemic area in patients with cerebral infarction. Methods From May, 2016 to May 2017, 65 spleen-kidney-deficiency patients with cerebral infarction at convalescence were randomly divided into group A (n=22, accepting routine treatment), group B (n=22, accepting routine treatment and Jianpi-bushen-huoxue Decoction) and group C (n=21, accepting routine treatment, Jianpi-bushen-huoxue Decoction and kinesiotherapy), and were observed for 14 days. On the first day and the 14th day of treatment, they were scanned with perfusion weighted imaging, and the regional cerebral blood flows (rCBF) of region of interest were measured.Results rCBF increased after treatment in each group (t>3.572, P<0.05), and it ranked as group C, group B and group A with the rCBF from more to less after treatment (P<0.05).Conclusion Jianpi-bushen-huoxue Decoction is effective on blood flow in ischemic area of spleen-kidney-deficiency patients with cerebral infarction at convalescence, and it is even more effective when combining with kinesiotherapy.
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Objective:To research the clinical effect of Yi-yuan moxibustion on the bladder dysfunction after incomplete spinal cord injury Method:Forty patients with urinary retention were randomized into treatment group and control group,20 cases in each group.The two groups were treated by rehabilitation training,and the treatment group received Yi-yuan moxibustion,once a day,5d a week,8 weeks in total.Bladder volume and residual urine were tested by B-scan ultrasonography.After 8 week treatment,the curative effect was assessed.Result:One week after all treatments,the results of B-scan ultrasonography showed that bladder volume and residual urine volume of both groups are were improved than before.The curative effect after 6 weeks treatment suggests that the effective rate in control group was 55％ and the treatment group was e 90％.The difference was statistically significant (P＜0.05).Conclusion:Yi-yuan moxibustion is a kind of good therapy to ameliorate urinary retention caused by spinal cord injury.
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@#Objective To observe the effect of needle warming moxibustion on cognitive dysfunction after stroke. Methods 76 stroke patients with cognitive dysfunction were randomly divided into treatment group (n=38) and control group (n=38). The treatment group received needle warming moxibustion and routine rehabilitation for 4 weeks, while the control group only received routine rehabilitation. They were assessed with Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale before and after treatment. Results The score of MoCA and ADL improved in both groups (P<0.05), and improved more in the treatment group than in the control group (P<0.05) after treatment. Conclusion Needle warming moxibustion could improve cognitive function in patients after stroke and activities of daily living.
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@#Objective To observe the effect of acupuncture combined with moxibustion on heart rate variability (HRV) in patients with post-stroke depression. Methods 120 patients were divided into control group (n=60) and treatment group (n=60). Both groups took fluoxetine and accepted acupuncture therapy, and the treatment group accepted moxibustion additionally. Hamilton Depression Rating Scale-17 (HAMD-17) and the change of HRV were compared before and after treatment. Results The score of HAMD was lower, and the reductive ratio was higher in the treatment group than in the control group (P<0.05). The standard deviation of the mean of qualified normal sinus interval (SDNN) and standard deviation of sequential five-minute R-R interval means (SDANN) increased in both groups after treatment (P< 0.05), and were higher in the treatment group than in the control group (P<0.05). The root mean square differences of successive R-R intervals (RMSSD) and percentage of differences between adjacent normal sinus intervals greater than 50 ms (PNN50) decreased in both groups after treatment (P<0.05), and were lower in the treatment group than in the control group (P<0.05). The low frequency (LF), high frequency (HF) and LF/HF were higher in both groups after treatment (P<0.05), and were higher in the treatment group than in the control group (P< 0.05). Conclusion Acupuncture combined with moxibustion therapy can better adjust the function of autonomic nerve and reduce depression in patients with post-stroke depression.
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@# Objective To explore the clinical efficacy of scalp acupuncture on allomnesia post stroke. Methods 60 stroke patients with allomnesia were randomly divided into observation group (n=30) and control group (n=30). The control group accepted routine rehabilitation training for 4 weeks, while the observation group accepted scalp acupuncture in addition. They were evaluated with Rivermead Behavioral Memory Test (RBMT-II) before and after treatment. Results RBMT-Ⅱ scores improved in both groups after treatment (P<0.05), and improved more in the observation group than in the control group (P<0.05). Conclusion Scalp acupuncture may improve the effects of rehabilitation on the memory dysfunction in patients with stroke.
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Objective To observe the effect of blood-letting puncture and cupping therapy on patients with sensory dysfunction after stroke. Methods 60 patients with sensory dysfunction after stroke were randomized into treatment group (n=30) and control group (n=30). Both groups were treated with conventional medical treatment and rehabilitation therapy. The treatment group received blood-letting punc-ture and cupping therapy in addition, twice a week for 4 weeks. They were evaluated with Fugl-Meyer Assessment and modified Barthel In-dex (MBI) before and after treatment. Results The score of Fugl-meyer Assessment and MBI increased after treatment (P<0.01), and the scores were higher in the treatment group than in the control group (P<0.01). Conclusion Blood-letting puncture and cupping therapy can improve the recovery of sensory dysfunction and activities of daily living of patients with sensory dysfunction after stroke.
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Objective To observe the clinical effect of umbilical moxibustion on constipation after stroke. Methods 60 patients were ran-domly divided into observation group and control group, with 30 cases in each group. Both groups were treated with rehabilitation training once a day, and the observation group received umbilical moxibustion treatment in addition, 1 hour every day, once in 2 days for 2 weeks. Total integral of clinical symptoms was collected and compared. Results The integrals decreased in both groups after treatment (P<0.001), and it was lower in the observation group than in the control group (P<0.05). The clinical effect was better in the observation group than in the control group (P<0.01). Conclusion Umbilical moxibustion can further improve the symptom of post-stroke constipation.
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Objective To investigate the clinical efficacy of heat-sensitive point thunder-fire moxibustion in treating knee osteoarthritis (KOA). Methods One hundred and forty-eight KOA patients were randomly allocated to treatment and control groups, 74 cases each. The treatment group received heat-sensitive point thunder-fire moxibustion and the control group took diclofenac sodium enteric-coated tablets. The Visual Analogue Scale (VAS) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and 50 yards fastest walking time were observed in the two groups before and after 30 days of treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the VAS score and WOMAC subscores in the two groups (P<0.01). There was a statistically significant pre-/post-treatment difference in 50 yards fastest walking time in the treatment group (P<0.05). There were statistically significant post-treatment differences in the VAS score, the WOMAC score and the WOMAC pain and stiffness scores between the treatment and control groups (P<0.01). There were statistically significant differences in the VAS and WOMAC scores at three months after treatment between the treatment and control groups (P<0.01). The total efficacy rate was 95.9%at the end of treatment and 95.6%at three months after treatment in the treatment group, and 86.1%at the end of treatment and 86.8%at three months after treatment in the control group; there were statistically significant differences between the two groups (P<0.05). Conclusion Heat-sensitive point thunder-fire moxibustion is an effective way to treat knee osteoarthritis.
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Objective To observe the effect of acupuncture combined with moxibustion on heart rate variability (HRV) in patients with post-stroke depression. Methods 120 patients were divided into control group (n=60) and treatment group (n=60). Both groups took fluox-etine and accepted acupuncture therapy, and the treatment group accepted moxibustion additionally. Hamilton Depression Rating Scale-17 (HAMD-17) and the change of HRV were compared before and after treatment. Results The score of HAMD was lower, and the reductive ratio was higher in the treatment group than in the control group (P<0.05). The standard deviation of the mean of qualified normal sinus in-terval (SDNN) and standard deviation of sequential five-minute R-R interval means (SDANN) increased in both groups after treatment (P<0.05), and were higher in the treatment group than in the control group (P<0.05). The root mean square differences of successive R-R inter-vals (RMSSD) and percentage of differences between adjacent normal sinus intervals greater than 50 ms (PNN50) decreased in both groups after treatment (P<0.05), and were lower in the treatment group than in the control group (P<0.05). The low frequency (LF), high frequency (HF) and LF/HF were higher in both groups after treatment (P<0.05), and were higher in the treatment group than in the control group (P<0.05). Conclusion Acupuncture combined with moxibustion therapy can better adjust the function of autonomic nerve and reduce depres-sion in patients with post-stroke depression.
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Objective To observe the effect of needle warming moxibustion on cognitive dysfunction after stroke. Methods 76 stroke pa-tients with cognitive dysfunction were randomly divided into treatment group (n=38) and control group (n=38). The treatment group re-ceived needle warming moxibustion and routine rehabilitation for 4 weeks, while the control group only received routine rehabilitation. They were assessed with Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale before and after treatment. Re-sults The score of MoCA and ADL improved in both groups (P<0.05), and improved more in the treatment group than in the control group (P<0.05) after treatment. Conclusion Needle warming moxibustion could improve cognitive function in patients after stroke and activities of daily living.
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Objective To explore the clinical efficacy of scalp acupuncture on allomnesia post stroke. Methods 60 stroke patients with allomnesia were randomly divided into observation group (n=30) and control group (n=30). The control group accepted routine rehabilita-tion training for 4 weeks, while the observation group accepted scalp acupuncture in addition. They were evaluated with Rivermead Behav-ioral Memory Test (RBMT-II) before and after treatment. Results RBMT-Ⅱscores improved in both groups after treatment (P<0.05), and improved more in the observation group than in the control group (P<0.05). Conclusion Scalp acupuncture may improve the effects of reha-bilitation on the memory dysfunction in patients with stroke.
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Objective To observe the effect of Du-moxibustion on cognitive impairment after stroke. Methods 60 patients with cogni-tive impairment after stroke were randomly divided into control group (n=30) and treatment group (n=30). They were treated with conven-tional medical treatment and rehabilitation training, the treatment group received Du-moxibustion treatment in addition with once a day, 6 days per week for 8 weeks. They were evaluated with modified Barthel Index (MBI) and Montreal Cognitive Assessment (MoCA) before and after treatment. Results The scores of MBI and MoCA increased after treatment (P<0.05) in both groups and the scores were higher in the treatment group than in the control group (P<0.05). Conclusion Du-moxibustion can further improve the cognitive function and activi-ties of daily living in stroke patients.
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@#Objective To observe the effect of needle warming moxibustion on cognitive dysfunction after stroke. Methods 76 stroke patients with cognitive dysfunction were randomly divided into treatment group (n=38) and control group (n=38). The treatment group received needle warming moxibustion and routine rehabilitation for 4 weeks, while the control group only received routine rehabilitation. They were assessed with Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale before and after treatment. Results The score of MoCA and ADL improved in both groups (P<0.05), and improved more in the treatment group than in the control group (P<0.05) after treatment. Conclusion Needle warming moxibustion could improve cognitive function in patients after stroke and activities of daily living.
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@#Objective To observe the effect of acupuncture combined with moxibustion on heart rate variability (HRV) in patients with post-stroke depression. Methods 120 patients were divided into control group (n=60) and treatment group (n=60). Both groups took fluoxetine and accepted acupuncture therapy, and the treatment group accepted moxibustion additionally. Hamilton Depression Rating Scale-17 (HAMD-17) and the change of HRV were compared before and after treatment. Results The score of HAMD was lower, and the reductive ratio was higher in the treatment group than in the control group (P<0.05). The standard deviation of the mean of qualified normal sinus interval (SDNN) and standard deviation of sequential five-minute R-R interval means (SDANN) increased in both groups after treatment (P< 0.05), and were higher in the treatment group than in the control group (P<0.05). The root mean square differences of successive R-R intervals (RMSSD) and percentage of differences between adjacent normal sinus intervals greater than 50 ms (PNN50) decreased in both groups after treatment (P<0.05), and were lower in the treatment group than in the control group (P<0.05). The low frequency (LF), high frequency (HF) and LF/HF were higher in both groups after treatment (P<0.05), and were higher in the treatment group than in the control group (P< 0.05). Conclusion Acupuncture combined with moxibustion therapy can better adjust the function of autonomic nerve and reduce depression in patients with post-stroke depression.