摘要
BACKGROUND@#Liver cancer is largely resistant to chemotherapy. This study aimed to identify the effective chemotherapeutics for β-catenin-activated liver cancer which is caused by gain-of-function mutation of catenin beta 1 ( CTNNB1 ), the most frequently altered proto-oncogene in hepatic neoplasms.@*METHODS@#Constitutive β-catenin-activated mouse embryonic fibroblasts (MEFs) were established by deleting exon 3 ( β-catenin Δ(ex3)/+ ), the most common mutation site in CTNNB1 gene. A screening of 12 widely used chemotherapy drugs was conducted for the ones that selectively inhibited β-catenin Δ(ex3)/+ but not for wild-type MEFs. Untargeted metabolomics was carried out to examine the alterations of metabolites in nucleotide synthesis. The efficacy and selectivity of methotrexate (MTX) on β-catenin-activated human liver cancer cells were determined in vitro . Immuno-deficient nude mice subcutaneously inoculated with β-catenin wild-type or mutant liver cancer cells and hepatitis B virus ( HBV ); β-catenin lox(ex3)/+ mice were used, respectively, to evaluate the efficacy of MTX in the treatment of β-catenin mutant liver cancer.@*RESULTS@#MTX was identified and validated as a preferential agent against the proliferation and tumor formation of β-catenin-activated cells. Boosted nucleotide synthesis was the major metabolic aberration in β-catenin-active cells, and this alteration was also the target of MTX. Moreover, MTX abrogated hepatocarcinogenesis of HBV ; β-catenin lox(ex3)/+ mice, which stimulated concurrent Ctnnb1- activated mutation and HBV infection in liver cancer.@*CONCLUSION@#MTX is a promising chemotherapeutic agent for β-catenin hyperactive liver cancer. Since repurposing MTX has the advantages of lower risk, shorter timelines, and less investment in drug discovery and development, a clinical trial is warranted to test its efficacy in the treatment of β-catenin mutant liver cancer.
Subject(s)
Mice , Animals , Humans , Methotrexate/therapeutic use , Mice, Nude , beta Catenin/metabolism , Fibroblasts/metabolism , Liver Neoplasms/metabolism , Hepatitis B virus , Nucleotides摘要
The epicanthus is mainly manifested by a wide intercanthal distance and a short palpebral fissure,which affects the aesthetics of eyes.The epicanthus correction is of great significance in improving eye shape and facial aesthetics.However,scar formation and hyperplasia after surgery in the surgical area have been bothering doctors and patients,and how to prevent or alleviate scar after epicanthus correction is still a difficult problem to be solved in clinic.Therefore,this article summarizes the prevention and treatment of scar after epicanthus correction based on the current research status at home and abroad,in order to provide a reference for clinic.
摘要
Objective To explore the effect and influencing factors of prosthesis placement angle on hip replacement for bone fusion of hip joint.Methods A total of 100 patients with bone fusion of hip joint who were admitted to our hospital from May 2019 to January 2022 were selected as the research objects and randomly divided into the observation group(n=50)and the control group(n=50).The prosthesis placement angle was 30° to 40° in the observation group and 41° to 50° in the control group.The clinical data,VAS score and Harris score before and after operation,and postoperative complications of the two groups were compared.The improvement of hip joint function of the two groups was compared by random walking model.According to the prognosis of patients,patients were divided into the poor prognosis group(n=32)and the good prognosis group(n=68).Univariate and multivariate Logistic regression analysis were used to analyze the independent influencing factors of the prognosis of hip replacement for bone fusion of hip joint,and a prediction model was constructed and verified.Results The Harris score 6 months after operation in the observation group was significantly higher than that in the control group(P<0.05),and there was no significant difference in VAS score before and after operation and incidence of complications after operation between the two groups(P>0.05).The results of random walking model showed that the improvement of hip joint function in the observation group was better than that in the control group.There were significant differences in age,hyperlipidemia,osteoporosis,prosthesis placement angle,intraoperative blood loss,emotional disorder,postoperative complications,rehabilitation training and postoperative outdoor activity time of patients between the good prognosis group and the poor prognosis group(P<0.05).Multivariate Logistic regression analysis showed that osteoporosis and prosthesis placement angle of 41° to 50° were the independent risk factors of the prognosis of hip replacement for bone fusion of hip joint(P<0.05),and rehabilitation training was the protective factor(P<0.05).A prediction model of the prognosis of hip replacement for bone fusion of hip joint was constructed.The calibration curve of the model fit well with the ideal curve,and the area under the receiver operating characteristic curve(AUC)was 0.854(95%CI:0.830 to 0.871),which indicates that the prediction model had good accuracy.The concordance index(C-index)of the model was 0.849(95%CI:0.817 to 0.868),which indicates that the model had high discrimination.Conclusion The prosthesis placement angle of 30° to 40° can significantly improve the postoperative hip joint function of patients,and the therapeutic effect is significant.Osteoporosis,prosthesis placement angle,and rehabilitation training are the independent influencing factors of the prognosis of hip replacement for bone fusion of hip joint.
摘要
Objective:To compare the bile bacterial diversity in patients with different types of common bile duct stones (CBDS).Methods:A total of 45 patients with CBDS diagnosed by abdominal ultrasound, abdominal CT and (or) magnetic resonance cholangiopancreatography (MRCP) and treated by endoscopic retrograde cholangiopancreatography (ERCP) in the First Affiliated Hospital of Air Force Medical University from August 2017 to January 2018 were divided into the non-stone (NS) group, the primary cholesterol stone (PCS) group, the primary pigment stone (PPS) group, and the recurrent stone (RS) group. 16S rRNA sequencing was used to analyze the microbile community structure and diversity in bile which was collected before contrast medium injection.Results:Thirty-three patients were in the non-RS group (8 in the NS group, 8 in the PCS group, and 17 in the PPS group) and 12 were in the RS group. The proportion of patients with intra-diverticular papilla [41.67% (5/12) VS 3.03% (1/33), χ2=8.27, P=0.004], loose stones [91.67% (11/12) VS 36.36% (12/33), χ2=10.77, P=0.001] and pigmental stones [100.00% (12/12) VS 51.52% (17/33), χ2=7.04, P=0.008] were significantly higher in the RS group than those in the non-RS group. There was no significant difference in other baseline data ( P>0.05). At the phylum and genus level, the bacterial abundance was similar in the RS and PPS group. Alpha and Beta diversity analysis showed that the microbial diversity was similar between the RS and PPS group, both of which were lower than those in the NS and PCS group ( P<0.05). MetaStat analysis revealed that Helicobacter pylori was the dominant bacteria in the RS group, and Proteobacteria and Escherichia coli were the dominant bacteria in both RS and PPS groups. Conclusion:Bacterial abundance of bile in the RS group is similar to that of the PPS group, but the diversity of biliary bacteria flora in the RS group and PPS group are significantly lower than those in the PCS group and NS group. Helicobacter pylori is the dominant biliary bacteria in the RS group.
摘要
Objective:To evaluate and compare efficacy of intravenous immunoglobulin (IVIG) versus recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (rhTNFR:Fc) in the treatment of toxic epidermal necrolysis (TEN) .Methods:Clinical data were collected from patients with TEN treated with IVIG or rhTNFR:Fc in Wuhan No.1 Hospital from 2013 to 2019. There were 11 patients in the IVIG group, including 3 males and 8 females, aged 25-72 years, and the median TEN-specific severity-of-illness score (SCORTEN) was 3 points; there were 10 patients in the rhTNFR:Fc group, including 5 males and 5 females, aged 32-84 years, and the median SCORTEN was 2 points. These patients all showed no response to the 5-day treatment with prednisolone acetate at a dose of 0.6-1.0 mg·kg -1·d -1, and then received IVIG at a dose of 400 mg·kg -1·d -1 for 5 consecutive days, or subcutaneous injection of rhTNFR:Fc at a dose of 25 mg every other day for 4-6 sessions. Changes in skin lesions and adverse events were recorded in the 2 groups. Statistical analysis was carried out by using Mann-Whitney U test. Results:Compared with the rhTNFR:Fc group, the IVIG group showed a significant decrease in the time to onset of reduction of skin lesion exudate (1.73 ± 1.19 days vs. 3.00 ± 1.56 days, P < 0.05) , time to onset of pain relief in the lesion area (1.64 ± 1.28 days vs. 3.70 ± 1.63 days, P < 0.05) , time to lightening of color of the lesion base (2.45 ± 1.12 days vs. 3.90 ± 1.59 days, P < 0.05) , time to onset of new epidermis growth (3.09 ± 1.13 days vs. 5.20 ± 1.22 days, P < 0.05) , and in the time to onset of lesion drying at the intertriginous sites (4.82 ± 2.22 days vs. 7.90 ± 3.14 days, P < 0.05) . However, there was no significant difference in the length of hospital stay between the IVIG group (17.70 ± 8.33 days) and rhTNFR:Fc group (16.70 ± 4.71 days, P > 0.05) . No adverse reactions were observed during the treatment, and no recurrence or complications were found in the 21 patients during the follow-up of 6 months. Conclusion:IVIG and rhTNFR:Fc are both effective in the treatment of TEN, but IVIG is superior to rhTNFR:Fc in terms of the time to onset of pain relief, skin lesion exudate reduction and epidermal growth.
摘要
Objective: To guide the patients with vertigo who are suitable for vestibular rehabilitation therapy (VRT), and to evaluate the curative effect through a remote guidance platform based on mobile internet. Methods: Adult outpatients, who were diagnosed as vestibular disorders and required VRT, were selected and conducted baseline evaluation and formulated vestibular rehabilitation plan according to their symptoms, diagnosis and vestibular function examination results. These patients downloaded and installed the mobile internet remote guidance platform app for VRT, and then registered and uploaded medical records. According to the VRT plan formulated by clinicians for patients, the platform launched corresponding exercise guidance videos to guide them to complete 4-week VRT exercise at home. Before and after VRT, the patients were scored with Visual Analogue Scale (VAS), Activities-specific Balance Confidence (ABC), Dizziness Handicap Inventory (DHI) and Self-rating Anxiety Scale (SAS). The rehabilitation effects were statistically analyzed by SigmaStat 4.0 software. Results: From October 2019 to October 2021, 233 patients with vertigo completed the registration of vestibular rehabilitation guidance platform, of whom 187 patients insisted on 4-week rehabilitation training and completed the scale evaluation. Among 187 patients, 65 were male and 122 were female; Age was (49.8±16.0) years; The medical history ranged from one to 192 months, with a median of eight months. Compared with that before rehabilitation exercise, the subjective feeling of vertigo in 170 patients was improved, and the overall effective rate was 90.9% (170/187). The subjective symptoms of vertigo were basically improved after rehabilitation training in patients with unilateral vestibular dysfunction, vestibular neuritis, sudden deafness with vertigo, Hunt syndrome and acoustic neuroma. There were significant differences in ABC, DHI and SAS scores before and after VRT (P<0.05). Of those patients with Meniere's disease in the intermittent period and the patients with Meniere's disease who underwent surgical treatment, more than 90% of their subjective symptoms of vertigo or dizziness improved after VRT, and there were significant differences in the scores of ABC, DHI and SAS before and after VRT exercise (P<0.05). In patients with vestibular migraine, 36.7% (11/30) had no improvement or even aggravation of subjective symptoms of vertigo after VRT, however, the DHI score after rehabilitation exercise was lower than that before exercise, and the difference was statistically significant (P<0.05). In patients with bilateral vestibular dysfunction, although most (6/8) subjective symptom scores were improved compared with those before exercise, there was no significant difference in ABC, DHI and SAS scores before and after rehabilitation (P>0.05). Conclusion: VRT with the help of vestibular rehabilitation mobile internet remote guidance platform can effectively improve the subjective symptoms of vertigo, balance ability and anxiety in patients with unilateral vestibular lesions.
Subject(s)
Adult , Female , Humans , Male , Dizziness , Internet , Postural Balance , Vertigo , Vestibular Neuronitis/diagnosis摘要
The rational medication in pregnant women is a clinical issue that clinicians and pharmacists must take seriously. Most tissues and organs undergo anatomical and physiological changes during pregnancy that affect the absorption, distribution, metabolism, and excretion of drugs in vivo, which ultimately lead to changes in bioavailability. In order to achieve an effective therapeutic concentration, dose adjustment might be required during this period. In the past ten years, the application of modeling and simulation methods in the field of drug development and clinical therapy has continued to expand, for instance, using population pharmacokinetic (PPK) and physiologically based pharmacokinetic (PBPK) modeling to adjust dosage regimen in special populations. Rigorously designed and validated models will effectively make up for the deficiencies of clinical trials, provide valuable references for the design of clinical research, and even replace part of them. This article will introduce the physiological changes that affect the pharmacokinetic properties of the drug during pregnancy and review the progress in the application of PBPK modeling in pharmacokinetic studies in pregnant women.
摘要
The existing doctor-patient communication pattern often falls prey to insufficient informed consent and even medical disputes. In the patient centered perspective, Zhejiang Provincial People′s Hospital explored a new communication mode centering on patients. Based on diagnosis-related groups catalogues and high-frequency surgeries catalogues of the departments, multimedia technology was called into play to produce dubbed PPTs and videos that were easy to understand, standardized and homogeneous, which were embedded into medical records system. Following observation of the PPT or video, patients could directly sign an informed consent on the computer. This practice not only deepens patient′s understanding and achieves homogeneous level of the communication, but also elevates doctor′s work efficiency, contributing to building a harmonious doctor-patient relationship.
摘要
The construction of safe hospital is the foundation of high-quality development of the hospital, and innovation provides power for the construction of safe hospital from the perspective of high-quality development. Taking Zhejiang Provincial People′s Hospital as an example, the authors introduced the innovation construction path of safe hospital in detail, and put forward the construction strategy of safe hospital with " two hearts" (patient-centered, employee-centered)and " four wings" (multimedia doctor-patient communication, Wulin aunt medical studio, integrated operation safety inspection, third-party medical liability insurance). Through the combination of basic safety management and innovative practice, the hospital vigorously promoted the culture of " two hearts" , and established an efficient collaborative information management system, so as to form replicable and promotable practical experience and promote the development of safe hospital.
摘要
Objective:Heart failure （HF） and cognitive impairment have become serious medical problems in China. This study used meta-analysis to comprehensively evaluate the prevalence of cognitive impairment in patients with HF in China， and provided suggestions for intervention and prevention of cognitive impairment in this population. Methods:A systematic retrieval was conducted by searching relevant literatures regarding cognitive impairment in Chinese HF patients. These reports were published on CNKI， Wanfang， SinoMed， VIP and PubMed， from January 1， 1980 to July 10， 2020. The Agency for Healthcare Research and Quality （AHRQ） criteria and Newcastle-Ottawa Scale were used to evaluate the literature quality of cross-sectional studies and case-control studies， respectively. Stata16.0 was used for combined prevalence and effect value. Results:A total of 20 articles with medium quality were included. Six of them were case-control studies， with a total sample size of 933 people， and healthy people as controls. The Odds Ratios （OR） value of the prevalence of cognitive impairment in patients with HF was 2.77 （95% CI： 2.05-3.74）. 14 articles were cross-sectional studies with a total sample size of 3000. In China， the prevalence of cognitive impairment in patients with HF was 54.3% （95% CI： 0.43-0.65）. Subgroup analysis showed that the prevalence of cognitive impairment was increased with age， and women had a higher prevalence （58.4%） than that in men （48.4%）. The prevalence in studies using the Montreal Cognitive Assessment （MoCA）to evaluate cognitive impairment （63.6%） was higher than those using Mini-mental State Examination （MMSE）（41.7%）. The limitations of this study include the following： only used the relevant literature on cognitive impairment in patients with HF in China； failed to explain the source of heterogeneity， unable to determine the impact of the study area on heterogeneity， and unable to determine the causality of HF and cognitive impairment. Conclusion:The prevalence of cognitive impairment in patients with HF in China is high and significantly affected by age， gender and other factors. Appropriate measures should be taken for prevention and timely intervention.
Subject(s)
Humans , Acupuncture Therapy , Facial Paralysis/therapy , Mind-Body Therapies , Postoperative Period , Tendons摘要
Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
Subject(s)
Female , Humans , Male , Chemotherapy, Adjuvant , Gastrectomy , Neoadjuvant Therapy , Neoplasm Staging , Prognosis , Retrospective Studies , Stomach Neoplasms/surgerySubject(s)
Humans , Acupuncture , Acupuncture Points , Acupuncture Therapy , Eczema/therapy , Moxibustion摘要
Objective: To assess the efficacy of a bioabsorbable steroid-eluting sinus stent in improving surgical outcomes when placed in the frontal sinus ostium (FSO) following full endoscopic sinus surgery (ESS) in patients with whole group chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients with whole group CRSwNP who had similar lesions on bilateral sinus between September 2019 and March 2020 in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital were chosen. Patients with CRSwNP who underwent extended ESS were randomly assigned to receive a steroid-eluting sinus stent in one FSO whereas the contralateral side received surgery alone. Endoscopic evaluations recorded at 30, 90 days postoperative were graded by an independent assessment panel to assess the need for interventions in the FSO. Semi-quantitative data with CT and endoscopic score were performed by rank sum test. The need for postoperative intervention and the patency rate of FSO were analyzed using the McNemar test. Results: Thirty-one patients with whole group CRSwNP met all eligible criteria, including 17 males and 14 females, with the age of (44.5±11.8) years(x¯±s). Stents were successfully placed in one FSO of all patients. At 30 days post-ESS, the assessment panel reported that steroid-eluting stents reduced the need for postoperative interventions by 41.0% (χ2=5.314,P=0.021), the need for oral steroid interventions by 40.0% (χ2=4.133,P=0.042) and the need for surgical interventions by 74.8% (χ2=4.292,P=0.038) compared to control sinuses with no stents. Clinical surgeons also reported greater diameter of FSO compared to control sinuses at 30 days post-ESS (74.2% vs 48.4%, χ2=4.351, P=0.037). These results at 90 days post-ESS were consistent with those at 30 days post-ESS. Conclusion: Bioabsorbable steroid-eluting sinus stents in the FSO can reduce polyp formation, adhesion, and the need for postoperative interventions in FSO of CRSwNP patients and improve the early postoperative outcomes.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Absorbable Implants , China , Chronic Disease , Endoscopy , Frontal Sinus/surgery , Nasal Polyps/complications , Paranasal Sinuses , Rhinitis/complications , Stents , Steroids , Treatment Outcome摘要
Objective:To investigate the effects of quaternary ammonium salt of chitosan combined with closed irrigation on ischemia-reperfusion injury (I/R) in rat skin flap.Methods:Fourty-five adult male SD rats were randomly divided into 3 groups: sham-operated group, I/R group and chitosan group. Before operation, collection of arterial blood for testing PCT and hs-CRP were used as basic values. Right low abdominal island flap fed by the superficial epigastric artery was created in rats of all three groups. After operation, we flushed and dressed the wound with 10% saline of sham-operated group and I/R group. Quaternary ammonium salt of chitosan combined with closed irrigation were used in chitosan group. Flaps were assessed histologically at 3 d, 5 d and 7 d of reperfusion. The tissue was collected to make the SOD, MDA and PCT, hs-CRP testing, pathological section observation and to calculate the flap survival rate.Results:Marked neutrophil infiltration and edema were observed in I/R group, while less neutrophil infiltration was observed in chitosan group. Compared with the sham-operated group, the PCT and hs-CRP levels of the I/R group after modeling for 3 and 5 days were significantly increased. There were statistically significant differences ( P<0.05); Compared with the sham-operated group, the PCT and hs-CRP levels of the Chitosan group after modeling for 3 days, 5 days were significantly increased. There were statistically significant differences ( P<0.05); Compared with the I/R group, the PCT and hs-CRP levels of the Chitosan group after modeling for 3 and 5 days were significantly induced. There were statistically significant differences ( P<0.05); after modeling for 7 days, the values between all groups were no statistically significant differences ( P>0.01). Compared with the sham-operated group, the SOD level of the I/R group after modeling for 3, 5 and 7 days was significantly induced. MDA level was significantly increaesd; compared with the sham-operated group, the SOD level of the Chitosan group after modeling for 3, 5 and 7 days were significantly induced. MDA level was significantly increaesd; Compared with the I/R group, the SOD level of the chitosan group after modeling for 3, 5 and 7 days were significantly increased. MDA level was significantly induced. They all had statistically significant differences ( P<0.05). In the chitosan group, the survival of flaps was (85.34±10.02)%, which was significantly greater than the I/R group, in which only (41.11±14.17)% of the flap survived ( P<0.05). Conclusions:Quaternary ammonium salt of chitosan combined with closed irrigation can significantly improve flap survival, reduce I/R in transplanted rats＇ skin flaps.
摘要
Professor -'s clinical experience of treating alopecia areata with combination of acupuncture and Chinese herbs based on theory was summarized. Professor divides alopecia areata into disease and disease. Alopecia areata belonging to disease locates on the skin and is related to the lung and kidney, and belonging to disease locates in the meridians and is related to the heart, spleen and stomach. Acupuncture is chosen when the disease locates in the skin and meridians. If both viscera and meridians suffered, acupuncture and Chinese herbs should be combined. As for the acupuncture, professor used the method of harmonizing needling to treat alopecia areata, which includes regulating the origin of , regulating the deficiency and excess of and regulating the operation of local . As for the Chinese herbs, disease can be washed out by Chinese herbs of relieving exterior wind and activating meridians and collaterals. The disease can be washed out by Chinese herbs in mild condition, and long course of disease can be given Guizhi decoction as the base, add or subtract according to syndrome.
摘要
Repeatitive transcranial magnetic stimulation can adjust cortical excitability and improve swallowing function in patients with dysphagia after stroke. High frequency stimulations with 90% to 130% resting motor threshold (rMT) in the early stage, as well as low frequency stimulations with 100% to 130% rMT for 1200 pulse in the recovery period, may be beneficial to the recovery of swallowing function, and bilateral stimulation may be more effective.
摘要
Objective: To establish a quantitative method for the simultaneous determination of arecaine,arecoline,norisoboldine and boldine in Xiangbin decoction by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-QqQ-MS/MS), and compare the variation of their contents between single and mixed decoctions. Method: The separation was carried on a Waters ACQUITY UPLC BEH Shield RP18(2.1 mm×150 mm,1.7 μm)column, with 0.1%formic acid solution-acetonitrile as mobile phase for gradient elution. The flow rate was 0.2 mL·min-1, and the column temperature was 30℃. The quantitative MRM transitions of the four components were m/z 142.10/44.11 for arecaine,m/z 156.20/44.07 for arecoline,m/z 314.29/265.12 for norisoboldine and m/z 328.13/265.10 for boldine. The determination was performed in multiple reaction monitoring (MRM) mode by mass spectrometry with electrospray ionization (ESI) source under positive mode. Result: The linear ranges of arecaine,arecoline,norisoboldine and boldine were 0.479 0-57.48,0.976 0-78.08,0.812 0-64.96, 0.091 2-18.24 μg·L-1,respectively. The average recoveries of the above compounds ranged from 93.73%to 104.34%, with RSD (n=6) of less than 5%. The contents of arecoline,arecoline,norbibeldine and boltinine in Xiangbin decoction were (90.07±1.26),(445.27±12.39),(742.35±38.39),(38.50±3.33) μg·g-1,which were significantly lower than the contents in Linderae Radix and Arecae Semen. Conclusion: The method is rapid,sensitive,accurate and reproducible,and suitable for the simultaneous determination of multiple components in Xiangbin decoction,so as to provide a basis for the quality control of Xiangbin decoction. The compatibility of Xiangbin decoction has a significant effect on the dissolution contents of arecaine,arecoline,norisoboldine and boldine.
摘要
Objective To evaluate the effect and safety of acupuncture combined with Mingmu-Dihuang pill in patients with dry eyes.Methods A total of 100 patients with dry eye were enrolled in line with the inclusion criteria and divided into experimental group and control group by random figure table.The experimental group was treated with acupuncture combined with Mingmu-Dihuang pill,and the control group was treated with artificial tears.After 2 months of treatment,the Schirmer test (schirmerI,SIT),tear film break up time (BUT),fluorescent staining (FL) and clinical symptom score were observed and compared,and the clinical efficacy and safety were evaluated.Results The total effective rate of the experimental group was 89.0％ (89/100) and the control group was 67.0％ (67/100),and the difference was significant (x2=14.121,P＜0.001).After treatment,the levels of BUT (7.89 ± 1.65 s vs.5.01 ± 1.72 s,t=8.543),SIT (7.45 ± 1.68 mm vs.5.01 ± 1.72 mm,t=5.991) in the experimental group were significantly higher than those of the control group,and the difference is significant (P＜0.01).The FL score and dry eye score in the experimental group were significantly lower than those of the control group (t were 11.551,12.342,P＜0.01).Conclusions Acupuncture combined with Mingmu-Dihuang pill has better clinical effect and good safety for the treatment of dry eye patients.
摘要
Objective:To design and implement a low-power and portable transcranial direct current stimulator controlled by mobile phones. Methods:The constant current stimulation circuit was realized by a field effect transistor, which could output stable and adjustable low-intensity direct current, and the impedance detection circuit and the over-current protection circuit increased the effectiveness and safety of the stimulator. The control and real-time detection of the stimulation circuit was realized through a microcontroller, and the parameters' settings of the stimulator and the display and preservation of the actual stimulus information were realized through the Android software on the smartphone. Results:The output current strength and accuracy, maximum load, as well as the timing, device connection, stimulus information collection and display all achieved the expected goals. Conclusion:The design realized the mobile control of the stimulator, with portability, low cost and low power consumption, providing a new solution for wider applications.