Prediction model of mid-term fatality risk after radical resection in patients with hepatocellular carcinoma based on ALBI-grade / 浙江大学学报·医学版

OBJECTIVE@#To establish a clinical prediction model of the mid-term fatality risk after radical resection in patients with primary hepatocellular carcinoma (HCC) based on the albumin-bilirubin (ALBI) grade and to assess its prediction value.@*METHODS@#Clinical data of 533 patients who received HCC radical resection in Jinhua Hospital of Zhejiang University, Jinhua People's Hospital, Jinhua Hospital of Traditional Chinese Medicine and Jinhua Guangfu Hospital from January 2010 to August 2016 were retrospectively reviewed. In the training group ( =407), Cox model was used to screen the clinical risk factors of postoperative death, and a predictive model based on ALBI grade was established and then examined in the validation group ( =126). The value of the prediction model was assessed by ROC curve and calibration curve; the prediction results of the model were visualized by the nomogram for the convenience of clinical use.@*RESULTS@#Cox model showed that ALT ≥ 80 U/L, tumor maximum diameter ≥ 5 cm, portal vein tumor thrombus and ALBI grade 2 were independent risk factors for the prognosis of patients with HCC radical resection. The prognosis index (PI) was 0.550×ALT+0.512×ALBI grade+0.872×maximum tumor diameter+1.377×portal vein tumor thrombus. The AUCs for predicting the risk of death in 12, 36 and 60 months were 0.872, 0.814 and 0.810, respectively (all < 0.01), and the goodness of fit ( ) of the established model were 0.953, 0.976 and 0.994. AUC of the established model for predicting risk of death in 36 months after resection was 0.814, which was higher than those of ALBI (AUC=0.683), BCLC (AUC=0.713), CLIP (AUC=0.689), Child-Pugh (AUC=0.645), TNM (AUC=0.612) ( < 0.05 or < 0.01).@*CONCLUSIONS@#ALT ≥ 80 U/L, maximum tumor diameter ≥ 5 cm, portal vein tumor thrombus and ALBI grade 2 are independent risk factors of patients after HCC resection, and ALBI grade-based prediction model is satisfactory in prediction of mid-term death risk of the patients.

The effect of electroacupuncture combined with repetitive transcranial magnetic stimulation on rats' learning and memory after middle cerebral artery occlusion and reperfusion / 中华物理医学与康复杂志

Objective To study the effect of electroacupuncture combined with repetitive transcranial magnetic stimulation on the infarct volume of rats with cerebral infarction as well as their behavior and their learning and memory ability.Methods Forty male Sprague-Dawley rats were randomly divided into a normal group,a sham-operation group,a model group and a treatment group,each of 10.Focal cerebral ischemia and reperfusion was modeled in the latter two groups using thread occlusion of the middle cerebral artery.The treatment group was treated for 14 days with electroacupuncture combined with repetitive transcranial magnetic stimulation,started 24 hours after the operation.The animals' neurological functioning was quantified using modified neurological severity scores.The area of cerebral infarct was measured using 5-triphenyltetrazolium chloride staining.The rats' learning and memory abilities were assessed using a Morris water maze and the expression of growth-associated protein 43 (GAP-43) in the peripheral area of the cerebral infarction.Results The average neurological deficit score (2.8± 0.84) was significantly lower in the treatment group than in the model group,the average infarct volume was smaller and the escape latency was less.In the treatment group the average expression of GAP-43 was greater than in the model group.Conclusion Electroacupuncture combined with repetitive transcranial magnetic stimulation can promote the expression of GAP-43 in the peripheral area of a cerebral infarct,promoting neuronal remodeling and thereby improving neurological functioning as well as learning and memory ability.

Review and prospect of clinical application of ear-acupuncture treating post-operative syndromes of breast cancer / 中国针灸

To analyze the application of ear-acupuncture for post-operative syndromes of breast cancer so as to provide method and evidence for the syndromes. The related clinical literature was retrieved from CNKI, WANFANG and VIP databases from the database establishment time to August 30, 2017. We found ear-acupuncture are mainly used in treating nausea and vomiting caused by radiation and chemotherapy (shenmen (TF), jiaogan (AH), wei (CO), pi (CO), etc), insomnia in the rehabilitation period (xin (CO), pizhixia (AT), shenmen (TF), etc), depression and anxiety (pizhixia (AT), shenmen (TF), pi (CO), wei (CO), xin (CO), gan (CO), etc), and joint pain (pain point), etc.

Simple and Rapid Differentiation of Mutong of Aristolochiaceae by Direct Spray Mass Spectrometry / 分析化学

Direct spray mass spectrometry was used to simply and rapidly differentiate Mutong of Aristolochiaceae from other two kinds of Mutong medicinal materials (Lardizabalaceae and Ranunculacea) by analyzing the chemical profile of Mutong of Aristolochiaceae.A novel method for determination of magnoflorine content in Mutong of Aristolochiaceae was established.The results showed that Mutong of Aristolochiaceae could be identified according to the symbolic component, magnoflorine.Under positive ion mode, semi-quantitative result based on the signal strength ratio of magnoflorine and nuciferin was obtained by choosing nuciferin as an internal standard.The method showed good linear coefficient in the concentration range of 0.50-20.00 mg/L of magnoflorine.The limit of detection was 0.1 mg/L.The method was simple and fast, and could be used for direct and rapid in-situ analysis and identification of Mutong of Aristolochiaceae from other closely related Mutong herbal species without sample pre-treatment.The results were important for the quality control of Mutong herbal medicine.

The effects of relaxation therapy on the sleep of patients with generalized anxiety disorder / 中华物理医学与康复杂志

Objective To explore the effect of relaxation treatment (RT) on the sleep quality of patients with generalized anxiety disorder (GAD).Methods Ninety-two GAD patients were recruited and evenly divided into a study group (n =46) and a control group.The control group was treated with conventional medications,while the study group received RT in addition.The Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to test for changes in sleep before and after treatment.Results There were no significant differences between the two groups before treatment in terms of average PSQI scores or PSG results.After treatment,both groups scored significantly better on the PSQI than before the treatment.PSG showed that after treatment there was less awakening,greater sleep efficiency and longer total sleep time.There was shorter sleep latency and rapid eye movement sleep latency,shorter duration of shallow sleep,and longer duration of deep sleep and rapid eye movement sleep in the study group,as well as fewer awakenings,greater sleep efficiency and longer total sleep time.The PSQI and PSG results of the two groups after treatment were significantly different.Conclusions RT can significantly improve sleep disorders in GAD patients.

Role of neuropeptide Y in regulating hypothalamus-pituitary-gonad axis in the rats treated with electro-acupuncture.

Neuropeptide Y (NPY) is an important regulator of reproductive axis, which mainly plays some roles in regulating secretion of gonadotropin-releasing hormone (GnRH) in hypothalamus. In previous studies, we found that the repeated low frequency electro-acupuncture (EA) down-regulated hypothalamus-pituitary-gonad (HPG) axis of common rats and rabbits during puberty. In this study, we investigated the role of NPY in regulating the reproductive axis of common rats at different developmental stages and rats treated with the repeated EA. Low frequency EA (3 Hz) was performed at acupoints (treatment groups) or non-acupoints (control groups) for 20 min daily for 10 days in Sprague-Dawley (SD) rats at four developmental stages, which were juvenile stage, early puberty stage, later puberty stage and adult stage. NPY expression in the hypothalamus were determined using RT-PCR and real-time quantitative PCR (qPCR) after 10 days-treatments. The results showed that NPY expression in the early pubertal group (EPG) was significantly depressed after repeated EA (P<0.05). Compared with the results of GnRH expression and body weights, the change of NPY expression was similar with the fluctuation of GnRH expression after EA and the increase of body weights of rats was not influenced by the depression of NPY expression after EA during early puberty. The results demonstrated that repeated low frequency EA was an effective method on down-regulating not only the GnRH expression but also the NPY expression in the hypothalamus without reducing body weights of rats during early puberty.

Effect of acupuncture on pubertal development of rats and rabbits at different developmental stages.

Physiological and endocrine studies on sexual development in animals and effects of acupuncture on sexual development are limited. Therefore, we investigated the effect of electro-acupuncture (EA) on the arcuate nucleus (Arc) and release of gonadotropin-releasing hormone (GnRH) in animals at different developmental stages. In Experiment 1, EA stimulation (30 Hz) was performed for 30 min per day in EA group of rabbits for 48 days, while the control group (mature rabbits) was not given EA. Arc discharges in those two groups were measured after the 48-day treatment. Arc discharge was also measured in the pre-pubertal group (as control) without EA treatment. Then, all three groups were treated with transient EA for 30 min and Arc discharges were determined again. In Experiment 2, EA (3 Hz) at the same acupoints or non-acupoints as that in the rabbits was performed for 20 min per day in different developmental group of Sprague-Dawley rats for 10 days. GnRH mRNA expression in the hypothalamus of rats was determined using RT-PCR and real-time PCR. The serum sexual hormone, sperm count, and body weight was measured. The results showed that the Arc discharge (P<0.01), testosterone (T) (P<0.01) and sperm count (P<0.01) in male rabbits were reduced by repeated EA. However, the body weight of rabbits was not changed after EA compared to the control in Experiment 1. In Experiment 2, GnRH mRNA expression in rats of the early pubertal group (EPG) and adult group (AG) were significantly depressed after repeated EA at acupoints (P<0.01). The sexual hormones were negatively influenced by repeated EA during puberty. Sperm count was reduced significantly after repeated EA at time of puberty (P<0.01). Repeated EA did not influence body weight of rats (P>0.01) and structures of the gonadial tissues during development. The results suggested that repeated EA is a good option that can be considered for regulating the function of the hypothalamus-pituitary-gonad (HPG) axis during puberty.