Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta-analysis.

It is unclear whether hepatic artery infusion chemotherapy (HAIC) or transcatheter arterial chemoembolization (TACE) is more efficient in the combination therapy of hepatocellular carcinoma (HCC). Head-to-head comparisons among HAIC-related therapies are lacking. For this network meta-analysis, PubMed, EMBASE and Cochrane Library databases were searched up to April 1, 2022. Randomized controlled trials (RCTs) were eligible if they evaluated the use or prolongation of TACE or HAIC in patients with advanced HCC and reported or collected survival data. A network meta-analysis was performed to synthesize data and make direct and indirect comparisons between treatments. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to explore the efficacy of various treatment options on overall survival (OS), odds ratios (ORs) with 95% CI were used for overall response rate (ORR), whereas risk ratios (RRs) with 95% CI were used for serious adverse events (SAEs). The analysis of 7 trials including a total of 1,073 patients found that sorafenib with HAIC-oxaliplatin improved survival (HR=0.33, 95% CI: 0.25-0.44); the ORR was also improved in patients treated with sorafenib plus HAIC-oxaliplatin and sorafenib plus PF-HAIC (OR=22.18, 95% CI: 10.69-52.56; and OR=2.72, 95% CI: 1.43-5.36, respectively). The incidence of liver injury was elevated in patients treated with sorafenib plus TACE (OR=5.93, 95% CI: 2.70-15.41). However, no differences in the incidences of other SAEs were identified among the treatment groups. The present meta-analysis provides preliminary evidence for the comparative safety and efficacy of HAIC and TACE combined with sorafenib, and indicates the dominance of HAIC-oxaliplatin in HCC interventional therapy. However, high-quality RCTs are required to further confirm the efficacy of HAIC-oxaliplatin. The present study has been registered with PROSPERO (registration no. CRD42021288497).

Machine Learning Method for Fatigue Strength Prediction of Nickel-Based Superalloy with Various Influencing Factors.

The accurate prediction of fatigue performance is of great engineering significance for the safe and reliable service of components. However, due to the complexity of influencing factors on fatigue behavior and the incomplete understanding of the fatigue failure mechanism, it is difficult to correlate well the influence of various factors on fatigue performance. Machine learning could be used to deal with the association or influence of complex factors due to its good nonlinear approximation and multi-variable learning ability. In this paper, the gradient boosting regression tree model, the long short-term memory model and the polynomial regression model with ridge regularization in machine learning are used to predict the fatigue strength of a nickel-based superalloy GH4169 under different temperatures, stress ratios and fatigue life in the literature. By dividing different training and testing sets, the influence of the composition of data in the training set on the predictive ability of the machine learning method is investigated. The results indicate that the machine learning method shows great potential in the fatigue strength prediction through learning and training limited data, which could provide a new means for the prediction of fatigue performance incorporating complex influencing factors. However, the predicted results are closely related to the data in the training set. More abundant data in the training set is necessary to achieve a better predictive capability of the machine learning model. For example, it is hard to give good predictions for the anomalous data if the anomalous data are absent in the training set.

Clinical and pathological analysis of 8 cases of mucoepidermoid carcinoma / 中华皮肤科杂志

Objective:To investigate clinical and histopathological features and differential diagnostic considerations of mucoepidermoid carcinoma (MEC) .Methods:A retrospective study was carried out on clinical manifestations, histopathological and immunohistochemical features, treatment and prognosis of 8 patients with MEC, who were collected from Department of Pathology, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College during 2018 - 2021.Results:Among the 8 patients, 5 were males and 3 were females, and their age at onset ranged from 19 to 67 years. Skin lesions were located on the lip mucosa in 5 cases, on the cheek in 2 cases, and on the nose in 1 case. Tumors were all located in the dermis and subcutaneous tissue, parts of which were connected to the epidermis; different proportions of mucous cells, epidermoid cells and intermediate cells were arranged in nests or clumps, and formed solid or cystic structures accompanied by varying degrees of formation of ducts and mucus lakes; all epidermoid cells and intermediate cells expressed cytokeratins AE1/AE3, CK5/6, P63, carcinoembryonic antigen and epithelial membrane antigen. According to the current Chinese grading system, 1 of the 8 patients was diagnosed with intermediate-grade MEC, and others were diagnosed with low-grade MEC. No abnormalities were found by systemic examination. All patients received surgical resections. After the follow-up of 12 - 36 months, no recurrence or distant metastasis was observed.Conclusion:MEC presents no characteristic clinical manifestations, its diagnosis mainly depends on histopathological features, and mucus in the cytoplasm of mucous cells as shown by alcian blue staining is specific for MEC.

Schroth exercises improve health-related quality of life and radiographic parameters in adolescent idiopathic scoliosis patients / 中华医学杂志(英文版)

BACKGROUND@#Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3-5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3-5) and moderate scoliosis (Cobb angle 20°-40°).@*METHODS@#From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation.@*RESULTS@#In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = -3.918, P = 0.001), and 3.7 ± 0.4 (t = -6.468, P < 0.001), respectively. No significant improvements of SRS-22 function domain (t = -2.825, P = 0.088) and mental health domain (t = -3.174, P = 0.061) were observed. The mean Cobb angle decreased from 28.9 ± 5.5° to 26.3 ± 5.2° at the final follow-up, despite no statistical significance was observed (t = 1.853, P = 0.102). The mean C2-C7 SVA value decreased from 21.7 ± 8.4 mm to 17.0 ± 8.0 mm (t = -1.224 P = 0.049) and mean T1 tilt decreased from 4.9 ± 4.2 ° to 3.5 ± 3.1° (t = 2.913, P = 0.011). No significant improvement of radiographic parameters and HRQOL were observed in observation group.@*CONCLUSIONS@#For AIS patients with a Risser 3-5 and a Cobb angle 20°-40°, Schroth exercises improved HRQOL and halted curve progression during the follow-up period. Both cervical spine alignment and shoulder balance were also significantly improved after Schroth exercises. We recommend Schroth exercises for patients with AIS.

Current status and future of non-genomic effects of phytoestrogens / 药学学报

Phytoestrogens exhibit various pharmacological estrogen-like effects, such as in the prevention and treatment of osteoporosis, cardiovascular diseases, tumors, etc., but the specific mechanism is still unclear. In recent years, estrogen receptor alpha-mediated rapid non-genomic effects have been identified to play an important role in the pathogenesis of estrogen-related diseases. The research of phytoestrogens exerting pharmacological effects through non-genomic effects has also received increasing attention. This article summarizes the research progress in estrogen receptor alpha-mediated non-genomic effects and analyzes the possible involvement of rapid non-genomic effects in certain pharmacological effects of phytoestrogens. The future prospects of estrogen receptor-mediated non-genomic effects by phytoestrogens are also discussed.

Research Progress on Anti-tumor of Cinobufacini / 中国实验方剂学杂志

Cinobufacini is an extract from skin of Bufo gargarizans, and composed of bufadienolides, peptides, alkaloids and cholesterol. With the deepening of research of its pharmacological effect, it has been proved that cinobufacini has important application value in anti-inflammation, anti-virus, anti-tumor, as well as swelling and pain relief. In recent years, more attention has been given to its anti-tumor activity. The molecular pharmacology studies showed that cinobufacini plays an important role on anti-tumor by enhancing the immunity, inhibiting the proliferation of tumor cells, inducing the apoptosis of tumor cells, reversing multidrug resistance of tumor cells, and inhibiting the tumor angiogenesis. Both intrinsic pathway mediated by mitochondria and extrinsic pathway mediated by death receptor are involved in cinobufacini-induced apoptosis. Clinical studies have shown that cinobufacini is broadly used as an anti-tumor traditional Chinese medicine, due to its advantages of low toxicity, less side effects, and wide anticancer spectrum. It is broadly used in the treatment of liver cancer, gastric carcinoma, lung cancer, colon cancer, esophageal carcinoma, carcinoma of gallbladder, and non-Hodgkinlymphoma. Either single or combined application plays an active role in improving the efficacy and reducing side effects. To promote the research of anti-tumor activity of cinobufacini, and expand its application prospects, this review focuses on anti-tumor mechanism and clinical application of cinobufacini.

Research Progress on Regulation of Proliferation and Differentiation of Neural Stem Cells by Traditional Chinese Medicine / 中国实验方剂学杂志

Neural stem cells (NSCs) have the potential of self-renewing and differentiation into neurons,astrocyte,as well as oligodentrocyte.Nowadays,neurogenesis and NSCs transplantation have become new strategies for the treatment of nervous system diseases.However,the disadvantages of NSCs transplantation also limit their progress,including low survival rate,difficulty in differentiation,tumorigenesis and difficulty in penetrating scar tissues.It is a novel issue on how to regulate the proliferation and differentiation of endogenous NSCs in adult neurogenesis.Drug-induced endogenous NSCs proliferation and differentiation is the potential strategy for the regenerative medicine,repairing damaged nerves and treating central nervous system diseases.As a traditional medicine in China,Chinese medicine has the characteristics of multi-target,multi-link and multi-channel treatment,and has unique advantages and broad prospects in promoting nerve regeneration.More and more studies have shown that Chinese herbal medicine could indirectly or directly regulate the proliferation and differentiation of NSCs through extracellular signaling pathways (such as Notch,Wnt/β-catenin,the Sonic Hedgehog (Shh) pathway),intracellular transcription factors,together with changing the microenvironment (neurotrophic factor BNDF).In this review,we focus on the traditional Chinese medicine formulae,Chinese patent medicine,single medicine,as well as their monomers,which regulate the proliferation and differentiation of NSCs,so as to provide a new strategy for the prevention and treatment of central nervous system diseases by traditional Chinese medicine.

Effect of Picroside Ⅱ on Expression of microRNA-1 in H2O2-induced H9c2 Cardiomyocytes Damage / 中国实验方剂学杂志

Objective: To study the effect of picroside Ⅱ on the expression of microRNA-1 (miR-1) in the H2O2-induced H9c2 cardiomyocytes damage, in order to explore the mechanism of picroside Ⅱ in protecting H9c2 cardiomyocytes from oxidative stress. Method: H9c2 cardiomyocytes were divided into 6 groups:control group, model group (H2O2 200 μmol·L-1), picroside Ⅱ (50, 100, 200 μmol·L-1)+H2O2 (200 μmol·L-1) group and picroside Ⅱ (200 μmol·L-1) group. Picroside Ⅱ group was incubated with picroside Ⅱ for 6 h and then cultured with H2O2 for 2 h. At the end of drugs treatment, the cell viability and the cellular damage of cardiomyocytes were respectively assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assays. 4',6-diamidino-2-phenylindole (DAPI) staining and cysteinyl aspartate specific proteinase-3 (Caspase-3) test were used to evaluate cell apoptosis. The mRNA expressions of Caspase-3,B-cell lymphoma-2 (Bcl-2) and miR-1 were measured by Real-time polymerase chain reaction (Real-time PCR). The protein expression of Bcl-2 was detected by Western blot. Result:Compared with the control group, H2O2 could significantly decrease the cell viability and increase the rate of apoptosis, up-regulate mRNA expression of Caspase-3 and miR-1, and down-regulate expression of Bcl-2 in H9c2 cells (PPPPPPPConclusion:Picroside Ⅱ has a protective effect on H9c2 cells from H2O2-induced cardiomyocyte injury by down-regulating mRNA-1 expression and up-regulating the expression of the downstream Bcl-2.

Application prospect of organoids and 3D-cell models in evaluation of cardiotoxicity of traditional Chinese medicine / 药学学报

Cardiotoxicity is one of the main causes of failure in new drug development or drug withdrawal from the market. However, current methods for evaluation of drug cardiotoxicity suffer the shortcomings such as low clinical relevance, low reproducibility and lack of high throughput screening capacity. Therefore, there is an urgent need for establishing more accurate and reliable methods for cardiotoxicity evaluation of drugs. As a new generation of drug cardiotoxicity evaluation, cardiac organs in culture retain the biological characteristics and functions of heart cells in the body, and can realistically and accurately respond to the effects of drugs. This article reviews recent progress of in vitro culture of cardiac organs and 3D-cell models, with focuses on application and development potential of cardiac organs for evaluation of cardiotoxicity of traditional Chinese medicine. The advantage and future prospective of such cell- and organ-based models for unique challenges in evaluation of cardiotoxicity of traditional Chinese medicine have been discussed.

Effect of CCNB1 silencing on cell cycle, senescence, and apoptosis through the p53 signaling pathway in pancreatic cancer.

Pancreatic cancer (PC) is a serious malignancy with high mortality and poor prognosis due to nonspecific incipient symptoms and early metastasis. Also, increasing evidence indicates that a panel of genes is newly identified in the pathogenesis of PC. As is a regulatory subunit, elevated cyclin B1 (CCNB1) expression has been detected in different cancers including PC. This study is designed to investigate the effects of CCNB1 silencing on cell cycle, senescence, and apoptosis through the p53 signaling pathway in PC. PC tissues and normal pancreatic tissues were collected. Cells were transfected and assigned into different groups. The expressions of CCNB1, p53, MDM2, Bax, caspase-9, caspase-3, and p21 in tissues and cells were detected by reverse transcription quantitative polymerase chain reaction and western blot analysis. ß-Galactosidase staining, MTT assay, and flow cytometry were conducted to test cell senescence, proliferation, cell cycle, and apoptosis. PC tissues showed higher expressions of CCNB1 and MDM2 and lower expressions of Bax, caspase-9, caspase-3, and p21. Cells transfected with shCCNB1 had lower expressions of CCNB1 and MDM2, whereas higher expressions of Bax, caspase-9, caspase-3, p53, and p21. The shCCNB1 group had decreased proliferation and S-phase cell proportion and increased apoptosis, senescence, and G0/G1-phase cell proportion. The PFT-α group showed higher expressions of MDM2 and lower expressions of Bax, caspase-9, caspase-3, p53, and p21. The PFT-α group had increased proliferation and S-phase cell proportion and declined apoptosis, senescence, and G0/G1-phase cell proportion. CCNB1 silencing inhibits cell proliferation and promotes cell senescence via activation of the p53 signaling pathway in PC.

A Novel Porcine Model of Septic Shock Induced by Acute Respiratory Distress Syndrome due to Methicillin-resistant / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sepsis is one of the main causes of mortality in critically ill patients following progression to septic shock. To investigate the pathophysiologic changes of sepsis, we developed a novel porcine model of septic shock induced by acute respiratory distress syndrome (ARDS) due to methicillin-resistant Staphylococcus aureus(MRSA) pneumonia.</p><p><b>METHODS</b>Twenty-six male Landraces (Lvyuanweiye, Beijing, China) weighing 30 ± 2 kg were divided into four groups: sham group (SH; n = 5); cotton smoke inhalation group (SM; n = 6); MRSA pneumonia group (MR; n = 6); and septic shock group with cotton smoke inhalation + MRSA pneumonia (SS; n = 9). Extensive hemodynamics, oxygen dynamics, and lung function were monitored for 24 h following the injury or until death. Tissues were collected, and histopathology evaluations were carried out.</p><p><b>RESULTS</b>Blood cultures from 6 of 9 animals in the SS group were positive for MRSA. Two hours following the injury, decreased mean arterial blood pressure (60-70 mmHg) and cardiac index (<2 L.min-1.m-2) were observed in the animals in the SS group, while systemic vascular resistance index was increased. The hemodynamic characteristics of septic shock were only observed in the SS group but not significant in the other groups. The PO2/FiO2in the SM and SS groups decreased to 300 and 100, respectively. In the SS group, extravascular lung water index increased to 20 ml/kg, whereas thoracopulmonary compliance decreased to 10 ml/H2O after injury. Deterioration of pulmonary function in the SS group was more serious than the SM and MR groups. Severe lung injury in the SS group was confirmed by the histopathology evaluations. The lung injury confirmed by high-resolution thin-section computed tomography and histopathology in the SS group was more serious than those of other groups.</p><p><b>CONCLUSIONS</b>In the present study, we developed a novel porcine model of septic shock induced by ARDS due to severe MRSA pneumonia with characteristic hyperdynamic and hypodynamic phases in 24 h, which mimicked the hemodynamic changing of septic shock in human.</p>

A Clinical Study of Related Acupoint Pain Threshold Detection in Cholecystitis Patients / 上海针灸杂志

Objective To explore the difference in pain threshold between related acupoints and the specificity of acupoints in cholecystitis patients.Method Actual measurement was made in 80cases, a normal group of 30 cases (volunteers without psychological and physiological diseases) and a patient group of 50 cases (volunteers with cholecystitis). The probe of an algometer was perpendicularly placed on the selected acupoint, the pressure point was pushed and pressing was stopped immediately after the subject felt pain. The pain thresholds displayed by the measured acupoints were recorded. The pain thresholds of the selected acupoints were compared between the normal and patient groups and thedifferences were analyzed to explore the specificity of acupoints.Result A comparison of the pain thresholds of the Back-Shu points of the Bladder Meridian of Foot-Taiyang between the patient and normal groups showed that there were no significant differences in the thresholds of the left Back-Shu points Geshu (BL17), Ganshu (BL18), Danshu (BL19), Pishu (BL20), Weishu (BL21) and Dachangshu (BL25) of the bladder meridian between the two groups (P>0.05) and there were significant differences in the thresholds of the right Back-Shu points Geshu, Ganshu, Danshu, Pishu, Weishu and Dachangshu of the bladder meridian between the two groups (P0.05). The pain thresholdwas significantly lower in thepatient group than in the normal group. There were no significant differences in thethresholds of the left points Liangmen, Riyue, Qimen and Taichong of the Liver Meridian of Foot-Jueyin, the Gallbladder Meridian of Foot-Shaoyang and the stomach meridian between the patient and normal groups (P>0.05).Conclusion The pain sensitivity of ipsilaterali related acupoints increase and the relative specificity of acupoints exist in cholecystitis patients.

Acteoside promotes proliferation of neural stem cells from adult mice by activating PI3 K/AKT pathway / 中国药理学通报

Aim Toclarifytheeffectofacteosideon proliferation of neural stem cells (NSCs ) from adult mice,as well as the involved signaling pathway.Meth-ods NSCswereisolatedfromthesubventricularzone (SVZ)of adult C57BL/6 mice,then identified by im-munofluorescence staining with Nestin,the marker of NSCs.NSCs were exposed to acteoside (5,10,20,40μmol·L-1 )in absence of mitogen(EGF/bFGF)for 24 h.We employed CCK8 assay to detect NSCs viability and BrdU staining to identify NSCs proliferation.We performed Western blot to quantify the expression level ofp-AktinducedbyacteosideonNSCs.Results With-out mitogen,acteoside increased NSCs proliferation by activating p-Akt,which can be blocked by LY294002, the inhibitor of PI3K/AKT signaling pathway.Conclu-sion ActeosidepromotestheproliferationofNSCsfrom adult mice by activating PI3K/AKT pathway.

Primary giant cell angioblastoma of bone:a clinicopathological study / 临床与实验病理学杂志

Purpose To analyze the clinicopathological characteristics of giant cell angioblastoma ( GCAB) presenting primarily in the bone. The differential diagnosis is discussed. Methods The clinical, radiological and histopathological profiles in three cases of bony GCAB were reviewed. Results The tumor occurred in two adult females and one boy. The lesion involved the second vertebrae, left distal femur and 3rd to 5th left metacarpal bones in one case each. Clinically, all three patients presented with bone pain. Two patients were accompanied with restricted mobility. Radiological examination showed bone destruction with involvement of adjacent soft tissue in two cases. Histologically, the tumor was composed of irregular angiomatoid nodules which showed striking plexiform architecture. On high power, the nodules were composed of small vessels surrounded by proliferative oval-to-spindled pericytes which showed concentric aggregation around the vascular channels. The hallmark of the lesion was the presence of multinucleated osteoclast-like giant cells scat-tered within the nodules. By immunohistochemistry, the endothelial cells were positive for CD31 and CD34, whereas the surrounding pericytes were positive for alpha smooth muscle actin and vimentin. CD68 staining highlighted the osteoclast-like giant cells. Conclu-sions GCAB is a distinctive vascular tumor of intermediate malignancy characterize by local aggressiveness. On rare occasions, GCAB may occur in adult patients and manifest as primary bone lesions. Awareness of its characteristic features will help in the distinction from a variety of disease including granulomatous lesions, plexiform fibrous histiocytoma, tufted hemangioma and Kaposiform heman-gioendothelioma.

Partial splenectomy and use of splenic vein as an autograft for meso-Rex bypass: a clinical observational study.

BACKGROUND: Meso-Rex bypass (MRB) surgery is being increasingly used to treat chronic prehepatic portal hypertension secondary to extrahepatic portal vein thrombosis (EPVT) and cavernous transformation (EPVCT) in children. Rather than using the internal jugular vein (IJV, the traditional venous graft), we used an autogenous splenic vein segment graft for MRB. MATERIAL/METHODS: We examined 25 children with extrahepatic portal hypertension and a history of recurrent upper gastrointestinal (GI) variceal bleeding despite previous endoscopic sclerotherapy. All patients had melena, splenomegaly, hypersplenism, or some combination thereof. Left portal vein (LPV) patency was verified in 22 patients using intraoperative direct portography through the umbilical vein. Partial splenectomy was performed to enable the harvest of the splenic vein trunk, which was anastomosed between the superior mesenteric vein (SMV) and the left portal vein (LPV). All patients were followed for 12-48 months (mean=25.6 months) and no patients were lost to follow-up. RESULTS: Preoperative Doppler ultrasound (US) imaging indicated that 18/25 patients had adequate intrahepatic portal veins for shunting, with no blood flow in the LPVs of 7 patients. LPV patency in 22/25 patients was verified using intraoperative direct portography, with successful MRB. Shunting was converted into a portosystemic shunt in the remaining 3/25 patients with thrombosed LPVs. A Doppler US evaluation of the vein conduit revealed excellent postoperative flow. The patients' mean hemoglobin, platelet, and white blood cell counts increased significantly, and in all cases the endoscopic status obviously improved after shunting. Occlusion or narrowing occurred in 2/22 patients after discharge. At 12 months (for 1 patient) and 24 months (for 1 patient), the shunt was converted into a portosystemic shunt. The cumulative graft patency rate was 91% (20/22). CONCLUSIONS: Partial splenectomy and splenic vein autografting in MRB surgery can successfully resolve prehepatic portal hypertension and hypersplenism in children.

MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation.

BACKGROUND: Postoperative anorectal malformation patients frequently have defecatory dysfunction. MRI may be useful in the management of these patients. OBJECTIVE: To analyze static and dynamic MRI findings in patients with defecatory dysfunction after correction of anorectal malformation (ARM), and compare differences between patients with constipation and fecal incontinence. MATERIALS AND METHODS: Pelvic MRI studies of 20 constipated and 32 incontinent postoperative ARM patients were analyzed retrospectively to determine the location and morphology of the neorectum, presence of peritoneal fat herniation, presence of scarring, development of the striated muscle complex (SMC) and any other abnormalities. The two groups were then compared using χ(2)-test. Eighteen patients also underwent MRI defecography to evaluate pelvic floor function and abnormalities are reported. RESULTS: The children with incontinence were more likely to have abnormal location of the neorectum (P = 0.031), increased anorectal angle (ARA) (P = 0.031) and peritoneal fat herniation (P = 0.032), and less likely to have dilation of the neorectum (P = 0.027), than the children with constipation. There were no significant differences between the two groups in incidence of focal stenosis of the neorectum (P = 0.797), presence of extensive scarring (P = 0.591) and developmental agenesis of the SMC (P > 0.05). MRI defecography showed 6 anterior rectoceles, 6 cystoceles and 18 pelvic floor descents. CONCLUSIONS: MRI is a helpful imaging modality in postoperative ARM patients with defecatory dysfunction, and it shows distinct differences between the children with constipation and incontinence and provides individualized information to guide further treatment.

Functional magnetic resonance imaging on acupuncturing Yuan-Source and He-Sea acupoints of stomach Meridian of Foot-Yangming / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the functional brain localization with magnetic resonance imaging (MRI) after acupuncturing the Yuan-Source and He-Sea acupoints of Stomach Meridian of Foot-Yangming (ST).</p><p><b>METHODS</b>The study was performed in 30 healthy volunteers who underwent acupuncture at Yuan-Source acupoint (Chongyang, ST42) and He-Sea acupoint (Zusanli, ST36) (ST group). Ten of these were also underwent acupuncture at the non-acupoints as the control group. Blood oxygenation level dependent functional MRI was performed.</p><p><b>RESULTS</b>In the ST group, signal increasing areas were demonstrated in bilateral superior temporal gyri (Broadmann 22), bilateral supramarginal gyri (Broadmann 40), bilateral cerebellar hemispheres, bilateral cingulate gyri and isthmus of cingulate gyri (Broadmann 32, 30), bilateral superior parietal lobules (Broadmann 7); signal decreasing areas were shown in bilateral orbital gyri (Broadmann 11), bilateral temporal pole (Broadmann 38), right inferior frontal gyrus (Broadmann 47) and right medial occipitotemporal gyrus (Broadmann 36). In the control group, signal increases areas were demonstrated in superior temporal gyri, precentral gyri, cingulate gyri, thalamus, insula and cerebellum. The size, signal intensity and number of increasing areas in control group are less than in ST group.</p><p><b>CONCLUSION</b>Combined acupuncture of Yuan-Source and He-Sea acupoints of ST can activate and decrease the multiple brain regions of "splanchnic brain" and thus reach a new functional balance to relieve pain.</p>