Objective:To observe the clinical effect of acupuncture on chronic obstructive pulmonary disease (COPD), and the improvements of patients’ pulmonary ventilation function and 6-minute walk test (6-MWT) distance. Methods:A total of 80 COPD patients [grade 3-4 in Global Initiative for Chronic Obstructive Lung Disease (GOLD), qi deficiency of the lung and kidney in traditional Chinese medicine (TCM) pattern] were randomly allocated into a treatment group (n=40) and a control group (n=40). Salmeterol Xinafoate and Fluticasone Propionate powder (Seretide,50μg/250μg) for inhalation was used for basic treatment in both groups (once in the morning and once in the evening). Patients in the treatment group received acupuncture at Feishu (BL 13), Shenshu (BL 23), Qihai (CV 6), Guanyuan (CV 4), Dingchuan (EX-B 1), Danzhong (CV 17) and Zusanli (ST 36) twice a week for 3 months. After 3 months of treatment, clinical effects, lung ventilation functions and 6-MWT distance were observed and compared in the two groups. Results:After 3 months of treatment, the total effective rate was 95.0% in the treatment group, versus 80.0% in the control group, showing a statistical difference (P<0.05); the phlegm expectoration, dyspnea and shortness of breath were more significantly improved in the treatment group than those in the control group (P<0.01,P<0.05); and the 6-MWT distance and forced expiratory volume in 1 second percentage of predicted value (FEV1%) were more significantly improved in the treatment group than those in the control group (P<0.05,P<0.01). Conclusion:Seretide inhaler combined with acupuncture can improve signs and symptoms in COPD patients, increase the 6-MWT distance, improve FEV1% and obtain better results than Seretide alone.

Objective To explore the effects of erythropoietin (EPO) on the expression of signal transducer and activator of transcription (STAT) 1,phosphorylated STAT1 (P-STAT1),STAT3,P-STAT3 and cell apoptosis in rat models of focal cerebral ischemia-reperfusion.Methods Eighty male SpragueDawley rats were randomly and evenly divided into four groups by completely random design method: shamoperation (group A),cerebral ischemia-reperfusion (group B),cerebral ischemia-reperfusion ± saline (group C) and cerebral ischemia-reperfusion ± EPO (group D).The model of focal cerebral ischemiareperfusion injury was established by blocking the left middle cerebral artery.All rats underwent MRI for the detection of the changes of infarct area between 2 h post ischemia and 24 h of reperfusion.Western blot was used to observe the expression of STAT1,P-STAT1,STAT3,P-STAT3.Terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) was used to evaluate the cell apoptosis including the relative area (ROI area/whole brain area of the same layer × 100％) of abnormal signal region,relative optical density (rOD) and apoptotic index.One-way analysis of variance and q test were used to analyze the data.Results On T2WI imaging,rats in group B and group C presented large hyperintense areas in the cortex and subcortex of left hemispheric ((28.00±4.60)％ and (29.70±4.80)％ respectively).Group D presented less hyperintense areas in the cortex and subcortex of left hemispheric compared with group B and group C ((21.10±2.40) ％; F=11.285,P＜0.01).The expression of STAT1 and STAT3 proteins was not significantly affected by ischemia-reperfusion and EPO intervention compared with normal brain tissue (F=0.806,1.558,both P＞0.05).However,the level of P-STAT1 was low in group A (rOD =0.75±0.13) but increased after cerebral ischemia-reperfusion.Compared with group B and group C,P-STAT1 expression was lower in group D (B-D: 2.08±0.15,2.05±0.16,1.92±0.05; F=3.274,P＞0.05).The level of P-STAT3was also low in group A (rOD=1.02±0.09).Compared with group B and group C,P-STAT3 expression in group D was significandy higher (B-D: 2.22±0.13,2.04±0.14,4.21±0.21 ; F=40.719,P＜0.01).The apoptotic index of group B and group C was (42.00±1.30)％ and (41.20±2.50)％,respectively,which was significantly higher than that of group D ((20.90± 1.46) ％ ; F=378.704,P＜0.01).Conclusion Intraperitoneal injection of EPO can reduce the cerebral ischemic area and the number of apoptotic cells in the ischemic penumbra in rat ischemia-reperfusion models through increasing P-STAT3 and decreasing P-STAT1 levels.

Objective: To isolate and identify the structures of triterpenoids from the extract of Acanthopanax sessiliflorus fruits. Methods:The chemical constituents were systematically isolated by column chromatography and liquid chromatography, and their struc-tures were determined by spectral data including 1 H-NMR, 13 C-NMR, HSQC and HMBC combined with ESI-MS. Results:Totally 8 trit-erpenoids compounds were isolated and identified from Acanthopanax sessiliflorus fruits, 22-α-hydroxychiisanogenin (1), chiisanogenin (2), 3-oxo-24-methylenecycloartan (3), mangiferonic acid (4), isomangiferolic acid (5), oleanolic acid (6), betulin (7) and betulin-ic acid (8). Conclusion:Compound 3, 4 and 5 are obtained from Acanthopanax genus for the first time.

Objective To summarize the CT characteristics of tumor deposition adjacent to colorectal cancer (CRC),and provide the evidences for differential diagnosis.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 26 CRC patients who were admitted to the Wuxi Second People's Hospital of Nanjing Medical University from May 2015 to April 2017 were collected.Patients underwent preoperative multi-slice spiral CT scan and double-phase enhanced scan,and then received open surgery.Observation indicators:(1) characteristics of multi-slice spiral CT scan;(2) differential comparisons;(3) follow-up.Follow-up using telephone interview was performed to detect patients' prognosis once every 3 months up to May 2017.Measurement data with normal distribution were represented as (x)±s.Comparisons between groups and among groups were respectively analyzed using the t test and the one-way ANOVA.Pairwise comparison was done using the SNK method.Results (1) Characteristics of multi-slice spiral CT scan:of 26 patients,17 underwent double contrast enhanced scans of chest,abdomen and pelvic and 9 underwent double contrast scans of abdomen and pelvic.Primary tumors of 18 and 8 patients respectively located in the colon and rectum.Forty-one tumor deposits of 26 patients were collected,with number of tumor deposits of 1.6±0.9 per case,and number of tumor deposits ＜ 3 and ≥3 respectively were found in 20 and 6 patients.Tumor deposits were often isolated in the fat spaces around the rectum or colon and unconnected with the surrounding primary tumor or lymph node.Distance to the center of primary tumor was (2.6±l.0)cm (range,0.2-5.0 cm),the distance ＜2.6 cm and ≥2.6 cm were respectively detected in 22 and 19 patients.Thirty-three tumors showed signs of lobulation,22 showed signs of burr and 7 showed liquefaction necrosis,and there was a combination of multiple imaging characteristics in the same tumor deposit.The maximum width,minimum width,maximum diameter,plain scan value of CT,CT enhancement values in the arterial phase and venous phase in 41 tumor deposits were respectively (1.15 ± 0.60)cm,(1.11±0.44)cm,(1.13±0.49)cm,(27±13)HU,(28±14)HU and (49±19)HU.Of 41 tumor deposits,34 demonstrated homogeneous density in the plain scan,and obviously enhancement in early enhanced scan,with homogeneous enhancement;7 demonstrated heterogeneous density in the plain scan,with internal liquefaction necrosis,and enhanced scans showed no enhancement in the areas of necrosis and obviously early enhancement in the areas of non-necrosis.(2) Differential comparisons:26 patients underwent open surgery,including 8 with right hemectomy,2 with transverse colon resection,4 with left semicolon resection,2 with simple sigmoid resection,2 with abdominoperineal resection of rectal cancer and 8 with low anterior rectal resection,and all patients received postoperatively individualized treatment.Fifty-two lymph nodes with distance to center of primary tumor ＜ 5.0 cm that were confirmed by pathological examination were collected,including 19 metastatic lymph nodes.Of 41 tumor deposits,33 were irregular,and 8 were regular and round-like or oval-like shape.Of 19 metastatic lymph nodes,16 were regularly round-like shape,1 showed irregular shape and edge blur,and 2 were irregular with a mutual integration.The maximum width,minimum width and maximum diameter of 19 metastatic lymph nodes were respectively (1.09± 0.33) cm,(1.01 ± 0.23) cm and (1.05 ± 0.20) cm,with statistically significant differences in the above indicators between metastatic lymph nodes and tumor deposits (t =5.48,4.80,7.75,P＜0.05).The plain scan value of CT,CT enhancement values in the arterial phase and venous phase were respectively (12±7) HU,(18± 12) HU,(42± 15) HU in 19 metastatic lymph nodes and (33±6) HU,(31 ±15) HU,(53± 14)HU in 26 primary tumors,showing statistically significant differences in the plain scan value of CT and CT enhancement values in the arterial phase among tumor deposits,metastatic lymph nodes and primary tumors (F=24.43,4.46,P＜0.05),and no statistically significant difference in CT enhancement value in the venous phase (F=2.41,P＞0.05).There were statistically significant differences in the plain scan value of CT and CT enhancement values in the arterial phase between tumor deposits and metastatic lymph nodes (q =5.48,2.50,P＜0.05) and between metastatic lymph nodes and primary tumors (q =6.82,2.84,P＜0.05),and no statistically significant difference between tumor deposits and primary tumors (q =2.15,0.65,P＞0.05).Of 19 metastatic lymph nodes,11 demonstrated homogeneous density in plain scan,with a lower density compared with tumor deposits and primary tumors,and relatively homogeneous enhancement in the arterial phase of enhanced scan;8 demonstrated heterogeneous density with internal liquefaction necrosis,and ring-shaped enhancement in enhanced scan with no enhancement in the areas of necrosis.The density and enhancement range in the arterial phase and venous phase of tumor deposits were similar to primary tumors.(3) Follow-up:24 patients were followed up for 1-25 months,with a follow-up rate of 92.3％(24/26) and a median time of 17 months.Of 24 patients,2 were dead,and survival time were respectively 9 months and 21 months;22 had good survival.Conclusions Multislice spiral CT examination of tumor deposits demonstrates larger and irregular shape,with the signs of lobulation and burr,and the density in plain scan is similar to the primary tumor,with obviously enhancement in early enhanced scan.The metastatic lymph nodes are mostly round-like shape,diameter is smaller than that of tumor deposits,density in the plain scan and CT enhancement values in the arterial phase are lower than that of tumor deposits.

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Objective: To prepare manganese-doped carbon quantum dots (Mn-CDs) dual-modal nanoprobe for fluorescent-magnetic imaging, and evaluate its characteristics and potential on fluorescence imaging and MRI. Methods: Mn-CDs were synthesized at 150 ℃. The form, diameter, component, fluorescent capability, T₁ relaxation rate, stability and cytotoxicity of Mn-CDs in vivo were verified. The fluorescence imaging of HO-8910 tumor-bearing mice was performed on small animal imager, and the whole-body enhanced imaging was performed on 3.0 T MRI scanner. One-way analysis of variance was used to analyze the data. Results: The Mn-CDs with the diameter of (4.64±0.85) nm showed a well-defined spherical morphology. The fluorescent spectra of Mn-CDs exhibited that the excitation maximum was at 360 nm and the emission maximum was at 440 nm. The T₁ relaxation rate was (3.26±0.04) mmol·L^-1·s^-1. The Mn-CDs had good stability of fluorescent and magnetic imaging capability at 0, 0.25, 0.5, 0.75, 1.0 and 2 months at room temperature with no significant differences of fluorescent and magnetic signals (F=1.566 and 0.987, both P>0.05). After injection of 200 μl Mn-CDs (15 g/L), mice were all alive and had no viscera damage. The tumor could be observed obviously on fluorescence imaging at 5 min. Enhanced MRI showed that the tumor was unevenly enhanced and Mn-CDs were mainly cleared away through urinary system. Conclusion Mn-CDs are stable and have good potential on fluorescence imaging and MRI, which provides a promising multimodal imaging method for tumor detection and monitoring.