OBJECTIVETo observe the clinical effect of acupuncture combined with TDP for treatment of postmenopausal patients with deficiency of liver and kidney syndrome and to explore its mechanism.

METHODSOne hundred and twelve cases were randomly divided into an acupuncture group and a medication group, 56 cases in each group. The acupuncture group was treated with acupuncture combined with TDP, Shenshu (BL 23), Mingmen (GV 4) and Guanyuan (CV 4) were selected as main points; the medication group was treated with oral administration of Nylestriol and Oryzanol. The therapeutic effects were evaluated after treatment of 3 months in the two groups, and the changes of estrogen,bone mineral density and endometrium of patients were observed before and after treatment.

RESULTSThe total effective rate of 94.6% in acupuncture group was superior to 75.0% in medication group (P<0.01), the acupuncture group was better than the medication group in increasing bone mineral density and decreasing the endometrial thickness (P<0.05, P<0.01), the medication group was better than the acupuncture group in decreasing the levels of serum follicular stimulating hormone (FSH) and luteinizing hormone (LH) and increasing the estradiol (E2) level (all P<0.01).

CONCLUSIONThe clinical effect of acupuncture combined with TDP for treatment of postmenopausal patients with deficiency of liver and kidney syndrome is significant, and it can increase bone mineral density, decrease endometrial thickness and obviously regulate the estrogen level.

Acupuncture Therapy ; Bone and Bones ; metabolism ; Estrogens ; metabolism ; Female ; Humans ; Kidney ; drug effects ; physiopathology ; Liver ; drug effects ; physiopathology ; Middle Aged ; Osteoporosis, Postmenopausal ; metabolism ; physiopathology ; therapy

Objective: To investigate the effects of postoperative analgesia with Dexmedetomidine combined with Sufentanil on pulmonary infection complications and immune function in patients with lung cancer. Methods: A total of 200 patients with lung cancer who underwent radical lung cancer in our hospital from July 2014 to June 2018 were randomly divided into the group A(n=100, receiving Sufentanil analgesia)and group B(n=100, receiving Sufentanil combined with Dexmedetomidine analgesia)according to the random number table method.The analgesic effect, pulmonary complication incidence and immune function were compared between the two groups. Results: The analgesic and sedative effects were better in the group B than in the group A at 4, 8, 12 and 24 hours after surgery, respectively(P<0.05). The visual analogue scale(VAS)and Ramesay score had statistically significant differences between the two groups at 4, 8, 12 and 24 hours after surgery, respectively(VAS: t=4.137, 2.575, 3.869, 12.676 and 9.945, all P<0.05; Ramesay score: t=6.771, 5.647, 16.763, 21.154 and 6.556, all P<0.05). The pulmonary infection, acute lung injury, focal lung infiltration, atelectasis and respiratory failure occurred in 1, 0, 1, 1 and 0 case in the group B and 3, 2, 3, 1 and 1 case in the group A, respectively.The incidence of pulmonary complications was lower in the group B than in the group A(3% or 3/100 vs.10% or 10/100, χ²=4.031, P=0.045). There were no significant difference in the levels of CD3⁺, CD4⁺, CD8⁺ and CD4⁺ /CD8⁺ cells before surgery between the two groups(P>0.05). The levels of CD3⁺, CD4⁺, CD8⁺ and CD4⁺ /CD8⁺ cells were higher in group B than in group A at 1 day after surgery(t=7.419, 7.867, 11.968 and 8.755, P=0.000). Conclusions Postoperative Dexmedetomidine combined with Sufentanil analgesia not only helps to reduce the incidence of pulmonary complications, but also improves the analgesic effect and immune function in patients with lung cancer undergoing radical surgery.

ObjectiveTo investigate the association between spontaneous portosystemic shunt （SPSS） and hepatorenal syndrome （HRS） in patients with liver cirrhosis. MethodsA retrospective analysis was performed for 93 patients with SPSS from Dezhou Hospital， Qilu Hospital of Shandong University， from January 2015 to January 2022， and the patients were followed up for 12 months with the onset of HRS as the observation endpoint. According to the presence or absence of HRS， the 93 patients with SPSS were divided into HRS group with 38 patients （40.86%） and non-HRS group with 55 patients （59.14%）， and the two groups were compared in terms of clinical data， laboratory data， complication， and shunt diameter. Based on the maximum shunt vein diameter of 1.5 cm， the 93 patients with SPSS were divided into high shunt group with 52 patients （55.91%） and low shunt group with 41 patients （44.09%）， and with the onset of HRS as the observation endpoint， the two groups were compared in terms of the incidence rate of HRS and survival time curve. The independent-samples t test was used for comparison of normally distributed continuous data with homogeneity of variance between two groups， and the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic （ROC） curve was used to predict cut-off values， the Kaplan-Meier curve was used for comparison of survival time， and the Log-rank test was used to compare the differences in survival curves. The multivariate Cox regression analysis was used to investigate risk factors. ResultsCompared with the non-HRS group， the HRS group had significant increases in Child-Pugh score， Child-Pugh class， MELD score， serum creatinine， blood urea nitrogen， alanine aminotransferase， aspartate aminotransferase， maximum shunt vein diameter， the incidence rates of hepatic encephalopathy and spontaneous bacterial peritonitis， and the degree of ascites， as well as significant reductions in main portal vein diameter， serum sodium and albumin （all P<0.05）. Compared with the low shunt group， the high shunt group had a significant increase in the incidence rate of HRS （51.92% vs 26.83%， χ²=5.974， P=0.015） and a significant reduction in the time to the onset of HRS （Log-rank P=0.033）. A maximum shunt vein diameter of >1.5 cm （hazard ratio ［HR］=1.123， 95% confidence interval ［CI］： 1.041‍ ‍—‍ ‍1.211， P=0.003）， an increase in MELD score （HR=1.205， 95%CI： 1.076‍ ‍—‍ ‍1.437， P=0.039）， a reduction in serum albumin （HR=0.890， 95%CI： 0.814‍ ‍—‍ ‍0.974， P=0.011）， an increase in the degree of ascites （HR=2.099， 95%CI： 1.066‍ ‍—‍ ‍4.130， P=0.032）， and spontaneous bacterial peritonitis （HR=2.259， 95%CI： 1.020‍ ‍—‍ ‍5.003， P=0.045） were independent risk factors for the onset of HRS in SPSS patients. ConclusionThere is an association between SPSS and HRS， and shunt diameter >1.5 cm was an independent risk factor for HRS in SPSS patients， which should be taken seriously and require early intervention in clinical practice.

Objective: To understand the etiological characteristics of hand, foot and mouth diseases (HFMD) in Dezhou city from 2010 to 2018, and to provide laboratory evidence for its prevention and control. Methods: A total of 5 186 fecal specimens were collected from patients with HFMD. Real-time RT-PCR was used to detect enterovirus (EV) and analyze its pathogenic characteristics. Results: From 2010 to 2018, 5 186 samples of HFMD cases were detected in Dezhou, with a total positive rate of 71.75%, including 1 357 cases of EV-A71 (26.17%), 874 cases of CV-A16 (16.85%) and 1 490 cases of other Enteroviruses (28.73%). There were significant differences in the overall detection rate in each month. The peak period of detection rate was from June to August. The dominant virus strains with different types appeared dynamically in different years. EV-A71 was the predominant serotype in severe and aggregated cases. Laboratory confirmed cases were mainly children under 5 years old (96.25%). Conclusions From 2010 to 2018, the pathogen of HFMD in Dezhou city showed a dynamic change, with obvious seasonal distribution of cases and high incidence of specific population. Etiological surveillance should be strengthened to focus on prevention and control of high-risk population in high-risk season.

Objective To observe the clinical effects of treating hypertensive intracranial hemorrhage with microreseting and aspiration.Methods 49 cases of cranial hemorrhage were treated by drilling skull,pancturing and aspiration the hemorrhage with YL-1 needle and by liquaficating the hematoma after located by CT scan.The effects were observed ac- cording the ADL grading.Results Those cases of recovery and improvement were 37(75.5%),unwarrwnted dis- charged cases were7(14.3%)and deaths in5(10.2%).Of those37 cases,the Ⅰ～Ⅴ grade of ADL were 13, 17,5,2 cases and 0 case respectively during half-year.Conclusion This operation is safe,simple,convenient and effective.

Diquat is a kind of conductive contact-killing herbicides. The damage of central nervous system is relatively common, but the peripheral neuropathy caused by diquat has not been reported yet. In September 2021, we treated a patient with diquat poisoning. During the hospitalization, the patient was diagnosed with peripheral neuropathy. Therapy for peripheral nerve injury was given on the basis of conventional treatment of poisoning. The patient was discharged after his condition was stable. The follow-up showed that the peripheral neuropathy of patient was better than before. According to the condition of this patient, it is suggested that we should not only protect the function of gastrointestinal tract, liver, kidney, and central nervous system early, but should also pay attention to the damage of peripheral nervous system in clinical work. We should intervene earlier to improve the prognosis of patients.
Humans ; Diquat ; Herbicides ; Kidney ; Liver ; Peripheral Nerve Injuries ; Poisoning

OBJECTIVE: To explore the effect of shikonin on the recovery of nerve function after acute spinal cord injury(SCI) in rats. METHODS: 96 male Sprague-Dawley(SD)rats were divided into 4 groups randomly:sham operation group (Group A), sham operation+shikonin group (Group B), SCI+ DMSO(Group C), SCI+shikonin group (Group D).The acute SCI model of rats was made by clamp method in groups C and D . After subdural catheterization, no drug was given in group A. rats in groups B and D were injected with 100 mg·kg^-1 of shikonin through catheter 30 min after modeling, and rats in group C were given with the same amount of DMSO, once a day until the time point of collection tissue. Basso-Beattie-Bresnahan(BBB) scores were performed on 8 rats in each group at 6, 12, and 3 d after moneling, and oblique plate tests were performed on 1, 3, 7 and 14 d after modeling, and then spinal cord tissues were collected. Eight rats were intraperitoneally injected with propidine iodide(PI) 1 h before sacrificed to detection PI positive cells at 24 h in each group. Eight rats were sacrificed in each group at 24 h after modeling, the spinal cord injury was observed by HE staining.The Nissl staining was used to observe survivor number of nerve cells. Western-blot technique was used to detect the expression levels of Bcl-2 protein and apoptosis related protein RIPK1. RESULTS: After modeling, BBB scores were normal in group A and B, but in group C and D were significantly higher than those in group A and B. And the scores in group D were higher than those in group C in each time point (P<0.05). At 12 h after modeling, the PI red stained cells in group D were significantly reduced compared with that in group C, and the disintegration of neurons was alleviated(P<0.05). HE and Nissl staining showed nerve cells with normal morphology in group A and B at 24h after operation. The degree of SCI and the number of neuronal survival in group D were better than those in group C, the difference was statistically significant at 24h (P<0.05). The expression of Bcl-2 and RIPK1 proteins was very low in group A and B;The expression of RIPK1 was significantly increased in Group C and decreased in Group D, with a statistically significant difference (P<0.05);The expression of Bcl-2 protein in group D was significantly higher than that in group C (P<0.05). CONCLUSION Shikonin can alleviate the pathological changes after acute SCI in rats, improve the behavioral score, and promote the recovery of spinal nerve function. The specific mechanism may be related to the inhibition of TNFR/RIPK1 signaling pathway mediated necrotic apoptosis.
Animals ; Male ; Rats ; Dimethyl Sulfoxide/metabolism* ; Naphthoquinones ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Rats, Sprague-Dawley ; Spinal Cord/metabolism* ; Spinal Cord Injuries/metabolism* ; Receptors, Tumor Necrosis Factor/metabolism* ; Receptor-Interacting Protein Serine-Threonine Kinases/metabolism*

Opioid analgesics are currently known as the best analgesics. However， toxicity and side effects such as constipation， tolerance and addiction severely limit their clinical application. With the in-depth understanding of the signal transduction mechanism of opioid receptors and the continuous advancement of drug design technology， researchers have managed to develop many promising new methods to get low-toxic and more efficient opioid analgesics， which are different from the traditional morphine skeleton structure modifications. This article focuses on three new research strategies of G-protein biased activation，“ one drug-multiple targets” and peripheral activation. The basic principles of relative separation of analgesic activity and adverse drug reaction by each strategy are introduced， and the latest research progress of representative drugs is briefly reviewed. Among them， the recently approved novel opioid analgesics oliceridine and tegileridine are G-protein biased μ-opioid receptor agonists， Cebranopadol is a typical “one drug-multiple targets” analgesic， and NFEPP is a representative drug of peripheral opioid receptor agonists. The above several strategies complement each other and provide reference for the development of new opioid analgesic drugs.

OBJECTIVETo study the clinical effects of acromiocoracoid ligament transfer to repair coracoclavicular ligament and acromioclavicular ligament in the treatment of acromioclavicular joint dislocation of type Tossy III in young patients.

METHODSFrom January 2005 to January 2007, 52 patients with acromioclavicular joint dislocation of type Tossy III were divided into therapeutic group I (32 cases) and therapeutic group II (22 cases). There were 17 males and 13 females with an average age of 31.0 years (ranged, 19 to 40 years) in group I; as well as 12 males and 10 females with an average age of 33.6 years (ranged, 20 to 42 years) in group II. All the patients were fresh injury and the acromioclavicular joint dislocations were type Tossy III according to X-ray findings. The duration from damage to the operation time ranged from 2 to 17 days (averaged, 7.6 days). All the patients had normal shoulder function before injury and were treated with clavicular hook plate implantation. The patients in group II were treated with normal desmorrhaphy method, and the patients in group I were treated with acromiocoracoid ligament transfer to repair coracoclavicular ligament and acromioclavicular ligament. Steel plate was taken out at about 4 to 6 months after clavicular hook plate implantation. The results were evaluated according to Karlsson's standards.

RESULTSAll the incisions healed without infection. The therapeutic effects of 52 patients were evaluated at the 6th month after internal fixation was taken out. Twenty-four patients in group I got an excellent results and 6 good; 17 patients in group II got an excellent results and 5 good. There was no significant difference between the two groups. Twenty-six patients in group I and 19 patients in group II had long-term follow-up, and the duration ranged from 3 to 5 years (averaged, 4.5 years ). Twenty patients in group I got an excellent results and 6 good; 9 patients in group II got an excellent results, 7 good and 3 bad. Three patients in group II had recurrence of acromioclavicular joint dislocation. The long-term therapeutic effects of group I was better than that of group II.

CONCLUSIONAfter clavicular hook plate implantation in treating type Tossy III dislocation of the acromioclavicular joint in young patients, it was necessary to use acromiocoracoid ligament transfer to repair coracoclavicular ligament and acromioclavicular ligament, which can improve the stability of acromioclavicular joint to prevent dislocation recurrence.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Case-Control Studies ; Clavicle ; surgery ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; surgery ; Ligaments, Articular ; Male ; Treatment Outcome ; Young Adult

OBJECTIVES: To study the annual variation of diatoms in Zhangweixin River, to provide theoretical support by using diatom examination to estimate the time and place of the corpse entering water, and to establish a diatom database. METHODS: Samples were taken from 4 sampling sites in Decheng section of Zhangweixin River for 12 consecutive months. Non-metric multi-dimensional scaling (NMDS) analysis was performed on the species and content of diatom samples. Based on the sampling site of Tianqu Road, Sprensen similarity coefficient analysis was conducted with the data of other 3 sites in Decheng section and Leling section of Zhangweixin River and Ningjin section in previous studies. RESULTS: The number of diatom species was positively correlated with diatom content. The average diatom content in different months ranged from 1 054 to 13 041/10 mL, and the species composition ranged from 8 to 16, with differences in dominant species. The similarity coefficient of diatom species within 2 km were all higher than 0.956 52, which could not be distinguished effectively. The similarity coefficients of Leling section and Ningjin section were 0.736 84 and 0.588 24 respectively, which could be effectively distinguished. CONCLUSIONS The species and content of diatom vary in different months in Zhangweixin River, and the composition of diatom species is different in different basins, which can provide reference for estimating the time and place of the corpse entering water in the river.
Cadaver ; Diatoms ; Drowning/diagnosis* ; Humans ; Rivers ; Water