OBJECTIVE: To investigate the effect of relaxing needling at the contracted sites of meridian-muscle regions in the patients with post-stroke shoulder-hand syndrome (SHS) at acute stage. METHODS: Eighty patients with post-stroke SHS at acute stage were randomized into an observation group (40 cases, 1 case dropped out) and a control group (40 cases, 1 case was eliminated). In the control group, the routine medication, basic rehabilitation training, and hyperbaric oxygen therapy were administered. In the observation group, besides the treatment as the control group, relaxing needling was delivered at the contracted sites of meridian-muscle regions. These contracted sites were distributed along three yin meridians of hand and three yang meridians of hand on the affected upper limbs. The intervention was given once daily, 5 times a week and for 4 weeks. Before and after treatment, the scores of visual analogue scale (VAS) for pain, edema degree, modified Barthel index (MBI), and Fugl-Meyer assessment (FMA) for motor function, and the integrated electromyography (iEMG) of surface electromyogram (sEMG) were observed in the two groups. The curative effect was evaluated after treatment and in follow-up of 2 months after treatment in the two groups. RESULTS: After treatment, VAS scores and the scores of edema degree were reduced when compared with those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). MBI and FMA scores increased after treatment compared with those before treatment in the two groups (P<0.05), and the scores in the observation group were higher than those in the control group (P<0.05) after treatment. The iEMG values of the biceps brachii, triceps brachii, and wrist extensors were elevated after treatment in comparison with those before treatment (P<0.05) in the two groups, and the values in the observation group were larger than those in the control group after treatment (P<0.05). The total clinical effective rate in the observation group was 92.3% (36/39), which was better than that of the control group (74.4%, 29/39, P<0.05) after treatment; and that of the observation group was 97.4% (38/39), which was better than 82.1% (32/39) in the control group (P<0.05) in follow-up. CONCLUSION Relaxing needling at the contracted sites of meridian-muscle regions in treatment of post-stroke SHS at acute stage can attenuate the symptoms such as upper limb pain, swelling and spasm, improve motor function and the activity of daily living of patients.
Humans ; Male ; Female ; Middle Aged ; Acupuncture Therapy ; Aged ; Meridians ; Stroke/complications* ; Reflex Sympathetic Dystrophy/etiology* ; Adult ; Acupuncture Points

Objective To assess the feasibility of establishing a nude mouse model of endometriosis fibrosis of human origin and to determine whether endometrial mesenchymal stem cells are involved in inducing endometriosis fibrosis.Methods Four endometrial tissue specimens were collected and transplanted 1∶3 into 12 BABL/c nude mice by subcutaneous injection.The morphology and volume of the lesions were recorded.The nude mice were sacrificed on the 15th day after transplantation to observe the morphology of the lesions and their adhesion to the periphery of the abdominal wall.HE staining was used to judge the result of modelling,Masson staining was used to assess the extent of fibrosis,and immunofluorescence was used to track the role of endometrial mesenchymal stem cells in the fibrotic process of endometriosis.Results The volume of ectopic lesions in nude mice increased over time and showed restricted,vesicular-like changes.The tight adhesion of the lesions to the abdominal wall,endometrioid glands,and collagen fiber deposition were seen microscopically.The success rate of the modelling was 83.4%,and the collagen fiber volume fraction of the lesions was significantly higher after modelling(P＜0.01).Confocal imaging suggested that endometrial mesenchymal stem cells(SUSD2+)differentiated into myofibroblasts(α-SMA+)in vivo.Conclusions The nude mouse model established by human allogeneic transplantation via subcutaneous injection was consistent with the lesion characteristics of endometriosis fibrosis.The modelling method is simple and feasible and provides a better reference model for further investigating the pathogenesis of endometriosis fibrosis.In addition,in vivo observations using the model indicated that endometrial mesenchymal stem cells are involved in inducing the formation of endometriosis fibrosis.

Background: and Purpose The eye-movement examination can be applied as a noninvasive method to identify multiple-system atrophy (MSA). Few studies have investigated eye movements during the early stage of MSA with predominant parkinsonism (MSA-P). We aimed to determine the characteristic oculomotor changes in the early stage of MSA-P. Methods: We retrospectively selected 17 patients with MSA-P and 40 with Parkinson’s disease (PD) with disease durations of less than 2 years, and 40 age-matched healthy controls (HCs).Oculomotor performance in the horizontal direction was measured in detail using videonystagmography. Results: We found that the proportions of patients with MSA-P and PD exhibiting abnormal eye movements were 82.4% and 77.5%, respectively, which were significantly higher than that in the HCs (47.5%, p<0.05). Compared with HCs, patients with MSA-P presented significantly higher abnormal proportions of fixation and gaze-holding (17.6% vs. 0%), without-fixation (47.1% vs. 0%), prolonged latency in reflexive saccades (29.4% vs. 5.0%), memory-guided saccades (93.3% vs. 10.0%), and catch-up saccades in smooth-pursuit movement (SPM, 41.2% vs. 0) (all p<0.05). Compared with those with PD, patients with MSA-P presented a significantly higher proportion of catch-up saccades in SPM (41.2% vs. 2.5%, p<0.001). Conclusions MSA-P presented the characteristic of catch-up saccades in SPM in the early stage, which may provide some value in differentiating MSA-P from PD.

Objective:This study aims to explore the impact of various clinical factors on the risk of polymyxin B induced DKI in patients.Methods:This is a single-center retrospective case-control study. A total of 139 patients receiving polymyxin B intravenous treatment in our hospital from January 1 to December 31, 2020 were collected. Baseline variables between polymyxin B induced DKI group and non-DKI group were compared using the Chi-square test or Fisher's exact test for categorical variables and the T-test or Wilcoxon rank sum test for continuous variables, as appropriate. Statistical analysis was performed using univariate and multivariate Logistic regression models, Logistic regression models, multivariate Logistic regression models, Kaplan Meier curve, as well as Log-Rank test.Results:Among a total of 139 patients receiving polymyxin B treatment, 49 cases have experienced DKI, 90 cases did not. The incidence of DKI was 35.25%. There was no statistical difference in general information of age, gender, and proportion of standard weight between the two groups. Among the related indexes of polycolistin B administration, the proportion of high daily dose [>25 000 U/(kg·d)] and the total dosage of medication in the DKI group were both significantly higher than that in the non-DKI group ( P< 0.05, respectively). Among the organ function indexes, there were significant differences in initial serum creatinine, blood urea nitrogen, uric acid, urinary occult blood and urinary specific gravity between DKI group and non-DKI group 48 hours before polymyxin B administration ( P< 0.05). Binary Logistic regression analysis suggested that daily dose and initial creatinine before medication were independent risk factors for DKI caused by polymyxin B ( P< 0.05). Kaplan-meier survival analysis showed that with the accumulation of Polymyxin B administration, the higher the daily dose of Polymyxin B was, the faster the DKI occurred (Log-Rank P= 0.0194). Conclusions:Using intravenous polymyxin B is associated with the risk of DKI, among which higher initial blood creatinine values and higher daily doses are independent risk factors for DKI.

Objective:To compare the efficacy of domestic and imported hemostatic clips in preventing delayed post-polypectomy bleeding (DPPB) after endoscopic resection of colorectal polyps ≥ 10 mm.Methods:Clinical data of 789 patients who underwent endoscopic resection of colorectal polyps (polyp diameter ≥10 mm) in Beijing Friendship Hospital, Capital Medical University from January 2018 to December 2019 were collected. The patients were divided into DPPB group ( n=15) and non-DPPB group ( n=774). Univariate and multivariate logistic regression models were used to analyze the influential factors for DPPB. The patients using one type of hemostatic clip were divided into the domestic hemostatic clip group ( n=499) and the imported hemostatic clip group ( n=208). The efficacy of hemostatic clips in preventing DPPB in the two groups was compared. Results:Among the 789 patients undergoing endoscopic resection of colorectal polyps, 1.9% (15/789) suffered from DPPB. Multivariate logistic regression analysis showed that pedunculated polyp was an independent risk factor for DPPB ( OR=6.621, 95% CI: 2.278-19.241, P=0.001), and closure of mucosal defect was an independent protective factor for DPPB ( OR=0.169,95% CI: 0.050-0.570, P=0.004). Regardless of physician experience, there was no significant difference between the domestic and imported hemostatic clip group in preventing DPPB after endoscopic resection of colorectal polyps ≥10 mm [experienced physicians: 1.8% (7/385) VS 0.6% (1/175), χ2=1.314, P=0.445; common physicians: 2.6% (3/114) VS 3.0% (1/33), χ2=0.010, P>0.999]. The domestic hemostatic clip group paid for less medical expenses than the imported hemostatic clip group (experienced physicians: 1 433.51±889.02 yuan VS 3 033.97±1 686.87 yuan, t<0.001 , P<0.001; common physicians: 1 181.58±815.29 yuan VS 3 303.46±1 690.43 yuan, t<0.001 ,P<0.001). Conclusion:Pedunculated polyp is an independent risk factor for DPPB after endoscopic resection of colorectal polyp larger than 10 mm, and clipping can significantly reduce the risk for DPPB. There is no significant difference in the prevention of DPPB between domestic and imported clips, but domestic clips compared with imported clips yield less medical burden, which are suitable for promotion to primary hospitals and major clinical centers.

Perilla (Perilla frutescens L.) is an important edible-medicinal oil crop, with its seed containing 46%-58% oil. Of perilla seed oil, α-linolenic acid (C18:3) accounts for more than 60%. Lysophosphatidic acid acyltransferase (LPAT) is one of the key enzymes responsible for triacylglycerol assembly in plant seeds, controlling the metabolic flow from lysophosphatidic acid to phosphatidic acid. In this study, the LPAT2 gene from the developing seeds of perilla was cloned and designated as PfLPAT2. The expression profile of PfLPAT2 gene was examined in various tissues and different seed development stages of perilla (10, 20, 30, and 40 days after flowering, DAF) by quantitative real-time PCR (qRT-PCR). In order to detect the subcellular localization of PfLPAT2 protein, a fusion expression vector containing PfLPAT2 and GFP was constructed and transformed into Nicotiana benthamiana leaves by Agrobacterium-mediated infiltration. In order to explore the enzymatic activity and biological function of PfLPAT2 protein, an E. coli expression vector, a yeast expression vector and a constitutive plant overexpression vector were constructed and transformed into an E. coli mutant SM2-1, a wild-type Saccharomyces cerevisiae strain INVSc1, and a common tobacco (Nicotiana tabacum, variety: Sumsun NN, SNN), respectively. The results showed that the PfLPAT2 open reading frame (ORF) sequence was 1 155 bp in length, encoding 384 amino acid residues. Functional structure domain prediction showed that PfLPAT2 protein has a typical conserved domain of lysophosphatidic acid acyltransferase. qRT-PCR analysis indicated that PfLPAT2 gene was expressed in all tissues tested, with the peak level in seed of 20 DAF of perilla. Subcellular localization prediction showed that PfLPAT2 protein is localized in cytoplasm. Functional complementation assay of PfLPAT2 in E. coli LPAAT mutant (SM2-1) showed that PfLPAT2 could restore the lipid biosynthesis of SM2-1 cell membrane and possess LPAT enzyme activity. The total oil content in the PfLPAT2 transgenic yeast was significantly increased, and the content of each fatty acid component changed compared with that of the non-transgenic control strain. Particularly, oleic acid (C18:1) in the transgenic yeast significantly increased, indicating that PfLPAT2 has a higher substrate preference for C18:1. Importantly, total fatty acid content in the transgenic tobacco leaves increased by about 0.42 times compared to that of the controls, with the C18:1 content doubled. The increased total oil content and the altered fatty acid composition in transgenic tobacco lines demonstrated that the heterologous expression of PfLPAT2 could promote host oil biosynthesis and the accumulation of health-promoting fatty acids (C18:1 and C18:3). This study will provide a theoretical basis and genetic elements for in-depth analysis of the molecular regulation mechanism of perilla oil, especially the synthesis of unsaturated fatty acids, which is beneficial to the genetic improvement of oil quality of oil crops.
Acyltransferases ; Cloning, Molecular ; Escherichia coli/metabolism* ; Fatty Acids ; Perilla frutescens/metabolism* ; Plant Oils ; Plant Proteins/metabolism* ; Saccharomyces cerevisiae/metabolism* ; Seeds/chemistry* ; Tobacco/genetics*

Objective:To explore the characteristics of illness perceptions and its effect on quality of life in adult epileptics.Methods:A cross-sectional study was conducted to evaluate 98 adult patients with epilepsy and 75 diabetic patients hospitalized at the same period.The Chinese illness perception questionnaire revised edition(CIPQ-R) was used to evaluate the differences in illness perception factors between the two groups.The quality of life in epilepsy-31(QOLIE-31) was used to assess the quality of life of 98 adult epilepsy patients and 55 healthy people, and the correlation analysis and multivariate regression analysis were used to investigate the effect of illness perceptions on the quality of life of epileptic patients.Results:The emotional representations factor score of CIPQ-R in the epilepsy group(21.73±5.79) was higher than that in the diabetes group (18.76±5.42) ( P<0.01). The scores of timeline acute/chronic, personal control and illness coherence factors of CIPQ-R in the epilepsy group((16.47±4.68), (20.91±4.03), (15.21±4.44)) were lower than those in the diabetes group ((19.16±4.75), (22.68±3.90), (16.56±3.73)) ( P<0.05). The scores of multiple factors in the quality of life scale of patients with epilepsy were lower than those in healthy controls( t=-2.264--8.203, P<0.01). Correlation analysis showed that the emotional statement dimension and consequences factors in CIPQ-R were significantly negatively correlated with the total scores of QOLIE-31 and all the other factors it belongs to ( r=-0.202--0.527, P<0.05); the identity, timeline acute/chronic, and timeline cyclical factors in CIPQ-R were negatively correlated with the total score of QOLIE-31 ( r=-0.272--0.342, P<0.01); the treatment control and illness coherence factors in CIPQ-R were positively correlated with the total score of QOLIE-31 ( r=0.259, r=0.307, P<0.01). Multiple stepwise linear regression showed that the identity, timeline acute/chronic, consequences, timeline cyclical, and emotional representations factors were important factors influencing the quality of life of adults with epilepsy. Conclusion:Adult epileptics have certain negative illness perceptions.Among them, identity, timeline acute/chronic, consequences, timeline cyclical and emotional representations factors have significant effects on the quality of life of adult epileptics.

Objective:To explore the effect of different intensity electrical stimulation combined with biofeedback pelvic floor muscle training on postpartum pelvic floor dysfunction (PFD) in vaginal delivery patients.Methods:Seven hundred and twenty patients with PFD after vaginal delivery from January 2017 to April 2019 in Jinshan Branch of Shanghai Sixth People′s Hospital were selected. The patients were divided into control group (358 cases) and observation group (362 cases) by random digits table method. The control group was treated with conventional electric stimulation combined with biofeedback pelvic floor muscle training, and the observation group was treated with enhanced electric stimulation combined with biofeedback pelvic floor muscle training. The electrophysiological indexes of pelvic floor, incidence of stress urinary incontinence (SUI), pelvic organ prolapse/urinary incontinence function questionnaire (PISQ-12) score and the 6 measurement points of quantitative stage of pelvic organ prolapse (POP-Q) staging method after treatment were compared between 2 groups. The 6 measuring points were 3 cm from central line of anterior wall of vagina to edge of the hymen (Aa point), furthest point in the upper part of anterior wall of vagina between top of vagina or anterior vault to Aa point (Ba point), 3 cm point from central line of vaginal posterior wall to hymen (Ap point), farthest point of posterior vaginal vault or upper part of posterior vaginal wall from top of vagina to Ap point (Bp point), farthest point of the top of vagina after cervix or hysterectomy (C point) and position of posterior fornix in presence of cervix (D point).Results:The fatigue degree of class Ⅰ muscle fibers, fatigue degree of class Ⅱ muscle fibers, average electromyography value of pre rest, average electromyography value of slow muscle, average electromyography value of post rest, maximum electromyography value of fast muscle and dynamic vaginal pressure in observation group were significantly better than those in control group: (- 2.51 ± 0.22)% vs. (- 3.29 ± 0.37)%, (- 2.89 ± 0.27)% vs. (- 3.18 ± 0.32)%, (3.41 ± 0.39) μV vs. (2.91 ± 0.28) μV, (30.12 ± 0.22) μV vs. (28.29 ± 0.37) μV, (3.14 ± 0.55) μV vs. (2.51 ± 0.30) μV, (39.89 ± 0.27) μV vs. (38.18 ± 0.32) μV and (76.92 ± 28.18) cmH 2O(1 cmH 2O=0.098 kPa) vs. (69.10 ± 30.66) cmH 2O, and there were statistical differences ( P<0.01). The incidence of SUI and PISQ-12 score in observation group were significantly lower than those in control group: 14.36% (52/362) vs. 27.09% (97/358) and (28.49 ± 3.61) scores vs. (37.62 ± 3.83) scores, and there were statistical differences ( P<0.01). The Aa, Ba, Ap and C points in observation group were significantly improved than those in control group: (- 2.69 ± 0.21) cm vs. (- 2.38 ± 0.13) cm, (- 2.30 ± 0.52) cm vs. (- 2.21 ± 0.33) cm, (- 2.91 ± 0.35) cm vs. (- 2.85 ± 0.24) cm and (- 5.33 ± 065) cm vs. (- 5.20 ± 056) cm, and there were statistical differences ( t=2.365, 2.469, 2.691 and 2.889; P<0.05); there were no statistical differences in Bp and D points between 2 groups ( P>0.05). Conclusions:After vaginal delivery, the patients with PFD who use strong electric stimulation combined with biofeedback pelvic floor muscle training can significantly improve the pelvic floor electrophysiological index and POP-Q staging, reduce the incidence of SUI, and improve the quality of sexual life.

Objective To evaluate the effect of compound glycyrrhizin on the prevention and cure of cytarabine syndromes. Methods A total of 130 patients with hematological malignancies treated by moderate or high dose of cytarabine in the 303th Hospital of PLA from July 2010 to July 2016 were included. Patients were randomly divided into the control group and the experiment group by using random number table method, and each group had 65 patients. In the control group, patients were treated with cytarabine alone. In the experiment group, patients were treated with cytarabine plus compound glycyrrhizin. Skin rash and fever in patients of the two groups were also recorded. Results of blood routine tests, liver and kidney function tests were monitored during the treatment. Results Sixty-one patients in the experiment group and 63 patients in the control group were enrolled finally. In experiment group and control group, the differences in the incidence of cytarabine syndromes [8.2 % (5/61) vs. 41.3 % (26/63), χ2＝ 18.1, P < 0.001], skin rash [1.6 % (1/61) vs. 12.7 % (8/63), χ2＝16.3, P <0.001], and fever [6.6 % (4/61) vs. 36.5 % (23/63), χ2＝5.63, P <0.017] were statistically significant. There was no significant difference of the incidence of liver injury and minimum blood cell count between the two groups (P＞ 0.05). Conclusion Compound glycyrrhizin can effectively reduce the incidence of cytarabine syndromes, but the larger size and multiple center studies are needed to further verify the effect.

Objective To explore the clinical effect of free postnatal delivery in the second stage of labor, and to provide evidence for clinical midwifery. Methods From March 2016 to November 2017, 120 maternity patients from the First People′s Hospital of Hefei were selected and divided into research group and control group, using simple random grouping and the method of random number table, with 60 cases in each group. At the second stage of delivery, the research group used free body position at different stages, while the control group took the position of supine bladder lithotomy position. The delivery outcome, duration of the second stage, postpartum vaginal bleeding within two hours, newborn asphyxia rate, degree of perineal laceration, perineum incision rate, delivery comfort and satisfaction and midwives job satisfaction were compared. Results The vaginal delivery rate of the research group was 96.7％(58/60), which was higher than that of the control group 86.7％ (52/60). The difference was statistically significant (χ2=3.93, P<0.05). The duration of the second stage in the research group was (31.97 ± 9.85) minutes, and that of the control group was (39.50 ± 12.19) minutes. There was a statistically significant difference between the two groups (t=-3.357, P<0.05). There was no significant difference in neonatal asphyxia rate and the amount of postpartum vaginal bleeding within 2 hours between the two groups (P>0.05). The perineum integrity rate in the research group was 10.4％(6/58), higher than that in the control group, which was 0. Perineal side cut rate in the research group was 0, lower than that in the control group, which was 21.1％(11/52). The difference was statistically significant (χ2=11.31, 13.63, P<0.05). Deliverycomfort, delivery satisfaction and midwives job satisfaction in the research group were 91.7％ (55/60), 100.0％ (60/60) and 100.0％ (60/60) respectively, while delivery comfort, delivery satisfaction and midwives job satisfaction in the control group were 38.3％(23/60), 83.3％(50/60) and 76.7％(46/60). The differences were statistically significant (χ2=37.51, 10.91, 15.85, P<0.05). Conclusion The second labor stage free position is effective safe childbirth way of delivery, which can improve the natural births, shorten the labor, lighten the perineal injury, improve the puerpera childbirth comfort and satisfaction, it also raised the midwives job satisfaction, and had no adverse effect on maternal and infant outcomes, so the method has clinical application and dissemination value.