[Objective]To explore the inheritance status and academic characteristics of SHI's acupuncture and moxibustion school in northern Zhejiang,and to further enrich the connotation of Xiushui medical school.[Methods]Using the method of reviewing and researching the traditional medical history literature and modern literature,the origin,inheritance and academic characteristics of SHI's acupuncture and moxibustion were excavated,analyzed and sorted out.[Results]The culture of traditional Chinese medicine in northern Zhejiang is profound,there are many genres of acupuncture and moxibustion,and many famous doctors and scholars.The more influential schools of acupuncture and moxibustion are LING,SHI,YAN,SHENG and JIN,which have been passed down from generation to generation and innovated repeatedly.As one of the typical representatives,SHI's acupuncture has a long history,active inheritance and rich content.In clinical practice,great importance is attached to the spleen and stomach,and the treatment principle is to strengthen the spleen and benefit the stomach,warm and transport Yang Qi of middle-Jiao,and be good at applying warm acupuncture,so that Qi can be warmed and operated easier,and the acupuncture can be helped to regulate Qi.SHI's acupuncture also pays attention to the combination of acupuncture and moxibustion,and the combination of acupuncture and medicine to improve clinical efficacy.SHI's descendants are constantly innovating while inheriting and keeping the right,so as to enrich the disease spectrum,enrich the treatment methods and improve the clinical efficacy.[Conclusion]In the process of continuous inheritance and innovation,SHI's acupuncture has gradually formed a diagnosis and treatment system with acupuncture characteristics in northern Zhejiang,which can provide learning and reference for clinical practice.

Objective    To analyze the risk factors for neurological complications after emergency surgery of acute type A aortic dissection. Methods    The clinical data of 51 patients with acute Stanford type A aortic dissection who were admitted to Shanghai Delta Hospital from October 2018 to May 2019 were retrospectively analyzed. There were 37 males (72.5%) and 14 females (27.5%), aged 29-85 (55.1±12.3) years. The patients were divided into two groups, including a N1 group (n=12, patients with postoperative neurological insufficiency) and a N0 group (n=39, patients without postoperative neurological insufficiency). The clinical data of the two groups were compared and analyzed. Results    There were statistical differences in age (62.6±11.2 years vs. 51.7±11.4 years, P=0.003), preoperative D-dimer (21.7±9.2 μg/L vs.10.8±10.7 μg/L, P=0.001), tracheal intubation time (78.7±104.0 min vs. 19.6±31.8 min, P=0.003), ICU stay time (204.1±154.8 min vs. 110.8±139.9 min, P=0.037) and preoperative coagulation factor activity R (4.0±1.5 vs. 5.1±1.6, P=0.022). Preoperative coagulation factor activity R was the independent risk factor for neurological insufficiency after emergency (OR=2.013, 95%CI 1.008-4.021, P=0.047). Conclusion    For patients with pre-emergent acute aortic dissection who are older (over 62.6-64.5 years), with reduced coagulation factor R (less than 4.0), it is recommended to take more active brain protection measures to reduce the occurrence of postoperative neurological complications in patients with acute aortic dissection, and further improve the quality of life.

In recent years, more and more studies had found that ferroptosis regulated the death of nerve cells in the process of ischemic stroke. The ferroptosis of nerve cells was composed of three pathways: iron metabolism, lipid metabolism and amino acid metabolism. During ischemic stroke, the abnormal intake and excretion of iron in nerve cells with the pathway of iron pathway made the increase of intracellular free iron cause Fenton reaction; the up-regulation of acyl-coenzyme A synthetase long-chain family member 4 and lipoxygenase in lipid pathway promoted the transformation of polyunsaturated fatty acids into lipid peroxides on cell membrane; the abnormality of cystine/glutamate reverse transporter and glutathione peroxidase 4 in amino acid pathway led to the excessive accumulation of lipid peroxides. These pathways were related to each other and eventually led to ferroptosis of nerve cells. Here, the relationship between ischemic stroke and ferroptosis was summarized, in order to provide new ideas for the diagnosis and treatment of ischemic stroke.

Objective:To explore the application value of three dimensional T 1 weighted sampling perfection with application-optimized contrasts by using different flip angle evolutions (3D T 1-SPACE) combined with three dimensional time of flight MR angiography (3D-TOF MRA) in the follow-up of stent-assisted coil embolization for intracranial aneurysm. Methods:From December 2017 to October 2018, 25 patients with intracranial aneurysm who underwent stent-assisted coil embolization in Henan Provincial People′s Hospital were enrolled. All of them had wide neck intracranial aneurysms and were followed up for 6 to 10 months after endovascular treatment using 3D-TOF MRA, 3D T 1-SPACE sequence and DSA. The DSA and 3D-TOF MRA were performed to evaluate aneurysm remnants using Raymond grade scale. Meanwhile, 3D-TOF MRA and 3D T 1-SPACE sequence were performed to evaluate in-stent lumen visibility using the 4-point scale. The paired sample Wilcoxon test was used to evaluate the aneurysm remnants and the parent artery patency. DSA was used as the gold standard to calculate the specificity and accuracy of the aneurysm remnants evaluated by 3D-TOF MRA. Results:Six to ten months′ follow up after the procedure, for aneurysm occlusion, the Raymond grade scale of the 25 patients evaluated by DSA indicated grade 1 in 23 patients, 2 in 1 and 3 in 1. For patients evaluated by 3D-TOF MRA, the results demonstrated grade 1 in 21 patients, 2 in 3 and 3 in 1. There was no difference between the 2 methods ( Z=-0.557, P=0.577). The in-stent lumens of parent vessel evaluated by 3D-TOF MRA showed that there were 14 patients with grade 3, 8 patients with grade 2 and 3 patients with grade 1. However, 3D T 1-SPACE demonstrated that all 25 patients were grade 4. The 3D T 1-SPACE was superior to evaluate the in-stent lumens than 3D-TOF MRA ( Z=-4.484, P<0.001). Taking DSA as standard, the specificity and accuracy of the aneurysm remnants evaluated by 3D-TOF MRA were 86.9% (20/23) and 84.0% (21/25), respectively. Conclusion:3.0 T 3D T 1-SPACE MR sequence can be used to assess parent artery patency, with in-stent lumen being clearly visible. 3D-TOF MRA can evaluate intracranial aneurysm remnants. The combination of these two MRI imaging techniques can be used as an optional follow-up evaluation after the endovascular treatment of intracranial aneurysms.

Objective:To compare procedural parameters and perioperative complications between the first-generation Pipeline embolization device (PED Classic) and the second-generation Pipeline embolization device (PED Flex).Methods:A total of 53 patients who underwent intracranial aneurysm treatment with the PED Classic from February 2015 to August 2016 and 118 patients who underwent treatment with the PED Flex from January 2018 to July 2019 at Zhengzhou University People's Hospital were enrolled in this retrospective study. Procedure time, contrast dosage, fluoroscopy time and perioperative complications in the two groups were recorded. Independent sample t-test was performed to analyze the difference of procedure time, contrast dosage and fluoroscopy time between the two groups, and Chi-square test was performed to analyze the perioperative complications. Results:There were 53 cases with 73 aneurysms in the PED Classic group and 118 cases with 146 aneurysms in the PED Flex group. The procedure time was (159.0±42.0) min in the PED Classic group, and (121.9±46.0) min in the PED Flex group. The difference was statistically significant ( t=5.012, P<0.001). The contrast dosage was (156.4±39.4) ml in the PED Classic group and (110.1±38.5) ml in the PED Flex group. The difference was statistically significant ( t=7.229, P<0.001). The difference of fluoroscopy time between PED Classic group and PED Flex group was also statistically significant ( t=10.196, P<0.001), with the average of (34.7±5.7) min and (22.8±7.6) min, respectively. The perioperative complications rate in the PED Classic group (9.4%, 5/53) was higher than that of the PED Flex group (2.5%, 3/118), but there was no statistical significance between the two groups (χ 2=2.503, P=0.114). Conclusion:The use of PED Flex seems safe in treating intracranial aneurysms, and the device deployment is easier compared with the use of PED Classic. However, serious complications remain to be noted.

OBJECTIVETo observe the safety and efficacy of biological patch (Biodesign Surgisis mesh, SIS) in hybrid technique for incisional herniorrhaphy.

METHODSClinical and follow-up data of 14 incisional hernia patients who underwent incisional herniorrhaphy with hybrid technique, using porcine small intestinal submucosa acellular matrix patch, at the First Affiliated Hospital of Sun Yat-sen University from January 1, 2012 to June 31, 2016 were analyzed retrospectively. This Biodesign Surgisis patch for incisional hernia is produced by the Cook company in the United States. The size of patch ranged from 9 cm × 15 cm to 20 cm × 25 cm. During operation, according to abdominal wall defect, the patch was cut to ensure the distance from its edge to the border of abdominal wall defect more than 5 cm.

RESULTSThere were four male and tenfemale patients with average age of (67.7±11.6) years and average body mass index(BMI) of (25.5±1.7) kg/m². As for operative history of these 14 cases, 7 cases had gastrointestinal tumor surgery, 2 had appendectomy, 1 had upper abdominal white line hernia repair, 1 had hysterectomy, 1 had cholecystectomy, 1 had splenectomy plus portal vein dissection, and 1 had right kidney and right ureter total resection plus partial excision of bladder wall. Ten casesdeveloped incisional infection after previous surgery. The duration of incisional hernia ranged 1 to 180 months (median, 8 months). Two cases were refractory hernia, 1 was incarcerated hernia, and 11 were reversible hernia. The locations of incisional hernia included 4 cases of right ventral wall, 1 case of left ventral wall, 2 cases of supra-umbilical incision, 4 cases of infra-umbilical midline incision, and 3 cases of peri-umbilical midline incision. There were 3 cases of middle incisional hernia, 5 cases of large incisional hernia and 6 cases of huge incisional hernia. All the patients completed operations eventlessly. The average operative time was (202.5±72.9) minutes. The average length and width of hernia ring were (10.9±4.3) cm and (9.3±3.9) cm, respectively. Clean operation was performed in 11 cases, potential contaminative operation in 2 cases and contaminative operation in 1 case. The amount of operative bleeding was (15.0±4.8) ml. The NRS pain scores within 24 hours after the operation, at POD3 and at POD7 were 5.1±0.9, 4.2±0.7 and 3.7±0.9, respectively. The time to flatus after operation was (2.5±0.9) days and the time to liquid diet was (3.8±1.2) days. No patient died during the perioperative period. The average hospitalization time was (21.5±12.0) days. Postoperative complications occurred in 8 cases, including 4 cases of fever, 8 cases of incision complications, 4 cases of abdominal infection, 4 cases of intestinal obstruction, 5 cases of effusion under patch, 2 cases of pneumonia, and 1 case of acute myocardial infarction. According to the Clavien-Dindo classification, 3 cases were grade zero, 3 cases were grade I(, 6 cases were grade II(, 1 case was grade III(, and 1 case was grade IIII(. Thirteen patients received follow-up and the average follow-up time was (33.2±12.3) (18.2-61.0) months. One patient died of cerebral infarction 38 months after operation. The chronic abdominal pain or discomfort was found in 4 cases. The recurrent incisional hernia developed in 5 cases and the average time of recurrence was (11.0±8.3) months.

CONCLUSIONSBiological patch can be used safely and effectively in hybrid technique for incisional herniorrhaphy. However, the morbidity of postoperative complication and the risk of recurrence are high. Terefore, the long-term outcome is still subject to observation.

Aged ; Animals ; Bioprosthesis ; Female ; Follow-Up Studies ; Hernia, Ventral ; surgery ; Herniorrhaphy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Surgical Mesh ; Swine

OBJECTIVE: To observe the clinical efficacy of long-time needle retaining at Baihui (GV 20) on post-stroke cognitive disorder of deficiency and blood stasis. METHODS: A total of 70 patients (3 cases dropping) with post-stroke cognitive disorder of deficiency and blood stasis were randomized into an observation group (34 cases) and a control group (33 cases). Neurological routine treatment and western medicine rehabilitation therapy were given in the control group as the basic treatment, on the basis of the treatment as the control group, long-time needle retaining at Baihui (GV 20) was applied in the observation group. The treatment was given once every other day, 3 times a week for a total of 4 weeks. The National Institute of Health stroke scale (NIHSS), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and deficiency blood stasis syndrome scale score were observed before and after treatment, and the clinical efficacy was compared between the two groups. RESULTS: After 4 weeks of treatment, the NIHSS scores of the two groups were lower than those before treatment (both <0.01), and the MMSE and MoCA scores were higher than those before treatment (<0.05, <0.01), and the scores in the observation group were better than those in the control group (all <0.01). After treatment, the scores of deficiency and blood stasis syndrome were lower than those before treatment (all <0.01). The scores of the shortness of breath, facial color, tongue pulse and dizziness in the observation group were better than those in the control group (all <0.05), there was no significant difference in the degree of spontaneous sweating between the two groups (>0.05). The total effective rate was 94.1% (32/34) in the observation group, which was higher than 75.8% (25/33) in the control group (<0.05). CONCLUSION Long-time needle retaining at Baihui (GV 20) is safe and effective in treating with post-stroke cognitive disorder of deficiency and blood stasis.
Cognition ; Cognition Disorders ; etiology ; therapy ; Humans ; Qi ; Stroke ; complications ; Treatment Outcome

Objective To evaluate the feasibility of transvenous embolization treatment for cerebral arteriovenous malformations(bAVM). Methods From November 2016 to April 2017, the information of 6 patients with brain arteriovenous malformation in our center accepting the intravenous radical embolization were collected, who were ruptured bAVM, bAVM with a single drainage vein, not suitable for surgery confirmed by neurosurgeon consultation or explicitly refused craniotomy. The modified Rankin Scale score of five patients were smaller than three before treatment.The location of draining vein flowing venous sinus was shown by rotational DSA and 3D reconstructed images.A liquid embolic agent was injected via Sonic catheter to completely embolism the brain arteriovenous malformation under controlling blood pressure and blocking the blood provisionally.The perioperative complications and modified Rankin Scale score were observed and recorded 30 days after treatment. Results The transvenous embolization treatment was successfully performed in six patients with 7 embolization procedures.There were no definite operation-related complications. the mRS of all cases were ≤1 within 30 days after operation. Conclusion The embolization technique via the internal jugular vein is feasible for bAVM patients with a single drainage vein,while the long-term outcome need more evaluations.

The secondary structures of hepatitis C virus (HCV) RNA and the cellular proteins that bind to them are important for modulating both translation and RNA replication. However, the sets of RNA-binding proteins involved in the regulation of HCV translation, replication and encapsidation remain unknown. Here, we identified RNA binding motif protein 24 (RBM24) as a host factor participated in HCV translation and replication. Knockdown of RBM24 reduced HCV propagation in Huh7.5.1 cells. An enhanced translation and delayed RNA synthesis during the early phase of infection was observed in RBM24 silencing cells. However, both overexpression of RBM24 and recombinant human RBM24 protein suppressed HCV IRES-mediated translation. Further analysis revealed that the assembly of the 80S ribosome on the HCV IRES was interrupted by RBM24 protein through binding to the 5'-UTR. RBM24 could also interact with HCV Core and enhance the interaction of Core and 5'-UTR, which suppresses the expression of HCV. Moreover, RBM24 enhanced the interaction between the 5'- and 3'-UTRs in the HCV genome, which probably explained its requirement in HCV genome replication. Therefore, RBM24 is a novel host factor involved in HCV replication and may function at the switch from translation to replication.
Cells, Cultured ; Hepacivirus ; genetics ; growth & development ; metabolism ; Humans ; Protein Biosynthesis ; RNA-Binding Proteins ; metabolism ; Virus Replication ; genetics

Objective: To observe the effect of acupuncture, tuina plus rehabilitative therapy on lower limb motor dysfunction in infants with spastic cerebral palsy.
Methods:A total of 60 infants with spastic cerebral palsy were randomly divided into a treatment group and a control group by random digital table, 30 cases in each group. The treatment group was treated with acupuncture, tuina therapy plus rehabilitative therapy of Western medicine. The control group was simply treated with rehabilitative therapy of Western medicine, as same as that for the treatment group. The assessment was respectively given to the sick infants before the treatment and after the treatment of six months, to evaluate lying and rolling scores in dimension A, to evaluate sitting score in dimension B, to evaluate crawling and kneeling scores in dimension C, and evaluate standing score in dimension D in the gross motor functions and determine the muscle tone of the gastrocnemius muscle by modified Ashworth scale (MAS).
Results:The differences were not statistically significant in comparison of the gross motor functions and the muscle tone of the gastrocnemius muscle between the two groups of sick infants before the treatment (P>0.05); after the treatment of six months, the above items were obviously improved in the two groups (P<0.01), better in the treatment group than in the control group, with the statistical significance in the differences between the groups (P<0.01).
Conclusion:Acupuncture, tuina plus rehabilitative therapy of Western medicine are remarkable in the therapeutic effects in the treatment of motor disorders of the lower limbs in the sick infants with spastic cerebral palsy. This therapeutic method is safe, simple and convenient and needs to be clinically popularized and applied.