The conception of evidence-based medicine (EMB) has a strong influence on the medical world since it built up.This concept has been widely used in all sorts of clinic and basic medical research,however,it is little reported to be practised in our fundamental medical education.As for it,this article will briefly analyze the importance of introducing the idea into fundamental medical education,and for one thing,suggest some more reform measures for medical teaching staff.

Abundant experiences have already been accumulated in treatment of stroke with acupuncture. Development of rehabilitation theory also brings unprecedented opportunity and challenge to acupuncture. Combined with the modern rehabilitation theory and practice, it is very helpful to deepen the understanding on treatment of acupuncture for cerebral apoplexy and enhance the therapeutic effect in clinic by studying the mechanism of acupuncture treatment, opportunity of intervention, selection of acupoints, needling manipulations and quantity of stimulations etc. Through analysis on the necessity and the way of combination of acupuncture and modern rehabilitation, it is concluded that rehabilitation evaluation, rehabilitation phases and obstacle analysis should be taken as references by acupuncturists to reinforce the therapeutic effect and creditability of acupuncture treatment on cerebral apoplexy.
Acupuncture Therapy ; methods ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Stroke ; therapy ; Stroke Rehabilitation

Objective To observe the clinical features and prognosis of endogenous bacterial endophthalmitis (EBE).Methods Ten eyes of 10 patients diagnosed with unilateral EBE were retrospectively reviewed,including 7 males and 3 females.The mean age was 57.6± 10.8 years old.Eight patients were with diabetes and 7 of them were diagnosed over 5 years.There were 3 patients with hepatocirrhosis,1 patient with hypertension,and 1 patient with coronary disease.Nine cases had infectious diseases,including liver abscess (7 cases),pulmonary infection (3 cases),erysipelas (1 case) and perianal abscess (1 case).Seven cases had fever history.Culture and drug sensitive tests for aerobic bacteria,anaerobic bacteria and fungal were performed for 9 eyes using vitreous samples from the procedures of vitrectomy and/or intravitreal injection.All patients were treated with broad-spectrum antibiotics and adjusted for drug use according to microbiological culture and drug sensitivity test results.After the diagnosis was established,vitrectomy combined with lens removal was performed in 5 hours (3 eyes) and 24 hours (5 eyes);Vitreous tamponade of C3F8 (1 eye) and silicone oil (7 eyes) was used;At the end of the operation,0.1 ml vancomycin (1 mg) and 0.1 ml ceftazidime (1 mg) were injected into the vitreous cavity.One eye received intravitreal injection of 0.1 ml vancomycin (1 mg) and 0.1 ml ceftazidime (mg),one eye received evisceration.During the follow up period from 6 to 24 months,visual function,slit lamp and fundus examinations were performed at each office visit.Results All patients complained of blurred vision and 5 patients had ocular pain.The visual acuity was no light perception (3 eyes),light perception (5 eyes);hand motion (1 eye) and 0.1 (1 eye).Corneal edema was found in all 10 eyes;hypopyon in 8 eyes;diffuse vitreous opacity in 10 eyes,including 3 eyes with retinal detachment.For 8 eyes treated by vitrectomy and intravitreal injection,1 eye was eviscerated due to uncontrolled inflammation.The eye treated with intravitreal injection was enucleated for its uncontrolled inflammation.For 9 eyes received vitreous culture and drug testing,8 eyes (88.9％) had positive results,including 5 eyes with Klebsiellar pneumonia,and 1 eye with Staphylococcus aureus,or Streptococcus agalactiae or Enterococcus faecalis respectively.At last office visit,2 eyes were with no light perception;4 eyes were with hand motion;and 1 eye with visual acuity of 0.1.Conclusions Most of the patients with endogenous bacterial endophthalmitis have systemic predisposing factors.Klebsiella pneumoniae is the leading cause of ocular EBE.Vitrectomy combined with intravitreal injection of antibiotics showed efficacy in treating EBE.

Objective:In this paper, based on the 4D dose distribution of the treatment plan, the effects of respiratory movement on the dose distribution of three-dimensional conformal radiation therapy (3DCRT) and sliding window intensity-modulated radiation therapy (SW-IMRT) techniques were analyzed, and the dose errors caused by respiratory movement based on the 4D dose distribution were evaluated.Methods:In this study, the dynamic thoracic phantom (CIRS-008A) was used to simulate the patient with a 3 cm spherical insert as the tumor. Four motion patterns were simulated with cos 4( x) and sin ( x) wave forms of 10 mm and 5 mm amplitudes. The 4DCT scans with the phantom were performed in different breathing modes, and the maximum intensity projection (MIP), average intensity projection (AIP) and 10 separate 4DCT phase images were transferred to the Eclipse treatment planning system. The targets were contoured on MIP, with corresponding 3DCRT and SW-IMRT plans designed and dose calculated on AIP. By copying the plan designed on the AIP to each phase image of the 4DCT set, the MATLAB software package was employed to register and superimpose all the phase-specific doses onto one of the reference phase to create a 4D-accumulated dose distribution. Both films (EBT2) and optically stimulated luminescence (OSLD) detectors were inserted in and around the target area of the phantom to measure the delivered doses. The calculated 4D-accumulated doses were compared to the measured doses and their differences were evaluated using Gamma analysis. Results:Under different respiration modes, the average Gamma index (3%/3 mm) passing rates between the 4D-accumulated doses and EBT2-measured doses for 3DCRT and SW-IMRT plans were (98.8±0.78)% and (96.4±1.89)%, respectively. The absolute measurements of OSLDs both inside and outside of the target area well matched the 4D-accumulated doses.Conclusions:4DCT can be effectively applied to evaluate the treatment plan dose distribution through 4D dose accumulation, which can potentially avoid cold spots and target under-coverage. Under different respiration modes, both 3DCRT and SW-IMRT plans provide dose measurements consistent with those predicted by the 4D-accumulated dose of treatment plan.

Haploinsuffieiency of the runt-related transcription factor 2 (Runx2) gene is widely known to be responsible for cleidocranial dysplasia (CCD).To date,more than 190 mutations in Runx2 gene have been reported to be related to CCD.In this study,a novel mutation of Runx2 gene was observed in a female with CCD.Genomic DNA was extracted from peripheral venous blood of the proband and eleven members of her family.Genetic testing on these twelve people identified a novel missense mutation (c.895T＞C,Y299H) in exon 5 of the RUNX2 gene in the proband.This mutation results in an amino acid change at codon 895 (P.Tyr 299 His.) from a tryptophan codon (TAT) to a histidine codon (CAT).Our finding may further extend the known mutation spectrum of the RUNX2 gene,and facilitate prenatal genetic diagnosis of CCD in the future.

Alzheimer disease (AD) is one of the most common types of dementia.Serotonin (5-HT) plays an important role in the pathogenesis of AD,causing alterations in patients' cognitive abilities,as well as learning and memory capabilities,by regulating the cholinergic and glutamatergic neurotransmission through the signal transduction pathway.Patients suffer from emotional disorders including depression and apathy and clinical manifestations such as unrestrained diet,which are all related to the signaling function of 5-HT receptors.Strengthening the 5-HT receptor-mediated transduction pathway and increasing the concentration of synaptic 5-HT have been used as a novel therapy for delaying the progression of AD.This articles reviews the AD therapies targeting 5-HT transduction pathway.

OBJECTIVETo observe the efficacy difference between meridian cosmetology and western medicine in the treatment of chloasma and explore the impacts of meridian cosmetology on E2 and PRGE.

METHODSThree hundreds cases of chloasma were randomized into a meridian cosmetology group and a western medication group according to the visit sequence, 150 cases in each one. In the meridian cosmetology group, the meridian regulation, acupuncture based on pattern/syndrome differentiation [at the body acupoints such as Qihai (CV 6), Xuehai (SP 10), Zusanli (ST 36), Sanyinjiao (SP 6), Ganshu (BL 18), Pishu (BL 20) and Shenshu (BL 23), etc.] and the local surrounding needling therapy on the chloasma skin lesion were adopted. In the western medication group, the oral administration of Vitamin C and E was prescribed for 3 months. The clinical efficacy was observed for the patients in the two groups. Additionally, 30 cases were collected from the meridian cosmetology group randomly for the detection of estrogen (E2) and progestin (PRGE) before and after treatment.

RESULTSThe effective rate in the meridian cosmetology group was 92.6% (126/136), which was superior to 67.0% (75/112) in the western medication group (P < 0.05). For the patients collected from the meridian cosmetology group, as compared with that before treatment, E2 level was decreased (P < 0.01) and PRGE level was increased (P < 0.05).

CONCLUSIONThe meridian cosmetology achieves the superior efficacy as compared with the western medication group for the chloasma and it can regulate the levels of E2 and PRGE.

Acupuncture Therapy ; Adult ; Cosmetic Techniques ; Estrogens ; metabolism ; Female ; Humans ; Melanosis ; metabolism ; therapy ; Meridians ; Progestins ; metabolism ; Young Adult

Objective:To systematically evaluate the effect of cognitive behavioral therapy (CBT) in elderly patients with depression.Methods:The randomized controlled trials on the effect of CBT in elderly patients with depression, published until December 15, 2022, were searched in PubMed, CINHAL, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, WanFang Data, and VIP. Two researchers independently screened the literature, extracted data, and used the revised Cochrane risk of bias tool for randomized trials (ROB 2.0) to evaluate the quality of the included studies. Statistical analysis was conducted using Stata 16.0, and the quality of evidence was rated using Appraisal of Guidelines for Research and Evaluation (GRADE) predictor software.Results:A total of 11 randomized controlled trials were included, with a total of 833 elderly patients with depression. Randomized effect models were used to analyze outcome indicators such as depression, anxiety, and quality of life by combining effect quantities. Meta-analysis and GRADE evidence quality showed that compared to the control group, medium quality evidence showed that CBT could relieve depression in elderly depression patients with a statistical difference [ SMD=-1.58, 95% CI (-2.16, -0.99), P<0.05]. Low quality evidence suggested that CBT could alleviate anxiety in elderly depression patients also with a statistical difference [ SMD=-2.25, 95% CI (-4.04, -0.47), P<0.05]. Very low quality evidence indicated that CBT did not significantly improve the quality of life in elderly depression patients compared to conventional or pharmacological treatment [ SMD=-0.09, 95% CI (-2.07, 1.88), P>0.05] . Conclusions:Existing evidence suggests that CBT can alleviate depression and anxiety in elderly depression patients, but its improvement in quality of life is not yet significant. Treatment feedback and forms of CBT may become a research focus in recent years on intervention for elderly depression patients.

OBJECTIVESTo study the effects of tumor suppressor in lung cancer-1 (TSLC1) on human hepatocyte carcinoma cell line HepG2.

METHODSA full length of TSLC1 cDNA was amplified from RNA of normal human liver cells by RT-PCR, and it was cloned into a pCI-neo expression vector and transfected into human hepatocellular carcinoma cell line HepG2. The HepG2 cells transfected with this plasmid (experimental group) and those treated with pCI-neo vector (control group) and without any treatment (blank group) were compared. Cell morphology was studied microscopically and cell growth was analyzed with MTT assay. FACSort flow cytometry analysis was performed to assess the cell cycle distribution and apoptosis.

RESULTSA stable cell line expressing TSLC1 protein was successfully established. Morphologically, cells of the experimental group were tightly aggregated when compared with those of the control and blank groups. The growth of TSLC1-transfected cells was significantly suppressed in vitro compared with those of the control and blank groups. The amount of G0-G1 cells was 63.66%+/-3.83% (P less than 0.01) in the experimental group, while those of the control and blank groups were 47.45%+/-0.91% and 54.47%+/-0.96% respectively. The amount of S phase cells in the experimental group, 22.90%+/-6.04%, was significantly lower (P less than 0.05) than that of the control group (36.58%+/-0.61%) and the blank group (33.61%+/-2.99%), which suggested a G0-G1 cell cycle arresting. The number of cells in early and late phase apoptosis (17.09%+/-0.20% and 16.11%+/-0.40% respectively) were significantly higher than those of the control and blank groups (P less than 0.01).

CONCLUSIONSTSLC1 strongly inhibits the growth of HepG2 cells in vitro and induces apoptosis of the cells, suggesting that TSLC1 may have a tumor suppressor function in HCC.

Apoptosis ; genetics ; Cell Adhesion Molecule-1 ; Cell Adhesion Molecules ; Cell Proliferation ; Hep G2 Cells ; Humans ; Immunoglobulins ; genetics ; Membrane Proteins ; genetics ; Transfection ; Tumor Suppressor Proteins ; genetics

OBJECTIVETo investigate the effect of apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like 3G (APOBEC3G) mediated antiviral activity against hepatitis B virus (HBV) and duck hepatitis B virus (DHBV).

METHODSTotal RNA was extracted from peripheral blood mononuclear cells (PBMCs), RT-PCR product was cloned into the EcoR I/Hind III restriction sites of the CMV-driven expression vector fused with a hemagglutinin fusion epitope tag at its carboxyl terminal. Replication competent 1.3 fold over-length HBV was constructed with full-length HBV of ayw subtype. The mammalian hepatoma cell HepG2 was cotransfected with the replication competent 1.3 fold over-length HBV and various amounts of CMV-driven expression vector encoding APOBEC3G-HA. Levels of HBsAg and HBeAg in the media of the transfected cells were determined by ELISA, HBV DNA. RNA from intracellular core particles was examined using Northern and Southern blot analyses. Chicken hepatoma cell LMH was cotransfected with head-to-tail dimer of an EcoR I monomer of DHBV and various amounts of CMV-driven expression vector encoding APOBEC3G-HA. DHBV DNA from intracellular core particles was examined using Southern blot analysis.

RESULTSCMV-driven expression vector encoding APOBEC3G-HA and replication competent 1.3 fold over-length HBV were constructed. There was a dose dependent decrease in the levels of intracellular core-associated viral (HBV and DHBV) DNA and extracellular production of HBsAg and HBeAg. Levels of intracellular core-associated viral RNA were also decreased, but the expression of HBcAg remained almost unchanged.

CONCLUSIONAPOBEC3G suppresses HBV and DHBV replication and also suppresses HBsAg and HBeAg expression.

APOBEC-3G Deaminase ; Cytidine Deaminase ; genetics ; Hep G2 Cells ; Hepatitis B Surface Antigens ; metabolism ; Hepatitis B Virus, Duck ; physiology ; Hepatitis B e Antigens ; metabolism ; Hepatitis B virus ; physiology ; Humans ; RNA, Messenger ; genetics ; Virus Replication