Objective To observe the clinical efficacy of enhanced external counterpulsation (ECP) in the treatment of non-proliferative diabetic retinopathy (NPDR).Methods It was a case-control study.83 patients (166 eyes) of NPDR were randomly divided into ECP treatment group (ECP group) and conventional therapy group (drug group) by date of visit odd and even number,each with 42 patients of 84 eyes and 41 patients of 82 eyes respectively.The blood glucose,glycated hemoglobin (HbAlc),low-density lipoprotein (LDL-C),corrected visual acuity,stages of diabetic retinopathy (DR) and hemodynamic index such as peak systolic velocity (PSV),diastolic velocity (EDV),resistance index (RI) of ophthalmic artery (OA) and central retinal artery (CRA) were not statistically different between these two groups (P＞ 0.05).All patients were regularly educated for lifestyle management and diabetes mellitus.The following parameters were controlled by drugs including blood glucose＜8.0 mmol/L,HbA1c＜7.5 ％,blood pressure ＜140/90 mmHg (1 mmHg=0.133 kPa) and LDL-C＜3.1 mmol/L.The ECP group received both ECP and medical treatments.The ECP parameters were gasbag pressure 0.35-0.45 kg/cm2,40 min/each time,1 time/d.35 days of ECP was one course,one course each year for 3 years.The treatment effectiveness was determined at the end of follow-up after 3 years of treatment.The blood glucose,HbA1c,blood pressure,LDL-C,visual acuity,fundus changes and hemodynamic index of OA and CRA before and after treatment were comparatively analyzed.Improved or stable visual acuity and fundus condition was judged as effective treatment.Results At latest follow up,the differences of blood glucose,HbA1c,blood pressure and LDL-C were not statistically significant (P＞0.05).Compared to drug group,the PSV and EDV of OA and CRA were increased,but RI of OA and CRA was decreased in ECP group (P＜0.05).The vision effective ratio was 91.67％ and 30.49％ in ECP group and drug group respectively with a significant different (x2 =65.56,P＜0.05).The fundus effective ratio was 92.86％ and 48.78％ in ECP group and drug group respectively with a significant different (x2 =43.38,P＜ 0.05).During follow-up,1 eye (1.19％) progressed to proliferative DR (PDR) in ECP group,while 6 eyes (7.32％) progressed to PDR in drug group.The difference of PDR incidence rate between two groups was significant (x2 =3.87,P＜ 0.05).During the ECP treatment,there were 2 patients with small blisters in the skin of lower limb and cured finally.There were no other treatment-related complications.Conclusion ECP in the treatment for NPDR can improve PSV and EDV,reduce RI of OA and CRA;improve vision and fundus state,reduce the incidence of PDR.

Objective To explore the functional activation cerebral areas evoked by mechanical stimulation induced pruritus perception imitating physiological process.Methods Scratching the planta gently to induce pruritus with brush pen wool in a group of 16 healthy volunteers,scanning BOLD-fMRI serials with a block design on a 3.0 T MR machine,and identifying the functional cerebral areas evoked by pruritus with SPM8 software for analysis.Student's t test was used to compare the difference of incidences with P＜0.05 for statistical significance.Results Several brain regions were activated by pruritus stimulus.The strongest activation evoked by pruritus was found at the contralateral thalamus and paracentral lobule(t=5.26,5.23),the most activation volumes were found at the contralateral paracentral lobule,postcentral gyrus and prefrontal lobule(146,151 and 326 volumes).Different degrees of activation were discovered at bilateral insula,preeentral and postcentral gyrus,thalamus,lentiform nucleus and cingulated gyrus.Conclusion The postcentral gyrus,paracentral lobule,insula,precentral gyrus and frontal lobe were the functional activation cerebral areas of pruritus perception evoked by mechanical stimulation.

Objective To evaluate the long-term clinical efficacy and toxicities of combined intracavitary hyperthermia and radiotherapy fur locally advanced uterine cervical cancer. Methods 310 patients with locally advanced uterine cervical cancer were assigned into intracavitary hyperthermia + radiotherapy group(TRT, 181 patients) and external-beam radiotherapy + traditional intracavitary radiation group (RT,129 patients). The external-beam radiotherapy were given with 60Co γ-my or 6-8 MV X-ray in traditional fractionation. In TRT group,radiotherapy was 40 Gy using the anterior-posterior pelvic fields and additional 20-25 Gy using the lateral fields. Hyperthermia was delivered by the 915 MHz microwave hyperthermia device within 15-60 min after external radiotherapy for 10-12 times(40 min each time,1-2 times per week). The temperature of tumor surface was 46-47℃. In the RT group, the external-beam radiotherapy of 40 Gy was delivered using the anterior-posterior pelvic fields. The intracavity radiotherapy of radium was delivered before 1989 ,with 50 mg radium in the vagina and 30 mg in uterine cavity for 24 hours ,weekly for 3 times to a total dose of 7200 mg·h. After 1989,intraeavity radiotherapy of 192Ir was delivered to a total dose of 30-36 Gy to point A in 5-6 Gy fractions,2 fractions per week. Results The 5-year survival of patients in TRT group and RT group was 67.4% versus 52.1% for stage Ⅱ disease (χ2=7.55,P=0.006), and 60.0% vemus32.3% forstage Ⅲ (χ2=7.06,P=0.007) . The 10-year survival was46.5% versus42.6% for stage Ⅱ (χ2=3.90,P=0.058), and 43.7% versus 20.6% for stage Ⅲ(χ2=17.28,P=0.000). Cox regression analysis showed that the tumor stage(P=0.023) and intracavitary hyperthermia( P=0.019) were prognostic factors. According to the RTOG criteria, the rate of mild to moderate late side effects of rectum and bladder in TRT and RT group was 17.7% and 33.1%, respectively (χ2=9.18, P=0.002). Rectovaginal fistula was developed in5 patients(3.9% ) in RT group and I patient (0.6%) in TRT group(χ2= 4.38,P=0.036). Conclusions The long-term survival of patients with stage Ⅲ uterine cervical cancer is better of TRT group than RT group. The TRT is well tolerated and the late toxicity rate is obviously low. It is necessary to carry out large randomized clinical trials to confirm these outcomes.

Objective:To investigate the clinical effect of focused ultrasound ablation surgery (FUAS) combined with suction curettage for mass-type cesarean scar pregnancy (CSP) and to analyze the influencing factors of vaginal bleeding and readmission.Methods:From January 2014 to December 2020, 88 patients with mass-type CSP were treated by FUAS combined with suction curettage in the Third Xiangya Hospital of Central South University. The clinical results and the influencing factors of bleeding and readmission for mass-type CSP were analyzed.Results:All the patients underwent one time FUAS treatment successfully. Immediately after FUAS treatment, color Doppler ultrasound showed obvious necrosis and no perfusion area in all lesions, and the blood flow in the mass-type CSP tissue significantly decreased. The median volume of blood loss in the procedure was 20 ml (range: 5-950 ml). Thirteen patients (15%, 13/88) had vaginal bleeding≥200 ml, and 15 patients (17%, 15/88) were hospitalized again. The average time for menstruation recovery was (28±8) days (range: 18-66 days). The average time needed for serum human chorionic gonadotropin-beta subunit to return to normal levels was (22±6) days (range: 7-59 days). The risk of large vaginal bleeding of patients were related to the blood supply of the mass ( OR=5.280, 95% CI: 1.335-20.858, P=0.018) and the largest diameter of the mass ( OR=1.060, 95% CI: 1.010-1.120, P=0.030). The risk of readmission were related to the largest diameter of the mass ( OR=1.055, 95% CI: 1.005-1.108, P=0.030) and the depth of the uterus cavity ( OR=1.583, 95% CI: 1.015-2.471, P=0.043). No serious complications such as intestinal and nerve injury occurred during and after FUAS treatment. Conclusions:FUAS combined with suction curettage is safe and effective in treating patients with mass-type CSP through this preliminary study. The volume of vaginal bleeding are associated with the blood supply of the mass and the largest diameter of the mass, the risk of readmission are related to the largest diameter of the mass and the depth of the uterus cavity.

Objective To establish the theories and methods for the compatibility of Chinese patent medicines in pre-scription review.Methods Based on the prescription combination theory and the classics literatures of traditional Chinese med-icine,the methods of prescription suitability review for the compatibility of Chinese patent medicines were discussed.Results Based on the examples of the compatibility of Chinese patent medicines,five basic principles of combined Chinese patent medi-cines and the key points for reviewing the combined Chinese patent medicines dosage form were discussed in detail.Conclusion The methods for the compatibility of Chinese patent medicines prescription review have been established,which can provide a theoretical reference for the review of combined Chinese patent medicines prescriptions.

In recent years, with the development of metabolic reprogramming research, people have changed their understanding of the biological effects of immune cells. Under the stimulation of inflammatory response, immune cells re-regulate their metabolism and bioenergetics, provide energy and substrates for cell survival, and initiate immune effect functions. Nod-like receptor protein 3 (NLRP3) inflammasome, as an important component of the innate immune system, has been shown to sense metabolites such as uric acid and cholesterol crystals, and can be inhibited by metabolites such as ketones. It is also regulated by mitochondrial reactive oxygen species and glycolytic components (such as hexokinase). Recent studies have shown that a variety of metabolic pathways converge as effective regulators of NLRP3 inflammasome. The paper reviews the metabolic regulatory pathways and specificity of NLRP3 inflammasome activation, and its role in renal diseases.