Objective To study effect of TCM-based syndrome differentiation combined with diet nursing and point massage on insomnia.Methods Five hundred and twelve patients with insomnia were randomized into control group(n=85)and intervention group (n=67).The patients in both groups received treatment by TCM-based syndrome differentiation.Besides,the control group was given conventional nursing while those in the intervention group received diet nursing and point massage.The two groups were compared in three months in terms of sleep quality and curative effect.Results In comparisons of sleep quality index,the two groups both had statistically significant improvements respectively(both P<0.05).In terms of time to sleep, duration of sleep an sleep efficacy and Pittsburg sleep quality index,the intervention group scored significantly lower than the control group(all P<0.05).In terms of curative effect,the intervention group was significantly higher than the control group(P<0.05).Conclusion The method of TCM-based syndrome differentiation combined with diet nursing and point massage is effective in improving the sleep quality of those with insomnia.

Objective To study the effect of extended nursing on puerperal melancholia incidence.Methods Two hundred perpetrates received interventions of extended nursing after delivery,including education about puerperal state,turning on hot line and creation of QQ group,follow-ups and supporting from family members.Result The incidence rate of puerperal melancholia since performance of extended nursing was significantly lower than what is after its performance(P<0.01).Conclusions The extended nursing can help perpetrates to receive nursing knowledge,alleviate their anxiety,strengthen the confidence to take care of baby.As the result,it can reduce the incidence of puerperal melancholia.

Picrotoxin is an anatagninst of gamma-aminobutyric acid, which is an internal inhibition-transmitter in the central nervous system, Picrotoxin exerts a biphasic action on the blood pressure and heart rate in rats and cats in vivo. That is to say, in the initial stage, picrotoxin can lower the blood pressure and heart rate, and then an elevation of these two even above the original level can be observed, up to the present, from the authors limited literature, there has been no report dealing with the problem whether picrotoxin can act on an isolated heart directly.In this study, the heart of a frog was isolated and routine intubation of the heart was done for its perfusion. Physiological polyconduction instrument was inserted through a mechanical transducer to record the heart rale and myocardial contractility. A suspending glass microelectrode coupling with a microamplifier is used to record the action potential of the ventricular myocardium. Real time analysis of all the data was accomplished with a microcomputer. The dosages of picrotoxin used were 1,5, 3.0, 6.0, and 12.0 mg per kilogram of body weight.It was found that picrotcxin can directly act on the isolated frog heart. The results were as follows.1 ) Picrotoxin exerts inhibition on the special conduction system of the heart,and the A-V node and venous sinus are very sensitive. Complete or partial transmission block can be induced.2 ) It can elicit clearly a fall of the heart rate but no biphasic action can berevealed. 3) It can reduce the myocardial contractility, suggesting that the calciuminflow during the functioning period of the action potential is effected. 4 ) It can reduce the amplitude of the action potential but no effect on themaximal depolarization speed is observed, suggesting that picrotoxin islikely to affect the level of resting potential but not the action potentialin the depolarized period.

Objective:To explore the effect of group visits on health condition among follow-up patients with chronic heart failure.Methods:Totally 126 outpatient follow-up patients with heart failure were divided into intervention group and control group by random number table from 2018 to 2019. The intervention group consisted of 63 cases and control group consisted of 59 cases. The intervention lasted 6 months. The intervention group received group visits, while the control group received routine outpatient follow-up. Medication adherence, quality of life and heart failure related indicators were evaluated at baseline and after 6 months of intervention.Results:At 6 months after intervention, the scores of medication adherence, total quality of life, body, emotion and others dimensions of the intervention group were (5.79±1.38), (30.11±8.22), (12.65±5.53), (5.24±4.57) and (12.22±4.76) points. These scores of the control group were (5.31±1.09), (37.26±9.02), (15.87±5.21), (7.03±5.14), (14.36±5.54) points. The differences between the two groups were statistically significant ( t values were -4.581-2.161, P<0.05 or 0.01). The BNP and proportion of New York Heart Association (NYHA) I the intervention group were (180.87±174.92) ng/L and 84.1% (53/63). These indicators of the control group were (351.02±268.13) ng/L and 67.8% (40/59). The differences between the two groups were statistically significant ( t value was -4.177, χ2 value was 4.484, P<0.01 or 0.05). Conclusions:Group visits program is an effective management mode to provide intensive patient education and foster peer support, improving medication adherence and quality of life of follow-up patients with heart failure.

Hirayama disease(HD),also known as juvenile muscular atrophy of the distal upper extremity,is featured by concealed onset clinically and often occurs in male adolescence.In most cases,one or both of the asymmetrical distal muscles of the upper extremities are weak and atrophied without objective sensory abnormalities and this disease naturally stops developing after several years.Early Hirayama disease is similar to motor neuron diseases in clinical symptoms like amyotrophic lateral sclerosis.The limitation of medical diagnostic techniques and the lack of understanding by clinicians lead to a higher rate of misdiagnosis of Hirayama disease,making their treatment plan and prognosis completely different.Therefore,a timely and accurate diagnosis of Hirayama disease is essential.In recent years,domestic and foreign scholars conducted researches in the diagnosis of Hirayama disease mainly through clinical manifestation combined with the magnetic resonance imaging of the cervical flexion position and the application of various neurophysiological detection techniques.As the number of clinical cases gradually increases,Hirayama disease draws more attention of clinicians and there are more and more reports and researches on related cases.With the development of research and application of imaging and neuroelectrophysiological techniques,the importance and effectiveness of early diagnosis and treatment of the disease have been affirmed and emphasized,thus people acquire a better understanding of its pathogenesis,clinical diagnosis and treatment.Especially for those suspected patients with juvenile muscular atrophy of the distal upper extremity,it is more important to be vigilant against the possibility of Hirayama disease.Based on this reality,this paper will discuss the new understanding and research progress of pathogenesis,clinical diagnosis and treatment of Hirayama disease,which is very important for clinicians to better understand and pay more attention to this disease.

Objective    To discuss the feasibility of establishment of animal model of "functional" bicuspid aortic valve with swine and observe its effect on the wall shear stress inside the aorta. Methods    Four common Shanghai White Swine with body weight between 50 kg to 55 kg were selected. Under general anesthesia and cardiopulmonary bypass, the aortic transverse incision approach was used, continuous suture with 6-0 polypropylene to align the left and right coronary valve leaflets to create a bicuspid valve morphology. After the operation, echocardiography was used to observe the aortic valve morphology and the hemodynamic changes of the aortic valve orifice. The effect on the wall shear stress inside the aorta was studied with 4D-Flow magnetic resonance imaging (MRI). Results    A total of 4 swine "functional" bicuspid aortic valve models were established, with a success rate of 100.0%. Echocardiography showed that the blood flow velocity of the aortic valve orifice was faster than that before the operation (0.96 m/s vs. 1.80 m/s). 4D-Flow MRI showed abnormally increased wall shear stress and blood flow velocity in the aorta of the animal models. After the surgery, in model animals, the maximal wall shear stress inside the ascending aorta was greater than 1.36 Pa, and the maximum blood flow velocity was greater than 1.4 m/s. Conclusion    Establishment of the animal model of "functional" bicuspid aortic valve in swine is feasible, scientific and reliable. It can be used in researches on evaluating the pathophysiological changes.

Severe muscle injury is hard to heal and always results in a poor prognosis. Recent studies found that extracellular vesicle-based therapy has promising prospects for regeneration medicine, however, whether extracellular vesicles have therapeutic effects on severe muscle injury is still unknown. Herein, we extracted apoptotic extracellular vesicles derived from mesenchymal stem cells (MSCs-ApoEVs) to treat cardiotoxin induced tibialis anterior (TA) injury and found that MSCs-ApoEVs promoted muscles regeneration and increased the proportion of multinucleated cells. Besides that, we also found that apoptosis was synchronized during myoblasts fusion and MSCs-ApoEVs promoted the apoptosis ratio as well as the fusion index of myoblasts. Furthermore, we revealed that MSCs-ApoEVs increased the relative level of creatine during myoblasts fusion, which was released via activated Pannexin 1 channel. Moreover, we also found that activated Pannexin 1 channel was highly expressed on the membrane of myoblasts-derived ApoEVs (Myo-ApoEVs) instead of apoptotic myoblasts, and creatine was the pivotal metabolite involved in myoblasts fusion. Collectively, our findings firstly revealed that MSCs-ApoEVs can promote muscle regeneration and elucidated that the new function of ApoEVs as passing inter-cell messages through releasing metabolites from activated Pannexin 1 channel, which will provide new evidence for extracellular vesicles-based therapy as well as improving the understanding of new functions of extracellular vesicles.
Creatine/metabolism* ; Extracellular Vesicles ; Muscle, Skeletal/metabolism* ; Myoblasts/metabolism* ; Regeneration ; Connexins/metabolism*