Objective:To observe the clinical efficacy of extemal application of Chinese medicine following tapping using a plum-blossom needle for allergic rhinitis.Methods:All 328 cases were randomized into an observation group of 206 cases,Chinese medicine group of 70 cases and point application group of 52 cases.Results:The differences between the observation and Chinese medicine groups (P＜0.01) and between the observation and point application group (P＜0.05) were both of statistical meaning.The cases in the observation obtained the best effect,the point application group obtained a moderate effect and the Chinese medicine group obtained the least effect.A younger age and an increased number of treatments contributed to a better effect.Conclusion:External application of Chinese medicine following tapping using a plum-blossom needle is safe and effective for allergic rhinitis.

Objective To explore the clinical curative effect of pidotimod on patients with respiratory tract infection and effect on immune function. Methods 120 children with recurrent respiratory tract infection in the Third Hospital of Qinhuangdao,the Third Staff Hospital of Baogang Group,the Third Hospital of Wulanchabu were selected,and were divided into two groups according to random number table.60 cases in control group were treated with routine treatment of anti-infection,relieving cough,eliminating phlegm,antipyretic;60 cases in experimental group were treated with pidotimod on the basis of routine treatment,oral with boiled water,0.4g per times,2 times a day,with a course of 60 days.Clinical curative effect after treatment and serum immunoglobulin (IgG,IgA,IgM)levels,T lymphocyte subsets (CD3+,CD4+,CD8+)levels and NK cells relative activities before and after treatment were compared between two groups.Results After treatment,the total effective rate of experimental group (95.00%)was significantly higher than that of control group (81.67%),and the difference was statistically significant (P<0.05);the immune indexes before treatment had no significant difference,and levels of serum immunoglobulin and T lymphocyte subsets were improved,and levels of serum immunoglobulin (IgG,IgA,IgM)and T lymphocyte subsets (CD3+,CD4+,CD8+)of experimental group were more higher than those of control group,and the difference was statistically significant (P<0.05 );relative activity of NK cells in both groups improved after treatment,but relative activity of NK cells in experimental group was significantly higher than that in control group,and the difference was statistically significant (P<0.05 );adverse reactions according minor rashes and anemia were observed in two groups,and there was no significant differece in the incidence of adverse reactions,and ADR was tolerable after symptomatic treatment.Conclusion Pidotimod could significantly improve the clinical curative effect of patients with respiratory tract infections and effectively improve the immune function of patients with recurrent respiratory tract infections with high security,which has a clinical significance.

Objective To observe the influence of coal-burning type of fluorosis on hypothalamic-pituitaryovary axis function and to explore possible mechanism in female rats.Methods Sixty SD rats were divided into two groups according to body weight with the method of random number table:control group and fluorosis group,30 rats in each group.Fluorosis group was feed with corn powder baked by high fluorine coal from Zhijin area.Changes of female rats' teeth during fluorine exposure were observed.After feeding for 180 days,24 h urine was collected in estrus and fluorine level was tested using fluoride ion-selective electrode; rats were executed and bone fluorine level was tested with high-temperature ashing-fluorine ion-selective electrode.Femoral artery blood was collected and serum was separated to test the contents of follicle stimulating hormone (FSH),luteinizing hormone (LH),testosterone (T),estradiol (E2) and progesterone (P) with electrochemiluminescence radioimmunoassay and gonadotropin-releasing hormone (GnRH),inhibin (INH) with enzyme-linked immunosorbent assay (ELISA),respectively.Organs,including hypothalamus,pituitary gland and ovary were weighted,and organ coefficients were calculated.Pathological morphology of hypothalamus,pituitary gland and ovary was observed after staining and ultrastructure of ovary was examined by electron microscopy.Results Coal-burning induced fluorine poisoning rat model was established successfully.There were no significant differences statistically in organ coefficients between fluorosis groups (0.032 ± 0.004,0.014 ± 0.008,0.037 ± 0.009) and controls (0.035 ± 0.005,0.012 ± 0.006,0.035 ± 0.004,t =0.46,0.87,0.64,all P ＞ 0.05).Rats serum GnRH,FSH,LH and T levels [(21.654 ± 4.765),(29.580 ± 5.221),(53.988 ± 6.506),(23.962 ± 2.255)μg/L] of fluorosis groups were all higher than those of controls [(10.384 ±2.250),(19.217 ± 4.743),(30.314 ± 4.443),(7.883 ± 1.973)μg/L,t =6.762,4.646,9.503,16.971,all P ＜ 0.05].But the level of P,INH [(12.635 ± 3.841),(18.926 ± 3.465)μg/L] were all lower than those of controls [(21.045 ±4.768),(48.076 ± 3.525)μg/L,t =4.344,18.649,all P ＜ 0.05].Serum E2 levels of control group and fluorosis group were (35.375 ± 10.662) and (27.500 ± 12.783)μg/L,respectively.The difference between groups was not statistically significant (t =1.821,P ＞ 0.05).No pathological changes were observed in the two groups of female hypothalamus,pituitary tissue by light microscopy and electron microscopy.Under light microscope,in the control group of normal ovarian tissue,more corpus luteum and different developmental stages of follicles were seen,granulosa cells were neatly arranged in a monolayer or multilayer.In fluorosis group,severe edema of ovarian interstitial cells and follicle degeneration increased.Cell structure and cell contours were blurred and unclear with occasional mature follicles.Under transmission electron microscope,in control group,normal ovarian granulosa cell ultrastructure was observed,nuclei were round,nuclear chromatin was uniform distributed,cytoplasm was rich in mitochondria and endoplasmic reticulum,and normal morphology.In fluorosis group,granulosa cells and interstitial cells showed apoptotic characters,such as nucleoli disappearing,mitochondrial swelling and chromatin aggregating at the nuclear membrane.Conclusions Fluorosis can induce ovarian tissue apoptosis,severely damage the micro environment.Reduction of P and INH affects ovarian,maturation and ovulation and leads to secretion of GnRH,FSH and LH.Fluorosis caused by coal-burning may induce the injury of ovary and cause abnormal secretion of hypothalamic-pituitary-ovary axis.Fluorosis has affected parts of female axis which may not be in the hypothalamus,pituitary,but causes ovarian tissue damage.

To investigate the effects of intratracheal instillation of PM2.5 suspension on bleomycin (BLM)-induced pulmonary fibrosis in mice and the intervention of neotuberostemonine (NTS), the BLM dose (1.5 or 3.0 U/kg) and PM2.5 frequency (1 or 2 times per week) were studied by factorial experiment design. After intratracheal instillation of BLM (1.5 or 3.0 U/kg) on day 0, PM2.5 (5 mg/kg) was intratracheally injected to mice once or twice a week from day 1 to day 21, and the mice in the treatment group were given 30 mg/kg NTS by gavage once a day from day 8 to day 21. The degree of pulmonary fibrosis was evaluated by lung coefficient, hydroxyproline (HYP) content, HE staining and Masson staining lung sections as well as their semi-quantitative index (HE inflammatory score and collagen volume fraction, CVF). The results showed that the HE scores increased significantly in mice singly given PM2.5 once a week, the HYP content and HE score increased in mice singly given PM2.5 twice a week, but their CVF values did not significantly increase. However, the CVF values increased significantly in mice treated with PM2.5 and BLM co-infusion. These results suggested that PM2.5 (administered singly) could significantly increase BLM-induced collagen deposition and greatly aggravate pulmonary fibrosis although it mainly caused pulmonary inflammation rather than pulmonary fibrosis. NTS could significantly reduce the CVF value and α-SMA protein level of the model mice. It can be concluded that PM2.5 has great influence on patients with respiratory diseases, while NTS can improve pulmonary fibrosis induced by the combination of PM2.5 and BLM.

Objective To investigate the correlation and significance of S100A12 with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Fifty-three patients with OSAHS were chosen as OSAHS group and 46 healthy volunteers were chosen as control group.The levels of S100A12 and hs-CRP in the two groups were compared,and its relationship with those of epworth (ESS),apnea hypopnea index (AHI),and minimum blood oxygen saturation (L-SpO2) were analysised.Results The scores of ESS,BMI,A HI,L-SpO2,hs-CRP and S100A12 in two groups were statistically significant (P＜0.05).The severity of hs-CRP in severe OSAHS group was significantly higher than that of mild OSAHS group (P＜0.05).There was no significant difference in hs-CRP between moderate OSAHS group and mild OSAHS group and severe group (P＞0.05).The level of S100A12 in severe OSAHS group was significantly higher than that of moderate OSAHS group and OSAHS mild group(P＜0.05).The level of S100A12 in moderate moderate group was significantly higher than that of mild group(P＜0.01).hs-CRP was negatively correlated with ESS and AHI (r=0.822,0.787,P＜0.01),was positively correlated with L-SpO2 (r=-0.740,P＜0.01),S100A12 was positively correlated with ESS and AHI (r =0.707,P ＜ 0.01),and negatively correlated with ESS and AHI (r =0.707,0.807,P＜0.01),and negatively correlated with with L-SpO2 (r=-0.670,P＜0.01).Conclusion S100A12 is associated with OSAHS.The higher the severity of OSAHS,the higher the S100A12 value,which can be used as a new predictor of cardiovascular disease risk in OSAHS patients.

Objective To evaluate the effect of bundles of care on the prevention of postoperative delirium among elderly patients with hip fractures.Methods A prospective randomized case control study was conducted on 80 patients (≥65 years old) with hip fractures from March 2017 to June 2017.The patients were divided into experimental group (n =43) and control group (n =37) according to the random number table method.The experimental group received bundles of care,while the control group received routine nursing.The patients in both groups were all surgically treated,and the confusion assessment method (CAM) was applied to diagnose delirium after surgery.Gender,age,fracture type,duration from injury to operation,internal fixation type,operation time,total amount of bleeding,visual analogue scale (VAS),incidence of delirium,complications,and adverse events were compared between the two groups.Results Among the 80 patients,there were 11 males and 69 females,aged averagely 79.3 years (range,65-95 years).No significant differences were found between experiment group and control group in terms of gender (male:6 cases vs.5 cases,females:37 cases vs.32 cases),age [(79.8 ± 7.8) years vs.(78.7 ± 8.9) years],cause of injury (traffic injuries:7 cases vs.4 cases;falling injuries:36 cases vs.33 cases),duration from injury to operation [(66.1 ±14.3)hours vs.(63.4 ±14.9) hours],fracture type (femoral neck:13 cases vs.10 cases;intertrochanteric:26 cases vs.24 cases;subtrochanteric:4 cases vs.3 cases),internal fixation type (artificial total hip:5 cases vs.5 cases;artificial femoral head:8 cases vs.5 cases;PFNA:29 cases vs.27 cases),operation time [(55.5 ± 16.8) minutes vs.(51.6 ± 17.0) minutes],total blood loss [(114.4 ± 73.9) ml vs.(108.1 ±72.0) ml] (P ＞ 0.05).After bundles of care intervention,the postoperative VAS [(2.2 ± 0.8) points vs.(4.3 ± 1.2) points],postoperative delirium incidence (9％ vs.32％),incidence of complications and adverse events (2％ vs.19％) in experimental group were significantly lower than those in control group (P ＜ 0.05).Conclusion Bundles of care can relieve the pain and effectively reduce the incidences of postoperative delirium,complications,and adverse events in elderly patients with hip fracture.

OBJECTIVETo study the clinicopathologic features, immunophenotype, histological diagnosis and prognosis of hepatic epithelioid angiomyolipoma.

METHODSClinical data of 25 cases of hepatic epithelioid angiomyolipoma were collected along with follow-up study of the patients. The pathological features were documented and immunohistochemical study of various markers was performed with an emphasis on diagnosis and differential diagnosis.

RESULTSHepatic epithelioid angiomyolipoma was more commonly found in young women without characteristic clinical symptoms. Its morphological features were characterized by marked cytological atypia, relatively rare mitotic figures; radial distribution of tumor cells around the thin-walled blood vessels or muscular vessels; and the presence of common multinucleated giant cells and large ganglion-like tumor cells. The tumor cells expressed both melanoma cell markers (HMB45, MART-1) and smooth muscle cell markers (SMA). Tumor cells expressed various other markers including ER 16% (4/25), PR 32% (8/25), TFE3 24% (6/25) and p53 60% (15/25).

CONCLUSIONSHepatic epithelioid angiomyolipoma has variable morphological features and characteristic immunohistochemical phenotype. The differential diagnoses include a variety of tumors. The biological behavior of the tumor tends to be benign.

Age Factors ; Angiomyolipoma ; genetics ; immunology ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; Giant Cells ; pathology ; Humans ; Immunohistochemistry ; Immunophenotyping ; Liver Neoplasms ; genetics ; immunology ; metabolism ; pathology ; MART-1 Antigen ; metabolism ; Melanoma-Specific Antigens ; metabolism ; Muscle, Smooth ; metabolism ; Prognosis

AIM: To examine the effects of blepharoplasty on the ocular surface and refractive state.METHODS:Retrospective study. A total of 70 patients(108 eyes)who underwent blepharoplasty in our ophthalmology department from January 2022 to June 2023 were selected, among which 40 cases(48 eyes)diagnosed with ptosis received levator muscle shortness, and 30(60 eyes)diagnosed with eyelid laxity/single eyelids received blepharoplasty. The ocular surface disease index(OSDI), tear meniscus height(TMH), Schirmer Ⅰ test(SⅠt), tear film break-up time(BUT), corneal fluorescein staining(FL), cylindrical(Cyl), surface regularity index(SRI), surface asymmetry index(SAI), keratometry(Km), and cylindrical(C).RESULTS:There were statistical differences in preoperative and postoperative OSDI, BUT, SⅠt, and FL of patients who received levator resection(all P<0.05), but no differences were found in TMH(P>0.05). At 1 mo postoperatively, OSDI, BUT, SⅠt, and FL were significantly different compared to preoperative values(all P<0.05). There were no significant differences in OSDI, BUT, SⅠt, FL, or TMH of patients received blepharoplasty before and after surgery(all P>0.05). No significant differences were found in Cyl, SRI, SAI, Km, or C in either group before and after surgery(all P>0.05).CONCLUSION:The levator resection has an early impact on the ocular surface of patients with ptosis, and corneal protection measures should be taken early. There was no significant impact on patients undergoing blepharoplasty; there was no significant effect on the refractive status of all patients.

ObjectiveTo decipher the mechanism of Wenxiao powder in alleviating corticosterone-induced depression-like behaviors in mice. MethodMale ICR mice were randomized into normal， model， paroxetine （20 mg·kg^-1）， and low- and high-dose （3.27， 6.54 g·kg^-1， respectively） Wenxiao powder groups. The mice in normal and model groups received equal volume of saline. Other groups except the normal group were injected with corticosterone subcutaneously 0.5 h after gavage to induce depression. Mice were tested for depression-like behaviors after drug administration. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the corticosterone content in the serum. Nissl staining was performed to observe the damage of hippocampal neurons. Immunofluorescence staining was employed to observe the expression of double cortin （DCX） in the dentate gyrus （DG） of the hippocampus. Western blot was employed to determine the expression of proteins in the brain-derived neurotrophic factor （BDNF）/tyrosine kinase receptor B （TrkB）/extracellular signal-regulated kinase （ERK）/cAMP-response element-binding protein （CREB） pathway in the hippocampus. ResultCompared with the normal group， the model group showed decreased sucrose preference rate， increased immobility time in the tail suspension test （P<0.01）， and reduced residence time in the central area of the open field and the total movement distance （P<0.05， P<0.01）. In addition， the modeling elevated the corticosterone level in the serum （P<0.01）， decreased the volume and intensified the nuclear staining of hippocampal neurons in the DG area， reduced the expression of DCX in the DG area， and down-regulated the protein levels of BDNF， phosphorylated （p）-TrkB， p-ERK， and p-CREB in the hippocampus （P<0.05， P<0.01）. Compared with the model group， low-dose Wenxiao powder improved the mouse behavivors in the sucrose preference， open field， and tail suspension tests （P<0.05， P<0.01）， and high-dose Wenxiao powder improved the behaviors in the sucrose preference and open field tests （P<0.05， P<0.01）. In addition， Wenxiao powder lowered the serum corticosterone level （P<0.01） and recovered the structure and morphology of neurons with obvious nuclei and presence of Nissl bodies in the DG area of the hippocampus. Moreover， Wenxiao powder at both doses promoted the expression of DCX in the DG area， and high-dose Wenxiao powder up-regulated the protein levels of BDNF， p-TrkB， p-ERK， and p-CREB in the hippocampus （P<0.05， P<0.01）. ConclusionWenxiao powder can alleviate corticosterone-induced depression-like behaviors and promote neurogenesis in mice possibly by activating the BDNF/TrkB/ERK/CREB signaling pathway.