Objective:To observe the clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia.
Methods:A total of 154 cases with post-stroke insomnia were randomly divided into a control group and an observation group by the random digital table, 77 cases in each group. The control group was treated by auricular acupoint sticking, while the observation group was treated by auricular acupoint sticking plus music therapy, to compare the clinical effects at the end of the treatment and three months after the treatment between the two groups.
Results:At the end of treatment, the total effective rate was 98.7% in the observation group, remarkably higher than 89.6% in the control group, with a statistically significant difference between the two groups (P<0.05). Three months after the end of the treatment, the total effective rate was 90.9% in the observation group, remarkably higher than 80.5% in the control group, with a statistically significant difference between the two groups (P<0.05).
Conclusion:Auricular acupoint sticking plus music therapy was affirmative in the clinical effects for post-stroke insomnia, providing a new idea to design a best nursing and rehabilitative plan for the patients with post-stroke insomnia.

Objective To find out about community residents' demands and intentions for health service and explore new ways of delivering life-long health service. Methods An investigation was made via sending questionnaires to each household into the health conditions and demands and intentions for health service of 700 residents in 5 neighborhood committees and 1000 discharged patients as well as sub-healthy groups of people in a certain area in Nanchang. Results Of those surveyed, the two-week morbidity was 438 per thousand; the chronic morbidity was 574 per thousand; only 31.1% of the residents went to eommanity hospitals for medical service; and 63.4% of the residents never took any health care service while 59.6% of the residents thought it necessary to take health care service. Conclusion The masses of people are in dire need of low-price life-long medical service. Second-grade third-tier and second-tier hospitals in big and medium-sized cities may explore viable new ways of medical service that will meet the needs of society.

Objective To explore the clinical application of improved thoracic closed drainage tube vacuum aspiration in treatment of elderly patients with trachea foreign body.Methods 32 elderly patients with trachea foreign body were divided evenly into group A and group B.Group A received treatment of improved thoracic closed drainage tube aspiration,while group B received treatment of bronchoscopy.One-time success rate of removing foreign body,operation duration,length of stay and occurrence of complications were compared between group A and group B.Results One-time success rate of removing foreign body in group A was significantly higher than group B (100.00％ vs 81.25 ％,x2 =6.720,P ＜ 0.05) ;operation time of group A was (1.79 ± 1.25)min,which was significantly shorter than (13.18 ± 4.37) min of group B (t =4.31,P ＜ 0.05).Conclusion The clinical effect of improved thoracic closed drainage tube vacuum aapiration in treatment of elderly patients with trachea foreign body was positive and better than treatment with bronchoscopy,it is worthy of clinical application.

Objective To investigate the differential diagnosis value between breast phyllode tumor and breast fibroadenoma by comprehensive analysis of multiple parameters on color Doppler ultrasonography.Methods The manifestations or characteristics on color Doppler ultrasonography were analysed in 17 cases with breast phyllode tumor and 92 cases with breast fibroadenoma.Results Thinned skin was found in 3 cases of phyllode tumor of the breast(17.65%).Cystic areas were observed in 11 cases with phyllode tumor of the breast(64.71%).Varication inside the tumor was found in 12 cases with phyllode tumor of the breast(70.59%).Conclusions Thinned skin,cystic areas and varication inside the tumor are the important indicators in differential diagnosis for breast phyllode tumor from breast fibroadenoma,which may improve the accuracy of diagnosis for phyllode tumor of the breast.

Objective To observe the effects of lycopene on fibrinolytic activity and nitric oxide in atherosclerosis rabbits. Methods 30 New Zealand rabbits were randomly divided into three groups. They were individually housed in metal cages. Throughout the experimental period, they were given restricted amounts of food. Control group was fed with normal diet,model group was fed with 1% cholesterol,10% lard and 89% normal diet, lycopene group was fed with 1% cholesterol,10% lard and normal diet plus 6% lycopene.At the time of the first day and the 8th week, blood samples were drawn from ear edge vein of rabbits. The activity and content of plashaa tissue type plasminogen activator(t-PA)and plasminogen activator inhibitor(PAI-1)were detected. The levels of serum Nitric oxide (NO)were determined.At the end of the study, the plaque areas were measured. SPSS 10.0 software was used to evaluate the differences among the three groups. Results Compared with control group, atherosclerosis rabbits had lower content and activity of t-PA, higher content and activity of PAI-1 and lower content of NO. Compared with model group, lycopene group had no significant difference about the content and activity of tPA and PAI-1.But lycopen increased the levels of serum NO, significantly diminished the area of lipid plaque. Conclusions The experimental results suggested that lycopene had antiatherogenic effects. The possible mechanisms might be that lycopene could decrease lipid peroxidation injure, maintain the concentration of NO and protect vascular endothelium. The antiatherogenic effects of lycopene had no correlation with the fibrinolytic activity.

Objective To investigate the relationship between pregnancy-associated plasma protein A(PAPP-A)level and restenosis after elective coronary stenting by coronary artery angiography(CAG)and intravascular ultrasound(IVUS). Methods The study consisted of 132patients with successful coronary stent placement:left anterior descending coronary artery(LAD)62,left circumflex coronary artery(LCX)36,right coronary artery(RCA)34.The follow-up CAG and IVUS were Derformed at the 6th month after stent placement.Diameter stenosis≥50%on CAG was regarded as in-stent restenosis.Neointimal areas(IA),stent volume(SV)and neointimal volume(IV)were measured by IUVS during follow-up.According to the PAPP-A level,lesions were divided into 2groups:high PAPP-A group(PAPP-A level≥12.11 mIU/L)and low PAPP-A group(PAPP-A level＜12.11 mIU/L). Results Total restenosis rate was 31.8%.There were no significant differences in age.sex and risk factors of coronary heart disease(hypertension,diabetes,smoking)between restenotic and nonrestenotie groups(all P＞0.05).The restenotic group had higher PAPP-A level than nonrestenotic group[(18.14±2.26)mIU/L vs. (10.95±2.12)mlU/L,P＜0.01].Angiographic restenosis occurred in 28 of 66 lesions(42.4%)in the high PAPP-A group and in 14 of 66 lesions(21.2%)in the low PAPP-A group(P＜0.01).Plasma PAPP-A level was positively correlated with IA,IV(r=0.47 and 0.54 respectively,all P＜0.05). Conclusions Elevated PAPP-A level is correlated well with the severity of the intimal hyperplasia.Plasma PAPP-A level affects restenosis after elective stent placement by promoting intimal hyperplasia.

BACKGROUND: Research has been reported that serum soluble CD146 (sCD146) expression was improved on the surface of endothelial cells and activated T cells by the stimulation of inflammatory factor. Therefore, it predicts that CD146 may participate in inflammatory reaction of tissue.OBJECTIVE: To investigate the expression and clinical significance of serum sCD146 in peripheral blood from patients with ankylosing spondylitis.METHODS: A total of 62 patients with ankylosing spondylitis were selected from the Sixth People's Hospital AffiUated to Shanghai Jiao Tong University. All patients were divided into two groups: active group (n=46) and inactive group (n=16); while, 20 healthy subjects were selected as the control group. Indicators including Bath Ankylosing SpondyUtis Disease ActivityIndex (BASDAI),Bath Ankylosing Spondylitis Functional Index (BASFI), patient's global assessment (PGA), night pain, visual analogue scale (VAS),morning stiffness time, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured in all patients. The serum concentration of sCD146 from 62 patients with ankylosing spondlitis and 20 healthy controls was measured by enzyme-linked immunosorbent assay. Westergren method was used to measure ESR and immunoturbidimetry for CRP. Clinical data of the patients were collected as well.RESULTS AND CONCLUSION: sCD146 levels of patients with ankylosing spondlitis were significantly higher than normal control group (P ＜ 0.05). The sCD146 expression in the active group was significantly higher than inactive and normal control groups (P ＜0.05). Positive correlations were observed between sCD146 and BASDAI index of patients with ankylosing spondlitis (P ＜ 0.05).The sCD146 levels of ankylosing spondUtis patients with peripheral joint involvement were significantly higher than the patients with axial involvement alone or the normal controls (P ＜ 0.05).The expression level of sCD146 in peripheral blood was positively correlated with disease activities of patients with ankylosing spondlitis. It may play important roles in the pathogenesis in ankylosing spondlitis.

Hypertrophic obstructive cardiomyopathy(HOCM)is a hereditary cardiac disorder characterized primarily by septal hypertrophy and left ventricular outflow tract obstruction.Traditional therapeutic modalities,such as medications and surgeries,do not yield satisfactory outcomes in a subset of patients.The advancements have been made in novel treatments,including new drugs and percutaneous intramyocardial septal radiofrequency ablation(PIMSRA),still need further observation to obtain long-term efficacy and safety.In recent years,stereotactic body radiation therapy(SBRT)has emerged as an innovative non-invasive approach for treating HOCM.Studies indicate that SBRT allows for precise targeting of the hypertrophied septal region,causing both direct and indirect damage to targeted myocardial cells.This can alleviate left ventricular outflow tract obstruction and myocardial ischemia,fulfilling the therapeutic objective.For those with HOCM who neither respond well to medications nor are surgical candidates,SBRT offers a potential new therapeutic alternative.However,the latent risks of radiation therapy persist,such as the onset of radiation-induced heart disease(RIHD).The preliminary investigations guarantee the safety and feasibility of SBRT in HOCM management,an increased volume of clinical studies and prolonged follow-up data are essential to evaluate its real efficacy and potential hazards.In addition,research regarding the therapeutic mechanisms of SBRT for HOCM,optimal dosages and treatment durations,indications and contraindications,prevention of complications,and enhancing the precision of radiation therapy,still needs to be further exploration,to determine the best therapeutic strategies.

Objective: To explore the curative effect and safety of botulintum toxin A (BTX-A) on depressive disorder in patients with Parkinson′s disease (PD). Methods: Forty-two cases of PD with depression prospectively recruited in the Second Hospital Affiliated to Soochow University from August 2016 to November 2018 were divided into two groups: 28 patients in BTX-A group (administered with 100 U BTX-A injection on patients′ eyebrow, forehead, bilateral lateral canthus and temporal region at 20 loci), 14 patients in sertraline (control) group (administered with 50-100 (55.36±14.47) mg/d sertraline). The scores of Hamilton Depression Rating Scale (HAMD), Self-rating Depression Scale (SDS), Hamilton Rating Scale for Anxiety (HAMA), Self-rating Anxiety Scale (SAS) after treatment for 2 weeks, 4 weeks, 8 weeks and 12 weeks were compared with the scores of each emotional rating scale for baseline respectively. Meanwhile, the differences in the scores of each emotional scale between the two treatment groups were compared. In addition, the remission rates of depression and anxiety (defined as HAMD, HAMA scores<7) at each follow-up time point between the two groups were compared to evaluate the efficacy and safety of BTX-A in the treatment of PD patients with depression. Results: The scores of HAMD, HAMA, SDS, SAS in the BTX-A group and the sertraline group reduced compared to baseline after treatment (at the 2nd, 4th, 8th, 12th weeks). The scores of HAMD and SDS in the BTX-A group (HAMD scores: F=12.930, P<0.01; SDS scores: F=5.022, P=0.001) and those in the sertraline group (HAMD scores: F=2.883, P=0.030; SDS scores: F=3.427, P=0.013) were significantly lower compared to baseline, but there was no statistically significant difference in the scores of HAMD and SDS between the two groups (P>0.05). HAMD score showed that the remission rate of depression in the BTX-A group (17.9% (5/28), 35.7% (10/28)) was higher than that of the sertraline group (2/14, 4/14) at the 2nd and 4th weeks. At the 8th and 12th weeks, the remission rate of depression in the sertraline group (7/14, 9/14) was higher than that of the BTX-A group (46.4% (13/28), 53.6% (15/28)). There was no statistically significant difference in remission rate of depression between the two groups at each follow-up time point (P>0.05). There was no statistically significant difference in HAMD scores between males and females in the BTX-A group (P>0.05). Two of the 28 patients in the BTX-A group had frown muscle stiffness, which lasted for two weeks and improved in one month. Two patients in the sertraline group had headache and dizziness, and two patients had dry mouth and nausea, which improved after two weeks. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P=0.197). Conclusion BTX-A intraocular facial muscle injection can significantly improve the depressive symptoms of PD patients, and the effect lasts for a long time, with low incidence of side effects and high safety, which can be considered as a safe and effective new method for PD patients with depressive symptoms.

Objective To explore the curative effect and safety of botulintum toxin A (BTX?A) on depressive disorder in patients with Parkinson′s disease (PD). Methods Forty?two cases of PD with depression prospectively recruited in the Second Hospital Affiliated to Soochow University from August 2016 to November 2018 were divided into two groups: 28 patients in BTX?A group (administered with 100 U BTX?A injection on patients′eyebrow, forehead, bilateral lateral canthus and temporal region at 20 loci), 14 patients in sertraline (control) group (administered with 50-100 (55.36±14.47) mg/d sertraline). The scores of Hamilton Depression Rating Scale (HAMD), Self?rating Depression Scale (SDS), Hamilton Rating Scale for Anxiety (HAMA), Self?rating Anxiety Scale (SAS) after treatment for 2 weeks, 4 weeks, 8 weeks and 12 weeks were compared with the scores of each emotional rating scale for baseline respectively. Meanwhile, the differences in the scores of each emotional scale between the two treatment groups were compared. In addition, the remission rates of depression and anxiety (defined as HAMD, HAMA scores<7) at each follow?up time point between the two groups were compared to evaluate the efficacy and safety of BTX?A in the treatment of PD patients with depression. Results The scores of HAMD, HAMA, SDS, SAS in the BTX?A group and the sertraline group reduced compared to baseline after treatment (at the 2nd, 4th, 8th, 12th weeks). The scores of HAMD and SDS in the BTX?A group (HAMD scores: F=12.930, P<0.01; SDS scores: F=5.022, P=0.001) and those in the sertraline group (HAMD scores: F=2.883, P=0.030; SDS scores:F=3.427, P=0.013) were significantly lower compared to baseline, but there was no statistically significant difference in the scores of HAMD and SDS between the two groups (P>0.05). HAMD score showed that the remission rate of depression in the BTX?A group (17.9% (5/28), 35.7% (10/28)) was higher than that of the sertraline group (2/14, 4/14) at the 2nd and 4th weeks. At the 8th and 12th weeks, the remission rate of depression in the sertraline group (7/14, 9/14) was higher than that of the BTX?A group (46.4% (13/28), 53.6% (15/28)). There was no statistically significant difference in remission rate of depression between the two groups at each follow?up time point (P>0.05). There was no statistically significant difference in HAMD scores between males and females in the BTX?A group (P>0.05). Two of the 28 patients in the BTX?A group had frown muscle stiffness, which lasted for two weeks and improved in one month. Two patients in the sertraline group had headache and dizziness, and two patients had dry mouth and nausea, which improved after two weeks. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P=0.197). Conclusion BTX?A intraocular facial muscle injection can significantly improve the depressive symptoms of PD patients, and the effect lasts for a long time, with low incidence of side effects and high safety, which can be considered as a safe and effective new method for PD patients with depressive symptoms.