OBJECTIVE: To explore the relationship between the effect of acupuncture and layered localization of computed tomography (CT) in treatment of lumbar disc herniation. METHODS: Based on the CT layered localization, the herniated lumbar discs were positioned in 5 layers, A, B, C, D and E among 300 patients with lumbar disc herniation. Combined with the horizontal and the frontal planes, the three-dimensional location was formed. Acupuncture was delivered at acupoints including bilateral Shenshu (BL23), Dachangshu (BL25), and Huantiao (GB30), Weizhong (BL40) on the affected side. One intervention of acupuncture was 30 min, once daily; 1 course of treatment was composed of 10 interventions and 2 courses were required. Before and after treatment, Japanese orthopaedic association (JOA) score was recorded, and the effect was evaluated. The curative effect was classified and compared with the CT layered localization. RESULTS: Of 300 patients, 226 cases were effective and the effective rate was 75.33%. The JOA scores of all patients, and in the effective group and the non-effective group were higher compared with the scores before treatment (P<0.05). With the layered localization considered, acupuncture was more effective on the cases positioned in C layer. Regarding the horizontal plane, the effect was better on the cases with zone 1 and zone 1-2 involved. In terms of the grade of frontal plane, acupuncture was more effective on the cases graded Ⅰ and Ⅱ. CONCLUSION The clinical effect of acupuncture on lumbar disc herniation is related with the layer and the horizontal zone of herniated disc positioned, as well as to the grade of the frontal plane.
Humans ; Acupuncture Therapy ; Intervertebral Disc Displacement/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Tomography, X-Ray Computed ; Lumbar Vertebrae/diagnostic imaging* ; Acupuncture Points ; Aged ; Young Adult ; Treatment Outcome

Background Schizophrenic patients have metabolic disorders,impaired language and information processing function.Inflammatory factors may play an important role in the occurrence and development of schizophrenia.Objective To explore the relationship of the inflammatory factor levels with metabolic levels,language fluency and information processing function in patients with schizophrenia,so as to provide references for clinical understanding of the neuropathological mechanisms of schizophrenia.Methods A total of 96 patients with schizophrenia were included in the study group,who were hospitalized in the Fourth People's Hospital of Hefei from January 2021 to December 2022 as well as met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)and Mini-International Neuropsychiatric Interview(MINI)6.0.Meanwhile,population who underwent physical examination at the same hospital were included in the control group(n=42).A high-sensitivity multi factor electrochemiluminescence analyzer was used to detect the levels of inflammatory factors IL-4,IL-5,IL-7,IL-8,IL-10 and IL-13.A fully automated biochemical analyzer was used to detect the levels of metabolic indicators such as fasting blood glucose,triglycerides,high-density lipoprotein,apolipoprotein A,creatinine and urea nitrogen.Verbal fluency and information processing function of all participants were assessed by using Verbal Fluency Test(VFT)and Stroop Color Word Test(SCWT).Results There were statistically significant differences in the levels of IL-4,IL-5,IL-7,IL-8,IL-10,IL-13 and IL-15 between the study group and the control group(P<0.05).There were statistically significant differences in BMI,waist circumference,fasting blood glucose,triglycerides,high-density lipoprotein,urea nitrogen,apolipoprotein A and creatinine levels between the two groups(P<0.05).The differences in the correct number of household appliances,animals,fruits,vegetables,names starting with"water"and"self"in VFT between the two groups were statistically significant(P<0.05).The differences in point reaction time,character reaction time and character color reaction time in SCWT between the two groups were statistically significant(P<0.05).Correlation analysis showed that except for creatinine levels,the levels of IL-4 and IL-5 in patients with schizophrenia were correlated with other indicators(P<0.05).IL-7 levels were correlated with creatinine levels,household appliances,animals,fruits,correct number of names starting with"water"in VFT,point reaction time and word reaction time in SCWT(P<0.05).IL-8 levels were correlated with triglyceride levels,household appliances,animals,fruits,vegetables,correct number of names starting with"water"and"self"in VFT and word reaction time in SCWT(P<0.05).Except for creatinine levels and the correct number of names starting with"self",IL-10 levels were correlated with all other indicators(P<0.05).Except for creatinine and urea nitrogen levels,IL-13 levels were correlated with other indicators(P<0.05).Conclusion The levels of inflammatory factors in patients with schizophrenia may be related to their metabolic levels,language fluency and information processing function.

Objective To investigate the correlations microRNA-203a-3p(miR-203a-3p)and paired allographic box protein 2B(PHOX2B)expression levels in glioma tissues with clinical features and prognosis.Methods Ninety-six glioma patients admitted to our hospital from June 2017 to April 2020 were included in the study.The resected glioma tissues and corresponding paracancerous tissues from the patients were collected intraop-eratively.qRT-PCR and immunohistochemistry were conducted to detect the expression of miR-203a-3p and PHOX2B mRNA in glioma tissues and paracancerous groups.Pearson's method was used to analyze the correlation between miR-203a-3p and PHOX2B mRNA.Kaplan-Meier survival curves were used to analyze the correlations of miR-203a-3p and PHOX2B mRNA with the prognosis of glioma patients.COX regression was used to analyze the risk factors affecting the prognosis of glioma patients.Results The miR-203a-3p level and positive expression rate of glioma tissues were significantly lower than that of paracancerous tissues(P<0.05),and the PHOX2B mRNA level and positive expression rate were significantly higher than that of paracancerous tissues(P<0.05).By Pearson correlation analysis,the miR-203a-3p and PHOX2B mRNA levels of glioma patients were negatively correlated(P<0.05).miR-203a-3p and PHOX2B were associated with KPS score,tumor tissue necrosis,and WHO grading(P<0.05).Kaplan-Meier curve analysis yielded the results that the survival rate of the miR-203a-3p highly expressed group was significantly higher than that of the lowly expressed group(P<0.05),and the survival rate of the PHOX2B mRNA highly expressed group was significantly lower than that of the lowly expressed group(P<0.05).COX regression analysis showed that miR-203a-3p,PHOX2B mRNA,tumor tissue necrosis,and WHO grading were the risk factors affecting the prognosis of glioma patients(P<0.05).Conclusion The expression level of miR-203a-3p is obviously reduced and the expression level of PHOX2B mRNA is obviously increased in glioma,both showing close correlation with clinical characteristics and prognosis.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Objective:To describe our experiences in application of the 2019 revision of "CCCG-WT-2016" for the diagnosis of Wilms tumors.Methods:Ninety-one cases of Wilms tumor diagnosed at Shanghai Children′s Medical Center from January 2015 to December 2018 were collected. All cases were reviewed by two senior pathologists, including one from China and the other from Singapore, according to the 2019 revision of "CCCG-WT-2016."Results:The specimens were obtained by core biopsy ( n=21), primary nephrectomy ( n=41), post-chemotherapy nephrectomy/resection ( n=18), or biopsy/resection of metastatic/relapse/post-chemotherapy metastatic lesion(s) ( n=11). The specimens of core biopsy and primary nephrectomy ( n=62) all had favorable histology.Twelve post-chemotherapy nephrectomy cases were subdivided into three risk groups: low risk ( n=0), intermediate risk ( n=10) and high risk ( n=2). Six post-chemotherapy resection cases were subdivided into 3 risk groups:low risk ( n=0), intermediate risk ( n=5) and high risk ( n=1). The remaining 11 cases were comprised of metastatic, relapse, and post-chemotherapy metastatic lesions. The concordance rate of the two senior pathologists was 100%(91/91). Conclusions:The 2019 revision of "CCCG-WT-2016" is clearly written and easy to use. It can serve as the basis of accurate classification for clinical treatment.

Objective:To investigate the clinical and pathological features of pediatric NTRK-rearranged tumors.Methods:Four NTRK-rearranged soft tissue tumors and one renal tumor at Shanghai Children′s Medical Center, Shanghai Jiaotong University and Singapore KK Women′s and Children′s Hospital from January 2017 to September 2019 were identified. Pan-TRK immunohistochemistry, and the ALK and ETV6 gene break-apart fluorescence in situ hybridizations (FISH) were performed. NTRK gene rearrangement was detected using sequencing-based methods.Results:There were 3 males and 2 females in this study. The patients were between 3 months and 13 years of age. Histologically, the tumors were infiltrative spindle cell tumors with variable accompanying inflammatory cells. Immunohistochemistry showed positive reactivity for pan-TRK in all tumors, with nuclear staining for NTRK3 fusion, and cytoplasmic staining for NTRK1 fusion. The molecular testing revealed NTRK gene fusions (one each of TPM3-NTRK1, ETV6-NTRK3 and DCTN1-NTRK1, and two cases of LMNA-NTRK1). Two patients were receiving larotrectinib. The others were are well without disease, with follow-up durations of 9 to 29 months.Conclusions:NTRK-rearranged mesenchymal tumors from soft tissue sites and kidney are identified. A novel DCTN1-NTRK1 fusion is described. Pan-TRK immunohistochemistry is useful for diagnosis. NTRK-targeted therapy may be an option for unresectable, recurrent or metastatic cases.

Objective To analyze the clinical features of patients with dengue fever (DF) accompanied by platelet count (PLT) reduction and their characteristics of traditional Chinese medicine (TCM) syndrome differentiation and treatment. Methods The clinical data of 1 570 patients with confirmed diagnosis of DF collected from the Information Management System (HIS) of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (TCM) from January 2013 to December 2017 were retrospective analyzed. According to the patients accompanied by platelet (PLT) reduction or not, they were divided into DF accompanied by PLT reduction group (1 211 cases) and non-PLT reduction group (359 cases); according to whether the cooling blood and dissipating blood stasis TCM (composed of red peony, peony bark, rehmannia root, salvia miltiorrhiza, rhinoceros horn, etc.) was used or not in TCM syndrome differentiation prescription, they were divided into cooling blood and dissipating blood stasis group (492 cases) and non-cooling blood and dissipating blood stasis group (719 cases). The differences in clinical characteristics, laboratory indicators, TCM syndrome differentiation and prescription characteristics in DF accompanied by PLT reduction group and non-PLT reduction group were compared and analyzed; the differences in changes of white cell counts (WBC) and PLT levels before and after treatment between cooling blood and dissipating blood stasis group and non-cooling blood and dissipate blood stasis group were compared and analyzed. Results The proportions of rash, hemorrhage, WBC reduction and aspartate transaminase (AST) elevation in DF accompanied by PLT reduction group were significantly higher than those in non-PLT reduction group [rash: 61.4% (744/1 211) vs. 14.8% (53/359), hemorrhage: 7.3% (89/1 211) vs. 1.1% (4/359), WBC reduction: 88.2% (1 068/1 211) vs. 60.4% (217/359), AST increased: 41.0% (497/1 211) vs. 29.5% (106/359)]; the PLT and WBC in the DF accompanied by PLT reduction group were significantly lower than those in the non-PLT reduction group [PLT (×109/L): 74.2±27.5 vs. 166.6±42.8, WBC (×109/L): 2.1±1.6 vs. 6.4±3.7, both P < 0.05], and AST in the DF accompanied by PLT reduction group were significantly higher than those in the non-PLT reduction group (U/L: 69.6±34.1 vs. 52.6±26.1, P < 0.05). The common syndrome of TCM syndrome differentiation in DF accompanied by PLT reduction group and non-PLT reduction group was mainly Wei-Qi syndrome [425 cases (35.1%) and 147 cases (40.9%) respectively]; Yinqiao powder was the main TCM prescription in the two groups [132 cases (10.9%) and 46 cases (12.8%) respectively]. In the comparisons between the cooling blood and dissipate blood stasis group and non-cooling blood and dissipate blood stasis group, there were no statistically significant differences in the proportion of combining use of drugs for increasing WBC and PLT and the levels of WBC and PLT after treatment (all P > 0.05). After treatment, the WBC, PLT levels and the proportions of above indexes returned to normal in the cooling blood and dissipate blood stasis group were significantly higher than those in the non- cooling blood and dissipate blood stasis group [WBC(×109/L): 4.5±3.1 vs. 3.2±2.4, proportion of WBC returned to normal: 42.7% (210/492) vs. 33.1% (238/719); PLT (×109/L): 85.9±26.2 vs. 79.3±24.8, proportion of PLT returned to normal: 41.1% (202/492) vs. 27.5% (198/719), all P < 0.05]. Conclusions The symptoms of skin rash and bleeding are more common in patients with DF accompanied by PLT reduction. The syndrome differentiation of TCM for this disease is mostly based on the combined disorders of Wei (defence) and Qi, both Qi and blood burning and blood stasis associated with toxin. Cooling blood and dissipating blood stasis may help the recovery of WBC and PLT in these patients, which is of great significance in reducing severity of dengue fever (such as bleeding).

OBJECTIVE: This study was aimed to compare the accuracy of Support Vector Machine (SVM) and Gaussian Mixture Model (GMM) in the detection of manic state of bipolar disorders (BD) of single patients and multiple patients. METHODS: 21 hospitalized BD patients (14 females, average age 34.5±15.3) were recruited after admission. Spontaneous speech was collected through a preloaded smartphone. Firstly, speech features [pitch, formants, mel-frequency cepstrum coefficients (MFCC), linear prediction cepstral coefficient (LPCC), gamma-tone frequency cepstral coefficients (GFCC) etc.] were preprocessed and extracted. Then, speech features were selected using the features of between-class variance and within-class variance. The manic state of patients was then detected by SVM and GMM methods. RESULTS: LPCC demonstrated the best discrimination efficiency. The accuracy of manic state detection for single patients was much better using SVM method than GMM method. The detection accuracy for multiple patients was higher using GMM method than SVM method. CONCLUSION: SVM provided an appropriate tool for detecting manic state for single patients, whereas GMM worked better for multiple patients’ manic state detection. Both of them could help doctors and patients for better diagnosis and mood state monitoring in different situations.
Bipolar Disorder* ; Diagnosis ; Discrimination (Psychology) ; Female ; Humans ; Methods ; Smartphone ; Support Vector Machine*

Objective To observe the effects of Suhuang Zhike capsules(SZC) on the guinea pig model of cough variant asthma(CVA), and to explore its therapeutic mechanism. Methods Fifty guinea pigs were randomly divided into normal control group, model group, prednisone acetate tablets group, and high-and low-dose SZC groups. With reference to the related literatures, we set up the guinea pig model of CVA. The observation indexes included cough frequency, lung histopathology, the percentage of eosinophils in bronchoalveolar lavage fluid (BALF), and the serum levels of interleukin 4(IL-4), interferon gamma(IFN-γ), tumor necrosis factor alpha (TNF-α), and immunoglobumin E(IgE). Results Compared with the normal control group, the cough frequency of the model group was significantly increased(P<0.05); compared with the model group, the cough frequency of high-dose SZC group was reduced obviously(P < 0.05). Compared with the normal control group , the percentage of eosinophils in BALF of the model group was significantly increased(P < 0.05); the percentage of eosinophils of the three medication groups was lower than that of the model group (P<0.05). The pathological changes of lung tissue in the medication groups were relieved compared to the model group. Compared with the normal control group, the serum IL-4, TN F-α and IgE levels of the model group were increased significantly (P < 0 . 05); compared with the model group , the serum IL-4 and TN F-α levels of prednisone acetate tablets group were significantly decreased, and the serum TNF-α and IgE levels of high-dose SZC group were decreased significantly (P < 0.05). Conclusion SZC could reduce the serum, TNF-α and IgE levels , and relieve the cough symptom, airway inflammation and the lung tissue pathology in CVA guinea pig, so as to achieve the therapeutic effect on CVA.

ObjectiveIn order to provide reliable sufficient information for making a policy to develop Emergency Departments in Chinese Medical Hospitals, a countrywide investigation on current situations of such departments was carried out.Methods Firstly, questionnaires which could be responded by filling out on line and paper were made respectively. The Departments of Emergency in 300 Chinese Medical Hospitals widely distributed in 27 provinces of China (municipalities directly under the central government) with technique level 2 or above were observed in this study by Red Cap database or Email.Results All together 280 questionnaires were sent out, and 200 questionnaires were responded. The information from 200 emergency departments of Chinese medical hospitals in 24 provinces was collected, the recovery rate being 71.42%. The investigative results were as follows: ① All Chinese medical hospitals involved in this study were equipped with an independent emergency department. The average occupation of ground area, numbers of ward beds and ambulances in these emergency departments were 713.6 m2, 18.93 and 2.81 respectively, and 75.8% of the hospitals were of the first aid local network units.② There were 26 emergency departments having internal, surgical, women and children emergency clinics, 83 hospitals had internal and surgical emergency clinics only, and in 91 hospitals there was no any special clinic in emergency department. In addition, only did 81 hospitals have intensive care units (ICU).③ The number of clinicians was 11.86±9.28 on average, and 26 hospitals even had no emergency specialists. In 39 hospitals, there were no emergency clinicians with high rank title, most of these clinicians had bachelor or master's degree, and only did 30 hospitals have emergency clinicians with PhD degree.④ The annual average patient admitted in emergency departments of these hospitals was 2.36 thousand cases, including 1197.38 rescue ones. The clinicians who could accomplish abdominocentesis and thoracentesis independently were accounting for 90.7% and 89.0%, respectively, 8.2% hospitals could carry out percutaneous coronary intervention (PCI), and more than 70% hospitals already had the emergency green channel.⑤ About 93.5% hospitals had established a management system of medical quality control, and 89.0% hospitals had already had a medical quality control group.⑥ 65.5% hospitals had assessment index of Utilization rate of traditional Chinese Medicine, and 52.5%hospitals routinely conducted discussions on cases treated primarily by Chinese medicine (CM).Conclusions The development levels of emergency departments of all Chinese medical hospitals involved are very uneven, on which more attention should be paid. The enhanced investment is required to construct the emergency clinics and improve medical techniques in order to meet the growing need of the first aid in our society.