In order to observe the febrifugal response of needling "Chang Qiang Point", and analyse its mechanism lumbar spinal cord of rabbits were damaged in the expermental study. The experimental findings were as follows: 1. It was found that cAMP content in csf was striking increased, when leukocytic pyrogen fever of rabbits was significant. During needling "Chang Qiang Point" of febrile rabbits, however, febrile response was markedly inhibited(at 60 min~?T℃ was 0.23?0.07 and TRI4 0.61?0.03). There was significant difference(P0.05). 3. After damaging lumbar spinal cord of rabbits, there were certain change of rectal temperature and the febrile response, but it had no effect on cAMP content in csf. The authors infered that the impulses from "Chang Qiang Point" transmiled Via spinal cord might be closely associated with reflex mechanism and the change of cAMP content might play an important role in the mechanism of febrifugal effect during needling "Chang Qiang Point" in febrile rabbits.

Paroxysmal supraventricular tachycardia includes atrioventricular node reentry tachycardia, atrioventricular reentry tachycardia and atrial tachycardia.At present, the commonly used methods in clinical diagnosis include ventricular pacing in tachycardia, pre ventricular stimulation in refractory/non refractory period of his bundle, pacing in different parts of the atrium, parahisian pacing in sinus rhythm and stimulation in different parts of the ventricle.Ventricular pacing is one of the most commonly used methods in clinical diagnosis.However, it may lead to " false V-A-A-V" sequence after pacing.The ventricular pre phase stimulation of his bundle refractory period may appear false negative or lead to termination of tachycardia, which is not condutive to differential diagnosis.The results may be affected by pacing position, bypass position and refractory period when parahisian pacing and ventricular stimulation at different sites/frequencies are performed in sinus rhythm.Because of their respective advantages and limitations, it is necessary to integrate a variety of identification methods to improve the accuracy of diagnosis and the success rate of operation.

To investigate collagen protein expressions in ischemic myocardium of rats with acute myocardial infarction (AMI) and the effects of qi-tonifying, yin-tonifying and blood-activating herbs and detoxifying and blood-activating herbs.

Objective To explore CTA and MRA characteristics of persistent trigeminal artery (PTA)with vascular disease. Methods 54 patients diagnosed as PTA by CTA and MRA were collected retrospectively,whose classification,variation and associated vascular disease were analyzed.Results There were more females than males in 54 patients,whose average age was 59.72±16.32,and the incidence of left ones were higher than that of the right ones.Type Ⅰ of Weon classification was 16 cases (29.63%),type Ⅱ 7 cases (12.96%),typeⅢ 16 cases (29.63%),type Ⅳ 1 1 cases (20.37%),type Ⅴ 4 cases (7.41%).The lateral type of Salas classification was significantly higher than that in the middle type.There were 16 cases (29.63%)with aneurysm,in which 3 cases (18.75%)were rupture.3 cases were with moyamoya disease (5.56%).39 cases (72.22%)were with basilar artery dysplasia.There were 33 cases (61.11%)with the postembryonic cerebral artery.There were 29 cases with cerebral infarction (53.7%),4 cases with cerebral hemorrhage (7.4%),3 cases with subarachnoid hemorrhage (5.5 6%).Cerebral arteriosclerosis with different degrees of stenosis was showed in 1 7 cases (31.48%). 2 cases were accompanied with trigeminal neuralgia (3.7%),and only 1 case was with ocular nerve palsy (1.85%).Conclusion CTA and MRA could be used to display the anatomical features and radiographic classification of PTA ,and also clearly display and evaluate PTA associated with vascular disease.

Objective To compare the clinical efficacies of endoscopy-assisted microvascular decompression and microscopic microvascular decompression.Methods PubMed,Cochrane Library,Embase,VIP,CNKI and Wanfang database were retrieved.The randomized controlled trials comparing trigeminal neuralgia and hemifacial spasm treated with endoscopy-assisted microvascular decompression and microscopic microvascular decompression were chosen.The retrieval time was from the establishment of the database to April 1st,2017.After the detected literatures being screened,extracted and evaluated,a Meta-analysis was performed using RevMan 5.3 software.Results Finally,a total of 10 trials with 1010 patients were enrolled.The results of Meta-analysis showed:(1) in the aspect of effectiveness,patients from the neuroendoscope group had significantly better prognosis (RR=1.110,95％CI:1.060-1.160,P=0.000) and statistically lower relapse rate (RR=0.100,95％CI:0.020-0.530,P=0.007) as compared with the microsurgery group;(2) in the aspect of safety,patients from the neuroendoscope group had fewer postoperative complications (RR=0.650,95％CI:0.530-0.800,P=0.000) and lower postoperative paralysis incidence rate (RR=0.580,95％CI:0.360-0.930,P=0.020) as compared with the microscope group.There were no significant differences in the operation time,incidence of cerebrospinal fluid leakage,hearing loss or intracranial infections between the 2 groups (P＞0.05).Conclusion As compared with those in patients accepted microscopic microvascular decompression,the prognosis of patients accepted endoscopy-assisted microvascular decompression is better,the relapse rate is lower,and safety is higher.

Glioma is a serious health threat for humans,so we urgently need to develop a more accurate,efficient and durable method to fight it.Immunotherapy is a fashionable treatment,which can stimulate the body's own immune system stimulation.And finding a reliable therapeutic target becomes the essential for glioma immunotherapy.The toll-like receptor 2 is form Ⅰ transmembrane receptor,which can be highly expressed in a variety of tumors and is closely linked to the aggressiveness and prognosis of the tumors.This article aims to explore the TLR2 expression and its association with tumors to provide new therapeutic targets for glioma immunotherapy.

Objective To evaluate the diagnostic value of transcranial doppler ultrasonography (TCD) for middle cerebral artery stenosis.Methods A comprehensive electronic search was performed in PubMed,EMBase,The Cochrane Library,CNKI,Wanfang Database and VIP Database to retrieve relevant studies on TCD in diagnosis of middle cerebral artery stenosis from initiation of the databases to January 2017.The general information and diagnostic parameters were documented from the retrieved studies.The quality of the prepared studies was evaluated by QUADAS-2 and the risk assessment maps brought by RevMan 5.3 statistical software.Pooled sensitivity,specificity,positive likelihood ratio (PLR),negative likelihood ratio (NLR) and the heterogeneity of the included studies were analyzed using the Stata 13.0 software.Summary receiver operating characteristic curve (SROC) was drawn and the area under the curve (AUC) was calculated.The publication bias was assessed with funnel plotting.Results A total of 11 studies were included for this Meta analysis,involving 2 550 patients.Heterogeneity test showed that the heterogeneity was established between studies in sensitivity,specificity,NLR and diagnostic odds ratio (DOR),resulting from disparity in study design and TCD test criteria (P＜0.05).Meta analysis revealed a pooled sensitivity of 0.88 (95％ CI:0.84～0.91),a specificity of 0.93 (95％ CI:0.91～0.95),a PLR of 12.93 (95％ CI:9.90～16.90),a NLR of 0.13 (95％ CI:0.09～0.17),a diagnostic score (SCORE) of 4.63 (95％ CI:4.32～4.94),a diagnostic odds ratio (DOR) of 102.64 (95％ CI:75.44～139.65),and an AUC of SROC of 0.96 (95％ CI:0.94～0.98).The sensitivity analysis after removing studies with sample capacity ＜100 showed that the confidence interval of the diagnostic parameters mostly overlapped with that of the original data.Conclusion As TCD shows good accuracy in diagnosing middle cerebral artery stenosis,it can be used in diagnostic screening of the disease.

Objective:To investigate the effect of linalutide on adipocytokine, blood glucose and renal function in diabetic nephropathy (DN) patients.Methods:One hundred DN patients diagnosed and treated by Chengdu Second People′s Hospital and Chunxi Community Health Service Center of Jinjiang District and Shuyuan Community Health Service Center of Jinjiang District from January 2018 to June 2019 were selected and divided into metformin group (48 cases) and combined group (52 cases) according to different treatment regimens. Metformin group was treated with metformin, the combined group was treated with linalutide on the basis of metformin group, and both groups were treated for 12 weeks. The therapeutic efficacy, adipocytokine index adiponectin (ADPN), secretory-type curl-related proteins-5(SFRP5), omentin-1; blood glucose index fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), insulin resistance index(HOMA-IR), and renal function index urinary albumin excretion rate (UAER), albumin creatinine ratio(ACR), liver-type fatty acid binding protein(L-FABP) were compared between the two groups and the prognosis was analyzed. Results:The total effective rate in the combined group at 4, 8 and 12 weeks were higher than those in the metformin group and the longer treatment, the higher total effective, there were statistical differences ( χ2 group = 4.61, χ2 time point = 78.57, P<0.05). Before treatment, there were no significant differences in serum FBG, 2hPBG, HbA 1c, FINS, HOMA-IR, ADPN, SFRP5, omentin-1, urine UAER, ACR and L-FABP between the two groups ( P>0.05). After treatment, the levels of serum FBG, 2hPBG, HbA 1c, FINS, HOMA-IR, urine UAER, ACR and L-FABP in the combined group were lower than those in the metformin group: (7.17 ± 1.62) mmol/L vs. (8.75 ± 2.11) mmol/L, (5.54 ± 1.11)mmol/L vs. (6.56 ± 1.08) mmol/L, (6.63 ± 0.92)% vs. (7.95 ± 0.89)%, (7.12 ± 1.17) mU/L vs. (8.72 ± 1.58)mU/L, 3.52 ± 0.88 vs. 4.04 ± 0.70, (28.65 ± 3.22) mg/24 h vs. (65.42 ± 6.85) mg/24 h, (56.24 ± 7.68) μg/mg vs. (92.68 ± 9.29) μg/mg, (8.62 ± 1.08) μg/(g·Cr) vs. (14.62 ± 1.85) μg/(g·Cr); the levels of ADPN, SFRP5 and omentin-1 were higher than those in the metformin group: (14.53 ± 2.43) mg/L vs. (10.21 ± 2.12) mg/L, (12.81 ± 2.31) μg/L vs. (8.75 ± 2.18) μg/L, (48.49 ± 5.28) μg/L vs. (36.57 ± 4.32) μg/L, there were statistical differences ( P<0.05). After treatment, the incidence of end-point events in the combined group was 7.69% (4/52), which was lower than that in the metformin group 22.92% (11/48), and there was statistical differences ( χ2 = 4.57, P<0.05). The survival analysis showed that the survival time and median survival time after treatment in the combined group were higher than those in the metformin group ( P<0.05). Conclusions:Linalutid can effectively improve blood glucose level and renal function in DN patients, and has obvious effect on adipocykine secretion, which is conducive to improve prognosis.

Objective:To analyze the demands of contracted family doctor service among uncontracted young and middle-aged people in Shanghai Baoshan.Methods:An online questionnaire survey on demands of contracted family doctor service was conducted in June 2021 among 702 uncontracted residents aged 18-60 years from Shanghai Baoshan district selected by stratified random sampling method. The demands of contracted family doctor service, including digital health file, routine laboratory tests and imaging investigation;health promotion;service convenience; home service were surveyed, and the factors related the demands were analyzed with regression analysis.Results:The survey showed that the demands of service convenience (3.8(3.0, 5.0)) and home service (4.0(3.0, 5.0)) were higher, while those of digital health file (3.0(2.0, 5.0)) and health promotion (3.0(2.0, 5.0)) were relatively lower. There were significant differences in the demands of all five contracted services among residents with different gender, age, education level, household register and family income (all P<0.05); while for young residents with different types of medical insurance there was significant difference in demands of all contracted services except digital health file (all P<0.05). Logistic regression analysis indicated that female( OR=1.83, P<0.001), high educational level( OR=4.81, P=0.019), household registered in Shanghai( OR=1.80, P=0.004)had higher demand for service convenience; female gender( OR=1.68, P=0.001), high educational level( OR=4.56, P=0.023)had higher demand for home service demands. Conclusion:The demands for contracted family doctor services are different among the uncontracted young and middle-aged people in Baoshan district, while the service convenience is generally most demanded. The study indicates that the contracted family doctor service should be provided accordingly.

Objective:To investigate the safety and the efficacy of percutaneous and surgical approach in femoro-femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation.Methods:All consecutive patients implanted with femoro-femoral VA-ECMO between January 2018 and December 2020 in Beijing Anzhen Hospital, Capital Medical University. Propensity score matching was used to compare outcomes of percutaneous and surgical groups while controlling for confounders.Results:Among the 276 patients who received femoro-femoral VA-ECMO (62 surgical and 214 percutaneous), propensity-score matching selected 52 pairs of patients with similar characteristics with mean age of(59.6±13.0)years old, in which 26 patients were female. There were a lower ECMO cannulation-associated complication (28.8% vs. 48.1%, P=0.044) and a lower hospital mortality (42.3% vs. 67.3%, P=0.010) in the percutaneous group. The circuit blood flow after ECMO initiation was similar in both groups[(3.3±0.8)L·min -1·kg -1 in percutaneous group vs. (3.2±0.7)L·min -1·kg -1 in surgical group, P=0.738]. The serum lactate was declined in both group after ECMO initiation[(5.4±5.8)mmol/L vs. (9.2±6.9)mmol/L, P<0.001 in percutaneous group; (6.3±6.2)mmol/L vs. (10.5±7.0)mmol/L, P=0.003 in surgical group]. Conclusion:Percutaneous approach is a safe and efficient technique in emoro-femoral VA-ECMO cannulation. Compared with surgical cannulation, percutaneous approach is associated with lower ECMO cannulation-associated complication and lower hospital mortality.