This study was aimed to summarize and analyze acupoint selection rule of acupuncture in the treatment of primary dysmenorrhea in recent years,and to guide acupoint selection and compatibility in clinical practice.Relevant literatures in recent years were retrieved from the China National Knowledge Infrastructure (CNKI) full-text database.And then,literatures involving acupuncture prescriptions were summarized.Data were integrated and input.Finally,the SPSS software was combined to analyze the data of acupoint selection in the acupuncture prescription to achieve the conclusion.The results showed that in the acupuncture treatment of primary dysmenorrhea,the main meridian selections were the Ren Meridian and the Spleen Meridian of Foot Taiyin.The generally used acupoints were SP6-Sanyinjiao,RN4-Guanyuan,SPS-Diji,and etc.The multi-point compatibility therapy was used.It was concluded that although the advantages of acupuncture in the treatment of primary dysmenorrhea are prominent,the pathogenesis is mainly related to the liver,spleen and kidney,which are recognized by most physicians.However,there are still large differences in acupoint compatibility and acupoint selection.Hence,there are still no unified,scientific and standardized diagnosis and treatment standards.Further exploration should be made to guide clinical practice.

This study was aimed to explore the medication rules of Chinese herbal medicine compound in the treatment of primary dysmenorrheal based on data mining.Relevant literatures on Chinese herbal medicine compound in the treatment of primary dysmenorrhea were retrieved from June 2006 to June 2016 in the Chinese Journal Full-text Database (CNKI) to establish a literature database.The Excel 2010,SPSS 22.0 and SPSS Modeler 14.2 software were used in the frequency analysis,cluster analysis,association analysis,and etc.The results showed that literatures related to Chinese herbal medicine compound in the treatment of primary dysmenorrhea,there were 74 compound formula and 76 kinds of Chinese herbal medicine involved.Angelica was the core single Chinese herbal medicine.Chinese herbal medicine with high-frequency usage was the type of removing blood stasis,invigorating qi and blood.Cluster analysis can form 5 clustering combination.Primary dysmenorrhea was mainly clustered to two syndromes,which were qi and blood deficiency with blood stasis,liver and kidney deficiency with qi stagnation and blood stasis.The association rules analysis showed that there were a total of 25 rules,with the most common combination of two or multiple combination from four kinds of Chinese herbal medicine,including Angelica,Radix Paeoniae Alba,Rhizoma Chuanxiong,and Rhizoma Corydalis.It was concluded that blood stasis was the direct cause of primary dysmenorrhea,many of which belonged to the deficiency of root (i.e.,deficiency of qi,blood and cold deficiency) and excess of branch.Chinese herbal medicine treatment should be focused on the regulation of both qi and blood,invigoration of both liver and kidney,as well as harmonization of the blood.

Objective To explore the effect of calreticulin (CRT) on cell proliferation and invasion of human hepatocellular carcinoma cell line SMMC-7721 and HepG2.Methods SMMC-7721 and HepG2 cells were transfected with small interfering RNA (siRNA).The transfection rate was detected by immunoflurescence and western blot.The cell proliferation,invasion and apoptosis of SMMC-7721 and HepG2 cells were determined by using cell counting kit-8 (CCK-8) assays,transwell assays and flow cytometry,respectively.The p-Akt and Akt levels were detected by western blot.Results The growth inhibition rate in the siRNA experimental group of SMMC-7721 and HepG2 cells for 24,36 and 48 h were (41.0 ±2.2) ％,(46.5 ±1.6)％,(59.7 ±2.2)％ and (36.8 ±2.7)％,(47.3 ± 1.8)％,(61.5 ±3.2)％,respectively.The apoptosis rate after down-regulating the expression of CRT in SMMC-7721 and HepG2 cells for 36h were (45.2 ± 9.1) ％ and (48.9 ± 8.0) ％,respectively.Compared with the blank group and the negative control group,the growth inhibition rate in the siRNA experimental group was lower (P ＜0.05),but the apoptosis rate was significantly higher (P ＜ 0.05).Transwell experiments confirmed that the numbers of invaded SMMC-7721 and HepG2 cells in the blank group and the negative control group and siRNA experimental group were (96.8±7.3),(95.6±5.4),(34.0±4.2) and (124.0 ±9.9),(121.6 ±7.0),(70.4±9.5),respectively,indicating that cell invasion in the siRNA experimental group was significantly suppressed (P ＜ 0.05).The expression of p-Akt was decreased (P ＜ 0.05) after down-regulating the expression of CRT for 36h.Conclusion CRT gene silencing by siRNA can inhibit the SMMC-7721 and HepG2 cell proliferation and invasion,but increase the cell apoptosis by regulating PI3K/Akt signal pathway.

Objective To investigate the clinical value of enhanced recovery after surgery (ERAS) in patients undergoing postoperative early enteral nutrition (EEN) with radical resection for hilar cholangiocarcinoma.Methods The clinical data of 48 patients with hilar cholangiocarcinoma who were admitted to the Drum Tower Clinical Medical College of Nanjing Medical University from July 2006 to September 2014 were retrospectively analyzed.All the 48 patients underwent radical resection for hilar cholangiocarcinoma,including 24 patients receiving postoperative EEN (EEN group) and 24 patients receiving total parenteral nutrition (TPN group).The serologic indices and liver function were detected regularly after operation.Ten percent of albumin (Alb) 10 g was administered by intravenous infusion when Alb ＜ 30 g/L.The indexes of all the 48 patients were compared in the 2 groups at postoperative day 3 and 7,including the serologic indices and liver function,the exhaust time,the volume of Alb infusion,the complications (incisional infection,abdominal infection,pleural effusion,peritoneal effusion and bile leakage) and the duration of hospital stay.The patients were followed up by outpatient examination and telephone interview till September 2014.The measurement data with normal distribution were presented as x ± s,comparison between groups and count data were analyzed using the t test and chi-squared test,respectively.Results Patients in the 2 groups were cured successfully and discharged,and no patient died perioperatively.Patients in the EEN group had a good tolerance for EEN and no occurrence of EEN-related complications was detected.The level of the GGT was (108 ± 73) U/L in the EEN group,which was significantly lower than (225 ± 121) U/L in the TPN group at postoperative day 3 (t =4.041,P ＜ 0.05).The level of the GGT was (142 ± 86) U/L in the EEN group,which was no significantly different from (183 ± 107)U/L in the TPN group at postoperative day 7 (t =1.477,P ＞ 0.05).The postoperative time to anal exsufflation and the duration of hospital stay were (73 ± 18) hours and (15 ± 4) days in the EEN group,which were significantly different from (97 ± 21) hours and (18 ± 4) days in the TPN group,and the volume of Alb infusion was (44 ± 29)g in the EEN group,which was significantly lower than (101 ± 92) g in the TPN group (t =4.295,2.615,2.916,P ＜ 0.05).All the 48 patients were followed up for 1 to 71 months (mediantime,10 months),no patients received reoperation or re-admitted to the hospital due to complications.Conclusion The application of postoperative EEN in enhanced recovery of patients undergoing radical resection for hilar cholangiocarcinoma is safe and effective,it could accelerate the recovery of enteral function,shorten the postoperative duration of hospital stay and reduce the supplement of extrinsic Alb,which is helpful for the fast recovery of patients.

Objective To investigate the safety and short-term effect of anatomical hepatectomy for the treatment of hepatolithiasis with the caudate lobe as the sole remnant liver.Methods The clinical data of 1 patient with hepatolithiasis combined with liver atrophy-hypertrophy syndrome who was admitted to the Hunan Provincial People's Hospital in April 2014 were retrospectively analyzed.The stones were located in the left and right liver, the involved liver became fibroatrophy, and the hepatic caudate lobe not containing stones became hypertrophy.The body surface area of the patient was 1.65 m2 , standard total liver volume was 1 167.63 mL.According to the result of CT, expected residual liver volume after hepatectomy was 706.12 mL, and the ratio of residual liver volume over the standard total liver was 60.47％.The radio of residual liver volume over the body mass index was 1.21％.The patient received the second exploration of common bile ducts, hepatectomy with the caudate lobe as the sole remnant liver and T tube drainage.The follow-up including recurrence of calculus was performed by outpatient examination and telephone interview up to April 2015.Results The patient underwent caudate lobe as the sole remnant liver following anatomical hepatectomy successfully without blood transfusion.The operation time and volume of intraoperative blood loss were 380 minutes and 350 mL.The peritoneal drainage tube was removed at postoperative day 2 and the patient was discharged at postoperative day 8 with a good recovery of liver function.The postoperative pathological examination showed that there were focal biliary epithelial papillary hyperplasia combined with light-medium atypical hyperplasia and no canceration.The T tube cholangiography two month later showed that there were unobstructed lower bile duct and no residual intra-and extra-hepatic stones.The liver function was normal.Then T tube was removed and patient resumed normal life.During the 1-year follow-up, no chills and fever, jaundice and abdominal pain occurred, no calculus was detected by B-ultrasonography, and computed tomography reexamination showed that remnant liver volume was increased and no intra-and extra-hepatic bile duct stones were detected.Conclusion Anatomical hepatectomy for the treatment of hepatolithiasis with the caudate lobe as the sole remnant liver is safe and feasible, with a good curative effect.

The association between atrial fibrillation (AF) after coronary artery bypass grafting (CABG) and the surgical techniques selected has been extensively reported.However,no consistent results were obtained.In the present study,a meta-analysis was conducted by searching the electronic databases PubMed,Embase,Web of Science,and Cochrane to identify the association of post-CABG AF with on-pump (conventional CABG,cCABG) or off-pump CABG (OPCABG).Outcomes from randomized clinical trials (RCTs) and propensity score matching (PSM) trials were pooled by using the fixed-effect or the random-effect modeling method,and verified by the quality-effect modeling method.There were 35 studies with 36 independent reports that met the inclusion criteria and were eventually included in our meta-analysis.The total odds ratio (OR) of the incidence of post-CABG AF between OPCABG and cCABG was 0.80 (95％ CI 0.71-0.91).The 25 randomized clinical trials (RCTs) had an OR of 0.69 (95％ CI 0.56-0.86),while the OR of the 11 PSM trials was 0.88 (95％ CI 0.77-1.00).Twenty-six studies involving the patients at a mean age no more than 65 years showed an OR of 0.76 (95％ CI 0.64-0.90),whereas 10 studies with patients greater than 65 years old showed an OR of 0.90 (95％ CI 0.78-1.05).The results of this meta-analysis suggest that OPCAB surgery may reduce the incidence of post-CABG AF when compared to cCABG and that younger patients may benefit more from OPCAB and have a lower incidence ofpost-CABG AF.

Objective To explore the application of artificial TiMesh in supporting the serious smashing hollow fractured skull to restore its complete cranial cavity structure. Methods We retrospectively analyzed the data of 21 patients with serious smashing hollow fractured skull, admitted to our hospital from January 2004 to November 2009: surgical approaches and follow-up results were reviewed; the results of such examinations as X-ray, CT, ECT were analyzed to determine the skull plastic situation and particle bone survival situation. Results No serious postoperative complications were found in these 21 patients and the reconstruction was very successful with survival particle bones.Conclusion The artificial TiMesh, being able to conform to the physiological anatomy of human being,supports the serious smashing hollow fractured skull to restore its complete cranial cavity structure with satisfied reconstruction results and little postoperative complications.

OBJECTIVETo study the effects of Down syndrome cellular adhesion molecule (DSCAM) on differentiation of rat marrow mesenchymal stem cells (MSCs) into neurons in vitro.

METHODSMSCs from Sprague-Dawley rats were induced into neurons by baicalin. The expression of DSCAM before and after induction was evaluated by immunocytochemical staining and Western blot assay. After knockdown of DSCAM by siRNA transfection, the differentiation rate of neurons derived from MSCs was measured.

RESULTSBefore induction, the expression of DSCAM was not detectable in MSCs. After bFGF preinduction for 24 hrs, DSCAM was slightly expressed in MSCs (1.71+/- 0.67%). The DSCAM expression increased 6 hrs after baicalin induction (15.79+/- 4.24%), reached a peak at 3 days (53.16+/- 5.94%) and then decreased gradually. The DSCAM expression 6 days after baicalin induction (28.99+/- 6.72%) was significantly lower than that at 3 days (P<0.01). However, after DSCAM-siRNA transfection, the DSCAM expression in MSCs was significantly reduced. MSCs did not express neuron-specific beta-III-tubulin before induction. After baicalin induction for 6 hrs, 3 days and 6 days, the expression of beta-III-tubulin was 1.40+/- 0.79%, 41.59+/- 3.17% and 59.11+/- 4.76% respectively. But the beta-III-tubulin expression significantly decreased 3 and 6 days after DSCAM-siRNA transfection (28.57+/- 2.91% and 43.90+/- 12.31% respectively).

CONCLUSIONSDSCAM may play an important role in MSCs differentiation into neural cells.

Animals ; Bone Marrow Cells ; cytology ; Cell Adhesion Molecules ; physiology ; Cell Differentiation ; Mesenchymal Stromal Cells ; cytology ; Neurons ; cytology ; RNA, Small Interfering ; genetics ; Rats ; Rats, Sprague-Dawley ; Transfection

Objective:To analyze the research status, development trend and frontier hotspots of midwifery education in China in recent 20 years.Methods:Based on the topic of "midwifery education" or "midwifery teaching", this paper searched the periodical literatures from 2001 to 2021 on CNKI database, and used CiteSpace5.7R5 software to analyze them visually and generate knowledge map.Results:A total of 548 Chinese papers were included in this study, and the annual number of published papers showed an overall upward trend. The research field of midwifery education in China formed an obvious core team, and there was few cooperation among core author groups. Health Vocational Education, Chinese Nursing Education and Chinese Higher Medical Education were the top three journals. The six topics with the highest frequency were midwifery specialty, midwifery personnel, midwifery education, practice teaching, delivery mode and teaching mode, forming 10 clusters of midwifery education. In recent three years, the research of midwifery education in China has gradually changed into simulation teaching, flipped classroom, postpartum rehabilitation and so on. Conclusion:The research scope of midwifery education in China is wide and has formed an obvious core team, but the correlation is weak and there is less communication and cooperation among the research teams. The research in the field of high-level midwifery education is insufficient. Midwifery educators and researchers should pay enough attention to carry out in-depth research on relevant aspects.