The paper introduces Professor SUN Shentian's experience in clinical practice of Ningshen (tranquilizing the mind) point. This point is an empirical point discovered by Professor SUN on the basis of meridian differentiation, nerve function and anatomic location, and in association with the years of clinical practice. The point is located in the prefrontal area, jointed with the distribution of the governor vessel, and responded to the body surface projection area of the frontal pole. It works on regulating the mind, regaining consciousness, improving cognition, alleviating depression, mutually treating physical and mental disorders, as well as unblocking collaterals, regulating the tendons and relieving spasm. This point is widely used in treatment of mental disorders, stroke and extrapyramidal diseases and obtains the reliable therapeutic effect in clinical practice.
Humans ; Acupuncture Points ; Acupuncture Therapy/history* ; China ; Meridians ; History, 20th Century

Objective The aim of this study was to explore the correlation between the methylation status of microRNA let-7a-3 in esophageal squamous cell carcinoma(ESCC)and the expression of insulin-like growth factor 2(IGF-Ⅱ).Methods The methylation specific PCR(qMSP)was used to detect the methylation status of let-7a-3 in 83 cases of esophageal cancer and corre-sponding adjacent normal tissues.The enzyme linked immunosorbent assay(ELISA)was used to detect the expression of IGF-Ⅱ in plasma.Results The degree of let-7a-3 methylation in cancer tissues of 83 patients with ESCC was significantly higher than that in normal tissues adjacent to cancer(P<0.001).The expression of IGF-Ⅱ in the plasma of 83 patients with ESCC was positively corre-lated with the methylation degree of let-7a-3,which was statistically significant(r=0.600,P<0.001).Conclusion microRNAlet-7a-3 may participate in the occurrence and progression of ESCC by regulating the methylation of downstream molecules,which is of great significance for understanding the mechanisms of ESCC development and providing a basis for the diagnosis and prognosis of ESCC.

Objective To explore the effect of multi-sensory artificial intelligence feedback gait training on the recovery of walking function in stroke patients based on enriched environment theory. Methods From July,2021 to June,2023,a total of 80 stroke patients in Huashan Hospital Affiliated to Fudan University were randomly divided into control group(n=40)and experimental group(n=40).Both groups received rou-tine rehabilitation in the lying and seated positions,for 40 minutes.The control group received ground walking training,for 20 minutes,while the experimental group received multi-sensory feedback gait training in enriched environment,for 20 minutes.Before and after four weeks intervention,the digital motion monitoring treadmill was used to mearsure step speed,step length,hip and knee swing angle and weight symmetry.They were as-sessed with Berg Balance scale(BBS),Fugl-Meyer Assessment-Lower Extremities(FMA-LE)and Barthel Index(BI). Results After intervention,the hip swing angle,step length of both sides and step speed significantly improved in both groups(|t|＞3.162,P＜0.05),and they were better in the experimental group than in the control group(|t|＞2.568,P＜0.05);the average knee joint swing angle and bilateral weight-bearing symmetry significantly im-proved in the experimental group(|t|＞3.249,P＜0.01);the scores of BBS,FMA-LE and BI improved in both groups(|t|＞3.569,P＜0.01),and they were better in the experimental group than in the control group(|t|＞2.922,P＜0.05). Conclusion Multi-sensory feedback gait training based on enriched environment theory could effectively improve the walking and balance of stroke patients,and increase the ability of independence.

Objective:To discuss the distinctive sonographic feature and the biological behavior of renal angiomyolipoma(RAML),and to provide the reference for the clinicians to make the accurate diagnosis of RAML.Methods:The clinical data of one patient with invasive classical RAML combined with pseudaneurysm formation were collected.The sonographic appearances were analyzed in conjunction with the pathological characteristics to clarify the biological behavior of RAML,and the relevant literatures were reviewed.Results:The patient,a 60-year-old female,visited the local hospital due to discomfort in the lumbar area,and received CT examination,and the CT examination results revealed a left renal mass,so the patient came to our hospital.The specialist clinical examinations and laboratory investigations were unremarkable.The ultrasound results indicated an enlarged left kidney with a cystic and solid mass at the upper pole,which featured pseudaneurysm formation(originating from the interlobar arteries);the enhanced CT image results suggested a high probability of upper pole renal carcinoma combined with aneurysmal formation within the tumor,alongside invasion into the left adrenal gland.The patient underwent laparoscopic radical left nephrectomy,and the postoperative pathology confirmed the diagnosis of invasive classical RAML.Conclusion:The classical RAML can exhibit the invasive biological behavior.The pseudaneurysm formation is a special sonographic manifestation of RAML,which can be challenging to differentiate from the other renal tumors.

Objective:To evaluate the effect of combining contralateral high-frequency transcranial magnetic stimulation (rTMS) with biofeedback-controlled empty swallowing training on dysphagia among stroke survivors.Methods:Eighty dysphagic stroke survivors were divided at random into a control group, a biofeedback group, an rTMS group and a combined treatment group, each of 20. In addition to routine dysphagia rehabilitation, the biofeedback group and the rTMS group received empty swallowing training based on biofeedback or high-frequency rTMS applied to the healthy motor cortex as appropriate. The combined treatment group was given both. The treatment was administered once daily, 5 days a week for 3 consecutive weeks. Before and after the treatment, all of the subjects′ swallowing was evaluated using the penetration aspiration scale (PAS), functional oral intake scale (FOIS) and a standardized swallowing assessment (SSA). The latency and amplitude of the mylohyoid muscle′s motor evoked potentials (MEPs) were also recorded before and after the treatment.Results:After the treatment, significant improvement was observed in the average PAS, FOIS and SSA scores as well as in the latency and amplitude of the MEPs in the four groups. The average results in the combined treatment group were significantly better than in the other 3 groups. The latency of the mylohyoid muscle′s MEP was significantly shorter in the combined group than in the control and biofeedback groups on average, while the amplitude was significantly greater than in the control group.Conclusion:Combining contralateral high frequency rTMS with empty swallowing training based on biofeedback can better improve the swallowing of dysphagic stroke survivors.

Objective:To evaluate the clinical efficacy of intermittent theta burst stimulation (iTBS) of the bilateral cerebellum in treating post-stroke dysphagia.Methods:Forty patients with dysphagia after a cerebral infarction were randomly divided into a control group and an iTBS group, with 20 cases in each group. In addition to routine swallowing rehabilitation training and nutritional guidance, the iTBS group underwent daily bilateral cerebellar iTBS 6 times a week for 3 weeks, while the control group was given sham stimulation. Before and after the treatment, both groups were evaluated by using the water-swallowing test and the standardized swallowing assessment (SSA), and the latency and amplitude of the mylohyoid muscle′s motor evoked potential (MEP) were also recorded. The SSA scores and MEP amplitudes of the mylohyoid muscle after treatment were tested for any correlation.Results:The treatment improved the water-swallowing test results in both groups, with that of the iTBS group significantly better than that of the control group. The clinical efficacy in the iTBS group was 95%, significantly higher than the control group′s 80%. The SSA scores decreased significantly in both groups after the treatment, with the iTBS group′s average score then significantly lower than that of the control group. The average latency and amplitude of the mylohyoid muscle′s MEP was also significantly better in the iTBS group after the treatment. In the control group only the average amplitude was significantly greater than before the treatment. Pearson correlation analysis showed that the SSA scores and the MEP amplitudes of the mylohyoid muscle after treatment were uncorrelated in both groups.Conclusions:Bilateral intermittent theta burst stimulation can effectively improve the swallowing of patients with post-stroke dysphagia.

Objective:To seek any differential effect of combining repeated transcranial magnetic stimulation (rTMS) with a modified version of constraint-induced movement therapy (mCIMT) on the walking ability of stroke survivors.Methods:Seventy-five stroke survivors were randomly divided into a sham rTMS group, an rTMS group and a combined group, each of 25. In addition to 40 minutes of routine rehabilitation daily, including balance training, transfer training, muscle strength training, and proprioceptive training five times a week for 4 weeks, the sham rTMS group and rTMS group received sham or genuine rTMS. The combined group received 20 minutes of rTMS followed by mCIMT training 30 minutes later. The treatment was performed once a day, 5 days a week for 4 weeks. Before and after the treatment, all groups were evaluated using the Fugl-Meyer lower extremity assessment, the Berg balance scale, a 10-metre walk test and the modified Barthel index.Results:Significant improvement was observed in the average scores of all three groups in all of the assessments. The combined group′s averages were, however, significantly better than those of the other two groups.Conclusion:Supplementing mCIMT with rTMS can better improve the walking and other abilities in the activities of daily living of stroke survivors.

Objective:To investigate abnormal urination and penile appearance satisfaction of preschool children (3-6 years old) after hypospadias repair.Methods:From January 2016 to December 2020, children with primary hypospadias, who had no postoperative complications for more than 1 year and were at pre-school age at the time of investigation (January 2022), were selected. The abnormal urination manifestations and satisfaction with penile appearance of the children after operation were investigated by questionnaires to their parents.The questionnaire was designed based on the reported abnormal urination after hypospadias surgery, including 4 items (urination spraying, urination dripping, deflection of urine line, small urine line). Another questionnaire was used to evaluate the penis appearance satisfaction according to the existing pediatric penile perception score (including 4 items: the position and shape of the external urethral orifice, the shape of glans, the appearance of the prepuce, and the overall appearance; items were scored according to the subjective satisfaction of the subjects: very satisfied 3 points, satisfied 2 points, dissatisfied 1 point, very dissatisfied 0 point). The patients were divided into two groups according to whether the penile curvature after degloving was more than 30°. In group Ⅰ (penile curvature≤30°), 28 patients without severe penile curvature underwent tubularized incised plate (TIP) surgery, with a median age of 3.2 years (ranged 1.1-5.4 years). In group Ⅱ (penile curvature>30°), there were 27 patients with severe penile curvature and they underwent staged flap operation. Their median age was 2.8 years (ranged 1.5-4.7 years). There was no significant difference in age at operation between the two groups ( P=0.82). The questionnaire content was analyzed and the differences between the two groups were compared. Results:Among the 55 children, 21(38%, 21/55) had abnormal urination, and there was a significant difference between group Ⅰ (25%, 7/28) and group Ⅱ (52%, 14/27)( P=0.04). All the items of penis appearance satisfaction were satisfactory (scores ≥2), and the total scores of group Ⅰ and group Ⅱ were respectively 10.3±2.2 and 9.0±2.9, with no significant difference between the two groups (P=0.63). Conclusions:In the postoperative follow-up of preschool children with hypospadias, parents were satisfied with the appearance of the penis.The abnormal urination was common. Compared with children without severe penile curvature treated by TIP surgery, abnormal urination was more common in children with severe penile curvature treated by staged flap operation.

Purpose: The aim of this study was to develop a scale to measure nursing students' competence in managing violence from patients and relatives in the hospital where nursing students perform clinical practicum. Methods: Literature review and Delphi expert consultation were utilized to develop the content of the management of workplace violence competence scale (MWVCS). A convenience sample of 797 nursing students responded to the questionnaire. Exploratory factor analysis of the scale was performed. Internal consistency and test–retest reliability were examined. Results: The MWVCS consisted of 40 items with a five-point scale. Seven factors explained 63.2% of the total explained variance. The content validity index for the scale was .99. Cronbach's α of the scale was .96, and test–retest correlations were found to be ≥ .76. Conclusion The MWVCS is a reliable and valid scale for nursing educators to assess the level of students' competence in violence management and to evaluate the effectiveness of education to enhance their ability to manage workplace violence.

Objective:To investigate the therapeutic effect of dorsal skin-tightening technique on the correction of mild penile curvature in children with hypospadias.Methods:The clinical characteristics of hypospadias patients (95 cases) with mild penile curvature (<30°) after degloving penis during operation in our hospital from Jan 2017 to Sep 2020 were analyzed retrospectively. Group A: A new technique, reconstructing penile pubic angle at 12 o'clock position of penile dorsal side after degloving and suturing forskin outer and inner plate with tension at 12 o'clock position, was performed in dorsal skin-tightening group (43 cases). Gtoup B: while in dorsal midline tunica albuginea plication group (52 cases), Buck fascia was incised on dorsal midline area, following by tunica albuginea plication with one or two stitches. The patients in Group A were 0.4 to 1.5 years old, and the median age was 1.1 years, urethral orifice were located on distal shaft in 36 cases, proximal in 7 cases.The patients in Group B were 0.5 to 2.6 years old, and the median age was 1.5 years, urethral orifice were located on distal shaft in 41 cases, proximal in 11 cases. The penile ventral curvature degree was recorded during regular follow-up (postoperative 6 and 12 months), as well as postoperative complications.Results:Artificial erection test showed penile curvature was corrected during surgery by measuring with protractor. There was no chordee by measuring with the side photos in all patients during an average of 1.6 years follow-ups. There were 4 case of urethral fistula in Group B and 3 cases in Group A. No cases of urethrostenosis, diverticulum or concealed penis was recorded. The difference of postoperative complications had no statistical significance.Conclusion:Hypospadias with mild penile curvature could be effectively corrected by dorsal skin-tightening technique, which showed a good result of early follow-up.