Objective To lay foundation for the establishment of national standards of electroacupuncture devices by exploring the problems existing in their clinical application.Methods An analysis was made of the models, stimulus waveforms and complex waveform characteristics, stimulus frequencies, current intensities and pulse widths of electroacupuncture devices reported in clinical literature. The actual output frequencies of three kinds of electroacupuncture devices were measured using RM6240C multi-channel physiological signal acquisition and processing system to observe the accuracy of their actual output parameters and summarize the problems existing in electroacupuncture devices. Results The reports on electroacupuncture device parameters showed that of the five indicators analyzed statistically, the frequency of described waveforms was the highest (96.2%); the frequencies of described models (88.8%), stimulus frequencies (61.7) and current intensities (11.2%) were next; the frequency of described pulse widths was the lowest (1.8%). The electroacupuncture device most commonly used clinically was G6805 series, but the subtypes were confused because of many manufacturers. The waveform was described more frequently but complex waveform characteristics were less. The difference of frequencies of clinical application of electroacupuncture was larger. They were from 0.8-400 Hz but described less accurately. The output frequency was indicated by the range in most of the literature. The output adjusters of the three kinds of electroacupuncture devices did not correspond to their actual output frequencies. There was a larger difference between the actual range of output frequencies and the adjustable frequency range indicated in the instruction.Conclusions Electroacupuncture devices have the problems of lacking a display unit of actual output parameter values, the adjusting parameters of the knob adjustable controller being not precise enough and the actual values of output frequencies not reaching the rated range in the instruction.

Objective To evaluate the effectiveness and safety of isometric neck strength training for the treatment of neck-type cervical syndrome.Methods The qualified patients with neck-type cervical syndrome were divided into two groups by stratified randomization: the treatment group(N=55)received isometric neck strength training,and the control group(N=40) received manipulation treatment.Two weeks constituted one treatmeat course.Visual Analog Scale(VAS) and Vernon Cervical Disability Index(VCDI) were used to evaluate the efficacy,and the safety was also monitored.Results All of the 95 enrolled patients were followed up for 3~11.4 months.No aggravation was found in the treatment group,but in the control group one patient developed into cervical spondylotic radiculopathy and one patient developed into sympathetic cervical spondylosis.The frequency of serious neck pain attack within 3 months was 6.65?2.62 times in the control group and 2.27?1.50 times in the treatment group,the difference being significant(P0.05);the result of follow-up on the 3rd month after treatment showed that the difference of VCDI score was significant between the two groups(P

AIM: Valproic acid (VPA) is a histone deacetylase inhibitor and is believed to have anti-tumor activity. The present study aims to investigate the effect of VPA on the, apoptosis and cytokine synthesis of human peripheral lymphocytes. METHODS: The activation and cytokine synthesis in lymphocytes in whole blood stimulated with phorbol dibutyrate (PDB) and ionomycin were evaluated with flow cytometry after fluorescent staining. The mitochondrial membrane potential was examined using 3, 3-dihexyloxacarbocyanine iodide [DiOC6(3)]staining. RESULTS: VPA at low doses (1 and 5 mmol/L) promoted CD69 expression in activated lymphocytes, whereas it turned to inhibit the expression of CD69 at a high dose (25 mmol/L). Meanwhile, VPA at low doses increased the mitochondrial membrane potential, while a high dose of VPA decreased it in activated lymphocytes. Furthermore, interleukin-2 (IL-2) synthesis was enhanced by low doses of VPA but inhibited by a high dose. However, interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) synthesis were dose-dependently enhanced by VPA as compared with those of PDB plus ionomycin-treated cells. CONCLUSION: VPA exerts biphasic effect on the further activation and apoptosis of human peripheral lymphocytes stimulated with mitogens and exhibits differential activity on the synthesis of several important cytokines in human lymphocytes.

Objective To study the cause and management of difficult laparoscopic appendectomy.Method A retrospective analysis of 102 difficult laparoscopic appendectomies was performed. Results The associating factors leading to operative difficulty were as follows:adhesion of peri-appendix in 44 cases,gangrene at root of appendix in 21 cases,special location of appendix in 17 cases,abdominal adhesion in 12 cases,obesity and inflatable intestine in 8 cases. Laparoscopic appendectomy was successfully performed in 96 cases(94.1%,96/102) ,and no intestinal leakage or massive hemorrahge occurred. Conclusions Adhesion of peri-appendix is the most common cause in difficult laparoscopic appendectomy,and gangrene at root of appendix is the most difficult one. Reasonable management for appendix stump contributes to successful operation.

OBJECTIVETo evaluate the association of early diarrhea and fecal volume with anastomotic leakage after low anterior resection (LAR) of rectal cancer.

METHODSClinical data of 541 patients with rectal cancer undergoing LAR at The Affiliated Hospital of Guangdong Medical College between January 2007 and January 2017 were analyzed retrospectively. Early postoperative diarrhea was defined as at least one occurrence of more than 50 ml watery stool or at least four times defecation per day within 7 days after surgery. The volume of fecal discharge from the transanal drain was measured at daily intervals for 3 days after surgery. Association of early diarrhea and anastomotic leakage was analyzed using logistic regression model. The accuracy of fecal volume in predicting anastomotic leakage was evaluated using receiver operating characteristics (ROC) curve.

RESULTSThere were 319 males and 222 females with mean age of 59.3 years. Early postoperative diarrhea occurred in 99(18.3%) patients, and 41(7.6%) patients developed anastomotic leakage. The incidence of anastomodc leakage in patients with early diarrhea was significantly higher as compared to those without early diarrhea (15.2% vs. 5.9%, P=0.000). Multivariate analysis revealed that early diarrhea (OR=33.940, 95%CI: 8.423 to 89.240) and the distance between the tumor and the anal verge less than 7 cm (OR=13.085, 95%CI: 2.117 to 44.556) were independent risk factors for anastomotic leakage, while the presence of a transanal tube was an independent protective factor (OR=0.474, 95%CI: 0.122 to 0.881). The total fecal volume for 3 days after surgery was calculated in 162 patients with a transanal tube. The median fecal volume was 210 (100 to 4360) ml and 60 (0 to 480) ml in patients with and without anastomotic leakage respectively(P=0.000). ROC curve showed that the cut-off value of fecal volume for anastomotic leakage was 110 ml and the area under the curve was 0.824 with a high sensitivity of 85.7% and specificity of 81.3%.

CONCLUSIONSEarly postoperative diarrhea after LAR procedure of rectal cancer may be an early predictor of anastomotic leakage, and fecal volume for 3 days after surgery ≥110 ml can accurately predict anastomotic leakage. Active prevention and management of early postoperative diarrhea may reduce the risk of anastomotic leakage.

Objective To investigate the therapeutic efficacy of laparoscopic surgery for treatment of the patients with advanced gastric cancer.Methods A total of 120 patients with advanced gastric cancer treated by D2 radical resection of distal gastric cancer from January 2015 to January 2017 in Affiliated Hospital of Guangdong Medical University were retrospectively analyzed.According to the method of operation,the patients were divided into laparoscopic group (60 cases) and laparotomy group (60 cases).The operation-related indexes,operation curative effect indexes and postoperative recovery were compared between the two groups by using x 2 test and t test.Results The operation time of the laparoscopic group was longer than that of the laparotomy group [(197±21) min vs.(178±23) min,t =4.759,P ＜ 0.001].Some parameters in the laparoscopic group were lower than those in the laparotomy group (all P ＜ 0.05),including intraoperative blood loss [(111±30) ml vs.(221±52) ml,t =14.103],the length of the surgical incision[(6.1±1.3) cm vs.(17.3±3.2) cm,t =25.117],postoperative anal evacuation time [(90±14) h vs.(110±18) h,t =6.983],the postoperative bed-out time [(2.9±0.8) d vs.(4.8±1.4) d,t =9.127],the postoperative liquid dietary intake time [(4.3±0.9) d vs.(5.7±1.2) d,t =7.230],and hospital stay time [(13.2±2.5) d vs.(15.5±3.2) d t =4.387].There were no statistical differences in the number of removed lymph nodes,the number of first-site removed lymph nodes,the number of second-site removed lymph nodes,the distance from the distal margin to the tumor,and the distance from the proximal margin to the tumor (t values 1.351,0.912,1.240,0.876,and 0.840 respectively,all P ＞ 0.05);The incidence of operative complications in the laparoscopic group was lower than that in the laparotomy group [6.67 ％ (4/60) vs.20.00 ％ (12/60),X 2 =4.615,P =0.032].Conclusion Laparoscopic surgery in the treatment of advanced gastric cancer patients has a favorable effect,with reliable results,less trauma,postoperative recovery and fewer complications.

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.

Objective To observe and compare the safety and short-term outcomes of laparoscopic surgery (LS)versus conventional open surgery(OS)for stage Ⅱor Ⅲ rectal cancer(RC). Methods One hundred and six patients with stage ⅡorⅢRC were divided into LS group(n=53)and OS group(n=53)according to the random double blind method. The related outcomes of two groups were compared ,including surgical duration , intraoperative blood loss , length of incision , distal margin length , proximal margin length , the number of lymph node dissection,residual cancer rate,exhaust time,first ambulation time,and postoperative hospital stay. Results Intraoperative blood loss,length of incision,postoperative hospital stay,exhaust time and the first ambu-lation time in LS group were significantly different from those in OS group (P < 0.05 for all comparisons). And there were no significant differences between the two groups in surgical duration ,the number of lymph node dissec-tion,distal margin length,proximal margin length and residual cancer rate(P > 0.05). Conclusions Laparo-scopic technology is safe and feasible in treating rectal carcinoma,with less trauma,quicker recovery,and shorter hospital stay.

Objective To study the value of breast vascularity in differential diagnosis of benign and malignant breast lesions. Methods The data of 37 patients with benign and malignant breast lesions in the Second Hospital of Shanxi Medical University from February 2017 to November 2017 were respectively analyzed. The number, diameter, length and breast-feeding arteries of bilateral breast vessel were recorded in the maximal intensity projection (MIP) of magnetic resonance imaging (MRI) and were scored according to Sardanellie. The patients were divided into the benign group and the malignant group according to the pathological results. Besides, ≥2 cm group and <2 cm group was also divided according to the maximum diameter of lesions. The differences in number and score of vascularity in both groups were compared. And the diagnostic efficacy of MRI was evaluated based on Sardanellie score and breast-feeding arteries. Results There were no significant differences in the number and score of vascularity between bilateral breast in benign breast lesions group (1.11 ±0.35 vs. 1.22 ±0.45, t= 0.19, P= 0.85; 0.89 ±0.38 vs. 0.95 ±0.21, t= 0.25, P=0.80). The number and score of vascularity of the affected side were higher than those of the healthy side in breast malignant lesions group (2.61 ±1.29 vs. 0.61 ±0.21, t= 6.18, P= 0.00; 1.78 ±0.65 vs. 0.61 ±0.21, t=6.30, P=0.00 respectively). The number and score of vascularity were statistically different between benign and malignant breast lesions (t= 8.57, P< 0.001; t= 12.61, P< 0.001). The number of vascularity in the malignant group was higher than that in the benign group with the maximum diameter of lesion<2 cm (1.27 ± 0.59 vs. 2.57±0.98, t=90.5, P< 0.05), and there was no significant difference in the scores of vascularity in the malignant group and the benign group (1.09 ±0.43 vs. 1.86 ±0.38, t= 87.0, P> 0.05); The number and score of vascularity in the malignant group were higher than those in the benign group with the maximum diameter ≥2 cm (0.92±0.63 vs. 2.64±1.50, t=47.5, P<0.05; 0.92±0.33 vs. 1.73±0.79, t=53.5, P< 0.05). There was no significant improvement in the diagnostic efficacy of MRI based on the score of vascularity and positive breast-feeding arteries in the identification of benign and malignant lesions when the maximum diameter of lesions were<2 cm, and it had a high diagnostic efficacy when the maximum diameter of lesions were ≥2 cm. Conclusions The vascularity of breast can be clearly seen by using breast dynamic contrast enhanced (DCE) MRI. The increase and score of vascularity in the differential diagnosis of benign and malignant breast lesions have a certain application value. The positive of breast-feeding arteries may increase the diagnostic efficiency of MRI.

Objective:To investigate the regulatory effect of long non-coding RNA (lncRNA) FTX on gastric cancer cell proliferation through miR-22-3p/NOD-like receptor protein 3 (NLRP3) inflammasome pathway.Methods:The gastric cancer cell line NCI-N87 were divided into blank control group, si-FTX-NC group, si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group. Quantitative real-time fluorescent PCR was performed to analyze the expression levels of lncRNA FTX and miR-22-3p, clone formation assay was performed to analyze the proliferation ability of NCI-N87 cells, western blotting was performed to analyze the expressions of NLRP3 inflammasome pathway proteins, and dual-luciferase reporter assay was performed to analyze the targeting relationship between lncRNA FTX and miR-22-3p.Results:The relative expressions of lncRNA FTX in the blank control group, si-FTX-NC group, si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group were 1.03±0.09, 1.01±0.15, 0.42±0.08, 0.45±0.06 and 0.46±0.13 respectively, with a statistically significant difference ( F=52.19, P<0.001). The relative expressions of miR-22-3p were 1.04±0.12, 0.97±0.08, 2.26±0.15, 2.23±0.13 and 1.15±0.11 respectively, with a statistically significant difference ( F=178.53, P<0.001). Compared with the blank control group and si-FTX-NC group, the relative expressions of lncRNA FTX in the si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group decreased (all P<0.001). Compared with the blank control group, si-FTX-NC group and si-FTX+miR-22-3p inhibitor group, the relative expressions of miR-22-3p in the si-FTX group and si-FTX+miR-22-3p inhibitor-NC group increased (all P<0.001). The clones of the five groups were 115.50±7.25, 112.33±8.46, 54.83±5.17, 56.17±6.32 and 85.67±9.43, with a statistically significant difference ( F=91.67, P<0.001). The levels of NLRP3 protein in the five groups were 1.84±0.17, 1.86±0.12, 0.95±0.09, 0.97±0.11 and 1.28±0.19, with a statistically significant difference ( F=60.62, P<0.001). Compared with the blank control group and si-FTX-NC group, the number of clones and the level of NLRP3 protein of the si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group decreased (all P<0.05). Compared with the si-FTX+miR-22-3p inhibitor group, the number of clones and the level of NLRP3 protein in the si-FTX group and si-FTX+miR-22-3p inhibitor-NC group decreased (all P<0.05). The dual-luciferase reporter assay found that miR-22-3p was the target gene of lncRNA FTX. Conclusion:Silencing the expression of lncRNA FTX can inhibit the proliferation of gastric cancer cells, and the mechanism may be related to the regulation of lncRNA FTX on the miR-22-3p/NLRP3 inflammasome pathway.