Acupuncture treatment of insomnia has been reported for many years,but its validity remains controversial up to now.In the present review,the authors took "Acupuncture","Insomnia" as the key words to do a literature search from databases in both Chinese and English via computer retrieval system and also conducted a hand-made retrieval from journals of Chinese medicine as Chinese Acu-moxibustion,and collections of theses of the related academic conferences.Then,they made a systemic evaluation on the original articles from methodology,diagnosis,criteria for the enlisted and excluded patients,intervention methods of acupuncture and control groups,standards for assessing the curative efficacy,follow-up visit,etc.Of the retrieved 80 clinical articles,20 are RCT(randomized controlled trails) composed of 1907 cases,including 4 high-quality trails and 16 lower-quality trails.Regarding the assessment of the therapeutic effect,measuring scales are often adopted in overseas studies,while in domestic researches,self-drawn standards are frequently used.In conclusion,there have had no high-quality clinical trails about acupuncture treatment of primary insomnia in China at the present,and the related evaluating methods could not definitely confirm the efficacy of acupuncture in relieving insomnia.Therefore,a strict and scientific clinical trail scheme being in line with evidence-based medicine is urgently needed in the coming studies on acupuncture treatment of primary insomnia.

Objective To evaluate the value of glycosylated hemoglobin (HbAlc) level in glucose monitoring,insulin therapy and neonatal birth weight prognosis in gestational diabetes mellitus (GDM) patients.Methods Data of 1074 women who were diagnosed as GDM and delivered at Peking University First Hospital between January 1,2005 and August 31,2011 were collected and retrospective analysis was conducted.The relationship of HbAlc level with plasma glucose level of oral glucose tolerance test (OGTT),insulin administration and neonatal birth weight were investigated with Pearson correlation analysis,Logistic regression analysis or receiver operating characteristic (ROC) curve.Results OGTT was done on 1074 women with (31.8± 4.0) years old during the second and third trimester and diagnosed GDM at (27.6 ± 3.4) weeks of gestational age.Among them,glucose level of fasting and 1 and 2 hours after OGTT were (5.2 ± 0.7),(10.9± 1.4) and (9.4±1.5) mmol/L.The levels of HbAlcwere (5.57±0.48)％ at the fist time of HbAlc testing at (31.8±4.3) weeks of gestational age.(1)The average value of HbAlc in 726 women determined at one month after OGTT was (5.54±0.47)％,and increased from (5.34±0.41)％ in women with one abnormal item in OGTT to (5.47±0.41)％ and (5.71±0.46)％ in women with two or three abnormal items inOGTT (t=3.025 and 6.399,all P＜0.01).(2) HbAlc level in women received insulin therapy was higher than those who did not [(5.78±0.58) ％ vs (5.42±0.37) ％,t=9.431,P＜0.01].The sensitivity and specificity were 57.8％ and 75.5％ respectively in predicting insulin requirement in women with GDM at the cut-off value of 5.67％ for HbAlc (Logistics analysis:OR＝6.847,95％CI:4.588-10.218,P＜0.01).(3) Maternal HbAlc levelat the third trimester was higher in large for gestational age(LGA) group than that in non-LGA group [(5.75±0.52)％ vs (5.54±0.42)％,t=6.845,P＜0.01].The sensitivity and specificity were 44.8％ and 73.8％ respectively in predicting LGA at the cut-off value of 5.75％ for HbAlc (Logistics analysis:OR=2.187,95％CI:2.097-3.783,P＜0.01).(4) Maternal HbAlc level at the third trimester was higher in macrosomia group than that in non-macrosomia group [(5.88±0.53)％ vs (5.57±0.45)％,t=5.990,P＜0.01].The sensitivity and specificity were 50.4％ and 79.8％ respectively in predicting macrosomia at the cut-off value of 5.85％ for HbAlc (Logistics analysis:OR=3.299,95％CI:2.237-4.865,P＜0.01).Conclusions HbAlc level at the time of GDM diagnosis could imply the severity of disease and might predict insulin requirement.While maternal HbAlc level at the third trimester may predict the occurrence of LGA and macrosomia.

Objective To discuss the safety and feasibility of percutaneous transhepatic biliary preset implantation of after-loading radiotherapy catheter in treating bile duct carcinoma of ampulla.Methods A total of 10 patients with carcinoma of ampulla were collected.After percutaneous transhepatic biliary stent implantation was accomplished,the after-loading radiotherapy catheter was inserted via the guide wire.Based on the lesion's location,the positioning of both the catheter tip and the simulation radioactive source implanted through catheter was conducted.Each time before irradiation,the positions of the catheter and the radioactive source were reset under CT or fluoroscopic guidance in order to ensure that the lesion could get adequate internal irradiation dose.Results Percutaneous transhepatic biliary implantation of after-loading radiotherapy catheter and the positioning of simulation radioactive source were successfully accomplished in all 10 patients,and the total internal irradiation dose was completed within 5-7 days after catheter implantation.No severe complications occurred during the whole therapeutic process.Conclusion The technology of percutaneous transhepatic biliary preset implantation of after-loading radiotherapy catheter is safe and feasible,it carries high success rate with less complications.This therapy can improve the patency rate of biliary stent,and,as a palliative treatment,it is suitable for patients with carcinoma of ampulla.This treatment is worthy of application and promotion.

Objective The staffs of biosafety level 3 laboratories (BSL-3) face with the stress of handling highly pathogenic microbs and special laboratory environment.The job stress may result in accidents in the laboratory as negative factor for the risk control.The research may provide support for the control of risk in biosafety laboratories.Methods In order to assess the job stress in the staff in BSL-3 laboratory, we modified “the Chinese simple job stress questionnaire”based on the theory of the JDC mode and ERI mode, and an investigation was carried out.The present study included the staffs (87 employees) from six BSL-3 laboratories located in five provinces ( Shanghai, Zhejiang, Jiangsu, Fujian and Wuhan) .Results Analysis of the data indicates that variables of age, working years, job duties, manipulating of animals, type of microorganisms and transmission route have a significant influence on the level of job stress in BSL-3 laboratory.Conclusion The BSL-3 laboratory staff in higher stress level have the characteristicses:20-39 years old, short work years, regular staff, operating on air-borne microbiology, manipulating of animals and operating on one more microbiology.

This study prospectively examined the intranasal distribution of nasal spray after nasal septal correction and decongestant administration.A cohort of 20 patients was assessed for the distribution of nasal spray before and after nasal septum surgery.Sprays were dyed and administered one puff per nostril when patients hold their head up in an upright position.Before and after decongestant administration,the intranasal distribution was semi-quantitatively determined by nasal endoscopy.The results showed that the dyed drug was preferentially sprayed onto the nasal vestibule,the head of the inferior turbinate,the anterior part of septum and nasal floor.As far as the anterior-inferior segment of the nasal cavity was concerned,the distribution was found to be influenced neither by the decongestant nor by the surgery (P＞0.05).However,both the decongestant and surgery expanded the distribution to the anatomical structures in the superior and posterior nasal cavity such as olfactory fissure,middle turbinate head and middle nasal meatus.No distribution was observed in the sphenoethmoidal recess,posterior septum,tail of inferior turbinate and nasopharynx.It was concluded that nasal septum surgery and decongestant administration significantly improves nasal spray distribution in the nasal cavity.

OBJECTIVE: To study the safety and feasibility after functional Endoscopic surgery(FESS), without no nasal packing in 74 patients,compare these patients with 20 packing patients, and discuss the possibility and indication of avoiding packing. METHOD: No nasal packing after FESS in 74 patients, the measures had been taken to reduce postoperative bleeding including appropriate case-chosen, medical administration before and after operation, alleviation of trauma in operation, and meticulous sinus clearance to prevent synechia. RESULT: The postoperative blood loss were less than 50 ml. No bleeding complication happened out of the 74 no-packing patients, the blood exudation ceased timely after FESS. CONCLUSION The nasal packing could be avoided in the majority of FESS through proper management. This choice will reduce the discomfort and the cost of the patients who have to receive FESS procedure, and increase their compliance.
Adolescent ; Adult ; Chronic Disease ; Endoscopy ; methods ; Feasibility Studies ; Female ; Hemostatic Techniques ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Postoperative Hemorrhage ; prevention & control ; Postoperative Period ; Sinusitis ; surgery ; Tampons, Surgical ; Treatment Outcome ; Young Adult

OBJECTIVES: To investigate the effet of nasal septum operation combined with nasal sinuses on postoperative nasal septum. METHOD: Sixty-five patients with deflection of nasal septum complicating chronic sinusitis were underwent nasal septum and nasal sinus operations under nasal endoscope. Postoperative nasal septum recover were observed and compared with patients underwent only simple nasal septum operation. RESULT: Patients underwent nasal septum operations combined with nasal sinus, postoperative symptoms were more serious at early than simple nasal septum operations. At 3 months after operation, satisfactory degree of the former group were higher than the latter, and the former group didn't have complications such as nasal septum infection. CONCLUSION Nasal septum operations combined with nasal sinus have no harmful effect on the prognosis of nasal septum, so it was safe and reliable.
Adolescent ; Adult ; Chronic Disease ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Paranasal Sinuses ; surgery ; Prognosis ; Sinusitis ; surgery ; Treatment Outcome ; Young Adult

Stroke flaccid paralysis is stroke patients with abnormal physical movement function and muscle tone decline as the main performance and is a kind of common pathological state after apoplectic stroke. The longer the flaccid paralysis is, the worse the prognosis. The theory of TCM holds that stroke is mainly due to "deficiency, wind, fire, phlegm, stasis, qi", and when the pathogenic factor accumulate and block the meridians, which would cause blood stagnation, muscle and tendon damage and flaccidity, resulting in stroke paralysis. Therefore, it is necessary to set up the "Tongjing Roujin" (stimulating the muscle and nourishing the tendon) as its main treatment. Fire-needling has the effect of stimulating muscle, warming yang, nourishing tendon, and relieving pain in the treatment of stroke flaccid paralysis. It can warm yang and dissipate cold, replenish and nourish meridian qi, release muscle nodules, promote the circulation of qi and blood, and nourish all limbs and bones. Fire-needling therapy can promote the recovery of neural pathway, strengthen local metabolism, improve local muscle tension, and thus restore limb function. The high-quality clinical research, acupoint selection rules, and standardized operating techniques of fire-needling treatment for stroke flaccid paralysis need to be further deepened.

Objective:To use the resting state functional network connectivity (FNC) method based on independent component analysis (ICA) to analyze the characteristics of FNC changes in patients with basal ganglia aphasia (BGA) after stroke, and to explore its occurrence and recovery mechanism under the intervention of acupuncture combined with language rehabilitation training.Methods:Using a prospective observational research method, 16 right-handed BGA patients who were treated at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from July 2021 to December 2022, as well as 14 healthy subjects matched in age, gender, education level, and handedness, were included. The resting state functional magnetic resonance imaging, demographic information, and Western Aphasia Examination data of healthy subjects and BGA patients before and after intervention were collected. The GIFT toolbox based on MATLAB platform was applied for ICA and resting state brain network FNC analysis. The FNC differences between BGA patients and healthy subjects were compared horizontally, and the FNC changes in BGA patients before and after intervention were compared vertically.Results:Compared with healthy subjects, post-stroke BGA patients showed decreased connectivity between the basal ganglia network, default network, and visual network before intervention, while increased connectivity between the auditory network, right frontoparietal network, and anterior cuneiform network; After the intervention of acupuncture combined with language rehabilitation training, the connectivity between the basal ganglia network, visual network, and anterior cuneiform network decreased, while the connectivity between the anterior convex network and bilateral frontoparietal network decreased, while the connectivity between the default network, auditory network, right frontoparietal network, and visual network increased. The BGA patient group showed enhanced connectivity between the basal ganglia network and the left frontoparietal network before and after intervention.Conclusions:The FNC changes between the basal ganglia network and other brain networks are key to reflecting the mechanism of BGA occurrence and language function recovery. Acupuncture combined with language rehabilitation training may improve language function by enhancing the connectivity between the basal ganglia network and the left frontoparietal network, and the redistribution of attention resources may also be one of the reasons for promoting language function recovery in BGA patients.

BACKGROUNDmiR-338-3p is a recently discovered miRNA and is involved in cell differentiation. However, few data are yet available on the aberrant expression of miR-338-3p in human colorectal carcinoma (CRC). This work aimed to investigate the relationship between miR-338-3p expression pattern and clinicopathological features of human CRC and the possible regulative mechanisms.

METHODSThe 40 CRC, adjacent nontumorous tissues and 2 human CRC-derived cell lines (SW-480 and SW-620) were collected, respectively, and the total RNA and protein were isolated routinely. The miR-338-3p expression pattern was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR) and Northern blotting. Smoothened (SMO, possible target of miR-338-3p) mRNA and corresponding protein expression pattern were detected by semiquantitative RT-PCR and Western blotting. miR-338-3p expression patterns were compared between nontumor mucosa and CRC samples, graded by progression-related factors. Disease outcome was calculated by Kaplan-Meier survival analysis to determine whether miR-338-3p was related to disease-free survival (DFS) and overall survival (OS) of patients. Moreover, SMO 3'-UTR fragment was PCR amplified from genome DNA of human colon and inserted into a luciferase reporter plasmid. The luciferase reporter plasmid construct was then transfected into CRC cells together with pre-miR-338-3p or anti-miR-338-3p and the luciferase activity in the transfected cells was detected.

RESULTSThe expression of miR-338-3p was significantly downregulated in CRCs than those in the adjacent nontumorous tissues, and the value was negatively related to advanced TNM stage and local invasion (P < 0.01). Furthermore, miR-338-3p value was decreased markedly in SW-620 cell line relative to SW-480 (P < 0.01). Low expression of miR-338-3p was associated with unfavorable outcome in DFS but not in OS independent of clinical covariates. Moreover, RT-PCR and Western blotting analysis demonstrated that there was no significant difference in SMO mRNA expression between the corresponding CRCs and nontumorous tissues, whereas SMO protein markedly increased in CRCs (P < 0.01). A significant increase in luciferase activity was detected in CRC cells, which were cotransfected with the luciferase reporter plasmid construct and anti-miR-338-3p (P < 0.01).

CONCLUSIONSmiR-338-3p is expressed differentially in CRC and associated with progression and prognosis of CRC. SMO might be a possible target of miR-338-3p, which made it a potential antitumor candidate for treatment and prevention of CRC.

Adult ; Aged ; Colorectal Neoplasms ; genetics ; pathology ; Disease Progression ; Female ; Gene Expression Regulation, Neoplastic ; genetics ; physiology ; Humans ; Male ; MicroRNAs ; genetics ; Middle Aged ; Prognosis