OBJECTIVETo investigate the clinical value of Paroxetine combined with mid-frequency electrical pulse acupoint stimulation (EPAS) in the treatment of premature ejaculation (PE).

METHODSTotally 69 PE patients were equally assigned to receive oral Paroxetine 20 mg/d, mid-frequency EPAS, or oral Paroxetine 10 mg/d combined with mid-frequency EPAS (P + EPAS) , all for 8 weeks. We obtained the intravaginal ejaculation latency time (IELT) and Chinese Index of Premature Ejaculation (CIPE-5) scores of the patients before and after treatment, and compared adverse reactions among the three groups of patients.

RESULTSOne patient of the Paroxetine group gave up treatment because of abdominal pain and nausea. Compared with the baseline, the patients in the Paroxetine, EPAS, and P + EPAS groups all showed markedly increased IELT ([0.92 ± 0.11] vs [4.07 ± 0.11] min, P < 0.01; [0.92 ± 0.12] VS [2.78 ± 0.17] min P < 0.05; [0.91 ± 0.09] vs [5.31 ± 0.13], P < 0.01) and decreased CIPE-5 scores (12.5 ± 3.0 vs 22.0 ± 2.1, P < 0.01; 12.8 ± 2.9 vs 19.5 ± 1.9, P > 0.05; 13.1 ± 2.8 vs 25.2 ± 2.1, P 0.01), with statistically significant differences between the P + EPAS group and the other two (P < 0.05). The total effectiveness rate was 95.7% in the P + EPAS group, remarkably higher than in the Paroxetine (72.7%, P < 0.05) and the EPAS group (47.8, P < 0.01).

CONCLUSIONOral Paroxetine combined with mid-frequency EPAS has a higher safety and efficacy than either Paroxetine or EPAS alone in the treatment of PE.

Acupuncture Points ; Aged ; Combined Modality Therapy ; methods ; Ejaculation ; Electroacupuncture ; methods ; Humans ; Male ; Paroxetine ; therapeutic use ; Premature Ejaculation ; therapy ; Serotonin Uptake Inhibitors ; therapeutic use ; Treatment Outcome

BACKGROUND: Intestinal and lymphoid tissues constitute an important part of intestinal immunity, which plays an important regulatory role in spleen deficiency and hydronephrosis. OBJECTIVE: To observe the effect of acupuncture on T lymphocyte subsets in lymph nodes of rats with spleen deficiency, and to investigate the correlation of spleen deficiency with intestinal immunity and the mechanism of acupuncture for spleen deficiency syndrome. METHODS: Thirty-six female Sprague-Dawley rats were randomly divided into three groups: model, acupuncture and blank control groups. The rat model of spleen deficiency was established by fatigue-induced spleen injury plus abnormal diet for 31 days. Afterwards, the rats in the acupuncture group received acupuncture at Zusanli(ST 36).Urine D-xylose excretion rate was detected during modeling and treatment.Then, the mesenteric lymph nodes were removed, and the changes in T lymphocyte subsets in the mesentericlymph nodes were observed by immunohistochemistry. RESULTS AND CONCLUSION: Urine D-xylose excretion rate under spleen deficiency in the modeling and acupuncture groups was significantly lower than that in the blank control group (P < 0.05 or P < 0.01); after acupuncture, the urine D-xylose excretion rate was significantly increased compared with the modeling group (P < 0.01), but still lower than that in the blank control group (P < 0.05). The count of CD4+T lymphocytes, count of CD8+T lymphocytes and ratio of CD4+/CD8+T lymphocytes were ranked as follows: blank control group >acupuncture group>modeling group(P<0.01 or P<0.05).These results suggest that acupuncture at Zusanli can improve the urine D-xylose excretion rate, regulate the balance of T lymphocyte subsets in mesenteric lymph node of rats with spleen deficiency, thus improving the intestinal immune function, spleen deficiency systems, disorder of intestinal digestive function, intestinal digestion and absorption, as well as anorexia, loose stool, diarrhea and other symptoms of the digestive system.

To determine the potential of the high mobility group box-1 protein 1 (HMGB1) to activate Toll-like receptor 4 (TLR4) signaling in hepatic stellate cells (HSCs) and investigate the subsequent transition of HSC towards the inflammatory phenotype. Three immortalized mouse HSC cell lines, wild-type (JS1), TLR4-/- (JS2) and MyD88-/- (JS3), were subcultured in plates and divided into groups of normal control (untreated), postive control (lipopolysaccaride, LPS treatment), and experimental (HMGB1 treatment). All groups were transfected with luciferase reporter plasmids carrying responsive elements for either the nuclear factor-kappa B (NF-kB) or activator protein-1 AP-1 transcription factors. Following stimulation with normal saline, LPS (100 ng/mL) or HMGB1 (100 ng/mL), the activation of NF-kB or AP-1 was detected by a dual-luciferase reporter assay system. The induction of monocyte chemotactic protein-1 (MCP-1) transcription was determined by measuring the mRNA levels using real time quantitative reverse transcription PCR (qRT-PCR). The secreted protein levels of MCP-1 were determined by enzyme-linked immunosorbent assay (ELISA) of the culture supernatants. Activation of NF-kB- and AP-1-responsive reporters was significantly up-regulated in JS1 cells treated with HMGB1 or LPS, and the activation was coincident with markedly up-regulated transcription and secretion of MCP-1. However, HMGB1 and LPS treatment produced no responsive of the NF-kB and AP-1 reporters, and no increase in expression or secretion of MCP-1, in JS2 or JS3 cells. As an endogeous ligand of TLR4, HMGB1 may activate TLR4 signaling and the TLR4-mediated inflammatory response of HSC.
Animals ; Cell Line ; Chemokine CCL2 ; genetics ; metabolism ; Gene Knockout Techniques ; HMGB1 Protein ; pharmacology ; Hepatic Stellate Cells ; drug effects ; metabolism ; Lipopolysaccharides ; pharmacology ; Mice ; NF-kappa B ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Signal Transduction ; drug effects ; Toll-Like Receptor 4 ; genetics ; metabolism ; Transcription Factor AP-1 ; genetics ; metabolism ; Transfection ; Up-Regulation ; drug effects

OBJECTIVETo explore the feasibility and the attention of perioperative management of goat lumbar fusion model for individualized 3D printing technology.

METHODSAccording to preoperative X-ray and CT three dimensional reconstruction data of 10 males Boer goat's lumbar(1-2 years old, weight 35-45 kg), the preoperative open height were determined, meanwhile, according to the theoretical entry point of nails, the length of steel plate, arc, and setting position, screw length for reference were determined, the lumbar lateral anterior plate was designed and 3D-printed. Goats lied on the right side, under the general anesthesia, the lumbar vertebrae of the goats and the adjacent intervertebral disc were resected, and the titanium cage after the bone graft was implanted into the goat, the 3D-print lateral bone plate was fixed. After operation, feeding, fluid infusion, anti infection, postoperative complications management, respiratory digestion perioperative management were performed.

RESULTSThe 10 models for goats were successful in results. Postoperative X-ray film and three-dimensional reconstruction of CT showed that titanium cage and bone plate were in good position and reliable. Three months after the operation, CT 3D reconstruction and micro-CT of the goat were observed, and the fusion of the spine was observed. Imaging studies showed that the fusion of the lateral bone plate fixation titanium cage was both at the end of the titanium cage and the dense bone trabecular formation between the vertebral bodies.

CONCLUSIONSThe 3D printing technology sets up the goat lumbar spinal fusion model successfully, which is a kind of effective, more successful, reliable and stable method, perioperative management. The method is scientific, practical, and more humanized, to ensure that lumbar lateral successfully implanted the nail plate of lateralanterior internal fixation system, with reduction of occurrence of surgical complications.

Upper cervical fracture-dislocations are series of pathological injuries occurred in occipital, atlas and axis caused by traumatic impact, which often results in severe clinical consequences, such as paraplegia, quadriplegia, and even death. In light of the potential severe clinical outcomes, it is important to define the type of upper cervical fracture-dislocations depending on which the clinician can deal with the disease properly. Owing to its specific anatomical structures, the upper cervical fractures occurr to the unique osseous structures or ligamentous connections always present in predictable patterns. Common fracture include occipital condylar fracture, atlanto-occipital dislocation, atlas fracture, and the three types of fractures of axis, including odontoid fracture, Hangman's fracture and axis body fracture. In this paper we will review the literatures about the classification and management of upper cervical fracture, to help the clinicians to treat their patients better.

Objective: To investigate the clinicopathologic and molecular features of the rare cribriform morular variant of papillary thyroid carcinoma (CMV-PTC). Methods: The clinicopathologic data of 10 patients with CMV-PTC were retrospectively reviewed. Immunohistochemical (IHC) staining was done using LSAB method. DNA sequencing for APC were applied using Sanger method. BRAF V600E mutation was examined using ARMS method. The cytological, morphological, IHC and molecular features were analyzed. Results: All patients were female at an average age of 27 years old. The tumors were mostly located in the right lobe of thyroid. Fine needle aspiration cytology was performed in three patients; two were diagnosed as suspicious for PTC and one as PTC. Nine tumors presented as solitary nodule and two as multiple nodules in both lobes. Infiltration was demonstrated in three cases. The average size was 2.6 cm. The neoplastic cells were arranged in papillary, cribriform, solid and glandular patterns, with rare or without colloid inside the lumen. The number of morula varied, ranging from zero to many. The neoplastic cells were variably enlarged, showing round, oval or spindle shape. Nuclear irregularity was identified as irregular membrane, nuclear grooves or pseudoinclusion, but no typical ground glass feature. Peculiar nuclear clearing could be observed in the morular cells. IHC staining showed the neoplastic cells were negative for thyroglobulin and p63, but positive for TTF1, cytokeratin 19 and estrogen receptor. Diffuse staining with cytokeratin was seen in the neoplastic cells and the morula. Specific cytoplasmic and nuclear staining of β-catenin was seen in the neoplastic cells but not the morula. Ki-67 proliferation index was 1%-30%. No recurrence or metastasis was observed. One patient was demonstrated to harbor both somatic and germline mutations of the APC gene, who was found to have adenomatous polyposis and her mother died of colonic carcinoma. No BRAF V600E mutation was detected. Conclusions CMV-PTC is rare and shows atypical cytological and clinicopathological features, and it is easily misdiagnosed.TG, TTF1, ER and β-catenin are specific IHC markers for CMV-PTC. The morula is negative for cytokeratin 19, in contrast to squamous metaplasia. Although CMV-PTC has indolent clinical behavior, a definite diagnosis is necessary to rule out the possibility of APC gene mutation and related extra-thyroidal neoplasm, such as FAP and Gardner syndrome.

OBJECTIVETo study the change trend of cervical range of motion(ROM) after single-level anterior cervical corpectomy and fusion(ACCF) in treating cervical spondylotic myelopathy.

METHODSThe clinical data of 23 patients with cervical spondylotic myelopathy was retrospectively analyzed from February 2015 to April 2016. There were 11 males and 12 females, with an average age of (54.6±13.3) years. All the patients were diagnosed as cervical spondylotic myelopathy by interrogation, physical examination and radiology, and were treated by ACCF. The Coda motion system was applied to assess the cervical range of motion pre-and post-operation. JOA and VAS scores were used to evaluate the clinical outcomes.

RESULTSThe mean follow-up time was (9.4±1.6) months. Cervical ROM in all directions at 3 months postoperatively were significantly lower except for the left rotation(<0.05). There was significant difference of cervical ROM in all directions between preoperative and 6 months postoperatively(>0.05). The right lateral bending and the left rotation at 9 months postoperatively increased significantly(<0.05). Postoperative extension at 6 months was significantly better than that of 3 months postoperatively(<0.05). The extension, left and right lateral bending and left rotation at 9 months postoperatively were significantly better than of 6 months postoperatively(<0.05). Postoperative JOA scores at each time points were significantly higher than that of preoperative(<0.05) and VAS scores at each time points were significantly lower than that of preoperative(<0.05).

CONCLUSIONSThe change trend of three-dimensional cervical ROM after single-level ACCF revealed that the ROM decreased in short term, and later increased and was better than the preoperative level. Meanwhile, the neurological function improved significantly. But the short-term and long-term change trend of ROM postoperatively and the change trend of ROM after multi-level ACCF need to be further studied.

In this study, ecological factors, occurrence records, the essential oil components content were used to predict the potential geographical distribution and quality division of Mentha haplocalyx in China based on the MaxEnt modeling and geographic information system(GIS). The AUC of ROC curve was above 0.950,indicating that the predictive results with the maximum model were highly precise. The results showed that the main environmental factors determining the potential distribution were annual average precipitation (the contribution rate, 45.87%), mean temperature of wettest quarter (11.92%), mean temperature of warmest quarter (7.84%), average monthly precipitation of May (6.80%), standard deviation of seasonal temperature variation (4.42%), mean temperature of the coldest quarter (3.47%) and altitude (2.92%). The environmental variables in the highly potential areas were determined as annual average precipitation around [530,1 465] mm, mean temperature of wettest quarter around [24.5,29] ℃, mean temperature of the warmest quarter around [25.5,29] ℃, average monthly precipitation of May around [67,133] mm, standard deviation of temperature seasonal change around [8 333,9 643], mean temperature of the coldest quarter around [1.7,8.3] ℃ and the altitude around [0,165] mm. The best quality distribution of M. haplocalyx was mainly located in Jiangsu, Anhui, Shandong, Zhejiang and Heilongjiang. The zoning results basically coincide with the actual situation. The quality division of M. haplocalyx can be used for providing a scientific basis for selection of artificial planting base and guidance of its production.

Antiviral Agents ; therapeutic use ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; Humans ; Pandemics ; Pneumonia, Viral ; drug therapy

This paper aimed to study the effect of Dalbergia cochinchinensis heartwood on plasma endogenous metabolites in rats with ligation of the left anterior descending coronary artery, and to analyze the mechanism of D. cochinchinensis heartwood in improving acute myocardial ischemic injury. The stability and consistency of the components in the D. cochinchinensis heartwood were verified by the establishment of fingerprint, and 30 male SD rats were randomly divided into a sham group, a model group, and a D. cochinchinensis heartwood(6 g·kg~(-1)) group, with 10 rats in each group. The sham group only opened the chest without ligation, while the other groups established the model of ligation. Ten days after administration, the hearts were taken for hematoxylin-eosin(HE) staining, and the content of heart injury indexes in the plasma creatine kinase isoenzyme(CK-MB) and lactate dehydrogenase(LDH), energy metabolism-related index glucose(Glu) content, and vascular endothelial function index nitric oxide(NO) was determined. The endogenous metabolites were detected by ultra-high-performance liquid chromatography-time-of-flight-mass spectrometry(UPLC-Q-TOF-MS). The results showed that the D. cochinchinensis heartwood reduced the content of CK-MB and LDH in the plasma of rats to relieve myocardial injury, reduced the content of Glu in the plasma, improved myocardial energy metabolism, increased the content of NO, cured the vascular endothelial injury, and promoted vasodilation. D. cochinchinensis heartwood improved the increase of intercellular space, myocardial inflammatory cell infiltration, and myofilament rupture caused by ligation of the left anterior descending coronary artery. The metabolomic study showed that the content of 26 metabolites in the plasma of rats in the model group increased significantly, while the content of 27 metabolites decreased significantly. Twenty metabolites were significantly adjusted after the administration of D. cochinchinensis heartwood. D. cochinchinensis heartwood can significantly adjust the metabolic abnormality in rats with ligation of the left anterior descending coronary artery, and its mechanism may be related to the regulation of cardiac energy metabolism, NO production, and inflammation. The results provide a corresponding basis for further explaining the effect of D. cochinchinensis on the acute myocardial injury.
Male ; Animals ; Rats ; Rats, Sprague-Dawley ; Dalbergia ; Myocardial Ischemia ; Metabolomics ; Heart ; Heart Injuries ; Creatine Kinase, MB Form