Objective To investigate the effect of adjusting tube current time product (mAs) according to head circumference index on head CT image quality and organ-specific-dose level based on Monte Carlo analysis platform.Methods A total of 92 patients including children and adolescents with different clinical symptoms undergoing head CT scan were prospectively selected between September 2017 and June 2018 in the First Hospital of Jilin University.Without limiting the size of the head circumference,there were 22 patients were selected as conventional group by random number table,whose head circumference was 48.1-59.2 cm.Low dose group was divided into following three subgroups according to different head circumferences:A group 54.1-57.0 cm (n=22);B group 51.1-54.0 cm (n=26) and C group 48.1-51.0 cm (n=22).Tube current time product was 250 mAs for conventional group,200 mAs for A group,150 mAs for B group and 100 mAs for C group,respectively.The organ-specific-radiation doses (brain,eye lens and salivary gland) were recorded by Monte Carlo analysis platform and the subjective and objective image quality score was evaluated.Analyses of the differences between four groups were compared with image quality score as well as organ-specific-radiation dose by single factor variance.Results Radiation dose to brain was conventional group (34.37±3.62),A group (25.91±0.99),B group (23.18±6.11) and C group (17.38 ± 3.23) mSv,respectively.The difference was of statistical significance in the four groups (F=54.51,P＜0.05).Dose to eye lens was conventional group (41.54± 1.04),A group (33.03±0.35),B group (26.18±2.72) and C group (20.88±4.45) mSv,with statistical significance in difference between the four groups (F=189.75,P＜0.05).Dose to salivary gland was conventional group (35.04 ± 4.94),A group (25.92 ± 0.99),B group (22.93 ± 6.54) and C (14.96±2.67) mSv,respectively,with statistical significance in difference between the four groups (F=65.74,P＜0.05).Image quality scores were respectively conventional group (4.97±0.13),A group (4.77 ± 0.49),B group (4.60 ± 0.49) and C group (3.98 ± 0.61),respectively,with statistical significance between them (F=3.89,P＜0.05),but without statistical significance in difference between the four groups (P ＞ 0.05).The signal-to-noise ratios of gray matter in A,B and C groups were conventional group (18.69 ± 3.55),A group (16.76 ± 2.87),B group (15.05 ± 2.80) and C group (13.65±2.53),respectively,without statistical significance in difference between the four groups (P＞ 0.05);The signal-to-noise ratios of white matter in conventional group (17.46±3.72),A group (15.54± 2.81),B group (13.71±2.43) and C group (11.77±2.18),respectively,without statistical significance in difference between the four groups (P＞0.05).Conclusions Adjusting the tube current time product (mAs) according to head circumference index of children and adolescents can make scanning program more personalized and reduce organ-specific-radiation doses to sensitive organs without compromise of image quality.

Postherpetic neuralgia is manifested as drastic lingering pain, which seriously impacts the survival quality of patient. In the paper, focusing on the time of postherpetic neuralgia and in association with the characteristics of symptoms such as the location and nature of pain and skin lesion, the etiology, location of sickness, nature of sickness and pathogenesis were differentiated, and the laws of acupoint selection and therapeutic operations were explored in the treatment with acupuncture. Regarding the apparent pain at night, especially during 23:00 to 3:00, Ashi points (Extra) and Jiaji (EX-B 2) were selected in terms of location differentiation. The acupoints on the liver and gallbladder meridians were specially selected and the supplementary acupoints were used according to general symptoms based on syndrome and symptom differentiation to improve the therapeutic effects. Regarding the therapeutic operation, the bloodletting puncture was used in terms of blood stagnation in collaterals. Additionally, the other operations were selected individually, such as filiform needle therapy, fire needling therapy, plum-blossom needle therapy and bleeding and cupping therapy.

To discuss the acupuncture and moxibustion thoughts of diagnosis and treatment for secondary dysmenorrhea of adenomyosis on the basis of disease location and pathogenesis. In clinic, we take the "principle, method, prescription, acupoint and technic" as the outline, paying attention to identify disease location and establishing the method of "promoting blood to remove stasis, regulating thoroughfare vessel and conception vessel" on the basis of the pathogenesis of "stasis obstructing uterus, disharmony of thoroughfare vessel and conception vessel". The prescription combines "dredging" with "conditioning", and the emphasis should be different in different periods. In menstrual period, we put emphasis on activating the circulation ofand blood as well as clearing meridians to relieve pain and choose the acupoints on the spleen meridian of foot-and experimental points, such as Diji (SP 8), Sanyinjiao (SP 6), Ciliao (BL 32), Shiqizhui (EX-B 8). In the intermenstrual period, we regulate theand blood of thoroughfare vessel and conception vessel, and the function of viscera. The acupoints for the disease root are mainly at spleen meridian of foot-and conception vessel, such as Sanyinjiao (SP 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36). And the reinforcing and reducing technic are applied accordingly.

OBJECTIVETo explore the clinical efficacy of herbal-partitioned moxibustion on moderate and severe persistent allergic rhinitis (AR) with spleen-deficiency syndrome.

METHODSWith prospective case series study method, forty-seven patients of moderate and severe persistent AR with spleen-deficiency syndrome were treated with herbal-partitioned moxibustion at Yintang (GV 29), Shenque (CV 8), Hegu (LI 4) and Zusanli (ST 36), once every two days, three treatments a week, continuously for 8 weeks. The visual analogue scale (VAS), rhinoconjunctivitis quality of life questionnaire (RQLQ) and scores of spleen-deficiency syndrome were recorded before treatment, 2 weeks, 4 weeks and 8 weeks into treatment as well as 4 weeks after treatment; in addition, the improvement rate of each index was compared before and after treatment.

RESULTSCompared before treatment, the VAS, RQLQ and scores of spleen-deficiency syndrome were significantly reduced 2 weeks, 4 weeks and 8 weeks into treatment as well as 4 weeks after treatment (<0.05,<0.01). The efficacy was gradually increased 2 weeks, 4 weeks and 8 weeks into treatment (all<0.01). On the 8 weeks into treatment, the improved and markedly effective rate was 59.6% (28/47) for VAS, 19.1% (9/47) for RQLQ and 14.9% (7/47) for scores of spleen-deficiency syndrome; the total effective rate was all 85.1% (40/47). Compared with 4 weeks after treatment, there was no significant difference (all>0.05).

CONCLUSIONSThe herbal-partitioned moxibustion has superior efficacy for moderate and severe persistent allergic rhinitis with spleen-deficiency syndrome.

Objective To investigate the effects of one-lung ventilation time on the concentration of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in the bronchoalveolar lavage fluid (BALF), serum inflammatory markers and early pulmonary infection after radical resection of esophageal cancer. Methods Ninety patients with thoracoscope and laparoscopic radical resection of esophageal carcinoma were chosen. According to the thoracoscope operation time, the patients were divided into 3 groups including a T1 (0.5–1.5 hours) group, a T2 (1.5–2.5 hours) group and a T3 (>2.5 hours) group. Immediately after the operation, the ventilated and collapsed BALF were taken. Enzyme-linked immunosorbent assay (ELISA) method was used to determine the concentration of IL-6 and tumour necrosis TNF-α. The concentrations of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) were measured on the first, third, fifth day after operation. The incidence of pulmonary infection was observed within 3 days after operation. Result The IL-6 values of the right collapsed lung in all groups were higher than those in the left ventilated lung. The TNF-α value of the right collapsed lung in the T2 group and T3 group was higher than that in the left ventilated lung (P<0.05). Compared with in the right collapsed lung, the TNF-α and IL-6 values gradually increased with the the duration of one-lung ventilation (P<0.05). Compared with the left ventilated lung groups, the IL-6 value increased gradually with the duration of one-lung ventilation time (P<0.05). The TNF-α value of the T3 group was higher than that of the T1 and T2 groups (P<0.05). The PCT value of the T3 group was higher than that of the T1 group and T2 group on the third, fifth day after operation (P<0.05). But there was no significant difference in CRP and WBC among the three groups at different time points. The incidence of pulmonary infection in the T3 group was significantly higher than that in the T1 group within 3 days after operation (P<0.05). Conclusion With the extension of one-lung ventilation time, the release of local and systemic inflammatory mediators is increased, and the probability of pulmonary infection is higher.

Exosomes are nanometer-sized vesicles that contain various types of biologically active components, including proteins, nucleic acids, carbohydrates, and lipids, which vary with the type and physiological state of the cell. In recent years, several studies have showed that exosomes can provide new non-invasive diagnostic and prognostic biomarkers in patients affected by cancers, including bladder cancer (BC), and the lipid bilayer membrane structure makes exosomes as promising delivery vehicles for therapeutic applications. Exosomes have the characteristics of high abundance, high stability, tissue specificity, and wide distribution in body fluids, and are secreted as various types by cells in different states, thereby possessing great potential as biomarkers for BC. Herein, we briefly summarize the functions and roles of exosomes in the occurrence and development of BC and the current progress of research on exosomes in BC, while focusing on potential clinical applications of the diagnosis, treatment, and prognosis of BC.

Objective     To evaluate the clinical efficacy of dexmedetomidine in perioperative management of on-pump cardiac surgery. Methods     Randomized controlled trials (RCTs) were identified through a systematic literature search of PubMed, EBSCO, Web of Science, Cochrane Library, CBM, CNKI, Wanfang Database (up to December 2016). RevMan 5.3 software was used for meta-analysis. Results     Sixteen studies with 1 432 patients were included. Dexmedetomidine significantly decreased the risk of postoperative delirium (RR=0.28, 95% CI 0.18 to 0.44, P<0.000 01) and postoperative atrial fibrillation (RR=0.65, 95% CI 0.44 to 0.98, P=0.04) compared with the controls. The duration of intubation (RR=–1.96, 95% CI –2.07 to –1.86, P<0.000 01), length of ICU stay (RR=–0.49, 95% CI –0.74, –0.24, P=0.000 1) and hospital stay (RR=–1.24, 95% CI –2.26 to –0.22, P=0.02) in the dexmedetomidine group were significantly shorter than those of the control group. In addition, dexmedetomidine was shown to improve the score of the the Montreal Cognitive Assessment (RR=0.88, 95% CI 0.42 to 1.35, P=0.000 2) compared to the control group. Conclusion     Dexmedetomidine can reduce the complications after cardiac surgery, which is safe and effective. However, more studies with good methodologic quality and large samples are still needed to make further assessment.

Bone formation and deposition are initiated by sensory nerve infiltration in adaptive bone remodeling. Here, we focused on the role of Semaphorin 3A (Sema3A), expressed by sensory nerves, in mechanical loads-induced bone formation and nerve withdrawal using orthodontic tooth movement (OTM) model. Firstly, bone formation was activated after the 3rd day of OTM, coinciding with a decrease in sensory nerves and an increase in pain threshold. Sema3A, rather than nerve growth factor (NGF), highly expressed in both trigeminal ganglion and the axons of periodontal ligament following the 3rd day of OTM. Moreover, in vitro mechanical loads upregulated Sema3A in neurons instead of in human periodontal ligament cells (hPDLCs) within 24 hours. Furthermore, exogenous Sema3A restored the suppressed alveolar bone formation and the osteogenic differentiation of hPDLCs induced by mechanical overload. Mechanistically, Sema3A prevented overstretching of F-actin induced by mechanical overload through ROCK2 pathway, maintaining mitochondrial dynamics as mitochondrial fusion. Therefore, Sema3A exhibits dual therapeutic effects in mechanical loads-induced bone formation, both as a pain-sensitive analgesic and a positive regulator for bone formation.
Humans ; Bone Remodeling ; Cell Differentiation ; Osteogenesis ; Semaphorin-3A/pharmacology* ; Trigeminal Ganglion/metabolism*