Objective: By sorting and analyzing pertinent modern studies targeting auricular point therapy treating primary insomnia (PI), to summarize the point selection rules and clinical efficacy of using auricular points alone or combining it with other therapies in treating PI. Methods: A search on China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed, Springer and Ovid were conducted from January 1, 1998 till January 31, 2020. Point selection, diagnostic criteria and Pittsburgh sleep quality index (PSQI) in the eligible studies were analyzed and summarized. Results: The difference in PSQI before and after using auricular point therapy alone was more significant than that of using Chinese medication alone (P<0.05), but less significant than that of combining auricular point therapy and acupuncture-moxibustion and Chinese therapeutic massage (tuina) (P<0.05). In the included studies, Shenmen (TF4) was the most commonly used (370 times), followed by Heart (CO15), which was 344 times, and Subcortex (AT4), which was 325 times. In terms of auricular points distribution, points in the auricular concha were the most commonly used (1500 times), followed by those in the antitragus (474 times) and triangular fossa (387 times). Correlation analysis showed that Shenmen (TF4) and Liver (CO12), Sympathetic (AH6a) and Heart (CO15) were used together more often, followed by Shenmen (TF4), Liver (CO12), Spleen (CO13), Kidney (CO10) and Subcortex (AT4), and then Shenmen (TF4), Liver (CO12), Sympathetic (AH6a), Subcortex (AT4) and Heart (CO15). Cluster analysis showed that the auricular points used for PI can be divided into 6 clusters in 2 major groups. One group was Heart (CO15), Subcortex (AT4), Shenmen (TF4), Sympathetic (AH6a), Spleen (CO13), Kidney (CO10), Liver (CO12) and Endocrine (CO18); the other was Occiput (AT3), Stomach (CO4), Pancrease-gallbladder (CO11), Chuiqian (LO4), Small Intestine (CO6), Central Rim (AT2,3,4i) and Sanjiao (CO17). In terms of patterns in traditional Chinese medicine, the pattern of dual deficiency of heart and spleen accounted for the largest proportion in the studies of using auricular points alone or combining it with other treatments to treatment PI, and then it was the pattern of liver depression transforming into fire. Conclusion: In treatment of PI with auricular points alone or combo therapy involving auricular points, Shenmen (TF4) was commonly used, and the commonly used point group consisted of Shenmen (TF4), Liver (CO12), Sympathetic (AH6a) and Heart (CO15). Auricular point therapy can be taken as a complementary therapy in treating PI.

Objeetive To explore the correlative factors of early progressive motor deficits in cerebral infarction of moderately size in basal ganglia and the relationship between motor deficit progression and the stem lesion of middle cerebral artery.Methods One hundred and fifty patients with single acute infarction located in white matter of basal ganglia region were recruited in this study retrospectively.All patients were performed brain and neck MRI and magnetic resonance angiography (MRA) within 72 h after onset.They were divided into two groups based on the maximal diameter of infarction on diffuse weighing imaging(DWI):moderate size infarction group(75 patients,maximal diameter of infarction from 1.5 cm to 3.0 cm) and lacunar infarction group(75 patients,maximal diameter of infarction lower than 1.5 cm).The scores of dynamic National Institutes of Health Stroke Scale(NIHSS) in 7 d after the admission and multiple Logistic regression analysis were used and the risk factors of the early progressive motor deficits were analyzed.Results The rate of early progressive motor deficits in moderate size infarction group was significant higher than that in lacunar infarction group [32.0 ％ (24/75) vs.8.0 ％ (6f75)] (P ＜ 0.05).The multiple Logistic regression analysis showed that elevated systolic blood pressure on admission was the independent risk factor for early progressive motor deficits (P =0.016).The rate of stem lesion of middle cerebral artery in moderate size infarction group was significantly higher than that in lacunar infarction group [41.3 ％ (31/75) vs.9.3 ％ (7/75)] (P ＜ 0.01).Conclusions Patients with acute single infarction located in white matter of basal ganglia and with the diameter of 1.5-3.0 cm are more prone to early progressive motor deficits and elevated systolic blood pressure on admission is the most significantly independent factor.The pathogenic mechanism may be associated with the stem lesion of middle cerebral artery.

Objective To discuss the influence of respiratory training and prompting effective discharging of sputum for chronic obstructive pulmonary disease (COPD) patients in acute aggravation period. Methods 50 patients were randomized into the intervention group and the control group with 25 cases in each group.The intervention group received respiratory training and prompting effective discharging of sputum while the control was only given routine treatment and nursing.The ratio of first second expiration volume to forced vital capacity, oxygen partial pressure (PaO2),carben dioxide partial pressure (PaCO2) ,blood oxygen saturation (SpO2)and the in-hospital days were compared between the two groups. Results The clinical effect in the intervention group was superior to that of the control group with shorter in-hospital days (P<0.01).Conclusion Better results could be obtained by application of respiratory training and prompting effective discharging of sputum for COPD patients in acute aggravation period.

OBJECTIVETo explore effects of Tongxinluo Capsule (TC) on platelet activating factor (PAF), vascular endothelial function, thrombolysis in myocardial infarction (TIMI) blood flow, and heart function in acute myocardial infarction (AMI) patients after delayed percutaneous coronary intervention (PCI).

METHODSTotally 80 AMI inpatients were recruited at Department of Cardiology, People's Hospital of Jiangxi Province, from Jan. 2008 to Sep.2013. Those in line with inclusion criteria were randomly assigned to TC treatment group and the conventional treatment group by random digit table, 40 in each group. Besides, another 40 healthy subjects from examinees at Outpatient Department were recruited as a healthy control group. PCI was performed after 1-week treatment. Then blood samples were collected, and then blood contents of CD62P, CD63, GP II b/III a, ET-1, NO, and plasma von Willebrand factor (vWF) levels were detected. Coronary TIMI blood flow and corrected TIMI frame count (CTFC) were determined during PCI. Meanwhile, noninvasive blood pressure (BP) and heart rate (HR) were recorded before and after PCI, and cardiac function measured. They were compared with the healty control group.

RESULTSCompared with the healthy control group, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, and ET-1 significantly increased, but NO significantly decreased in AMI patients (all P < 0.05). After 1-week intervention of TC, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, NO, and ET-1 significantly decreased (P < 0.05, P < 0.01). Compared with the conventional treatment group at the same time point, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, and ET-1 decreased more significantly in the TC group (P < 0.05, P < 0.01), increased NO levels were also more obviously seen (P < 0.01). The aforesaid parameters changed more obviously at day 30, as compared with those changes at week 1 (P < 0.05, P < 0.01). The TIMI blood flow grade and CTFC were more obviously improved after PCI in the two treatment groups. Better TIMI blood flow was seen in the TC group. TIMI level 3 blood flow rate was higher in the TC group than in the conventional treatment group with statistical difference (P < 0.05). The left ventricular ejective factor (LVEF) after PCI was obviously elevated in the TC group and the conventional treatment group (P < 0.01), and the improvement was more obviously seen in the TC group (P < 0.05). There were 6 cases of recurrent angina, 3 cases of ventricular tachycardial (VT)/ventricular fibrillation (VF), 6 cases of heart failure (HF), 1 case of cardiac sudden death in the conventional treatment group, with the total incidence of cardiovascular events being 40% (16/40). There were 2 cases of recurrent angina, 2 cases of VT/VF, 2 cases of HF, no cardiac sudden death in the TC treatment group, with the total incidence of cardiovascular events being 15% (6/40). There was statistical difference in the recurrent rate of cardiovascular events between the two groups (χ² = 2.27, P < 0.05).

CONCLUSIONTC not only could prevent coronary embolism of AMI patients after delayed PCI, attenuate vascular endothelial injury, but also could improve TIMI blood flow, and strengthen cardiac systolic function.

Angioplasty, Balloon, Coronary ; Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; Fibrinolytic Agents ; therapeutic use ; Heart ; drug effects ; Heart Rate ; Humans ; Myocardial Infarction ; drug therapy ; surgery ; Percutaneous Coronary Intervention ; Platelet Activating Factor ; metabolism ; Regional Blood Flow ; von Willebrand Factor ; metabolism

Objective To analyze mRNA and protein expressions of plasminogen activator and plasminogen activator inhibitor-1 using microdissection and quantitative real-time PCR,and to analyse their associations with microvascular diseases in IgA nephropathy.Methods Twenty-four IgA nephropathy patients treated in Kidney Center and Kidney Laboratory of PLA from 2000 to 2004 were admitted into the study;20 renal glomeruli or 200 renal tubules and peritubular interstitial per patient were captured by Laser Microdissection System from IgA nephropathy renal biopsy slides(8 ?m),and mRNA was extracted.PA mRNA and PAI-1 mRNA levels in glomerulus and tubulointerstitial area were measured by Taqman quantitative real-time PCR.Capillaries densities in glomerulus and tubulointerstitial area were measured using immunohistological staining method and computer image analysis system.Results With the aggravation of lesions,the glomeruli and peritubular capillaries densities of IgA nephropathy decreased.The glomerular and peritubular capillaries densities were negatively associated with the level of serum creatinine(R2=0.6946 and R2=0.6271,P

OBJECTIVE To evaluate the capabilities of nosocomial infection control in local general hospitals in handling public health emergencies,and to provide reliable data for future work.METHODS A random sampling questionnaire method was adopted to investigate how nosocomial infection control in local hospitals performed their functions and handled public health emergencies.RESULTS The 15 hospitals which were surveyed had all been equipped with computer network of directly reporting epidemic situations of infectious diseases.Four from 15 hospitals had full-time employees reporting epidemic situations,and 11 had part-time employees.Twelve hospitals established,according to standards,a department of infectious diseases or a department of pre-examination and sorting diagnosis.Seven hospitals did not have full-time staff of infection control till 2003.The rate of the staff's knowledge of nosocomial infection control was 73.7%.The medical wastes of the 15 hospitals were all disposed at the local medical waste disposal center.CONCLUSIONS Our city,in terms of nosocomial infection control,has acquired certain capabilities of handling public health emergencies.But the capabilities vary from hospital to hospital.Further improvement in some work is still needed.

OBJECTIVE: To investigate the influential factors associated with the long-term effect of allergic rhinitis (AR) specific immunotherapy (SIT). METHOD: Retrospective analyzed the following visual analog scale(VAS) before and after the specific immunotherapy of 219 patients with allergic rhinitis. Logistic regression and pair t-test were used to explore the key factors influencing the prognosis. RESULT: (1) The gender and the VAS before specific immunotherapy (P < 0.05) were associated with the long-term effect of allergic rhinitis specific immunotherapy, while family history, the age of specific immunotherapy, number of allergens and stitches and with other allergic diseases (P > 0.05) were not associated with the long-term effect of specific immunotherapy; (2) Compared VAS of different endpoints with VAS before the treatment,there were significant differences. The primary endpoints were the time following no more than half a year (total effective rate: 50.0%), half a year to 1 year (total effective rate: 51.7%), 1 to 2 year (total effective rate: 47.1%), 2 to 3 year (total effective rate: 54.5%) and over 3 year (total effective rate: 40.7%). CONCLUSION Apart from the gender and the VAS before specific immunotherapy,genetic and other factors can not significant influence the long-term effect of specific immunotherapy. The effect of specific im- munotherapy seems to last for 3 years at least. Increasing stitches can not improve long-term effect of SIT,but it can consolidate the effect. The long-term effect of specific immunotherapy tends to drop off with fluctuations over time and the higher of VAS before SIT,the better effect of long-term SIT. Further more, the long-term effect of SIT of male is worse than female. In consequences, we speculate epigenetics related to the interaction between environmental factors and genetic factors plays an important role in the long-term effect of allergic rhinitis specific immunotherapy.
Allergens ; Female ; Humans ; Hypersensitivity ; Immunotherapy ; Male ; Retrospective Studies ; Rhinitis, Allergic ; therapy ; Sex Factors ; Time Factors

Objective To investigate the relationship between white-matter hyperintensities (WMHs) and hemorrhagic transformation and neurological outcome at 3 months after recombinant tissue plasminogen activator (rt-PA) treatment in patients with acute ischemic stroke.Methods The chnical data of 132 patients with acute ischemic stroke who had received intravenous rt-PA therapy were retrospectively reviewed.The severity of WMHs according to the modified Schelten scale was assessed.Hemorrhagic transformation included hemorrhagic infarct (HI) and cerebral parenchymal hemorrhage (PH).Hemorrhagic transformation after thrombolytic therapy and clinical neurological outcome based on modified Rankin scale (mRS) at 3 months was also analyzed.Favorable neurological outcome as mRS 0-1 score and unfavorable neurological outcome as mRS 2-6 scores was defined.Results Hemorrhagic transformation was found in 26 patients (19.7％,26/132) among 132 patients receiving intravenous rt-PA treatment.Seventeen patients were HI type and 9 patients were PH type.Multiple Logistic regression analysis showed that baseline American National Institute of Health Stroke Scale (NIHSS) score,diastolic pressure,WMHs score was not correlated with HI type hemorrhagic transformation (P ＞ 0.05) ; and WMHs score was not correlated with PH type hemorrhagic transformation (P ＞0.05),but baseline NIHSS score,diastolic pressure was the independent risk factor of PH type hemorrhagic transformation (P ＜ 0.05).Dicho-Logistic regression analysis showed that WMHs score was the independent risk factor of unfavorable neurological outcome (OR =1.136,95％ CI 1.037-1.245,P =0.008).Conclusion Severe WMHs are not associated with hemorrhagic transformation but independently associated with unfavorable neurological outcome after thrombolytic therapy in patients with acute ischemic stroke.

An introduction to the telemedicine service of the hospital in its web-based hospitalprogram which covers theweb-based healthcare center,and thehealthcare cabin to interact with the center remotely.The center operates on the telehealth management platform based on cloud computing, offering remote monitoring,health assessment,health management,follow-up,online consultation,pre-registration and mobile payment.Theweb-based hospitalcan simplify the medical service flow,alleviate the complaints incurred by concentrated quality medical resources,influx of patients and limited physical space of tertiary hospitals,and the tense doctor-patient relationship as well.

Objective To discuss the application of early time window modified stereotaxic aspiration in converting operation therapy on the specified acute epidural hematoma.Methods 21 patients with the specified acute epidural hematoma were treated with early time window modified stereotaxic aspiration drainage,using YL-1 hematoma puncture needle with silica gel ventricular drainage tube.Results The successful rate of puncture was 100％.Hematoma was completely cleared in 19 cases.A small amount of epidural effusion was remained in 2 cases.1 case had concomitant rebleeding during the puncture,and shifted to craniotomy.Conclusion Early time window modified stereotaxic aspiration drainage is a minimally invasive,safe and effective treatment on the specified acute epidural hematoma when mastering the indications,timing and skills of puncture.