Objective:To explore the effects of electroacupuncture(EA)on rats with chronic unpredictable mild stress(CUMS)-induced depression and proteins related to endoplasmic reticulum stress(ERS). Methods:Thirty-two Sprague-Dawley rats were randomly divided into a control group,a CUMS group,an escitalopram(ESC)group,and an EA group.Except for the control group,rats in other groups were exposed to CUMS.From the 1st day of modeling,the EA group was treated with EA at Baihui(GV20)and Yintang(GV29)every day,15 min each time;the ESC group was given intragastric intervention[ESC 10 mg/(kg·bw)every day],both for 28 d.Body mass measurement,open field test(OFT),and sucrose preference test(SPT)in each group were performed before(day 0)and after experiment(day 28)to record body mass growth,sugar preference index,and total distance and duration of central area in OFT.The protein expression levels of glucose-regulated protein 78(GRP78),caspase-12,and C/EBP homologous protein(CHOP)in the hippocampus and frontal cortex were detected by stain-free total protein normalization method of Western blotting.Meanwhile,the TdT-mediated dUTP-biotin nick end labeling assay was performed to determine the percentage of cell death in the frontal cortex. Results:After EA at Baihui(GV20)and Yintang(GV29),the body mass growth,sugar preference index,and total distance and duration of central area in OFT were effectively improved(P<0.05 or P<0.01);compared with the CUMS group,the expression levels of GRP78 and CHOP in the hippocampus,and caspase-12 and CHOP in the prefrontal cortex of rats were significantly reduced(P<0.05),and the apoptosis rate of cells in the prefrontal cortex decreased significantly(P<0.05). Conclusion:EA at Baihui(GV20)and Yintang(GV29)can significantly mitigate behavioral deficits of rats with CUMS-induced depression.The mechanism may be related to adjusting the ERS and inhibiting cell apoptosis.

Objective To investigate the distribution and antimicrobial resistance of pathogens causing pneumonia in acute stroke patients,and guide clinical antimicrobial use.Methods Patients with stroke-associated pneumonia (SAP)admitted to a tertiary first-class hospital from 2008 to 2013 were investigated retrospectively,distribution and antimicrobial susceptibility testing results of pathogens from sputum were analyzed.Results A total of 98 pa-tients with SAP were investigated,124 stains were isolated from sputum specimens,75 strains (60.48% )were gram-negative bacteria,44 (35.49% )were gram-positive bacteria,and 5 (4.03% )were fungi. There were 21 cases of mixed infection (21.43% ),bacterial alterations during treatment process existed among 23 cases(23.47% ).The top 4 isolated pathogens were Staphylococcus aureus (S. aureus,n= 43,34.68% ),Klebsiella pneumoniae (K. pneumoniae,n= 19,15.32% ),Pseudomonasaeruginosa(P. aeruginosa,n= 18,14.52% ),and Acinetobacterbau-mannii(A. baumannii,n= 18,14.52% ). Antimicrobial resistance rates of K. pneumoniae were all <32% ,and susceptibility rates to ceftazidime,piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin,and tobramycin were all 100% . Both A.baumannii and P.aeruginosa showed severe multidrug resistance. Resistance rates of A.baumannii to ceftazidime was >80% ,resistance rates of P.aeruginosa to imipenem was 33 .33% . No resistant strains were detected among fungi.Conclusion The main pathogens causing SAP in this hospital are S.au-reus,K.pneumoniae,A.baumannii,and P.aeruginosa,except K.pneumoniae,the other strains are severely re-sistant to antimicrobial agents,clinicians should choose antimicrobial agents according to the distribution character-istics and antimicrobial susceptibility testing results.

Objective To compare theγpassing rate between measurements at actual degree gantry angle and zero degree gantry angle for dose verification of intensity?modulated radiotherapy ( IMRT) in the treatment of nasopharyngeal carcinoma ( NPC) and cervical carcinoma. Methods Thirty patients with NPC and thirty patients with cervical carcinoma were randomly chosen from 87 patients with NPC and 54 patients with cervical carcinoma, respectively. Using a gamma criterion of 3 mm/3%, the γ passing rates at actual gantry angle and zero degree gantry angle were measured using ArcCHECK and compared by paired t test. Results The γ passing rate was significantly lower at actual gantry angle than at zero degree gantry angle in patients with NPC or cervical carcinoma ((93.8±3. 6)% vs. (97.8±1. 1)%, P=0. 00;(96.3±2. 1)% vs. (98.2±1. 0)%, P=0. 00). Moreover, the variation range of the γ passing rate at actual gantry angle was larger than that at zero degree gantry angle. Bothγpassing rates at actual gantry angle and zero degree gantry angle were lower in the patients with NPC than in the patients with cervical carcinoma . Conclusions Compared with that at zero degree gantry angle, theγpassing rate at actual gantry angle is closer to reality. Therefore, the actual gantry angle is recommended for dose verification. In order to meet the clinical requirement, a higher standard of γ passing rate should be proposed when zero degree gantry angle is used for dose verification.

Objective To investigate podocyte number, the expression of nephrin and transforming growth factor-β1(TGF-β1) in adriamycin-induced-nephropathy rat model and its significance. Methods The rat adriamycin nephrosis model was constructed to detect blood and urine biochemical indicators and observe the pathological changes of renal tissues by light microscope and electron microscope. The expression levels of nephrin and TGF-β1 as well as the podocyte number were examined at different time points by immunohistochemistry. Results The pathological changes of the renal tissues were obvious. Nephrin presented a weak signal at the end of the first week (P<0.05). TGF-β1 started to increase (P<0.05) while the podocyte number started to decrease at the end of the eighth week (P<0.05). Expression of nephrin was negatively correlated with the P<0.05) and serum creatinine (r=-0.71, P<0.05). Expression of TGF-β1 was blood urea nitrogen (r=0.62, P<0.05) and serum creatinine (r=0.59, urinary protein (r=-0.63, P<0.05), blood urea nitrogen (r=-0.72, P<0.05) and serum creatinine (r=-0.76, P<0.05); it was positively correlated with nephrin (r=0.78, P<0.01) but negatively correlated with TGF-β1 (r=-0.64, P<0.05). Conclusion The acute and chronic adriamycin nephrosis models were twice every two weeks. The genesis and development of proteinuria are closely related to the abnormal expression of nephrin. Focal segmental glomerulosclerosis occurs when the podocyte number decreases and TGF-β1 accelerates it.

Objective To investigate podocyte number,the expression of nephrin and transforming growth factor-?1(TGF-?1) in adriamycin-induced-nephropathy rat model and its significance.Methods The rat adriamycin nephrosis model was constructed to detect blood and urine biochemical indicators and observe the pathological changes of renal tissues by light microscope and electron microscope.The expression levels of nephrin and TGF-?1 as well as the podocyte number were examined at different time points by immunohistochemistry.Results The pathological changes of the renal tissues were obvious.Nephrin presented a weak signal at the end of the first week(P

Objective:To observe the antidepressant effect of Tongdu Qishen electroacupuncture method; To explore its mechanism of regulating the oxidative stress pathway of protein kinase C (PKC)/reduced coenzymeⅡ (NADPH) in depression model rats.Methods:Totally 32 SD rats were divided into control group, model group, Tongdu Qishen electroacupuncture group and escitalopram group according to random number table method, with 8 rats in each group. The model of depression was established by chronic unpredictable stress except control group. After the start of modeling, Tongdu Qishen electroacupuncture group was treated with electroacupuncture every day, 15 min/time/day; escitalopram group was given 30 mg/kg intragastric intervention. 1 day before the start of the experiment and the 28th day of the experiment, the growth of body mass was observed, and sugar preference experiment and open field experiment were performed. The protein expression levels of protein kinase C α (PKC α), p47phox, t and RAS related C3 botulinum toxin substrate 1 (Rac1) in hypothalamus were detected by Western blot, and the positive area ratio of NOX2 protein in hypothalamus was detected by immunofluorescence technique; ROS content in hypothalamus was detected using DCFH-DA fluorescent probe technique.Results:Compared with the model group, the Tongdu Qishen electroacupuncture group and the escitalopram group showed the body mass growth ( P<0.01) and sugar preference index increased ( P<0.01), and the moving distance ( P<0.05) and residence time ( P<0.01) in the central area of the open field experiment were longer; the protein expression levels of hypothalamic PKC α, p47phox and Rac1 decreased ( P<0.05 or P<0.01), the positive area ratio of NOX2 protein decreased ( P<0.05), and the level of ROS also decreased significantly ( P<0.01) in Tongdu Qishen electroacupuncture group and escitalopram group. Conclusion:Tongdu Qishen electroacupuncture group can improve the behavior of depressed rats, inhibit the oxidative stress response of PKC/NADPH pathway, and reduce the production of ROS, thereby reducing the brain damage caused by oxidative stress, and improving the symptoms of depression.

Objective:To evaluate the effect of individualized blood pressure management on postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.Methods:One hundred and sixty elderly hypertensive patients of both sexes, aged 60-80 yr, with body mass index of 19-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective radical resection for gastrointestinal tumor under general anesthesia, were divided into 2 groups ( n=80 each) using a random number table method: standardized blood pressure management group (group S) and individualized blood pressure management group (group I). Combined intravenous-inhalational anesthesia was performed, and BIS values were maintained at 40-60 and heart rate at 50-100 times/min during surgery in both groups. In group S, intraoperative systolic blood pressure was maintained above 90 mmHg with a decrease of less than 30% of the baseline value, while intraoperative fluctuation of systolic blood pressure was maintained less than 10% of the baseline value in group I. The use of vasoactive agents, numerical rating scale scores within 3 days after operation, and length of hospital stay were recorded. Postoperative delirium was evaluated by Confusion Assessment Method within 5 days after surgery. Results:Compared with group S, the intraoperative usage rate of norepinephrine was significantly increased, the incidence of postoperative delirium was reduced( P<0.05), and no significant change was found in the numerical rating scale scores and length of hospital stay in group I ( P>0.05). Conclusions:Individualized blood pressure management can reduce the development of postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.

Objective To analyze the acupoint compatibility law and the application characteristics of acupuncture moxibustion treatment for depression based on complex network technology;To provide a basis and ideas for formulating prescriptions of acupuncture antidepressant therapy.Methods Related clinical literature about acupuncture for the treatment of depression was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Embase,Cochrane Library,and Web of Science from the establishment of the databases to 21st,Sep.2022.According to the inclusion and exclusion criteria,the literature was screened,and the clinical literature database of acupuncture in anti-depression was established.Excel 2010 was used for frequency analysis of acupoints.SPSS Modeler 18.0 was used for association rule analysis,and Gephi 0.9.5 was used for complex network analysis.Results Totally 579 articles were included,involving 172 acupoints,with a total frequency of 3 222.The results of descriptive analysis showed that the main meridians of acupoints were Governor Vessel,bladder meridian and liver meridian,and the specific acupoints such as Yuan-primary point,Shu-stream point,Back-shu point,Luo-connecting point,Eight confluence points,Front-mu point,He-sea point were frequently used.Association rules analysis showed that the combination of the highest correlation acupoints were"Yintang(GV29)-Baihui(GV20)".Through the complex network k-core analytic hierarchy process and community analysis,two core acupoint groups were finally obtained.The acupuncture angle,depth and direction were based on safety and meridian circulation direction,the tonifying and reducing method was based on syndrome differentiation,and the prescription was based on syndrome differentiation and symptomatic selection.Conclusion Acupuncture for depression has the following characteristics:the principle of acupoint selection is based on meridian selection and specific acupoints,the selection of core acupoints focuses on the treatment of spirit and the regulation of viscera,channels and functions,and the emphasis on syndrome differentiation and symptomatic acupoint selection in clinical treatment.While,it was important to pay more attention to the specificity of acupuncture and moxibustion.

Objective:To evaluate the safety and efficacy of ciprofol and propofol for gynecological surgeries with general anesthesia through a meta-analysis.Methods:Electronic databases including PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure, Wanfang Data, China Biomedical Literature Database, and China Science and Technology Journal Database were searched for randomized controlled trials comparing the safety and efficacy of ciprofol and propofol in gynecological surgeries with general anesthesia from inception to May 2023. Meta-analysis was performed using Revman 5.4 software.Results:Six randomized controlled trials were included, involving 741 patients, of which 371 received ciprofol and 370 received propofol. Compared with propofol group, the emergence time was significantly prolonged, the difference in mean arterial blood pressure, systolic blood pressure and diastolic blood pressure before and after anesthesia induction was decreased, and the incidence of injection pain, respiratory depression, body movement and hypotension was decreased in ciprofol group ( P<0.05). There were no significant differences between the two groups in terms of time of successful anesthesia induction, difference in BIS values and heart rate before and after anesthesia induction, and incidence of tachycardia, bradycardia and hypertension ( P>0.05). Conclusions:Ciprofol is comparable to propofol in terms of efficacy and has better safety than propofol when used in gynecologic surgeries with general anesthesia.

Objective:To understand the epidemic characteristics and influential factors of brucellosis patients in Laizhou, Shandong Province, and to provide scientific basis for prevention and control of brucellosis.Methods:Retrospective analysis was conducted to collect the surveillance data and epidemiological investigation results of confirmed cases of brucellosis in Laizhou from 2016 to 2019 through the "Infectious Disease Report Information Management System of the China Disease Prevention and Control Information System". The general situation, epidemiological characteristics, and clinical characteristics of brucellosis were analyzed by descriptive epidemiology. Using the case-control study method, 81 confirmed cases of brucellosis and 162 healthy people in the same area, same gender and same age as confirmed cases were selected to analyze the influential factors of brucellosis.Results:Totally 222 cases of brucellosis had been reported in Laizhou, with an average annual incidence of 6.57/100 000. The onset age of brucellosis was mainly from 45 to 59 years old, accounting for 46.40% (103/222); male-to-female ratio was 2.42 ∶ 1.00 (157 ∶ 65); the occupation distribution was mainly farmer, accounting for 95.95% (213/222). The onset time of brucellosis was mainly from March to July, accounting for 58.11% (129/222). Cases of brucellosis were reported in 17 townships (streets) of Laizhou, and the top five townships were Zhuqiao, Shahe, Tushan, Chengguo and Yidao towns in order of incidence. Among 222 cases of brucellosis, the shortest interval from onset to diagnosis was 5 d, the longest was 36 d, and the median was 11 d. The main clinical manifestations of the patients were fever (89.19%, 198/222), fatigue (80.63%, 179/222), joint muscle soreness (72.97%, 162/222), and a few accompanied by liver, spleen and testis enlargement. The logistic regression analysis showed that contact with urine, feces and other excrements of diseased animals [odds ratio ( OR) = 6.244, 95% confidence interval ( CI): 1.609 - 24.231] and family members suffering from brucellosis ( OR = 16.363, 95% CI: 2.250 - 119.023) were risk factors of brucellosis. Conclusions:The incidence of brucellosis is mainly among 45 - 59 middle-aged farmers in Laizhou and the incidence peaks in spring and summer. Direct contact with excrements of diseased animals and family members suffering from brucellosis are the risk factors of brucellosis. Health departments should carry out health education and behavioral intervention for farmers in the season and areas with high incidence of brucellosis, so as to improve personal awareness of protection.