Objective: To observe the efficacy of acupoint sticking with Jianpi Tongjing Zhitong ointment in the treatment of functional dyspepsia due to liver-qi stagnation and spleen deficiency and its effect on serum 5-hydroxytryptamine (5-HT) and ghrelin contents. Methods: One hundred patients with functional dyspepsia due to liver-qi stagnation and spleen deficiency were divided into a treatment group and a control group by the random number table method, with 50 cases in each group. The treatment group received acupoint sticking with Jianpi Tongjing Zhitong ointment and the control group was treated with mosapride citrate orally. Patients were treated for 4 weeks as a course. The therapeutic efficacy was compared after one-course treatment and the differences in gastric emptying rate, and serum 5-HT and ghrelin contents between groups were compared before and after treatment. Results: The total effective rate was 79.6％ in the control group and 89.4％ in the treatment group, showing significantly different between groups (P<0.05). After treatment, the gastric emptying rate and serum ghrelin content of the two groups increased significantly, and the serum 5-HT content decreased significantly, the intra-group differences were significant (all P<0.01). After treatment, the gastric emptying rate and serum ghrelin content were significantly higher in the treatment group than those in the control group, while the serum 5-HT was significant lower in the treatment group, the inter-group differences were significant (all P<0.05). A negative correlation (r=-0.59) was observed between serum 5-HT content and gastric emptying rate, and a positive correlation (r=0.64) was observed between serum ghrelin content and gastric emptying rate, showing statistical significance (all P<0.01). Conclusion: Acupoint sticking with Jianpi Tongjing Zhitong ointment has a remarkable clinical efficacy in treating patients with functional dyspepsia due to liver-qi stagnation and spleen deficiency and is able to influence the secretion of serum 5-HT and ghrelin. Improving the gastrointestinal motility through the regulation of related brain-gut peptides is suggested as an underlying mechanism for this therapy.

BACKGROUND: Pergolide and madopar are the effective medicines to treat Parkinson disease, but the effects on the prognosis of patients with Parkinson disease are still under discussion. The progress of neuroimaging makes it possible to evaluate quantitatively the effect of the drug treatment on the prognosis of Parkinson disease.OBJBCTIVE: To observe the influence of pergolide or madopar as initial treatment on the prognosis and the striatal dopaminergic neuron in patients with early Parkinson disease by means of 99Tcm-TRODAT-1 dopamine transporter imaging single-photon emission computed tomtheography (SPECT) in combination with Parkinson disease scale.DESIGN: A randomized grouping, parallel control and placebo control trial.SETTING: Department of Neurology, the 81 Hospital of Chinese PLA;Department of Neurology and Department of Nuclear Medicine, Changhai Hospital of the Second Military Medical University of Chinese PLA.PARTICIPANTS: Thirty-six patients with early Parkinson disease who were recruited at the Specific Clinic of Parkinson Disease in the Shanghai Changhai Hospital affiliated to the Second Military Medical University of Chinese PLA and did not receive any drug treatment before, were enrolled between February and July 2002. They were randomly divided into artane control group (n=12), pergolide-treated group (n=12) and madopar-treated group. The diagnosis accorded with the clinical diagnostic standard set by United Kingdom Society of Parkinson Disease. This protocol was approved by the Medical Ethics Committee of Changhai Hospital, and all the subjects were enrolled in this study with informed consent.INTERVENTIONS: After test with unified Parkinson disease rating scale (UPDRS) and 99Tcm-TRODAT-1 SPECT, patients in the artane control group, pergolide-treated group and madopar-treated group were treated with corresponding drugs respectively, and each capsule of artane, pergolide and madopar contained drug of 0.05, 0.05 and 125 mg respectively. In the 1st week, the dosage was 1 capsule for each time, once a day, and then the daily dosage was increased by 1 capsule per week later, and the daily dosage reached 0.2, 0.2 and 500 mg respectively after 1 month, and then the dosages were kept constant. The curative effects were evaluated with UPDRS at 6 and 10 months after treatment. At 10 months after treatment,the 99Tcm-TRODAT-1 specific intakes of ipsilateral or contralateral striatum of the affected limb were tested with striatum dopamine transporter SPECT and semi-quantitative analysis.MAIN OUTCOME MEASURES: ① Changes of percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb at 10 months after treatment were compared among the three groups;② Changes of UPDRS scores before and after treatment were compared among the three groups.RESULTS: Totally 36 patients were involved in the study, and 1 case lost in each of the 3 groups respectively at 10 months after treatment, finally 33 cases entered the analysis of results. ① Changes of percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb at 10 months after treatment: At 10 months after treatment, the percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb were obviously higher in the madopar-treated group than in the artane control group and pergolide-treated group [(46.3±19.4)%, (28.9±13.0)%, (34.4±18,1)%; (47.5±20.8)%, (31.8±15.6)%, (33.8±17.2)%; P all ＜ 0.05]. ② Changes of UPDRS scores before and after treatment: As compared with the UPDRS scores before treatment, there was no obvious change in the artane control group at 10 months after treatment,but those in the madopar-treated group and pergolide-treated group were obviously decreased [(15.5±8.68), (6.4±9.05); (15.8±6.75), (10.36±8.30); Pall ＜ 0.05].CONCLUSION: Both madopar and pergolide can ameliorate the symptoms of early Parkinson disease, but they had different influences on the prognosis of patients with Parkinson disease. Madopar may accelerate the apoptosis of dopaminergic neuron and then aggravate the severity, but pergolide does not affect the prognosis of Parkinson disease, so it is a more suitable selective drug for the treatment of early Parkinson disease.

BACKGROUND: Selegiline can effectively alleviate motor disorder symptoms during the earlier stage of Parkinson disease(PD),but the influence on prognosis is still warmly discussed. With the development of neuroiconologicai study,the objective predictor for dopaminergic neuronal degeneration in PD would became possible.OBJECTIVE: To observe the influence of selegiline on dopaminergic neurons in earlier stage of PD with the aid of iconology.DESIGN: Randomized controlled study based on patients.SETTING: Neurological department in a military hospital of Chinese PLA,the nuclear medicine and neurological department in a military medical hospital of Chinese PLA.PARTICIPANTS: Between April and December 2001,25 patients were selected from PD specific clinic of Changhai Hospital,the Second Military Medical University of Chinese PLA. They were confirmed of earlier stage of PD without given any related drugs.INTERVENTIONS: Totally 25 patients were randomly divided into placebo group of 13 cases and selegiline group of 12 cases. After assessed with unified PD rating scale(UPDRS),they were given placebo and selegiline respectively with the dosage gradually increased from 0.05 mg at the beginning and added with 0.05 mg every week for four weeks until reaching the sustaining dosage of 0.2 mg. Dopamine transporting protein (99Tcm-TRODAT-1) examination and single photon emission-computerized tomography (SPECT) were performed at entering the experiment and after the treatment for 13 months,and semi-quantitative analysis was used for counting striatal emission of the ipsilateral and contralateral side. Scores for UPDRS were obtained at entering the experiment,after the treatment for 6months and 13 months.MAIN OUTCOME MEASURES:①Main outcomes:The differences ofstriatal 99Tcm-TRODAT-1 specific intake decreasing percentage on ipsilateral and contralateral side were compared between the two groups after the treatment for 13 months.②Subordinate outcome:Scores for UPDRS of the two groups was also compared.RESULTS: After the treatment for 13 months,striatal 99Tcm-TRODAT-1 specific intake decreasing percentages were (28.9 ± 13.0)% and(31.8 ± 15.6) % on ipsilateral and contralateral side of placebo group compared with the corresponding (30.39 ± 14. 7)% and(32.6 ± 16. 6)% of the selegiline group,the difference was of no statistical significance( P ＞ 0.05). Scores for UPDR was(23.7 ±4.3) in placebo group and(13.1 ± 5.5) in selegiline group after the treatment for 6 months,and(27.0 ±4.3) and(9. 8 ±4. 8) after the treatment for 13 months,indicating that slegiline group was obviously better than placebo group( P ＜ 0. 05).CONCLUSION: Selegiline showed better therapeutic effect in the treatment of earlier-stage PD without increasing the apoptosis of striatal dopaminergic neurons.

Objective To evaluate the clinical reliability and feasibility of computerized endoscopic balloon manometry in vitro and in vivo, in measurement of pressure of esophageal varices. Methods Computerized endoscopic balloon manometry was used to measure the pressure of variceal model with different diameter (3 mm, 6 mm and 8 mm) and intraluminal pressures (ranging from 8 to 36 mm Hg), and the findings were compared with actual pressures. The technique was also applied in 23 patients with liver cirrhosis and esophageal varices, and its correlation with hepatic venous pressure gradient and other factors related with varices bleeding. Results The study in vitro showed that the measured intraluminal pressure was correlated significantly with the actual value ( r ≥ 0. 993, P ＜ 0. 001 ) without obvious measurement bias(95% CI = -0.13 cm H2O to 0. 33 cm H2O). The measurement in 23 patients were success with little variation coefficient (r≥0. 998) between repeated procedures. Regression analysis showed a good correlation between variceal pressure and hepatic venous pressure gradient (r=0. 858, P ＜ 0. 001 ). A higher variceal pressure was strongly associated with presence of previous bleeding episodes, vascular diameter and presence of red color signs, but did not correlate with the parameter of Child-Pugh classification ( t = 0. 31, P =0. 76). Conclusion Computerized endoscopic balloon manometry is reliable and feasible to examine esophageal variceal pressure, and is very likely to be a valuable clinical index for variceal bleeding.

BackgroundThe immunotherapy for retinoblastoma(RB) is gradually concerned recent year.To seek relative immune-associated antigen is a basis of immunotherapy.NY-ESO-1 and NY-SAR-35 are two kinds of genes of cancer testis antigen( CTA ).To understand their expressions in RB tissue can offer index for relative study.ObjectiveThis study was to investigate the expressions of two CTA NY-ESO-1 and NY-SAR-35 in RB and explore the possibility of them as potentially promising targets for antigen-specific immunotherapy of RB.Methods The samples were obtained from 15 RB eyes,12 non-tumor retinopathy eyes and 22 normal eyes with other benign eye diseases.Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the expressions of NY-ESO-1 mRNA and NY-SAR-35 mRNA in the samples.Genes of positive PCR results were sequenced randomly.The relevance of the expression of the two cancer-testis antigen genes with the clinical characteristics such as tumor stage,tumor size and clinical stage were analyzed.This study was approved by Ethic Committee of Guangxi Medical University.Written informed consent was obtained from each patient before operation. Results NY-ESO-1 mRNA was positively expressed in 6 RB samples and NY-SAR-35 mRNA was expressed in 9 RB samples.In the non-tumor retinopathy samples and normal eye tissues,NY-ESO-1 mRNA and NY-SAR-35 mRNA were absent.No significant relevances were found between the expressions of the NY-ESO-1 mRNA and NY-SAR-35 mRNA with clinical characteristics such as age ( P =0.426,0.822 ),gender ( P =0.180,0.464 ),pathological classification ( P =0.744,0.582 ),tumor size ( P =0.760,0.790),and clinical stage ( P =0.868,0.707 ).Conclusions NY-ESO-1 and NY-SAR-35 have high expressing frequencies in RB tissue and their expressions in RB have specificity.These results offer a clue for the identification of targets antigen of RB.

OBJECTIVETo evaluate the efficacy and safety of etanercept plus Tripterygium wilfordii polyglycoside (TWP) in elderly patients with active rheumatoid arthritis (RA).

METHODSTotally 46 elderly patients with active RA were randomly assigned to the treatment group (22 cases) and the control group (24 cases). All patients received subcutaneous injection of etanercept, 25 mg each time, twice per week. The dosage was reduced to once per week 3 months later. Patients in the treatment group took TWP Tablet (10 mg each time, three times per day), while those in the control group took methotrexate (MTX), 10 mg each time, once per week. The whole course lasted for 24 weeks. Patients' rest pain, tender joint number, swollen joint number, health assessment questionnaire (HAQ), patients' global assessment, physicians' global assessment, erythrocyte sediment rate (ESR), C reactive protein (CRP), rheumatic factor were assessed at week 0, 4, 8, 12, and 24. The curative effect was statistically evaluated by the United States Institute of Rheumatology ACR20, ACR50, and ACR70 improvement criteria. Meanwhile, any adverse event was recorded and evaluated.

RESULTSTotally 41 completed the trial, and 5 dropped off (3 in the treatment group and 2 in the control group). Compared with the control group, there was no statistical difference in ACR20, ACR50, or ACR70 in the treatment group (P > 0.05). Compared with before treatment in the same group, there was some improvement in tender joint number, swollen joint number, visual analogue scale (VAS) for patients' global assessment, VAS for physicians' global assessment, ESR, CRP, and HAQ between the two groups, showing statistical difference (P < 0.05). Compared with the control group in the same phase, there was no statistical difference in the treatment group (P > 0.05). There was no statistical difference in the occurrence of adverse events between the two groups.

CONCLUSIONSEtanercept plus TWP could achieve equivalent therapeutic effect to that of Etanercept plus MTX. The two regimens could improve clinical signs, symptoms, and QOL related to RA. They were well tolerated in the treatment of elderly patients with active RA.

Aged ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Etanercept ; Female ; Glycosides ; therapeutic use ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Treatment Outcome ; Tripterygium ; chemistry

Objective To study the surface electromyographic signal characteristics of submental and infrahyoid muscles when swallowing in patients with nasopharyngeal carcinoma (NPC) following radiotherapy.Methods Fifteen post-radiotherapy NPC patients with pharyngeal dysphagia confirmed by videofluoroscopie swallowing study (VFSS) were selected into the patient group,while another 15 healthy subjects were recruited into the healthy group.Surface electomyography (sEMG) was used to collect sEMG signals from submental muscles and infrahyoid muscles during both dry and 3 ml thick liquid swallowing,and sEMG duration,average amplitude and peak amplitude parameters were compared between the two groups.Results Compared with healthy subjects,the patient group showed significantly longer sEMG duration of submental muscles and infrahyoid muscles during dry swallowing and 3 ml thick liquid swallowing (P＜0.05).Moreover,significantly longer sEMG duration of submental muscles and infrahyoid muscles was observed when swallowing 3 ml thick liquid,compared with dry swallowing (P＜0.05).The average sEMG amplitude and peak amplitude of submental muscles and infrahyoid muscles of patients when dry swallowing and 3 ml thick liquid swallowing were both significantly higher than those of healthy subjects (P＜0.05).Conclusion Submental muscles and infrahyoid muscles manifested enhanced contractions during swallowing in NPC patients with dysphagia,which played a compensatory role after radiotherapy.

Non-invasive manometry of esophageal varices is a cynosure of researchers. This paper develops a method based on computer vision. Experiments results reveal that correct pressure value can be got quickly.
Aged ; Algorithms ; Artificial Intelligence ; Automatic Data Processing ; Esophageal and Gastric Varices ; physiopathology ; Female ; Humans ; Male ; Manometry ; instrumentation ; methods ; Middle Aged ; Pattern Recognition, Automated ; Venous Pressure

Objective: To summarize the clinical application patterns in acupuncture-moxibustion treatment of AD by reviewing the clinical literatures on acupuncture-moxibustion for Alzheimer disease (AD) published between January 2009 and December 2019. Methods: China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), Chinese Medicine Acupuncture-moxibustion Information Database, PubMed Medical Data Retrieval Service System, Springer Database and Ovid Technologies (OVID) were retrieved to screen clinical studies of acupuncture-moxibustion treatment of AD according to the inclusion and exclusion criteria to conduct quantitative, clustering and association analyses. Results: In acupuncture-moxibustion treatment of AD, the frequently used points were Baihui (GV 20), Zusanli (ST 36), Sishencong (EX-HN 1), Taixi (KI 3), Sanyinjiao (SP 6), and Neiguan (PC 6) in the descending order. Regarding meridians, the most frequently used one was the Governor Vessel, followed by the Stomach Meridian of Foot Yangming and Gallbladder Meridian of Foot Shaoyang. From the perspective of body regions, the points in the head-face region and the lower-limb region had the highest frequencies, followed by the upper-limb, back and chest-abdomen regions. The point group, Baihui (GV 20) and Sishencong (EX-HN 1)-Neiguan (PC 6)-Sanyinjiao (SP 6), showed the most significant association, and the group winning the second place was Baihui (GV 20) and Sishencong (EX-HN 1)-Neiguan (PC 6)- Zusanli (ST 36). The clustering analysis showed that the commonly used point pairs included Zusanli (ST 36)-Sishencong (EX-HN 1) and Taixi (KI 3)-Sanyinjiao (SP 6), which were closely associated with Baihui (GV 20). By analyzing the three commonly used acupuncture-moxibustion methods, acupuncture plus medication was found achieving the best result in the total effective rate and mini-mental state examination (MMSE) score, followed by monotherapy of electroacupuncture therapy, and these two methods were superior to acupuncture alone (P<0.05); the scores of MMSE, Alzheimer disease assessment scale-cognitive section (ADAS-cog) and activity of daily living scale (ADL) showed significant improvements after treatment (all P<0.01). Conclusion: In the acupuncture-moxibustion prescriptions for AD, the main points are Baihui (GV 20), Sishencong (EX-HN 1), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). Monotherapy of acupuncture has the highest frequency amongst the treatment methods, but its effective rate is lower than that of acupuncture plus medication and monotherapy of electroacupuncture.

Objective: To observe the intervention effect of auricular point sticking on dry eye in myopia patients after small-incision lenticule extraction (SMILE) surgery.Methods: This was a prospective randomized controlled study conducted among the myopia patients who received SMILE surgery at Eye and ENT Hospital of Fudan University. The post-SMILE operation patients who screened by the inclusion and exclusion criteria were randomized into a control group and a treatment group. Patients in the control group were given 0.1％ fluorometholone and 0.5％ carboxymethylcellulose sodium eye drops, while the treatment group was given additional unilateral auricular point sticking for 1 month. The patients were estimated using ocular surface disease index (OSDI), Schirmer tear test-1 (STT-1), tear film break-up time (TF-BUT), corneal fluorescein staining (CFS) score, corneal sensitivity (CS) and visual quality (VQ) at 1 d, 1 week and 1 month after surgery; the changes in anxiety and depression were also observed in the patients. Results: Compared with the first day after operation, CS in the nasal region was improved in the treatment group, and the VQ score increased in the control group patients at 1 week after operation (both P<0.05); at 1 month after operation, the TF-BUT increased, CFS score decreased, CS in the central and nasal regions increased (all P<0.05), and VQ score increased (P<0.01) in the treatment group, and the CS in the central, upper, lower and nasal regions were improved (all P<0.05), and VQ score increased (P<0.01) in the control group. The between-group comparison showed that the differences in the change of TF-BUT were statistically significant at 1 week and 1 month after surgery, respectively (both P<0.05). Conclusion: Auricular point sticking therapy can increase the TF-BUT and accelerate the repair of ocular surface function in post-SMILE patients.