Objective To analyze the general situation of acupuncture-moxibustion in treating perimenopausal insomnia, as well as the treatment methods and acupoints selection.Method Domestic databases including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, and database of China Biomedical Literature (CBM) were retrieved by using computer, and the literatures related to acupuncture-moxibustion in treating perimenopausal insomnia, published till December of 2014 were recruited. The general data, treatment methods, and acupoints selection of the eligible studies were statistically analyzed.Result Finally 85 studies were enrolled, of which, 76 were clinical trials with acupoints recorded; according to the frequency, the treatment methods were dry acupuncture-moxibustion methods (57.9%), comprehensive treatment of Chinese medicine (23.7%), and integrated method of Chinese and Western medicine (18.4%); the use of body acupuncture ranked the top (51.3%) among the acupuncture-moxibustion methods, followed by auricular point therapy (23.7%), moxibustion (9.2%), abdominal acupuncture (7.9%), and acupoint application (7.9%); the following acupoints ranked the top 10 among the used acupoints: Sanyinjiao (SP 6), Shenmen (HT 7), Baihui (GV 20), Shenshu (BL 23), Taichong (LR 3), Xinshu (BL 15), Taixi (KI 3), Neiguan (PC 6), Pishu (BL 20), and Zusanli (ST 36). The corresponding meridians in order were the Bladder Meridian, Spleen Meridian, Kidney Meridian, Governor Vessel, Liver Meridian, Heart Meridian, Stomach Meridian, Conception Vessel, Pericardium Meridian, Gallbladder Meridian, Large Intestine Meridian, and Triple Energizer Meridian; the used points were mostly distributed on lower limbs, then head and neck, back, upper limbs, and chest and abdomen.Conclusion Currently, the research in this field is focused on clinical prevention and treatment, while the theory and mechanism studies are comparatively less; based on the treatment principle of targeting the fundamental cause, it also presents the principle of selecting points according to meridians and regions in the treatment of perimenopausal insomnia with acupuncture-moxibustion.

Objective To investigate the effects of sphingosine kinase 1 (SphK1 ) inhibitor N, N-dimethylsphingosine (DMS)combined with 5-fluorouracil (5-FU)on the proliferation and apoptosis of gastric cancer MGC-803 cells and to explore the possible mechanisms involved.Methods MGC-803 cells were cultured in vitro.The effects of DMS and 5-FU on cell proliferation,apoptosis,and cell cycle distribution of MGC-803 cells were detected by MTT assay and flow cytometer (FCM),respectively.The expressions of SphK1 ,TS,DPD,NF-κB p65 and Bcl-2 proteins were detected by Western blot.Results Different concentrations of DMS or 5-FU alone or in combination could obviously inhibit the proliferation of MGC-803 cells in a dose-dependent and time-dependent manners (P<0.05 ).And the proliferation inhibition rate of MGC-803 cells in the combination group was significantly higher than that in the single drug groups (P<0.05).Treatment of MGC-803 cells with DMS did not affect the cell cycle distribution (P>0.05).As compared with the cells without drug treatment,DMS or 5-FU alone could obviously increase the apoptosis rate of MGC-803 cells (P<0.05);the apoptosis rate in the combination group was significantly higher than that in the single-drug groups (P<0.05).The expression levels of SphK1,NF-κB p65 and bcl-2 proteins were down-regulated with the treatment of DMS alone or in combination,whereas those of TS and DPD were not affected.Conclusion DMS can inhibit the proliferation and induce apoptosis of gastric cancer MGC-803 cells in vitro.It shows a good synergetic effect in combination with 5-FU,probably by down-regulating the expressions of SphK1,NF-κB p65 and Bcl-2 proteins.

Objective:To evaluate the effectiveness of hierarchical management for patients with bronchial asthma.Methods:One hundred and eighty seven patients with bronchial asthma were recruited from January 2018 to November 2019 in Daxing District People′s Hospital. Patients were randomly divided into two groups, 94 patients received disease management education and therapeutic guidance from doctors in the community hospital and district hospital (study group), and 93 patients were followed up in outpatient visits only (control group). After one year, the scores of inhalation technique, treatment adherence, disease management awareness, the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ) and pulmonary function were evaluated and compared between two groups. The annual acute attack times and time to first exacerbation were also compared between the two groups.Results:After one year of management the treatment adherence rate in study group was higher than that in control group [80.85% (76/94) vs. 51.61% (48/93), χ2=2.834, P=0.02]. The scores of inhaled corticosteroids (ICS) inhalation technique [(6.47±1.28) vs. (4.05±1.37), t=2.241, P=0.04], the correct rates of exhaling before ICS inhalation [94.68% (89/94) vs.56.98% (53/93), χ2=4.436, P=0.01],inhalation [90.43%(85/94) vs.68.82% (64/93),χ2=2.943, P=0.04],holding breath after inhalation [89.36% (84/94) vs.58.06% (54/93),χ2=4.098, P=0.02],rinsing mouth after ICS inhalation [92.55%(87/94) vs.65.59%(61/93),χ2=2.876, P=0.04] in study group were higher than those in control group. The awareness rates of chronic inflammatory airway disease [70.21%(66/94) vs.44.08% (41/93),χ2=2.673, P=0.02], causative factors [85.10% (80/94) vs. 56.99% (53/93),χ2=2.760, P=0.02],treatment misunderstanding [88.29%(83/94) vs.53.76%(50/93),χ2=4.874, P<0.01], therapeutic goal [86.17% (81/94) vs. 49.46% (46/93),χ2=4.491, P<0.01] and requiring long-term treatment [90.43% (85/94) vs.48.38% (45/93),χ2=4.503, P<0.01] in study group were higher than those in control group. The scores of ACT [(22.71±2.81) vs. (19.50±5.34), t=2.041, P=0.04] and miniAQLQ [(84.28±11.16) vs. (64.23±14.38), t=3.298, P<0.01] in study group were higher than those in control group. The number of annual acute exacerbation was less [0(0, 1) vs.2(1, 3), Z=-3.237, P<0.01] and the time to first exacerbation was longer [184(96, 284)d vs. 96(59, 177)d, Z=3.873, P<0.01] in study group than those in the control group after one year of management. Conclusion:The hierarchical management can effectively enhance the inhalation technique and treatment adherence of the patients with bronchial asthma, and improve the quality of life of patients.

Objective To detect beta-human papilloma virus (HPV) and determine its genotype in actinic keratosis (AK) lesions.Methods Tissue specimens were collected from the lesions of 39 patients with AK and normal skin of 40 healthy controls.A nested PCR was performed to detect alpha-HPV and beta-HPV DNA in these specimens.The genotype of beta-HPV was determined in beta-HPV DNA-positive specimens by a common PCR using specific primers targeting 12 HPV genotypes,including HPV 5,8,15,17,19,20,21,23,36,38,49 and 80.Results The detection rate of beta-HPV DNA was 84.6％ (30/39) in the patients with AK,and 30.0％ (12/40) in the healthy controls (x2 =6.76,P ＜ 0.05),while no significant difference was observed in the detection rate of alpha-HPV DNA between the two groups (12.8％ vs.7.5％,x2 =0.91,P ＞ 0.05).HPV 38 was the predominant genotype of beta-HPV in these patients with a detection rate of 36％ (12/33),followed by HPV36.The prevalence of all the 12 genotypes of HPV was consistently low in the healthy controls.Mixed HPV infections were observed in 10 AK lesions,but in none of the healthy controls.No statistical difference was noted in the positivity rate of beta-HPV among patients at different ages,of different genders,with different occupations or clinical courses (x2 =0.53,0.94,0.81,0.73,respectively,all P ＞ 0.05).Conclusions Compared with healthy controls,the patients with AK showed a higher beta-HPV infection rate,with HPV38 as the predominant genotype.

Objective To study the clinical use of the ulnar-basilic arteriovenous fistula as a long-term vascular access in patients with hemodialysis.Methods The clinical data of 36 patients with 1-year follow-up who had a wrist ulnar-basilic arteriovenous fistula formed in China-Japan Friendship Hospital from January 2013 and December 2014 were retrospectively analyzed.The outcomes for this study including the surgical results,complication rate of ulnar-basilic arteriovenous fistula,immediate patency rate,average maturation time,1-year primary patency rate and true patency rate were analyzed.Results Thirty-four cases patients got successful ulnar-basilic arteriovenous fistula formed with palpable vascular thrill.There were no death cases and no severe cardio-cerebrovascular complications.No infection,heart failure,distal swelling and ischemia occurred.The immediate patency of ulnar-basilic arteriovenous fistula was 94.4%(34/36),the average maturation time was (67±4) d,1-year primary patency rate was 63.9%(23/36),and true patency rate was 67.6%(24/36).Conclusion Ulnar-basilic arteriovenous fistula with adequate 1-year primary patency and low risk of infection and complications can be a viable alternative as the hemodialysis vascular access.

Objective To study the application of dynamic ultrasound countercurrent extraction technology in industrialization of Lianhua Qingwen Capsule by multi-index optimization. Methods Ultrasonic temperature and ultrasonic time were investigated by using single factor design. The three factors of dry extract yield, the active ingredient content, and fingerprints were selected as the optimization indexes to investigate the solvent consumption and extraction time between the dynamic ultrasound countercurrent extraction process and the original reflux extraction process under the fixed conditions of process parameters. Results Compared with traditional reflux extraction technology, dynamic ultrasound countercurrent extraction technology effectively reduced the alcohol consumption and saved extraction time on the basis of guarantee of the active ingredient content. Conclusion Dynamic ultrasound countercurrent extraction process, with simple and fast advantages, can be used to Lianhua Qingwen Capsule production, which can significantly reduce production costs and increase productivity.

Objective To study the clinical outcome of endoscopic vessel harvesting system (EVH) for the treatment of lower limbs varicose veins.Methods Patients (n =41) with varicose veins admitted from Jan 2011 to May 2013 were randomly divided into EVH group (n =20) and stripping group (n =21).Indexes as postoperative VAPS (48 hours and 1 week),subcutaneous ecchymosis (1 week),hematoma(1 week),skin numbness (1 week),CEAP classification (3 months),surgery effect and satisfaction scores(3 months) were compared between the two groups.Results 48 hours and 1 week VAPS was lower in EVH group(P ＜0.01).After EVH there was less subcutaneous ecchymosis (1 week),hematoma(1 week) and skin numbness (1 week) (all P ＜ 0.01).Postoperative CEAP classification improved significantly in both groups (P ＜ 0.01),while surgery effect and satisfaction scores (3 months) were better in EVH group (P ＜ 0.05).Conclusions EVH is a safe and minimally invasive technique in treatment of varicose veins of the lower limbs.

[Summary] The clinical and genetic characteristics of a patient with male pseudohermaphroditism, being considered as an isolated 17, 20-lyase deficiency case, were analyzed. The social gender of the patient aged 30-year-old was female. The patient presented with 46, XY karyotype, unclosed epiphysis, after perineal block resection, hypergonadotropic hypogonadism, while the production of mineralocorticoids and glucocorticoids hormone was intact. A503V heterozygous mutation in exon 13 and a deletion in intron 11 of POR gene were detected. The gene mutations may lead to the occurrence of the isolated 17,20-lyase deficiency.

Objective:To analyze the effectiveness of antiviral therapy on adolescents and adults with infectious mononucleosis (IM).Methods:The clinical data of patients aged≥16 years old with IM who were hospitalized in Peking University First Hospital from January 1, 2005 to December 31, 2018 were analyzed retrospectively, and the patients were divided into antiviral treatment group and non-antiviral treatment group. The duration of hospitalization day, fever duration, ratio of lymphocytes and duration for normalization of Epstein-Barr virus (EBV) markers were compared between the two groups through single factor and propensity score matching analysis. Statistical analysis was conducted by independent sample t test, Mann-Whitney U test, chi-square test or Fisher exact probability method. Results:A total of 274 cases were enrolled and 176 cases (64.23%) were divided into antiviral treatment group and 98 cases (35.77%) into non-antiviral treatment group. The proportion of male (56.25%(99/176) vs 56.12%(55/98)), age (21.0(18.0, 26.0) years old vs 21.0(18.0, 27.0) years old), the ratio of fever (98.30%(173/176) vs 93.88%(92/98)), sore throat (90.34%(159/176) vs 88.78%(87/98)), lymphocyte ratio (0.648(0.568, 0.707) vs 0.663(0.581, 0.711)), atypical lymphocyte ratio (0.150(0.100, 0.235) vs 0.135(0.060, 0.250)) and serum EBV DNA level (2.71(2.70, 3.47) lg copies/mL vs 2.70(2.70, 3.28) lg copies/mL) were comparable between two groups at admission, and the differences were all not statistically significant(all P>0.05). The durations of hospitalization and fever in antiviral treatment group were 14.0(10.0, 18.0) d and (14.91±7.24) d, respectively, which were both significantly longer than those in non-antiviral treatment group (11.0(7.0, 15.0) d and (9.95±5.67) d, respectively). The differences were both statistically significant ( Z=-3.294 and t=-5.035, respectively, both P<0.01). Twenty-six patients each in the antiviral treatment group and non-antiviral treatment group were included in the propensity score matching assessment. The fever days of the two groups were 15.0(10.0, 18.0) d and 7.5(5.0, 12.5) d, respectively, and the hospitalization days were (15.4±5.5) d and (12.0±5.7) d, respectively. The differences were both statistically significant ( Z=-3.781 and t=-2.187, respectively, both P<0.05). However, there were no significant differences in the time required for the ratio of lymphocytes returning to normal, the time required for the ratio of atypical lymphocytes decreasing to <0.100, and the time required for serum EBV DNA becoming negative(all P>0.05). Conclusion:The antiviral treatment could not improve the prognosis of adolescent and adult IM patients.

Objective:To analyze the invasion characteristics and prognostic factors of patients with Masaoka-Koga stage Ⅲ thymoma.Methods:The tumor invasion characteristics of 179 patients who were diagnosed with Masaoka-Koga stage Ⅲ thymoma and treated in Affiliated Cancer Hospital of Zhengzhou University from January 2000 to June 2018 were analyzed retrospectively. According to the treatment methods, all patients were divided into the radical operation group ( n=94), palliative operation group ( n=39) and simple biopsy group ( n=46). The χ2 test was used to compare the classified variables, Kaplan- Meier method was utilized to calculate the cumulative survival rate, log-rank method was used for group comparison and univariate analysis, and Cox’s regression model was used for multivariate analysis. Results:Mediastinal pleural invasion (86.0%) was the most common site, followed by pericardium (50.8%), great vessel (40.8%) and lung (36.3%). The proportion of macrovascular invasion in the radical operation group was 14.9%, significantly lower than 79.5% and 60.9% in the palliative surgery group and biopsy group (both P<0.001). Multivariate analysis showed that the nature of operation ( P<0.001), age ( P=0.011), radiotherapy ( P=0.020) were the independent factors affecting overall survival (OS), while nature of operation ( P<0.001), age ( P=0.004), radiotherapy ( P=0.020), number of invasive organs ( P=0.023) and pathological type ( P=0.016) were the independent factors affecting progress-free survival (PFS). Conclusions:For patients with Masaoka-Koga stage Ⅲ thymoma, mediastinal pleura is the most common site of invasion, pericardium, lung and great vessels are also commonly invaded. The invasion of mediastinal pleura, pericardium and lung exerts slight effect on surgical resectability, whereas great vessel involvement can significantly affect surgical resectability. OS and PFS in patients undergoing radical resection are significantly better than those in patients treated with palliative resection and biopsy. Radical resection is the most important factor affecting prognosis.