OBJECTIVE: To observe the clinical efficacy of acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux for gastroesophageal reflux cough (GERC). METHODS: A total of 120 GERC patients were randomly assigned to an observation group (60 cases, 1 case dropped out) and a control group (60 cases, 1 case was eliminated). The observation group received acupoint thread-embedding treatment at positive response points of governor vessel. If no such points were detected, the following acupoints were used: Dazhui (GV14), Fenghu (Extra), Shendao (GV11), Lingtai (GV10), and Zhiyang (GV9). Treatment was administered once every two weeks. The control group received oral rabeprazole enteric capsules at 20 mg twice daily. All the treatment was given for 6 weeks. Clinical outcomes were assessed using cough symptom score, reflux disease questionnaire (RDQ) score, and Leicester cough questionnaire (LCQ) score before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. RESULTS: After treatment, both groups showed decreased cough symptom scores and the each item scores and total scores of RDQ (P<0.001), and increased LCQ scores (P<0.001) compare with those before treatment. The observation group exhibited lower cough symptom score and chest pain, reflux and total score of RDQ, and higher LCQ score compared to those in the control group (P<0.05). The total effective rate in the observation group was 94.9% (56/59), which was higher than 84.7% (50/59) in the control group (P<0.05). CONCLUSION Acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux could effectively alleviate cough and reflux symptoms in patients with GERC and improve their quality of life.
Humans ; Acupuncture Points ; Gastroesophageal Reflux/physiopathology* ; Male ; Female ; Cough/physiopathology* ; Middle Aged ; Aged ; Acupuncture Therapy ; Adult ; Treatment Outcome ; Lung/physiopathology* ; Meridians

Portal vein thrombosis （PVT） is one of the common complications during the natural course of liver cirrhosis and has an important influence on the progression of liver cirrhosis. This article mainly summarizes the research advances in the risk factors for PVT. There are many risk factors for PVT， and Virchow’s triad， namely venous stasis， hypercoagulability， and vascular endothelial injury and systemic inflammation caused by surgery or trauma， are considered the main reasons for the development and progression of PVT. At present， more prospective studies are still needed to validate the predictive models for the risk of PVT that have certain application prospects in clinical practice. Cirrhotic patients with PVT tend to have a poor prognosis， and complete obstructive PVT is associated with increased mortality after liver transplantation. Recent studies have shown that prophylactic anticoagulant therapy is safe and effective in patients with liver cirrhosis and can thus help with the prevention and treatment of PVT.

OBJECTIVE To explore the mechanism of Baihe Dihuang decoction in the treatment of Alzheimer's disease(AD) based on network pharmacology, molecular docking and animal experiment. METHODS TCMSP were used to predict the active components and targets of Baihe Dihuang decoction and disease-related targets were collected from GeneCards, OMIM and DRUGBANK databases, respectively. Target protein interactions were analyzed with STRING database and biological function and pathway were analyzed with Metascape database. Lastly relevant results were analyzed with Cytoscape 3.8.0. AutoDock vina software was used for molecular docking to analyze the binding energy of the active components and key targets of Baihe Dihuang decoction. PyMOL software were used to visualize the optimal docking results. ICR male mice were randomly divided into control group, model group, Rolipram group, low, medium and high dose group of Baihe Dihuang decoction. After 14 days of administration, the neurobehavioral scores of mice in each group were collected, and the expression of related proteins in brain tissue was detected, ELISA and Western blotting were used to detect the expression of the key protein cAMP, PKA, p-CREB and BDNF. At last, the adverse reaction of Baihe Dihuang decoction was observed by vomiting experiment. RESULTS A total of 13 active components and 39 key targets were collected from network pharmacology. The docking results showed that the first 10 core targets all performed well and their effects were closely related to PRKACA. Compared with the control group, the model group mice's recognition rate of new objects and the spontaneous alternation reaction rate were significantly reduced, the escape latency was significantly prolonged, and the target quadrant stay time, the number of crossing platforms were significantly reduced; cAMP, PKA, p-CREB and BDNF in the hippocampus of mice was significantly decreased. Baihe Dihuang decoction could reverse the behavior of AD mice and the expression of cAMP, PKA, p-CREB and BDNF. In the vomiting experiment, the anesthesia recovery time of the Rolipram group was significantly prolonged, while that of the Baihe Dihuang decoction group was not significantly affected. CONCLUSION The mechanism of Baihe Dihuang decoction in the treatment of AD may be related to its influence on cAMP-PKA and regulation of cAMP-PKA-CREB-BDNF signal pathway, and the adverse reactions are milder than those of clopramide.

Objective To predict the mechanism of Chaihu Shugan Powder against depression based on network pharmacology and molecular docking technology;To verify them through animal experiment of chronic unpredictable mild stress(CUMS)depression model rats.Methods TCMSP was used to screen the active components of Chaihu Shugan Powder and the related targets were obtained.Disease targets were retrieved by DisGeNET,GeneCards and GEO databases.The protein-protein interaction(PPI)network construction,GO and KEGG pathway enrichment analyses were conducted to determine the action pathway of Chaihu Shugan Powder against depression.Molecular docking of main active components and potential targets was performed.The depression model was established by CUMS combined with solitary rearing method,in which Chaihu Shugan Powder and PI3K specific inhibitor LY294002 were used to intervene depression model rats.Western blot and qPCR were respectively used to detect the action pathway related proteins and mRNAs.ELISA was used to detect the contents of monoamine neurotransmitters 5-HT and NE in hippocampal tissue,and their pathways of action were integrated and analyzed.Results Totally 118 active components of Chaihu Shugan Powder against depression and 74 potential targets were screened;KEGG pathway enrichment analysis indicated that action pathway of Chaihu Shugan Powder against depression were closely related to PI3K-Akt signaling pathway,AGE-RAGE signaling pathway in diabetic complications,etc.Molecular docking showed that quercetin,kaempferol,β-sitosterol,isorhamnetin,naringenin had good binding activity with AKT1,PIK3CA,GSK3B,IL6,IL1B.The animal experiments showed that Chaihu Shugan Powder could improve the depression-like behavior of model rats,increase the phosphorylation levels of PI3K and Akt in hippocampal tissue,down-regulate the expression of GSK3β,and increase the contents of 5-HT and NE.LY294002 could reverse the effect of Chaihu Shugan Powder.The results of integration analysis showed that PI3K/Akt signaling pathway of Chaihu Shugan Powder was closely related to metabolism of 5-HT and NE.Conclusion Chaihu Shugan Powder can exert antidepressant effects by activating the PI3K/Akt signaling pathway,inhibiting the expression of GSK3β,and increasing the levels of monoamine neurotransmitters 5-HT and NE.

Objectives:To analyze the factors relative to the short-term preservation of ipsilateral renal function after partial nephrectomy.Methods:The clinical data of 83 patients who were treated with partial nephrectomy from December 2014 to December 2019 in the Department of Urology, Sun Yat-sen University Cancer Center were retrospectively analyzed. There were 54 males and 29 females, aging ( M (IQR)) 49 (17) years (range: 27 to 74 years). The ischemia time in operation was 25 (18) minutes (range: 10 to 67 minutes). Emission computed tomography scan and CT scan were performed before (within 1 month) and after (3 to 12 months) surgery. The volume of the ipsilateral and contralateral kidney was measured on the basis of preoperative and postoperative CT scans. The glomerular filtration rate (GFR) specifically in each kidney was estimated by emission computed tomography. Recovery from ischemia is determined by the formula: GFR preservation/volume saved×100%. Linear regression was used to explore the factors ralative to the short-term preservation of ipsilateral renal function after partial nephrectomy. Results:The GFR preservation of the ipsilateral kidney was 80.9 (25.2) % (range: 31.0% to 109.4%). The volume loss of the kidney resulted in a decrease of 12.0% (5.8 ml/(min×1.96 m 2)) of GFR, while the ischemic injury resulted in a decrease of 6.5% (2.5 ml/(min×1.96 m 2)) of GFR. The volume saved from the ipsilateral kidney was 87.1 (12.9) % (range: 27.0% to 131.7%). Recovery from ischemia was 93.5 (17.5) % (range:44.3% to 178.3%). In multivariate analysis, GFR preservation of the ipsilateral kidney was significantly correlated with the volume saved of the ipsilateral kidney ( β=0.383, 95% CI: 0.144 to 0.622, P=0.002). It was not related to the ischemia time ( β=0.046, 95% CI:-0.383 to 0.475, P=0.831). Conclusion:In the condition of limited ischemic time, in the short term ipsilateral renal function after partial nephrectomy is mainly determined by the loss of kidney volume, while ischemic injury only plays a minor role.

Objectives:To analyze the factors relative to the short-term preservation of ipsilateral renal function after partial nephrectomy.Methods:The clinical data of 83 patients who were treated with partial nephrectomy from December 2014 to December 2019 in the Department of Urology, Sun Yat-sen University Cancer Center were retrospectively analyzed. There were 54 males and 29 females, aging ( M (IQR)) 49 (17) years (range: 27 to 74 years). The ischemia time in operation was 25 (18) minutes (range: 10 to 67 minutes). Emission computed tomography scan and CT scan were performed before (within 1 month) and after (3 to 12 months) surgery. The volume of the ipsilateral and contralateral kidney was measured on the basis of preoperative and postoperative CT scans. The glomerular filtration rate (GFR) specifically in each kidney was estimated by emission computed tomography. Recovery from ischemia is determined by the formula: GFR preservation/volume saved×100%. Linear regression was used to explore the factors ralative to the short-term preservation of ipsilateral renal function after partial nephrectomy. Results:The GFR preservation of the ipsilateral kidney was 80.9 (25.2) % (range: 31.0% to 109.4%). The volume loss of the kidney resulted in a decrease of 12.0% (5.8 ml/(min×1.96 m 2)) of GFR, while the ischemic injury resulted in a decrease of 6.5% (2.5 ml/(min×1.96 m 2)) of GFR. The volume saved from the ipsilateral kidney was 87.1 (12.9) % (range: 27.0% to 131.7%). Recovery from ischemia was 93.5 (17.5) % (range:44.3% to 178.3%). In multivariate analysis, GFR preservation of the ipsilateral kidney was significantly correlated with the volume saved of the ipsilateral kidney ( β=0.383, 95% CI: 0.144 to 0.622, P=0.002). It was not related to the ischemia time ( β=0.046, 95% CI:-0.383 to 0.475, P=0.831). Conclusion:In the condition of limited ischemic time, in the short term ipsilateral renal function after partial nephrectomy is mainly determined by the loss of kidney volume, while ischemic injury only plays a minor role.

Objective:To establish a green fluorescent protein(GFP)and firefly luciferase(Luc)double-labeled Epstein-Barr virus(EBV)infec-ted B lymphoblastoid cell lines(B-LCL)and apply them to mouse models,then compare the advantages and disadvantages of models inocu-lated by intravenous(IV)or subcutaneous(SC).Methods:B lymphoblastoid cell lines double-tagged with GFP/Luc(B-LCL-GL)were con-structed through lentivirus transduction,puromycin intervention.Subcutaneous xenograft and hematogenous metastasis models were re-spectively established by subcutaneous or intravenous injection of B-LCL-GL cells at three concentrations in(NOD)/Prkdcscid/IL-2Rγnull(NPG)mice for in vivo bioluminescence imaging.Results:In the B-LCL-GL group,the ratio of the GFP-positive cell population was 92.5%,and the average luminescence intensity was as high as 4.80E+08 Photons/s,which was considerably higher than that of untreated B-LCLs.In the hematogenous metastasis models,tumor bioluminescence was initially located in the peritoneal area and then spread throughout the en-tire body between 7 and 28 days.In the subcutaneous xenograft models,strong central and weak peripheral tumor-related biolumines-cence signal was detected on day 7 in the three groups,which then spread throughout the body on day 28 in the high-dose group.Taken to-gether,there was no significant difference in tumor progression between the two routes of administration when using the same dose of B-LCL-GL cells.However,the survival analysis indicated that the IV injection group,in which all the mice ultimately died,had a shorter time frame for testing than that of the SC injection group,in which the mice survived until day 100 in the low-dose and medium-dose groups,thus allowing for long-term testing.Conclusions:GFP and Luc dual-positive B-LCLs were successfully established to generate hematogenous metastasis and subcutaneous xenograft models,which allow the monitoring of the location and size of lymphomas in vivo.It provide plat-form for the study of tumor characteristics and selecting anti-tumor drugs.

This article reviews the overview of digital integration of geriatric patients and related influencing factors, the current situation of smart outpatient service, and the aging measures of smart outpatient service, with a view to providing reference for Chinese scholars to further study digital integration of geriatric patients.

Objective:To evaluate the static symmetry in patients with early facial paralysis after masseteric-to-facial nerve transfer combined with fascia lata graft.Methods:Clinical data of paralyzed patients who treated with masseteric-to-facial nerve transfer combined with fascia lata graft in Shanghai Jiao Tong University School of Medicine Affiliated Ninth People’s Hospital from January 2016 to December 2018 were retrospectively analyzed. Patients were divided into two groups according to the degree of preoperative oral commissure dropping: slight asymmetry (Scale Ⅱ, Group A) and severe asymmetry (Scale Ⅲ, Group B). Facial muscle contraction was evaluated by Terzis Facial Grading System to evaluate smile function, which was divided into Score Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ. The higher the score, the better the facial muscle contraction and the better the dynamic symmetry during preoperatively and one year postoperatively. The static symmetry of oral commissure was evaluated by Symmetry Scale of Oral Commissure to evaluate symmetry at rest, which was divided into Scale Ⅰ, Ⅱ, Ⅲ and Ⅳ, the higher the scale, the worse the static symmetry. Face-gram software was adopted to measure bilateral vertical differences(D 1) or horizontal differences(D 2) in the oral commissure position of the patients with facial paralysis for evaluating the postoperative static symmetry objectively. Statistical analyses were performed with SPSS version 26.0. Numeration data were analyzed by chi-square test. Intragroup quantitative data was analyzed by paired t-test and intergroup quantitative data was analyzed by two-sample t-test. The significance level was set at 0.05. Results:A total of 58 patients were included, including 30 patients in group A [male 12, female 18, age (43.5 ±8.1) years], and 28 patients in group B[male 12, female 16, age (40.6 ±9.6) years]. There was no significant difference in sex, age at surgery, paralyzed side and denervation time between groups ( P>0.05). The patients were scored Ⅰ on Terzis’ smile functional evaluation scale preoperatively. The score of smile function in postoperative percentage in all patients was improved to Score Ⅲ (Group A, 9/30, 30.0%; Group B, 10/28, 35.7%) or Score Ⅳ (Group A, 21/30, 70.0%; Group B, 18/28, 64.3%), according to the Terzis Facial Grading System. There was no significant difference in the improvement of smile function between groups ( P>0.05). In Group A, 73.3% patients had postoperative improvement in static symmetry (Scale Ⅱ to Scale Ⅰ, 22/30) and 26.7% patients were still Scale Ⅱ according to Symmetry Scale of Oral Commissure to evaluate symmetry at rest. In Group B, 39.3% of patients achieved static symmetry effect (Scale Ⅲ to Scale Ⅰ, 11/28), 42.9% patients had postoperative improvement (Scale Ⅲ to Scale Ⅱ, 12/28) and 17.8%(5/28) of them were still Scale Ⅲ. The proportion of achieving static symmetry effect (Scale Ⅰ) in Group A was higher than that in Group B ( P<0.01). D 1 values of one-year postoperation were smaller than that of preoperation [Group A: (5.27 ±0.74) mm vs. (2.24 ±0.57) mm; Group B: (8.22 ±1.37) mm vs. (4.42 ±0.95) mm, P<0.01]. Similarly, D 2 values of one-year postoperation were smaller than that of preoperation [Group A: (6.11 ±1.18) mm vs. (2.98±1.13) mm; Group B: (8.84 ±2.16) mm vs. (5.24 ±1.85) mm, P<0.01]. There were significant differences between groups in preoperative comparison and one-year postoperative comparison( P<0.01). Conclusions:Masseteric-to-facial nerve transfer combined with fascia lata graft achieved dynamic and static symmetry in patients with different levels of asymmetry. The postoperative static symmetry effect at rest may be influenced by the different levels of oral commissure asymmetry preoperatively.

Objective:To evaluate the static symmetry in patients with early facial paralysis after masseteric-to-facial nerve transfer combined with fascia lata graft.Methods:Clinical data of paralyzed patients who treated with masseteric-to-facial nerve transfer combined with fascia lata graft in Shanghai Jiao Tong University School of Medicine Affiliated Ninth People’s Hospital from January 2016 to December 2018 were retrospectively analyzed. Patients were divided into two groups according to the degree of preoperative oral commissure dropping: slight asymmetry (Scale Ⅱ, Group A) and severe asymmetry (Scale Ⅲ, Group B). Facial muscle contraction was evaluated by Terzis Facial Grading System to evaluate smile function, which was divided into Score Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ. The higher the score, the better the facial muscle contraction and the better the dynamic symmetry during preoperatively and one year postoperatively. The static symmetry of oral commissure was evaluated by Symmetry Scale of Oral Commissure to evaluate symmetry at rest, which was divided into Scale Ⅰ, Ⅱ, Ⅲ and Ⅳ, the higher the scale, the worse the static symmetry. Face-gram software was adopted to measure bilateral vertical differences(D 1) or horizontal differences(D 2) in the oral commissure position of the patients with facial paralysis for evaluating the postoperative static symmetry objectively. Statistical analyses were performed with SPSS version 26.0. Numeration data were analyzed by chi-square test. Intragroup quantitative data was analyzed by paired t-test and intergroup quantitative data was analyzed by two-sample t-test. The significance level was set at 0.05. Results:A total of 58 patients were included, including 30 patients in group A [male 12, female 18, age (43.5 ±8.1) years], and 28 patients in group B[male 12, female 16, age (40.6 ±9.6) years]. There was no significant difference in sex, age at surgery, paralyzed side and denervation time between groups ( P>0.05). The patients were scored Ⅰ on Terzis’ smile functional evaluation scale preoperatively. The score of smile function in postoperative percentage in all patients was improved to Score Ⅲ (Group A, 9/30, 30.0%; Group B, 10/28, 35.7%) or Score Ⅳ (Group A, 21/30, 70.0%; Group B, 18/28, 64.3%), according to the Terzis Facial Grading System. There was no significant difference in the improvement of smile function between groups ( P>0.05). In Group A, 73.3% patients had postoperative improvement in static symmetry (Scale Ⅱ to Scale Ⅰ, 22/30) and 26.7% patients were still Scale Ⅱ according to Symmetry Scale of Oral Commissure to evaluate symmetry at rest. In Group B, 39.3% of patients achieved static symmetry effect (Scale Ⅲ to Scale Ⅰ, 11/28), 42.9% patients had postoperative improvement (Scale Ⅲ to Scale Ⅱ, 12/28) and 17.8%(5/28) of them were still Scale Ⅲ. The proportion of achieving static symmetry effect (Scale Ⅰ) in Group A was higher than that in Group B ( P<0.01). D 1 values of one-year postoperation were smaller than that of preoperation [Group A: (5.27 ±0.74) mm vs. (2.24 ±0.57) mm; Group B: (8.22 ±1.37) mm vs. (4.42 ±0.95) mm, P<0.01]. Similarly, D 2 values of one-year postoperation were smaller than that of preoperation [Group A: (6.11 ±1.18) mm vs. (2.98±1.13) mm; Group B: (8.84 ±2.16) mm vs. (5.24 ±1.85) mm, P<0.01]. There were significant differences between groups in preoperative comparison and one-year postoperative comparison( P<0.01). Conclusions:Masseteric-to-facial nerve transfer combined with fascia lata graft achieved dynamic and static symmetry in patients with different levels of asymmetry. The postoperative static symmetry effect at rest may be influenced by the different levels of oral commissure asymmetry preoperatively.