Objective To treat the patients with primary dysmenorrhea by puncturing Shiqizhui (EX-B8) and observe the change and regularity of the analgesic effect with different needle-retaining time, for providing evidence for the optimal needle-retaining time. Method Ninety eligible subjects with primary dysmenorrhea were randomized into a 20 min group of 30 cases, a 30 min group of 30 cases, and a blank control group of 30 cases. Visual Analogue Scale (VAS) was used to observe the change before and after intervention with the time, and to compare the intergroup differences. Result The acupuncture groups started to show analgesic effect 10 min after needling, and the effect increased with the needle-retaining time (P＜0.05);the therapeutic efficacy of the 30 min group was significantly superior to that of the 20 min group (P＜0.01). Conclusion Acupuncture at Shiqizhui can produce a real-time analgesic effect for patients with primary dysmenorrhea, and retaining the needle for 30 min is superior to 20 min.

Objective To explore the utilization and effectiveness of ultrasound screening for neural tube defects (NTDs),so that to provide scientific evidences for the secondary prevention of NTDs.MethodsFour hundred and fifty-nine women who delivered or gestated NTDs babies or fetuses were randomly selected from Shandong Province and Shanxi Province,and the related information was collected with structured questionnaire by trained interviewers.Results Of the 459 cases,the ultrasonography utilization rate was 98.7%,and 6 cases (1.3%) never took examinations by ultrasonography during the whole pregnancy period.The total diagnosis rate of ultrasound screening for NTDs was 85.9%,and those of anencephalus,spina bifida and encephalocele were 96.4%,79.6% and 73.8% respectively (P<0.05).The average diagnosis week of NTDs was 24.0 and those of anencephalus,spina bifida and encephalocele were 21.2,27.1 and 24.7 respectively (P<0.05).The detection rates of NTDs before 16 weeks,16-20 weeks,20-24 weeks,24-28 weeks and after 28 weeks were 14.1%,49.4%,46.3%,49.2% and 52.1% respectively (P<0.05).The detection rates of NTDs in hospitals,maternal and child care service centers and family planning centers were 46.4%,52.0% and 28.1% respectively (P<0.05).The detection rate of NTDs by two-dimensional ultrasound equipment was 41.3% and 83.3% by three-dimensional ultrasound equipment (P>0.05).Conclusions The detection rates of NTDs and the subtypes by ultrasonography are low at different pregnant periods and in different medical institutions.It is important to increase the utilization rate of ultrasound screening by pregnant women and improve the NTDs diagnostic level of primary health care institutions,so that to improve the efficacy of secondary prevention strategy for NTDs in China.

Aim:To compare the effect of cilazapril and metoprolol on the compliance o f brachial artery in essential hypertension(EH). Methods:Compliance of brachial artery was determined by Pulsed Doppl er techniques. Brachial artery diameter(Dd),flow velocity(Vm),volumic blood flow (Q) and the distensibility(Dis) increased markedly,the resistance(R) used as the indexes of compliance of brachial artery. Results:Sixty seven EH were divided into two groups(A,B) random ly. Group A were treated with Cilazaril,Group B with Metoprolol. Aft er 6 months treatment, BP in all the patients decreased. In Group A,the Dd,Vm,Q and Dis increased markedly,but R of brachial artery decreased obviously. In group B,no obvious changes of branchial artery were found. Conclusion:Cilazapril may improve the compliance of brachial artery partially.

Traditional Chinese medicine has been paid more and more attention in the development of modern healthcare,and its clinical diagnosis and treatment have broad prospects and enormous potential.However,the current traditional Chinese medicine diagnosis and treatment model have serious shortcomings in service capacity and,diagnosis,and treatment effect.The rapid development of big data and artificial intelli-gence technology provides an opportunity for the iterative upgrade of traditional Chinese medicine diagnosis and treatment models.This article reviewed the current situation of artificial intelligence empowering tradi-tional Chinese medicine clinical diagnosis and treatment,clarified the problems and challenges faced by artifi-cial intelligence technology in data integration,data quality,and data analysis in traditional Chinese medicine clinical diagnosis and treatment,and proposed to empower from the aspects of disciplinary integration,data quality optimization,data privacy protection,and promotion and application,so as to provide reference for im-proving the effectiveness of traditional Chinese medicine clinical diagnosis and treatment.

Objective To evaluated the clinical significance of embolization of arterio-portal venous shunt (APVS) in hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus (MPVTT) treated by transcatheter arterial chemoembolization (TACE) and portal vein stenting. Methods Twenty-six HCC patients with MPVTT and marked APVS, who were treated with TACE and portal vein stenting, were enrolled in this study. Portal vein stenting was performed via percutaneous transhepatic approach, which was followed by the embolization of the feeding arteries of APVS by using suitable embolic agents. The portal vein pressure levels were separately measured before, after portal vein stenting and after APVS embolization. The results were statistically analyzed. Results Both the portal vein stenting and APVS embolization were successfully accomplished in all the 26 patients. Hepatic angiography and portal venography performed before portal vein stenting revealed bidirectional portal flow in 16 cases and hepatofugal portal flow in 10 cases. Among the 16 patients with bidirectional portal flow, remarkable improvement of portal vein to liver blood flow after portal vein stenting was seen in 14, and obvious recovery of main portal vein to liver blood flow after APVS embolization in 2. Obvious recovery of main portal vein to liver blood flow after APVS embolization was also demonstrated in 10 cases with hepatofugal portal flow. The portal vein pressure determined before, after portal vein stenting and after APVS embolization was (50.1±6.3) cmH2O,(43.5± 7.5) cmH2O and (36.9 ±8.2) cmH2O respectively. After portal vein stenting the portal vein pressure was significantly decreased when compared with the preoperative pressure, and the difference was statistically significant (P<0.05); after APVS embolization the portal vein pressure was further decreased (P<0.05). Conclusion For HCC patients with MPVTT and marked APVS, portal vein stenting can effectively restore the portal blood flow and reduce the portal vein pressure; and embolization of APVS can further reduce the pressure of portal vein, thus the bidirectional portal flow or hepatofugal portal flow will return to normal hepatopetal flow.

Objective To discuss the technical skill of super-selective catheterization for “one-way valve occlusion” of the common hepatic artery during transcatheter arterial chemoembolization (TACE). Methods A total of 128 patients with “one-way valve occlusion”of the common hepatic artery were enrolled in this study, who were admitted to authors’ department to receive TACE during the period from 2000 to 2011. The lesions included hepatocellular carcinoma (n = 110), cholangiocellular carcinoma (n = 3) and hepatic metastasis (n=15). “One-way valve occlusion”of the common hepatic artery occurred in 90 patients (70.3%, 90/128) after 2-5 times of TACE had been carried out, and in the other 38 patients (29.7%, 39/128) the “one- way valve occlusion” of the common hepatic artery was recognized at the initial TACE procedure. Super-selective hepatic catheterization was performed via the superior mesenteric artery (SMA) approach or celiac artery (CA) approach using coaxial micro-catheter catheterization technique. The success rate and fluoroscopy time of super-selective catheterization were recorded, and the results were compared between the two approaches. Results A total of 337 times of hepatic super-selection catheterization were performed in 128 patients, with a mean of 2.6 times for each case. The success rate was 100%. Of the 337 procedures, the catheterization was via CA approach in 148 (43.9%, 148/337) and via SMA approach in 189 (56.1%, 189/337). The mean fluoroscopy time in CA approach group was 3.2 minutes(ranged 1-6 minutes), and in SMA group was 15.3 minutes(ranged 5-40 minutes). The difference between the two groups was statistically significant (P < 0.05). Conclusion Super- selective hepatic catheterization for “one-way valve occlusion” of the common hepatic artery can be achieved through SMA approach or CA approach by using coaxial micro-catheter catheterization. Compared with SMA approach, the technique of hepatic catheterization through CA approach is much simpler and the fluoroscopy time is significantly shorter.

Base Sequence ; Child ; Female ; Heart Septal Defects, Atrial ; complications ; diagnosis ; Humans ; Molecular Sequence Data ; Noonan Syndrome ; complications ; diagnosis ; genetics ; Protein Tyrosine Phosphatase, Non-Receptor Type 11 ; genetics

Background and Objectives: Apoptosis is an outstanding determinant of glucocorticoid (GC)-induced osteonecrosis of the femoral head (ONFH). Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been demonstrated to be associated with apoptosis in diseases models. However, the role of hUC-MSCs in GC-induced ONFH via regulating apoptosis still needs further study. Methods: and Results: In the present study, a GC-induced ONFH model was built in vivo through a consecutive injection with lipopolysaccharide (LPS) and methylprednisolone. The necrosis and apoptosis of the femoral head was evaluated by histological and Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) assay. The level of collagen and TRAP positive cells were determined by Masson and TRAP staining, respectively. M1 macrophage polarization was assessed using immunofluorescence assay. The level of proinflammatory cytokines including tumor necrosis factor (TNF)‐α, Interleukin (IL)‐1β and IL-6 of femoral head was determined by enzyme-linked immunosorbent assay (ELISA) kits. The protein expression of AKT, mTOR, p-AKT and p-mTOR was detected using western blot assay. The results showed that hUC-MSCs treatment prominently promoted the GC-induced the decrease of the collagen level and the increase of TRAP positive cells. Besides, hUC-MSCs treatment decreased necrosis and apoptosis, macrophage polarization, the level of TNF‐α, IL‐1β and IL-6, the protein expression of p-AKT and p-mTOR, and the radio of p-AKT to AKT and p-mTOR to mTOR of femoral head in vivo. Conclusions Therefore, the present study revealed that hUC-MSCs improved the necrosis and osteocyte apoptosis in GC-induced ONFH model through reducing the macrophage polarization, which was associated with the inhibition of AKT/mTOR signaling pathway.

Objective: To investigate the origin of infection and risk factors of a case with SARS-CoV-2 infection associated with overseas countries in the Ningbo-Zhoushan Port, Zhejiang Province, so as to provide the evidence for improving the COVID-19 control measures at ports. Methods: Ningbo Center for Disease Control and Prevention ( CDC ) and Beilun CDC conducted case finding and epidemiological surveys immediately after being informed. The general information, history of vaccination and the travel during the latest 14 days were collected from the positive case, and all close contacts were tracked. Saliva samples were collected for SARS-CoV-2 nucleic acid testing and whole-genome sequencing, and the sequencing results were aligned with the GISAID's EpiCoV database. The origin of infection and transmission route of the positive case was investigated. Results: A case was identified positive for SARS-CoV-2 nucleic acid during company M's routine screening in the Ningbo-Zhoushan Port on August 10, 2021, and was confirmed positive for SARS-CoV-2 nucleic acid by Beilun CDC and Ningbo CDC on August 11. Whole-genome sequencing showed SARS-CoV-2 B.1.617.2 ( Delta ) variant, which shared the highest homology with the virus sequence uploaded by Russia on June, 2021 ( Russia/MOW-RII-MH27356S/2021 ). The case was a bundling worker for overseas container ships, and reported communicated with foreign boatmen and contacted materials without protected interventions on the SINOKOR AKITA Container Ship between August 4 and 5, 2021. This ship anchored at Vladivostok, Russia from July 27 to 29, anchored at Ningbo Harbor on August 4, and departed on August 5. Then, 11 boatmen from this ship were tested positive for SARS-CoV-2 nucleic acid on August 8. One asymptomatic case was reported in this epidemic; 254 close contacts and 617 secondary close contacts were identified, and all were tested negative for SARS-CoV-2 nucleic acid. No new cases with SARS-CoV-2 infections were detected until August 25, 2021, and the emergency response was therefore terminated. Conclusions The infection was a sporadic COVID-19 epidemic associated with overseas countries, which was caused by Delta variant infection through contacts with foreign boatmen or materials by a bundling worker in Ningbo-Zhoushan Port; fortunately, no epidemic spread occurred. Intensified closed-loop management and increased frequency of SARS-CoV-2 nucleic acid test among high-risk populations, and improving the precision and rapid emergency treatment of COVID-19 epidemics are required for the containment of COVID-19 at ports.

Objective: To investigate the IL-10+CD19+ regulatory B cells (Breg) in peripheral blood of patients with rheumatoid arthritis (RA), and analyze the correlation between the expression of IL-10+CD19+ Breg cells and disease severity. Methods: A total of 40 patients with active RA and 30 healthy individuals (healthy controls, HC) were involved in this study. The peripheral blood mononuclear cells (PBMC) were isolated. The isolated PBMC were co-cultured with CpG oligodeoxynucleotide 2006 (CpG ODN 2006) and phorbol myristate acetate (PMA) in vitro. Flow cytometry was employed to analyze the expression of Breg before and after stimulation. The correlations of Breg expression with ESR, CRP and DAS28 were analyzed. Results: Before stimulation in vitro, the expression of Breg in PBMC of RA group and HC group were 1.92%(1.58%, 2.56%) and 2.04%(1.73%, 2.93%) respectively. There was no significant difference between the two groups (P=0.258). After induction in vitro, the expression of Breg of RA group [13.00%(9.75%, 14.85%)] was significantly higher than that of HC group [9.12%(6.83%, 10.22%)], P＜0.001. Spearman correlation analysis showed that Breg expression was negatively correlated with DAS28 (P=0.002), but not with ESR and CRP (P＞0.05). Conclusion The expression of Breg was significantly increased after stimulation in vitro and negatively correlated with DAS28, which indicated Breg may play important regulatory roles in pathogenesis and development of RA.