目的探讨康复训练配合针刺治疗脑卒中患者吞咽功能障碍的疗效。方法 87例脑卒中伴吞咽功能障碍者分为综合治疗组(56例)和对照组(31例)。综合治疗组进行针灸和康复训练 ,对照组仅进行内科常规治疗。结果综合治疗组与对照组在统计学上有非常显著性差异(P<0.01)。结论脑卒中吞咽功能障碍患者早期进行综合康复能促进功能恢复、减少鼻饲并发症。

BACKGROUND:Traditional coculture methods for directional differentiation of bone marrow mesenchymal stem cells, such as direct contact method and Transwel coculture system, appear to have low purity and slow proliferation. OBJECTIVE:To compare the inductive effect of microcapsule coculture system and traditional transwel coculture system on the differentiation of bone marrow mesenchymal stem cells. METHODS:The passage 2 microcapsuled chondrocytes and the passage 3 bone marrow mesenchymal stem cells harvested from rabbits were co-cultured at a ratio of 1:1 in a Transwel chamber. Another passage 2 chondrocytes and passage 3 bone marrow mesenchymal stem cells were co-cultured using traditional transwel coculture system. Pure bone marrow mesenchymal stem cells were served as controls. MTT assay was used to compare cellproliferation, toluidine blue staining and safranine O staining were used for observation of cartilage matrix synthesis, alcian blue staining and ELISA test were used to measure glycosaminoglycans and synthesis of type II col agen, respectively. RESULTS AND CONCLUSION:Compared with the traditional co-culture method, the microcapsule coculture system and pure culture method showed better cellproliferation (P<0.05). The levels of glycosaminoglycans and type II col agen were higher in the microcapsule coculture group than the traditional coculture group and pure culture group (P<0.05). Moreover, the microcapsule coculture group showed better outcomes in toluidine blue staining and safranine O staining than the traditional coculture group and pure culture group. These findings indicate that the microcapsule coculture system is more effective in the induction of bone marrow mesenchymal stem cells than traditional Transwel coculture system.

Objective:To explore the association between different feeding patterns, emotional states, and salivary oxytocin (OT) levels during breastfeeding.Methods:From January to December 2019, 153 pairs of 3-month-old infants and their mothers were recruited from 4 maternal and child health hospitals in Chongqing, Liuzhou, Dalian and Hangzhou in China.Saliva samples were collected from the mothers at the first 5 minutes of feeding, 5 minutes during feeding, and 10 minutes after feeding.Edinburgh postnatal depression scale (EPDS) was used to evaluate maternal depression.Infants were divided into exclusive breastfeeding group and artificial feeding group according to feeding patterns.ELISA of salivary oxytocin was performed by ELISA kits, and the OT levels measured at the 3 time points were converted using linear interpolation.Area under the curve with respect to ground(OTAUCG) was used to represent the total concentration of salivary OT during the mother's breastfeeding.SPSS 25.0 software was used for statistical analysis.Multiple linear regression analysis and two factors analysis of variance were used to explore the association between different feeding methods, emotional state and salivary oxytocin during breastfeeding.Results:The results of the two factors analysis of variance showed that the interaction between feeding pattern and mother's emotion was not significant ( F=2.440, P=0.120), the main effect of mother's emotion was not significant ( F=0.380, P=0.539), and the main effect of feeding style was significant ( F=3.350, P=0.021). The level of OTAUCG under pure breastfeeding ((151 561.47±75 738.11) pg/mL) was higher than that under artificial feeding ((122 269.03±65 029.88) pg/mL), and the difference was statistically significant ( P=0.02). There was no statistically significant difference in OTAUCG levels between mothers with normal emotions ((146 106.37±75 106.76) pg/mL) and mothers with depressed emotions ((129 079.56±67 565.87) pg/mL) ( P=0.221). Multiple stepwise regression analysis showed that artificial feeding had a negative predictive effect on maternal salivary OT levels compared to exclusive breastfeeding( β=-0.211, t=-2.513, P=0.013). Conclusion:Feeding pattern is a factor that affects the mother's salivary OT level, and breastfeeding can improve the mother's OT level.

ObjectiveBy analyzing the research related to medical humanistic care， the aim is to understand its research status and development trends， and provide theoretical and data support for research in this field. MethodsThe relevant literature in the China National Knowledge Infrastructure （CNKI） database were systematically searched. Excel 2019 was used to analyze the situation of annual publication volume， journal distribution， and other content of the literature. CiteSpace software was used to visually analyze the knowledge graph related to authors and keywords. ResultsA total of 825 articles were included in the study and the overall number of articles showed an upward trend since 2000. The research hotspots included humanistic care， medical humanities， nursing education， etc. It was found by analyzing that there were three problems in the research of humanistic care in medicine：the research focus is mainly on the need for medical staff to provide patients with more humanistic care， and there is relatively little research on the humanistic care of medical staff themselves；The types of journals are scattered， and the funding support is insufficient；No medical education collaborative research model has been formed. ConclusionMedical humanistic care is the essence of the professional spirit of physicians and an important indicator in testing the effectiveness of medical humanistic education. In the future， the research on medical humanistic care should strengthen multi-dimensional humanistic care to effectively protect the rights and interests of medical staff， pay more attention to the combination of theoretical research and clinical practice， exploit the instrumental value of narrative medicine， increase support efforts from fund， and improve top-level design.

Objective To observe the effect of Shoutai Pills on endometrial decidualization of mice with recurrent spontaneous abortion(RSA);To explore its possible mechanism in the treatment of RSA based on histone modification.Methods Totally 40 female CBA/J mice were divided into normal group,model group,Shoutai Pills low-dosage group(7.5 g/kg),Shoutai Pills high-dosage group(15 g/kg)and dydrogesterone group(3 mg/kg).The normal group were co housed with BALB/C male mice,while the other groups were co housed with DBA/2 male mice to establish an RSA mouse model.After modeling,the administration groups were given corresponding medication solution by gavage,while the normal group and model group were given equal volume of pure water by gavage for 10 consecutive days.The embryo condition was observed and the embryo loss rate was calculated,ELISA was used to detect serum prolactin(PRL)content,HE staining was used to observe the morphological changes of decidual tissue,RT-PCR was used to detect PRL mRNA expression in decidual tissue,Western blot was used to detect the protein expressions of H4ac,H3K27ac,H3K27me3.Results Compared with the normal group,the model group mice showed a significant increase in embryo loss rate,a significant decrease in serum PRL content,disordered arrangement of decidual cells,and extensive bleeding and necrosis;the expression of PRL mRNA and protein in decidual tissue significantly decreased,the protein expressions of H4ac and H3K27ac significantly decreased,while the expression of H3K27me3 protein significantly increased,with statistical significance(P<0.05).Compared with the model group,the embryo loss rate of Shoutai Pills low-and high-dosage groups and the dexamethasone group significantly decreased,the serum PRL content significantly increased,tightly arranged decidual cells,reduced necrosis,and intact glands;the expression of PRL mRNA and protein in decidual tissue of mice in Shoutai Pills high-dosage group and the dexamethasone group significantly increased,the protein expressions of H4ac and H3K27ac significantly increased,the expression of H3K27me3 protein significantly decreased,with statistical significance(P<0.05).Conclusion Shoutai Pills can promote endometrial decidualization in RSA mice,which is related to the changes of histone modification in endometrial stromal cells.

Stroke is one of the most common cerebrovascular diseases， including hemorrhagic stroke and ischemic stroke. From a modern medical perspective， stroke is caused by cerebrovascular damage or embolism leading to impaired blood circulation. From the traditional Chinese medicine （TCM） perspective， the pathogenesis of this disease is mainly due to the disorder of Qi and blood， which ascend to the brain， causing either blood extravasation or blockage of brain collaterals. Stasis is a pathological factor that runs throughout the entire course of stroke， and the method of promoting blood circulation and resolving stasis has been a core treatment for stroke for a long time. Hirudo， as a traditional insect drug， has shown good effects in promoting blood circulation and resolving stasis. Modern pharmacological research has confirmed that Hirudo contains anticoagulant components， which provide significant advantages in dissolving thrombi in ischemic stroke and facilitating hematoma absorption in hemorrhagic stroke. Hirudo and its related preparations have been proven to exert an anti-stroke effect through anticoagulation， anti-thrombosis， and protection of vascular endothelium. As a result， they have been widely used in the treatment of stroke. This article explored the theoretical basis and research status of using Hirudo for treating stroke based on its main active components and hemostatic properties and summarized the current research status of commonly used Hirudo-based formulations and preparations， aiming to provide references for the involvement of Hirudo in stroke treatment.

Objective : To explore the mechanism of ferroptosis induced by endoplasmic reticulum stress (ERs ) in acute respiratory distress syndrome (ARDS) . Methods : In order to determine the effects of LPS on oxidative stress and Fe2 + level of mouse capillary alveolar epithelial cells (MLE12 cells ) , the cells were treated with LPS (0 , 1 , 2 , 5 μg/ml) for 24 h . To verify the role of ferroptosis in lipopolysaccharide ( LPS)-induced cell death , MLE12 cells were divided into control ( Con ) group , iron removal inhibitor ( Fer-1) group , LPS group and LPS + Fer-1 group . LPS + Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h , then the cells were exposed to 5 μg/ml LPS for 24 h . Con group was treated with solvent DMSO for 24 h . Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h , and then treated with DMSO for 24 h . The cells in LPS group were exposed to 5 μg/ml LPS for 24 h . The MLE12 cells were divided into three groups : Con + Vector group , Con + sequence similarity family 134 mem ber B ( FAM134B ) group , LPS + Vector group and LPS + FAM134B group . After transfected with vector or FAM134B overexpression plasmid for 48 h , the cells were exposed or not exposed to 5 μg/ml LPS for 24 h . Cell viability was measured by CCK-8 . The levels of malondialdehyde (MDA) , glutathione and iron , the protein levels of ferroptosis markers [ cyclooxygenase 2(PTGS2) , glutathione peroxidase 4(GPX4)] and ERs markers [glucose reg ulatory protein 78( GRP78) , activated transcription factor 4 ( ATF4) and C/EBP homologous protein ( CHOP)] were measured in different groups . In order to further confirm the results of in vitro cell experiments , 40 mice were randomly divided into Con + Vector group , Con + FAM134B group , LPS + Vector group and LPS + FAM134B group , with 10 mice in each group . LPS induced sepsis models were established in LPS + Vector group and LPS + FAM134B group , and the levels of GPX4 and ERs in lung tissue were evaluated by immunofluorescence staining and protein blot. Results : LPS treatment increased the levels of PTGS2 and MDA , and decreased the levels of GPX4 and GSH in MLE12 cells in a dose dependent manner. Compared with LPS group , the cell viability , GPX4 and GSH levels in LPS + Fer-1 group increased significantly (P < 0.05) , while the PTGS2 protein level and MDA level decreased significantly (P < 0.05) . Compared with LPS + Vector group , LPS + FAM134B group significantly increased cell viability (P < 0.05) , decreased PTGS2 protein level (P < 0.05) and increased GPX4 level ( P < 0.05) . At the same time , the level of MDA in LPS + FAM134B group was lower than that in LPS + Vector group (P < 0.05) , and the level of GSH was higher than that in LPS + Vector group (P < 0.05) . In animal experiment , compared with LPS + Vector group , the expression levels of 4 HNE , ATF4 and CHOP in lung tissue of LPS + FAM134B group decreased significantly ( P < 0.05 ) , and the expression levels of GPX4 , FAM134B group in creased significantly (P < 0.05) . Conclusion LPS induces ferroptosis and ERs in MLE12 cells in a dose depend ent manner. Activating the endoplasmic reticulum autophagy associated FAM134B receptor helps to inhibit ERs and alleviate cell ferroptosis .