With the development of patient-centered medical model,patient values and preferences have become a hot research topic.This paper starts from the concept of patients'values and preferences,analyzes the important importance of patients'values and preferences;Based on the published literature,the importance of patients'values and preferences in the development of acupuncture clinical guidelines,the positive role in doctor-patient co-decision,the value of patients'cognition and value promotion in acupuncture"Deqi"were sorted out,and the influencing factors of patients'values and preferences and acupuncture compliance were summarized.According to the influencing factors,the corresponding solutions were proposed to help patients establish correct values,and thus improve patients'acupuncture compliance.

Objective:To compare the postoperative adjacent segment degeneration (ASD) between the microscopically anterior cervical discectomy with fusion (ACDF) and anterior cervical corpectomy with fusion (ACCF) in the treatment of cervical spondylotic myelopathy and its influencing factors.Methods:Fifty patients with cervical spondylotic myelopathy treatment in the Qinzhou Second People′s Hospital from July 2018 to July 2020 were selected, they were divided into two groups, 25 patients performed ACDF (ACDF group), and 25 patients performed ACCF (ACCF group). The perioperative period, efficacy and incidence of ASD were compared between the two groups, and the influencing factors of ASD were analyzed.Results:The intraoperative blood loss, operation time, length of hospital stay and postoperative drainage in ACCF group were higher than those in ACDF group: (58.34 ± 8.61) ml vs. (46.77 ± 7.24) ml, (99.57 ± 10.72) min vs. (86.14 ± 9.64) min, (8.97 ± 1.43) d vs. (7.56 ± 1.24) d, (17.92 ± 2.95) ml vs. (14.28 ± 2.66) ml, there were statistical differences ( P<0.05). The postoperative Japanese Orthopaedic Association (JOA) scores and Neck Disability Index (NDI) scores in the two groups were improved significantly ( P<0.05), but the scores of JOA and NDI in the two groups had no significant differences ( P>0.05). The incidence of ASD in the two groups had no significant differences ( P>0.05). The Cox univariate analysis showed that age >59 years, intervertebral disc degeneration, number of fusion segments >2, osteoporosis and postoperative ASD were risk factors for ASD( P<0.05). Conclusions:The effect of microscopically ACDF is similar to that of ACCF in the treatment of cervical spondylotic myelopathy, but ACDF has the advantages of less trauma and quick recovery. The risk of postoperative ASD should be vigilant for patients with age >59 years old, intervertebral disc degeneration, number of fusion segments >2 or osteoporosis.

Objective:To evaluate the long-term efficacy and safety of a novel type of cobalt-chromium sirolimus-eluting stent (CoCr-SES) in patients with coronary artery disease (CAD) complicated with diabetes mellitus (DM ) .Methods:A total of 1 045 Chinese patients with DM were enrolled into a prospective ,multicenter registered research and followed up for the incidence of death ,myocardial infarction (MI) ,blood circulation reconstruction and thrombosis (ST) among other events . The primary endpoint was a major adverse cardiovascular event (MACE) ,which was composed of cardiovascular death ,non-fatal myocardial infarction (MI) and target vessel revascularization (TVR) ,with a clinical follow-up of 3 years .Results:During the 3-year follow-up ,among 1 045 cases of coronary heart disease complicated with diabetes mellitus ,the rate of MACE was 10 .0% ,including 41 cases (3 .9% ) of cardiovascular death ,38 cases (3 .6% ) of non-fatal MI and 25 cases (2 .4% ) of TVR . The incidence of stent thrombosis (ST ) was 1 .1% in 3 years ,including 7 cases (0 .7% ) of early ST and 4 cases (0 .4% ) of advanced ST .Conclusions:The incidence of MACE and ST is low in patients with coronary heart disease complicated with diabetes at 3 years after implantation of CoCr-SES ,providing compelling evidence for the wide use of domestic CoCr-SES in patients with coronary heart disease complicated with diabetes .

Glomerulocystic kidney disease(GCKD),a rare nephrocystic disorder,was the focus of this study.The FAT1 gene,comprising 27 exons,encoded a single-pass transmembrane protein with multiple biological functions.The extracellular portion of this protein consisted of 33 cadherin repeat sequences,5 epidermal growth factor-like domains,and a G-layer associated domain.This report detailed a case of glomerular cystic disease caused by a mutation in the FAT1 gene,which was treated with the traditional Chinese medicine formula'Shen Jiu Fang Modified'.This formula included Astragalus,Atractylodes,Poria,Angelica,Clematis,Silkworm,Hedyotis diffusa,Hibiscus leaf,among other ingredients,and aimed to invigorate the spleen and promote diuresis,as well as to nourish the kidneys and promote blood circulation.This case demonstrated the potential of traditional Chinese medicine in addressing rare kidney diseases,offering new insights for the diagnosis and treatment of similar complex cases.

OBJECTIVETo analyze the therapeutic effect of excision of hypomere esophagus and proximal stomach (Phemister operation) on portal hypertension and upper gastrointestinal bleeding.

METHODSRetrospectively analyze the clinical data of 136 cases treated with the Phemister operation for portal hypertension and upper gastrointestinal bleeding from August 1999 to May 2005.

RESULTSVarication of the patients improved markedly, 50.8% of the varication disappeared completely, incidence of complications was 5.0%, rebleeding rate was 4.4%, mortality rate was 0.7%.

CONCLUSIONSThe Phemister operation could treat the upper gastrointestinal bleeding and prevent rebleeding effectively in portal hypertension, it is a radical, precise and secure disconnection for portal hypertension with varication in fundus of stomach and esophagus.

Adolescent ; Adult ; Aged ; Esophagectomy ; methods ; Female ; Gastrectomy ; methods ; Gastrointestinal Hemorrhage ; etiology ; surgery ; Humans ; Hypertension, Portal ; complications ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo study the mechanism of enhancement of the CTL activity in mice co-expressing of CD80, CD86 and CD137L genes.

METHODSThe mice were randomly divided into five groups, named A, B, C, D and E. The group A and B were control groups (CG). H22-BAL B/c HCC mouse model was established by subcutaneous injection with hepatocellular carcinoma cells of cell line H22-Wt (group A), H22-neo (group B), H22-CD80/CD86(+) (group C), H22-CD137L(+) (group D) and H22-CD80/CD86/CD137L(+) (group E), respectively. On the 14th, 35th, 56th and 84th day after the first inoculation of tumor cells, TUNEL staining and DNA ladder examination were used to detect apoptosis of splenic T lymphocytes in all groups at each post-inoculation time point. Electrophoretic mobility-shift assay (EMSA) method was used to detect the activity of nuclear factor kappaB (NF-kappaB) in splenic T lymphocytes in each group at each time point post-inoculation.

RESULTSApoptosis was found in a great number of T lymphocytes in CG on the 14th day, much more than that in group C and E. The number of apoptotic T cells in group C had a significant difference compared with that in the group E from 14th to 84th day (P = 0.003). DNA ladder analysis showed typical positive results in group C and E. The significant apoptosis fragments were found in group C on 21st, 35th and 84th days. NF-kappaB activity of T cells in groups C and E was remarkably higher than that of groups CG and D, with higher in group D than that of CG (P = 0.002), and with no significant difference between group C and E on 14th day. The activity in group E was stable and remarkably higher than that of group C on 56th and 84th days after the first inoculation.

CONCLUSIONH22-CD80/CD86/CD137L(+) induces higher NF-kappaB activity of the host T cells by synergistic action of CD28 and CD137, which may be one of the mechanisms of enhancement of the host CTL activity induced by co-expression of CD80, CD86 and CD137L genes.

4-1BB Ligand ; metabolism ; Animals ; Apoptosis ; B7-1 Antigen ; metabolism ; B7-2 Antigen ; metabolism ; CD28 Antigens ; Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; Liver Neoplasms, Experimental ; immunology ; metabolism ; pathology ; Lymphocyte Activation ; Mice ; Mice, Inbred BALB C ; NF-kappa B ; metabolism ; Random Allocation ; Spleen ; pathology ; T-Lymphocytes ; metabolism ; pathology ; T-Lymphocytes, Cytotoxic ; immunology

We developed a method for detecting encephalitis and meningitis virus by using multiplex PCR combined with invasive reaction and a chromogenic reaction catalyzed by gold nanoparticles.Primers were designed based on the conservative regions of encephalitis and meningitis virus (Eastern equine encephalitis virus,EEEV;Western equine encephalomyelitis virus,WEEV;West Nile virus,WNV;Nipah virus,NiPA;Japanese encephalitis virus,JEV).Multiplex PCR system,invasive reaction and a chromogenic reaction catalyzed by gold nanoparticles were established to detect different encephalitis and meningitis virus in one reaction.Tick-borne encephalitis virus (TBEV),St Louis encephalitis virus (StLEV),Chikungunya virus (CHIKV) and Dengue virus(DV) were used to test its specificity.Quantitative RNA transcribed in vitro and PCR fragments were used to assess its sensitivity.Clinical specimens collected from JEV patients were detected by this method.A method for detecting encephalitis and meningitis virus by using multiplex PCR,invasive reaction and a chromogenic reaction catalyzed by gold nanoparticles were successfully established.This method can detect targeted pathogens specifically,and it has no cross reaction with TBEV,StLEV,CHIKV and DV.The detecting limitation for different targets was 103 copies/μL.Clinical samples were positive for JEV nucleic acids for above assay.The method presented here has characteristic of high specificity,sensitivity and throughput.The results can be observed by visual inspection.This method has broad application prospects in pathogen detection.

Objective To grasp the distribution status of Oncomelania hupensis snails in Poyang Lake area,so as to provide the evidence for formulating and adjusting the schistosomiasis prevention and control strategy in lake areas. Methods The vec-tor grid was created and sampled randomly by 200 m × 200 m in the spatial database of grassland,and the distribution of snails was investigated in the selected grid by using the method of mechanical sampling by 50 m × 50 m. At the same time,the eleva-tion of investigation points was extracted based on the topographic map of Poyang Lake. Results Totally 949 and 210 investiga-tion points were collected from the south and north of Poyang Lake areas,accounting for 3.04%and 3.21%of all the investiga-tion points in the respective region. The number of investigation points,the appearance rate of snail frame,and the average den-sity of alive snails were 15231,8.15%,and 0.463/0.1 m2,respectively. The elevation of snail distribution area of the south and north Poyang Lake areas were 11-16 m and 9-16 m respectively. The elevation of concentrated snail belts of the south Poyang Lake area were 12-13 m and 15-16 m,and the elevation of concentrated snail belts of the north Poyang Lake area was 12-14 m. Conclusions The distribution of snails is in the range of 9-16 m. The suitable habitats of snail breeding are moving from the south Poyang Lake area to the north Poyang Lake area,and from high elevation to low elevation. In the future,the schistosomia-sis prevention and control measures could be formulated based on the geographical characteristics of current snail distribution in order to consolidate the achievements of schistosomiasis control.

Objective To investigate the expression of PLCD3 mRNA in the synovium of osteoarthritis(OA)and its relationship with immune cell infiltration.Methods Based on the differentially expressed genes of OA found in the previous study,the expression of phospholipase Cδ3(PLCD3)mRNA was detected by col-lecting synovial samples from OA group and control group.CIBERSORT algorithm was used to analyze the infiltration pattern of immune cells in OA group and control group,and the correlation between PLCD3 and infiltrating immune cells was further analyzed.Results Compared with the control group,the relative expres-sion level of PLCD3 mRNA was significantly increased in synovial samples of OA group(P<0.05).The pro-portions of B cells naive,NK cells activated,M2 macrophages and mast cells activated in synovial tissues of OA group were relatively high(P<0.05).PLCD3 was positively correlated with the proportion of these four immune cells(P<0.05).Conclusion PLCD3 may be a key biomarker for the diagnosis of OA,which may be involved in the pathogenesis of OA by interacting with infiltrating immune cells.

Objective:To analyze the occurence and prognosis of stent thrombosis (ST ) after implantation of the Firebird 2 cobalt-chromium drug-eluting stent (DES) so as to provide abundant clinical evidence for the wide application of domestic second-generation drug-eluting stents .Methods: This study retrospectively analyzed 5 084 DES patients on the Firebird 2 cobalt-chromium alloy platform during the 3-year follow-up in the large-scale ,international ,multicenter FOCUS registry .Three-year cumulative incidence of ST was reported .The clinical features of ST patients ,duration of dual antiplatelet therapy (DAPT ) , and the treatment and as prognosis of ST were the main focuses of this study .Results: The 3-year cumulative incidence of ST was 0 .67% (35 cases) ,including 8 cases of acute ST ,11 cases of subacute ST ,8 cases of late ST and 8 cases of very late ST .Among them ,28 patients of ST were recovered after re-intervention or thrombolysis ,while 7 patients were died because of treatment failure .The mortality of ST patients was 20 .6% .All ST patients were treated with DAPT for at least 12 months except for 3 patients who had stopped taking DAPT and 1 patient who took clopidegrel only . Conclusions:The 3-year follow-up FOCUS study shows that , the cumulative incidence of ST is less than 1% after DES implantation on the domestic second-generation Firebird 2 cobalt-chromium alloy platform ,providing reliable safety evidence for the clinical application of Firebird 2 stents .