OBJECTIVE: To compare the clinical efficacy of acupuncture with yin-yang regulation method versus local acupuncture in treating chronic low back pain (CLBP) in elderly patients with lumbar disc herniation (LDH), and to evaluate the changes in the multifidus muscle before and after treatment using musculoskeletal ultrasound. METHODS: A total of 128 elderly patients with CLBP due to LDH were randomly assigned to an observation group (64 cases, 2 cases dropped out) and a control group (64 cases, 2 cases dropped out). The control group received local acupuncture at bilateral L₃-L₅ Jiaji points (EX-B2), Shenshu (BL23), Dachangshu (BL25), Weizhong (BL40), Yaoyangguan (GV3), and ashi points. The observation group received acupuncture with yin-yang regulation method, which included an abdominal protocol with Baihui (GV20), Zhongwan (CV12), Qihai (CV6), Guanyuan (CV4), bilateral Tianshu (ST25), and Dahe (KI12), etc., and a lumbar protocol with Baihui (GV20), Dazhui (GV14), Jizhong (GV6), Yaoyangguan (GV3), and ashi points, etc., alternated bilaterally. Both groups were treated once every other day, three times per week, for a total of 12 sessions. The visual analogue scale (VAS) score, Oswestry disability index (ODI) score, and the indexs of musculoskeletal ultrasound multifidus muscle (resting and functional thickness and Young's modulus values) were observed before and after treatment, and the clinical efficacy was evaluated in the two groups. RESULTS: After 1 and 4 weeks of treatment, both groups showed lower VAS scores compared to baseline (P<0.05), the VAS scores in the observation group were lower than those in the control group (P<0.001). ODI scores in both groups were decreased after 1 and 4 weeks of treatment compared to baseline (P<0.05), with a further reduction at 4 weeks of treatment compared to 1 week of treatment (P<0.05); the observation group showed lower ODI score than the control group after 1 week of treatment (P<0.001). After treatment, both groups demonstrated increased resting and functional multifidus muscle thickness bilaterally compared to baseline (P<0.01), with an increased right-side thickness change rate (P<0.01), though no significant difference was observed between groups (P>0.05). Compared to baseline, after treatment, the observation group exhibited decreased Young's modulus values for bilateral resting and functional multifidus muscle (P<0.01), while the control group showed reductions only in bilateral resting and right-side functional Young's modulus values (P<0.01). After treatment, the bilateral functional Young's modulus values in the observation group were lower than that in the control group (P<0.05), and the bilateral resting and functional changes in Young's modulus values were greater in the observation group than those in the control group (P<0.01). The overall effective rate was 93.5% (58/62) in the observation group, which was higher than 79.0% (49/62) in the control group (P<0.05). CONCLUSION Acupuncture with yin-yang regulation method effectively alleviates pain, improves functional disability, increases multifidus muscle thickness, and reduces Young's modulus values in elderly patients with CLBP due to LDH, which has superior therapeutic effect compared to local acupuncture.
Humans ; Low Back Pain/physiopathology* ; Male ; Acupuncture Therapy ; Female ; Aged ; Intervertebral Disc Displacement/physiopathology* ; Middle Aged ; Yin-Yang ; Lumbar Vertebrae ; Acupuncture Points ; Treatment Outcome

Objective To investigate the protective effect and mechanism of astragaloside Ⅳ(AS-Ⅳ)on the pulmonary arterial hypertension(PAH)model induced by monocrotaline(MCT)/monocrotaline pyrrole(MCTP)in SD rats/human pulmonary artery endothelial cell(HPAEC).Methods In vivo experiment,60 male SD rats were randomly assigned to control group,PAH model group,AS-Ⅳ low-dose(20 mg/kg)group,AS-Ⅳ medium-dose(40 mg/kg)group,AS-Ⅳ high-dose(80 mg/kg)group,or sildenafil(Sil,100 mg/kg)group,with 10 rats in each group;except for the control group,PAH rat models were established by single intraperitoneal injection of MCT(60 mg/kg)in other groups.In vitro experiment,HPAECs were randomly assigned to control group,PAH model group,AS-Ⅳ low-dose(10 μmol/L)group,AS-Ⅳ medium-dose(20 μmol/L)group,MCTP+AS-Ⅳ high-dose(40 μmnol/L)group,or p38 mitogen-activated protein kinase(MAPK)signaling pathway inhibitor(SB203580,5 μmol/L)group;except for the control group,in vitro PAH cell models were established by MCTP(60 μg/mL)induction for 24 h in other groups.In vivo experiments,after 4 weeks of drug intervention,the right ventricular systolic pressure(RVSP)and mean pulmonary artery pressure(mPAP)of rats were measured by hemodynamic methods,the right ventricle hypertrophy index was measured by weighing methods,the percentage of pulmonary arteriole wall thickness to outer diameter(WT％)and percentage of the wall area to total vascular area(WA％)were observed by hematoxylin-eosin staining,the expression of cysteine aspartic acid specific protease 3(caspase 3)protein in lung tissue was observed by immunohistochemistry(IHC),and the apoptosis of lung tissue cells was detected by TUNEL assay.In vitro experiments,JC-1 staining was used to detect the mitochondrial membrane potential in cells,and immunofluorescence was used to detect caspase 3 protein expression.In vitro and in vivo experiments,Western blotting was used to detect the expression of caspase 3,B-cell lymphoma gene 2(Bcl-2),Bcl-2 associated X protein(Bax),p38 MAPK,and phosphorylated p38 MAPK proteins in lung tissue and HPAECs.Results In vivo experiments,the RVSP,mPAP,and right ventricle hypertrophy index were decreased in the Sil group and each dose group of AS-Ⅳ(all P＜0.01);the WA％and WT％of each dose group of AS-Ⅳ were decreased(all P＜0.01),the expression of caspase 3 protein in lung tissue was decreased(all P＜0.01),and the apoptosis of lung tissue cells was decreased(all P＜0.01).In vitro experiments showed that after intervention with each dose of AS-Ⅳ and SB203580,the mitochondrial membrane potential of HPAEC was increased(all P＜0.01)and the expression of caspase 3 was decreased(all P＜0.01).In vivo and in vitro experiments,each dose of AS-Ⅳand SB203580 reduced the expression of Bax and phosphorylated p38 MAPK proteins,and increased the expression of Bcl-2 protein(all P＜0.01).Conclusion AS-Ⅳ reduces apoptosis by inhibiting p38 MAPK signaling pathway,improving PAH in SD rats.

Objective:To investigate the changes of respiratory function and lung volume after bariatric surgery using spiral CT three-dimensional imaging technology.Methods:Using the prospective study method, the medical records of 30 subjects undergoing sleeve gastrectomy (LSG) in the Eighth Department of General Surgery, the Second Hospital of Hebei Medical University from Jan. 2023 to Jun. 2024 were collected. Among them, 12 were males and 18 were females, aged from 20 to 45 years, with the average age of 31.1 years old. Chest CT scans were completed within 1 week before surgery and 6 months after surgery. The subject′s CT plain scan reconstructed thin-layer images of the mediastinal window were transferred to a GE workstation, and the lung volumes of both lungs and each lobe and the tracheal wall area of the five bronchial segments (RB1, RB4, RB10, LB1 + 2 and LB10) were calculated as a percentage of the airway cross-sectional area (WA%), and the posterior intercostal position corresponding to the diaphragm was recorded. Paired t-test and rank-sum test were used to compare preoperative and postoperative differences.Results:Compared with pre-operation, the subject′s body mass index decreased significantly 6 months after bariatric surgery [(42.22±7.31) kg/m 2vs (30.12±5.59) kg/m 2,t=7.31, P<0.001)]. Except for left lower lobe [(1.15±0.23) L vs (1.27±0.24) L, t=1.97, P=0.054] and right middle lobe [(0.57±0.16) L vs (0.83±0.16) L, t=1.38, P=0.172], the remaining lung parts were significantly larger after surgery than before surgery: right upper lobe [(0.80±0.17) L vs (0.94±0.19) L, t=2.79, P=0.007], right lower lobe [(1.08±0.14) L vs (1.22±0.19) L, t=3.23, P=0.002], left upper lobe [(1.12±0.20) L vs (1.24±0.23) L, t=2.26, P=0.014]. Overall, right lung volume [(2.44±0.33) L vs (2.79±0.41) L, t=3.62, P=0.001], left lung volume [(2.27±0.36) L vs (2.52±0.39) L, t=2.53, P=0.014] and total lung volume [(4.71±0.60) L vs (5.30±0.71) L, t=3.48, P=0.001] all increased significantly at 6 months after surgery compared with before surgery. All five segments of bronchus (WA%) were significantly reduced after surgery than before surgery: RB1: [(62.82±4.66) vs (66.85±3.99), t=3.60, P=0.001]; RB4: [(61.24±5.28) vs (64.31±5.51), t=2.20, P=0.031]; RB10: [(60.03±4.64) vs (62.97±5.73), t=2.18, P=0.033]; LB1+ 2: [(63.61±5.05) vs (67.90±4.30), t=3.54, P=0.001]; LB10: [(58.73±6.49) vs (62.01±5.06), t=2.17, P=0.034)]. The posterior intercostal position corresponding to the diaphragm dropped from an average of 7-8 intercostal spaces to 8-9 intercostal spaces, with a significant difference (rank mean 22.77 vs 38.23, Z=-3.67, P<0.001). Conclusion:Bariatric surgery can significantly reduce weight, reduce the pressure of chest and abdominal, improve lung compliance, reduce the internal pressure of the chest, lower the diaphragm, expand the lung volume and airway cross-sectional area, restore the original airway anatomy and respiratory physiology, so it can effectively improve the respiratory function and lung structure abnormalities caused by obesity.

Objective:To establish a rapid, sensitive and specific detection method for important imported viruses based on the recombinase aided amplification (RAA) method and clustered regularly interspaced short palindromic repeats-associated protein 13a (CRISPR-Cas13a) system.Methods:In this study, we selected Japanese encephalitis virus (JEV), Yellow fever virus (YEV), West Nile virus (WNV), Middle East respiratory syndrome coronavirus (MERS-CoV)、Ebola virus (EBOV), Dengue virus (DENV), Rift Valley fever virus (RVFV), Zika virus (ZIKV) as subjects, and designed specific RAA primers and CRISPR RNA(crRNA). The sensitivity and specificity of the method were evaluated. We detected suspected clinical samples of dengue fever and compared with the fluorescent reverse transcriptase-polymerase chain reaction (RT-PCR) technology. Clinical simulation samples of the remaining seven viruses were also detected.Results:The RAA method combined with CRISPR-Cas13a can detect eight pathogens within 40-52 min at 39 ℃. The sensitivity was 1-10 copies/μl. There was no cross-reaction among eight viruses and all clinical samples could be detected by this method.Conclusions:The established RAA combined with CRISPR-Cas13a detection method can sensitively, specifically and quickly detect eight imported infectious disease pathogens.

Objective:To compare the anti-androgenic effect of cyproterone acetate (CPA) and spironolactone (SPL) on male-to-female transsexuals.Methods:From January 2012 to September 2021, 185 male-to-female transsexuals (95 using CPA and 90 using SPL) who visited the Peking University Third Hospital and under stable medication for ≥3 months were enrolled, aged 16 to 40 (23±5) years. General information and laboratory indicators of the last visit were collected for a cross-sectional study.Results:The median doses of antiandrogens in the CPA group and SPL group were 25 mg/d and 80 mg/d, respectively. And the median dose of oral estradiol valerate in both groups was 2 mg/d. Testosterone level in the CPA group was significantly lower than the SPL group [0.7 (0.7-1.5) nmol/L vs. 13.2(6.7-18.4) nmol/L, U= 6 970.500, P<0.001]. The CPA group also had better subjective effects on testicular atrophy, erection decrease, body hair decrease, skin softening and figure feminization (all P<0.05). The prolactin level of CPA group was significantly higher than that of SPL group [21.5 (12.6-30.1) ng/ml vs. 11.9 (7.7-20.0) ng/ml, U= 2 053.500, P<0.001]. Conclusions:CPA has a more significant effect on lowering testosterone levels than SPL, and is better than SPL in terms of testicular atrophy, erection decrease, body hair decrease, skin softening and figure feminization, albeit with a potentially higher risk of hyperprolactinemia.

Purpose: The current meta-analysis combining mid and low rectal cancer with no meta-analysis only for low rectal cancer was seen. This meta-analysis was to compare the short- and mid-term outcomes of the transanal total mesorectal excision (TaTME) vs. laparoscopic total mesorectal excision (LaTME) for low rectal cancer. Methods: A systematic literature search was conducted using the web-based databases; China National Knowledge Infrastructure, Chinese BioMedical Database, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Wanfang Database. Randomized controlled trials (RCTs) were evaluated using the Jadad scale and non-RCTs (NRCs) were evaluated using the Newcastle-Ottawa Scale. Results: Ten studies (2 RCTs and 8 NRCs) involving 772 patients were included. Among them, 378 patients underwent TaTME and 394 patients underwent LaTME. Compared with the LaTME group, the conversion rate was low (risk ratio [RR], 0.25; 95% confidence interval [CI], 0.11–0.54; P < 0.001), the circumferential resection margin (CRM) involvement was low (RR, 0.48; 95% CI, 0.27–0.86; P = 0.010), and the hospital stay was short (mean difference, –1.72; 95% CI, –2.89 to –0.55; P = 0.004) in the TaTME group. No significant differences were seen in the mesorectal resection quality, CRM distance, distal resection margin (DRM) involvement, DRM distance, local R1 resection, intraoperative complications, morbidity, anastomotic leakage, severe morbidity, mortality, operative time, intraoperative blood loss, harvested lymph nodes, and local recurrence rate (P > 0.05). Conclusion The TaTME is a promising surgical technique and is fully a safe and efficacious option in managing low rectal cancer.

Objective: To assess the association of single nucleotide polymorphisms (SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods: 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen. A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag-SNPs) were selected. We investigated the association of tag-SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag-SNPs. The hazard ratio (HR) and 95% confidence interval (CI) for progression or death were calculated by multivariable-adjusted Cox regression model. Results: Seven tag-SNPs (rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11~1.75) and the HR (95% CI) for death being 1.38 (1.04~1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P=0.041), with the HR (95% CI) for death being 0.65 (0.44~0.94). The number of risk allele was significantly associated with PFS (P=0.012) and OS (P=0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95% CI) for progression being 1.37 (1.09~1.72) and the HR (95% CI) for death being 1.36 (1.02~1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11～1.75) and the HR (95% CI) for death being 1.38 ( 1.04～1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P＝0.041), with the HR (95% CI) for death being 0.65 (0.44～0.94). The number of risk allele was significantly associated with PFS (P＝0.012) and OS (P＝0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09～1.72) and the HR ( 95% CI) for death being 1.36 (1.02～1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11～1.75) and the HR (95% CI) for death being 1.38 ( 1.04～1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P＝0.041), with the HR (95% CI) for death being 0.65 (0.44～0.94). The number of risk allele was significantly associated with PFS (P＝0.012) and OS (P＝0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09～1.72) and the HR ( 95% CI) for death being 1.36 (1.02～1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective To develop a risk index scoring for predicting perioperative mortality risk in aged patients undergoing non-neurologic and non-cardiovascular surgery.Methods A total of 11 144 inpatients aged ＞65 years old undergoing non-neurologic and non-cardiovascular surgery in the People's Hospital of Peking University from December 2012 to March 2016 were selected and divided into the death group and survival group.The following variables were compared between the 2 groups:general data,comorbidities,preoperative laboratory tests and operation anesthesia.A multivariate Logistic regression analysis was performed on the risk factors for perioperative death in this group.The Bootstrapping method was performed for conducting internal validation.The parameters weighing of risk index scoring was established by correcting the partial regression coefficient of equation.Results The perioperative mortality was 1.0％ (111 cases).Eight independent predicting factors were obtained by the regression analysis.Then the risk index scoring was defined:classification of the Association of American Physicians (grade Ⅰ:0 point;grade 1:3 points;grade Ⅲ or 1:4 points),BMI(＜24 kg/m2:0 point;＞24 kg/m2:-1 point),renal insufficiency(1 point),chronic obstructive pulmonary disease(3 points),diabetes needing insulin treatment(2 points),preoperative hypoalbuminemia (1 point),preoperative hyponatremia (1 point) and general anesthesia (1 point).The patients with risk scores＜6 points were classified as low risk,patients with risk score 6-7 points were classified as intermediate risk and those with risk score＞ 7 were classified as high risk.The actual predicting risk of perioperative death in high risk patients ＞10％.The perioperative mortality risk index exhibited better diagnostic recognition ability (c-statistic=0.878).Conclusion The perioperative mortality risk of aged patients undergoing non-neurologic and non-cardiovascular surgery can be predicted by the risk index scoring,which can help to screen the high-risk individuals of perioperative death in order to give more carefully perioperative management.