This article reports a case of multiple cranial nerve injury after gamma knife radiosurgery treated with acupuncture and moxibustion combined with rehabilitation therapy. The patient presented with weakness of facial and tongue muscles, hoarseness, choking on water, and swallowing difficulties. The syndrome was attributed to qi and blood deficiency, and blood stasis obstructing the collaterals. The treatment principle focused on replenishing qi and blood, promoting blood circulation and unblocking collaterals. Yintang (GV24⁺), Lianquan (CV23), Qihai (CV6), Guanyuan (CV4), and Cuanzhu (BL2), Yangbai (GB14), Jingming (BL1), Sizhukong (TE23), Yingxiang (LI20), Sibai (ST2), Juliao (ST3), Quanliao (SI18), Dicang (ST4), Jiache (ST6), Xiaguan (ST7), Taiyang (EX-HN5) on the affected side, bilateral Jinjin (EX-HN12), Yuye (EX-HN13), Hegu (LI4), Zusanli (ST36), Sanyinjiao (SP6), Tianshu (ST25) were selected. Among these, bilateral Jinjin (EX-HN12) and Yuye (EX-HN13) were treated with pricking, Dicang (ST4) and Jiache (ST6) on the affected side were connected to an electroacupuncture device, and warming acupuncture was applied at Guanyuan (CV4). Rehabilitation therapy and electromyographic biofeedback were also incorporated. The treatments were given 2-3 times a week. After 18 months of intermittent treatment, the patient reported significant improvement, House Brackmann (H-B) facial nerve function grade was Ⅳ, and Sunnybrook facial nerve rating scale score was 53 points. After 2-month of follow-up, the patient reported normal swallowing ability and restored social engagement.
Humans ; Acupuncture Points ; Acupuncture Therapy ; Cranial Nerve Diseases/therapy*

This article reports a case of adult scoliosis with limb tremor treated with electroacupuncture. The patient presented with neck stiffness accompanied with limb tremor as the primary symptoms. The pattern was attributed to yang qi deficiency, and the treatment principle focused on unblocking the governor vessel, warming yang, and regulating qi. Acupuncture was applied to Dazhui (GV14), below the spinous processes of C₄-C₆ and bilateral C₄-C₆ Jiaji (EX-B2) points, Feishu (BL13), Xinshu (BL15), Pishu (BL20), Ganshu (BL18), Shenshu (BL23), Dachangshu (BL25). After achieving deqi sensation, bilateral C₄ Jiaji (EX-B2) and C₆ Jiaji (EX-B2) points were separately connected to an SDZ-Ⅴ electroacupuncture device, with continuous wave, 2 Hz of frequency, intensity should be within the tolerance of the patient, the needles were retained for 20 min. For the first 5 months, the treatment was 1-2 times a week, then reduced to 1-2 times a month thereafter. After 30 times of treatment, the patient's bilateral lower limb tremor resolved, the clinical rating scale for tremor (CRST) score was 13 points, the scoliosis showed improvement with about 10° reduction in Cobb angle. At 1-month follow-up, the condition remained stable without progression of scoliosis.
Adult ; Humans ; Acupuncture Points ; Electroacupuncture ; Scoliosis/physiopathology* ; Tremor/complications*

This article reports 2 cases of urinary retention in Alzheimer's disease with agitation treated by acupuncture. Based on patients' clinical symptoms, the etiology and pathogenesis were determined, and acupuncture was applied to Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), and bilateral Ciliao (BL32), Zhongliao (BL33), Fengchi (GB20), Taiyang (EX-HN5), etc. to regulate the mind and promote water metabolism. The positive and negative electrodes of the SDZ-Ⅴ type electroacupuncture device were attached to ipsilateral Ciliao (BL32), Zhongliao (BL33) respectively, with continuous wave, at the frequency of 15 Hz, and the current of 3 to 10 mA, depending on patients' tolerance. The needles were retained for 20 min. The treatment was delivered once every other day, 3 interventions a week and 12 interventions as 1 course. Both patients reported the micturition desire after 1 intervention with acupuncture and the catheter was removed on the same day. The urination was ameliorated without dysuresia after 1-2 courses of treatment, and the agitated behavior was alleviated. It can be the reference for the clinical treatment of urinary retention in patients with Alzheimer's disease with agitation.
Humans ; Alzheimer Disease/psychology* ; Acupuncture Therapy ; Urinary Retention/etiology* ; Male ; Female ; Aged ; Acupuncture Points ; Psychomotor Agitation/complications*

Silent mutations within the RAS  gene have garnered increasing attention for their potential roles in tumorigenesis and therapeutic strategies. Kirsten-RAS ( KRAS ) mutations, predominantly oncogenic, are pivotal drivers in various cancers. While extensive research has elucidated the molecular mechanisms and biological consequences of active KRAS  mutations, the functional significance of silent mutations remains relatively understudied. This review synthesizes current knowledge on KRAS  silent mutations, highlighting their impact on cancer development. Silent mutations, which do not alter protein sequences but can affect RNA stability and translational efficiency, pose intriguing questions regarding their contribution to tumor biology. Understanding these mutations is crucial for comprehensively unraveling KRAS -driven oncogenesis and exploring novel therapeutic avenues. Moreover, investigations into the clinical implications of silent mutations in KRAS -mutant tumors suggest potential diagnostic and therapeutic strategies. Despite being in early stages, research on KRAS  silent mutations holds promise for uncovering novel insights that could inform personalized cancer treatments. In conclusion, this review underscores the evolving landscape of KRAS  silent mutations, advocating for further exploration to bridge fundamental biology with clinical applications in oncology.
Humans ; Mutation/genetics* ; Neoplasms/genetics* ; Proto-Oncogene Proteins p21(ras)/genetics* ; Animals

Objective:To evaluate the effectiveness of anti-G straining maneuver (AGSM) in pilots by surface electromyography (sEMG), and to explore the relationships between characteristics of sEMG and anti-G endurance in pilots.Methods:Thirty-eight male high-performance fighter pilots who completed the human centrifuge test at the Air Force Medical Center were selected. Among them, 25 completed the 8.0 G for 10 s anti-G endurance test and 13 completed the 9.0 G for 10 s anti-G endurance test. The sEMG tester was used to keep track of the changes of sEMG in rectus abdominis, rectus femoris, anterior tibial and gastrocnemius muscles while pilots were engaged in AGSM. The anti-G endurance was evaluated according to the changes of visual fields and consciousness. The pilots were divided into 3 groups: the good vision and consciousness group, peripheral visual field narrowing group and endurance endpoint group. The differences in the integral electromyogram (iEMG), mean power frequency (MPF) and muscle input rates between the 3 groups were investigated.Results:A total of 25 pilots completed the 8.0 G for 10 s anti-G endurance test. Among them, 8 (32.0%) were in the good vision and consciousness group, 13 (52.0%) in the peripheral visual field narrowing group and 4 (16.0%) reached the endurance endpoint. Among the 13 pilots who completed the 9.0 G for 10 s anti-G endurance test, 3 (23.1%) were in the good vision and consciousness group, 6 (46.1%) in the peripheral visual field narrowing group, and 4 (30.8%) in the endurance endpoint group. The results of sEMG showed that the iEMG values of the anterior tibialis muscle in pilots under the 9.0 G for 10 s load were significantly different across endurance groups ( H=7.54, P=0.023), and that the iEMG values of the tibialis anterior muscle in the good vision and consciousness group were higher than those in the endurance endpoint group ( P=0.036). The negative slopes of MPF for the rectus abdominis, rectus femoris, anterior tibialis, and gastrocnemius muscles were higher in the good vision and consciousness group than in the other 2 groups, but the differences were not statistically significant ( P>0.05). During the 8.0 G for 10 s anti-G endurance test, there were significant differences in lower limb muscle contribution rates between the 3 groups ( F=4.19, P=0.029). The endurance endpoint group exhibited a lower contribution rate than the good vision and consciousness group ( P=0.025). During the 9.0 G for 10 s anti-G endurance test, there were significant differences in tibialis anterior muscle contribution rates between the 3 groups ( F=4.16, P=0.049). The endurance endpoint group demonstrated a lower contribution rate than the good vision and consciousness group ( P=0.049). Conclusions:The full and balanced activation of abdominal muscles and lower limb muscles, especially the effective mobilization of calf muscles, plays a pivotal role in improving pilots′ AGSM efficiency in high G environments.

Objective:To evaluate the effectiveness of anti-G straining maneuver (AGSM) in pilots by surface electromyography (sEMG), and to explore the relationships between characteristics of sEMG and anti-G endurance in pilots.Methods:Thirty-eight male high-performance fighter pilots who completed the human centrifuge test at the Air Force Medical Center were selected. Among them, 25 completed the 8.0 G for 10 s anti-G endurance test and 13 completed the 9.0 G for 10 s anti-G endurance test. The sEMG tester was used to keep track of the changes of sEMG in rectus abdominis, rectus femoris, anterior tibial and gastrocnemius muscles while pilots were engaged in AGSM. The anti-G endurance was evaluated according to the changes of visual fields and consciousness. The pilots were divided into 3 groups: the good vision and consciousness group, peripheral visual field narrowing group and endurance endpoint group. The differences in the integral electromyogram (iEMG), mean power frequency (MPF) and muscle input rates between the 3 groups were investigated.Results:A total of 25 pilots completed the 8.0 G for 10 s anti-G endurance test. Among them, 8 (32.0%) were in the good vision and consciousness group, 13 (52.0%) in the peripheral visual field narrowing group and 4 (16.0%) reached the endurance endpoint. Among the 13 pilots who completed the 9.0 G for 10 s anti-G endurance test, 3 (23.1%) were in the good vision and consciousness group, 6 (46.1%) in the peripheral visual field narrowing group, and 4 (30.8%) in the endurance endpoint group. The results of sEMG showed that the iEMG values of the anterior tibialis muscle in pilots under the 9.0 G for 10 s load were significantly different across endurance groups ( H=7.54, P=0.023), and that the iEMG values of the tibialis anterior muscle in the good vision and consciousness group were higher than those in the endurance endpoint group ( P=0.036). The negative slopes of MPF for the rectus abdominis, rectus femoris, anterior tibialis, and gastrocnemius muscles were higher in the good vision and consciousness group than in the other 2 groups, but the differences were not statistically significant ( P>0.05). During the 8.0 G for 10 s anti-G endurance test, there were significant differences in lower limb muscle contribution rates between the 3 groups ( F=4.19, P=0.029). The endurance endpoint group exhibited a lower contribution rate than the good vision and consciousness group ( P=0.025). During the 9.0 G for 10 s anti-G endurance test, there were significant differences in tibialis anterior muscle contribution rates between the 3 groups ( F=4.16, P=0.049). The endurance endpoint group demonstrated a lower contribution rate than the good vision and consciousness group ( P=0.049). Conclusions:The full and balanced activation of abdominal muscles and lower limb muscles, especially the effective mobilization of calf muscles, plays a pivotal role in improving pilots′ AGSM efficiency in high G environments.

Objective:To explore whether Corona Virus Disease 2019 (COVID-19) has any impact on human centrifuge training of flying cadets and to provide references to the human centrifuge training for the recovered flying personnel by comparing the changes of flying cadets′ G-tolerance and physiological indicators in human centrifuge training.Methods:Twelve flying cadets who underwent the current batch of human centrifuge training in 2022 were selected and divided into rehabilitation group and control group according to whether they had been infected with COVID-19, with 6 in each group. The rapid G onset rate (ROR) and gradual G onset rate (GOR) were respectively chosen for human centrifuge test. At the same time, the changes of their heart rate and respiratory rate during the tests were recorded, and the G-tolerance situations of the subjects were collected.Results:The average relaxed G-tolerance under GOR (GOR tolerance 1) was (4.2±0.8) G in rehabilitation group, and their average anti-G straining maneuver aided G-tolerance under GOR (GOR tolerance 2) was (5.7±0.6) G. Compared with that of the control group, there was no significant difference in GOR tolerance 1 and GOR tolerance 2 (both P>0.05). There was no significant changes in heart rate and respiratory rate in ROR and GOR human centrifuge tests between 2 groups (all P>0.05). Conclusions:COVID-19 didn't impact the recovered flying cadets' performance in human centrifuge training, as well as the anti-G straining maneuver effect and cardiovascular regulation.

Objective To establish a scientific training program that takes into account both anaerobic and aerobic training for pilots,and to explore the appropriate ratio of aerobic and anaerobic training.Methods According to the physical examination standards for pilots,a total of 16 healthy subjects aged 18-24 were selected from two batches.The two batches of subjects were trained with different aerobic and anaerobic ratios.Training period was 3 months.The changes in cardiopulmonary function of the subjects before and after training were evaluated using the cardiopulmonary function exercise testing system(CPET),and the changes in anaerobic capacity were evaluated using changes in strength as an indicator.Results After training,the weight load of the subjects in the two training programs,including barbell squats,leg flexion and hard pull,and barbell under 10RM and 3RM,was significantly increased(P<0.001),and there was no statistically significant difference in anaerobic strength growth between the two groups.The results of CPET showed that the maximum load,maximum heart rate,and respiratory quotient in the two groups were significantly increased after than before the training(P<0.01).The maximum load(Experiment group 1:29.12±19.69,Experiment group 2:72.00±46.24)and respiratory quotient(Experiment grouop 1:0.11±0.09,Experiment group 2:0.28±0.16)of the subjects in experiment group 2 before and after training were greater than those in experiment group 1.The difference was statistically significant(P<0.05).Conclusion The anaerobic and aerobic capacities of the subjects in the experiment group 2 are effectively improved,indicating that ratio of aerobic and anaerobic of the training scheme is better.

Objective:To discuss the application of gradual-onset rate run (GOR) of human centrifuge on G-tolerance evaluation and training by analyzing the training results of (student) pilots in GOR centrifuge run.Methods:The G-tolerance and anti-G straining maneuver effect of 440 student pilots and 368 pilots participated centrifuge training in recent years were analyzed. The (student) pilots were grouped by age (20-25 years,26-30 years,31-35 years,36-40 years, >40 years). The 392 student pilots and 335 pilots who completed rapid onset rate run (ROR) were divided into 8 G 10 s training high G tolerance group (group A), 8 G 10 s training low G tolerance group (group B), 9 G 10 s training high G tolerance group (group C) and 9 G 10 s training low G tolerance group (group D) according to pass the 8 G 10 s or 9 G 10 s run one-time or not. The relation of G-tolerance and anti-G straining maneuver effect of GOR to ROR was discussed.Results:The average distribution range of relaxed G-tolerance under GOR (GOR tolerance 1) was (4.1±0.7) G, and the average distribution range of anti-G straining maneuver aided G-tolerance under GOR (GOR tolerance 2) was (6.2±0.8) G. The average HP anti-G straining maneuver effect was (2.1±0.6) G. There was a significant difference in GOR tolerance 1 ( H=11.94, P=0.018), no significant difference in GOR tolerance 2 ( H=4.80, P=0.308), and a significant difference in the effect of HP anti-G straining maneuver among pilots in different age groups ( F=3.01, P=0.018). The effect of HP anti-G straining maneuver in the age group over 40 years old was greater than that in other age groups ( P=0.027, 0.034, 0.009, 0.006). There was no significant difference in GOR tolerance 1, GOR tolerance 2 and HP anti-G straining maneuver effect between pilots and student pilots (all P>0.05). There were significant differences in GOR tolerance 2 ( H=15.38, P=0.002) and the effect of HP anti-G straining maneuver ( H=8.22, P=0.041) among group A, group B, group C and group D. The GOR tolerance 2 of group B was lower than that of other anti-G tolerance groups ( P=0.003, 0.001, 0.040). Conclusions:The centrifuge GOR training could reflect the G-tolerance and anti-G straining maneuver effect of (student) pilots and provide references for predicting the human centrifuge training result and improving accelerate training and tolerance evaluating.

Objective:To explore the application of isokinetic muscle strength test in the evaluation of flying cadets′ G-tolerance by investigating the leg strength characteristics of different G-tolerance flying cadets.Methods:G-tolerance test: the AMSACC-4E human centrifuge closed-loop mode was used to test the +8 G z tolerance of 89 male fighter flying cadets. The G-tolerance end point of the flying cadets were determined according to physiological signal monitoring, facial expression characteristics and objective comments. According to the test results, the flying cadets were divided into 3 groups: excellent group, good group and failing group.The grouping criteria: excellent group: could complete the +8 G z 10 s test at one time, with no change in the main complaint light and good consciousness. Good group: could complete the +8 G z 10 s test at one time, the main complaint peripheral light dimmed or disappeared, the central light did not change. Failing group: failure to complete the +8 G z 10 s test at one time, occur G-induced loss of consciousness or almost loss of consciousness. Isokinetic muscle strength test: Biodex System 4 Pro isometric test system was used to test the maximum strength, strength endurance and muscle force balance of the leg flexor and extensor muscles of flying cadets. The test indicators include: peak torque, relative peak torque, average power and peak torque flexion ratio. The test site was knee joint of legs. The test angular speeds were 60°/s and 180°/s. The flying cadets were tested once at each angular speed. They were required to do their best to complete 5 times of consecutive flexion and extension at 60°/s, and 20 times of consecutive flexion and extension at 180°/s. Resting 1 min between different speed, and 3 min between different legs test. The leg strength characteristics were compared among 3 groups. Results:There were 52 flying cadets in excellent group, 29 in good group and 8 in failing group. In terms of leg strength: ①maximum strength: under the test of angular speed 60°/s, there was no significant difference in the peak moment and relative peak moment of leg flexor and extensor muscles among 3 groups (all P>0.05). The peak moment and relative peak moment of flexor muscle of left leg in excellent group were lower than those of right leg, with significant differences ( t=2.14, 2.20, P=0.037, 0.032). ②Strength endurance: under the test of angular speed 180°/s, there was a significant difference in the average power of right leg extensor muscle among 3 groups ( F=3.39, P=0.038). The average power of right leg extensor muscle in excellent group was higher than that in good group, with significant difference ( P=0.015). The average power of the left leg flexor muscle in the excellent group was lower than that of the right leg ( t=2.78, P=0.008). ③Muscle force balance: there were no significant differences between the leg peak torque flexion ratio of flying cadets at 60°/s and 180°/s angular speeds (all P>0.05). The peak torque flexion ratio of the left leg of the excellent group was lower than that of the right leg at both angular speeds ( t=3.96, 3.30, P<0.001,=0.002). Conclusions:The strength endurance of the right leg extensor muscles of the flying cadets with excellent G-tolerance is better, suggesting that under the test of angular speed 180°/s, there may be a certain correlation between the average power of leg extensor muscles and the G-tolerance. Maximum strength and muscle balance of the leg are not significant to the G-tolerance of the flying cadets.