ObjectiveTo explore the effect of cluster scalp acupuncture combined with Taijiquan training on depressive symptom, motor function, activities of daily living, serum markers, as well as brain functional connectivity (FC) and network topological properties in patients with post-stroke depression (PSD). MethodsA total of 40 PSD patients in the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September, 2022 to September, 2023 were enrolled and randomly divided into control group (n = 20) and experimental group (n = 20). The control group received cluster scalp acupuncture alone, while the experimental group underwent Taijiquan training in addition, for four weeks. They were assessed with Hamilton Depression Scale-17 (HAMD-17), Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and after treatment, while the serum levels of dopamine (DA), 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected with enzyme-linked immunosorbent assay. Resting-state functional magnetic resonance imaging (rs-fMRI) was applied to assess brain FC, as well as the global efficiency (Eg) and small-world property (σ) of brain networks. ResultsThe scores of HAMD-17, FMA and BI improved in both groups (t > 2.922, P < 0.01) after treatment, and improved more in the experimental group than in the control group (t > 2.517, P < 0.05). The serum levels of DA and 5-HT increased in both groups (t > 2.637, P < 0.05), and increased more in the experimental group (t > 2.192, P < 0.05). The serum levels of IL-6 and TNF-α decreased in the experimental group after treatment (t > 4.059, P < 0.001), and they were less than those in the control group (t > 2.154, P < 0.05). FC between left middle frontal gyrus and right anterior cingulate gyrus, as well as between left hippocampus and right precuneus were higher in the experimental group than in the control group after treatment (t > 3.867, P < 0.001), while Eg and σ increased in both groups (t > 2.828, P < 0.05), and they were higher in the experimental group (t > 2.675, P < 0.05). ConclusionCombination of Taijiquan training is more effective on depressive symptoms, motor function and activities of daily living in PSD patients, which may be related to up-regulation of serum DA and 5-HT, reduction of inflammatory factors, enhancement of prefrontal-limbic system functional connectivity and optimization of brain network topological properties.

Objective:To observe the electrosensitization of Sifeng(EX-UE10)in children with constipation due to excessive heat in intestine.Methods:The meridian values of Sifeng(EX-UE10)in 80 children with constipation due to excessive heat in intestine and in 80 healthy children were measured using a traditional Chinese medicine(TCM)meridian detector,and the variation rule of the point meridian values was analyzed by SPSS version 26.0 statistical software.Results:The meridian values of Sifeng(EX-UE10)of the index finger,middle finger,and ring finger in the observation group were statistically different from those in the control group(P<0.01).There was no statistical difference in the meridian value of Sifeng(EX-UE10)of the little finger between the two groups(P>0.05).Conclusion:Electrosensitization occurs at Sifeng(EX-UE10)of the index finger,middle finger,and ring finger in children with constipation(syndrome of excessive heat in intestine),and thus the treatment can focus on stimulating the index finger,middle finger,and ring finger.

Objective To investigate the role and possible mechanism of celastrol(Cel)in sodium oxalate(NaOx)-induced acute kidney injury(AKI)and crystal deposition in the kidney tissues in mice.Methods Male C57BL/6 mice(aged 8～12 weeks,weighing 22～24 g)were randomly divided into 3 groups.Saline group(control group,intraperitoneal injection with normal saline and drinking water freely),NaOx group(injured group,intraperitoneal injection of 75 mg/kg NaOx,and drinking water containing 50 μmol/L NaOx),and NaOx+Cel group(treatment group,intraperitoneal injection of 1 mg/kg Cel firstly and then 75 mg/kg NaOx in 24 h later,drinking water containing 50 μmol/L NaOx).All specimens were collected in 24 h after NaOx injection.HK-2 cells were randomly divided into 4 groups:Medium group(no treatment),NaOx group(500 μmol/L NaOx),NaOx+Cel group(400 nmol/L Cel pre-treatment for 2 h followed by 500 μmol/L NaOx treatment),and NaOx+Cel+BA group[8 μmol/L betulinic acid(BA,NF-κB agonist)after the interventions as the NaOx+Cel group].Cells of each group were collected in 24 h after corresponding treatments.Von Koosa and cell adhesion assays were used to observe crystal deposition.HE staining was employed to observe renal histopathology and score the damage.CCK-8 assay was utilized to detect cell viability to obtain the optimal concentrations of NaOx and Cel.Serum urea and creatinine levels were detected.Immunohisotochemical assay was conducted to detect the expression of OPN,CD44,KIM-1,NGAL,p65,IL-1β,BAX,and Caspase-3,and Western blotting was performed for protein levels of OPN,CD44,KIM-1,p65,P-p65 and IL-1β.Results The mice in the NaOx+Cel group showed reduced crystal deposition(P<0.0001),attenuated renal tubular damage(P<0.01),decreased serum urea and creatinine levels(P<0.05),and declined expression levels of the renal adhesion molecules OPN and CD44,the kidney injury molecules KIM-1 and NGAL,the inflammation-associated molecules p65 and IL-1β,and the apoptosis related molecules BAX and Caspase-3 when compared with the NaOx group(P<0.05).In in vitro study,the NaOx+Cel group showed reduced crystal adhesion(P<0.0001),decreased expression of the adhesion molecules OPN and CD44(P<0.05),down-regulation of the inflammatory molecule IL-1β and P-p65/p65 ratio(P<0.05),and down-regulation of the renal injury molecule KIM-1(P<0.05)when compared with the NaOx group.In the NaOx+Cel+BA group,crystal adhesion was significantly increased(P<0.0001),the inflammatory molecule IL-1β and the ratio of P-p65/p65 were increased(P<0.05),and the kidney injury molecule KIM-1 was increased when compared with the NaOx+Cel group(P<0.05).Conclusion Cel may reduce NaOx-induced crystal deposition and AKI by inhibiting NF-κB activation.

Objective:To observe the electrosensitization of Sifeng(EX-UE10)in children with constipation due to excessive heat in intestine.Methods:The meridian values of Sifeng(EX-UE10)in 80 children with constipation due to excessive heat in intestine and in 80 healthy children were measured using a traditional Chinese medicine(TCM)meridian detector,and the variation rule of the point meridian values was analyzed by SPSS version 26.0 statistical software.Results:The meridian values of Sifeng(EX-UE10)of the index finger,middle finger,and ring finger in the observation group were statistically different from those in the control group(P<0.01).There was no statistical difference in the meridian value of Sifeng(EX-UE10)of the little finger between the two groups(P>0.05).Conclusion:Electrosensitization occurs at Sifeng(EX-UE10)of the index finger,middle finger,and ring finger in children with constipation(syndrome of excessive heat in intestine),and thus the treatment can focus on stimulating the index finger,middle finger,and ring finger.

Objective To discuss the prediction value of the early efficacy of hepatic arterial infusion chemotherapy(HAIC)in treating stage Ⅱ-Ⅲ hepatocellular carcinoma(HCC).Methods The clinical data of 81 patients with stage Ⅱ-Ⅲ HCC,who received at least 3 times of HAIC at the Nanchang Municipal Central Hospital of China from November 2021 to March 2024,were retrospectively analyzed.CT or MRI was used to compare patient's local tumor response after each treatment cycle.Based on modified Response Evaluation Criteria in Solid Tumors(mRECIST),the curative effects of patients after receiving the first,the second,and the last HAIC treatment were compared between each other.The prediction value of the early efficacy of HAIC in treating patients with stage Ⅱ-Ⅲ HCC was analyzed.Results In the 67 patients,the efficacy of the last time HAIC was equal or similar to that of the first time HAIC,and in the remaining 14 patients the efficacy of the last time HAIC was different from that of the first time HAIC,with an efficacy prediction rate of 82.72％.The efficacy of the last time HAIC was equal or similar to that of the second time HAIC in 71 patients,and in the remaining 10 patients the efficacy of the last time HAIC was different from that of the second time HAIC,with an efficacy prediction rate of 87.65％.Conclusion In treating stage Ⅱ-Ⅲ HCC with HAIC,the early efficacy can be used to predict the final efficacy after completion of the total treatment course.

This study was designed to investigate the effects of TNFSF14 on mitochondrial function in ischemia/reperfusion-induced acute kidney injury(I/R-AKI)and its mechanism.TNFSF14-/-and TNFSF14+/+mice underwent renal ischemia-reperfusion operation to establish I/R-AKI models,and their histopathology changes were compared by using Periodic Acid-Schiff stain,transmission electron microscopy.Immunohistochemistry(IHC)was used to detect levels of TNFSF14,HVEM,LT[3R,mitochondrial activity related proteins(Dpr1 and Mfn2)and inflammatory cells infiltration in kidney tissues of mice and relevant patients.In vitro cell experiments,immunofluorescence and immunoblotting were used to observe the effects of exogenous recombinant TNFSF14 factor on the damage and mitochondrial activity of renal tubular epithelial cell line HK-2 cells.Data showed that the expression of TNFSF14 and its receptors were significantly increased in kidney tissues of I/R-AKI mice and clinical human renal tissues of acute tubular injury.Compared with the sham group,I/R mice showed significantly higher levels of renal tubular injury score,inflammatory cells infiltration,cell apoptosis,mitochondrial damage,and Drp1 expression,while knocking out the TNFSF14 gene,the above indicators were significantly reduced.In vitro,exogenous TNFSF14 stimulation could aggravate the hypoxia-induced apoptosis and the decrease of mitochondrial membrane potential in HK-2 cells,while increasing phosphorylation of Drp1 at Se616 to promote its transfer from cytoplasm to mitochondria,leading to an abnormal increase in mitochondrial fission.In conclusions,TNFSF14 may mediate the pathological process of I/R-AKI by promoting mitochondrial damage.

Objective:To compare the efficacy of robot assisted laparoscopic partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) in the treatment of pediatric renal tumors.Methods:A retrospective analysis was conducted on the clinical data of 29 children with renal tumors admitted to Xinhua Hospital from March 2019 to March 2024. Among them, there were 10 cases in the RAPN group, including 6 males and 4 females; The median age is 7.5 (4, 12) years old, with a tumor diameter of (4.3±1.6) cm, a median R. E. N. A.L. score of 9 (8, 11), and relative tumor size (tumor volume/contralateral kidney volume) of (34.0%±19.3%). There were 19 cases in the LPN group, 8 males and 11 females; the median age is 5.0(4, 11) years old, with a tumor diameter of (4.4±1.6) cm, a median R. E. N. A.L. score of 9 (8, 11), and relative tumor size(37.7%±18.1%). There was no statistically significant difference in preoperative characteristics between the two groups ( P>0.05). Both groups underwent partial nephrectomy, with renal artery occlusion and then warm ischemia. Clinical data from both groups during and postoperatively were compared, and a simple linear regression analysis was utilized to assess the correlation between the relative size of the tumor and the duration of intraoperative warm ischemia. Results:All 29 cases underwent a successful surgery. Compared with the LPN group, the total surgery time in the RAPN group was (115.0±28.4) minutes versus (127.9±28.2) min( P=0.25); the warm ischemia time was (20.9±3.0) min versus (27.0±4.5) min, respectively( P<0.01); the intraoperative bleeding was (50.0±24.5) ml and (80.0±21.2) ml( P<0.01); the difference in hemoglobin level before and after surgery was (10.3±3.5) g/L versus (12.9±2.7) g/L( P<0.05), respectively; the median postoperative drainage time was 3.5 (3, 4) days versus 4.0(3, 6) days( P=0.17); the median postoperative hospital stay was 4.5 (4, 8) days versus 6.0(5, 10) days( P<0.05). There were 3 cases of renal cell carcinoma associated with the MiT family translocation, 2 cases of mixed epithelial and stromal tumors, and 2 cases of cystic nephroma by postoperative pathological examination in the RAPN group. There were 10 cases of nephroblastoma, 3 cases of teratoma, 2 cases of renal cell carcinoma associated with the MiT family translocation, 2 cases of metanephric adenoma, 1 case of unclassified renal cell carcinoma, and 1 case of cystic nephroma in the LPN group. Apart from one child in the LPN group who developed a postoperative fever over 39℃, no other severe complications occurred during or after the surgery in the remaining patients. Compared with preoperative parameters, eGFR decreased (8.9±18.9) ml/(min·1.73m 2) and (21.4±34.8) ml/(min·1.73m 2) in the RAPN group and LPN group, respectively, 1 month postoperatively( P=0.36); three months after surgery, eGFR was followed up, and the RAPN group and LPN group showed a decrease of (5.9±23.4) ml/(min·1.73m 2) and (13.9±20.1) ml/(min·1.73m 2) compared with preoperative levels, respectively( P=0.42). Linear regression analysis indicated that in the LPN group, intraoperative warm ischemia time exhibited a progressively increasing trend with the augmentation of the tumor's relative size, and warm ischemia time = 0.1688×tumor relative size+ 20.64, ( R2=0.46, P<0.01). Based on this, it is estimated that when the tumor's relative size exceeds 55.5%, the intraoperative warm ischemia time often surpassed 30 minutes. However, in the RAPN group, this trend is not statistically significant (P>0.05). Conclusions:Both LPN and RAPN are safe and feasible for the treatment of pediatric renal tumors. Compared with LPN, RAPN surgery has advantages of shortening warm ischemia time and reducing intraoperative bleeding, which helps patients recover early. RAPN is a better choice for children with a relative renal tumors size over 55.5%.

Objective:To compare the efficacy of robot assisted laparoscopic partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) in the treatment of pediatric renal tumors.Methods:A retrospective analysis was conducted on the clinical data of 29 children with renal tumors admitted to Xinhua Hospital from March 2019 to March 2024. Among them, there were 10 cases in the RAPN group, including 6 males and 4 females; The median age is 7.5 (4, 12) years old, with a tumor diameter of (4.3±1.6) cm, a median R. E. N. A.L. score of 9 (8, 11), and relative tumor size (tumor volume/contralateral kidney volume) of (34.0%±19.3%). There were 19 cases in the LPN group, 8 males and 11 females; the median age is 5.0(4, 11) years old, with a tumor diameter of (4.4±1.6) cm, a median R. E. N. A.L. score of 9 (8, 11), and relative tumor size(37.7%±18.1%). There was no statistically significant difference in preoperative characteristics between the two groups ( P>0.05). Both groups underwent partial nephrectomy, with renal artery occlusion and then warm ischemia. Clinical data from both groups during and postoperatively were compared, and a simple linear regression analysis was utilized to assess the correlation between the relative size of the tumor and the duration of intraoperative warm ischemia. Results:All 29 cases underwent a successful surgery. Compared with the LPN group, the total surgery time in the RAPN group was (115.0±28.4) minutes versus (127.9±28.2) min( P=0.25); the warm ischemia time was (20.9±3.0) min versus (27.0±4.5) min, respectively( P<0.01); the intraoperative bleeding was (50.0±24.5) ml and (80.0±21.2) ml( P<0.01); the difference in hemoglobin level before and after surgery was (10.3±3.5) g/L versus (12.9±2.7) g/L( P<0.05), respectively; the median postoperative drainage time was 3.5 (3, 4) days versus 4.0(3, 6) days( P=0.17); the median postoperative hospital stay was 4.5 (4, 8) days versus 6.0(5, 10) days( P<0.05). There were 3 cases of renal cell carcinoma associated with the MiT family translocation, 2 cases of mixed epithelial and stromal tumors, and 2 cases of cystic nephroma by postoperative pathological examination in the RAPN group. There were 10 cases of nephroblastoma, 3 cases of teratoma, 2 cases of renal cell carcinoma associated with the MiT family translocation, 2 cases of metanephric adenoma, 1 case of unclassified renal cell carcinoma, and 1 case of cystic nephroma in the LPN group. Apart from one child in the LPN group who developed a postoperative fever over 39℃, no other severe complications occurred during or after the surgery in the remaining patients. Compared with preoperative parameters, eGFR decreased (8.9±18.9) ml/(min·1.73m 2) and (21.4±34.8) ml/(min·1.73m 2) in the RAPN group and LPN group, respectively, 1 month postoperatively( P=0.36); three months after surgery, eGFR was followed up, and the RAPN group and LPN group showed a decrease of (5.9±23.4) ml/(min·1.73m 2) and (13.9±20.1) ml/(min·1.73m 2) compared with preoperative levels, respectively( P=0.42). Linear regression analysis indicated that in the LPN group, intraoperative warm ischemia time exhibited a progressively increasing trend with the augmentation of the tumor's relative size, and warm ischemia time = 0.1688×tumor relative size+ 20.64, ( R2=0.46, P<0.01). Based on this, it is estimated that when the tumor's relative size exceeds 55.5%, the intraoperative warm ischemia time often surpassed 30 minutes. However, in the RAPN group, this trend is not statistically significant (P>0.05). Conclusions:Both LPN and RAPN are safe and feasible for the treatment of pediatric renal tumors. Compared with LPN, RAPN surgery has advantages of shortening warm ischemia time and reducing intraoperative bleeding, which helps patients recover early. RAPN is a better choice for children with a relative renal tumors size over 55.5%.

Objective:To explore the value of ultrasound measuring gastric sinus cross-sectional area (CSA) to guide early individualized enteral nutrition implementation strategies in sepsis patients.Methods:Thirty septic patients admitted to the EICU and comprehensive ICU of The Second Affiliated Hospital of Nanjing University of Chinese Medicine between January 2021 and December 2022 each were included. EICU patients used bedside ultrasound for gastric sinus CSA to guide the implementation of early enteral nutrition in septic patients, and a routine nutritional support strategy was adopted in the integrated ICU. The correlation of CSA and feeding intolerance in patients with septic gastrointestinal dysfunction, the ROC curve and other relevant indicators of gastrointestinal dysfunction gastrointestinal dysfunction score, SOFA score, APACHEⅡ score, intra-abdominal pressure (IAP), serum protein (PA), [albumin (Alb)]. By comparing the indicators related to inflammation, nutritional status and days of ICU stay after different strategies of the two groups, the advantages of different strategies were analyzed.Results:The baseline data of the two groups were balanced and comparable; the incidence of feeding intolerance was significantly higher (36.67%) than the conventional group (10.00%), with aggressive and early individualized treatment, the incidence rate on the third day was only 10.00%, significantly lower than that in the conventional treatment group (40.00%). Treatment up to the 5th day, the related function scores (gastrointestinal dysfunction score, APACHEⅡ score, SOFA score, IAP), nutritional status indicators (5 d hot card reaching the standard rate, PA, Alb) and inflammation indicators (WBC, PCT, hs-CRP) were significantly improved compared with admission, and is better than the conventional treatment group. In addition, the ICU hospital days and the incidence of aspiration were lower in the ultrasound treatment group ( P <0.05). CSA showed favorable correlation with gastrointestinal dysfunction score, APACHEⅡ score, SOFA score, IAP, PA and Alb, correlation coefficients were 0.79、0.60、0.66、0.71、-0.6 and -0.64( P <0.05). The ROC curve for predicting feeding intolerance by CSA showed the AUC was 0.828, 95% CI was 0.737-0.919, its optimal cutoff value for predicted feeding intolerance was 7.835 cm 2, the sensitivity and specificity were 88.20% and 71.80%. Conclusions:Ultrasound measuring CSA can early and effectively found the feeding intolerance in the patients with sepsis , via giving individualized enteral nutrition implementation strategy, significantly improve the organ function score, nutritional status and inflammation index, reduce the ICU hospital days and aspiration, and correlate with the conventional evaluation index, and sensitivity and specificity are high, worthy of the clinical further promotion.

BACKGROUND:Medium-and large-diameter polytetrafluoroethylene artificial blood vessels have been widely used in clinical practice.However,most of the products were imported from other countries.Small-diameter porous polytetrafluoroethylene vessels are easy to form thrombosis and intimal hyperplasia,resulting in an extremely low long-term patency rate,which is difficult to fulfill clinical requirements. OBJECTIVE:To review and summarize the research progress of polytetrafluoroethylene in the field of artificial blood vessels,which can provide a reference for the functional modification of small-diameter polytetrafluoroethylene artificial blood vessels and the improvement of their long-term patency rate. METHODS:The relevant articles published from October 2022 to March 2023 in CNKI,Web of Science,Wiley Online Library,SpringerLink,Science Direct and IOP Science databases were searched by the first author.The search terms in Chinese were"porous polytetrafluoroethylene,vascular graft,electrospinning,medical application,functional modification".The search terms in English were"ePTFE,porous polytetrafluoroethylene,vascular graft,electrospinning,medical application,functional modification".All the articles about the preparation and modification of polytetrafluoroethylene artificial blood vessels were retrieved. RESULTS AND CONCLUSION:The preparation and functional modification of porous polytetrafluoroethylene artificial blood vessels were still research hotspots and difficult problems.From the research progress in and outside China in recent years,the preparation of porous polytetrafluoroethylene artificial blood vessels mainly adopted the rapid thermal stretching method,but the preparation of polytetrafluoroethylene artificial blood vessels by electrospinning was a promising new method.By analyzing and summarizing different functional modification methods,it was found that the long-term patency rate of porous polytetrafluoroethylene artificial blood vessels had been improved.However,the functional modification of small-diameter polytetrafluoroethylene artificial blood vessels still needed further exploration and optimization.