OBJECTIVE:To systematically evaluate the effects of transcranial direct current stimulation on lower limb motor function in patients with stroke.METHODS:The randomized controlled trials about the effects of transcranial direct current stimulation on patients with stroke were retrieved from databases(PubMed,Web of Science,Embase,Cochrane Library,Scopus,CNKI,VIP,and WanFang Data)from the establishment of the databases to September 22,2024.RevMan 5.4 software and Stata 14.0 software were used for traditional meta-analysis and network meta-analysis,respectively.GRADE was used to evaluate the level of evidence.RESULTS:A total of 17 studies involving 851 patients were included.Traditional meta-analysis showed that transcranial direct current stimulation improved the Fugl-Meyer Lower Extremity Motor Function Scale scores[MD=1.97,95％CI(0.78,3.16),P＜0.01],Berg Balance Scale scores[MD=3.92,95％CI(1.67,6.17),P＜0.01],and Tinetti Balance and Gait Scale score[MD=2.62,95％CI(0.44,4.80),P＜0.05],and reduced the Timed Up-and-Go Test time[MD=-1.82,95％CI(-2.51,-1.12),P＜0.01]and Five Times Sit-To-Stand test time[MD=-0.78,95％CI(-1.31,-0.26),P＜0.01].Network meta-analysis showed that transcranial direct current stimulation was more effective in the treatment of lower limb motor function in stroke patients aged 50-60 years with a disease duration of ≤ 6 months,and that a treatment regimen with a current intensity of 2 mA,a treatment duration of＞30 minutes per day,and a period of intervention of＞3 weeks was more effective in the improvement of lower limb motor ability in stroke patients.CONCLUSION:Current evidence suggests that transcranial direct current stimulation has a better therapeutic effect on lower limb motor function,walking ability,and balance in patients with stroke,in which the improvement of lower limb motor function is affected by the patient's age and duration of the disease,and there is a dose-response relationship between the current intensity,the duration of the daily treatment time,and the cycle of the intervention to a certain extent.

OBJECTIVE:To systematically evaluate the effects of transcranial direct current stimulation on lower limb motor function in patients with stroke.METHODS:The randomized controlled trials about the effects of transcranial direct current stimulation on patients with stroke were retrieved from databases(PubMed,Web of Science,Embase,Cochrane Library,Scopus,CNKI,VIP,and WanFang Data)from the establishment of the databases to September 22,2024.RevMan 5.4 software and Stata 14.0 software were used for traditional meta-analysis and network meta-analysis,respectively.GRADE was used to evaluate the level of evidence.RESULTS:A total of 17 studies involving 851 patients were included.Traditional meta-analysis showed that transcranial direct current stimulation improved the Fugl-Meyer Lower Extremity Motor Function Scale scores[MD=1.97,95％CI(0.78,3.16),P＜0.01],Berg Balance Scale scores[MD=3.92,95％CI(1.67,6.17),P＜0.01],and Tinetti Balance and Gait Scale score[MD=2.62,95％CI(0.44,4.80),P＜0.05],and reduced the Timed Up-and-Go Test time[MD=-1.82,95％CI(-2.51,-1.12),P＜0.01]and Five Times Sit-To-Stand test time[MD=-0.78,95％CI(-1.31,-0.26),P＜0.01].Network meta-analysis showed that transcranial direct current stimulation was more effective in the treatment of lower limb motor function in stroke patients aged 50-60 years with a disease duration of ≤ 6 months,and that a treatment regimen with a current intensity of 2 mA,a treatment duration of＞30 minutes per day,and a period of intervention of＞3 weeks was more effective in the improvement of lower limb motor ability in stroke patients.CONCLUSION:Current evidence suggests that transcranial direct current stimulation has a better therapeutic effect on lower limb motor function,walking ability,and balance in patients with stroke,in which the improvement of lower limb motor function is affected by the patient's age and duration of the disease,and there is a dose-response relationship between the current intensity,the duration of the daily treatment time,and the cycle of the intervention to a certain extent.

ObjectiveTo explore the improvement effect of Flos Puerariae， Hoveniae Semen， and their compatibility on acute alcoholic gastric mucosal injury， and lay a foundation for further development of Flos Puerariae， Hoveniae Semen， and their compatibility in the prevention and treatment of alcohol-induced multiple organ injury. MethodThe acute alcohol-induced gastric mucosal injury model of mice was established by multiple intragastric administration of 56% Hongxing Erguotou liquor （15 mL·kg^-1）. A total of 120 male ICR mice were randomly divided into 8 groups， namely， the blank group， model group， omeprazole group （0.026 g·kg^-1）， Flos Puerariae-Hoveniae Semen （compatibility） high， medium， and low-dose groups （29.2，14.6， 7.3 g·kg^-1）， Flos Puerariae group （19.5 g·kg^-1）， and Hoveniae Semen group （19.5 g·kg^-1）， with 15 mice in each group. After one week of adaptive feeding， the animals were pre-administrated with the corresponding drug at the rate of 10 mL·kg^-1 for 3 d. From the 4^th day， after 1 h of administration， Erguotou liquid was administrated at the rate of 15 mL·kg^-1 and the blank group was administrated with the same volume of deionized water to record the drunkenness and sober up time. The administration was lasted for 3 d. One hour after the last administration， the eyeballs were removed and the mice were sacrificed. The concentration of ethanol in serum was determined by gas chromatograph， and the activity of ethanol dehydrogenase （ADH） in gastric mucosa was determined by ultraviolet-vis spectrophotometer. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in gastric mucosa. Serum inflammatory factors were determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA expression of nuclear transcription factor-κB （NF-κB） p65 and NF-κB inhibitory protein α （IκBα） were detected by real-time polymerase chain reaction （Real-time PCR）. ResultAs compared with the normal group， the content of interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in serum of mice in the model group was increased （P<0.05）， the mRNA expression of NF-κB p65 in gastric mucosa tissues was increased （P<0.01）， and the mRNA expression of IκBα was decreased （P<0.01）. As compared with the model group， the drunkenness time of the omeprazole group， high and medium-dose compatibility groups， and Flos Puerariae group was prolonged （P<0.05）， the sober up time of the high and medium-dose compatibility groups was shortened （P<0.05）， the ethanol concentration in the serum of the high-dose compatibility group was decreased （P<0.05）， the ADH activity in the gastric mucosa of the omeprazole group and high and medium-dose compatibility groups was increased （P<0.05）， the macroscopic injury score of the high， medium， and low-dose compatibility groups and Flos Puerariae group was decreased （P<0.05）， the score of pathological injury in the omeprazole group， high， medium， and low-dose compatibility groups， and Flos Puerariae group was decreased （P<0.01）， the expression of IL-6 in serum of all drug groups was decreased （P<0.05）， the expression of IL-1β in serum of the omeprazole group， high， medium， and low-dose Flos Puerariae groups， and Hoveniae Semen group was decreased （P<0.05）， the expression of TNF-α in serum of high and medium-dose groups was decreased （P<0.05）， the mRNA expression of NF-κB p65 in gastric mucosa tissues of all drug groups was decreased （P<0.05）， and the mRNA expression of IκBα in gastric mucosa tissues of the omeprazole group and high， medium， and low-dose compatibility groups was increased （P<0.05）. As compared with the high-dose compatibility group， the drunkenness time in the low-dose compatibility group and Hoveniae Semen group was shortened （P<0.01）， the sober up time in the Flos Puerariae and Hoveniae Semen groups was prolonged （P<0.01）， the concentration of ethanol in the serum of the medium and low-dose compatibility groups， Flos Puerariae group， and Hoveniae Semen group increased （P<0.05）， the macroscopic injury score of the medium and low-dose compatibility groups and Hoveniae Semen group was increased （P<0.05）， the pathological injury score of the medium and low-dose compatibility groups， Flos Puerariae group， and Hoveniae Semen group was increased （P<0.01）， the content of IL-1β in serum of low-dose compatibility group， Flos Puerariae group， and Hoveniae Semen group was increased （P<0.01）， and the mRNA expression of IκBα in gastric mucosa of the Flos Puerariae group and Hoveniae Semen group was decreased （P<0.05）. As compared with the medium-dose compatibility group， the drunkenness time in the Hoveniae Semen group was shortened （P<0.05）， the sober up time in the Flos Puerariae group was prolonged （P<0.05）， the pathological injury score in the Flos Puerariae group and Hoveniae Semen group was increased （P<0.01）， and the content of IL-1β in serum of the low-dose compatibility group， the Flos Puerariae group， and Hoveniae Semen group was increased （P<0.05）. As compared with the low-dose compatibility group， the pathological injury score of the Hoveniae Semen group was increased （P<0.05）. ConclusionFlos Puerariae， Hoveniae Semen， and their compatibility play a role in preventing and treating acute alcoholic gastric mucosal injury in mice， which may be related to the inhibition of the expression of NF-κB signal pathway in gastric mucosa， and the high-dose compatibility group has the optimal effect.

ObjectiveTo systematically evaluate the efficacy of electrical stimulation on shoulder-hand syndrome after stroke, and compare the curative effect of different electrical stimulation therapies. MethodsThe randomized controlled trials (RCT) about the effect of electrical stimulation on shoulder-hand syndrome after stroke were retrieved from eight databases, including PubMed, Web of Science, Embase, Cochrane Library, CNKI, CBM, VIP and Wanfang data, from the establishment to February 14th, 2023. Two researchers selected and screened the literature, and evaluated the quality of methodology independently. RevMan 5.4 software and Stata 14.0 software were used for meta-analysis and network meta-analysis, respectively. ResultsA total of 18 RCT were selected, including 1 310 cases. Compared to conventional rehabilitation therapy alone, electrical stimulation combined with conventional rehabilitation therapy could improve the scores of Fugl-Meyer Assessment-Upper Extremities (MD = 8.17, 95%CI 6.90 to 9.45, P < 0.001) and modified Barthel Index (MD = 11.80, 95%CI 10.18 to 13.42, P < 0.001), and reduce the Visual Analogue Score (MD = -1.68, 95%CI -2.03 to -1.32, P < 0.001) and edema score (MD = -0.98, 95%CI -1.18 to -0.79, P < 0.001). The best effect of improving upper limb function followed as intermediate frequency electrotherapy, electroacupuncture, low frequency electrotherapy and routine rehabilitation therapy. The best effect of improving pain followed as electroacupuncture, intermediate frequency electrotherapy, low frequency electrotherapy and routine rehabilitation therapy. ConclusionElectrical stimulation therapy can relieve pain and edema of patients with shoulder-hand syndrome after stroke, and improve upper limb activity and activities of daily living. Intermediate frequency electrotherapy is the best in improving upper limb function, and electroacupuncture is the best in relieving pain.

ObjectiveTo explore the relationship between Kansui Radix and Glycyrrhizae Radix et Rhizoma in the Gansui Banxiatang based on cytochrome P450 （CYP450） enzyme and ascites rats. MethodA total of 150 Wistar rats were randomized into blank group （distilled water， ig）， model group （distilled water， ig）， Gansui Banxiatang group （5.68 g·kg^-1·d^-1， ig）， Gansui Banxiatang without Kansui Radix group （5.57 g·kg^-1·d^-1， ig）， Gansui Banxiatang without Glycyrrhizae Radix et Rhizoma group （4.01 g·kg^-1·d^-1， ig）， and Gansui Banxiatang without Kansui Radix And Glycyrrhizae Radix et Rhizoma group （3.90 g·kg^-1·d^-1， ig）， with 25 rats in each group. The Gansui Banxiatang was composed of 1.1 g Kansui Radix， 9 g Pinelliae Rhizoma Praeparatum， 15 g Paeoniae Radix Alba， 16.7 g Glycyrrhizae Radix et Rhizoma praeparata cum melle， and 15 g honey. The rats， except for the blank group， were injected （ip） with Walker-256 cells to induce cancerous ascites. The administration lasted 7 days for each group. The concentration of probe drugs was detected by high performance liquid chromatography （HPLC） and based on the metabolic rates of the drugs， the CYP450 enzyme activity was yielded. The CYP450 enzyme gene expression was determined by Real-time PCR， and CYP450 enzyme protein expression by Western blot. ResultCompared with the blank group， the model group showed high activity of CYP1A2 and CYP2C9， low activity of CYP2E1， CYP2C19， and CYP3A4， low mRNA expression of CYP2E1， CYP2C19， CYP2C9， and CYP3A4， and low protein expression of CYP2E1 and CYP3A4 （P<0.05）. Compared with the model group， Gansui Banxiatang group displayed low activity of CYP2C9 and high expression of CYP3A4 mRNA （P<0.01）， and Gansui Banxiatang without Kansui Radix group demonstrated low activity of CYP1A2， high activity of CYP2E1 and CYP3A4， high mRNA expression of CYP1A2， CYP2E1， CYP2C19， and CYP3A4， and high protein expression of CYP2E1 and CYP3A4 （P<0.05）. In comparison with the model group， the Gansui Banxiatang without Glycyrrhizae Radix Et Rhizoma group showed low activity of CYP2C9， high activity of CYP3A4， and high mRNA expression of CYP2E1 and CYP2C19 （P<0.05）， and Gansui Banxiatang without Kansui Radix and Glycyrrhizae Radix Et Rhizoma group had low activity of CYP2C9， high activity of CYP3A4， and high CYP3A4 mRNA expression （P<0.01）. The activity of CYP2E1， CYP2C9， and CYP3A4 was higher， and the mRNA expression of CYP1A2， CYP2C19， and CYP3A4 and CYP3A4 protein expression were higher in the Gansui Banxiatang without Kansui Radix group than in the Gansui Banxiatang group （P<0.05）. The activity of CYP2C9 and CYP3A4， and CYP2C19 mRNA were higher and mRNA expression of CYP3A4 was lower in the Gansui Banxiatang without Glycyrrhizae Radix Et Rhizoma group than in the Gansui Banxiatang group （P<0.05）. The activity of CYP2C9 and CYP3A4 in the Gansui Banxiatang without Kansui Radix and Glycyrrhizae Radix et Rhizoma group was higher than that in the Gansui Banxiatang group （P<0.01）. ConclusionThe four prescriptions all showed certain efficacy in the perspective of CYP450 enzyme， among which Gansui Banxiatang without Kansui Radix had the best effect and was better than Gansui Banxiatang. The Kansui Radix and Glycyrrhizae Radix et Rhizoma did not show antagonism in Gansui Banxiatang， but reduced the effect. Thus， in this study， the medicinal pair may show mutual inhibition.

Aim To investigate the role of phospho-lipase C epsilon 1 ( PLCE1 ) in modulating the apoptot-ic mechanism in esophageal cancer ( Eca ) cells. Methods Eca cell lines, OE33 and CP-C cells were cultured to assess the expression of PLCE1 . siRNA suppress expression of PLCE1 . The expression of PLCE1 and p53 was evaluated by quantitative real time PCR and Western blot. Methylation analyses of p53 were performed by bisulfite conversion of genomic DNA. Apoptosis was assessed by flow cytometry. Results OE33 and CP-C cells expressed high levels of PLCE1 . Knockdown of PLCE1 markedly increased the expression and hypomethylation of p53 , and in-creased the frequency of apoptosis. Conclusion PLCE1 suppresses apoptosis of Eca cells via promoting p53 promoter methylation and inhibiting expression of p53 .

AIM:To investigate the role of phospholipase C epsilon 1 ( PLCE1 ) in modulating the apoptotic mechanism in lung adenocarcinoma A 549 cells.METHODS:PLCE1 inhibitor U-73122 was used to suppress the expres-sion of PLCE1.The expression of PLCE1 and p53 in A549 cells was evaluated by quantitative real-time PCR and Western blotting.Apoptosis was assessed by flow cytometry .RESULTS:A549 cells expressed high level of PLCE1 and low level of p53.Inhibition of PLCE1 markedly increased the expression of p 53, and increased the apoptosis of A 549 cells.CON-CLUSION:PLCE1 suppresses apoptosis of A549 cells via inhibiting the expression of p53.

ObjectiveTo explore the application value of thoracoscopic pleural lavage for empyema after liver transplantation (LT).MethodsClinical data of 5 patients who underwent thoracoscopic pleural lavage for empyema after LT in the Third Afifliated Hospital of Sun Yat-sen University from October 2002 to October 2013 were analyzed retrospectively. All 5 patients were males with the age ranging from 42 to 56 years old and the median of 51 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients received thoracoscopic pleural lavage for empyema under endotracheal general anesthesia. The thoracoscope was introduced in the seventh intercostal space on the mid-axillary line. The aspirator was inserted in the third intercostal space on the anterior line to drain the pus. And the pleural ifberboard was peeled off. The intraoperative situation and perioperative recovery of the patients were observed.ResultsFive patients received successful operations and recovered and were discharged from hospital. The median length of operation was 2(1-3) h. The length of respirator assisted ventilation was 26(6-42) h. The intraoperative blood loss was 600(300-1 000) ml. The length of indwelling chest drainage tube was 4(2-6) h. The volume of chest drainage was 680(350-1 200) ml. No mortality, empyema recurrence and other serious complications were observed. The postoperative hospital stay was 7(5-11) d.ConclusionThoracoscopic pleural lavage for empyema after LT is a safe and effective treatment.

Objective To evaluate the degree of hypothermia cerebral resuscitation patients by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and judge the prognosis,so as to prove the effectiveness of its application.Methods Data of 34 cases of patients with mild hypothermia cerebral resuscitation in ECIU or ICU were continuously observed,calculated the scores of APACHE Ⅱ and verify for establishing the regression model.Results The APACHE Ⅱ score was 20-47 (33.86 ± 5.12) scores.The APACHE Ⅱ score in 9 patients who were survived within 72 h was (27.83 ± 4.89) scores,and in 25 patients who were dead within 72 h was (35.56 ± 7.12) scores,there was significant difference (P ＜ 0.01).Logistic regression analysis showed that APACHE Ⅱ score was the risk factor (P ＜ 0.01).Conclusion APACHE Ⅱ score can be applied to evaluate the degree of mild hypothermia cerebral resuscitation and prognosis,it can guide the clinical decision making.