This paper discusses the treatment of polycystic ovary syndrome(PCOS)based on the midnight-noon ebb-flow theory.The midnight-noon ebb-flow theory is a Chinese medicine science that combines the time and space of nature with the internal rhythm of the human body.PCOS is characterized by disappearance of the reproductive monthly rhythm.Its etiology is based on kidney deficiency.The key to its pathogenesis is the excess of yin and deficiency of yang,the hyperactivity of yang and deficiency of yin,and the lack of smooth connection between yin and yang.PCOS patients have circadian rhythm disorders,and the oscillation of the core clock gene is attenuated,which leads to the interruption of the circadian rhythm gene in the ovary,the imbalance of yin and yang trans-formation in the kidney,and the asynchrony of qi and blood flow with the time rhythm.Therefore,the treatment focuses on harmonizing yin and yang and rebuilding the normal reproductive rhythm of women.Using the midnight-noon ebb-flow theory,combined with the reproductive physiological characteristics of women,choosing different drug administration time and selecting meridians and acupoints according to the time will be helpful to unlock the"time code"of the female reproductive system,and assist clinical menstruation regu-lation,pregnancy and treatment of diseases.

Objective:To investigate the application value of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver trans-plantation.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 4 donors and 4 recipients undergoing right lobe living donor liver transplantation in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School and 17 donors and 17 recipients undergoing right lobe living donor liver transplantation in the First Affiliated Hospital with Nanjing Medical University from June 2015 to August 2018 were collected. Of 21 donors, there were 10 males and 11 females, aged from 35 to 57 years, with a median age of 46 years. The median body mass of 21 donors were 64 kg, with a range from 56 to 72 kg. Of 21 recipients, there were 16 males and 5 females, aged from 21 to 68 years, with a median age of 42 years. The median body mass of 21 recipients were 63 kg, with a range from 47 to 77 kg. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect graft function, tumor recurrence, vascular graft complications, patency of vascular graft and survival of recipients up to August 2020. All recipients will be followed up for all their lives. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range). Count data were represented as absolute numbers or percentages. The Kaplan-Meier method was used to calculate patency rates of hepatic vein outflow tract and survival rates to draw patency curve and survival curve. Results:(1) Surgical and postoperative situations: the operation time, the weight of donor graft, graft to recipient weight ratio and duration of hospital stay of 21 donors were (367±72)minutes, (557±68)g, 0.89%±0.16% and (10+2)days, respectively. No major complication requiring reoperation or intervention occurred in any of the 21 donors. One donor undergoing mild bile leakage preserved peritoneal drainage for one week. All 21 recipients underwent classic orthotopic liver transplantation successfully. The time of hepatic vein outflow tract reconstruction in donor graft, operation time and time of anhepatic phase of 21 recipients were (24±4)minutes, (326±66)minutes and (42±6)minutes, respectively. The number of reconstructed middle hepatic vein in hepatic segment 5 and 8 were 18 and 15, with the diameter of (6.1±1.3)mm and (7.2±1.2)mm, respectively. The number of reconstructed inferior right hepatic vein were 10, with the diameter of (6.3±1.3)mm. The postoperative treatment time at intensive care unit and duration of hospital stay of 21 recipients were (1.5±0.9)days and (22.6±6.7)days, respectively. Ten of 21 recipients underwent postoperative complications. Five recipients underwent graft dysfunction including the level of alanine aminotransferase and aspartate aminotransferase >1 000 IU/L and the level of bilirubin slightly increasing, combined with increased ascites. Enhanced computed tomography scan showed congestion in the right anterior of graft and thrombosis in the middle hepatic vein of hepatic segment 5 and segment 8. All 5 recipients undergoing graft dysfunction recovered with normal liver function and ascites decreasing after symptomatic treatment including liver protection therapy, anticoagulation and albumin infusion. Two recipients underwent inferior vena cava thrombosis and intractable pleural effusion one month after operation. Vena cava venography examination showed thrombosis in the graft vascular. Of the 2 recipients, one case with collateral circulation formation recovered undergoing balloon dilatation and stent placement combined with anticoagulation therapy of warfarin. The other one case recovered after anticoagulation therapy of warfarin. One recipient undergoing bile leakage and abdominal infection with klebsiella pneumoniae recovered after symptomatic treatment. Two recipients undergoing abdominal infection or pulmonary infection recovered after symptomatic treatment. There was no serious complication or death during perioperative period. (2) Follow-up: all 21 recipients were followed up for 10 to 57 months, with a median follow-up time of 38 months. During the follow-up, no recipient underwent graft dysfunction and 2 recipients had tumor recurrence at postoperative 6 months. Six of the 21 recipients died within 2 years after operation including 3 cases dying of tumor recurrence, 2 cases dying of acute hemorrhage and 1 case dying of liver failure. There was no death caused by vascular graft complica-tions. The postoperative 1, 3, 6-month, and 1-year and 2-year potency rates of hepatic vein outflow tract in 21 recipients were 88.4%, 88.4%, 82.4%, 68.0% and 42.1%, respectively. The 6-month, 1-year and 2-year overall survival rates in 21 recipients were 100%, 94.4%, 71.4%, respectively.Conclusion:Application of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver transplantation is safe and feasible.

Objective:To explore the influence of childhood psychological abuse, neglect and alexithymia on the boredom proneness of college students.Methods:The boredom proneness scale for college students(BPS), child psychological abuse and neglect scale (CPANS) and the Toronto alexithymia scale (TAS-20) were used to investigate 1 557 college students, and SPSS 22.0 was used for descriptive statistics, correlation analysis and regression analysis.Results:Childhood psychological abuse (26.540±8.985), neglect (32.665±10.651), recognition emotion in alexithymia dimension (19.359±4.835), description emotion dimension (14.173±3.001), extroverted thinking dimension in alexithymia (20.383±3.429) had positive correlation with the total score of boredom tendency (101.109±19.735) and the dimension of external stimulus (66.022±21.079)( r=0.160-0.559, all P<0.01). And there were negative correlations with the internal stimulus dimension (35.132±8.207)( r=-0.302--0.104, all P<0.01). The hierarchical regression analysis showed that after controlling the effects of gender and age, psychological abuse and neglect were the influencing factors of boredom proneness, internal stimulus and external stimulus, which explained 14.3%, 5.1% and 18.2% of the total variation (△ F=130.561, 41.968, 172.711, all P<0.01). Recognition of emotions, description of emotions and extroverted thinking in alexithymia were the influencing factors of boredom proneness, internal stimulus and external stimulus, which explained 17.5%, 9.9% and 25.5% of the total variation (△ F=134.274, 60.696, 234.383, all P<0.01). Conclusion:Childhood psychological abuse, neglect and alexithymia have significant effect on boredom proneness of college students, and mainly on external stimuli of boredom proneness. Among them, alexithymia has the greatest influence and the highest explanatory power.

Brain ; pathology ; China ; Humans ; Organ Preservation ; standards ; Tissue Banks ; ethics ; standards

Objective To observe any effect of hyperbaric oxygen therapy on cognitive dysfunction caused by traumatic brain injury,and to explore possible neural mechanisms.Methods Sixty-four patients with cognitive impairment after a traumatic brain injury were randomly divided into a hyperbaric oxygen group (n =32) and a control group (n=32) using a random number table.Both groups accepted routine medical therapy and cognitive rehabilitation training,but the hyperbaric oxygen group additionally received hyperbaric oxygen treatment.Both groups' cognitive functioning was assessed using the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) before and after the treatment.Fifteen patients were randomly selected from both groups to receive T1WI and diffusion tensor imaging scans.The correlation between the two evaluation resuhs was analyzed.Results After the intervention,improvement was observed in the average MMSE and MoCA scores of both groups,with the improvement in both average scores in the hyperbaric oxygen group significantly greater than among the control group.There was no significant correlation between the fractional anisotropy (FA) values of damaged white matter and the average MMSE or MoCA score in the controi group,but in the hyperbaric oxygen group there were significant positive correlations between the FA values of the corpus callosum,the anterior limb of the internal capsule and the left superior longitudinal fasciculus and the average MMSE and MoCA scores.Conclusions Hyperbaric oxygen therapy combined with rehabilitation training can further improve cognition after a traumatic brain injury.This is probably due to its adjusting the structure and function of the corpus callosum,of the anterior limb of the internal capsule and of the left superior longitudinal fasciculus.

Objective To observe the effect of hyperbaric oxygen therapy (HBOT) on the improvement of executive function of the patients with traumatic brain injury (TBI) by using resting state functional magnetic resonance (rs-fMRI).Methods Fifty patients with executive disorder after traumatic brain injury were randomly divided into the HBO group (n =25) and the control group (n =25).The patients of the control group received routine treatment and executive function rehabilitation training,while the patients of the HBO group were supplemented with HBOT in addition to the treatment received by the control group.The applied HBO pressure was 2.0 MPa,one session a day with a duration of 105 minutes,five days a week,for a total of 20 sessions.Both before and after treatment,all the subjects received executive function assessment and rs-fMRI examination by using the drawing of clock test,the Chinese version Stroop color word test and the Wechsler adult intelligence scale similarity subtest.In the study,we closely observed the effects of HBOT on the intensity of metabolic activities in the brain,changes in neuron cell synchronization and coordination in TBI patients through the approach of rs-fMRI technique combined with ReHo and ALFF analysis methods.At the same time,the correlation between imaging data and neuropsychological assessment results was also analyzed in the study.Results (1) After intervention,Stroop-A time-consumption and Stroop-C time-consumption,correct reading scores,as well as interference scores of the HBO group were all significantly better than those of the control group,and statistical significance could be found when comparisons were made between the 2 groups (P ＜ 0.05).(2) Following intervention with different methods,obvious differences in the ALFF value of superior parietal lobe in the common brain regions of the TBI patients in the 2 groups could be seen,with statistical significance (P ＜ 0.05).Correlation analysis revealed that there was a positive correlation between the superior parietal lobe and interference time in the HBO group (P ＜ 0.05).(3) There was also a positive correlation between correct readings of Stroop-A in the middle frontal gyrus of the HBO group (P ＜ 0.05).Conclusion Executive function rehabilitation training,HBO therapy combined with executive function rehabilitation training could improve the executive function of TBI patients to various degrees.HBO therapy combined with executive function rehabilitation training was more beneficial to further improvement of executive function in patients with TBI.The improvement of executive function in TBI patients by HBO therapy might be achieved through the regulation of spontaneous activity and regional homogeneity of neurons in the middle frontal gyms,and superior parietal lobe.

Objective To observe the effect of hyperbaric oxygen therapy (HBOT) on the improvement of executive function of the patients with traumatic brain injury (TBI) by using resting state functional magnetic resonance (rs-fMRI).Methods Fifty patients with executive disorder after traumatic brain injury were randomly divided into the HBO group (n =25) and the control group (n =25).The patients of the control group received routine treatment and executive function rehabilitation training,while the patients of the HBO group were supplemented with HBOT in addition to the treatment received by the control group.The applied HBO pressure was 2.0 MPa,one session a day with a duration of 105 minutes,five days a week,for a total of 20 sessions.Both before and after treatment,all the subjects received executive function assessment and rs-fMRI examination by using the drawing of clock test,the Chinese version Stroop color word test and the Wechsler adult intelligence scale similarity subtest.In the study,we closely observed the effects of HBOT on the intensity of metabolic activities in the brain,changes in neuron cell synchronization and coordination in TBI patients through the approach of rs-fMRI technique combined with ReHo and ALFF analysis methods.At the same time,the correlation between imaging data and neuropsychological assessment results was also analyzed in the study.Results (1) After intervention,Stroop-A time-consumption and Stroop-C time-consumption,correct reading scores,as well as interference scores of the HBO group were all significantly better than those of the control group,and statistical significance could be found when comparisons were made between the 2 groups (P ＜ 0.05).(2) Following intervention with different methods,obvious differences in the ALFF value of superior parietal lobe in the common brain regions of the TBI patients in the 2 groups could be seen,with statistical significance (P ＜ 0.05).Correlation analysis revealed that there was a positive correlation between the superior parietal lobe and interference time in the HBO group (P ＜ 0.05).(3) There was also a positive correlation between correct readings of Stroop-A in the middle frontal gyrus of the HBO group (P ＜ 0.05).Conclusion Executive function rehabilitation training,HBO therapy combined with executive function rehabilitation training could improve the executive function of TBI patients to various degrees.HBO therapy combined with executive function rehabilitation training was more beneficial to further improvement of executive function in patients with TBI.The improvement of executive function in TBI patients by HBO therapy might be achieved through the regulation of spontaneous activity and regional homogeneity of neurons in the middle frontal gyms,and superior parietal lobe.

Objective To evaluate risk factors for surgical site infection(SSI) in patients with thoracolumbar fracture,and provide basis for making prevention and control measures.Methods Patients with thoracolumbar fractures operation in the department of spinal surgery of a hospital between January 2010 and March 2015 were monitored through information monitoring system,on-site visit,and telephone follow-up,incidence of SSI was investigated,risk factors were performed univariate analysis.Results A total of 326 patients undergoing thoracolumbar fracture operation were monitored,15(4.60％) had SSI.SSI were high in patients≥60 years old,underwent operation at nonlaminar air flow operation room,didn't receive antimicrobial prophylaxis 30 minutes prior to operation,preoperative hospital stay ＞3 days,operation duration ＞3 hours,as well as with diabetes mellitus and chronic respiratory disease (all P＜ 0.01).Conclusion Risk factors for SSI in patients undergoing thoracolumbar fractures operation were patients with older age,receive operation at non-laminar air flow operation room,didn't receive antimicrobial prophylaxis,long length of preoperative hospital stay and operation duration,as well as combined with diabetes mellitus and chronic respiratory disease,preventive measures should be taken to reduce the incidence of infection.

Objective To observe the effects of hyperbaric oxygen (HBO) on the expressions of stromal derived factor-1 (SDF-1) and CXC chemokine receptor 4(CXCR4) in rats with traumatic brain injury and also to discuss potential mechanism of HBO in the protection of the nerve system of the rats with TBI.Methods The experimental models of traumatic brain injury were developed by modified Feeney free-falling method.Seventy-two SD male rats were randomly divided into 3 groups: the sham surgery group, the model group and the HBO group, each consisting of 24 rats.Then, in accordance with HBO intervention time, the HBO group was subdivided into the 3-day and 10-day subgroups.The rats in the HBO group received HBO therapy 24 hours after development of the model, one session a day.Recovery of the nerve system, 24 hours after development of the model, 3 and 10 days after therapy, was assessed by using Neurological Severity Scores (NSS), and neurological function recovery was compared between the groups.At the same time, samples of damaged brain tissues were taken for the detection of expression levels of SDF-1 and CXCR4 by using Western blotting.Results (1)Neurological function deficiency was not noted in the sham surgery group.There were no significant differences in neurological function deficiency scores detected 24 hours after the development of the model, when comparisons were made between the model group and the HBO group(P ＞0.05).Three and 10 days after therapy, neural function recovered gradually, with the neural function deficiency scores of the HBO group being(8.7 ± 0.4)and(4.7 ±0.6)respectively, which were obviously lower than those of the model group(10.5 ±0.6 and 6.40.6 respectively)(P ＜0.01).(2)The expressions of SDF-1 and CXCR4 in the sham surgery group were low, and there was no statistical significance in the expression levels at different time points(P ＞0.05).Three days after therapy, the expression levels of SDF-1 and CXCR4 for the model group were all significantly increased, as compared with those of the sham surgery group(P ＞ 0.05).Ten days after therapy, the expression level of SDF-1 for the model group was decreased, which tended to be the identical level of the sham surgery group(P ＞0.05).Though the expression level of CXCR4 was also decreased, it was obviously higher than that of the sham surgery group (P ＞ 0.01).Three and 10 days after therapy, the expression levels of SDF-1 and CXCR4 for the HBO group were significantly increased, as compared with those of the model group(P ＞ 0.01).Conclusions HBO therapy could accelerate neurological function recovery of the rats with TBI and promote homing of endogenous mesenchymal stem cells to the injured brain tissues by upregulating SDF-1/CXCR4 axis.

Objective To observe the effects of hyperbaric oxygen (HBO) on the expressions of stromal derived factor-1 (SDF-1) and CXC chemokine receptor 4(CXCR4) in rats with traumatic brain injury and also to discuss potential mechanism of HBO in the protection of the nerve system of the rats with TBI.Methods The experimental models of traumatic brain injury were developed by modified Feeney free-falling method.Seventy-two SD male rats were randomly divided into 3 groups: the sham surgery group, the model group and the HBO group, each consisting of 24 rats.Then, in accordance with HBO intervention time, the HBO group was subdivided into the 3-day and 10-day subgroups.The rats in the HBO group received HBO therapy 24 hours after development of the model, one session a day.Recovery of the nerve system, 24 hours after development of the model, 3 and 10 days after therapy, was assessed by using Neurological Severity Scores (NSS), and neurological function recovery was compared between the groups.At the same time, samples of damaged brain tissues were taken for the detection of expression levels of SDF-1 and CXCR4 by using Western blotting.Results (1)Neurological function deficiency was not noted in the sham surgery group.There were no significant differences in neurological function deficiency scores detected 24 hours after the development of the model, when comparisons were made between the model group and the HBO group(P ＞0.05).Three and 10 days after therapy, neural function recovered gradually, with the neural function deficiency scores of the HBO group being(8.7 ± 0.4)and(4.7 ±0.6)respectively, which were obviously lower than those of the model group(10.5 ±0.6 and 6.40.6 respectively)(P ＜0.01).(2)The expressions of SDF-1 and CXCR4 in the sham surgery group were low, and there was no statistical significance in the expression levels at different time points(P ＞0.05).Three days after therapy, the expression levels of SDF-1 and CXCR4 for the model group were all significantly increased, as compared with those of the sham surgery group(P ＞ 0.05).Ten days after therapy, the expression level of SDF-1 for the model group was decreased, which tended to be the identical level of the sham surgery group(P ＞0.05).Though the expression level of CXCR4 was also decreased, it was obviously higher than that of the sham surgery group (P ＞ 0.01).Three and 10 days after therapy, the expression levels of SDF-1 and CXCR4 for the HBO group were significantly increased, as compared with those of the model group(P ＞ 0.01).Conclusions HBO therapy could accelerate neurological function recovery of the rats with TBI and promote homing of endogenous mesenchymal stem cells to the injured brain tissues by upregulating SDF-1/CXCR4 axis.