Objective:To observe the clinical efficacy of exercise-based acupuncture in treating ischemic stroke and its effects in improving the patient's motor function and daily living ability. Methods:A total of 106 patients with motor dysfunction due to cerebral infarction were randomized into a trial group and a control group,each consisting of 53 cases.Both groups received conventional rehabilitation;in addition,the control group was given point-toward-point acupuncture at scalp points,and the trial group was offered exercise-based acupuncture,3 times weekly for 4 consecutive weeks.Before treatment,after 2 and 4 weeks of treatment,and at the 2-month follow-up,the Fugl-Meyer assessment(FMA)scale,Lovett scale for muscle strength,modified Ashworth scale(MAS),and activities of daily living(ADL)scale were used to assess the patient's motor function,muscle strength,muscle tension,and daily living ability. Results:After treatment,both groups gained improvements in motor function and daily living ability;after 4-week treatment and at the 2-month follow-up,the trial group had higher FMA and ADL scores than the control group(P<0.05).The MAS score decreased after treatment in both groups;after 2 and 4 weeks of treatment and at the 2-month follow-up,the MAS score was lower in the trial group than in the control group(P<0.05).After the intervention,the Lovett score increased in both groups;after 4 weeks of treatment,the Lovett score was higher in the trial group than in the control group(P<0.05). Conclusion:Based on routine rehabilitation,exercise-based acupuncture and scalp point-toward-point acupuncture both can improve the motor function and daily living ability in ischemic stroke patients;exercise-based acupuncture performs better than scalp point-toward-point acupuncture.

Plasticity in the glutamatergic synapses on striatal medium spiny neurons (MSNs) is not only essential for behavioral adaptation but also extremely vulnerable to drugs of abuse. Modulation on these synapses by even a single exposure to an addictive drug may interfere with the plasticity required by behavioral learning and thus produce impairment. In the present work, we found that the negative reinforcement learning, escaping mild foot-shocks by correct nose-poking, was impaired by a single in vivo exposure to 20 mg/kg cocaine 24 h before the learning in mice. Either a single exposure to cocaine or reinforcement learning potentiates the glutamatergic synapses on MSNs expressing the striatal dopamine 1 (D1) receptor (D1-MSNs). However, 24 h after the cocaine exposure, the potentiation required for reinforcement learning was disrupted. Specific manipulation of the activity of striatal D1-MSNs in D1-cre mice demonstrated that activation of these MSNs impaired reinforcement learning in normal D1-cre mice, but inhibition of these neurons reversed the reinforcement learning impairment induced by cocaine. The results suggest that cocaine potentiates the activity of direct pathway neurons in the dorsomedial striatum and this potentiation might disrupt the potentiation produced during and required for reinforcement learning.

Objective:To study the clinical effect of Microbotox in improving mandibular fat accumulation, lifting mandibular contour and achieving lower face and neck rejuvenation.Methods:From May 2020 to January 2021, patients with mandibular fat accumulation and skin relaxation of mandible and neck were treated in Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Multiple microdroplets of botulinum toxin type A was injected into the dermis or the interface between the dermis and the superficial muscle layer in lower face and neck. Botulinum toxin was diluted to 20 U/ml and injected with 0.6 U per point. The scope of Microbotox was demarcated by the line between earlobe-mouth corner as the upper border, the depressor anguli oris as the anterior border, the front edge of sternocleidomastoid muscle front edge as the posterior border, and the jugular notch as the inferior border. Treatment effect was evaluated postoperatively by the subjective satisfaction of patients and the accessment of a third-party physicians.Results:A total of 25 patients were included, including 10 males and 15 females, with the age of 39.4±3.7 years. The patient subjective satisfaction was 96%(24/25), and 96%(24/25) of patients received improved result , evaluated by a third-party physician. There were no serious complications except one case of local congestion and four cases of local pain and swelling, which could be relieved in a short time.Conclusions:Characterized by improving mandibular fat accumulation, lifting mandibular contour, reducing cervicomental angle, improving skin texture and neck wrinkles, Microbotox is effective and practical.

Objective:To explore the application effect of failure mode and effect analysis (FMEA) on reducing the unplanned extubation rates in patients with neurosurgical catheterization.Methods:FMEA theory was used to analyze the causes of unplanned extubation in neurosurgical patients with catheterization. The Risk Priority Number (RPN) was calculated and the failure modes with higher RPN were selected. The causes were analyzed, and the improvement measures were formulated to optimize the nursing plan. A total of 585 patients admitted to the Department of Neurosurgery of the Sixth Medical Center of PLA General Hospital from January 2018 to December 2019 were recruited as the FMEA group, the 631 patients admitted before FMEA application, from January 2016 to December 2017, were recruited as the control group. The control group was given routine nursing of Neurosurgery pipeline, and the FMEA group was given FMEA intervention on this basis. The difference of unplanned extubation rate between the two groups was compared.Results:The total incidence of unplanned extubation in FMEA group was 1.48% (21/1 417) , which was lower than 5.11% (72/1 408) in control group, with statistical significance ( P<0.001) . The unplanned extubation rates of gastric tube, urinary tube and operation related drainage tube in FMEA group were lower than in control group, and the differences were statistically significant ( P<0.05) . There was no significant difference in the incidence of unplanned extubation of endotracheal intubation and deep vein catheterization between the two groups ( P>0.05) . Conclusions:The FMEA model can be effective in reducing the rate of unplanned extubation for patients in neurosurgery, which is worthy of clinical application.

Objective:To study the clinical effect of Microbotox in improving mandibular fat accumulation, lifting mandibular contour and achieving lower face and neck rejuvenation.Methods:From May 2020 to January 2021, patients with mandibular fat accumulation and skin relaxation of mandible and neck were treated in Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Multiple microdroplets of botulinum toxin type A was injected into the dermis or the interface between the dermis and the superficial muscle layer in lower face and neck. Botulinum toxin was diluted to 20 U/ml and injected with 0.6 U per point. The scope of Microbotox was demarcated by the line between earlobe-mouth corner as the upper border, the depressor anguli oris as the anterior border, the front edge of sternocleidomastoid muscle front edge as the posterior border, and the jugular notch as the inferior border. Treatment effect was evaluated postoperatively by the subjective satisfaction of patients and the accessment of a third-party physicians.Results:A total of 25 patients were included, including 10 males and 15 females, with the age of 39.4±3.7 years. The patient subjective satisfaction was 96%(24/25), and 96%(24/25) of patients received improved result , evaluated by a third-party physician. There were no serious complications except one case of local congestion and four cases of local pain and swelling, which could be relieved in a short time.Conclusions:Characterized by improving mandibular fat accumulation, lifting mandibular contour, reducing cervicomental angle, improving skin texture and neck wrinkles, Microbotox is effective and practical.

Objective To investigate the incidence of motor system disorders or symptoms that occurred among naval afloat personnel onboard a certain naval surface ship after a prolonged distant voyage.Methods In the year of 2015,a randomized questionnaire survey was carried out among the naval afloat personnel,who experienced a prolonged ocean-going voyage greater than 5 months with a total distance as far as 32 500 nautical miles,covering 4 continents and crossing 2 great oceans.All the subjects finished the questionnaire survey independently and all the questionnaire survey forms were recovered on site and statistical analyses were made by Excel and SPSS 13.0 software.Results Totally,109 copies of questionnaire were issued and 95 copies were recovered,and 90 copies were confirmed valid,with a total valid rate of 94.7％.The average age of the subjects (11 females and 79 males) was (25.12 ± 4.63) years.There were 22 naval afloat personnel with past motor system chronic diseases,accounting for 24.4％.Before prolong distant voyage,52 people complained of motor system disorders (52/90),accounting for 58％,but after prolonged distant voyage,58 people complained of motor system disorders (58/90),accounting for 65.2％.Before prolonged distant voyage,in the ship crew who lived in the relatively dry cabins,22 people complained of motor system disorders (22/33),accounting for 66.7％,but after prolonged distant voyage,21 people complained of motor system disorders (21/33),accounting for 63.6％.However,Before prolonged distant voyage,in the ship crew who lived in the relatively humid cabins,25 people complained of motor system disorders (25/46),accounting for 54.3％,but after prolonged distant voyage,34 people complained of motor system disorders (34/46),accounting for 73.9％.Conclusions Various environmental factors during prolonged distant voyage,particularly humidity in living cabins,exerted negative effects on musculoskeletal system.More strict prophylactic countermeasures should be applied.Due to high incidence of musculoskeletal system disorders,poor knowledge of the naval ship crew about the prevention and treatment of the disorders and their urgent desire to obtain required necessary consultation on the disorders,corresponding medical service should be provided in accordance with the above-mentioned features.

Objective To investigate the incidence of motor system disorders or symptoms that occurred among naval afloat personnel onboard a certain naval surface ship after a prolonged distant voyage.Methods In the year of 2015,a randomized questionnaire survey was carried out among the naval afloat personnel,who experienced a prolonged ocean-going voyage greater than 5 months with a total distance as far as 32 500 nautical miles,covering 4 continents and crossing 2 great oceans.All the subjects finished the questionnaire survey independently and all the questionnaire survey forms were recovered on site and statistical analyses were made by Excel and SPSS 13.0 software.Results Totally,109 copies of questionnaire were issued and 95 copies were recovered,and 90 copies were confirmed valid,with a total valid rate of 94.7％.The average age of the subjects (11 females and 79 males) was (25.12 ± 4.63) years.There were 22 naval afloat personnel with past motor system chronic diseases,accounting for 24.4％.Before prolong distant voyage,52 people complained of motor system disorders (52/90),accounting for 58％,but after prolonged distant voyage,58 people complained of motor system disorders (58/90),accounting for 65.2％.Before prolonged distant voyage,in the ship crew who lived in the relatively dry cabins,22 people complained of motor system disorders (22/33),accounting for 66.7％,but after prolonged distant voyage,21 people complained of motor system disorders (21/33),accounting for 63.6％.However,Before prolonged distant voyage,in the ship crew who lived in the relatively humid cabins,25 people complained of motor system disorders (25/46),accounting for 54.3％,but after prolonged distant voyage,34 people complained of motor system disorders (34/46),accounting for 73.9％.Conclusions Various environmental factors during prolonged distant voyage,particularly humidity in living cabins,exerted negative effects on musculoskeletal system.More strict prophylactic countermeasures should be applied.Due to high incidence of musculoskeletal system disorders,poor knowledge of the naval ship crew about the prevention and treatment of the disorders and their urgent desire to obtain required necessary consultation on the disorders,corresponding medical service should be provided in accordance with the above-mentioned features.

Objective To explore the cost-effectiveness and clinical effect of three platinum based chemotherapy regiments for advanced non small cell lung cancer (NSCLC).Methods 100 patients who were diagnosed as NSCLC,were randomly divided into four groups.The group Ⅰ received NP which was given NVB and DDP.The group Ⅱreceived GP which was given GEM and DDP.The group Ⅲ received TP which was given taxotere and DDP.The clinical effect,adverse reaction and cost effectiveness of the three groups were assessed.Results The clinical effective rates of the three groups were 31.43%,36.36%,37.50% from Ⅰ to Ⅲ group.The adverse events of the group Ⅰ and group Ⅱ were more than those of the group Ⅲ.In the adverse effects of treatment,the major cytotoxicity was digestive reaction and leukopenia in the two groups,but they were tolerable.The ratios of cost effectiveness in the four groups were 550.22yuan,556.48yuan,583.23yuan from Ⅰ to Ⅲ group.Conclusion The NP group is the best one in total cost.

AIM:The direct renin inhibitor aliskiren displays antihypertensive and antialbuminuric effects in humans and in animal models . Emerging evidence has shown that aliskiren localizes and persists in medullary collecting ducts even after treatment was discontinued . The purpose of the present study was to investigate whether aliskiren regulates renal aquaporin expression and improves urinary concen -trating defect induced by lithium .METHODS:The mice were either fed with normal chow or LiCl diet (40 mmol/kg dry food per day for first 4 days and 20 mmol/kg dry food per day for last 3 days ) for seven days .Some mice were intraperitoneally injected aliskiren ( 50 mg/kg BW per day in saline ) .RESULTS:Mice injected aliskiren developed decreased urine output and increased urine osmolal -ity when compared with controls .Aliskiren significantly increased protein abundance of AQP 2 and phosphorylated-S256 AQP2 in the kidney inner medulla .Immunohistochemistry and immunofluoresence showed increased apical and intracellular labeling of AQP 2 and pS256-AQP2 in collecting duct principal cells of kidneys in mice treated with aliskiren .Aliskiren treatment prevented urinary concen-trating defect in lithium-treated mice , and improved the downregulation of AQP 2 and pS256-AQP2 protein abundance in inner medulla of the kidney .In primary cultured rat inner medulla collecting duct cells , aliskiren dramatically increased AQP 2 protein abundance which was significantly inhibited either by PKA inhibitor H 89 or by adenylyl cyclase inhibitor MDL 12330, indicating an involvement of the cAMP signalling pathway in mediating aliskiren-induced increased AQP 2 expression .CONCLUSION: The direct renin inhibitor aliskiren upregulates AQP 2 protein expression in inner medullary collecting duct principal cells and prevents lithium -induced nephro-genic diabetes insipidus ( NDI) likely via PKA-cAMP pathways .

Objective To evaluate the cardioprotection induced by ischemic preconditioning ( IPC) and hypoxic preconditioning ( HPC) which were carried out by using the double cardiopulmonary bypass ( CPB) circuits in in vivo hearts of dogs. Methods Eighteen healthy male dogs, weighing 17?5-24?5 kg, aged 13-24 months, were divided into 3 groups ( n=6 each) using a random number table: my?ocardial ischemia?reperfusion group (group I∕R), IPC group and HPC group. The double CPB circuits were established as follows: systemic and coronary circulation, and independent systemic and coronary cir?culation was carried out. In group IPC, the aorta was clamped, and the coronary circulation pump was sus?pended for 5 min followed by 5 min opening, repeating for 3 cycles. In group HPC, the aorta was clamped, the coronary circulation was started, and pure nitrogen was insufflated for 5 min followed by 5 min of oxygen insufflation, repeating for 3 cycles. CPB was performed for 1 h starting from the time point immediately after IPC or HPC. Before splitting of sternum ( T1 ) , after establishment of double CPB circuits ( T2 ) , at the end of preconditioning ( T3 ) , and at 60 and 120 min after restoration of spontaneous heart
beat ( T4,5 ) , heat rate, mean arterial pressure, central venous pressure, left ventricular end?systolic pres?sure, left ventricular end?diastolic pressure and the maximum rate of increase∕decrease of left ventricular pressure were recorded. Blood samples were collected from the right internal jugular vein at T1 and T4,5 for determination of serum cardiac troponin I concentrations. The animals were sacrificed after determination of the parameter or after blood sampling at T5 , myocardial specimens were obtained for examination of the ul?trastructure and for detection of apoptosis in cardiomyocytes, and apoptosis index was calculated. Before aortic clamping, immediately after aortic unclamping and at 30 min after aortic unclamping, myocardial specimens were obtained for determination of ATP contents in cardiomyocytes. Results Compared with I∕R group, left ventricular end?systolic pressure was significantly increased, and the serum cardiac troponin I concentrations were significantly decreased at T4,5 , the myocardial ATP contents were significantly in?creased immediately after aortic unclamping and at 30 min after aortic unclamping, apoptosis index was sig?nificantly decreased ( P<0?05 or 0?01) , and the pathological changes were significantly attenuated in IPC and HPC groups. Compared with group IPC, the myocardial ATP contents were significantly increased (P<0?05), and the pathological changes were attenuated in group HPC. Conclusion Both HPC and IPC can exert cardioprotection when carried out by using the double CPB circuits, and HPC provides better cardioprotection than IPC in in vivo hearts of dogs.