Objective This study aimed to develop an experimental animal platform for evaluating the feasibility and safety of intelligent acupuncture robots and to lay the foundation for further research.Methods Six 2-month-old Guangxi Bama miniature pigs were used as experimental subjects for acupuncture verification after anesthesia.First,manual acupuncture verification was carried out.Six acupoints were selected for each experimental animal and the needles were left for 20 min after the lifting,inserting,and twisting manipulation.Before and after controls were included.The experiment was carried out for 28 days,and each experiment was conducted once every 2 days for a total of 10 times.After verification of manual acupuncture,a point 10 mm from each of the six selected acupoints was selected,with a total of 12 points,and acupuncture operations were carried out on the experimental animals using the intelligent acupuncture module of the acupuncture robot at different frequencies and angles,to further verify the stability and feasibility of the animal platform.Results Routine safety-related blood indicators and blood biochemistry indicators after the procedure were normal and stable compared with those before the procedure.The average heart rate of the animals was 124 beats/min,the average blood pressure was 87/36 mmHg,and the average body temperature of was 36℃at a room temperature of 25℃,with no significant change in body temperature during and after the experiment.On the basis of this experimental platform,acupuncture manipulation using the intelligent acupuncture module of the acupuncture robot was completed successfully,with no abnormalities related to acupuncture such as bending,breaking,or stagnation of needles during the experimental process,and the experimental animals showed no obvious abnormalities.Conclusions This study established a stable experimental animal platform for evaluating the feasibility and safety of acupuncture carried out by intelligent acupuncture robots,based on the existing experimental method of miniature pigs.These result lay a foundation for further research related to the use of intelligent acupuncture robots.

Objective To explore the risk of venous thromboembolism (VTE), especially lower-extremity deep vein thrombosis (DVT) and pulmonary embolism (PE), for stroke patients in rehabilitating, and the functional outcome. Methods A total of 3 557 stroke patients in the neurological rehabilitation center of Beijing Bo'ai Hospital for stroke rehabilitation from January, 2015 to October, 2020 were reviewed through the electronic medical record system. Demographic characteristics, stroke characteristics (type and location), laboratory data (D-dimer polymer and arterial partial pressure of oxygen), motor function (Brunnstrom stage, Fugl-Meyer Assessment of motor and balance, modified Ashworth Scale score of triceps crus, and Holden Walking Ability Classification), activities of daily living (Barthel Index), and anticoagulant/antiplatelet treatment data were collected and analyzed. Results The incidence of DVT and PE was 28.5% and 1.29%, respectively. Most were found 30 days later after onset. The incidence of PE was higher after ischemic stroke (χ2 = 12.49, P < 0.001) rather than hemorrhagic stroke. The patients with hemispheric stroke, severe lower-extremity paralysis, and poor activities of daily living were more prone to complications associated with VTE. After rehabilitation, the function of stroke patients with PE could be improved (|t| > 4.302, P < 0.001). Conclusion The risk of DVT and PE in patients during stroke convalescence may not be negligible, and those with older age, previous history of thrombosis, severe stroke, and severe limb paralysis may be stratified in high-risk. Following anticoagulation treatment, early individualized comprehensive rehabilitation can be done for patients with PE to improve their function and activities of daily living.

Objective:To explore the feasibility of CT angiography (CTA) in investigating vascular dilatation of anterior choroidal artery (AChA) and posterior communicating artery (PComA) in patients with Moyamoya syndrome (MMS).Methods:From July 2017 to July 2018, the clinical and imaging data of MMS patients with brain CTA and DSA performed were analyzed retrospectively. According to DSA results, 71 MMS patients were divided into unilateral MMS group (20 cases, 20 hemispheres) and bilateral MMS group (51 cases, 102 hemispheres). There were 20 cases in unilateral MMS group, 10 males and 10 females, with an average age of (45±9) years; 51 cases in bilateral MMS group, 24 males and 27 females, with an average age of (44±12) years. The hemispheres were divided into dilated group and non-dilated group according to the dilatation of AChA or PComA. Kappa analysis was used to evaluate the consistency of two inspection methods to judge the expansion of AChA. The lumen diameters of PComA, P1 and P2 segments of posterior cerebral artery were measured on CTA images, and the ratio of PComA/P1 and PComA/P2 were calculated. The repeatability of CTA measures was evaluated by intra-group correlation coefficient. Independent sample t-test was used to compare CTA measurement results between PComA dilated group and non-dilated group, and ROC curve was drawn to calculate the best threshold for diagnosis of PComA expansion. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA measures were calculated. Results:The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA diagnosis of AChA expansion inunilateral MMS were all 100.00%. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA diagnosis of AChA expansionin bilateral MMS were 90.00%, 93.90%, 93.14%, 78.26% and 97.47%. Compared with DSA, there was no significant difference in the diagnostic performance of AChA expansion between single and bilateral MMS diagnosed by CTA ( P>0.05). The two methods had strong consistency (Kappa value was 1.00 and 0.79 respectively, P<0.01). A total of 46 patients (69 cerebral hemispheres) were included in the evaluation of PComA. PComA/P1 (1.09±0.41) and PComA/P2 (0.86±0.13) in the dilated group were significantly higher than those in the non-dilated group (0.71±0.21 for PComA/P1 and 0.75±0.23 for PComA/P2). The differences were statistically significant ( t=-4.59, -2.50, P<0.05). The best threshold in diagnosing PComA expansion was 0.87 (PComA/P1) and 0.76 (PComA/P2), and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 84.62%, 83.33%, 84.06%, 86.84%, 80.65% and 79.49%, 60.00%, 71.01%, 72.09% and 69.23%, respectively. Compared with DSA, the Kappa value of CTA measures in diagnosis of PComA expansion was 0.68 (PComA/P1) and 0.40 (PComA/P2), respectively, and the difference was statistically significant ( P<0.05). Conclusions:CTA has a strong consistency with DSA in evaluating the AChA expansion in MMS. When the PComA/P1 ratio on CTA is greater than 0.87, it can be used as the diagnosis criterion for PComA expansion.

Objective: To explore the characteristics of tumor recurrence after liver transplantation in patients with hepatocellular carcinoma (HCC) associated with hepatitis B and to analyze the risk factors that influence the recurrence and prognosis. Methods: The clinicopathological and survival data of 162 patients with hepatitis B –associated liver cancer who underwent liver transplantation in Peking University People’s Hospital from January 2002 to December 2016 were retrospectively analyzed. The postoperative survival rate (OS) and tumor free survival rate (DFS) was statistically analyzed by using the log-rank test. Univariate analysis was performed for various clinicopathological indicators, and the Cox proportional risk regression model was used for multivariate analysis. Results: Univariate analysis showed that the age of the recipients (P_OS = 0.047, P_DFS = 0.045), the maximum tumor size (P < 0.001, P_DFS < 0.001), preoperative AFP levels (P_OS < 0.001, P_DFS < 0.001), preoperative HBV-DNA levels (P_OS = 0.035, P_DFS = 0.029), vein tumor thrombosis (P_OS < 0.001, P_DFS < 0.001), and tumor differentiation degree (P_OS <0.001, P_DFS < 0.001) were associated with overall prognosis and tumor recurrence. Multivariate analysis revealed that preoperative AFP levels (P_OS = 0.014, P_DFS = 0.013), the maximum tumor size (P_OS < 0.001, P_DFS = 0.001), vein tumor thrombosis (P_OS = 0.012, P_DFS < 0.004), and tumor differentiation degree (P_OS = 0.004, P_DFS = 0.009) were independent risk factors affecting overall prognosis and tumor recurrence. Conclusion The major prognostic factors linked to tumor biological characteristics after liver transplantation in HBV-related HCC patients are preoperative AFP levels, the largest tumor size, and vein tumor thrombosis and tumor differentiation degree.

Objective To investigate the expression of EpCAM (epithelial cell adhesion molecule) in patients undergoing liver transplantation for hepatocellular carcinoma (HCC),and to explore the relationship between EpCAM expression level and HCC recurrence.Methods 83 HCC tissue samples were collected and analyzed retrospectively.EpCAM was detected by immunohistochemistry staining and the correlation between EpCAM and clinicopathological features,prognosis and recurrence were analyzed retrospectively from patients undergoing liver transplantation in Peking University People's Hospital from 2000 to 2010.Results Log-rank univariate survival analysis showed that the 5-year overall survival (41.2％ vs.73.3％,x2 =4.935,P =0.026) and 5-year disease free survival (41.2％ vs.73.3％,x2 =4.634,P =0.031)of HCC patients with high EpCAM expression level was significantly lower than that with low expression level of EpCAM.COX multivariate survival analysis showed patients with high EpCAM expression had a higher risk of recurrence(HR =2.860,95％ CI:1.012-8.083) and death (HR =2.909,95％ CI:1.030-8.217)after liver transplantation than those with low EpCAM expression,which was an independent predictor of 5-year overall survival and 5-year disease free survival recurrence (P =0.044).Furthermore,EpCAM expression level was highly related to tumor distant metastasis (P =0.01).Conclusion There was positive relation between high expression of EpCAM and high HCC recurrence after liver transplantation,suggesting that EpCAM can be a predictor for HCC recurrence and long-term survival of patients with HCC after transplantation.

The chemotherapy resistance of glioblastoma is one of the main reasons leading to treatment failure. To date, many studies suggest that hypoxia microenvironment can induce resistance to chemotherapy and radiotherapy. Glioblastoma cells grow fast, and poor oxygen cannot supply enough nourishment. Thus, hypoxia microenvironment occurs. However, hypoxia can affect chemotherapy resistance of glioblastoma through different kinds of mechanisms. In this review, we by summarize the formation of hypoxic microenvi-ronment and the pathogenesis of glioblastoma chemotherapy resistance induced hypoxia.