Objective: To assess the dynamic changes of microcirculation at acupoints in patients with primary dysmenorrhea and cold congelation and blood stasis syndrome using laser speckle blood flow imaging. Methods: Patients with primary dysmenorrhea and cold coagulation and blood stasis syndrome (primary dysmenorrhea group, n=53) and healthy female college students(control group, n=57) who met the inclusion and exclusion criteria from October 2020 to July 2022 were enrolled at Hebei University of Chinese Medicine. On the premenstrual and first day of menstruation, a laser speckle blood flow imaging system was used to measure the microcirculation blood flow perfusion on the surface of acupoints related to the conception, thoroughfare, and governor vessels, and stomach, spleen, and bladder meridians in the abdomen and lumbosacral regions. The dynamic changes in microcirculation were calculated based on the difference in average blood flow perfusion at each acupoint before and after menstruation. Receiver operating curve (ROC) analysis was used to analyze the diagnostic efficacy of dynamic changes in microcirculation on the surface of each acupoint. The microcirculation sensitization rate of acupoints was calculated. Results: Compared with the control group, the dynamic changes in microcirculation at the following acupoints in the primary dysmenorrhea group were increased (P<0.05): conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]); left thoroughfare vessel (left Huangshu[KI16], left Zhongzhu[KI15], left Siman[KI14], left Qixue[KI13], left Dahe[KI12], left Henggu[KI11]); left stomach meridian (left Tianshu[ST25], left Wailing[ST26], left Qichong[ST30]); left spleen meridian (left Daheng[SP15], left Fujie[SP14]); right thoroughfare vessel (right Huangshu[KI16], right Zhongzhu[KI15], right Siman[KI14], right Qixue[KI13], right Dahe[KI12], right Henggu[KI11]); right stomach meridian (right Wailing[ST26], right Daju[ST27], right Shuidao[ST28], right Guilai[ST29], right Qichong[ST30]); and right spleen meridian (right Fujie[SP14]). The area under the ROC curve of conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]), thoroughfare vessel (right Siman[KI14], left Huangshu[KI16], right Qixue[KI13], right Zhongzhu[KI15], right Dahe[KI12], left Zhongzhu[KI15], left Siman[KI14], right Huangshu[KI16], left Qixue[KI13], right Henggu[KI11], left Henggu[KI11], left Dahe[KI12]); stomach meridian (left Tianshu[ST25], right Guilai[ST29], left Wailing[ST26], right Shuidao[ST28], right Daju[ST27], right Wailing[ST26], right Qichong[ST30], left Qichong[ST30]), and spleen meridian (left Daheng[SP15], left Fujie[SP14], right Fujie[SP14]) was 0.610-0.682 (P<0.05). Compared with the control group, the sensitization rate of some acupoints in the primary dysmenorrhea group increased (P<0.05). Conclusion With the onset of menstruation, the blood flow perfusion of some acupoints in the abdomen (thoroughfare, and conception vessels, and stomach and spleen meridians) of patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome increased, and the status of acupoints changed from a resting state to an active state. These acupoints are sensitive in patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome and have a certain diagnostic efficacy, providing a basis for further analyzing the efficacy and mechanism of acupuncture and moxibustion to treat primary dysmenorrhea with cold blood coagulation and blood stasis syndrome.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To explore the diagnostic value of serum soluble semaphorin 4D (sSema4D) and soluble CD40 ligand (sCD40L) in left ventricular hypertrophy (LVH) in patients with primary hypertension (EH).Methods:Eighty-four patients with EH combined with LVH admitted to Qingdao Hospital of Shandong First Medical University from December 2022 to December 2023 were prospectively selected as the study group, and 84 patients with EH and without LVH admitted to Qingdao Hospital of Shandong First Medical University during the same period were regarded as the control group. Enzyme linked immunosorbent assay was applied to detect the levels of sSema4D and sCD40L. Employing Pearson correlation coefficient, the study assessed the association between concentrations of sSema4D and sCD40L in serum and various echocardiographic measurements. A multivariate Logistic regression model was engaged to probe into the contributing factors for the development of LVH. ROC curve was plotted to analyze the diagnostic value of serum sSema4D and sCD40L for EH combined with LVH.Results:Serum sSema4D and sCD40L levels were significantly higher in the study group than in the control group: (8.56 ± 2.19) μg/L vs. (5.12 ± 1.43) μg/L, (4.02 ± 1.03) μg/L vs. (3.22 ± 0.98) μg/L, and the differences were statistically significant ( P<0.05). The duration of hypertension, LVEDD, IVSTD, LVPWT, and LVMI were significantly higher in the study group than in the control group: (7.33 ± 1.53) years vs. (4.26 ± 1.35) years, (50.28 ± 3.33) mm vs. (44.45 ± 3.76) mm, (11.64 ± 3.21) mm vs. (9.53 ± 2.89) mm, (12.45 ± 1.52) mm vs. (9.13 ± 0.98) mm, (126.11 ± 15.28) g/m 2 vs. (81.15 ± 11.31) g/m 2, and the differences were statistically significant ( P<0.05). According to Pearson correlation analysis, it was known that both serum sSema4D and sCD40L were positively correlated with LVEDD, IVSTD, LVPWT and LVMI ( r = 0.425 and 0.533, 0.612 and 0.436, 0.513 and 0.628, 0.589 and 0.618; P<0.05). Multivariate Logistic regression analysis showed that hypertension duration, LVEDD, IVSTD, LVPWT, LVMI, sSema4D, sCD40L were risk factors for LVH in EH patients ( P<0.05). According to the ROC curve, the AUC for diagnosing EH combined with LVH with serum sSema4D was 0.848, the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.725, and the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.888, the combination of sCD40L and sCD40L was superior to their respective individual diagnoses ( Z = 2.651 and 2.526, P<0.05). Conclusions:The serum levels of sSema4D and sCD40L in patients with EH combined with LVH are obviously elevated, which are influencing factors for the occurrence of EH combined with LVH. Combined testing of the two has high diagnostic value for EH combined with LVH.

Objective:To explore the diagnostic value of serum soluble semaphorin 4D (sSema4D) and soluble CD40 ligand (sCD40L) in left ventricular hypertrophy (LVH) in patients with primary hypertension (EH).Methods:Eighty-four patients with EH combined with LVH admitted to Qingdao Hospital of Shandong First Medical University from December 2022 to December 2023 were prospectively selected as the study group, and 84 patients with EH and without LVH admitted to Qingdao Hospital of Shandong First Medical University during the same period were regarded as the control group. Enzyme linked immunosorbent assay was applied to detect the levels of sSema4D and sCD40L. Employing Pearson correlation coefficient, the study assessed the association between concentrations of sSema4D and sCD40L in serum and various echocardiographic measurements. A multivariate Logistic regression model was engaged to probe into the contributing factors for the development of LVH. ROC curve was plotted to analyze the diagnostic value of serum sSema4D and sCD40L for EH combined with LVH.Results:Serum sSema4D and sCD40L levels were significantly higher in the study group than in the control group: (8.56 ± 2.19) μg/L vs. (5.12 ± 1.43) μg/L, (4.02 ± 1.03) μg/L vs. (3.22 ± 0.98) μg/L, and the differences were statistically significant ( P<0.05). The duration of hypertension, LVEDD, IVSTD, LVPWT, and LVMI were significantly higher in the study group than in the control group: (7.33 ± 1.53) years vs. (4.26 ± 1.35) years, (50.28 ± 3.33) mm vs. (44.45 ± 3.76) mm, (11.64 ± 3.21) mm vs. (9.53 ± 2.89) mm, (12.45 ± 1.52) mm vs. (9.13 ± 0.98) mm, (126.11 ± 15.28) g/m 2 vs. (81.15 ± 11.31) g/m 2, and the differences were statistically significant ( P<0.05). According to Pearson correlation analysis, it was known that both serum sSema4D and sCD40L were positively correlated with LVEDD, IVSTD, LVPWT and LVMI ( r = 0.425 and 0.533, 0.612 and 0.436, 0.513 and 0.628, 0.589 and 0.618; P<0.05). Multivariate Logistic regression analysis showed that hypertension duration, LVEDD, IVSTD, LVPWT, LVMI, sSema4D, sCD40L were risk factors for LVH in EH patients ( P<0.05). According to the ROC curve, the AUC for diagnosing EH combined with LVH with serum sSema4D was 0.848, the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.725, and the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.888, the combination of sCD40L and sCD40L was superior to their respective individual diagnoses ( Z = 2.651 and 2.526, P<0.05). Conclusions:The serum levels of sSema4D and sCD40L in patients with EH combined with LVH are obviously elevated, which are influencing factors for the occurrence of EH combined with LVH. Combined testing of the two has high diagnostic value for EH combined with LVH.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Background and purpose:Despite the significant advancements that have been made in the treatment of gastric cancer,there are still problems such as poor prognosis and low five-year survival rate in advanced gastric cancer.Therefore,exploring effective treatment options remains a key focus of clinical research.As a new type of immune checkpoint inhibitor,the clinical efficacy and safety of pembrolizumab still need to be confirmed by extensive research.Therefore,this study conducted regression analysis of the effect of pembrolizumab combined with XELOX regimen in the treatment of advanced gastric cancer,providing a reference for clinical treatment.Methods:Clinical data of patients with advanced gastric cancer who were admitted to Shanxi Province Cancer Hospital from March 2020 to August 2022 were retrospectively collected.Inclusion criteria:patients with HER2-negative,untreated advanced gastric cancer or adenocarcinoma of the esophagogastric junction,confirmed by clinical histopathological examination and meeting relevant diagnostic criteria;TNM stage Ⅳ;age≥20 years;expected survival≥6 months;no severe organ damage before treatment;Karnofsky score＞60;patients with complete clinical data.Exclusion criteria:patients with concurrent major organ dysfunction;hypothyroidism or hyperthyroidism;blood or coagulation disorders;autoimmune diseases;lactating or pregnant women;individuals with mental illnesses or a history of mental illness;those with concurrent other malignancies;those with severe liver or kidney dysfunction;patients with incomplete clinical data.Based on the inclusion and exclusion criteria,91 patients with advanced gastric cancer were selected.Among them,45 received XELOX regimen treatment(control group),and 46 received pembrolizumab combined with XELOX regimen treatment(observation group).After establishing the database,one patient in the observation group was found to have logical errors in their treatment information and was therefore excluded.Ultimately,90 patients were included in the study,with 45 in each of the control and observation groups.The efficacy,median overall survival(OS),median progression-free survival(PFS),toxic side effects,improvement in quality of life,and levels of carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),Escherichia coli,Bifidobacterium and Lactobacillus before and after treatment were compared between the two groups.This study was approved by the ethics committee of Shanxi Province Cancer Hospital(ethics number:KY2023081).Results:After treatment,the proportion of progressive disease(PD)in the observation group was 20.0%(9/45),which was lower than that in the control group(40.0%,18/45).However,there was no significant difference between the two groups in proportion of stable disease(SD),complete response(CR)and partial response(PR)(P＞0.05).The improvement rate of quality of life in the observation group after treatment was 60.0%(27/45),which was higher than that in the control group,with a rate of 37.8%(17/45)(P＜0.05).The median OS and PFS in the observation group were longer compared with the control group(P＜0.05).After treatment,the levels of CEA and CA19-9 in peripheral blood of the observation group were lower compared with the control group(P＜0.05).After treatment,the number of Escherichia coli was lower in the observation group than in the control group,while the numbers of Bifidobacterium and Lactobacillus were higher(P＜0.05).There was no significant difference in the incidence of nausea and vomiting,diarrhea,leukopenia,rash,liver function damage between the two groups(P＞0.05).Conclusion:The combination of pembrolizumab and XELOX regimen can regulate the expression levels of tumor markers in patients with advanced gastric cancer,prevent disease progression,improve patient quality of life,and help maintain intestinal microecology balance.

Objective:To explore the expression of PICK1 in hepatocellular carcinoma (HCC) and its clinical significance.Methods:A retrospective case series study was conducted. Cancer tissues and paracancerous tissues (1cm from the edge of cancer tissues) were collected from 30 HCC patients undergoing surgical resection in Shanxi Province Cancer Hospital from August 2020 to April 2023. The relative expression level of PICK1 mRNA in 30 fresh HCC samples was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The clinicopathological data from 132 HCC patients undergoing surgical resection in Shanxi Province Cancer Hospital from January 2015 to November 2018 were collected. Meanwhile, paraffin specimens were collected from cancer tissues and paracancerous tissues, and relative expression level of PICK1 protein was detected by using immunohistochemistry method. According to the PICK1 protein expression, 132 HCC patients were divided into the low expression group (immunohistochemistry scores < 3 points) and the high expression group (immunohistochemistry scores ≥ 3 points). Kaplan-Meier method was used to compare the overall survival (OS) and disease-free survival (DFS) of the 2 groups, and log-rank test was also performed.Results:The result of qRT-PCR showed that the relative expression level of PICK1 mRNA in fresh cancer tissues of 30 HCC patients was lower than that in corresponding paracancerous tissues (0.43±0.38 vs. 1.10±0.12), and the difference was statistically significant ( t = -13.66, P < 0.001). Among 132 HCC patients, 86 (65.2%) cases had PICK1 protein low expression and 46 (34.8%) cases had PICK1 protein high expression; among the corresponding paracancerous tissues, 37 (28.0%) tissues had PICK1 protein low expression and 95 (72.0%) tissues had PICK1 protein low expression. The high expression rate of PICK1 protein in HCC tissues was lower than that in paracancerous tissues, and the difference was statistically significant ( χ2 = 35.07, P < 0.001). There were statistically significant differences in PICK1 protein expression level of HCC patients with different tumor diameter, tumor number, tumor type, TNM staging, encapsulation or not and vascular invasion (all P < 0.05). Kaplan-Meier survival analysis showed that the median OS time was 54.9 months (95% CI: 41.0 months-not reached) and 17.8 months (95% CI: 13.1-25.0 months), respectively in the PICK1 high expression group and the PICK1 low expression group after surgery; and the OS in the PICK1 high expression group was better than that in the the PICK1 low expression group, and the difference was statistically significant ( P < 0.001). The median DFS time was 43.0 months (95% CI: 31.0 months-not reached), 15.0 months (95% CI: 11.1 months-20.1months), respectively in the PICK1 high expression group and the PICK1 low expression group; and the DFS in the PICK1 high expression group was better than that in the PICK1 low expression group, and the difference was statistically significant ( P < 0.001). Conclusions:PICK1 is lowly expressed in HCC tissues, and HCC patients with PICK1 low expression have poor prognosis.

Objective To develop an asymmetric porous guided bone regeneration(GBR)membrane made from antibacterial zinc oxide nanoparticle(nZnO)/poly(3-hydroxybutyrate-co-4-hydroxy butyrate)copolymer(P34HB),and detect its osteogenic performance.Methods Ultrasonic dispersion technique,solvent displacement method and freeze-drying technique were used to prepare P34HB composite GBR membrane loaded with nZnO at different doses(0％,0.5％,1.0％and 1.5％).Scanning electron microscopy(SEM)and energy spectrometry(EDS)were conducted to determine the load of nZnO and observe the structure of the prepared membrane.Then MC3T3-E1 cells were implanted in a 24-well culture plate with the prepared GBR membrane pre-laid in the well.Thus the experiment included blank control group(no membrane)and groups with membranes composing 0％,0.5％,1.0％and 1.5％nZnO,respectively.CCK-8 and cell scratch assays were used to detect cell proliferation capacity and migration ability.The protein adsorption capacity of GBR membrane was detected by protein adsorption experiment.The in vitro degradation of GBR membrane was tested;the activity of alkaline phosphatase(ALP)was detected with chemical test.And calcified nodules were observed with alizzarin red staining;the antibacterial ability of GBR membranes was tested with in vitro antibacterial experiments.Results Four groups of nZnO/P34HB composite GBR membranes with 0％,0.5％,1.0％and 1.5％nZnO were successfully prepared.SEM results showed that the composite membrane was porous on one side and dense on the other side.EDS indicated the incorporation of zinc elements in the composite membrane.The results of cell proliferation assay showed that 0.5％and 1.0％nZnO/P34HB group promoted the proliferation of MC3T3-E1 cells,when compared with the blank control group and 0％and 1.5％nZnO/P34HB groups(P＜0.05).The results of cell scratch assay showed that MC3T3-E1 cells in the 0.5％nZnO/P34HB group migrated significantly over the scratch edge,with the cell mobility higher than that of the other 3 membrane groups in 48 h after culture(P＜0.01).Protein adsorption experiment displayed there was no significant difference in optical density of the 4 group of membrane,indicating that the addition of nZnO had no effect on the protein adsorption capacity of the material itself.The results of enzymatic experiment showed that though the quality of the 4 membranes was continuously decreased with elapse of time,the degradation rate was still relatively lower after 28 d of treatment.ALP staining and alizarin red staining displayed that the 0.5％nZnO/P34HB group obtained the strongest ALP activity and the largest amount of calcified nodules when compared with the other 3 groups(P＜0.01).Higher mineralization was observed in the 0％and 0.5％nZnO/P 34 HB groups than the other 2 groups(P＜0.01).The results of in vitro antibacterial experiments showed that the number of colonies in the 0.5％nZnO/P 34 HB group was significantly less than that in the blank control group and the 0％nZnO/P34HB group(P＜0.01).Conclusion Our prepared P34HB composite GBR membrane loaded with nZnO is in asymmetric porous structure,and can promote cell proliferation,facilitate cell osteogenesis and have bacteriostatic ability.

OBJECTIVE: To explore the genetic characteristics of a child with Focal segmental glomerulosclerosis and neurodevelopmental syndrome (FSGSNEDS). METHODS: A child with FSGSNEDS who had visited Shengli Oilfield Central Hospital on September 15, 2019 was selected as the study subject. Clinical data of the child was collected, and trio-whole exome sequencing (trio-WES), Sanger sequencing, chromosomal karyotyping analysis, and copy number variation sequencing (CNV-seq) were used to analyze the child and his parents. RESULTS: The child, a 3-year-old boy, had manifested developmental delay, nephrotic syndrome, and epilepsy. Trio-WES and Sanger sequencing showed that he has carried a heterozygous c.1375C＞T (p.Q459*) variant of the TRIM8 gene, for which both his parents were of the wild type. Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic. No abnormality was found in the chromosomal karyotyping and CNV-seq results of the child and his parents. CONCLUSION The child was diagnosed with FSGSNEDS, for which the c.1375C＞T variant of the TRIM8 gene may be accountable.
Male ; Humans ; Child ; Child, Preschool ; DNA Copy Number Variations ; Glomerulosclerosis, Focal Segmental/genetics* ; Genomics ; Heterozygote ; Karyotyping ; Carrier Proteins ; Nerve Tissue Proteins

OBJECTIVE: To observe the skin surface microcirculation of acupoints of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea using laser speckle contrast imaging (LSCI), and provide acupoint selection basis of acupuncture-moxibustion for primary dysmenorrhea. METHODS: Ninety-nine healthy female college students with regular menstrual cycles (normal group) and 94 female college students with primary dysmenorrhea (dysmenorrhea group) were recruited. Before menstrual period, on the first day of menstruation, and on the third day after menstruation, LSCI was used to observe the surface microcirculation at the abdominal acupoints of conception vessel, i. e. Yinjiao (CV 7), Qihai (CV 6), Shimen (CV 5), Guanyuan (CV 4), Zhongji (CV 3) and Qugou (CV 2), acupoints of thoroughfare vessel, i. e. Huangshu (KI 16), Zhongzhu (KI 15), Siman (KI 14), Qixue (KI 13), Dahe (KI 12), Henggu (KI 11) and acupoints of lumbosacral region of governor vessel, i. e. Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3), Yaoshu (GV 2) as well as two non-acupoints. RESULTS: Before menstrual period, there was no significant difference in the surface blood perfusion of the acupoints between the dysmenorrhea group and the normal group (P>0.05). On the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) and right Huangshu (KI 16) in the dysmenorrhea group was higher than that in the normal group (P<0.05, P<0.01). On the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) in the dysmenorrhea group was lower than that in the normal group (P<0.05). CONCLUSION In patients with primary dysmenorrhea, on the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) of governor vessel, and the right Huangshu (KI 16) of thoroughfare vessel is increased, while on the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) of thoroughfare vessel is decreased. These findings might provide a basis for acupoint selection in the acupuncture-moxibustion treatment of primary dysmenorrhea.
Humans ; Female ; Microcirculation ; Dysmenorrhea/therapy* ; Menstrual Cycle ; Acupuncture Points ; Acupuncture Therapy