In recent years, non-invasive brain stimulation has been widely used in clinical rehabilitation due to its safe and non-invasive features.Particularly for stroke patients, this technique has become a new type of rehabilitation by virtue of its role in improving gait disorders, aphasia, dysphagia, and other complications. Previous research on stroke rehabilitation mainly focused on the cerebral cortex, while the recent evidences suggest that the cerebellum, with its rich synaptic plasticity and extensive structural and functional connectivity with the brain, has emerged as a promising target for non-invasive intervention in stroke rehabilitation. Non-invasive stimulation of the cerebellum is expected to improve patients' impaired function and quality of life. This review discusses the possible mechanisms and clinical applications of non-invasive cerebellar stimulation technology in regulating stroke rehabilitation, aiming to provide new treatment directions and application value for individualized stroke rehabilitation.

In recent years, non-invasive brain stimulation has been widely used in clinical rehabilitation due to its safe and non-invasive features.Particularly for stroke patients, this technique has become a new type of rehabilitation by virtue of its role in improving gait disorders, aphasia, dysphagia, and other complications. Previous research on stroke rehabilitation mainly focused on the cerebral cortex, while the recent evidences suggest that the cerebellum, with its rich synaptic plasticity and extensive structural and functional connectivity with the brain, has emerged as a promising target for non-invasive intervention in stroke rehabilitation. Non-invasive stimulation of the cerebellum is expected to improve patients' impaired function and quality of life. This review discusses the possible mechanisms and clinical applications of non-invasive cerebellar stimulation technology in regulating stroke rehabilitation, aiming to provide new treatment directions and application value for individualized stroke rehabilitation.

Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
Humans ; Consensus ; Endodontics/methods* ; Tooth ; Printing, Three-Dimensional ; Dental Care ; Cone-Beam Computed Tomography ; Root Canal Therapy

Background Indoor air pollution is an important risk factor affecting health of the respiratory system. Studies on indoor air pollution in China are mostly limited to the central and eastern regions, and there are few studies in the rural areas of northwest China. Objective To explore the influencing factors of lung ventilation function and its relationship with indoor air pollution in rural areas of Gansu Province based on a cross-sectional investigation. Methods A total of 399 subjects were selected from four villages in Baiyin and Yuzhong of Gansu Province. Questionnaires were used to collect demographic information, lifestyle, disease history, fuel use, and other information, and physical and functional tests were ordered such as height, weight, and lung function. The Indoor Air Pollution (IAP) exposure index was calculated based on smoking, fuel type, and weekly ventilation. IAP > 5 was defined as a high level of indoor air pollution. Lung function indexes included forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, forced vital capacity as a percentage of predicted value (FVC%), and forced expiratory volume in the first second as a percentage of predicted value (FEV1%), which were used to determine pulmonary ventilation dysfunction. Logistic regression model was used to evaluate the relationship between indoor air pollution and pulmonary ventilation function, and subgroup analysis was further conducted according to home address and BMI , in order to identify the high-risk population of pulmonary ventilation dysfunction. Results The mean age of the subjects was (56.75±7.31) years old; 155 subjects (38.85%) had normal pulmonary ventilation function, and the other 244 subjects (61.14%) had impaired pulmonary ventilation function; about 89.97% of the subjects were exposed to high level of indoor air pollution (IAP > 5). We found that IAP > 5 (OR=2.327, 95%CI: 1.089-4.974) and use of bituminous coal as the main heating fuel in winter (OR=3.467, 95%CI: 1.197-10.037) increased the risk of pulmonary ventilation dysfunction after adjusting for age, BMI, residence, gender, smoking, drinking, and cardiovascular disease. The subgroup analysis results showed that no ventilation in the living room/bedroom (OR=3.460, 95%CI: 1.116-10.268) increased the risk of pulmonary ventilation dysfunction in Baiyin. Heating with coal stoves and Chinese Kang in the bedroom (OR=2.092, 95%CI: 1.030-4.247) and cooking in the bedroom in winter ( OR =2.954, 95% CI : 1.046-8.344) also increased the risk of pulmonary ventilation dysfunction in the residents with BMI≤24 kg·m⁻². IAP > 5 (OR=3.739, 95%CI: 1.147-12.182) was associated with a significantly increased risk of pulmonary ventilation dysfunction in the BMI > 24 kg·m⁻² subgroup. Conclusion The pulmonary ventilation function of rural residents in Gansu is poor, which is negatively correlated with indoor air pollution. Coal use, overweight, cooking in bedroom, and use of coal stoves and Chinese Kang for heating may increase the risk of pulmonary ventilation dysfunction, while room ventilation is a beneficial factor.

Objective To evaluate the efficacy and safety ofGuipi Decoction vs. antidepressants for depression. Methods Articles about the randomized controlled trials (RCTs) ofGuipi Decoction for depression were searched in the databases of CNKI, VIP, Wanfang Data, CMB, Embase, PubMed, and Cochrane Library. Two researchers independently screened the articles, extracted the data, and evaluated the methodological quality. Meta-analyses were performed by using RevMan 5.2 software.Results A total of 9 RCTs articles involving 893 cases were included. Meta-analysis results suggested that as compared with antidepressants only,Guipi Decoction together with antidepressants was associated with a significantly greater reduction in HAMD scores (MD=-4.63, 95%CI [-5.95, -3.32];P<0.001). There was no significant difference in HAMD scores betweenGuipi Decoction used alone and antidepressants (MD=-0.30, 95%CI [-4.22, 3.62];P=0.88). As compared with antidepressants,Guipi Decoction together with antidepressants increased in the rates of total effective events (RR=1.26, 95%CI [1.14, 1.38];P<0.001). No serious adverse reactions were reported. Meta-analysis results suggested that the incidence of adverse reactions of Guipi Decoction(RR=0.48, 95%CI [0.40, 0.58];P<0.001) andGuipi Decoction together with antidepressants (RR=0.51, 95%CI [0.30, 0.85];P=0.010) were lower than that of antidepressants alone.Conclusion The present evidence suggests thatGuipi Decoction is effective and relatively safe for patients with depression. However, because the quality of included research was low, more large-scale RCTs with multicenter and high quality are needed for further verification.

Objective To investigate the role of endothelial progenitor cells ( EPCs ) transplantation in rats with sepsis induced by endotoxin ( lipopolysaccharides, LPS ). Methods Sixty clean grade Sprague-Dawley ( SD ) rats with genetic background were divided into three groups according to random number table method:control group, model group, and EPCs transplantation group, with 20 rats in each group. The sepsis model was reproduced by intravenous delivery of LPS 5 mg/kg. Rats in control group were injected with the same amount of normal saline. EPCs were isolated, and cultured and identified were fluorescently labeled with the green fluorescent protein ( GFP ) adenoviral transfection method. The EPC transplantation group was injected with LPS, then a fluorescently labeled EPCs suspension was injected via the tail vein 1 hour later. The expression of fluorescent markers of EPCs was detected with both small animal in vivo imaging instrument and frozen section. Seven days after transplantation, abdominal aorta blood was collected to determine interleukins ( IL-6 and IL-10 ) in peripheral blood with enzyme linked immunosorbent assay ( ELISA ), and the lung, liver, and kidney tissues were harvested, the wet/dry ratio of the lung ( W/D ) was calculated, and hematoxylin and eosin ( HE ) staining was performed to observe, the change in histopathology. Toll-like receptor 4 ( TLR4 ) mRNA expression in lung, liver, and kidney tissues was determined with real-time reverse transcription-polymerase chain reaction ( RT-PCR ). Results The positive rate of EPCs cells with double marking of CD133 and CD34 was 99.0% at the 5th generation of subculture by using flow cytometry. After the transplantation of EPCs labeled with the green fluorescent protein, the appearance of fluorescence indicated that EPCs were mainly localized in the chest, and a stronger fluorescence was observed near the blood vessels. EPCs transplantation could significantly reduce the inflammatory cell infiltration and cell damage in lung, liver, and kidney tissue in septic rats. Compared with control group, the expression of IL-6 and IL-10 in the peripheral blood, W/D ratio, and TLR4 mRNA in lung, liver, and kidney were increased significantly in the model group. Compared with model group, the expressions of IL-6 and IL-10 in the peripheral blood were significantly reduced after EPCs transplantation [ IL-6 (μg/L ):2.127±0.118 vs. 2.664±0.438, IL-10 ( ng/L ): 24.5±3.9 vs. 31.5±3.8, both P < 0.01 ]. EPCs transplantation reduced the W/D ratio of lung, liver and kidney tissues ( lung: 4.68±0.24 vs. 5.48±0.15, liver: 3.33±0.11 vs. 3.94±0.09, kidney: 4.08±0.20 vs. 4.84±0.21, all P < 0.05 ], and down-regulated the expression of TLR4 mRNA ( ×103, lung: 782±131 vs. 1 136±126, liver: 39.1±14.0 vs. 69.2±8.7, kidney: 52.2±15.2 vs. 83.5±17.1, all P < 0.01 ). Conclusions EPCs can enter the lung, liver and kidney tissues of the rat successfully after transplantation of EPCs via vein. EPCs transplantation can down-regulate pro-inflammatory process, help to recover the balance of pro-and anti-inflammatory processes, alleviate the damage to the lung, liver, and kidney tissue significantly.

Objective To explore the clinical regularity of drugs on epidemic encephalitis B with text mining technique. Methods The data set on epidemic encephalitis B was downloaded from CBM database. The regularities of Chinese herbal medicine, Chinese patent medicine (CPM), western medicine and the combination of CPM and western medicine on epidemic encephalitis B were mined by data slicing algorithm. The results are showed visually with Cytoscape 2.8 software. Results The main function of herbal pieces was focused on clearing heat and removing toxicity. The herbal pieces such as Rehmanniae Radix Isatidis Raxis, Isatids Folium, Paeoniae Radis rubra and Scutellariae Radix were most often used. Angong Niuhuang Wan and Qingkailing Injection were usually used as CPM. For western medicine, antiviral drugs such as interferon and ribavirin were often used, and they were often used together with brain cells nutrition medicine, hormone, immunopotentiator and so on, and they were also frequently used together with CPM such as Angong Niuhuang Wan and Qingkailing Injection. Conclusion Text mining approach provides an important method in exploring the medication regularity for diseas, and provide refenrence for clinical use.

Objective To explore the clinical significance of the changes of renal artery blood stream parameters in patients with essential hypertensive by color Doppler ultrasonography. Methods Ninety patients with essential hypertension were enrolled and divided into three groups (grade 1,2,3 ) according to their clinical blood pressure from May 2006 to July 2010 and each group included 30 cases. Thirty normal individuals were assigned to the control group. Color Doppler ultrasonography was used to determine the blood flow spectrum of bilateral main renal arteries, segmental arteries and interlobar arteries of kidneys. The parameters included Vmax, Vmin, Vmin/Vmax, resistance index (RI) were recorded and analyzed. Results In the control group, the Vmax,Vmin,Vmin/Vmax and RI in main renal arteries were (63.99 ± 7.68)cm/s, (23.86 ± 3.07) cm/s,0. 38 ± 0. 05 and 0. 62 ± 0. 05 ;in segmental arteries were ( 52. 93 ± 4. 24) cm/s, ( 20. 89 ± 2. 47 ) cm/s,0. 40 ±0. 04 and 0. 60 ±0. 04;in interlobar arteries were (35. 32 ±4. 22)cm/s, ( 15.07 ±2. 54) cm/s,0. 43 ±0. 04 and 0. 57 ± 0. 04. Compared to the control, only Vmin, Vmin/Vmax and RI in interlobar arteries were statistically changed in grade 1 hypertension group ( P ＜ 0. 05 ). While in grade 2 hypertension group, all the blood flow parameters except Vmax in main renal arteries statistically changed compared to the control group(P ＜ 0.05 ). In grade 3 hypertension group, all the blood flow parameters showed statistically differences when compared to control group (P ＜ 0. 05 ). The Vmax, Vmin, Vmin/Vmax decreased along with the blood pressure increased,however, the RI increased along with BP. Conclusion The renal artery blood stream parameters determined by color Doppler ultrasonography can provide important information to evaluate abnormal renal function in patients with hypertension.

Objective To determine the possible genetic background and the source of our hospital's 43 clinical isolates of multidrug-resistant Acinetobacter baumannii, and the category of gene cassettes in type 1 integrons of all strains.Methods Restriction enzyme Apa I was chosed for all strains in pulsed-field gel electrophoresis (PFGE) methods.Multilocus sequence typing ( MLST) was used to compare the allelic profiles of all the strains. PCR method was used for amplify the integrons of all strains. Results PFGE results showed that 43 strains were divided into four types. A-type and B-type were divided into 4 and 2 subtypes, respectively. The MLST results showed the existing of three allelic profiles; 1-3-3-2-2-7-3, 1-3-3-2-2-11-3, and 1-3-3-2-2-14-3.B-type and D-type of PFGE have the same allelic profile(1-3-3-2-2-11-3).A-type strains were detected mainly in ICU, and in burn unit only found B- and D-type.The same integron was detected in 62.8% of the strains.The constituent ratio of A1,A2,A3,A4,B1,B2,C and D-type was 40.7% , 18.5% , 7.4% , 3.7% , 14.8% , 3.7% , 3.7% and 7.4% , respectively.Conclusions The coexistence of multiple cloning system in this region was proved by the PFGE and MLST, and the same clone can evolve to different subtypes when stimulated by different environmental conditions; and the different carrying-situationt of the same integron in strains prove the possibility of the change during the evolution of resistance mechanisms.

Objective To detect the encoding gene of efflux pump and two-component system, and investigate the effect of efflux inhibition on the multiresistance of Acinetobacter baumarmii. Methods PCR was used to detect the adeB, adeR and aries gene. Agar dilution was used to determine the minimum inhibitory concentrations(MIC) of ciprofloxacin, cefotaxime, amikacin and imipenem of 50 multiresistance Acinetobacter baumannii, with or without 25 μg/ml reserpine. Results 94%, 96% and 92% of 50 muhiresistance of Acinetobacter baumannii were detected for adeB, adeR and aries gene,respectively. At least four fold decrease of MIC was observed in 49, 50, 50 and 46 isolates for ciprofioxacin, cefotaxime, amikacin and imipenem, respectively. Conclusion The multiresistance of Acinetobacter baumannii is related to the effect of the efflux system.