OBJECTIVE: To compare the clinical efficacy of acupuncture with Neiguan (PC6)-to-Waiguan (TE5) and esmolol on hemodynamics during anesthesia induction and postoperative nausea and vomiting. METHODS: A total of 100 patients undergoing elective laparoscopic hernia repair or gynecological surgery under general anesthesia were randomly divided into an acupuncture group (50 cases, 3 cases were eliminated) and an esmolol group (50 cases, 2 cases were eliminated). In the acupuncture group, before anesthesia induction, patients were applied to acupuncture with Neiguan (PC6)-to-Waiguan (TE5), and the needles were retained for 15 min on the right side and 30 min on the left side. Patients in the esmolol group were intravenously injected with 20 mg esmolol hydrochloride injection 5 min before anesthesia induction. The systolic blood pressure (SBP) and heart rate (HR) of the two groups were recorded at 5 min after entering the operating room (T₀), before anesthesia induction (T₁), after anesthesia induction (T₂), before tracheal intubation (T₃) and 1 min after tracheal intubation (T₄). The visual analogue scale (VAS) scores of pain and the incidence of nausea and vomiting in the two groups were observed at the time of entering postanesthesia care unit (PACU) (T₅), leaving PACU (T₆), 6 h after operation (T₇) and 24 h after operation (T₈). The dosage of anesthesia-related drugs in the two groups was counted. RESULTS: The SBP and HR of the two groups at T₂, T₃ and T₄ were lower than those at T₁ (P<0.05). SBP and HR at T₃ in the acupuncture group were higher than those in the esmolol group (P<0.05). Compared with the esmolol group, in the acupuncture group, the VAS scores of pain at T₆ and T₇ were decreased (P<0.05), the incidence of nausea and vomiting at T₇ and T₈ and the nausea and vomiting visual analogue scale (NVAS) scores were decreased (P<0.05). Compared with the esmolol group, the dosage of propofol in the acupuncture group was decreased (P<0.05). CONCLUSION Acupuncture with Neiguan (PC6)-to-Waiguan (TE5) can relieve hemodynamic fluctuations during anesthesia induction, reduce postoperative pain and nausea and vomiting, and reduce the dosage of propofol. The curative effect is better than that of esmolol.
Humans ; Female ; Adult ; Middle Aged ; Acupuncture Points ; Male ; Hemodynamics ; Propanolamines/administration & dosage* ; Postoperative Nausea and Vomiting/drug therapy* ; Young Adult ; Heart Rate ; Aged ; Blood Pressure ; Acupuncture Therapy

Objective:To explore the histopathological factors affecting the stiffness of papillary thyroid carcinoma (PTC).Methods:Ninety-six patients with PTC confirmed by surgery and pathology in Shanxi Bethune Hospital from January 2019 to December 2020 were selected, including 101 nodules. Two-dimensional ultrasound and shear-wave elastography (SWE) were performed before surgery and the average Young's modulus (Emean) of PTC nodules were measured. Histopathological examinations on the nodules were conducted after surgery to decide the lesion size, number of lesions, calcification type, presence or absence of capsular and extracapsular invasion, degree of fibrosis, microvessel density, and number of tumor cells. The correlations between the lesion size, degree of fibrosis, microvessel density, and number of tumor cells and the Emean were analyzed. The Emeans of nodules with different numbers of lesions, presence or absence of capsular and extracapsular invasion, and different pathological calcification types were compared. The multiple linear regression analysis was used to evaluate the histopathological factors influencing the Emean.Results:The ranges of the lesion sizes, degrees of fibrosis, microvascular density, numbers of tumor cells, and the Emeans of the 101 investigated PTC nodules were (1.29±0.95) cm, (30.64±18.37)%, (101.64±30.7) vessels per high power field, (373.52±149.87) cells per high power field, and (36.47±19.62) kPa, respectively. Correlation analysis showed that the lesion size of PTC and the degree of fibrosis were positively correlated with the Emean ( r=0.660, P＜0.001; r=0.789, P＜0.001), while the microvessel density was negatively correlated with the Emean ( r=-0.198, P=0.047). The Emean of the group with capsular and extracapsular invasion was higher than that of the group without ( P=0.014). There were statistical differences in the Emeans among different types of pathological calcification ( P＜0.001). The multiple linear regression analysis showed that the lesion size ( β=0.325, P＜0.001), degree of fibrosis ( β=0.563, P＜0.001), psammoma bodies ( β=0.177, P=0.001), stromal calcification ( β=0.164, P=0.003), and mixed calcification of both psammoma bodies and stroma ( β=0.163, P=0.003) were independent influencing factors for the Emean. The degree of fibrosis had the greatest impact on the Emean. Conclusions:The Emean of PTC lesions was correlated with the histopathological characteristics of PTC. The lesion size, degree of fibrosis, and calcification had significant impact on the Emean, among which the degree of fibrosis had the greatest impact.

Objective:To explore the histopathological factors affecting the stiffness of papillary thyroid carcinoma (PTC).Methods:Ninety-six patients with PTC confirmed by surgery and pathology in Shanxi Bethune Hospital from January 2019 to December 2020 were selected, including 101 nodules. Two-dimensional ultrasound and shear-wave elastography (SWE) were performed before surgery and the average Young's modulus (Emean) of PTC nodules were measured. Histopathological examinations on the nodules were conducted after surgery to decide the lesion size, number of lesions, calcification type, presence or absence of capsular and extracapsular invasion, degree of fibrosis, microvessel density, and number of tumor cells. The correlations between the lesion size, degree of fibrosis, microvessel density, and number of tumor cells and the Emean were analyzed. The Emeans of nodules with different numbers of lesions, presence or absence of capsular and extracapsular invasion, and different pathological calcification types were compared. The multiple linear regression analysis was used to evaluate the histopathological factors influencing the Emean.Results:The ranges of the lesion sizes, degrees of fibrosis, microvascular density, numbers of tumor cells, and the Emeans of the 101 investigated PTC nodules were (1.29±0.95) cm, (30.64±18.37)%, (101.64±30.7) vessels per high power field, (373.52±149.87) cells per high power field, and (36.47±19.62) kPa, respectively. Correlation analysis showed that the lesion size of PTC and the degree of fibrosis were positively correlated with the Emean ( r=0.660, P＜0.001; r=0.789, P＜0.001), while the microvessel density was negatively correlated with the Emean ( r=-0.198, P=0.047). The Emean of the group with capsular and extracapsular invasion was higher than that of the group without ( P=0.014). There were statistical differences in the Emeans among different types of pathological calcification ( P＜0.001). The multiple linear regression analysis showed that the lesion size ( β=0.325, P＜0.001), degree of fibrosis ( β=0.563, P＜0.001), psammoma bodies ( β=0.177, P=0.001), stromal calcification ( β=0.164, P=0.003), and mixed calcification of both psammoma bodies and stroma ( β=0.163, P=0.003) were independent influencing factors for the Emean. The degree of fibrosis had the greatest impact on the Emean. Conclusions:The Emean of PTC lesions was correlated with the histopathological characteristics of PTC. The lesion size, degree of fibrosis, and calcification had significant impact on the Emean, among which the degree of fibrosis had the greatest impact.

Objective To investigate the value of shear wave elastography(SWE)to early predict clinical efficacy of breast cancer neoadjuvant chemotherapy(NAC).Methods Fifty-three patients(55 lesions)with breast cancer who underwent NAC were enrolled in this study.SWE was performed at baseline and after the end of 2,4,6 cycles of NAC.According to the postoperative pathological results,the lesions were divided into major pathologic response group and minor pathologic response group.The maximum diameter of the lesions between the baseline and the end of the last cycle of the two groups were measured and the maximum diameter changes(ΔDmax)of the two groups were compared.The maximum elastic modulus(Emax)and the maximum elastic modulus changes(ΔEmax)of the two groups were measured and compared at baseline and after the end of 2,4,6 cycles of NAC.The ROC curves of ΔEmax at the end of 2 and 4 cycles were used to evaluate the predictive value of NAC response.Results The ΔDmax of the major pathologic response group[(64.82±21.06)%]was higher than that of the minor pathologic response group[(26.49±26.1 1)%,P <0.001].With the prolongation of NAC,the values of Emax were significantly decreased in the two groups,but the decreasing degrees were different.The Emax was significantly decreased at the end of 2 cycles in the major pathologic response group(P <0.05),however, at the end of 4 cycles in minor pathologic response group(P <0.05).The value of ΔEmax in the major pathologic response group was higher than that in the minor pathologic response group in every cycle significantly(all P <0.05).The ΔEmax threshold of the 2 cycles for predicting the NAC response was 26.1%(81.8% of sensitivity,75% of specificity),while the threshold of the 4 cycles was 35.5%(87.9%of sensitivity,83.3% of specificity),there was no significant difference between the areas under the two curves(P =0.264).Conclusions The value of ΔEmax in breast cancer lesions can predict the efficacy of NAC early.SWE can provide a valuable complement for two-dimensional ultrasound in the evaluation of NAC efficacy in breast cancer.

Objective: To study the clinicopathologic features, immunophenotype and differential diagnosis of atypical type A thymoma. Methods: Clinicopathologic and follow-up data of three cases of atypical type A thymoma from 2004 to 2016 were reviewed. Immunohistochemical staining was performed. Results: All three patients were male with average age of 59 years. Clinically, the lesions presented as anterior mediastinal masses. Grossly, the tumor ranged in size from 4 to 6 cm in greatest dimension and partially enclosed within fibrous capsule. The cut surface was homogenously fleshy, tan to brown in color, with multinodular and lobulated configurations. Cystic changes and necrosis were seen. Microscopically, the tumor was composed of plump spindle or oval-shaped cells arranged in storiform, microcystic, glandular, rosettes-like and hemangiopericytoma-like histological patterns. The tumor cells showed mild cytological atypia and mitotic activity ranged from 4 to 5/10HPF. Necrosis was present in all tumors. All tumors showed diffuse CK(AE1/AE3), CK19, p63 and vimentin expression. TdT, CK20, CD20, CD5 and CD117 were negative. The proliferative index, as measured with Ki-67, was 15.2% to 26.4%. None of the cases had recurrence or metastases during the follow-up period (9 to 27 months). Conclusions Atypical type A thymoma presents atypical features including tumor necrosis and increased mitotic activity. However, the implications of such atypical features to the biological behavior of the tumor remain to be determined.

Objective To observe the changes of the depressive behavior and amygdaloid nucleus nerve growth factor(NGF)expression in estro?gen?deprived female rats and explore the possible mechanism and targets of estradiol in depression treatment. Methods A total of 30 adult SD fe?male rats were randomly assigned to 3 groups:sham operation group(SHAM,n=10);ovariectomized group(OVX,n=10)and ovariectomized rats treated with estradiol group(OVX+E,n=10). The behavior changes were observed by tail suspension test(TST)and sucrose preference test (SPT) after 8?week estradiol treatment. Subsequently ,immunohistochemical staining detect NGF expression in amygdaloid nucleus. Results Compared with the SHAM group rats,sucrose preference ratio significantly decreased in SPT(P<0.01),immobile time prolonged in TST(P<0.01),serum estradiol level and amygdaloid NGF expression significantly decreased(all P<0.01). 8?week estradiol treatment ameliorated depres?sion?like behavior and increased serum E2 level and NGF expression in amygdaloid nucleus in OVX+E group rats when compared with the OVX group(all P<0.01). Conclusion Estradiol treatment can improve the depressive behavior of ovariectomized rats ,which may be related to the in?crease of serum estradiol level and the expression of NGF in amygdaloid nucleus.

Common mental health problems from the perspective of prevention among medical stu-dents were discussed in this activity which was learning from the concept and method of PBL. Participants had to find the solutions themselves by small-group discussion so as to improve their mental health. Results showed that most participants confirmed the innovation, interest and intellectuality of this activity. Moreover, students could not only learn knowledge related to mental health, but also improve their friendship as well as communication skills which were beneficial to medical students' mental health.

Objective This study aims to investigate the moral disgust cognitive processing of patients with obses?sive-compulsive disorder (OCD) and its relationship with OCD symptoms. Methods Twenty-eight OCD and 30 healthy controls matched for gender, age and education completed lexical decision task, recording reaction time and accuracy of words and assessing the degree of disgust. Yale-Brown obsessive-compulsive scale (Y-BOCS) and Padua Invento?ry-Washington State University Revision (PI-WUSR) were used to assess the symptoms. Results OCD group showed significantly longer reaction time to core disgust-related words [(762.69 ± 128.25) ms vs. (648.69 ± 162.66) ms] and moral disgust-related words [(798.73 ± 115.26) ms vs. (727.00 ± 106.06) ms] than the healthy controls (P<0.05). OCD group showed significantly higher aversion degree to core disgust-related words [(6.38 ± 1.78) vs. (5.03 ± 1.64)] and moral dis?gust-related words [(7.08 ± 1.23) vs. (5.77 ± 1.44)] than control group (P<0.05). Y-BOCS total score, Y-BOCS obsessive thoughts score, Y-BOCS compulsive behavior score, total score of PI-WUSR, cleaning/pollution force factor score, hurt?ing themselves and others force factor were positively correlated with two types of disgust-related words in patients group (P<0.05). Multiple stepwise regression analysis between disgust words and Y-BOCS/PI-WUSR scores pointed that only CWCF influenced disgust degree of core disgust-related words (β=0.61, P<0.01) and moral disgust-related words (β=0.54, P<0.01), respectively. Conclusion The core disgust and moral disgust of OCD are stronger compared to controls.

The fast transmission and large range of emergence of infectious diseases jeopardize human health, social and economic development, which is a great threat to global public health. World Health Organization for the new features of infectious diseases on theInternational Health Regulations was revised to help member countries improve the ability to respond to public emergencies. Our government promptly revised theCommunicable Disease Prevention Act, enacted a series of laws and strategies to promote the establishment of infectious disease surveillance and response systems. Chinese medicine was included in the country infectious disease prevention and control system. After nearly 10 years of development, the prevention and treatment of Chinese medicine on emergence of infectious diseases, the clinical medicine and research capacity of respond infectious diseases has been significantly improved, and become an important part of our system of infectious disease prevention and control.

The widespread application of traditional medicine has attracted increasing attention. To promote the security of traditional medicine, WHO has established a series of global policies and strategies with consistency since 1960s. It also formulated guidelines for harvesting, production and operation, and quality control of botanical medicine according to the development of traditional medicine in different times. Thanks to the technical support of WHO, member states have established technical regulations for traditional medicine according to their own situations, and made significant achievements in the promotion of traditional Chinese security.