OBJECTIVE:Most of the existing studies are based on traditional Meta-analysis to study the efficacy of single stimulation protocols such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor dysfunction in stroke patients,and it is not possible to clarify which stimulation protocol is the optimal choice.This study used network meta-analysis to systematically evaluate the clinical efficacy of different regimens of non-invasive brain stimulation in the treatment of lower limb motor dysfunction after stroke.METHODS:CNKI,WanFang,VIP,CBM,PubMed,Medline and Web of Science databases were searched to collect randomized controlled trials on different regimens of non-invasive brain stimulation for lower limb motor dysfunction after stroke from inception to October 1,2024.Data extraction was performed on the included studies.RevMan 5.4.1 software was used for traditional meta-analysis and the quality of the included studies was evaluated.Stata 17.0 software was used for network meta-analysis.RESULTS:(1)A total of 39 studies involving 2 920 patients were included,involving 6 treatment methods:conventional rehabilitation training,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,continuous theta burst stimulation,and transcranial direct current stimulation.(2)The results of network meta-analysis showed that high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,and transcranial direct current stimulation were superior to conventional rehabilitation training in the Fugl-Meyer assessment for lower extremity motor function.(3)In terms of improving Berg balance scale score,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,and intermittent theta burst stimulation were significantly different from conventional rehabilitation training(P＜0.05),and there was a significant difference between high-frequency repetitive transcranial magnetic stimulation and intermittent theta burst stimulation(P＜0.05).(4)In improving modified Barthel index and Barthel index,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,and transcranial direct current stimulation were superior to conventional rehabilitation training.(5)Under the cumulative ranking chart,high-frequency repetitive transcranial magnetic stimulation showed the best efficacy in Fugl-Meyer assessment for lower extremity motor function,Berg balance scale score,modified Barthel index and Barthel index,followed by low-frequency repetitive transcranial magnetic stimulation.CONCLUSION:Both high-and low-frequency repetitive transcranial magnetic stimulation can improve the lower limb motor function and balance function of patients with stroke,and can improve the activities of daily living of patients to varying degrees.Moreover,the effect of high-frequency repetitive transcranial magnetic stimulation is better than that of low-frequency repetitive transcranial magnetic stimulation.

OBJECTIVE:Most of the existing studies are based on traditional Meta-analysis to study the efficacy of single stimulation protocols such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor dysfunction in stroke patients,and it is not possible to clarify which stimulation protocol is the optimal choice.This study used network meta-analysis to systematically evaluate the clinical efficacy of different regimens of non-invasive brain stimulation in the treatment of lower limb motor dysfunction after stroke.METHODS:CNKI,WanFang,VIP,CBM,PubMed,Medline and Web of Science databases were searched to collect randomized controlled trials on different regimens of non-invasive brain stimulation for lower limb motor dysfunction after stroke from inception to October 1,2024.Data extraction was performed on the included studies.RevMan 5.4.1 software was used for traditional meta-analysis and the quality of the included studies was evaluated.Stata 17.0 software was used for network meta-analysis.RESULTS:(1)A total of 39 studies involving 2 920 patients were included,involving 6 treatment methods:conventional rehabilitation training,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,continuous theta burst stimulation,and transcranial direct current stimulation.(2)The results of network meta-analysis showed that high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,and transcranial direct current stimulation were superior to conventional rehabilitation training in the Fugl-Meyer assessment for lower extremity motor function.(3)In terms of improving Berg balance scale score,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,and intermittent theta burst stimulation were significantly different from conventional rehabilitation training(P＜0.05),and there was a significant difference between high-frequency repetitive transcranial magnetic stimulation and intermittent theta burst stimulation(P＜0.05).(4)In improving modified Barthel index and Barthel index,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,and transcranial direct current stimulation were superior to conventional rehabilitation training.(5)Under the cumulative ranking chart,high-frequency repetitive transcranial magnetic stimulation showed the best efficacy in Fugl-Meyer assessment for lower extremity motor function,Berg balance scale score,modified Barthel index and Barthel index,followed by low-frequency repetitive transcranial magnetic stimulation.CONCLUSION:Both high-and low-frequency repetitive transcranial magnetic stimulation can improve the lower limb motor function and balance function of patients with stroke,and can improve the activities of daily living of patients to varying degrees.Moreover,the effect of high-frequency repetitive transcranial magnetic stimulation is better than that of low-frequency repetitive transcranial magnetic stimulation.

Objective:To offset the shortage of traditional large-scale population surveillance and provide early-warning signals in the early stage of the outbreak of COVID-19, people in Chongqing had carried out severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monitoring since 2023.Methods:After COVID-19 was managed with measures against Class B infectious diseases, we selected five sewage treatment plants with automatic sample collection facilities in four districts of the main city. Two samples of sewage from each sewage treatment plant were collected every week. Then SARS-CoV-2 from these samples was concentrated by aluminum hydroxide adsorption-precipitation, detected and analyzed by multiple real-time fluorescent RT-PCR.Results:From January 16 to December 31 of 2023, a total of 496 sewage samples were monitored, of which 285 samples were positive by SARS-CoV-2 nucleic acid assay, with a total detection rate of 57.46%. The detection rate of SARS-CoV-2 in weeks 3-5, 18-21 and 40-47 was 100.00%. The daily mean nucleic acid concentration of SARS-CoV-2 in sewage peaked in the 18th week, and then began to decline, entering a low level and fluctuated in epidemic period. The variable trend of daily mean concentration of SARS-CoV-2 nucleic acid was basically consistent with daily number of SARS-CoV-2 infected patients or SARS-CoV-2 positive rate in fever clinic counted by infectious disease monitoring system.Conclusions:The detection rate of SARS-CoV-2 in sewage of Chongqing is relatively high, especially in April to May, and sewage monitoring can indirectly reflect the status of COVID-19 infection.

Objective: To investigate the effect of warm acupuncture combined with Western medicine on cardiac function in patients with CHF. Methods: A total of 120 patients with CHF who met the inclusion criteria were randomly divided into two groups, 60 in each group. The control group was treated with conventional medicine, and the Chinese and western medicine group was combined with warm acupuncture on the basis of the control group. Both groups were treated for 4 weeks. The 6 min walking distance were compared. The LVEF%, LVEDd, and LVESd were measured by color Doppler ultrasound. The Plasma NT-proBNP was detected by ELISA. Results: The total effective rate was 95.0% (57/60) in the Chinese and western medicine group and 90.0% (54/60) in the Western medicine group. The difference was statistically significant (Z=-2.218, P=0.027). After treatment, the LVEF% level of the Chinese and western medicine group (49.5% ± 4.7% vs. 47.0% ± 4.5 %, t=2.976), 6 min walking distance (348.9 ± 38.1 m vs. 319.7 ± 35.0 m, t= 5.107) were significantly higher than those of the Western medicine group (P<0.01); and the LVEDd (47.3 ± 4.0 mm vs. 50.0 ± 4.6 mm, t=-3.431), LVESd (38.5 ± 3.5 mm vs. 40.8 ± 3.9 mm, t=-3.400), NT-proBNP (750.2 ± 158.5 ng/L vs. 900.4 ± 183.7 ng/L, t=4.960) were significantly lower than those of the western medicine group (P<0.01). Conclusions Warm acupuncture combined with Western medicine can improve the heart function of CHF patients.

ObjectiveTo summarize point Shenmai(BL62)indications and the characteristics of acupuncture and moxibustion by sorting out literature on point Shenmaiin ancient literature.MethodShenmai, Yangqiao and Guilu were used as search words to search Chinese Medical Classics to sift out items on indications for point Shenmai and its combination and the characteristics of point combination and acupuncture and moxibustion and establish the relevant database. Statistical analysis was made using the SPSS19.0 software.ResultTwo hundred and eighty-seven items on point Shenmai and 274 items on the indications met the inclusion criteria. There were 47 indications for the single acupoint and 19 kinds of diseases on which the single acupoint had a marked therapeutic effect. Lumbago, ophthalmalgia, vertigo, headache and mania were ranked in the top five. There were 64 indications for its combination and 22 kinds of diseases on which its combination had a marked therapeutic effect. Epilepsy, Lumbago, stroke, podalgia and headache were ranked in the top five. The commonly used depth of needle insertion was 3 fen, acupuncture time was 6-7 respiratory cycles and stimulation intensity of moxibustion was 3 moxa cones.ConclusionSingle point Shenmai and its combination are both good at treating internal medicaldiseases and especially meridian diseases in the limb. Acupuncture and moxibustion are the commonly used methods.

Science of Meridians and Acupoints is the bridge between basic medicine and clinical medicine of acupuncture and moxibustion. This teaching practice was conducted in reference to the teaching mode of problembased learning (PBL), in association with the clinical design problems, by taking as the students as the role and guided by teachers. In order to stimulate students' active learning enthusiasm, the writers implemented the class teaching in views of the typical questions of clinical design, presentation of study group, emphasis on drawing meridian running courses and acupoint locations, summarization and analysis, as well as comprehensive evaluation so that the comprehensive innovative ability of students and the teaching quality could be improved.
Acupuncture ; education ; Acupuncture Points ; Humans ; Meridians ; Problem-Based Learning ; Science ; education ; Teaching

BACKGROUND:Previous studies have shown that kainic acid injected into hippocampus can significantly upregulate the expression of excitatory KA1 subunit of the kainate receptor in the hippocampus, and endoplasmic reticulum stress markers, phosphorylation of the alpha subunit of eukaryotic initiation factor 2, accompanied by celldeath. OBJECTIVE:To explore the mechanism of endoplasmic reticulum stress after kainic acid is injected into the hippocampus.METHODS:0.15 nmol kainic acid was injected into the hippocampal CA1 region of 32 adult male Kunming mice, the injection time was 60 seconds. At different time points (1, 2, 3, 4, 5, 6, 8 and 12 hours) after kainic acid was injected, the Bederson score analysis was performed, and then the brain was harvested after cerebral perfusion. FJB staining of brain sections and immunofluorescence double labeled observation were also performed. RESULTS AND CONCLUSION:(1) At 3, 4, 5, 6, 8 hours after kainic acid injection, Bederson score showed severe injury of central nervous system function, and FJB staining showed the increased of celldeath in the hippocampus (P<0.05);At 1, 2, 12 hours after injection, Bederson score showed no obvious injury of central nervous system function, and FJB staining showed unobvious celldeath in the hippocampus (P>0.05). (2) According to the results of FJB staining, the brain sections were selected at 3, 8 hours for immunohistochemistry. The expressionlevels of KA1 receptors and endoplasmic reticulum stress marker P-eIF2αwere up-regulated at the same time after kainic acid was injected into hippocampus. Two single-staining KA1 and P-eIF2αimmunofluorescence images were synthesized into one over-lapped double-stained image, and two images overlapped, indicating that the up-regulated expression of KA1 and endoplasmic reticulum stress occurred in the same nerve cells. Kainic acid first up-regulated the excitatory receptor KA1 expression, which may cause cellendoplasmic reticulum dysfunction and result in the endoplasmic reticulum stress response, further promoting neuronal celldeath.