OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing modified radical mastectomy for breast cancer. METHODS: A total of 140 female patients scheduled for unilateral modified radical mastectomy for breast cancer undergoing general anesthesia were randomized into a TEAS group (70 cases) and a sham TEAS group (70 cases, 2 cases dropped out). Patients in both groups received TEAS or sham TEAS at bilateral Neiguan (PC6), Zusanli (ST36), and Danzhong (CV17), respectively, from 30 min before anesthesia induction until the end of surgery, and on 1st, 2nd, and 3rd days after surgery for 30 min a time, once a day. On 1st, 2nd, and 3rd days after surgery, the pain visual analogue scale (VAS) score was observed; on 3, 6, 12 months after surgery, the incidence rate of chronic pain was observed; before surgery, and on 1st, 3rd, and 7th days after surgery, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 were detected; the number of analgesia pump press, rescue analgesia, and the occurrence of adverse reaction after surgery were recorded in the two groups. RESULTS: In the TEAS group, the VAS scores on 1st and 2nd days after surgery, and the incidence rates of chronic pain on 3 and 6 months after surgery were lower than those in the sham TEAS group (P<0.05). On 1st, 3rd, and 7th days after surgery, the serum levels of TNF-α, IL-6, and IL-10 were increased compared with those before surgery in both groups (P<0.05, P<0.01); the above indexes in the TEAS group were lower than those in the sham TEAS group (P<0.05). The number of analgesia pump press and the incidence rate of rescue analgesia after surgery in the TEAS group were lower than those in the sham TEAS group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions after surgery between the two groups (P>0.05). CONCLUSION TEAS can effectively improve both the postoperative acute pain and chronic pain in patients undergoing modified radical mastectomy for breast cancer, the mechanism may relate to inhibiting the inflammatory reaction.
Humans ; Female ; Acupuncture Points ; Pain, Postoperative/blood* ; Middle Aged ; Breast Neoplasms/surgery* ; Adult ; Transcutaneous Electric Nerve Stimulation ; Mastectomy, Modified Radical/adverse effects* ; Interleukin-6/blood* ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-10/blood* ; Aged

Objective To analyze relevant literature on the essence of traditional Chinese medicine syndromes using bibliometric methods;To understand the current research status and hotspots in this field;To provide references for relevant research.Methods Research literature about the essence of TCM syndromes was retrieved from CNKI,VIP,Wanfang Data and CBM from 1st Jan.1979 to 30th June 2024.CiteSpace 6.2 software was used to conduct visualization analysis on authors,institutions,keywords,etc.Results A total of 695 articles were included,with an overall upward trend in publication volume followed by stabilization.The authors who published more articles included Luo Ren(13 articles),Zhao Xiaoshan(13 articles),Li Zegeng(12 articles),etc.The institutions with more publications included Shandong University of Traditional Chinese Medicine(35 articles),Beijing University of Chinese Medicine(33 articles),Chengdu University of Traditional Chinese Medicine(26 articles),etc.Institutions were clustered regionally,and cooperation was mostly between TCM universities and their affiliated hospitals,with less cross regional communication.High frequency keywords included kidney yang deficiency syndrome,metabolomics,animal models,TCM syndrome types,coronary heart disease,lung qi deficiency syndrome,spleen qi deficiency syndrome,liver depression and spleen deficiency syndrome,etc;Keyword clustering covered aspects such as biomolecules and metabolism,TCM syndromes,pathology,disease models,and animal research.Conclusion Research in the field of the essence of TCM syndromes is gradually receiving more attention.Exploring the essence of TCM syndromes at the molecular level through techniques such as genomics,transcriptomics,metabolomics and proteomics is a research hotspot and trend in this field.

Infectious pneumonia caused by bacteria,viruses,or other pathogenic microorganisms remains a huge threat to human health.Immunocyte-derived biomimetic nano-drug delivery systems can be used for drug delivery by taking advantage of the natural anti-inflammatory effect of immune cells and thus show great potential in lung-targeted therapy.This review begins by introducing different types of immune cells in the lung.The preparation methods of immunocyte-derived biomimetic nano-drug delivery systems and their applications in bacterial pneumonia,viral pneumonia,acute respiratory distress syndrome and cytokine storms are also reviewed.The review is expected to provide data for the targeted therapy of infectious pneumonia.

Objective To establish an efficient and stable model of pelvic inflammatory disease in rats via a non-surgical method,and to evaluate its application in pharmacodynamic testing.Methods Female Sprague-Dawley rats were divided randomly into the following groups:control group;model group with phenol for 7 d;model group with phenol for 10 d;treatment group modeled with phenol;model group with low concentration of bacteria;model group with high concentration of bacteria;and treatment group modeled with bacteria.Rats in the model and treatment groups were injected with 25%phenol gel and 2×107 or 2×108 Escherichia coli and Staphylococcus aureus mixture via a non-surgical method,to construct a rat model of pelvic inflammatory disease.Rats in the treatment groups received the Chinese patent medicine Jingangteng capsules by gavage,and rats in the control group received the same volume of solvent solution.The health status,weight changes,and uterine appearance were monitored and the uterine coefficient was calculated.Pathological changes in the uterus and fallopian tubes,endometrial thickness,and number of glands were detected by hematoxylin and eosin staining.Serum levels of interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-α were detected by enzyme-linked immunosorbent assay.Protein expression of the macrophage marker CD68 was detected by immunofluorescence.Expression of Toll-like receptor 4(TLR4)/nuclear factor(NF)-κB pathway-related proteins in the uterus was detected by Western blot.Results The mortality rate in the model group was only 5%.Compared with the control group,model rats showed decreased body weight,increased uterine coefficient,pathological changes in the uterus and Fallopian tubes,thinner endometrium,fewer glands,significantly higher serum levels of IL-1β,IL-6,and TNF-α and more macrophages in the uterine tissue,and activation of the TLR4/NF-κB signaling pathway.The 7 d phenol and low-concentration bacterial solution models were judged to be mild pelvic inflammatory disease models,and the 10 d phenol and high-concentration bacterial solution models were considered severe pelvic inflammatory disease models.Treatment with Jingangteng capsules relieved the pathological symptoms in the uterus and fallopian tubes,in line with the efficacy evaluation of clinical pelvic inflammatory disease.Conclusions We established rat models of pelvic inflammatory disease using phenol and a mixed bacterial solution via a non-surgical method,to simulate the different pathological states of pelvic inflammatory disease caused by different factors.These models will be suitable for evaluating drug efficacy and elucidating the pathological mechanism of pelvic inflammatory disease.

Objective:To investigate the influencing factors for gastroesophageal reflux disease (GERD) after laparoscopic Heller-Dor surgery for esophageal achalasia.Methods:The retrospective case-control study was conducted. The clinical data of 210 patients with esophageal achalasia who were admitted to Shanxi Provincial Cancer Hospital from January 2021 to December 2023 were collected. There were 119 males and 91 females, aged (47±12)years. All patients underwent laparoscopic Heller-Dor surgery. Observation indicators: (1) surgical situations; (2) follow-up; (3) influencing factors for GERD after laparoscopic Heller-Dor surgery; (4) development and evaluation of a predictive model for GERD after laparoscopic Heller-Dor surgery. Univariate and multivariate analyses were performed using stepwise Logistic regression. Results of multivariate analysis were used to construct a nomogram in predicting GERD. The predictive performance was assessed using the area under the receiver operating characteristic curve. The calibration curve was used to evaluate the accuracy of the model, and the decision curve was used to assess the overall net benefit of the model.Results:(1) Surgical situations. All 210 patients underwent laparoscopic Heller-Dor surgery. The operation time was (128±31)minutes, volume of intraoperative blood loss was (25±9)mL, and length of lower esophageal sphincter (LES) myotomy was (5±3)cm. The length of low esophageal myotomy >6 cm was performed in 49 patients, and length of gastric fundus myotomy >2 cm was performed in 58 patients. Intraoperative mucosal perforation occurred to 3 patients and was repaired intraoperatively. One patient required conversion to open surgery. Postoperative complications occurred in 18 patients. The duration of postoperative hospital stay was (4.3±2.4)days. (2) Follow-up. All 210 patients were followed up for 4(range,7-33)months after surgery. During follow-up, 32 pati-ents had GERD, including 17 cases presenting dysphagia and 25 cases presenting acid regurgitation and heartburn (the same patient may have two symptoms). There were 29 cases with body mass index (BMI) >28 kg/m2. Symptom severity scores of 210 patients showed heartburn of 0.6(range, 0-3.0), reflux of 0.7(range, 0-3.0), chest pain of 0.4(range, 0-2.0), cough and hoarseness of 0.5(range, 0-2.0), nausea and vomiting 0.3(range, 0-2.0), dysphagia 0.8(range, 0-3.0). The LES pressure was (15±8)mmHg (1 mmHg=0.133 kPa), LES relaxation rate was 81%±13.0%, and integrated relaxation pressure was (9±6)mmHg. Esophageal manometry classification showed type Ⅰ, Ⅱ, and Ⅲ in 0, 8, and 0 patients, respectively. There were 208 patients achieved symptom relief after drug or symptomatic treatment. Only two patients with severe symptoms were unresponsive to medication and subsequently underwent surgery at another hospital, with symptoms improving postoperatively. (3) Influen-cing factors for GERD after laparoscopic Heller-Dor surgery. Results of multivariate analysis showed that male, smoking history, length of lower esophageal myotomy >6 cm, and postoperative BMI >28 kg/m2 were independent risk factors for GERD after laparoscopic Heller-Dor surgery ( odds ratio=4.02, 6.34, 5.41, 7.38, 95% confidence interval as 1.50-10.78, 3.31-12.31, 1.77-13.47, 2.80-15.42, P<0.05). (4) Development and evaluation of a predictive model for GERD after laparoscopic Heller-Dor surgery. A predictive nomogram model for GERD was constructed based on the results of multivariate analysis. The receiver operating characteristic curve of predictive nomogram model for GERD had an area under curve of 0.91 (95% confidence interval as 0.82-0.97), demonstrating good discrimination. The calibration curve showed good agreement between predicted and observed probabilities, with a mean absolute error of 0.033. The decision curve demonstrated that within a threshold probability range of 0.2-0.8, the predictive model had greater net benefit than "treat-all" or "treat-none" strategies, indicating clinical utility of this model in clinical decision. Conclusions:Male, smoking history, length of lower esophageal myotomy >6 cm, and postoperative BMI >28 kg/m2 are independent risk factors for GERD after laparoscopic Heller-Dor surgery for esophageal achalasia. The predictive model for GERD after laparoscopic Heller-Dor surgery based on these factors shows strong predictive accuracy.

Background:Colorectal cancer(CRC)is a major cause of cancer death worldwide,and about 30%to 35%of CRC arises from the serrated pathway.Aims:To analyze the clinicopathological and histomorphological characteristics of colorectal superficially serrated adenoma(SuSA),and to investigate the malignant transformation potential of SuSA and further elucidate the role of RSPO2 and RSPO3 in its carcinogenic mechanism.Methods:A total of 169 serrated colorectal lesions confirmed pathologically and fulfilling the inclusion criteria were collected from Shanxi Bethune Hospital from February 2019 to May 2023.Among them,there were 84 cases of SuSA,23 sessile serrated lesions(SSL),32 traditional serrated adenomas(TSA),and 30 hyperplastic polyps(HP).Thirty-nine cases of tubular adenoma(TA),32 CRC,and 33 normal colorectal mucosal tissues were served as controls.The clinicopathological and histomorphological parameters were collected and recorded.Immunohistochemical staining was used to detect the protein expressions of RSPO2,RSPO3,p53,MLH1 and β-catenin.Results:Patients with SuSA were male predominance,with a mean age of 51.89 years.The average diameter of the lesions was 0.20 cm,predominantly located in the left colon and rectum,and frequently complicated with other polyps/adenomas.The histomorphological features of SuSA were as follows:the glandular necks and crypt bases exhibited straight tubular structure with low-grade dysplasia;the superficial layer demonstrated a serrated architecture,with or without dysplasia,and contained a variable number of goblet cells.Immunohistochemically,there were no statistically significant differences in RSPO2,RSPO3,and p53 expressions between SuSA and TSA(all P>0.05).A strong positive correlation was observed between RSPO2 and RSPO3 in colorectal lesions,excluding HP.Expressions of MLH1 and β-catenin showed no statistically significant differences between SuSA and other colorectal lesions(all P>0.05).Conclusions:SuSAs are more common in males,occur mostly in the left colon and rectum,and are often associated with other polyps/adenomas.They might be precursors of KRAS-mutated TSA and microsatellite stable CRC with high malignant potential.RSPO2 and RSPO3 might play an important role in the carcinogenesis of SuSA.

Objective To establish an efficient and stable model of pelvic inflammatory disease in rats via a non-surgical method,and to evaluate its application in pharmacodynamic testing.Methods Female Sprague-Dawley rats were divided randomly into the following groups:control group;model group with phenol for 7 d;model group with phenol for 10 d;treatment group modeled with phenol;model group with low concentration of bacteria;model group with high concentration of bacteria;and treatment group modeled with bacteria.Rats in the model and treatment groups were injected with 25%phenol gel and 2×107 or 2×108 Escherichia coli and Staphylococcus aureus mixture via a non-surgical method,to construct a rat model of pelvic inflammatory disease.Rats in the treatment groups received the Chinese patent medicine Jingangteng capsules by gavage,and rats in the control group received the same volume of solvent solution.The health status,weight changes,and uterine appearance were monitored and the uterine coefficient was calculated.Pathological changes in the uterus and fallopian tubes,endometrial thickness,and number of glands were detected by hematoxylin and eosin staining.Serum levels of interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-α were detected by enzyme-linked immunosorbent assay.Protein expression of the macrophage marker CD68 was detected by immunofluorescence.Expression of Toll-like receptor 4(TLR4)/nuclear factor(NF)-κB pathway-related proteins in the uterus was detected by Western blot.Results The mortality rate in the model group was only 5%.Compared with the control group,model rats showed decreased body weight,increased uterine coefficient,pathological changes in the uterus and Fallopian tubes,thinner endometrium,fewer glands,significantly higher serum levels of IL-1β,IL-6,and TNF-α and more macrophages in the uterine tissue,and activation of the TLR4/NF-κB signaling pathway.The 7 d phenol and low-concentration bacterial solution models were judged to be mild pelvic inflammatory disease models,and the 10 d phenol and high-concentration bacterial solution models were considered severe pelvic inflammatory disease models.Treatment with Jingangteng capsules relieved the pathological symptoms in the uterus and fallopian tubes,in line with the efficacy evaluation of clinical pelvic inflammatory disease.Conclusions We established rat models of pelvic inflammatory disease using phenol and a mixed bacterial solution via a non-surgical method,to simulate the different pathological states of pelvic inflammatory disease caused by different factors.These models will be suitable for evaluating drug efficacy and elucidating the pathological mechanism of pelvic inflammatory disease.

Objective:To investigate the influencing factors for gastroesophageal reflux disease (GERD) after laparoscopic Heller-Dor surgery for esophageal achalasia.Methods:The retrospective case-control study was conducted. The clinical data of 210 patients with esophageal achalasia who were admitted to Shanxi Provincial Cancer Hospital from January 2021 to December 2023 were collected. There were 119 males and 91 females, aged (47±12)years. All patients underwent laparoscopic Heller-Dor surgery. Observation indicators: (1) surgical situations; (2) follow-up; (3) influencing factors for GERD after laparoscopic Heller-Dor surgery; (4) development and evaluation of a predictive model for GERD after laparoscopic Heller-Dor surgery. Univariate and multivariate analyses were performed using stepwise Logistic regression. Results of multivariate analysis were used to construct a nomogram in predicting GERD. The predictive performance was assessed using the area under the receiver operating characteristic curve. The calibration curve was used to evaluate the accuracy of the model, and the decision curve was used to assess the overall net benefit of the model.Results:(1) Surgical situations. All 210 patients underwent laparoscopic Heller-Dor surgery. The operation time was (128±31)minutes, volume of intraoperative blood loss was (25±9)mL, and length of lower esophageal sphincter (LES) myotomy was (5±3)cm. The length of low esophageal myotomy >6 cm was performed in 49 patients, and length of gastric fundus myotomy >2 cm was performed in 58 patients. Intraoperative mucosal perforation occurred to 3 patients and was repaired intraoperatively. One patient required conversion to open surgery. Postoperative complications occurred in 18 patients. The duration of postoperative hospital stay was (4.3±2.4)days. (2) Follow-up. All 210 patients were followed up for 4(range,7-33)months after surgery. During follow-up, 32 pati-ents had GERD, including 17 cases presenting dysphagia and 25 cases presenting acid regurgitation and heartburn (the same patient may have two symptoms). There were 29 cases with body mass index (BMI) >28 kg/m2. Symptom severity scores of 210 patients showed heartburn of 0.6(range, 0-3.0), reflux of 0.7(range, 0-3.0), chest pain of 0.4(range, 0-2.0), cough and hoarseness of 0.5(range, 0-2.0), nausea and vomiting 0.3(range, 0-2.0), dysphagia 0.8(range, 0-3.0). The LES pressure was (15±8)mmHg (1 mmHg=0.133 kPa), LES relaxation rate was 81%±13.0%, and integrated relaxation pressure was (9±6)mmHg. Esophageal manometry classification showed type Ⅰ, Ⅱ, and Ⅲ in 0, 8, and 0 patients, respectively. There were 208 patients achieved symptom relief after drug or symptomatic treatment. Only two patients with severe symptoms were unresponsive to medication and subsequently underwent surgery at another hospital, with symptoms improving postoperatively. (3) Influen-cing factors for GERD after laparoscopic Heller-Dor surgery. Results of multivariate analysis showed that male, smoking history, length of lower esophageal myotomy >6 cm, and postoperative BMI >28 kg/m2 were independent risk factors for GERD after laparoscopic Heller-Dor surgery ( odds ratio=4.02, 6.34, 5.41, 7.38, 95% confidence interval as 1.50-10.78, 3.31-12.31, 1.77-13.47, 2.80-15.42, P<0.05). (4) Development and evaluation of a predictive model for GERD after laparoscopic Heller-Dor surgery. A predictive nomogram model for GERD was constructed based on the results of multivariate analysis. The receiver operating characteristic curve of predictive nomogram model for GERD had an area under curve of 0.91 (95% confidence interval as 0.82-0.97), demonstrating good discrimination. The calibration curve showed good agreement between predicted and observed probabilities, with a mean absolute error of 0.033. The decision curve demonstrated that within a threshold probability range of 0.2-0.8, the predictive model had greater net benefit than "treat-all" or "treat-none" strategies, indicating clinical utility of this model in clinical decision. Conclusions:Male, smoking history, length of lower esophageal myotomy >6 cm, and postoperative BMI >28 kg/m2 are independent risk factors for GERD after laparoscopic Heller-Dor surgery for esophageal achalasia. The predictive model for GERD after laparoscopic Heller-Dor surgery based on these factors shows strong predictive accuracy.

Background:Colorectal cancer(CRC)is a major cause of cancer death worldwide,and about 30%to 35%of CRC arises from the serrated pathway.Aims:To analyze the clinicopathological and histomorphological characteristics of colorectal superficially serrated adenoma(SuSA),and to investigate the malignant transformation potential of SuSA and further elucidate the role of RSPO2 and RSPO3 in its carcinogenic mechanism.Methods:A total of 169 serrated colorectal lesions confirmed pathologically and fulfilling the inclusion criteria were collected from Shanxi Bethune Hospital from February 2019 to May 2023.Among them,there were 84 cases of SuSA,23 sessile serrated lesions(SSL),32 traditional serrated adenomas(TSA),and 30 hyperplastic polyps(HP).Thirty-nine cases of tubular adenoma(TA),32 CRC,and 33 normal colorectal mucosal tissues were served as controls.The clinicopathological and histomorphological parameters were collected and recorded.Immunohistochemical staining was used to detect the protein expressions of RSPO2,RSPO3,p53,MLH1 and β-catenin.Results:Patients with SuSA were male predominance,with a mean age of 51.89 years.The average diameter of the lesions was 0.20 cm,predominantly located in the left colon and rectum,and frequently complicated with other polyps/adenomas.The histomorphological features of SuSA were as follows:the glandular necks and crypt bases exhibited straight tubular structure with low-grade dysplasia;the superficial layer demonstrated a serrated architecture,with or without dysplasia,and contained a variable number of goblet cells.Immunohistochemically,there were no statistically significant differences in RSPO2,RSPO3,and p53 expressions between SuSA and TSA(all P>0.05).A strong positive correlation was observed between RSPO2 and RSPO3 in colorectal lesions,excluding HP.Expressions of MLH1 and β-catenin showed no statistically significant differences between SuSA and other colorectal lesions(all P>0.05).Conclusions:SuSAs are more common in males,occur mostly in the left colon and rectum,and are often associated with other polyps/adenomas.They might be precursors of KRAS-mutated TSA and microsatellite stable CRC with high malignant potential.RSPO2 and RSPO3 might play an important role in the carcinogenesis of SuSA.

Objective To analyze relevant literature on the essence of traditional Chinese medicine syndromes using bibliometric methods;To understand the current research status and hotspots in this field;To provide references for relevant research.Methods Research literature about the essence of TCM syndromes was retrieved from CNKI,VIP,Wanfang Data and CBM from 1st Jan.1979 to 30th June 2024.CiteSpace 6.2 software was used to conduct visualization analysis on authors,institutions,keywords,etc.Results A total of 695 articles were included,with an overall upward trend in publication volume followed by stabilization.The authors who published more articles included Luo Ren(13 articles),Zhao Xiaoshan(13 articles),Li Zegeng(12 articles),etc.The institutions with more publications included Shandong University of Traditional Chinese Medicine(35 articles),Beijing University of Chinese Medicine(33 articles),Chengdu University of Traditional Chinese Medicine(26 articles),etc.Institutions were clustered regionally,and cooperation was mostly between TCM universities and their affiliated hospitals,with less cross regional communication.High frequency keywords included kidney yang deficiency syndrome,metabolomics,animal models,TCM syndrome types,coronary heart disease,lung qi deficiency syndrome,spleen qi deficiency syndrome,liver depression and spleen deficiency syndrome,etc;Keyword clustering covered aspects such as biomolecules and metabolism,TCM syndromes,pathology,disease models,and animal research.Conclusion Research in the field of the essence of TCM syndromes is gradually receiving more attention.Exploring the essence of TCM syndromes at the molecular level through techniques such as genomics,transcriptomics,metabolomics and proteomics is a research hotspot and trend in this field.