OBJECTIVE: To investigate the effects of Huayu Tongluo (transforming stasis and unblocking collaterals) moxibustion on cognitive function and insulin resistance in patients with type 2 diabetes mellitus (T2DM) and cognitive decline. METHODS: Ninety patients with T2DM and cognitive decline were randomly divided into a moxibustion group (n=45, 3 cases dropped out, 2 cases were eliminated) and a waiting moxibustion group (n=45, 2 cases dropped out). Both groups received routine hypoglycemic treatment for 12 weeks. The moxibustion group additionally received Huayu Tongluo moxibustion at Baihui (GV20), Shenting (GV24), and Dazhui (GV14). Pressing moxibustion was applied to Baihui (GV20) for 20 min, while suspended moxibustion was applied to Shenting (GV24) and Dazhui (GV14) for 20 min each. Treatments of moxibustion were administered every other day (three times per week) for 12 weeks. All patients were followed up for 12 weeks, during which their original hypoglycemic medication regimen was maintained. Before treatment, after 12 weeks of treatment, and at the 12-week follow-up, the scores of Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), Addenbrooke's cognitive examination Ⅲ (ACE-Ⅲ), symbol digit modalities test (SDMT), and Athens insomnia scale (AIS) and the insulin resistance index (HOMA-IR) were observed in the two groups. RESULTS: Compared with before treatment, the MoCA scores, MMSE scores, ACE-Ⅲ subscale scores (attention, memory, language fluency, language, visuospatial ability) and total scores, and SDMT scores were increased (P<0.01), while the AIS scores were decreased (P<0.05) in the moxibustion group after treatment and at follow-up. Compared with before treatment, the MMSE score, ACE-Ⅲ subscale scores (memory, attention) and total score after treatment, as well as the ACE-Ⅲ subscale scores (language, memory, attention) and total score, and SDMT score at follow-up were increased (P<0.05, P<0.01) in the waiting moxibustion group. Compared with before treatment, HOMA-IR was decreased in both groups after treatment and at follow-up (P<0.01). At follow-up, ACE-Ⅲ subscale scores (attention, memory), and the total score in the moxibustion group were lower than those after treatment (P<0.05, P<0.01), and the ACE-Ⅲ language subscale score, total ACE-Ⅲ score, and SDMT score in the waiting moxibustion group were higher than those after treatment (P<0.01, P<0.05). After treatment and at follow-up, compared with the waiting moxibustion group, the moxibustion group had higher MoCA scores, MMSE scores, SDMT scores, ACE-Ⅲ subscale scores (attention, memory, language fluency) and total scores (P<0.05, P<0.01), and lower HOMA-IR (P<0.05). CONCLUSION Huayu Tongluo moxibustion can effectively improve cognitive function in patients with T2DM and cognitive decline. This improvement may be associated with the reduction in insulin resistance.
Humans ; Insulin Resistance ; Diabetes Mellitus, Type 2/complications* ; Male ; Female ; Moxibustion ; Middle Aged ; Aged ; Cognition ; Acupuncture Points ; Adult ; Cognitive Dysfunction/therapy*

Objective To explore the influencing factors for delayed resuscitation from anaesthesia in patients undergoing pancreatic cancer surgery and to develop a prediction model and evaluate its predictive performance.Methods This study included 300 patients who had surgery under general anaesthesia for pancreatic cancer at a Tier-IIIA hospital in Jiangsu Province between September 2023 and February 2024.The patients who had the surgery between September and December 2023(n=208)were assigned to the modelling group,and those between January to February 2024(n=92)to the validation group.Baseline perioperative data were recorded.Binary logistic regression was used to identify risk factors for delayed resuscitation,and a risk prediction model was finally developed and validated.Results Over 60 years of age,bispectral index(BIS)monitoring,combined with regional block anaesthesia,and rescue analgesia were identified as the risk factors for delayed resuscitation(all P<0.05).The Hosmer-Lemeshow test confirmed a good model fit(P>0.05).The C-index value was 0.807 for the modelling group and 0.841 for the validation group.The area under the curve(AUC)of receiver operating characteristic(ROC)was 0.807(95%CI 0.738～0.876)for the modelling group and 0.841(95%CI 0.742～0.940)for the validation group,with both calibration curves close to the ideal curve.Conclusion The developed prediction model for delayed resuscitation exhibits a good predictive performance and it can serve as a reference for clinical staff.

Objective:To observe any therapeutic effect of kinesio taping the orbicularis oris and cervical swallowing muscle groups on drooling among children with cerebral palsy (CP).Methods:Fifty-two children with CP salivating excessively were divided at random into a control group and an experimental group, each of 26. Both groups received routine oral and facial exercise training and sensory stimulation, but the experimental group was additionally provided with kinesio taping of the orbicularis oris muscle and related neck muscle groups. The taping was applied twice a week for 12 hours each time, continuing for 6 months. Before and after the treatment, both groups′ drooling and language use were evaluated using the teacher drooling grading method (TDS) and a language developmental delay assessment (S-S), respectively. Kendall rank correlation coefficients were computed to compare the treatment efficacy for children with the same TDS grading, cerebral palsy classification, and S-S segmentation.Results:After the treatment the average TDS scores of both groups had decreased significantly. The average TDS score of the experimental group was then significantly lower than that of the control group. The total effectiveness rate for those in the experimental group with TDS grades II or V was significantly higher than those controls with the same TDS grades, the effectiveness rate for those with spastic and mixed type or language function in stage 4-2 and stage 5-2 in the experiment group was also significantly higher than for those of the control group. According to the correlation analysis, the language function of both groups was significantly correlated with the therapeutic effect.Conclusions:Supplementing routine rehabilitation training with kinesio taping of the orbicularis oris muscle and the cervical swallowing muscle group can significantly relieve CP children′s excessive salivation. Their language use is significantly positively correlated with the effectiveness of such combined treatment.

Objective:To investigate the effect of Omaha system interventional management on therapeutic effect and incidence of major adverse cardiovascular events(MACE)during follow-up in patients with heart failure(HF).Methods:This randomized controlled study enrolled 110 HF patients treated in Second Affiliated Hospital of Chi-nese PLA Air Force Military Medical University between January 2021 and January 2023.They were divided into control group(n=55,routine nursing)and intervention group(n=55,interventional management based on Omaha system).Both groups received intervention for 1 month and were followed up for 6 months.The heart function,negative emotion,self-care capacity,quality of life,and cumulative incidence of MACE during the 6-month fol-low-up were compared between two groups.Results:Compared with patients in the control group,those in the in-tervention group had significant higher left ventricular ejection fraction(LVEF)[(60.32±4.79)％vs.(50.11±4.58)％],scores of exercise of self-care agency(ESCA)[(142.33±6.58)points vs.(89.26±7.19)points]and General Quality of Life Inventory 74(GQOLI-74)[(88.61±4.15)points vs.(70.59±7.85)points](P＜0.001 all),and significant lower left atrial diameter(LAD)[(36.18±2.98)mm vs.(40.25±3.05)mm],left ventricu-lar end-systolic diameter(LVESd)[(42.11±3.46)mm vs.(48.49±3.78)mm],scores of hospital anxiety and depression scale[HADS(A)][(10.05±2.11)points vs.(14.33±2.05)points]and HADS(D)[(9.15±1.31)points vs.(13.37±2.18)points](P＜0.001 all).The incidence rate of MACE in intervention group(9.09％vs.29.09％)was significantly lower than that of control group(P=0.004).Conclusion:Omaha system interventional management could significantly improve cardiac function and negative emotions,improve self-care capacity and quality of life,and reduce the incidence of MACE during follow-up in patients with heart failure.

Percutaneous renal denervation(RDN)is a minimally invasive interventional treatment for hypertension that has been used in clinics at home and abroad,primarily for patients with resistant hypertension or who cannot tolerate antihypertensive drugs.Current clinical studies have confirmed the safety and efficacy of this technique.As RDN is still in its promotional and popularization stage,the expert group has written this clinical pathway to promote the orderly implementation of this technology,standardize the operating process,and standardize diagnostic and therapeutic behaviors.The pathway describes the clinical assessment of patients in detail(including indications,contraindications,and the patient screening process),the standardized operating process for RDN(including perioperative medication,anaesthesia,ablation,and management of complications),and the postoperative follow-up plan(including follow-up content,methods,and timing).It is hoped that this will serve as a reference for physicians involved in RDN clinical work,standardize diagnostic and therapeutic behaviors,and promote the standardized,precise,and sustainable development of the RDN discipline.

Aim To study the therapeutic effect of al-licin on senna-induced diarrhea in mice and to explore the underlying mechanism.Methods Forty-eight C57BL/6J mice were randomly divided into six groups:control,model,loperamide positive control group(2 mg·kg-1),allicin low-dose group(6 mg·kg-1),allicin medium-dose group(12 mg·kg-1)and allicin high-dose group(18 mg·kg-1).Except for the con-trol group,the diarrhea model was induced in the other groups by intragastric administration of senna leaf ex-tract.After drug administration,several diarrhea indi-ces were measured:the rate of loose stools,diarrhea index,accumulated frequency of loose stools at differ-ent time points within 5 hours,and small intestine pro-pelling rate.Serum levels of TNF-α and IL-6 were de-tected by ELISA.Serum NO content was determined u-sing the Griess method.The activities of SOD and CAT,as well as MDA content in the ileum and colon,were measured.The pathological changes and the ex-pression of mRNA related to intestinal barrier proteins in the ileum and colon were evaluated using HE stai-ning and RT-qPCR.Results Allicin improved diar-rhea symptoms in mice induced by senna leaf.It re-duced the rate of loose stools,diarrhea index,cumula-tive number of loose stools in five hours,and the intes-tinal propulsion rate.Allicin also protected the intesti-nal mucosa,decreased serum TNF-α and IL-6 levels,and lowered MDA content in the intestines.It in-creased serum NO levels and enhanced SOD and CAT activities in the intestines.Additionally,allicin upreg-ulated the mRNA expression of AQP1,AQP4,and ZO-1 in intestinal tissues.Conclusions Allicin has a significant therapeutic effect on senna-induced diarrhea in mice.The underlying molecular mechanisms may involve anti-inflammatory and antioxidant effects,in-creased NO content,and upregulation of mRNA ex-pression of aquaporins and tight-junction proteins.

Breast cancer is the leading cause of cancer-related mortality among women worldwide and has drawn extensive research attention.Owing to its molecular heterogeneity,drug resistance,and low therapeutic response,single-modality treatments often fail to achieve satisfactory efficacy or broad applicability.Combination therapy,designed based on the pathophysiological characteristics,related signaling pathways,and biomarkers of breast cancer,has emerged as a promising approach for improving therapeutic outcomes.With the advancement of research on combination strategies,the understanding of their molecular mechanisms—particularly key signaling pathways and biomarkers—has become increasingly important.However,comprehensive reviews addressing these molecular mechanisms and synergistic strategies remain scarce.This article summarizes recent advances in combination therapy for breast cancer,providing a comprehensive review of recent combination therapies for breast cancer and their underlying molecular mechanisms,and focusing on key signaling pathways involved in combination therapy and synergistic strategies,thereby providing theoretical insights and reference for researchers,graduate students,and clinicians engaged in the development of novel combination therapeutic strategies for breast cancer and related malignancies.

Objective To investigate the changes in oral microbiota of db/db mice and provide an experimental basis for exploring the relationship between type 2 diabetes mellitus and oral microecology.Methods Eight 10-week-old male db/db mice were designated as the diabetes experimental group(db/db group),while eight 10-week-old male db/m mice were assigned as the normal control group(db/m group).After a 5-day adaptive feeding period,tail venous blood samples were collected on the 6th and 37th days,and fasting blood glucose(FBG)levels and oral glucose tolerance test(OGTT)were performed for both groups to verify the reliability of the diabetes model.On the 15th day of feeding with the same diet,oral microbiota samples were collected from the buccal mucosa,dorsal and ventral tongue surfaces,oral floor mucosa,hard palate mucosa,and the gingival areas of both the upper and lower jaws of the two groups.Genomic DNA from the oral microbiota was extracted,and the V3-V4 regions of the 16S ribosomal RNA(16S rRNA)gene were amplified using a GeneAmp 9700 thermocycler.The composition of the oral microbiota was evaluated through double-labelled amplification and sequencing on the Illumina MiSeq platform,followed by bioinformatics analysis using QI I ME software(version 1.6.0).Results The FBG levels and OGTT results on the 6th and 37th days after the start of the experiment indicated that db/db mice exhibited more pronounced symptoms of type 2 diabetes compared to db/m mice.Alpha diversity(αdiversity)analysis showed no significant difference in the diversity of oral microbiota between the two groups(P＞0.05);however,there was a significant difference in richness(P＜0.05).Principal coordinate analysis(PCoA)revealed differences in the oral microbiota composition between the db/db group and db/m group(P＜0.05).Species composition analysis and LEfSe analysis demonstrated that the relative abundance of oral microbiota in db/db group mice,predominantly composed of p_Proteobacteria,increased significantly at the phylum level(P＜0.05).At the genus level,the relative abundances of g_Proteus and g_Enterococcus showed a significant increase(P＜0.001).Conclusion The composition and diversity of oral microbiota in db/db mice with type 2 diabetes mellitus significantly differed from those without the disease.

Objective:To investigate the effects of ultrasound-guided intermuscular brachial plexus anesthesia on shoulder arthroscopic surgery.Methods:A total of 300 patients who underwent shoulder arthroscopic surgery at Dongyang Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were prospectively included in this study. A randomized controlled trial design was used. The patients were divided into an observation group ( n = 150) and a control group ( n = 150) using a random number table method. The control group received intravenous general anesthesia, while the observation group underwent intermuscular brachial plexus nerve block combined with intravenous general anesthesia. The clinical efficacy, surgical indicators, hemodynamic levels, and incidence of adverse reactions were compared between the two groups. Results:The Visual Analog Scale (VAS) scores and the muscle strength scores for elbow and wrist flexion in the observation group at 2 and 3 h postoperatively were (4.12 ± 0.21), (2.32 ± 0.62), (3.35 ± 0.61), and (4.19 ± 0.57), respectively. There values were significantly superior to those in the control group [(6.54 ± 0.32), (1.21 ± 0.23), (4.62 ± 0.21), (3.25 ± 0.63), t = 77.44, 20.56, -24.11, 13.55, all P < 0.01]. The intraoperative lavage fluid volume, remifentanil dosage, propofol dosage, and duration of surgery in the observation group were (6.32 ± 2.11) L, (0.13 ± 0.03) μg·kg?1·min?1, (0.11 ± 0.03) mg·kg?1·h?1, and (73.23 ± 15.86) min, respectively, all of which were significantly lower than those in the control group [(8.52 ± 3.23) L, (0.15 ± 0.02) μg·kg?1·min?1, (0.15 ± 0.02) mg·kg?1·h?1, and (79.88 ± 15.56) min, t = 6.98, -6.79, -13.59, -3.67, all P < 0.01]. The clarity of the surgical field in the observation group was rated at (1.02 ± 0.21) points, which was significantly higher than that in the control group [(1.75 ± 0.32) points, t = -23.36, P < 0.01]. At the start of surgery (T1) and 30 min into the procedure (T2), the systolic blood pressures in the observation group were (106.65 ± 7.12) mmHg (1 mmHg = 0.133 kPa) and (97.02 ± 5.01) mmHg, which were significantly lower than those in the control group [(108.69 ± 7.21) mmHg, (98.26 ± 5.12) mmHg, t = -2.47, -2.12, both P < 0.05]. The heart rates in the observation group at T1, T2, 60 min into the procedure (T3), and 10 min post-extubation (T4) were (71.69 ± 5.32) beats/min, (62.32 ± 4.85) beats/min, (61.12 ± 4.25) beats/min, and (79.28 ± 3.52) beats/min, all of which were significantly lower than those in the control group [(91.23 ± 5.21) beats/min, (90.12 ± 4.63) beats/min, (92.21 ± 4.31) beats/min, (92.32 ± 3.51) beats/min, t = -32.14, -50.78, -62.91, -32.13, all P < 0.01]. The total incidence of adverse reactions, including allergies, nausea, vomiting, and dizziness, in the observation group was 28.67% (43/150), which was significantly lower than that in the control group [45.33% (68/150), χ2 = 8.94, P < 0.01]. Conclusions:Ultrasound-guided intermuscular brachial plexus anesthesia improves intraoperative anesthetic effects, reduces the volume of lavage fluid, remifentanil, and propofol used, shortens duration of surgery, and enhances the clarity of the surgical field. Additionally, it also effectively controls blood pressure and hemodynamic changes, leading to a reduction in adverse reactions.

Objective:To observe any therapeutic effect of kinesio taping the orbicularis oris and cervical swallowing muscle groups on drooling among children with cerebral palsy (CP).Methods:Fifty-two children with CP salivating excessively were divided at random into a control group and an experimental group, each of 26. Both groups received routine oral and facial exercise training and sensory stimulation, but the experimental group was additionally provided with kinesio taping of the orbicularis oris muscle and related neck muscle groups. The taping was applied twice a week for 12 hours each time, continuing for 6 months. Before and after the treatment, both groups′ drooling and language use were evaluated using the teacher drooling grading method (TDS) and a language developmental delay assessment (S-S), respectively. Kendall rank correlation coefficients were computed to compare the treatment efficacy for children with the same TDS grading, cerebral palsy classification, and S-S segmentation.Results:After the treatment the average TDS scores of both groups had decreased significantly. The average TDS score of the experimental group was then significantly lower than that of the control group. The total effectiveness rate for those in the experimental group with TDS grades II or V was significantly higher than those controls with the same TDS grades, the effectiveness rate for those with spastic and mixed type or language function in stage 4-2 and stage 5-2 in the experiment group was also significantly higher than for those of the control group. According to the correlation analysis, the language function of both groups was significantly correlated with the therapeutic effect.Conclusions:Supplementing routine rehabilitation training with kinesio taping of the orbicularis oris muscle and the cervical swallowing muscle group can significantly relieve CP children′s excessive salivation. Their language use is significantly positively correlated with the effectiveness of such combined treatment.